What is Psychedelic Integration Therapy?
Psychedelic-assisted therapy is gaining traction as a potential innovation in mental health treatment. Research suggests that this therapy may have longer lasting effects when paired with integration therapy — but what is integration and how does it work?
In the face of a global mental health crisis, where 1.1 billion people are living with some form of mental health condition, nearly half of people suffering from depression do not respond to conventional therapies. Shining a light of potential help, research is demonstrating that psychedelic-assisted therapy (PAT) may hold benefits as a mental health treatment for resistant conditions.
Despite the potential of psychedelics and psychedelic-assisted therapy, there is additional work needed to deliver the best possible results for patients in need.
Which brings us to integration: the process of revisiting, making sense of, and incorporating the profound insights and experiences into a patient’s daily life. The integration process is considered to be a crucial bridge between the psychedelic experience and lasting positive change.
Integration is a vital part of psychedelic-assisted psychotherapy, with research suggesting that this pairing can create lasting beneficial changes in mental health symptoms.
Psychedelics alter perception and can facilitate a range of experiences from emotional and personal insights to divine encounters, ego dissolution and interconnectedness. Making sense of these experiences can be challenging, and integrative therapy seeks to support people through this process.
Psychedelic integration prepares people for their psychedelic treatment and helps them to understand and create meaning from what they experienced following treatment.
In this article, we explore PAT, its benefits, and how to find support.
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Understanding Psychedelic Integration Therapy
PAT utilises psychoactive substances such as psilocybin, MDMA or ketamine, to support the treatment of mood disorders. It has been gaining interest due to its ability to produce lasting changes from only a few treatments.
The therapy aims to work through trauma and facilitate introspection and emotional processing. Research shows that PAT may be beneficial for mental health due to the neurobiological effects of the substances.
Psychedelic integration therapy is a crucial part of the PAT process, as it helps in the preparation, the treatment, and post-integration therapy that is delivered following treatment.
Before the experience, integrative therapy seeks to prepare people for their psychedelic experience. Following treatment, integrative therapy aims to help people understand their psychedelic experience and apply the insights into their everyday life.
These insights can come from the thoughts, emotional breakthroughs or sometimes “profound” experiences that can come from taking psychedelics.
Importantly for post-integration, these substances create a ‘critical’ window of time when neuroplasticity is enhanced following treatment. It is this timeframe where integrative therapy can work with this enhanced plasticity of the brain to help create improved behaviours and thoughts.
Why Is Integration Important?
Psychedelic-assisted psychotherapy is the psychedelic therapy experience itself. Integrative therapy is applying the learned skills and insights into everyday life to improve well-being and maximize results.
Integrative therapy utilizes different styles of therapy such as cognitive behavioural therapy, somatic therapy, parts therapy or Eye Movement Desensitization and Reprocessing (EMDR) therapy.
This holistic approach addresses the whole individual on psychological, emotional and social levels. The goal is to create meaning, enable emotional processing, and improve emotional regulation, creating long-term changes in behaviour and support long-term wellbeing.
People may often assume that the experience itself will automatically change their life, however, these experiences alone rarely lead to lasting change without integrating the insights.
Integration is vital for psychedelic therapy as it can help to process these experiences and help people better understand the potentially life-changing experiences they may have during psychedelic therapy.
Integration can also help to produce longer lasting beneficial effects, and without it, the insights, thoughts, ideas or new perspectives from a psychedelic-assisted therapy experience can quickly be lost.
Research suggests that psychological flexibility and reduced depression symptoms are sustained for longer when psychedelic therapy is combined with integration, and a review of studies on the outcomes of integration therapy combined with psychedelic-assisted therapy shows that integration is critical for sustained benefits.
Integrative therapy can be implemented long after a psychedelic experience has taken place and psychedelic therapy does not need to be continued to benefit from ongoing integration therapy.
When and Who Might Seek Psychedelic Integration Therapy?
People who are taking part in psychedelic-assisted therapy may desire to seek out integration therapy.
While many PAT programmes are often delivered in conjunction with PAT, those taking part in PAT may wish to continue their integration therapy with an integrative specialist after the support from their programme has concluded.
This can be helpful for both people experiencing a psychedelic treatment for the first time, and for those who are experienced with psychedelic treatment but may be seeking deeper understanding.
In particular, people who may have had a challenging or overwhelming experience during a psychedelic treatment may benefit from sustained integration support.
Those who have taken part in retreats, ceremonies or other psychedelic clinical sessions, such as ketamine therapy, for example, may also benefit from sustained integration therapy.
The Psychedelic Integration Process: What Does It Involve?
The psychedelic integration process consists of three parts; preparation for the experience, the experience itself, and post-experience support.
Here are some of the main aspects of the psychedelic integration process:
- As part of the preparation phase, for a number of weeks before taking part in PAT, therapy participants will be informed in a deeper context about PAT, the science of how psychedelics work, the importance of set and setting, and about what they may expect from their experience.
- Preparing the mind, body and spirit for the experience is part of this preparation phase. This may consist of group therapy, meditation, breathwork, journaling and exercise and healthy eating to ensure that the mind, the body and the emotions are prepared for what may arise.
- Participants may be asked to set an intention for their journey and to practice grounding.
- Participants will be working with therapists to develop a level of trust before the experience begins.
- During the experience, PAT is supported with a clean, calm environment, and oftentimes includes the use of music to guide and support the emotions and mind during the experience.
- A psychedelic “guide” will be present to supervise, along with other healthcare professionals such as a psychotherapist, to support the individual during their journey.
- Following the psychedelic experience, participants are supported through integration through reflection and narrative processing, emotional regulation support, making meaning of insights gained during the experience and applying them to daily life.
Types of Psychedelic Integration
There is currently no single, defined modality for psychedelic integration, however, a variety of different therapy methods can be utilised.
- Emotional integration can help participants to process feelings, grief, fear, joy, or vulnerability.
- Somatic — meaning body-based — integration can help with nervous system regulation, embodiment, and trauma awareness.
- Cognitive and psychological integration can help participants with reframing their beliefs about themselves, any identity shifts that may be experienced, and can help an individual better understand insights they may have gained about themselves, their lives, or others, during their experience.
Psychedelics can often induce mystical visions or metaphysical belief shifts, and psycho-spiritual integration can help participants make meaning of these shifts, existential insights, or any value-based or worldview changes.
Furthermore, relational and social integration can help participants implement new personal boundaries, improve communication skills, and better connection with others, while lifestyle integration can help participants form new, healthier habits and routines, improve creativity, and support daily life alignment.
Psychedelic Integration Specialists: Who Provides Integration Support?
What Is a Psychedelic Integration Therapist?
A psychedelic integration therapist is a qualified and licensed psychotherapist who holds further training or experience in psychedelic therapy.
These therapists are able to work with participants of psychedelic therapy before and after a psychedelic experience. Psychedelic integration therapists are not qualified or permitted to provide psychedelic treatments.
Sometimes, psychedelic integration therapists will have experience taking psychedelics which can provide a deeper understanding of what participants may be experiencing. They may come from holistic backgrounds and are experienced in harm reduction related to psychedelic experiences.
These therapists often take a flexible approach to support, utilising a range of different therapies to support participants.
What Is an Integration Therapist (More Broadly)?
Integration therapists do not always work with psychedelic therapy. More broadly, integration therapists take a holistic, individual, person-centred approach to working with clients, incorporating a variety of different therapy modalities, and can work with people who are not undergoing psychedelic treatment.
Choosing the Right Professional
While there is currently no regulation or official courses for psychedelic integration therapy, there are a variety of unofficial courses and training that can support therapists to become psychedelic integration therapists.
When seeking a psychedelic integration therapist, it is important to ensure they are registered with the relevant psychotherapy body in your country, such as the British Association for Counselling and Psychotherapy (BACP) or the UK Council for Psychotherapy (UKCP) in the UK, or the relevant State Licensing Board in the US.
It is also important to ensure that your therapist has the relevant professional qualifications in psychotherapy, such as a relevant degree, accredited qualifications, and extensive training, usually of more than 450 hours.
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How Long Does Psychedelic Integration Take?
There is no set timeline for how long integration can take when it comes to PAT. This is because every individual has unique wellness needs and unique experiences stemming from their psychedelic treatment.
However, a typical protocol for psychedelic integration may see participants take part in immediate integration one or two days following the experience, followed by weekly therapy sessions for a number of weeks, and sometimes with extended support for up to three months.
Challenges and Risks in Integration
Integration is not always easy, and can sometimes pose a number of challenges for people taking part in this therapy.
For example, a global survey of people who had taken part in ayahuasca ceremonies reveals that the process can sometimes take years, with participants finding it difficult to integrate their experiences from the ceremony into their everyday lives.
Furthermore, the survey found that participants sometimes felt disconnected or lonely following their experience, as family and friends did not understand their psychedelic experience and its impact. A number of participants also revealed that therapists were not able to support psychedelic integration, highlighting the importance of working with a psychedelic-informed therapist.
While integration can often help participants with risk and harm reduction related to psychedelic treatment, such as challenging or distressing experiences, researchers have highlighted there is a lack of research on the effectiveness of specific models and have called for further research to evaluate and develop methods for psychedelic integration.
Finding Support and Resources
Professional integration therapy is recommended for people taking part in psychedelic treatments.
Licensed therapists who provide integrative psychedelic support may be found through directories, through therapy websites, or programme websites. It is vital to ensure the directory you are searching lists licensed therapists, or that the directory belongs to an official psychotherapy body.
Additionally, peer groups and community support can also be accessed to support integration, which can sometimes be provided by the therapy programme itself.
Integration as a Meaningful Ongoing Process
Psychedelic integration therapy is a key support tool in helping to sustain the long-term effects of psychedelic treatments.
Integration can help prepare participants for what they will experience, translate insights gained during a psychedelic experience into lasting changes in wellbeing, and support people in understanding new thoughts or beliefs they may encounter.
The therapy is not a quick-fix, and takes time and patience to see the full, meaningful benefits.
While research into both psychedelic-assisted psychotherapy and supporting integration is still in its early stages, a number of countries across the world such as Australia, Canada and the US are now enabling therapeutic access to psychedelic treatments.
This highlights the importance of understanding integration for those who may be participating in these therapies.