3 ms·

The problem with restricting (psychedelic) therapy to supervised, one-on-one clinical settings is that these places by their nature cannot provide experiences,

The problem with restricting (psychedelic) therapy to supervised, one-on-one clinical settings is that these places by their nature cannot provide experiences, intimate connections and understanding that are necessary for self-discovery, -healing and -improvement. The transactional institution that doctors, therapists and mental health hospitals represent can only provide a foundation and safe environment for such opportunities. Talking to people who have or had similar life experiences, who truly know how the pain one suffers feels and what it means to live that way from the inside is of the highest value.

anigbrowl 7y ago
Completely agree. While I'm very, very much in favor of psychedelics as therapy aid, the idea of therapist-guided trips is extremely offputting. At best it will Disney-fy the whole experience, at worst create far more problems.
- travisjungroth 7y ago
  Just for an alternate perspective, there's a therapist I'd completely trust to be my guide. I certainly wouldn't expect a Disney experience.
  - deleted 7y ago
    [deleted]
ketamine__ 7y ago
Taking psychedelics in a therapy setting is even more risky than off-label prescription itself. The patient may think there is little risk but there is a chance of making the condition worse.
- pas 7y ago
  Sources? Data? Evidence? Studies? Citations please. This is a very strong claim! And I'm saying this because my gut feeling sort of agrees with you, but so far MAPS' FDA approved studies doesn't seem indicate that there's this risk factor. Who knows what will happen if it hits mainstream though. (As with any other therapies, at first everything is magical, because truly motivated people practice them, then it just becomes something done by certified professionals, then it just becomes a big section in a regular textbook.) That said, there is very good chance that even if it's risky, it has at least the potential to do real work. ( https://slatestarcodex.com/2019/11/26/mental-mountains/ https://slatestarcodex.com/2019/11/26/mental-mountains/ )
  - ketamine__ 7y ago
    Commentary: https://www.mdedge.com/psychiatry/article/24216/depression/d-cycloserine-ptsd-proves-underwhelming https://www.mdedge.com/psychiatry/article/24216/depression/d... Paper: https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/issues/articles/70486_main_9.pdf https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s...
elric 7y ago
This is an interesting take on things. Are you saying that you can't heal/grow/improve by means of talking to someone who hasn't had the same (negative?) experiences as you? Or are you suggesting the lack of intimacy is the detrimental factor? I'm not an expert on intimacy by any means, but I think there's a difference between "feeling understood" and "being understood", and the former strikes me as being the more important of the two.
- 7373737373 7y ago
  Psychotherapy is mostly about achieving an internal perspective change and being able to apply that continually mentally and through interactions in relationships with others. Not that this is impossible to achieve with a therapist (especially if they are experienced), but when they never had ones own perspective, communicating, actually being and feeling understood and achieving that change can be difficult. If only feeling understood mattered, one might as well talk to a a pet or an inanimate object, say your favorite plushy. When one thinks of psychotherapy, typically an image of the "client" lying on a couch, talking to a psychologist, taking notes, comes to mind. Most of psychotherapy is language (conversation) oriented, but there are many other modes of sensation, being and action. So one shouldn't restrict oneself conceptually to considering only these two-person, fixed-place, conversational/analytical interactions as 'true' psychotherapy.
pas 7y ago
Understanding? Maybe. Intimate connections? Who knows. Also, it seems very effective[0] for PTSD. Sure, it can't give you amazing friends to go through life with, or experiences of fantastic sensations as the sun comes up while you are having a blast. But the basics are important too. Knowing yourself, talking about your problems, analyzing them, your life, etc. [0] https://images.squarespace-cdn.com/content/v1/584a381a8419c22ce765fbf9/1504567188498-ZNDJNKZD6YZJ8BR1OVAK/ke17ZwdGBToddI8pDm48kD-04o75zThnYqEIole7iXEUqsxRUqqbr1mOJYKfIPR7LoDQ9mXPOjoJoqy81S2I8N_N4V1vUb5AoIIIbLZhVYxCRW4BPu10St3TBAUQYVKci-PmFmc7dKRUfMEr9nq0jB-gUStxH4FTi1aiMkoZ6rLvrA-vgDwzdZupALeoD8Qv/prepost_results_simple.jpg https://images.squarespace-cdn.com/content/v1/584a381a8419c2... - just a random image to illustrate the effectiveness.

anigbrowl 7y ago

Completely agree. While I'm very, very much in favor of psychedelics as therapy aid, the idea of therapist-guided trips is extremely offputting. At best it will Disney-fy the whole experience, at worst create far more problems.

travisjungroth 7y ago
Just for an alternate perspective, there's a therapist I'd completely trust to be my guide. I certainly wouldn't expect a Disney experience.
- deleted 7y ago
  [deleted]

ketamine__ 7y ago

Taking psychedelics in a therapy setting is even more risky than off-label prescription itself. The patient may think there is little risk but there is a chance of making the condition worse.

pas 7y ago
Sources? Data? Evidence? Studies? Citations please. This is a very strong claim! And I'm saying this because my gut feeling sort of agrees with you, but so far MAPS' FDA approved studies doesn't seem indicate that there's this risk factor. Who knows what will happen if it hits mainstream though. (As with any other therapies, at first everything is magical, because truly motivated people practice them, then it just becomes something done by certified professionals, then it just becomes a big section in a regular textbook.) That said, there is very good chance that even if it's risky, it has at least the potential to do real work. ( https://slatestarcodex.com/2019/11/26/mental-mountains/ https://slatestarcodex.com/2019/11/26/mental-mountains/ )
- ketamine__ 7y ago
  Commentary: https://www.mdedge.com/psychiatry/article/24216/depression/d-cycloserine-ptsd-proves-underwhelming https://www.mdedge.com/psychiatry/article/24216/depression/d... Paper: https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/issues/articles/70486_main_9.pdf https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s...

elric 7y ago

This is an interesting take on things. Are you saying that you can't heal/grow/improve by means of talking to someone who hasn't had the same (negative?) experiences as you? Or are you suggesting the lack of intimacy is the detrimental factor? I'm not an expert on intimacy by any means, but I think there's a difference between "feeling understood" and "being understood", and the former strikes me as being the more important of the two.

7373737373 7y ago
Psychotherapy is mostly about achieving an internal perspective change and being able to apply that continually mentally and through interactions in relationships with others. Not that this is impossible to achieve with a therapist (especially if they are experienced), but when they never had ones own perspective, communicating, actually being and feeling understood and achieving that change can be difficult. If only feeling understood mattered, one might as well talk to a a pet or an inanimate object, say your favorite plushy. When one thinks of psychotherapy, typically an image of the "client" lying on a couch, talking to a psychologist, taking notes, comes to mind. Most of psychotherapy is language (conversation) oriented, but there are many other modes of sensation, being and action. So one shouldn't restrict oneself conceptually to considering only these two-person, fixed-place, conversational/analytical interactions as 'true' psychotherapy.

pas 7y ago

Understanding? Maybe. Intimate connections? Who knows. Also, it seems very effective[0] for PTSD. Sure, it can't give you amazing friends to go through life with, or experiences of fantastic sensations as the sun comes up while you are having a blast. But the basics are important too. Knowing yourself, talking about your problems, analyzing them, your life, etc. [0] https://images.squarespace-cdn.com/content/v1/584a381a8419c22ce765fbf9/1504567188498-ZNDJNKZD6YZJ8BR1OVAK/ke17ZwdGBToddI8pDm48kD-04o75zThnYqEIole7iXEUqsxRUqqbr1mOJYKfIPR7LoDQ9mXPOjoJoqy81S2I8N_N4V1vUb5AoIIIbLZhVYxCRW4BPu10St3TBAUQYVKci-PmFmc7dKRUfMEr9nq0jB-gUStxH4FTi1aiMkoZ6rLvrA-vgDwzdZupALeoD8Qv/prepost_results_simple.jpg https://images.squarespace-cdn.com/content/v1/584a381a8419c2... - just a random image to illustrate the effectiveness.