On the second night of the ayahuasca ceremony, I had a dangerous episode.
I saw my teenage self disintegrate into particles and finally disappear altogether. I took off my sleep mask and saw the people around me turn into shadows. I thought I was dying or perhaps losing my grip on reality.
Suddenly Kat, my guide, appeared and started singing to me. I couldn't make out the words, but the rhythm was soothing. After a minute or two, the fear disappeared, and I fell back into a peaceful half-sleep.
There were 12 of us — nine women and three men — taking ayahuasca in a private home in San Diego under the guidance of two trained guides, Kat and her partner Sarah. Together they have more than 20 years of experience with psychedelics, including ayahuasca, an herbal blend containing the natural hallucinogen — DMT.
Kat and Sarah work as a team, providing psychedelic drugs every month in different cities. Their main role is to create a space where everyone feels safe enough to let go of emotional defenses and open up to the potential of drugs to change their attitudes, moods and behaviors.
These ceremonies cause a lot of anxiety, especially for people who have never experimented with psychedelics. The fear of what you might see or feel can be overwhelming. But guides like Kat will be your refuge in the storm. When things are turbulent, they respond with a firm and calm hand.
I saw my teenage self disintegrate into particles and finally disappear altogether. I took off my sleep mask and saw the people around me turn into shadows. I thought I was dying or perhaps losing my grip on reality.
Suddenly Kat, my guide, appeared and started singing to me. I couldn't make out the words, but the rhythm was soothing. After a minute or two, the fear disappeared, and I fell back into a peaceful half-sleep.
There were 12 of us — nine women and three men — taking ayahuasca in a private home in San Diego under the guidance of two trained guides, Kat and her partner Sarah. Together they have more than 20 years of experience with psychedelics, including ayahuasca, an herbal blend containing the natural hallucinogen — DMT.
Kat and Sarah work as a team, providing psychedelic drugs every month in different cities. Their main role is to create a space where everyone feels safe enough to let go of emotional defenses and open up to the potential of drugs to change their attitudes, moods and behaviors.
These ceremonies cause a lot of anxiety, especially for people who have never experimented with psychedelics. The fear of what you might see or feel can be overwhelming. But guides like Kat will be your refuge in the storm. When things are turbulent, they respond with a firm and calm hand.
Although psychedelic drugs remain illegal, guided ceremonies or sessions are held across the country, especially in major cities such as New York, San Francisco, and Los Angeles.
The guided profession has become a viable profession both underground and above ground as more and more Americans seek a safe, structured environment to utilize psychedelics for spiritual growth and psychological healing. This new world of psychedelic therapy functions as a kind of parallel mental health service. Access to it remains limited, but it is evolving faster than one might expect.
Most Americans now support the legalization of marijuana, and while a 2016 public poll about psychedelics showed them to be less than favorable, it's possible that attitudes will change when research findings about their therapeutic potential become mainstream.
But what would a world in which psychedelics are legal look like? And what cultural structures will we need to guarantee the responsible use of these drugs?
Psychedelic drugs like LSD infiltrated American society in the 1960s, and the results were mixed at best. They certainly revolutionized the culture, but ultimately left us with draconian drug laws and a cultural backlash that pushed psychedelics underground.
The guided profession has become a viable profession both underground and above ground as more and more Americans seek a safe, structured environment to utilize psychedelics for spiritual growth and psychological healing. This new world of psychedelic therapy functions as a kind of parallel mental health service. Access to it remains limited, but it is evolving faster than one might expect.
Most Americans now support the legalization of marijuana, and while a 2016 public poll about psychedelics showed them to be less than favorable, it's possible that attitudes will change when research findings about their therapeutic potential become mainstream.
But what would a world in which psychedelics are legal look like? And what cultural structures will we need to guarantee the responsible use of these drugs?
Psychedelic drugs like LSD infiltrated American society in the 1960s, and the results were mixed at best. They certainly revolutionized the culture, but ultimately left us with draconian drug laws and a cultural backlash that pushed psychedelics underground.
Today, however, a revival is taking place. At institutions such as Johns Hopkins University and New York University, clinical trials of psilocybin as a therapy for treatment-resistant depression, addiction and other anxiety disorders are yielding encouraging results.
Recently, the Food and Drug Administration took the extraordinary step of giving psilocybin therapy for depression «breakthrough therapy» status. This means that the treatment has shown such potential that the FDA has decided to speed up the process of developing and testing it. This is a sign of how far research and public acceptance of psychedelics has come.
It is because of this progress that we must seriously consider what comes next and how we integrate psychedelics into the broader culture. For the past three months, as part of the conceptual dialog on our bbgate forum, I've been talking to guides, researchers, and therapists who train clinicians to deliver psychedelic therapy. We've learned the nuances of conducting so-called «underground ceremonies» and talked to people who claim to have conquered their drug addiction after a single psychedelic experience.
Our current laws authorize the use of various poisons, including booze and cigarettes. These are drugs that destroy lives and feed addiction. Yet one of the most striking features of recent (limited) research on psychedelic substances is that the drugs are not addictive and have no side effects when a guide is involved. Many researchers believe that these drugs, if used under the supervision of trained professionals, could revolutionize mental health care.
Recently, the Food and Drug Administration took the extraordinary step of giving psilocybin therapy for depression «breakthrough therapy» status. This means that the treatment has shown such potential that the FDA has decided to speed up the process of developing and testing it. This is a sign of how far research and public acceptance of psychedelics has come.
It is because of this progress that we must seriously consider what comes next and how we integrate psychedelics into the broader culture. For the past three months, as part of the conceptual dialog on our bbgate forum, I've been talking to guides, researchers, and therapists who train clinicians to deliver psychedelic therapy. We've learned the nuances of conducting so-called «underground ceremonies» and talked to people who claim to have conquered their drug addiction after a single psychedelic experience.
Our current laws authorize the use of various poisons, including booze and cigarettes. These are drugs that destroy lives and feed addiction. Yet one of the most striking features of recent (limited) research on psychedelic substances is that the drugs are not addictive and have no side effects when a guide is involved. Many researchers believe that these drugs, if used under the supervision of trained professionals, could revolutionize mental health care.
What does history tell us?
The countercultural movement of the 1960s was transformational in many ways. Among other things, it catalyzed the environmental movement, the civil rights movement, modern feminism, and the anti-war movement. But it also sparked years of backlash against psychedelic drugs, which until recently made clinical research virtually impossible.
Back in the distant 1960s, psychedelics were completely legal and widely regarded as a promising area of psychological research. But just a few years later, the political and cultural winds changed so dramatically that a full-blown panic over psychedelics swept the country. In 1965, the federal government banned the production and sale of all psychedelic drugs, and shortly thereafter the companies that produced these drugs for research ceased production.
In his book How to Change Your Mind, Pollan gives a comprehensive answer to why psychedelics can never escape the shadow of the countercultural revolution they themselves helped instigate.
Timothy Leary, who is a «psychedelic evangelist» who advised children to «turn on, tune in, and drop out», is a scapegoat for many. Leary was allegedly too reckless, too confrontational and frightening for the mainstream in those years. Leary was such a threat that at one point President Richard Nixon called him «the most dangerous man in America».
The countercultural movement of the 1960s was transformational in many ways. Among other things, it catalyzed the environmental movement, the civil rights movement, modern feminism, and the anti-war movement. But it also sparked years of backlash against psychedelic drugs, which until recently made clinical research virtually impossible.
Back in the distant 1960s, psychedelics were completely legal and widely regarded as a promising area of psychological research. But just a few years later, the political and cultural winds changed so dramatically that a full-blown panic over psychedelics swept the country. In 1965, the federal government banned the production and sale of all psychedelic drugs, and shortly thereafter the companies that produced these drugs for research ceased production.
In his book How to Change Your Mind, Pollan gives a comprehensive answer to why psychedelics can never escape the shadow of the countercultural revolution they themselves helped instigate.
Timothy Leary, who is a «psychedelic evangelist» who advised children to «turn on, tune in, and drop out», is a scapegoat for many. Leary was allegedly too reckless, too confrontational and frightening for the mainstream in those years. Leary was such a threat that at one point President Richard Nixon called him «the most dangerous man in America».
But Leary isn't the only reason for what happened. The culture at the time was simply not ready for the psychedelics of the 1960s. The experience of these drugs is so powerful that it can be compared to a kind of rite of passage. But when they appeared on the scene, the public had no experience with them, no sense of their significance. As Pollan once said in an interview, «Young people had this radically new experience that heterosexual culture couldn't handle».
Psychedelics were released so quickly that there were no cultural structures to absorb them, no receptacles or norms around them. Cultures around the world, from the ancient Greeks to the indigenous peoples of the Amazon, have embraced psychedelics for millennia, and each has developed specialized rituals for them, led by experienced guides. Because there was no established community in the U.S., people were left to their own devices. When you combine this with a general ignorance of the drugs themselves, it's no wonder things went wrong.
But a lot has changed since the 1960s. The political and cultural landscape has become different and much more receptive to psychedelics. Rick Doblin, a longtime advocate of psychedelics and founder of the Multidisciplinary Association for Psychedelic Studies (MAPS), made an interesting point:
Psychedelics were released so quickly that there were no cultural structures to absorb them, no receptacles or norms around them. Cultures around the world, from the ancient Greeks to the indigenous peoples of the Amazon, have embraced psychedelics for millennia, and each has developed specialized rituals for them, led by experienced guides. Because there was no established community in the U.S., people were left to their own devices. When you combine this with a general ignorance of the drugs themselves, it's no wonder things went wrong.
But a lot has changed since the 1960s. The political and cultural landscape has become different and much more receptive to psychedelics. Rick Doblin, a longtime advocate of psychedelics and founder of the Multidisciplinary Association for Psychedelic Studies (MAPS), made an interesting point:
«In the '60s, the psychedelic counterculture was a direct challenge to the status quo... it was about leaving the culture. Today, things like yoga and mindfulness meditation are fully integrated into mainstream culture. We've integrated spirituality and all these things that seemed so foreign and alien in the '60s. So we've been culturally preparing for this for 50 years».
At the same time, psychedelics can also play a role in combating new health threats such as the opioid crisis (more than 70,000 Americans died from opioid overdoses in 2017, more than the total number of Americans who died in Vietnam). They are used, for example, to treat veterans suffering from post-traumatic stress disorder, or to treat cancer patients struggling with their intolerable pain and inevitable death.
Psychedelics are becoming tools for healing rather than a threat to social order. And leading scientists, organizations and educational institutions are working within the system to reduce the likelihood of backlash. This is very different from the approach taken in the 1960s, and it is still a success.
Endorsement in academia and universal recognition
Psilocybin has been the drug of choice for most researchers in recent years for a number of reasons. First, it carries the least cultural baggage than LSD and is therefore preferred by study participants. Psilocybin also has strong safety data based on studies conducted before the ban, so the FDA has authorized a small number of small clinical trials.
Despite the large pool of studies, most are still preliminary in nature and the sample sizes are quite small, although the results so far are compelling. In one 2014 Johns Hopkins study, 80% of smokers who participated in psilocybin-based therapy were completely abstinent six months after the study. In comparison, smoking cessation trials using varenicline have a success rate of about 35%.
In a 2016 study of cancer-related depression or anxiety, 83% of 51 participants reported a significant increase in quality of life and «sense of well-being or satisfaction» six months after taking psilocybin once (67% said it was one of the most significant events in their lives).
Psychedelics are becoming tools for healing rather than a threat to social order. And leading scientists, organizations and educational institutions are working within the system to reduce the likelihood of backlash. This is very different from the approach taken in the 1960s, and it is still a success.
Endorsement in academia and universal recognition
Psilocybin has been the drug of choice for most researchers in recent years for a number of reasons. First, it carries the least cultural baggage than LSD and is therefore preferred by study participants. Psilocybin also has strong safety data based on studies conducted before the ban, so the FDA has authorized a small number of small clinical trials.
Despite the large pool of studies, most are still preliminary in nature and the sample sizes are quite small, although the results so far are compelling. In one 2014 Johns Hopkins study, 80% of smokers who participated in psilocybin-based therapy were completely abstinent six months after the study. In comparison, smoking cessation trials using varenicline have a success rate of about 35%.
In a 2016 study of cancer-related depression or anxiety, 83% of 51 participants reported a significant increase in quality of life and «sense of well-being or satisfaction» six months after taking psilocybin once (67% said it was one of the most significant events in their lives).
A classic psilocybin session lasts about 4-6 hours (compared to 12 hours with LSD), but it results in a lasting reduction in depression and anxiety in patients. That's why researchers like Roland Griffiths of Johns Hopkins University believe that psychedelics represent an entirely new model for treating serious mental illness. Traditional antidepressant treatments fail to help many patients and can have many side effects.
This is the main reason many researchers believe that the FDA will eventually change the list of psychedelics and legalize them for medical use — although the timing of this move is far from clear. Most recently, Oregon officials approved a 2020 bill that would allow medical professionals to provide psilocybin-based therapies. On November 2, 2023, Oregon has already begun accepting applications for a license to provide such psilocybin-assisted therapy.
To learn more about the broad medical potential of psychedelics, I highly recommend you read Herman Lopez's 2016 scientific review. Here, it's important to focus on how psilocybin works and why it's so effective for people who take it. Understanding the clinical side of such studies is helped by comments from Alan Davis and psychologist Mary Cosimano (research coordinators and trained guides) from Johns Hopkins University. They help conduct psilocybin sessions at Hopkins.
This is the main reason many researchers believe that the FDA will eventually change the list of psychedelics and legalize them for medical use — although the timing of this move is far from clear. Most recently, Oregon officials approved a 2020 bill that would allow medical professionals to provide psilocybin-based therapies. On November 2, 2023, Oregon has already begun accepting applications for a license to provide such psilocybin-assisted therapy.
To learn more about the broad medical potential of psychedelics, I highly recommend you read Herman Lopez's 2016 scientific review. Here, it's important to focus on how psilocybin works and why it's so effective for people who take it. Understanding the clinical side of such studies is helped by comments from Alan Davis and psychologist Mary Cosimano (research coordinators and trained guides) from Johns Hopkins University. They help conduct psilocybin sessions at Hopkins.
They have worked with a variety of populations since they received FDA approval to study psilocybin in 2000: healthy adults without any psychological problems; cancer patients; anxiety and depression sufferers; smokers; and even experienced meditators.
A key part of the process at Hopkins is what they call a «life review». Before providing the medication, they want to know who you are, what stage of your life you are at, and what emotional or psychological walls you have built up around yourself. The idea is to work with patients to identify what is holding them back in life and explore how they can overcome it.
Psilocybin sessions are quite intense and in some cases can last all day. The rooms they use are a curious mix of moody doctor's office décor and New Age decorations. There's a vanilla-colored couch covered with embroidered pillows and draped on either side with South American artwork. Near the couch, on a coffee table, is a ceremonial bowl and mini sculptures of magic mushrooms; it's not quite an altar, but it could very well be.
A key part of the process at Hopkins is what they call a «life review». Before providing the medication, they want to know who you are, what stage of your life you are at, and what emotional or psychological walls you have built up around yourself. The idea is to work with patients to identify what is holding them back in life and explore how they can overcome it.
Psilocybin sessions are quite intense and in some cases can last all day. The rooms they use are a curious mix of moody doctor's office décor and New Age decorations. There's a vanilla-colored couch covered with embroidered pillows and draped on either side with South American artwork. Near the couch, on a coffee table, is a ceremonial bowl and mini sculptures of magic mushrooms; it's not quite an altar, but it could very well be.
Sessions can evolve in different directions, depending on the depth of the experience (which is difficult to predict) and the mental state of the person. Generally, patients lie on a couch with a sleep mask covering their eyes. Cosimano, Davis and other clinical guides act as guideposts: they hold the patient's hand and help them realize what they're seeing and what it means.
«I never get bored of it. Every session is unique, every experience is unique, and I'm just blown away by the fact that I get to witness each person's journey» — says Cosimano.
However, scientists are not entirely clear what it is about these experiences that cause such profound changes in attitude, mood, and behavior. Is it a sense of awe? Is it what American philosopher William James called a «mystical experience», something so overwhelming that it undermines the authority of everyday consciousness and alters our perception of the world? In any case, it is clear that psychedelic journeys often go beyond linguistic explanation.
Taking psychedelics is like shaking a snow globe, Carhart-Harris said. It disrupts formed patterns and breaks down cognitive barriers. It also interacts with the so-called default mode network (DMN), the part of the brain associated with mental chatter, self-centeredness, memories and emotions. Every time you worry about the future, fret about the past, or engage in compulsive introspection, this part of the brain is activated. When researchers studied images of the brain under the influence of psychedelics, they found that the DMN is almost completely shut down.
At Hopkins, the experience of drug use is only part of treatment. Follow-up therapy is just as important. People regularly tell researchers that a psilocybin session is the most personal and spiritually meaningful experience of their lives, including the birth of a child and the loss of loved ones.
But, according to Davis, it is essential to «make sense of the experience and bring it into your daily life in a way that doesn't diminish its significance». It doesn't have to be therapy or individual guided counseling, but it's crucial to integrate the experience into your daily life, whether that means learning a new practice (yoga or meditation), spending more time in nature, or simply developing new relationships.
Recognizing the need for even greater integration, schools such as the California Institute for Integral Studies and psychedelics researcher Elizabeth Nielson of New York University are focusing on training professional therapists to work specifically with psychedelic users. Nielson is a member of the Psychedelic Education and Continuing Care Program, which does not provide psychotherapy but offers training to clinicians who want to learn about psychedelics.
«People who have already been able to use psychedelics or will use psychedelics in the future will need help integrating their experiences, and many of them will feel safest doing so in a therapist's office. That means we're going to need more therapists who understand these experiences and know how to have these kinds of conversations with patients» — says Elizabeth Nielson.
Meanwhile, we are seeing a parallel growth of a more informal support system for people experimenting with psychedelics that exists largely underground.
But, according to Davis, it is essential to «make sense of the experience and bring it into your daily life in a way that doesn't diminish its significance». It doesn't have to be therapy or individual guided counseling, but it's crucial to integrate the experience into your daily life, whether that means learning a new practice (yoga or meditation), spending more time in nature, or simply developing new relationships.
Recognizing the need for even greater integration, schools such as the California Institute for Integral Studies and psychedelics researcher Elizabeth Nielson of New York University are focusing on training professional therapists to work specifically with psychedelic users. Nielson is a member of the Psychedelic Education and Continuing Care Program, which does not provide psychotherapy but offers training to clinicians who want to learn about psychedelics.
«People who have already been able to use psychedelics or will use psychedelics in the future will need help integrating their experiences, and many of them will feel safest doing so in a therapist's office. That means we're going to need more therapists who understand these experiences and know how to have these kinds of conversations with patients» — says Elizabeth Nielson.
Meanwhile, we are seeing a parallel growth of a more informal support system for people experimenting with psychedelics that exists largely underground.