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Lower-dose psycholytic therapy – A neglected approach

Summary

This review examines psycholytic therapy, a method using lower doses of LSD or psilocybin combined with ongoing psychotherapy to help people process psychological conflicts and trauma. Developed in Europe during the 1960s-1970s and used successfully at over 30 clinics, this approach was largely abandoned when psychedelics became illegal but is now being reconsidered. Historical research shows it was effective for anxiety, depression, and personality issues in treatment-resistant patients, with safety profiles comparable to conventional therapy.

Background

Psycholytic therapy, involving lower-dose LSD and psilocybin sessions in a psychoanalytic framework, was developed and widely used in Europe from 1960-1975 at over 30 clinical centers. Despite historical significance and demonstrated efficacy, psycholytic therapy has been largely neglected in contemporary psychedelic research in favor of the psychedelic approach using high-dose single sessions.

Objective

To provide comprehensive background information on psycholytic therapy, outline its essential features and methods, review evidence for its efficacy, and make a case for inclusion of the psycholytic approach in substance-assisted psychotherapy alongside the more recently emphasized psychedelic approach.

Results

Historical data showed psycholytic therapy achieved success rates of approximately 66% in treatment-resistant cases including anxiety disorders (70%), depressive neuroses (62%), and personality disorders (61%). Risk of major complications was comparable to conventional psychotherapy. Leuner’s research identified specific psychological mechanisms and two characteristic courses of experience: continuous-scenic and stagnating-fragmentary.

Conclusion

Psycholytic therapy represents a valuable and evidence-supported approach that has been unjustly neglected. Its integration with contemporary psychedelic research could expand treatment options, particularly for chronic and treatment-resistant conditions. Modern clinical trials using rigorous methodology are needed to validate historical findings and determine optimal applications.
  • Published in:Frontiers in Psychiatry,
  • Study Type:Narrative Review,
  • Source: PMID: 36532196
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