Preparing the body for psilocybin therapy: receptive and generative interoception in cancer patients
Anthony L. Back, Cynthia J. Price, Bonnie A. Mcgregor, Andrew Markell
Frontiers in Psychiatry October 8, 2026 DOI: 10.3389/fpsyt.2026.1890966 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Meditation Psilocybin |
| Keywords | Cancer Interoception Predictive coding Psychological therapy |
| Key points | Proposes that cancer-related depression and anxiety treated with psilocybin therapy involve an underspecified somatic substrate, and that preparation protocols neglect the body. Argues for distinguishing interoception as perception from "interoceptive engagement," and presents a six-category taxonomy of somatic experiences plus receptive and generative practices to train these capacities, to be tested in an ongoing Phase 2 trial. |
Abstract
Cancer patients arrive for psilocybin therapy with bodies altered by illness and treatment — bodies that they have learned to brace against, dissociate from, or scan for threat. Research on psilocybin-assisted therapy for cancer-related depression and anxiety consistently identifies the quality of the acute subjective experience — reflected in constructs such as acceptance, surrender, boundlessness, and emotional breakthrough — as a key predictor of therapeutic benefit. Yet most preparation protocols focus on cognitive intention-setting and basic mindfulness while neglecting to address the body directly. We propose that anxiety and depression in this setting may involve a somatic substrate that has not been adequately specified. We distinguish two capacities to ‘feel into the body’ relevant to psychedelic therapy: interoception as perception (the perceptual access to bottom-up bodily signal) and interoceptive engagement (the broader capacity that links bodily perception to posture, breath, structural intent, and affective stance). We describe a six-category phenomenological taxonomy of somatic experiences in psilocybin therapy (exteroceptive, deep somatic, visceral, vestibular, nociceptive, emergent). We also map receptive practices, designed to improve interoception as perception, and generative practices, designed to improve interoceptive engagement. The framework is grounded in current predictive-coding accounts of interoception, but does not depend on any single neuroscientific model. An ongoing Phase 2 trial of group retreat psilocybin therapy for metastatic cancer patients will provide an initial test of our hypothesis that interoceptive training may influence therapeutic outcomes in psilocybin therapy for patients with cancer.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Proposes a framework distinguishing interoception as perception from interoceptive engagement and describes receptive and generative somatic practices for psilocybin therapy preparation.
Synthesized
Comparable studies
Other theoretical and historical papers on psilocybin and meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin-Assisted Compassion Focused Therapy for Depression | 2022 | Theoretical or philosophical paper | |
| Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy | 2022 | Theoretical or philosophical paper | |
| Psilocybin: The most effective moral bio‐enhancer? | 2023 | Theoretical or philosophical paper |