Psychedelic-Assisted Therapy: Ayahuasca

Psychedelic experiences can produce lasting therapeutic change when embedded in a supportive psychotherapeutic program. This chapter examines whether such transformational change operates through the therapeutic reconsolidation process (TRP), where symptom-generating mental schemas are disconfirmed and unlearned at the neural level. Analysis of a documented case of ayahuasca-assisted therapy for a 29-year-old woman with complicated bereavement and depression following her mother's suicide reveals that the critical steps of TRP occurred repeatedly. The ayahuasca-induced subjective experiences specifically disconfirmed her pre-existing schemas, enabling memory reconsolidation and permanent symptom elimination—a mechanism fundamentally different from pharmacological suppression.

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Abstract

It is well established that psychedelic experiences can result in potent therapeutic change when induced within a program of psychotherapy that skillfully provides preparation of mindset, an environment of accompaniment, safety, and supportiveness during the experience(s), and a subsequent process of review, reflection, and integration. The question addressed in this chapter is whether psychedelic experiences that produce transformational change—the complete and lasting elimination of a problematic state of mind and/or behavior—do so by creating experiences that fulfill the therapeutic reconsolidation process (TRP). We examine a well-documented, peer-reviewed report of therapeutically facilitated ayahuasca experiences that permanently ended a 29-year-old woman's intensely distressed condition of complicated bereavement and depression stemming from her mother's suicide. It is apparent in the client's account of her ayahuasca experiences that the critical, specific steps of the TRP occurred repeatedly, that is, pre-existing, symptom-generating schemas were disconfirmed with high specificity by the ayahuasca-induced subjective experiences, as required for driving the unlearning and nullification of those schemas at the level of their neural encoding through memory reconsolidation. In such unlearning, the revised neural encoding completes the reconsolidation process, which is a fundamentally different mechanism of change than the pharmacological aborting of the reconsolidation process.