Psychedelic-Assisted Psychotherapy for treatment-resistant eating disorders.

With EpiphanyClinics Dr A. Ocana, MD, ADHD and Addictions Specialist

and Barbara Heiman, MA, LMFT, Psychotherapist

I recently found a good article summing up the main concepts that apply to the management of eating disorders with psychedelic assisted psychotherapy.

Reid Robison, MD: In eating disorders, you need to have some self-awareness inserted into the mix. People don't choose eating disorders. 

No one wakes up and says, 'I'd like to have anorexia.'  They are not choices, they're biologically influenced illnesses. And so we need interventions that aren't band aid approaches to treating symptoms, like numbing out anxiety. We need to get underneath the hood of these complex, multifaceted illnesses. And if there is an underlying anxiety disorder, we need to go for that root cause. 

If there's trauma contributing, we need to do some trauma healing. And these are (can be) serious illnesses that require intensive treatment. 

But on the positive side (thankfully), even deeply ingrained patterns and behaviors (they're learned) that can be unlearned. It just takes time. And with psychedelic medicines being 'therapy accelerators,' if you will, these become important tools in helping the individual see with a new perspective, and also creating more cognitive flexibility around one's relationship with food and body- and perhaps the patterns, behaviors, and rules that they  imposed on themselves around food and eating. So from an eating disorder standpoint, as I mentioned, they're not choices- they're well-intended. 

The reason someone develops the disorder and keeps it are very different. So there may be a conscious decision to decide to purge, or restrict, or over-exercise the first time or 2, but then they become a subconscious pattern that takes on a life of its own. 

Psychedelic medicines are more and more understood to relax the grasp that these patterns have on us by creating a, what you could call, a window of neuroplasticity- where things can be both seen more clearly and shaped. And this applies to ketamine, as well as classic psychedelics like psilocybin. 

Mind you, there's more. There's much more research that needs to be done to understand fully how psychedelics may help and the best ways of pairing them with therapy. But we are already seeing in early research that psychedelics can come in with this different approach. With that new perspective and that flexibility can help someone get unstuck, who might have been in a stuck place for years.