The paradigm of Exposure therapy under psilocybin for general anxiety disorder and claustrophobia

Abstract

Exposure therapy is a form of psychotherapeutic intervention wherein individuals are gradually and systematically exposed to the object or situation they fear, all within a controlled and secure setting. This method is widely regarded as the most effective treatment for specific phobias, when combined with psychedelics assisted psychotherapy, exposure therapy may prove effective in reducing fear and anxiety associated with phobias. This is achieved by aiding the formation of new, constructive memory representations and diminishing fear responses to the feared stimuli. One of the primary anticipated mechanisms involves inducing a powerful disconfirmatory experience: individuals under the influence of psychedelics experience altered emotions, perceptions, and thoughts, leading to an entirely different outcome compared to their usual, deeply ingrained fear reaction. 

This paradigm is illustrated by a case study involving a patient suffering from Generalized Anxiety Disorder (GAD) and claustrophobia who underwent exposure therapy with the assistance of psilocybin assisted psychotherapy. The patient had previously not shown improvement with conventional psychotherapeutic approaches. Following three sessions of psilocybin-assisted psychotherapy, the patient reported a notable decrease in anxiety and fear related to confined spaces, elevators, and airplanes. The treatment protocol encompassed both an imaginative exposure exercise and a traditional exposure therapy session conducted while under the influence of psilocybin.

Biography

Dr. Gabriel Thorens is a psychiatrist and serves as a Privat Docent at the University Hospital of Geneva. Specializing in Psychiatry and Addictology, he boasts over 12 years of expertise in addiction-related fields. Dr. Thorens has led and published numerous research projects focused on behavioral addictions. Furthermore, he is proficient in cognitive and behavioral therapy and is a member of the director committee for the Master of Advanced Studies in Cognitive Behavioral Therapy within the Geneva Faculty of Medicine. Additionally, he holds the position of president within the "Association professionnelle Suisse – Psychédéliques en thérapie ASPT". Dr. Thorens is currently actively involved in promoting the integration of psychedelic-assisted psychotherapy treatments within the Department of Psychiatry at the University Hospital of Geneva.