An Overview of Integration
Dan Siegel has defined integration as the linkage of differentiated aspects of a system (Siegel, 2012b). When a system is highly integrated, it is neither too rigid nor too chaotic, and it is therefore flexible, adaptive, and resilient.
We can think of the brain and the mind in this manner: to create healthy flexibility, adaptability, and resilience, the too rigid and too chaotic brain and mind require differentiation and linkage creating more optimal states. Essentially, integration is the re-writing or re-wiring of old, dysfunctional mental and neural patterns into newer, more flexible, and more resilient ones. To bring this about, new information must be incorporated into and linked within the system.
Integration provides the opportunity for clients to explore ongoing or emergent emotional material, make meaning of altered states, and reflect on how to make behavioural and life changes (Gorman et al., 2021; Mithoefer, 2016; Pilecki et al., 2021). In addition, the health professional can mitigate potential adverse psychological effects through assessing the client’s state post experience and with therapy. While integration can be done by the individual independently, engaging with a therapist or guide is encouraged.
We can think of the brain and the mind in this manner: to create healthy flexibility, adaptability, and resilience, the too rigid and too chaotic brain and mind require differentiation and linkage creating more optimal states. Essentially, integration is the re-writing or re-wiring of old, dysfunctional mental and neural patterns into newer, more flexible, and more resilient ones. To bring this about, new information must be incorporated into and linked within the system.
Integration provides the opportunity for clients to explore ongoing or emergent emotional material, make meaning of altered states, and reflect on how to make behavioural and life changes (Gorman et al., 2021; Mithoefer, 2016; Pilecki et al., 2021). In addition, the health professional can mitigate potential adverse psychological effects through assessing the client’s state post experience and with therapy. While integration can be done by the individual independently, engaging with a therapist or guide is encouraged.
Integration Needs Framework
There are several important aspects to integration. What follows is a framework developed through our applied integration, clinical work, and the literature (Watts & Luoma, 2020; Wong, 2020; Woods et al., 2019). It has been derived from a variety of sources, intended to give health professionals and those working underground a structure for assessing the common client integration needs at any given stage of the integration process. The following needs framework includes the following phases.
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Regulation
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Normalizing
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Metabolizing
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Meaning-making
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Keeping it alive
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Connection to others
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Committed actions
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Spiritual needs
Throughout this module, we will be breaking down the integration needs framework to better understand how this aligns with optimal outcomes of psychedelic-assisted therapy.
Health Professional Tip
How can you help clients prepare for Integration Sessions after their Medicine Session?
Prior to the Integration Sessions, you may provide clients with the following questions to reflect on to assist them in preparing for the integration work.
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What was learned, if anything?
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What are the main themes that came up from the session?
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What do I notice that is different, if anything?
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What might be the value of the experience as applied to my intention, values, and life going forward?
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How might I actualize my intentions and what was learned through committed actions?
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Looking at my schedule, how can I allocate time to reflect and be in relationship with this experience?
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Are there any sensations in my body (pleasant or unpleasant) that feel new or different, or surface when I'm thinking about aspects of the session?
References
Curtis, R., Roberts, L., Graves, E., Rainey, H. T., Wynn, D., Krantz, D., & Wieloch, V. (2020). The Role of Psychedelics and Counseling in Mental Health Treatment. Journal of Mental Health Counseling, 42(4), 323-338.
Gorman, I., Nielson, E. M., Molinar, A., Cassidy, K., & Sabbagh, J. (2021). Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice [Hypothesis and Theory]. Frontiers in psychology, 12(710).
Mithoefer M. (2016) A Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder. http://www.maps.org/research/mdma/mdma-research-timeline/4887-a-manual-for-mdma-assisted-psychotherapy-in-the-treatment-of-ptsd
Phelps, J. (2017). Developing Guidelines and Competencies for the Training of Psychedelic Therapists. Journal of Humanistic Psychology, 57(5), 450-487.
Pilecki, B., Luoma, J. B., Bathje, G. J., Rhea, J., & Narloch, V. F. (2021). Ethical and legal issues in psychedelic harm reduction and integration therapy. Harm reduction journal, 18(1), 40.
Schenberg, E. E. (2018). Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development. Frontiers in Pharmacology, 9(733). https://doi.org/10.3389/fphar.2018.00733
Siegel, D. (2012b). Pocket Guide To Interpersonal Neurobiology: An Intergrative Handbook Of The Mind. WW Norton.
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.
Wong, A. (2020, May). Why you can't think your way out of trauma. Psychology Today. Retrieved May 24, 2022, from https://www.psychologytoday.com/ca/blog/the-body-knows-the-way-home/202005/why-you-cant-think-your-way-out-trauma
Woods, S. L., Rockman, P., & Collins, E. (2019). Mindfulness-based cognitive therapy: Embodied presence and inquiry in practice. New Harbinger Publications.