The Journey of 1,000 Miles: Hallucinogen-Assisted Psychotherapy for Trauma

In 2006 I made my personal discovery of local treasure Michael Pollan, courtesy of Terry Gross, the voice and brains behind National Public Radio’s iconic program “Fresh Air.” The dean of UC Berkeley’s School of Journalism, Pollan was already a prolific writer, but my first encounter with him was through his then new Omnivore’s Dilemma which has since become perhaps my favorite book of all time. It is a book about food (admittedly one of my favorite subjects!) but presented comprehensively including anthropology, history, culture and ethnicity, religion, nutrition, agriculture, ethics, psychology, art and science, wow! and even written skillfully with a poetic hand. I was stunned. And also amazed that for a bookworm like me, I had a rare if not first experience, of having one book actually significantly alter my view of more than one thing. I remember when I joined the throng of attendees at a (then free of charge!) public reading in the basement of Grace Cathedral early on a Sunday morning. I lined up with everyone else to have (an additional copy of) my book signed, I told Pollan, as I shook his hand, “You are perhaps the first author I have ever encountered in all of my bookworm years, who can actually change my mind!” Those words “Changing Our Minds,” later became part of my professional logo. Of course I loved it when his 2018 blockbuster came out, and with the title How to Change Your Mind. He of all people would know.

In 2018, my husband and I drove 50 miles each way and paid $20.00 a ticket for the reading. Still we were lucky to get a parking space and two seats together. The crowd was mostly boomers, veterans of the Timothy Leary and Alan Watts generation, some accompanied by a subsequent generation or two. The topic of the book was evolving and expanding field of hallucinogenic substances. As ever, Pollan’s writing is exquisitely personal, a style I find compelling, believable and inspiring. As with sourdough baking, home brewing, and even hunting, Pollan’s first research subject was himself. He had the guts not only to experiment at the edges of the laws surrounding controlled and illegal substances, but to write about them.

Later that same year, I read somewhere that Daniel Siegel, the renowned attachment neuroscience researcher, infant psychiatrist cum Buddhist practitioner and teacher of mindfulness meditation, was studying the use of hallucinogens to address end of life issues. Perhaps most importantly, however, I found that Bessel van der Kolk, the North Star of my professional career was featuring at his annual Trauma Conference, my decades long go-to for cutting edge next steps in professional practice, full day workshops about the latest research in the use of psychedelics in the treatment of PTSD.

Although I was no stranger to altering my own state, as many of us struggling to tame wildly dis-regulated nervous systems, I quit everything in 1983 and became a grateful, sober endurance athlete. Considering these substances as a possible accelerated vehicle for healing, was mind expanding in itself. Attending that first workshop, although I had already read Pollan’s book, was inspiring to say the least. Most significantly because seeing the video presentations of Iraq war veterans before and after a series of guided sessions using MDMA, and observing the transformation, was like watching the old time-lapse photography films where a caterpillar morphs into a butterfly in a period of moments before my very eyes. Sadly I recalled the one year, fresh out of graduate school, that I worked at the San Francisco VA. Back in the early 80’s when we barely had a name for PTSD, let alone effective treatments, veterans of the Vietnam war suffered in their own personal never-ending war. Many of them looped in a revolving door-like cycle, in and out of the hospital, carefully not improving too much and having their benefit payments cut. The young men and women in the MDMA trials, in the mind-blowing videos, would most certainly go on to have lives and families, purposeful work and joy.

Since that first workshop I have attended the subsequent three including the virtual one during the Pandemic year. The progress in research and also FDA approval trials, is exciting. Psilocybin (magic mushrooms) LSD and Ketamine, are all also being carefully researched, including a to me local study, led by UCSF Nurse Practitioner Andrew Penn, on the use of Psilocybin for treatment- resistant depression. Ketamine is now fully legal for use as a prescription medicine. And MDMA is edging up on approval for prescribed use for PTSD, with luck in the next year or so.

None of these medicines are or will be “stand-alone” treatments. All are to be administered by a trained, skilled and licensed health or mental health care provider. The treatment is defined and described as, for example, “MDMA Assisted Psychotherapy.” Psychotherapy is the treatment, the medicines are components of said treatment, or “assistants” to the clinician. Similarly the clinician “assists” the journeying client. Training programs for how to assist are popping up like mushrooms in graduate programs around the country. I know in my area, they are exclusive and in high demand. Scoring a spot to even learn to be a guide, is growing to be increasingly competitive. I am cautiously optimistic and enthused by that, because it may mean the seriousness of the students, and thus growing public acceptance of the modality.

I do not see myself becoming a guide, much as I would love being able to add this remarkable treatment option to my armamentarium. The great task of the guide, apart from carefully crafted and executed pre and post psychotherapy sessions, is to be impeccably present. The guide might sit quietly for much of the six-hour journey, gently tracking, making observational notes and writing down whatever few words the client might say. In all candor I would have to say, I am not so good at the sitting quietly part, being much more inclined to interaction and reciprocity in my work. Thankfully there are already a number that are, some of whom have studied and trained with the true experts, indigenous people of both the US, and countries south of our borders. I am finding them and connecting with them so I will be well prepared with information and referrals.

I remember when I first heard about the Concorde jet, which could fly from New York City to London in 2 hours, 52 minutes and 59 seconds. For one who is not so good at sitting quietly for any length of time, that sounded beyond imagination. The work with hallucinogens may be the next “Concorde jet for PTSD, Developmental Trauma and Neglect!” I am hopeful! Meanwhile, Pollan has another brand new book: This Is Your Mind on Plants. In his inimitable style he expounds on his personal and then scientific explorations of Opium, Caffeine and Mescalin. Another highly recommended read. Happy Trails!

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” is out now. It  provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

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