Psychedelics and the Importance of the Therapeutic Relationship
What to Consider Before Embracing Psychedelic Therapy
As of late, psychedelic therapy has been on the forefront of the mental health circuit and is slowly making its way into the public eye through documentary essays and videos presented through media such as Vice News and Netflix. You’ve likely heard about or perhaps even voted on the legalization or decriminalization of psilocybin on the latest ballot. It is an important time for psychedelics and psychedelic therapy and while more practitioners are becoming curious and open to utilizing the tool of psychedelics in their practice, it is important to understand the best ways to administer this kind of therapy and what type of client psychedelic therapy is going to benefit most.
Psychedelic Therapy - Is it for everyone?
The emergence of psychedelic therapy is incredibly exciting and validating in the psychedelic community and is understandably met with intense optimism and enthusiasm. However, this misnomer that psychedelics are good for everyone isn’t entirely correct.
Just like all types of therapy, psychedelic therapy is not a one size fits all approach. While psychedelic therapy opens up the potential for healing, especially when it comes to particular wounds of the psyche, it is not going to cure every case a therapist is presented with. In order to truly understand whether a particular type of psychedelic therapy is appropriate for a client, we really want to look at the relational model and the symptoms that we are trying to manage and treat, as well as the underlying cause of those symptoms.
Recent studies have shown that psychedelic therapy is going to be an incredibly viable choice for individuals who have experienced major trauma. This refers to individuals who have possibly been in the military and witnessed an atrocity or someone who experienced a one-time abuse or violent act. For these individuals, MDMA is going to be an amazing option for treating their acute one-time traumas and the PTSD that has developed due to those traumas.
Psychedelic Therapy and Attachment Trauma - Fixing Unhealthy Past Relationships with Healthy Therapeutic Relationships
While psychedelics like psilocybin or MDMA will work wonders for individuals experiencing PTSD caused by acute one-time traumas, studies have found that more complex attachment trauma, which is having an unhealthy attachment to a caregiver during childhood, is not going to be so easy to treat with MDMA, ketamine, or psilocybin due to the recurring nature of the trauma. This isn’t to say that psychedelics can’t or shouldn’t be utilized with clients displaying attachment trauma within the context of long-term therapy to boost or continue supporting the therapeutic relationship, but it takes a skilled practitioner to be able to learn and know when to utilize this tool.
What I find in all the years of my work with both psychedelics and intense therapy is that the most impactful way to heal attachment trauma is the therapeutic relationship. In order to be a very skilled psychedelic therapist, you first and foremost need to be a skilled therapist. This may seem like an obvious statement, but in order to best serve the client, you need to be able to identify the root cause and the longevity of the trauma. You need to be able to determine if you are looking at PTSD from a singular event or are you looking at long-term attachment trauma from childhood. In doing this, you will be able to identify which medicines are going to be most effective in the context of the type of therapy you are going to give your client.
The relationship between therapist and client is going to be the essential healing component of attachment trauma when we’re talking about a relationship with primary caregivers or a lack of a relationship with those caregivers. Once that relationship is developed and nurtured, then the idea of pairing that therapy with psychedelics can be considered.
Final Thoughts
By reframing our thinking and looking at psychedelics as tools that exist within the larger context of psychotherapy, and the therapeutic relationship, we are going be to better able to utilize these new medicines in ways that are effective and helpful to our clients rather than throwing these psychedelic tools at folks without having the right concept about whether this therapy is right for them.
Most importantly, we must not forget the impact of the therapeutic relationship that these tools are a part of rather than allowing these tools to exist in isolation. I think that this is something that we need to keep in mind in the psychotherapy community as psychedelics become more available and not allow ourselves to be overly excited and provide these tools to individuals who may not be ready to benefit from this experience.
To learn more about the brain and attachment, check out Attached by Dr. Amir Levin or Wired for Love by Stan Tatkin.
To learn more about approaching trauma with psychedelics, sign up for the Reflective Healing newsletter or request a free consultation for more information on psychedelic therapy in Fort Collins.