How to Conduct a Psilocybin Therapy Session
Psilocybin—a naturally occurring psychoactive and hallucinogenic compound found in magic mushrooms—has experienced a surge in interest over the last few years, especially due to its rising use as part of specialized psychedelic-assisted psychotherapy sessions. The psychedelic drugs are being used to aid patients in overcoming (or lessening) mental health conditions deeply rooted in trauma, addiction, and treatment-resistant depression, among other maladies. This article will explain how to conduct a psilocybin therapy session.
When used during these psychedelic-assisted treatments, psilocybin mushrooms help patients through the therapeutic process to discover insights into their own thought-fueled behaviors. The therapy sessions provide patients with the psychological support they need to tap into past experiences so that they can reprocess them in a safe, therapeutic setting.
Psychedelic-assisted therapy is usually conducted over a span of several months in several different types of psilocybin-induced sessions. These differing types of sessions include preparatory, administration and monitoring, and integration.
During the preparatory session, a specially trained therapist and a patient get to know one another, and hopefully establish a strong sense of bilateral trust. During this type of session, patients work to decrease their anxiety and other negative feelings associated with psychotherapy by talking about these emotions with their therapist.
The importance of this initial preparatory session (or sessions, in some cases) cannot be underrated, as it forms the foundation of the patient-therapist relationship going forward in the psychedelic therapy.
Once reaching the administration and monitoring psychedelic sessions, the patient is given a capsulized dose of psilocybin and is attended by the trained therapist for the entire session, which can sometimes last six to eight hours.
In the integration sessions, patients discuss with their therapist just how the psychedelic session affected their thoughts and mood. Psilocybin effects can either be positive or negative. The patient and therapist then discuss how any insights from the psilocybin treatment might be integrated into any behavioral change.
What is Psilocybin-Assisted Psychotherapy?
A typical psilocybin-assisted psychotherapy session is conducted in a comfortable, living room-like setting with dimmed lighting. Before reaching their administration and monitoring session, patients are asked to abstain from consuming alcohol or drugs for a certain number of days. They are also instructed not to take certain medications and to abstain from smoking tobacco products.
During the psilocybin-assisted psychotherapy session, patients lie down while their therapist sits with them. Other than some type of music playing in the background, patients remain silent during the session so they can focus inwardly without distraction. Shortly after taking psilocybin, many patients notice changes in their perception of color and sound, which is also known as sensory distortion or hallucination. The experience has been described as similar to dreaming while awake.
Patients who participate in psilocybin-assisted psychotherapy are instructed to expect an altered sense of self and identity. They often describe feeling like they’ve let go of the ego that defines who they think they are, and instead enter a pure consciousness state.
Psychedelic drugs can also affect the way patients perceive themselves and their surroundings. Sensory input is intensified during psilocybin experiences. Music often feels louder, colors seem more vibrant, and time passes differently (either faster or slower) than usual.
Patients also undergo an extensive preparation process prior to the psilocybin-assisted psychotherapy session, which includes five meetings over several months. Patients should be monitored carefully during the therapy session to ensure they are healthy, comfortable, and safe. Throughout the therapy session, patients engage with their specially trained therapists, who guide them through their entire psychedelic experience.
Although risks associated with administering psilocybin to patients are relatively negligible in such a supportive setting, it is important that patients do not drive or operate heavy machinery until the effects of psilocybin have worn off completely. With repeated administration of psilocybin, psilocybin-use tolerance has been reported in recreational users. This psilocybin-use tolerance can be prevented by administering psilocybin at least 2 days before the desired psilocybin effect.
Psilocybin is not currently approved for medical use in most countries, but the substance is being used in clinical research settings as a therapeutic tool for patients suffering from mood disorders such as treatment-resistant depression and anxiety.
The Four Stages of a Psychedelic Therapy Session
The psychedelic experience of a psilocybin-assisted psychotherapy session can be divided into four different stages. These include the following:
- A pre-hallucinatory stage occurs immediately after psilocybin is administered. For most patients, the experience of a psilocybin-assisted psychotherapy session includes a feeling of relaxation rather than anxiousness. They may also notice colors seeming more intense or sounds becoming amplified. This enables them to let go of their ego without anxiety getting in the way.
- A second psychedelic stage is when patients start to see abstract visual patterns known as form constants. These patterns might take the shape of tunnels, spirals, and multicolored geometric shapes.
- A third psychedelic stage is when psilocybin begins to have a more profound effect on a patient’s perception. For example, patients start seeing vivid imagery that is difficult to describe with words. They also experience synesthesia, or the perception of two or more senses combining into a seemingly unified sense. An example of this would be the perception of sound as visible colors.
- An introspection stage is when patients report feeling like they’ve entered a new realm, where time and space don’t exist as they do in the patient’s reality. Experiences can include feeling a deep connection with nature, memories from past lives, and new spiritual revelations about the world.
How Psilocybin-Assisted Psychotherapy works
So, just how does psilocybin-assisted psychotherapy work? The therapy works because psychedelic compounds—in this case, psilocybin mushrooms—are used to affect the neural circuits in a patient’s brain that utilize the neurotransmitter, serotonin. These actions cause changes of a patient’s perception and consciousness. For most patients, psilocybin can cause distortions in both the perception of time and location.
There have been great advances in psychedelic and consciousness research on the psychological support that patients can benefit from through undergoing psilocybin-assisted therapy. These patients are usually suffering from certain mood disorders and other psychological ailments. Many believe that serotonergic hallucinogens—such as psilocybin, when used during psychedelic-assisted therapy—provide patients with numerous, yet-untapped therapeutic benefits.
Preliminary clinical research involving studies of psychedelic drugs like psilocybin have associated these therapy sessions with acute and sustained antidepressant responses in patients diagnosed with treatment-resistant major depressive disorder. Psilocybin has also been found to alleviate symptoms of obsessive compulsive disorder, a condition that has been difficult to treat through existing medications.
How Effective is Psychedelic-Assisted Therapy?
In low doses, psychedelics like psilocybin have proven to be effective for treatment-resistant depression in early research from several studies, but its effects are short-lived. For patients experiencing severe depressed states such as schizophrenia, research has demonstrated marked improvements during a psilocybin treatment period, which generally lasts about six to 10 weeks.
During psilocybin-assisted psychotherapy, patients can become anxious or uncomfortable since psilocybin tends to induce a psychedelic experience that is often very emotionally intense for patients with no previous experience with psychedelic therapy. Some psilocybin users will speak up if they feel like they need help during their session while other patients might prefer to be left alone so the psilocybin experience can unfold without any outside influences.
After a psilocybin-assisted psychotherapy session is completed, there is a psilocybin aftercare process that includes integration therapy sessions. In psilocybin-assisted therapy, it is important for patients to have access to a support network with which to share their psilocybin experiences once the psilocybin-assisted psychotherapy is completed.
Therapy sessions using psychedelic substances such as psilocybin mushrooms aren’t likely to cause side effects. Since the psilocybin is given orally in the form of a pill or capsule, the psychedelic experience comes on gradually, with people first noticing subtle changes in their perception immediately after taking psilocybin.
Over time, psilocybin amplifies sensory input and causes stimulation to seem intensified. Patients may feel physically relaxed rather than anxious during psilocybin-assisted psychotherapy sessions. Some patients report feeling nauseous or vomiting as part of the psychedelic experience before having intense hallucinations.
Benefits of Psilocybin-Assisted Therapy
Psilocybin-assisted psychotherapy sessions have been shown to have lasting benefits for patients. Anxiety disorders often last a lifetime if left untreated or inadequately treated. As a result of such therapy sessions involving the administration of psilocybin in a controlled environment, many patients report reduced anxiety levels long after treatment has concluded.
Most patients feel secure during psilocybin-assisted therapy sessions because they don’t feel alone. They work closely with their therapist throughout the entire psychedelic experience. The session’s format increases the effectiveness of helping to treat many anxiety disorders.
Psilocybin-assisted psychotherapy sessions should always be conducted in a controlled environment, with medical assistance on hand if needed. While psilocybin is relatively safe, it is still possible to have an unpleasant psychedelic experience while taking psilocybin. Patients who are prone to seizures or heart problems may not want to take psychedelics because doing so could lead to adverse—and therefore potentially dangerous—reactions.
Psychedelic-assisted therapy has several additional benefits compared with conventional psychotherapy. In psilocybin-assisted psychotherapy sessions, psychedelics allow patients to confront their issues through a mental journey that is otherwise difficult to do in normal psychotherapy sessions.
Psychedelics also have fewer side effects compared with conventional psychiatric medications. Also, psilocybin and other psychedelics may have the potential for lasting changes in a patient’s brain function, which is something that cannot be said for other psychiatric medications.
How we reviewed this article:
Kirstie is a Certified Cannabis Coach with over 10 years in the medical cannabis field. She has worked at The Sanctuary Wellness institute since 2021 and has helped countless patients with questions pertaining to medical cannabis.