Beyond the Journey: Why New Language Might Transform Psychedelic Therapy
"You're about to embark on a journey," the therapist explained to David as he prepared for his first psilocybin session. "Think of me as your guide, and remember that whatever happens, you're just traveling through different landscapes of consciousness. Trust the process and let the medicine show you what you need to see." This language of journeys, guides, and medicine has become so common in psychedelic therapy that many people assume it's the only way to think about these experiences. But what if the words we use to describe psychedelic therapy are actually shaping the outcomes in ways we don't fully understand? What if different metaphors might lead to different results, or appeal to different types of people?
New research suggests that the metaphors commonly used in psychedelic therapy – while helpful for many people – may not be the best fit for everyone. A groundbreaking paper published in Cognitive and Behavioral Practice argues that the language we use to frame psychedelic experiences has a profound impact on expectations, outcomes, and even therapist wellbeing [1]. The authors propose that it might be time to expand our metaphorical toolkit, offering new ways of thinking about psychedelic therapy that could make these treatments more accessible and effective for a broader range of people.
Current Metaphors and Their Hidden Limitations
The language of psychedelic therapy has evolved organically over decades, drawing from various sources including indigenous traditions, 1960s counterculture, and modern neuroscience. Three metaphors have become particularly dominant: the journey metaphor, the brain rewiring metaphor, and the medicine metaphor. While each of these has value, researchers are beginning to recognize that they may also have unintended consequences. The journey metaphor is perhaps the most pervasive in psychedelic therapy. Patients are told they're "embarking on a journey," therapists are described as "guides" or "trip sitters," and difficult experiences are framed as "challenging terrain" to navigate. This metaphor has clear benefits – it suggests that psychedelic experiences have a beginning, middle, and end, and that difficult moments are temporary parts of a larger process. It also implies that there's something to be learned or discovered along the way.
However, the journey metaphor may also create problematic expectations. Journeys are typically something we take occasionally, for special purposes, rather than as part of our regular routine. This framing might make psychedelic therapy seem disconnected from everyday life and ordinary therapeutic work. The journey metaphor can also imply that the therapist is an expert guide who knows the territory, when in reality, each person's psychedelic experience is unique and unpredictable.
The brain rewiring metaphor has gained popularity as neuroscience research has revealed how psychedelics affect neural plasticity. Patients are told that psychedelics will "rewire their brain," create "new neural pathways," or "reset their default mode network." While this language is grounded in legitimate scientific research, it may create unrealistic expectations about how quickly and dramatically change will occur. The rewiring metaphor can also be problematic because it suggests that the brain is like a computer that can be reprogrammed, when in reality, psychological change is typically a gradual process that requires ongoing effort and practice. People might expect that a single psychedelic session will automatically "rewire" their depression or anxiety, leading to disappointment when they discover that integration work and ongoing therapy are still necessary.
The medicine metaphor frames psychedelics as healing substances that work primarily through their pharmacological effects. While this metaphor has been important for legitimizing psychedelic therapy in medical settings, it may downplay the crucial role of psychological and social factors in determining outcomes. The medicine metaphor can also create passive expectations, suggesting that the substance itself will do the healing work rather than empowering patients to take an active role in their recovery. Perhaps most importantly, these dominant metaphors may not resonate with everyone. The journey metaphor might not appeal to people who prefer structured, goal-oriented approaches to problem-solving. The brain rewiring metaphor might feel too mechanistic for people who understand their mental health challenges in more holistic or spiritual terms. The medicine metaphor might not fit well with cognitive-behavioral approaches that emphasize skill-building and active coping strategies.
As the authors of the new research note, these metaphors "may not appeal to all clients and might not provide an ideal focus for interventions devoted to learning and cognition, such as those used in cognitive-behavioral therapies" [1]. This limitation becomes particularly important as psychedelic therapy moves into mainstream healthcare settings where patients will come from diverse backgrounds and therapeutic orientations.
The Baseball Metaphor: A New Way to Think About Psychedelic Therapy
To address the limitations of current metaphors, researchers Mitch Earleywine, Henry MacConnel, and Joseph De Leo have proposed an innovative alternative: thinking about psychedelic therapy as "batting practice" from the sport of baseball [1]. While this might initially seem like an unusual comparison, the batting practice metaphor offers several advantages that could make psychedelic therapy more accessible and effective for certain populations. The batting practice metaphor emphasizes autonomy, agency, and personal responsibility in ways that the journey metaphor does not. In batting practice, the player is actively working to improve their skills, rather than passively being guided through an experience. The player decides how to approach each pitch, what techniques to try, and how to learn from both successful hits and misses. This active stance aligns well with cognitive-behavioral approaches to therapy that emphasize skill-building and personal empowerment.
In this framework, the psychedelic experience becomes "time in the cage" – a focused practice session where the patient can work on specific psychological skills in a supportive environment. Just as batting practice provides a safe space to experiment with different techniques without the pressure of a real game, psychedelic therapy provides a unique psychological space where patients can explore new ways of thinking and feeling without the usual constraints of everyday consciousness. The therapist's role in this metaphor shifts from "guide" to "coach." Coaches don't lead players through predetermined paths; instead, they provide support, encouragement, and expertise while allowing the player to do the actual work. A good coach helps players identify areas for improvement, suggests techniques to try, and provides feedback on performance, but ultimately the player must develop their own skills through practice and effort.
This coaching relationship has several advantages over the guide relationship. Coaches are expected to have expertise and training, but they're not expected to have traveled the exact same path as their players. A batting coach doesn't need to have been a professional baseball player to help someone improve their swing. Similarly, psychedelic therapists don't need to have had identical experiences to their patients to provide effective support.
The batting practice metaphor also emphasizes the incremental and skill-building nature of psychological change. In baseball, players don't expect to become expert hitters after a single practice session. They understand that improvement comes through repeated practice, gradual refinement of technique, and learning from both successes and failures. This expectation aligns much better with the reality of psychological change than metaphors that might suggest dramatic, immediate transformation. The metaphor naturally incorporates the concept of "seasons" – periods of focused work followed by rest and reflection. Just as baseball players have training seasons, regular seasons, and off-seasons, psychedelic therapy can be understood as involving periods of intensive work (preparation and treatment sessions) followed by periods of integration and practice in daily life.
Perhaps most importantly, the batting practice metaphor emphasizes process over outcomes. In batting practice, the goal isn't to hit a home run every time; it's to improve technique, build consistency, and develop skills that will be useful in real game situations. Similarly, the goal of psychedelic therapy isn't necessarily to have a profound mystical experience, but to develop psychological skills and insights that will be helpful in navigating life's challenges.
The metaphor also naturally accommodates the reality that progress isn't always linear. Even professional baseball players have slumps, bad days, and periods where their technique needs adjustment. The batting practice metaphor normalizes these fluctuations and frames them as natural parts of the learning process rather than failures or setbacks.
Choosing the Right Language for Your Therapy
The research on metaphors in psychedelic therapy highlights an important principle: there's no one-size-fits-all approach to framing these experiences. Different metaphors will resonate with different people based on their personality, cultural background, therapeutic goals, and personal preferences. The key is finding language that feels authentic and helpful for each individual patient. For people who are drawn to adventure, exploration, and spiritual seeking, the journey metaphor might be perfect. For those who prefer scientific explanations and are motivated by understanding biological mechanisms, the brain rewiring metaphor might be most appealing. For people who are focused on skill-building, personal responsibility, and gradual improvement, the batting practice metaphor might be ideal.
Cultural considerations are also important when choosing therapeutic metaphors. The journey metaphor draws heavily from certain spiritual and cultural traditions that may not resonate with people from different backgrounds. The baseball metaphor, while distinctly American, emphasizes values like practice, coaching, and skill development that may translate across cultures more easily than spiritual journey language. Individual personality factors also play a role. People who are highly goal-oriented and prefer structured approaches might find the batting practice metaphor more appealing than the more open-ended journey metaphor. Those who are naturally introspective and spiritually inclined might prefer journey language over sports metaphors.
The authors of the research emphasize that "clients and therapists can collaborate on metaphorical language to optimize outcomes in psychedelic-assisted CBT" [1]. This collaborative approach recognizes that the best metaphors are often those that emerge from the therapeutic relationship itself, rather than being imposed from the outside. Some therapists are beginning to experiment with entirely different metaphors. Some use artistic metaphors, framing psychedelic experiences as opportunities to "paint on a blank canvas" of consciousness. Others use gardening metaphors, emphasizing the need to "plant seeds" of intention and then "tend the garden" of integration work. Still others use musical metaphors, describing psychedelic experiences as opportunities to "tune the instrument" of consciousness or "compose new melodies" of thought and feeling.
The key is flexibility and responsiveness to what works for each individual. As the field of psychedelic therapy continues to evolve, we're likely to see an expansion of metaphorical frameworks that can accommodate the diverse needs and preferences of different patients.
What This Means for Your Treatment Journey
For people considering psychedelic therapy, the research on metaphors offers several practical insights. First, pay attention to how potential therapists talk about psychedelic experiences. Do they rely heavily on one particular metaphor, or do they seem flexible in their language? Are they willing to explore different ways of framing the experience based on your preferences and goals?
Don't be afraid to discuss metaphors explicitly with your therapist. If journey language doesn't resonate with you, say so. If you prefer more scientific explanations, ask for them. If you're drawn to skill-building approaches, explore how that might inform your treatment. The language you use to think about your psychedelic experience can significantly influence how you prepare for it, experience it, and integrate it afterward. Consider what metaphors naturally appeal to you in other areas of your life. Are you someone who thinks in terms of journeys and adventures? Do you prefer sports analogies? Are you drawn to artistic or creative metaphors? Your natural metaphorical preferences can provide clues about what language might be most helpful in your psychedelic therapy.
Remember that metaphors are tools, not truths. No single metaphor can capture the full complexity of psychedelic experiences or psychological healing. The goal is to find language that helps you understand and work with your experience, not to find the "correct" way to think about psychedelic therapy.
The Future of Therapeutic Language
The research on metaphors in psychedelic therapy represents a broader recognition that language matters in healing. The words we use to describe psychological experiences don't just reflect our understanding – they actively shape our experiences and outcomes. As psychedelic therapy becomes more mainstream, developing a richer vocabulary for these experiences will be crucial for making them accessible to diverse populations. This work also highlights the importance of cultural humility in psychedelic therapy. The dominant metaphors in the field have emerged primarily from specific cultural contexts, and expanding our metaphorical toolkit is one way of making these treatments more inclusive and culturally responsive.
For people like David, who was introduced to psychedelic therapy through journey language, this research suggests that there are many other ways to think about and approach these experiences. Whether you're drawn to the adventure of a journey, the precision of batting practice, or some entirely different metaphor, the key is finding language that empowers you to engage actively and authentically with your healing process. As the field continues to evolve, we can expect to see continued innovation in how we talk about and frame psychedelic experiences. The goal isn't to replace existing metaphors, but to expand our options so that everyone can find language that resonates with their unique perspective and supports their individual path to healing.
References
[1] Earleywine, M., MacConnel, H. A., & De Leo, J. A. (2025). Intentional Choices of Metaphors for Psychedelic-Assisted Therapy. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2025.04.002
[2] Schipper, S., Nigam, K., Schmid, Y., Piechotta, V., Ljuslin, M., Beaussant, Y., Schwarzer, G., & Boehlke, C. (2024). Psychedelic-assisted therapy for treating anxiety, depression, and existential distress in people with life-threatening diseases. Cochrane Database of Systematic Reviews, 9(9), CD015383. https://pubmed.ncbi.nlm.nih.gov/39260823/#https://pubmed.ncbi.nlm.nih.gov/39260823/
Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.