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Publications

This page lists scientific publications reviewed to date, starting from 2007. The list will be updated monthly.

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  • Albert, A. E., & Back, A. L. (2025). Psychoanalytically informed MDMA-assisted therapy for pathological narcissism : A novel theoretical approach. Frontiers in Psychiatry, 16, 1529427. https://doi.org/10.3389/fpsyt.2025.1529427

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Pathological narcissism (PN) is a complex, treatment-resistant disorder characterized by unstable self-esteem that fluctuates between grandiosity and vulnerability, complicating the formation of a stable self-image. With few empirically supported therapies, treatment has traditionally relied on long-term psychoanalytic approaches, but these often face high attrition. Recent research suggests a potential therapeutic synergy between psychedelics and psychoanalytic therapy, offering a novel approach to addressing entrenched personality structures. Studies on MDMA (3,4-methylenedioxymethamphetamine), a compound known for enhancing empathy, trust, and social interactions, demonstrate potential to reopen critical periods for social learning in adults, offering the possibility of therapeutic benefits for conditions with core issues in relatedness, such as PN. MDMA promotes psychological flexibility and openness, allowing for deeper self-exploration and strengthening the observing ego, considered in psychoanalytic therapy to be an essential component for recognizing and modifying maladaptive patterns. By reducing fear-based avoidance in the brain, MDMA facilitates access to unconscious emotions, helping individuals process overwhelming feelings linked to early relational trauma commonly seen in PN. Additionally, MDMA’s capacity to enhance compassion and empathy can fortify the therapeutic alliance, increasing its potential to facilitate relational change. This paper presents an MDMA-assisted therapy (MDMA-AT) tailored for narcissistic patients which is currently being conducted as an investigator-initiated trial (IIT). It explores the model’s theoretical foundations, mechanisms of change, treatment framework, and clinical challenges. Combining MDMA with an evidence-based depth therapy like psychoanalytic psychotherapy may offer an innovative treatment for conditions associated with attachment and developmental trauma, particularly personality disorders. While the role of psychotherapy in psychedelic treatments remains a topic of debate, with some proposing psychedelics be administered without psychotherapy, we assert that individuals with early relational trauma stand the most to gain from an integrated psychedelic-assisted therapy (PAT) model, where MDMA enhances the therapeutic alliance and emotional openness while psychoanalytic interventions provide the structure for lasting change.

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  • Artru, E., & Rabeyron, T. (2021). Psychédéliques, psychothérapie et symbolisation : Une revue de littérature dans le champ de la dépression. L’Évolution Psychiatrique, 86(3), 591‑616. https://doi.org/10.1016/j.evopsy.2021.03.013
 

This article proposes a literature review focused on the so-called “classic” psychedelics (LSD, psilocybin, DMT, and mescaline) and, more specifically, on their use in the psychotherapy of major depressive disorders and the way they affect symbolization processes. After some introductory remarks on psychedelics and depressive disorders, we describe some modern clinical trials, and then explore the peculiar phenomenology occurring in the psychedelic experience, as well as its therapeutic effects on depressive symptoms. The underlying mechanisms are discussed from a perspective at the crossroads of cognitive neurosciences and psychoanalysis. We conclude with some reflections on the crucial role of the setting. The results already obtained suggest that a single dose, taken in a supportive environment, may be sufficient to produce significant and immediate therapeutic effects, which are still present six months after the dose, although less so for some patients. Clinical response depends on the subjective aspects of the individual experience. More specifically, it seems correlated with the ability to “let go” and to allow autobiographical memories to emerge, along with the intense emotions they carry. It also relies on the presence and intensity of mystical-type experiences, characterized by feelings of “ego dissolution,” unity with everything, transcendence of space and time, and ineffability. Psychedelic-assisted therapy seems to promote the emergence of primary processes and the lifting of defense mechanisms. Psychedelics would thus catalyze the resumption of symbolization processes, favoring in particular the integration of unconscious conflicts as well as the remodeling of pathogenic object relationships. On the neurobiological level, these processes would be underpinned by a decrease in the activity of the default mode network – sometimes considered the primary biologic substrate of the Freudian ego –, associated with an increase in brain entropy and in neuroplasticity. These different elements entail a decrease in depressive symptomatology, particularly ruminations. Common factors identified as the cause of positive changes in classical psychotherapies appear naturally amplified in the psychedelic experience, which requires the containing function of a therapist and a supportive clinical setting to allow a resumption of symbolic processes. To ensure the perpetuation of the observed transformations, which often exceed the simple withdrawal of symptoms, an extended psychotherapeutic monitoring would be appropriate. The psychedelic substance acts as a catalyst, allowing an access to otherwise inaccessible unconscious materials, which can then be processed both spontaneously and within the therapeutic relationship. Considering the data discussed in this review, we emphasize the need for further research exploring the potential of this treatment, which also offers the hope of a renewed dialogue between psychiatry and psychology, neurosciences and psychoanalysis.

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After a two-decade moratorium on psychedelic research in the United States, new studies on psychedelic assisted psychotherapy have shown promising results in the treatment of psychiatric disorders and the betterment of well people. Little has been written in contemporary psychoanalytic journals about the possi­ ble use of psychoanalytic theory as an underpinning for this research. This paper examines three concepts from psychoanaly­ tic thinkers that may contribute to an understanding of what is curative in psychedelic assisted psychotherapy. First, I examine the possibility of psychedelics as a catalyst in changing a patient’s implicit relational patterns. Second, I use the work of Winnicott and Christopher Bollas to explore the psychedelic experience. Finally, I look at the role of mystical experience in psychedelic assisted psychotherapy.

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  • Buchborn, T., Kettner, H. S., Kärtner, L., & Meinhardt, M. W. (2023). The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression. Frontiers in Neuroscience, 17, 1232459. https://doi.org/10.3389/fnins.2023.1232459

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The ego is one of the most central psychological constructs in psychedelic research and a key factor in psychotherapy, including psychedelic-assisted forms of psychotherapy. Despite its centrality, the ego-construct remains ambiguous in the psychedelic literature. Therefore, we here review the theoretical background of the ego-construct with focus on its psychodynamic conceptualization. We discuss major functions of the ego including ego boundaries, defenses, and synthesis, and evaluate the role of the ego in psychedelic drug action. According to the psycholytic paradigm, psychedelics are capable of inducing regressed states of the ego that are less protected by the ego’s usual defensive apparatus. In such states, core early life conflicts may emerge that have led to maladaptive ego patterns. We use the psychodynamic term      character in this paper as a potential site of change and rearrangement; character being the chronic and habitual patterns the ego utilizes to adapt to the everyday challenges of life, including a preferred set of defenses. We argue that in order for psychedelic-assisted therapy to successfully induce lasting changes to the ego’s habitual patterns, it must psycholytically permeate the characterological core of the habits. The primary working principle of psycholytic therapy therefore is not the state of transient ego regression alone, but rather the regressively favored emotional integration of those early life events that have shaped the foundation, development, and/or rigidification of a person’s character – including his or her defense apparatus. Aiming for increased flexibility of habitual ego patterns, the psycholytic approach is generally compatible with other forms of psychedelic-assisted therapy, such as third wave cognitive behavioral approaches.

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  • Burton, J., Ratner, A., Cooper, T., & Guss, J. (2022). Commentary : Psychedelics and psychotherapy: Cognitive-behavioral approaches as default. Frontiers in Psychology, 13, 1020222. https://doi.org/10.3389/fpsyg.2022.1020222
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  • Carhart-Harris, R. (2007). Waves of the Unconscious : The Neurophysiology of Dreamlike Phenomena and Its Implications for the Psychodynamic Model of the Mind. Neuropsychoanalysis, 9(2), 183‑211. https://doi.org/10.1080/15294145.2007.10773557

 

​This paper reviews scientific literature on four subjective states: the dream state, the dreamy state of temporal lobe epilepsy and temporal lobe stimulation, the acute psychotic state, and the psychedelic state. Evidence is cited showing that underlying the emergence of dreamlike phenomena in all four states is the occurrence of high-voltage bursts of theta and slow-wave activity (2–8 Hz) in the medial temporal lobes. The medial temporal regions are recognized to play an important role in memory and emotion. In the dream state, medial temporal lobe bursts are tightly correlated with PGO waves. It has been widely speculated that PGO waves are direct neuro-physiological correlates of dreaming. On a phenomenological level, the dream state, the dreamy state, the acute psychotic state, and the psychedelic state have all been viewed as conducive to the emergence of unconscious material into consciousness. An argument is made that bursts of electrical activity spreading from the medial temporal lobes to the association cortices are the primary functional correlate of discharging psychical energies, experienced on a subjective level as the emergence of unconscious material into consciousness. The implications of these findings for the scientific legitimacy of the psychodynamic model are discussed.

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  • Carhart-Harris, R. L., & Friston, K. J. (2010). The default-mode, ego-functions and free-energy : A neurobiological account of Freudian ideas. Brain, 133(4), 1265‑1283. https://doi.org/10.1093/brain/awq010

 

​This article explores the notion that Freudian constructs may have neurobiological substrates. Specifically, we propose that Freud’s descriptions of the primary and secondary processes are consistent with self-organized activity in hierarchical cortical systems and that his descriptions of the ego are consistent with the functions of the default-mode and its reciprocal exchanges with subordinate brain systems. This neurobiological account rests on a view of the brain as a hierarchical inference or Helmholtz machine. In this view, large-scale intrinsic networks occupy supraordinate levels of hierarchical brain systems that try to optimize their representation of the sensorium. This optimization has been formulated as minimizing a free-energy; a process that is formally similar to the treatment of energy in Freudian formulations. We substantiate this synthesis by showing that Freud’s descriptions of the primary process are consistent with the phenomenology and neurophysiology of rapid eye movement sleep, the early and acute psychotic state, the aura of temporal lobe epilepsy and hallucinogenic drug states.

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  • Choi, C., Johnson, D. E., Chen-Li, D., & Rosenblat, J. (2024). Mechanisms of psilocybin on the treatment of posttraumatic stress disorder. Journal of Psychopharmacology, 02698811241286771. https://doi.org/10.1177/02698811241286771

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Posttraumatic stress disorder (PTSD) is a condition that can develop after a traumatic event, causing distressing symptoms, including intrusive reexperiencing symptoms, alterations in mood and cognition, and changes in arousal and reactivity. Few treatment options exist for patients who find conventional psychotherapy and pharmacotherapy to be inaccessible, ineffective, or intolerable. We explore psilocybin as a potential treatment option for PTSD by examining the neurobiology of PTSD as well as psilocybin’s mechanism of action. Based on both pharmacodynamic and psychoanalytic principles, psilocybin may be an underexplored treatment option for patients with PTSD, though further research is required.

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  • Fischman, L. (2024). Meaningfulness and attachment : What dreams, psychosis and psychedelic states tell us about our need for connection. Frontiers in Psychology, 15, 1413111. https://doi.org/10.3389/fpsyg.2024.1413111

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The human need to find meaning in life and the human need for connection may be two sides of the same coin, a coin forged in the developmental crucible of  attachment. Our need for meaningfulness can be traced to our developmental need  for connection in the attachment relationship. The free energy principle dictates  that in order to resist a natural tendency towards disorder self-organizing  systems must generate models that predict the hidden causes of phenomenal  experience. In other words, they must make sense of things. In both an  evolutionary and ontogenetic sense, the narrative self develops as a model that  makes sense of experience. However, the self-model skews the interpretation of  experience towards that which is predictable, or already « known. » One may say it  causes us to « take things personally. » Meaning is felt more acutely when defenses  are compromised, when the narrative self is offline. This enables meaning-making  that is less egocentrically motivated. Dreams, psychosis, and psychedelic states  offer glimpses of how we make sense of things absent a coherent narrative self.  This has implications for the way we understand such states, and lays bare the  powerful reach of attachment in shaping what we experience as meaningful.

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New research in psychedelic-assisted psychotherapy merits a reexamination of the neurobiology and phenomenology of psychedelic states. First person accounts of psychedelic-assisted psychotherapy are used to re-conceptualize the ego boundary as a defense mechanism which regulates the significance that objects hold for the self. Therapeutic action is attributed to ego dissolution, which enables subjects to see new significance in things. This process coincides neurobiologically with uncoupling certain midline cortical structures, and psychodynamically, with deactivating defense mechanisms which mitigate the threat of losing the loved object. It also enables the dreamlike imagery, symbols, and metaphor of the primary process, a regression to earlier ways of relating to objects, and feelings of love and connectivity. The process supports Freud’s ideas about the oceanic mode of relating to the world existing alongside the narrower, mature ego feeling. The former is better suited for finding meaning in life, while the latter is better suited for survival. The noetic quality of the psychedelic state derives from an unconscious recognition that experiences without character defenses feel more genuine than others, and conform to earlier ways of feeling and thinking. The accessibility of the primary process makes psychedelic-assisted psychotherapy transformative, not just informative. An analogy is drawn to Fonagy’s developmental model of mentalization. Absent the defensive, selfcritical lens of a prior self-concept, psychedelic-assisted psychotherapy serves as an ideal paradigm for the transformative experience of seeing oneself through the eyes of another, leading to greater self-acceptance. Flight instructions for navigating this royal road to the unconscious are considered.

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  • Frontiers Production Office. (2024). Erratum : Meaningfulness and attachment: what dreams, psychosis and psychedelic states tell us about our need for connection. Frontiers in Psychology, 15, 1509670. https://doi.org/10.3389/fpsyg.2024.1509670
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As interest in psychedelics as treatments for psychological problems grows, it is important for psychoanalysts to learn about them. Our patients will come to us to discuss their psychedelic experiences; additionally, psychedelics deserve reconsideration as meaningful col­ laborators with our field, at both the theoretical and clinical levels. After a brief history of these agents, the paper engages three specific areas: 1) psychedelics’ capacity to evoke egolysis, or ego dissolution, and mystical states; 2) their capacity to support hyperassociative states, free association, and emergence of unconscious material, and 3) the role of set and setting in psychedelic therapy. Drawing from the fields of neuropsychoanalysis, phenomenological research and neuroanthropology, the paper offers a discourse that connects mind and brain and psychedelics in ways meaningful for psychoanalysts.

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An analytic treatment of a patient with psychopathic traits offers a rich opportunity to examine the multi-layered interactions among the treatment, a psychedelic mushroom journey and Dr. Burton’s narrative approach to telling the reader about it. In particular, relational ele­ ments were prominent as part of the setting in which the treatment, the journey, and the integration occurred. Unconscious aspects of both therapist and analyst emerged in a particularly vivid way as illuminated by the effects of a psychedelic experience on the clinical process.

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  • Hill, G. (2024). Jung, the Rebirth Motif and Psychedelics I : Documenting Jung’s Contact with the British Pioneers. Journal of Analytical Psychology, 69(4), 526‑549. https://doi.org/10.1111/1468-5922.13030

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C. G. Jung wrote very little about psychedelic drugs and he took a sceptical view of them. However, he was sufficiently impressed by Aldous Huxley’s 1954 account of taking mescaline, The Doors of Perception, to invite Huxley to visit him in Switzerland. Huxley declined Jung’s invitation but Huxley’s collaborator Humphry Osmond met Jung instead. This paper documents Jung’s contact with the British pioneers of psychedelics research and presents the scant material illuminating his views about these drugs. It also determines the efforts of British psychiatrist Ronald Sandison, who was the first to develop an “explicitly Jungian approach” to psychedelic-assisted psychotherapy (Hill, 2013), and it highlights a connection between Sandison’s initiative and the Society of Analytical Psychology (SAP) through the involvement of two SAP members: Margot Cutner, Sandison’s colleague, and Michael Fordham, who supervised a trainee working with one of Sandison’s former patients. Despite Jung’s objections to the use of psychedelics, Sandison and Cutner developed ground-breaking protocols during the 1950s and they were among the first to document the phenomenon of “spiritual rebirth symbolized in the birth experience known to many LSD therapists” (Sandison, 2001). In two companion papers, I consider Jung’s treatment of the rebirth motif in his commentary on The Tibetan Book of the Dead, which later became a central text in the psychedelic movement, and I chart the evolution in psychedelics research from an association with schizophrenia during the 1950s to the mystical paradigms of the 1960s and beyond.

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  • Koslowski, M., De Haas, M.-P., & Fischmann, T. (2023). Converging theories on dreaming : Between Freud, predictive processing, and psychedelic research. Frontiers in Human Neuroscience, 17, 1080177. https://doi.org/10.3389/fnhum.2023.1080177

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Dreams are still an enigma of human cognition, studied extensively in psychoanalysis and neuroscience. According to the Freudian dream theory and Solms’ modifications of the unconscious derived from it, the fundamental task of meeting our emotional needs is guided by the principle of homeostasis. Our innate value system generates conscious feelings of pleasure and unpleasure, resulting in the behavior of approaching or withdrawing from the world of objects. Based on these experiences, a hierarchical generative model of predictions (            priors ) about the world is constantly created and modified, with the aim to optimize the meeting of our needs by reducing prediction error, as described in the predictive processing model of cognition. Growing evidence from neuroimaging supports this theory. The same hierarchical functioning of the brain is in place during sleep and dreaming, with some important modifications like a lack of sensual and motor perception and action. Another characteristic of dreaming is the predominance of primary process thinking , an associative, non-rational cognitive style, which can be found in similar altered states of consciousness like the effect of psychedelics. Mental events that do not successfully fulfill an emotional need will cause a prediction error, leading to conscious attention and adaptation of the priors that incorrectly predicted the event. However, this is not the case for repressed priors (RPs), which are defined by the inability to become reconsolidated or removed, despite ongoing error signal production. We hypothesize that Solms’ RPs correspond with the conflictual complexes, as described by Moser in his dream formation theory. Thus, in dreams and dream-like states, these unconscious RPs might become accessible in symbolic and non-declarative forms that the subject is able to feel and make sense of. Finally, we present the similarities between dreaming and the psychedelic state. Insights from psychedelic research could be used to inform dream research and related therapeutic interventions, and vice versa. We propose further empirical research questions and methods and finally present our ongoing trial “Biological Functions of Dreaming” to test the hypothesis that dreaming predicts intact sleep architecture and memory consolidation, via a lesion model with stroke patients who lost the ability to dream.

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  • Lichtenstein, J., & Hoeh, N. R. (2024). Psychedelics and psychoanalysis : The journey from talking cure to transformation. Journal of Psychedelic Studies. https://doi.org/10.1556/2054.2024.00373

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There is a developing dialogue between the psychoanalytic and psychedelic fields of psychotherapy. This paper contributes to this emerging collaboration by applying Winnicott’s concept of transitional experience to psychedelic clinical work. By analyzing two Ketamine-Assisted Psychotherapy (KAP) cases, we explore in depth how transitional experience facilitates psychedelic transformation. We review clinical touch and introduce hand-holding as a transformational experience that can occur in the amplified relational field of the psychedelic space. Applying these ideas will deepen clinicians’ theoretical understanding and experiential practice of KAP.

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  • Maggio, C., Fischer, F. M., Modlin, N. L., & Rucker, J. (2023). Psychoanalytic Formulations in Psychedelic Therapy for Treatment Resistant Depression (TRD). Journal of Psychology & Psychotherapy, 13.

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Recent studies have shown promising data regarding the safety and efficacy of psychedelic therapy for Treatment Resistant Depression (TRD), providing initial evidence of rapid and sustained response in this population. Despite lack of rigorous data pertaining to the role of the therapist, historically and in modern trials, the therapeutic alliance is considered a central component in the treatment model, and conceived as inextricable from the drug’s subjective effects in achieving therapeutic outcomes. In modern psychedelic research, transpersonal and third-wave cognitive-behavioural psychology have played a primary role in guiding the conceptualisation of the treatment and the chosen interventions of the therapist. However, the intense emotional episodes that may emerge during the psychedelic experience also alludes to the presence of intersubjective dynamics, such as the existence of transference and countertransference in the therapeutic relationship, which psychoanalytic theory may offer insights on and whose scope and significance have not yet been the subject of study.

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  • Modlin, N. L., Stubley, J., Maggio, C., & Rucker, J. J. (2023). On Redescribing the Indescribable : Trauma, Psychoanalysis and Psychedelic Therapy. British Journal of Psychotherapy, 39(3), 551‑572. https://doi.org/10.1111/bjp.12852

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The psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal and spiritual happening which encourages, perhaps both to the relief and dismay of those participating in the experience, the shocking and impressive emergence of one’s unconscious desires and traumata’s; a state which may be experienced as cathartic or healing, and as anxiety-provoking and confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand in hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental ill health, significant gaps of knowledge remain. Additional studies exploring the impact of the extra-pharmacological factors and adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation and psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking-dream to better tolerate reality; immersing self in a wilful state of vulnerability, to develop trust in one’s agency and capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self and to others the traumatic past.

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This essay examines the combination of psychoanalytic therapy and psychedelic substances in mid-20th century Argentina. Through document analysis, it examines the intersection of psychedelics and psychoanalysis, drawing from historical texts and writings by local psychoanalysts to develop a comprehensive understanding of the distinctive clinical practices and therapeutic approaches in the Argentine context. It details the experimental use of these substances, the clinical practices developed, and the professional and societal challenges encountered. Notably, psychoanalysts Luisa de A´lvarez de Toledo, Alberto Tallaferro, and Alberto Fontana conducted pio­ neering research, exploring the therapeutic potential of these substances and publishing their findings in aca­ demic papers and books. According to these psychoanalysts, the use of psychedelic drugs in therapy could enhance transference, catalyze catharsis, and circumvent unconscious defenses, allowing for a vivid exploration of the patient’s psyche that necessitated interpretation. Despite the innovative nature of this work, resistance from within the Argentine Psychoanalytic Association led to the eventual cessation of psychedelic research in this country. The essay calls for a reconsideration of the psychoanalytic community’s relationship with psychedelics, emphasizing the potential for renewed dialogue and incorporation of these substances in contemporary thera­ peutic practices. In conclusion, this article sheds light on an overlooked chapter of psychoanalysis in a local setting and serves as a call for future explorations in broader scenarios. The resurgence of interest in psychedelics for mental health treatment presents an opportunity for psychoanalysts to engage with emerging research, enriching both theory and practice.

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By way of an introduction to a panel on psychedelics and psycho­ analysis, the author recounts his young adult experiences with psy­ chedelic drugs and how they forever influenced his perspectives on mental health and psychotherapy before there were conventions in our literature to ground his observations. The author’s experience foreshadows markers in research and clinical practice for which an evolving theoretical scaffolding is demonstrated in the articles that follow. The essay explores how neuroscience research on psychedelics suggests applications for psychotherapy, particularly as it can aug­ ment and deepen psychoanalytic treatment when used in the context of a long-term process. The author frames the use of psychedelics in relation to a theory of psychoanalytic play.

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We will explore the future mutual benefit between the worlds of psychedelics and psychoanalysis by raising questions and imagining possibilities for both. We propose that psychoanalysis will profit from this unfolding dialog that promises to cross disciplines and expand our limited diagnostic world. We will show how psychedelics can be utilized to enhance the therapeutic alliance, self-regulation, structural dissociation, and trauma exposure. Finally, we ponder how deeper levels of consciousness made accessible with these medicines trans­ forms our theories of self and field, moving us beyond intersubjectivity to the generative and emergent potentials of a unified field.

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As the use of psychedelic agents become a part of mental health treatment, psychoanalysts have the challenge of theorizing how they affect the psyche and the relational field, as well as how they might become part of an analytic process. In this paper, I explore three aspects of psychedelic experience and some ways we might start to understand them in analytic terms. I discuss states of consciousness, transformations to psyche-soma, and the relationally mediated nature of transformational experience. I also describe a case in which I used the psychedelic agent ketamine in the context of a long-term psycho­ analysis. This case illustrates ways that psychedelic psychoanalysis can be useful in repairing early attachment wounds, facilitate the healing of transgenerational ancestral trauma, as well as intensify and compli­ cate the transference/countertransference matrix.

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How do psychedelic drugs produce their characteristic range of acute effects in perception, emotion, cognition, and sense of self? How do these effects relate to the clinical efficacy of psychedelic-assisted therapies? Efforts to understand psychedelic phenomena date back more than a century in Western science. In this article I review theories of psychedelic drug effects and highlight key concepts which have endured over the last 125 years of psychedelic science. First, I describe the subjective phenomenology of acute psychedelic effects using the best available data. Next, I review late 19th-century and early 20th-century theories—model psychoses theory, filtration theory, and psychoanalytic theory—and highlight their shared features. I then briefly review recent findings on the neuropharmacology and neurophysiology of psychedelic drugs in humans. Finally, I describe recent theories of psychedelic drug effects which leverage 21st-century cognitive neuroscience frameworks—entropic brain theory, integrated information theory, and predictive processing—and point out key shared features that link back to earlier theories. I identify an abstract principle which cuts across many theories past and present: psychedelic drugs perturb universal brain processes that normally serve to constrain neural systems central to perception, emotion, cognition, and sense of self. I conclude that making an explicit effort to investigate the principles and mechanisms of psychedelic drug effects is a uniquely powerful way to iteratively develop and test unifying theories of brain function.

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  • Vaid, G. (2023). Psychoanalysis and Psychedelic Psychotherapy – A New Modern Synthesis? In P. Azzone (Éd.), The Wounds of Our Mother Psychoanalysis—New Models for Psychoanalysis in Crisis. IntechOpen. https://doi.org/10.5772/intechopen.109095

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Our chapter traces the origins of the psychoanalytic method back to experiences of non-ordinary states of consciousness achieved through the practice of hypnosis. Psychedelic medicines have the capacity to reveal hidden aspects of the unconscious mind that include symbolic elements and early organizational structures that correspond to Freud’s primary process thinking and which underpin conscious experience. These previously inaccessible layers comprise the building blocks of inner world formation, ideas about the self, and lenses, which serve to organize, construct and shape outer world experience. The chapter describes the signature features and experience of several popular psychedelic agents. Essential theoretical principles and process components found in psychedelic-assisted psychotherapy are elaborated. The author asserts that essential psychoanalytic tenets along with the subjective and intersubjective relational spaces described by Freud, Wilfred Bion and Donald Winnicott correspond to the unique experiential frameworks and psychotherapeutic capacities that can be rapidly achieved and become readily available in psychedelic-assisted psychotherapy. Psychoanalytic principles and technique become supremely relevant, even renewed, within the current climate of interest in psychedelic pharmacology and offers an array of fresh theoretical and practical applications in an emergent field that celebrates human being’s inner creativity, relational creativity and innate capacity to heal.

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  • Yaden, D. B., Earp, D., Graziosi, M., Friedman-Wheeler, D., Luoma, J. B., & Johnson, M. W. (2022). Psychedelics and Psychotherapy : Cognitive-Behavioral Approaches as Default. Frontiers in Psychology, 13, 873279. https://doi.org/10.3389/fpsyg.2022.873279

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The acute subjective effects of psychedelics are responsive to users’ expectations and surroundings (i.e., “set and setting”). Accordingly, a great deal of thought has gone into designing the psychosocial context of psychedelic administration in clinical settings. But what theoretical paradigms inform these considerations about set and setting? Here, we describe several historical, sociological influences on current psychedelic administration in mainstream European and American clinical research settings, including: indigenous practices, new age spirituality from the 1960s, psychodynamic/psychoanalytic approaches, and cognitive-behavioral approaches. We consider each of these paradigms and determine that cognitive-behavioral therapies, including newer branches such as acceptance and commitment therapy (ACT), have the strongest rationale for psychedelic-assisted psychotherapy going forward. Our primary reasons for advocating for cognitive-behavioral approaches include, (1) they avoid issues of cultural insensitivity, (2) they make minimal speculative assumptions about the nature of the mind and reality, (3) they have the largest base of empirical support for their safety and effectiveness outside of psychedelic therapy. We then propose several concepts from cognitive-behavioral therapies such as CBT, DBT, and ACT that can usefully inform the preparation, session, and integration phases of psychedelic psychotherapy. Overall, while there are many sources from which psychedelic psychotherapy could draw, we argue that current gold-standard, evidencebased psychotherapeutic paradigms provide the best starting point in terms of safety and efficacy.

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