How do psychedelics heal?
We’ve been hearing a lot about the promise of psychedelics with studies and trials showing impressive results for many different conditions such as depression, anxiety, eating disorders, post traumatic stress disorder (PTSD), end of life anxiety, obsessive-compulsive disorder (OCD), migraines & cluster headaches, phobias, and more. But how do they help with so many different issues? I’ve tried to group together the different methods of action that I’ve read in the literature, that I’ve heard from clients in psychedelic integration, and that I’ve experienced myself. I’m going to break them into three broad categories - physiological (body), psychological (mind), and spiritual (spirit), although there is a lot of crossover between them.
Update: I realised I missed an integral lens in my initial post - that of relationships. We are in relationship to everything around us and inside of us, so I've added this relational lens below
There is so much to write about each area, but I’ll keep it brief and leave the deep dive up to you (there are some references at the end).
The Physiological Lens
Neuropsychology
Classic psychedelics such as psilocybin (from magic mushrooms), mescaline (from san pedro cactus), DMT (most ayahuasca brews contain DMT) and LSD are referred to as tryptamines and bind primarily to serotonin 2-A neuroreceptor sites, along with other serotonin receptors, while also affecting the neruotransmitters dopamine, GABA and glutamate. One of the effects of this is the disruption of the "Default Mode Network", a designation of interconnected brain systems located in the prefrontal cortex, hippocampus, and amygdala (the fear centre) that act like our ego’s operating system – the structure that contains our beliefs about ourselves and the world, and that automatically filters out information that isn’t important to keep the ego safe.
Instead of filtering out sensory information in the external and internal world, suddenly it is experienced fully and is significant to consciousness. We perceive sensations and stimuli intensely and with fresh eyes - things become novel (which helps us learn) and take on new meaning. Normally disparate parts of the brain start communicating with each other to create new insights. We see patterns, visually and psychologically, and experience synesthesia – seeing sound waves and tasting colours, or interpreting numbers as shapes and colours. We are in a constant state of amazement like wide-eyed children (and thus our functioning in physical reality is significantly impaired!).
Neurobiology
The tryptamine psychedelics, along with others such as iboga and ketamine, stimulate neurogenesis and neuroplasticity by switching on various genes and proteins such as Brain Derived Neurotropic Factor (BDNF). These neurotropic factors cause the dendrites connecting brain cells together to increase in size, density and complexity and promote growth of new brain cells in the hippocampus! Throughout the brain and nervous system they can create new neural connections and strengthen existing connections, and re-establish connections that had faded away such as memories from childhood. This neuroplasticity effect extends beyond the psychedelic session - opening up a critical window, or critical period, where the brain is more able to learn new behaviours and skills by re-organising itself - similar (though weaker) to the neuroplasticity we experienced as children. This may last for days, weeks or even months after the experience - the length of this effect seems to be correlated with the depth and duration of the psychedelic experience.
Anti-Inflammatory
Compounds such psilocybin and DMT are also anti-inflammatory, helping to regulate and heal a wide range of inflammatory conditions. Of particular interest is that they also help conditions where science cannot find an underlying physiological cause such as chronic pain, fibromyalgia, cluster headaches, migraines and Functional Neurological Disease (FND). Recent research shows these compounds can also be helpful for things like stroke or traumatic brain injury by reducing inflammation, signalling the release of neurotrophic factors for neuroprotection and neurogenesis, and keeping the critical window open to allow the patient more time to re-learn damaged brain functions (this critical window opens for a limited time following brain injury).
Somatic Processing
A common effect of psychedelics is that the body starts to tremor or shake. As the nervous system lights up and connects the body together, unprocessed trauma / survival energy that has been stored in the body suddenly starts to release, assuming the person feels safe to do so. If the person doesn't feel safe, it can end up being highly traumatic - storing yet more survival energy in the body! This is why set (mindset & preparation) and setting (the space, other people, music etc) is so important, along with the [generally] fear dampening action of psychedelics. Consensual touch from a trusted facilitator can be incredibly powerful here as it can help regulate and calm the nervous system while it processes pain and survival energy, and also help establish secure attachment patterning.
During the peak of experiences, people often start breathing with rapid deep breaths into the chest without a pause at the top or bottom of the breath (this is where holotropic breathwork originated from, and from where many other breathing styles evolved). This hyperventilation style of breathing can intensify the sensations of a psychedelic journey, bringing with it increased shaking and tetany (involuntary muscle contractions), that can help discharge survival energy. This spontaneous shaking has lead to increased interest in body based, or bottom up, therapy approaches such as Trauma Release Exercise (shaking medicine) and Somatic Experiencing.
The Psychological Lens
A Mental Reset
Psychedelics (both the classic tryptamines as well as MDMA and ketamine) seem to give the brain a reset – helping to alleviate mental health conditions like depression, anxiety and OCD. In addition to the above effects, the proposed mechanisms of actions of this reset include these compounds acting like a circuit breaker on negative or obsessive thoughts, as well as their ability to re-harmonise brainwave patterns within and between neural networks.
The analogy often used is that our thoughts are like that of a skier going down a snow covered mountain – we typically use the well worn and safe pathways, and psychedelics act like a fresh layer of dense snow covering the mountain, allowing us to create new pathways. The continued use of these new pathways (new neural networks) allows us to create and embed new habits and beliefs.
The Narrative Approach
We are story telling creatures, and we make meaning of things by the story we tell ourselves, and others. Sometimes these stories are harshly self-critical, especially at times when we didn’t know any better (such as during our formative years), or times when we didn’t have a choice due to a lack of safety (such as physical abuse or rape). In both these cases, we assume things that happened to us were our fault, and these beliefs colour our entire life.
During the psychedelic experience we may be taken back to a memory where such a story / belief originated, and also shown memories where this belief was reinforced over and over again, but this time seeing it all from a more detached / third person perspective. We come to understand that the situation wasn’t our fault - it was something that happened to us, and that the perpetrator(s) were dealing with deep-seated issues of their own (often the result of inter-generational trauma). Hopefully we can find compassion for ourselves, and the other(s), but more importantly we realise that the story we told ourselves wasn’t true. Cognitively this makes sense to us, but experientially this is deeply transformational and frees us from guilt and shame, allowing us to soften and open psychological and emotional defences.
Parts Work
From a certain perspective, we are a collection of different parts, with a true / higher Self [hopefully] running the show. Parts, or ego states, are created during traumatic experiences (or in shamanic language, a fragment of the soul is split off), and thus as adults we have many immature parts that fight amongst each other and the Self, creating havoc and self-sabotage.
In the psychedelic experience you may meet these parts, either visually or somatically, and you can interact with them. Asking them why they are here, what are they burdened with, or what they need, can lead to very real healing, especially if these parts have been desperately wanting your attention. You can help them release the burden they are carrying and make them feel safe, held and loved, which in turn helps you feel safe, held and loved. And hopefully that part no longer has to fight for your attention by taking control of your behaviour or creating somatic dis-ease!
There are various psychotherapeutic modalities that use the parts work lens such as Internal Family Systems (IFS), inner child work and even shamanic journeying (from a more psychological perspective) - these are all powerful tools, but they are significantly more powerful in the psychedelic space.
The True Self
Beneath all the experiences we have had since conception is who we are at our deepest level – at a DNA or soul level. Psychedelics strip away our defensive structures (the default mode network) to allow us to make contact with the True Self, giving rise to the experience of remembering who we really are, which has often been forgotten due to long standing traumas. We remember our personality, our desires and drives - a feeling like we have come home. This also creates psychological distance between the Self (the blueprint) and these experiences (the imprints), removing the identification of the Self with the trauma - the trauma becomes something that happened to us, rather than being a part of us.
The Spiritual Lens
Energetic Work
Everything is energy, and in the psychedelic experience we experience this deeply, especially interoceptively and visually. Often we become aware of dark or dense energy located somewhere in our body that is the result of some trauma, negative belief or attachment. We can pull this energy out of us and discard it, and this is so intuitive that people without training in energy work have used this approach with great results. Shamans and healers can also perform healing techniques on you while you are in this energetically expanded and connected space to great effect.
External Entities
All sorts of external entities such as gods and goddesses, angels, ascended masters (e.g. Jesus and Buddha), ancestors, plant spirits, animal spirits, mythical creatures, or even aliens may come in and perform energetic work / psychic surgery on you. They may pull dense energy out of you, clean your energetic system, or place a powerful item inside your body. They may even rip your body apart (this can be rather terrifying) and then put you back together again.
Medicines such as tobacco (which is not psychedelic) and ayahuasca are very strong plant spirits that will carry out deep energetic work on you when you ingest them.
Mystical Experiences
Having an experience of merging with nature, with mother earth, with all of humanity or with god/source consciousness makes you realise that you are deeply connected with all of these things – there is no separation. You may be taken to the pinnacle of the mystical experiences – a space of infinite white light and boundless love. You may not remember who or what you are in this space, only that you are consciousness. Much espoused and cliché spiritual expressions suddenly make sense, and you realise how futile it is to describe these experiences in language. In my view, the importance of the mystical experience in the healing outcome is over-emphasised in some of the literature, but regardless, these experiences are deeply healing and transformative.
Note that often to get to a mystical experience, you need to go through some form of purification or ego death [and rebirth]. With the ego death/dissolution experience, you literally feel like you’re dying (also rather terrifying). Once you surrender to this death, you are reborn into your new expanded sense of self (ego state). While many people try and “kill the ego” (I fell for this idea too), ego is a necessary structure for our individuated experience and spiritual journey – we just need to keep it in check.
The Relational Lens
The Internal / Biological Relationship
Psychedelics unlock interoception and sensations in the body which is particularly useful for people who are too much in their heads (this is most of us), or out of their body entirely. These medicines help to reverse disassociation and compartmentalisation and bring awareness back to our physical bodies. Obviously there is some risk here – this process can be too much, too fast – bringing up traumatic content and overwhelming energy in the body, leading to paranoia and psychosis, which sometimes has an enduring negative impact (i.e. a bad trip).
As we become more aware of the body’s sensations, we come to understand the interplay between the body and the mind and how so much unconscious/sub-conscious content originates in, or is stored in, the body. Sensations, a song or a scent can trigger all sorts of memories including traumas.
We might also become aware of our bodies containing billions of individual cells, all working together cooperatively. These cells self-organise into communities of organs, and these into systems. We might become aware of the billions of alien bacteria in and on our bodies that work in symbiosis with our body’s own systems, especially those bacteria that interact with our brain via neurotransmitters!
Instead of seeing it as a vehicle that requires maintenance, or our meat sack that houses our brain, we come to realise it’s immense complexity, along with the pleasure and energy it can generate. As we come into better relationship with our bodies, healthier habits come naturally and effortlessly, and addictions fall away.
Interpersonal Relationships
None of us come into this world alone, nor do we exist alone. We might feel that we are all alone, but this is a fabrication of our egoic mind and a construct of our culture. Psychedelics bring forth so much interpersonal content, that we are forced to see how deeply connected we are to friends, family, ancestors, and society at large. As [sometimes semi-detached] memories of formative relationships come up, we gain new insights and see how these relationships have helped to form our identity, behaviours and attachments. People frequently report the experience of energetic connections to loved ones and the communications that took place with them - sometimes seeing them visually and talking with words, sometimes just psychically. Sometimes these experiences are validated by those people that we felt the connection with – they thought about us, or dreamt about us, in that very moment, and may have even experienced corresponding emotions.
During a psychedelic journey, the other people present in the space may become projections of internal relational issues – i.e. the target of transference. Issues with father figures, or with the masculine in general, may be projected upon a male present, and likewise with the feminine. In a therapeutic setting, someone who can hold space and/or a skilful therapist can then help re-parent or re-template the client, providing a felt and experiential example of what healthy masculine and feminine energies are. As powerful as all of these different ways psychedelics can heal, this is perhaps the most profound when it occurs, and of course the medicine itself can carry this out – notably Ayahausca as the spirit of the Mother / Grandmother, and Tobacco as the spirit of the Father / Grandfather
Psychedelics, and medicine work in general, highlights the importance of these relationships, while also helping to heal them. This leads to people forming healthier and stronger social bonds, and to seek out like-minded community.
The Outer / Ecological Relationship
Another often reported phenomena of psychedelic journeys is connection to the environment – to the trees and the land, to the sun, the moon and the stars, and seeing how all of these things are connected to each other. You might feel like you’re breathing with the trees around you – they breathe oxygen out, we breath oxygen in; we breath carbon dioxide out, they breath it in. Seeing how intimately connected we are to the earth - it’s seasons and it’s life, and how all the planetary bodies exert an energetic influence over us – however small and distant that might be. This realisation can have the effect of making us feel small and insignificant, or promote feelings of wonder and awe over the vastness of the galaxy - how little we understand of what is going on, and knowing there is always more to learn.
Is the trip real or all in my head?
There are two classic ways of looking at this question. One way is the indigenous/shamanic perspective - these cultures believe all the entities are autonomous and these encounters and experiences are every bit as real as consensus reality. The other way is the psychological model where everything is a manifestation of your imagination. Both seem to hold true - the important thing is the outcome.
Quantum physics and magical theory would say these entities are created by thought-forms and beliefs, therefore if you perceive it in your internal world, it is real. If you believe you healed your inner child or pulled some dark energy out of yourself and it healed you, then it did (this is the power of the placebo effect) - those around you, and the field around you, is affected by your new state.
This also brings up another question about where your locus of control is – did you do the work to create the change and healing in your journey, or did external beings come in to help, or was it a collaboration of the two? Of course you can do all the work, but there are also many spiritual beings that are there waiting to help if you ask.
Note: If you are seeking healing with these medicines, please be careful - they are powerful substances to be treated with respect, and there are risks. Set (mindset) and setting (the space and people present) are hugely important. There are legal avenues available - trials running in Australia, and psychiatrists can prescribe psilocybin and MDMA for limited conditions, or there are many retreats overseas. Do your research to ensure you feel safe with the facilitators and that they are experienced.
You can book in a free call or a preparation & integration session and we can go more deeply into preparation (if you are going to a retreat) or integration (if you’ve already had an experience and want to get the most out of it), or to discuss treatment options currently available. Or contact me if you have other questions
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