Session facilitation and therapeutic holding

The manuals converge on the idea that session facilitation is primarily a steady, supportive holding function. Across the extracts, therapists are described as staying present throughout the session, offering calm and compassionate containment, and helping participants remain with difficult material rather than moving away from it. Several sources also emphasise grounding, reassurance, inward focus, and support for intense affect or altered states, with an overall preference for nonintrusive accompaniment over heavy direction. They also agree that verbal intervention is often minimal and carefully timed. The manuals describe brief support, quiet presence, silent witnessing, and short communications, alongside checking in when needed. In this shared frame, the therapist is attentive to whether the participant is processing, avoidant, stuck, or overwhelmed, and adjusts the level of engagement accordingly. The main differences are in emphasis and session style. The LSD trial document places strong weight on continuous dyadic presence across a long session with two therapists, a quiet environment, and music, while the MDMA manuals focus more on balancing silence with intervention and on how to respond when distress, defensiveness, or stuckness appears. The adherence manual for MDMA also adds a clearer caution against distracting, over-cognitive, or humour-based manoeuvres, whereas the other sources frame the same territory more generally as calm presence, containment, and noninvasive witnessing.