On philosophy, theology and ‘psychedelic integration’

‘You went into psychiatry to try and cast light on the mystery of suffering. Did it?

‘Not really. It’s a theological question, you can’t expect medicine to answer it.’

RD Laing, interviewed near the end of his life

In this article I’m going to look at definitions of ‘psychedelic integration’ and suggest that philosophy and theology inevitably play a role in the evaluation of the truth and wisdom of post-trip beliefs.

The latest refrain in the psychedelic renaissance is the importance of ‘integration’. It’s one of the ways the modern psychedelic movement sets itself apart from the Sixties: Timothy Leary may have emphasized the importance of ‘set and setting’ but we moderns have the holy trinity: set, setting and integration. There are now many people offering integration therapy (not all of them trained therapists), integration ‘circles’ around the world, many courses and books offering advice on integration, and training courses on how to be an ‘integration expert’. In Oregon, the new law on psychedelic therapy mandates at least one session of integration after a psychedelic experience.

But what does ‘psychedelic integration’ actually mean? You’re not alone if you’re wondering. In a recent survey of clinicians who received training in psychedelic-assisted therapies, a majority stated a desire for a better understanding of the concept of integration.

Let’s start with the history of the term. As far as I know, the first person to speak of ‘psychological integration’ was Swiss psychoanalyst Carl Jung in the early 20th century. He suggested psychodynamic therapy can help people integrate material from the unconscious which might emerge during dreams. Jung thought our psyches seek wholeness, and our unconscious helps us to seek wholeness by offering wisdom and insight in dreams. So integration was part of this search for a whole self.

One also finds the idea of psychospiritual integration, in the writings of integral thinkers like Sri Aurobindo, Rene Guenon, Aldous Huxley and Ken Wilber, who all speak of integrating the different levels of the self into personal wholeness and unity with the divine.

The first person to discuss ‘psychedelic integration’, as far as I know, was the transpersonal psychologist Stanislav Grof. In his 1980 book, LSD Psychotherapy, Grof writes of the importance of the post-trip integration of an ‘unconscious gestalt’, using methods like talk therapy, art therapy, group therapy, and so on. He suggests that, if a trip is not ‘integrated’, you haven’t absorbed the wisdom and meaning which your unconscious is offering you, and this requires another descent into the unconscious, either through holotropic breathwork (an ecstatic technique based on rapid breathing) or another psychedelic trip.

One notes that the term ‘psychedelic integration’ first appears in a quasi-theological context. Grof believes there is such a thing as the unconscious, that it has wisdom and intelligence, that it is part of the Self’s search for wholeness, and also part of humanity’s evolution into spiritual awakening and unity with the divine cosmos. Materialist psychiatry has mistakenly labelled spiritual experiences as ‘psychosis’, according to Grof, when in fact they are part of humanity’s spiritual evolution.

You may be sympathetic to this theology, but it is a theology . To be clear, saying that ecstatic experiences are pathological brain delusions is also a theological position. I am suggesting psychology and psychiatry inevitably involve philosophical and theological questions, but psychedelic therapy especially does.

2) What does ‘psychedelic integration’ mean today?

A paper published this week by Bathje et al examined current definitions and models of psychedelic integration and came up with 24 definitions. The authors write:

In the great majority of definitions, we encountered the idea of the participant implementing and incorporating the key insights and awareness gained in the psychedelic experience into their life.

For example, in an important and often-cited paper, Gorman et al (2021) wrote: ‘Psychedelic integration is a process in which the patient integrates the insights of their experience into their life’.

In an attempt to synthesize these different definitions, Bathje et al came up with this:

Integration is a process in which a person revisits and actively engages in making sense of, working through, translating, and processing the content of their psychedelic experience. Through intentional effort and supportive practices, this process allows one to gradually capture and incorporate the emergent lessons and insights into their lives, thus moving toward greater balance and wholeness, both internally (mind, body, and spirit) and externally (lifestyle, social relations, and the natural world).

Another new paper, published by Earleywine et al in April 2022, interviewed 30 integration therapists to explore their definition of what they do. The authors came up with this shared definition of integration:

a bridge from the psychedelic experience to everyday life that helps clients make sense of their experience in a personalized way, leading to lasting behavior change and a sense of wholeness or completion

So there seems to be an emerging consensus that ‘psychedelic integration’ means something like ‘incorporating insights from the psychedelic experience into everyday life / making sense of the experience / achieving a sense of wholeness and completion’.

3) On the importance of philosophy and theology to ‘psychedelic integration’

I want to suggest that philosophy and theology both should and inevitably do play a role in psychedelic integration.

All psychotherapies touch on philosophical and theological questions of meaning, identity, human nature, suffering and the ultimate nature of reality, but (as I said earlier) psychedelic therapy especially does.

Ecstatic experiences, including trips, often contain strong and deeply-felt new beliefs about the self and reality. These may be highly unusual beliefs. And they may be frankly delusional and harmful (see Timmerman, Watts and Dupuis’ March 2022 paper on this).

It’s not enough for integration simply to incorporate new ‘insights’ into everyday life. People need to evaluate these ‘insights’ and ask if they are actually true, wise, and worth acting upon. When you do that sort of evaluation, especially of beliefs about the universe, God etc, you’re doing philosophy and theology.

In October 2020, Chris Letheby brought out a book called Philosophy of Psychedelics, which is the first serious philosophical exploration of psychedelic therapy that I’ve come across (although other philosophers have written on psychedelic experiences more broadly).

Letheby tackles the Comforting Delusion Objection — a psychedelic experience may be beautiful and healing, but is it true? Does it matter if it isn’t?

The CDO is a central concern of psychedelic therapy, going back to Stanley Cohen, pioneering psychedelic psychiatrist of the 1950s, who wrote: ‘Central to the entire LSD controversy is: ‘With how much credence should the chemical experience be accepted?’’ The CDO was also discussed in Nicolas Langlitz’s excellent book, Neuropsychedelia (2012) and I discussed it in my 2018 Aeon piece, ‘Is psychedelic therapy closer to theology than science?’

In fact, the CDO discussion goes all the way back to William James’ 1902 masterpiece, The Varieties of Religious Experience. James says, to paraphrase, we can’t know precisely whether a religious experience is true, but we can look at the consequences and ask if it enhanced a person’s flourishing.

James’ book helped to inspire Alcoholics Anonymous and other 12-step programmes, in which people with addiction problems are taught to ‘surrender to a higher power’ to find salvation from their addiction. Does it matter if the higher power really exists, if the people find salvation from their addiction?

Now, psychedelic therapy probably doesn’t want to see itself as a form of AA. But there is a further problem. People on trips don’t just have experiences of a ‘higher power’ or ‘divine cosmos’. They get all kinds of experiences, beliefs, messages and instructions.

For example, in 2017 I went on a 10-day ayahuasca retreat in the Peruvian Amazon, as discussed in my book Holiday from the Self. During five ayahuasca ceremonies, I often received what felt like lessons from the spirit of Ayahuasca. I received information and new beliefs about my self, my relationship with my dead grandfather, my friends, my role in life. I decided that plant animism was true, and was deeply affirmed in my pre-existent belief that reincarnation was true (indeed I ‘remembered’ a specific past life). In the days after the retreat I then became very dissociated and decided I might be in a dream or the afterlife (thankfully I decided this was not literally true).

Others on the retreat came to all sorts of powerful new beliefs — that it was their destiny to be an artist, or to work with kampo frog healing, that they had been sexually abused as children, that they had visited the Akashic Records, that they had encountered their ancestors, that they had discovered the cosmic meaning of personal tragedies. One participant even decided that his depression was connected to ‘the suffering of the Mongolian people’ (he was from Iowa).

If you read psychedelic reports online, you often come across people who come to strong new beliefs, such as ‘uncovering’ childhood abuse (see Simon Amstell’s autobiography), or receiving instructions to invest in crypto (see this interview with psychedelic investor Christian Angermayer), or even being ordered to construct a pyramid on the Amazon to communicate with aliens.

Clearly, it’s not enough to say ‘psychedelic integration involves integrating the insights from a trip into everyday life’. We have to evaluate the new beliefs and ask — is this belief or instruction true, wise and helpful? Does it stand up to what Letheby calls ‘sober scrutiny’?

4) Philosophical Integration

Now, obviously, not all beliefs are scientifically testable. But we can ask if a belief is helpful and if it supports our flourishing. This is the Jamesian pragmatist position. You can’t know if there really is a spiritual entity called ‘Mama Ayahuasca’ but you can see how your crypto portfolio is doing. Or, less facetiously, you can look at the moral fruits after an ecstatic experience — have you become kinder, wiser, more capable of coping with the ups and downs of life?

Letheby’s position is less agnostic. He argues that naturalism and materialism are definitely true, therefore we should ignore any non-materialist beliefs we may arrive at during trips. But any insights into the self we arrive at may very well be insightful, useful and true.

Psychedelic therapy, Letheby argues, does not depend for its efficacy on people having mystical experiences of divine oneness. It is not an essentially religious form of therapy. Rather, the active element in psychedelic therapy is changes to your narrative of self.

This is an important point, as if psychedelic therapy only works by convincing people of the divine cosmos, it’s unlikely to gain mainstream acceptance in psychiatry and mental health.

He doesn’t use the phrase, but Letheby’s book emphasizes the importance of ‘philosophical integration’. We need to subject ‘apparent epiphanies’ to ‘sober scrutiny’ in the ‘post-session integration period’, he writes.

Integration is important because in the days and weeks after a trip, we sift through the material to decide what is gold (worth keeping) and what is sand (worth discarding).

And, as philosophy PhD student Chiara Caporuscio writes, in a useful response to Letheby, the integration phase is also important because that’s when people (perhaps together with an integration therapist or group) rehearse and habituate new beliefs about their self, their story, their past and their future, and thereby make them ‘real’.

But more than that. As Timmerman, Letheby et al discovered this year, many people say that psychedelic experiences shift their core metaphysical beliefs from materialism to non-materialism. This can lead to ontological shock and existential bewilderment: what do I fundamentally believe about the universe and my self? What is the meaning of my life now and after I die? They may not follow Letheby’s advice and simply ignore any non-physicalist leanings.

This is where friends, guides, books, online videos, integration groups and integration experts come in — they help the person make sense of their experience, sift the new beliefs, and choose what to habituate. In other words, how to choose a new possible self and possible ontological universe.

Letheby suggests psychedelic therapists and retreat centres should ‘maintain clinical equipoise’ on such ultimate questions, rather than imposing their own explanatory framework. I agree, and argued as much in The Art of Losing Control.

But in practice, I doubt whether that always happens when trippers go to integration therapists, 40% of whom told Earleywine et al that they had received ‘shamanic training’, and the remainder of which, I would bet, come from a Jungian / transpersonal psycho-theological framework. That framework will inform how they make sense of trips, and how they make sense of suffering (ie bad trips).

And in practice, people who try psychedelic therapy return to a culture that still sees ecstatic experiences as delusional, so they will be drawn to subcultures which will have their own strong beliefs about what trips ‘mean’.

One hopes that every trip is subjected to at least a bit of ‘sober scrutiny’ before people quit their job and invest their life savings into Solana. But the risk is that the psychedelic renaissance leads to what enlightenment philosophers called ‘enthusiasm’ — fanatical delusions about the self, society, politics, God, gurus, the future of humanity etc.

This is why I argue western culture urgently needs improved ecstatic literacy, so people don’t get liberated from one ‘reality tunnel’ only to get sucked into an even more dogmatic and fanatical reality tunnel (like, say, Qanon).

‘Philosophical Integration’ could help people to practice critical thinking and learn to be open to mystery, ambiguity, uncertainty and epistemic pluralism without any irritable reaching after dogmatic certainty.

The basic principles of Philosophical Integration are training in epistemic flexibility and critical thinking — not jumping to conclusions, testing the probability of beliefs, seeing how our cultural beliefs are historically conditioned and not necessarily always true for everyone, learning how insights and symbols can be interpreted at different levels of meaning, learning it’s OK not to have answers for everything, and so on. None of it requires a degree in philosophy, and integration therapists and groups could learn these basic principles in a session, or indeed from an article.

It might mean that fewer people get sucked down reality tunnels, and instead are supported to stay open-minded, reasonable and psychologically flexible. Of course, it wouldn’t replace integration therapy, it could just be a useful addition to it.

Conclusions:

• There are lots of definitions of psychedelic integration. The most common is: ‘integrating insights from your trip into everyday life
• But this raises the need for philosophy and theology — are your post-trip beliefs actually true and wise?
• Philosophical Integration means subjecting your new beliefs to ‘sober scrutiny’ to evaluate if they’re true and helpful
• This could be done by integration therapists, groups and wider society as part of integrating ecstatic experiences back into western culture in a healthy way.

Articles and books mentioned in this:

Stanislav Grof, LSD Psychotherapy

Chris Letheby, Philosophy of Psychedelics

William James, Varieties of Religious Experience

Hauskeller and Sjostedt-Hughes (editors), Philosophy and Psychedelics: Frameworks for Exceptional Experience

Ali et al, Practical and Ethical Considerations for Psychedelic Therapy and Integration Practices [link here]

Bathje et al, ‘Psychedelic integration: an analysis of the concept and its practice’ Frontiers in Psychology, 4/8/2022 [link here]

Chiara Caporuscio, ‘Belief Now, True Belief Later: The EpistemicAdvantage of Self-Related Insights inPsychedelic-Assisted Therapy’, PhiMiSci, 19/4/2022[link here]

Earleywine et al, ‘Integration in Psychedelic-Assisted Treatments: Recurring Themes in Current Providers’ Definitions, Challenges, and Concerns’, Journal of Humanistic Psychology, 2/4/2022 [link here]

Gorman et al, ‘Psychedelic integration and harm reduction: a transtheoretical framework’, Frontiers of Psychology, 15/3/2021 [link here]

Timmerman et al, ‘Psychedelics alter metaphysical beliefs’, PsyArXiv, 4/6/2021 [link here]

Timmerman, Watts, Dupuis, ‘Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations’, Transcultural Psychiatry, 22/3/2022 [link here]

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