Neuropsychoanalysis
January 1, 2007
Robin Carhart‐Harris
59 citations
Four subjective states—dreaming, the dreamy state of temporal lobe epilepsy, acute psychosis, and the psychedelic state—share a common neural basis: high-voltage bursts of theta and slow-wave activity (2–8 Hz) in the medial temporal lobes. These regions are crucial for memory and emotion. In dreaming, medial temporal bursts correlate tightly with PGO waves, widely considered direct neurophysiological correlates of dreaming. All four states are viewed as allowing unconscious material to emerge into consciousness. The argument proposes that electrical bursts spreading from the medial temporal lobes to association cortices are the primary functional correlate of discharging psychical energies, experienced as unconscious material entering consciousness. The findings support the scientific legitimacy of the psychodynamic model.
Neuropsychoanalysis
July 3, 2019
Lawrence G. Fischman
44 citations
Psychedelic-assisted psychotherapy can be transformative by dissolving the ego boundary, which normally acts as a defense mechanism regulating the significance objects hold for the self. This ego dissolution uncouples midline cortical structures and deactivates defenses that mitigate the threat of losing loved objects, allowing dreamlike primary process imagery, regression to earlier object relations, and feelings of love and connectivity. The noetic quality of the psychedelic state arises from recognizing that experiences without character defenses feel more genuine. The process supports Freud's oceanic mode of relating to the world, better suited for finding meaning, alongside the narrower ego feeling suited for survival. An analogy to Fonagy's mentalization model suggests that psychedelic-assisted psychotherapy enables transformative self-acceptance by seeing oneself through another's eyes.
Neuropsychoanalysis
January 1, 2023
As psychiatry moves toward a dimension-based classification system, psychedelic-assisted psychotherapy may improve outcomes across diagnostic categories by targeting dimensions like defensiveness, acceptance, and connectedness. This theoretical paper draws on research with psychedelics, infant observation, social psychology, and psychoanalysis to explain why this therapy is well-suited for such dimensions. It begins with existential anxiety in cancer patients, then discusses awe, omnipotence, creativity, and authenticity using models from Winnicott, Stern, and Carhart-Harris/Friston. The paper suggests psychedelic-assisted psychotherapy functions as a transitional space for working through disconnection via illusion-disillusionment, fostering gradual acceptance, and concludes by relating acceptance, connectedness, defensiveness, and the sense of self.