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Reviewed by Psychology Today Staff. As a result, the substances can lastingly induce changes in thoughts and feelings. Plant-derived hallucinogens such as psilocybin, mescaline, and ibogaine have been safely used, primarily in traditional cultures, since ancient times. Typically, they are consumed ritualistically in healing ceremonies and religious rites to facilitate communication with the gods, all under the guidance of experienced elders. Since the s, psychedelic substances have been illegal in the U. But starting the s, at first quietly, then openly, medical interest in psychedelics has been resurgent. The resurgence of interest can be attributed to the ability of the substances to induce lasting benefits with a remarkably short course of treatment—two or three doses. This time around, however, it is recognized that the presence of a trained and supportive therapist in a safe and comfortable environment is essential for obtaining the benefits of psychedelic agents. The U. Food and Drug Administration has indicated that, pending the outcome of ongoing clinical trials, it is willing to approve the use of psychedelic-assisted psychotherapy. Psychedelic-assisted psychotherapy promises a brightened outlook for an array of psychiatric afflictions and drug treatment delivered with compassion. Psychedelic-assisted psychotherapy PAP is proving to work for so many conditions, researchers believe, because the substances target the brain region central to so many brain operations and involved in so many disorders—the prefrontal cortex—and revamp its structure. Drugs that induce the psychedelic experience share a molecular mechanism of action—they activate a specific serotonin receptor 5-HT2A on a specific subset of neurons in the cerebral cortex, cells that are essential for integrating incoming information to create our experience of reality. They cause the neurons to fire in a very disorganized way , messing up all the inputs. They also vastly expand the formation of synapses, intensifying neural plasticity , which many consider key to their therapeutic action. Neural plasticity is the portal to possibility and change. The experience is felt as ego dissolution, a significant part of the psychedelic experience.. Psychedelics pharmacologically return the brain to what can be considered neural childhood. The effects mimic conditions during neurodevelopment, creating the optimal brain state for environmental input to have enduring effects. Experientially, this translates into a renewed, often very positive, sense of possibility. Also, psychedelics increase disorder in the way brain cells operate, which has the effect of prioritizing incoming sensory input over existing beliefs, encouraging novel responses to incoming information. That may, for example, keep those who experience depression from becoming stuck in repetitive negative thought patterns. Patients find the experience powerful and full of meaning. Dissolution of the sense of ego makes people feel at one with the world, and the intensity of the experience makes it highly meaningful to people. The drugs act primarily on serotonin receptors. Not only is serotonin involved in processing sensory information, it also influences our emotional responses, such as fear , excitement, and empathy. There are likely many ways by which the drugs improve mental health. They stimulate the growth of new neurons, promoting learning. They heighten the impact of new experiences over old memories. And the ego dissolution effect of psychedelics enables people to see their thoughts and life from a less subjective, more objective standpoint. Ego dissolution may provide the link between psychedelic action and therapeutic effects in the brain. The effect of psychedelics on ego dissolution is similar to the effect achieved by long-time practitioners of meditation. Under the influence of psychedelic drugs, the perception of our familiar self vanishes. People describe such ego dissolution as a diminished sense of self and an increase in the feeling of being at one with the universe, an experience felt as pleasurable and enriching. The sense of self normally arises from the constant synthesis of sensory input your brain is doing every second of every day, with the help of the neurotransmitter serotonin. You experience your sense of self as a coherent whole, but it is actually constantly being updated by incoming sensory information. The distortion of our subjective experience of self is a core part of the psychedelic experience, which also includes an increase in emotional empathy, the ability to respond to the mental state of others. Because our ego separates us from others, ego dissolution causes people to feel much closer to others, whether they know them well or not. Classic psychedelics are derived from plants found in nature and include psilocybin, dimethyltryptamine DMT , mescaline, and LSD, which is derived from naturally occurring ergotamine. All have a long history of safe use in many cultures, typically in religious ceremonies and in the presence of spiritual guides. Non-classic psychedelics include manipulated molecules such as MDMA and ketamine. Psilocybin is a naturally occurring compound in some species of mushrooms found in tropical regions and is undergoing clinical trials for the treatment of people with resistant depression. It is also in the early stages of testing for opioid addiction. Alzheimer's disease, post- traumatic stress disorder PTSD , post-treatment Lyme disease syndrome formerly known as chronic Lyme disease , anorexia nervosa, and alcohol use in people with major depression. MDMA 3,4-methylenedioxymethamphetamine , also called Ecstasy or Molly, is a synthetic compound that has successfully undergone confirmatory Phase 3 clinical trials for the treatment of moderate to severe PTSD. MDMA is not a classic psychedelic, but it influences the release of serotonin and other neurotransmitters and alters perception. Studies indicate that MDMA reduces hyperactivity in the amygdala and increases connectivity between the amygdala and the hippocampus so that memories can be processed and safely stored without constantly intruding on the present. MDMA also releases the hormone oxytocin , boosting the sense of social connectedness. MDMA is also being tested for use as a treatment for depression, anxiety , and substance use. LSD, or lysergic acid diethylamide, is derived from a fungus. Ketamine is not a classic psychedelic but a synthetic agent with a long history of safe use as an anesthetic agent in human and veterinary medicine. It produces dissociation and distortions of sights and sounds. Ketamine does not act on serotonergic 5-HT2A receptors. It is currently used in special clinics as a rapid-acting antidepressant. Psychedelic-assisted therapy is on the horizon. Because psychedelic agents present vivid new information and enable patients to approach memories and feelings they were unable to process before, patients need good guides for interpreting the contents of their minds and integrating the insights into their lives. Even before the drug is administered, patients need to be in a soothing environment to maximize the efficacy of psychedelic agents—one that conveys complete safety, minimizes anxiety, and delivers preparatory therapy that sets expectations for the possibility of real benefit. Patients typically receive a moderate to large dose of psychedelic drug in each of two or three sessions spaced over several weeks. All current legal administration of psychedelic drugs is conducted under the direct supervision of specially certified therapists. Importantly, researchers contend that it is the psychotherapy that transforms MDMA, psilocybin, and other hallucinogens from a novelty into a medicine. Psychedelic drugs such as psilocybin, LSD, MDMA, and other hallucinogens are controlled substances under federal law and, by statute, are deemed to have no medical use and high potential for abuse. Possession of such agents is, in short, criminal. However, several states such as Oregon and Colorado and municipalities Ann Arbor, Michigan; Denver, Colorado, for example have approved ballot initiatives decriminalizing possession of certain hallucinogens. Since the Millennium, however, psychedelic agents have been gathering the interest of researchers. Starting with Johns Hopkins, several American universities and research organizations have obtained approval from the Food and Drug Administration to study the medical use of hallucinogenic drugs , largely for the treatment of disorders that have resisted treatment. The drugs are administered in moderate to large doses in a specially soothing setting in the presence of a trained psychotherapist who also delivers psychotherapy. Researchers argue that taking psychedelics is not a passive experience : The mindset of the patient matters. Taking the drug opens the mind; therapy helps people through the experience and guides them to do the necessary work of digesting the newly exposed information and, eventually, recalibrating their psychological reality. Therapy allows patients to explore and come to terms with challenging psychological material that is keeping them stuck. It also helps them reorganize their consciousness in the wake of the psychedelic experience. To a considerable degree, the therapeutic value of the psychedelic experience hinges on the quality of the patient-therapist relationship. Therapists, who must receive special training and certification in the use of psychedelics, prepare patients for the experience by establishing a completely safe and trusting environment. They provide a reassuring presence even before the drug is administered, during the time it is active, and after the effects have worn off. Therapists help patients revisit past events and emotions that have been problematic. They also conduct subsequent debriefing sessions to help patients consolidate insights and establish new ways of seeing themselves in relation to the world. In clinical studies using standardized treatment protocols, drug effects may last for three to six hours, during which time a therapist is always present. The therapy session usually lasts for about six to eight hours. Each treatment session is usually followed by one or more standard therapy sessions in which the experience is discussed and integrated. After the completion of two or three treatment sessions, researchers have documented continued therapeutic gains over the next year. Psychedelic drugs are non-addictive and have few negative cognitive effects. They do not impair memory , nor do they cause stupor or narcosis such as that seen with alcohol or heroin. Neither do they produce excessive stimulation like that experienced with cocaine or amphetamine. Used therapeutically under the guidance of a trained therapist, few drug-related adverse events have been reported in clinical trials. Many believe it is essential that the drugs be administered only by trained therapists in controlled settin gs in order to maximize benefits and minimize potential risks. There has been increasing interest in studying psychedelic and meditation-based interventions in recent years, for mental health issues and as tools for understanding the mind. Psychedelic drugs can influence our beliefs about religion and politics, but whether these represent insights or false impressions about the world remains unclear. New research reveals why we need to let go of the 'lazy stoner' stereotype. Psychedelic group therapy can foster deep connection and healing. By sharing experiences, patients find love and support, suggesting a shift that could transform lives. Plant compounds like caffeine, L-theanine, tryptamines, and polyphenols can alter brain function, potentially influencing focus, stress, cognition, and mental health. Psychedelics are not reliable agents of change. Rather they can offer moments of revelation and epiphany, which can be leveraged into change. Psychotherapy is the lever. Cutting-edge therapies like psychedelic-assisted treatment and TMS are revolutionizing mental health care, offering new hope for conditions like PTSD and depression. A novel psychedelic-assisted combination therapy for the treatment of depression, anxiety, stress and PTSD. One woman's journey of healing from OCD. Plant life is rich in synchronized intelligent communication. Humans share this skill through emotional empathy, which contrasts starkly with AI. A diagnosis often brings relief, but it can also come with as many questions as answers. Psychedelics Reviewed by Psychology Today Staff. What do psychedelics do in the brain? Created with Sketch. Why are psychedelics so effective? How do psychedelics improve mental health? What does the psychedelic experience feel like? What happens to the sense of self during a psychedelic experience? What is psilocybin? What is MDMA? What is LSD? What is ketamine? Are psychedelic agents legal? Why is it important to work with a specially-trained therapist? What does the therapist do? How long do the effects last during a therapeutic session? What are the risks of psychedelic-assisted psychotherapy? What is the history of using psychedelics to treat mental health disorders? Essential Reads. Magic Mushrooms, Teens, and Young Adults. Some states have decriminalized psilocybin-containing magic mushrooms, which are not FDA-approved as a medicine. They are particularly dangerous to teens and young adults. There was only one way to find it. Psychedelic use tends to increase belief in God, but decrease belief in monotheism. Why did the FDA reject it? Revelation or Delusion? The Impact of Psychedelics on Belief. Debunking a Key Myth About Marijuana. Back Psychology Today. Back Find a Therapist. Back Get Help. Mental Health. Passive Aggression Personality Shyness. Personal Growth. Low Sexual Desire Relationships Sex. Family Life. Child Development Parenting. View Help Index. 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Not All Psychedelics Are Made Equal

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Posted June 27, Reviewed by Jessica Schrader. The field of psychedelic research has been gaining traction, with significant interest in substances like MDMA and psilocybin for their therapeutic potential. This decision has stirred debate within the psychedelic community about the inherent challenges and varying approaches in psychedelic-assisted therapy. Among these concerns are the potential for therapist over-enthusiasm and the risk of abuse, as well as blinding issues that may have compromised study results. While these concerns are particularly relevant to MDMA-assisted psychotherapy, it is crucial to recognize that psychedelics are used in various contexts and with different modalities. Each psychedelic substance and its corresponding method of administration can significantly influence the therapeutic process. Psychedelic research encompasses a range of modalities, each with distinct therapeutic approaches and impacts. These modalities can be broadly categorized based on the dosage and the role of the psychedelic in therapy. Here are a few examples of well-known psychedelic treatment modalities:. Psychedelics represent a diverse and evolving field of therapeutic research that holds great promise, in which each modality offers unique benefits and challenges. For example, microdosing modalities are not expected to have issues with functional unblinding, and treatment that does not include psychotherapy will have less abuse potential. As the scientific community continues to explore these substances, it is essential to address concerns about safety and efficacy while appreciating the distinct characteristics of each psychedelic and its therapeutic application. Understanding the varied modalities of psychedelic therapy can help tailor treatments to meet individual needs, ultimately advancing the potential of psychedelics in mental health care. Adi Zuloff-Shani, Ph. A diagnosis often brings relief, but it can also come with as many questions as answers. Adi Zuloff-Shani Ph. Psychedelics to the Rescue. Concerns include therapist enthusiasm, abuse potential, and functional unblinding. Addressing these concerns while recognizing diverse psychedelic modalities is crucial. Therapy Essential Reads. The Transformative Power of Questions in Psychotherapy. About the Author. More from Adi Zuloff-Shani Ph. More from Psychology Today. Back Psychology Today. Back Find a Therapist. Back Get Help. Mental Health. Passive Aggression Personality Shyness. Personal Growth. Low Sexual Desire Relationships Sex. Family Life. Child Development Parenting. View Help Index. Do I Need Help? Talk to Someone. Back Magazine. September Back Today. Essential Reads. Trending Topics in South Africa. See All.

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