Expansion without Erasure: A Psychoanalytic Response to Peoples and Rundel

Abstract

Peoples and Rundel argue that oceanic experiences in psychedelic-assisted treatment need not indicate regression but may reflect expansions of consciousness. I respond by examining how the self enables survival yet contributes to suffering, distinguishing expanded states from perspective, and proposing perspective as the hinge that transforms transient ego-dissolution into lasting growth. I differentiate pain from suffering and note how ketamine’s modulation of the default mode and anti-reward networks uniquely fosters equanimity, opening analytic space. Because psychedelics can overwhelm defenses, preparation, and set and setting remain decisive. I propose integration practices that consolidate the observing stance—variously described as observing ego, thirdness, mindful awareness, or Atman. Psychedelic psychoanalysis, I suggest, builds upon rather than abandons analytic commitments, translating oceanic states into enduring capacities for reflection, equanimity, and relatedness. I close with a clinical vignette and proposals for distinguishing restorative union from defensive fusion, sequencing ketamine-assisted analysis, and sustaining perspective.