Do Psychedelics Actually Help in Therapy?

That’s a question nobody answered

Over the last few years, psychedelic-assisted psychotherapy and psychedelic coaching have become fashionable in the mental health industry!

Some people describe it as revolutionary. Others dismiss it as dangerous.

But I think there’s a much more important question to ask.

How is it actually supposed to work?

Not whether people sometimes improve.

Not whether people have profound experiences.

But what is the actual proposed mechanism that turns a temporary altered state into lasting psychological healing?

Watch the video HERE:

Over the last few decades, Neuroscientists have made considerable progress in understanding what happens to the mind during the psychedelic experience.

Brain imaging suggests that psychedelics temporarily reduce the normal organisation of the brain’s Default Mode Network—the network involved in our sense of self

At the same time, communication between normally separate brain networks appears to increase.

 

The result is a brain that becomes temporarily more flexible.

That makes sense But here’s the question nobody answered.

Is making the brain more flexible the same thing as healing it?

 

Traditionally, indigenous cultures used psychedelics to gain power and vision, usually after long training – but there is little evidence that they used them to heal psychological distress.

Throughout history, human beings have entered altered states through ascetic practice: discipline, fasting, prayer, meditation, breathwork, chanting, and natural psychedelics.

Altered states themselves are not unusual.

As someone who spent decades practising Raja Yoga, Buddhist meditation and later Christian contemplative practice, I found that many of the states described during modern psychedelic experiences could also be reached through disciplined ascetic training.

The difference is that ascetic practice delivers repeatable insight, increased stability and voluntary control.

Psychedelics produced a state that is far less predictable. In clinical trials, participants are chosen very carefully.

That doesn’t mean psychedelics are ineffective, It means they may be better understood as creating an opportunity rather than producing the cure itself.

From a psychotherapeutic perspective, lasting recovery isn’t simply about having a profound experience, It’s about building new patterns that become your brain’s habit of mind.

That’s how neuroplasticity can be put into action.

An altered state may open the door.

Walking through it is a different process altogether.

References:

Critical papers on psychedelic-assisted psychotherapy

Colcott, J., et al. (2024) ‘Side-effects of MDMA-assisted psychotherapy: A systematic review and meta-analysis’, Neuropsychopharmacology, 49, pp. 1665–1677.

Jacobs, E., et al. (2026) ‘Psychedelic medicine: mechanisms, evidence, and translation to practice’, BMJ, 392, e081723.

The Lancet Psychiatry (2025) ‘Quality of reporting of psychological interventions in psychedelic treatments: A systematic review’, The Lancet Psychiatry, 12(2), pp. 123–135.

Butler, M., et al. (2022) ‘Potential risks and benefits of psychedelics: A systematic review of the clinical literature’, Annals of Internal Medicine, 175(7), pp. 1032–1044.

 

Mechanisms and supportive papers

Carhart-Harris, R.L. and Friston, K.J. (2019) ‘REBUS and the Anarchic Brain: Toward a unified model of the brain action of psychedelics’, Pharmacological Reviews, 71(3), pp. 316–344.

Carhart-Harris, R.L., et al. (2018) ‘Psychedelics and connectedness’, Psychopharmacology, 235(2), pp. 547–550.

Yaden, D.B. and Griffiths, R.R. (2021) ‘The subjective effects of psychedelics are necessary for their enduring therapeutic effects’, ACS Pharmacology & Translational Science, 4(2), pp. 568–572.

Daws, R.E., et al. (2022) ‘Increased global integration in the brain after psilocybin therapy for depression’, Nature Medicine, 28, pp. 844–851.

 

Pharmacology and safety

Nichols, D.E. (2016) ‘Psychedelics’, Pharmacological Reviews, 68(2), pp. 264–355.

Vollenweider, F.X. and Preller, K.H. (2020) ‘Psychedelic drugs: Neurobiology and potential for treatment of psychiatric disorders’, Nature Reviews Neuroscience, 21, pp. 611–624.

Nutt, D., Erritzoe, D. and Carhart-Harris, R. (2020) ‘Psychedelic psychiatry’s brave new world’, Cell, 181(1), pp. 24–28.

 

Ascetic practice

Newberg, A. and Waldman, M. (2009) How God Changes Your Brain. New York: Ballantine Books.

McClintock, C.H., et al. (2019) ‘Contemplative practices and mental health: A review of neurobiological mechanisms’, Harvard Review of Psychiatry, 27(3), pp. 162–178.

Austin, J.H. (1998) Zen and the Brain. Cambridge, MA: MIT Press.

Austin, J.H. (2006) Zen-Brain Reflections. Cambridge, MA: MIT Press.