Do psychedelics facilitate emergence of unconscious psychological processes
Abstract
Psychedelic substances have a long history of use in traditional healing and religious ceremonies worldwide and are increasingly being investigated for their possible therapeutic usage. However, there is still a lack of consensus regarding how best to characterize the psychological effects of psychedelics and how they bring about the positive therapeutic outcomes observed in clinical studies. The aim of this article is to review available evidence from quantitative and qualitative studies on psychedelic-assisted therapy, as well as neurobiological studies, in relation to the hypothesis that psychedelics facilitate the emergence of emotionally charged unconscious material, originally proposed by pioneering psychedelics researcher Stanislav Grof. The reviewed process studies of therapeutic mechanisms in psychedelic-assisted therapy and qualitative studies of treatment participants clearly indicate that the psychedelic experience is associated with the subjective experience of having increased access to and awareness of emotions, memories, and perceptions that are normally avoided or outside of conscious awareness. Brain-imaging studies point to several different neurobiological effects of psychedelics that might be related to these subjective psychological experiences. Available evidence also indicates that this process might constitute an important therapeutic mechanism in psychedelic-assisted therapy, worthy of further investigation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Clinical studies consistently link psychedelic experiences to increased access to emotions, memories, and perceptions typically avoided or outside conscious awareness.
“Clinical studies consistently link psychedelic experiences to increased access to emotions, memories, and perceptions typically avoided or outside conscious awareness (99, 100).”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [99]
Cites
The free-energy principle: a unified brain theory?
Friston, K. (2010) · Nature Reviews Neuroscience · doi:10.1038/nrn2787 · Cited by 8,120 · see citing works
Nichols, D. E. (2016) · Pharmacological Reviews · doi:10.1124/pr.115.011478 · Cited by 1,762 · see citing works
Wells, F. L., Freud, S., & Brill, A. A. (1913) · The Journal of Philosophy Psychology and Scientific Methods · doi:10.2307/2013727 · Cited by 1,341 · see citing works
REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics
Carhart-Harris, R. L., & Friston, K. J. (2019) · Pharmacological Reviews · doi:10.1124/pr.118.017160 · Cited by 1,180 · see citing works
Psilocybin with psychological support for treatment-resistant depression: six-month follow-up
Carhart-Harris, R. L., Bolstridge, M., Day, C. M. J., Rucker, J., Watts, R., Erritzoe, D. E., Kaelen, M., Giribaldi, B., Bloomfield, M., Pilling, S., et al. (2018) · Psychopharmacology · doi:10.1007/s00213-017-4771-x · Cited by 970 · see citing works
Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2017.00974 · Cited by 808 · see citing works
Psychopathology of everyday life.
Freud, S., & Brill, A. A. (1914) · doi:10.1037/10012-000 · Cited by 751 · see citing works
Psychedelics and the essential importance of context
Carhart-Harris, R. L., Roseman, L., Haijen, E., Erritzoe, D., Watts, R., Branchi, I., & Kaelen, M. (2018) · Journal of Psychopharmacology · doi:10.1177/0269881118754710 · Cited by 657 · see citing works
Psychedelics and Psychedelic-Assisted Psychotherapy
Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., Rodriguez, C. I., Kalin, N. H., McDonald, W. M., & and the Work Group on Biomarkers and Novel Treatments, A. D. O. T. A. P. A. C. O. R. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2019.19010035 · Cited by 649 · see citing works
The passion of the Western mind : understanding the ideas that have shaped our world view
Tarnas, R. (1991) · Dominican Scholar (Dominican University of California) · Cited by 643 · see citing works
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017) · Journal of Humanistic Psychology · doi:10.1177/0022167817709585 · Cited by 589 · see citing works
The default-mode, ego-functions and free-energy: a neurobiological account of Freudian ideas
Carhart-Harris, R. L., & Friston, K. J. (2010) · Brain · doi:10.1093/brain/awq010 · Cited by 574 · see citing works
Psychedelic drugs: neurobiology and potential for treatment of psychiatric disorders
Vollenweider, F. X., & Preller, K. H. (2020) · Nature Reviews Neuroscience · doi:10.1038/s41583-020-0367-2 · Cited by 570 · see citing works
Psilocybin-Occasioned mystical experiences in the treatment of tobacco addiction.
Garcia-Romeu, A., Griffiths, R., & Johnson, M. (2015) · Current Drug Abuse Reviews · doi:10.2174/1874473708666150107121331 · Cited by 476 · see citing works
Gasser, P., Kirchner, K., & Passie, T. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881114555249 · Cited by 456 · see citing works
Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory
Roseman, L., Haijen, E., Idialu-Ikato, K., Kaelen, M., Watts, R., & Carhart-Harris, R. (2019) · Journal of Psychopharmacology · doi:10.1177/0269881119855974 · Cited by 413 · see citing works
Davis, A. K., Barrett, F. S., & Griffiths, R. R. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.11.004 · Cited by 375 · see citing works
Prediction of Psilocybin Response in Healthy Volunteers
Studerus, E., Gamma, A., Kometer, M., & Vollenweider, F. X. (2012) · PLoS ONE · doi:10.1371/journal.pone.0030800 · Cited by 369 · see citing works
Greenwald, A. G., & Lai, C. K. (2020) · Annual Review of Psychology · doi:10.1146/annurev-psych-010419-050837 · Cited by 364 · see citing works
Nightmares and bad dreams: Their prevalence and relationship to well-being.
Zadra, A. L., & Donderi, D. C. (2000) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.109.2.273 · Cited by 344 · see citing works
A systems model of altered consciousness: integrating natural and drug-induced psychoses
Vollenweider, F. X., & Geyer, M. A. (2001) · Brain Research Bulletin · doi:10.1016/s0361-9230(01)00646-3 · Cited by 339 · see citing works
LSD enhances suggestibility in healthy volunteers
Carhart-Harris, R. L., Kaelen, M., Whalley, M. G., Bolstridge, M., Feilding, A., & Nutt, D. J. (2015) · Psychopharmacology · doi:10.1007/s00213-014-3714-z · Cited by 320 · see citing works
Realms of the Human Unconscious: Observations from LSD Research
McLaughlin, S. C., & Grof, S. (1976) · Journal for the Scientific Study of Religion · doi:10.2307/1385643 · Cited by 311 · see citing works
The Scientific Status of Unconscious Processes: Is Freud Really Dead?
Westen, D. (1999) · Journal of the American Psychoanalytic Association · doi:10.1177/000306519904700404 · Cited by 311 · see citing works
Belser, A. B., Agin-Liebes, G., Swift, T. C., Terrana, S., Devenot, N., Friedman, H. L., Guss, J., Bossis, A., & Ross, S. (2017) · Journal of Humanistic Psychology · doi:10.1177/0022167817706884 · Cited by 311 · see citing works
Vollenweider, F. (1999) · Neuropsychopharmacology · doi:10.1016/s0893-133x(98)00108-0 · Cited by 305 · see citing works
Effective connectivity changes in LSD-induced altered states of consciousness in humans
Preller, K. H., Razi, A., Zeidman, P., Stämpfli, P., Friston, K. J., & Vollenweider, F. X. (2019) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1815129116 · Cited by 292 · see citing works
Cessation and reduction in alcohol consumption and misuse after psychedelic use
Garcia‐Romeu, A., Davis, A. K., Erowid, F., Erowid, E., Griffiths, R. R., & Johnson, M. W. (2019) · Journal of Psychopharmacology · doi:10.1177/0269881119845793 · Cited by 287 · see citing works
Psychedelic therapy for smoking cessation: qualitative analysis of participant accounts
Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018) · Journal of Psychopharmacology · doi:10.1177/0269881118780612 · Cited by 285 · see citing works
Griffiths, R. R., Hurwitz, E. S., Davis, A. K., Johnson, M. W., & Jesse, R. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214377 · Cited by 247 · see citing works
Therapist Affect Focus and Patient Outcomes in Psychodynamic Psychotherapy: A Meta-Analysis
Diener, M. J., Hilsenroth, M. J., & Weinberger, J. L. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.6.936 · Cited by 238 · see citing works
Breeksema, J. J., Niemeijer, A. R., Krediet, E., Vermetten, E., & Schoevers, R. A. (2020) · CNS Drugs · doi:10.1007/s40263-020-00748-y · Cited by 224 · see citing works
A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy
Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2020.1769878 · Cited by 212 · see citing works
Models of psychedelic drug action: modulation of cortical-subcortical circuits
Doss, M. K., Madden, M. B., Gaddis, A., Nebel, M. B., Griffiths, R. R., Mathur, B. N., & Barrett, F. S. (2021) · Brain · doi:10.1093/brain/awab406 · Cited by 198 · see citing works
Swift, T. C., Belser, A. B., Agin-Liebes, G., Devenot, N., Terrana, S., Friedman, H. L., Guss, J., Bossis, A. P., & Ross, S. (2017) · Journal of Humanistic Psychology · doi:10.1177/0022167817715966 · Cited by 195 · see citing works
Umbricht, D., Vollenweider, F. X., Schmid, L., Grübel, C., Skrabo, A., Huber, T., & Koller, R. (2003) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300005 · Cited by 187 · see citing works
Davis, A. K., Barrett, F. S., So, S., Gukasyan, N., Swift, T. C., & Griffiths, R. R. (2021) · Journal of Psychopharmacology · doi:10.1177/0269881120967878 · Cited by 169 · see citing works
Peill, J. M., Trinci, K. E., Kettner, H., Mertens, L. J., Roseman, L., Timmermann, C., Rosas, F. E., Lyons, T., & Carhart-Harris, R. L. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811211066709 · Cited by 141 · see citing works
Increased thalamic resting‐state connectivity as a core driver of LSD‐induced hallucinations
Müller, F., Lenz, C., Dolder, P. C., Lang, U. E., Schmidt, A., Liechti, M. E., & Borgwardt, S. (2017) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12818 · Cited by 137 · see citing works
Individual experiences in four cancer patients following psilocybin-assisted psychotherapy
Malone, T. C., Mennenga, S. E., Guss, J., Podrebarac, S. K., Owens, L. T., Bossis, A. P., Belser, A. B., Agin-Liebes, G., Bogenschutz, M. P., & Ross, S. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00256 · Cited by 131 · see citing works
Bogenschutz, M. P., Podrebarac, S. K., Duane, J. H., Amegadzie, S. S., Malone, T. C., Owens, L. T., Ross, S., & Mennenga, S. E. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00100 · Cited by 128 · see citing works
Lafrance, A., Loizaga-Velder, A. K., Fletcher, J., Renelli, M., Files, N., & Tupper, K. W. (2017) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2017.1361559 · Cited by 125 · see citing works
Timmermann, C., Watts, R., & Dupuis, D. (2022) · Transcultural Psychiatry · doi:10.1177/13634615221082796 · Cited by 124 · see citing works
Lebois, L. A. M., Li, M., Baker, J. T., Wolff, J. D., Wang, D., Lambros, A. M., Grinspoon, E., Winternitz, S., Ren, J., Gönenç, A., et al. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.19060647 · Cited by 115 · see citing works
What science tells us about false and repressed memories
Otgaar, H., Howe, M. L., & Patihis, L. (2021) · Memory · doi:10.1080/09658211.2020.1870699 · Cited by 90 · see citing works
Working with dreams in therapy: What do we know and what should we do?
Pesant, N., & Zadra, A. L. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.05.002 · Cited by 87 · see citing works
Brown, R. J., & Donderi, D. C. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.50.3.612 · Cited by 77 · see citing works
Kramer, U., Pascual‐Leone, A., Despland, J., & de Roten, Y. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0037979 · Cited by 75 · see citing works
Holotropic Breathwork: A New Approach to Self-Exploration and Therapy
Grof, S., Grof, C., & Kornfield, J. (2010) · doi:10.1515/9781438433950 · Cited by 64 · see citing works
Town, J. M., Abbass, A. A., & Bernier, D. C. (2013) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2013.67.1.89 · Cited by 50 · see citing works
Holotropic Breathwork: A New Approach to Self-Exploration and Therapy
Grof, S., Grof, C., & Kornfield, J. (2010) · Cited by 49 · see citing works
Implicit Cognition and Psychopathology: Looking Back and Looking Forward
Teachman, B. A., Clerkin, E. M., Cunningham, W. A., Dreyer-Oren, S. E., & Werntz, A. J. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050718-095718 · Cited by 49 · see citing works
The mystical experience and its neural correlates.
Woollacott (2020) · The Journal of near-death studies · doi:10.17514/jnds-2020-38-1-p3-25 · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Weiss, B., Roseman, L., Giribaldi, B., Nutt, D., Carhart-Harris, R. L., & Erritzøe, D. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-024-01253-9 · Cited by 34 · see citing works
Walther, R. F. E., & van Schie, H. T. (2024) · Psychoactives · doi:10.3390/psychoactives3030026 · Cited by 20 · see citing works
Lashgari, N., Khalaji, M., Rana, P., Badrabadi, F., Rahnama, M., Nasoori, H., Roudsari, N. M., Nia, M. M. K., & Shafaroodi, H. (2025) · Molecular Neurobiology · doi:10.1007/s12035-025-05097-9 · Cited by 10 · see citing works
Psychedelics and Suicide-Related Outcomes: A Systematic Review
Meshkat, S., Malik, T., Zeifman, R. J., Swainson, J., Zhang, Y., Burback, L., Winkler, O., Greenshaw, A. J., Reichelt, A. C., Vermetten, E. H. G. J. M., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14051416 · Cited by 7 · see citing works
Albert, A. E., & Back, A. L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1529427 · Cited by 6 · see citing works
Ketamine, Psychedelics, and Psychotherapy: Reframing, Redefining, Renaming Treatment Models
Swainson, J., Brietzke, E. M., Khullar, A., McIntyre, R. S., & Soares, C. N. (2025) · The Canadian Journal of Psychiatry · doi:10.1177/07067437251389090 · Cited by 6 · see citing works
Psychedelic-Associated Depersonalization-Derealization Disorder
Michal, M. (2025) · Current topics in behavioral neurosciences · doi:10.1007/7854_2025_599 · Cited by 6 · see citing works
Bublitz, C. (2025) · Journal of Applied Philosophy · doi:10.1111/japp.70053 · Cited by 3 · see citing works
Natural language analysis of the structure of altered states of consciousness
Dikovskaya, D., Desikan, B. S., Frohlich, J., Hossain, N., Panariello, G., Johnson, L., & Murray, C. H. (2025) · Journal of Psychedelic Studies · doi:10.1556/2054.2025.00441 · Cited by 2 · see citing works
Psychedelic Christianity: Commentary and reply
Winkelman, M., Barnard, G. W., Blainey, M. G., Brown, J. B., Roberts, T. B., Lorenz, J., Clark‐Soles, J., Richards, W. A., Hunt, H. T., Gabrielli, T. R., et al. (2024) · Journal of Psychedelic Studies · doi:10.1556/2054.2024.01356 · Cited by 1 · see citing works
Nondual Mindfulness and Psychedelic Assisted Therapy: Frameworks for Clinical Integration
Tempone-Wiltshire, J. (2025) · Human Arenas · doi:10.1007/s42087-025-00535-5
Murray, C. H., Dzirasa, K., Sawyer, D. W., Waconda-Lewis, K., Pollack, L., & Muglia, L. J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1751131
Integration of the Psychedelic Experience Among Brazilians: A Survey Study
Garcia, A. C. M., Maia, L. O., Meireles, E., Barco, J. A. V., & Tófoli, L. F. (2026) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2026.2673842
Modlin, N. L., Elek, Z., Maggio, C., Agrawal, M., Lepow, L., Rucker, J., Stubley, J., & Guss, J. R. (2026) · Psychodynamic Psychiatry · doi:10.1521/pdps.2026.54.2.338
Beyond access: The SIGNAL model of internal guidance in psychedelic preparation and integration
Rush, S. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100027
Dames, S., Williams, K., Campbell, A., Taylor, W., Harder, M., Gagnon, M., Manson, G., & Kryskow, P. (2026) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.70556
Shinozuka, K., Dumanis, S. B., & Williams, N. (2026) · Springer eBooks · doi:10.1007/978-3-032-31497-0_6
Ketamine-Assisted Intensive Short-Term Dynamic Psychotherapy
Kalpin, A. (2026) · Psychoanalytic Inquiry · doi:10.1080/07351690.2026.2721956
- Authors
- Lindegaard, T.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Lindegaard, Tomas
- ORCID
- Lindegaard, Tomas
- Venue
- Psychodynamic Psychiatry
- Publisher
- Guilford Publications
- Published
- 2023-09
- Volume
- 51
- Issue
- 3
- Pages
- 270-286
- ISSN
- 2162-2590 (ISSN-L)
- OpenAlex
- W4386758009
- Cited by
- 18
- References
- 53
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 3
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychodynamic Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Social Psychology › Paranormal Experiences and Beliefs
- Social Sciences › Psychology › Social Psychology › Jungian Analytical Psychology
- Keywords
- psychedelics, psychedelic therapy, unconscious processes, Stanislav Grof, therapeutic mechanisms, memory retrieval, neuroimaging, psychedelic experience, psychotherapy
- MeSH terms
- Brain, Emotions, Hallucinogens, Humans, Neurobiology, Qualitative Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review