Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations

Abstract

A striking feature of psychedelics is their ability to increase attribution of truth and meaningfulness to specific contents and ideas experienced, which may persist long after psychedelic effects have subsided. We propose that processes underlying conferral of meaning and truth in psychedelic experiences may act as a double-edged sword: while these may drive important therapeutic benefits, they also raise important considerations regarding the validation and mediation of knowledge gained during these experiences. Specifically, the ability of psychedelics to induce noetic feelings of revelation may enhance the significance and attribution of reality to specific beliefs, worldviews, and apparent memories which might exacerbate the risk of iatrogenic complications that other psychotherapeutic approaches have historically faced, such as false memory syndrome. These considerations are timely, as the use of psychedelics is becoming increasingly mainstream, in an environment marked by the emergence of strong commercial interest for psychedelic therapy. We elaborate on these ethical challenges via three examples illustrating issues of validation and mediation in therapeutic, neo-shamanic and research contexts involving psychedelic use. Finally, we propose a pragmatic framework to attend to these challenges based on an ethical approach which considers the embeddedness of psychedelic experiences within larger historical and cultural contexts, their intersubjective character and the use of practices which we conceptualise here as forms of psychedelic apprenticeship. This notion of apprenticeship goes beyond current approaches of preparation and integration by stressing the central importance of validation practices based on empathic resonance by an experienced therapist or guide.

Validation of the Psychological Insight Scale: A new scale to assess psychological insight following a psychedelic experience

“…The matter of the accuracy of alleged insight in relation to psychedelic experiences has previously been the topic of an extensive review paper (Letheby, 2016). What the experiencer chooses to do with his or her self-perceived insight, and how it is dealt with therapeutically, is a rich topic for future research and debate (Timmermann et al, 2020). Moreover, considering the psychedelic state can entail transient psychotomimetic symptoms including delusional beliefs and paranoid thinking (Johnstad, 2021), future studies might explore whether any persisting delusions are being misinterpreted as insights.…”

Working with Weirdness: A Response to “Moving Past Mysticism in Psychedelic Science”

“…The validation of such insights introduces ethical and metaphysical challenges, especially in the context of psychedelic therapy, which only underscores the responsibilities of therapists in helping patients make sense and meaning of their "revelatory" experiences, without resorting to any ontological truth claims. 15 The weird status of mystical and other extraordinary experiences is further complicated by the seemingly onesided reliance on white, heterosexual, WEIRD (Western, Educated, Industrialized, Rich and Democratic) participants in many psychedelic studies. 16 The emerging commercialization and medicalization of psychedelic-assisted psychotherapy is likely to exacerbate this problem, limiting accessibility to affluent educated Westerners.…”

The Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ): A theory-based approach to psychedelic drugs’ effects on psychological flexibility

“…Likewise, such experiences may bring not clarification of meaning but, to the contrary, obfuscation or confusion. As a result, the individual may acquire strengthened implicit fears and even entirely new “pathogenic meanings” (Frank and Frank, 1993), that is, previously unburdened topics become associated with severe threats to basic psychological needs (see Timmermann et al, 2021, for an illustrative example). In situations where these types of challenging experiences remain unresolved (i.e.…”