Abstract

Patient Experiences of Therapeutic Touch in Psychedelic-Assisted Therapy

Results from a Clinical Trial and Implications

Psychedelically-induced altered states of consciousness often entail profoundly challenging experiences that can be frightening or overwhelming for participants. However, a number of factors may compromise the effectiveness of verbal support from therapists during dosing sessions (e.g., ineffability, acutely impaired communication; risk of interrupting therapeutic internal experiences).

Therapeutic touch (e.g. holding a patient’s hand during challenging experiences) was identified early in psychedelic research as a valuable tool for reassuring distressed patients, and generally providing support. However, the use of therapeutic touch in psychedelic therapy remains controversial. Beyond major transgressions such as reports of sexual misconduct associated with psychedelic treatment, issues raised include problematic patient-therapist power dynamics, compromised capacity to consent whilst ‘intoxicated’, and participants experiencing touch as unpleasant, unintentionally sexual, or coercive. Critically, no research to date has investigated participant experience and therapeutic utility of touch for patients undergoing psychedelic-assisted therapy.

This talk will explore patient experiences of therapeutic touch within a clinical trial of psilocybin-assisted therapy for participants with Generalised Anxiety Disorder. This trial used an advanced care directive approach, where therapeutic touch is well specified and limited, negotiated ahead of time during non-drug psychotherapy sessions, and supplemented by in-session consent. Based on qualitative and quantitative data gathered both before and after dosing sessions, this talk presents the first empirical findings and a nuanced discussion on participant experiences of receiving therapeutic touch, and their changing attitudes towards touch across the course of treatment.

Results indicate that touch may be uniquely indicated within psychedelic-assisted therapy, and that the advanced care directive is evaluated positively by participants. Participants report that touch can enhance therapeutic alliance and facilitate psychotherapeutic progress. However, touch was not always regarded as universally positive, and considerations for the use of touch will be discussed. In a time of exponential growth in investment, research activity, and patient access for psychedelic treatments, the findings from this study can help to shape the role of therapeutic touch within standards of clinical psychedelic care.