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H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
Psychedelic-assisted EMDR therapy (PsyA-EMDR): A
memory consolidation approach to psychedelic
healing
As access to psychedelic therapy is rolled out, there is a need to develop
comprehensive preparation and integration protocols, particularly to support
individuals with an impaired capacity to self-regulate. Moreover, there is an immediate
need to develop comprehensive, trauma-informed harm reduction and risk
minimalisation models as illegal, underground psychedelic therapy rapidly expands.
This article outlines a 12-session protocol for psychedelic-assisted eye movement
desensitisation and reprocessing therapy (PsyA-EMDR), where the 8-phases are
utilised to enhance the preparation and integration stages of this ground-breaking
psychotherapeutic intervention. Because the memory consolidation model of EMDR
is suited to support complex post-traumatic stress disorder (cPTSD), it is proposed
that it would also work well in supporting those experiencing regressed ego states as
well as the somatic dysregulation that is often caused during work with psychedelics.
This trauma-informed framework focuses on stabilisation, resourcing, tolerance
testing, and embodiment before individuals receive any psychedelic treatments.
Introduction
After years of restrictions on research into the healing properties of psychedelic
substances, recent developments in the field have seen a second wave of trials take
place. The pharmaceutical trials have now reached phase 3 in America and the UK
(e.g. Mitchell, 2021; Gukasyan et al., 2022), where psychedelic treatments are being
studied with large, clinical cohorts (300+ participants), in conjunction with
psychotherapy in outpatient settings. Treatment protocols have naturally emerged
from the research because of the ethical requirement for a therapeutic container for
the participants. These psychedelic-assisted therapeutic protocols have been
developed to aid the integration of insights gained through the administration of
psychedelic compounds and facilitate sustained positive change (Mithoefer et al.,
2015; Watts & Luoma, 2020; Wolff et al., 2020; Brennan & Belser 2022). Rapid
expansion of this field – in both research and underground – has highlighted a need
for a trauma-informed approach to facilitate preparation and integration as well as
harm reduction and risk minimisation. This article highlights some of the limitations
within current psychedelic therapy protocols, specifically when treating clinical
populations with complex post-traumatic stress disorder (cPTSD) and those with
undiagnosed sensitivities. Furthermore, this article outlines why eye movement
desensitisation and reprocessing (EMDR) therapy (Shapiro, 2001; 2018) is a potential
candidate for psychedelic-assisted psychotherapy.
This forms part of a series of articles exploring how the 8 phases of EMDR therapy
can be adapted to support individuals receiving psychedelic therapy.
The AIP model in the psychedelic space
The Adaptive Information Processing (AIP) framework was developed alongside
EMDR therapy to conceptualise the pathogenesis of psychological issues and change
(Shapiro, 2007; Hase et al., 2017). A central tenet of the framework is that
maladaptively stored memories that are inadequately processed by the brain during
periods of dysregulation, are the root cause of many psychological disorders (Scelles
& Bulnes, 2021). The AIP model proposes that impairments to the information
processing systems of the brain under stress cause memories to be stored in an
unprocessed, state-specific form that is not connected to adaptive information such as
a sense of safety in the present (Van der Kolk, 1989; Hamner et al., 1999; Hase et al.,
2017).
A key reason for the combination of therapeutic interventions such as EMDR with
psychedelic treatment is the neuroplasticity that they promote (Ly et al., 2018;
Aleksandrova & Phillips, 2021). From an AIP perspective, these neuroplastogenic
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
effects could facilitate the reprocessing and integration of emotionally salient material
(Vollenweider & Preller, 2020) that is maladaptively stored in the memory networks
through the use of EMDR therapy.
‘Dissociation’ of overwhelming experience from conscious awareness has been
recognised as a psychological defence for over 120 years (Janet, 1901; Putnam,1996;
Schore, 2009). The resulting compartmentalisation of sensory material (Nijenhuis &
van der Hart, 2011) can disrupt general functioning if it is re-activated by stressors in
the present (Bourne et al., 2013). With this in mind, neuroimaging studies have shown
that psychedelics fire up many pathways of the brain, creating connectivity that mimics
that of an infant (Carhartt-Harris, 2016). From an AIP perspective, psychedelics
facilitate the integration of dissociated memory networks as well as the maladaptively
stored sensory material encoded within them. On a neurological level, this could
explain the underlying mechanism for the integration of trauma whilst under the
influence of psychedelics. During this time, subconscious psychological barriers are
removed, enabling an individual to connect with the aforementioned sensory
information (Carhart-Harris et al., 2014).
In this concept lies a warning for individuals with complex trauma histories or individual
sensitivities that have not been addressed in therapy prior to the administration of
psychedelics. The dissociative barriers are there to keep the nervous system stable
(Maldonado & Spiegel, 1991). There is a risk that individuals can become
overwhelmed by the sudden reconnection with compartmentalised traumatic material
that can cause lasting side-effects such as severe dissociation or heightened anxiety
levels (Hopper et al., 2007; Halpern et al., 2018). The pathology ‘hallucinogen
persisting perception disorder’ (HPPD, American Psychological Association, 2013)
has been used to describe a non-psychotic disorder where an individual experiences
visual hallucinations that persist after the use of any drug, including psychedelics.
From an AIP perspective, this could be conceptualised as the reactivation of visual or
somatic fragments of a maladaptively stored memory of a psychedelic experience, if
the brain was sufficiently dysregulated whilst hallucinating.
Stanislav Grof coined the term ‘holotropic state’ to describe a non-ordinary state of
consciousness, experienced on psychedelics or during meditation or breathwork
(Grof, 2003). The term holotropic is derived from Greek and means ‘moving in the
direction of wholeness’. During re-processing the therapist sets up the conditions for
the brain to naturally move towards wholeness through the implementation of bilateral
stimulation (BLS). There is a similarity between the holotropic state elicited by
psychedelics and the re-processing phase of EMDR because the dream-like state
elicited during re-processing allows sensory material to naturally emerge in a manner
that clearly delineates from the ‘normal,’ everyday realm of consciousness. This shift
in subjective awareness, allows access to subconscious material which adheres to
definitions of altered states of consciousness (Krippner, 1972; Stein et al., 2004).
Winkelman’s (2019) research into the neuroanthropology of consciousness defines
four modes of consciousness – waking mode, deep sleep mode, REM sleep /dreaming
mode and the integrative mode. He places psychedelics, hypnosis and meditation in
the integrative mode but it is possible EMDR would traverse the REM mode because
the eye-movements cause similar neural activations to saccades during REM sleep
(Andrillon et al., 2015) and the integrative mode because of the way dissociated
material emerges and is integrated using BLS. It is possible that the action of the
bilateral stimulation of the brain in re-processing is partly responsible for this, and the
working memory taxation model of EMDR goes some way to account for the brain
gaining access to emotionally salient material during re-processing (van den Hout et
al., 2011; 2014 Matthijssen et al., 2017). Bilateral stimulation of the brain also appears
to facilitate free association and memory retrieval through interhemispheric
connectivity (Bergmann, 1998; Yaggie et al., 2015), that mimics the interconnectivity
seen in psychedelic studies, albeit at a lower level.
Critics of PsyA-EMDR have questioned the need for the use of psychedelics when
EMDR therapy is such an effective intervention that adapts to many different
psychological presentations. However, if we consider the example of cPTSD clients
who have experienced severe abuse or neglect in childhood, there is often no
embodied memory of safety and/or positive emotional connection (Siegel, 2020).
Developing psychological resources with this client group can be difficult because
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
there is very little adaptive information in the networks. This is where substances such
as ‘empathogen’ 3,4-methylenedioxy-methamphetamine (MDMA) can be particularly
useful, because as well as impacting fear extinction, emotional processing, and
memory reconsolidation (Feduccia & Mithoefer, 2018) it elicits feelings of ‘love’ and
‘sociability’ (Bedi et al., 2010). This clear experience of embodied positive,
interpersonal affect can then be explicitly strengthened as a psychological resource to
utilise in later re-processing sessions. Developing this type of adaptive information is
vital for clients with chronic, early attachment trauma.
Limitations of current protocols
Phase 3 psychedelic trials, where new treatments are compared with the best currently
available treatment, have been conducted for MDMA (Mitchell, 2021) and approved
for psilocybin (Compass, 2022). Research has moved on from dose tolerance,
pharmacokinetics, and safety testing to large-scale, multi-site, international clinical
treatment groups. Once an evidence base is formalised, these compounds will be
prepared for market. After which, investigations commence into the implementation of
various psychotherapeutic interventions to optimise the efficacy of psychedelic
therapy. As yet, there is a dearth of literature available on the impact of the therapeutic
input, and this needs to be addressed. The concept of ‘psychedelic-assisted therapy’
is key because psychedelics alone are not a silver bullet for psychological issues, as
shown by recent ketamine trials where the participants depressive symptoms did not
improve. These results may have been due to the lack of adjunct therapy as part of
the protocol to address the underlying cause of their presentation (Atai Life Sciences,
2023).
In the context of clinical research, the number of integration phases offered differs
depending on the ethics committee’s recommendations, the compound used, and the
number of doses offered. Phase 2a (first trials in a clinical population) will require more
therapy. For example, a trial offering two doses could involve the following (in this
order):
• 1-hour recruitment telephone interview conducted by the recruitment team
• 1-hour psychiatric online pre-screen conducted by the therapy team
• 2-hour in-person screening with the study psychiatrist
• 1 x 3-hour preparation session with the therapy team
• A psychedelic treatment with the therapy team on day 0 and day 14
• Integration therapy on day 0, +1 (in person), +7, +15, +23 (online), and a follow
up call on day +90 (with the therapy team).
The integration sessions generally consist of non-directive exploration of the
psychedelic experience to facilitate emotional processing of the experience (Mithoefer
et al., 2015). A goals-based approach is used to refer back to the participant’s intention
and consolidate the ‘take-home’ message from the experience that they want to
integrate into their daily lives (Watts, 2021).
Despite research focusing heavily on psychedelic substances in the early phase trials,
psychotherapeutic interventions and protocols have inevitably emerged from the
research because a psychological container is required for the participants.
Therapeutic input is minimal because a researcher’s priority is to address the efficacy
of the compound. In the UK, one of the main protocols that is being used on psilocybin
trials is based on the ‘Cognitive Flexibility Model’ (CFM) (Hayes et al., 2006), the
theoretical framework that underpins Acceptance and Commitment Therapy (ACT
[Hayes, 2004]). This model has been augmented for use in the psychedelic healing
space, using qualitative and quantitative data from ongoing trials to create the
Acceptance, Connection & Embodiment model (ACE [Watts & Luoma, 2020]). CFM
and ACT have a large evidence base (1000+ research papers as well as cognitive
behavioural research from the wider field) and this possibly accounts for its use in
these trials. However, as the field expands to more complex clinical populations, the
gaps in the ACE model are becoming clear.
The ACE model focuses on cultivating the acceptance of difficult emotions and bodily
sensations as they arise, and connecting to the meaning behind the feelings. This is
achieved through a series of interventions designed to develop the three areas of
acceptance, connection and embodiment. Embodiment is practiced during the
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
preparation phase with a guided visualisation where participants are encouraged to
‘let go and dive into their bodies’ using a body scan. The diving metaphor is used to
encourage the participant to go towards difficult emotions and look for the ‘pearls of
wisdom’ from the difficult emotion, then set an intention for the following day based on
this. A key point highlighted by Watts is that the ACE interventions are flexible and not
prescriptive (Watts & Luoma, 2020; Watts, 2021).
Further research is being conducted to enhance the embodiment element of the ACE
protocol, which currently consists of learning to sit with somatic responses as they
arise during guided meditation. This is not comparable to the strong somatic
responses that can emerge during a psychedelic treatment and does not adequately
prepare the participants to navigate this.
The developing ACE model is currently lacking in a comprehensive somatic framework
in the following areas:
• Adequately preparing the participant for experiencing bodily affect during the
psychedelic phase.
• Developing the capacity and strategies to manage strong bodily affect and
uncomfortable emotions.
• Developing an embodied set of psychological resources to support the
participant during any dysregulation caused during the psychedelic therapy
phase.
• Facilitating the integration of somatic and emotional material that may arise
during the psychedelic phase.
• Stabilising participants who experience ‘adverse events’ (Instruments, 2004)
during dosing.
Participants are thoroughly screened using a combination of their GP’s medical
records, questionnaires, and psychiatric interviews. Stringent exclusion criteria in early
the phases of clinical research means that samples are not representative of the
general population. Phase 3 trials are performed in a less homogeneous patient
population (with higher levels of risk) than phase 2 trials, to better reflect real-world
results and so an increase in adverse events is expected.
During the ACE preparation phase, participants are asked about any biographical
material that could emerge during the treatment which is then used as a mechanism
to prepare participants for difficult material that may encounter, bringing it into their
awareness. The non-directive ACE case conceptualisation is future focused and goal
oriented (Watt & Luoma, 2020).
In contrast, the PsyA-EMDR protocol explicitly co-creates a case conceptualisation by
exploring the relationship between presenting issues and their history using the AIP
model and psychoeducation. . This information is then used to inform interventions
throughout therapy, particularly the resourcing and stabilisation phases.
Psychoeducation, through applying the AIP model to clients presenting issues,
empowers them and develops metacognitive ability and the capacity to self-regulate.
Understanding the AIP model also encourages the client to consider the salience of
material that might emerge during their psychedelic therapy.
EMDR as an alternative psychedelic preparation and
integration therapy
The AIP model posits that negative emotional and somatic responses are often the
result of maladaptively stored memories in the brain (Hase et al., 2017). Therefore,
the aim of the work in EMDR therapy is to release the somatic tension that is being
triggered in the present, by targeting the corresponding maladaptively stored material
with bilateral stimulation of the brain and in so doing eliminating the somatic response.
The ACE concept of accepting and embodying the somatic response fails to address
the maladaptively stored content. ACE seems to rely on exposure and then
acceptance to support an individual’s process. It is a passive approach to addressing
pathological content. This works for many but is insufficient for those with more
complex presentations. EMDR is well positioned to address this shortfall.
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
Deactivation of the stress response and the resulting reduction of somatic symptoms
are key aims of EMDR therapy, illustrated by the constant monitoring of the Subjective
Units of Disturbance (SUD) (Wolpe & Lazarus, 1966) throughout the phases. If the
ACE model is translated to participants who have been unable to fully integrate their
psychedelic experience and suffer from symptoms of PTSD such as sustained
dissociation or flashbacks, it is not adequately equipped to facilitate the integration of
the traumatic memory responsible for the debilitating psychological and somatic
intrusions in PTSD presentations.
It is clear that psychedelics cause a significant amount of dysregulation to the nervous
system (Lerner et al., 2014) and the current preparation phases of the ACE protocol
do not address this which is probably because the participants are stringently
screened and deemed psychologically stable. A trauma-informed preparation phase,
such as the resourcing, stabilisation, and preparation phases of AI-EMDR therapy
(Shapiro, 2018; Parnell, 2013) could be developed to stabilise and prepare trauma
clients for the dysregulation caused by re-processing, using BLS. This is particularly
important for individuals with cPTSD who often had impaired attachment relationships
in childhood that impact the development of their capacity to self-regulate (Schore,
2003).
Learning from the cPTSD population
Reactivation of maladaptively stored sensory material during a psychedelic
experience poses the risk of flooding the nervous system, causing sustained
psychological distress (Carbonaro et al., 2016). The cPTSD population should not
automatically be screened from receiving psychedelic treatments, they may just
require additional support in the preparation stages to develop their resources and
affect regulation capacities. Attachment-informed EMDR is well equipped to do this,
and an individual’s tolerance to the dysregulation caused by memory work with BLS
can also be used as an indicator of suitability for psychedelic therapy.
Re-processing traumatic memories with BLS of the brain, activates the nervous
system and causes some degree of dysregulation. However, this can be stopped at
any point to ground the client, unlike psychedelics that often have prolonged
hallucinogenic effects. This is why the re-processing phase of EMDR therapy is an
ideal ‘test phase’ in preparation for a psychedelic treatment. If the client is too
dysregulated by this test phase, more time may need to be spent in the resourcing
phase or they may be screened from psychedelic therapy completely.
The use of EMDR to treat psychotic clients is an example of how the AIP framework
can be used to support unstable populations (Adams et al., 2020). The integrative
nature of EMDR therapy makes it an ideal candidate to support the cPTSD population
because it can easily be combined with other trauma-informed modalities such as
Internal Family Systems (Schwartz, 1994). This combination is already widely used to
treat severely dissociated clients, facilitating the integration of fragmented aspects of
the psyche (Gonzalez et al., 2012). In the future, these adaptions of EMDR therapy
for cPTSD will likely be a key part of supporting this population in the psychedelic
healing space. Additional techniques such as Flash (Manfield et al., 2017) and EMDR
2.0 (Matthijssen et al., 2021) can also be utilised to facilitate integration with minimal
activation of the nervous system.
Another issue with the current ACE protocol is the lack of pacing. This is an issue for
those experiencing adverse reactions to psychedelics, or for those with more complex
presentations. For some, embodied connection with psychedelic content, can cause
flooding and be counter-therapeutic/retraumatising. The efficacy of current pacing in
ACE is skewed because many of the trials screen out participants with complex trauma
histories giving unrealistic populations. As testing becomes more inclusive, trauma-
informed embodiment protocols need to be developed to support participants with
experiences outside the limits of affect tolerance. PsyA-EMDR borrows tools that have
been shown to be clinically effective when working with cPTSD presentations, allowing
the pace of exposure to be slowed to tolerable levels and then worked with once
stabilisation is achieved.
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
The AIP model can be used to conceptualise the complexity of the client’s trauma
history as well as a general guide for the pacing of psychedelic work in the same way
it is used in a standard trauma practice when treating cPTSD. Standardised trauma
measures such as the Dissociative Experiences Scale (DES [Carlson & Putnam,
1993]) should play a role in this assessment.
Working with historic psychedelic content
The ACE model does not provide a framework for working with content from ‘historic
psychedelic experiences’, defined by the authors as psychedelic content that has been
non-responsive to other forms of integration treatment and still elicits affect for more
than one year post psychedelics. The standard protocol from EMDR therapy can be
used to integrate historic content that is unprocessed and causes reactivations
(flashbacks), looping and blocking beliefs. EMDR can also be used as a tool to explore
representative subconscious material to gain a deeper understanding of the self (Jung,
1951).
The somatic bridge
In psychedelic integration work using EMDR therapy, the somatic bridge (Watkins,
1971) is a key intervention to identify subconscious material that has emerged. It can
be used in a similar way to working with dreams, whereby the image, cognition, feeling
and sensation from a significant moment of the psychedelic experience can be bridged
from, to identify the subconscious material they represent. Often this will be
biographical trauma and childhood attachment experiences which can then be
reprocessed using the standard protocol, with attachment-informed interventions if
necessary. Sometimes more abstract material is bridged to, which can also be
explored and reprocessed using BLS.
The transpersonal
One key impact of psychedelics is on the subjective experience of the self (Nour et al.,
2016), that is characterised by increased feelings of ‘connectedness’ with others and
one’s surroundings (Mason et al., 2020). This experience has been termed ‘ego
dissolution’; the mystical experiences that occur during this process result from the
disruption of boundaries between the self and the world (Nour & Carhartt-Harris,
2017). A dramatic shift in perception like this can be transformative for people who
suffer from issues such as long-term depression, and studies have shown that
psychedelic experiences that include a mystical experience have better therapeutic
outcomes (Ko et al., 2022). The integrative nature of EMDR therapy means that it is
possible to support transpersonal development through the use of interventions such
as the intergeneration protocol (Brayne, 2019) and archetypal resource figures in the
imaginal space (Parnell, 2013). The AIP framework is well aligned with key concepts
in the field of psychedelics and Jungian Depth Psychology (Jung, 2014) in particular.
Moreover, the AIP model and its conceptualisation of memory networks, mirrors that
of Jung’s concept of ‘complexes’ (Jung, 1933) and Grof’s Systems of Condensed
Experience (COEX) theory (Grof, 2009), two key figures in psychedelic research. The
main difference is that Grof’s COEX systems expand further to perinatal stages and
even to the transpersonal realm of past-lives (or more often, deaths). There is the
potential to combine these theories to conceptualise the work through a transpersonal
AIP lens, for example, when bridging somatically to abstract material. Intergeneration
and attachment informed protocols may also be appropriate here.
Summary of the application of the 8 phases in PsyA-
EMDR
Preparation for psychedelics (6 sessions)
Phase 1: History taking
The AIP model is used to create a case conceptualisation and develop a treatment
plan. This is based on the complexity of the individual’s trauma history – which
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
determines the pace of the work and the amount of time spent in the
preparation/resourcing phases; and also on the client’s goals for therapy and more
specifically for their psychedelic journey (also referred to as ‘intentions’ in psychedelic
therapy). Psychoeducation is used to conceptualise the client’s presenting symptoms
in terms of the AIP model and applied to the psychedelic space to prepare them for
what might emerge.
Phase 2: Resourcing
Resources are developed to explicitly prepare for the psychedelic space. Slight
adaptions have been made to the traditional resourcing interventions, as follows:
• Preparing the client through psychoeducation about the psychedelic treatment
and development of coping strategies.
• Physical objects can be chosen to represent the client’s resources, in a similar
way to the altar that is commonly used in the psychedelic space (Metzner,
1998). This is to have a tactile reminder of their team, peaceful place, and
intention while potentially disoriented under the influence of psychedelics or
phase 4 reprocessing.
• If the client is particularly anxious about the psychedelic journey, it can be
beneficial to strengthen memories of courage by ‘tapping in’ memories of
negotiating challenging situations.
• Psychoeducation around vagal mapping (Porges, 2011) can also be a helpful
preparation tool for any dysregulation cause by psychedelics.
Intentions for the psychedelic experience are solidified in response to the client’s goals
for therapy and case conceptualisation. The ‘wisdom figure’ from the resource team
can be utilised at this stage to explore their intention.
Phases 3-7: Reprocessing as psychedelic preparation
One or two sessions of reprocessing with BLS are used to assess the client’s affect
tolerance, develop their somatic awareness/mindfulness training, practice
embodiment through encouragement and coaching, develop dual attention skills,
develop emotional literacy and finally explore metaphor/symbolic content – i.e., power
animals/protector figures.
A target memory is selected to test the client’s ability to tolerate strong affect when
reprocessing and after the session has ended. Although this potentially causes milder
dysregulation than the psychedelic phase, it is deemed a good assessment of the
individual’s readiness to proceed to this phase. This stage is particularly important for
cPTSD clients who may require extra reprocessing sessions to stabilise the system
adequately before considering the psychedelic phase.
It is suggested that the choice of target is oriented towards their intention or their
connection with resources (or blocks preventing connection with resources). For those
with high anxiety about the treatment, the flash forward protocol (Logie & De Jong,
2014) and then future template (Shapiro, 2018) can be used to target this.
At this stage, it is useful to work in an attachment focused manner and bridge back
from the target to reprocess earlier biographical material because reparative
attachment work can be done in the imaginal space to strengthen their sense of self
(Parnell, 2013) and increase their capacity to self-regulate. They can also connect with
their resource figures during re-scripting to strengthen the connection with them which
may help with grounding in the psychedelic phase. Beginning to define/acknowledge
needs that were missed during childhood can inform the choice of intention for
psychedelic therapy.
Psychedelic therapy treatment phase
Currently in the UK, the only way individuals can access legal psychedelic therapy is
via ongoing clinical trials or private ketamine treatment centres. People can also
access legal treatments in countries such as Holland where the drugs laws are more
relaxed. The quality of care offered across treatment centres varies dramatically and
very few preparation and integration and phase 1 trials with ‘healthy normal’ volunteers
offer therapy. This is also the case for the underground treatments on offer in the UK
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
where facilitators have very little training and are most often not trauma-informed in
their interventions.
Post psychedelic treatment integration – 6 sessions
The post psychedelic therapy integration phase is where EMDR has the potential to
work very effectively. The sensory material that has previously been experienced in
the psychedelic space can be explored using techniques such as the somatic bridge
to directly target the subconscious material that has emerged.
Phase 1: History taking
The client can talk through the whole journey with BLS on in the background and the
therapist can note down any key themes, NCs/PCs, somatic and emotional responses
that emerge. This information can then be added to the developing case
conceptualisation.
Phase 2: Preparation
Any positive material from the journey can be strengthened with slow BLS and used
as a resource. If it was a difficult journey, grounding and resourcing can be used here
to stabilise before reprocessing.
Phase 3: Assessment of target
• Together, decide on an appropriate target from the psychedelic therapy phase
based on their intentions/goals for therapy.
• Client to define the image, thought, feeling, sensation, NC and SUD linked to
the chosen psychedelic material. Note: this can also include an underwhelming
experience, ‘lack of material’, as well as the thoughts, feelings or physical
sensations triggered by this.
• Use the somatic bridge into the memory network and identify the corresponding
biographical target to reprocess. Client to define image, thought, feeling,
sensation, NC and SUD of target ready to reprocess.
• Or, reprocess and rescript the material directly without bridging, as if it is a
memory. Consider that this could be pre-verbal/perinatal or transpersonal
material, and encourage radical acceptance of whatever emerges.
For very difficult experiences that have cause PTSD-type symptoms, discuss the use
of Flash, EMDR 2.0, pendulation or similar to reduce the SUD to a low enough level
to then bridge/re-process with the standard (AI informed) protocol.
When working with content from historic psychedelic use, the somatic bridge can be
used from either the memory of the psychedelic experience or corresponding
flashbacks/somatic material that is triggered in the present.
Phases 4, 5, 6: Desensitisation, installation, body scan
Activation and stimulation of target memory. Desensitisation and reprocessing. AI-
EMDR informed re-scripting of memory and inner child work.
Phase 7: Closure
Ensure clients’ stability in the session and between sessions through use of grounding
visualisations such as the light stream or container.
Phase 8: Re-evaluation
In the following session, the historical target and the psychedelic journey can be re-
evaluated to ensure that reprocessing is complete and that all the sensory information
has been integrated. If there is still an emotional/somatic charge, the somatic bridge
can be used to find other targets that may be blocking the reprocessing. The material
is re-visited in subsequent sessions until the psychedelic material no longer holds
negative emotional charge and is deemed fully processed/integrated. Additionally, the
three-pronged approach is used to address past, present and future aspects of the
clients’ intentions moving forward.
Summary
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
Psychedelics offer up a rich source of content from the deep psyche, and these
expanded states seem to create optimum neurological conditions for the integration of
trauma. As access to psychedelic therapy expands, both legitimately and in the
underground scene, there is a distinct lack of suitable trauma-informed frameworks to
adequately support the broad range of people engaging with these treatments.
Whilst suitable for many, the ACE model that is being developed in the UK is not
adequately targeted or comprehensive enough to reliably prepare individuals for the
dysregulation to the nervous system that can be caused during a psychedelic
experience. EMDR therapy and its conceptual framework is proposed as a trauma-
informed alternative to the current preparation and integration protocol, and elements
could be translated for harm-reduction on the underground. The AIP model is well
aligned with prominent theories from the field of psychedelics. Furthermore, its trauma-
informed theory of memory consolidation is well placed to support participants with
complex trauma histories.
Bridging techniques can be used to explore psychedelic content and access the
memory matrix to re-process material from formative early years experiences, as well
as intergenerational content and material from collective/cultural trauma. Adaptions to
the standard protocol since its inception have broadened its application to areas such
as the transpersonal, which is a common emergent theme from psychedelic therapy.
The AIP model of pathology, with its conceptualisation of memory encoding and
meaning-making across a lifetime, is mirrored in key theories from psychedelic
research. The similarities between the altered states of consciousness elicited by both
psychedelics and bilateral stimulation of the brain are further indicators that EMDR is
well aligned as an integration tool in psychedelic-assisted psychotherapy.
Limitations
The authors acknowledge that some of the assertions in this article are based on
anecdotal evidence from their clinical work. However, this is currently the only way
that EMDR therapy is being investigated in the field of psychedelic research. We
propose that this is a starting point for peer-reviewed research to commence.
Ideas for further research
• Incorporate EMDR protocols into clinical practice where possible.
• Empirical research into the use of reprocessing as a screening tool to identify
more complex presentations that are not otherwise picked up during psychiatric
assessments.
• Research into the development of affect tolerance through the use of EMDR in
preparation for psychedelic therapy.
• Investigate the use of BLS during psychedelic therapy to counteract looping or
chaining.
• Investigate EMDR therapy as a treatment for: HPPD, integrating historic
psychedelic material, individuals experiencing adverse events as a
consequence of dosing in a trial setting where other integration therapies have
been ineffective.
• Use the principles of the AIP framework and the preparation phases of EMDR
as a guide for training psychedelic therapists across modalities.
Conflict of interest statement
The authors have declared that no competing interests exist.
Hannah is an integrative psychotherapist, clinical supervisor and researcher working
in private practice. She was trained in EMDR therapy (MSc) at the University of
Worcester and studied the neuroscience of psychedelics and EMDR therapy on a
cognitive neuroscience masters at Cardiff University. info@bridgetothematrix.com.
Jocelyn is a psychedelic therapist working in clinical research, and training with the
Institute of Psychedelic Therapy. She is also a psychodynamic psychotherapeutic
counsellor, EMDR practitioner and supervisor working in private practice.
jocelynclairerose@protonmail.com
H., Raine-Smith & J., Rose. Published by the EMDR Association on 15th Feb 2023
Found at: https://etq.emdrassociation.org.uk/paper/psychedelic-assisted-emdr-therapy-
psya-emdr-a-memory-consolidation-approach-to-psychedelic-healing/
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