Mystical Experience and Psychedelic-Assisted Psychotherapy: Insights from Guided-Imagery Therapy with Cancer Patients

By Jerry B. Brown and Julie M. Brown

“There is something about the core of this experience that opens people up to the great mystery of what it is that we don’t know.”
-Roland R. Griffiths, Johns Hopkins School of Medicine

It is well-established that mystical experiences have historically played a pivotal role in indigenous shamanism and world religions (the miracles surrounding Moses’ burning bush and Jesus’ baptism). What is less well-known and quite unexpected is the discovery that mystical experiences are the catalyst for healing in contemporary psychedelic research.

Both the Johns Hopkins and NYU studies of the impact of psilocybin on cancer patients found that “In both trials, the intensity of the mystical experience described by patients correlated with the degree to which their depression and anxiety decreased.”

In other words, research scientists have consistently occasioned mystical experiences ̶ “flights of the soul” traditionally thought to be beyond the scope of empirical science ̶ in clinical settings by administering high-dose synthetic psilocybin. Furthermore, it turns out that these experiences hold the key to positive patient outcomes in psychedelic-assisted psychotherapy. Let this enigma sink in for a moment.

Three Seminal Studies

In the 1960s urban legends began circulating, claiming that psychedelics could allow intrepid trippers to meet spirit guides, to travel to other dimensions, and even to know God. In fact, the new science of psychedelics was in part inspired by the mystical experiences of early psychonauts: Grof’s cosmic consciousness revelations on LSD in Prague; Harner’s near-death journey on ayahuasca in the Amazon; and Leary’s mind-expanding awakening on psilocybin mushrooms in Cuernavaca, Mexico, to name but a few. Over time, the ability of psychedelics to generate authentic mystical experiences was confirmed in three seminal studies.

Stanislav Grof, MD, PhD

The first, the Miracle of Marsh Chapel (also called the “Good Friday Experiment”), was a psychedelic research experiment carried out by Walter N. Pahnke under the auspices of Leary’s Harvard Psilocybin Project. On Good Friday 1962, Pahnke randomly divided twenty volunteer Protestant divinity students into two groups assembled in a small room in the basement of Marsh Chapel. In this controlled double-blind study, half the students received capsules containing thirty milligrams of psilocybin and the other half received a large dose of niacin (vitamin B3) as a placebo. The results were compelling. Almost all members of the group receiving psilocybin reported profound mystical experiences. 

As Pahnke reports, “the persons who received psilocybin experienced to a greater extent than did the controls the phenomena described by our typology of mysticism.” He built a follow-up survey into the research design, which found that six months after the experiment the psilocybin subjects reported persistent positive, and virtually no negative, changes in their attitude and behavior. 

The second study showed that the Good Friday Experiment would withstand the test of time and scrutiny by independent reviewers. A 25-year follow-up investigation conducted in 1987 by then-graduate student Rick Doblin, founder of the Multidisciplinary Association for Psychedelic Studies, documented that “all seven psilocybin subjects participating in the long-term follow-up, but none of the controls, still considered their original experience to have had genuinely mystical elements and to have made a valuable contribution to their personal lives.” Doblin concluded that Pahnke’s research on synthetic psilocybin “cast considerable doubt on the assertion that mystical experiences catalyzed by drugs are in any way inferior to nondrug mystical experiences.” 

In assessing Pahnke’s research, Walter H. Clark, recipient of the American Psychological Association’s Award for contributions to the psychology of religion, writes “There are no experiments known to me in the history of the scientific study of religion better designed or clearer in their conclusion than this one.”

A third round of studies initiated more than 40 years after the Good Friday Experiment was conducted at Johns Hopkins School of Medicine under the direction of psychopharmacologist Roland R. Griffiths. In two papers, published in 2006 and 2008, Griffiths empirically demonstrated that psilocybin could regularly result in mystical experiences with lasting benefits for participants. These double-blind studies found that: psilocybin was safe in structured, clinical settings; generated one of the five most meaningful experiences for most participants; and produced improvements in mood and quality of life that lasted more than one year (up to 14 months) after the sessions.

Roland R. Griffiths, PhD

Mystical Experience Questionnaire 

Our understanding of the common elements in mystical experience is largely based on the insights of William James (The Varieties of Religious Experience, 1902) and Walter T. Stace (Mysticism and Philosophy, 1960). These elements were refined, validated, and incorporated into a 30-question operational definition of mysticism, the Mystical Experience Questionnaire (MEQ30) utilized in the Johns Hopkins psilocybin studies. 

The five common elements of mystical experience are:

  • Unity/Sacredness – deep sense of unity with all of existence; knowledge that “all is one”; profound sense of reverence.
  • Positive Mood/Ecstasy – deeply felt sense of well-being; experience of ultimate peace and tranquility; irrepressible feelings of joy and amazement.
  • Transcendence of Time and Space/Eternity – loss of usual sense of time and space; existing beyond past, present and future; entering in a liminal, mythical dimension.
  • Authoritative/True Self – ability to know reality beyond the illusion of the senses; encounter with all-knowing divine presence; understanding one’s authentic or true self. 
  • Ineffable/Indescribable – difficulty describing the experience in words; impossibility of adequately communicating it to others.

Psychedelic-Assisted Psychotherapy

Since 2006, Johns Hopkins School of Medicine has been conducting the first research since the 1970s administering psilocybin to human subjects, including studies of personality changes and of psychedelic therapy for treating tobacco/nicotine addiction and cancer-related distress.

In 2016, Johns Hopkins undertook the largest ever study of psilocybin in treating chronic depression and anxiety among patients with life-threatening cancer. In this randomized, double-blind, cross-over trial, 51 patients were given a low placebo-like dose (1-3 mg/70 kg weight) vs. a high dose (22 or 30 mg/kg) in two sessions with a six-month follow-up.

In a Journal of Psychopharmacology article, Roland R. Griffiths, Matthew W. Johnson, and colleagues report that “High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety.” A six-month follow-up study showed that these results were sustained in most of the participants.

Some 70% of the cancer patients rated the high-dose psilocybin sessions as among the top five “most meaningful” and “spiritually significant” life experiences. In addition, their post-session mystical experience scores served as statistically significant predictors of therapeutic efficiency in reducing anxiety and depression.

Source: Matthew W. Johnson, “Psilocybin in the treatment of cancer-associated depression and anxiety,” Powerpoint presentation, Ottawa, 2018

The daughter of one study participant noted that “This opportunity allowed my dad to have vigor in his last couple of weeks of life ̶ vigor that one would think a dying man could not possibly demonstrate.  His experience gave my father peace. His peace gives me strength.”  These outcomes prompted Griffiths to observe that “It’s very common for people who have profound mystical-type experiences to report very positive changes in attitudes about themselves, their lives, and their relationships with others.” And to exclaim that “As a scientific phenomena, if you can create a condition in which 70 percent of the subjects achieve positive, lasting results…in one or two sessions!”

Guided Imagery-Assisted Psychotherapy

Julie M. Brown, coauthor of this article, is a psychotherapist who for thirty years worked with women’s issues and cancer patients. In her private practice, she utilized a variety of therapeutic modalities, including guided imagery which she studied under her mentor in psychosynthesis.

Guided imagery, also known as visualization, is a technique in which psychotherapists help clients focus on mental images in order to facilitate relaxation, healing, and resolution of life issues. In guided imagery-assisted psychotherapy, a person can call on mental images to improve both emotional and physical health.  

Typically, Brown’s cancer patients turned to psychotherapy after conventional treatments (chemotherapy, radiation, pharmaceuticals) failed to reduce or eliminate tumors. By combining guided imagery with a complementary cancer approach, Brown found clients could enter states of mystical experience that empowered both emotional (anxiety, depression) and physical (cancer) self-healing. The profiles and outcomes for three clients are summarized in this table.

Client Profiles and Guided Imagery Therapy Outcomes

Unlike the controlled Johns Hopkins study involving 51 participants, these three case studies were not validated by independent observers nor subjected to methodological controls. Nevertheless, the seminal role of mystical experience in both psychedelic-assisted psychotherapy and guided imagery psychotherapy raises important questions.

Comparative Questions for Future Research

In the case of Brown’s guided imagery outcomes with cancer patients, significant questions are:

  • Can success in healing cancer via guided imagery be validated?  Beyond Brown’s anecdotal cancer outcomes have other therapists been able to reduce or eliminate tumors utilizing guided imagery? Could healing have taken place in this context without a strict sugar-free diet, or was it the combination of diet and guided imagery that facilitated remission? 
  • Can psychedelic therapy protocols be integrated into guided imagery therapy?  As an experienced psychonaut, Brown recognizes that the ability to administer psilocybin to clients could have significantly shortened the therapeutic healing process, possibly from years to months. Given that clinical trials on psilocybin for treating depression have been given “breakthrough therapy” status by the U.S. Food and Drug Administration, what changes in state and federal policies and professional regulations would have to take place so that psychiatrists and psychotherapists could legally integrate psychedelics into more conventional treatment modalities?

In the case of Johns Hopkins psychedelic therapy outcomes with cancer patients, significant questions are:

  • Can psychedelic-assisted psychotherapy be used not only to alleviate psychological anxiety and depression in terminal cancer patients but also to facilitate physiological healing in cancer patients? 

Given the pivotal role of mystical experience in both short-term psychedelic-assisted psychotherapy and long-term guided imagery psychotherapy, could psychedelic therapy combined with guided imagery possibly reduce or eliminate tumors in cancer patients, if integrated into a mid-term treatment protocol?

Will long-term, costly psychotherapy eventually be replaced by short-term, more affordable psychedelic psychotherapy?  Since short-term psychedelic therapy has achieved positive and sustained outcomes in 70% of the participants, based on one or two high-dose psilocybin sessions administered over several weeks, will it eventually replace long-term psychiatric and psychotherapeutic modalities which require years of treatment and cost thousands of dollars?

How Does Mystical Experience Facilitate Healing?

These rigorous psychedelic therapy studies of psychological stress reduction and anecdotal guided imagery therapy cases of physiological cancer remission suggest that mystical experience can facilitate both mental and physical healing. “How” this healing takes place is the theoretical Holy Grail of the new science of psychedelics. 

Our quest to unravel this mystery begins with the insights of four mind explorers: Roland R. Griffiths, grandfather of the psychedelic renaissance; Robin Carhart-Harris, pioneer of psychedelic brain imaging; Stanislav Grof, founder of LSD psychotherapy; and Carl G. Jung, who with Sigmund Freud laid the foundations of modern psychotherapy.

In essence, Griffiths concludes that “the psilocybin experience enables a sense of deeper meaning and an understanding that in the largest frame everything is fine and that there is nothing to be fearful of.” How the brain expands from normal consciousness to encompass this “largest frame” is visually revealed in Carhart-Harris’s magnetic resonance imaging (MRI) of the brain’s neural pathways before and after ingesting psilocybin mushrooms. Psychedelics allow us to leave the “brain’s default-mode network,” the brain’s everyday information highways, and travel into areas of the mind only available in expanded states of consciousness, clearing the way for mystical experience.

Carhart-Harris: Brain’s Neural Pathways:
Before and After Magic Mushrooms

Source: G. Petri, P. Expert, et. al., “Homological scaffolds of brain functional networks,” Journal of the Royal Society, December 2014

What is the source of this expanded consciousness?  Based on guiding thousands of psychedelic sessions, in The Holotropic Mind, Grof reaches this paradigm-shifting conclusion: “I see consciousness and the human psyche as expressions and reflections of a cosmic intelligence that permeates the entire universe and all of existence. We are not just highly evolved animals with biological computers embedded inside our skulls; we are also fields of consciousness without limits transcending time, space, matter, and linear causality.”

Jung’s concept of the “spiritual self” (also called “spiritual consciousness”) embodies knowledge that emerges from these transcendent “fields of consciousness.” Beyond Freud’s three-fold model of the self, comprised of the body, emotions, and intellect, Jung proposes the existence of a “spiritual self.” Through dreams, messages from the spiritual self are brought into awareness. This paper shows that, in addition to appearing in dreams, the authentic spiritual self may emerge through mystical experiences occasioned by psychedelic-assisted psychotherapy and guided imagery.

Mystical experiences arise when the doors of perception are flung wide open so that the spiritual self can emerge from the depths of the psyche, empowering us to heal and understand that in the cosmic scheme of things “all is well.”

Grof suggests that “the potential significance of LSD and other psychedelics for psychiatry and psychology was comparable to the value the microscope has for biology or the telescope has for astronomy.” We propose that, just as in astrophysics “dark matter” cannot be directly “detected” but only “implied” by gravitational effects, so in psychology, mystical experience cannot be easily “accessed” but can be regularly “occasioned” through psychedelics. Hidden from ordinary consciousness, mystical experience manifests from the dark matter of the mind.

Hopefully, these reflections on the role of mystical experience in psychotherapy will inspire further exploration of this unique phenomena that holds a key to health and well-being.

About the Authors

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Jerry B. Brown, Ph.D., is an anthropologist and Julie M. Brown, M.A., LMHC, is a psychotherapist. They are coauthors of The Psychedelic Gospels: The Secret History of Hallucinogens in Christianity, 2016. 

Everything You Need To Know About Psychedelic Integration

Jasmine Virdi 

Undoubtedly, psychedelics are valuable tools for self-understanding, transformation, and healing, enabling us to peer into our inner workings and understand the world around us in new ways. By nature, psychedelics are destabilizing as they facilitate non-ordinary states of consciousness, catapulting us outside the bounds of our everyday perceptions. They heal us by disrupting our normative flow of consciousness leading to a  multitude of insights ranging from the somatically strange to the mystically ineffable. 

But, psychedelics and the realizations they enable will not necessarily change your life if you are not committed to working with the experience afterwards. This step is known as “psychedelic integration” and it involves chewing on our experiences, digesting any insights, and taking practical steps to implement those insights as positive change.

Psychedelic researchers and psychedelic-assisted psychotherapists have long considered integration a key component in psychedelic healing. In fact, they place major emphasis on post-experience “integrative follow-up sessions” as a scientific approach to aftercare. Many believe that integration protocols and strategies play a crucial role in positive long-term therapeutic outcomes, and some even argue that the value of integration is greater than the psychedelic sessions themselves.

What Does Psychedelic Integration Mean in Practical Terms? 

Going on a psychedelic trip is a lot like physical travel. If you’ve ever gone backpacking or traveled for an extended period of time, you will know that returning home can often come as a major shock to the system, sometimes taking weeks—months, even—to re-adjust to our former lives. 

Similar to travel, psychedelic experiences can also shift our perceptions about the world, pushing us outside our comfort zones and into self-realization. Returning to our regular work-life patterns can be psychologically jarring, as we find ourselves irrevocably changed whilst everything we left behind remains the same. Thus, reshaping our lives to mirror the inward changes we’ve undergone can be profoundly challenging.

The psychedelic experience produces a spectrum of insights, ranging from personal to transpersonal to ecological. Sometimes a person will gain a new perspective on who they are, shifting the landscape around their professional purpose, intimate relationships, and lifestyles.

Psychedelic integration, then, is the process of weaving the practical with the mystical, taking profound, ineffable experiences beyond the temporality of the psychedelic state and grounding them in our day-to-day lives in the form of enduring, positive changes.

In this sense, integration is an active, intentional process where an individual consciously reflects on their psychedelic experience and what it means for them personally. It involves exploring how insights can be translated into bite-sized actionable steps. The personal nature of integration means that an individual needs to find an authentic way of implementing their experience in a way that suits their unique needs and personality.

After an initial revelation, the experience, materials accessed, and insights gained can quickly fade into a dreamlike memory or become psychically compartmentalized, getting lost in the busy pulse of modern life. Thus, it is important to carve out time to consciously work with these experiences.

Integration and the Importance of Pre-Session Intention Setting

Preparation and pre-session intention setting are critical components to integration. Returning to the metaphor of travel, preparing for a psychedelic experience is likened to all the work that goes into preparing for a long-distance trip. We would never go to the airport to catch a flight without the basic essentials: passport, money, a bag with at least the bare necessities, and a destination.

Similarly, setting an intention is akin to having a destination. It can provide a grounding anchor in a psychedelic session, helping guide an individual and give them a lens through which to process insights that arrive post-trip. Integration is unique to each individual — it’s inextricably intertwined with their reason for using psychedelics in the first place.

In the cult classic, The Psychedelic Experience, former Harvard researchers Timothy Leary, Ralph Metzner, and Richard Alpert write: “In planning a session, the first question to be decided is ‘what is the goal?’” Whether your intention is to heal from a traumatic experience, overcome addiction, deepen your connection to nature, or examine a specific aspect of yourself, it is important to know what you’re aiming for. 

According to clinical psychologist, psychedelic integration therapist and author of The Psychedelics Integration Handbook, Dr. Ryan Westrum, psychedelic integration is a continuous process similar to an infinity wheel in that “future stories will be cultivated, supported and benefitted if you are thinking about them prior.”

Another crucial element of preparation involves tending to your set and setting. “Set” generally refers to a person’s pre-session mindset. However, it can also include both immediate and long-range states of mind, covering everything from fears, hopes, and expectations about the session to personal history and enduring personality traits. The better the preparation, the more equipped an individual is to integrate their experiences.

The “setting” is the container of the experience. It factors into account when and where the experience will take place. In The Psychedelic Experience, the description of “setting” includes a temporal dimension, encouraging individuals planning for a psychedelic session to set aside up to three days to process their insights, so there’s “sufficient time for reflection and meditation.” The text cautions that returning to work too hastily will likely “blur the clarity of the vision and reduce the potential for learning.”

Similarly, Dr. Westrum advises:

“One could argue that the first hours and the days that immediately follow the psychedelic experience are the most crucial when it comes to integration. In general, our modern-day, contemporary lifestyles are so hectic, and we find ourselves constantly working, traveling and moving. It is important if you are considering taking a psychedelic, to take the proper time to do so, more appropriately thinking of it as a two-day experience. We need to carve essential time out to reflect and digest what happened, using the second day for purposes of integration.”

When considering healthy integration practices, it is essential for an individual to carve out the time and space needed for processing. Individuals are generally advised to avoid making any major life changes in the weeks that follow a psychedelic experience, and instead take time to rest, digest and distill insights before initiating dramatic changes.

Integration, Intuition and “Inner Healing Intelligence”

The concept of psychedelic integration is closely linked to “inner healing intelligence,” a notion originally developed by Stanislav Grof, and later refined by Michael Mithoefer, Clinical Investigator and Medical Director at the Multidisciplinary Association for Psychedelic Studies (MAPS). 

The notion of “inner healing intelligence” is built on the premise that nature is intelligent by design. For example, when we injure ourselves physically, bruising a knee or cutting a finger, our body automatically initiates its own sophisticated healing process. Just like a seed contains within it all the knowledge to become a tree, humans have an innate capacity to heal when they are in the right environment. Similarly, the psyche has its own innate healing capacity to extend towards wholeness. In the integration process, individuals are encouraged to connect with their inner healing intelligence and take responsibility for mending. 

The Emerging Field of Psychedelic Integration Therapy 

With the psychedelic renaissance in full swing and the resurgence of research illuminating the therapeutic potential of hallucinogens, it’s no surprise that the public opinion of psychedelics is beginning to shift.

But, the stigma around psychedelics still exists. For this reason, individuals who undergo psychedelic experiences outside of a psychotherapeutic or clinical paradigm meet challenges upon reentering their day-to-day lives.  The reason is that they usually have no one to openly share the experience with and no available resources to help sift through the intricacies of the trip.

Sometimes individuals need to reach out for professional support in order to digest the experience properly. Unfortunately, most mainstream therapists aren’t equipped to have a constructive conversation about psychedelics, however.  As a result, many patients feel reluctant to talk about their experience for fear of being judged.

This gap in the mental health system paired with the growing public interest in psychedelics creates a higher demand for psychedelic therapists. As a result, the number of professional integration therapists, coaches, and specialists is increasing. The newly growing subdiscipline of psychedelic integration has risen to prominence, creating a bridge between traditional psychotherapeutic practice and the “psychedelic underground” in which the two cross-pollinate. 

Many individuals who have not followed the institutional track to become an accredited mental health professional are emerging as practitioners within this space. But, what makes an individual qualified to be an integration expert?  To an extent, it seems that a bona fide psychedelic experience takes greater precedence than formal certifications. 

In choosing an integration therapist or coach to work with, integration expert Dr. Ryan Westrum expressed his concern over individuals falling into the wrong hands:

“Neo-integration therapists and coaches that don’t have a psychological background or a deep understanding of the world of consciousness scare me. There is beauty if calling something a ‘spiritual emergence,’ but if you start to recognize a person has suicidal ideation or chronic depression that didn’t break, you need healthy psychiatric and psychological support.”

He is careful to emphasize that beyond having the training to deal with such difficult scenarios, he believes “relationship is number one” and that ultimately “there needs to be a relationship established that feels safe, is psychedelic friendly, without judgment and is willing to hear where you need to go.”

Beyond psychotherapeutic and research paradigms, psychedelic integration is beginning to take root in the mainstream. Spanning across the US, there is now a variety of public integration circles emerging in the form of in-person and online groups. Psychedelic integration circles provide individuals who cannot afford therapy or private coaching a low-cost alternative. It gives them a judgment-free space to talk about their experience and provides access to a community that otherwise might not be there. 

Recognizing the growing need for psychedelic literacy in mental health, Psychedelics Today founders, Kyle Buller and Joe Moore, created an online course “Navigating Psychedelics For Clinicians and Therapists” especially directed at healthcare professionals looking to deepen their knowledge of psychedelic research and to support their clients with psychedelic integration. The next eight-week online course is currently open for enrollment, scheduled to begin on May 7, 2020. 

Is Integration Always Necessary?

I asked Dr. Westrum for his thoughts on the importance of integration after a psychedelic experience. Is it always necessary? He cautioned:

“It is never that you’re not taking enough medicine or not having enough experience. Rather, it is that you aren’t processing it appropriately. In 90% of cases, you look at people’s behaviors and lifestyles only to find they’re still stuck, they’re not taking what they are learning through psychedelic experiences and integrating it.”

It can be helpful to envision integration as existing on a spectrum or continuum. Four days of consecutive ayahuasca ceremonies will likely require more time for integration than a microdosing experience. Even if we feel that we don’t have anything that needs integrating, Dr. Westrum urges us to “at least process the experience at the level of ruling it out,” emphasizing that “everything deserves to be integrated into our lives.”

Jasmine Virdi is a freelance writer, editor, and proofreader. She currently works for the fiercely independent publishing company Synergetic Press, where her passions for ecology, ethnobotany and psychoactive substances converge. Jasmine’s goal as an advocate for psychoactive substances is to raise awareness of the socio-historical context in which these substances emerged in order to help integrate them into our modern-day lives in a safe, grounded, and meaningful way.

Musings around Psychedelic Integration Therapy

By: Debbie Kadagian, LCSW, HHC

Throughout my twenties, I spent a lot of time wondering what the meaning of my life was.  I was reading Hermann Hesse, Viktor Frankl, and other similar authors, but I couldn’t quite connect those books to my own life.  I wanted to know what it was like to experientially engage in a vocation.  Reminiscing on this struggle, I was motivated to write an article on my experiences thus far with psychedelic integration, share what has been helpful to me, and provide insight to those either wondering about this practice, studying it, or actually beginning it.

My path towards becoming a licensed psychotherapist was not direct, as I did not receive my clinical license until my late 50s!  I can now see, with that lovely 20/20 hindsight, that everything I did led me here, with valuable insight that I would not have had if my path had been more direct.  I studied food, nutrition, and painting, had children, taught yoga, and became a certified Ayurvedic counselor before landing on my current path.

My Ayurvedic practice began to really crystalize my direction.  Ayurveda is a science of life and embodies the mind, body, and spirit to integrate a lifestyle most suited for each individual.  Much of my Ayurvedic practice had to do with clients’ emotional states.  As such, I became more focused on the mind.  This led me to a conversation with the dean of a nearby university, and shortly after, I enrolled in a Master’s program that had not even been an idea in my conscious awareness the year before. 

Plant medicine was not on my radar at the time of my schooling.  This path evolved through witnessing the healing that close friends and family experienced.  Having had my fair share of psychedelic experiences as a young adult living through the ‘70s, I was always comfortable with the experience but did not yet see it as a healing therapy.  After going directly to the source again and having my own experience with this new idea in mind, I now KNEW this was an unprecedented healing modality.  I have since expanded my mindset to welcome plant medicines/psychedelic experiences as one of the most effective healing therapies that exists. 

For thousands of years, people have been using psychedelic substances to further their understanding of themselves and the universe.  Sadly, most of these medicines have been labeled as Schedule 1 drugs in the USA, though this is changing with several FDA clinical trials currently taking place.  These research trials are studying the efficacy of using psilocybin as a treatment for depression, and MDMA as a treatment for PTSD.  The trials for MDMA are in Phase 3, and the hope is to have this as a valid form of therapy by 2021.  In the meantime,  outside the US, there are countries where plant medicine is legal now.

Psychedelic Integration is designed to assist those seeking support in connection with psychedelic experiences.  Individuals who have had difficult experiences can benefit from a better understanding of the often-challenging feelings stirred up by psychedelics; while those who have found the use of psychedelics to be a positive method of gaining insight can use supportive therapy to bolster and integrate that knowledge into their daily lives (  This part of the process, before and after the experience itself, is such an integral component of the whole journey.  Working together, the therapist helps the client to understand what may happen, guiding them toward the safest set and setting (this phrase describes the physical, mental, social and environmental context that an individual brings into a psychedelic experience), and then fully integrates the experience afterward, perhaps even for months or years to come.  We all have the capacity to understand our own selves, but having a guide makes sense of a plant medicine journey or psychedelic experience leads to deeper healing and a deeper understanding of self.  I like to think of it like this: if plant medicine is a teacher, then an integrative therapist is a tutor, helping the traveler understand the teachings.

There are 3 categories in which I have been offering integration to clients, not one necessarily more prevalent than any of the others.

Category One: “My husband is freaking out!  He did Bufo 3 days ago and he is sitting on the floor of the shower, shaking and crying… he can’t seem to come out of it.”

Category Two: “I found your name on an integration list and I need to talk to someone about an experience I had…”

Category Three: “I’ve been thinking a lot about going to do ayahuasca (or psilocybin, etc).  I’ve read so much about it but I feel scared.  I’ve never done anything like this before.”

All names and details are changed to protect privacy as I proceed to describe a sample of each category:

Category one:

I received a call from Ron, who was clearly in distress, evidenced by the urgency and desperation in his voice.  He was begging me to see him (he lived 2 hours away).  He had experienced a powerful bufo journey (the strongest known natural psychedelic on planet earth, tryptamine 5-MeO-DMT, produced by Bufo Alvarius, a toad of the Sonoran Desert).  I found out that he was not an inexperienced partaker in psychedelics, as he had gone on an ayahuasca retreat for a week the year before.  Regardless, the bufo experience floored him.  Until I was able to get him in to see me, I instructed him to go to the beach, assisted by his friend, and sit on the sand, feeling the sand under his hands and legs, and breathe in the healing salty air, using a mantra of “I am safe, I am right here” repetitively.  This mantra was to ground him to the here and now.  I also had him eat grounding (comforting) foods, which his friend was able to provide (warm stew, butternut squash, soup, etc.).

He arrived the next morning to my office wrapped in a blanket with sand on his feet, as he was coming straight from his second day of sitting on the beach.  He was trembling and he didn’t understand what had happened to him.  Having been further informed by his friend, and thankfully, with the knowledge of Dr. Stanislav Grof’s work with “spiritual emergency,” I was able to normalize this intensity for him.  He was experiencing past trauma (that he re-lived during his ayahuasca ceremonies the year before), but now he was somatically experiencing it, coming up and out of his body, resulting in uncontrollable shaking.  Through his tears, he described his trauma as his body continued to tremble.  As a child, Ron had been repeatedly molested by his older brother, and when he went to his mother, she told him he was lying.  Confused and traumatized, he left home at 11 years old to stay with a friend, and his mother never came to collect him.  I encouraged him to just keep on letting his body tremble- that this was a necessary part of releasing the traumatic experience.  I found myself moving closer to him and making sure he felt safe.  After giving him the encouragement that this was exactly what needed to happen, and with the support of his loving friends and family, he was eventually able to go home, instead of what normally would have resulted in an ER visit (I have to admit, when he first arrived, I thought I would have to refer him to the ER, but am very thankful that this didn’t happen).  His trusted friend kept very close by, physically assuring him that he wasn’t alone and he was safe. 

Two of his friends brought him back the next morning.  Ron already looked better and was able to articulate more about his experience.  He went on to meet with me several more times and has been able to process these very difficult events to the point where they are no longer stuck in his body. He has since described a sense of calm that he couldn’t ever remember feeling.

Because of the knowledge of what each of the particular plant medicines can do and how the body processes trauma, we were able to prevent what could’ve been a very detrimental stay in a psychiatric hospital.  This is a very clear example of why integration is so important, and particularly with a trained therapist, with prior experience working in an acute care unit of a psychiatric hospital.

People who reach out for integration are looking to understand their experience and process it through their own history and trauma.  They’ve turned to plant medicines or psychedelics because what they have been doing hasn’t been working and they’re not happy with how they’ve been living.  They have not been able to get through the walls they built to keep them safe growing up (but no longer serve them as an adult). 

In a therapeutic environment, there are no “bad trips.”  The experience referenced above may appear to be frightening, but as we can see, it was very intense, and yet, very healing.

Category Two:

As for Category Two, I’ll share an example I had with Paul.  He called to tell me that he wanted an appointment because he had a psilocybin experience that left him feeling happy for the first time since he could remember.  He had been on the verge of suicide many times for the 3 years prior, seeking different forms of therapy and medication to no avail.  He could not get out of a deep sadness and numbness that he felt, no matter what he tried.  Plant medicine was a last resort, and in his words, if it didn’t work, he was done. 

He tentatively arrived in my office and described this feeling of peace and love that he was somewhat desperate to hold on to.  This integrative therapy evolved in a way that I didn’t expect, because over the course of a year of our work together, Paul went through some physical symptoms that derailed him for quite some time, but was so closely connected to the fear that kept him from experiencing any joy in his life.  As he came to realize that these symptoms were connected to past trauma, and as he realized that he was, indeed, a very sensitive person (this was met with almost disdain when it was suggested in the early stages of therapy), he truly began to heal and come alive.  This is an example of what the “spectrum of trauma” means.  Paul’s repressed grief had a lot to do with his intense emotions around the death of a beloved pet when he was 11 years old.  He was shamed for his grief by family members and peers.  By pushing down these feelings of grief, coupled with this new shame, his capacity to feel was also pushed down, and depression became his norm.  While this trauma may not appear to be nearly as intense as Ron’s trauma, it affected Paul to the point where he had disconnected from himself, and ultimately, didn’t think life was worth living, although he had no understood connection to the repressed grief at the time. 

The psilocybin journey showed him what was possible, but it did not enable him to live a happy life until he got underneath his “firewall” (described below) and worked at it.  There was a lot of grief for him to process, and tears came along with shame until it moved its way out.  Today, I can happily say that smiling is the norm for him, and spontaneity is part of his daily life.  He embraces his sensitivity and sees how it has become a gift to him.  He worked hard to get there. 

We all have unresolved trauma.  Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel the full range of emotions and experiences.  Some of us have experienced more intense trauma than others, but some of us are more sensitive than others as well.  If a disturbing experience led you to disconnect from your true self because what you were feeling was too much, that is the internal impact of trauma.  We create a “part” that protects us from this overwhelming emotional pain, assuring us that we will not feel it again.  Most of the time, we are completely unaware that we have done this.

These traumas become more clear during integration therapy, as the plant medicine helps to reveal that which we have buried deep in our subconscious.  I truly believe that psychedelics/ plant medicine, when used properly, are here to bring us back to our whole self- to show us our own “operating system” that we have created as a result of our experiences, and how there may be some “firewalls” up that are protecting us from pain and keeping us from our true nature. Why would we want to pull down this firewall that has protected us for so long?  Because that pain we are protecting is where we are going to find ourselves the most alive.  We need to sit with it, feel it, allow it, and finally, let it move its way through us and out.  What is depression, but a condition where we feel disconnected from self and others, where nothing will make us feel better because we have lost our way?  What is anxiety, but an unprocessed fear that we are not going to be ok?  We may have felt like we couldn’t survive this emotional pain as a child (emotional pain can be very intense and confusing for a child, and none of us are exempt from this), but we need to know that we will survive it now.  This is also what integration therapy is about- having a safe place to be reminded that you will be okay now.  You are safe.  You can learn to witness and feel at the same time, thus allowing the firewalls to gently move out of the way. 

Category Three:

Finally, I’ll touch on Category Three.  Terry called to tell me that she wanted to take psilocybin but was very scared to.  Her husband and brother had both taken it and assured her that they would be there for her.  Her motivation for wanting to do this was to help understand and heal her Misophonia, a condition meaning “hatred of sound,” which manifested in her becoming highly irritated at many sounds, with the sound of someone chewing or sniffing causing her the most distress.  She loved her husband and children, but these sounds, even coming from them, created anger inside of her, which in turn, stressed her out even more. 

We talked about some of her history and when the Misophonia began.  She described overhearing a conversation between her parents that involved her father being unfaithful with a man.  Terry loved her dad, and I believe she did not know what to do with any feelings of anger towards him, and she remembers being really angry at him chewing his food.  This wasn’t the first time she thought there was a connection, but she didn’t know how to remove the root of it.  We talked about what the set and setting would be like for her journey: music, a mantra she could use as she began preparing for the day, and what her husband could do as her “sitter.” 

When we met after her journey, she described feeling so much love and no fear at all.  She shared that she had a sure feeling that whatever was going on, there was something inside of her that was going to know how to handle it and know what to do.  This was the plant medicine reminding her who she really was.  Our subsequent sessions were about connecting with the anger that she was sidestepping and sitting with feeling uncomfortable around that, as she was able to understand that while it wasn’t safe for her at the time to feel anger towards her father, she transferred it to something that did feel safe.  Obviously, this was no longer serving her and it was hurting her and her family members.  Because of the inner knowing that she received from her experience with psilocybin, she was more easily able to access the anger in our integration sessions afterward, without feeling like she couldn’t handle it.  She worked hard through these sessions and in-between, and while the Misophonia isn’t completely gone, she feels it very rarely now, and she is able to easily ride through the irritation.

As a therapist, it is a very rewarding experience to see the recognition in someone’s eyes that “yes, I can handle this and I will be ok.”  This concept, called “therapeutic alliance,” allows a client to let go- to begin to trust.  Many clients aren’t aware that they don’t trust because they’ve never experienced trust in the first place.  They don’t know what it feels like to let go and still feel safe.  Somewhere along their road of life, usually in early childhood, the world became an unsafe place to be.  This is often due to parents or caregivers unable to see their child’s pain, or not knowing what to do with it, likely due to their own unrealized traumas.  The child then learns to do whatever is necessary to survive because their world depends on them burying their intense emotions and “pushing through.”  Intense emotions can make someone feel as if they are going to die.  The emotion is too big for the child to bear, and often, there are no words to communicate this.  If they are not seen by someone who cares, then the child has to figure it out for themself.  This is where plant medicine can reveal deep traumas, underneath all of their survival mechanisms, beyond the “firewall.”  Of course, there are other methods, but here, we focus on plant medicine.

It takes a great deal of courage (doing something in spite of fear) to put yourself in the hands of a shaman or sitter and enter the unknown.  Most clients will say that they were scared but did it anyway.

Another final case I’d like to share:  Brian had been addicted to heroin on and off for about 7 years.  Many rehabs and detoxes did not accomplish what a 10-day stay at an ibogaine clinic did.  

Brian had been on and off with me for about 3 years.  We were working on a harm reduction approach away from opiates.  This approach involved cannabis and kratom (an extract from a tropical evergreen tree from Southeast Asia, often used to help wean someone off opiates).  Brian had already been through Buprenorphine and Methadone enough times to realize they weren’t going to keep him from relapsing back to opiates.  The cannabis and kratom approach was up and down, and he still felt desperate.  After much talk about ibogaine (ibogaine is a plant-based substance extracted from the iboga shrub, which originates in Africa), he went to a clinic out of the country and was administered ibogaine from a medical doctor.  I believe that it is an immense disservice to addicts that ibogaine has not yet been legalized in this country for opiate addiction, although that is a subject for another article (stay tuned!).  Two weeks later, he was back in session with me describing his experience, and it was clear that something had truly changed.  He was able to see different paths that he took in his life, and how he always had other options.  These paths were shown to him in a way that he reports “almost felt like it had rewired my brain.  My interest in opiates is just not there”.  A year and a half later, still clean from opiates, Brian has been working on creating that trusting relationship with his own self, developing confidence that he can withstand uncomfortable and painful emotions.  Without integration, the uncovering of painful emotions could have led back to a relapse.

Thus, integration involves creating that relationship with yourself, dialoguing with that younger version of yourself, and helping your inner child to heal- integrating your OWN self.  The word integration is so perfect, because as we are integrating the plant medicine experience, what we are really doing is integrating our true self, beyond all of our ego’s constructions of what was necessary at the time, but no longer serves us in being whole.

What has been most helpful to me as an integrative therapist was my own experiences with plant medicine, particularly ayahuasca.  It’s not always easy to “hold space” for some of the pain that is releasing from clients, as the energy can be intense.  One of the most important visions I had during an ayahuasca journey in Peru was the night I had a matrix in front of me of all happenings between humans for a long timespan.  Certain squares of the matrix would become the focus as I observed specific human mental suffering, abuse, some more benign scenes… some family members and friends I knew… I could move the scene out of the way if it wasn’t something I felt I needed, and focus closer on scenes that were meaningful to me in some ways.  I witnessed a scene between a relative and her father that was devastating, as well as several others like this.  The reason this was the most important vision for me was I was a silent observer.  I was aware of the pain and tragedy, but I wasn’t in pain myself.  This is not usually true for me in my daily life, as I feel pain in my own body when someone else is experiencing pain.  It has, at times, made it difficult for me as a therapist to hold back tears when a client is in tears, and I have had to momentarily think of something funny to pull me out of this empathic experience.  Being able to be aware of the pain in this matrix experience, but not be in pain myself, has helped me tremendously in my practice, as well as with friends and family.  I feel less responsible to “fix” it, in a way, because I clearly realize the pain is not mine.  This has not made me less empathetic in any way, but it has enabled me to have more clarity.  Therapy isn’t about fixing, but helping people to uncover their own guide within; their own inner wisdom.  This has become my purpose, to just be a guide in the storm of someone’s life and allow them to see that they’ve known all along who they are, they just need to move their “firewalls” out of the way.

If you are reading this and have been wondering what it might be like to work with people in this capacity, I hope this has been helpful.  As Terence McKenna once said, “It’s all about love… making someone else’s existence just a little easier… nothing else matters.  I know this now.”

About the Author

Debbie Kadagian became certified as a Holistic Health Practitioner in 2007, specializing in Ayurvedic Health Counseling.  She traveled to India to study at the Jiva Institute with Dr. Partap Chauhan.  She received her Masters in Social Work from Fordham University and became a licensed clinical social worker.  She has worked at inpatient psychiatric hospitals and outpatient treatment centers prior to setting up her private practice.  Debbie is also a certified yoga teacher since 2001.  Debbie has a true desire to assist people in finding meaning in their lives in order to transcend suffering, addiction, and trauma.

Debbie is the producer of the film, “Healing the Mind: The Synthesis of Ayurveda and Western Psychiatry.”

Available to view at

“If plant medicine is a teacher, then an integrative therapist is a tutor, helping the traveler understand the teachings.”