Incorporating interoceptive and somatic practices, including body awareness, breathing and movement, into psilocybin preparation may help patients engage with bodily sensations and challenging emotional experiences
This paper aimed to develop a framework for incorporating interoceptive awareness into preparation for psilocybin-assisted therapy in patients with cancer. The authors propose that preparation should address both receptive interoception (noticing and interpreting internal bodily sensations) and generative interoceptive engagement (actively working with these sensations through breathing, posture, movement and attention).
They outline a six-category framework for bodily experiences during psychedelic sessions and propose a three-session preparation protocol incorporating body awareness and somatic techniques. The authors hypothesise that developing interoceptive capacity may help patients engage with challenging bodily and emotional experiences during psychedelic therapy. However, this is a hypothesis-and-theory paper, not a completed clinical trial; the proposed benefits are yet to be demonstrated experimentally.
Abstract
Cancer patients arrive for psilocybin therapy with bodies altered by illness and treatment - bodies that they have learned to brace against, dissociate from, or scan for threat. Research on psilocybin-assisted therapy for cancer-related depression and anxiety consistently identifies the quality of the acute subjective experience — reflected in constructs such as acceptance, surrender, boundlessness, and emotional breakthrough — as a key predictor of therapeutic benefit.
Yet most preparation protocols focus on cognitive intention-setting and basic mindfulness while neglecting to address the body directly. We propose that anxiety and depression in this setting may involve a somatic substrate that has not been adequately specified. We distinguish two capacities to ‘feel into the body’ relevant to psychedelic therapy: interoception as perception (the perceptual access to bottom-up bodily signal) and interoceptive engagement (the broader capacity that links bodily perception to posture, breath, structural intent, and affective stance). We describe a six-category phenomenological taxonomy of somatic experiences in psilocybin therapy (exteroceptive, deep somatic, visceral, vestibular, nociceptive, emergent).
We also map receptive practices, designed to improve interoception as perception, and generative practices, designed to improve interoceptive engagement. The framework is grounded in current predictive-coding accounts of interoception, but does not depend on any single neuroscientific model. An ongoing Phase 2 trial of group retreat psilocybin therapy for metastatic cancer patients will provide an initial test of our hypothesis that interoceptive training may influence therapeutic outcomes in psilocybin therapy for patients with cancer.
Back AL, Price CJ, McGregor BA and Markell A (2026) Preparing the body for psilocybin therapy: receptive and generative interoception in cancer patients. Front. Psychiatry 17:1890966. doi: 10.3389/fpsyt.2026.1890966 Read Paper
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