The first phase is thorough preparation, where we delve into the individual's intentions for the plant medicine or ketamine-assisted therapy journey. We deeply explore their background and life story to understand their defense mechanisms, vulnerabilities, and determine what kind of experience would be optimal for them. We also conduct a comprehensive screening and assessment to rule out any contraindications. The second phase is the medicine journey itself, where we implement certain parameters to ensure safety and meaningful experiences. We modify the environment and create a sense of containment, creating a holding space for the individual and making them feel safe as the medicine ‘manifests their mind to them.’ Finally, the third and most crucial phase is integration. This is where the individual translates the insights gained from the journey into meaningful and lasting behaviour change because, ultimately, that's what this therapy is about. Psychedelics serve as a catalyst for behaviour change, and it requires a well-trained clinician to guide the integration process effectively. If we're fragmenting rigid pathways in the mind and dismantling defense mechanisms, we must offer a structured and rigorous program to help individuals put themselves back together in a healthy way. Unfortunately, this is a deficit we've observed in some shamanic or non-empirically verified models. They often lack thorough screening and preparation, pay minimal attention to the setting of the medicine journey itself, and provide little to no integration therapy. In such cases, the medicine journey can become a mere memory of a dream at best or even a traumatic experience at worst. CAM: Could you give us an example of a typical patient's journey from beginning to end, showcasing their transformation? I'd like to have a visual understanding of the process. Brad : Absolutely, I'd be delighted to share a case example and I'll modify some details to protect the client's identity.
Brad: That's an excellent question, and I don't want to downplay the risks involved. The fact is that psychedelic medicines are not suitable for everyone. Certain individuals with underlying predispositions, such as schizophrenia or other psychotic disorders, already have a fragile state of mind. Further fragmenting the mind by disabling its defence mechanisms with psychedelic compounds is not beneficial for them. Therefore, there are contraindications for these medicines, and we invest a significant amount of time in screening individuals to ensure their suitability for treatment. CAM: That sounds interesting. So, you're saying that you're creating new neural pathways, essentially allowing the mind to transcend its limitations. However, in this uncharted area, what are the possibilities? From your experience, are there any risks involved? For instance, when reintroducing trauma, could it lead to secondary traumatization? How do you handle that? And how safe is the space you provide? How much containment is there for such cases? Now, for individuals without these underlying predispositions like schizophrenia, psychosis, or active mania associated with bipolar disorder, these medicines can be extremely beneficial. In conditions like major depressive disorder, chronic anxiety, addiction, severe OCD, or severe eating disorders, we often find that people's defence mechanisms are too rigid and stuck. The capacity of psychedelics to soften and break down these defence mechanisms is precisely what they need to heal and recover. However, it's important to note that even for individuals without contraindications, psychedelic-assisted therapy is only beneficial within a specific and rigorous therapeutic framework. Renowned institutions like Johns Hopkins, Harvard, Yale, and Imperial College London have pioneered a three-part framework that ensures optimal safety during the experience.
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June 2023 | Collective Action Magazine
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