By Molly Lena
Certificate of Psychedelic Therapy Essay on the desirable attributes and qualities of a Therapist working in psychedelic-assisted therapy (PAT).
“We don’t see things as they are, we see them as we are.” Anaïs Nin
I had never planned to be a doctor; kids from small public schools in remote Australia didn’t plan to be doctors then at all.
I went to university to study Consciousness. There was no such degree, of course, so I pieced one together through neuroscience, neuroanatomy, and psychology. I never planned much at all, thanks to a moderately severe case of ADHD, but 27 years later, I seem to have meandered into exactly the right place to be. Once again, a student of consciousness — this time through altered states in psychedelic-assisted therapy with Mind Medicine Australia’s outstanding Certificate in Psychedelic-Assisted Therapies (CPAT).
Throughout the weekly lecture series and readings, we have learned there are six core competencies of a PAT therapist — empathetic abiding presence, trust enhancement, spiritual intelligence, knowledge of the neurological and psychological effects of psychedelics, self-awareness and integrity, and proficiency in complementary techniques.
I suggest you read that sentence again.
After two decades of CPD in my career I had never once seen those attributes and qualities described as desirable all at once. And I had never been surrounded by such a diverse group of health practitioners, the respect for each other’s respective skills was breathtaking. The thing about professional elitism is, you often do not recognize the edges of your own map. And the thing about caring for patients is, that we cannot connect to those we do not recognize as belonging on that map. Flinders and Newcastle University had realized that just as I was nearing the end of my non-consequential degree and tempted to head to a Vedic Monastery as my PhD. They realized that there are greater desirable qualities in doctors than just top marks, urban elitism and a generation of Specialists as relatives. I cannot emphasize the value of diversity in our future health practitioners to the future of our nation’s population health enough, and I commend the broad-mindedness of Mind Medicine for this.
After 8 years of university and 3 years as a junior doctor, I began my training as a Psychiatrist with the Royal Australian and New Zealand College of Psychiatrists at an even larger tertiary hospital. I resigned from my training position as a Psychiatrist because of the Psychiatrists, not the patients. I found their measured, restrained no-transference approach to people with horrific trauma from their life events to be an immense tragedy in failed human connection.
Each day became harder, and I was becoming burnt out. Emotionally bruised and battered. On the final day was the session that broke me. A young man — let’s call him Daniel — sat before my supervisor; my third psychiatrist, his thirtieth, in two decades of involuntary admissions under alternating labels: schizophrenia, psychosis, schizoaffective disorder.
Reading through his file, I knew what psychiatry seemed disinterested in at that time (2006) – his childhood trauma. While the Psychiatrist was focused on what was Happening to Daniel, I was ruminating on what had Happened to him. Childhood trauma so horrific and repeated that the man before us seemed to me a scrambled, frizzing chaos of human consciousness. So disorganized in thought processes and perceptions that he heard voices, believed things that were not real, jumbled his words and rocked back and forth in the High Dependency Unit in total, institutionalized fear. By the time I met him I don’t think there were many thoughts other than how to get the f4^k out of this indeterminable and indefinite, infinite age of Horror Error Processing.
I look back at my diary notes from that period and still wonder, did Daniel say that? Or did I feel it?
I watched Daniel rock on the sterile bed, whispering words jumbled with ‘mother’, as the Psychiatrist loudly instructed ‘note he is thought disordered’. ‘After the ward round I wrote a prescription I wished he could fill:
1 × Attached Mother, per body/mind, per day, for life
That night I took a sleeping tablet called Stillnox and had a strange reaction. I should mention this pill is also known as the “Lazurus drug” for bringing people who had been in comas in ICU for years back into our world. No one knows how exactly it works, or how it performed these miracles. But clearly it has something to do with consciousness, as my reaction was an altered conscious state.
Suddenly my mattress was a raft on an enormous ocean, there were no walls. I was rocking along slowly and admiring the shimmer of silver in the water when I realized the shimmer was everywhere. There were millions of strings, spider-silk fine, running between me and the lamp, me and the walls, me and everything I thought was empty. No empty space. None. Just threads, in perfect geometry like a fishing net, moving just as a net on the surface of the ocean does.
I lifted a hand and the strings shivered, rippling out like a plucked guitar. I laughed—couldn’t help it—and the laugh itself shook the net, sent vibrations racing back, so I didn’t know if I was laughing or if the room was.
I woke up the next morning with a complete and utter awareness that those little strings, those world-threads, are there all the time. Always. There is no space between us. And those little strings go between one person to the next, they are a bridge, a connection and they wobble away at the slightest hint of energy … or emotion.
I realized that the failed human connection I was bearing witness to daily was real. That the pain I felt at witnessing the patient’s distress being minimized was real. That everything, and everyone, is connected.
Now, 13 years later, I am learning that “empathetic abiding presence” is a desirable quality of a psychedelic-assisted therapist, and that it refers to a way of being with someone that combines deep empathy with an abiding presence; ‘a steady, grounded, non-judgmental companionship that doesn’t waver even in difficult circumstances.
I reflect on how Daniel would have felt if the Psychiatrist had empathetic abiding presence. I admire the Psychiatrists that are leading the way in CPAT. I wonder how different all our health might be with our GP, therapist, clinician, had empathetic abiding presence.
From Melbourne I moved to a country within our country called East Arnhem Land and became a Rural Generalist. Straddling the space between psychiatrist and GP and psychologist, neither of each yet a little of both. A Venn diagram in which I meet in the middle of the three, in the space between. It turns our this is “the missing middle” of our mental health system, which in Australia at least, would number in the millions.
They are the patients who are a little too sick for GP’s, not quite sick enough for Psychiatrists, and unable to afford Psychologists. Those with the resources (both external and internal) often seek out the therapists not often recognised by Western medicine, but who are a group who create more healing than those that shun them. The Buddhist teachers, the Yogi’s, breathwork, bodywork and energy work. The Shamans and Spiritual healers. In my own journey, both personal and professional, both patient and doctor, I encountered many of these types of healing therapies, and had such a deep respect for their knowledge I began to study some of them (Yoga philosophy/history, Energy work, bodywork and meditation).
Of the six therapist competencies required for psychedelic-assisted therapy, I had begun my own journey to become proficient in complementary techniques. It is a journey I wish to continue now.
Currently my Venn diagram of professional knowledge has expanded so that I can see Chakras in human anatomy, meditation in physics, bodywork in the nervous system and energy work in death. By the latter I mean the energy that I have witnessed in death.
It has been a great privilege as a doctor to be present the moment a person passes on (when the death is expected and even welcomed, such as palliative care). Bearing witness to these moments is when my spiritual intelligence CPD took a new turn.
The very first occasion in a tertiary hospital as an Intern, when I was caring for an elderly man who had been admitted with a heart attack (more like broken heart) and had lost his love of his life, his wife of 60 years a month earlier. He never spoke of his own ailments, only of joining her. That took a full 8 days, and in that time, we got to know each other quite well.
Each morning and evening I could see his life begin to loosen from his body. Almost as though a gaseous haze followed him, like falling flakes of dead skin. His eyes were the first to lose their store, blue flecks became caught within his tears and sight slid down the channels of his face.
His hearing was dense with conversations, magpies, sports commentators and lawnmowers of eighty-five years’ noise. Like lime in pipes, life closed within his ears.
Late on the 8th evening of his admission, in the wandering hours, as nurses’ mumblings drifted by his heart failed, and his vitals beeped warnings for the nurses to call a Code Blue. Before the ‘crash-cart’ and Resuscitation team had moved I cancelled the Code with an assurance that did not fit an Intern, and certainly not one with the bush-kid imposter syndrome.
I closed his door behind me and held his hand as he took the last breath. The soul’s last sigh as I have come to call it. I felt a subtle cool brush of air, as the last of his life drifted through his skin and filtered between world threads, some-where.
Then I found myself turning to open wide the small window on the 4th floor hospital room. Years later a Shaman explained it was to let him fly.
Over the years that followed I witnessed time and time again the energy that left with death, which appears so enormous, so profound an altered state… and yet was never described in my medical studies at all.
Then one morning in East Arnhem Land, as the morning star, Venus, rose just before the sun rise, she was trailing behind her the rope that Yolngu believed connects to the place where souls reside. I was fortunate to be part of a sacred women’s ceremony that connects the living and the dead, and I felt the presence of a recently departed Elder sit beside me.
I was determined to try to understand the Soul.
Later that day I sat under the Tamarind tree on the beach of this Yolngu Homeland, with the gentle lapping sounds of tropical sea on its shores, and I tried to calculate what this energy was. Using Einstein’s E=mc2, and my very basic physics 101, even if the difference in weight once a person has passed equals 21 grams, approximately 0.021 kilograms, the energy I witnessed would be 0.021 kg multiplied by the speed of light (approximately 3 x 10⁸ m/s) squared.
I stared at this incredibly large number, around 1.88 x 10¹⁵ joules, and realized if the difference in weight between alive and death was even 1 gram, then that thing I saw leave a body so many times, the thing I was now prepared to call a soul, contains an immense amount of energy. Is our consciousness preserved, our sense of ‘I’ amongst that massive translation of energy, of presence?
If I had stayed in southern, western medicine as a GP or Psychiatrist, I never would have thought to ask the question about a soul. But working for 10 years in Yolngu Country altered me, shifted me off standard Western medicine. I now see it was a direction simila to the attributes and qualities required in psychedelic therapy. Spiritual intelligence being one, and the delicate dance of trust between patient and doctor another.
Earning trust in Yolngu Country required patience, silence, and authenticity. Elders might take two full minutes to answer a question, and I learned that silence is often the most respectful form of presence. I also learned that trust enhancement is a product of authenticity.
Gradually the trust spread outside the hospital walls, as Yolngu became like family, and I even birthed my own family on their country. My boys were raised with weekends spent on the Homeland and learning to make spears, hunt and sit quietly around the fire listening to stories from their most Senior Uncle; a rare knowledge holder and high initiate for whatever it is these men endure each step of the way. I was changed by what I learned, from Yolngu medicine, healing and ceremony.
Most importantly for the first time in my life I stepped out of my own world view and saw it for what it was.
I don’t think there is a word in English for stepping outside of one’s own world view. Most likely because of the European colonization’s determination to assert its intellectual authority. English-speakers are the least likely to even realise that the world is as they see it only because it is their view.
There are terms in other cultures for the concept, or something similar, such as Ubuntu (Southern Africa, Nguni Bantu) language translated as “I am because we are.” It emphasizes interconnectedness and understanding the self through others. While not exactly “stepping outside one’s worldview”, it reflects deep relational empathy.
In the studies so far listening to presenters on the panel discussion, it seems that therapists who are competent in psychedelic-assisted therapy have this kind of deep empathy and awareness of the world view encircling them. Moreover, the ability to step out of it when with a patient, and step into altered- states, and an awareness of interconnectedness between us all.
Running parallel my career was my personal life – fourteen years of coercive control in my marriage. In the REBUS theory lecture I thought about what it was that I suppressed in order to live in that world. To survive I severed my mind from my body. I had to ignore its constant warnings, the fight or flight of a sympathetic nervous system in hyperdrive. Reconnecting the two is ongoing work, I found somatic therapy, massage, meditation, and freediving essential. They remain on my self-improvement list, alongside breathwork, yoga, shadow work, and gratitude. Each helps rebuild trust within myself — a prerequisite to offering it to others.
Anaïs Nin reminds us that we never see things “as they are”, only as we are. My journey through medicine, psychiatry, Yolngu Country, complementary practices, and personal challenge has shown me just how true this is. Things are as we are because we are experiencing being human. What began as an academic curiosity about consciousness has become a lived exploration of altered states, trauma, healing, and interconnectedness.
The six PAT competencies are threads woven through my career and life. Empathy, presence, trust, spiritual intelligence, knowledge, integrity, complementary techniques — each has grown in me through both practice and trial. I see no end to their exploration and growth; their journey has no destination.
Focusing on their growth now they will prepare me for this next step: to work with consciousness in its most profound and transformative forms, through altered psychedelic states.
This essay was written by Molly Lena as part of Mind Medicine Australia’s Certificate in Psychedelic-Assisted Therapies (CPAT). Learn more about CPAT.
