Treatment with psychedelics is psychotherapy: beyond reductionism
Gerhard Gründer, Manuela Brand, Lea J. Mertens, Henrik Jungaberle, Laura Kärtner, Dennis Scharf, Moritz Spangemacher, Max Wolff
The Lancet Psychiatry December 12, 2023 DOI: 10.1016/s2215-0366(23)00363-2 via OpenAlex
Summary
AI-generated from the abstractTreatment of psychiatric disorders with psychedelic substances is promising, but there is debate over whether therapeutic effects come solely from the drug or require psychotherapy. Some recent studies suggest the substance alone may be responsible, with therapists providing only safety support. This Personal View argues that viewing psychedelic treatment as a purely biological intervention with psychological support for safety reflects an outdated, reductionistic dualism that has long dominated psychiatry. The discussion has important implications for how these compounds are studied and regulated.
Study at a glance
| Characteristics | Personal View Peer reviewed |
|---|---|
| Keywords | Reductionism Psychotherapist Psychology Medline Epistemology |
| Citations | 103 |
| Key finding | Characterizing psychedelic treatment as a purely biological intervention with psychological support as a safety measure is an outdated reductionistic dualism. |
Abstract
Treatment of psychiatric disorders with psychedelic substances represents one of the most promising current treatment approaches in psychiatry. Since its inception in the 1950s, therapy with psychedelics has been conceptualised as psychedelic-assisted psychotherapy-ie, a form of psychotherapy that uses the profound biological effects of this class of substances as a catalyst for changing thinking, emotions, and behaviour. In this view, the psychotherapy component of the treatment is considered as being of the utmost importance for both the safety and efficacy of the therapy. This conceptualisation has been challenged by the idea that the latest clinical studies suggest that the potential therapeutic effects of psychedelics must be attributed solely to the substance itself, with no role for psychotherapy. Here, accompaniment by therapists is understood as mere psychological support, to maintain the safety of the substance administration. In this Personal View, we contrast these two views and argue that the characterisation of treatment with psychedelics as a biological intervention (with psychological support as a purely safety-related component) represents an outdated and reductionistic dualism that has dominated psychiatric treatment and research for far too long. This discussion has important implications for the study and the regulation of these compounds.