I apologize if I misunderstand you, which is very possible.

I interpret you as saying that unless there is a "trip" there is only a placebo effect left on the table so to speak. I think this is somewhat refuted by the fact that the standard ketamine infusion protocol (that does not normaly induce "trips") has an effect size that dwarfs the effect size of placebo (say 0.2 - 0.4). Some studies have shown ketamine approaching ECT-effect sizes. This makes me sound like a ketamine nut, which I am not. I am a bit of an ECT nut though. I have just not excluded the fact that the phenomenology of certain treatments actually mediate the treatment effects in a non-placebo way.