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Psilocybin Therapy: The Complete Guide (Updated 2021)

June 24, 2021
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You’ve heard good things about psilocybin assisted therapy, and you’d like to understand more. Perhaps your motivations are to heal past trauma, overcome limiting beliefs, to expand your consciousness, or to deepen your spirituality. 

Or maybe, you’re just curious about this psychedelic experience. 

If you haven’t heard yet, the traditional pharmaceutical drug industry is about to be shaken up by psychedelic psychotherapy. The resurgence of psychedelics, also known as the ‘third wave,’ is capturing the attention of researchers, psychiatrists, investors, and the general public. 

Mental illness is on the rise, with an outstanding 970 million people worldwide having mental health conditions such as depression, or substance abuse disorder (Richie & Roser, 2018).

People are tired of taking a drug with numerous side effects everyday to mask the pain. In this way, we are treating the symptom, not the cause… and here is where psilocybin may be a promising solution for some. 

Whether you or a loved one are dealing with a mental health issue, psilocybin therapy may be the better option than turning to a pharmaceutical drug or traditional therapy - and this guide will try to show you why. 

Numerous studies show the potential for psilocybin and other psychedelic substances like MDMA to treat depression, anxiety, and addiction disorders. In fact, the research shows their effectiveness exceeds the typical pharmaceutical drug and does so in only one or two exposures. That is why ketamine treatment centers are popping up all over the world, psilocybin research is making front-page headlines, MDMA assisted therapy is being normalized within psychotherapy, and psilocybin products for micro-dosing are being made readily available in places such as The Netherlands and Oregon, in the USA.

Not only that, psilocybin has been shown to also help those who are looking to increase their overall well-being, joy for life, creativity, and address root causes of unwanted behaviours or blockages. 

What is psilocybin therapy?

Psilocybin therapy is a psychedelic assisted psychotherapy whereby treatment of a patient by a trained therapist or practitioner administers psilocybin mushrooms (psychedelic mushrooms) or synthetic psilocybin alongside psychological support. 

It is an approach being investigated for the treatment of mental health challenges such as psychiatric disorders and severe depression that is treatment-resistant with a pharmaceutical drug. It is also used to treat those with psychological distress in other forms such as anxiety and addiction.

Psilocybin is a naturally occurring psychoactive/ psychedelic compound that is found in many species of fungi, also commonly known as “magic mushrooms.” When ingested, they produce a profound psychedelic effect lasting several hours, facilitating a deeply introspective, immersive and often mystical experience.

These hallucinogenic mushrooms have been used since ancient times for medicinal and spiritual purposes in Aztecs, Mazatecs, and Celtic cultures. 

Modern studies have shown psilocybin to be a safe and effective medicine for patients with depression, anxiety, addiction, post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and other mental illnesses, when administered with psychological support and specially trained therapists. 

Disclaimer! Those experiencing recent suicidal behavior or suicidal ideation, active addiction, psychosis, or severe trauma should ALWAYS seek professional medical guidance before taking any psychedelic compounds or psychoactive substances, as many of these conditions pose a life-threatening risks when combined with psychedelics.

How does psilocybin-assisted psychotherapy work?

Current and past-life experiences such as trauma, loss, discrimination, and poverty shape our beliefs and meaning of the world, ourselves, and others.  This influence can give rise to negative and overwhelming psychological, emotional, and physical symptoms, including how we react and respond to life and our ability to navigate our emotions. 

Psilocybin can help patients break out of self-destructive, habitual thought patterns and behaviours that contribute to suffering by allowing us to experience new perspectives, address the root cause of problems, and reconnect with a greater sense of purpose, meaning, and creativity in life. 

You don’t necessarily need to have a condition like depression to benefit from these qualities. Anyone looking to elevate their current state of consciousness and connect more with themselves and those around them will be rewarded by this experience. 

There are two factors at play here; one being the science behind how psilocybin works in the brain. And the other being the mystical, spiritual component. Studies have shown that psilocybin induces mystical experiences which directly correlate with the benefits that users report after their experience.  

Additionally, study participants are supported by various forms of therapy, for example schema therapy, cognitive behavioral therapy, or jungian psychotherapy.

How does psilocybin affect the brain?

Upon entering the body, psilocybin is quickly metabolized into psilocin which is responsible for the mushroom's psychedelic effects. Acting on serotonin receptors and increasing the amount of serotonin available in the brain, profound changes in perception occur.

 Specifically, it is believed that psilocin’s actions at the 5-HT2A receptor are most linked for the psychoactive effects. The activation of this receptor is connected to changes in cognition such as visual and auditory hallucinations, tactile perceptions, and synaesthesia. 

Psilocybin has been shown to promote neurogenesis and neuroplasticity (read our article here) and to reduce the control of the brain network known as the DMN (default mode network) (read more about the DMN here). The reduction of activity and control of the DMN has been linked to boosts in creative thinking and reductions in negative and reoccurring thought patterns. 

Those with depression or anxiety tend to have an overactive DMN. The “resetting” and demodulation of the DMN with psilocybin has been suggested to be a large factor in its antidepressant effects which have been shown to last months after initial treatment. 

What is a psilocybin experience like?

Psilocybin mushrooms/truffles are generally eaten in their whole, dried form, but are often consumed as a tea, smoothie, or ground up and inserted into capsules. At times they may be grinded and mixed with lemon juice or prepared with cacao.

There are four basic phases of a psilocybin journey; ingestion, onset, peak, and the comedown, each with their own set of perceptions. The peak typically occurs two hours after ingestion and holds the most intense sensory and psychological shifts. The entire journey typically lasts from 4-6 hours.

Around 20 minutes after ingestion, the psychological effects may become apparent. Many report entering a profound state of expanded consciousness where realizations about the self and the universe may be found. It is often described with feelings of unity, interconnectedness, infinite love, and peace. 

 Rushes of emotions, sense of total immersion in the surroundings, visual changes, and ego-dissolution are common. Thoughts might become more cohesive, creative, and connecting and characters may take on new identities or significance.

At a moderate psilocybin dose of 1-2.5g you might feel an increased intensity of emotional experiences, increased introspection, a sense of openness to thoughts and feelings, and peace and connection with others and the world around you. You may experience perceptual changes such as synesthesia, visuals, vivid colours, the sense that the world is breathing around you, and a distorted sense of time. Strong emotions, both pleasant and challenging may arise. 

At 2.5g-3.5g You will likely see visual hallucinations, including patterns and fractals, time and depth perception will be distorted but you will still be able to grasp your surroundings. Common effects include life-changing introspective or philosophical insights, increased flow of ideas, enhanced appreciation for art and music, and humor.

At a higher dose of 4-5+g you will likely experience intense hallucinations (both open and closed eyes visions), ego death, mystical experiences, deep introspection, synesthesia, and no conception of time.


Physical effects vary for each individual, but can include a change in heart rate, a change in blood pressure, nausea, dilated pupils, dizziness, disorientation, compulsive yawning, restlessness, deep relaxation, and trouble with coordination.

Is psilocybin therapy legal? 

Psilocybin itself is a prohibited substance in most countries, with the exception of The Netherlands, Jamaica, Brazil, and the British Virgin Islands. 

Institutions such as John’s Hopkins University, Imperial College London, Harvard University, California Institute of Integral studies and MAPS (Multidisciplinary Association for Psychedelic Studies) are all contributing towards the legalization of psilocybin therapy with their clinical studies. 

The movement to decriminalize psilocybin in the United states began recently in the late 2010’s, with Denver, Colorado the first city to decriminalize psilocybin in 2019. Since then, Oakland and Santa Cruz in California have followed suit. 

The FDA (U.S Food and Drug Administration) is helping to speed up this process of researching and approving psilocybin to retreat depression and anxiety, designating psilocybin therapy in clinical trials run by Compass Pathways as a “breakthrough therapy” for treatment resistant depression. 

In 2020, Health Canada granted 20 exemptions for psilocybin therapy to 20 cancer patients to treat their end-of-life distress. 

What does the research tell us about psilocybin therapy?

Modern trials show promising effectiveness in the treatment of anxiety, major depressive disorder, obsessive compulsive disorder, OCD, cluster headaches, addiction, and more, often for several months after just one psilocybin session.  

Roland Griffiths, Ph.D, a professor in the Departments of Psychiatry and Neurosciences at the Johns Hopkins University School of Medicine dives into results from recent studies in his Ted Talk on “The science of psilocybin and its use to relieve suffering.” You can watch it 

The results of the studies were incredible. 

In one clinical trial, about 80% healthy volunteers rated the experience (psilocybin treatment) to be among the top 5 of the most personally and spiritually significant of their lives. And about 90% reported increased life satisfaction and positive behavioural change, including increased positive move and better social relationships. 

In 2016 they conducted a study with psilocybin for the treatment of existential distress, anxiety and depression in people with a life-threatening cancer diagnosis which showed significant relief from depressive symptoms. 

In the study on this palliative care, cancer patients were given a low or high dose of psilocybin treatment and were observed 5 weeks and 6 months after the treatment to determine the effects of the clinical trial. The results revealed that 32% of participants who received the low dose, and 92% of those who received the high dose showed a clinically significant improvement in their anxiety and depression symptoms 5 weeks after their session. 79% of those who were treated with a high dose still showed significant improvement, in fact remission to a normal range, 6 months after treatment. 

Long-term benefits were greater for those whose psilocybin subjective experiences included a mystical-type experience, which is characterized by “a sense of unity, a noetic quality, positive mood, transcendence of time and space, and ineffability.” (Carhart-Harris et. al. 2016)

Griffiths states “These effects are really quite remarkable. What we’re showing here is a single exposure to substance producing substantial and enduring antidepressant and anti-anxiety effects. Such an effect actually is unprecedented within the field of psychology.”

Another study by Johns Hopkins was conducted on smokers seeking abstinence through the integration of CBT (cognitive behavioural therapy) and psilocybin assisted therapy. Participants experienced 3 psilocybin sessions and after 6 months showed a 80% abstinence rate. Generally, most other methods result in a 15%-30% smoking cessation rate. 

Griffiths also reveals how psilocybin and meditation are complementary processes for the investigation of the nature of the mind. When studied, both activities show similar changes in brain regions related to a sense of self. He says “if meditation is the tried and true course for the investigation of the nature of the mind, then psilocybin surely represents the crash course.” 

Another study published in 2020 in JAMA Psychiatry also shows great effectiveness in the treatment of major depressive disorder. 

“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” says Alan David, Ph.D, adjunct assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. 

The study showed that 67% of participants showed more than 50% reduction in depression symptoms at the 1-week follow up and 71% at the 4-week follow up. The researchers will report their findings a year after the study to see how long the antidepressant effects of the treatment last. 

In another study, psilocybin again showed promise for addictive disorders, with alcohol-dependent patients demonstrating significantly reduced drinking behaviours over 8 months after just one or two psilocybin sessions. 

There is also evidence showing that psilocybin may be effective in terminating cluster headaches and preventing the regular occurrence of them.

Psilocybin therapy for “healthy people”? 

While the majority of research is focused on psychological conditions like anxiety, depression, and addiction, studies also show how psilocybin therapy can promote overall well-being in healthy individuals. 

Improvements in wellbeing and optimism lasting for more than one year were observed in healthy individuals given a single dose of psilocybin (Johnson & Griffiths, 2017). This may be attributed to the observation of enhanced cognitive flexibility, associative learning, and cortical neural plasticity after psychedelic experiences in human beings (Johnson & Griffiths, 2017). 

Although much more research is needed on this topic, there is evidence suggesting that psilocybin can enhance creative, flexible thinking and emotional empathy (Mason et. al, 2019). Specifically, in one study, psilocybin was shown to increase the rating of spontaneous creative insights, with the number of novel ideas increasing after seven days.

At Behold Retreats, we work with expert coaches, facilitators, and therapists to help elevate consciousness and well-being with our 7 week life accelerator and 1 week immersive plant medicine retreat. 

If you are interested in learning more, schedule a call with us today! 

What are the other types of psychedelic therapy?

Psychedelic assisted therapy is not exclusive to psilocybin; in fact, the majority of psychedelic research is focused on mdma assisted psychotherapy and ketamine assisted psychotherapy. Mdma (a drug often known by its street name xtc or molly) and ketamine (a drug primarily used for anesthesia) are both synthetic substances showing promise for the treatment of PTSD, major depression, and anxiety. 

Other substances such as the psychedelic drug LSD and natural brew of ayahuasca are being studied for their effectiveness for mental health disorders and overall well-being. 

With the proper psychological support, psilocybin assisted psychotherapy and other psychedelic assisted therapies show great promise in the revolutionization of psychiatry and pharmaceuticals as we know it. 


Davis AK, Barrett FS, May DG, et al. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78(5):481–489.

Griffiths, Roland (2015). The Science of Psilocybin and its use to relieve suffering. TEDMED Conferences. https://www.tedmed.com/talks/show?id=526825 

Hannah Ritchie and Max Roser (2018) - "Mental Health". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/mental-health' [Online Resource]

Johnson, M.W., Griffiths, R.R. Potential Therapeutic Effects of Psilocybin. Neurotherapeutics 14, 734–740 (2017).

Mason, N.L., Kuypers, K.P.C., Reckweg, J.T. et al. Spontaneous and deliberate creative cognition during and after psilocybin exposure. Transl Psychiatry 11, 209 (2021).

 Natasha L. Mason, Elisabeth Mischler, Malin V. Uthaug & Kim P. C. Kuypers (2019) Sub-Acute Effects of Psilocybin on Empathy, Creative Thinking, and Subjective Well-Being, Journal of Psychoactive Drugs, 51:2, 123-134

Robin L Carhart-Harris, Mark Bolstridge, James Rucker, Camilla M J Day, David Erritzoe, Mendel Kaelen, Michael Bloomfield, James A Rickard, Ben Forbes, Amanda Feilding, David Taylor, Steve Pilling, Valerie H Curran, David J Nutt, Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study, The Lancet Psychiatry, Volume 3, Issue 7, 2016: 619-627.

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