Dr. Lindsay Mackay, MD, CCFP (Addictions Physician & Psychedelic Medicine Researcher) Explains the Basics of Psychedelic Integration

What is psychedelic integration and why is it so important?

The effectiveness of using psychedelics for mental health and addictions is not by direct effect. It is thought to work by changing your perception and with the right setting, intention and integration, can provide insights to help facilitate change. Psychedelic integration refers to the period of time after taking a psychedelic where you try to understand your experience, find meaning and incorporate those insights you gain into your everyday life. It’s essentially a debrief of your thoughts, feelings, memories and realizations you may have had during your experience. Integration is usually best done with the support of a therapist who is experienced with providing psychedelic assisted therapy. An experienced therapist can help you find meaning and understanding in any experiences that you are unsure of how it relates to you and your life. Most importantly, they can help you manage and work through any challenging experiences that may occur or difficult memories that came up for you. 


How long can an integration period usually last? 

In research studies the integration period usually involves 2-3 therapy sessions over a period of 2-3 weeks, although I think people should take as much time as they need to find meaning and to learn from their experience. For some people their experience is difficult to interpret or work though and it may take a long time which is okay. The key is that people take the time they need to integrate. 


In psychedelic-assisted therapy, what are some of the most important integration questions asked to the patient?

The important questions to ask always depend on the individual, the experience and intentions set in advance. If someone had a challenging experience or had past trauma or difficult memories arise, they should seek support from an experienced therapist to help work through them.  Three broad important areas to ask questions about relating to the psychedelic experience are; What emotions, memories and thoughts came up and why? How do these thoughts and emotions relate to intentions set prior to the experience and what insights can be gained? Finally, how can these learnings and insights contribute to personal growth and change moving forward?


Integration after taking plant medicine is the key to a successful therapeutic outcome, but what do you have to do before the psychedelic experience to ensure you will be prepared to integrate afterwards?

Preparation prior to an experience with psychedelics is central to the process.  In research studies, participants usually have multiple preparation sessions with a trained therapist over a number of weeks prior to taking the medicine.  This helps to reduce any fear and anxiety and allows for time to set intentions for the experience. During this time, any questions can be answered, what can be expected during the experience can be discussed (potential changes in perception etc.) and a plan can be made for integration afterwards. Preparing with an experienced therapist in advance creates a therapeutic relationship and comfort level that is important for providing support during the integration period. It can also be beneficial to develop a mindfulness meditation practice and breathing techniques to help guide you through the experience and afterwards. 


What are the best tools to gain emotional and mental clarity about your psychedelic experience?

In our research studies we encourage people to take a break from their usual day-day activities and technology and spend time in nature and connect with loved ones. We encourage writing down your experience and other thoughts in a reflective journal. It is helpful to engage in activities that are healing to the body and mind such as yoga and hiking. It can also be supportive to take part in personally meaningful activities like volunteering. Developing a meditation and/or breathwork practice to support through integration is beneficial. 


How does integration offer clarity on the next steps you should take in your life?

Psychedelics have the potential to shift perspective and allow for what is referred to in the research as “unconstrained cognition”. I think this idea is best explained by Aldous Huxley in his 1954 book The Doors of Perception, “To be shaken out of the ruts of ordinary perception, to be shown for a few timeless hours the outer and inner world, not as they appear to an animal obsessed with survival or to a human being obsessed with words and notions, but as they are”. Just as many people find clarity after a good night's rest, a walk in nature or meditation, psychedelics can offer this same benefit but significantly amplified. Much of this benefit however, is gained during integration where the time is taken to understand how the experience and insights gained can help you grow and make changes (if desired) moving forward. 


Is it good to take time to yourself to be alone after your experience? 

If you have had a difficult experience or are dealing with past trauma, I think it is important to have the support of a therapist and people close to you that you trust. If you are doing well after an experience and feel drawn to want to spend some time alone, then being alone can be a good thing to gain more clarity and reflect. Taking some time and space away from your usual routine and work can allow for deeper introspection and can facilitate finding meaning. Many people find that spending time in nature by themselves after an experience can enhance feelings on connectivity and healing. 


If someone has a super intense psychedelic experience, and didn’t know who to talk about it with, what are other avenues they can use to help their own integration?

The Zendo Project run by the Multidisciplinary Association for Psychedelic Studies (MAPS) provides psychedelic harm reduction and is a great online for integration support after a challenging psychedelic experience. There are also other online options like Tam Integration that host free integration virtual groups over platforms like zoom, including women only groups. IDEAS is a peer lead psychedelic integration group in Vancouver facilitated by three registered therapists with backgrounds in substance use, harm reduction and integration.Try to frame your experience as an opportunity for healing and growth and seek support to guide you through your integration. 


Not all trips are healing, how do you make sense of a trip that doesn’t seem to have any particular meaning to you at first glance? Is it helpful to revisit trips at a later point?

I think this is a really important point. Every encounter with a psychedelic is different and will vary in intensity and significance. It’s okay to just let your experience be as it is. Try to avoid thinking of it as a problem that needs to be solved. It can be helpful to write down your experience shortly after, otherwise just like any experience or dream, the details will fade and it will become harder to find meaning in. Having a written record allows you to revisit and appreciate your thoughts and shifts in perspective at a later date.

Answers by Dr. Lindsay Mackay

Questions by Yawn

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