NLP and Psychedelic/Entheogenic Assisted Psychotherapy Treatment

Richard Bolstad R.Cp.N, Member NZ Association of Psychotherapists

Therapeutic Benefits?

Psychedelic Assisted Therapy is increasingly in the news world-wide. I’m a Registered Nurse, a Member of the New Zealand Association of Psychotherapists, and an NLP Trainer, and I think it is useful for us in the NLP community to clarify our thoughts about it. I think there is now pretty good evidence that a couple of treatment sessions with psychedelic drugs like psilocybin are extremely beneficial for many people with depression, PTSD, and distress caused by terminal illness etc. (Khan et alia 2022, Gukasyan et alia 2022, Griffiths et alia 2016). Research on treatment with the related drug MDMA (ecstasy) shows 83% remission from PTSD diagnosis, lasting to 3.5 year follow-up (Mithoefer et alia, 2018).

I have five cautions which it is best to declare before you read on.

  • Firstly, there is some evidence that for people with reality testing difficulties (esp. those diagnosed psychotic) the treatment may be too distressing.
  • Secondly, the treatment is enormously labour intensive, requiring prolonged pre and post interview discussions and two highly trained professional therapeutic “sitters” staying with each client for 8 hours during each session.
  • Thirdly, for PTSD, the NLP based RTM protocol provides even higher remission rates with considerably less input of time, so, astonishing as the therapeutic results with these drugs are, we can sometimes do even better.
  • Fourthly, each drug has its own specific effects: classical or serotonergic psychedelics such as psilocybin, mescaline, DMT/Ayahuasca and LSD are different to MDMA/ecstasy (the latter usually delivers a powerful positive experience, but is less likely to raise and resolve traumatic memories), and ketamine is a different substance again (with a more time-limited effect on the body).
  • Fifthly, in the research, the drugs are being used as an adjunct to psychotherapy and human presence, not as a replacement for it.

Those cautions aside, you can expect to hear a lot more about Psychedelic Assisted Therapy. In a discussion on WebMD (https://www.webmd.com/mental-health/story/psychedelic-assisted-therapy) Paul Frysh says “There are more than 50 studies on psilocybin alone, and similar numbers for MDMA, LSD, DMT, and other psychedelics…. Rick Doblin, for one, sees this as a tipping point. Psychedelic research today is far more advanced than at the height of the 1960s, he says, and prescription approval is well within range. “We are no longer investigating whether psychedelics can help,” says Doblin. “The evidence is pretty clear.”” As for safety, research on psilocybin use in the Netherlands “concluded that the physical and psychological dependence potential of magic mushrooms was low, that acute toxicity was moderate, chronic toxicity low and public health and criminal aspects negligible. The combined use of mushrooms and alcohol and the quality of the setting in which magic mushrooms are used deserve, however, attention.” (van Amsterdam et alia, 2011)

How does it Work?

In research, the main hypothesized methods of action of these drugs are a) by neurogenesis, especially growth of new nerve cells in the hippocampus, b) by increasing synaptic plasticity (nerve cells develop the ability to make new connections and let go of old ones), and c) by reducing amygdala reactivity (Catlow et alia, 2013, Krediet 2020). Specifically, in the case of classical psychedelics, they bind as “agonists” or enhancers to the serotonin 5‐HT2A post-synaptic receptors in the cortex, relaxing prior assumptions/beliefs that modify experience and memory processing (Carhart-Harris 2018). The Default Mode Network (DMN) is a set of related brain areas that are active whenever the brain is “at rest” and which provide a sense of a stability to return to after each task. In depressed and anxious people the default mode network is severely contaminated with unhelpful patterns. Psychedelics disrupt this network, an experience sometimes described as “ego death” by those in psychedelic therapy, and followed by a sense of oneness with all. “This systematic review provides evidence to support the notion that classical psychedelics are capable of modulating the DMN, which is correlated with ego dissolution, increased brain entropy, and improved mental health and well-being.” (Gattuso et alia, 2023)

I have watched many videos of doctors and nurses who do this work discussing the effects, and they often say that a) the benefit is partially due to the fact that reduced conscious mind resistance (due to the drug) enables ordinary psychotherapy to work better in the latter part of the session, and b) that much of the change is described as reframing symptoms rather than eliminating them (i.e. “I know that I can think unhelpful thoughts and feel bad, but it doesn’t really matter because life is so much more than this”). Note that because psychedelics disrupt traditional interpretations of experience, the person’s responses are particularly affected by expectations and contextual cues. This emphasises the importance of creating a comfortable, quiet and aesthetically pleasing environment, and building a trusting therapeutic relationship with clear boundaries and emphasis on empathy and reassurance rather than “therapeutic pressure”. Gukasyan and Nayak (2022) discuss how experiences during Psychedelic Assisted Therapy are affected by “four major contextual “common factors” shared by various healing traditions: 1) the therapeutic relationship; 2) the healing setting; 3) the rationale, conceptual scheme, or myth; and 4) the ritual.” They argue that these factors cannot be separated from the effects of any psychotherapy, let alone psychedelic assisted therapy. Kaelen et alia (2018) even argue that a lot of the effects of Psychedelic therapy are mediated by the music usually played in the background. They show that mystical experiences are correlated with the use of inspiring music more than with any adjustment of dose of psychedelic drug, and that subjects usually report that the music profoundly altered their experience.

What the researchers have previously been reluctant to discuss (because of this placebo effect?) is the “spiritual” outframing of problems by an experience of “bliss” and “oneness”, that has often (although not always) happened. The famous “Good Friday” 1962 research on 20 Protestant divinity students shows how this works. This was replicated several times recently (Griffiths et alia 2008), and shows that years later subjects will rate a single experience with psilocybin as one of, if not the most, spiritually significant experience/s in their life. Hence the tendency for some researchers to coin the term “entheogens” (literally, generating a sense of God within) for the drugs. Wikipedia says Entheogens are “psychoactive substances that induce alterations in perception, mood, consciousness, cognition, or behavior for the purposes of engendering spiritual development or in sacred contexts” – for example in Native American contexts, in the Ancient Greek Eleusinian mysteries, and in the Biblical record of holy anointing oils using cannabis (Exodus 30:22-25). As a counter-argument to this trend, Matthew Johnson (2022) has cautioned that it is inappropriate for medical and paramedical practitioners to imply religious theories and to use poorly defined words such as “entheogen” and “altered consciousness” when discussing these experiences with their clients. He suggests that such terminology risks confusing the role of the support person with traditional religious figures such as gurus.

Relationship to NLP?

It is no secret that LSD and psilocybin were in use at Esalen when NLP was being pre-developed there, and before the drugs were made illegal in the USA. Virginia Satir experienced the effects of LSD there and in research at the University of California (Satir in Banmen 2008 p. 56). Milton Erickson wrote an article (Erickson, 1965; Erickson, 2006) about his year-long work with Aldous Huxley in which they made “a review in extensive detail of his psychedelic experiences with mescaline, later to be recorded in his book (Huxley, A. The Doors of Perception. New York:Harper and Brothers, 1954).” Robert Dilts explains about the development of NLP that “Another significant influence on Bandler, Grinder, and the members of the “Meta” group at that time were the writings of Carlos Castaneda. Castaneda’s works provided explicit descriptions of different states of consciousness, and outlined specific steps to achieve perceptual flexibility and explore the relationship between conscious and unconscious processes. They relate his experience of the visionary reality of the Native Americans guided by the character of Don Juan, a Yaqui Indian who introduced Castaneda to different states of consciousness by means of hallucinogens. For instance, some of the interactions between Don Juan and another Yaqui “sorcerer,” Don Genaro, inspired Bandler and Grinder to create the NLP “double induction” process.”” (in Grinder and Pucelik, 2012, p. 263). In fact Robert Dilts met LSD advocate Dr Timothy Leary, who held that LSD helped people release the “imprints” of early life trauma. “Leary considered imprints to be associated with certain biochemical states, and believed that if the state could be reaccessed through drugs (such as LSD) a person could be ‘re-imprinted’ and substitute new experiences for those which had originally been associated during the initial imprinting period. Leary became interested in NLP and hypnosis as other methods to change imprints that avoided the uncertainties and ecological problems of LSD.” Dilts says this significantly contributed to his development of an important NLP change process called Re-imprinting. (Dilts, 1996)

Given this close association between NLP and the early psychedelic movement, it is sad that most models of psychedelic assisted psychotherapy are currently stuck in very old models of what change means, and presuppose that change is primarily the “release of bad stuff” from the being (Coleman, 2020, p. 11, 13). R. Coleman, who wrote “Psychedelic Psychotherapy” is a Reichian therapist who sees psychotherapy almost entirely as revealing and “releasing” trauma, and also suggests telling explorers reframes such as “There’s nothing wrong with you. There was something wrong with your parents” (Coleman, 2020, p. 50). I think we can do so much better with a positive psychology approach, and a belief that everyone has positive higher intentions and is doing the best they can with the resources they have at the time. Coleman’s book is one of the few books written on the process, and a very useful resource in general; AND I recommend “The Psychedelic Explorers Guide” by James Fadiman (2011) as the most useful text for those wanting a guide. Another non-NLP approach is also concerning, by the way: in the research studies there is often a strong medical model imposed on the subjects (for example telling them that depression is a “thing” they have, rather than simply the result of unhelpful responses learned at earlier times). As a result there is a kind of acceptance of subjects “lapsing back” into their old thinking patterns months after the treatment, as if this was biologically inevitable. Using a cognitive behavioural model for depression treatment (such as that taught by Ericksonian hypnotist Dr Michael Yapko, 2001) would help immensely with subjects learning new cognitive skills.

On the other hand, it is also important to say that an NLP background is not at all adequate training for sitting with people taking these drugs. A guide needs to have had multiple “journeys” themselves, just as an NLP Practitioner needs to have had experiences of being guided through NLP processes. And being a psychedelic therapist is very different from engaging with a person’s normal mind. It requires a calm, accepting state, it requires anticipation of multiple unusual responses and knowing which responses to “allow” (including, for example strong expressions of emotion) as well as which responses to refuse (including for example sexual advances, or ideas to phone up people from the therapy room and tell them what has just been experienced). Perhaps obviously, such practitioners should always have a medical backup plan, in case an unexpected medical emergency occurs (usually completely irrelevant to the drug). Calling a helicopter from the nearest city in the Amazon rainforest is not an adequate medical backup plan.

Personal Experience in New Zealand

My only personal experiences with psychedelic chemicals were with LSD, in the period from 1972 to 1974. Over this time I probably took about 60 individual doses (usually California Red, or Orange Sunshine, brands produced by Owsley Stanley and the “Brotherhood of Eternal Love” in the USA). These brands were circulated worldwide as tablets or later as a small square of paper saturated with the drug, and each contained 300mgs which could be divided into 3 doses. My first 3 experiences with LSD were profoundly spiritually inspiring, and also altered my approach to life. For example on my first experience I actually laughed for the first time in many years; the experiences pulled me out of a suicidal depression; and the experiences probably enabled me to stop binge drinking alcohol twice a week: I decided to stop drinking at the end of one of these sessions, and continue to hold to that decision 50 years later, with no feeling of ambivalence. By the end of that time period of experimentation, although I felt that I was “more awake” during the sessions than in my daily life, I also strongly felt that I wanted to create this kind of experience without the drug (i.e. by meditation, psychotherapy), and so I stopped taking the drugs.

In my teens I saw many people taking psychedelics as part of an addictive lifestyle. It is almost as if the neurogenesis and synaptic plasticity was just making random connections in their brains. They would also become increasingly paranoid. There’s a reason our brains have a reality testing area. At the time, I and many of my friends believed that “LSD saves”. Then we would take LSD before going to a movie (Yellow Submarine, for example) just for the random visual associations it would create. Then I saw that people in the motorbike gangs were taking LSD and getting into physical fights while under the influence of the drugs. So just taking these chemicals doesn’t solve everything, and is not intrinsically spiritual. The state of openness that they create can be used to experience spiritual awareness, to creatively discover better ways of responding to emotional trauma, or just to have a party. This was why Timothy Leary (who seriously believed that some great spiritual awakening was happening) was so disappointed with Ken Kesey and the “Merry Pranksters” (who distributed LSD at huge parties with rock music, without even telling people what was in the Kool-Aid – Wolfe, 1968). I suspect that the first 3 times I took LSD, it enabled me to break out from the straitjacket of my childhood, and actually experience what meditation offered instead of sitting and talking to myself about meditating. The next 50 times, I almost took it because I didn’t have a better plan for how to create meaning in my life. This, I think, is why the psychedelic mix in Exodus 30:22-25 is only supposed to be taken by the priests; this is why the Eleusinian mysteries were restricted to people trained to interpret them, this is why Native American peoples urge that these drugs or “medicines” be taken only inside a ritual “container”.

Over the last two years (2021-2023), as research on psychedelic use and legalization have spread across the USA, I have begun studying the work of the Psychedelic Support community (https://psychedelic.support/): a group providing training to certified mental health professionals who want to become support people for such therapies. Psychedelic Support also provide free educational material for those without professional backgrounds who may be assisting others in a non-legal arrangement, on the grounds that some education is better than none. Generally, in legal situations, the drugs are administered by a medical prescriber (in many countries only ketamine can be legally prescribed “off label” for this therapy currently, but the laws are changing very fast worldwide) and a certified psychotherapist sits with the person through their experience. Ketamine, taken “sublingually” as prescribed by a medical doctor (i.e. not handled by the “sitter”), costs about US$5 a dose, and experiences generally are complete within a two hour session, unlike with classical psychedelics.

Current day LSD and Psilocybin research is even being done in my own country, Aotearoa / New Zealand. “University of Auckland associate professor Suresh Muthukumaraswamy, a psychologist, had returned to New Zealand from the UK in 2015 and soon noticed a loophole in New Zealand law that could reopen the door to LSD research. It turned out New Zealand was one of the few countries where LSD could be legally administered to patients. “We are allowed to prescribe class A substances,” he told a podcast in September. “It’s not really ever been done, but it’s just sitting in the legislation saying that this is allowed to be done.”” (Gates, 2023) Since there are 9 species of Psilocybe mushrooms found in New Zealand, many of them native only to this land (more than most countries), this is a Treaty of Waitangi issue. The treaty guarantees to Māori people full control over all their taonga – treasures, and legally that is already accepted to include rongoā or native medicines. Rua Bioscience co-founder Manu Caddie says about Psilocybe weraroa mushrooms (Radio New Zealand 2023) “”I pointed that out to them – what right does the Crown or government have to control a taonga if Māori haven’t given government the right to do that?” While the legal status of weraroa remains a grey area, Caddie says, he’s busy building a body of evidence for its therapeutic benefits. “We’re working with clinical researchers, medical researchers on the protocol design for the clinical study and that would [then] go through that mainstream approvals process.” Mycologists, health professionals and rongoā practitioners are also involved in the project.”

It is possible that eventually I would complete the Psychedelic Support one year therapist training, but right now I’m busy completing my Archaeology degree (in which, for my dissertation, I am studying the use of trance and entheogen experiences in the cult of Aphrodite in Cyprus). I think in future, health professionals trained in NLP are likely to explore the use of Psychedelic assisted NLP changework. In the meantime it’s also interesting to note that (from my own archaeological research as well as from my experience as an NLP Trainer) very similar (“entheogenic”) experiences can sometimes be induced by use of hypnotherapy, drumming and “ecstatic dancing”, fasting, breathwork and meditation, though in these cases significant training is required for the experiencer.

   

Finally, above is a brief video report on drug trials for depression treatment with psilocybin. “In our work we’re using primarily psilocybin, which is a psychoactive chemical found in many species of mushrooms, and it can produce profound states of meaning and transcendence; but most every patient I’ve worked with at some point reports the sense of love being a part of the experience; that, the sense that it’s all going to be alright.”

If you found this article interesting you may also enjoy the following articles: “An NLP Based Guide to Supporting People in Altered States” and “Getting There“

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