The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression

The ego is one of the most central psychological constructs in psychedelic research and a key factor in psychotherapy, including psychedelic-assisted forms of psychotherapy. Despite its centrality, the ego-construct remains ambiguous in the psychedelic literature. Therefore, we here review the theor...

Full description

Bibliographic Details
Main Authors: Tobias Buchborn, Hannes S. Kettner, Laura Kärtner, Marcus W. Meinhardt
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnins.2023.1232459/full
_version_ 1827798830573158400
author Tobias Buchborn
Hannes S. Kettner
Hannes S. Kettner
Laura Kärtner
Laura Kärtner
Marcus W. Meinhardt
Marcus W. Meinhardt
author_facet Tobias Buchborn
Hannes S. Kettner
Hannes S. Kettner
Laura Kärtner
Laura Kärtner
Marcus W. Meinhardt
Marcus W. Meinhardt
author_sort Tobias Buchborn
collection DOAJ
description The ego is one of the most central psychological constructs in psychedelic research and a key factor in psychotherapy, including psychedelic-assisted forms of psychotherapy. Despite its centrality, the ego-construct remains ambiguous in the psychedelic literature. Therefore, we here review the theoretical background of the ego-construct with focus on its psychodynamic conceptualization. We discuss major functions of the ego including ego boundaries, defenses, and synthesis, and evaluate the role of the ego in psychedelic drug action. According to the psycholytic paradigm, psychedelics are capable of inducing regressed states of the ego that are less protected by the ego’s usual defensive apparatus. In such states, core early life conflicts may emerge that have led to maladaptive ego patterns. We use the psychodynamic term character in this paper as a potential site of change and rearrangement; character being the chronic and habitual patterns the ego utilizes to adapt to the everyday challenges of life, including a preferred set of defenses. We argue that in order for psychedelic-assisted therapy to successfully induce lasting changes to the ego’s habitual patterns, it must psycholytically permeate the characterological core of the habits. The primary working principle of psycholytic therapy therefore is not the state of transient ego regression alone, but rather the regressively favored emotional integration of those early life events that have shaped the foundation, development, and/or rigidification of a person’s character – including his or her defense apparatus. Aiming for increased flexibility of habitual ego patterns, the psycholytic approach is generally compatible with other forms of psychedelic-assisted therapy, such as third wave cognitive behavioral approaches.
first_indexed 2024-03-11T19:41:39Z
format Article
id doaj.art-961b01ca091f4d2fa7db8563f8130b64
institution Directory Open Access Journal
issn 1662-453X
language English
last_indexed 2024-03-11T19:41:39Z
publishDate 2023-10-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neuroscience
spelling doaj.art-961b01ca091f4d2fa7db8563f8130b642023-10-06T08:26:47ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-10-011710.3389/fnins.2023.12324591232459The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regressionTobias Buchborn0Hannes S. Kettner1Hannes S. Kettner2Laura Kärtner3Laura Kärtner4Marcus W. Meinhardt5Marcus W. Meinhardt6Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, GermanyCentre for Psychedelic Research, Department of Medicine, Imperial College London, London, United KingdomPsychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, CA, United StatesCentre for Psychedelic Research, Department of Medicine, Imperial College London, London, United KingdomDepartment of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, GermanyInstitute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, GermanyDepartment of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, GermanyThe ego is one of the most central psychological constructs in psychedelic research and a key factor in psychotherapy, including psychedelic-assisted forms of psychotherapy. Despite its centrality, the ego-construct remains ambiguous in the psychedelic literature. Therefore, we here review the theoretical background of the ego-construct with focus on its psychodynamic conceptualization. We discuss major functions of the ego including ego boundaries, defenses, and synthesis, and evaluate the role of the ego in psychedelic drug action. According to the psycholytic paradigm, psychedelics are capable of inducing regressed states of the ego that are less protected by the ego’s usual defensive apparatus. In such states, core early life conflicts may emerge that have led to maladaptive ego patterns. We use the psychodynamic term character in this paper as a potential site of change and rearrangement; character being the chronic and habitual patterns the ego utilizes to adapt to the everyday challenges of life, including a preferred set of defenses. We argue that in order for psychedelic-assisted therapy to successfully induce lasting changes to the ego’s habitual patterns, it must psycholytically permeate the characterological core of the habits. The primary working principle of psycholytic therapy therefore is not the state of transient ego regression alone, but rather the regressively favored emotional integration of those early life events that have shaped the foundation, development, and/or rigidification of a person’s character – including his or her defense apparatus. Aiming for increased flexibility of habitual ego patterns, the psycholytic approach is generally compatible with other forms of psychedelic-assisted therapy, such as third wave cognitive behavioral approaches.https://www.frontiersin.org/articles/10.3389/fnins.2023.1232459/fullpsychedelicsego regressionego defensesego boundarycharacterpsycholytic therapy
spellingShingle Tobias Buchborn
Hannes S. Kettner
Hannes S. Kettner
Laura Kärtner
Laura Kärtner
Marcus W. Meinhardt
Marcus W. Meinhardt
The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
Frontiers in Neuroscience
psychedelics
ego regression
ego defenses
ego boundary
character
psycholytic therapy
title The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
title_full The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
title_fullStr The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
title_full_unstemmed The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
title_short The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
title_sort ego in psychedelic drug action ego defenses ego boundaries and the therapeutic role of regression
topic psychedelics
ego regression
ego defenses
ego boundary
character
psycholytic therapy
url https://www.frontiersin.org/articles/10.3389/fnins.2023.1232459/full
work_keys_str_mv AT tobiasbuchborn theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT hannesskettner theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT hannesskettner theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT laurakartner theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT laurakartner theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT marcuswmeinhardt theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT marcuswmeinhardt theegoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT tobiasbuchborn egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT hannesskettner egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT hannesskettner egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT laurakartner egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT laurakartner egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT marcuswmeinhardt egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression
AT marcuswmeinhardt egoinpsychedelicdrugactionegodefensesegoboundariesandthetherapeuticroleofregression