Essential Skills for Participants of Psychedelic-Assisted Therapy

Typically in Preparation Sessions, the therapist would focus on working with you to develop some essential skills that will be useful during your Medicine Sessions.

Many of these skills we have already practiced throughout Fundamentals of Psychedelic-Assisted Therapy and Applied Psychedelic-Assisted Therapy in addition to some of the other courses offered at Numinus. Some of these skill include:

  • Resourcing
  • Grounding
  • Mindfulness
  • Parts Work

Audio Guides

In preparation for your Experiential Period, below are some audio guides intended to refresh your memory on how to apply these skills to yourself as a participant undergoing psychedelic-assisted therapy.

Because these audio guides are intended to help direct your reflection and meditation, you are encouraged to go through the content in whatever way will be the most impactful for you. The content of this page is also available on SoundCloud if you want to step away from your computer, tablet, or phone screen to focus on the meditation. You could even go for a walk and listen to the playlist on SoundCloud.

Please ensure that you read through all items before proceeding by selecting each title.

Resourcing

As we’ve learned, trauma can manifest in both the mind and body leading to dysregulation. Sensations, images, and behaviour can be felt or observed when you are experiencing a challenging moment. For example, when reflecting on a negative memory, you may notice that your chest tightens up, your heart beats faster, or your breathing becomes shallower.

To help counteract these sensations, you can anchor a resource which could be a person, a location, or a positive memory to help lead you away from those felt sensations. A good resource is one where you may experience positive sensations, images, and behaviours such as feeling warm inside, feeling safe, or experiencing slower breathing.

Resourcing can also be a helpful tool for regulation, regardless of whether the disturbance from a traumatic memory or anything else. Resourcing is an act of connecting with your own inherent inner strengths which support you in moving from a state of distress or dysregulation to a state of calm or regulation. A resource could be anything. Often people will choose a person, a place, or a memory. You could also bring something from home that provides a sense of safety like a sacred object or favourite pillow, blanket, or stuffed animal.

Audio Guide

In the following audio guide, you will be led through an activity to help identify resources.

Note that [...] represent moments where the speaker has paused. Please take liberal pauses during these moments as needed.

I'm going to take you through this brief resourcing practice. And so finding a comfortable position. This could be lying down. Could be sitting up. Just a position where you can feel relaxed, safe, and able to reflect on internal experience and making whatever adjustments are called for to settle in, allowing the eyes to close. Turning attention inward and taking three deep breaths, focusing on the out breath in particular, allowing for the breath to be longer than the breath.

[...]

And when that's feeling complete, sing, it's possible to find an anchor for attention. This is commonly the sensations of breathing at the belly or chest, or maybe at the tips of the nostrils. It could also be a sound. It could be the palms of the hands or the fingertips. It could also be the soles of the feet. Any anchor will do.

[...]

The idea is simply to hold attention on whatever that is for a moment, just to help allow the mind to settle a little bit. Testing with that anchor as best you can, and then seeing if it's possible to broaden awareness, to notice the entire body, noticing the chest and the abdomen, the back, the neck and shoulders, the arms in the hands, the legs and the feet, the face and the head.

[...]

And just dwelling here for a moment in this spacious awareness, if that's available to you. And then when you're ready, bring to mind a moment in your life, a time in your life when you felt particularly safe, peaceful, and well, that moment could be in a particular place, like in the woods or by a lake or on a mountaintop or something like that.

[...]

You could be with a particular person, a pet or an important object. And so going back to this moment, in your mind and doing your best to really remember to go back there, to get into the details, exploring the sights, sounds and smells, how you felt as you're exploring that moment, seeing if it's possible to notice what's arising in the body. So what sensations may be present, if there's any emotion present, any impulses to act.

[...]

Just exploring this with curiosity, really savoring the pleasantness of it, the peacefulness, the experience of feeling resourced. You're welcome to soothe yourself with supportive, touch your. It might be helpful, for example, to hold your hands over your heart. Holding your hands or gently rubbing your hands may also be supportive to cross your arms and rubber. Tap the opposite arms with your hands.

[...]

So breathing here, savoring this experience, and then when you're ready, beginning to transition back. Opening the eyes and bring your attention back into the room.

Reflection

Consider three resources that you could use during your Medicine Session (and also your Integration and Preparation Sessions) when experiencing a challenging moment. Communicate these resources to your therapist prior to the Medicine Session so that they can remind you of these as needed.

Please record your thoughts in your Experiential Period Preparation Worksheet for your portfolio.

Grounding

Grounding is a method of self-regulation which allows you to stay within your window of tolerance. You can attempt to connect with your present moment environment by bringing awareness to your senses:

  • Touch three physical objects in the space and focus on the touch sensation and how it makes you feel
  • Listen for any noticeable sounds in the space (ticking clock, tapping of foot, music)
  • Identify three physical objects that you can see
  • Inhale deeply through your nose and identify what smell is most prominent

Audio Guide

In the following audio guide, you will be led through an activity to practice one approach to grounding.

Note that [...] represent moments where the speaker has paused. Please take liberal pauses during these moments as needed.

I'm going to take you through this brief grounding practice, and we're going to start with some breathing and just knowing that you can do this with the eyes closed, if that's supportive and helpful or with the eyes open, if that feels more comfortable. Finding a comfortable position to be sitting or lying down, making whatever adjustments are called for, to lie there, settling in.

[...]

And let's take a few breaths, a few deep breaths together, really focusing on the air, coming in and out of the body and allowing the breath to be longer. It might be helpful to breathe in through the nose and then exhale through the mouth, even allowing for a sigh.

[...]

If that feels right, and coming perhaps to the fifth and final breath and pointing your attention to the soles of your feet, really noticing the contact with the ground or whatever they're in contact with, if you're lying down, perhaps it's the heels in contact with the ground or whatever you're lying on.

[...]

Just getting curious about what those sensations are like, really feeling into that part of the body, noticing hardness, softness, and then slowly moving attention up the legs. So you might notice on the way the top of the foot, perhaps the toes, the ankle, the lower part of the leg, the calves, the shins, the knees, the thick muscles in the thighs, really feeling into the sensations in the legs, moving attention from up in the head down into the lower part of the body, and then seeing if it's possible to shift attention to the hands, noticing the palms of the hands, noticing the fingers, noticing where the hands are in contact with something else, whatever the textures might be, the temperature there's any tingling or warmth or moisture in the hands. Just getting curious.

[...]

So the unfolding of those sensations at the hands as best you can. And then if the eyes are closed, allowing them to open and looking around the room or wherever you are and see if you can just name five objects that you see in the room, point your attention at one, name it out loud, and move on to four more.

[...]

And then doing the same thing with sound that might be available. Noticing three or four sounds, naming them that loud, and then once again coming back to the sensations of breathing, noticing what it's like to be in the body in this moment.

[...]

And when you're ready, letting go of this practice and reorienting back to your day.

Mindfulness

Mindfulness is another strategy that supports focusing on the present-moment experience. Under the effects of the medicine, having mindfulness skills may be helpful to avoid getting too caught up in worries or rumination and to focus on grounding attention in the unfolding of sensory and embodied experience.

Audio Guide

If you are not already practicing mindfulness, please use the audio guide below for a brief mindfulness exercise.

Note that [...] represent moments where the speaker has paused. Please take liberal pauses during these moments as needed.

I'm going to take you through a brief mindfulness practice. And so finding a way of sitting or lying down, a position that's going to be helpful, to relax, feel calm, but also alert and dignified.

[...]

And so taking a moment to settle into this position and making whatever adjustments are called for transitioning into the practice and just allowing the eyes to close, if that feels comfortable, if you prefer to keep the eyes open, maybe just looking down at the floor or the desktop in front of you with a soft gaze and noticing and now taking three deep breaths with the emphasis on the breath, making the breath longer than the breath.

[...]

Sometimes that kind of breathing could just help the mind in the body settle into the present moment, and now opening up to whatever is already present in your experience. And so noticing what's happening at the level of thoughts, what thoughts are present, the mind could be very busy. There could be racing thoughts, noticing if there are any images could be quieter in there. It's all good. Just noticing, observing what's there without needing to do anything in particular with those thoughts

[...]

And then noticing what's already present at the level of emotions or feeling tune. There may be some nervousness, there may be some joy or happiness, there may be some frustration or irritability. There may be some subtle preferences playing out on your mind right now. All of that is welcome.

[...]

Just noticing with some curiosity without needing to do anything about it and then dropping down into the body. Perhaps some of the emotions or feelings that you noticed are manifesting in the body. Or maybe they're just some sensations that are calling on your attention just observing what's there with curiosity. There may be tension, there may be spaciousness, noticing contact with the chair or whatever it is that your body is in contact with noticing.

[...]

If there are any impulses to act as you check in with the body, all are welcome.

[...]

And now transitioning to attending to the sensations of breathing. And so sometimes the sensations of breathing can be most available at the abdomen. The sensations of the abdomen expanding and contracting. Sometimes it's the sensations of the chest rising and falling. Sometimes it's the air moving in and out of the nostrils, just picking one of those anchors and holding attention there as best you can, seeing if it's possible to cultivate a sense of interest or curiosity into this rhythmic unfolding that you're observing.

[...]

This isn't a matter of brute force, just holding attention tightly there, but taking an interest in seeing how these sensations unfold moment by moment. It's perfectly normal, perfectly okay. If attention is jumping around in a kind of monkey mind sort of way, which is very common for humans to experience that and as being as gentle and as kind as possible and noticing, observing attention being pulled and slowly escorting attention back to the anchor that you've chosen for this practice, even if you have to do that many times, that's just part of the practice.

[...]

It's part of mindfulness, of waking up to what's currently in attention and coming back to an intention which here is staying with the anchor. Once again, the practice is just noticing, waking up, coming back, coming back to the anchor, and staying with the unfolding of these sensations moment by moment, and now seeing if it's possible to expand awareness from that very specific location in the body and opening up to more so noticing the entire upper body, the chest in the abdomen and the back and the sides of the body noticing the neck and shoulders, noticing the arms in the hands, noticing the pelvis and the legs and the butt against the chair or whatever you're sitting on and noticing the legs and the feet noticing the head and the face.

[...]

And as best you can, holding the entire body in awareness, cultivating a sense of spacious awareness and just breathing in this spaciousness, aware of the entire body, and then noticing the limits of the body, noticing where the body's in contact with other things, noticing perhaps sound around you, arriving at the ears, noticing the air that you're swimming in, coming into contact with your skin, noticing what your hands are in contact with, noticing the soles of the feet as you do that, seeing if it might be helpful to set some kind of intention for how you'd like to approach the next moment or the rest of the day or the rest of the week. Whatever. Feels supportive.

[...]

What's your intention coming out of this practice and entering back into the flow of your life?

[...]

And when that feels complete, allowing the eyes to open if they've been closed and coming back to the outside.

Reflection

What are 2-3 ways that will be helpful for you to ground or regulate yourself if needed during your Preparation, Medicine, and Integration Session?

Please record your thoughts in your Experiential Period Preparation Worksheet for your portfolio.

Parts Work

Dick Shwartz, the creator of Internal Family Systems therapy, among others has argued that the mind is made of a multiplicity of parts (Schwartz & Sweezy, 2019). Individuals have various internal parts which are organized around specific roles, such as protector parts, manager parts, and wounded parts. Each part develops through different phases of development, often as adaptations to adversity or stress. Typically, parts take on roles of protecting individuals from unwanted or difficult emotional experiences.

In the case of trauma, some parts can take on extreme roles and dominate one’s life, as is the case in Structural Dissociation. Getting to know these parts and entering into dialogue with them can be profoundly liberating and healing for people.

Audio Guides

In the following audio guide, you will be led through a meditation to begin exploring your parts.

Note that [...] represent moments where the speaker has paused. Please take liberal pauses during these moments as needed.

Okay. I'm going to take you through a short parts meditation. And so, yeah, maybe beginning by setting yourself up for a meditation and you can do that in a traditional meditation posture or sitting on a chair or even lying down, whatever is going to be supportive to you, kind of paying attention inwards and feeling relaxed and also alert.

[...]

And so taking a few moments here to kind of settle in and making the last few adjustments to your posture that are called for. And if it's helpful, I be taking three deep breaths and ideally making the breath a little longer than the breath. And so just leaving some space to settle in. And so noticing as your attention is now inward noticing what's already present here, there may be some thoughts, there may be some images, there may be some emotions or a feeling tone.

[...]

There may be some sensations in the body and possibly even some impulses to act just noticing what's here without any need to do anything about it or change anything. And everything is welcome. And then noticing if one of the sensations in the body is calling out to you, one in particular seems to want your attention. You don't need to overthink this.

[...]

Just seeing what is most salient in your attention in this moment, and then focusing attention on those sensations on that part of the body, just staying with it, really localizing it in the body, being with it just as it is, and as you're attending to these sensations, to this part, noticing how you feel toward it. Are you welcoming it?

[...]

Do you dislike it? Does it annoy you? Are you afraid of it? You want to get rid of it? Maybe so. Just noticing your relationship to this part and now seeing if it's possible to ask the parts that aren't welcoming the original part those sensations to just relax inside and give you a little space to get to know it a little bit more.

[...]

To be curious about it as though it might have something to tell you if you can't get there, that's totally okay. You can proceed by talking to the parts that don't want to relax or step aside about their fears of letting you talk to that part. And if you can become curious about those original sensations, that part, then it's probably safe to begin interacting with it, talking to it, and it may feel a little strange to it, to interact with parts of yourself in this way, but just give it a try.

[...]

And so directing attention back on the sensations in the body, the part that was calling out for attention earlier, really noticing it in the body and see what happens if you ask it, if there is something it wants you to know, you know, try not to think about what the answer is. Just wait for an answer while you're attending to the sensations in the body, waiting silently until an answer arises.

[...]

And if nothing arises, that's okay to just staying with those sensations just as they are and seeing if that part has something it wants you to know. If you do get an answer, follow up with another question, which is What is it afraid would happen if it didn't do what it's doing, if it didn't take on this role inside?

[...]

What is that part afraid would happen if it didn't play this role inside? An answer will teach you something about how that part is trying to protect you and seeing if it's possible to extend some gratitude to that part for at least trying to keep you safe. Somehow and then noticing how it reacts to your appreciation. And let's go ahead and ask that part one more question.

[...]

That's the part what it needs from you in the future. What does this part need from you in the future? And now, thinking this part for whatever it let you know and actually thinking all the parts that you met during this practice for sharing what they had to share with you and letting all these parts know that this won't be the last chance for them to express themselves to you.

[...]

Now that you've gotten to know them a little bit, you're going to try to connect with them a little more often in the future. Just noticing how these parts react and then transitioning now to reconnecting with your surroundings, wrapping up the practice, opening the eyes at your own pace and shifting your focus back to the outside world.

Now that you have completed the meditation, you will be led through a parts mapping activity where you will be able to write out a list of parts.

Note that [...] represent moments where the speaker has paused. Please take liberal pauses during these moments as needed.

I'm going to guide you through a parts mapping practice. For this practice, you're going to need a piece of paper and something to write or draw with. So pen, pencil marker, etc.. And just so you know, through this practice, we're going to be shifting back and forth from inward to outward. And so the idea here is to set yourself up for a kind of meditation practice.

[...]

So sitting comfortably in a dignified posture in a way that will support internal reflection, but then also setting yourself up. So you've got the paper and the pen on the tabletop in front of you.

[...]

And then when you're ready, settling in for the first part, which is internal. So allowing the eyes to close, if that's comfortable for you, making whatever final adjustments are called for to transition into this practice and then starting with three deep breaths and focusing on the Oprah. So it's a little longer than the breath when that breathing feels complete, checking in with what's happening, what's already present in the body and mind.

[...]

So noticing what thoughts are already present in your experience, perhaps images, any emotions present nervousness, joy, sadness, or any kind of subtle feeling, tone, some irritability, preferencing.

[...]

Noticing how any of these things, the thoughts, the images, the emotions might be showing up in the body. So what body sensations are present in your experience? And then any impulses to act? Noticing all of this without any need to do anything about it, all are welcome. And now, seeing if any of these sensations are calling out to you seem to want your attention pointing attention to this sensation, this part really locating it in the body, developing a clear sense of its presence as best you can, and spending enough time with it so that you can get a feel for how you might represent it on the page in front of you or what it might look like.

[...]

And when you have that sense, go ahead and open your eyes and draw on the page. Any kind of image will do even a really basic scribble. It doesn't have to be a piece of fine art, but when the drawing feels relatively complete, once again, closing the eyes and dropping back in, coming back to that same part, focusing on that part again, noticing where it is in the body and staying with it until you notice some kind of shift.

[...]

Another thought arises another image, emotion, sensation, impulse. Some other part arises and calls out to your attention.

[...]

And when that shift occurs, focusing on that new one, that new part, finding it in the body and staying with it until you have a sense for how you might represent it on the page in front of you. Also.

[...]

And so when you feel ready to do that, opening the eyes and drawing the part, once that feels complete. Putting the pen down once again, dropping in to internal experience with the eyes closed and finding that second part again and staying with it in the same way until you notice another shift, another part emerges and shifting your focus to this new one, finding it in the body and staying with it until you feel you're able to represented on the page when you're already going ahead and drawing that part.

[...]

And when that feels complete, putting the pen down, dropping back in, going back to that third part, focusing on it again, finding it in the body, staying present with it until yet another part comes forward. Shifting to that new part, finding it in the body and staying with it until you feel you're able to represented on the page when you're already going ahead and opening the eyes and drawing.

[...]

And so when that drawing feels complete, keeping the eyes open here, putting the pen down and picking up the piece of paper and holding it out in front of you and looking at these parts that you've represented from this perspective. Just getting curious about what you're noticing as you take a look at these parts. And I might help guide this reflection by offering a few questions and you're welcome to take notes or continue drawing.

[...]

As you reflect on the questions I offer. And so the first question is how do these parts relate to each other? Do some protect others? Do some fight with each other? Is there some kind of alliance in there as a finding a way to represent the answers to those questions on the page? And then the second question is how do you feel towards each of these parts?

[...]

And then finally, if you were to try to help this system, this cluster of parts inside of you, where might you start and what might it need from you capturing your answers to that question as best you can on the page.

[...]

And then when that feels complete for now, once again, putting down the pen, dropping back inside, closing the eyes, and taking a moment to thank each of the parts for revealing themselves to you, letting them know this isn't the last time you'll be talking with them. And when that feels complete, allowing the eyes to open and shifting attention back to the outside.

Reflection

What parts of yourself are you aware of and what roles do they have in your life?

Do you have any parts who are not fully keen to participate in psychedelic-assisted therapy? What are their concerns? How do you feel toward that part? Do you have a “therapist part” that is keen to learn how to become a better psychedelic-assisted therapist? Can you gently ask that part to relax and step aside for this part of the training?

Bring these thoughts to your Preparation Session to discuss with your therapist.

Please also record your thoughts in your Experiential Period Preparation Worksheet for your portfolio.

References

Fisher, J. (2017). Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation. Routeledge.

Schwartz, R. C., & Sweezy, M. (2019). Internal Family Systems Therapy (2nd ed.). Guilford Press.