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My Awakening…

Here I was a successful entrepreneur living a millionaire lifestyle. I had made it! Or so I thought. But something was missing. I didn’t feel the happiness that I’d been promised by society. I felt lied too, that I’d been somehow tricked.  The success, I had valued and strived my whole life for, had left me empty and in a marriage that had died in the process. I don’t think anyone can describe the loss of a marriage. The loss of the family you had always wished for, the loss of everything you essentially knew, the look of despair in your children’s eyes, the dreams you had created together. Your combined friends, family and memories.  They all disappear. In the midst of all the trauma, change and never-ending tears something else dawns on you too.

I am now…alone.

In my aloneness, I grew afraid. The world had lost all meaning and I felt completely disconnected from everyone and everything. Nothing bought me joy and I was trapped in extreme suicidal ideations that left me unable to work and be social. My family was unable to understand me, and I was gradually losing all my friendships. Leaving me more disconnected and isolated. For 3 years I struggled through, tortured by my thoughts and grief. I went to every western Doctor and tried various medications that made my symptoms worse. Then I tried yogis, naturopaths, psychics, body somatic work, acupuncture, counselling, hypnosis and meditation. I even went vegan and moved to the beaches of Byron Bay. You name it, I did it. I was desperate!

Synchronistically, in a yoga class, I met a girl that had just come back from the Amazon and said she had been healed of her depression.  She told me that what I was experiencing, in shamanic terms, was what can only be described as a ‘dark night of the soul’ and that the mystics before me spoke of an experience that is likened to a deep spiritual depression or existential crisis that was necessary to live an authentic life.  They saw it as an initiation. A rebirth. A transformation from the old self into a profoundly liberated state and new way of being in the world. Could this explain my intense and prolonged suffering? The reason why I’d divorced, why I’d lost everything?  At last, I felt understood, I felt hope, I felt called into something greater.

Within 3 months, I was sitting in the Peruvian jungle at the feet of a renowned and very powerful shaman.

The Amazon is not an easy place to be. But It’s hauntingly beautiful with the most ancient lush green trees. The tallest I’ve ever seen. With beautiful hummingbirds and colourful butterflies that land on your arms. You are also dangerously aware that there’s anacondas, tarantulas and Piranha around too. But I had nothing to lose, because I already felt dead. So what was there to be afraid of?

I was wrong.

I was living with an indigenous tribe in very poor conditions. The shaman spoke no English but was so welcoming and kind. He told me in Spanish that my spirit was very sick and my energies needed to be realigned. I had ceremonies in which he sung icaros (their magical songs) and gave me various plant medicines including Ayahuasca (the vine of the soul). The first night was one of the most frightening nights of my life. I was confronted with all my grief and trauma and challenged to find my power within it. I felt the shaman and medicine, training me to be strong, resilient and face all my fears. I’d had an initiation that was sacred and profound.  I felt new, clean, strong. Most importantly, I had been given the ability to dream again. I could actually see a future. I had direction, I had hope. I was ready to dream my new life into being.

But the greatest gift of all was that I wanted to live.

Words can’t describe the sense of freedom and possibilities that I now felt. I realised the key to my mental and spiritual health was the complete letting go of my old life, past, ancestral history, culture, trauma and subconscious programming.  It was more than a psychological healing though. I had awakened into something new. It was like choosing the red pill in the matrix.

“You take the blue pill—the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill—you stay in Wonderland, and I show you how deep the rabbit hole goes. Remember: all I’m offering is the truth. Nothing more”. Morpheus

I’d chosen a different path to others. I wanted the TRUTH. It was a far cry from Western medicine and taking a pill to fix things quickly.  I don’t believe in a happiness pill. There is no such thing. I’d worked hard for my mental health. I’d fought hard for my life. And it was all without a doubt for my 2 boys. I had to get well for them. The greatest loves of my life.

My way is not for everybody. I’d searched for my own truth, and worked out what was true for me. In the process, I was profoundly connected with something greater than myself. The realisation had dawned on me that I was never ……alone. It really was a divine journey that had been orchestrated by a divine force to lead me back to my authentic self, to bring me home.

How lucky am I, how blessed to have taken this path that others would traditionally interpret as a descent into mental illness. It was far from that!! I’d reconnected with life, humanity, my divine purpose. I guess it’s in times of crisis that we finally yield and discover who we really are.  I have a peaceful acceptance of my past now, as painful as it was, and I realise that nothing happened by accident. I see clearly now why I had to go through that suffering. I felt like a warrior returning from war into a bright, new world filled with possibilities.

On my return from the Amazon I worked for World Vision Australia as Head of Social Enterprise, which enabled me to economically empower women globally.  I was then voted in the top 50 Business People of the Year in Australia by Inside Business magazine for my contribution to humanity. I am currently CEO of a national organisation and a guest lecturer for Monash University. Most importantly I am a loving and present mum to my two gorgeous boys.

Big love Sim

Healing A Troubled Mind: A Personal Perspective On Victoria’s Stagnant Mental Health System

Person standing near lake

The Royal Commission’s report on the Victorian mental health system sent shockwaves throughout the State, one of which landed squarely on a patient of mine. They noted that Victoria’s mental health system is “not geared for…change”. Just to ensure we got the message, and despite a Federal Government TGA approval, my request to treat my traumatized patient with MDMA-assisted therapy was declined by our state’s regulatory authority.

To be clear, my disappointment lies not with the state government regulators, nor with the medical opinions suggesting MDMA-assisted therapy should not be used for treatment of traumatized patients (despite excellent emerging evidence that it works with little risk). I understand these opinions, though I certainly do not agree with them.

My issue is a more troublesome one. Underlying these opinions is a problem with how we practice psychiatry, which in turn reflects the alienated community in which we live. Mental health paradigms are always a reflection of the society which supports them. You see, us Australians are alienated both intra-personally (from our own emotional worlds) and inter-personally.

Our current paradigms tend to view mental illnesses in a biologically reductive way. In other words, mental illnesses are both understood and treated primarily as biological diseases (which they are not). The posters at your doctor’s rooms will teach you – depression is just like any other medical disease, such as heart-failure or emphysema. In this paradigm, entities such as addictions and depression are seen as distinct phenomena. They are treated in our current system as totally different diagnoses by entirely different teams. The alienated individual who suffers from depression and addiction is labeled with the alienating and erroneous term ‘dual-diagnosis’, which enshrines the division. Furthermore, if addictions are understood (as they are) as inherited conditions (which they are not), and primarily as brain diseases based in dysfunctional dopamine rewards circuits, they will be primarily treated as inherited brain diseases, by doctors with medications.

But what if we have got it all wrong (which we do). You see, addictions are heritable but not inherited (there is a big difference, I recommend looking it up), and the chemical dopamine in no-way explains addictions. Rather, it is the human experience of dopamine (along with numerous other chemicals) which explains addictions, suggesting that addictions are rooted in difficulties with the human experience of life, rather than the neural correlates of those experiences.

The events which lie at the root of illnesses such as addictions and depression are those which overwhelm the mind’s ability to process and integrate. We know that the presence of adverse childhood experiences is present in the majority of (if not all) people with addictions and chronic depression. But rather than seeing these conditions as consequences of trauma (which they are) and treating the underlying emotional issues (which would help), our society mistakes the symptoms (depression and anxiety) for the disease itself. We treat depression as depression and addiction as addiction and all the while we are missing the forest for the trees. The real disease is the high prevalence of trauma, alienation, and neglect in our society. After all, it is these conditions which twist and distort the mind into the contortions which fill the latest catalogues of mental illnesses.

Which brings me back to my patient. Traumatized when young, she has suffered from every diagnosis a psychiatrist’s finger can point at. She has had every treatment a medical guideline can fathom. Yet her trauma remains in place, because no-one has been able to reach it. Suddenly, on the horizon, a change is coming. Treatments like MDMA-assisted therapy appear to touch the root of the trauma, allowing individuals to process the unintegrated parts of their minds, and offer the chance of real healing. But we don’t change. Our outlooks have ossified, our diagnoses have desiccated. And all the while we suffer in our own blindness. People continue to kill themselves, and my patient will continue to suffer in silence until the Victorian Government allows me to access a new treatment which may finally bring peace to a troubled mind.

Dr Eli Kotler

MBBS MPM FRANZCP Cert. Old Age Psych. AFRACMA

Eli is a consultant psychiatrist, holds an academic position at Monash University through the Alfred Psychiatry Research Centre, and is the medical director of Malvern Private Hospital, the first addiction hospital in Australia. He is a member of the Australasian Professional Society on Alcohol and other Drugs (APSAD). Clinically, Eli is interested in the deep connections between trauma and addiction and works within a neuro-psychoanalytic framework. Eli has overseen the development of a clinical program for addictions focused on trauma, particularly developmental trauma. This has led to an interest in medication-assisted trauma therapy. Eli worked for many years researching neurodegenerative diseases and was the principle investigator on numerous trials for novel therapeutics. He is founding member of the Melbourne Neuropsychoanalytic Group and welcomes new members. Through involvement with Monash University, Eli oversees the addiction rotation for medical students.

Utilizing Eye Movement Desensitization and Reprocessing Therapy to Help Process Challenging Experiences with Psychedelics

EMDR

The last twenty years has arguably led to a renaissance of scientific investigation into the therapeutic benefits and risk of a range of psychedelics. LSD, ecstasy, psilocybin and ayahuasca that are increasing in popularity as alternative therapies used to address a host of mental health challenges [1] [2] [3]. These include anxiety, depression, trauma, addiction [4] [5], existential fear, relationship issues, addiction, obsessive compulsive disorder, and post-traumatic stress disorder [6] [7].

Psychedelics can cause profound shifts in consciousness, personal belief structures, relationships and alter the trajectory of one’s life [8]. Although psychedelics may provide you with 10 years of psychotherapy in one night this does not necessarily equate to 10 years of practical insights that can be translated and integrated easily into one’s daily life. Many people require psychological support and a range of integration practices to process these profound states of consciousness [9].

High quality psychedelic integration can help facilitate deep exploration and processing of the bio-psycho-social-cultural-spiritual and political domains of the individual. Examples of these can be found across multimodal and complementary therapies such as somatic experiencing, movement, music, nature, exercise, nutrition, acupuncture, massage, yoga, breathwork, art and creative forms of expression, rituals, prayer, meditation and psychotherapies [9] [10].

 

What is EMDR and how can it help people integrate their psychedelic experience?

The writer is the National Practice Manager at Mind Medicine Australia Psychological Support Services. One of the writer’s psychedelic integration tools in her tool kit is Eye Movement Desensitization and Reprocessing (EMDR) therapy. EMDR can be used to support psychedelic assisted psychotherapy as an integration tool. Clients safely confront material that arose during the psychedelic experience and continue to process meaning, body sensations, emotions, blocked and challenging content.

EMDR was originally designed to reduce the distress associated with traumatic memories [11]. There have been more than 30 controlled outcome studies with positive results conducted on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. It is now recognized as an effective form of treatment for trauma by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense and Australian Medicare system.

For a detailed outline of the EMDR phases and results of clinical trials refer to www.emdr.com/frequent-questions.

EMDR had expanded beyond trauma and is often used to help clients access new perspectives, improve self-esteem and to shift and expand rigid belief systems [12]. The writer has utilized bilateral stimulation, which is a left and right repetitive eye movement technique with clients requesting psychedelic integration. The client follows the therapist’s fingers and is assisted to concentrate on a distressing memory, emotion and/or challenging and dynamic psychedelic content whilst moving their eyes rapidly back and forth [13].

People naturally do bilateral stimulation every night in during REM sleep. The left to right eye movement is believed to be storing our memories from the day [14]. Retrieving a traumatic memory and following eye movements requires more working memory capacity than is available and subsequently the clients working memory is taxed. Consequently, the client is able to experience the distressing content with fewer associations with fear, anger or sadness.

As the process unfolds, the client often taps into somatic experiencing (e.g., crying, shaking, sensations in their gut, throat etc.) and one’s natural ability to locate helpful beliefs, perspectives and anchors to process and integrate the challenging experience emerge. Clients often report a sense of experiencing new insights and downloads (e.g., information, shifts in core beliefs, a new way to interpret and experience the psychedelic content). Furthermore, clients can process any left-over tensions, emotions and energetic blocks from the previous psychedelic experience; this often results in clients feeling more relaxed, grounded and a sense of ease with the psychedelic material.

Bilateral movements also happen when we walk, run, write, read, cook, play music, and when we are making art. Therefore exercise, hobbies, creative arts, and expressive arts are effective ways to help people with trauma healing and integrating challenging psychedelic experiences.

 

Can EMDR be used to support Hallucinogen-Persisting Perception Disorder?

HPPD is a very rare condition which causes a person to keep reliving the visual element of an experience caused by psychedelics. Little is known about why HPPD occurs and the specific mechanisms behind the experience. However, it should be noted that HPPD does not cause people to have full delusions [15]. HPPD flashes are typically characterized by seeing bright lights, circles, blurry patterns and various size and shape distortions [15]. Due to the persistent nature of these flashbacks and the persons inability to stop them from occurring randomly people can experience agitation, fear and anxiety [15].

 

There are two types of HPPD

Type 1: This is where people experience HPPD in the form of random, brief flashbacks.
Type 2: People with this kind of HPPD experience ongoing changes to their vision, which may come and go.

[16].

The writer has also utilised EMDR to help people who are experiencing HPPD to confront the distressing visual content, and the associated emotions and physical responses. Throughout the session the client visualizes the hallucination and what this image means for them in regard to associated negative beliefs, fear and anger. Clients can organically construct a more meaningful narrative (whilst releasing somatic movements, sounds and sensations) and often reported seeing the visual/hallucination in a new light. In so doing, clients often make the commitment to have a different relationship with the imagery post sessions (e.g., as a reminder to ground, a teacher, a cue to slow down etc.) thus integrating the psychedelic experience and overcoming anxious and fear-based states.

To date there is little research regarding the efficacy of EMDR, psychedelic integration, and/or treatment of HPPD. Future research could explore how the mechanisms of bilateral stimulation (left and right repetitive eye movement technique) and strong therapeutic rapport can support these clinical experiences.

If you would like to know more about psychedelic integration and EMDR please email alana@mindmedicineaustralia.org

 

References

[1] J. Daniel and M. Haberman, “Clinical potential of psilocybin as a treatment for mental health conditions”, Mental Health Clinician, vol. 7, no. 1, pp. 24–28, January, 2017. doi:10.9740/mhc.2017.01.024

[2] Curtis, R, Roberts, L, Graves, E, Rainey, HT, Wynn, D, Krantz, D & Wieloch, V 2020, “The Role of Psychedelics and Counseling in Mental Health Treatment”, Journal of Mental Health Counseling, vol. 42, no. 4, pp. 323–338, October, 2020. doi:10.17744/mehc.42.4.03.

[3] J. Sarris et al. “Ayahuasca use and reported effects on depression and anxiety symptoms: An international cross-sectional study of 11,912 consumers”, Journal of Affective Disorders Reports, vol. 4, 100098, pp. 1–8, 2021. doi:https://doi.org/10.1016/j.jadr.2021.100098

[4] M. Winkelman, “Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca”, Current drug abuse reviews, vol. 7, no. 2, pp. 101–116, 2014. doi:10.2174/1874473708666150107120011

[5] A. Loizaga-Velder and R. Verres, “Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence — Qualitative Results”, Journal of Psychoactive Drugs, vol. 46, no. 1, 63–72, doi:10.1080/02791072.2013.873157

[6] M. Ot’alora et al. “3,4-Methylenedioxymethamphetamine- assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial”, Journal of Psychopharmacology, vol. 32, no. 12, pp. 1295–1307, 2018. doi:10.1177/0269881118806297

[7] M. Mithoefer et al. “Durability of improvement in posttraumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3, 4-methylenedioxymethamphetamine- assisted psychotherapy: A prospective long-term follow-up study”, Journal of Psychopharmacology, vol. 27, pp. 28–39, 2013. doi:10.1177/0269881112456611

[8] R.R Griffiths et al. “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial”, Journal of Psychopharmacology, vol. 30, no. 12, pp. 1181–1197, 2016. doi:10.1177/0269881116675513

[9] A. Garcia-Romeu and W.A. Richards, “Current Perspectives on Psychedelic Therapy: Use of Serotonergic Hallucinogens in Clinical Interventions.” International Review of Psychiatry, vol. 30, no. 4, pp. 291–316, 2018. doi:10.1080/09540261.2018.1486289.

[10] J. Guss, R. Krauseand and J. Sloshower, “The Yale Manual for Psilocybin-Assisted Therapy of Depression (using Acceptance and Commitment Therapy as a Therapeutic frame)”, 13th August 2020, [Online], Available: https://psyarxiv.com/u6v9y/

[11] F. Shapiro, (1989). Eye Movement Desensitization: A New Treatment for Post-Traumatic Stress Disorder. Journal of Behavior Therapy and Experimental Psychiatry [Online]. 20(3), pp. 211–217. Available: https://www.sciencedirect.com/sdfe/reader/pii/0005791689900256/pdf

[12] Griffioen, B.T. Van Der Vegt, A.A. De Groot, I.W and De Jongh, A, “The effect of EMDR and CBT on low self-esteem in a general psychiatric population: A randomized controlled trial” Frontiers in Psychology, vol. 8, 1910, pp. 1–12, November, 2017. doi:10.3389/fpsyg.2017.01910

[13] F. Shapiro, “Efficacy of the Eye Movement Desensitization Procedure in the Treatment of Traumatic Memories” Journal of Traumatic Stress, vol. 2, no. 2, pp. 199–223, 1989. doi:10.1002/jts.2490020207

[14] F. Shapiro, Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. New York: Guilford Press, 2001.

[15] J. Halpern and H. Pope “Hallucinogen persisting perception disorder: what do we know after 50 years?”, Drug and Alcohol Dependence, vol. 69, no. 2, pp. 109–119, 2003. doi:10.1016/S0376–8716(02)00306-X

[16] L. Orsolini et al. “The ‘Endless Trip’ among the NPS Users: Psychopathology
and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review”, Frontiers in Psychiatry, vol. 8, pp. 1–10, November, 2017, doi:10.3389/fpsyt.2017.00240

Dr Alana Roy

Ph. D Psychology, B. A Social Work (MHSW)

Dr Alana Roy is a psychologist, social worker and therapist and has spent the last 13 years working in mental health, suicide prevention, trauma, sexual abuse, family violence and the disability sector. Alana has worked with borderline personality and dissociative identity disorder in various roles in the community such as: Rape Crisis Centres with victims of ritual abuse, childhood and adult sexual assault, supporting women in the sex industry, survivors of human trafficking and now as a psychedelic integration specialist.

Alana focuses on harm minimisation, community and connection. She is dedicated to psychedelic-assisted psychotherapy and plant medicines. She has engaged with, and provides integration therapeutic support services for communities across Australia. Alana works at several universities as a Research Fellow and supervisor of students on placement. Alana passionately advocates for public policy, community education and legislative changes so that these treatments are regulated and supported by a strong, connected and skilled sector.

When You Trip Upon A Star

 

Unraveling the inspiration behind various acclaimed Disney films.

Can psychedelics be used to address childhood trauma and better understand imagination?

Walt Disney films are a cornerstone of childhood. Today, the Disney corporation is one of the most powerful media and entertainment enterprises in the world. Without even realising it, the company has probably influenced your own imagination, and in some way shaped your beliefs, values, and morals. However, before it turned into a global giant, it all began with a mouse.

Undeniably, Walt Disney had an enormous influence on the animation industry. He is the most renowned animator, filmmaker, screenwriter, and producer in cinematographic history. Hailed as “the Father of Animation”, he was the first to pioneer full length cartoons with synchronised sound and technicolour. Walt had one of the most important impacts on the development of animation and ultimately produced over 650 films or shorts in a career that spanned decades. Since then, Disney researchers and animators have continued his legacy, with further contributions to animation, science, and technology.

While Walt Disney’s career is not without pitfalls and controversy, it is indisputable that he changed the world with his creativity. How did he manage to always keep that childlike perspective? As Walt himself said, “That’s the real trouble with the world, too many people grow up.”

Disney was known for being an innovator. He was continually one step ahead of his peers and was constantly seeking new ideas. Could it be that the act of his creative mind was influenced by psychedelics? Walt is not alive to confirm or deny these rumours, yet widespread speculation of his use of hallucinogens is commonly assumed. Perhaps we will never be able to prove these claims, but there is one thing that is certain — the magic of Mr. Disney was his ability to preserve his childlike imagination throughout his lifetime.

There has long been reports that members of the creative Disney team were involved in the use of psychoactive substances. Is it such a far cry for Walt himself to have indulged as well? According to a letter by Paul Laffoley, an American visionary artist, Disney was indeed influenced by the hallucinogen mescaline, found in the Peyote cactus (Lophophora williamsii).

The letter goes on to say that in an attempt to explain “artistic implications of the new field of animation”, Walt arranged an interview with Josef Albers, the artistic director for the experimental liberal arts school — Black Mountain College in North Carolina. Josef, however, turned down the request. As a result, Walt then switched his intentions to the students at the college to aid his animated ventures. It was during this interaction with the students that he learned of their avid use of mescaline during their summer breaks in Northern Mexico. Laffoley claims this was the catalyst needed for Disney to become a frequent user himself.

Mescaline is a psychedelic alkaloid that occurs naturally in Peyote, San Pedro, Peruvian Torch, and other cactus varieties. These plants produce an experience similar to LSD or magic mushrooms: extravagant visuals, increased sense of connection, appreciation toward small and mundane details, and novel interpretations of the world around you. Studies show that mescaline can enhance creativity, which would explain why the art students would be enthusiasts of the substance.

Walt genuinely was determined to make real art. He was not only inspired by the natural world, but also by other visionary artists. This motivated him to team up with famed surrealist artist Salvador Dalí for the movie ‘Destino’, which initially started in 1945 but only saw eventual completion in 2003 by Walt’s nephew Roy E. Disney. Although the project was put on the back burner, both artists got more than what they bargained for out of their partnership. What started as a creative collaboration led to a lifelong friendship. Salvador Dalí is well known to have incorporated the psychedelic experience in many of his creations. With infamous artwork such as ‘The Psychedelic Flower’ and ‘The Hallucinogenic Toreador’, it would seem Dali was very open about referencing psychedelic terminology.

Another good friend of Walt Disney was none other than well-known and prolific English writer Aldous Huxley. Best recognised for his novel ‘Brave New World’ which presents a world where psychological manipulation is encouraged by regularly taking the drug ‘Soma’ — a potent hallucinogen that creates a strong sense of well-being. Additionally, Huxley is known for the notorious psychedelic inspired ‘Doors of Perception’ where he openly recounts his experience with the psychoactive compound mescaline.

In the fall of 1945, Disney brought in Huxley to work on the live action animation script for what was to become ‘Alice and the Mysterious Mr. Carroll.’ It has been stated that Walt rejected the script because it was too “literary” and didn’t capture what he wanted. Sadly, a fire destroyed more than four thousand of Huxley’s annotated books and documents, including most of his involvement on the ‘Alice’ project. Fortunately, the Disney Archives still has some of the story meeting notes and parts of the original script.

The classic children’s book ‘Alice’s Adventures in Wonderland’ by Lewis Carroll, is a tale that revolves around a girl who quite literally falls down a rabbit hole and finds an entirely new world to explore. Examining the psychedelic undertones within Alice in Wonderland’s storyline is not a recent phenomenon. The theory has been pursued by artists and critics alike. There is a possibility that people attribute this because it was written during an era when psychedelic use was rampant, not necessarily because Carroll was actually under the influence of anything. However, with characters like the hookah smoking caterpillar and the fact that Alice finds herself under the influence of a mushroom does make you wonder if the story was a by-product of mind-altering drugs.

No one knows for sure if Walt Disney himself was truly an avid user of hallucinogens. None the less, there is no doubt that he had many connections with certain collaborators who were well-documented in partaking in altered states of consciousness. Additionally, Disney’s work frequently reflected that of the psychedelic experience itself.

These references in Disney films are not an unusual occurrence. The feature film ‘Fantasia’ was even re-released in 1969 with a psychedelic poster and embraced by the counterculture amid speculation that Walt was under the influence when he produced it. The popular hallucinogen at that time was LSD, which wasn’t brought to the USA until 1949, too late to have been the original driving force behind Disney’s Fantasia. It is more likely that mescaline was involved.

The combination of classical music and visuals of nature coming to life is a typical blueprint of the entire psychedelic experience. Even the casual observer would notice the impressive context and landscapes in Fantasia. In particular, scenes such as the dancing Amanita Muscaria toadstool mushroom fuels the psychedelic influence speculation. The species contains two main psychoactive compounds, ibotenic acid and muscimol.

This scene was created by animator Art Babbitt, who was fully aware of the gossip surrounding the film and its possible link to drugs. So much so that in an interview, he sarcastically quipped: “Yes, it is true. I myself was addicted to Ex-lax and Feenamint” — which are merely over the counter laxatives. Other psychedelic plants can similarly be spotted in the film. These include: Morning Glory (LSA), Angel Trumpets (Scopolamine), Poppies (Opium), and what appears to be Datura (Atropine).

Fantasia is still considered one of the best visual works of all time. It continues to astound even though it was made in 1940. It’s mythological, spiritual, and occult visuals mixed with massive musical scores paved the way for animation. It allowed other animators to think outside the box. Walt even invented the multiplane camera to give the film the depth and dimensions to immerse the viewers visual senses. Disney was aware that the feature was an intricate and complex piece of art, that was unlikely to grab the attention of young children. What he wanted was to create discussion among the adults by presenting a work that changed the way they thought.

Fantasia is not the only Disney film that includes psychedelic undertones. Another infamous substance inspired clip was in the 1941 film Dumbo. The Pink Elephants on Parade is one of the most iconic trippiest scenes in cinematic history. Naturally at the time, it was negatively received and a risky move for a company who was in financial distress. The song is the result of a drunken trip Dumbo and Timothy have after inadvertently drinking a bottle of champagne. The pair start to hallucinate a collection of Pink Elephants. The lyrics of the song do a decent job of summing up the intensity of a psychedelic trip — “Technicolor pachyderms is really too much for me.” The scene is unlike anything Disney had ever done or has ever done since.

Countless other scenes in Disney animations such as Pinocchio, Peter Pan, 101 Dalmatians and The Little Mermaid show characters smoking. As a result, these movies have now had their availability limited on streaming services. Obviously, not all these scenes are referring to psychedelic use, however, some do seem questionable. In particular, the clip of Pinocchio’s reaction after inhaling what appears to be an ordinary tobacco cigar. His head spin seems fairly intense after his ne’er-do-well friend Lampwick tells him he is not doing it right. “Take a big drag. Like this.” The effect suggests many Disney animators might have been familiar with a bong.

You may be asking yourself; okay Disney was possibly inspired by psychedelics? So what? Well, since psychoactive compounds are still illegal in most countries, I believe it is critical to expose and emphasise the numerous key public figures that used these medicines. Not only have they certainly been the motivation for art and music, but behind notable innovations that have impacted the world, and changed the course of history. We may owe a lot more to psychedelics than we think.

They additionally have the potential to change the current mental health paradigm. Statistically this is getting worse every year, especially in children, and exaggerated by the current Covid-19 pandemic.

Sure, back in Walt Disney’s time the state of the world was certainly not all positive. Post World War II would have had an enormous traumatic effect on the collective consciousness. However, in general people’s lives would have been much more sheltered, contained and community based.

Humans today are exposed to more information than ever before. Scientists concluded that in 2011, Americans took in five times as much information every day as they did in 1986. This overwhelms the brain and continues to cost our mental faculties a great deal. The rise of social media in combination with consumerism, has led to an unrealistic view of our ourselves and what we think we should be. Constant exposure to the world’s troubles, have a detrimental effect on our psyche and raises levels of depression, anxiety, and addiction.

Walt was always focused and dedicated to family entertainment. He was determined to create Disneyland even when it was shunned by the rest of the Disney team. It was a major financial risk to the company, and Walt had to borrow from his life insurance to help fund the project. Fortunately, his vision paid off and today Disneyland is considered the most successful amusement park of all time. Walt truly wanted a place for children and adults to come together. Encouraging grown-ups to connect to their imagination without fear of judgement.

Interestingly, psychedelics seem to aid in connecting fully developed adult brains to their childhood state of mind. Carhart-Harris, a popular psychedelic researcher and Alison Gopnik, a researcher of Psychology at UC Berkeley, have both stated that the effects of psychedelics seem to resemble the mind of an infant.

Research using fMRI scans show that children have decreased default mode network (DMN) activity compared to adults, something that is observed in psychedelic users as well. The DMN is thought to be involved with ‘resting state consciousness’ and tasks requiring one’s attention seem to suppress this network. The DMN is not as strong in children because they have yet to develop strategies of ‘auto-pilot’ work, requiring more immediate awareness than adults. It also has to do with a less conditioned state of mind, as the DMN can be known as our ‘inner critic’.

Dr. Robin Carhart-Harris explains how the effects of psychedelics can assist those struggling with psychopathologies, that can be caused by certain childhood traumas and experiences. “Certain patterns, certain configurations in the brain can become overly reinforced. And some of the range of brain activity becomes sort of narrowed and limited. If you have these very debilitating disorders, then perhaps you could introduce something like LSD, which works to introduce a kind of window of plasticity or malleability — conditions for change, essentially — to try and sort of dismantle these entrenched patterns.”

It goes without saying that these medicines should only be used by adults. Legalising psychedelic psychotherapy could greatly assist those struggling, therefore, having an immediate effect on the way we raise the children of tomorrow. If done so with careful preparation, attendant psychotherapy, and proper integration psychedelics perhaps have the power to create a better future for all.

Disney Pixar’s newly released ‘Soul’, is an incredible exploration of the meaning of life. It is not the first time a Disney movie has posed the kind of big-life questions that face many middle-aged adults. The film is known in the Disney community as a sort of next chapter of the animation ‘Inside Out’ (which depicts characters that represent certain emotions, in the hopes of explaining psychological concepts to children). Both were equally successful at the box office and in exploring the metaphysical.

Soul’s protagonist, Joe, goes on a spirited adventure and is faced with questioning his purpose, if his dream was enough to fulfill him, and what life is really about. After finally getting his big break, Joe accidently dies and is drawn towards the proverbial light (similar to descriptions of 5meo-DMT and near-death experiences). Ultimately, spoiler alert, one of the movie’s many morals is that it is the little things that truly make life worth living. Joe realises that happiness may not arrive from accomplishing that which he dreamed of, but rather, by appreciating each quotidian moment.

In the film, “lost souls” wander the astral plane because they are anxious and depressed. Becoming too obsessed with anything, even if you believe it is your purpose, can lead to dissatisfaction and a disconnection from reality. Moonwind, the captain of a psychedelic galleon bearing a troupe of “mystics without borders”, helps rescue the lost souls. These characters also mention other transcendental practices or techniques such as yoga, meditation, drumming and psychotherapy.

The movie wants to leave its audiences asking questions about the meaning of life and the human experience as a whole. Introducing complex themes to children such as the idea of the flow state in the creative process, the fleeting nature of life itself and other philosophical debates. The fact that Disney animation is so comfortable with talking about the meaning of existence is a testament to how far we have come.

Personally, it is similar to my own experience with taking psychedelics, which in fact was the inspiration behind this article. I suppose the teachings and insights I received were similar to those themes explored through various Disney movies, even once seeing the Cheshire Cat during an Ayahuasca session in Peru. While there is already wisdom behind this character, the cat strangely explained to me through various visions that life is a riddle, and I will never figure it all out. Further reminding me that life is absurd and laughing at that is part of life’s whole trip.

I have directly struggled with mental health issues, especially with my own self-image. I believe this is associated with my childhood experiences; however, it has been further exaggerated by societies focus on the external. Psychedelics helped me better embrace my quirks, talents, and gifts that I have to give to the world. It was the first time I truly saw myself for who I am — a spiritual being having a human experience. It gave me a deeper understanding of the reasons why we are here.

Disney has always provided its audience with profound meanings. Some films are majorly influenced from ancient cultures and native indigenous spirituality, some who are well-documented for using plant medicines as a healing tool. These messages can be heard in the soundtracks from films such as Pocahontas, Brother Bear, The Lion King, Tarzan, Moana, Mulan, and the Hunchback of Notre Dame. Disney has forever been teaching children about understanding those with different backgrounds. With lyrics like “Show us that in your eyes, we are all the same” from Brother bear or “You think you own whatever land you land on; the Earth is just a dead thing that you claim” from the renowned ‘Colours of the Wind’. And who could forget the deep-rooted ideas in the iconic ‘Circle of Life’ from The Lion King, showing us the connectivity of everything.

In a world that is trying to make us fit in, Disney inspires us to stand out. What makes us different, makes us unique. As we grow older, we are no longer encouraged to be creative or playful. Becoming an adult is inevitable and can be wonderful when we hold onto our childlike curiosity. Certainly, nobody wants to be that person with Peter Pan syndrome. Yet, it is healthy to be reminded that we once were all children, trying to figure out and navigate the world around us. We still have an inner child; we must learn how to connect and heal them. A great deal of work is done in therapy around parenting your own inner child.

The reason Disney films are notorious for striking a chord with our emotions, is because it reminds us of our own childhood. We become nostalgic of a more innocent time when we would let our imaginations run wild. Sentimental of a period when the little things in life bought us so much joy. This is a key ingredient to healing the trauma of our collective past. Psychedelics reminds us of the magnificence of creation. They push us to take better notice of the beauty in nature or the emotion behind music. They help us see the interconnectedness of everything.

So, perhaps next time you sit down to watch a treasured Disney film or go to play one of their unforgettable classic movie soundtracks; you will have greater appreciation for those magical plants that maybe inspired fantasy worlds to be bought to life. I believe that they influenced and even played a starring role in countless Disney masterpieces. Seems in many ways, psychedelics and Disney go hand in hand, always encouraging us to bring more animation into our lives.

 

REFERENCES

Fast Company. 2021. Why It’s So Hard to Pay Attention, Explained by Science. [online] <https://www.fastcompany.com/3051417/why-its-so-hard-to-pay-attention-explained-by-science> [Accessed 6 March 2021].

Flicks.com.au. 2021. The meaning of Fantasia, Disney’s beloved psychedelic masterpiece. [online] <https://www.flicks.com.au/features/the-meaning-of-fantasia-disneys-beloved-psychedelic-masterpiece/> [Accessed 2 February 2021].

Maltin, L., 2021. When Disney got trippy. [online] Bbc.com. <https://www.bbc.com/culture/article/20151112-when-disney-got-adult-and-trippy> [Accessed 2 February 2021].

Medium. 2021. LSD, Childhood Memories, And the Science of Nostalgia. [online] <https://medium.com/@psychedelicsaremedicine/lsd-childhood-memories-and-the-science-of-nostalgia-32bebb1fe1e9> [Accessed 6 March 2021].

Npr.org. 2021. NPR Cookie Consent and Choices. [online] <https://www.npr.org/2016/04/17/474569125/your-brain-on-lsd-looks-a-lot-like-a-babys> [Accessed 6 March 2021].

Open Culture. 2021. When Aldous Huxley Wrote a Script for Disney’s Alice in Wonderland. [online] <https://www.openculture.com/2014/12/when-aldous-huxley-wrote-a-script-for-disneys-alice-in-wonderland.html> [Accessed 15 February 2021].

Paullaffoley.net. 2021. » Walt Disney and Josef Albers Official Paul Laffoley Website. [online] <https://paullaffoley.net/writings-2/walt-disney-and-josef-albers/> [Accessed 21 February 2021].

Psychology Today. 2021. “Soul:” A Psychedelic Adventure into Meaning. [online] <https://www.psychologytoday.com/us/blog/psyche-meets-soul/202101/soul-psychedelic-adventure-meaning> [Accessed 25 February 2021].

Gwerky science. 2021. The Phoenix Effect: Reversing Mental Age with Psychedelics. [online] <https://mad.science.blog/2020/08/16/the-phoenix-effect-reversing-mental-age-with-psychedelics/> [Accessed 6 March 2021].

Secret of the Vine. 2021. Disney Psychedelics & the Occult | Secret of the Vine. [online] <https://www.secretofthevine.com/disney-psychedelics-and-the-occult> [Accessed 28 January 2021].

A Magic Medicine Journey

Psychedelic Prism

I want to start with a snapshot of how I am possibly different from the average person. I don’t smoke or drink. Before this chapter of my life began, I’d never taken any drugs besides prescription medication (and those as rarely as possible). I live in Melbourne, the coffee capital of Australia, and don’t even drink it.

Yet today, my life revolves around psychedelic medicines – heavily stigmatised substances still illegal in most countries. This huge shift is likely confusing. However, my personal journey can hopefully provide a deeper understanding of why I co-founded Mind Medicine Australia (MMA), and how psychedelic-assisted therapy could change the face of mental health treatment.

Helping People find their Voice

Over the past two decades, I’ve founded 6 companies, 3 charities and am a Member of the Order of Australia. I’m a global speaker and an international soprano – performing both as a soloist and as part of a group and have released 12 albums.

Singing has always been a huge part of my life. This motivated me to create the charity Creativity Australia and social inclusion program, With One Voice. My mission was to bring together people from different backgrounds, generations, faiths, and cultures by forming social inclusion choirs that bring together ‘haves’ with ‘have-nots’. Singing together can help alleviate loneliness, depression, and social isolation. I explain this further in my recent TED talk, which has received over 100,000 views so far.

I’ve personally witnessed that helping people find their voice can unlock their full creative potential. Similarly, I also believe psychedelics have a monumental role in helping achieve this. I know they will allow me to scale this mission… but I’ll get back to that. First, I think it’s important to tell you about my own experiences with psychedelics.

From Sober to Psilocybin Seeker

Taking an illegal substance had never occurred to me until I stumbled across Michael Pollan’s article in The New Yorker titled ‘The Trip Treatment.’ Reading it not only made me aware of the current resurgence in psychedelic research but also helped me to understand how these ancient plant medicines were assisting people to heal from a host of mental health issues.

From that point on, my interest in trying these hallucinogenic plants began to grow. I had no idea what it was like to be drunk or out of control. Yet the majority of people expose themselves to these altered states on a regular basis. I wondered if perhaps I was missing out on an essential human experience. What could psychedelics teach me about who I am or who I could be? Through exploring my psyche, what unknown parts of myself and our cosmos could psychedelics grant me access to?

So, I recruited the support of my now-husband Peter, and set out on a quest to have a therapeutic experience with psilocybin mushrooms. Having sadly lost his father to suicide in his early teens, Peter was also interested in dealing with past traumas.

However, being able to do this in a safe and legal setting proved difficult. After first trying and failing to get into global trials for healthy patients, we were ultimately referred to a private therapist in the Netherlands, where the use of psychoactive truffles is legal. We ingested a large dose of psilohuasca – a combination of psilocin-containing fungi and Syrian Rue, a MAO inhibitor used to enhance and prolong the effects of a trip.

The Inner Journey

Fair warning – describing what it’s like when you take psychedelic substances is difficult. My first time was completely removed from anything I’d encountered before. Unless you’ve personally experienced it, there’s really no reference point for understanding what it’s like. However, I can tell you that from then on, my life veered off in a very different direction.

The combination of having never lost control before and hearing stereotypes around psychedelics, made me incredibly nervous. I believed that it was going to destroy my brain. Turns out, this is far from reality. What happened was one of the most meaningful experiences of both our lives.

Firstly, the medicine completely shot us into space and, at the same time, through the Earth, rivers and oceans. What initially overwhelmed me was this incredible sense of oneness.It was as if all boundaries dissolved and I was left with the sheer magnificence of our planet. The connectivity of everything was indescribable. I haven’t been able to eat meat or even step on an ant since.

Being confronted with personal pain is a common experience during a psychedelic trip. For myself, as the daughter and granddaughter of Holocaust survivors, I’ve lived with transgenerational trauma my whole life. I was faced with this horror during my experience and have undergone transformational healing as a result.

These realisations were profound, but it’s the deeper insights we gained about ourselves that have left a lasting impression. The self-development Peter and I dove into following that first overseas expedition was vital for us to really integrate our life-changing experience. These lessons were so powerful, we didn’t feel compelled to have another session for a whole year. Research shows that the psychedelic experience significantly decreases activity in the brain’s default mode network. However, it’s the work that’s achieved in subsequent integration that leads to lasting wisdom. Incorporating the experience into your life, is just as important as the experience itself.

The neurogenesis and increased neural plasticity created by the medicines is truly remarkable. It’s like hitting the reboot button on your brain’s computer and defragging the faulty drives. I’ve noticed my creativity has increased tremendously. I’m able to access more moments of flow and purity in my singing, public speaking and writing. I’ve also recognised real lifts in my energy and consciousness. I feel many neural pathways have reconnected for me, new ones have formed and missing parts of myself have been found.

Psilocybin and Placebo

Creating a Movement and Making a Difference

Fast forward a few years later and Peter and I now seek out a session every four to six months. We call it our reset button. Every time we work with these medicines, we get new downloads and join more dots. Not only have we woven psychedelics into our lives, but the immense value we’ve gained from these magical medicines is what inspired us to establish our fifth charity, Mind Medicine Australia in 2019. Whilst our other charities are helping thousands of people through women’s shelters, social inclusion choirs, educational programs, poverty alleviation and microfinance, we acknowledge that at the heart of any kind of social isolation or disadvantage lies mental illness.

Mental illness keeps a person isolated. Sufferers often deal with rigid, negative thought patterns and intense feelings of despair. Every day we get emails and calls from those who’ve tried medication or therapy and are at the end of the road. We need to treat the underlying cause if people are to genuinely heal and lead more meaningful lives.

Having celebrated our second anniversary in February 2021, MMA is focused on expanding the treatment paradigm available to specialist health practitioners to reduce Australia’s terrible mental health statistics, which are worsening because of the current and ongoing COVID-19 pandemic. Of particular concern and pertinence are the high levels of mental illness, addiction, and suicide amongst the veteran, first responder and other marginalised population groups.

Before the pandemic, 1 in 5 Australians were experiencing some type of mental illness. 1 in 8 adults, 1 in 4 older people and 1 in 30 children (some as young as four) were estimated to be on anti-depressants. Their use across the country has risen by a massive 95% over the past 15 years. Still, mental health statistics continue to get worse, resulting in one of the highest rates of mental illness in the world. Recently, mental health experts announced that the COVID-19 crisis could lead to a 25% increase in suicide rates. Incidence of trauma, anxiety, depression and substance abuse are all accelerated by the pandemic.

Depression treatment methods haven’t substantially changed for decades and reversion rates are as high as 80% following medication. Side effects and withdrawal symptoms are common problems. Anti-depressants and psychotherapy lead to remission for less than 35% of suffers and the rates for PTSD are around 5%.

On the other hand, MDMA and psilocybin-assisted therapies are considered safe with remission rates of between 60-80% being achieved from over 150 current and recent trials. Evidence suggests psychedelics are low in toxicity, non-addictive, and show no signs of producing organ damage or neuropsychological side effects. These medicines are also proving to be very effective at treating various addictions. Practitioners describe them as ‘antibiotics for the mind’ due to their outstanding efficiency and short nature of treatment programs.

Research showing the benefits of these therapies are taking place at many of the world’s most prestigious universities including Johns Hopkins, Yale, UCLA, Harvard, Oxford and Imperial College London. Furthermore, these therapies are already legally available in the USA, Switzerland, Canada, Israel via Special Access Schemes. Some psychiatrists and prescribing physicians we work with have also recently received approvals for use of MDMA and psilocybin-assisted therapy for their treatment resistant patients via Australia’s SAS-B pathway.

Psilocybin-assisted therapy for depression and MDMA-assisted therapy for PTSD have achieve “Breakthrough Therapy” designation from the FDA in the USA. This designation is only granted to medicines that could be vastly superior to existing treatments to fast-track the approval process. MDMA, which is in Phase 3 trials, is likely to be a prescribed treatment for PTSD in the USA within 18 months. There are also trials underway for the treatment of end-of-life depression and anxiety, alcohol and drug addiction, dementia, strokes, anorexia and other eating disorders, cluster headaches and chronic pain.

Scaling the Mission to Set People Free

In preparation, we need to ensure that practitioners are properly trained. Our Certificate in Psychedelic-Assisted Therapies commenced in January 2021. This is the first course of its kind in this field in the Southern Hemisphere and is being designed in collaboration with the world’s leading programs and features a Faculty of global leaders in this field. Both our intakes for 2021 are proving popular with practitioners including psychiatrists, psychologists, GPs, mental health nurses and social workers.

Mind Medicine Australia is in the process of establishing an Asia-Pacific Centre for Emerging Mental Health Therapies. Its main mission is to expand the mental illness treatment paradigm in Australia and boldly position Australia as a global leader in mental health innovation, with partnerships encompassing University, philanthropic, private industry, and government sectors. MMA is also a part-funder of the nation’s first psychedelic clinical trial, currently underway at Melbourne’s St Vincent’s Hospital. We are also currently planning a Major International Summit for 2021, attracted a great Board, Advisory Panel and have support from major players in the psychedelic space. These include pioneers Roland Griffiths from Johns Hopkins University, David Nutt and Robin Carhart-Harris from Imperial College London, Rick Doblin from MAPS and many others.

What psychedelic medicines provide is an extremely effective treatment option for medical professionals who are desperately seeking innovation in the way we treat mental illness. They can help us rediscover our connection to ourselves. We can’t love others unless we first love ourselves. Psychedelics used intentionally also have the potential to help us solve other serious challenges, such as environmental and political issues, homelessness, and domestic violence.

A great deal of pain and suffering could be alleviated by introducing genuine connection back into people’s lives. If the pandemic is teaching us anything, it’s that humans are social creatures, and losing that connection can drastically affect our health and wellbeing. My first mission was to heal through the power of music, and don’t get me wrong, I’m still very dedicated to doing this. Yet today, with MMA, we’re taking that mission and scaling it in a way I could’ve never imagined possible.

Tania de Jong AM

LL.B (Hons), GradDipMus

Tania de Jong AM is a trail-blazing Australian soprano, award-winning social entrepreneur, creative innovation catalyst, spiritual journey woman, storyteller and global speaker. Tania is one of Australia’s most successful female entrepreneurs and innovators developing 5 businesses and 3 charities including Creative Universe, Creativity Australia and With One Voice, Creative Innovation Global, Mind Medicine Australia, Dimension5, MTA Entertainment & Events, Pot-Pourri and The Song Room.

She works across the public, private, creative and community sectors and is passionate about mental health, innovation, diversity and inclusion.  Tania speaks and sings around the world as a soloist and with her group Pot-Pourri releasing twelve albums. She is Founder and Executive Producer of future-shaping events series, Creative Innovation Global.

She was appointed a Member of the Order of Australia in June 2008 and named one of the 100 Women of Influence and the 100 Australian Most Influential Entrepreneurs in 2018. Tania’s TED Talk ‘How Singing Together Changes The Brain’ has sparked international interest. Tania’s mission is to change the world, one voice at a time!

Psychedelic Hedonism — The Ethics Of Psychedelic Therapy

Psychedelic trip

INTRODUCTION

Psychedelic-assisted psychotherapy is a novel approach to treating mental illness which has recently been (re)gaining significant public and scientific attention. Current clinical trials are demonstrating promising results which suggest that not only might these medicines be effective at treating a wide array of mental illnesses[1], but in some instances they might be more effective than currently available treatments[2]. However, despite the growing body of empirical work regarding the efficacy of psychedelic-assisted psychotherapy, the socio-cultural history of these compounds along with their unique psychological effects raises a host of normative ethical questions which need to be addressed to ensure that the return of psychedelics to western psychiatry is done in a responsible and ethically sound manner. “Prescribing Meaning: Hedonistic Perspectives on the Therapeutic Use of Psychedelic-Assisted Meaning Enhancement”[3] is a paper which aims to begin the task of addressing the ethics of psychedelic-assisted psychotherapy. The paper does so by applying the moral theory of Hedonism to analyse the ethical justifiability of psychedelic-assisted psychotherapy.

 

HEDONISM

Hedonism is a well-known type of consequentialist moral theory. In other words, Hedonism is a moral theory which places moral value in the outcomes of actions[4]. This means that for an act to be considered moral, said act must produce outcomes which are of moral value. So then, according to Hedonism, what outcomes are of moral value?

Hedonism or Hedonist moral theories are moral theories which place moral value in the outcomes of pain and pleasure[5]. That is to say that according to Hedonism, an act is morally good if it produces more pleasure than pain, or morally bad if it produces more pain than pleasure. There are some nuances of Hedonism which are explored further in the paper, and which subdivide Hedonist moral theory further into Qualitative Hedonism, Quantitative Hedonism, Hedonistic Utilitarianism, and Hedonistic Egoism.

 

PSYCHEDELICS AS MEANING ENHANCERS

It has been suggested that psychedelics exert their effects via a phenomenon known as the meaning-response[6]. The meaning-response refers to the body’s ability to respond physiologically to perceived meaning or symbols in the environment. For example, when someone takes a pill believing it will heal them — even if it has no pharmacologically active component (e.g. a sugar pill) — the body responds in such a manner which is in turn conducive for healing, as the very act of taking a pill is symbolically active[7]. That is to say that even though there are no chemically active ingredients in the pill, the very action of taking a pill carries certain symbolic connotations which lead to physiological changes in the body that change the body in ways which lead to health. This ability of the body to heal itself via mere symbols of healing might initially sound far-fetched, however it is a very well recognised phenomenon, so much so that the scientific community controls for this effect in its research designs — where it is perhaps better known as the placebo effect.

An important thing to note here is that the proposed mechanism of psychedelics as meaning enhancers is not saying that the effects of psychedelic-assisted psychotherapy are merely due to placebo. But rather the same mechanism which gives rise to the placebo effect also underlies the therapeutic effects of psychedelic-assisted psychotherapy. So how is this possible? It is proposed that during psychedelic states of consciousness the perception of meaning is enhanced. That is to say that psychedelics alter the world such that there is a general increase of ‘meaningfulness’ in the things which are experienced. This extra meaningfulness, when experienced in a therapeutic set and setting, results in an increased perception of therapeutic meaning (i.e. symbolically active meaning which is conducive for healing). This enhanced perception of therapeutic meaning leads to a stronger meaning-response, such that the body/mind of the person undergoing psychedelic-assisted psychotherapy will respond with a host of physiological/psychological sequalae conducive for healing. In other words, psychedelic-assisted psychotherapy heals by increasing the ‘meaningfulness’ of experience in such a way that leads to a dramatically increased meaning-response.

 

ETHICS

This is all very academically interesting, but how does this relate to the ethics of psychedelic-assisted psychotherapy? Well, the proposed mechanism of psychedelics as meaning enhancers raises the following ethical question: is it ethically justifiable to pharmacologically enhance the perception of meaning in order to heal patients?[6]. As was explored above, Hedonism would justify pharmacologically increasing the perception of meaning in order to heal patients so long as doing so led to more pleasure than pain. As is explored in greater deal in “Prescribing Meaning: Hedonistic Perspectives on the Therapeutic Use of Psychedelic-Assisted Meaning Enhancement”[3] the current literature on the effectiveness of psychedelic-assisted psychotherapy, its relative safety, as well as the epidemiology and morbidity of mental illness, would suggest that the introduction of psychedelic-assisted psychotherapy to psychiatry would produce more pleasure than pain.

But what if there is more to morality than pain and pleasure? This is the question that Robert Nozick asks people to consider when he presents his famous anti-Hedonist thought experiment: The Experience Machine[8]. To put his thought experiment simply, Nozick invites readers to imagine a machine which creates a completely realistic simulated reality. Before entering the Experience Machine people are allowed to select to kinds of experiences they want to have. Once inside, people become unaware that they have been wired up to the Experience Machine. According to Nozick, if pain and pleasure were the only relevant moral consequences, people would be morally obliged to enter the Experience Machine forever and live a life full of simulated pleasures. Nozick assumes that most readers would find this conclusion unappealing. Hence, Nozick argues that there is more to morality than just pain and pleasure. Nozick suggests that what also matters in determining morality is contact with an actual reality[8].

It has been suggested that psychedelic states of consciousness are analogous to the Experience Machine in Nozick’s thought experiment, and therefore represent a false reality. This analogy of psychedelic states representing a simulated false reality poses a further ethical challenge: are the effects of psychedelic-assisted psychotherapy ethically justifiable if they are produced by contact with a false reality? Two responses are suggested to such a question. Firstly, emerging research on the neuroscience of psychedelic states of consciousness could suggest that psychedelic states do not represent a false reality, but rather a different way of experiencing actual reality. Secondly, even if psychedelic states do represent a false reality, the use of psychedelic-assisted psychotherapy can still be justified in cases of extreme suffering, where concerns about contact with an actual reality are outweighed by extreme reductions in pain — e.g. treatment resistant patients.

 

CONCLUSION

The psychedelic renaissance is providing hope for many who have not responded to currently available psychiatric treatments. However, along with this hope comes a significant burden of responsibility for those researching and advocating for the medicalisation of psychedelics. Those living with mental illness are among some of the most vulnerable patient populations in society. Therefore, it is of utmost importance that the field of psychedelic science proceed with critical reflection to ensure that the work being done is ethically sound and not detrimental to those it is trying to serve. It is hoped that by beginning the process of applying moral theories to the experience of psychedelic-assisted psychotherapy, more discussion will ensue regarding some of the ethical challenges that this promising new paradigm presents.

 

REFERENCES

1. Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM, Work Group on Biomarkers and Novel Treatments, a Division of the American Psychiatric Association Council of Research. Psychedelics and psychedelic-assisted psychotherapy. American Journal of Psychiatry. 2020 May 1;177(5):391–410.

2. Davis AK, Barrett FS, May DG, Cosimano MP, Sepeda ND, Johnson MW, Finan PH, Griffiths RR. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA psychiatry. 2020 Nov 4.

3. Miceli McMillan R. Prescribing meaning: hedonistic perspectives on the therapeutic use of psychedelic-assisted meaning enhancement. Journal of Medical Ethics Published Online First: 04 November 2020. doi: 10.1136/medethics-2020–106619

4. Sinnott-Armstrong W. The Stanford encyclopedia of philosophy: Consequentialism. Available: https://plato.stanford.edu/entries/consequentialism/

5. Moore A. The Stanford encyclopedia of philosophy: Hedonism, 2019. Available: https://plato.stanford.edu/entries/hedonism/

6. Hartogsohn I. The meaning-enhancing properties of psychedelics and their mediator role in psychedelic therapy, spirituality, and creativity. Front Neurosci 2018;12:129.

7. Moerman, D. Meaning, Medicine and the “Placebo Effect”. Cambridge; New York, NY: Cambridge University Press, 2002.

8. Nozick R. Anarchy, state, and utopia. New York: Basic Books, 1974

Medically Assisted Psychotherapy in a Global Context

 

World from space

Written by Amelia French and Dr Alana Roy

Psychedelics and plant medicines have been used around the world since early humanity for spiritual, ritual, divination and recreational purposes.[1] Indigenous cultures used plants as medicines for millennia and many cultures carry on this tradition today.[2] Despite the growing evidence for use of psychedelics by humans as modern-day medicine for mental health disorders, they were abruptly made illegal to supply and possess by the United Nations convention in 1971 as a result of President Nixon’s War on Drugs.[3] Studies suggest psychedelics could be a breakthrough therapy for mental health issues including depression, anxiety, addiction, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder through their ability to work on a deep emotional as well as biological level. [4] Currently statistics of Mental Health in Australia is one in four people.[5] Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.[6] There needs to be innovation and change for the treatment of mental illnesses. MMA are advocating for the therapeutic use of Psilocybin and MDMA to support people with treatment resistant depression and Post traumatic stress disorder, respectively.

Current pharmacotherapy treatments for depression and anxiety work in 20–40% of cases.[7] Psilocybin has been shown to alleviate depression in 67% of patients within one to two doses even where standard treatments have failed.[8] Current pharmacotherapy has even lower efficacy in the treatment of PTSD with success rates of around 20%, MDMA has been shown lead to remission from PTSD in 78% of cases where standard treatments have not worked.[9] Current treatments such as antidepressants must be taken every day for months, often years. With medicine-assisted psychotherapy, patients frequently experience long-lived reductions in symptoms within a few single dose sessions.

Around the globe we are seeing countries take the lead in medically assisted psychotherapy with the legalization or decriminalization of psychedelics with logical, research-based, and tolerant policies on psychoactive substances. There are currently no countries in which psychedelics are regulated and approved medicines. Also, psilocybin is legally available in the Netherlands and both psilocybin and MDMA are decriminalized for personal use in Portugal, Czech Republic and several countries in South America.[10] When we explore the research into countries with decriminalization of MDMA and Psilocybin from across Europe there is statistics to show the positive outcomes for mental health.

“When delivered safely and professionally, psychedelic therapy holds a great deal of promise for treating some very serious mental health conditions.” Dr Robin Carhart-Harris Head of the Centre for Psychedelic Research

Portugal allows the use of psychedelic drugs through the decriminalization of drugs since 2001 and opted for a harm minimization approach to drug use.[11] Portugal have found that removing criminal penalties for personal drug possession did not cause an increase in levels of drug use but rather drug use is dependent on social and cultural factors and trends.[12] Decriminalization allowed space for research into mental health, supporting those with addictions better access to services by reducing the taboo and shame around drug use.[13] The Dutch drug policy is also driven by the idea that each person should make informed decisions on matters of their own health and recognize that drug policy is also a social issue.

The Dutch are world-renowned for their more logical, research-based, and tolerant policies on psychoactive substances. However, this does not mean psychedelics are completely legal in the Netherlands. Just like many other countries, the Dutch government classifies some drugs, including certain psychedelics, as illegal substances however the use of psychedelics is regulated. Drug policy in the Netherlands is guided by the principle that suppressing drug use and having a blanket ban on all drugs does not make mental health illnesses associated with drug use disappear but quite the opposite, makes mental health outcomes worse.[14] This is reflected in literature that mental health issues become far more difficult to minimize and control without appropriate education and prevention of drug abuse disorders is one of the most effective ways to reduce the impact of mental health on individuals and wider society, this is done through education, effective treatments and reducing cultural stigma or shame around mental health. Mental health disorders are exacerbated through lack of recognition to research and suppression through drug policy.[15] Psychedelic assisted therapies can positively impact mental health outcome and has shown to be safe in therapeutic contexts.[16] The Netherlands are embracing medically assisted psychotherapies through clinics, which are leading a movement to transform the way people approach emotional, cognitive, and spiritual well-being, through safe and legal medically assisted psychotherapy backed by research.[17]

Switzerland have allowed the legal therapeutic use of LSD and MDMA for treatment of post-traumatic stress disorder and depression when used alongside non-drug psychotherapy sessions with an experienced practitioner.[18] In Switzerland, limited medical use of non-registered drugs, or compassionate use is available from psychiatrists to prescribe MDMA for therapeutic use in conjunction with talk therapy for the treatment of trauma disorders.[19] Subjects with chronic, treatment-resistant posttraumatic stress disorder experienced clinically meaningful improvements and no evidence of harm after participating in a Swiss study evaluating MDMA-assisted psychotherapy.[20] The field of medicine-assisted psychotherapy needs to be driven by evidence-based studies to inform policies and law. Through evidence-based research we can effectively improve the quality of people’s lives and to promote healthier societies through policy reform of medicine-assisted psychotherapy. Mind Medicine Australia are advocating for clinical changes to bring these new innovative mental health treatments to Australia. Law is socially constructed by the culture and social influence, and it is ever changing with new research and knowledge emerging. Psychedelics have been shown to have significant therapeutic potential which is seen to outweigh ill-informed anti-drug laws.[21]

There is significant evidence to support the safe use of medicine-assisted psychotherapy when used in a clinically controlled space and appropriate screening is conducted.[22] Research suggests that there is no link between the use of psychedelics and the development of mental illnesses.[23] Further to this, there has been no negative health outcomes associated with the use of psychedelic medicines.[24] However, psychedelic use is highly context dependent and we only advocate for clinical use of psychedelics.

Mind Medicine Australia is an Australian registered charity (with DGR-1 status) seeking to broaden the treatment paradigm available to medical practitioners and their patients and improve treatment effectiveness by establishing, safe, accessible and effective Medicine-Assisted Psychotherapy in Australia for major Mental Illnesses.

 

References

[1]. Nicola Bragazzi et al., ‘Ancient Shamanism and Modern Psychotherapy: From Anthropology to Evidence-Based Psychedelic Medicine,’ Cosmos and History: The Journal of Natural and Social Philosophy 4, no. 1 (2018): 142, https://cosmosandhistory.org/index.php/journal/article/view/688; David Smith, ‘The Role of the Journal of Psychedelic Drugs in the Evolution of Psychedelic Medicine,’ Journal of psychoactive drugs 51, no. 2 (December 2019): 98–101, https://doi.org/10.1080/02791072.2019.1589607

[2]. Richard Doblin, Merete Christiansen, Lisa Jerome, and Brad Burge, ‘The Past and Future of Psychedelic Science: An Introduction to This Issue,’ Journal of psychoactive drugs 51, no. 2 (April 2019):93–97, https://doi.org/10.1080/02791072.2019.1606472; Smith, ‘The Role of the Journal of Psychedelic Drugs,’ 98–101; Michael Winkelman, ‘Shamanic guidelines for psychedelic medicine,’ in Psychedelic medicine: New evidence for hallucinogenic substances as treatments, ed. Thomas Roberts (Connecticut: Praeger Publishers, 2007), 143–168, https://www.academia.edu/4165474/Shamanic_Guidelines_for_Psychedelic_Medicines

[3]. Doblin, Christiansen, Jerome, and Burge, ‘The Past and Future of Psychedelic Science,’ 93–97; Smith, ‘The Role of the Journal of Psychedelic Drugs,’ 98–101

[4]. Tanya Calvey and Fleur Howells, ‘An introduction to psychedelic neuroscience,’ Progress in Brain Research 242, no. 1 (2018): 1–23, https://doi.org/10.1016/bs.pbr.2018.09.013

[5]. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results. Canberra: ABS, 2008. https://www.abs.gov.au/statistics/health/mental-health/national-survey-mental-health-and-wellbeing-summary-results/latest-release

[6]. World Health Organization. Prevention of Mental Disorders Effective Interventions and Policy Options. France: WHO, 2004. https://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf?ua=

[7]. Courtney Hutchison and Sara Bressi, ‘Social Work and Psychedelic‑Assisted Therapies: Practice Considerations for Breakthrough Treatments,’ Clinical Social Work Journal (January 2020), https://doi.org/10.1007/s10615-019-00743-x

[8]. Mind Medicine Australia. A new paradigm for mental health. Australia: MMA, 2020. https://mindmedicineaustralia.org/wp-content/uploads/2020/10/Mind-Medicine-Australia-EBook-09102020-small.pdf

[9]. Smith, “The Role of the Journal of Psychedelic Drugs,” 98–101

[10]. Jeff Lebowe, ‘A Global Guide to Where Magic Mushrooms and Psilocybin Are Legal or Decriminalized,’ Mary Jane, May 29, 2020, https://merryjane.com/culture/a-global-guide-to-where-magic-mushrooms-and-psilocybin-are-legal-or-decriminalized

[11]. David Bronner, ‘The Unified Field Theory of Psychedelic Integration and Portugal Style Decriminalization,’ Multidisciplinary Association for Psychedelic Studies 30, no. 1 (2020): 14–19, https://maps.org/news/bulletin/articles/439-bulletin-spring-2020/8126-the-unified-field-theory-of-psyhedelic-integration-and-portugal-style-decriminalization

[12]. Linnae Ponté, ‘Decriminalization and Harm Reduction in Portugal: An Interview with Dr. João Goulão,’ Multidisciplinary Association for Psychedelic Studies 25, no. 1 (2015): 18–21, https://maps.org/news/bulletin/articles/387-bulletin-spring-2015/5671-decriminalization-and-harm-reduction-in-portugal-an-interview-with-dr-jo%C3%A3o-goul%C3%A3o

[13]. Scott Bernstein, Emily Amirkhani, Dan Werb, and Donald MacPherson, ‘The regulation project: Tools for engaging the public in the legal regulation of drugs,’ International Journal of Drug Policy 86, no. 1 (December 2020):102949, https://doi.org/10.1016/j.drugpo.2020.102949

[14]. Bronner, ‘Unified Field Theory’

[15]. Bernstein, Amirkhani, Werb, and MacPherson, ‘The regulation project,’ 102949; WHO, Prevention of Mental Disorders

[16]. Calvey, and Howells, ‘Intro to psychedelic neuroscience,’ 1–23.

[17]. Bernstein, Amirkhani, Werb, and MacPherson, ‘The regulation project,’ 102949

[18]. Peter Gasser, ‘Psychedelic Group Therapy in Switzerland,’ Multidisciplinary Association for Psychedelic Studies 27, no. 1 (2017): 28–29, https://maps.org/news/bulletin/articles/420-bulletin-spring-2017/6622-research-update-psychedelic-group-therapy-in-switzerland

[19]. WHO, Prevention of Mental Disorders

[20]. WHO, Prevention of Mental Disorders

[21]. David Nichols, ‘Psychedelics,’ Pharmacological Reviews 68, no. 2 (April 2006):264–355, https://doi.org/10.1124/pr.115.011478; Tingying Chi and Jessica Gold, A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses,’ Journal of the Neurological Sciences 411, no. 1 (Jan 2020): 116715, https://doi.org/10.1016/j.jns.2020.116715

[22]. Jacob Aday et al., ‘Long-term effects of psychedelic drugs: A systematic review,’ Neuroscience and Biobehavioral Reviews 113, no. 1 (June 2020): 179–189, https://doi.org/10.1016/j.neubiorev.2020.03.017

[23]. Teri Krebs and Pål-Ørjan Johansen, ‘Psychedelics and Mental Health: A Population Study,’ PLoS ONE 8, no. 8 (August 2013): 1–9, https://doi.org/10.1371/journal.pone.0063972

[24]. Krebs and Johansen, ‘Psychedelics and Mental Health,’ 1–9

Dr Alana Roy

Ph. D Psychology, B. A Social Work (MHSW)

Dr Alana Roy is a psychologist, social worker and therapist and has spent the last 13 years working in mental health, suicide prevention, trauma, sexual abuse, family violence and the disability sector. Alana has worked with borderline personality and dissociative identity disorder in various roles in the community such as: Rape Crisis Centres with victims of ritual abuse, childhood and adult sexual assault, supporting women in the sex industry, survivors of human trafficking and now as a psychedelic integration specialist.

Alana focuses on harm minimisation, community and connection. She is dedicated to psychedelic-assisted psychotherapy and plant medicines. She has engaged with, and provides integration therapeutic support services for communities across Australia. Alana works at several universities as a Research Fellow and supervisor of students on placement. Alana passionately advocates for public policy, community education and legislative changes so that these treatments are regulated and supported by a strong, connected and skilled sector.

Amelia French

On the Need for a Bioethics of Psychedelic Psychotherapy: A Few Preliminary Challenges

Psychotherapy assisted by psilocybin, a naturally occurring compound in ‘magic mushrooms’, has recently received ‘Breakthrough Therapy’ status from the FDA, in recognition of the substantial benefits witnessed in clinical trials investigating treatment-resistant depression. A number of trials of psilocybin-assisted therapy are also underway for major depressive disorder, one of the most significant causes of disability worldwide (1), and the modality has the potential to support the long-term cessation of tobacco- addiction to which kills some 5,000,000 people per year – more effectively than any other available treatment (2). As such, it seems certain that therapy assisted by psilocybin and other psychedelics will receive significant interest from the biotechnology sector, psychiatry research and public health policy over the coming years.

However, for all its apparent promise, psychedelic-assisted psychotherapy remains extremely under-researched from a bioethical perspective. This is a serious shortcoming, and with licensing around the corner, it is now also an urgent problem. Against the backdrop of regular healthcare, the experience of psychedelic-assisted psychotherapy, its mechanisms of action, and its downstream consequences, are all pretty unusual. So perhaps unsurprisingly, pre-existing bioethical accounts of mental health treatments are challenged by this new treatment along a number of directions.

A full account of potential ethical challenges embedded in psychedelic-assisted psychotherapy, and a clear articulation of the clinical and policy choices that can defuse these challenges, will be a vital component in establishing psychedelic-assisted psychotherapy within the mainstream of healthcare.  The clinical promise of psychedelics is only part of the story – the success of a technology or treatment depends not just on its efficacy, but also on a slew of social facets of the culture it is embedded in. Not only do we want to have our ethical house in order before there is widespread uptake of psychedelic psychotherapy, but getting the ethics right will also facilitate widespread uptake.

Suppose we forge ahead without deep, critical ethical engagement, and we overlook something that we could have fixed, that leaves patients feeling let down, violated, or otherwise not properly considered. Not only would that amount to a failure of a physician’s duty of care, it would cost the psychedelic psychotherapy movement itself: maybe the loss of the public goodwill that has been so hard to build, maybe a series of litigation actions that make treatment providers, insurers, and decision-makers in other jurisdictions considerably less enthusiastic about facilitating psychedelic psychotherapy, ultimately meaning that many other people who could benefit would miss out. By seeking out potential problems now, and thinking about how to manage or accommodate them, we thereby minimise these risks.

A useful prism through which to understand some of these bioethical challenges is the tranche of unusual, non-clinical ‘side-effects’ of psychedelic experiences. Alongside the target clinical effect, psychedelic experiences can increase prosocial disposition, affect attitudes towards death, enhance aesthetic appreciation and improve patients’ sense of personal well-being and life satisfaction (3,4,5,6). Perhaps most interestingly, they can induce mystical experiences of long-lasting spiritual significance (7), and produce robust changes to religious belief (8) and personality (9,10). Such experiences appear to be a feature, rather than a bug, of psychedelic psychotherapy, with the intensity of the mystical experience correlating with the extent of clinical benefit. Of potentially wider significance, they might cause long-term changes to political values and, perhaps, behaviours (3, 11).

The focus on the therapeutic potential of psilocybin-assisted therapy has meant that the significance of these non-clinical outcomes has been underestimated. But their importance could hardly be overstated: even where psilocybin-assisted psychotherapy proves an effective treatment, participants can report this clinical success as one of the least important effects of the experience, when compared to the other changes (6). Given the unique power that this treatment has to influence facets of a patient’s character that cut to the very core of their identity, it is imperative that the breadth of its potential impact is carefully and critically examined. With the knowledge of these changes, clinicians who conduct psychedelic-assisted psychotherapy are knowingly changing people in a fundamental sense, far beyond the bounds that are usually seen within medicine.

The reflexive response to such ‘side-effects’ from some strains of medical ethics would be to square them away by appeal to the dominance of autonomously given, informed consent: so long as a patient is adequately briefed of the possible consequences of a treatment, their decision to continue with a treatment is conclusive. But the intuitive understanding of informed consent faces a number of challenges with psychedelic-assisted psychotherapy. The superficial challenge is that the very nature of the mystical experience induced by psychedelics runs contrary to the mainstream understanding of informed consent. A core characteristic of mystical experiences is that they are ineffable – inexpressible or incomprehensible in linguistic terms. Insofar as patient briefing takes place linguistically, securing informed consent will not be straightforward.The deeper problem with understanding informed consent in the context of psychedelic medicines, is to find a secure standpoint from which to make judgments of autonomy.  Commonplace advice to people considering whether to undertake a medical intervention, is to choose whichever option leads to a better quality of life, all things considered. But judgments about quality of life are necessarily dependent on a system of values, and values themselves can be changed by psychedelic-assisted psychotherapy. If you know your perspective on life may radically change following psilocybin, how do you adjudicate between your current evaluation of prospective quality of life after psilocybin, and your likely post-psilocybin evaluation of quality of life after treatment? (12) This is not a mere philosophical puzzle. How might we counsel a prospective patient considering psilocybin-assisted therapy who has debilitating depression and is a fervently proud, card-carrying materialist atheist. From this patient’s perspective, coming out of treatment believing in God or some sense of Ultimate Reality may be more horrendous to consider than continued clinical suffering. But, were this patient to proceed with treatment and have a religion-inducing ‘God-encounter experience’ (8), they would not have nearly as negative an evaluation of this newfound belief, after the fact.

With the non-clinical changes following psilocybin administration come questions of authenticity, self-conception, and self-development. Psychedelics are far from the first treatment to challenge these notions in psychiatry. The expansion of SSRI prescription in the 1990s led to worries about ‘cosmetic psychopharmacology’ and patients ‘losing themselves’ to Prozac (13,14) . The personality characteristics and outlooks that develop in users of SSRIs do not truly belong to them, it is argued, given their lack of connection to the patient’s overall narrative arc and  environment (14). Prima facie, some drivers of change seem more authentic than others. Changes that come about from slower-acting, experiential factors (a period of missionary work, the raising of a child) seem intuitively more plausibly ‘authentic’ than those that come about by faster acting, exogenous, artificial factors clearly linked to neurological disruption (a railroad spike through the left frontal lobe, a six week course of SSRIs). But psychedelic-assisted psychotherapy refuses categorisation under this schema. Although the changes are detectable rapidly, and come about following the administration of a drug with a dramatic acute and post-acute effect on brain function (15,16), psychedelic experiences are, nonetheless, experiences. Indeed, they are experiences that tend to be ranked among the most meaningful in a patient’s life (3), making them more credible candidates for authentically cohering with, or indeed shaping, the narrative arc of a patient’s life. Further exploration and elaboration of these ideas, as well as being philosophically interesting, can usefully feed into public narratives about the meaning and significance of clinically administered psychedelic experiences: it is a strange medical treatment indeed that returns patients to their loved ones not only freed from their tobacco addiction, but also with a perceptibly different personality, a penchant for spending time in nature and art galleries, and a newfound spirituality (2, 6). A clear articulation of the authenticity of these changes, if they can be understood as a natural and comprehensible expression of continuity, rather than an exogenously-imposed transfiguration, could serve to assuage suspicion or mistrust of psychedelic medicine among patients’ loved ones, and the wider public.

These are just a few of the surprising ethical quandaries that lurk within psychedelic medicine. While some of the challenges may seem theoretical or philosophical, the sharp end of each of them is to be found in the clinic, requiring sincere and critical reflection on the part of the psychedelic research community, and perhaps ultimately incorporated into the soon-to-be-expanding training programmes for therapists.

 

By Eddie Jacobs

 

References

1.     https://www.who.int/news-room/fact-sheets/detail/depression

2.     Johnson, M. W., Garcia-Romeu, A., & Griffiths, R. R. (2017). Long-term follow-up of psilocybin-facilitated smoking cessation. The American journal of drug and alcohol abuse, 43(1), 55-60.

3.     Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., …& Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology, 30(12), 1181-1197.

4.     Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., … & Su, Z. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of psychopharmacology, 30(12), 1165-1180.

5.     Garcia-Romeu, A., R Griffiths, R., & W Johnson, M. (2014). Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Current drug abuse reviews, 7(3), 157-164.

6.     Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018). Psychedelic therapy for smoking cessation: qualitative analysis of participant accounts. Journal of Psychopharmacology, 32(7), 756-769.

7.     Doblin, R. (1991). Pahnke’s “Good Friday experiment”: A long-term follow-up and methodological critique. Journal of Transpersonal Psychology, 23(1), 1-28.

8.     Griffiths, R., Hurwitz, E. S., Davis, A. K., Johnson, M. W., & Jesse, R. (2019). Survey of  subjective” God encounter experiences”: Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT. PloS one, 14(4), e0214377.

9.     MacLean, K., Johnson, M., & Griffiths, R. (2011). Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. Journal of Psychopharmacology, 25(11), 1453-1461.

10.  Erritzoe, D., Roseman, L., Nour, M. M., MacLean, K., Kaelen, M., Nutt, D. J., & Carhart‐Harris, R.L. (2018). Effects of psilocybin therapy on personality structure. Acta Psychiatrica Scandinavica,138(5), 368-378.

11.  Lyons, T., & Carhart-Harris, R. L. (2018). Increased nature relatedness and decreased authoritarian political views after psilocybin for treatment-resistant depression. Journal of Psychopharmacology, 32(7), 811-819.

12.  Schick, F. (1997). Making choices: A recasting of decision theory. Cambridge University Press.

13.  Kramer, P. D., & Kramer, P. D. (1994). Listening to prozac. London: Fourth Estate.

14.  Elliott, C. (1998). The tyranny of happiness: Ethics and cosmetic psychopharmacology. Enhancing human traits: Ethical and social implications, 177-188.

15.  Carhart-Harris, R. L., Erritzoe, D., Williams, T., Stone, J. M., Reed, L. J., Colasanti, A., … & Hobden, P. (2012). Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Proceedings of the National Academy of Sciences, 109(6), 2138-2143.

16.  Carhart-Harris, R. L., Roseman, L., Bolstridge, M., Demetriou, L., Pannekoek, J. N., Wall, M. B., … & Leech, R. (2017). Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific reports, 7(1), 13187.

 

Common Views and Attitudes Towards Psychedelic Medicines and Therapies

 


Psychedelics have a rich history, from use amongst indigenous people, guided by ancient knowledge passed on through centuries of traditional practices, to their discovery by modern science leading into a hampering period of criminalisation and finally through to a resurgence of research into uses in modern psychological treatment. A brief insight into the research, past and present, shines a light on the profound potential of psychedelics. Many studies have perfected the formula for safe therapeutic use, right dose and setting with skilled facilitators. This combination, with few treatment sessions, has provided sufferers of treatment resistant major depressive disorder, depression and anxiety associated with diagnosis of terminal illness, severe posttraumatic stress disorder (PTSD) and substance use disorder, with exceptional enduring therapeutic benefits (Bright & Williams, 2018; Carhart-Harris et al., 2018; Daniel & Haberman, 2017).

The state of mental health is at a tipping point, on the verge of further decline with exacerbation from an imminent economic depression and the increased psychological distress experienced due to the COVID-19 situation. A new approach to mental health treatment is an impending necessity, to help curb future burdens associated with increasing levels of mental distress. Psychedelic research has provided promising results, making psychedelic medicine an obvious candidate for the progression into a new paradigm for treating mental illness. Given the significant benefits of psychedelic medicines, relaying this information to the general public effectively is an important step towards the acceptance and integration of psychedelic-assisted therapy.

This exceptional period of rapid change that we currently find ourselves in has exposed a deep divide in understandings, views and opinions amongst individuals, communities, governments and within institutions. The COVID-19 situation, which is both symbolic and symptomatic of this complex time, has on the one hand produced an enormous amount of conflicting information coming from multiple sources, while on the other hand has not produced a single authoritative position, making it hard for most to differentiate fact from opinion and science from politics. These tensions are not unfamiliar to researchers in the area of psychedelic medicines; however, the scale of the current crisis changes the way we see the problem and directs us to new ways of responding. The COVID-19 situation has shown that when deciphering information, there is an obvious disparity between and within, science, medicine, politics and industry.

Information from highly influential sources leading to impulsive decision-making, has the capacity to produce unforeseen undesirable implications. We have seen an example of this recently with the initial predicted COVID-19 death rate — later found to be highly inaccurate — resulting in the instantaneous introduction of new policies worldwide. With the implementation of these policies, we are now witnessing a rise in mental illness, substance abuse and suicide risk (Wesley Mission & Suicide Prevention Australia, 2020). In hindsight the inadequacies and long-term implications of these policies are becoming visible, highlighted by new and upcoming research (Atkeson et al., 2020; Kaplan et al., 2020; Madhi, et al., 2020; Miles et al., 2020).

The complexity and tensions inherent within the COVID-19 situation present a unique opportunity for reflective research in that it surfaces, in a very explicit way, the challenges associated with the delivery and receipt of information. Learning from the COVID-19 situation, more focus can be placed on the fundamentals of the spread of information within the area of psychedelic medicines and how information flows impact on consensus and associated behaviour and attitudes.

The public perception of psychedelic medicines, relates back to the criminalisation of psychedelics in the 1960’s. The residual effects of this classification, including stigmatisation, rejection and fear, is central to the continuous spread of confusing and incorrect information within the public domain (Belouin & Henningfield, 2018; Bright & Williams, 2018; Sessa, 2016). The spread of this information has both created serious limitations for scientific research, and the uptake of the medicines and therapies themselves (Belouin & Henningfield, 2018; Bright & Williams, 2018; Sessa, 2016).

The way in which information is delivered can either be, a shortcoming for the distribution of correct information, or a catapult for the distribution of incorrect information, leading to a myriad of challenges for policymakers and public health. The dissemination of information in the COVID-19 environment has brought into focus the associated challenges, highlighting how advancements in the use of psychedelic assisted therapy may be curtailed. It is an important consideration when making informed decisions regarding the delivery of information, to examine and understand the sources, intended purposes behind, and the interpretation.

Misinformation can be described as information that originates from an absence or lack of supporting empirical or factual evidence. History tells us that the current scheduling of psychedelics follows on from the criminalisation of LSD in 1966 (Belouin & Henningfield, 2018; Sessa, 2016). LSD was completely banned for any use, including research purposes, on the basis that it posed a danger to the public, despite thousands of studies on the therapeutic use of LSD during the 1950’s and 1960’s deeming LSD, when used in controlled settings, to be “overwhelmingly safe and effective” (Sessa, 2016, p. 8). Based on this, the criminalisation and stringent scheduling of psychedelics is not supported by empirical evidence and based on misinformation.

In understanding the roots and propagation of misinformation, it is important to examine the sources. A study by McCright and Dunlap (2017) discusses the origins and spread of political misinformation and outlines that it is; often based on ideological agendas, deeply ingrained and mutually reinforced by the public, and cohesively promoted through collaborative relationships with industries and media outlets. This study highlights the disregard for accuracy in the delivery of highly influential information and also the difficulties in rectification at this level.

Research suggests that information is often selectively chosen, skewed or sensationalised for entertainment purposes (Klin & Lemish, 2008). With the media driven stigma of a ‘dangerous party drug’, ecstasy is an unregulated drug found to often not contain MDMA at all (Rickwood et al., 2005). MDMA, the psychedelic component in what’s been classified as breakthrough treatment for PTSD (Doblin et al., 2019) is often misleadingly referred to as ecstasy. This demonstrates the potential for incorrect terminology to exacebate misconceptions. However, becoming aware of misleading terminology allows for intervention to expose and correct it, helping to conteract misconceptions.

Aside from understanding and acknowledging the origins of information and misinformation, it is equally important, to recognise and understand how it is received and absorbed. Deciphering whether information is correct or incorrect involves not only the way it is delivered but also how it is interpreted, transferred into knowledge and beliefs, and interacts with prior knowledge and beliefs. Amongst the general population there are many misconceptions associated with psychedelics as a result of misinformation, such as, they are dangerous, toxic and addictive physically, psychologically and/or socially (Belouin & Henningfield, 2018; Byock, 2018). These misconceptions have been refuted by the large amount of research that has taken place since psychedelic medicines were discovered by scientists in the 1890’s (Bright & Williams, 2018; Nichols, 2016; Sessa, 2016), but the obvious dilemma is that such research is not readily available to, or accessed by the general public.

Misconceptions and misinformation are difficult to counteract, as they become imbedded in beliefs and attitudes. The “war on drugs” campaign, led by politics and propagated by mass media has left an unfortunate legacy. The campaign established psychedelics position as an enemy and threat to society. In establishing this position, knowledge was tactfully directed, shifting and cementing the general public opinion of psychedelics. In a study reviewing literature on cognitive biases that influence social perceptions, Marks and Miller (1987) found that values and beliefs held by individuals are often influenced by social groups and the selective exposure to biased samples of information that agrees with and maintains a desired or already held position.

It has been proposed that individuals generally only seek new knowledge when it is necessary or vitally important to do so (Thon & Jucks, 2017), and when it comes to acknowledging new information — whether it is evidence based or not — an individual’s prior knowledge and beliefs are often defended and upheld (Pennycook, 2020). Clearly, prior knowledge and beliefs play a significant role in the adoption of new information, exemplifying the difficulties in shifting firmly held beliefs and gaining trust and acceptance.

The “war on drugs” has been described as, a war on “sovereignty over consciousness” (Hancock, 2015, p. 3). In the current media climate we are witnessing an increase in censorship and a polarisation of information, which similarly to the “war on drugs” can be described as a war on sovereignty over knowledge. Ideally there should be accountability for ingenuousness within sources of information, but it is instead, left to the individual to firstly identify misinformation and secondly rationally and logically question it. Awareness leads to change and begins with acknowledgement and acceptance. Acknowledging and accepting the dilemmas within the delivery and uptake of information, will therefore bring about awareness necessary for change.

Misinformation is somewhat complicated and incorporates many variables from all parties including the sources of information and the intended audience, and many aspects that influence the interpretation and accommodation of information. Misinformation has effectively sustained misconceptions and stigmatisation surrounding psychedelics. It is therefore relevant to investigate and understand in order to move forward and create a model for initiating and establishing positive views and attitudes towards psychedelic medicines and therapies. Further research is needed to explore the barriers surrounding misinformation, to aid successful advocation for psychedelic medicines and promote their place in therapeutic, psychological and clinical practice.

By Candice Folkard

 

References

Atkeson, A., Kopecky, K., & Zha, T. (2020). Four stylized facts about COVID-19. NBER Working Paper №27719. https://doi.org/10.3386/w27719

Belouin, S. J., & Henningfield, J. E. (2018). Psychedelics: Where we are now, why we got here, what we must do. Neuropharmacology, 142, 7–19. http://doi.org/1016/j.neuropharm.2018.02.018

Bright, S., & Williams, M. L. (2018). Should Australian psychology consider enhancing psychotherapeutic interventions with psychedelic drugs? A call for research. Australian Psychologist. https://doi.org/10.1111/ap.12345

Byock, I. (2018). Taking psychedelics seriously. Journal of Palliative Medicine, 21(4), 417–421. https://doi.org/10.1089/jpm.2017.0684

Carhart-Harris, R.L., Bolstridge, M., Day, C.M.J. et al. (2018). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, 235, 399–408. https://doi.org/10.1007/s00213-017-4771-x

Daniel, J., & Haberman, M. (2017). Clinical potential of psilocybin as a treatment for mental health conditions. Mental Health Clinician, 7(1), 24–28. https://doi.org/10.9740/mhc.2017.01.024

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Psychedelic-Assisted Therapy For Criminal Offenders — A New Paradigm For Rehabilitation?

I have a lifelong interest in decreasing violent crime and imprisonments rates. For 21 years I was a proudly activist judicial officer seeking to reduce both — definitively a barbed-wire fence proposition.

I have a more recent interest in the treatment of mental health issues by the use of psychedelic assisted therapy. At first glance, it may appear that these two interests are disconnected. The purpose of this short blog is to explain that they are intricately linked, and thus my excitement at being on the advisory panel for Mind Medicine Australia.

I have personal experience of vicarious trauma detailed in my Tristan Jepson Memorial Foundation lecture[1], and am happy to disclose that I have been flirting with the idea of psychedelic assisted therapy for myself.

So, let’s play ‘what if’ for a while.

1. What if psychedelic assisted therapy could make a real dent in the numbers of those suffering from substance abuse disorder, PTSD and depression/anxiety?

2. What if a substantial proportion of those who commit crimes and are imprisoned are suffering from those conditions?

3. What if there was broad availability of these treatments for violent offenders?

4. What if there was broad outspoken support from the criminal justice sector?

As to the first ‘what if’, having read the research, I am comfortably satisfied that psychedelic assisted therapy including psilocybin and MDMA has great results in treating conditions such as substance abuse disorder, PTSD and depression/anxiety. The phase three trials will undoubtedly cement psychedelic assisted therapy as a key treatment to these ailments. However, I notice that much of the recent research has been on those perceived to be worthy — those dying of terminal illness, Vietnam veterans, AIDS survivors, anorexia patients and the like. There are some studies of those with substance abuse disorders, but having read that research it is notable that violent offenders are not the target tested group.

Yet, and this answers the second ‘what if’, those suffering abuse disorder, PTSD and depression/anxiety are responsible for much of the violent crime in Australia.

I know it’s academically sound to start with the empirical evidence-based studies, however sometimes anecdotal evidence has more punch. As a children’s court magistrate, I noticed something very quickly — there were no repeat violent offenders who had not witnessed or been the victim of violence in the home. None, zero. Every sentencing report detailed PTSD from living in fear as a child. Every single one. All of these kids I had to lock up had experienced seeing their mum beaten up, or been abused themselves.

And with violent women offenders, it soon became apparent that the vast majority had been victims of sexual abuse and suffered from PTSD or substance abuse disorder as a result. For men, the picture was more complex with a range of diagnoses — until the Royal Commission. Suddenly, it became acceptable for men to admit to the abuse they had suffered and a PTSD diagnosis became more and more common. For most violent male criminals, alcohol abuse disorder was a regular feature.

This anecdotal evidence is, unsurprisingly, supported by the research. For women prisoners, two thirds had a mental health condition, and one third for men. A third of women had a history of self-harm. A quarter of all entrant prisoners were taking medication for a mental health condition[2]. This is a world-wide phenomenon — for example, the prevalence of psychosis in a London prison population was found to be more than 20 times that of the general community, and almost 70% of people in prison had more than one mental health disorder[3].

The figures don’t distinguish between violent and other offenders, and nor do they inform of the type of mental illness. I plan to dig deeper on these issues, however my hypothesis is that the research will conform with my observations –the vast majority of violent offenders have mental health issues that lend themselves to psychedelic treatment. There are two important caveats to this hypothesis worth keeping in mind — firstly, the vast majority of those who have mental health conditions are not violent. Secondly, those with mental health conditions are much more likely to be victims of violent crime.

And to the third ‘what if’ — imagine if there was broad availability of psychedelic assisted treatment of these violent offenders. I’m not suggesting we lace prison water with LSD a la Timothy Leary, however surely psychedelic therapy holds more likelihood of rehabilitation than the rigid discipline of time behind bars and a lifetime of psychiatric medication. I opine that violent offenders ought to be the first for whom this treatment is available — because there is a sure and clear test of effectiveness. They either re-offend or they don’t.

And finally, to the fourth ‘what if”. There certainly are some barriers to getting criminal justice support for psychedelic therapy — there are deeply entrenched views that mimic those of Mr Mackey in South Park — all drugs are bad. Of course, the logical flaws in that approach are obvious but should not be discounted as it is the dominant hegemony. Such views are shared by the majority of police, judges and lawmakers in the country. Medicinal cannabis has faced decades of prohibition until very recent times in this country, and still the barriers are significant. Legitimising psychedelics is a hurdle that may take some time and effort.

The other hurdle is that psychedelic treatment will not of itself impact on the sociological causes of crime for which treatment of individuals is but a small part. Chronic inequality, institutionalised racism, toxic masculinity and a lack of rehabilitation services all contribute to rising crime. There are no magic bullets for these. However, if the focus is on violent crime — particularly domestic and family violence — then criminal justice system support may be easier to garner.

So, if we are serious about decreasing the prison population and reducing violent crime the criminal justice system ought support psychedelic therapy availability. The current law and order ‘solutions’ to violent crime — more police, longer sentences, tougher prisons — demonstrably are not working. It is time to try a more scientific approach.

By David Heilpern

References
[1] https://www.judicialcollege.vic.edu.au/sites/default/files/2019-07/Helipern%20%282017%29%20TJMF%20Lecture%20-%20Lifting%20the%20Judicial%20Veil.pdf

[2] https://www.aihw.gov.au/getmedia/2e92f007-453d-48a1-9c6b-4c9531cf0371/aihw-phe-246.pdf.aspx?inline=true

[3] Bebbington P, Jakobowitz S, McKenzie N, Killaspy H, Iveson R, Duffield G & Kerr M 2017. Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder. Social Psychiatry and Psychiatric Epidemiology 52(2):221–9. doi: 10.1007/s00127–016–1311–7

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