PeaceTalks Radio
HealingPsychedelics
Today on Peace Talks Radio, we explore the therapeuticuse of psychedelic drugs to address trauma and a pursuit of inner calm andpeace. We’ll hear from researchers and clinicians.
Trauma happens when someone witnesses or participatesin something that is such an affront to their morals that they then have toreorganize how they see the entire world. Wrapped up in that is a lot of guiltand shame and not knowing what to do with it. Under MDMA, you just sort of knowthat you have to deal with it.
Meet a social worker in the UK who has been in atrial.
One of the motivating factors that influenced mebecause I was looking at these studies. They were treating people who had PTSD,people who had been diagnosed with terminal cancer and people were saying, “Idon’t just feel better, I feel transformed.”
Finding peace and mental health through thetherapeutic use of psychedelic drugs on this episode of Peace Talks Radio.
Since this episode was recorded, the FDA has declinedto approve the use of MDMA as a treatment for Post Traumatic Stress Disorder.Experts say the work is far from over and the research will continue.
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This is Peace Talks Radio, the radio series andpodcast on peacemaking and nonviolent conflict resolution. I’m Jessica Ticktin infor series producer Paul Ingles.
Today correspondent Danielle Preiss will help us delveinto the world of psychedelics such as MDMA and psilocybin and explain how theyare being used as part of therapeutic practice and what the research says abouthow they work.
After a golden age of research in the 1950s and ‘60s, researchon therapeutic uses of psychedelic drugs were grounded for much of the 20thcentury after they were classified as Schedule I drugs meaning they have nomedical use and a high potential for abuse.
In recent years though, scientists have challengedthose assumptions, and this line of research has started to gain new momentumwith particular focus on how these substances may relieve suffering for peoplestruggling with trauma and PTSD. Scientists are still trying to understandexactly how they work therapeutically but believe substances like MDMA, psilocybinand LSD help the brain rewire in a way that allows new perspectives onpsychiatric problems.
While these drugs may be better known for theirrecreational uses, researchers say they have huge potential to help peoplestruggling with mental health conditions that are sometimes resistant to othertreatments or require indefinite use like antidepressant medications.
First, we’ll hear from Shannon Miller, a licensedclinical social worker and the owner and Clinical Director of Apricity ExpatTherapy who works with clients who use psychedelics. We’ll also hear fromShawn, a humanitarian aid worker from the UK who tried psilocybin commonlyknown as magic mushrooms as a therapeutic to address issues around trauma. Laterin the program, we hear from a researcher about the science behind thesepowerful substances and why they have the power to heal.
Now, here’s Danielle Preiss with Shannon Miller.
DP: What do we understand about how psilocybinsupported therapy works?
SM: What we’re coming to understand is thatit’s happening on two levels. There is a biochemical thing happening in thebrain where it allows both sides of the brain to better talk to each other andit builds neuroplasticity. It’s during that window of neuroplasticity that wecan get in there with some really good therapy and build new neural networks.
The other thing that’s happening isagain, under the influence of psilocybin, we don’t get hung up on details orfluidity of stories. Things come at us in pieces, and we seem to know what todo with the pieces. Again, it’s getting to that inner healing intelligencewithout getting caught up in the details. You flow with it a bit better andit’s more of a perceived sense of what you have to do rather than somethingthat can be articulated. You don’t need words in the experience, you just know.
DP: As a therapist, what is your role when yousit with clients who are taking psychedelic medication?
SM: I’m not giving the medication. I’m notmanaging the medication. I’m not making any decisions about the medication. Iam the safety blanket that is in the room with them. I am their comfort zonebecause presumably I have a preexisting relationship with them.
DP: What is it like to walk someone throughthis experience as their therapist?
SM: If someone says, “Hey, I’m going to do mushrooms.Will you trip sit?” Of course, I will agree to it nine times out of ten if Ithink that’s a good choice for that person.
How other organizationsdo it is that the guide shows up and they bring the medication with them. Thereis a lot of talk so that everyone gets comfortable and familiar with eachother. The guide will grind up the mushrooms and put them into a tea and thengive the tea to the client. The client chooses to take however much they wantat whatever pace they want.
Eventually, when theystart to feel the effects coming on, they climb in bed, put a facemask on andlisten to music. I’ve seen it start with a guided meditation and go into music.Some people don’t want music, but most do. It tends to really guide the tripvery well. Then for about five hours, they’re having their experience.
When the experience comesto a close, the guide makes themselves available to then talk through with themwhatever they want to talk through. In my experience, what I have seen is thatpeople don’t necessarily want to talk right away and so then a guide will stickaround until the person says, “I’m okay” and the guide feels comfortable thatthe person is sober enough and that they are not a danger to themselves oranyone else.
The following day, I willwork with that person to integrate their experience which entails asking themwhat it was like for them and what it meant to them. We talk about things thatcame up and the meaning that they assign it. My job is to help them process.
DP: Is the guide initiating conversation ordiscussion with people or is it totally up to them?
SM: It’s completely up to the client. Eachperson typically wants something very different from their guide. I have seenwhere people just lay there stiff as a board and don’t move for four or fivehours. I have seen where people want to be up and walking around, which guidesdon’t encourage because it distracts them from the actual trip. We wantpatients to be internal to themselves. It’s not really an external experience.They’re wearing a facemask, and we encourage them to stay in their mind becauseagain, this isn’t recreational. I’ve seen guides redirect over and over back tointernal to them.
DP: And what about the music? Are the clientschoosing the music themselves? Are there specific types of music that bettersupport the experience?
SM: There are playlists on Spotify and they’repretty good. There is also a new website out where, as a therapist or as aguide, you can tailor the music very specifically to the drug, the client, thelength. There is a whole science to the music.
DP: That’s fascinating. Shannon Miller, whatkinds of things do people tell you about their experiences afterwards? Whatimpacts have they seen?
SM: First of all, I always warn people whopursue psychedelic assisted therapy. We go over expectation management. Yes,this is something that may help, but it’s not going to be a cure all. I’veheard a brilliant analogy that said, “When you’re done doing it, it will feellike summer, but winter always returns.” Everybody describes it as very, verypowerful. They get their intentions addressed, but not in the way that theythought that they would.
We encourage people toask the medication a question. That question is universally answered, but notin any way shape or form. It’s actually very surprising to them but it makes100% complete sense to them.
DP: I would assume that the question is alsocompletely individual, that people are doing it based on what their needs are.
SM: Yes, but a trend that I’ve seen is that universallyit is relational things, people wanting to connect better with someone orsomething in the world around them.
DP: Do people ever express that they arescared?
SM: Yes, absolutely there tends to be someanxiety going into it. I’ve worked with people to calm them down becausethey’re afraid of what the medication will show them. What they are actually isafraid of themselves. They can always change their mind, but for some people,it activates things that they have long since tucked away somewhere and it canbe very scary. I will say that it’s never more than the person can handle. Itis never a horrible super bad trip, man. It’s never that kind of stuff at allever. It may bring up things that were particularly frightening or saddening toyou, but you can handle it.
DP: Is that part of the therapeutic approach,bringing up these things?
SM: Yes, because that’s the stuff that you needto touch and to get in there and to heal.
DP: I was able to speak with someone who hasfirsthand experience trying psilocybin therapeutically. Shawn is a humanitarianaid worker from the UK. Due to the stigma around psychedelic use, she prefersto use only her first name.
Shawn wanted to exploreissues around intergenerational trauma, the idea that traumatic things thathappened to your parents, your grandparents or great-grandparents can affectyou, but also, like most people, Shawn has dealt with some hard things in life.Her mother passed away some years back and the end of a long-term relationshipwas difficult.
She has also worked inconflict zones where she worked with people who had suffered a lot and wassometimes in scary and dangerous situations herself. She wanted to see howthese substances might help her understand those traumas.
Here is my conversationwith Shawn about her experience.
Do you remember what you thoughtabout when you first understood it? Was it something that you considered thatyou might ever do?
S: At the time that I was first aware thatit was something that people were using, definitely not because what I wasreading about was people who experienced really significant trauma, soldierswho returned from Vietnam, people with extremely severe PTSD.
DP: Psychedelics are used to treat a varietyof mental health conditions, for example, depression, PTSD, demoralization.What kinds of things were you looking to address with therapeutic psychedelics?
S: The work that I’ve been doing with mytherapist has been really wide ranging. We’ve been speaking with each other fora long time. The main thing was that I wanted to explore this idea ofgenerational trauma, the idea that the things that your parents, grandparentsor great-grandparents experienced get indirectly passed down to you.
It seemed like a goodforum to explore that, but because you can’t necessarily pick and choose what’sgoing to come up, I was also aware that because of my job and things that havehappened to me over the course of my adult life, that I picked up some directtraumas. I wanted to see if it would help me process some of those things.
DP: Can you now walk me through theexperience? Start from the beginning as much as possible and just explain whatit was like.
S: The location was in Amsterdam. Atmid-morning we started. Two people were guiding me, my therapist and hercolleague who is a mushroom expert, so he was in charge of dosing. What happensis they explain to you what’s going to happen and the key difference from mostpeople’s experiences with mushrooms is that you will be alone for theexperience.
I drank the mushroom teaand then a few minutes later I laid down. They played music for me. They playedAlan Watts; someone I knew to start with. They said, “If you want anything orneed to take a bathroom break, it will last for eight hours.” The snacks, Iwouldn’t have picked them. There were grapes, mango and some crisps.
You’re laying down andyou have the typical experience of starting to feel slight body temperaturechanges. It’s a really strange experience because initially it was black butthen it became a kaleidoscope. The kaleidoscope was multicolored. I had no senseof time. You’re advised not to have your watch or your phone. Somebody said,“You’ve just got to follow the river.”
It’s a bit like watchinga film that you’re a little bit in control of. If you’ve ever had a lucid dreamwhere you feel like you have some control, it’s a little bit like that exceptthat it feels like things are coming from very deep inside of you.
In my case, I saw thingslike my dad, seeing him transform into people that I didn’t know, but it seemedto me that they were relatives going back into time.
DP: When you were seeing these figures ofpeople who seemed to be relatives or ancestors, were they doing anything? Wasanything happening? Were there specific traumatic things that you could seeexpressed?
S: Yes, that’s how it started. That was atthe beginning. It was kind of like a play. They would show me things aboutmyself. They didn’t speak to me directly, but it was like they were showing methings. This probably isn’t an uncommon experience. I carry a bit ofuncertainty and worry that the decisions that I’ve made are not right or thatI’m not making people proud. It felt like they were trying to communicatesomething to me. It’s something that you have to interpret.
When the whole thing finished, Ispent a long time furiously writing. And to be honest, some of it I still don’tfeel like I fully understand.
DP: You said that you had wanted to addressintergenerational trauma. It sounds like that’s what was happening when you sawthis vision of your father and relatives going back. Had you set an intentionto see that?
S: I had set an intention. I had writtendown what I wanted to explore. The guy who was accompanying me said, “Themushroom is the medicine. It knows what you need to look at and consider.” Thatdid feel like that’s what happened.
DP: Did you ever feel scared during the trip?
S: Yes, I did, but it wasn’t traumatic. Ihad some moments of fear. People may have this experience when they take drugsrecreationally, you see yourself unvarnished. One of the things that happenedto me is that I had a bit of a freakout at one moment because I started to feelguilty about a relatively trivial thing that happened two days before.
I wasn’t allowed to havemy phone, and I made a decision at that moment that I needed to rectify thatproblem. That’s the reason you have a guide, to talk you down, “You’re havingsome feelings, but it’s not a big deal, just chill. Eat some snacks.” After 15or 20 minutes, I calmed down again.
I didn’t spend the wholeperiod in the process that I was supposed to be having wearing the mask. Iwould say that I did about half of it. I felt like I was at the limit of what Icould carry and also what I could remember and therefore be able to process.
I had my therapist withme. She sat next to me. I was talking through with her some of the things thatI had seen and that were on my mind. Everybody’s experience is going to be veryunique. I definitely wouldn’t want anybody to have any fear if they wereconsidering doing it that anything dramatic would happen, but I would reallyrecommend not to be in a messy emotional place at that time because even atrivial thing messed with me.
You need to be able torelax and you also need to have some confidence that whatever is going on inyour life with work and family, that everything is going to be okay. You wantto do it at a moment where you have actually got the time and the mental spaceto be able to concentrate with no feelings like you should be somewhere else.
DP: I spoke also with a therapist and aresearcher who work on therapeutic psychedelic medicine and they both talkedabout how this kind of medicine helps you access things in your subconsciousand helps you see them in a different way. I’m wondering if you had that typeof experience.
S: Yes, I did. I think I’m very luckybecause of the job that I do and the life that I’m living, I don’t have to dayto day put on too much of a mask or a special hat while I’m going about myeveryday life. Even so, we’re all keen to present our best selves.
One of the negativethings that I picked up from where I grew up and the family that I grew up inis that if something that you don’t like happens to you, just keep it moving.That works quite well when you’re a kid and you fall over, but it doesn’t workso well when you’ve got mounting personal crises. Because of the nature of thejob that I do, sometimes I’ve been in situations where not very nice thingshave happened and I’ve had to swallow it and keep going.
I do think it helps youto see things in another light, but that’s not necessarily going to solve theproblem. I can only speak for myself. I didn’t get to the end of that day andwhile lying in bed thought that’s super, that’s sorted, back to work.
It gives you a glimpse ifyou like and helps you see in totality why you have made some of the decisionsthat you’ve made, what is the impact of some of things that you’ve experienced hasbeen and that’s really helpful, but you also then need to do the work and makedecisions and make changes whether it’s practical changes or changes in the waythat you’re going to go through your life.
I’m sure it’s perfectlypossible that you could have the experience and be like, “Oh, that’sinteresting,” and then just carry on. That’s why it’s helpful to do it with atherapist and, in my case, a therapist that I know quite well.
DP: How long ago was it that you did it?
S: Two months ago.
DP: Do you feel like you have any differentthoughts or insights about the issues that you were looking to address throughthe session now that there has been some time and space from it?
S: I’d quite like to do it again actually.I feel like I only scratched the surface, and it felt like there was somereally big identity related things that I needed to process. There were a lotof other things that I could have explored but didn’t. I would definitely beopen to doing it again.
DP: How open are you talking to people in yourregular life about the fact that you did this?
S: I have told a few people. I think it’sreally interesting because I think that the reasons that I want to do it arecompletely legitimate. There are factual things that my friends and familywould say are important for me to process and get help for if need be.
I do carry a bit ofconcern and worry about what people will think about it. To make a very poorcomparison, it’s not like with marijuana where people use it for pain relief.That’s quite well accepted now and because it’s a physical thing, most peopleare relatively tolerant. I would be concerned that it would change people’sperceptions of me.
DP: I think that’s a good comparison withmarijuana because I remember five years ago my grandmother was using medicinalmarijuana for pain relief from cancer treatment, but even so, it was hush hushthat grandma was doing it. Nobody thought that she was getting high in herspare time.
S: I think we’re in a period, luckily, ofquite profound and fast-moving change which is great. It’s really good thatpeople are becoming more open to the idea and it’s super cool especially inAmerica that researchers are now being given licenses to actually be able toexplore and actually present some evidence about effects.
I’m more concerned aboutthe older generation who grew up with a very zero tolerance attitude to drugs. Alot of unpacking needs to happen because the real tragedy is that we’ve hadaccess to these medications all along. Some of my friends are much moreeducated on the subject than me, but there are people who have been attemptingto provide this type of therapeutic service for people with these drugs formany years. They’ve basically been sidelined and maligned in some cases becauseof the stereotypes surrounding hippies and yet if you remove all the culturalbaggage that we have, what we actually have is something that does help people.
I was looking at studiestreating people with PTSD and people who had been diagnosed with terminalcancer who not just felt better but felt transformed. No other medications havethat type of impact on people. It’s sad that it has taken a long time, but I’malso very grateful that within my lifetime we have the opportunity to try it.
I’ve got complicatedfeelings about it, but I do hope that if people feel like it can help them andthey’re able to access it, then I would encourage people to do that because themore we normalize it, the more likely we will put pressure on our policymakersto make changes, make investments and change their ways of thinking.
JT: That was Shawn, a humanitarian aid workerfrom the UK who tried psilocybin as a therapeutic to address issues aroundtrauma.
We also heard from Shannon Miller,Licensed Clinical Social Worker and the owner and Clinical Director of ApricityExpat Therapy. Shannon is training in the integration of psychedelic use intotherapy through MAPS, the Multidisciplinary Association for PsychedelicStudies. You can find links to some of the Spotify playlists used duringpsychedelic therapy sessions at www.peacetalksradio.com.
After the break, Danielle Preisswill speak with a researcher to explain the science behind these powerfulsubstances and how they can help a brain damaged by trauma to heal. Stay tuned.
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You’re listening to Peace TalksRadio, the radio series and podcast on peacemaking and nonviolent conflictresolution. I’m Jessica Ticktin in for series produce Paul Ingles.
How do psychedelic medicinesactually interact with therapy? Today correspondent Danielle Preiss takes usinto the world of psychedelics being used for healing trauma. We heard a first-personaccount from Shawn earlier and also from licensed clinical social workerShannon Miller who we’ll hear more from in this hour.
Shannon is trained in theprocess of integrating psychedelic experiences into therapeutic practices andhelps clients who have tried psychedelics work through what they’ve discoveredduring their trips.
Before we hear more fromShannon Miller, Danielle Preiss first interviews Dr. Jennifer Mitchell aprofessor in the UCSF Department of Neurology and an Associate Chief of Stafffor Research and Development at the San Francisco VA about the science behindthese drugs as therapeutic tools.
DP: Dr. Jennifer Mitchell, can you tell me alittle bit more about the work that you do?
JM: Sure, for many years now our group hasbeen involved in identifying and developing novel therapeutics for mentalhealth disorders like depression, anxiety, alcohol and substance use disorders,etc. For the past eight plus years now, that work has focused on the testingand development of a class of drugs that we term psychedelics.
DP: What exactly is a psychedelic drug?
JM: Well, I think it depends on who you ask,but the word means “mind manifesting.” The idea is that a psychedelic compoundallows you access to parts of your subconscious or parts of your mind thatmight otherwise often be hidden from view. This aspect of you can help garnersome sort of insight that might make you better.
DP: How did you first get into the field ofpsychedelic medicine?
JM: I’m a native San Franciscan and I’m old. Iwas born in 1970 and so as a child I was perfectly poised to see some of thegood and the bad of psychedelic use within the community. I remember beingafraid of them as a very young child because I would hear whispers, “poor Dannytook too much LSD, and he has never come back.”
Then in early adolescenceI saw them in action. I went to a high school that had a lot of psychedelic usein San Francsico and I was amazed by this idea of a tabula rasa, it broughtpeople back to this childhood state of innocence and curiosity and opportunity.You could see that in the wrong hands that could be very damaging, but in theright hands it was this incredible opportunity for healing and growth.
By the time I was incollege, I thought that it was crazy that no one had studied these compounds,so in graduate school I remember asking if I could have access to some of themthrough a National Institute of Health called NIDA, The National Institute onDrug Abuse. I was told no, so we instead spent some time contemplating theireffectiveness and reverse engineering some of those effects as best we could.You could mimic the effects pharmacologically and see what that does tobehavior. We did that for a long time.
Finally, I heard thatMAPS, [Multidisciplinary Association for Psychedelic Studies] had put moneytogether for a Phase 3 trial in humans and we were lucky enough to be invitedto join those studies.
DP: What types of psychedelics are beinglooked at by researchers currently?
JM: Well, there are a whole bunch, but the topthree are MDMA, which is being investigated as a therapeutic for PTSD,psilocybin otherwise known as magic mushrooms and that’s being looked at as atreatment for depression and then LSD which is being studied as a treatment forgeneralized anxiety disorder. There are other compounds as well that we knowbased on their use in indigenous groups seem to have some sort of therapeuticefficacy, but these have yet to be thoroughly tested in clinical trials.
DP: Can you tell me a little bit about howMDMA works? First off, what is it exactly for people who don’t know?
JM: MDMA is shorthand for 3,4-Methylenedioxymethamphetamineand it’s a substituted amphetamine, so it has an amphetamine backbone to it. Inthe ‘80s, maybe even early ‘90s, it was used mostly as a street drug calledecstasy.
First of all, on a neurosciencelevel, we believe that the drug acts on part of the brain called the amygdala andalso on a circuit in the brain that enables plasticity and new learning andgrowth. That’s on a neuroscience level.
On more of an interpersonal level,what they found back in the ‘70s and ‘80s is that when you administer MDMA tosomeone, especially in a therapeutic environment, they were very able to openup and access emotionally things that had happened to them in a way that didn’tmanifest as shameful, scary or embarrassing which helps tremendously in atherapeutic setting.
DP: Do we know why exactly that’s happening?Is the research able to connect what is happening at a neuroscience level withthose impacts that you just described?
JM: To some degree, yes. A lot of ourneuroscience research depends on animal models. You can’t really look at a ratand say, “Are you feeling better? How do you feel about your childhood?”
But what we can do is aseries of behavioral tests that suggests that one of the important things thatMDMA is doing is it’s allowing retrieval and reconsolidation of a fear-ladenmemory in a way that removes some of the emotional valance. We know where inthe brain exactly that’s happening. It happens at the level of the amygdala andthat process of retrieval and reconsolidation is likely key for the therapeuticbenefit of MDMA.
DP: Is it possible to break that down just alittle bit exactly what you mean by “emotional valance”?
JM: Sure, in general as an example, a fluffyexample, is the idea that perhaps if you have a memory that is particularlysalient and particularly painful and you have a tendency to let your mindwander there and relive it over and over again, perhaps the MDMA will helpremove some emotional valance from the memory so you will still remember it,but it won’t trigger the pain in your tummy or the rapid heartbeat or the heavybreathing or panic that has typically been associated with that memory. Youdon’t forget anything. You don’t suddenly forget something that’s happened toyou. You just process it differently and more comfortably.
DP: Is it similar to what be known as exposuretherapy where you have the memory again to have a different response to it?
JM: You know, that’s a great question. We doalso study exposure therapy. We study exposure therapy combined with drugs thatare somewhat related to MDMA. The idea is that you bring back the memory andthrough exposure therapy relive it over and over again so that it will stopbeing so sensitized. You will habituate to it. It won’t be so painful anymore.I will say that from my personal experience, going through that process formany people is too painful to relive the memory over and over again. One of theremarkable things about MDMA is that it allows you to access that memorywithout it being so painful and that’s what makes the therapeutic effect somuch more intriguing from a science perspective.
DP: You mentioned the term “neuroplasticity”early. Is that what you’re talking about here with how the changes arehappening? Could you explain what neuroplasticity is exactly?
JM: I think what’s interesting in the fieldright now is that neuroplasticity means different things to different people.Originally it had to do with mechanisms called long-term potentiation andlong-term depression and those were found through a very specific methodology.Now people are looking for other markers that might indicate some form ofneuroplasticity. I’d say it’s early days in terms of determining how muchpsychedelics impact neuroplasticity.
The general idea thatmany people believe is that perhaps there are critical periods in your brainfor learning certain things and that at the end of that critical period, itcloses and makes it harder to learn certain things.
I think the best examplethat many people feel that they can gravitate towards is that of language. Whenyou are a little child, if you’re trotting around the world, you might learntwo or three languages before the age of eight and you’ll speak them beautifullyand fluently for the rest of your life.
If you try to learn alanguage after early adolescence, it’s actually quite difficult. What peoplefind is that they never fully embrace that language. When they get older,perhaps it’s something that they lose again. When they’re quite old, they don’tremember it at all.
The idea is that there isa critical period for language acquisition, a critical period for visual acuity,a critical period for social and emotional learning. Perhaps psychedelicsreopen that critical period for social and emotional learning. I think itshould come as no surprise to people that based on animal models, it looks likethat critical period closes at the end of adolescence and that it is mostactive during adolescence. If you’ve ever had an adolescent in your house,you’re probably likely to agree with that statement.
One of the interestingthings that MDMA appears to do is to reopen that critical period for socialemotional learning so that an adult animal suddenly looks like an adolescent interms of how they want to interact with other animals. The idea is that on aphysiological level, that form of plasticity may allow for additional learning.“You can’t teach an old dog new tricks,” so you get a new dog for a period of afew hours to a few weeks and maybe psychedelics allow you to be a new dog.
DP: Dr. Jennifer Mitchell, there has beenresearch into psychedelics since the 1950s. Why has it taken so long tounderstand their benefits?
JM: That’s an interesting question. I thinkthere are a few reasons. The first is that in the last ‘60s and early ‘70s inthis country, psychedelics went into the general population and were widelyused. They scared a lot of people, so the DEA came along and scheduled them,and they didn’t just sort of schedule them, they put them in the mostrestrictive DEA category, Schedule I, that says they have no medical use andthat they are highly addictive. We believe both of those statements to bewrong, but they were a response to the social ethos of the time.
That made these medications verydifficult to study scientifically because it meant that there was no money availablethrough state or federal sources to do so. It has taken us a long time to catchup and calm down from the panic of the late ‘60s and early ‘70s.
Maybe under the right conditions andin the right hands, those are very powerful and effective medications. Maybesome of the indigenous groups that have been using them for thousands of yearsgot it right. Maybe we should look at how Native Americans have been doing itand figure out how we can get it right ourselves.
DP: Is it difficult to get research funded nowwith the legal implications?
JM: Yes, it’s painful frankly. We have reliedprimarily on philanthropy for the past eight years which is something that I amabsolutely grateful for and at the same time I wish that the federal governmentwould get on board more quickly to help continue these research studies becauseI think that they could be very fruitful.
It’s time to acknowledge that someof the doctrine that was prevalent in the ‘80s was not true but rather scaretactics. My generation was raised on eggs in frying pans, and “this is yourbrain on drugs.” I still remember a big black hole, “this is your brain onecstasy.” The big black hole doesn’t even make sense neurologically.
I don’t yet know if it is toxicunder some conditions and at some doses. That’s something that we have toinvestigate. What we do know is that it can be safe and effective at certaindoses in certain populations.
DP: Do we know anything about the long-termimplications of the drugs? Do we know how long the benefits last for example?Do people have to continue long-term or is it a one dose and you’re better?
JM: It’s not a one and done. I think a lot ofpeople are hoping that it will be a one and done. What is intriguing aboutpsychedelics is that they appear to be particularly durable treatments. Forpsilocybin and MDMA, there is the most data. Those data suggest that for somepopulations, after one to three doses of a drug, which is pretty minor when youthink about the general scheme of things, you’re better for years.
Most people will need atouch up every so many years. Maybe depression trickles back in or maybe thereis another trigger in your life, and you’ll need to go back again for anotherround of therapy.
The idea is thatpsychedelics can be quite different from some of the other drugs that areconsidered gold standard treatments that you have to take every day foreverlike SSRIs. The idea is that maybe there would be a lot more freedom and a lotmore opportunity for growth if you instead were able to take a psychedelic.
DP: How much is the field suffering now fromreputational issues? Is it difficult for people to take the science seriouslybecause of the associations with recreational drug use?
JM: I think for many people it is. Some peoplehave come around to acknowledging that there is both good and bad for manysubstances. I think often of cancer treatments. Cancer treatments will kill youif you have to do them for long enough. The hope is to rid the cancer beforekilling the host. Radiation is something that I wouldn’t want to see everyoneuse, but we know that radiation is a very important therapeutic at this pointin our development as a species. I think of psychedelics similarly. In theright hands, they are very powerful tools.
DP: Has the research shown any risks ordownsides to psychedelic therapies?
JM: It’s early days, so I caution people. Justbecause we haven’t found that many risks doesn’t mean that they might noteventually pop up especially in certain subgroups, but I think that the largestrisk from my perspective is still that these compounds shouldn’t be used incertain populations with predispositions or with other comorbidities, otherdiagnoses that could make the drugs dangerous. We screen out people who have afamily history of schizophrenia. I don’t believe the drugs should be used inindividuals who have personality disorders or that have certain cardiacconditions that could be exacerbated by these drugs. I think it’s reallyimportant to be well screened by a healthcare team before you engage inpsychedelic therapy.
DP: How do you think we should view thesedrugs and their potential going forward?
JM: One of the most interesting things aboutpsychedelics is that they have power. There’s power in a mushroom, power in apill. Because they have power, they have a tendency to be somewhat scary, sortof like radiation where it could be very healing but obviously you have to bevery careful. My personal feeling is that we don’t want to repeat some of themistakes of the late ’60s and early ‘70s and just go crazy and think thatthey’re safe and everyone should try them. We want to tread carefully andslowly to make sure that we really understand these substances and how best touse them so that we can help all the people who need help without panic andbacklash and shutting the door for another 30 to 40 years.
DP: Joining us today on Peace Talks Radio isShannon Miller, a licensed clinical social worker and the owner and ClinicalDirector of Apricity Expat Therapy based in the U.S.
Shannon Miller, can you explain whatwe’re talking about when we say, “psychedelic assisted therapy”? What does thatmean?
SM: This is going to be the leading edge ofpsychological care in the future. We’re talking about things like MDMA,psilocybin, LSD, anything that alters the state and that we consider hallucinogenic.It is a hallucinogenic that also has therapeutic purposes.
DP: How are these substances usedtherapeutically?
SM: Basically, we’re treating them currently asa therapy accelerant. We are developing protocols and the protocol for MDMA isestablished which would be preparatory sessions leading up to the dosagefollowed by a one dose, one day session. You meet immediately the next day toprocess everything, and we have integration sessions which is just a fancy termused to describe what came up for the patient while they were taking themedication.
Specifically, with MDMA,we would do another dose to complete three rounds for the complete course oftreatment as was getting approved by the FDA. What we are seeing at the end ofthose three sessions is that people who tested pretty high on the CAPS-5, whichis our screener for PTSD. They are then at subclinical levels for symptoms andremain there well into the future so there wouldn’t be a need to do it again.
DP: What about psilocybin; how do weunderstand what that is doing for people therapeutically?
SM: What we’re coming to understand is thatit’s happening on two levels. There is a biochemical thing happening in thebrain where it allows both sides of the brain to better talk to each other andit builds neuroplasticity. It’s during that window of neuroplasticity that wecan get in there with some really good therapy and build new neural networks.
The other thing that’s happeningunder the influence of psilocybin, we don’t get hung up on details or fluidityof stories and things like that. Things just come at us in pieces, and we seemto know what to do with the pieces without getting caught up in the details.You flow with it a bit better and it’s more of a perceived sense of what youhave to do rather than something that can be articulated. You don’t need wordsin the experience, you just know.
DP: Are there other forms of therapy that areused to access that besides psychedelic supported?
SM: Yes, often that’s what mindfulness andmeditation are. They get in touch with a part of themselves that’s just verycalm and just knowing. We can get to it lots of different ways that seem todovetail quite well with psychedelic assisted therapies. It’s assisted therapy.It doesn’t do any good if you stop doing therapy. Then you’re just gettinghigh.
DP: Do you find that to be a difficult conceptfor people who are not familiar with this type of therapy to wrap their headsaround, it’s not just about taking substances, but rather it’s part of atherapeutic package?
SM: I think for people who are on the outsideand don’t know much about it, if people are seriously interested, I think theyabsolutely understand that and welcome it. It is a bit of a PR obstacle toovercome in the beginning.
DP: Who is psychedelic assisted therapy for?Who should consider trying this approach?
SM: Really it could be for anybody, anybody whowants to deepen work on themselves, their own self-awareness, processunresolved issues, just gain a better sense of self. It’s really open toanybody even those who just want to explore. There doesn’t have to besignificant trauma to sort through although as a therapist I give preference topeople who are sorting through things, but really, it’s not limited to justthose people.
DP: Can you tell me more about the integrationsessions? These are therapy sessions after someone has taken the drugs. Whathappens during these sessions?
SM: It’s asking questions like, “What was thatlike? What did that mean?” It’s letting the person process and metabolize theexperience out loud. What we find the MDMA does is it allows you to get intouch with inner healing intelligence with belief being that we have everythingthat we need to heal inside of us, but things block access to that and the MDMAsoftens those blocks so we can get to it and do the things we need to do inorder to heal.
DP: What are those blocks?
SM: Guilt, shame. A lot of times what we’redealing with as well is PTSD as well as moral injury which means that someonewitnessed or participated in something that was such an afront to their moralsthat they then have to reorganize how they see the entire world. Wrapped up inthat is a lot of guilt and shame and not knowing what to do with it. UnderMDMA, you just know what to do to deal with it or you’re more open to beingable to process it. It lowers the inhibition of shame and guilt and there ismore of a love and an acceptance both for yourself and for those around you.
DP: Is inner health intelligence somethingthat people are able to access in different ways? Is this something that’savailable via other types of supportive therapy?
SM: One methodology that I practice quite a bitis called “internal family systems” or IFS. It’s getting a lot of traction, andI hope it will become more and more mainstream. It’s this idea that we’re madeup of a collection of parts. The movie Inside Out does a great job ofillustrating that. That inner healing intelligence is that part of you that isa bit dispassionate meaning it’s not emotional, it’s just observational and itjust knows. We might call it intuition. We all have different words for it, butit’s that part of us that just knows how things should happen. It’s that innerintelligence.
DP: Are there other types of mental healthconditions or situations that it has also been found to be beneficial forbesides trauma or PTSD?
SM: It depends on which substance we’rereferring to. MDMA is specifically for PTSD right now. More research is goingon for depression and anxiety. A lot of research is being done right now on theeffects of psilocybin for depression and anxiety.
DP: What should people know who areconsidering trying psychedelic supported therapy? What should they considerbefore doing it?
SM: I would say that this is an experience thatcan make someone very vulnerable, so they need to be very confident in theperson in whom they choose to guide them and to be present with them. Becauseof its legal status and because people are choosing to do it before it’sentirely legal, making sure you have a therapist who is willing to be a tripsitter with them, asking your therapist to do psychedelic assisted therapy is ano go. Therapists are not going to be willing to do that because they valuetheir licenses. You have to trust the person you’re with because it puts you ina vulnerable state. That’s the number one thing that I would say for people.
DP: Because of the legality of thesesubstances, what should someone look for in a guide to walk them through tryingpsychedelic supported therapy?
SM: I think that you have to shop around foryour guide. You don’t want someone who seems cool and has a hookup. There isbecoming standardized care, but there isn’t any manualized care for psilocybinright now. There is for MDMA and that would be getting training through MAPS oran organization that they support.
For psilocybin, I think it’s comingvery soon. The tea leaves say that psilocybin will be up next for approval andin order to get that, there has to be manualized care.
Do your research on who you letguide you and check to see where they’ve done their studying of it, not just“Hey, I want to do this because it’s cool.” You can, but I don’t think you’llget much out of it in terms of therapy. Bring it up with your current therapistand they may know somebody or tell you the best way to go about doing it orwhat to look for.
DP: Shannon, is there anything else that youwant people to know about this type of treatment?
SM: Therapy has to be part of it otherwise it’sjust getting high. You’ve got to do the work. You can’t just take some drugsand think you’re going to be healed. It doesn’t work like that. In fact,science has shown us that the therapy part is essential. Therapists need to dotheir work going into it as well and recognizing their own vulnerabilities whilein relationship with these people, while being a trip sitter.
JT: That was Shannon Miller, a licensedclinical social worker and the owner and Clinical Director of Apricity ExpatTherapy.
We also heard from Dr.Jennifer Mitchell, a Professor in the UCSF Department of Neurology andAssociate Chief of Staff for Research and Development at the San Francsico VA.
Earlier in the program we heard fromShawn, a humanitarian aid worker from the UK, on her experience tryingtherapeutic psilocybin.
You can find links to some of theSpotify playlists used during psychedelic therapy sessions at www.peacetalksradio.com.
For more informationabout our guests, to see photos and to link to their bios or to read more aboutthe therapeutic use of psychedelic drugs, go to www.peacetalksradio.com.That’s where you can go to hear all the programs in our series dating back to2002. You can also sign up for our podcast, drop us a line, tell us what youliked or learned from one of our programs and make a donation to keep thisprogram going into the future all at www.peacetalksradio.com.
Support comes fromlisteners like you, also the McCune Charitable Foundation and the AlbuquerqueCommunity Foundation Ties Fund. Support too from KUNM at the University of NewMexico.
Nola Daves Moses is ourexecutive director. Ali Adelman composed and performs our theme music. Forseries producer Paul Ingles and correspondent Danielle Preiss, I’m JessicaTicktin. Thanks so much for listening to and for supporting Peace Talks Radio.
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