Rethinking Integration in Psychedelic Therapy
The Quiet Bias Shaping Psychedelic Therapy—and What We’re Missing
There’s a growing belief in psychedelic spaces that "the journey is just the beginning," and that what really matters is what you do afterward—the integration. In some circles, integration is even considered more important than the psychedelic session itself, since that’s where the benefits are expected to translate into daily life.
This framework can be incredibly supportive for those approaching the work from a coaching, wellness, or goal-oriented lens. In those contexts, psychedelic experiences may be used to move through mental obstacles, clarify intentions, increase self-understanding, and align with personal or professional goals. It's not necessarily about resolving early wounding, but about using powerful altered-state experiences as fuel for growth and insight.
But for those entering psychedelic therapy to address complex trauma—not just to understand why their relational patterns exist, but to experience something different in real time, like intimacy, boundary-setting, or being met with attuned presence—this model leaves something essential out. Much like other insight-driven modalities in the mental health field, it risks overemphasizing understanding at the expense of deeper, bottom-up healing. These patterns show up not just in coaching or self-help spaces, but in much of psychedelic therapy, where integration is often positioned as the path to resolving trauma.
There’s a quiet bias in the integration-heavy frame: that insight leads to change. But in trauma-informed and psychoanalytic perspectives, insight is often secondary. What catalyzes healing is affective experience—what the body comes to know through direct experience, often in the context of an attuned relationship. This is especially true for developmental and attachment trauma. You can’t think your way into secure attachment. You have to live it—in real time, with another. Insight might help make sense of the shift, but it rarely initiates it.
For the people I work with, integration is less about applying insights to create behavioral change, and more about helping them make sense of what unfolded during the session—both relationally and intrapsychically—and how those experiences are subtly reorganizing their internal world. It's a process of orienting around the shifts that are already happening, rather than trying to encourage change based on post-session reflections. One approach helps understand and support organic shifts; the other tries to make it happen through will, intentions, or strategy. Both have value. But when behavioral change is emphasized without corresponding nervous system shifts or relational repair, the results often don’t last. The imprint of earlier experiences remains untouched, and the charge around those unmet needs continues to shape how one moves through the world.
The overemphasis on integration creates an interesting setup within some pockets of the psychedelic world. In many cases, integration involves more human relationship, active engagement, and attunement to one’s experience, while the session itself allows for more space and less relational involvement. And yet, during the session, there’s often so much more available: raw emotions, unprocessed memories, transference1, reenactments2, and vivid internal experience brought forward by the medicine. Still, the relational field often takes a backseat in those crucial moments, only to reenter the foreground days or weeks later, once the medicine has worn off.
I don’t see anything inherently wrong, unethical, or dangerous about this integration-heavy approach—as long as the client has enough internal and external stability to safely explore psychedelic work. But for those working with complex or developmental trauma, this model can miss crucial therapeutic opportunities. It often overlooks the deeply reparative potential of the relational field during the session itself—those moments when old ruptures surface and could be met differently. It bypasses the chance to offer a good object3, to metabolize the affective charge held in the transference, or to experience corrective emotional moments as they arise in real time.
I consistently see that capacities integration often tries to build—self-trust, intimacy, boundaries, emotional expression—emerge most naturally when the regressed self is met and attuned to in real time with the therapist. When these relational needs aren’t addressed, efforts to cultivate these capacities afterward through integration alone often miss the mark, because the very self that provides the foundation hasn’t had a chance to form. It is this formation of the self in-session that allows these capacities to arise organically and take hold.
I think there are a range of reasons why psychedelic integration has become so prominent over the past 5–10 years. The most obvious is the rising interest and demand for psychedelic therapy and medicine work. But other factors play a role too—such as the legal ambiguity around these compounds, which has led many clinicians, practitioners, and coaches interested in psychedelic work to gravitate toward integration as a safer, more accessible entry point. Structural influences from mainstream mental health models, like CBT, and the broader coaching and wellness movements have also shaped how integration is framed—often with a focus on goal-setting, insight, and behavioral change. Finally, I think the popularity of integration reflects a collective effort to make psychedelic work more effective. In a cultural moment saturated with promise and idealized outcomes, integration has become the default solution for translating insight into change—perhaps, in part, because many don’t yet know that more direct and lasting resolution is possible through embodied relational repair within the session itself.
To understand why these trends toward integration often favor insight over embodied change, several cultural and structural factors contribute. Psychedelics, by their nature, can drop people directly into vivid, often immersive bottom-up experiences. These are the raw materials for deep nervous system reorganization. Yet in many settings, these experiences get reframed through an insight-first bias. The meaning a client makes from the journey is elevated as the “real” change agent, while the embodied shift itself fades into the background.
Several factors contribute to this bias:
Western cultural and therapeutic bias toward cognition, where understanding is equated with progress
Integration models that focus on “What did you learn?” rather than “What shifted in you?”
Client defenses that make staying in the realm of insight feel safer than staying with raw affect or relational vulnerability
Therapist training backgrounds, often rooted in talk-based modalities where change is assumed to follow awareness
Without naming these dynamics, we risk overlooking the very mechanism most likely to create lasting change for people with complex trauma.
My concern isn’t with the presence or popularity of the integration-focused model—it has real value and meets the needs of many. What concerns me is how this framework quietly shapes the field’s assumptions about what healing looks like, and what gets prioritized in psychedelic care. For individuals struggling with complex PTSD and developmental trauma, we need to ensure that there’s space for other approaches—ones that center embodied, relational healing and allow for deeper reparative experiences within the session itself.
Just as I’ve written elsewhere about the importance of distinguishing symptom management from trauma resolution, I believe we also need more discernment around how change actually happens—and for whom. Without that clarity, we risk offering models that misalign with the goals and needs of the very people seeking this work. These conversations matter. They shape how we show up, what we offer, and who we’re ultimately supporting.
And maybe that’s part of the integration we don’t talk about enough—the integration of perspectives within our field. Making room for complexity, for nuance, for models that don’t just explain healing, but actually make it possible.
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1 Transference: The unconscious redirection of feelings, expectations, or relational patterns from early significant figures onto the therapist or clinician, often revealing unresolved emotional dynamics.
2 Reenactment: Unconscious repetitions of past relational or attachment patterns—often rooted in trauma—where the primitive system seeks familiar dynamics and situations to process unmet needs or unresolved experiences.
3 Good Object: A mental representation of a reliable, nurturing caregiver internalized during early development, serving as a template for emotional security and guiding healthy relational functioning.
