“I have been trying to tell myself this very thing for years but it hasn’t sunk in…until now.”
My patient sat there, mouth agape, wondering how she could be so certain about something she had tried to tell herself for years, something that had caused her debilitating anxiety and grief. And for some reason, it now felt crystal clear.
It’s a line I hear over and over during integration of a psychedelic journey. It’s not that the medicine is a magic cure. But it is magical, if you think about it. You can try to wrap your head around a concept, even one that you will know could help you feel better, and yet, no matter how much self-convincing you do, it can feel untrue. Until it doesn’t.
Disclaimers:
➡️ There’s nothing about psychedelics that negates the need for cognitive or mindfulness based therapy. In fact, it can only augment that necessary resource.
➡️ Psychedelics are not a cure-all. And they don’t work for everybody.
But neither of those negate the power of what is possible with these medicines.
And it’s not as much about ‘tripping out’ as you might think. I would say it’s more about stepping back in to your life, and your body.
It’s about embodying a belief rather than thinking it out. It’s about knowing it to be true rather than thinking it’s true.
It may have to do with the turning down of the default mode network in the brain, the part of us that refers to self and orients us in the physical world. When those lines are blurred, we feel more one with and connected to the world. And possibly, we feel our way into the world in those moments rather than trying to find our way.
The way I think about it after working with patients both in clinical practice and clinical trials is that:
Psychedelic medicine rearranges the material of your life in your mind and heart so that the unseen can be seen.
I’ve seen war veterans debilitated by PTSD and guilt of leaving their wounded squadron mates on the battlefield to save a greater number of people then find the strength to have self-compassion and honor that they did the best they could. And that being human means sometimes the best you can do is still horrific.
I’ve seen patients debilitated by anxiety feel safe enough again to function in the world.
Do people still struggle after using these medicines? Yes, they are only human. But the experience is a catalyst for the work they need to do to thrive. Or gives them the clarity of what they need to do and which medicine they need to adhere to. Mental health is complex and there is no one answer but sadly, in my 25+ years of treating patients, there are often not enough answers and this is one more to add to the mix.
This is not a dissertation on how the different medicines work, those pharmokinetics are varied depending on the particular compound. (Although I am happy to talk about that in future articles if people are interested.) The truth is that even knowing the biochemistry does not fully explain how they work.
Yes, there is neuroscience involving the default mode network and dampening of the threat centers. But what is unclear is how the transcendental or mystical pieces impact anxiety, depression or PTSD. If you have a ‘more mystical’ journey, do you feel better? Those are the questions we are trying to suss out in trials as well.
What I can tell you is that the essential truths that emerge about the world in a psychedelic journey are more clear because we feel them in our body in some ineffable way. I don’t have a trial to prove this, but clinical experience is yet a valid measuring stick.
Just this week, a patient told me after her journey that she had a clear understanding of “what beauty is” and it felt awe-inspiring and monumental for her. She saw beauty in things you would not expect, like cracks in cement, and knew in that moment that she had discovered a profound truth. She didn’t need my or your reassurance or confirmation. It felt true.
Every time I hear a patient come to a profound truth, I feel grateful to witness the human capacity to shift perspective on something they thought was fixed and solid. It reminds me that our capacity to heal means much more than feeling better (although that is critical.) It also means trusting ourselves, that our hearts and minds can expand. And that we can trust the world to receive our expanded selves.
Have you tried psychedelic medicine or been curious? Have you ever felt something to be true but not able to explain why you think it to be true? Come over to the comments and let’s connect as a community on this!
Yes!!! Psychedelics have been so transformative for my own trauma recovery and mental health. I’m actually working on a post right now about my experiences! Ketamine-assisted therapy has been extraordinarily effective at treating my depression symptoms. It absolutely rewired my default mode network and essentially reset my brain. Thank you for writing about this!
I haven't tried psychedelic medicine yet, buf I really want to some day. I think it's so promising, and I've heard, just like you wrote in this post, how life changing it can be if it's done at the right time and in the right setting.
You mentioned how it can help with PTSD and that got me particularly interested. I wanted to ask though, are there any psychiatric contraindications to using psychedelics? I'm dealing with C-PTSD and a severe dissociative disorder, and as much as I am interested in trying psychedelics, it also scares me quite a bit...
But I guess it most definitely depends on how well you are accompanied before, during and after the sessions, with a trusted medical team and therapist...?