Psychedelic-Assisted Psychotherapy (PAP) is a technique that involves the use of psychedelics such as psilocybin, LSD, ketamine, MDMA, ayahuasca, and DMT to aid in the therapeutic treatment of various psychological disorders.

Psychedelic substances are combined with other types of psychotherapy, mindfulness training, and meditation to treat various conditions. In fact, it’s good for just about anyone’s well-being.

Psychedelics have been used for thousands of years in holistic medicine and spiritual practices among many cultures. While research originally thrived in the 1950s and 60s, studies stopped when the substances were made illegal in the United States. Prohibition significantly hindered the advance of such effective therapies.

Over the last 20 years, researchers were given the approval to conduct trials on the research of psychedelics’ effectiveness in treating multiple conditions.

Substances Used In Psychedelic-Assisted Therapy

There are a number of substances that produce psychedelic effects that have been proven successful in the treatment of multiple conditions. Here are a few of the most common:

• Psilocybin

Psilocybin is the active ingredient in “magic mushrooms”. It can provide feelings of euphoria and sensory distortion. Euphoria can include an altered state of consciousness, perception, and mood, generally leading to positive psychological effects. In 2006, a groundbreaking study published by researchers at John Hopkins Center for Psychedelic and Consciousness Research found psilocybin is not only safe but has positive psychological effects. This substance is being used and researched for psychological illnesses such Post Traumatic Stress Disorder (PTSD), depression, anxiety, and even addiction.

• Ayahuasca

Ayahuasca is a hallucinogenic drink made from the stem bark of the tropical liana Banisteriopsis caapi and other botanical ingredients. It originated in South America and is used for many spiritual rituals. The ayahuasca ceremonies are typically held by a trained and able shaman and are a deep, spiritual experience. It’s currently being used to treat depression, anxiety, and addiction.

• Ketamine

Ketamine is a dissociate anesthetic typically used for induction and anesthesia. It leaves you in a dream-like state making you feel detached. You may experience an altered perception of time and space, even causing you to hallucinate. If you ingest too much, there’s a potential you may temporarily be able to move. This is called a “K-Hole.”

“Ketamine can produce feelings of unreality; visual and sensory distortions; a distorted feeling about one’s body; temporary unusual thoughts and beliefs; and a euphoria or a buzz,” says John Krystal, MD, chief of psychiatry at Yale-New Haven Hospital and Yale School of Medicine in Connecticut, where he is a leader in studying ketamine’s antidepressant effects.

Ketamine is already used in some states to treat depression, post-traumatic stress disorder (PTSD), and anxiety. The FDA approved a ketamine-based antidepressant nasal spray called esketamine. More studies are being done on its effectiveness with bipolar and other mood disorders.

• 3,4-Methyl​enedioxy​methamphetamine (MDMA)

3,4-Methylenedioxymethamphetamine is the scientific (and very long) name for MDMA. When being sold as a street drug, it may also go by the names ecstasy, molly, or mandy. The desired effects are altered sensations, increased energy, empathy, arousal, and sociability. Research shows it can be significantly effective in the treatment of post-traumatic stress disorder (PTSD).

• N, N-Dimethyltryptamine (DMT)

N, N-Dimethyltryptamine, or DMT, is a fast-acting, naturally occurring molecule similar to serotonin – a neurotransmitter that is most closely affiliated with happiness regulation and emotional well-being. Even sleep!

Everyone’s experience with DMT varies greatly. Patient reports typically consist of visual hallucinations and out-of-body experiences. A feeling of an ‘entity’ being in their presence is also commonly expressed. They explain the experience was a feeling of goodness and benevolence.

The experiences have made some patients see inside themselves like never before. They may reach insights about themselves and their lives that may have never been revealed.

Research has shown the main function of DMT is to regulate or disrupt the ingrained neuron process responsible for internalizing disorders such as anxiety or depression.

• Lysergic acid diethylamide (LSD)

LSD is a potent hallucinogen synthetically made from lysergic acid, found in ergot, a fungus that grows on rye and other grains. Doses tend to be in micrograms due to LSD’s potency. The effects can be stimulating, pleasurable, and mind-altering.

These effects can be somewhat unpredictable and may vary from person to person. Mood changes may occur. If taken in high doses, you may experience delusions or hallucinations.

Studies show that LSD can effectively treat anxiety, depression, and addiction. Evidence shows LSD is most effective in treating alcoholism. Bill W., the founder of Alcoholics Anonymous, believed that LSD could help alcoholics stop drinking.

Treatment Techniques

During a psychedelic session, elements known as the set and the setting are crucial. The set refers to things such as mood and expectation. The setting refers to the environment in which the session takes place and the level of the patient-therapist relationship. It is ideal to feel comfortable with your therapist and the area the session is taking place. It is important for you to go into your session feeling calm and attentive.

With the exception of the ayahuasca ceremonies, most psychedelic-assisted are held in any type of comfortable therapeutic setting. Sessions are held in safe therapeutic areas, such as outdoors or in a calming indoor area. Therapists may include comfortable elements like a couch, ambient music, or neural tones where the session is being held.

But since there is no standardized treatment method, therapists develop their own structure. Some common elements may include:

• Administration of a low or moderate dose of a psychedelic drug
• Professional supervision during the psychedelic experience
• Repeating the session and psychedelic dose in one to two weeks

Some patients report mystical or spiritual experiences after taking psychedelic substances. They report feelings of peace, joy, unity, and empathy. There is even a study published in the Proceedings of the National Academy of Sciences that shows the mood improvements produced by this treatment can be long-lasting. Participants reported continued positive benefits, including increased well-being and social connectedness after the substances had worn off.

After your psychedelic experience, the next step is a process called integration. This process is designed to help you process, make sense of, and find meaning in your psychedelic experience.

Conditions Psychedelic Therapy Can Help With

Multiple conditions have been found to respond positively to psychedelic-assisted therapy. These conditions include:

• Anxiety and Mood Disorders

Researchers have uncovered numerous potential benefits of psychedelic-assisted therapy in the treatment of depression. Psychedelics may provide positive therapeutic benefits to those suffering from anxiety, mood disorders, and other ailments. In 2016, a study found psilocybin treatment significantly decreased symptoms of anxiety and depression in patients undergoing treatment for cancer.

• Alcoholism and Substance Abuse Disorders

Research published in The British Journal of Psychiatry showed strong evidence LSD could be effective in the treatment of alcoholism. This study dates back to 1970. Recent evidence has also shown the potential benefits of psychedelic therapy in the treatment of addiction disorders.

• Post-Traumatic Stress Disorder (PTSD)

A randomized, double-blind study done in 2018 found an active dose (75 mg and 125 mg) of MDMA combined with psychotherapy to be a safe, effective treatment in veterans and first responders suffering from PTSD. There is an estimated 40-60% of patients suffering from PTSD do not respond to the standard treatment. A more recent study has shown MDMA to significantly reduce the symptoms in these patients.

Your Brain On Psychedelics

To fully investigate the potential benefits psychedelics may have on these conditions, it’s important for scientists to understand how these substances interact with the brain at a molecular level to cause such dramatic biological events to take place.

For the first time, scientists discovered the high-resolution structure when these compounds were actively bound to the 5-H2A serotonin receptor (HTR2A) on the surface of the brain. HTRA is expressed at very high levels in the human cerebral cortex. Scientists believe that this activation is key to the beneficial effects of psychedelic substances,

“When activated, the receptors cause neurons to fire in an asynchronous and disorganized fashion, putting noise into the brain’s system,” said Bryan Roth, MD, Ph.D., who holds a joint faculty appointment at the UNC Eshelman School of Pharmacy. “We think this is the reason these drugs cause a psychedelic experience. But it isn’t at all clear how these drugs exert their therapeutic actions.”

Some beneficial effects of these substances are:

• Feelings of relaxation
• Increase of well-being
• Increased social connectedness
• Introspection
• Spiritual experiences
• An altered state of consciousness
• Transformative experience

While psychedelics can produce significantly positive benefits, as with any treatment, there are risks and possible side effects such as:

• Altered sense of time and place
• Distortions of reality
• Intense or distorted perceptions or emotions
• Paranoia
• Hallucinations: Seeing, hearing, or sensing things that aren’t there

This is why it’s important to be under the care and supervision of a professional that understands the process and can integrate these experiences.

Is It Effective?

Studies have shown promising results in the treatment of multiple mental health disorders with the use of psychedelics. Classic psychedelics have been shown to cause no brain damage and they are non-addictive substances. Long-term use of psychedelics has shown a significant decrease in mental health symptoms and the need for hospitalization.

Lifetime LSD use has shown a significant decrease in outpatient mental health treatment and the use of psychiatric medications. Lifetime use of psilocybin significantly reduced inpatient treatments, the use of medications, and panic attacks

In 2018, a study found psychedelics produce an increased number of connections between neurons and other structural changes. This suggests psychedelics may be able to repair and rewire these connections, leading to improved mood and reduction in anxiety symptoms.

While further research is needed, clinical studies are being performed now to explore the potential benefits these substances may have for people suffering from serious mental health disorders.

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