Expansion without Erasure: A Psychoanalytic Response to Peoples and Rundel
Psychoanalytic Dialogues November 2, 2025 D. Brenner
Expanded states in psychedelic treatment need not be regressive but can expand consciousness. The self enables survival yet contributes to suffering; perspective transforms transient ego-dissolution into lasting growth. Pain and suffering are differentiated, and ketamine's modulation of the default mode and anti-reward networks uniquely fosters equanimity and analytic space. Preparation and set-setting are decisive because psychedelics can overwhelm defenses. Integration practices consolidate an observing stance—observing ego, thirdness, mindful awareness, or Atman. Psychedelic psychoanalysis builds on analytic commitments, translating oceanic states into enduring reflection, equanimity, and relatedness. A clinical vignette and proposals for distinguishing restorative union from defensive fusion, sequencing ketamine-assisted analysis, and sustaining perspective are offered.