Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Pharmacopsychiatry. 2021 Jul;54(4):167-175. doi: 10.1055/a-1312-7297. Epub 2020 Dec 7.
Psychedelics have shown great promise in modern clinical trials for treating various psychiatric conditions. As a transdiagnostic treatment that exerts its effects through subjective experiences that leave enduring effects, it is akin to psychotherapy. To date, there has been insufficient discussion of how psychedelic therapy is similar to and different from conventional psychotherapy. In this article, we review the shared features of effective conventional psychotherapies and situate therapeutic psychedelic effects within those. We then discuss how psychedelic drug effects might amplify conventional psychotherapeutic processes-particularly via effects on meaning and relationship-as well as features that make psychedelic treatment unique. Taking into account shared features of conventional psychotherapies and unique psychedelic drug effects, we create a framework for understanding why psychedelics are likely to be effective with very diverse types of psychotherapies. We also review the formal psychotherapies that have been adjunctively included in modern psychedelic trials and extend the understanding of psychedelics as psychotherapy towards implications for clinical ethics and trial design. We aim to provide some common conceptual vocabulary that can be used to frame therapeutic psychedelic effects beyond the confines of any one specific modality.
致幻剂在治疗各种精神疾病的现代临床试验中显示出巨大的潜力。作为一种通过产生持久影响的主观体验发挥作用的跨诊断治疗方法，它类似于心理疗法。迄今为止，对于迷幻疗法如何与传统心理疗法相似和不同，讨论还不够充分。在本文中，我们回顾了有效传统心理疗法的共同特征，并将治疗性致幻效应置于其中。然后，我们讨论了迷幻药物的作用如何增强传统心理治疗过程——特别是通过对意义和关系的影响——以及使迷幻治疗具有独特性的特征。考虑到传统心理疗法的共同特征和迷幻药物的独特作用，我们创建了一个理解为什么迷幻剂可能对非常不同类型的心理疗法有效的框架。我们还回顾了现代迷幻试验中附加使用的正式心理疗法，并将迷幻剂作为心理疗法的理解扩展到临床伦理和试验设计的影响。我们旨在提供一些通用的概念词汇，可用于在任何特定模式的限制之外构建治疗性致幻效应。
