Do you always need psychotherapy with psychedelic therapy?
When people think of psychedelic therapy, Often, this is automatically linked to psychotherapy. The idea is that psychedelics are only a tool and that real healing only occurs through intensive conversations with a psychotherapist. But is this true? More and more empirical evidence and scientific insights show that this picture is too limited. For a large proportion of people, the power of psychedelic therapy lies primarily in the biochemical effects of the drug itself and the inner processes that ensue as a result.
The biochemical basis of healing
If we look at the effects of psychedelics like psilocybin, LSD en ayahuasca, In the brain and body, we see that powerful processes are activated that directly contribute to recovery and growth. These processes are so fundamental that they occur independently of conversations or interpretations. The biological processes described below occur regardless of the form of support.
BDNF increase
Psychedelics stimulate the production of BDNF (Brain-Derived Neurotrophic Factor), BDNF is a growth factor that is essential for neuroplasticity. BDNF promotes the formation of new neural connections, the strengthening of existing networks, and the repair of damaged neurons. This means that the brain becomes literally more flexible and is better able to let go of old patterns and develop new ways of thinking and feeling. People often experience this as a breakthrough: sudden clarity, emotional space, or the feeling of being able to take control of their lives again.
The mTOR signaling pathway
A second important route that psychedelics activate is MTOR (mammalian target of rapamycin). This signaling pathway plays a key role in cell growth and synaptic strengthening. By activating mTOR, recovery mechanisms are initiated that ensure more resilient brain cells, improved signal transmission, and a better integration of new experiences. In this way, insights that emerge during a psychedelic session gain a solid biological basis in the brain, and the brain functions better overall.
Inflammation reduction
Chronic, low-grade inflammation (neuroinflammation) is increasingly associated with mental health conditions such as depression and anxiety disorders. Psychedelics appear to be powerful anti-inflammatory properties Having. Systematic reviews of preclinical studies show that in the majority of cases psychedelics reduce the production of inflammatory cytokines and stimulate a more balanced immune response. This reduces the “noise” in the brain, literally creating more space for clarity, peace, and emotional stability.
Cell rejuvenation
There is evidence that psychedelics even contribute to rejuvenation at the cellular level. Recent studies show that psilocybin leads to the prolongation of human cell lifespan, preservation of telomere length, and reduction of oxidative stress. This is mainly due to more telomerase enzymes after psilocybin use. In animal studies, this has translated into a higher survival rate and better overall health. This indicates that psychedelics go beyond symptom management: they address underlying biological wear and tear.
The effect without a therapist
What all of the above processes have in common is that they Intrinsic They do not occur as a result of therapeutic conversation, but through the interaction of psychedelics with the brain and body. During a session, the nervous system literally has a new chance: connections are restored, inflammation decreases, and cells are renewed. This allows a person to break through entrenched patterns and experience space for emotional release, insights, or spiritual experiences.
It is precisely this biochemical basis that explains why so many people experience tremendous progress after a psychedelic experience, even without long-term psychotherapy. The substance itself opens the way to change and often a safe and experienced guidance is sufficient to allow these processes to unfold optimally.
Emotional and spiritual experiences
In addition to the biochemical effects, many people experience a deep emotional release, new insights, or a spiritual breakthrough during a session. This can feel like letting go of accumulated emotions, seeing a problem from a new perspective, or experiencing connection with the greater whole. Such experiences arise from the process itself. The psychedelic state opens doors that normally remain closed.
Many participants report that the experience itself has a healing effect. It is not necessarily necessary for a psychotherapist to be present immediately to try to capture the feeling in words, as this can blur the deep, inexplicable meaning. Often, it is sufficient for an experienced facilitator to be present who ensures safety, provides practical support, and knows what to do should resistance or fear arise.
Why does research place such emphasis on psychotherapy?
It is striking that scientific publications often talk about Psychotherapy assisted by psychedelics. The studies are structured in such a way that psychedelic sessions often go hand in hand with many hours of psychotherapy sessions. This is not only due to the nature of the studies, but also to who conducts them. Many studies are conducted by psychotherapists and psychiatrists, who are naturally inclined to combine the effects of psychedelics with their own field of expertise.
This creates the impression that the added value of psychedelics is only truly realized in combination with psychotherapy. In reality, this can be a distortion: most people experience significant progress already through the biochemical and emotional effects of the drugs themselves, without requiring a long-term therapeutic course.
Fortunately, more and more scientific studies are emerging that demonstrate the positive biological effects of psychedelics, but they also raise concerns about the need for more psychotherapy.
Psychedelic-assisted psychotherapy can be valuable
It would be too simplistic to say that psychotherapy should never play a role in combination with psychedelic therapy. There are certainly groups of people who do benefit from a combination of both. These are often people who would benefit from psychotherapy without psychedelics. These are people with a more complex background or people who need specific guidance to properly integrate the insights gained into their daily lives. Based on our experience, we estimate that 10% of the people who benefit the most from psychedelic therapy in a full psychotherapeutic container are those with the following problems.
Severe trauma
People who struggle with deep or multiple traumas, such as complex PTSD, may encounter memories or emotions during a psychedelic session that are overwhelming. Although psychedelics have the ability to break through blockages and provide access to repressed feelings, processing these intense experiences is often a long-term process. In such cases, it may be valuable to work with a psychotherapist in the weeks or months following the session to interpret, organize, and integrate these feelings. This way, the session does not become a detached experience but a building block within a larger healing process.
Complex personality problems
In people with, for example, borderline personality disorder or another personality disorder, a psychedelic experience can sometimes intensify unstable emotions or evoke strong identity questions. Here, a therapist can play an important role in structuring and stabilizing the experiences. Not because the psychedelic experience itself is lacking, but because the complexity of the mental state requires long-term guidance.
The need for guidance in psychedelic sessions
Scientific research therefore shows that psychedelics also independent therapeutic effects You can have it without formal psychotherapy. Studies with ayahuasca for depression, LSD for pain, and psilocybin or LSD for cluster headaches show that the substances themselves can already bring about powerful changes. However, this does not mean that everyone can safely and effectively do it on their own. Sometimes a psychotherapeutic approach is actually the right choice, and sometimes you just need practical support.
There is therefore a spectrum of support needs. On the one hand, there are people who are satisfied with the drug itself; while others actually benefit from an intensive psychotherapeutic framework. There are also people who can never safely use psychedelics.
Between full psychotherapy and being completely alone, there is a practical middle ground that consists of medical screening and checking for contraindications, a safe and supportive set and setting, the presence of an experienced guide or trip supervisor (not necessarily a psychotherapist) who monitors safety and dosage, and integration check-ins afterwards, such as coaching or reflective assignments; this is consistent with most studies that did not use psychotherapy but did have a safe setting and monitoring in place.
The distribution of guidance needs
Based on our practical experience and assessment, the following distribution applies:
25% Of the people, a first psychedelic session can be safe and effective only Do if the dosage is not too high.
60% benefited from Support from a psychedelics expert, This can be done by a trip counselor or trip therapist. Also, several psychologists, coaches, and shamans are sufficient for good support.
10% has a psychotherapeutic framework required due to serious problems.
5% is not suitable for psychedelic sessions due to medical or mental contraindications.
What do you need?
Everyone who chooses to have a psychedelic experience does so with their own background, goals, and desires. There is thus no universal recipe that is the same for everyone. What is important, however, is that you ask yourself: What do I need to make this process safe and valuable? We know that in fact be physically safe important, but that you yourself feeling safe in a psychedelic session, it is at least as essential. Only when both are present can the experience unfold to its fullest.
For some, this means especially the certainty that there is someone nearby who knows what can happen during a session and who is present calmly and supportively. For others, it is just as important that there is also possible psychotherapeutic follow-up, because old traumas or deeply rooted patterns may emerge. And again, others feel sufficiently supported by the session itself and the biochemical processes that then take place.
What Triptherapie can be offered
Fortunately, in the Netherlands we can already offer a lot of support during psychedelic sessions. Triptherapie You can choose from different therapists who can support you further if you are more interested in the therapeutic side of psychedelic therapy. We also have highly experienced trip counselors and coaches who are well-versed in working with deep psychedelic trips. Furthermore, we are increasingly hiring mental health professionals such as psychotherapists and GZ psychologists who are being trained to deal with psychedelics. This way, we can now and in the future help a wide range of support needs with psychedelic therapies. Below you can see which trip counselors and therapists work with us and what the level of experience is.
With a background in chemistry, a passion for philosophy, combined with a wealth of knowledge on psychology and health, his approach is holistic. Marcel is a full-time trip guide. With more than 2,450 guided sessions, Marcel has the most experience on our team.
Ronald is a psychosocial therapist and has completed the following training: Jungian Philosophical Therapist, Psychodrama Therapist, Master Voice Dialogue, Transformation Psychology, Internal Family Systems (IFS), and Mindfulness and Compassion Trainer.
Janneke studies Applied Psychology, is a lifestyle coach, handles initial client contact, draws up lifestyle plans and carries out administrative tasks. She also acts as a confidential adviser. Alongside these duties, she has limited availability for facilitating sessions.
As a psychologist, Reineke combines both conventional and alternative care methods. She uses various techniques, such as talk therapy, yoga, breathing exercises, and EMDR in combination with the therapeutic effects of psychedelics.
With her degree in psychology, Master's in Clinical Psychology, and work experience as a psychologist in addiction care, (specialised) mental healthcare, and rehabilitation, Sascha has a strong foundation as a psychedelic therapist. She has additional training in cognitive behavioural therapy and EMDR.
With her Master’s degree in psychology, her training as an integrative psychotherapist at the AIHP, and her many years of work experience as a psychotherapist, lecturer and supervisor, Elke has a solid foundation as a psychedelic therapist. She has additional training in existential wellbeing (KU Leuven), Zendo SIT (Sitting and Integration Training) and Internal Family Systems (IFS).
Gijs has 20 years of experience in outpatient mental health care. He taught and supervised the MGZ-GGZ program at the HAN (Hogeschool Arnhem Nijmegen). Furthermore, Gijs has developed extensively in mindfulness, conversational therapy, neurofeedback, meditation, compassion training, and ACT.
Supportive therapist
Ylva is a BIG-registered Healthcare Psychologist and supports Triptherapie as a consultant in the fields of psychological care, mental healthcare frameworks, safety and integration. Ylva does not offer psychedelic sessions, but is available for additional support.
Fill out an intake form and discover your path
Because every situation is unique, we always recommend that you first consult a application form To be filled in. Based on this, we can together determine which course suits you best: an individual or group session, with or without additional therapeutic support. This way, we ensure that you not only feel safe, but also safe within yourself, and that you receive the guidance that suits your personal process.