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Psychedelic Psychotherapy
Traumatic memory, core programming, dissociated material all live in the non-declarative unconscious. Psychedelic medicines in combination with the body allow therapeutic access to this layer that is unprecedented.
There are a variety of ways to explain how psychedelic medicines work and why they are so effective in mental health. There are biochemical explanations looking at receptors and neurotransmitters, brain imaging explanations looking at how the flow of information is changed in the brain, spiritual and meta-physical explanations and psychotherapeutic explanations. The fact is, as with many things in psychiatry, we don’t know exactly why or how these medicines work. There is likely truth in all of these different ways of understanding such a unique and mysterious process. What we can measure is effectiveness, safety, the subjective sense of how you feel and the conditions under which these medicines work best.
Conscious & Unconscious Levels of Experience
What you think of as you— your conscious rational mind, your thoughts, beliefs, your story—is actually a very small part of who you are. It is the tip of the iceberg you can see floating above the surface of the water. Your subconscious mind— the part of you that is non-rational, non-verbal, non-cognitive, that is far older, more primal and shares the same nervous system as other mammals—plays a much larger role in your emotions, mood, symptoms, and reactivity. This is the 90% of the iceberg below the surface of the water. This is where your core programing resides. We see glimpses of the subconscious mind through dreaming, meditation and naturally occurring altered states of consciousness but perhaps the most significant access we have to the subconscious mind is through psychedelic medicines.
Most of modern psychotherapy has focused on the explicit, visible, conscious, thought based aspects of how we function for the simple reason that cognition and behavior are easy to measure and easier for clinicians to work with. Contrast that to forces that exist deep in your subconscious mind that are non-rational, difficult to see, difficult to measure and difficult to tame. In doing so, the field of psychotherapy has mostly missed the subconscious mind: the part of us where the core programing resides.
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Submerged beneath the surface of our awareness, it contains our autonomic nervous system responses to stress and trauma, as well as non-verbal, pre-verbal and dissociated memories that deeply shape who we are and what we think about our world. The subconscious holds our core beliefs– some of which we might recognize but many of which we would be surprised to learn are actually what we believe to be true. We tend to live in and identify with the tip of the iceberg. We think we are our thoughts, beliefs, values, our story about ourselves but it is the subconscious that runs the show.
PTSD symptoms such as anxiety, panic, fear, hyper reactivity to stimuli as well as depression, psychological numbing, depersonalization and varieties of dissociation are autonomic nervous system responses. In other words, our mental health symptoms have more to do with our subconscious psychobiological responses than our thoughts. The fact that these emotional and mood phenomena are fundamentally non-verbal in nature is consistent with the experience most of us have that talk therapy is not very effective at resolving mental health disturbances. We may learn effective coping strategies and tools to manage anxiety, panic, depression and numbing states but we don’t resolve them by understanding or insight.
Accessing the Unconscious
To access the hidden places in us where symptoms have their roots, to work with this larger part of ourselves, we need to leave the limited, rational state of ordinary consciousness and enter non-ordinary states of consciousness. We are actually designed to enter non-ordinary states of consciousness. Medication, birth, death, music, sex, substances all generate non-ordinary states of consciousness but most notably, dreaming is perhaps the most common and routine non-ordinary state for us. In the dreaming state, your mind manifests you, your history, your emotional world (fears, joys and anxieties), your relationships as symbolic images. Dreams do not have a clear, linear narrative that would make sense to anyone one else but they make sense to you as the dreamer. Dreams have an internal logic that feels right to you because they are being generated by your mind.
The idea is that you are processing psychological material while you are in this non-ordinary state. You are processing underlying stresses, complicated feelings, relationships, desires, needs, impulses, and conflicts that might go unnoticed in the light of your ordinary consciousness. Every night we set aside control and let go of rational reality. The conscious mind releases control and you move into your own subconscious, internal psychedelic world. This is all to say that non-ordinary states of consciousness are healthy, necessary, natural and routine for us. Our minds are designed to go there and draw replenishment from that deep well. Things are revealed to us there and we can accomplish things there that we can’t get at through ordinary waking consciousness.
Psychedelic medicines operate in a very similar way. They give access to the subconscious mind but in a much more profound, lucid way. You can take an ally, a trained clinician, in to this space to help you navigate and work with the memories, images, feelings, sensations and programing that are housed there.
Healing
Fortunately, there are some remarkable factors working in our favor when we enter into primary consciousness. The first is that along with access to traumatic memory and core programing, we also encounter remarkable innate healing tendencies when we enter the subconscious. Just like your body knows how to mend a broken bone or heal a cut, there are psychological capacities that turn on when we work in the subconscious. People become capable of a level of movement and healing that we just don’t see in ordinary waking consciousness. Doors that your psyche may keep closed out of protection to your conscious mind and identity willingly open with the support of these medicines and a warm, caring, skilled therapist. We see homeostatic self correction mechanisms that are part of your mind and body become far more accessible and active in the psychedelic state.
Secondly, we have psychotherapies that purposefully target and support clients entering a non-ordinary state of consciousness for the purpose of healing. A modality and clinician who is trained to embrace non-rational , non-linear, non-verbal, non-ordinary states can support and guide the process in ways that ‘tip of the iceberg’ modalities will not. In other words, a non-ordinary state psychotherapy is required to harness and make best use of non-ordinary states of consciousness. Hypnosis, for example, attempts to work below the layer of the conscious mind. Art and music therapies aim to drop below rationality. Stanislov Grof’s Holotropic breathwork allows people to enter a non-ordinary state. The modality we use at PSI is a body-based, relational approach that focuses on direct visceral experience and autonomic processing. We’ve chosen this because we feel the body is key in the processing of traumatic material.