Seeing without self: Discovering new meaning with psychedelic-assisted psychotherapy

Abstract

ABSTRACTNew research in psychedelic-assisted psychotherapy merits a reexamination of the neurobiology and phenomenology of psychedelic states. First person accounts of psychedelic-assisted psychotherapy are used to re-conceptualize the ego boundary as a defense mechanism which regulates the significance that objects hold for the self. Therapeutic action is attributed to ego dissolution, which enables subjects to see new significance in things. This process coincides neurobiologically with uncoupling certain midline cortical structures, and psychodynamically, with deactivating defense mechanisms which mitigate the threat of losing the loved object. It also enables the dreamlike imagery, symbols, and metaphor of the primary process, a regression to earlier ways of relating to objects, and feelings of love and connectivity. The process supports Freud's ideas about the oceanic mode of relating to the world existing alongside the narrower, mature ego feeling. The former is better suited for finding meaning in life, while the latter is better suited for survival. The noetic quality of the psychedelic state derives from an unconscious recognition that experiences without character defenses feel more genuine than others, and conform to earlier ways of feeling and thinking. The accessibility of the primary process makes psychedelic-assisted psychotherapy transformative, not just informative. An analogy is drawn to Fonagy's developmental model of mentalization. Absent the defensive, self-critical lens of a prior self-concept, psychedelic-assisted psychotherapy serves as an ideal paradigm for the transformative experience of seeing oneself through the eyes of another, leading to greater self-acceptance. Flight instructions for navigating this royal road to the unconscious are considered.