February 22, 2022
February 22, 2022
Is Your Psychedelics Use a Disservice to Your Mental Health?
The therapeutic context is foundational to achieving positive mental health outcomes with psychedelics. Digital therapeutics software can support psychedelic care providers.
While psychedelics are boasted as incredible healing substances, it’s important to keep in mind the work and supports needed to attain real, effective, and targeted outcomes. Such substances yield incredible power, and it takes responsible, knowledgeable administration and guidance for that power to be fully harnessed. Research into the safety profiles of psychedelics like MDMA, LSD, and psilocybin show they are considerably less harmful (societally and individually) than legal, socially accepted drugs like tobacco and alcohol. Still, the effectiveness of psychedelic use in psychotherapy relies on structured integration of the substance, as a mere tool in the overall process, rather than as a stand-alone panacea.
The Role of Psychedelics in Healthcare
In the last decade, there has been an explosion of psychedelic research. We’re currently in the midst of the second wave of a fascinating investigation into these mysterious compounds, with the “psychedelic renaissance” truly upon us.
Still, is the hype accurate? And, as a pharmaceutical, could misuse (without proper tools, protocols, support, and guidance) harm one’s intentions for healing — not to mention the overall psychedelic industry?
Twitter feeds overflow with positive stories of radically improved lives thanks to the wonders of psychedelics. Microdosing trends and at-home kits can make psychedelics seems like a magical one-stop shop for healing anything. Yet, this ideology is part of what psychedelic researchers are pushing against.
The keyword of psychedelic-assisted psychotherapy is “assisted.” The medicine is a tool, rather than the key to overcoming issues like depression, trauma, anxiety, pain, and more. While psychedelics do suggest a new paradigm for mental health care, what’s at stake is much too important to throw it all away for a second time by using these powerful compounds inappropriately or reinforcing misleading stigmas. In working with regulators to develop groundbreaking insights into the safe use of psychedelics in therapy, psychedelic researchers have brought us a long way.
So, how can care providers ensure proper care is taken to use psychedelics appropriately and effectively in psychotherapy? Answer: A centralized bank of tools for practitioners and their patients.
Before we make a case for digital solutions to optimize psychedelic therapy, let’s explore the landscape of stigma, uses, goals, and intentions.
Overcoming Modern-Day Obstacles
The positivity surrounding psychedelic research is in stark contrast to mindsets during the height of the counterculture movement of the ’60s and ’70s when media coverage of psychedelics was exclusively negative. Of course, that had very little to do with the drugs and a lot to do with people using them.
This was laid bare by then domestic policy chief John Ehrlichman, who unapologetically admitted to the following scandal:
“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or blacks, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
The Nixon administration’s racially motivated propaganda implanted a wild misrepresentation of psychedelics into the minds of the Western world. Ripple effects have since permeated the general public, particularly older generations, many of whom continue to hold negative views on psychedelics due to misinformation.
These unfortunate views are often reinforced by sensationalized, scaremongering headlines akin to “man on LSD who thought he could fly jumps out of a window,” or “kids on LSD go blind from staring at the sun.”
While Nixon’s no longer the president, we now have obstacles of a different sort impeding advances in this intriguing field of study.
Making the Case for Bad Trips
Hindering the continued success of psychedelic research is the widely espoused misconception that psychedelics lack the ability to induce meaningful experiences. Rather, a commonly held opinion is that psychedelics are used exclusively by hippies merely wanting to “get high” so they can experience superficial improvements in mood and “trippy” trances characterized by multicolored kaleidoscopic visuals. The nerve.
“The term getting high is irrelevant,” however, at least according to psychedelic therapy expert Bill Richards, “unless one wants to understand it in the context of glory to god in the highest.”
Alternatively, there’s the notorious “bad trip” characterized by challenging visions, crippling fear, and unnerving paranoia. This foray into the murky waters of the unconscious commonly referred to as a “bad trip” is widely weaponized by skeptics seeking to cool growing excitement around psychedelic research. No good could possibly come from them, they claim.
Obviously, these conceptualizations fall (very) short.
Psychedelic-trained therapists and psychonauts alike know that, in the therapeutic context at least, there is no such thing as a bad trip. Rather, there are difficult trips that can be significantly distressing but ultimately are revelatory, cathartic, and life-changing. The power of embracing these challenging moments lies in integration and psychotherapy.
In Johns Hopkins’ landmark 2006 paper, one-third of participants given psilocybin reported their experience to be the most spiritually significant of their entire lives, while simultaneously reporting it to be one of their scariest experiences.
In trials investigating the effectiveness of MDMA-assisted psychotherapy as a treatment for post-traumatic stress disorder (PTSD), many participants wonder why MDMA was ever given the nickname “ecstasy.” MDMA-induced journeys to the deep recesses of one’s inner space don't exactly scream joy.
However, it’s believed by many experts that going through these psychologically demanding and, in some cases, reality-shattering experiences may be necessary to achieve long-term positive outcomes, and for true healing to manifest.
In the case of MDMA-assisted psychotherapy, for example, patients may safely enter their unconscious mind to effectively address memories and traumas — that would otherwise remain inaccessible — with a fresh, willing, and unfearful mindset. While challenging, it’s a route that’s yielding positive results.
A Time, Place, & Goal
The common trait between classic psychedelic compounds is their ability to induce mystical type, altered states of consciousness and consequential changes in our sense of self. With psychedelics, people are exposed to a new set of phenomenological conditions characterized by heightened interoception and an expansion of perceptual phenomena.
The psychedelic experience can instill doubts about some of our most basic assumptions about reality and how we typically define and position ourselves in the world. This can either be profoundly liberating or psychologically damaging depending on the context in which the drug is taken.
According to Dr. Matthew Johnson, Professor of Psychiatry and Behavioral Sciences at Johns Hopkins, about a third of research participants who take psilocybin have a difficult experience, despite having received the best possible preparatory therapy sessions. One could assume, then, that negative experiences occur at a considerably higher rate when psychedelics are taken in a recreational context, where safety protocols are not followed or accessible.
There is always a danger of significant experiences being dismissed, mocked, or belittled in a recreational context by peers lacking psychedelic education. In a therapeutic context, each person’s experience is treated with the utmost respect and genuine concern. Psychedelic therapists lean on the teachings of humanistic psychologists such as Carl Rogers to treat patients with empathy and unconditional positive regard.
The guide matters as much as the trip.
Can Psychedelics Harm You?
Without the proper support, targeted goals, and set and setting, experts urge that recreational use of these powerful compounds can backfire on those seeking to improve mental health issues.
At an expert Q&A event, Dr. Itai Danovitch, Chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai, warned that psychedelics are “powerful substances” that “need to be handled with care and with humility.” Danovitch says, “As a clinical intervention, psychedelic medications should always be paired with therapy. Therapy helps people prepare, process, integrate, and respond to the insights that psychedelics stimulate.”
That’s not to say that people can’t derive benefits from recreational psychedelic use. Many people take psilocybin-containing mushrooms for fun or personal exploration, for example, and experience spontaneous curative effects. If it weren’t for such uses and anecdotal experiences, we wouldn’t have the knowledge we do today, and the psychedelics industry would likely not exist. Still, there’s a time, a place, goals, and resources to consider before attempting to reconfigure one’s mind.
The Importance of Preparation
It’s important to emphasize that a controlled setting is foundational to positive outcomes in psychedelic-assisted psychotherapy. One’s experience is shaped by the therapeutic environment, and so the importance of getting it right cannot be understated.
One of the main aims of preparatory sessions in the lead-up to psychedelic sessions is to foster the development of a therapeutic rapport between the therapist and patient. Trust is established throughout hours of conversation, promoting a spirit of honesty and openness.
Because therapists are trained to relay the right message at the right time, their role during psychedelic therapy sessions is crucial to the overall success of the treatment. Providing reassurance in a moment of uncertainty, encouragement to delve deeper, or simple instructions to trust, let go, and be open can turn the tide in the patient's favor.
Should interpersonal grounding be necessary, the simple warmth of the guide's hand or a few brief words will often suffice to evade panic and maximize the probability that the session will prove beneficial.
These methods of guiding get much easier with a technological advancement like iSTRYM, which houses a suite of coping and integrative activities, resources, and personalized interventions. With its music integration, iSTRYM helps clinicians effectively deepen or soften the energy around sentiment and emotion throughout their healing session.
During preparatory sessions, patients receive a didactic explanation of what the experience could be like, which includes a long laundry list of potentialities due to the high phenomenological variability. Informal terms “upper” and “downer” are used to describe drugs with stimulant or depressant effects. Well, Dr. Matthew Johnson has coined the term “all arounders” to describe the unpredictable, highly variable effects of psychedelics. One person’s psychedelic trip could be the most beautiful, awe-inspiring introspective journey of their entire lives, while for another it could be quite terrifying.
Where psychological discomfort, fear, or confusion can arise in psychedelic sessions, therapists and clinicians have complete access to iSTRYM’s bank of music protocols and breathwork sessions. Such practices can help individuals ease tension and encourage healing.
Integration in Psychedelic Healing
An often overlooked yet vitally important aspect of psychedelic therapy is the integration that takes place in the aftermath of psychedelic sessions and long after treatment. Fear, panic, paranoia, or confusion may be harmful if they remain unresolved, and so logical interpretation of one’s experience is crucial.
In the hours proceeding psychedelic therapy sessions, patients are given some light homework to complete. This is usually something as simple as journaling about the experience, which ranges from a few bullet points to 20-page detailed descriptions.
iSTRYM has the ability to streamline integration activities like journaling by creating sentiment maps that provide patients with a comprehensive view of how they generally communicate. This allows patients, in the words of MINDCURE CEO Kelsey Ramsden, to become “colleagues in their care.”
Post-session, patients are invited back to the therapist’s office for an integration session where they can reflect on what emerged and develop a rough understanding of its potential significance.
iSTRYM’s Speak Ai integration feature facilitates voice-to-text transcription during their psychedelic therapy session. In addition, iSTRYM’s Natural Language Processing (NLP) technology can be used either in the therapist's office during therapy sessions or after the therapy session to capture dialogue, code content for themes, and detect the presence of specific moods, for example, by examining the patient’s language. NLP can also be applied to iSTRYM’s mindful structural activities, which are incorporated in the app to ensure that valuable insights can be successfully integrated.
Over time, awareness moves in a state of constant flux from memories of the experience to the decisions and approaches required in daily living. Further psychotherapy sessions and mindfulness practices such as yoga and meditation may assist during this stage of personal and spiritual development.
Founder of the Multidisciplinary Association for Psychedelic Studies (MAPS), Rick Doblin, has stated that “It’s not just about the MDMA experience itself, it’s about what you do with it. The whole point is not to need any MDMA.” Doblin continues, “Once people learn that they don’t need to suppress their trauma, but they can process it, they keep getting better on their own.” This, in a sentence, is the true essence of integration.
Thankfully, MINDCURE has developed an answer to the calls for accessibility, efficient services, and effective care.
The Dawning of Digital Therapeutics
Up until very recently, efficiency-enhancing, innovative technologies have been absent in mental health care. This has largely been due to regulatory issues and the challenges associated with using technology in a medical environment.
The demand for mental health services, to which there is a distinct lack of access, has been significantly exacerbated by the pandemic. Further, 77% of US counties face a serious shortage of psychiatrists, 60% of whom are over the age of 55 and nearing retirement. The introduction of digital health tools can go a long way towards addressing these issues.
MINDCURE’s signature digital therapeutics platform, iSTRYM, is a uniquely sophisticated software application designed to provide data-driven support throughout the healing journey and optimize therapeutic outcomes. iSTRYM extends the reach of providers through expanded care delivery channels, allowing patients to access expert care regardless of geography or socioeconomic status.
Biometric and behavioral data gathered through the use of wearables are combined with artificial intelligence (AI) to provide holistic insights into the patients' journey. This multimodal assessment allows therapists to tap into patients’ functioning from a variety of therapeutic angles, providing more meaningful engagement and comprehensive care.
Importantly, industry-standard encryption is used to make sure that data is encrypted both at rest and in transit, assuring that anonymized data will not be intercepted. Patients can rest assured that MINDCURE takes privacy and security very seriously.
Not only does iSTRYM provide better care for patients, but it also helps therapists with treatment protocols, tools, and therapeutic guidance to inform evidence-based care. It lightens the load for care providers with administrative solutions.
iSTRYM provides an intersection between therapist and patient for a seamless patient experience, from intake to discharge and beyond.