Psychedelic-assisted therapy
Therapeutic Use of Psychedelics
Psychedelics or entheogens (from the Greek entheos "of the divine" and genestai "which comes into being") are psychoactive substances which induce altered states of consciousness and which are traditionally used by indigenous peoples in a ritual context for therapeutic and spiritual purposes. According to these cultures, these substances open the consciousness to the reality of the spiritual world. For several years now, these substances have been used in the context of Western medicine to treat various physical and psychological issues. Although their use is still at the experimental stage, the research data are very interesting.
These substances can be used in a therapeutic context as Dr Olivier Chambon points out: “A psychedelic is a natural or synthetic substance, the consumption of which causes changes at the physical, emotional, mental and spiritual levels. It is a powerful medicine that does not cause physical dependence. It can be used with safety for the body and the mind, provided that very specific precautions for use are respected. A psychedelic is not a drug” (Chamon, 2020;17).
The best known psychedelic substances are LSD, psilocybin, peyote, ayahuasca, ibogaine. Cannabis is also considered by some to be part of the entheogens. Among these substances, psilocybin is the most used in clinical research and its therapeutic potential is impressive.
Entheogens are not legal over-the-counter substances. For example, LSD and psilocybin (a psychoactive substance found in “magic” mushrooms) remain illegal in Canada although several organizations are campaigning for its legalization for therapeutic purposes. However, certain substances such as psilocybin, ketamine and MDMA can be prescribed by a doctor via Health Canada's Special Access Program (SAP) for therapeutic reasons. People who experience anxiety and existential anguish linked to a chronic terminal illness are a clientele targeted by the PAS. To find out more about psilocybin, visit the Health Canada website. The Découverte program broadcast on Radio-Canada recently devoted a complete report on the therapeutic use of hallucinogens. This report may provide relevant information on the subject.
The use of psychedelic substances in the healthcare context is commonly referred to as “psychedelic-assisted therapy” in various studies. The consumption of the substance takes place in a context of therapeutic and, for our part, spiritual support. The substance itself has extraordinary potential for inner transformation and can be considered as a “treatment” or an adjunct to therapy or spiritual support. In indigenous cultures where these substances have been used for centuries, their uses are never associated with psychotherapy. As one group of researchers points out: “In summary, the term “psychedelic-assisted therapy” does not convey the actual changes induced by the psychedelic experience. The effects observed in the best controlled clinical studies must be attributed to the medication itself and not to psychotherapy (Goodwin et al., 2021;17).
In Quebec, psychotherapy is an act reserved for psychologists and psychotherapists. We therefore do not offer psychotherapy but rather psilocybin-assisted therapy in the context of broader spiritual support. This treatment is offered in a safe context by a spiritual care worker trained at Therapsil, which is the most rigorous training in Quebec currently. It is therefore in this context that we offer this specialized spiritual accompaniment for people who can access medication from their attending physician. We can also refer interested people to doctors open to these innovative approaches who will be able to prescribe the medication. The medical literature explains the therapeutic potential of these treatments, among other things, through the mystical experience experienced by the people who participated in these clinical studies. This deeply spiritual experience proves to be a mechanism of psychological action to explain beneficial, substantial and lasting changes related to existential distress. A large proportion of people who participated in these studies say that it was one of the five most significant experiences of their lives.
Understanding how psychedelics work
Neurologically, psychedelics act on the brain in a complex way. Without going into detail about pharmacodynamics and pharmacokinetics, let us instead say how these substances act on consciousness from a psychological and phenomenological point of view. To do this, the mapping of the psyche (Figure 1) made by the Italian neuropsychiatrist Roberto Assagioli proves enlightening. In light of this model, ordinary consciousness (the feeling of being me in contact with the environment) represents only a fraction of consciousness which turns out to be a much larger reality, namely the unconscious. This unconscious has lower (subconsciousness) and higher (supraconsciousness) dimensions. It is through superconsciousness that the human being can enter into relationship with the transcendent dimension of his being and make contact with his true nature, namely the higher or spiritual Self. This contact results through what we could describe as a mystical experience: “There are also people who, thanks to a relentless practice of prayer or meditation, manage to temporarily project their consciousness towards the levels of the supraconscious, arriving sometimes very close to the transpersonal Self, or even in contact with it” (Assagioli, 1991;183). However, like meditation or other spiritual practices, it seems that psychedelics act as a catalyst which promotes the broadening of consciousness which, for a specific time, comes into contact with other dimensions of reality.
Our hypothesis is that psychedelics decompartmentalize the field of ordinary consciousness and thus make it permeable to the unconscious. This temporary abolition of the "borders" of ordinary consciousness promotes the emergence of either the lower unconscious or the higher unconscious depending on the preparation and orientation given to the experience. In a classic psychotherapeutic approach the orientation is generally focused on the lower unconscious with the aim of releasing repressed emotions linked to previous experiences. Hence the therapeutic experience of emotional breakthrough experienced by people. For our part, we deliberately direct the experience with the aim of promoting contact or relationship with the supraconsciousness of which the mystical experience proves to be the desired result and which, in medical literature, is identified as a therapeutic factor dispelling fear of death and existential distress.
Thus the work of Roberto Assagioli, contemporary of Carl G. Jung and Sigmund Freud, of whom he was a disciple, can serve as an interpretive framework for psychedelic experiences. His model of the psyche allows us to understand that experiences of emotional liberation (emotional breakthrough) and mystical experience - two therapeutic mechanisms of action identified in medical literature - are possible through the emergence into consciousness of unconscious realities which, this is our opinion, can be mentioned during preparation and elicited by the therapist during the experience. Moreover, Assagioli says about the experience of self-transcendence that it is: “a true “phenomenological” experience, an inner reality which can be verified empirically and voluntarily provoked by appropriate techniques” ( Assagioli, 1991, p.28). He specifies that: “the experience of the Self [mystical experience] does not only present itself spontaneously; it can be favored, or even provoked, by the use of different methods of meditation and concentration” (Idem, p.29).
Risks and benefits associated with the therapeutic use of psilocybin
When used in a therapeutic context, that is to say in a supervised environment with competent and trained health professionals, the consumption of psychedelic substances carries very few risks. On a medical level, the risks identified in the literature are an increase in blood pressure, presence of nausea and sweating, physical discomfort, headaches. On a psychological level, some people may experience a temporary dissociative episode (in very rare cases this may continue), changes in personality, values and belief system, psychological discomfort, an episode of anxiety, visual hallucinations and temporary paranoid ideas. Some cases of suicidal ideation have been recorded but only among clients treated for refractory chronic depression (and not in the context of existential distress). As for the benefits associated with the therapeutic use of psychedelics in the context of existential distress, we observe a significant reduction in symptoms of anxiety, depression, despair, fear of death as well as symptoms associated with demoralization. In return, we observe an increase in the feeling of peace, an increased understanding of the meaning of existence, an increase in spiritual and psychological well-being and an improvement in social relationships (Agin-Liebes et al., 2020).
Stéphane Rivest 2024©
Figure 1. Diagram of Roberto Assagioli’s psyche
Fig. 1 Diagram of Assagioli's psyche
Understanding how psychedelics work
Neurologically, psychedelics act on the brain in a complex way. Without going into detail about pharmacodynamics and pharmacokinetics, let us instead say how these substances act on consciousness from a psychological and phenomenological point of view. To do this, the mapping of the psyche made by the Italian neuropsychiatrist Roberto Assagioli proves enlightening. In light of this model, ordinary consciousness (the feeling of being me in contact with the environment) represents only a fraction of consciousness which turns out to be a much larger reality, namely the unconscious. This unconscious has lower (subconsciousness) and higher (supraconsciousness) dimensions. It is through superconsciousness that the human being can enter into relationship with the transcendent dimension of his being and make contact with his true nature, namely the higher or spiritual Self. This contact results through what we could describe as a mystical experience: “There are also people who, thanks to a relentless practice of prayer or meditation, manage to temporarily project their consciousness towards the levels of the supraconscious, arriving sometimes very close to the transpersonal Self, or even in contact with it” (Assagioli, 1991;183). However, like meditation or other spiritual practices, it seems that psychedelics act as a catalyst which promotes the broadening of consciousness which, for a specific time, comes into contact with other dimensions of reality.
Our hypothesis is that psychedelics decompartmentalize the field of ordinary consciousness and thus make it permeable to the unconscious. This temporary abolition of the "borders" of ordinary consciousness promotes the emergence of either the lower unconscious or the higher unconscious depending on the preparation and orientation given to the experience. In a classic psychotherapeutic approach the orientation is generally focused on the lower unconscious with the aim of releasing repressed emotions linked to previous experiences. Hence the therapeutic experience of emotional breakthrough experienced by people.
For our part, we deliberately direct the experience with the aim of promoting contact or relationship with the supraconsciousness of which the mystical experience proves to be the desired result and which, in medical literature, is identified as a therapeutic factor dispelling fear of death and existential distress.
Thus the work of Roberto Assagioli, contemporary of Carl G. Jung and Sigmund Freud, of whom he was a disciple, can serve as an interpretive framework for psychedelic experiences. His model of the psyche allows us to understand that experiences of emotional liberation (emotional breakthrough) and mystical experience - two therapeutic mechanisms of action identified in medical literature - are possible through the emergence into consciousness of unconscious realities which, this is our opinion, can be mentioned during preparation and elicited by the therapist during the experience. Moreover, Assagioli says about the experience of self-transcendence that it is: “a true “phenomenological” experience, an inner reality which can be verified empirically and voluntarily provoked by appropriate techniques” ( Assagioli, 1991, p.28). He specifies that: “the experience of the Self [mystical experience] does not only present itself spontaneously; it can be favored, or even provoked, by the use of different methods of meditation and concentration” (Idem, p.29).
Risks and benefits associated with the therapeutic use of psilocybin
When used in a therapeutic context, that is to say in a supervised environment with competent and trained health professionals, the consumption of psychedelic substances carries very little risk.
On a medical level, the risks identified in the literature are an increase in blood pressure, presence of nausea and sweating, physical discomfort, headaches. On a psychological level, some people may experience a temporary dissociative episode (in very rare cases this may continue), changes in personality, values and belief system, psychological discomfort, an episode of anxiety, visual hallucinations and temporary paranoid ideas. Some cases of suicidal ideation have been recorded but only among clients treated for refractory chronic depression (and not in the context of existential distress).
As for the benefits associated with the therapeutic use of psychedelics in the context of existential distress, we observe a significant reduction in symptoms of anxiety, depression, despair, fear of death as well as symptoms associated with demoralization. In return, we observe an increase in the feeling of peace, an increased understanding of the meaning of existence, an increase in spiritual and psychological well-being and an improvement in social relationships (Agin-Liebes et al. 2020)
Entheogens are not legal over-the-counter substances. For example, LSD and psilocybin (a psychoactive substance found in “magic” mushrooms) remain illegal in Canada although several organizations are campaigning for their legalization for therapeutic purposes. However, certain substances such as psilocybin, ketamine and MDMA can be prescribed by a doctor via Health Canada's Special Access Program (SAP) for therapeutic reasons. People who experience anxiety and existential anguish linked to a chronic terminal illness are a clientele targeted by the PAS. To find out more about psilocybin, visit the Health Canada website.
The use of psychedelic substances in the healthcare context is commonly referred to as “psychedelic-assisted therapy” in various studies. Consumption of the substance takes place in a context of therapeutic and sometimes psychotherapeutic support. The substance itself has extraordinary potential for inner transformation and can be considered a “treatment” in itself. As one group of researchers points out: "In summary, the term 'psychedelic-assisted therapy' does not convey the actual changes induced by the psychedelic experience. The effects observed in the best controlled clinical studies must be attributed to the medication itself and not to psychotherapy ( Goodwin et al ., 2021;17 ).
In indigenous cultures where these substances have been used for centuries, their uses are never associated with psychotherapy. This treatment is offered in a safe context by a spiritual care worker trained at Therapsil, which is the most rigorous training in Quebec currently. It is therefore with this in mind that we offer this specialized spiritual accompaniment for people who can access medication from their attending physician. We can also assist you in your efforts to find a professional likely to make a request to Health Canada .
The medical literature explains the therapeutic potential of these treatments, among other things, through the mystical experience experienced by the people who participated in these clinical studies. This deeply spiritual experience proves to be a mechanism of psychological action to explain beneficial, substantial and lasting changes related to existential distress. A large proportion of people who participated in these studies say that it was one of the five most significant experiences of their lives.
Understanding how psychedelics work
Neurologically speaking, psychedelics act on the brain in a complex way. The study by Petri and colleagues (2014) demonstrates that psilocybin activate brain regions connexions. Without going into detail about pharmacodynamics and pharmacokinetics, let us instead say how these substances act on consciousness from a psychological and phenomenological point of view. To do this, the mapping of the psyche (image below) made by the Italian neuropsychiatrist Roberto Assagioli proves enlightening. In light of this model, ordinary consciousness (the feeling of being me in contact with the environment) represents only a fraction of consciousness which turns out to be a much larger reality, namely the unconscious. This unconscious has lower (subconsciousness) and higher (supraconsciousness) dimensions. It is through superconsciousness that the human being can enter into relationship with the transcendent dimension of his being and make contact with his true nature, namely the higher or spiritual Self. This contact results in what we could describe as a mystical experience: “There are also people who, thanks to a relentless practice of prayer or meditation, manage to temporarily project their consciousness towards the levels of the supraconscious, sometimes arriving very close of the transpersonal Self, or even in contact with it” (Assagioli, 1991;183). However, like meditation or other spiritual practices, it seems that psychedelics act as a catalyst which promotes the broadening of consciousness which, for a specific time, comes into contact with other dimensions of reality .
Our hypothesis is that psychedelics abolish the boundries of ordinary consciousness and thus make it permeable to the unconscious. This temporary abolition of the "borders" of ordinary consciousness promotes the emergence of either the lower unconscious or the higher unconscious depending on the preparation and orientation given to the experience. In a classic psychotherapeutic approach the orientation is generally focused on the lower unconscious with the aim of releasing repressed emotions linked to previous experiences. Hence the therapeutic experience of emotional breakthrough experienced by people.
For our part, we deliberately direct the experience with the aim of promoting contact or relationship with the supraconsciousness of which the mystical experience proves to be the desired result and which, in medical literature, is identified as a therapeutic factor dispelling fear of death and existential distress.
Thus the work of Roberto Assagioli, contemporary of Carl G. Jung and Sigmund Freud, of whom he was a disciple, can serve as an interpretive framework for psychedelic experiences. His model of the psyche allows us to understand that experiences of emotional liberation (emotional breakthrough) and mystical experience - two therapeutic mechanisms of action identified in medical literature - are possible through the emergence into consciousness of unconscious realities which, this is our opinion, can be mentioned during preparation and elicited by the therapist during the experience. Moreover, Assagioli says about the experience of self-transcendence that it is: “a true “phenomenological” experience, an inner reality which can be verified empirically and voluntarily provoked by appropriate techniques” ( Assagioli, 1991, p.28). He specifies that: “the experience of the Self [mystical experience] does not only present itself spontaneously; it can be favored, or even provoked, by the use of different methods of meditation and concentration” (Idem, p.29).
Risks and benefits associated with the therapeutic use of psilocybin
When used in a therapeutic context, that is to say in a supervised environment with competent and trained health professionals, the consumption of psychedelic substances carries very little risk.On a medical level, the risks identified in the literature are an increase in blood pressure, presence of nausea and sweating, physical discomfort, headaches. On a psychological level, some people may experience a temporary dissociative episode (in very rare cases this may continue), changes in personality, values and belief system, psychological discomfort, an episode of anxiety, visual hallucinations and temporary paranoid ideas. Some cases of suicidal ideation have been recorded but only among clients treated for refractory chronic depression (and not in the context of existential distress).
As for the benefits associated with the therapeutic use of psychedelics in the context of existential distress, we observe a significant reduction in symptoms of anxiety, depression, despair, fear of death as well as symptoms associated with demoralization. In return, we observe an increase in the feeling of peace, an increased understanding of the meaning of existence, an increase in spiritual and psychological well-being and an improvement in social relationships (Agin-Liebes et al. 2020).
