The field of psychedelic therapy is experiencing a resurgence, along with psychedelics themselves, which are once again being viewed with the respect (and slowly, the legality) that they deserve. The Woodstock generation may have seen this coming, but it is truly astounding how many therapeutic modalities are now utilizing MDMA, ketamine, and psilocybin to help people heal from all kinds of trauma and depression. The new kid on the block in this field is Psychedelic Somatic Interactional Psychotherapy (PSIP).
PSIP uses either cannabis or ketamine, but since cannabis is more widely accessible, it has become the preferred medicine of this modality. PSIP essentially aims to expel trauma from the body, through the body. The crux of the model is that the body knows what to do, and is actually more capable than the cognitive mind at dealing with trauma and traumatic memories.
According to Saj Razvi, Director of Education at the Psychedelic Somatic Institute, and the creator of the PSIP model, “Psychedelics give profound access to feelings. The body can help feel your way through anxiety, depression, and PTSD. Mental health symptoms are created by the body and psychedelics work through the body for healing.”
Razvi’s background training and clinical experience is as a psychotherapist. He was also a researcher with the Multidisciplinary Association for Psychedelic Studies, in their trials investigating MDMA for post-traumatic stress disorder. Razvi’s focus for both personal and professional reasons has been on PTSD and complex, early childhood, developmental trauma.
“The impetus for PSIP came from the fact that I had done a great deal of traditional talk therapy and it never made much of a difference to my own symptoms and inability to have stable, lasting relationships,” Razvi continues. “What made sense experientially to me was that trauma was a bottom up experience, and entering into the somatic, autonomic process for resolution was entering into a non-ordinary state of consciousness all by itself…meaning non-rational, non-linear, and frequently non-verbal processing that may or may not lead to insight. Until 2016, the model did not have psychedelics in it, but our clients in private practice who used cannabis would tell us, ‘It’s weird that when I go home and use cannabis, my body moves into the same processing that I have here.’ This was hugely surprising to us because up until then, I had thought the therapeutic magic was in MDMA, which was not the case.”
Razvi discovered that any medicine that takes ordinary consciousness offline and grants access to primary consciousness also gives access to a very fluid and responsive nervous system. The state of primary consciousness is akin to a more animal-like consciousness and is optimal for discharging trauma from the body. Primary consciousness rules all of the systems that are autonomic, meaning involuntary or unconscious, whereas secondary consciousness deals more with narratives, thought formation, the ability to reason, and understanding time.
Primary consciousness rules all of the systems that are autonomic, meaning involuntary or unconscious, whereas secondary consciousness deals more with narratives, thought formation, the ability to reason, and understanding time.
“Primary consciousness is non-linear; it’s harder to differentiate time in this state,” says Rahel Stein, LMSW and trainee in a recent PSIP cohort. “It goes according to the body’s autonomic response. Cannabis helps someone enter into this state more easily, as do other psychedelics, but cannabis works well because it keeps the sessions to around two hours and the onset of the medicine is more immediate.”
The PSIP model’s ability to heal trauma that has been stored in the body relates, in part, Stein says, to Memory Consolidation Theory, which states that stable, long-term memories are subject to change when two factors are present. The first involves the reactivation of the target memory through recollection, which pulls the synapses back into a more fluid and less stable state. “So first, it’s recalling or reliving the memory, which is what we’re doing in a sense,” explains Stein. “The second factor is prediction error—when the brain engages in reformulation of a long-term and consolidated memory because the memory is recalled in the same way, but the response doesn’t match what’s expected.”
For instance, if someone has abandonment in their past and now suffers from avoiding relationships, when that memory is evoked as part of a re-exposure therapy session, along with repeated corrective relational experiences between client and therapist, healing is possible. “That’s the interactional component of PSIP. In essence, we can change the emotional charge around certain long-term memories,” adds Stein.
PSIP advocates state the greater the threat, the greater the body’s nervous system response. So greater trauma will embed itself more deeply in the body. If someone wishes to resolve their symptoms, as opposed to just managing them, PSIP is not necessarily an easy, happy journey, but may be an effective one.
“My sense is that all psychedelics have some things in common such as disrupting the default mode network through their affinity with the serotonin 5-HT2A receptor, and they all have their unique qualities,” Razvi says. “Cannabis and MDMA are both very body-oriented medicines that bring sensation, and interoceptive experience into focus. Cannabis does not dull pain or fear, it does not operate by re-establishing a sense of connection to self, other, and world—the way MDMA does. It operates by disrupting executive function and the suppressive, censorship capacity of our mind.”
“Cannabis does not dull pain or fear, it does not operate by re-establishing a sense of connection to self, other, and world—the way MDMA does. It operates by disrupting executive function and the suppressive, censorship capacity of our mind.”
Thus, Razvi says, the unique gift of cannabis is that it will disable dissociative numbing; causing clients to become associated with what they previously had to numb out. Razvi has found that working with events that would ordinarily cause people to feel blank or heavy, when cannabis is used, clients feel the reactivity that leads them to having to dissociate in the first place, and then they can make a different choice. Cannabis moves people into what’s called sympathetic active defensive responses, he says, much more quickly than even MDMA (which itself does this far more quickly than other psychedelics).
Razvi is now heavily involved in training cohorts of practitioners who will be offering the PSIP model. “Initially, we would let in life coaches and people who were working with medicine for years but didn’t know trauma or have a background in therapy, such as human developmental or how to work with transference,” Razvi adds. The vast majority of psychedelic therapy is being conducted underground by warm, well-meaning people who are not clinically trained, so we thought we could do some good by adding therapeutic skill sets. While I think this is a good idea generally speaking, we quickly learned that this was not a good idea with our particular modality.”
When you combine a psychedelic with the body process, and focus is on clearing dissociation, the client’s system very frequently takes that opportunity to dive more deeply into their history, programming, and trauma, says Razvi. Razvi and his team have found that what emerges requires a strong container, which needs to be held by someone who has experience working with people in a mental health context, and who is already trained in the basics of psychotherapy.
The feedback that Razvi and his team have been receiving is that the number one factor in people learning this work is whether they experience it from the inside out. They found that a cognitive understanding of it is helpful, but the part of the brain that does that simply can’t grasp the non-rational, non-narrative-based, visceral process that takes place in the body in primary consciousness. Because of this, they are developing a highly-individualized, experiential apprentice model for the new PSIP training cohorts, which will consist of groups of three at a time. “We will likely turn out fewer graduates this way and it will be more expensive than the current group training model, but the depth at which this student will master the material will be significant,” Razvi says.
Razvi has witnessed some exquisite, breakthrough moments during his time with the PSIP model, and in the training he offers. Once, he supported a client whose muscles were engaged, breathing was fast and shallow, and body was autonomically enacting the defensive responses of a past event. At one point during this, her right hand moved from a protective outward push gesture and turned inward on herself, pressing her head and face into the couch. All of the fast breathing, sounds, and reactivity came to an abrupt stop. “What is your hand doing?” he asked. “It is making me be still,” she replied.