"The Psychedelink" part 2

- The Purpose of Psychotherapy and the refusal of "Therapeutic Fascism"

The purpose of therapy is not to impose a ready-made blueprint of health, but to support the unfolding of a person’s own capacity to live more fully. A good outcome is not measured by compliance with external ideals, but by whether someone can orient themselves from their own inner compass — able to love, to work, to depend on others when needed, to enjoy pleasure and serenity.

Wilhelm Reich, Austrian psychoanalyst and psychiatrist, famously wrote that “love, work, and knowledge are the wellspring of our life” (Reich, 1949/1933). From this perspective, the purpose of psychotherapy is not primarily the elimination of symptoms, but the facilitation of greater freedom to live fully. To sustain meaningful relationships, to engage in productive activity, and to cultivate both knowledge and pleasure. Ketamine, with its capacity to temporarily soften entrenched defenses and open access to pre-reflective experience, may thus be especially well-paired with a character-analytic approach.

The psychodynamic stance of non-directiveness, privileging autonomy, space, and time, provides the conditions in which ketamine’s destabilization of rigid structures can be integrated rather than prematurely organized into external narratives. This is why psychodynamic therapy can be a valuable companion to ketamine-assisted work. At its best, psychodynamic and psychoanalytic practice is not about persuasion, correction, or counseling, but about holding space for autonomy to be sensed, felt, and strengthened - so that symptom relief is possible. It is a stance of trust, a refusal of therapeutic fascism, that honors the client’s inner healing capacity, and allows it to come forward in its own time. In this way, therapy does not dictate the path, but makes room for it, by fostering a process where the individual can truly live from their core rather than from the reassurance of others. A positive outcome may therefore be defined less by external compliance and more by the individual’s ability to navigate life coherently from their own inner compass (Shedler, 2010; Fonagy & Allison, 2014).

Merleau-Ponty’s concept of the lived body can be understood as complementary to Reich’s notion of character armor in illuminating the potential of ketamine-assisted therapy. Reich emphasized how healing emerges not from suggestion or persuasion, but from dissolving the rigidities that constrain vitality - and focusing on the analysis of defensive structures, the “character armor” that organizes both psychic and somatic resistance. In this sense, Reich’s emphasis on embodied character structures aligns with contemporary psychedelic research that describes an “inner healing intelligence” guiding the process (Mithoefer et al., 2017; Watts & Luoma, 2020). In Maurice Merleau-Ponty’s philosophy (1962), he emphasized that perception and existence are always embodied: our orientation toward the world is mediated through the lived body, rather than through abstract cognition alone. We encounter the world not as detached observers, but with our whole “body-mind being”, as I like to call it.

Ketamine, by loosening habitual patterns of perception and disrupting embodied defenses, creates a temporary suspension of these rigidities. When held within a psychodynamic frame, this suspension can allow clients to encounter both their defenses and their perceptual world anew — not as fixed and given, but as fluid, open, and susceptible to transformation. In this way, Reich’s analytic focus on embodied defenses and Merleau-Ponty’s phenomenology of perception converge to offer a powerful theoretical foundation for understanding the therapeutic potential of ketamine-assisted psychotherapy. (Although evidence remains anecdotal, some accounts suggest that Merleau-Ponty and other contemporaries in mid-20th-century French intellectuals, may have experimented with psychedelic substances. This possibility is intriguing in light of his reflections on perception, embodiment, and the lived world).

Psychedelic experiences often radically alter the structures of perception and embodiment in ways that resonate with phenomenological insights: they reveal how the boundaries of self and world are constituted through lived bodily intentionality. When situated within a psychodynamic frame, ketamine-assisted psychotherapy can therefore be understood not only as symptom relief, but as a phenomenological reorientation — a temporary loosening of rigidified patterns that allows clients to re-inhabit their existence with greater fluidity, presence, and vitality.

References

Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372–380. https://doi.org/10.1037/a0036505

Merleau-Ponty, M. (1962). Phenomenology of perception (C. Smith, Trans.). Routledge & Kegan Paul. (Original work published 1945)

Mithoefer, M. C., Grob, C. S., & Brewerton, T. D. (2017). Novel psychopharmacological therapies for psychiatric disorders: Psilocybin and MDMA. The Lancet Psychiatry, 3(5), 481–488. https://doi.org/10.1016/S2215-0366(16)30372-3

Reich, W. (1949). Character analysis (3rd ed., V. R. Carfagno, Trans.). Orgone Institute Press. (Original work published 1933)

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. https://doi.org/10.1037/a0018378

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. https://doi.org/10.1016/j.jcbs.2019.12.004