Altered States of Autonomy: Entities, Agency, and Intentionality in Psychedelic-Assisted Therapy and Addiction Recovery

The use of psychedelic-assisted therapy in addiction recovery raises complex challenges regarding alterations of autonomy. Addiction narratives and ayahuasca practices both frequently involve encounters with external entities perceived as influencing one’s sense of agency. In the case of addiction these entities impede it, yet autonomy may be restored. Through processes such as surrender to a higher power in 12-Step programs and ego-dissolution in psychedelic-assisted therapy, autonomy is paradoxically restored by relinquishing control. The questions regarding agency and autonomy which these raise will require new frameworks which emphasize connectedness. These frameworks also allow for the consideration of the role of community in shaping external agents and altering autonomy. Being shaped by the wider set and setting of culture, input from the humanities is needed to adequately explore the potential clinical applications of the various communities, practices, and frameworks confronting these altered states of autonomy.