Entheogen-assisted psychotherapy: Psilocybin and MDMA, a new emerging paradigm in mental health

Currently , spirituality, ceremonies, shamanism, and sacred plants (entheogens) have opened a vast door to exploring the human being, from their mental, behavioral, and spiritual patterns. Today, this seems to be a highly relevant topic to address, since the therapeutic framework of a ceremony or a session with entheogenic plants, versus psychotherapy assisted by them, opens a wide range of possibilities and differences in the development of the process, and therefore in its benefit. To better understand the difference between these contexts, I invite you to read the article "Psychology, Clinical Psychology, and Psychotherapy: Contexts and Differences for the Professional," also published on this website.

Psychotherapy with entheogens began with LSD in the 1960s, and MDMA joined in the 1970s. Both have been criminalized throughout history and across the globe; even today, we can observe a considerable increase in their use and distribution. However, other psychedelic substances, also considered medicinal (Master Plants), such as Ayahuasca, Washuma, Peyote, Bufo Alvarius , and Magic Mushrooms, among others, have existed for centuries and have been used by various indigenous peoples to aid in the healing process and spiritual connection.

After years of working in the field of drug addiction and studying entheogens, I have come to recognize, both personally and professionally, the therapeutic context these substances offer for our mental health. They allow the brain to connect with other dimensions of our physical and material being: our spiritual world. This is something that science still doesn't fully understand, yet we know it exists and is an important part of our reality. In recent decades, entheogen-assisted psychotherapy has re-emerged as one of the most promising fields within mental health. Indeed, numerous neuroscientific and psychological studies address its benefits.

Substances such as PSILOCYBIN, present in the so-called Magic Mushrooms of the genus Psilocybe , and MDMA ( 3,4-methylenedioxymethamphetamine ), better known as Ecstasy in its purest form, have gone from stigma to scientific evidence, showing relevant clinical results in the treatment of treatment-resistant depression . to pharmacotherapy, Post-traumatic stress disorder (PTSD) and severe trauma . Beyond their therapeutic potential, these compounds also open a door to a deep understanding of the self , integrating psychological, neurological, and spiritual dimensions.

Although clinical research focuses on measurable outcomes, many people report experiences of unity, transcendence, or contact with a sacred dimension of existence—what we call spirituality. From the perspective of transpersonal psychology and contemplative traditions, these states are interpreted as the dissolution of the ego and the expansion of consciousness , revealing a profound sense of interconnectedness with life and allowing for the recognition of emotional states of well-being and enjoyment never before experienced.

Far from being isolated mystical phenomena, these experiences often achieve longer-lasting and faster therapeutic effects than conventional psychotherapy. This is due to the reconfiguration of one's sense of identity and purpose, as they open up a new way of seeing the world and oneself—physically, mentally, and spiritually. This leads to a complete reinterpretation of the experience.

The convergence of neuroscience, psychology, and spirituality leads us toward a new paradigm in mental health, medicine, and treatment. Psilocybin and MDMA are not simply drugs, but catalysts for inner openness , facilitators of emotional neuroplasticity that allow us to reconfigure the circuits of pain, fear, defense , and disconnection —what we now know as trauma.

On the other hand, psilocybin , unlike LSD or MDMA , is the substance found in different types of psilocybin mushrooms . Today, it is possible to consume these substances recreationally, ceremonially, and/or for psychotherapeutic purposes. When consumed within a professional and psychotherapeutic context, there is legal protection and support that is not always available in other contexts.

The symptoms that can be experienced may encompass the different bodily senses and also the accessing of memories that were hidden in the subconscious. Interestingly, the use of these substances, both natural and synthetic, is that no scientific evidence of harmful side effects has been found. However, when MDMA and/or LSD are used recreationally, a phenomenon known as the "comedown" or "low" often occurs when the effects of the substance wear off, as the brain returns to its normal state of functioning, and this is often perceived as more discouraged and/or depressed. On the other hand, when used in psychotherapeutic settings, it has been shown that this "comedown" does not occur, since the experience is not only produced by the effects of the substance, but also by the guidance and support of the therapist.

Our nervous system is capable of keeping us in a state of constant alertness, a consequence of severe trauma, as well as maintaining states of calm, tranquility, trust, and love. Thanks to these substances, we teach our brain, and therefore our mind, that it is possible, real, and absolutely safe to lower our guard and experience calm; therefore, the relief and sense of change for those seeking help begins from the very first session.

Neuroscience as a gateway:

At the neuronal level, that is, within our Central Nervous System, psilocybin acts as a partial agonist of the 5-HT2A serotonin receptors , increasing connectivity between brain regions that normally operate independently. This means that our brain is able to experience a greater sense of well-being, thanks to the increased absorption of serotonin, a hormone and neurotransmitter associated with sleep, mood, and digestion.

Neuroimaging studies, particularly those conducted by Imperial College London, have shown that psilocybin use reduces activity in the default mode network (DMN), a neural system associated with self-awareness and rumination. Thus, microdosing psilocybin under psychotherapeutic guidance can lead to a greater sense of well-being and happiness, along with increased openness, cognitive flexibility, and a reorganization of rigid thought patterns that perpetuate depression and/or unhappiness.

On the other hand, MDMA (3,4-methylenedioxymethamphetamine) , also known as Ecstasy, unlike psilocybin, is a substance created in a laboratory through the combination and extraction of different chemicals. Like psilocybin, this substance acts on our serotonin channels, as well as on dopamine channels and, primarily, on the oxytocin and prolactin channels in our brain. This means that, in addition to feeling well-being and calm thanks to serotonin, the brain allows the body to experience pleasure (dopamine), love and intimacy (oxytocin and prolactin).

What's interesting about this substance, unlike psilocybin and other entheogens, is that thanks to its effects on our central nervous system, the activity of the hypothalamic amygdala, the primitive nervous system where fear and our emotions reside, is significantly reduced. This allows us to experience and remember deeply traumatic and painful events without reliving the emotional intensity of fear, sadness, or anger. Therefore, it's the best alternative for repairing patterns of severe trauma and reframing them.

The importance of the clinical and psychotherapeutic context:

When these substances are consumed within a psychotherapeutic setting—that is, under the guidance and support of a mental health professional—there is legal protection that safeguards the physical and psychological well-being of both parties. Professional training in this area provides the necessary knowledge and tools to safely and responsibly guide the client through this process.

Furthermore, having a professional guide will make it easier for the mind to surrender to the experience and for the body to experience sensory and perceptual states that the person may never have experienced before, thus generating a profound and important reset at a mental and physical level.

As mentioned earlier, the use of these substances allows us to access aspects of our psyche that have been buried deep within to preserve the mental stability we need to navigate life. This doesn't necessarily mean that this stability is compatible with our happiness, motivation, interests, and zest for life. Therapy with these substances is extremely helpful in finding this outlet, since pain and/or internal conflict don't only occur on a psychological or mental level; they also manifest on a physical and spiritual level.

The study of trauma today has allowed us to recognize its physical consequences on our bodies, affecting not only mental but also physical health. This is due to the high levels of cortisol that keep our central nervous system in a state of constant alert and cause our minds to rigidify their defense mechanisms . Ultimately, this perpetuates the difficulty in relating to the world and adapting to life's challenges. Therefore, the use of these substances, by working at a neurological level, provides such important tools and content for the development of the psychotherapeutic process and the relief of those seeking help.

The number of sessions and their dosages will be directly related to the patient's history, diagnosis, and therapeutic goals. Those with a psychiatric diagnosis will require a longer therapeutic process than those without. In cases of psychotic traits and/or a psychotic diagnosis, the use of these substances will require prior evaluation and preparation. Furthermore, in my experience, I always recommend a therapeutic process that includes at least three sessions with one of these substances, primarily recommending MDMA due to the effects mentioned earlier. However, some prefer the use of Psilocybe mushrooms, as they are natural.

Finally, thanks to the study and use of these substances in my professional practice, I have been able to clearly observe the difference between each one and how profound the transformation can be for someone exploring a new state of consciousness. It's about resetting our nervous system and giving it the opportunity to experience peace, tranquility, love, trust, surrender, happiness, energy, power, and the vital energy that has long been disconnected from our experience.

It's possible to observe that when there's no underlying therapeutic space, the experience is often what we call psychedelic experiences, which can also be extremely revealing and transformative for the individual; however, it can be more difficult to delve deeper into them, release what's stuck, and integrate what was experienced. And/or in other cases, they can trigger severe psychotic episodes that further deteriorate mental health and/or endanger the life of the person who uses them.

Once the session with the substance has taken place, the most important thing is the subsequent integration of the session, since here it is possible to integrate the experience under the effects of the substance, with the mental configuration that existed previously; and thus internalize what was experienced with greater clarity and inner strength.

This type of psychotherapy reminds us that mental health is not limited to the absence of symptoms , but rather encompasses the capacity to live with presence, compassion, and inner coherence . This emerging field invites us to unite science and spirit, reason and mystery, in a profound dialogue for the liberation of the self and its complete sovereignty—physical, mental, and spiritual.