Regulation

We can think of regulation as primarily associated with managing emotion and the nervous system. Regulating one’s emotion is a skill that can be applied prior to a potentially dysregulating situation or once emotional reactivity is already present.

Psychedelic experiences can disrupt clients’ existing resources for coping. They may help to deconstruct or loosen tightly held views and disrupt habitual ways of being that can be perceived as dysregulating or exciting, depending on the person and their circumstances. Explanations for this process may be framed in terms of the entropic brain hypothesis (Carhart-Harris, 2018). Through the use of therapeutic techniques such as ACT, Cognitive Behavioural Therapy, Motivational Interviewing, Somatic Experiencing, and Mindful Inquiry, clients may be supported to reconstruct their relationship with themselves, others, and the world around them.

Health professionals support clients’ opening, reconstructing, and embodying of the learning that arises from the altered state. This may take the form of assisting clients in developing novel cognitive, emotional, or behavioural responses that are aligned with their newly formed values and intentions. This is consistent with the committed action dimension of ACT and other third wave therapies (Walsh & Thiessen, 2018; Watts & Luoma, 2020; Wolff et al., 2020).

Down-Regulation

Down-regulation refers to reducing the intensity of activated states.

Up-Regulation

Up-regulation may be necessary when more energy (nervous system arousal) is required.

Example

For example, prolonged exhale breathing, box breathing, grounding exercises, or co-regulation as discussed in Modules 3 and 4.

Example

For example, assisting clients to bring in 'vitality' energy using embodied inquiry, using prosody, facial expression and gestures to enhance ventral vagal engagement, and guiding conscious connected breathing.

Health Professional Tip

What strategies can be used to manage dysregulation?

A number of strategies can be used to manage dysregulation, and these include but are not limited to:

  • Orienting mindful attention to the environment

  • Recalling associated or pleasant (or neutral) bodily sensations

  • Working with the breath

  • Working with rhythmic or other movement

  • Acceptance or a willingness to have acceptance of what is present

  • Re-directing one’s attention

  • Re-appraisal

  • Changing the situation

Movement in Therapy

Movement in Therapy

Movement is an important component of integration, and elements of values or meaning can be anchored through a dedicated movement or gesture that reflects them; exploring a system of movement such as yoga, continuum, dance, or tai chi can also be practiced as a form of integration, encouraging further exploration into the corners of the body and what might yet be held and waiting for expression and release.

via GIPHY

References

Carhart-Harris, R. L., Bolstridge, M., Day, C. M. J., Rucker, J., Watts, R., Erritzoe, D. E., . . . Nutt, D. J. (2018). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology (Berl), 235(2), 399-408.

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., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102.

Wolff, M. Evens, R., Mertens, L. J., Koslowski, M., Betzler, F., Gründer, G., and Jungaberle, H. (2020). Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance. Frontiers in Pschiatry, 11(5). https://doi.org/10.3389/fpsyt.2020.00005