Psychotherapy and Psychedelics – What’s it all about?

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Medical Editor: Dr. David Cox, PhD, ABPP

What is psychotherapy?

The roots of the word psychotherapy are psykhē, meaning of the soul, mind, spirit, life; and therapeia, meaning curing, healing in Greek. Psychotherapy, also known as talk therapy, is a way of treating mental health problems with the help of a trained provider. The goal of psychotherapy is to promote healing and increase well-being so that the person can enjoy life as much as possible.

While psychotherapy is a relatively recent concept in the span of human history, psychedelics have been used by humans for thousands of years. The word psychedelic, which means mind manifesting in Greek, pertains to a class of substances ranging from plants and fungi to synthetic chemicals which induce an altered state of consciousness when consumed. Psychedelics are being examined for their potential to catalyze more psychological healing inside and outside the therapy room.

There are many different types of psychotherapy treatments, techniques and practitioners, both within and outside of the psychedelic world. Some therapists help people heal directly with psychedelic use. Some therapists do not facilitate psychedelic journeys, but they support people before and after to integrate those experiences into their daily life. With or without psychedelics, psychotherapy is an evidence-based way to address and treat depression, anxiety, living with chronic illness, dealing with a loss, healing from trauma, coping with daily life, and much more.

Psychotherapy vs Counseling

A psychotherapist is trained and experienced in helping clients understand, address, cope with, and heal mental health conditions. A counselor offers guidance and support to help their clients overcome specific issues with more short-term solutions. While the terms may be used interchangeably, and there is a lot of overlap between the two roles, you may want to be aware of some distinctions.

Psychotherapists focus on feelings and experience, and may help the client link the past to the present. The psychotherapeutic techniques that they use are intended to facilitate greater insight, long-term solutions, and healing. Psychotherapy can go on for several years, either continuously or intermittently.

Psychologists, psychiatrists, and social workers are all equipped to practice psychotherapy, although the training of each varies. Psychiatrists are medical doctors who specialize in psychological issues, whereas psychologists typically have obtained a doctorate of psychology (a Ph.D. or PsyD) and social workers have obtained a master’s degree in social work.

A counselor provides guidance and support. Anyone who is advising someone could be called a counselor; it does not require specific training. Counseling may focus on external behavior and circumstances more than internal processes. A counselor could work with a client for a few weeks or up to several months. The goal is to find solutions and ways to deal with specific problems coming up in one’s life. While a psychotherapist may employ counseling techniques in therapy with their clients, a counselor does not practice psychotherapy without the proper training.

Types of psychotherapy

There are many evidence-based, clinically proven types of psychotherapy to choose from. Therapy can be done individually, in a group, as a couple, with family, and more. Each person comes to therapy with their own unique set of circumstances, history, needs and desires, so what works for one person may not work for another. The therapist-client relationship is an integral part of therapy, although its significance may be greater or lesser depending on the type of therapy. Some more well-known types of psychotherapy today are:

Cognitive Behavioral Therapy (CBT)

This therapy approaches the human experience through the lens of thought (cognition) and behavior. CBT consists of interventions designed to challenge unhelpful patterns of thought and behavior, recognize and regulate emotions, and develop strategies for coping with daily life. CBT requires a certain level of mental insight and is regarded as a “solutions-focused” form of psychotherapy.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy was created by Dr. Marsha Linehan in the 1980s, and involves aspects of cognitive therapy as well as the Buddhist principle of mindfulness. DBT has four nodes: emotion regulation, interpersonal effectiveness, distress tolerance, and core mindfulness. This form of treatment may be useful for anyone, but has been shown especially effective for individuals with eating disorders, borderline personality disorder, suicidality, PTSD, and mood disorders.

Psychodynamic Therapy

Psychodynamic therapy, sometimes called psychoanalysis, is an adaptation of the work of Sigmund Freud. The process involves uncovering repressed memories and other unconscious material that might be at the root of the client’s depression, anxiety, and/or harmful patterns of thought and behavior. Exploring something called transference is common in psychodynamic therapy. Transference occurs when the client unconsciously displaces or transfers emotions/expectations they have toward an important person in their life (such as a parent or spouse) onto their therapist. Dream analysis is another common feature of psychodynamic therapy. The therapist-client relationship is a central part of the healing process.

Humanistic Therapy

Rather than looking at a client through the lens of thoughts, behaviors, history, and symptoms, humanistic or experiential therapy views each person as a unique individual deserving of unique treatment. A key component of humanistic therapy is unconditional positive regard for clients. Humanistic therapists focus on the here and now, and work to help their clients become more accepting of, and comfortable as, themselves. Like psychodynamic therapy, trust in the practitioner is a central part of this modality.

Transpersonal Therapy

Transpersonal means “beyond the personal,” referring to experiences that transcend the individual experience. The most holistic of all of the therapies described here, transpersonal therapy, is concerned with “wider aspects of humankind, life, psyche or cosmos.” Transpersonal therapists will concern themselves with the health and vitality of their client’s spirit. They may use meditation, hypnosis, dream interpretation, visualization, mindfulness, and the arts to help their clients.

Other forms of therapy are interpersonal, supportive, narrative, expressive, somatic, feminist, psychedelic-assisted psychotherapy, and many more. In the treatment of addiction, engaging in some form of group therapy is often recommended for best results.

Psychotherapy techniques

Most therapists today employ some combination of different types of therapy. In general, you can expect to find practitioners utilizing techniques like listening, relating, exploring, educating, validating, intervening, analyzing, and other modalities. Therapists often use tests with their clients to determine if they have a diagnosable condition such as depression, anxiety, OCD, PTSD, and other diagnoses.

Why is psychotherapy effective?

In general, research indicates that psychotherapy can work as well or better than medication for addressing mental disorders. Scientists have even found that, depending on the person, therapy can bring more long-term and enduring changes in one’s life. Psychotherapy alone has been shown to produce measurable changes in the brain!

There are many reasons why psychotherapy is effective. Many people who attend therapy report that simply carving out the time to focus on themselves and speak with a trained, objective, and supportive professional is helpful in and of itself. Psychotherapy can enhance the client’s problem-solving abilities, provide validation and understanding for their struggles, help them recognize and regulate their emotions, integrate the past, and make positive changes in the present and future.

When should a person seek psychotherapy?

If you’re unsure about whether to seek psychotherapy, consider these questions:

  • Do your problems feel beyond your control?
  • Do you feel off, disconnected from yourself, moody, or overcome with worry?
  • Are you falling into addictive/abusive patterns with things like food, sex, shopping, social media, video games, work and/or substances?
  • Are you in an abusive relationship? Are you concerned that you might be in one?
  • Did you experience trauma or abuse in the past that still seems to affect you today?
  • Do your family, friends, coworkers express concern about you not acting like yourself?
  • Have you lost enjoyment for activities that used to bring you pleasure or good feelings?
  • Do you find yourself lost in thought often? Are you unable to focus?
  • Do you feel helpless to address the issues coming up in your life?
  • Are you sleeping more or less than you think you should? Do you experience nightmares or other sleep disturbances such as insomnia?
  • Are your actions hurting yourself or others?
  • Do you have thoughts about suicide or of harming yourself or others?

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.

What is a Psychotherapist and how do I choose one?

Shopping for a therapist can be overwhelming. If you have insurance, it may be worthwhile to call your insurance company and ask if you have behavioral health included in your plan. Most insurance companies have databases of therapists who accept that type of insurance. Some people find that it is worthwhile to pay for the therapist who they want to work with, even if that practitioner doesn’t accept their insurance.

You can find many psychotherapist listings through Psychology Today and the American Psychological Association.

It is not uncommon for people to speak with several different therapists or try different types of therapy before they find the right one for them. Be sure to vet your therapist by asking about their credentials and making sure their license is in good standing. Psychotherapy is a collaborative relationship that involves trust, communication, and mutual respect, so take time to fully investigate your options. We all deserve the support to feel our best, and psychotherapy can be a great vehicle toward greater self-acceptance, more fulfilling relationships, and enjoyment of life.

Should I find a psychotherapist who understands Psychedelics?

The modern world is seeing a psychedelic renaissance right now. Anyone who is working with psychedelics would probably benefit from having a therapist to support them. It’s not only a kind thing to do for yourself, but also for the people in your life.

Many therapists are still unaware, uninformed, or misinformed about psychedelics and their benefit for treating different mental disorders, accessing creativity, exploring consciousness, and more.

A therapist who is not familiar with psychedelics should be open and willing to educate themselves in the area. Although it could take some more time to find a psychedelic-friendly therapist, that will likely be the better choice. Describing a psychedelic experience in words can be hard enough, without having to explain it to someone who doesn’t have practical experience with the terrain. A psychotherapist who is aware of psychedelics will be much more helpful in helping clients integrate the experience into their lives.

 

Dave Cox
Medical Editor

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