What Psychedelics and Acceptance Commitment Therapy May Share

Depression has a way of trapping people. I see it almost every day as a therapist and have experienced it myself. It holds us in thought loops and rumination making most everything feel meaningless. Over time, that lack of meaning can turn to inactivity, lost relationships, and even self-neglect. As well, it can also be tempting to engage in destructive methods such as substance use, binge eating, or overspending as ways to escape depression's dark clouds.

Acceptance and Commitment Therapy (ACT) has a way of freeing one from some of depression's snares. ACT builds psychological flexibility through six pivots--defusing us from tangled thoughts, giving space to allow for emotions, reconnecting with the present, creating a self-view based on the person behind our eyes rather than limiting tags, clarifying our values, and ultimately living toward a values-based life.

Psychological flexibility sparked by ACT gives freedom from the life-limiting ruminative cycles depression produces, moving one instead toward taking action. When effective, the result can be more than an escape from depression. One can cultivate a life that aligns with what a person finds to be most meaningful.

New Research

A recent article published in the journal Nature's Scientific Reports proposes that psilocybin-assisted therapy could have a similar mechanism of change (Sloshower et al., 2024). Psilocybin is a type of psychedelic mushroom.

A 16-week study during which individuals were given a dose of placebo followed by psilocybin four weeks later in addition to Acceptance Commitment Therapy found that both treatments had significant effects on psychological flexibility and living a value-based life, which also correlated with a decrease in depression (Sloshower et al., 2024). This adds to evidence that ACT may be an ideal psychotherapy modality to pair with psilocybin treatment. Acceptance Commitment Therapy is already utilized within the Yale Manual for Psilocybin-Assisted Therapy of Depression (Guss et al., 2020).

The exact mechanism of change of psilocybin on depression remains largely unknown. Yet, some speculate that, like Acceptance Commitment Therapy, psilocybin may loosen one from the cages that psychological inflexibility packs us in potentially by forcing an altered perspective. The experience may provide an opportunity to connect with the present moment and defuse one's typical ruminative pathways- that respite could be key in creating a changed mindset to identify and move toward one's valued goals and benefit from talk therapy.

Closing

This is exciting. While psilocybin is still an investigational medication for depression available at this point primarily through clinical trials, Acceptance Commitment Therapy is widely practiced throughout the United States.