Why Integration is Important in Psychedelic Assisted Therapy
Psychedelic Assisted Psychotherapy has made a significant introduction onto the stage of traditional therapy. Since landmark findings in the early 2000s, there has been a renewed interest in psychedelics in modern psychiatry. However, key components of the research have included integration sessions – where the participant discusses their experience with a guide. This departure from traditional psychopharmacology, where therapy is recommended, proven to be more effective than medication alone, but is ultimately optional, makes psychedelic assisted therapy stand out.
The Multidisciplinary Association for Psychedelic Studies (MAPS) should conclude its phase three trials with the FDA in October 2022 to approve MDMA assisted therapy for Post Traumatic Stress Disorder (PTSD). Note that it’s not MDMA, but MDMA assisted therapy. Why is this therapeutic component so vital to the healing process? What about current practices, like ketamine infusions, where integration therapy is optional?
Integration is important because it provides a clinical framework to process the experience. Without integration, a subject may still receive some benefit, as the foundational study by Rick Strassman demonstrated with the mystical experience, but working through insights and wisdom gained can prove to be dramatic and influential in the participant’s ongoing mental health. On a biochemical level, psychedelics increase the brain derived neurotropic factor (BDNF) which facilitates neurogenesis and neuroplasticity by creating new synaptic connections. Integration therapy reinforces these new neural pathways in the brain, increasing the likelihood of persistent neurologic change.
On a personal, subjective level, integration therapy calls out the practical applications derived from the mystical experience. There can be intentionality and decision making made going forward and integration brings those from an ineffable abstraction to a concrete, deliberate change. Many people have reported psychedelic experiences to be among the most meaningful in their lives, and having a trained and talented therapist can help move an otherworldly experience to one grounded in this world. Furthermore, harm reduction plays a key role in integration. Psychedelic experiences can, at times, be frightening. Psychedelics used recreationally don’t have the clinical protocols to prepare a participant for the intensity. Integration provides a safe and supportive space to discuss so called “shadow work” that arises from a “bad trip”, allowing the processing of feelings arising from difficult experiences.
Can people experience transformative change with psychedelics alone? Certainly. But the indigenous cultures many of these plant medicines come from deliver them in a controlled ceremony. The best practices of western research also indicate a before-during-and after approach with a clinical team to produce the most efficacious results. integrative therapy is inextricably linked with the current ongoing clinical trials. The recent Psychedelic Assisted Therapy Summit in October 2022 predicted the need for 50,000 trained therapists within the next ten years. MAPS has a training program based on its clinical research, as does the California Institute of Integral Studies, Naropa University, and others. Having a cohort of competent, well-trained therapists conducting ethical and compassionate integration therapy at the highest level is vital to the psychedelic renaissance.