Marc Aixala

Marc Aixala

Marc Aixalà is an engineer, psychologist, psychotherapist and Holotropic Breathwork facilitator. He leads the ICEERS Integration & Support service and has supported hundreds of people who faced challenging experiences with psychedelics.
Marc Aixala

Recently, the concept of integration has become a hot topic in the context of the use of psychedelic substances, and particularly in the Western ayahuasca-drinking circles. Emphasis is placed on the need for integration; new professionals are emerging who offer integration services, and many people request integration of their psychedelic experiences. However, if we ask what integration is, what it consists of and how it is done, the answers are unclear.

Since 2013, the ICEERS Integration and Support Service has supported hundreds of people who have had difficult experiences with psychoactive substances. Through this experience, we’ve gained a deeper understanding of the meaning of, and factors that contribute to, integration.

The Shamanic World vs the West

In shamanic cultures, the concept of integration does not seem to exist per se, although there are practices that go in the direction of integrating what happens during entheogenic experiences. However, in shamanic cultures and in the traditional context of ayahuasca churches, in places such as in Rio Branco or Mapiá, but not so much in Western urban churches, the concept of integration does not exist because the experiences that members of the community have are already part of the shared social worldview.

Therefore, both experiences and practices are already socially integrated; there is no separation between what happens during the person’s experience and their daily life. There is a worldview and a community that sustains these kinds of experiences, and any phenomenon that occurs during or after the experience considered “normal.” In addition, beliefs around health and disease and their causes are different, and the concept of “personal development” is something new that has been incorporated through contact with the West. Therefore, in shamanic cultures, integration has a social and ontological dimension.

In the West, however, the experiences we may have when under the influence of a psychedelic substance are often quite separated from the prevailing materialistic and consumerist worldview. The contexts in which these experiences are carried out, and the practices associated with them, again, are something alien to the social celebrations considered normal. Our peers, in most cases, do not have a deep understanding about these experiences, so sharing them with others can pose a risk of misunderstanding, rejection or even pathologization. In the places where these substances are new to our culture, we approach them to learn and discover, and to cure mainly psychological problems. We understand that it is access to the depths of our personal psyche that can have a therapeutic effect (this, of course, is a simplification).

These extraordinary experiences are totally separate from everyday experiences, both in content and in form. Upon returning from them, we have the sensation of having lived a punctual fact, separate and independent from the rest of our life narrative. And sometimes the experience does not fit into that narrative, our worldview, or the conception of ourselves or of reality; this is when the need for “integration” arises. Therefore, integration is a Western concept, psychological, and mostly individual.

Integration in the Early Days

After the first attempts to use psychedelic substances in a Western therapeutic framework by people like Stanislav Grof, it was acknowledged that many patients needed post-experience interviews to discuss in what happened . It was also understood that people needed support before the experience to receive information that would prepare them for what could happen. In addition, different methods of conducting psychedelic sessions were also developed. Thus was developed the model of 1) Preparation 2) Session and 3) Integration.

In the early days, examinations of the therapeutic potential of these substances focused primarily on the experience itself: on the effects caused by the substance. It was observed that it was the kind of experience that caused the healing, so those developing the therapies paid attention to leading the experience in the best possible way, so that the result would be positive. For example, under the psychedelic paradigm, LSD-induced peak experiences had the potential to heal alcoholism because of their specific phenomenological nature. A transcendent experience of unity, ineffability, and numinous characteristics seemed to be what it took to heal.

Therefore, at that time, the objective of integration was to facilitate the landing after the session and to manage the possible complications. But what was really healing was the positive resolution of psychedelic experiences.

Grof proposed certain techniques for integration. Say, if, after a session, the person presented a worsening of the symptoms, another psychedelic session would be scheduled as soon as possible, with the intention of solving the unconscious material that was stuck in the psyche of the patient. (Warning for navigators: They could do this because they had a team of doctors, nurses, and psychologists 24 hours a day, and worked in a hospital context. Do not try this at home.)

Modern Times: Today’s Integration

After decades of psychedelic self-experimentation, psychonauts and therapists have realized that, while positive psychedelic experiences can bring benefits and improve our lives, it is possible, and even likely, that positive results will fade over time. It seems that something must be done after the experience to maintain the benefits, and for those benefits to impact our daily lives and our relationships. Now, integration is understood as the work that needs to take place after the experience to ground the outcomes, to maximize the benefits, and to incorporate the things we learned from the session into our day-to-day lives.

Another dimension of integration, however, is linked to the work we have been doing at ICEERS since 2013 through our Integration and Support service. There are people who, after an experience with psychoactive substances, experience difficult situations in the days that follow. These situations include anxiety, insomnia, panic attacks, and feelings of depersonalization and derealization, among other symptoms. In these situations, it is not a question of maximizing benefits or learning, but of dealing with a traumatic situation and treating these unpleasant symptoms.

One of the main risks of experiences with psychoactive substances is that a traumatic experience or re-traumatization can occur. In such cases, what integration deals with are symptoms similar to those of Acute Stress Disorder, which can lead to Posttraumatic Stress if it becomes chronic. To recap, there are two different dimensions to integration: a) interventions to maximize benefits and incorporate lessons into everyday life, and b) interventions to treat the symptoms of a traumatic experience.

Integration: Are We Creating a New Need?

Usually, after intense experiences in expanded states, each of us does (or doesn’t do) our own integration. The experience remains in our memory, and when we reflect on it, there is usually a certain echo of what was experienced. These memories can be brought up in certain situations or circumstances.  One can feel how that experience has had an impact on our life and how it has influenced our being.

Most times in these situations we do not have the feeling of needing anyone to help us integrate the experience. In the worst case, if we do nothing to integrate the experience, the positive effects will fade over time, and we will return back to the same point we were at before.

However, when I hear talk about integration these days, it is stated like an essential need; something we were not aware of before; as though, if we do not “do the integration,” we are doing it wrong, and that one must go to someone else to integrate an experience. Lately, there are many groups, therapists, coaches, and counselors who offer sessions to helping people integrate their experiences. A few years ago, everyone wanted to be a psychedelic shamans or therapist. Now, it seems that what is fashionable is to be an integration therapist, whatever that is! And, while it may be extremely useful to do some integration session with a therapist with experience in the field, it seems to me that creating the need to do so is against one of the greatest benefits that visionary experiences can bring us: empowerment and responsibility.

I strongly believe that the benefits of using psychoactive substances are much greater when they are used in a structured context; and, if the purpose is therapeutic, framed in a therapeutic process in which there is preparation and integration. In such cases, a few psychedelic sessions can have a profound and beneficial impact. However, when we hold sessions for our own self-exploration, it is not imperative that we then “do the integration.” We must take responsibility for what we would like to better understand about what we received from the experience, and then decide how we want to tackle it, and what kind of integration we need.

Integration and psychotherapy

In the same way that there are different integration needs—either to maximize benefits or to deal with the symptoms of a traumatic experience—there are different integration practices; sometimes there is confusions about these. When we engage in an integration process to maximize the benefits of a session, and do not endure a particularly traumatic process, the usual activities offered at retreats or integration circles are usually enough:  drawing mandalas, writing a report of the experience, sharing the experience in a context of respect and support, making commitments, and proposing achievable goals for our day-to-day lives.

One can perform these types of activities alone, or with one’s partner or friends. You do not have to go to a therapist to do it. Integration circles have the advantage of incorporating the social dimension, which is extremely important. One of the possible benefits of the current culture of integration is that experiences of expanded states and associated practices become more understood in our society and stop being relegated to the underground.

You can also go to a therapist to talk about a particular experience and try to get more insight about that experience. We could call these “integration sessions,” or “integration therapy”; but this should not be confused with a psychotherapeutic process. The scope and purpose of integration is clearly defined to address aspects related to the psychedelic experience.

It may be easy to make the mistake of wanting to do more analytical psychotherapy, and desiring to “deepen” and relate the psychedelic experience to biographical or relational aspects of the person who comes to integrations sessions. In such cases, the result is usually that the client, understandably, feels their intimacy invaded and resistances to dealing with issues that are not strictly related to the psychedelic experience arise.

Integration sessions work best when they are limited to only the scope of the psychedelic experience itself and the aspects directly related to it. In this sense, integration is not psychotherapy, although the results of it may be therapeutic.

In cases where there has been a traumatic experience and the symptoms that we have described before appear, the approach is different. In this case, the approach is clinical and psychotherapeutic. Psychotherapy is needed in this case, mainly to restore a symptomatic “normality” and functionality. The techniques used will depend on each psychotherapeutic school, but they are not the same strategies as those used to maximize benefits. Sharing the experience, drawing mandalas, and other practices that in other cases are indicated, in traumatic situations do not usually have the expected effect. More specific interventions are required: You have to do psychotherapy.

Therapists, Coaches, Facilitators

This leads us to ask what type of professional is best to go to integrate an experience. What training does a person need to integrate psychedelic experiences? Must they have had their own psychedelic experiences? Do they need to be psychologists? Therapists? Due to the different needs mentioned above, we can understand that the professional profiles required in each case may also be different.

It is probably not necessary to be a psychotherapist to provide circles of integration, to provide a space in which artistic expression, drawing or writing can happen, and to run peer-to-peer sharing circles,. Someone with a sensitivity, who has worked through their own processes, who is humble, with good intentions, and who knows how to create a welcoming and safe environment, is more than enough.

In cases of difficult experiences, however, it takes a professional who knows how to do therapy and to treat anxiety and the traumatic aspects of the experience. In this case, having psychedelic experience can help, but a good psychotherapist should be able to treat these cases even if he has had no contact with psychedelic substances (It helps, of course, if the therapist is open-minded and free of prejudice).

To develop integration sessions for people who are not at one end or the other, which is usually the case, it is important to understand the nature of the processes in expanded states of consciousness; to have diverse maps and cartographies; to be be humble with respect to one’s own knowledge and to have worked on one’s power, money, and sex issues; and to maintain a healthy relationship with the client that can empower and not lengthen therapy unnecessarily. Most likely, having training in psychotherapy will be very helpful in these cases as well.

Therefore, I think the important point is for those of us who are dedicated to this work to be honest about what our capabilities are, what we know how to do, and what we don’t. Perhaps the best therapist does not have skills to lead a group of 15 people, or doesn’t know how to be supportive but non-directive during sharing circles. And, perhaps, someone with hundreds of psychedelic experiences does not know where to begin to treat an acute stress disorder with symptoms of derealization.

In that sense, psychotherapists can be trained to better understand the peculiarities of psychedelic experiences, but it may be more complex to train a psychonaut in the arts of psychotherapeutic intervention. Pathological cases of anxiety and trauma require a clinical practitioner, while integration circles work best with a non-clinical and supportive perspective.

The Future of Integration

The field of integration of psychedelic experiences is still young. We are beginning to define what practices and therapeutic approaches help with integrating these types of experiences. There is still a long way to go, and it is fascinating to think that we are only at the beginning.

In the future, we will have to learn which tools are best suited to maximize the potential of psychedelic medicine. We will have to develop practices that make the use of psychoactive substances in therapeutic contexts more effective. We must create spaces in which these experiences can be understood and shared. Also, we will need to develop new language to define what we do after a psychedelic experience, what aspects have been transformed, and how we can facilitate that transformation. We will see how the social dimension of these experiences becomes more and more important, and it is probably in the interpersonal field that these tools can have the greatest impact if we are moving towards a worldview in which experiences in expanded states of consciousness—rites of passage—become a core part of social cohesion among peoples.

Finally, what we should aspire to is to develop greater understanding about the use of visionary substances, ensuring that those who want to use them do so knowing the potential risks and benefits, and that they are properly prepared. Also, that those who offer sessions and ceremonies are well trained and work ethically and professionally, and that we can all share these experiences in a context of respect, solidarity, support, and fraternity, as was done at the beginning of humanity.

The natural way of using these visionary tools has been to gather with those we trust, create a shared ritual, and give and receive support to our tribal members before, during, and after the experience. Let’s hope that the day will come when no one has traumatic experiences with psychoactive substances, and that each of us can take responsibility for the knowledge gained through our visionary experiences and apply it in ourselves, our relationship with others, and with the planet. The future of integration is that we no longer have to talk about it because the work is done; the future of integration is that we do not need integration.