Psychedelics Don't Work the Way You’ve Been Told
It’s a Long Winding Road, not a Done-for-You Insta-Cure
“In three sessions, I took back my body, broke the chains of trauma secrets, and declared my intention to live the life I was born to lead – a life of wholeness and choice, self-respect, and connection. In three sessions, I evolved from victim to warrior….But that’s the beginning of the story. Not the end.”
Change is hard. But rumor has it that psychedelics are changing change. Hoorah!
The “good news” is inescapable. Just look at the hyperbole of recent headlines sourced from respected journals:
Psychedelic-Assisted Therapy Could Cure Mental Illness
Psychedelics Are the New Wonder Drugs
Psychedelics Are About to Change the World
The enthusiasm is contagious. Recently, a colleague told me that he’d never had any significant emotional distress or any need of therapy, but the avalanche of wonder drug stories is making him consider taking the plunge.
Uh oh.
It’s time to have “the talk” my friends. NO! I am not talking about sex ed! I’m talking about psychedelics-ed and it should be a whole-population educational requirement at this point.
So today, let’s start a conversation about psychedelic-assisted therapy (PAT). In an effort to clarify a smidge of the confusion in the field, I’ll…
take you through my first few journeys,
demonstrate the indisputable success of this endeavor, and
disappoint you with the truth of the outcome.
Don’t worry. This story is more of an action-adventure than a tragedy. I won’t leave you high and dry. But it’s been a wild ride and I’d like to spare you some unnecessary twists and turns if you opt in on a similar quest.
I’ll be Your Guide, so Here’s an Itty Bitty Background on Psychedelics & Me
Just so you know who’s feeding your head for the next few minutes: I’m a psychologist, assistant professor of psychiatry and behavioral science, a conscious leadership business coach, and a practitioner of East-meets-West healing arts (mindfulness meditation, Qi Gong, and acupressure).
I’m also – and much more importantly – a patient and psychonaut, endeavoring to resolve life-long treatment-resistant depression (TRD) and complex post-traumatic stress disorder (CPTSD) – the most researched conditions associated with PAT treatment outcomes.
So, I live on both sides of the issue and my mission is to share what I’ve learned and help others grow and change.
On to the nitty gritty…
Most PAT research protocols consist of three “journeys” – multi-hour sessions in which the drug is administered in a controlled setting with two highly skilled guides present at all times to assist the participant as needed. These journeys are book-ended with a few preparatory and integration therapy sessions.
The media has jumped on this research in its usual sensationalized manner and promoted PAT as a three-session cure. Miracle cures win eyeballs. Methodical and thoughtfully reasoned presentations of risks and rewards do not.
And, just for the uninitiated, even the term “psychedelic” lives on shaky grounds. True psychedelics are a class of hallucinogenic drugs that include LSD, psilocybin, DMT, and mescaline. Other drugs – like MDMA (otherwise known as Molly or Ecstasy) and Ketamine – are not technically in the same class but can behave like hallucinogens at the right dose and in a therapeutic context. There’s a continuing lively discourse on the proper way to refer to these drugs. But for our purposes, I’m calling the whole lot psychedelics.
All these mind-altering substances relax mental boundaries, so their use in therapy can be deeply effective and meaningful. It’s also been shown that psychedelics (at least used in this manner) promote neuronal growth. New neural networks can result in positive alterations in emotional states and behavior.
Awesome! So what’s the problem? Well…
Psychedelics don't work the way you think they do.
As mentioned, this process is billed as a three-session cure. But for most people, there are many journeys within the bigger journey. What’s more, the whole concept of “cure” is questionable. What’s more likely is healing – the ability to feel whole and connected despite whatever pain you carry. The journey is worthwhile, but only with informed consent, meaning that you know what you're signing up for. And that information isn’t readily accessible in the midst of the adoring media frenzy.
What I’m saying is this: If healing is what you want, prepare for battle. You, my friend, are a warrior, and you’re best off entering the fray with that clarity and conviction.
Fundamental Principle: Change is Hard and Probably Always Will Be
Snakes shed their skin as they grow. When his old skin no longer fits, Mr. Snake will wriggle right out of it. The process looks a bit like a sultry dance. Notably, it doesn’t hurt.
When I learned that this process is pain-free for snakes, it made me a little jealous. A little angry.
Why does it hurt to be human – so often, so much? Shouldn’t growing feel good? Who’s responsible for this fakakta design?
Side note: I get Yiddish when I get angry. Fakakta is a great word to say. Try it. Spit it out a bunch of times. It fills up your mouth and it’s guttural and it looks/feels/sounds like a curse. Your lip will curl up in a snarl. Sooo juicy. It’s my kind of speech therapy. Oh, and it means “lousy, messed up, ridiculous” but packs so much more punch. You’re welcome.
Back to our regularly scheduled programming…
Despite the difficulty and suffering involved, I have changed. A lot. Miraculously so. Oh sure, I still get into a bit of mortal combat with my old skin, trying to slough it off as it clings like a shadow. But, with a mixture of psychedelics, profoundly good therapy, grit, and determination, I’ve come through a long dark tunnel.
That said… this process sure wasn’t quick and easy as promised by Michael Pollen in the seminal How to Change Your Mind and his media brethren. (Not to diss Pollen too much. I adore him. You can read about that here)
It Begins On a Tightrope
A couple of years ago, I wrote a book chapter on psychedelics. By the time I wrapped up, I was a true-believer convert. I was ready to sign up as both a guide and a patient.
The results of treatment outcome studies with both TRD and CPTSD were shocking – sometimes demonstrating “cure” rates (meaning that the participant no longer meets diagnostic criteria for the disorder) as high as 86% after only three psychedelic journeys.
An easy pass off my mental health tightrope? No more energy depleted by managing symptoms of TRD and CPTSD? No more heroic emotional regulation measures (like exercising and meditating several hours a day)?
Sign me up.
Treatment Success: The MDMA Sessions
Finding a qualified guide to provide an illicit substance is no small thing if you don’t already travel in psychedelic circles. But, eventually, a friend of a friend of a friend was found. I committed to three MDMA (otherwise known as Ecstasy or Molly) journeys in six months. I traveled to my guide’s location for the treatments and then returned home to work with Jeff, a psychologist specializing in integration and somatic therapy.
Journey One: Bonding with My Body
CPTSD disconnects survivors from their bodies. We tend to be unable to feel both physical sensations and gut intuitions. My intention going into this first session was “to come out feeling more connected and be on the road towards healing.” And this is precisely what MDMA delivered.
My body moved of its own accord for eight solid hours – tremoring, dancing, rowing with my guide (sitting on the floor cross-legged, facing each other, arms outstretched, hands clasped, rocking backward and forwards like we formed a horizontal pendulum). All my mind had to do was get out of the way and MDMA made that possible.
There were waves of intense pain. I instantly “knew” this was the medicine’s attempt to resolve my long-COVID muscular pain, the way a good sports massage is both horrible and healing. And the effect was substantial in the ensuing days.
Throughout the journey, there were no thoughts. No emotions. Just movement.
With no previous training or experience with somatic therapy, I was baffled. What did this mean? How was this supposed to heal my emotional wounds?
Jeff helped me understand that all this movement was, in fact, releasing trauma stored viscerally. We worked on strengthening the connection between my mind and body, using what I’d internalized (the new neural networks formed with the help of MDMA) in an ongoing way.
Journey Two: Unleashing My Memories
Psychedelics loosen deeply entrenched psychological constraints on revealing trauma experiences. These are typically locked away in an internal vault – protecting perpetrators but trapping victims, isolated in their painful memories. In this second journey, my entire trauma history (from childhood and, sadly, from the therapy I sought to work through my childhood issues) spewed out of me like bullets erupting from an assault rifle. Hours and hours of words and descriptions. And, as in my first journey, no emotions were present.
At least a year’s worth of therapy seemingly accomplished in eight hours. Except…
When I sobered up later, alone in my hotel room, I realized what I’d done: broken every vow of silence (the implicit contract with perpetrators that accompanies all interpersonal trauma). I experienced the return of emotions in a flood of fear, guilt, and shame. Again, Jeff kept me afloat with encouragement and support, recognizing that a dam of sorts had been broken and the healing could now begin.
Journey Three: Declarations of Purpose and Dreams of Deliverance
PAT has a curious habit of creating a narrative similar to an easy-to-see arc you might find in a novel. I’m told that once a patient sets the brain’s expectations regarding the number of journeys in a series (in this case, three), the brain somehow divides the experience and delivers a manageable chunk to process within each session.
My third session completed such an arc. From clearing somatic blocks in journey one to unlocking cognitive knots in journey two, I concluded my triumvirate with declarations about my future and my purpose. In journey three, I spoke for hours about my hopes and dreams and all I planned to demand of my future robust and fulfilling life.
I was speaking my truth without vacillation: This is how I feel. This is what I think. This is what I want.
“I want my feelings back,” I demanded from the powers that be, after years of emotional shutdown.
“I can sing again,” I declared, delighting the former singer/songwriter in me.
“I can be cold and move. I can be scared and move. I can be resistant and move.” This, after years of feeling perpetually stuck.
In three sessions, I took back my body, broke the chains of trauma secrets, and declared my intention to live the life I was born to lead – a life of wholeness and choice, self-respect, and connection. In three sessions, I evolved from victim to warrior.
Treatment Success?
I know. I know. It sounds like I’m saying that PAT was an unmitigated, indisputable success. Right. It sounds that way. And herein lies the rub.
If I was participating in a study, I’d have looked great on paper (and IRL) as the research wrapped up. And I’d even have looked like a winner a couple of months later, on follow-up.
But, the trauma that emerged from my psychedelic work, wasn’t cured. It was simply brought to the surface. The therapy that followed was rewarding but also grueling. As I did the work, my mood became erratic, and flashbacks – perhaps a necessary part of trauma processing – wore me to the bone.
So, months later, I entered a second stage of healing, this time working with Jeff, who offers the legal (at least in the US) and readily available ketamine-assisted therapy.
I’ll save that story for another time, but suffice it to say that many journeys over the course of a year ensued (more like 23 rather than the promised three). I have just recently come around the bend. By this, I mean that I feel whole – a radical departure from my CPTSD-ridden self.
Eighteen months. That’s a small price to pay for healing. No complaints. I’d do it all over again and I’d recommend it to anyone who’s suffering and has no prohibitive medical or financial constraints (don’t even get me started on the cost of this venture and the lack of safe, meaningful solutions).
What I am saying, though, (and, yes, I am purposely being redundant) is that this is no three-session cure for most people. And the research – beautifully conducted and robust as it is – fails to capture the average person’s experience.
Conclusion
Psychedelic-assisted therapy is probably the most effective treatment available for TRD and CPTSD. But I’ll say it again: Psychedelics don't work the way you think they do. There be dragons ahead.
In lobbying to make these drugs legal, a myth has been propagated that this is a fast, easy cure for a cornucopia of ills. It's not any of that. I believe in this treatment modality, but there are definite risks and dangers. I’ll be discussing those in detail in the coming weeks.
Meanwhile, if you choose this path, know that the journey is likely to be rocky and shake you to your core. You will need to find a therapist and a guide (sometimes they may be the same person, as my ketamine adventures have been with Jeff). And you’re unlikely to heal if that therapist/guide isn’t safe, skilled, and ethical. Consider this the battle of your life. Prepare for the journey.
One of my friends recently called me a warrior. I found the label preposterous at first but eventually had to agree. I am, indeed, a warrior. And you can be, too.
* Note: All images by the inimitable Hokusai, known – among other things – for his work with perspective (the foundation of all change). His work has accompanied me throughout my journey.
Thank you for sharing Lyssa. As someone who has benefited tremendously from PAT, I appreciate everything you've shared. So much hard earned wisdom. I too have faced demons and battled my past with the support of psychedelics and great facilitators. I wish I had read this before my journey, but I'm grateful to get it now.
I'd love to talk about your experiences and see if there are ways to support each other on our parallel (at least from what I can tell so far) journeys.