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Therapie mit psychoaktiven Substanzen - Praxis und Kritik der Psychotherapie mit LSD, Psilocybin und MDMA
... Daher werden in der psycholytischen und psychedelischen Therapie bevorzugt Substanzen wie MDMA und LSD verwendet, bei denen erfahrungsgemäß (je nach Dosis) ein beobachtender Ich-Anteil erhalten bleibt oder zumindest in Ritualen, die den "Trip" unterbrechen sollen, reaktiviert wird (Jungaberle et al. 2008 (Scharfetter 1991, S. 32). ...
... angemessen umzugehen erfordert von professioneller Seite eine außerordentlich differenzierte Kompetenz, die z.B. durch Selbsterfahrung mit psychoaktiven Substanzen mit Intervision und/oder Supervision gefördert werden kann. Im Buch unserer Heidelberger Arbeitsgruppe über "Therapie mit psychoaktiven Substanzen"(Jungaberle et al. 2008) werden viele dieser Techniken ausführlich geschildert.Der niederländische Psychiater Jan Bastiaans, Professor für psychosomatische Medizin an der staatlichen Universität in Leiden, veranschaulichte dieses Prinzip am Beispiel der Psychotherapie ehemaliger Insassen von Nazi-Konzentrationslagern, die er unter LSD-Einfluss mit Begleitung des Psychotherapeuten die posttraumatischen grauenhaften Albträume noch einmal durchleben ließ und unter der Wirkung von LSD die nachträglich aufgebauten aber nicht hilfreichen Abwehrmechanismen aufzuweichen versuchte. Voraussetzung hierfür war, dass die gewählte Dosis von LSD einerseits ein tiefes Eintauchen in die traumatischen Erinnerungen förderte, aber gleichzeitig die Fähigkeit des Patienten, während des LSD-unterstützten Traumerlebens mit dem Therapeuten sprachlich in Kontakt zu bleiben, trainiert wurde ...
... Characteristic episodes of deep introspection where intense emotions are met with exceptional openness are commonly reported, and indeed often described in ways suggestive of underlying psychotherapeutic processes, by psychedelic therapy patients and others who have used psychedelics with therapeutic intent (Breeksema et al., 2020). That these episodes involve corrective experiences is in line with the view that the therapeutic potential of psychedelic states arises from the same general change mechanisms that are shared by all effective psychotherapies (Jungaberle et al., 2008;Nayak and Johnson, 2020). Following a distinction introduced by Grawe (1997) based on broad empirical psychotherapy research, corrective experiences of mastery/coping can strengthen the belief of being able to accommodate situations, feelings, thoughts, memories, etc. that were previously experienced as too painful or frightening to cope with. ...
Background:
Many benefits and some harms associated with psychedelic use could be attributable to these drugs’ acceptance/avoidance-promoting effects and corresponding changes in psychological flexibility. Underlying psychological mechanisms are insufficiently understood.
Aim:
The purpose of this study was the validation of a psychological model of acceptance/avoidance-promoting psychedelic experiences, which included the development of a theory-based self-report instrument: the Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ). Its two main scales, acceptance-related experience (ACE) and avoidance-related experience (AVE), represent the theorized model’s core constructs. We aimed to test the model’s central assumptions of complementarity (ACE and AVE may occur alternatingly but not simultaneously, and are therefore empirically independent), intertwinedness (subaspects within ACE and AVE are mutually contingent and therefore highly inter-correlated), context-dependence (ACE and AVE depend on context factors) and interaction (longer-term outcomes depend on the interplay between ACE and AVE).
Method:
A bilingual retrospective online survey including 997 English- and 836 German-speaking participants. Each participant reported on one psychedelic experience occasioned by lysergic acid diethylamide (LSD), psilocybin, mescaline, or ayahuasca.
Results:
Whereas ACE and AVE were found to be relatively independent aspects of participants’ reported psychedelic experiences (complementarity), their subaspects were mostly distinguishable but strongly correlated among each other (intertwinedness). Therapeutic, escapist, and hedonic use motives were differentially associated with ACE and AVE (context-dependence), which were in turn associated with retrospective changes in psychological flexibility following participants’ reported experiences. The positive association between ACE and increased psychological flexibility was significantly moderated by AVE (interaction).
Conclusion:
These results provide an initial validation of the APEQ and its underlying theoretical model, suggesting the two can help clarify the psychological mechanisms of psychedelic-induced benefits and harms. Both should be further investigated in prospective-longitudinal and clinical studies.
... When under investigation as potential treatments, MDMA and psychedelics are used in settings where a psychotherapeutic intervention is the basic element of treatment. Thus, the use of these substances is not considered as beneficial in itself, but rather as an adjunct ingredient within a psychotherapeutic process (MDMA-or LSD-assisted psychotherapy) (Jungaberle 2008;Mithoefer, Grob, and Brewerton 2016). Following this concept, the interactions between the set (the individual), the substance (the pharmacological properties of the chosen agent), and the setting (the therapeutic framework and relationship) are considered to be of crucial importance. ...
Differences in mental health (MH) of users of distinct psychoactive substances have been shown. Both substance use (SU) and MH in users are influenced by stressful life events. This study compared MH parameters in distinct groups of substance users and evaluated the impact of stress factors on these outcomes. Data stem from the longitudinal Swiss Cohort Study on Substance Use Risk Factors (C-SURF) involving 4,475 young adult men. Distinct groups were created for the past 12 months’ use of psychedelics, MDMA, psychostimulants, and cannabis. MH measurements (depressive symptoms, overall MH, perceived stress, life satisfaction) were used as outcome variables, while indicators of past family functioning and stressful life events served as covariates. The MH of psychedelics users was not significantly different from the no-drug-use group, whereas poorer MH was found in the other SU groups. Observed effects were influenced by the tested stress factors. The absence of association between use of psychedelics and worsening of MH deserves further investigation in male and female samples. Stressful life experiences must be considered when assessing the MH of users of illicit substances. These findings suggest that some men practice SU as self-medication to cope with life adversity.
... Az integrációt legkönnyebben pszichoterápiával és erre megfelelôen képzett szakember igénybevételével lehet segíteni, a jelenlegi jogi tiltás mellett utólag, az élmény hagyományos pszichoterápiás eszközökkel történô feldolgozásával (32). Ezt azonban nehezíti, hogy rendkívül kicsi azoknak a szakembereknek a száma, akik otthonosan mozognak az ilyen élmények világában. ...
Ayahuasca, which originates from the Amazon Basin, is a psychoactive brew of two components. Its active agents are betacarboline and tryptamine derivatives. Near the spring of the Amazon River this brew is still a central component of many healing and tribal rituals. During the past few decades, the substance has become known among both laymen and scientistss and nowadays its use is spreading all over in Europe. In the present paper we give an overview of the scientific research and describe ayahuasca's main features, the main questions raised over its use, the risk factors and potential benefits. A growing number of scientific results seem to support the psychotherapeutic potential of ayahuasca, which has a strong serotonergic effect, whereas studies on its effect on the immune system also raise the possibility that certain ethno-medical observations can be scientifically proved.
Background
Despite the growth of psychedelic research, psychedelic-assisted group psychotherapy (PAGP) has received little attention in comparison to individual psychedelic-assisted psychotherapy models.
Methods
In this article, we aim to discuss the therapeutic potential of PAGP, as well as outline existing models and the challenges of this approach. Using Irvin Yalom’s 11 therapeutic factors of group therapy as a basic framework, we analyse current literature from clinical studies and neurobiological research relative to the topic of PAGP.
Results
We argue that combining psychedelic substances and group psychotherapy may prove beneficial for increasing group connectedness and interpersonal learning, potentially enhancing prosocial behaviour with direct opportunities to practice newly acquired knowledge about previously maladaptive behavioural patterns. Challenges regarding this approach include a more rigid therapy structure and potential loss of openness from patients, which may be ameliorated by adequate therapeutic training.
Conclusion
We hope for this article to support clinical research on PAGP by presenting a therapeutic framework and outlining its mechanisms and challenges.
In dieser theoretischen Arbeit soll versucht werden, das Rätsel der subjektiven Zeit in gewöhnlichen und außergewöhnlichen Bewusstseinszuständen (ABZ) mit der Selbstwahrnehmung zu erklären. Die Erfahrung der Veränderlichkeit des Zeitverlaufs ist in ABZ noch extremer ausgeprägt. Dort kommt es zu einer gemeinsamen Modulation der Zeit und des Selbst. Die veränderten Zeit- und Selbsterfahrungen von Patienten mit psychischen Erkrankungen der Depression, Angst und Substanzabhängigkeit – eine Überrepräsentation der Zeit und des Selbst – sollen in einen Kontext
möglicher komplementärer Interventionen wieMeditation, Floatation-REST (Restricted Environmental Stimulation Technique) und Psychedelikaanwendungen gesetzt werden; diese basieren auf den skizzierten psychologischen und neuronalen Grundlagen der Zeit- und Selbstwahrnehmung.
Der Beitrag thematisiert den Freizeitgebrauch von LSD und Psilocybin-Pilzen um die Jahrtausendwende. Entsprechende Konsummuster sind bislang – und vor allem im deutschsprachigen Raum – kaum Gegenstand sozialwissenschaftlicher Forschung gewesen. Es wird eine explorative, qualitative Studie vorgestellt, in deren Kontext 32 Personen mittels narrativer Interviews zu ihrem Konsumverhalten befragt wurden. Als Voraussetzung zur Teilnahme galt dabei eine Lebenszeitprävalenz von mindestens fünf Erfahrungen mit LSD bzw. halluzinogenen Pilzen, von denen die letzte maximal zwölf Monate zurückliegen sollte. Als ein zentraler Befund der vorliegenden Studie kann angeführt werden, dass das Wie des Psychedelika-Konsums (also das Gebrauchsverhalten und favorisierte Settings) durch das Warum (also die Motivationen der Berauschung) determiniert wird. Dabei sind die Motivationen beim Konsumeinstieg von denen zur Fortsetzung des Gebrauchs zu unterscheiden.
Psychotherapy with psychoactive substances is a topic with a long and controversial history. Due to cultural and legal reasons, as well as theoretical and practical concerns, the possible therapeutic potential of some psychoactive substances has been disregarded by the medical community for the last decades. Today academic interest in the topic is on the rise: advances in psychopharmacology and increasing evidence of the safety and efficacy of some substances with psychedelic properties open up new perspectives for the stagnant treatment of mental disorders. This thesis explores the topic by the example of MDMA in the treatment of PTSD. A thorough examination of the history, effects and risk profile of MDMA is conducted. Based on existing evidence, the apparent potential of the substance is merged with contemporary models of PTSD and its treatment. The cornerstones of an existing treatment manual and outcomes from completed therapy trials are presented as well. Psychotherapy with the assistance of psychoactive substances faces some specific methodical, theoretical and practical issues which are critically discussed. The thesis concludes that MDMA-assisted therapy for PTSD is a viable option that deserves further investigation.
ist ein Mensch spirituell oder nicht? Sondern: welchen Einfluss hat diese Spiritualität auf seine Konflikte und Symptome, seine Leidensfähigkeit oder weiter gefasst auf seine psychosomatische und soziale Gesundheit, seinen Kohärenzsinn, seine neuropsychologische Konsistenz
- Die Behandlungsrelevante Frage Lautet Nie
Die behandlungsrelevante Frage lautet nie: ist ein Mensch spirituell oder nicht?
Sondern: welchen Einfluss hat diese Spiritualität auf seine Konflikte und Symptome,
seine Leidensfähigkeit oder weiter gefasst auf seine psychosomatische und soziale
Gesundheit, seinen Kohärenzsinn, seine neuropsychologische Konsistenz-und wie
sonst die Zielbereiche von Psychotherapie konzeptualisiert werden mögen.