Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness

by Marc Aixalà, Jose Carlos Bouso (Foreword by)

Overview

Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness is a trailblazing guidebook for anyone interested in psychedelic-assisted therapy and integration.

When psychologist and psychotherapist Marc B. Aixalá began fielding questions from people around the world seeking help integrating their own psychedelic experiences, he couldn’t find a singular source of collected research and support. What began as an attempt to help others became Psychedelic Integration, a work that traces the evolution of psychedelic-assisted therapy and integration research from the 1960s to the present moment, explains therapeutic techniques and outlines a clinician’s real-world observations on the deep work of healing.

Written for practitioners and the generally curious, this book offers 11 metaphors for understanding integration and concisely explains the seven dimensions of integration, which Aixalá sees as part of a process inextricably linked to preparation and the psychedelic session experience. 

Grounded in the idea that integration work serves two main objectives: maximizing the benefits of a psychedelic experience and dealing with adverse effects, Aixalá maintains that understanding why an individual seeks integration support can inform therapeutic techniques. Psychedelic Integration outlines foundational practices like rest and nutrition, spiritual approaches including water rituals and tarot, embodied techniques of dance and singing, and frameworks including Holotropic Breathwork, Gestalt therapy and integration circles. 

The author acknowledges that psychedelic experiences can be difficult and even traumatic, and he confronts that reality with compassion. In this book, Aixalá shares stories and artwork created by some of his patients as they progressed through their own integration journeys. 

Psychedelic Integration is an essential companion for practitioners, their patients, and those seeking integration work not as a solution but as a tool for self and collective discovery. 

Product Details

ISBN-13:	9780907791393
Publisher:	SYNERGETIC PR
Publication date:	08/23/2022
Pages:	410
Product dimensions:	6.00(w) x 9.00(h) x (d)

About the Author

Marc B. Aixalà is a telecommunications engineer, psychologist, psychotherapist and certified Holotropic Breathwork facilitator specializing in supporting people who face challenging experiences with expanded states of consciousness. Since 2013, in collaboration with the International Center for Ethnobotanical Education, Research and Service (ICEERS), Aixalá has offered integration psychotherapy sessions for those seeking support after psychedelic experiences. At ICEERS, Aixalà also works to develop theoretical models of intervention and trains and supervises therapists. 

Aixalà has served as a team leader and trainer in emergency psychological assistance at Boom Festival through the Kosmicare harm reduction program. He also worked on the first-ever medical trial on the use of psilocybin for treatment-resistant depression, a study chronicled in the 2018 documentary, “Magic Medicine.” He continues to work as a therapist in clinical trials researching psychedelic substances.

Aixalà is trained in the therapeutic use of Non-Ordinary States of Consciousness as well as in MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD) by the Multidisciplinary Association for Psychedelic Studies (MAPS). Aixalà works as a psychologist in his private practice in Barcelona, Spain and offers trainings, lectures, and talks related to psychedelic psychotherapy and integration.

José Carlos Bouso is a Clinical Psychologist with a PhD in Pharmacology. He developed his scientific actitives while at the Universidad Autónoma de Madrid, the Instituto de Investigación Biomédica IIB-Sant Pau de Barcelona, and the Instituto Hospital del Mar de Investigaciones Médicas de Barcelona (IMIM). During this time, he developed studies about the therapeutic effects of MDMA (“ecstasy”) and psychopharmacological studies on the acute and neuropsychiatric long-term effects of many substances, both synthetic and plant origin. As the Scientific Director at the International Center for Ethnobotanical Education, Research and Service (ICEERS), José Carlos oversees studies on the potential benefits of psychoactive plants, principally cannabis, ayahuasca, and ibogaine, with the goal of improving public health. He is co-author of numerous scientific papers and several book chapters.

Table of Contents

Foreword xv

Preface xxxiii

Acknowledgments xli

1 The Origins and Evolution of Integration 1

The Origins of Integration: Psycholytic and Psychedelic Therapy 1

Integration in Psycholytic Therapy 4

Integration in Psychedelic Therapy 12

The Psychedelic Renaissance 20

Integration in Modern Psychedelic Research 20

More Frameworks for Integration 26

Integration Circles 26

Holotropic Breathwork 27

Gestalt 28

2 About Integration 31

What is Integration? 31

Preparation and Screening 32

A Broader View of Screening: The Holotropic Attitude 41

Psychedelic Session 43

Integration 45

Distinguishing Integration from Psychotherapy 46

Useful Metaphors to Understand Integration 48

Ontological Integration vs. Therapeutic Integration 60

Purposes of Integration 65

Seven Dimensions of Integration 68

3 Theoretical Foundations of the Clinical Intervention 99

The Need for a Theoretical Paradigm for Integration Work 99

Common Paradigms 102

An Integrative Paradigm 104

Psychedelic Experiences and Psychotherapy: Two Conflicting Logics 109

Paradoxes: Fear of the Symptom 110

Applying a Constructivist Perspective 113

First and Second Order Realities 113

Mechanisms of Change: Type 1 Change and Type 2 Change 118

Solutions and Problems 121

Therapeutic Mechanisms in Psychedelic and Integration Therapy 124

Corrective Emotional Experiences 125

Induction of a Type 2 Change 128

Catharsis, Abreaction, and Elaboration 129

Cognitive and Emotional Reframing 131

4 Maximizing Benefits 135

The Need for Integration After a Positive Experience 135

The Risks of Non-Integration 139

Not Taking Advantage of the Experience 140

Ego Inflation 142

Spiritual Bypass 147

Attachment and Addiction to Experience 150

Immanence and Transcendence 153

Levels of Consciousness 153

The Transcendental and the Immanent Schools 157

Useful Techniques and Tools for Integration 159

Techniques that Attend to Our Physiological and Psychological Needs 162

Techniques for Cognitive and Emotional Processing and Sense-Making 165

Techniques for Processing and Expressing Emotions 175

Social Techniques 178

Techniques to Promote Spiritual Integration 181

Therapeutic Interventions at the Ontological Level 188

5 Cartography and Adverse Effects 191

Adverse Effects Following a Psychedelic Experience 191

Cartography of Adverse Effects: A Review 193

Common Problems in Integration: A New Cartography Based on Clinical Experience 199

Lack of Preparation or Context 200

Unresolved Difficult Experience 205

Emergence of a Previously Unknown Traumatic Memory 211

Abuse by the Facilitator/Shaman and Interpersonal Difficulties 226

Traumatic Dissociative Experiences 230

Seeking out Repeated Experiences without Proper Integration 235

Previously Existing Mental Disorders 241

Hic Sunt Leones: Spiritual Emergency, Psychosis, and Integration 244

6 Intervention in Integration Psychotherapy 281

Context in which the Intervention Format was Developed 281

Evolution of the Therapeutic Method 283

Basic Intervention Principles 286

Regarding Treatment Duration and Number of Sessions 286

Radical Respect for the Client, their Experience, and Worldview 288

The Need for a Clear Definition of the Problem 291

Bottom-Up & Top-Down Approaches: Symptoms and Narratives 294

Do Not Rush, "Go Slow" 298

Using Language: Suggestive Communication, Reframing, and Paradoxical Prescriptions 300

Intervention in Different Scenarios 303

Lack of Preparation or Context 305

Unresolved Difficult Experience 307

Emergence of an Unknown Traumatic Memory 325

Abuse by the Facilitators 335

Very Traumatic Experience with Dissociation 342

Intervention in States of Hyper-Alertness and Re-Experimentation 344

Intervention in Cases of Dissociative Symptoms, Avoidance, and Low Mood 350

Repeated Experiences without Integration 357

Previous Mental Disorder 366

Summary and Conclusions 372

Epilogue 389

Appendix I Medical Form for Screening 393

Appendix II Additional Resources for Integration 397

Notes 401

References 411

Alphabetical Index 432

What People are Saying About This

From the Publisher

“This insightful and pioneering work illuminates the path towards the next steps in this collective journey: making sure that with increased access to powerful therapeutic substances, we also have increased access to compassionate, grounded, and equally powerful integration methods. This book is a unique and much needed contribution to the emerging field of psychedelic-assisted therapy.” — Rick Doblin, PhD, Founder and Executive Director of the Multidisciplinary Association for Psychedelic Studies 

“Psychedelic Integration shows the importance of an integration process for facilitating the transition from the experience to deep, long-term and sustainable change. Marc’s book is an essential read for anyone who is, or aspires to become, a psychedelic therapist or integration provider.” — Ido Cohen, PsyD, Founder of The Integration Circle

“Marc's comprehensive and precise work taps right into the Achilles heel of the Psychedelic Renaissance: with access to psychedelics expected to increase exponentially, so does the need for efficient and replicable frameworks and structures aimed at helping people ground their exciting intra-psychic, interpersonal or transcendental insights into the less glamorous, mundane dimensions of ordinary life. Marc's book is precisely that: a wonderful, elaborate and heart-based blueprint for those of us who are at the service of helping each other make sense and create meaning out of our non-ordinary journeys so we can induce long-lasting positive changes in our lives, our communities, and the world at large” — Adam Aronovich, PhD Cand, Director of Therapy and Integration at Rē Precision Health, and Ayahuasca community committee at Chacruna 

“With a clear and direct language, Marc immerses us in ancient and modern psychedelic research, therapeutic practice, and their spiritual dimensions. Drawing from his clinical experience, Marc opens new horizons in the field of “skillful integration,” and gives us an innovative vision that is anchored both in therapeutic traditions and psychedelic lineages. Without a doubt, this work will be of great help for future psychedelic therapists.” — Chris Timmermann, PhD, at the Centre for Psychedelic Research, Imperial College London

“Marc approaches everyone and everything with humility and compassion, and his insightful book on psychedelic therapy and integration is no different. Marc’s focus on integration is needed more than ever. As psychedelic therapy continues to mainstream, many are left without understanding of the most fundamental part of psychedelic healing: integration. This book emphasizes the social dimensions of integration, and Marc’s therapeutic model demonstrates how community is key to personal growth, and simultaneously social change. An incredibly helpful read for anyone considering psychedelic therapy!” — Natalie Lyla Ginsberg, MSW, Global Impact Officer at the Multidisciplinary Association for Psychedelic Studies

“Marc’s dynamic model for psychedelic integration gathers insights both from Indigenous and spiritual traditions and Western psychology alike. Marc's work can inspire therapists from different schools, facilitators from multiple traditions and anyone interested in psychedelic therapy, regardless of their background.” — Bia Labate, PhD, Executive Director of Chacruna Institute for Psychedelic Plant Medicines

“In his writing, Marc eloquently navigates the tension between rigorous scientific research and real-world clinical practice. His model is an important contribution to psychedelic-assisted therapy, integrating various psychological and therapeutic schools of thought, supported by his clinical experience. The field of psychedelic integration is in need of replicable approaches that can be studied, taught to professionals, and disseminated to patients in need. Marc has provided us with such a model with resounding success.” — Ingmar Gorman, PhD, Co-Founder & Chief Executive Officer, Fluence

“Integration is the watchword of the psychedelic community, the reminder for how to go slow, metabolizing our insights into practical gains, weaving indigenous knowledge with harm reduction precepts, helping transformational medicines work to their fullest potential, with support, compassion, and practice. Marc Aixalà’s book highlights this and more – required reading for anyone interested in what psychedelics have to offer.” — Julie Holland, MD, Author of Good Chemistry: The Science of Connection, From Soul to Psychedelics

“Marc's book is an important contribution in an evolving field of specialism that offers a necessary framework for supporting experiences in expanded states. His book will accompany many practitioners as they support people on their journey into the deep.” — Maria Papaspyrou, co-founder of the Institute of Psychedelic Therapy and Co-Author of Psychedelics & Psychotherapy: The Healing Potential of Expanded States 

“With years of experience and a comprehensive understanding of non-ordinary states of consciousness, Marc offers us a necessary and timely book that anyone interested in healing or growth through psychedelics, breathwork, or contemplative practices could benefit from—truly examining and understanding the process of integration. Without integration, assisted or on one’s own, the full journey isn’t complete.” — Anne Wagner, PhD, Psychologist, and Founder of Remedy and Remedy Institute