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Liberating the Soul: Multiple Self-States and the Mystical in the Treatment of Substance Abuse

Noelle Burton

Psychoanalytic Inquiry August 13, 2025 DOI: 10.1080/07351690.2025.2541549 (opens in new tab)

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Characteristics Theoretical or philosophical paper Peer reviewed
Key points Argues that multiple self-state treatment of addictions, Alcoholics Anonymous and other Twelve Step groups, and psychedelic medicine for substance abuse share a common feature: each sets the stage for a mystical experience. Proposes that clinicians be sensitized to mystical elements and help cultivate them, and that childhood spiritual losses may foreclose a wholesome spirituality in adulthood, requiring the analyst's sensitivity and responsiveness.

Abstract

ABSTRACT There is a common feature linking together the efficacy of the developmental multiple self-state treatment of addictions, the therapeutic power and impact of Alcoholics Anonymous (and other Twelve Step groups), and the successful use of psychedelic medicines to treat substance abuse: they all set the stage for a mystical experience. This paper will focus on how psychoanalytic treatment cultivates aspects of mystical experience, specifically in the multiple self-state treatment of substance abuse. The mystical roots of AA, and how the Twelve Steps cultivate mystical experience is presented. My purpose is to sensitize clinicians to mystical elements, as well as facilitate their cultivation, in order to potentiate their impact, whether this work is used alone or in conjunction with psychedelic medicine. Some patients may experience spiritual losses in childhood which may foreclose a wholesome spirituality in adulthood and necessitates the analyst’s sensitivity, curiosity, and responsiveness. Clinical cases illustrate how self-state work cultivates mystical experiences, the emergence of the mystical in the course of treatment, as well as spiritual losses in childhood.

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