Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy.
Lauren Lepow, Hirofumi Morishita, Rachel Yehuda
FOCUS: The Journal of Lifelong Learning in Psychiatry July 1, 2023 DOI: 10.1176/appi.focus.23021012 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Randomized Peer reviewed |
|---|---|
| Topics | Neuroplasticity Psychedelic-assisted therapy |
| Keywords | Biological psychiatry Critical period plasticity Psychedelics Psychotherapy Visual system |
| Citations | 9 |
| Key points | Proposes that psychedelics may remove brakes on adult neuroplasticity, inducing a state similar to a developmental critical period, which could explain how the combination of medication and psychotherapy produces enduring neurobiological changes. |
Abstract
As psychedelic compounds gain traction in psychiatry, there is a need to consider the active mechanism to explain the effect observed in randomized clinical trials. Traditionally, biological psychiatry has asked how compounds affect the causal pathways of illness to reduce symptoms and therefore focus on analysis of the pharmacologic properties. In psychedelic-assisted psychotherapy (PAP), there is debate about whether ingestion of the psychedelic alone is thought to be responsible for the clinical outcome. A question arises how the medication and psychotherapeutic intervention together might lead to neurobiological changes that underlie recovery from illness such as post-traumatic stress disorder (PTSD). This paper offers a framework for investigating the neurobiological basis of PAP by extrapolating from models used to explain how a pharmacologic intervention might create an optimal brain state during which environmental input has enduring effects. Specifically, there are developmental "critical" periods (CP) with exquisite sensitivity to environmental input; the biological characteristics are largely unknown. We discuss a hypothesis that psychedelics may remove the brakes on adult neuroplasticity, inducing a state similar to that of neurodevelopment. In the visual system, progress has been made both in identifying the biological conditions which distinguishes the CP and in manipulating the active ingredients with the idea that we might pharmacologically reopen a critical period in adulthood. We highlight ocular dominance plasticity (ODP) in the visual system as a model for characterizing CP in limbic systems relevant to psychiatry. A CP framework may help to integrate the neuroscientific inquiry with the influence of the environment both in development and in PAP. Appeared originally in Front Neurosci 2021; 15:710004.
Comparable studies
Other theoretical and historical papers on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance | 2020 | Theoretical or philosophical paper | |
| Awe: a putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy | 2018 | Theoretical or philosophical paper | |
| Ethical and legal issues in psychedelic harm reduction and integration therapy | 2021 | Theoretical or philosophical paper | |
| Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations. | 2022 | Theoretical or philosophical paper |
Citations in the library
Cited by 6
- Psychedelic Science of Spirituality and Religion: An Attachment-Informed Agenda Proposal December 25, 2021
- Mechanisms of therapeutic change after psychedelic treatment in OCD. Psychiatry Research June 1, 2024
- Psychotherapeutic and neurobiological processes associated with ayahuasca’s mental health and wellbeing outcomes: a proposed model and implications for therapeutic use February 14, 2022
- Psychedelic Modulation of Excitation/Inhibition Balance: A Dual-Phase Neurodevelopmental Model. ACS Chemical Neuroscience January 7, 2026
- From molecules to meaning: unpacking the antidepressant mechanisms of psychedelic drugs. Expert Review of Clinical Pharmacology June 11, 2025
and 1 more in the library
Cites 32
- Psychedelics Promote Structural and Functional Neural Plasticity Cell Reports June 1, 2018
- Global Street Food: la cocina de la calle Diseño interior 2009
- The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects. ACS Pharmacology & Translational Science December 10, 2020
- Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors Journal of Psychopharmacology October 11, 2017
- Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology Journal of Psychopharmacology November 16, 2016
and 27 more in the library