Many people have questions about the actual process of psychedelic-assisted therapy and how it is carried out in practice. When I was going to try the process on myself to quit smoking cigarettes after 18 years, there was a lot of information I had to go through. Although there are variations between study protocols and there have been some changes since the 1960s, there are still some elements that are common. I will address these common denominators here.
Qualification
The first step is the qualification for psychedelic-assisted therapy. You are often given a lot of forms to fill out, focused on physical and mental illness history. Candidates who have experienced psychosis or bipolar disorder, or have it in their close family (parents or siblings), are disqualified. However, there are many who have had psychotic experiences and bipolar disorder who say that they have had good therapeutic effects from psychedelic experiences. The world's most experienced researcher in the field, Stanislav Grof, believes that it works as therapy even for that group. I believe that this group is disqualified for two reasons. The first is that there is a greater risk of worsening symptoms over a period of time and that this group often requires many treatments and closer psychiatric follow-up. And since it is a risk-prone group, there is also a greater chance that the study and research will be put at risk by receiving negative press coverage.
In addition, it is common to disqualify patients with high blood pressure, heart rhythm disorders or other cardiovascular diseases. For MDMA, there is a direct pharmacological connection as some of the side effects of MDMA are increased heart rate, blood pressure and body temperature. For psilocybin and LSD, any mental stress is also a physical stress. In addition, the therapist will review any medications you may be taking and ask you to stop taking any that have interactions, especially antidepressants (read more about which in this thorough review here ).
Intention setting
After you are qualified, the intention setting begins. This is about defining the goal or intention of the psychedelic experience together with a therapist. For me, the intention was something as simple as quitting smoking. Once it is defined, you begin to prepare. You can do this by talking about it with your therapist and others, and by taking in new information. I talked a lot with my partner and read a new smoking cessation book, for example. Then you will work on getting your intention "top of mind" before the experience. I did this by sitting in silence and thinking about my intention for 5 minutes every morning for two weeks before the experience. In addition, I planned to do a little less in the last few days before the experience so as not to be too distracted by other things. This is done in collaboration with a therapist.
Read about the options available within psychedelic therapy
The experience itself
The experience itself usually takes place in a clinic or hospital where you show up in the morning on an empty stomach. The room will likely be somewhat homely with a sofa, some pictures on the walls and chairs where the therapists sit. You will be given the medicine and will have about 30-60 minutes to talk and reflect on your intention before the medicine takes effect.
When you start to feel the effect, you will lie down and relax on the couch. As the effect increases further, you will be helped to put on headphones with relaxing music and a sleep mask. The combination of the sleep mask and music allows you to focus on yourself and not be distracted by your surroundings. You will mostly lie on the couch with headphones and a sleep mask, and take a break every hour or two to drink some water/tea, eat some fruit or visit the toilet. If you wish to talk to the therapist, you can remove the sleep mask and headphones at any time. The therapist will always be in the room, and it is the therapist's responsibility to keep you safe and take care of all your needs during the experience. A pen and paper are usually available if you wish to write or draw. After the effect wears off, you will be able to sit and talk to the therapist or otherwise do whatever you want, as long as you do not leave the room.
Read about the cost of psychedelic therapy
Integration
The main part of the work starts after the psychedelic experience, and now you start working on how to integrate the experience into everyday life. Here you will have 2-3 follow-up hours with the therapist to help with the integration and answer questions. Then the procedure is repeated perhaps two more times if the patient wishes, with 4-6 weeks between each. This gives the patient time to let the insights from the first treatment settle down and integrate. Read more in the article What is integration of a psychedelic experience?