Abstract

There is currently no generally agreed-upon definition of the mechanism of action of psychedelic therapy. Existing proposals have approached the issue from various perspectives, utilizing concepts on many layers of abstraction. Most commonly, mechanisms based on neurotransmitters have been proposed. From a clinical perspective, explanations on the psychological level would be more useful. This study provides one such explanation, focusing on the destabilization of trauma-related memories and their replacement with memories that allow for more adaptive behaviors. This mechanism is not specific to psychedelics, and the study therefore illustrates a non-pharmacological process involving it. The study features a male entrepreneur in his early fifties who suffered from chronic but non-debilitating anxiety and depression since his teenage years. In his mid-30s, he suffered from severe burnout but partially recovered. The amount of alcohol consumed was constantly relatively high. More recently, due to simultaneous relationship and workplace stress, he experienced a more severe episode of burnout, depression, anxiety, and insomnia. He felt completely exhausted when trying to get something done and became fearful of the workplace. Psychotherapy and various pharmaceutical medications provided little benefit. After three months on sick leave, a trip to the mountains triggered severe insomnia. Sleep deprivation likely contributed to a spontaneous experience of altered states of mind, including a two-day period of hallucinatory visions. There was the feeling of being a complete failure, but through a new relationship initiated just before the trip, he received love and validation from his new partner, which contradicted the feeling of worthlessness. The combination of an altered state of mind and love induced an alteration of identity that resolved his depression, burnout, and sleep disorders. After three more months of self-organized rehabilitation, he successfully returned to work. Six months after the trip, financial decline caused by his absence and unchanged stressful conditions at the workplace led to disappointment, motivational issues, and stress, but his work performance remained good regardless. One year after the trip, although his work-related stress had increased rather than decreased due to the financial situation of his company being more demanding than before his burnout, the positive outcome prevailed, proving its long-term stability.