Is the future of psychoanalysis psychedelic?

On the surface, the only similarity between psychedelics and psychoanalysis is controversy. In both, the ‘audience’ tends to consist of fanatic enthusiasts and staunch critics. As a result, both schools have had to contend with the (not unjustifiable)scrutiny that typically comes when a mode of thought edges closer to a belief system than an academic one. However, thanks in part to neuroscientific advancements and in part to the devasting opioid crisis in the US (which left us open to thinking differently about treatment), psychedelic research is in the midst of a renaissance. In so doing, it has, perhaps unintentionally, brought psychoanalytic thought with it.

Specifically, one of the main issues with psychoanalytic psychotherapy is how long it takes to achieve any noticeable or meaningful change. Many either spend years in therapy or leave before anything really happens. However, due to the changes that psychedelic-assisted treatment can create in the brain, this years-long psychoanalytic psychotherapy could become a thing of the past.

Psychedelics enhance neuroplasticity
Neuroplasticity refers to our brain’s malleability. Instead of being a static and impermeable organ, it is ever-changing and adaptsin response to new experiences or environmental input. This means we are constantly forming and strengthening neural connections while pruning unused connections.

Psychedelics have been shown to increase neuroplasticity by promoting the growth of new neural connections and stimulating the brain’s ability to reorganise itself. In so doing, it can aid in treating mental health conditions, because you become more receptive to new information or interpretations (e.g., when you have a phobia, during psychedelic-assisted therapy you become more receptive to new interpretations about that phobic object).

This idea that the brain is not static but malleable is at the heart of psychoanalytic work. For example, the fundamental tool of psychoanalysis is free association, essentially meaning that you speak about whatever comes to mind. In so doing, the idea is to create new neural connections and pull forth otherwise unknown neural connections.

In addition, Freud and his colleagues laid the groundwork for our understanding of neuroplasticity, Specifically, he argued that childhood is a highly ‘plastic’ period of development and because of this, we end up with neural imprints of our experiences inour adulthood. Should those imprints be causing us pain, we can alleviate that pain by obtaining insights into our unconscious processes. In other words, if you speak about your traumatic experiences with a professional, they can help you reinterpret the event, creating neuroplastic changes in the brain.

The Ego is first and foremost a bodily Ego
Digging even deeper, countless studies have shown that psychedelic substances, particularly psilocybin-targeted serotonin receptors in the brain, enhance sensory input. As a result, you experience sensory hallucinations, such as changes to your sense of smell, touch, sight and hearing. In other words, the couch you’re sitting on will feel different, or you might start to hallucinate images that aren’t there, and so on. In other instances, you can cross-sense, which means you might see sounds or hear colours.

Psychoanalytically, Freud famously said that the ego is ‘first and foremost a bodily ego’ (1929). By this, he meant that the infant’s sense of self is closely tied to its experience of bodily sensations, and we essentially come to be who we are as a result of them. Wilfred Bion elaborated on Freud’s findings to argue that sensory experiences were crucial to the development of mental functioning and that disruptions in sensory experiences could lead to mental health issues. That is why psychotic states of being are so often an attack on your link to reality (i.e., you hear, see, smell or touch something that is not there). With these theories in mind, Bion advocated for the ‘alpha function’, which refers to the ability to transform raw sensory data into meaningful mental representations. For Bion, the therapeutic encounter often meant helping clients strengthen their alpha-function, a process similar to the mentalisation-based therapies we have today.

With these theories in mind, it would seem that what psychedelic-assisted psychotherapy appears to do is create the ideal neurological ‘grounds’ upon which psychotherapeutic processes that have long been established can work. Enhancing neuroplasticity and opening up your sensory experience enhances your capacity for transforming sense data into meaning. Or, put simply, you can get out of your own way. Back in the day, this process typically took years of therapy to achieve. However, that could be the crux of this renaissance: while psychedelics can potentially speed up your recovery, they are a tool, not a cure.

Written by Molly Fitz