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Integrative Psychiatry

Psychedelics for the Exploration of Self

By January 18, 2024February 5th, 2024No Comments

The felt experience is the essence of being human. Psychedelic medicines are revolutionizing the mental health field, in part because they break down barriers of the psyche, opening up alternative avenues in perception. Altered states of consciousness, like altered sensations, proprioception, and visions, can create vibrant connections with the senses. Even dissociative effects of ketamine that cause strange feelings of disembodiment, spaciness, and boundlessness are thought to contribute to long-term antidepressant effects and lifestyle changes. Simultaneously, the experience of the self shifts away from egocentricity, toward an “unselfing” known as ego dissolution. Therefore, the psychedelic experience is often ineffable, a felt sense rather than a conceptually known and measurable experience (though scientists do their best to quantify it). These experiences are the starting point for psychedelic-assisted psychotherapy, which supports the exploration of newly accessed consciousness, poignant insights, meaning-making, and self-growth processes.

A Neuroscience Perspective

Psychedelic-induced altered states of consciousness are proposed to arise from increased spontaneous activity or “cross-talk” between neural circuits in the brain. It is thought that the breakdown of what are normally highly organized regional activities leads to a loosening of perceptual control; those patterns and assumptions of reality created by the brain to make sense of the world are shattered. In these states of consciousness, possibility exists–the environment becomes less predictable, enriching the experience of consciousness. It is during this influential period of brain activity that persons exhibit psychological flexibility, or the ability to think about self and situations in novel ways. Increases in psychological flexibility provide opportunities for reconstructing self narratives and deconstructing negative self-beliefs. 

The Inner Experience of Self

Altered states of consciousness inherently shake up previous understandings of self. Changes in reality, transcendence of self, and mystical experiences can leave people contemplating the nature of existence and who they are. In psychologically flexible states, individuals are more easily able to redefine their identities and their own judgments about them. Thus, psychedelic-assisted therapy appears to be a successful tool for connecting to self, heightening self awareness, and improving coping skills. For example, trauma can lead to difficulties in relating to self and others. A recent study has shown that MDMA-assisted therapy positively modifies self capacities like identity, relationships, and emotional regulation while enhancing mindfulness of internal states among individuals with posttraumatic stress disorder (PTSD); alterations of the self experience largely corresponded with improvement in PTSD symptoms. Changes in relationship to self–the concept of self and felt experience of self, including emotional distress–may be key components of psychological healing. 

The Social Self

Interpersonal relationships act as a reflection for the conceptualized self. Relationships exist between self and other people, but also self and nonhuman beings: plants, animals, microbes, the collection of species on the earth. Psychedelics often tap into these relationships, with persons experiencing a sense of unity and connection beyond themselves. Increased empathy heightens feelings of interconnectedness that are evolutionarily and existentially critical to human survival and wellbeing. Psychedelic-assisted psychotherapy takes place in the context of the therapeutic relationship, offering the potent recipe of time, trust, and witnessing to the client. Affirmations that come with sharing vulnerable states of self can be powerful influencers of reconstructing individual self-narratives. New and strengthened connections between self and others may initiate reorganization of the relational self that embraces more positive emotions such as awe, intimacy, and love (as in, self-as-lover and self-as-loved).

The Compassionate Self

Psychedelics can support self-compassion by increasing empathy and fostering a sense of connection, not only with others but also with one’s own inner experiences. During a psychedelic experience, individuals may confront their past traumas, regrets, or self-criticisms through altered perspectives. This altered state can facilitate empathy toward their own suffering, leading to a more compassionate self-dialogue and deeper self acceptance. Many people report an uncovering of new parts, or an altered relationship to parts of themselves, emphasizing the importance of honoring multiplicity in psychedelic-assisted therapy. These emerging parts can help participants make sense of and feel compassion towards defense strategies and coping mechanisms.

Takeaway

It is becoming increasingly evident that psychedelics hold great promise for personal transformation and healing by engaging self-exploration. Held within supportive contexts for psychedelic-assisted therapy, who we are, what our identities mean to us, and the feelings we ascribe to our self-concepts can become less rigid and more fluid, open to interpretation. It may be important for psychedelic therapy trainings to include a contemplative approach, emphasizing the inner experience of clients and their relationship to self, others, and the world.

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.