An important part of the preparation phase of psychedelic-assisted therapy is intention setting. An intention is an aspiration that clients have for their healing journey that is personally meaningful. Setting an intention is like pointing oneself in their chosen direction of growth while also accepting that new perspectives will be encountered along the way that may shift the course.
The process of setting an intention helps to begin connecting with what your clients value most and with an awareness that they’re an active participant in their healing journey. One’s own inner healing ability is what has brought them this far; setting an intention helps to tap into that part of them. Having an intention is about understanding that while they cannot know exactly what will happen, they can aspire in a general direction anyway and thus play a role in their future. An intention can also be an anchor to remember while they are in their psychedelic experience, bringing renewed focus to what is important to them.
Intention setting is a means to help the client set a direction or aim for the psychedelic-assisted therapy process and has been correlated with peak experiences, well-being, and better outcomes (Carhart-Harris, 2018). Intention setting, as part of the preparation process for psychedelic-assisted therapy, provides the opportunity to educate the client about the value of psychological flexibility, acceptance, and the importance of reducing experiential avoidance.
The Numinus approach to psychedelic-assisted therapy, including PHRI, relies in part on principles and techniques derived from Acceptance and Commitment Therapy (Watts et al., 2017; Watts & Luoma, 2020). A small but growing evidence-base supports the overlap of third-wave therapies like ACT and psychedelic-assisted therapy. That promote openness, acceptance, cognitive and psychological flexibility, and the enhanced capacity to approach experiences versus trying to resist or avoid them (Walsh & Thiessen, 2018; Watts et al., 2017; Wolff et al., 2020).
What are the main aims of intentions?
Intentions aim to:
Encourage curiosity and reflection about the client’s motivations
Orient the client toward the applying of what will be learned in daily life
Encourage the client to turn toward difficult states and challenges rather than engaging in experiential avoidance
Serve as a frame of reference for deriving meaning from the psychedelic journey and Integration Sessions
Provide a perspective from which to process the psychedelic session during Integration Sessions
The key principles of intention setting (Watts & Luoma, 2020) include:
Intentions can change throughout Preparation Sessions. They can be used to clarify what is important and act as a focus during Integration Sessions.
Organizing the intention setting around a specific framework can help clarify the intention and keep it more accessible during the psychedelic journey.
Please ensure that you read through all items before proceeding by selecting each title.
The Show me, Help me, Teach me is a framework to support clients to refine their intentions to keep it simple and focused. It encourages clients to pick either show me, help me, or teach me and then a basic emotion (fear, anger, guilt, sadness, shame, joy), essential quality (peace, love, compassion, connection), or a key theme that they feel they want support with. This could be an area they feel stuck, blocked, or a potential resource.
Watch the video below for an example of this framework.
The miracle question, developed by Steve de Shazer and Insoo Kim Berg, can support the client to make an intention and to imagine the possibilities of what would look, feel, and be different if the intended outcomes of the psychedelic-assisted therapy were achieved (Walter & Peller, 2013). The outcomes are stated in positive terms (Watts, 2021). The miracle question is particularly useful when intentions are vague or the client feels stuck or hopeless. The miracle question can be used as an exercise with the client and may be adapted for psychedelic-assisted therapy:
If a miracle happened during your psychedelic journey, what would be different after it was over? How would you know?
What are you longing for from this work? If it happened, what would be different in your day-to-day life? What would you be doing differently?
Setting intentions can take time and may require that the health professional help to elicit these from the client. It is important that the health professional does not impose their own agenda or make assumptions about what the client needs. Rather, the health professional leads by following the client’s process, reinforcing, and amplifying those aspects of the dialogue that lead in the direction of forming, making overt, and refining the client’s intentions.
Remember to resource first prior to completing the ACE body scan.
To learn more about intention setting, please watch How to set intentions for psychedelic therapy…and life facilitated by Numinus therapists Dr. Steve Thayer and Dr. Reid Robison.
Carhart-Harris, R. L., Roseman, L., Haijen, E. C., Erritzoe, D., Watts, R., Branchi, I., Kaelen, M. (2018). Psychedelics and the essential importance of context. Journal of Psychopharmacology, 32(7), http://dx.doi.org/10.1177/0269881118754710
Walter, J. L., & Peller, J. E. (2013). Becoming solution-focused in brief therapy. Routledge.
Walsh, Z., & Thiessen, M. S. (2018). Psychedelics and the new behaviourism: considering the integration of third-wave behaviour therapies with psychedelic-assisted therapy. Int Rev Psychiatry, 30(4), 343-349.
Watts, R. (2021) Psilocybin for Depression: The ACE Model Manual. https://doi.org/10.31234/osf.io/5x2bu
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017). Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression. Journal of Humanistic Psychology, 57(5), 520–564.
Watts, R., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102.