Psychedelic Therapy & Mental Health

Over 100 years of western research suggests psychedelic medicines have an effect on the mental health and wellness in humans and other animals.

Psychedelic therapy can have a meaningful effect on your ongoing mental health and well-being. There are various modalities which may help prepare you for the experience of working with a psychedelic medicine, support you during your experience, and help you integrate and make sense of your experience afterwards and apply it to your daily life. These modalities include psychotherapy and psychiatry which diagnose and treat mental illness, as well as life coaches, wellness coaches, spiritual practice, somatic (body) practice including massage and somatic experiencing.

Cultures and communities around the world support the psychedelic experience through what Westerners generally call shamanic practices, although many of these healers would not use that label. In Western medicine, the support for this type of medicine work has been studied and practiced in conjunction with specially trained psychotherapists, facilitators, guides and coaches.

Research spanning more than 100 years suggests that medicines that elicit the psychedelic experience may have an ongoing positive psychological benefit. Psychedelic-assisted therapy is currently being shown in studies to improve some chronic and persistent mental health issues including anxiety, treatment-resistant depression, post traumatic stress disorder (PTSD), and end-of-life / death anxiety in people with chronic and/or terminal illnesses, chemical dependency issues and eating disorders.

“We can’t start history of psychedelics in the ‘60s in the Americas; that needs to stop. We [indigenous people] used this medicine before Jesus Christ walked this Earth.”

– Lisa M. Macias Red Bear, Injustice, Intersectional Trauma, and Psychedelics, 2017

CLINICAL TRIALS THAT INCLUDE PSYCHEDELIC MEDICINES ARE NOT MENTAL HEALTH TREATMENTS, THEY ARE SCIENTIFIC STUDIES HTTPS://CLINICALTRIALS.GOV/

ClinicalTrials.gov

The Psychedelic Mental Health Institute resources are not a replacement for licensed medical or mental health treatment.

“psychedelics reduce the weight of held beliefs and increase the weight of incoming sensory input, allowing the beliefs to be more readily changed by the new sensory information”

— Carhart-Harris & Friston 2019 – REBUS and the Anarchic Brain

Review of the literature describing ketamine as a psychedelic medicine

(2025) Posttraumatic stress disorder (PTSD) is a severe, often difficult-to-treat condition, highlighting the need for innovative therapies. Interventional treatments, including neuromodulation, rapid-acting pharmacotherapies such as intravenous ketamine (IV-KET) and esketamine (ESK), and emerging psychedelic-assisted psychotherapies, offer promising solutions. This systematic review evaluates the efficacy, safety, and future research priorities of these treatments for PTSD.

“We want for there to be greater knowledge of these ancestral plant medicine practices so that they do not become forgotten, and we believe that they are not the exclusive domain of anyone,” says Lu. “Yet, with availability and education, we also do not want for them to become so widespread that their origins are forgotten, taken for granted, or culturally appropriated.”

A solid overview of a bigger overall picture of psychedelic medicine

Writer, Michael Pollan shares his experience in researching and exploring consciousness, including working with psychedelic medicines

PSYCHEDELIC INTEGRATION

Psychedelic integration is about bearing witness and making meaning that lasts beyond the ayahuasca ceremony, magic mushroom velada, religious experience, meditation retreat, dream work, sexual ecstatic experience, or k-hole. These experiences may sometimes be considered mystical experiences or transpersonal experiences. Integration involves mind, body, heart (relational) and spirit (consciousness) and may involve therapy, coaching, massage, relationship counseling and other practices which support mental health and wellness.

In psychedelic medicine practice, your guide is not there to interpret your experience, but to help you apply what might be helpful as your experience continues to unfold before, during and after your experience to maintain a sense of self-actualization that may result from transcendent experiences. Integration is learning to come to a deep understanding from within.

What Maslow called “peak experiences”, seems to lead people to what Rational Emotive Behavior Therapy would call a "radical philosophical shift".

Integration may start with support from a mental health provider and be maintained by support in a variety of mind, body and/or philosophical/spiritual approaches for ongoing mental health practice at home as discussed with your licensed mental health provider.

ADDITIONAL READINGS, NEWS, RESEARCH, AND RESOURCES

**Preliminary evidence demonstrates that Ketamine-Assisted Psychotherapy (KAP) can significantly improve depression, demoralization and existential distress in seriously ill people.** We will discuss: 1. the history and science of psychedelics; 2. ketamine pharmacology, and KAP indications and delivery models; 3. putative KAP mechanisms of action; and 4. examples of KAP program development, including making the case, potential obstacles, and creative solutions.

Relatively few pharmacologic agents are proven safe and effective in adults with TRD. NNT estimates for investigational psilocybin and esketamine in TRD indicate clinical meaningfulness. The NNH profile for both aforementioned agents is clinically acceptable. Our results underscore the clinical relevance of these treatment options in adults with TRD.

NUMBER NEEDED TO TREAT (NNT) FOR KETAMINE AND ESKETAMINE IN ADULTS WITH TREATMENT-RESISTANT DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS (KWAN, ET AL, 2024)

A low number to treat and a high number to harm suggests efficacy and safety of racemic ketamine and esketamine across thousands of clients. It takes not very many ketamine treatments to help, and a large number of treatments to statiscally help and harm, also indicating a range of safe repeated dosing.

DEEP POSTEROMEDIAL CORTICAL RHYTHM IN DISSOCIATION (2020) Dissociation in human beings is a self-reported state of mind, and no experimental technique in rodents or in humans can currently define this subjective experience in full. However, the clinically guided paradigm reported here could provide a framework of behavioural, optical and physiological tools to enable exploration of the neural activity that underlies dissociative states (**Vesuna, et al, 2019**).

KETAMINE IN NEUROPSYCHIATRIC DISORDERS: AN UPDATE (JOHNSTON, ET AL, 2023)

Considerable clinical research supports the use of—or further research with—subanesthetic-dose ketamine and its (S)-enantiomer esketamine in multiple neuropsychiatric disorders including depression, bipolar disorder, anxiety spectrum disorders, substance use disorders, and eating disorders, as well as for the management of chronic pain.

While the neural underpinnings remain to be clarified, the psychedelic-induced state seems to allow one to recollect and process deep autobiographical information, achieve new understandings of one's self and relationships with others, and gain greater appreciation of one's place within the cosmos.5,61,62This state is closely linked to the concept of “mystical experience” which in multiple studies with classic psychedelics predicts therapeutic efficacy.9,11,45,47,55 “Ego dissolution” is another term used to describe a loss of the usual sense of self as separate entity.13 The quality and degree of psychedelic-induced ego dissolution and mystical experience are typically measured in clinical trials with validated psychometric instruments such as the 5-Dimensional Altered States of Consciousness Questionnaire and the Mystical Experience Questionnaire.9,11,45,47,49,55,61

THE NMDA RECEPTOR ANTAGONISTS MEMANTINE AND KETAMINE AS ANTI-MIGRAINE AGENTS (PODKAWA, ET AL, 2023) Migraine is a debilitating disorder affecting females more frequently than males. There is some evidence that drugs targeting glutamate receptors: memantine and ketamine might be beneficial in the therapy of this entity. Therefore, the purpose of this work is to present NMDA receptor antagonists, memantine and ketamine, as potential anti-migraine agents.

KETAMINE AND THE CONSCIOUS MIND (1972)

It is a matter of opinion whether or not a chemically induced transcendental experience should be available to anyone who desires it, but to induce such a state when it is not requested by the patient is a different ethical problem.

Infusions were well tolerated in both groups. Dissociative symptoms during infusion were more intense with ketamine than midazolam (t(12.3) = 3.61, p = 0.01), but they resolved by 40 min after infusion in both groups. Post-infusion adverse events were at the expected low levels in both groups.

COMBINING KETAMINE AND PSYCHOTHERAPY FOR THE TREATMENT OF POSTTRAUMATIC STRESS DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS (PHILIPP-MULLER, ET AL, 2023) Pharmacologically enhanced psychotherapy is one potential means of prolonging ketamine’s effects, with the class of psychedelic medications (in which ketamine is included) yielding encouraging results

TIAM1-MEDIATED SYNAPTIC PLASTICITY UNDERLIES COMORBID DEPRESSION–LIKE AND KETAMINE ANTIDEPRESSANT–LIKE ACTIONS IN CHRONIC PAIN (RU, ET AL, 2023) stress and chronic pain appear to drive alterations in Tiam1-Rac1 signaling and synapse connectivity and function that are rescued by ketamine treatment, but the manner of change and the brain regions/neural circuits involved may differ.

TOWARD SYNERGIES OF KETAMINE AND PSYCHOTHERAPY (MATHAI, ET AL, 2022) Finally, it is valuable to recognize the similarities between ketamine and classic (serotonergic) psychedelics such as psilocybin and lysergic acid diethylamide (LSD), which produce overlapping subjective phenomena in spite of diverging pharmacological mechanisms of action (*Bowdle et al., 1998*; *Studerus et al., 2010*). For classic psychedelics, it is well-established that a subset of psychoactive effects, often referred to as mystical-type effects and characterized by a sense of unity, predict greater therapeutic response across a variety of conditions such as depression, existential distress, and substance use disorders (*Garcia-Romeu et al., 2014*; *Griffiths et al., 2016*; *Roseman et al., 2018**). Interestingly, it has been hypothesized that the same mechanisms that drive the efficacy of these treatments may also be responsible for dose-dependent psychiatric risks, like that of psychosis (**Haarsma et al., 2021**). However, the relevant psychoactive effects of classic psychedelics appear to be optimized in careful experimental conditions that consider the benefit, safety, and tolerability of such (**Johnson et al., 2008*; *dos Santos et al., 2018*). While similar optimization has not been pursued for ketamine, increasing research suggests that mystical- and peak-type experiences, such as measured by the Hood Mysticism Scale (HMS) and 11D-ASC questionnaire, increase the likelihood of various therapeutic benefits (*Dakwar et al., 2014*, *2018*; *Mollaahmetoglu et al., 2021*; *Rothberg et al., 2021*; *Sumner et al., 2021*).

KETAMINE’S ROLE IN SPIRITUALITY: HOW ONE SYNTHETIC DRUG CATALYZES A NATURAL EXPERIENCE (WOODS, 2021)

The psychedelic effects associated with ketamine encourages a detachment from these thoughts processes— bringing forth a sense of intense and often overwhelming spiritual vulnerability for the patient. Therefore, an individual’s perception of pain may be significantly altered by ketamine because he or she is not experiencing typical, waking-reality thought processes but is instead experiencing unfamiliar, subconscious levels of thought. That is to say, these spiritual experiences are ordinarily invisible to us and are inaccessible using our normal states of consciousness (Strassman 54). Consequently, these spiritual-in-nature, ketamine variables may alter the patients’ response to various pain experiences, thus affecting their recovery options (Dedeli).

KETAMINE CAN BE PRODUCED BY POCHONIA CHLAMYDOSPORIA: AN OLD MOLECULE AND A NEW ANTHELMINTIC? (FERREIRA, ET AL, 2020) "…we isolated and characterized molecules from the nematophagous fungus Pochonia chlamydosporia and tested these compounds on three nematodes: Caenorhabditis elegans; Ancylostoma ceylanicum; and Ascaris suum.”

“…WE FOUND A CLEAR INCREASE IN SIGNAL DIVERSITY FOR ALL THREE PSYCHEDELIC AGENTS AT THE GROUP LEVEL, WITH EFFECTS BEING STRONGEST FOR KET. THESE INCREASES WENT BEYOND THOSE EXPECTED FROM THE CHANGES TO THE FREQUENCY SPECTRUM.”

NEURAL MECHANISMS AND PSYCHOLOGY OF PSYCHEDELIC EGO DISSOLUTION (STOLIKER ET AL, 2022)

Surmising that the experience of ego dissolution exists at the center of the psychedelic experience and that its neural mechanisms may be close to the roots of the subject-object dichotomy may explain why phenomenological encounters with this experience can be intimate and fundamentally change self-identification and interactions with the world. Continued investigation of the neural mechanisms of ego dissolution and the dichotomy of separation between the self and the world may advance scientific understanding of sentience. The value of psychedelics may then, under appropriate conditions, be their power to catalyze meaningful philosophical and scientific understanding of the “u” (i.e., self) in the universe.

The safety and efficacy of psychedelic-assisted therapies are currently under investigation. No psychedelic-assisted therapy has been approved by the FDA or other regulatory authorities; no therapy works for everyone; and all therapies, even in clinical settings, carry risks.

The FDA does not regulate the practice of psychotherapy or coaching.

(2019): "Currently, ketamine is the only legal psychedelic medicine available to mental health providers for the treatment of emotional suffering. Over the past several years, ketamine has come into psychiatric use as an intervention for treatment resistant depression (TRD), administered intravenously without a psychotherapeutic component. In these settings, ketamine's psychedelic effects are viewed as undesirable "side effects." In contrast, we believe ketamine can benefit patients with a wide variety of diagnoses when administered with psychotherapy and using its psychedelic properties without need for intravenous (IV) access. Its proven safety over decades of use makes it ideal for office and supervised at-home use. The unique experience that ketamine facilitates with its biological, experiential, and psychological impacts has been tailored to optimize office-based treatment evolving into a method that we call Ketamine Assisted Psychotherapy (KAP). This article is the first to explore KAP within an analytical framework examining three distinct practices that use similar methods. Here, we present demographic and outcome data from 235 patients. Our findings suggest that KAP is an effective method for decreasing depression and anxiety in a private practice setting, especially for older patients and those with severe symptom burden."

Building Community Around Integration: A Guide for Community-Led Peer Integration (2019)

How not to do a psychedelic Assisted Psychotherapy Session

A nuanced look at the life of María Sabina & the origins/Colonization of Psilocybin (Magic Mushrooms)

A Single Belief-Changing Psychedelic Experience Is Associated With Increased Attribution of Consciousness to Living and Non-living Entities

‘pivotal mental state’- hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation (2021)

Unifying Theories of Psychedelic Drug Effects (Swanson, 2018)

THERAPEUTIC KETAMINE - LOWER ADDICTION POTENTIAL THAN PREVIOUSLY THOUGHT

PERCENTAGE OF HEAVY DRINKING DAYS FOLLOWING PSILOCYBIN-ASSISTED PSYCHOTHERAPY VS PLACEBO IN THE TREATMENT OF ADULT PATIENTS WITH ALCOHOL USE DISORDER (BOGUNSCHUTZ, ET AL, 2022)

COMPARISON OF PSYCHEDELIC AND NEAR-DEATH OR OTHER NON-ORDINARY EXPERIENCES IN CHANGING ATTITUDES ABOUT DEATH AND DYING (SWEENEY, ET AL, 2022)

PSYCHEDELIC DRUGS CHANGE STRUCTURE OF NEURONS

WHITE MATTER ALTERATIONS IN CHRONIC MDMA USE: EVIDENCE FROM DIFFUSION TENSOR IMAGING AND NEUROFILAMENT LIGHT CHAIN BLOOD LEVELS (ZIMMERMAN, ET AL, 2022)

TOWARDS AN UNDERSTANDING OF PSYCHEDELIC-INDUCED NEUROPLASTICITY (CALDER, ET AL, 2022)

PSYCHEDELIC INTEGRATION: AN ANALYSIS OF THE CONCEPT AND ITS PRACTICE (BATHJE, ET AL, 2020)

**PSYCHEDELIC-ASSISTED THERAPY AND PSYCHEDELIC SCIENCE: A REVIEW AND PERSPECTIVE ON OPPORTUNITIES IN NEUROSURGERY AND NEURO-ONCOLOGY** **(DANIEL, ET AL, 2023)**

**CLASSICAL AND NON-CLASSICAL PSYCHEDELIC DRUGS INDUCE COMMON NETWORK CHANGES IN HUMAN CORTEX** **(DAI, Et AL, 2023)**

MULTI-MEDIA〰️

ONGOING RESEARCH

AMERICAN PSYCHOLOGICAL ASSOCIATION (APA) SAYS “RESEARCH CONFIRMS THE THERAPEUTIC POTENTIAL OF #MDMA #KETAMINE, AND #PSILOCYBIN TO HELP PEOPLE WITH TREATMENT-RESISTANT MENTAL HEALTH CONDITIONS” (2024)

“If we rely on antidepressants for treatment, it can take several weeks before people experience amelioration of symptoms, if at all,” said Nora Volkow, MD, director of the National Institute on Drug Abuse. “Psychedelics may offer the opportunity to get a very fast and lasting response, and with some conditions, this could be lifesaving.” The latest research findings are also uncovering the potential neurobiological mechanisms that might make it possible for these controlled substances to produce mental health benefits.”

AT-HOME KETAMINE ASSISTS PSYCHOTHERAPY IN-PERSON OR VIA TELEHEALTH

Licensed psychotherapists have offered telehealth before the pandemic. Some licensed psychotherapists specialize in psychedelic-assisted psychotherapy where we can sit with you in person in your home, in our office, or remotely via video conferencing. Out-of-clinic ketamine has been prescribed since before the pandemic, largely made by compounding pharmacies, for pain management and in psychiatry-- check out "Ketamine for Depression", (Snyder, 2015), and "The Ketamine Papers" (Wolfson, et al, 2016).

At-home ketamine from companies that are price-gouging for a 15 minute medical visit to get a prescription for a generic drug that's been used in millions of humans and animals since the 1960's in various settings-- and leaving you to it, is NOT the same as ketamine-assisted psychotherapy done in an office, at home, or any other setting standard in our field. This includes telehealth. If the person working with the client before during and after is with them physically in person, and something goes wrong, we are going to call 911, the same as we would if they were in an office. Additionally, some telehealth clinicians require an adult sober-sitter on premises with the client, to physically check on a client if something seems out-of-the-ordinary. That is in addition to the mental health specialist being remotely available the entire time the client is under the acute effects of the medicine.

Ketamine is legally available throughout North America and has demonstrated remarkable efficacy in treating anxiety and depression. The presentation will highlight how ketamine therapy, whether in a clinical setting or through at-home administration, offers relief and restores hope to patients. We will cover the benefits provided by in-clinic sessions, as well as the empowerment clients experience with at-home ketamine therapy when supported by trained professionals.

IAI.TV : THE REALITY OF THE MYSTICAL EXPERIENCE As is well documented, during the mystical experience, the subject-object distinction breaks down. The idea that ‘I am in here’ and ‘the world is out here’ disappears. For my consciousness of the world takes up the very same space as that which I call my mind. There is, in perception, no ‘inside’ the mind and ‘outside’ to the world. Look around you. All you can see is the outside! All you see is the room, and the window, and the sky. You do not see the interior of your mind – unless the world itself makes up that interior. Douglas Harding’s book ‘On Having No Head’, explains this idea very simply and allows for the clearest perception of the non-duality of the mystical experience. But Heidegger’s ‘being-in-the-world’ and Sartre’s ‘being and nothingness’ approach the same idea. And yet, while the mystical experience allows us to come to this truth that there really is no subject-object distinction, no ‘me vs the world’, this truth still holds for everyday reality too.

SCIENTISTS SAY A MIND-BENDING RHYTHM IN THE BRAIN CAN ACT LIKE KETAMINE- **"It was like pointing a telescope at a new part of the sky," Deisseroth says. "And something really unexpected jumped out at us."**

CHACRUNA PUBLISHES ARTICLE CHALLENGING DEA AYAHUASCA REPORT

Health professionals need to recognize the historical and cultural values of these plant medicines for Indigenous and traditional populations. These groups have been using ayahuasca and other plant medicines for centuries as part of their traditional healing systems. It is important to understand that we are dealing with traditions that do not abide by the concepts of Western healing, and that have their own logic and value. These practices must be recognized on their own terms. It is not a matter of opposing traditional healing systems and Western medicine, but of recognizing the uniqueness and importance of the former. In fact, it is widely known that in order to develop research and policy on ayahuasca it is crucial to consider the gathered knowledge and the experience of the groups that have been taking ayahuasca for centuries – Bia Labate, PhD, Executive Director, Chacruna Institute

NATURAL HISTORY MUSEUM-- BEYOND GENDER: INDIGENOUS PERSPECTIVES- A LIMITED SERIES ON SOME OF THE WORLD'S THIRD GENDER INDIGENOUS PEOPLEApr 13, 2023gender affirming therapist, gender-affirming therapy, gender around the world, gender is a construct

KETAMINE PSYCHEDELIC EXPERIENCE RELATED TO OUTCOME OF TREATMENT (PSYCHIATRIC TIMES, 2018) A cautious approach also seems imperative given evidence that ketamine demonstrates agonist activity at Î¼-opioid receptors and dopaminergic effects that may confer acute relief of depressive symptoms but also greater risk for positive drug reinforcement and dependence. With further insight into psychological responses mediated by ketamine, it may be that a therapy-based framework for ketamine administration optimizes treatment efficacy and sustainability, while also minimizing unnecessary drug exposure, adverse effects of chronic use, and dependency risk.

**THE PSYCHEDELIC SUPPORT LINE PROVIDES EMOTIONAL SUPPORT DURING AND AFTER PSYCHEDELIC EXPERIENCES. HTTPS://FIRESIDEPROJECT.ORG/**

DYNAMICS OF SEXUAL HARM IN PSYCHEDELIC & ENTHEOGENIC SPACES