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Integrative Psychiatry

Psychedelics and Eating Disorders

By March 12, 2024No Comments

Eating disorders affect millions of Americans, manifesting along a spectrum and without diagnoses for many more. Presentation of symptomatology is unique for each person, influenced by a combination of genetic, environmental, and psychological factors; however, eating disorders often manifest as disturbances in body image, nutritional intake, weight control, and emotional wellbeing. Eating disorders impact nourishment, altering a wide range of physiological systems in addition to psychological states. A sociocultural perspective of eating disorders suggests that systemic factors play into social messaging around gender, beauty standards, idealized body image, and eating behaviors. Some schools of thought believe eating disorders are a symptom of deeper, underlying wounds. Research suggests that psychedelics may support the treatment of eating disorders through confronting root causes, such as negative core beliefs, and embodying self-love and care.

Treatment Approaches

While traditional therapeutic modalities such as cognitive-behavioral therapy and medication management have their places in the treatment of eating disorders, their efficacy can be variable. Many individuals continue to struggle with symptoms despite receiving standard interventions, highlighting the need for alternative approaches.

Psychedelic substances like psilocybin, MDMA, and ayahuasca have garnered attention for their potential to catalyze profound therapeutic experiences. Research suggests that these medicines may facilitate therapeutic breakthroughs by promoting introspection, emotional processing, and neural plasticity. Psychedelic-induced flexibility of consciousness and altered sense of self (see more on this here) may support the introduction of healthy relationships between body, spirit, and mind among individuals with eating disorders. It is theorized that psychedelics may rewire reward pathways, loosen patterns of rigidity, instill self-compassion, and promote spiritual connection. 

Recent qualitative and observational studies describe decreases in comorbid symptoms of depression and anxiety associated with eating disorders following psychedelic- assisted therapy; meanwhile, psychedelics increase feelings of empowered embodiment, trauma processing, and overall wellbeing. While results are limited, pilot studies of MDMA and psilocybin show promising results for clinically meaningful reduction of eating disorder symptoms. However, there is still much to be explored in this realm and larger clinical trials are currently underway. For example, one outstanding medical question is the influence of nutritional status on psychedelic experiences and long-term outcomes.

Roles of Clinicians

Clinicians act as educational facilitators, disseminating data from research studies, dispelling myths, setting expectations (which might include removing expectations), and ethical informed consent for clients. An essential aspect of psychedelic-assisted therapy is the integration of experiences into daily life. Navigating cultural landscapes and differential needs, clinicians collaborate with clients to explore the insights gained during psychedelic sessions. They also develop strategies for applying these insights to behavior change and emotional healing. Ongoing therapy and community resources can help ensure lasting therapeutic benefits. Thus, training in psychedelic-assisted therapy approaches and techniques is essential. Furthermore, psychedelics do not replace clinicians’ specialized training and competency in working with eating disorders.

Conclusion

Psychedelic medicines, in combination with psychotherapy, are under investigation for a number of mental health diagnoses due to their potential to support rewriting of self narratives. It may benefit clinicians to approach this emerging field with curiosity, striving to leverage the unique therapeutic benefits of psychedelics while also holding the complexity of evolving evidence-based practices, heightened vulnerability of psychedelic consciousness, and sensitivity around safety and trust in this space.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.