Sarah Russo | August 23, 2022
When it comes to integration therapy, Marc Aixalà has witnessed a vast evolution being shaped by the increasing interest in psychedelics. He was the first person to field people’s requests for guidance when the ICEERS Integration and Support Centre opened in 2013. He then volunteered to assist people having challenging psychedelic experiences at festivals in Europe.
Marc, born and raised in Catalonia, Spain, has a multifaceted background that includes a degree in Psychology, training in Transpersonal Psychology and Holotropic Breathwork, a focus on music in expanded states of consciousness, comparative religion studies, and even telecommunications engineering (before becoming a therapist). As the need for integration expanded, Marc’s practice began to take a new form. But he also recognized some questions remain unanswered and that there was a lack of reliable resources to help guide people in the process.
Marc was unable to find a comprehensive source of information on the topic of integration therapy to support his clinical practice as a therapist. So, he set to write Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness, a manual for practitioners and those curious about the topic. His new book follows the history of integration research and psychedelic-assisted therapy from the 1960s to the present day and offers a clinical perspective from real-world cases he has seen over the past decade.
Psychedelic Integration outlines 11 metaphors for understanding integration and explains the seven dimensions of this field, which Marc views as an essential part of the process to prepare for a psychedelic experience. The book is now available both in the original Spanish (published by Editorial Eleftheria) and English (translated by Adam Aronovich and published by the Synergetic Press).
Direct Experience via the ICEERS Support Centre
The foundational experience that deepened Marc’s craft of psychedelic integration was during the first years the ICEERS Integration and Support Centre was open. He writes how for most of the preliminary cases that came in, he worked “in the dark.” He lacked tangible maps to help guide the integration process. Yet after being at the Support Centre for a while, he began picking up on common patterns and formed a greater interest in the reasons why people reached out for help. In 2018, the ICEERS Integration and Support Centre got a grant from the European Union, which allowed it to expand.
Between 2015 and 2016, Marc began classifying the different types of people who requested guidance at the Support Center. The model presented in his book is the “first attempt to map out the therapeutic needs of psychedelic integration, which will continue to develop and unfold in upcoming years.” Marc clarifies that he did not create many of the principles he describes, but rather offers a synthesis of different theories with roots in psychotherapy, philosophy, and spirituality.
In the first years of the Support Center program, the building blocks of Marc’s work involved active, empathic listening and education on the practice of psychedelic therapy. More than anything he centered on the client’s own story to offer different possible interpretations. He then looked for further clinical approaches to apply to the cases he saw.
In 2014, Marc had the opportunity to participate in the MAPS MDMA-assisted psychotherapy training, where he explored the field in more depth and observed other professionals leading integration sessions. This inspired him to reconsider his past approaches to integration. He began to focus on maximizing benefits and reducing adverse effects by analyzing the different scenarios that arise with integration. This concept became a fundamental point that guided the future development of his clinical approach at the ICEERS Support Centre.
During that time, those contacting ICEERS were typically from Europe and the United States, with inquiries spanning those new to psychedelics to the seasoned travelers of altered states. When the program first began, correspondence was done via email, with a video call if needed. Via this arrangement, Marc carried out hundreds of single visit interventions. The main goal at that time was not to solve the client’s problems per se, but rather to help them find support for the healing process in their community.
Since then, the needs have changed. More people began requesting Support Centre services, which have since grown to incorporate other staff members and consultants. The ICEERS Support Centre has tended to over 1,000 cases to date and has a caseload of up to 10 people at a time, with integration sessions being offered both in Spanish and English.
Why Integration is Needed: The Impetus for the Book
Due to an ever-increasing interest in psychedelics, more people are being introduced to plant medicines and other entheogens. There is increasingly more information online leading people to have experiences alone, with friends, or with skilled or novice space holders. Sometimes, people undergoing altered states are not able to receive the support they need from their community to make sense of the experience. In this instance, integration with a trained professional can help to resolve lingering issues after an experience with mind-altering substances.
This is particularly needed in the Global North, where methods to access non-ordinary states of consciousness are not part of the societal framework. This contrasts with cultures that have maintained an unbroken connection to plant medicine, such as in some Indigenous communities, where the notion of integration is not necessary. Psychoactive plants are fundamentally woven into ways of life and worldview and are not considered separate. They are foundational to their cosmovision and healing repertoire from the land that surrounds them.
People from areas with broken cultural references to psychoactive plants generally gravitate towards medicines outside their countries of origin. Psychedelic Integration explores the tendency of turning to cultures that are exotic and foreign to them. As Marc writes, at the same time these seekers “lack the proper structures that can integrate these practices into a functioning society.”
To help bridge this gap and to provide cultures from the Global North with some tools to integrate altered states, Psychedelic Integration is part literature review, part clinical experience, infusing comparative religion and cultural references from books and movies to give the reader a deep dive into the topic of integration therapy. After gleaning the past research on psychedelics in a therapeutic framework, Marc includes examples of specific techniques and modalities that consistently appear in his clinical work. His intention was to offer an overview of his methods in the hope that it can “inspire other therapists to reflect deeply about their approach to integration.”
What is Psychedelic Integration? A Multifaceted Approach to an Ever-Evolving Practice
Integration therapy is a diverse topic with a multifaceted definition. Instead of laying out the what of this field, Marc illustrates the various aspects that integration can be. He draws on metaphors to illustrate the process of integration. On a practical level, Marc outlines some of the classic tools for integration that have been used in psychedelic-assisted therapy historically and aspects he uses in his practice. Some of the integration tools that get mentioned include drawing, writing, communion with nature, dance, and other practices. These various activities are typically recommended for the client to do outside of sessions so that they can continue to integrate and process on their own.
For the sake of clarity, there is a difference between psychedelic-assisted therapy and integration therapy. Psychedelic-assisted therapy is done when someone, a trained professional or sometimes an informal “sitter,” accompanies a participant in a therapeutic psychedelic session. Researchers were able to do these standardized treatment regimens in the era when psychedelics were still legal. Currently, clinical trials are being conducted internationally on psilocybin and MDMA. Sessions are also being done underground as these substances remain illegal in much of the world.
Psychedelic-assisted therapy is different from integration therapy, which occurs after a psychedelic session has been completed. Integration therapy addresses lingering issues or may involve helping the patient process the experience. Mind-altering substances are not worked with during these sessions. Psychedelic Integration focuses on integration therapy as opposed to psychedelic-assisted therapy. But much of the research Marc examines in the book stems from the classic studies done in the 1950s where psychedelics were included in treatment sessions.
While integration work can be rewarding, it isn’t without its share of complexity. Using a balanced perspective, Marc explores various paradoxes associated with integration during psychedelic states. He notes that “even though psychedelics such as MDMA and ayahuasca can be used to treat trauma, they can also induce it.” Marc gives case reports from his practice, offering examples of when the case has been resolved and other times when the client is still exploring the integration process.
Settling into Life After a Psychedelic Experience
How does someone know when the process of integration is complete? While this depends on the person, Marc describes that once the psychedelic experience has been well integrated, no adverse effects should be perceived. With proper integration, the client is emotionally stable, and anxiety and other physical symptoms should have dissipated. However, as Marc writes, “the absence of adverse effects or reactions does not always indicate the successful integration of an experience.”
Psychedelic Integration also mentions how even positive transcendental experiences can fade over time, and their impact on our well-being can become a fleeting memory. Due to the temporary state of psychedelic experiences, integration is complete when the knowledge someone gained is well incorporated rather than being “volatile and ethereal.” Further integration is needed when remaining undesirable effects pop up, such as spiritual bypassing and ego inflation.
Many people begin chasing further mind-altering experiences to find these lessons again, all the while “deluding themselves that they are doing great inner work.” Marc writes: “Excessive attention to our internal worlds can become counterproductive when we are out of balance with the rest.” Integrative psychotherapy is not merely about the elimination of symptoms, but rather examining the symptoms as a way to settle the present conflict.
“If we manage to relate the symptoms to unconscious conflicts (traumas, values, past experiences), we are accomplishing true integration and, above all, we are helping the person get better control over both dimensions since by intervening in one we are influencing the other. Once we bridge the deep with the superficial, both aspects become one; it does not matter which one of the two dimensions we focus on.” (Psychedelic Integration, page 244)
What are some practical next steps so the lessons from altered states can be realized in our lives? Marc discusses how people are often very eager to implement new ways of living and make positive changes after having a profound psychedelic experience. Beyond having emotional and mental stability, signs of good integration also include positive changes on an ethical and behavioral level.
However, Marc cautions that these decisions should not be made in haste, often telling his clients, “If a decision is appropriate right after an experience, it will remain appropriate for the following month.” He explains that the human psyche often acts in symbols and metaphors and that the changes we envisioned during a psychedelic experience may not be the literal outcome.
The Future of Integration Therapy
We live in exciting times where we can access altered states and a movement is building to help us integrate these experiences into an evolving society. The psychedelic experience is, by definition, out of the ordinary, and at times ineffable. Bridging the gap between these states is the act of integration where “the therapeutic effects and long-lasting changes following a successful psychedelic therapy have to manifest in this ordinary reality as well.”
To fully integrate psychoactive plants into society, there is a big role for mental health professionals, researchers, and advocates to play. In Marc’s words, “Psychedelics can bring to mental health a renewed and much-needed compassion and respect towards those who suffer. Psychedelics also show us that healing and learning are processes, not events, and therefore mental health treatments should be planned accordingly.”
Those interested in exploring these topics in greater depth may check out an excerpt of Psychedelic Integration via the Synergetic Press website. The Spanish language version of the book, Integración Psiquedélica, is available from Editorial Eleftheria.
Praise for Psychedelic Integration by Marc Aixalà
“As psychedelic therapy continues to mainstream, many are left without understanding of the most fundamental part of psychedelic healing: integration. This book emphasizes the social dimensions of integration, and Marc’s therapeutic model demonstrates how community is key to personal growth, and simultaneously social change. An incredibly helpful read for anyone considering psychedelic therapy!” — Natalie Lyla Ginsberg, MSW, Global Impact Officer at the Multidisciplinary Association for Psychedelic Studies.
“More than ten years of experience grant [Marc] the authority to write this pioneering book, which inaugurates, I would say, a new bibliographic genre which will oscillate in the future from scientism on one hand to the purest esotericism on the other, and which will flood our libraries in the coming years, since integration is now in fashion.” — José Carlos Bouso, Scientific Director of ICEERS, in the forward of Psychedelic Integration.
“An essential part of any psychedelic session is the subsequent integration of the experience, to ground the knowledge gained from the other side. Marc’s book traces the history of integrating psychedelic visions so that they can serve as a useful aid to enrich our lives. People participating in the ICEERS Support Centre services and with Kosmicare commend this comprehensive work that brings freshness and vitality.” — Igor Domsac, editor of Psychedelic Integration.
Further Resources
- Marc Aixalà | From Integrating Experiences to Integrated Practice [VIDEO]
- E-Course on Integration & Crisis Support | ICEERS
- Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness (Synergetic Press)
- Integración Psiquedélica: Lógicas no ordinarias y retos de la psicoterapia en estados expandidos de consciencia (Editorial Eleftheria)
Categories:
NEWS
Tags:
psychology
, mental health
, psychotherapy
, psychedelic therapy
, integration
, plant medicine