Psychedelic Healing in Practice

Integration, Challenges, and a Call for Change

We’ve journeyed through the science of Memory Reconsolidation (MR), the mechanisms that trigger it, the neurobiology of psychedelics, and the revolutionary Addiction as Dissociation Model (ADM). Now, let’s bring it all together to understand how a psychedelic sessions unfold in practice, and the profound implications and challenges facing this transformative field.

A trauma resolution or psychedelic session can be understood as a direct, facilitated engagement with the MR algorithm, leveraging the unique properties of psychedelic compounds. The dynamics unfold in a manner that directly aligns with the three steps of MR:

1. Activation (Step 1 MR): As the psychedelic medicine acts as a Mechanism of Action (MoA), psychological defense mechanisms are lowered, and the conscious mind begins to quiet. The individual enters an Altered State of Consciousness (ASC), and the body initiates a process of regulation. A “feeling body” emerges, communicating through images, symbolic meanings, and somatic expressions. This process is akin to an inherent intelligence guiding the selection of implicit scenes, where time, space, and even genetic memory can be accessed.
2. Contrast/Conflict (Step 2 MR): As feelings are allowed to be experienced, memory networks become activated, often triggering a chain reaction of emotionally connected memories. This can bring forth unprocessed trauma, past abuses, or, conversely, states of profound bliss, heavily influenced by the individual’s mindset, the therapeutic setting, and their pre-established intentions. The cognitive, left-brain functions may initially feel “stunned,” observing the unfolding internal landscape and attempting to make sense of the experience. This often leads to a sense of “learned helplessness” and eventual surrender, as the individual recognizes their inability to consciously control the experience. Patterns of understanding begin to emerge from this dissonance between past experiences and present awareness.
3. New Acquired Knowledge/Integration (Step 3 MR): With acceptance of the loss of control, a deeper wisdom begins to surface. The “inner-rings” of the self, representing unconscious aspects, are acknowledged and communicate profound insights, revealing unfinished business, alternative actions, and the true intentions behind past behaviors. This phase, often likened to the dying process, facilitates an adaptive resolution of the individual’s identity and composition. As the medicine’s effects gradually subside, the individual enters a deep state of relaxation, with the body energized by healing agents like the endocannabinoid system, endorphins, and oxytocin, while the quieted mind idles in a state of repair. This allows for the integration of new information and insights.

The neurobiological underpinnings of PT directly support its capacity for MR. Psychedelics are known to decrease activity in the Default Mode Network (DMN), which is associated with self-referential thought and rumination. This reduction in DMN activity, coupled with the thinning of the Amnesia Barrier (AB)—the metaphorical veil between conscious and unconscious —readily allows for MR to occur. Furthermore, psychedelics increase neural activity, impact gene expression, help resolve intergenerational cycles of abuse, and are directly implicated in performing MR.

The role of intention and the therapeutic guide is critical in psychedelic healing work. The client’s intentions, typically related to their presenting issues, serve to access the orienting system of the brain. The guide, maintaining a state of dual attunement, acts as a “grounded MoA agent,” facilitating the client’s entry into the dissociative/somatic memory system where imagery, symbolism, and felt-senses are the primary modes of communication. The importance of “set, setting, and skill” for positive outcomes is paramount. The “euphoric stress” induced by the psychedelic, functioning as a Dual Attention Stimulus (DAS), brings unconscious awareness into conscious awareness.

The emergence of “negative states” during a PT session further facilitates MR. These states, which can manifest as unconscious personality shifts, regressions to earlier ages, or reenactments of unresolved trauma, arise as the drug thins the Amnesia Barrier. This natural shift in states inherently sets up step two of MR—the confrontation with conflict. The unique aspect of PT is the opportunity for the client to consciously engage with these “negative states” in a therapeutic setting, with the AB lowered. This direct engagement with internal conflict is crucial for facilitating the reconsolidation process.

Broader Implications and Critiques:

The evidence strongly positions PT as a viable candidate for an evidence-based practice. However, the field faces significant challenges and calls for critical self-reflection:

• “Chemical Dissociation”: There’s a need for a clear operational definition of addiction to fully grasp this phenomenon, as the traumatic and dissociative nature of drug use memory is not adequately accounted for in current literature.
• Universality of Dissociation: The Addiction as Dissociation Model (ADM) proposes a universality to the spectrum of dissociation, asserting that it is symptomatically overlapping, process-dependent, and conditional based on internal and external stimuli.
• Critique of Diagnostic Frameworks: Current diagnostic tools like the Dissociative Experience Scale (DES) exclude drug influence, and the DSM-5 (Criteria A) does not identify medical procedures or medications as potentially life-threatening experiences to the unconscious intelligence. This leads to a misrepresentation of dissociation’s prevalence, despite epidemic levels of trauma. The paper argues that addiction and depression are miscategorized and should be understood as Trauma and Stress-Related Disorders.
• The “System of Denial”: The repeated emphasis on how current diagnostic frameworks and professional understanding disregard or exclude drug-induced states, medical procedures as trauma, and the prevalence of dissociation points to a broader “system of denial” within the mental health establishment. This pattern of exclusion, misinterpretation, and stigmatization impedes effective treatment and perpetuates suffering.

Special Considerations for Psychedelic Therapy:

While PT may appear novel, it’s a re-engagement with ancient healing practices. Its success hinges significantly on thorough preparation and post-session integration. Trauma-competent therapists and addiction specialists possess a unique skill set, adept at exploring memory systems within a grounded dissociative state. Therefore, all clinicians engaging in psychedelic therapy must be proficient in understanding, assessing, educating clients on, navigating, and treating the broad spectrum of dissociation using MR principles.

A compelling observation is that the medicine itself is often perceived by clients as “much more reliable and trustworthy than people/clinicians or the therapeutic process”. This often stems from past relational traumas, underscoring the importance of the therapeutic relationship for successful outcomes. A critical consideration is the common recommendation for clients to discontinue psychiatric medications prior to dosing sessions. This practice, while considered best, is not always managed with sufficient information or support. The paper calls for self-reflection within the medical model regarding historical prescribing practices and its symbiotic relationship with the pharmaceutical industry. Particularly in the light of the Addiction as Dissociation Model’s meta-cognitive analyses of the system as an abusive parent, behaving like a traumatized child, and a bully who is not getting what they want or making the sale. Clients undergoing medication tapering would benefit immensely from the support of trauma-dissociation-addiction informed clinicians who utilize “parts work” and incorporate biological regulation techniques like Neurofeedback. The use of psychedelic cannabis (THC/CBD) is also highlighted as offering a broader range of access and support, aiding in medication transition and deepening the therapeutic process. The observation that the medical professionals send their patients/clients home to take their medicine, instead of being with the person, particularly with the implicit nature of all the legal warning labels, tells everything that we need to know about who is who and who is doing what.

The explicit statement that “Medical and psychological professionals (and Big Pharma) have to come to terms that they have created (and are creating) a lot of traumas in an effort to help people heal out of their own ignorance, arrogance, and desire to help” serves as a direct accusation and a call for profound moral-ethical reflection and systemic change within healthcare. This implies that conventional mental healthcare has inadvertently caused iatrogenic harm. For psychedelic to be truly ethical and effective, it must not only integrate trauma-informed principles but also actively address these historical harms.

Ultimately, the paper underscores that desperation, often arising from the obsessive, compulsive, and impulsive acts characteristic of addiction or chronic trauma, can paradoxically serve as the most potent motivation for genuine and lasting change. Suffering, in this view, is not a random malfunction but a purposeful disruption of maladaptive patterns, a “forcing open” of the mind to the heart’s wisdom when conscious awareness resists. This encourages a more respectful, less adversarial approach to mental and physical distress, viewing it as a guide towards necessary internal shifts and deeper integration.

In our next post, we’ll dive into the current political landscape surrounding psychedelic therapy, examining the hope it brings and the critical questions it raises about responsible implementation.

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References

O’Brien, A. (2023a). Addiction as Trauma-Related Dissociation: A Phenomenological Investigation of the Addictive State. International University of Graduate Studies. (Dissertation). Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/

O’Brien, A. (2023b). Memory Reconsolidation in Psychedelics Therapy. In Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/

O’Brien, A. (2023c). Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/

O’Brien, A. (2024a). Healer and Healing: The re-education of the healer and healing professions as an advocation. Re-educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/

O’Brien, A. (2024e). Path of the Wounded Healers for Thrivers: Perfectionism, Altruism, and Ambition Addictions; Re-education and training manual for Abusers, Activists, Batterers, Bullies, Enablers, Killers, Narcissists, Offenders, Parents, Perpetrators, and Warriors. Re-Education and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/

O’Brien, A. (2025). American Made Addiction Recovery: a healer’s journey through professional recovery. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/