Abstract
ABSTRACT Psychopathy has long been considered untreatable. The purpose of this paper is to provide a report from the field on therapeutic gains made in the case of a psychopathic personality and to outline what appear to be the most effective aspects of the treatment, as well as to help integrate current psychedelic research and theory with psychoanalytic theory. These therapeutic factors include: tactful acknowledgment and confrontation of the patient’s behavior and the disclosure to him of the diagnosis of psychopathy; a focus on his resentment toward existence itself; the cultivation of a relationship between the patient and his future self through the engagement of his imagination using mental time travel; the patient’s psilocybin-induced mystical experience which occurred several months into treatment; and finally, the impact of the analyst’s spiritual work that shaped the countertransference. The patient made dramatic improvements subsequent to his mystical experience, and was able to make use of the psychoanalytic work done during the “pre-mystical experience” period of his treatment. This case is an addition to the accumulating evidence for the efficacy of psychedelic-induced mystical experiences, and provides guidance on the provision of psychoanalytic treatment prior to treatment with psychedelic medication.
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