Psychedelic psychotherapy is the process of taking a psychedelic substance within a therapeutic setting, which typically includes psychotherapy. In clinical studies, psilocybin (magic mushrooms) and MDMA are two compounds that are being investigated for their therapeutic use in treating certain mental health conditions, like depression and PTSD, and improve overall mental health. Most of the psychedelic therapy taking place is within clinical research studies in the underground and in places where psychedelics are legal.
Psychedelic therapy is widely discussed as an innovative development within psychiatry, yet the ironic truth is that mind-altering substances have been used to promote mental health for thousands of years. And while the ceremonial ingestion of plants like ayahuasca in South America, peyote in North America, and iboga in Africa may seem a far cry from Western psychotherapy, researchers are increasingly looking to indigenous cultures in order to learn how to utilize these potent medicines.
Anthropologists who study the ceremonial use of psychedelic plants often write about the skilled manner in which shamans guide their patients into "managed altered states of consciousness." Through the manipulation of sounds, symbols, and other aesthetic elements in a ritual context, these traditional healers are able to steer participants' visions and hallucinations in certain desirable directions. Overall, the ritual context provides a controlled, supportive, and safe environment for participants to engage in reflective emotional work that is often difficult.
A recent study of Westerners attending a mental health retreat run by indigenous ayahuasca healers found that 36 percent rated the actions of these shamans as the single most important factor in the improvement of their well-being. The non-indigenous users attributed the benefits of ayahuasca to their immersion in the traditional aspects of the ayahuasca experience, which were often intense or difficult to endure, echoing the ascetic experiences of the traditional users. Research indicates that the beneficial elements of ayahuasca are enhanced when the cultural and spiritual aspects of its use are emphasized. And while shamanic rituals may not be fully appreciated by conventional psychiatrists, it is widely agreed that psychedelic experiences are the product of more than just mere pharmacology.
Set and Setting
Back in the 1960s, famed psychologist and LSD evangelist Timothy Leary helped to popularize the notion of "set and setting", which holds that the effects of psychedelics are largely determined by the mindset of the user as well as the environment in which they are taken, rather than the properties of the substances themselves. "Set" refers to the expectations and intentions the person brings to the experience, and "setting" is the outward circumstances in which it takes place. Additionally, the expectations and experiences of participants in a traditional ceremonial setting are often influenced by the shamans' shaping of those aspects.
For this reason, set and setting has been incorporated into recent psychedelic trials. Typically, this is achieved by manipulating the therapeutic environment with low lighting and carefully selected music playlists. This last element is considered to be of particular importance, as research has revealed that music amplifies the capacity of psychedelics to enhance activity within the parts of the brain that process emotion.
A Clash of Worldviews
Indigenous people view creation as a living process, resulting in a living universe in which a kinship exists between all things. There is no such thing as an individual in the same way that we take for granted in the west. There is no separateness. We are all one consciousness. It's a different way of looking at things. For those of us who have been raised as staunch materialists, such a concept can be difficult to understand, let alone accept. We are conditioned to see the world as populated by distinct, independent entities that can be methodically isolated from one another, whereas indigenous cultures view the universe as one unified conscious system, in which everything is connected to everything else.
In line with this perspective, mental health problems are understood not as the product of faulty brain chemistry or personal psychological quirks, but as a symptom of misalignment with the encompassing whole. Healing, therefore, is typically a collective affair and is achieved by restoring the patient's sense of connectedness to their community and wider environment.
While most research into the efficacy of psychedelics to treat mental health disorders continues to focus on individual treatments, a number of studies are beginning to recognize the importance of contextual factors like the shared togetherness of indigenous group rituals. A global study of people who have used psychedelics in group settings found that group bonding during ceremony was significantly correlated with increases in psychological well-being, social connectedness, and other salient mental health outcomes.
Conclusion
While researchers have demonstrated the benefits of psychedelics as a treatment for mental illness in Western users, the traditional context associated with the use of psychedelic plants is also an essential aspect of the experience. Like indigenous users who emphasize the ascetic aspects of the psychedelic experiences, the immersion in an intense, often challenging ceremony leads to benefits for Western users who understand the necessity of these difficult experiences in reaping benefits. Overall, the traditional ceremony accounts for important aspects of the psychedelic experience such as social and environmental connections. Adapting indigenous approaches to psychedelics may well be the key to psychedelic healing.
