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.
I tillegg er det vanlig å diskvalifisere pasienter med høyt blodtrykk, hjerterytmeforstyrrelser eller andre hjerte- og karsykdommer. For MDMA er det en direkte farmakologisk sammenheng da noen av bivirkningene til MDMA er økt puls, blodtrykk og kroppstemperatur. For psilocybin og LSD har det med at enhver mental påkjenning også er en fysisk påkjenning. I tillegg vil terapeuten gå gjennom hvilke medisiner man eventuelt går på og be en om å slutte med de som har interaksjoner, og da spesielt antidepressiva (les mer om hvilke i denne grundige gjennomgangen her).
Intention setting
Etter man er kvalifisert, begynner intensjonssettingen. Dette handler om å definere målet eller intensjonen med den psykedeliske opplevelsen sammen med en terapeut. For meg var intensjonen noe så enkelt som det å slutte å røyke. Når det er definert, begynner man å forberede seg. Det kan man gjøre ved å snakke om det med sin terapeut og andre, og ved å ta inn ny informasjon. Jeg snakket mye med min samboer og leste for eksempel en ny røykeslutt-bok. Deretter vil man jobbe med å få intensjonen sin “top of mind” før opplevelsen. Det gjorde jeg ved å sitte i stillhet og tenke på min intensjon i 5 minutter hver morgen i to uker før opplevelsen. I tillegg planla jeg litt mindre å gjøre de siste dagene før opplevelsen for ikke å bli for distrahert av andre ting. Dette gjøres i samarbeid med en terapeut.
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
Hoveddelen av arbeidet starter etter den psykedeliske opplevelsen, og nå begynner man å jobbe med hvordan man kan integrere opplevelsen inn i hverdagen. Her vil man ha 2-3 oppfølgingstimer med terapeuten for å hjelpe med integrasjonen og svare på spørsmål. Deretter gjentas prosedyren kanskje to ganger til om pasienten ønsker dette, med 4-6 ukers mellomrom. Dette gir pasienten tid til å la innsikten fra den første behandlingen falle til ro og integrere. Les mer i artikkelenHva er integrasjon av en psykedelisk opplevelse?