Affect and Psychedelic Therapy: From Raw Emotion to Narrative Memory
In recent years, psychedelic-assisted therapy (PAT) emerged as a promising approach for treating various mental health disorders. Using psychedelic substances in combination with psychotherapy seems to work by facilitating emotional breakthroughs and supporting deep psychological healing. Unlike conventional treatments that rely on verbal processing and cognitive restructuring, psychedelics seem to activate raw, pre-verbal emotional states that are difficult to express through language. This may allow individuals to engage with emotions in a fundamentally different way (van Elk & Yaden, 2022).
Affect theory offers a useful framework for understanding this process. It focuses on the primary, bodily experiences of emotion that precede cognitive interpretation (Bazinet & Van Vliet, 2020; Massumi, 1995; Tomkins, 1984). This article examines how psychedelics help individuals integrate raw affect into coherent personal narratives, both in individual and group therapy settings. Drawing on neuroscientific research and clinical case studies, it investigates how psychedelics influence key brain structures to impact memory reconsolidation and emotional integration, while also exploring how shared experiences in group settings influence emotional processing and meaning-making. Many patients undergoing PAT describe deeply emotional experiences that are difficult to articulate – from unexplained tears to waves of sensation or joy unconnected to specific memories – suggesting that psychedelics engage affect before it is structured into recognizable emotions or integrated into personal narratives.
Part I: Psychedelics and the Individual Integration of Affect
The Pre-Verbal Nature of Affect in Psychedelic Experiences
To comprehend how psychedelics influence emotion, we first need to distinguish between affect and emotion. Affect refers to the immediate, physiological experience of feeling and can be understood as a bare sensation before the mind is able to categorize it or express itself verbally. Emotions, in contrast, are affect that has been processed and framed within personal and cultural narratives (Neurolaunch, 2024; Russell, 2003).
Metaphorically, affect is the electric charge behind an emotional response: The racing heart before fear is recognized or the lump in the throat predisposing sadness. This distinction is important because psychedelics seem to amplify affect by bringing people into direct contact with these raw states before their mind has a chance to digest them.
Psychedelic experiences often feel overwhelming and difficult to articulate. Psychedelic users describe profound yet elusive emotional shifts: “Something deep inside” moved, a flood of feeling beyond words (Yaden et al., 2024). This aligns with affect theory’s emphasis on the physical, non-verbal nature of emotions. Rather than just recognizing feelings, psychedelics allow individuals to live them before they are shaped by habitual thought patterns.
Many personal accounts shared online illustrate this deeply embodied transformation. For example, one individual sharing their experience with psilocybin recalls, “Instead of knowing we are worthy of love, we actually felt worthy of love and held the memory of that sense in our bodies long after the experience” (Mind Medicine Australia, 2022). What is described is the physical feeling before making meaning from it. Another describes an unfolding awareness: “While initially I didn’t understand what I was seeing, the more I engaged with a conversation inward, the more I heard back and saw very clearly LIGHT” (Piece in the Journey, 2023). Others report intense emotional release, as one recounts, “Fifteen minutes after gulping down the psychedelic tea my eyes start streaming… emotions erupt and spread like wildfire” (Coxon, 2018), again showing that the physical sensation can predispose its understanding.
This therapeutic mechanism could be valuable because it engages emotions in a way that conventional treatments often do not, allowing individuals to feel before understanding.
Psychedelics, Memory Reconsolidation, and Narrative Integration
Beyond heightening affect, psychedelics also facilitate memory reconsolidation, which is understood as a process in which deeply ingrained emotional memories become malleable, open to reorganization and reinterpretation (O’Brien, 2023). This is especially relevant in therapies for PTSD and trauma, where patients revisit painful memories with newfound emotional flexibility.
PAT seems to address both affect and its cognitive integration. Looking at how psychedelics influence the brain may help explain their role in affect. Neuroscientific research suggests that psychedelics affect brain regions involved in emotional processing.
The amygdala regulates fear and threat responses. Psychedelics appear to reduce its hyperactivity, which allows individuals to engage with traumatic memories in a less defensive manner (Stoliker et al., 2024).
The hippocampus is critical for memory formation and retrieval. Psychedelics seem to influence neurogenesis, the formation of new neurons, in this brain structure, which may promote new associations between past experiences and present emotional states. This in turn may promote more adaptive responses (Catlow et al., 2016).
The prefrontal cortex helps integrate experiences into coherent narratives. Psychedelics have shown to be able to promote both the functional and structural plasticity of this brain region and may increase its connectivity to emotion-processing centers. This may enable individuals to reframe past experiences with greater clarity and self-compassion (Ly et al., 2018).
Furthermore, psychedelics impact the default mode network (DMN), which is linked to self-reflection, mind-wandering, and personal identity. In PTSD and depression, an overactive DMN reinforces rigid thought patterns and negative self-perception. By temporarily disrupting this network, psychedelics may induce cognitive flexibility, which could lead the individual to form new insights and reframe emotions. This shift may help reprocess memories and integrate past experiences more adaptively, explaining the effectiveness of PAT in treating trauma (Gattuso et al., 2022).
Integrating this knowledge into clinical practice is essential for therapists to remain sensitive and responsive to the unique needs of each client.
From Affect to Meaning: Why This Matters for Healing and Clinical Practice
Effective psychological healing involves more than just the re-experiencing of emotions; it requires the capacity to process and integrate affective states into a coherent self-narrative. Many individuals experience affective dysregulation, wherein unresolved emotional residues from past trauma contribute to psychopathologies (Dvir et al., 2014). PAT seems to bring these affects to the surface and has the potential for the reassessment and integration of cognitive and emotional experiences, leading to lasting psychological transformation.
The role of the psychotherapist is essential in guiding this process. Within a structured therapeutic setting, the clinician supports individuals in maintaining engagement with difficult affective material while reducing the risk of dysregulation or re-traumatisation. Psychedelics may bring unresolved affect to the surface, but without proper therapeutic support, individuals may struggle to make sense of these experiences (Phelps et al., 2017).
The psychotherapist plays a crucial role in recognizing and addressing the challenges that arise when raw affective states emerge in PAT (Carbonaro et al., 2016, Gashi et al., 2021). Several key considerations include:
Overwhelm and Emotional Flooding The intensity of raw affective experiences can be difficult to manage, potentially leading to emotional dysregulation or re-traumatization if not properly supported.
Difficulty in Verbalizing Affect Because psychedelics engage pre-verbal emotional states, individuals may struggle to articulate their experiences, making post-session integration challenging.
Variability in Responses Not all individuals experience affect in a transformative or coherent way. Some may have fragmented or distressing experiences that require careful therapeutic navigation.
The Need for Structured Integration Support Without proper guidance, psychedelic experiences can remain disorganized, offering temporary emotional release without deeper psychological integration.
To address these challenges, psychotherapists may adopt specific strategies:
Providing a safe environment Previous research found the importance of set and setting for the success of psychedelic experiences and PAT (Borkel et al., 2023). By offering a therapeutic setting, reassurance, and emotional containment, therapists help individuals remain present with challenging affective states.
Facilitating meaning-making PAT often incorporates elements of other behavioral interventions that therapists should be trained in (Luoma et al., 2019). Through dialogue and reflection, therapists assist in linking psychedelic experiences to personal history, helping individuals integrate affect into an adaptive self-narrative.
Preventing overwhelm and dissociation The acute effects of psychedelics can often be overwhelming or challenging (Barrett et al., 2016). By monitoring distress levels and offering grounding techniques, therapists ensure that the therapeutic process remains constructive rather than overwhelming.
Supporting long-term integration Psychedelic integration is an important aspect of PAT and requires training from the psychedelic therapist (Bathje et al., 2022). Beyond the psychedelic session itself, therapists help individuals apply insights gained during PAT to their daily lives, reinforcing sustained improvements in mental health and well-being.
Without this structured framework, psychedelic experiences risk remaining intense but disorganised, offering emotional release without deeper psychological integration. By combining affect theory with clinical practice, therapists can optimize PAT’s effectiveness, ensuring that psychedelically induced affective shifts contribute to meaningful and lasting change.
Looking Ahead
Looking at the role of affect in PAT in different contexts could provide important information about how to maximize therapeutic results. To make sure that psychedelic therapy is tailored to each patient’s needs, future studies could examine the subtleties of these processes.
What is already clear is that psychedelics do not simply evoke emotion; they offer a powerful mechanism for transforming it. By engaging with affect at its most fundamental level, they provide a unique window into the relationship between feeling, memory, and meaning. However, special attention must be paid to the integration and transformation into understandable emotions to achieve this therapeutic effect.
A better understanding of affect and its role in PAT may have the potential to improve its treatment protocols and emphasizes the importance of the psychedelic psychotherapist.
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