The Hard Work of Psychedelic Therapy – part 1

“I have been born again. I have been through a psychiatric experience which has completely changed me. I was horrendous. I had to face things about myself which I never admitted, which I didn’t know were there. Now I know that I hurt every woman I ever loved. I was an utter fake, a self-opinionated bore, a know-all who knew very little. I found I was hiding behind all kinds of defences, hypocrisies and vanities. I had to get rid of them layer by layer. The moment when your conscious meets your subconscious is a hell of a wrench. With me, there came a day when I saw the light.”
-Cary Grant, discussing his breakthroughs with LSD therapy

I’ve talked about the incredible revelations and breakthroughs I’ve experienced in psychedelic-assisted therapy in several other posts. How MDMA Saved My Life described my first encounter with a truly psychoactive substance, MDMA, and, as the title proclaims, how it very literally saved my life. In the ~3.5 years since I’ve started this work I believe I’ve worked through more trauma and soul-wounds than I could have in 3.5 decades of standard therapy.

Several of these posts talk about not only the immensely positive results but also the sometimes excruciating experiences needed to produce them. The work of psychedelic-assisted therapy is anything but a 60s style love-in of smiling, unshaven people seated in a tie-dyed circle staring vacantly at the cosmos and chanting “far out, man” over and over. It is raw, vulnerable, frightening, and will expose parts of you that your conscious self may not have been able to imagine.

I am not talking about recreational use of psychedelics. I don’t have a problem with such usage; I believe casual use is likely to have beneficial psychological effects even without specific intent. What I am writing about is the difficult and often harrowing work of dedicated and focused psychedelic-assisted therapy that can and does lead to profound healing.

Let me be unequivocally clear- this is actual work. Hard, often brutal confrontations with the darkest and most scarred parts of ourselves are the norm. We approach our sacred task very seriously, with clear and noble intent. We know that by healing ourselves we also begin to heal the world.

The work of becoming well is a lifestyle. Psychedelic therapy is not all we do. Each of us has our own unique blend of therapeutic practices and methodologies we employ in our everyday lives. Most of us are, or have been, in extended mainstream psychotherapy of some sort. We meditate and attend classes on somatic healing, we focus our lives around growing our capacity for inward and outward compassion. The actual psychedelic experiences can happen relatively rarely, sometimes with months or more passing between them.

The intensity of teaching the medicines provide requires time to process. Psychedelic-assisted therapy is especially hard because of the powerful effects of the molecules.  They can condense a lifetime of suffering into a single moment, a seemingly infinite singularity of pain.

It would be a natural question to ask why we are willing to endure such agonising experiences. Something I learned very quickly after beginning this work is- the only way out is through. You have to confront your injuries or they will never heal. This is the nature of trauma. We do this work because we must face our demons or we will never be free of their control.

An extreme simplification of trauma is to say that it is created from exceptionally potent experiences that activated some aspect of our survival response. Due to their intense nature, these experiences remain unprocessed and unintegrated into our psyche.  Yet they need to be for us to be healthy.  In order to process and integrate these experiences we must re-engage and re-experience them. Re-encountering our trauma is the only way we will ever move past it.

Trauma is a roadblock to growth. It holds us still at a certain place in our development and does not let us pass around or over or under it. If we try, we find the trauma still blocking our path. We have to go through the roadblock and dismantle it in order to see what’s on the other side.

Our psyche is highly effective at building pathways to discourage or evade this re-engagement. This is why mainstream therapies can take years or more to make even small headway. In my own case, my shame and anger were so entrenched into who I thought I was that I find it difficult to imagine that any amount of talk-based or other mainstream therapies alone would have had any real impact on my life.

Combining mainstream therapies with psychedelic-assisted therapy provides a way to do what we often have great difficulty doing for ourselves. Psychedelics can remove the barriers between us and our trauma so that we can begin the process of re-engagement.

I describe the effects of most psychedelics in the following way. Imagine a glass of water, mostly full, with a layer of cooking oil floating on top. All of the liquid in the glass is you; the Self or psyche. The oil is our conscious mind, the ego that believes it is individual and separate, floating on top of the rest. It’s where we are aware and where we tend to consciously live most of the time. The water below is the vast underworld of the unconscious: our primitive self, emotions, instincts, traumas, the reptilian brain etc. Psychedelics are a spoon. When we take a psychedelic and stir the liquid with the spoon the water and oil commingle in a swirling jumble so that at a certain point you can’t tell where one ends and the other begins.

Any mental health care professional will tell you that we store our wounds primarily in the water and not the oil. If this were not true, getting over traumas and abuse would be easy. We could easily rationalise it, talk it out in a few sessions, and be done with it. Anyone who has tried to work through trauma will tell you just how difficult it can be and how effective our trauma-based defences are at thwarting any attempt at healing.  Many, like myself, have been able to avoid the very idea that they were traumatised at all for many years.

The incredible potential of psychedelic therapies comes from this mixing of layers; allowing aspects of the unconscious to rise up and be clearly seen. When this happens in a way a subject can articulate and remember it can be a tremendous catalyst for engaging with our painful past. Psychedelics have the potential of being a shortcut around years of work, such as mainstream psychotherapy and mindfulness training, that may be needed merely to find the source of a wound, let alone to begin the work towards treating it.

I am in no way denigrating or minimising the healing potential of mainstream therapies.  I have found great benefit in them.  I am merely drawing the comparison that using the tools nature has gifted to us can, especially in conjunction with the proven and reliable methodologies of the psychological sciences, provide an accelerated and powerful path towards improved mental health.

The traumatic experience itself is always pushing upward, trying to be noticed and processed, but our trauma-based defences thwart it and keep it where it is. When the spoon disrupts the status quo, the water that wants to rise to the top can finally do so.

Many of us that do this work have, momentarily lost in our unresolved pain, howled in primal, atavistic agony. We have bathed in the steel-melting inferno of rage at the injustice at having a childhood ripped away from us. Another time we wailed in grief as the shadow of the wounded child released the grief that had been held in silent suffering across the decades. We have been overwhelmed with sorrow, shame, regret, self-loathing, even anger.

Diving deeply into our sadness, agony, shock, anger, mourning, abandonment, betrayal, disgust, shame, and whatever else we carry with us is the work. If it sounds terrifying and exhausting, it is.

It is also the most joyful and liberating experience I have ever had.

I have been on many psychedelic journeys  in which I delved into the darkest, loneliest, most painful places of my soul, inhabiting them so completely that it seemed the entire universe was filled with suffering. Yet I am so eternally grateful for every foray into the netherworld. Each time, without fail, I have emerged healed in some way.

The pain of trauma does not go away on its own. It is stored in our bodies and minds and does not diminish with the passage of time. To move forward, it must be felt and expressed.

Professional therapists who assist with psychedelic therapy use a concept called the “inner healing intelligence.”¹ This is the idea that the individual knows, deep in their unconscious, what there is within us that needs attention or expression. This is why it is important to let a psychedelic journey run its course no matter how terrible and painful it looks to those watching.

In Here Be Dragons I described how I screamed out a lifetime of pent-up emotions in a series of the most powerful vocalisations I have ever made. It was an incredibly profound, cathartic, and altogether difficult experience as the scabs were ripped off of 30 year old wounds. In that moment, even as I was floundering for understanding while the old energy worked its way to the surface for the first time since my childhood, there was a part of me rejoicing in anticipation. I’d been unknowingly waiting for this release for years. Experiences with similar upwellings in the past told me that while this had to be endured, something glorious awaited me. As I vomited old suffering from my throat the rejoicing voice, smiling expectantly in the back of my mind, encouraged me to scream even louder, with every bit of myself that I could, because it knew how vital this process was.

This is the first step in the healing of trauma- you have to feel it again. Reencountering the trauma begins the process of integration.

Integration is the expected result of every experience we have, no matter how insignificant or banal. The experiences you’ve had today; waking up, going to work, playing with your children, even reading this blog post, all go into short-term memory and await processing. At some point in the near future, possibly when you are next sleeping, your experience of reading this post will move up from this ‘holding area’ to the parts of the brain responsible for long-term memory and other functions. It will be processed, catalogued, and entered into the database of your Self. That experience is now integrated into you. It literally becomes a part of who you are and will affect you for all your days to come. This is the basis for the old saying that ‘you wake up every day as a slightly different person.’

Trauma is such a powerful experience it actively avoids or rejects processing and integration by engaging the fear circuits of the mind. This is where psychedelics can do their work. By disrupting the fear-based barriers that keep oil and water from mixing they offer an opportunity to bypass the defences we’ve built around our injured places.

For some, this may mean a re-experiencing of the trauma itself. For victims of abuse, violence, sexual assault, or life-threatening tragedy this reliving of the past can be truly terrifying or abhorrent. Yet psychedelics can make the connections we are loathe to and often do so in a way that is bearable. In their individual ways each of the medicines gives us a pathway to our pain by allowing us to inhabit it, hopefully without re-traumatisation.

I say ‘hopefully’ because this work is not to be undergone lightly and there are dangers. This work is very serious and deals with extremely powerful psychological processes. I would never advise using psychedelics to encounter your personal demons without having first worked with a professional therapist as well as practicing other techniques for self-awareness. Ideally one could work with a therapist who is open to and skilled at healing with these medicines.

Going in blind, without any insight into your trauma and the psychological pathways it creates around it, could be potentially harmful. Imagine if, like me, you had been abused as a child yet part of your trauma pathology was that you had no idea that what you had endured was abusive. You would be entirely unprepared should the medicine cause the old pain to rise up and hit you with it all at once. It would very likely be terribly frightening without the understanding of why you were having this experience.  This could possibly further trauamatise you in way you were not prepared for.

I suspect this is where the concept of the ‘bad trip’ comes from- a person taking a psychedelic who is entirely unprepared for what will bubble up from below. Because those of us actively engaged in this therapy are prepared, perhaps even eager, to deal with our demons, bad trips aren’t really something we worry about.  The old wounds that rise up are welcomed as opportunities to heal the ravaged parts of ourself.

It is a fundamental law of nature that something can’t exist without it’s opposing aspect. Dark is meaningless without light, up would not be a concept without down, and pain could not limit and bind us were it not for the existence of joy. The same is true for psychedelic-assisted therapy.

I have focused on the difficult and daunting aspects of the work until now to drive home that this work is anything but fun or easy. There is, of course, another side to it- the ecstatic and sacred.  This work can open our minds to a higher state of connectedness and sense of belonging with our friends, family, and all of  humanity.

Psychedelic therapy not only shows us our wounds and trauma, it also uncovers the beauty of who we are are inside. It reveals our intrinsic worth to those of us who have lost sight of it. It creates a sacred bond not only with our true selves but with the world, all its creatures, and the Universe itself.

I have had visions of unsurpassable beauty, existed in a place where compassion and love give shape to reality instead of mass and gravity. I have wondered in awe as I saw the Universe come into being and watched generations of stars be born and die until our solar system, this spinning condensate of stellar waste products we call home, formed and created us and everything we know.

I have stared into the eyes of God to see myself within.

One vision I remember clearly:

A dusty path winds through a valley surrounded by high peaks. The grass is as brown as it is green, the trees sparse of leaves. An old wattle and thatch hut slowly returns to the earth near a bend in the path. In the middle of the arid roadway a Buddhist monk reclines on one hand in the lightly blowing dust. A desperate thirst aches in his throat and mouth. It has been some time since water has passed the lips that clearly tell the tale of his depravation through their split and flaking skin. He stares up to the sky, at no specific thing, and draws a breath into his lungs. A deep and unqualified gratitude fills him for this single breath. There is no expectation or need for another, this breath is enough, it is all there is. In this moment there is life, sacred and bountiful. The monk is content.

This vision taught me many lessons and continues to do so. This vision allowed me to take one of my first big steps in ‘getting over myself,’ a phrase some friends I bandy about regularly. It taught me to be grateful for the precious and unique gift of my life regardless of the pain I’ve endured. It reminded me that I’m not special, that others have endured as much or more than I have. It showed me there is another way, the way of peaceful acceptance. The monk in my vision was having a terrible day, perhaps his last, yet he was wholly present and appreciative of this moment in which he existed.

There have been many other such visions. They are often not based on describable imagery but in emotion or other senses, completely abstract concepts or viewpoints, or nothing more than an idea. No matter their form they have each brought deep meaning and wisdom with them.

Though we often feel like we are drowning in blackness, there is immense beauty in this work as well. Trauma can teach us to look at the world in small, limited ways. It can train us to be afraid of beauty and avoid meaningful connection with others.

Despite the life-altering experiences one may have in a session of psychedelic-assisted therapy, it is only the beginning of the work. When we return to normal space all of the lessons and experiences now have to dealt with, interpreted, processed, and integrated.

to be continued…

 

1. Mithoefer, M. (2016). A Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder: Professional manual. Multidisciplinary Association for Psychedelic Studies: Santa Cruz, CA.