By Leslie Cohen, Psychedelic Guide, and Ari Kellner, PsyD
True healing is possible. It can look like a growing capacity for peace and self‑acceptance, meeting challenges with more choice and less reactivity, slowly aligning body, mind, and spirit in ways that feel more authentic and alive. Psychedelic medicines offer one path that can help awaken this capacity, inviting movement where things have felt stuck.
In the broader cultural conversation, psychedelic medicine sometimes gets framed as a breakthrough cure, a single powerful experience that can undo years of suffering. For some people, particularly those who approach these medicines as seekers drawn by curiosity or spiritual exploration, this framing can feel partly true. These individuals often come with relatively stable nervous systems and lives already functioning well. The medicine may open doors, deepen awareness, and catalyze perspective shifts that feel expansive. Integration still matters profoundly, but the experience itself is less likely to disrupt the basic structures of their lives.
For others, the pull toward psychedelic therapy arises from long‑standing suffering, often treatment‑resistant depression, anxiety, or trauma rooted in early experiences of not feeling safe, loved, or protected. These individuals arrive seeking relief more than expansion. Many have already tried years of psychotherapy, medication, and alternative approaches. They carry nervous systems shaped by attachment wounds and repeated experiences of not being helped. For them, psychedelic experiences can be profoundly revealing and hold enormous potential, yet they require particular care: more preparation, more relational holding, and more integration support than standard protocols typically provide.
In trauma‑impacted populations, psychedelic experiences can be destabilizing as well as illuminating. These medicines can soften protective defenses and bring long‑buried emotions, memories, and sensations into awareness. With adequate preparation, support, and follow‑through, this opening can become an opportunity for repair and reconnection. Without it, the experience can feel overwhelming, leaving a person raw, disoriented, and exposed.
What Surfaces When Defenses Soften
What can complicate assessment is that early adaptation doesn’t always show up in obvious ways. Someone might describe a childhood that sounds manageable, parents who were emotionally unavailable, a household that was structured but cold, experiences they feel have been worked through in previous therapy. What becomes visible through the work itself, sometimes only when psychedelic experiences temporarily shift protective structures, is that certain adaptations, while serving someone well in many areas of life, can also require significant energy to maintain. Attunement to others might be a genuine strength yet make deep rest difficult. Achievement and competence might create real success while also constraining which emotions feel safe to explore. Managing unpredictability might translate well professionally but make vulnerability feel unfamiliar or risky.
These patterns aren’t pathology. They’re adaptations, often brilliant adaptations to circumstances that required them. The question becomes not whether someone appears stable, but what their nervous system has learned about safety, what defenses have been necessary, and what aspects of experience have been easier to access versus what has been held at a distance. Insight alone does not resolve trauma. It needs relationship, safety, practice, and time to take root.
What Integration Asks For
A recent study examining psilocybin‑assisted therapy for alcohol use disorder found that even when participants showed significant improvements in mood and quality of life, those psychological changes didn’t translate into changes in drinking behavior at four weeks or six months (Mikulić et al., 2025). The researchers concluded this highlights the need for “more resource‑intensive psilocybin‑assisted therapy regimens” including “longer‑term follow‑up psychotherapeutic sessions.” Insight alone, even profound insight accompanied by genuine shifts in mood, doesn’t automatically reorganize patterns that developed over time as responses to particular circumstances.
This is where the quieter, less visible work between and after medicine experiences becomes essential. Psychedelics do not replace therapy, nor do they bypass the slow, relational process of healing a nervous system shaped by early experience. For many people, medicine sessions actually make ongoing support more important. The medicine may offer a new relationship to pain, deeper self‑understanding, a release from feeling stuck in unproductive patterns, but it is the consistent presence of a skilled mental health professional that helps translate these experiences into felt safety, coherence, and lasting change. Healing unfolds through learning to regulate, building trust, and tolerating emotion, a process that is often unpredictable and nonlinear, requiring patience, commitment, and skilled guidance. Research on patient perspectives found that people going through psychedelic therapy identified “the need for a more comprehensive treatment” as a major theme, wanting more preparation sessions, more integration support, and access to sustained psychotherapy with therapists who knew their histories (Kopra et al., 2024). The people doing this work could feel what was missing, could sense that brief protocol models, however well designed, weren’t quite enough to support the depth of change they were reaching for.
The work might involve nervous system recalibration: learning what regulation feels like when it’s not based in control, developing capacity to be with emotional intensity without shutting down or becoming overwhelmed. It might include working with attachment patterns, noticing how connection and distance get negotiated in relationships, exploring what vulnerability actually feels like in the body rather than just as an idea. Sometimes it involves welcoming back parts of experience that were set aside earlier, vulnerability, anger, grief, need, material that asks to be witnessed and metabolized gradually over time. Often there is somatic work, practice inhabiting the body, learning to trust its signals, and developing new patterns through co‑regulation and patient repetition.
What Becomes Possible
When people receive the support their process asks for, when the therapeutic relationship can hold both strengths and vulnerabilities, something shifts beyond symptom reduction. People discover they can rest in ways that previously felt
impossible, that vulnerability doesn’t mean collapse, that difficult emotions can be felt without needing immediate resolution. Someone who spent years being defended finds they can be more present. Achievement and worth begin to separate. The capacity to simply be, without performing, starts to feel more available.
This isn’t about becoming less capable. Often it’s discovering that genuine connection, actual rest, and authentic vulnerability don’t threaten what’s been built. They enrich it. Work becomes more sustainable when it’s not carrying the entire weight of self‑worth. Relationships deepen when there’s room for fuller experience. Capacities for joy, creativity, and spontaneity can emerge, not in ways that destabilize but in ways that make life feel more fully inhabited.
The Longer Arc
When supported well, psychedelic experiences become less isolated events and more part of a gradual return to wholeness. Psychedelic medicine is not a shortcut around the work, but it can be a meaningful companion to it. For those who have suffered, whether obviously or more quietly, its greatest potential emerges when integrated into an ongoing, well‑resourced, relational healing process. Within that context, transformation becomes less about a single breakthrough and more about sustained reconnection, with self, with others, with life.
This asks willingness to be surprised by what emerges, flexibility to meet what’s actually happening, honesty about needing more support than expected, and patience with healing that unfolds through relationship over time. When that support is available, when the therapeutic relationship has room for both strength and vulnerability, something authentic gets to shift. Not dramatic transformation, but something more like coming home to who someone has always been.
References
Hall, H., & Sexton, M. (2024). Psychedelic‑assisted EMDR therapy (PsyA‑EMDR): A memory consolidation approach to psychedelic healing. EMDR Therapy Quarterly.
Kopra, E. I., Lappalainen, J., Schevers, E. J., Muukkonen, I., Karvinen, A., Louhivuori, L. M., Therman, S., & Horacek, J. (2024). Patient perspectives and experiences with psilocybin treatment for treatment‑resistant depression: A qualitative study. Scientific Reports, 14, 2984.
Mikulić, I., Walter, M., Strasser, J., Koenig, S., Ley, L., Baumgartner, M. R., Robbe, O., Denier, N., Bendfeldt, K., Lang, U. E., Baumgartner, D., Schmidt, A., & Borgwardt, S. (2025). Psilocybin‑assisted therapy for relapse prevention in alcohol use disorder: A phase 2 randomized clinical trial. eClinicalMedicine, 79, 102971.
Modlin, N. L., Creed, M., Sarang, M., Maggio, C., & Rucker, J. J. (2024).
Trauma‑informed care in psychedelic therapy research: A qualitative literature review of evidence‑based psychotherapy interventions in PTSD and psychedelic therapy across conditions. Neuropsychiatric Disease and Treatment, 20, 189–215.
