The 5 Stages of Psychedelic Psychotherapy
When first hearing of psychedelic psychotherapy, most people usually think of the psychedelic experience as the sole focus of this new therapy. But there is so much more to the process, and all of it is equally important for the transformation and health of the client.
Let’s take a closer look at what I call the five stages of psychedelic psychotherapy.
- Intake, screening, and informed consent
- Preparation
- Go time!
- Integration
- Embodiment
1. Intake, screening, and informed consent
I wish psychedelics and psychedelic psychotherapy could be the answer for everybody, but that is simply not the case. As with all medicines and medicinal plants, some are healing and others are toxic. Psychedelics are no different; they do not work well with all bodies or minds, meaning not every person should use them. Does a prospective client have medical or psychiatric conditions that are contraindicated for the medicines and this type of therapy? Due to a variety of complications that may arise between a medical or psychiatric condition and psychedelic medicines, saying no to a client might very well save them from severe consequences. There are too many contraindicated conditions to list in this article, so please read my book, Truth Medicine, for a more extensive list.
The informed consent process is essentially a mutually protective contract between the therapist and the client. It is there first and foremost so the client is fully aware of the risks and benefits, and has agency in deciding what works or does not work for them before they begin the transformational journey. During the informed consent process, the client is made aware of the potential medical risks of the therapy and is asked to make a collaborative plan in case an emergency arises during the session.
2. Preparation
Preparation is one of the most essential tasks in all psychedelic therapies, especially in psychedelic psychotherapy. Preparation serves multiple purposes, and its importance for preparing both therapist and client to engage in this type of transformational work cannot be overstated.
Preparation helps us orient toward what the client wants most out of the experience and in their life. While the medicine does what the medicine will, it is both the therapist’s and the client’s responsibility to uncover what is most seeking to be healed and what growth is most desired. Being clear about our intentions and therapeutic goals helps us get what we are actually longing for. When done well, deep prep sessions deliver relief just by bringing hidden things to light.
3. Go Time!
The medicine itself, whether it is ketamine, psilocybin, or MDMA, is a core component of the experience because each works on different neural pathways and with different neurochemistry to create a vast array of subjective, phenomenological experiences. Any substance that dramatically changes ordinary states of mind into altered states of consciousness unlocks vast portions of the unexplored psyche, and this takes courage to undergo.
Facing the unknown is a powerful practice. I use the time before the onset of the medicine to work with any of their fears and anxiety and to help strengthen their resolve to face the unknown with courage and trust. This is good medicine in itself, and we should be conscious and aware of how we face these minutes before departure.
The strength of the onset is medicine- and dose-dependent. Each medicine evokes different experiences, and even the same medicine on a different day can have entirely different effects.
This coming on can trigger a variety of emotional responses we want to attend to and take note of. How the client handles novel experiences during a session under the influence of a medicine can be indicative of how they may handle themselves during new situations in their normal lives.
During the session, the therapist and client examine everything that comes up and arises in their consciousness. The client is the explorer of the cosmos and their own psyche. The therapist is a guide, a psychological surgeon, a trusted friend, a confidant, and an attendant in this process. Good exploratory questions help the client deepen their relationship with what is surfacing in the present moment.
One role of the therapist is to help the client make sense of the experience and the material that arises during the journey in relation to the client’s transformational goals and intentions. However, the medicine does what the medicine will, so we must remain open to where the medicine and the client’s wisdom and intuitive senses take us.
4. Integration
Integration is when we incorporate our insights and new understandings from the psychedelic experience into our daily lives. Whereas the psychedelic psychotherapeutic experience can be helpful, healing, and transformational in itself, the lessons must be turned into daily practices and behaviors to concretize the changes we are making.
The really hard part of this whole process is going home and facing the parts of our lives that were created out of the trauma, resentment, anxiety, and depression we were seeking to work through and heal. Old habits and old feelings continuously surface because these conditions take time to dissolve within the newfound spaciousness and loving awareness that we built during therapy.
The integration process is focused on creating and committing to practical and reasonable changes in behavior, perception, and thinking in our daily life. We are not looking for huge shifts because they are difficult to sustain. We want to focus on small, realistic changes.
5. Embodiment: The Art of Living Deeply
What is the point of this whole process if not to feel at home within ourselves and to live a life worth living?
After all, we don’t just want relief from symptoms. We want to flow in life with ease. To feel confident in who we are, and to live by our heart’s values. To make wise choices and skillfully correct or repair when we don’t. And to be fully authentic.
There is no stopping point for our growth, but things do get easier. The volume on our symptoms, old reactions, and miserable thoughts gets turned down as newer, healthier responses are created and integrated. After your integration phase, you become more attuned to your needs and meet them for yourself. This creates confidence, assuredness, and inner strength—all together being embodiment.
As with life, our process of transformation is fluid and continuous. This new way of being is ever unfolding.
