Virtual Grand Rounds: Illusion-Disillusionment: A Winicottian Framework for Psychedelic-Assisted Therapy
Presented by:
Dr. Lawrence Fischman
Psychiatrist and Psychoanalyst
People who discuss their psychedelic journeys often remain guarded about their most intimate, confusing, or personally significant experiences, which bridge the liminal space between subjective and objective reality. Exposing experiences which are held as real, risks something like deflation. Winnicott’s understanding of transitional phenomena informed his clinical approach to the human need for illusion. This approach, which he called “illusion-disillusionment,” is well-adapted to working with psychedelic experiences, and affords a way to discuss them without bursting the bubble. Using the dynamics of awe and some of the personal experiences of William James as a bridge, I link Winnicott’s description of absolute dependency in infancy with later tension between powerlessness and a belief in “something more,” a tension which, I argue, underlies the fear of bursting the bubble, or subjecting psychedelic-induced transpersonal beliefs to the scrutiny of others. Two vignettes illustrate how the illusion-disillusionment approach can encourage people to explore, share and make better use of their private psychedelic experiences.
Educational Objectives: As a result of participating in this activity, you should be able to:
- Describe what Winnicott meant by the need in healthy development to allow for illusion-disillusionment, and how this can be translated into a clinical attitude towards transpersonal experiences
- Describe the caregiver’s role in mediating the tension between “continuity of being” and “falling to pieces” during infancy, and how this bears on the therapist’s role in mediating transpersonal experience in psychedelic-assisted therapy
- Discuss when it would be risky to implement an illusion-disillusionment approach to experiences arising under psychedelic drugs, and what the concept of “double-entry bookkeeping” means
Accreditation Statement: Silver Hill Hospital is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.
Designation Statement: Silver Hill Hospital designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
NASW/Connecticut Statement: This program has been approved for 1.5 Continuing Education Credit Hours by the National Association of Social Workers, CT and meets the continuing education criteria for CT Social Work Licensure renewal. Approval also meets the continuing education criteria for CT LMFTs, LPCs, and licensed psychologists. NASW/CT approvals are valid in MA, RI, and VT.
New York Social Worker Statement: Silver Hill Hospital is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0728. This program is approved for 1.5 contact hours.
New York Psychologist Statement: Silver Hill Hospital is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0227. This program is approved for 1.5 contact hours.
Speaker Disclosure: No one in control of content has indicated a relevant financial relationship with an ACCME defined commercial interest.
None of the planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.