About fifteen years ago, whenever someone invited me to talk about the healing value of meditation, I would start—somewhat mischievously—by saying, “If you’re still wondering whether meditation is healing, you haven’t been paying attention. Its benefits have been proven beyond reasonable doubt.” Even with today’s ever-growing body of research pointing strongly in that direction, when it comes to psychedelics, we’re not there yet.
Psychedelics are being explored for a wide array of purposes: fibromyalgia, dementia, brain injury, Parkinson’s, ALS, Alzheimer’s, and chronic pain. More specifically in mental health (which will be our focus): anxiety, PTSD, depression, anorexia, alcohol and substance use, eating disorders, OCD, bipolar II, smoking, and existential distress. Researchers clearly suspect that these substances hold significant potential across many conditions1.
Not “what”, But “How”.
Although “What can psychedelics heal?” is an important question, there’s another one that’s not asked as often: How do they heal?
Of course, a neuroscientist could answer that psychedelics temporarily loosen rigid brain networks and boost neural plasticity by binding to serotonin receptors—creating a window to reconfigure entrenched pathways into new, more adaptive patterns.
However, I am not a neuroscientist, and I am not sure how many of my readers are, so let’s take a different route. If we look beyond the brain into current research and what I’ve observed with clients, growing evidence shows that psychedelics and psychotherapy heal through the same core mechanisms—the difference being intensity, not kind. Integrated wisely, each strengthens and completes the other. Let’s unpack it:
Beyond neuropsychological explanations, there are several theories that try to explain the mechanisms involved in psychedelic healing:
- Set & setting: Mindset, expectations, the quality of the relationship, and the surrounding environment shape and enhance the healing potential of the experience.
- Network reset: Psychedelics disrupt entrenched neural patterns—and the fixed beliefs they sustain—promoting neural flexibility and the restructuring of pathways.
- Receptivity: Heightened openness and reduced defensiveness allow for deep exploration, insight, and the learning and retention of new ways of being.
- Cognitive updating: By widening perspective, old organizing principles are revised into more adaptive meanings, greater agency, and healthier narratives.
- Emotional release/catharsis: By relaxing the brain’s control systems within a safe relational container, traumatic memories, repressed emotions, and somatic tension trapped in the body can surface, to be completed or reconfigured in an improved emotional context.
- Mystical insight and self-transcendence: The sense of self expands beyond the wounded ego, merging or identifying with a larger Self or Cosmos, offering a broader perspective and reducing existential fear.
While painted with broad strokes, these ideas form the backbone of how many researchers now understand psychedelic healing.
So, there you have it. That’s how they heal. Now we know… or do we?
Let’s explore it a bit longer. These theories are elegant and plausible, but much of the research is still young. Serious scientific study has only recently resumed, and since the only way to know what’s happening inside someone’s mind is to ask them, researchers usually rely on questionnaires and interviews to access participants’ inner worlds.
Let’s try another approach. Since we already know that psychotherapy works (trust me on that, okay?2), let’s explore how it brings about change and see if we can find some parallels.
How Therapy Works
Even before Freud, this question has been heatedly debated3. Although we don’t have a definitive answer, decades of research have produced a set of “common factors” that play a part in healing4:
- A reasonable expectation that therapy, through specific methods, will actually work.
- A meaningful, safe relationship where the client feels seen, accepted, and understood.
- The facing, correction, and integration of painful or unresolved emotional experiences, often—but not necessarily- linked to childhood.
- Insight, meaning-making, and the creation of new personal narratives.
- Updating of rigid beliefs and practicing new behaviors and ways of thinking.
- Development of accountability, agency, and self-efficacy.
- Desidentification beyond limiting self-stories and an expansion of the sense of self.
Although the language differs, it’s easy to spot the parallels. Both emphasize the importance of the relationship (part of the setting), the value of positive expectations (part of the mindset), and the opportunity to face and correct painful past experiences, often through emotional release. Both emphasize insights, updated beliefs, the chance to create new narratives, try new behaviors, expand perspectives, and reclaim agency.
It seems that what helps people change in therapy may be the very same processes at work in psychedelic healing. This would also explain the popular meme that psychedelics are like three (or five, or even ten) years of therapy in one night. But if that were true, why would anyone choose psychotherapy at all?
Old Habits Die Hard
Good question. First, psychedelics are still illegal in most of the world. But even setting legality aside, this isn’t really about choosing one over the other—it’s about understanding their respective strengths and limitations.
The “three years in one night” meme captures only part of the truth. There’s more to it. Over decades, psychotherapists have learned that change is hard. We cling to old—even painful—ways of being. Old beliefs, like habits, die hard.
Psychedelics are intriguing because they seem to produce immediate results. I often hear a version of the meme. This may stem from heightened receptivity, intense emotional release, and powerful, luminous insights—often mystical in nature—that appear to open a broad window of neural plasticity. Psychotherapy, on the other hand, relies on slow, repeated emotional nudges and controlled exposure to unresolved issues. Growth is painstakingly slow and cannot be rushed. It takes time to develop a strong relationship where a person feels safe enough to challenge old patterns and belief systems. Insights must be practiced repeatedly before they become part of who we are.
Therapy, through weekly sessions and the continual revisiting of core themes, consolidates and deepens this process. This slow phase is often frowned upon in a society where “faster” is assumed to mean “better”.
It is misleading to say that psychedelics work faster than psychotherapy. Yes, the openness, catharsis, and insights feel dramatic when compared with regular therapy, but those transient and extraordinary psychedelic states need to be converted into enduring psychological traits. In other words, experience shows that to ensure the jewels gathered in psychedelic sessions aren’t lost, we must develop the necessary structures to help them take root in our lives. This is why, like other experts in the field, I emphasize the importance of preparation and integration as absolutely essential parts of any healing psychedelic process.
Complementary, Not Better
So, how do psychedelics heal? As I explain to my clients, this is not an either/or dilemma but a both/and integration. The change mechanisms of psychotherapy and psychedelics alike foster openness, enhance plasticity, reduce reactivity, facilitate insight, help complete unfinished emotional business, generate new narratives, strengthen agency and responsibility, and expand—or decenter—the sense of self.
Both rely on the same healing principles: psychedelics amplify; psychotherapy stabilizes. Together, they create a more complete path to transformation.
Beyond Psychology
Before ending, it’s worth remembering that it is in the modern West that psychedelics are seen almost exclusively as therapeutic tools, as “psychedelic-assisted therapy”. In contrast, shamanic traditions, which have worked with sacred plants for millennia, the concept of healing includes and transcends the psychological. There, psychedelics are seen as wise teachers in the broadest sense of the word. In my work, I try to honor both approaches.
The West could learn much from these ancient traditions—if only we approach them with respect and humility, but that is a topic for another article…
- You’ve probably guessed from the title that this article is ambitious, thus a bit longer than others. Please note that every claim is backed by scientific research, but to avoid making it even longer, I’ve left out the references. If you’re curious, just reach out — I’ll be glad to oblige. ↩︎
- Many may question this assertion; however, there is solid evidence that the average therapy client ends up doing better than about 75% of comparable people who receive no treatment. See https://pubmed.ncbi.nlm.nih.gov/921048/ ↩︎
- Making the unconscious conscious, reworking old relationship patterns, strengthening the ego, through a corrective emotional experience, catharsis, replacing unhealthy beliefs, taking responsibility, bringing closure to unfinished emotional business, self-transcending egoic patterns, etc. All of these have been advanced as reasons why therapy heals. ↩︎
- Of course, beyond these, there are many other alleged factors, but these are generally agreed upon. ↩︎