Binaries, Multitudes, and Beyond: A Client-Authored Case Study in Psychedelic-Assisted Therapy, Artificial Intelligence, and Narrative Agency
Mark A. Michaels
Study at a glance
AI-extracted from the abstract| Characteristics | Autoethnographic case study Case report |
|---|---|
| Sample size | 1 |
| Population | The author/client |
| Interventions | EMDR ketamine MDMA psilocybin creative expression AI-assisted reflection and writing |
| Duration | 10-week course of collaborative therapy |
| Topics | Psychedelic-assisted therapy |
| Key findings | Recognition of core affects, rupture-and-repair processes, and reclamation of narrative agency contributed to rapid, positive change in a 10-week course of collaborative therapy integrating multiple modalities. |
Abstract
This client-authored, autoethnographic case study documents a 10-week course of collaborative therapy integrating EMDR, ketamine, MDMA, psilocybin, creative expression, and AI-assisted reflection and writing. Drawing on affect theory, mentalization, earned secure attachment, and Dabrowski's theory of positive disintegration, the paper analyzes how recognition of core affects, rupture-and-repair processes, and the reclamation of narrative agency contributed to rapid, positive change. Psychoeducation supported a deep exploration of these concepts throughout. Data sources include session transcripts, journals, creative writing, and AI-mediated reflections; all substantive interpretation was performed by the author. The case critiques traditional psychoanalytic framings, diagnostic overreach, and hierarchical therapeutic structures, arguing for a model that emphasizes collaboration, agency, and narrative coherence. It also highlights the potential and limitations of generative AI as an adjunct in psychotherapy and narrative self-reclamation. Framed as an effort to "seize the means of therapeutic production," the study proposes a paradigm that moves beyond binaries toward a multidimensional understanding of identity, attachment, and transformation.
Comparable studies
Other case reports and case series on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic Therapy (Utilizing LSD) with Cancer Patients Cancer patients | 1970 | Clinical description and case report | |
| Ketamine-assisted psychotherapy in adolescents with multiple psychiatric diagnoses. Adolescents aged 14–19 with comorbid psychiatric diagnoses including... | 2023 | Case series | n = 4 |
| Prolonged adverse effects from repeated psilocybin use in an underground psychedelic therapy training program: a case report | 2025 | Case study | |
| Suicide of a patient shortly after psilocybin-assisted psychedelic therapy: A case report 60-year-old man with recurrent depression and history of delusions | 2025 | Case study | n = 1 |
| Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report 28-year-old female with complex dissociative posttraumatic stress disorder | 2023 | Case study | n = 1 |
Citations in the library
Cites 3
- Psychedelic integration: An analysis of the concept and its practice Frontiers in Psychology August 4, 2022
- Diversity, equity, and access in psychedelic medicine Journal of Psychedelic Studies December 27, 2019
- Ketamine for Treatment of Posttraumatic Stress Disorder: State of the Field. FOCUS: The Journal of Lifelong Learning in Psychiatry July 2023