Fischman Lawrence
Department of Psychiatry, Tufts University School of Medicine, Maine Medical Center, Maine Track Program, Boston, MA, United States.
Front Psychol. 2025 Jan 15;16:1469559. doi: 10.3389/fpsyg.2025.1469559. eCollection 2025.
The MAPS (Multidisciplinary Association for Psychedelic Studies) sponsored MDMA-assisted therapy protocol has had greater success in treating trauma in preliminary clinical trials than any prior psychotherapeutic, pharmacologic, or combined approach. It is predicated on a synergy between drug action and the participant's inner healing intelligence. The latter is described mainly by analogy with the body's capacity to heal itself, and the treatment is characterized as a means of activating or accessing this capacity. How is this rather mysterious-sounding process so effective? I suggest that the therapist's full commitment to, and trust in this treatment framework, along with the medication's subjective enhancement of trust, encourages individuals who have suffered trauma and have difficulty trusting others to engage the therapist as a kind of witness. I discuss parallels between the therapeutic attitude implied in the inner healing intelligence model and the way a therapist can act as witness in the resolution of dissociative enactment in relational psychoanalysis. Trusting the healing capacity of one's inner healing intelligence is dynamically equivalent to trusting the relational process. This makes trusting one's inner healing intelligence a process of feeling witnessed. In both settings, the therapist's willingness to acknowledge her technical limitations or failings, coupled with a conviction that the participant/patient's primary need in processing trauma is to feel witnessed, facilitates the integration of dissociated experience.
多学科迷幻研究协会（MAPS）发起的摇头丸辅助治疗方案在初步临床试验中治疗创伤方面比以往任何心理治疗、药物治疗或综合治疗方法都更成功。它基于药物作用与参与者内在治愈智慧之间的协同作用。后者主要通过与身体自我修复能力的类比来描述，并且该治疗被视为激活或运用这种能力的一种方式。这个听起来颇为神秘的过程为何如此有效呢？我认为，治疗师对这一治疗框架的全心投入与信任，再加上药物对信任的主观增强作用，会促使那些遭受过创伤且难以信任他人的个体将治疗师视为一种见证者。我探讨了内在治愈智慧模型所蕴含的治疗态度与治疗师在关系精神分析中解决解离性表现时作为见证者的行为方式之间的相似之处。信任自己内在治愈智慧的治愈能力在动态上等同于信任关系过程。这使得信任自己内在的治愈智慧成为一种被见证的感受过程。在这两种情境中，治疗师愿意承认自己的技术局限或失误，同时坚信参与者/患者在处理创伤时的首要需求是被见证，这有助于解离经验的整合。
