How Psychedelics are Challenging the Western Medicine Model

Psychedelic therapy is prompting a reevaluation of long-standing assumptions in Western medicine, urging researchers and healthcare providers to adopt broader, more holistic notions of mental health and healing processes. One key assumption being challenged is the “technological” or “materialist” paradigm of psychiatry. Under this model, mental health issues are seen primarily as the result of faulty physiological or psychological mechanisms—depression, for example, is viewed as the expression of neurotransmitter imbalances like serotonin, dopamine, and norepinephrine. If these imbalances are corrected with the appropriate drug, symptoms should theoretically subside.

In this framework, the context for these faulty processes shouldn’t matter, and the treatment should work reliably regardless of the patient’s reasons for seeking help, who provides the treatment, or how the patient feels about it. The patient doesn’t need to be enthusiastic about taking an antidepressant for it to be effective. This approach reduces the patient to a passive recipient of care, viewed as a victim of a diseased brain. It’s a reductive approach but allows for the effectiveness of therapeutic interventions to be tested reliably, usually within randomized controlled trials. It helps determine whether improvements in well-being are due to the placebo effect or the direct impact of an intervention, providing a strong basis for why the treatment works based on predictable changes in the participant’s biology.

While this method has led to the development of numerous life-saving treatments since the 1960s, some interventions are particularly ill-suited to the materialist paradigm. Psychedelic therapy is one of these.

Psychedelics: Beyond the Materialist Paradigm

Although psychedelics have measurable impacts on the body—such as stimulating neuroplasticity and neurotransmitter release by binding to specific serotonin receptors—it’s challenging to explain the full range of therapeutic outcomes based solely on these physical changes. Psychedelic healing processes are highly subjective and idiosyncratic, characterized by emotional breakthroughs rather than clear-cut corrections to neurochemical imbalances. The therapeutic potential of these drugs heavily depends on the setting, the company, and the user’s mindset before the experience. Therefore, the experience needs to be carefully programmed to ensure the best possible outcomes. Individuals taking psychedelics are anything but passive recipients; they are actively engaged in the healing process, co-creating it with the medicine.

This makes empirically testing the efficacy of psychedelic therapy difficult. It’s hard to determine where the drug effect ends and where the subjective meaning-making processes begin. In other words, it’s challenging to quantify how much of psychedelic therapy is due to the psychedelic itself and how much is due to the therapeutic context. These processes tend to be unlike any other seen in mainstream medicine, not just because of their subjective nature but also because they often have a uniquely “mystical” quality. These experiences can fundamentally change the user’s understanding of time, space, and self, revealing a higher truth about the world and their place within it. This deeply spiritual experience has significant therapeutic potential.

Psychedelics and Spirituality

There is mounting evidence suggesting that the most therapeutic psychedelic experiences tend to be “mystical” in nature, often leading to a sort of “spiritual awakening” that results in more positive attitudes toward oneself, others, and improved life satisfaction. American psychologist Abraham Maslow even posited that a psychedelic-induced “glimpse of heaven” could potentially prevent suicide, violence, addiction, and existential meaninglessness through a reorganization of values and beliefs akin to a religious conversion. But can healthcare providers prescribe a “glimpse of heaven” to treat a mental health condition?

In the growing shift toward secularism in Western medicine, spiritual development and healthcare provision have become two distinct enterprises with relatively little overlap. Most healthcare providers receive very little, if any, training on how spiritual wellness plays into a patient’s overall wellness, and even less on how to mobilize spiritual processes for therapeutic ends. Attempting to do so can easily slip into religious prescriptivism, violating the ethical codes seen across many disciplines.

However, due to the frequent emergence of the spiritual element in psychedelic healing processes, psychedelic care providers need to develop unique professional competencies. These competencies allow them to help clients navigate psychedelic experiences that disrupt their most foundational assumptions about the world, themselves, and reality. This needs to happen without the care provider casting themselves as a savior, guru, or healer. Establishing institutions and policies that teach and mandate these competencies within a medical industry that has traditionally outsourced spiritual matters to chaplains and religious communities is a far more challenging task than most researchers, legislators, and clinicians realize.

A Paradigm Shift in Western Medicine

Psychedelics are driving a paradigm shift in Western medicine—one that demands a keen awareness of how humans heal, grow, and thrive. It asks healthcare providers and researchers to see humans as more than biochemical machines and to recognize the transformative potential of spiritual experiences in therapeutic processes. This shift requires integrating the best parts of established systems, discarding what isn’t working, and developing complementary approaches to meet the unique demands of this breakthrough therapy.

We are uniquely poised at this moment to lay a solid foundation for a new era in psychedelic therapy. By embracing this holistic approach, we can create a more comprehensive and effective model of mental health care.