The Role and Ethics of Touch and Non-touch in Psychedelic-Assisted Therapy.

MDMA-assisted therapy (MDMA-AT) is an emerging treatment modality, with recent phase 3 trials indicating its potential for regulatory approval. Central to this therapy is the role of touch, yet its empirical evaluation in MDMA-AT, and psychotherapy in general, remains limited. The use of touch in combination with MDMA raises concerns about power imbalances and ethical boundaries. This article reviews existing literature on therapeutic touch and introduces the Touch Outcomes Measurement Inventory (TOMI). The TOMI is developed to assess client perceptions of touch in MDMA-AT, addressing a critical gap in the current research landscape. The main outcome of this research is the creation of TOMI, a tool aimed at evaluating the impact of touch on clients in MDMA-AT. The review highlights the lack of empirical evidence in this area and the necessity for such a measure. With the increasing likelihood of MDMA-AT becoming a widely used therapy, understanding how therapeutic touch affects clients is imperative. This article emphasizes the need for evidence-based and ethical guidelines for the use of touch in MDMA-AT. The development of TOMI is a step towards achieving this, providing a means for researchers and program evaluators to assess the implications of touch in MDMA-AT and psychedelic-assisted therapy more generally.

SPECIAL ISSUE: Do Biofeedback, Neurofeedback, and Neuromeditation Have a Role in Psychedelic-Assisted Therapies?

Altered states of consciousness (ASCs), induced e.g. during psychedelic-assisted therapy, show potential to treat prevalent mental health disorders like depression and posttraumatic stress disorder. However, access to such treatments is restricted by legal, medical, and financial barriers. Circular breathwork may present a non-pharmacological and hence more accessible alternative to engage similar therapeutic processes. Scientific studies of breathwork are only just emerging and its physiological and psychological mechanisms are largely unknown. Here, we track physiological and experiential dynamics throughout a breathwork session, comparing two forms of breathwork: Holotropic and Conscious-Connected breathwork. We show that a reduction in end-tidal CO2 pressure due to deliberate hyperventilation is significantly correlated to ASC onset (r = -0.46; p < 0.001). Based on standard questionnaires (MEQ-30 and 11-DASC), the ASCs evoked by breathwork resembled those produced by psychedelics across several experiential domains such as ego dissolution, and their depth predicted psychological and physiological follow-on effects, including improved well-being and reduced depressive symptoms. Further analysis showed that different breathwork approaches produced highly similar outcomes. Our findings identify physiological boundary conditions for ASCs to arise in a non-pharmacological context, shedding light on the functional mechanisms of breathwork as well as its potential as a psychotherapeutic tool.

The current psychedelic renaissance intersects with Christian practices in two key ways. First, as psychedelic-assisted therapy (PAT) becomes more common, Christians undergoing therapeutic medical treatment may seek outside support for integrating into their religious lives mystical experiences that occur during psychedelic sessions. Second, with increasing legal access to psychedelics, more Christians may explore their spiritual potential outside of a medical context, either individually with spiritual guides or collectively in organized retreats. Many will have mystical encounters related to the Divine. Whether the experience involves the overwhelming presence or absence of the Divine, these Christians, too, will seek integration support. This essay argues that the Bible can serve as a rich source for such integration, because it contains significant material about mystical experiences marked by altered states of consciousness. First, I summarize the importance of the psychedelic renaissance, especially the scientific studies being conducted, as it relates to Christian practices of spiritual formation. Second, I explore new work being conducted by biblical scholars regarding embodied religious experiences with the Divine (and others), including mystical experiences. Third, I consider the Apostle Paul’s embodied mystical experience, with special attention to 2 Corinthians 12:1–10, as one example of biblical material that might intersect with or inform psychedelic mystical encounters that contemporary Christians might experience (whether in a medical therapeutic or non-medical spiritual formation setting). Finally, I indicate directions for further research and discussion.

Background and aimsPsychedelic and MDMA-assisted psychotherapy are at the forefront of new treatment models for mental illnesses such as PTSD and depression, as well as improving well-being. Mindfulness meditation and loving-kindness meditation have also gained research traction, showing promise for enhancing emotional regulation and psychological well-being. This paper explores the therapeutic convergence of these modalities, highlighting their neurobiological, psychological, and phenomenological overlap, and suggesting potential bidirectional synergy as a foundation for psychedelic or MDMA-assisted therapy.MethodsA narrative and theoretical review of the current literature was conducted, examining the neurobiological, psychological, and phenomenological effects of MDMA, psychedelics, and meditation. Studies focusing on their potential synergy and mechanisms of action were prioritized and used as a backing for a theoretical framework.ResultsPsychedelics may improve psychological flexibility, prosocial behaviors, empathy, and neuroplasticity. Meditation research suggests similar benefits, including enhanced decentering capacity, emotional regulation, and well-being. Both modalities influence overlapping neural circuitry, particularly the amygdala, hippocampus, and default mode network. Integrating meditation with MDMA or psychedelic-assisted therapy may stabilize insights gained during altered states of consciousness, promote sustained therapeutic benefits, and minimize distress during therapy.ConclusionsThe convergence of meditation and psychedelics or MDMA-assisted therapy is a novel and promising approach for enhancing mental health treatments. Future research should investigate structured protocols combining these modalities, focusing on optimizing “set and setting” and long-term integration practices.

Physical Contact Promotes the Development of Emotional Contagion Between Mice

The growing interest in psychedelic-assisted therapy (PAT) for treating psychiatric disorders such as treatment-resistant depression, PTSD, and anxiety has led to an increasing demand for specialized training. In Switzerland, MDMA, psilocybin, and LSD are applied in the framework of limited medical use as exceptional treatment options since 2014. The Swiss Medical Association for Psychedelic Therapy (SÄPT) has been a key player in addressing the need for education, offering a comprehensive, three-year training program for physicians and psychologists. This curriculum integrates theoretical knowledge with hands-on experience, emphasizing the therapeutic relationship, ethical considerations, and the management of altered states of consciousness induced by psychedelics. This article gives an overview of the structure and framework of the training and addresses topics covered by the program through theoretical teaching and retreats focusing on practical learning. However, the demand for these programs far exceeds supply. This gap is expected to widen as psychedelics potentially become regulated prescription medications. In response, several organizations have expanded their educational offerings, including further education trainings, workshops, conferences, and symposia. Overall, there is a need for more comprehensive and accessible training programs to meet the growing demand. The evolving landscape of psychedelic research, regulatory changes, and diverse patient populations require flexible and adaptive training models. As the field progresses, it is essential to establish certification standards and ensure the continued quality of training programs to ensure the safe and effective use of PAT in clinical trials and practice.

This perspective on experiential training delves into the potential benefits and counterarguments related to integrating firsthand experience of psychedelic-assisted therapy (PaT) to enhance the competency of trainees. Experiential training serves a dual purpose: promoting therapists' mental wellness and refining their skills in facilitating healing in nonordinary states of consciousness. With a rising demand for PaT amid a growing mental health crisis, therapists are increasingly seeking PaT training, including experiential training from underground sources. Educators actively strive to establish formal PaT competencies and training standards, recognizing the need to consider both perspectives in this discourse. The emergence of differing opinions on the therapeutic value of firsthand exposure to PaT and concerns about potential bias underscores the necessity for further research to substantiate claims on both sides. Whether or not consensus is achieved, the persistent demand for experiential training remains. Offering this form of training in regulated settings has the potential to reduce reliance on illicit sources for this sought-after form of training, ensuring a more controlled and ethical approach.

As most philosophers recognize, the body’s central role in touch differs from the role it plays in the other sense modalities. Any account of touch must then explain the pivotal nature of the body’s involvement in touch. Unlike most accounts of touch, this paper argues that the body’s centrality in touch is not phenomenological or experiential: the body is not felt in any special way in tactile experiences. Building on Aristotle’s account in De Anima, I argue that the body is central in touch because it is the medium of tactile perception. Touch depends on the body as vision and audition depend on air or any medium that can transmit light or sound waves. I show that it is precisely because the body must be transparent in order to transmit tangible properties that it cannot be perceived or experienced in tactile perception. Although this account conflicts with the widespread view that tactile perception is mediated by bodily sensations, I maintain that it explains how the structure and constitution of the human body contribute directly to what we feel in tactile experiences and that it provides a better understanding of the relation between the sense of touch and our bodily feelings.

ABSTRACTThis study explores how physical contact is used in parent‐infant dyads from 9 to 12 months of age, focusing on the role of touch and the use of objects in supporting language development. Thirty‐five monolingual Spanish‐speaking dyads were observed longitudinally in a free play situation. We analyzed physical contact, considering who initiated the contact, its function, the use of objects and the coordination with speech. Results showed that adults initiated physical contact more frequently than infants, particularly at 9 months, while infant‐initiated touch tended to be longer in duration and predominantly affective in nature. In contrast, adult‐initiated touch was often functional and, when involving objects, frequently accompanied by verbal input. Notably, these object‐mediated tactile cues were used to convey social meanings and were synchronized with speech, suggesting a scaffolding function for lexical development. As infants’ comprehension increased, the frequency of these cues decreased, indicating a developmental shift toward more distal communication strategies. These findings highlight the importance of tactile interaction in multimodal communication and in the establishment of joint attention frames, especially during the period of transition to first words, underscoring the need for a broader understanding of language as a multimodal phenomenon.

Background:Physical touch is often included as a supportive or therapeutic tool in psychedelic-assisted therapy (PAT), involving instrumental forms of physical contact, supportive touch and somatic techniques. However, participants under the influence of psychedelics have reduced capacity to provide consent, are more suggestible and may experience and interpret therapeutic touch in ways they did not expect prior to taking the drug. Yet little research has been conducted on the considerations and approaches to therapeutic touch in clinical trials of PAT.Objectives:This study explored the experiences and perspectives of PAT researchers on the use and consent to therapeutic touch in clinical trials of PAT.Design:A qualitative study using semi-structured interviews.Methods:Sixteen PAT researchers involved in clinical trials of PAT were interviewed. Reflexive thematic analysis was used to analyse the data. The reporting of this study conforms to the Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ).Results:Three themes were uncovered through reflexive thematic analysis: (1) flexible frameworks, (2) therapeutic alliance and (3) boundary management. Researchers discussed consent challenges across the broad spectrum of physical contact existing in PAT protocols at the time. Researchers indicated that consent to therapeutic touch should be established prior to the dosing sessions and continually managed throughout the course of treatment. Flexibility in consent protocols enabled researchers to interpret and approach consent through the development of a strong therapeutic alliance; however, flexibility could also lead to challenges in boundary management. Researchers emphasised the need for greater ethical guidance in instances where trial participants change their established preferences during dosing sessions, and limits on expanding consent after drug administration.Conclusion:Clear guidelines for obtaining consent, managing changing preferences and training on the management of boundary transgressions were viewed as essential for ethical research and practice of PAT.

An overarching goal of this book is to design new methods of haptic feedback informed by the properties of the human haptic system. As the previous chapters illustrate, the soft mechanics of the skin play an important role in touch sensing. In contrast, existing tactile feedback devices frequently rely on rigid actuated elements. This chapter presents a very different approach, in the form of a soft and conformable tactile display that can provide distributed dynamic haptic feedback to large areas of the skin. This display combines electrostatic attraction with hydraulic amplification provided by a liquid dielectric encapsulated in a compliant pouch. Voltage supplied to six pairs of opposed hydrogel electrodes generates dynamic variations in pressure on the encapsulated liquid. Mechanical amplification by the liquid enables the device to render tactile feedback with substantial displacements (>2 mm) and forces (>0.8 N) via a thin (<3.5 mm) compliant surface with a large active area (75 cm\(^2\)). This chapter presents the design of the device from the perspective of its performance, reliability, and safety. It describes a fabrication method that enables the device to be easily reproduced by others. The user study shows that the device can produce unique haptic experiences, such as fluid-mediated haptic effects of motion across the skin.

In this descriptive study, the potentially communicative functions of non-vocal behaviors produced by two species of dolphin, Atlantic spotted (Stenella frontalis) and Indo-Pacific bottlenose (Tursiops aduncus), were examined in the context of three focal events: depart (one or more dolphins depart company of others), join (two or more dolphins come together), and contact (dolphin makes contact with another using a part of its body). These particular events were chosen because they involve interactions between dolphins and so provide an opportunity to examine possible precursors or antecedents to specific social behaviors. Non-vocal behaviors occurring before and/or after these focal events were documented and analyzed in an attempt to determine if certain behaviors were consistently associated with the departure (depart) or arrival (join) of another dolphin, or with physical contact (contact) between dolphins in each species. Touch behaviors were found to be significantly related to each of the three focal events so were examined in further detail. Overall, in comparing species, the Indo-Pacific bottlenose and Atlantic spotted dolphins in this descriptive study exhibited more similarities than differences in their use of touch behaviors in potentially communicative situations across five broad behavioral contexts. However, a difference in the use of touch behaviors produced before departing or after joining a conspecific was noted. Specifically, the spotted dolphins were more likely to use contact after joining than before departing, whereas the bottlenose dolphins were equally likely to use contact in both situations.

The integration of psychedelic substances into modern Western therapeutic practice has sparked a critical examination of many topics including: efficacy of psychedelics to treat mental health diagnoses without psychotherapeutic intervention, what models of therapy to use, and ethical implications related to altered states of consciousness. Of utmost concern are issues of power dynamics leading to incidents of sexual abuse. These issues underscore the importance of understanding therapeutic dynamics within the context of psychedelic-assisted therapy. This paper aims to explore these intersections, addressing sexual abuse issues in Western psychedelic-assisted therapy while elucidating pathways towards ethical practice and regulatory frameworks.

There is an urgent need to develop better treatments for mental health conditions that affect one in every eight people in the world. To combat this concern, psychedelic drugs have been combined with psychotherapy and studied in clinical trials in the United States and Europe. Psychedelics are hallucinogenic drugs that alter brain activity and facilitate altered states of consciousness. The proposed benefits of psychedelic-assisted therapy (PAT) include relatively short treatment times and stronger effects compared to other treatments. Although results of trials using MDMA for trauma or psilocybin for depression are promising, PAT is controversial because many questions about its safety and effectiveness are unanswered. This is evident in the recent ruling by the US Food and Drug Administration against the approval of MDMA therapy for post-traumatic stress disorder and the retraction of several papers about MDMA trials owing to unethical conduct by study therapists and data integrity, among other concerns. This field is at a crossroads, and the research community must address several obstacles to transition from exploratory trials to established, evidence-based treatments while avoiding pitfalls that can hinder advancement.