What is Psychedelic Integration Therapy, Anyway?

In popular culture, psychedelics are famous for the warpy visuals, perplexing shenanigans, and mind-bending experiences they can inspire. For some, these alternate states of consciousness can be deeply meaningful—and sometimes challenging. So, how do you make sense of your journey after the fact? 

The days and weeks following psychedelics can hold their own significance: You may notice an internal shift. You might feel different, or see the world and others in new ways. Or, it’s possible you don’t notice much change at all, and carry on as you were.

Whether you notice it or not, the period following a psychedelic experience offers a window of opportunity to examine and interpret what emerged, possibly gleaning insight that supports you in the long term. This process is now widely referred to as psychedelic integration, and it has naturally found a home in therapy practices as more mental health professionals seek training in psychedelics.

Psychedelic integration is a topic of boundless complexity. This exploration is meant to be an introductory look at its fundamentals, and offer a glimpse into how psychedelic integration therapy looks in practice.

What is Psychedelic Integration?

Psychedelic integration, broadly speaking, is the process of interacting with material that emerged in altered states of consciousness. 

Dr. Ido Cohen—a clinical psychologist, therapist, and co-founder of the Integration Circle—defines psychedelic integration as both a way of being and an active reflective process. “On a macro scale, it is an attitude towards life—one of curiosity, reflection, exploration, and introspection,” he told DoubleBlind. “It is a process of reflecting and connecting with the feelings, sensations, thoughts, images, and spiritual experiences you’ve had, and starting to see how they relate to you in the present.”

The nebulous process of psychedelic integration can look different between individuals and cultures. For some indigenous cultures with longstanding plant-medicine traditions and a worldview that naturally interprets the interconnection of life, integration may not be a formal separate process. As psychologist Marc Aixala writes for the Chacruna Institute, “In shamanic cultures and in the traditional context of ayahuasca churches, in places such as in Rio Branco or Mapiá, but not so much in Western urban churches, the concept of integration does not exist because the experiences that members of the community have are already part of the shared social worldview.”

Read: Here’s What’s Missing From Conversations About Psychedelic Integration

Some scholars argue that, in Western cultures, the influence of dualism may underlie the emergence of formal integration processes. Dualism refers to a worldview that tends to see things in discrete binaries. Western societies may tend to think of the psychedelic experience—and what comes before and after—as distinct, rather than innate and intertwined with everyday reality. Hence why many psychedelic-assisted therapy programs, like the Multidisciplinary Association of Psychedelic Studies (MAPS), include specific integration protocols.

Integrating a psychedelic experience can be a solo endeavor, often involving journaling, art, music, meditation, or any other practice that helps you connect with the experience afterward. But there’s also often a natural inclination to connect with people, hence the draw to communal spaces of integration, some of which are referred to as integration circles.

“The main benefit from group integration work is that you learn a lot about your own experience from others sharing about theirs,” said Tony Moss, an artist and producer who has worked with plant medicines for over 25 years. “Oftentimes, it’s from others’ experience that pieces and memories of your experience are triggered and fall into place.”

“It is a process of reflecting and connecting with the feelings, sensations, thoughts, images, and spiritual experiences you’ve had, and starting to see how they relate to you in the present.”

Why Integrate?

Psychedelic experiences can offer profound psychological shifts long after the effects wear off—shifts that are now being studied through the lens of neuroscience. Researchers are trying to understand how psychedelic experiences present biological opportunities for brain connections to reorganize and change.

Sometimes these shifts feel inspiring or enlightening. They can also be disturbing, raw, or confusing, leaving you feeling disconnected from yourself, others, or reality. Either presentation—and any in between—may be better understood in the context of your life through supportive processing.

As the authors of a 2022 paper on integration describe, Western worldviews often lack “adequate cultural references to comprehend complex, abstract, and symbolic content that often emerges with psychedelics, necessitating therapeutic support throughout the process, including during the integration stage.”

The MAPS protocol for MDMA-assisted psychotherapy includes a lengthy explainer of psychedelic integration and its importance in achieving broader therapeutic goals. The manual reads, “The challenges during the integration stage are to facilitate continued emotional processing and address any difficulties that arise as the experience from the session continues to unfold, and at the same time to help the participant apply the benefits gained in the MDMA- assisted sessions to daily life.

Integration may not be a relevant concept for all cultures, and not everyone uses psychedelics with the intent to process material or incite personal change. But for those who do have this intent, or are struggling in the aftermath of a psychedelic experience, psychedelic integration therapy may offer a supportive path forward.

Read: How to Become A Psychedelic Therapist

Read: Sexual Abuse in Psychedelic Therapy: Important Steps Being Taken to Support Survivors

Psychedelic Integration Therapy

Psychedelic integration therapy typically refers to the “container” provided by a professional with specialized training to support individuals as they approach the thoughts, feelings, memories, and other material that emerged during a psychedelic experience.

“Integration therapists, as I know, are individuals with degrees in psychology, psychiatry, or social work who go through studies, training, and acquire clinical experience,” Cohen said. “These individuals may be trained in trauma treatment, treating various psychological issues such as addiction, depression, anxiety, relational issues, and the like.”

In the U.S. especially, the term “therapist” is a guarded title applied to those who have completed training and licensure that prepares them for the sensitive psychological material clients present, as well as the complicated ethical dilemmas frequently encountered in the intimate space of counseling. Therapists claiming specialization in any particular area, including psychedelic integration, should have completed targeted training that specifically prepares them to work competently with particular issues or interventions.

What Should You Expect? 

Psychedelic integration therapy may look different depending on two things: the therapist’s approach and the material you choose to bring to the session from your psychedelic experience. A therapist’s approach to psychedelic integration will inevitably be informed not only by their professional training, but also their culture and identity. 

“Integration is already blending with many therapeutic approaches, which allows for a wide diversity of approaches to working with a psychedelic experience,” Cohen said, adding that integration may occur using Western psychology, Eastern philosophy, somatic body-focused approaches, or through indigenous wisdom and cosmologies. “There is still no uniform theory of integration.”

How psychedelic integration plays out in therapy will also be determined by what a client brings to the counseling space. Personal or spiritual development, trauma processing, existential exploration, managing symptoms following a psychedelic experience—your reasons and goals for counseling will ultimately define how the therapy unfolds.

The process of integration therapy can be gentle, sometimes leading to a deepened appreciation for relationships, nature, creativity, or self. It can also be a stormy, turbulent experience that reaches into the depths of memory and trauma in a challenging confrontation.

“Psychedelics and entheogens connect us to our unconscious and body, where traumatic events and trauma-induced beliefs and patterns are stored, then come to consciousness in the psychedelic experience,” Cohen says. “This can be profoundly healing, but can also be psychologically and emotionally challenging.”

Uprooting unconscious and traumatic material can evoke anxiety, depersonalization, derealization, panic attacks, and other disruptions. This is why it is particularly important to identify professionals who are equipped to meet the acuity of your needs, especially when trauma is involved.

What’s the Difference Between Psychedelic Guides and Integration Therapists?

Generally speaking, the word “therapist” refers to a person who has received a specific type of mental health training, often influenced by scientific and medical practice, although training and licensing requirements for psychotherapists differ around the world. Regulations on therapist licensure generally aim to enforce standards of experience, training, and ethical conduct. In other words, a therapist can have their license revoked or suspended when harm is done to a client, so there’s a system of accountability.

The terms “guide” or “coach” are often used to refer to people who work with psychedelics or integration outside of the formal therapy context. This role and related initiation rites inevitably vary across cultures, such as those with long traditions of spiritual community guidance.

“The role of the plant medicine ‘guide’ is to safely guide you through the initial plant medicine experience,” Moss said, adding that therapists, guides, and integration coaches carry their own unique skill sets. A therapist trained in psychedelic-assisted therapy could theoretically occupy all three roles. “But they seldom are, and don’t need to be,” Moss added.

“Some [guides] may have experience and education either facilitating psychedelic experiences or supporting in preparation and integration,” Cohen said. “These individuals are not necessarily therapists or have medical or psychological education, though some do. They may go through some training in ‘psychedelic therapy’ training or coaching, a shamanic initiation, or some certificate program such as Hakomi or somatic experiencing.”

Read: Why Everyone Cares So Much About Colorado’s Psilocybin Bill

Unlike therapists, there is no universally equivalent regulatory body that defines or oversees guides or their associated standards of conduct—although recent legalization initiatives have made the first attempts to create a system of standardization. Outside of the context of legalization, some collectives, communities, and religious organizations may establish their own best practices and systems of accountability, without oversight from a larger regulatory body. 

Still, the aftermath of a psychedelic experience can be both formative and vulnerable. So, it’s crucial that therapists, guides, and integration coaches alike are adequately vetted.

Psychedelic Integration Resources

If this idea of integration piques your curiosity, or if you’re in need of integration support, this list of integration resources can help get your research started.

• MAPS’ Psychedelic Integration List: Browse integration professionals by location.
• Psychedelic.Support: Search a network of licensed providers, community groups, and clinical trials (also offers this guide to starting a peer-led integration circle).
• Fireside Project: A peer-support service that can assist with integration.
• Zendo Project: An in-person volunteer program offering integration services at select festivals and events.

Note that DoubleBlind does not endorse any particular practitioner or group listed—directories are provided for informational research purposes only.