What makes psychedelic psychotherapy work? Is it the induction of psychedelic experience, with its distinct patterns of hallucinations and insights, or is it the neural ‘shakeup’ that moves the brain out of its regular mode of functioning and into a more disordered state? We consider the role that attention-related phenomenological changes play in psychedelic transformation and psychotherapy. We review Letheby’s account of psychedelic psychotherapy, which appeals to increases in phenomenal opacity as the central mechanism of psychotherapeutic transformation. We argue that there is an alternative vehicle of psychedelic transformation that this account overlooks, involving radically transparent experiences. We outline the common kinds of phenomenal transparency shifts typical of psychedelic experiences, and argue that in many cases, such shifts are responsible for the psychotherapeutic benefits. This argument motivates an alternative approach to possible mechanisms of psychedelic self-transformation, and opens up a new venue of empirical research into the role of attention and phenomenology in psychedelic psychotherapy.
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