Consciousness expansion for the masses

Therapy

Do the public care about therapy with their infusion? They do when trips get intense

From ‘K Hole’ by Ted Vasin

Veronika Gold has a front row seat at the new psychedelic healthcare reality.

The family psychologist worked on ketamine treatments at Cleveland’s New Pathways before heading to SF, training with MAPS and co-founding Polaris Insights.

Unsurprisingly, when psychedelics hit the general public it can get quite messy. Never mind your neighbours falling down the K-hole – can you explain that it’s only ego death and it’ll be alright soon? (Encounters with Anne Shulgin’s (RiP) ‘death door’ may be more complex).

“Even if you don’t agree with areas of psychedelic therapy, like the re-living the birth process and perinatal matrices, they can come up in patients. We’ve had girls go through that process,” says Veronica, who’s KAP program has been honed by what she sees in her treatment rooms each working day.

Accompanying psychotherapy for ketamine treatment is not covered by US insurance policies, as things stand. Over here in the UK its benefits aren’t exactly stressed by, for example, London’s Safe Minds. Besides haven’t we all gone round in circles with our psychotherapists enough by now?

“Patients might struggle with things coming up that conflict with their established beliefs”

Compass Pathways exec, psychiatrist and ketamine veteran Dr Steve Levine, who’s treated over 6,000 people with 60,000 infusions, urges caution over ketamine’s efficiency without therapy, and shakes his head over standards on the off-label scene. One Vital student who tried out their local K-clinic said he was very much left to his own devices. “It didn't necessarily engage in what I would consider best practices, preparation and integration, stuff like that,” he tells Veronika in her Vital lecture Q&A, “During the higher doses, I would get lost. I wouldn't know where it was, what was going on, or I just didn't have any sort of focal point, even with the music.”

A study group fellow on a series of ketamine treatments tells me anecdotally, “You get what you pay for.” Veronika is of course appalled at rookies being left alone in drab treatment rooms. Attention is important for first-timers especially, she says. 

Most of all Veronica’s own Ketamine Assisted Therapy (KAP) program stresses flexibility. “The medicine may be too much for psychedelic therapy where they process internally, so you lower the dose and try a psycolitic approach with talk therapy while they are under a lighter influence. Or the patient could pull back from a shamanic experience where they confront the trauma, to discuss insights on a transpersonal level. They might struggle with that as things are coming up that conflict with their established beliefs.”

It seems clinic staff need to stay light on their feet.

“It was exciting to see that for some people, home treatment worked better”

And, prepared.

“We have a long intake questionnaire, we as well ask about trans-generation trauma, we ask about their birth process, we ask about you know relationships in their life, we're asking about religious and spiritual history, discuss how they may want to be held,” says Veronika. Screening patients is key to unproductively disturbing scenes. “We have though, had referrals asking for the medicinal treatment alone who’ve had a difficult time and needed attention,” she warns. 

“We see people moving a lot, kicking, pushing, shaking off trauma physically,” says Veronika, “patients subconsciously feel more able to do this when they‘re not connected to the IV, so switching administrations can be useful too.”

If the unwashed masses crashing down main street on K wasn’t concerning enough, moral guardians gasped when the pandemic struck and ketamine therapy was offered… via Zoom.

“We weren't sure how it's how it's going to work,” says Veronika, “it was really exciting to see that for some people it worked better. They didn't have to end the session at the three hour mark, get everything together to leave the clinic, have somebody pick them up or take a ride home. They were able to stay in their space.” Sounds groovy.

Vital student and first responder Kelli Ann Dumas, who talks about her own ketamine treatment experience elsewhere in this issue of the unofficial Vital Student Zine took her later lozenges accompanied only by her two terriers, snug in her beloved RV surrounded by Louisiana woodland. She thinks it wouldn’t have been as effective without applying her own self-healing skills, which range from to participation in ayahuasca ceremonies to frontline trauma counselling work and a transpersonal psychology qualification. 

“Pulling into the observing ego was my benefit,” says Kelli, “I’ve learned how to access an observing space, but that’s through years of yoga, meditation and eastern studies. Plus from my career I have advanced skills in narrative therapy. I don’t think someone without access to those would have as effective an experience.”

Psychedelic overground

Space

Rugby lads on ibogaine, reality stars in hyperreality and tarot cards swapped for toys. Turns out the revolution will be fun

Inevitably, models gather in St Tropez for a charity fundraiser hosted by Christian Angermeyer’s Aurora Institute

With celebs like Sharon Osborn extolling the virtues of ketamine therapy get ready for the neighbourhood popping their heads through the door of your clinic.

The psychedelic renaissance has flowed beyond the dinner party circuit on to the high street. Ketamine treatment is even more of a talking point than the toad thing. KAP got a shout out from UK TV’s Loose Women co-host Frankie Bridge (the striking one out of The Saturdays who had short hair) and Hello! mag went large.

Dr Leary’s orbiting urn would spin at an angle that defied conventional physics to see trite psychedelic lifestyle design clichés replaced by… trite lifestyle design clichés.

Sports stars have been hot on their daytime TV counterparts’ heels: gridiron megastar Aaron Rogers puts a late career surge down to ayahuasca and other football players extol psychedelic healing for concussion and stubborn injuries. Combat sports are beloved of thugs but played by gentlemen so being miles ahead doesn’t count.

Even the middle market are getting out there. Gen-X footwear designer Patrick Cox spoke about his new life as an Ibizan 5-MEO DMT facilitator to Hadley Freeman in The Guardian this summer. Ever intrepid, Freeman ‘smoked toad’ [sic] despite her editor’s express instructions.

A Vital study group chum undergoing ketamine therapy recently declared that sock puppets had been added to her clinic’s table of tripping props (with the spirit animal cards and crystals). She spent the session happily playing with them. 

Maybe this doesn’t sound ‘mystical’ enough to those of us with well-thumbed copies of The Tibetan Book of the Dead. 

Chatting away to the guides during the medicine experience, or wanting to go outside, can be a distraction from the work you’re there to do apparently. After you’ve come down you could be disappointed you didn’t get any of that done. I don’t disagree that it could feel like a waste of time for all concerned.

“Wit is the ability to find hidden similarities linking two ideas which are contrasted with each other”

But on psychedelics ‘what comes up, comes up’ to use the platitudinous truism. TV’s Dr Bill Richards, the veteran John Hopkins’ researcher featured in Netflix’s How to Change Your Mind said laughter “May be what’s needed” in his own Vital lecture.

I rubbished Freudian psychoanalysis in issue #11 by ranting about how the only therapeutic system that’s been established as ‘fact’ for 100 years has poisoned our intellectual conversation and our mental healing.

Turns out Freud wrote about the importance of humour in 1905’s The Joke and its Relation to the Unconscious. Before putting pen to paper he took the opportunity to discuss the subject with hilarious cards from his Viennese social whirl.  The many positive conclusions included, ‘Wit is the ability to… find hidden similarities… linking two ideas which in some way are contrasted with each other.’

Laughter is the yang of meditative, non-dual understanding’s yin. The unconscious plays a leading role both in devising clever quips and responding to them in real time, without conscious analysis. On top of healing relational trauma, laughter and play in adults are also ‘positively correlated’ with increased sociability, spontaneity, tension release, innovation, de-stressing, longevity, immunity, energy levels, teamwork and parasympathetic nervous system activation. 

“Whether I was crying or laughing, was not too important”

And never mind the cave paintings, because psychedelics gave us jokes. The 2021 research paper Psychedelics, Sociality, and Human Evolution says, ‘In particular, the interpersonal and prosocial effects of psilocybin may have mediated the expansion of social bonding mechanisms such as laughter, music, storytelling, and religion.’ 

LSDExperience.com a compendium of the finest, trip writing includes this anonymous quote: “Whether I was crying or laughing was really not too important, except on the conventional level. The important point was that the tree of my emotions was being vigorously shaken and liberated of some withered leaves which had hung on too long.”

Spiritual emergencies, fearful reactions, and sudden life changes are likely to be of more concern for ketamine entrepreneurs and therapists than the number of mystical versus humorous experiences per week going down in their clinic. But not for nothing does the Bible call humour ‘the best medicine.’ It could be comparable to spirituality, or philosophy for coming to terms with complex and contrasting themes.

At dinner, or on the high street.

It’s legislators who seem out on the fringes now.

MDMA Assisted Therapy with Michael and Annie Mithoefer

My unofficial Vital Study Zine #12 with observations from Vital Psychedelic Training and recent happenings in the space

Jeremy Deller, ‘The Problem with Humans’ available here

Gotta love MAPS PBC, the Multi-Disciplinary Association for Psychedelic Studies Public Benefit Corporation.

An MDMA ban in 1984 inspired its founder Rick Doblin to somehow keep the flame alive. Decades later, in July 2022 a letter leaked to The Intercept’s Mattha Busby implied the Biden administration are stepping up for country-wide medicalisation of MDMA and psilocybin. MAPS expects legalisation in the USA by 2024.

MAPS is technically a ‘non-profit’ entity with a public benefit corporation bolted on. In June 2022 the MAPS C-suite was joined by Boston Consulting Group managing director Dan Grossman, and former Sandoz CEO Jeff George a managing partner at VC fund Maytal Capital, boardroom heavy hitters both. The ‘extractive’ big pharma model is under challenge, it seems, from empowered non-profits like MAPS and in the UK, Amanda Fielding’s Beckley PsyTech. 

“We facilitated out first Grof holotropic breathwork session where Vital is based near Vermont, with Vital’s patrons Lenny and Elizabeth Gibson”

MAPS will be distributing its radical new treatment program, including its accompanying talk therapy, ‘MDMA-AT’, for free. MDMA-AT has obtained a ‘special protocol’ from the FDA so it does not need to be revised before MDMA itself is available legally. That’s an incredible achievement for the veteran healers who devised, wrote and guided it to American federal approval, Vital Week 12 lecturers Michael and Annie Mithoefer.

The young Dr Michael Mithoefer was up to his scrubs in gore for ten years as medical director at the emergency departments of Charleston County and Georgetown County hospitals, North Carolina. He turned to psychiatry in 1991. The trauma specialist is trained in Internal Family Systems, EMDR and Grof Holotropic Breathwork. His wife and dyad partner Annie is a certified nurse and Hakomi therapist who’s also Groffed-up. The two have worked for MAPS since the early 2000s and are also on the advisory board of Bristol’s AWAKN; they’ve been to Ben Sessa’s house in Somerset. Check it out:

Awakn’s Ben Sessa hosts the Mithoefers in Somerset, England

“We facilitated out first Grof holotropic breathwork session where Vital is based near Vermont, with Lenny and Elizabeth Gibson who can’t be a hundred feet away from the offices right now, so there’s symmetry there,” said Dr Mithoefer to open the eight hours of workshops he and Annie graciously provided for Vital students.

Here’s the Mithoefers on Psychedelics Today’s podcast, and on Aubrey Marcus for the bros. More on the New Psychonaut YouTube channel. And here’s this issue:

Next issue: Ketamine therapy thought-leader Veronika Gold direct from her bustling Polaris Insights clinic in San Francisco

Drugs are the Love

Space

MDMA for couples' therapy: 4/4 octopuses can’t be wrong

Ithell Colquhoun, ‘Song of Songs’ via Unit London

Can the inner healer mend a broken relationship?

Next up for MAPS therapy program designers Dr Michael Meithofer and his wife Annie AKA ‘Annie and Michael’ in spacespeak, is MDMA for couples’ counselling.

“We knew that MDMA was useful for communication… and some of the other anecdotal things about it,” Annie told none other than Professor David Nutt on the Drug Science podcast (where you can hear Dr Nutt, the David Attenborough of drugs, a UK national treasure say ‘Back to the show!’)

Annie collaborated on the initial research for a new era in MDMA couples’ therapy with Toronto’s Dr Anne Wagner. The Remedy clinic director has come up during further investigations into juicy subjects two weeks in a row (sync). Last week it was in a call for further research into psychedelic treatment for borderline personality disorder (BPD).

Yet Dr Wagner is not the only intrepid sailor of the soul cooking up excellent experiments using ecstasy. John Hopkins’ university neuroscience department, not to be outdone, gave E to octopuses. They’d noticed ‘that octopuses and humans had nearly identical genomic codes for the transporter that binds the neurotransmitter serotonin to the neuron's membrane.’

The California double-spot octopus is a solitary creature, barely interacting with others of its kind besides once a year, briefly, for mating. Even then the male uses a sex arm and it looks like mid-air refuelling. 

Would you believe though, that when researchers put the octopuses ‘in a beaker containing a liquified version of the drug’ according to National Geographic, they exhibited significantly more social behaviour?

‘Particularly telling, said scientist Gul Dolen, was that after being returned to their tanks at Woods Hole Oceanographic Institute in Massachusetts, the octopuses went on to reproduce.’ 

During the Q&A after Annie and Michael’s lecture the pair were asked about giving MDMA to animals. After all, dogs are given anti-depressants. When I got my own chance to talk to them, I celebrated group ceremonial use of the ecstasy sacrament in the form of our rave culture then made a bad taste joke about giving MDMA to our pets hadn’t gone nearly as well. Now we know to shove them in a beaker of it.

’At no point did the octopuses ink, which would be a sign of stress,’ Dr Dolan told Nat Geo in response to all of our ethical concerns. 

Inner space of safety

Medical

MDMA boasts striking therapeutic properties beyond increased connection

Chemical X, ‘Spectrum’

“I believe MDMA is the ideal drug for psychotherapy,” says non-nonsense Awakn founder and trauma expert Dr Ben Sessa.

The exciting bits are MDMA triggers a ‘oxytocin-dependent reopening’ of a ‘social reward learning critical period’. It puts your brain in the state of early childhood and adolescence, when it establishes key neural pathways. The hypothesis is that dysfunctional thought patterns can be adjusted in this state.

MDMA increases pre-frontal cortex activity like an ADHD stimulant, lowers activity in the amygdala ‘fear centre’ deep in the reptile brain, and is notable for its relationship to both dopamine and serotonin. It creates an ‘optimal level of arousal’ that is neither too little nor too much for the brain to process its thoughts and instincts. 

Added neuroplasticity helps memories reconsolidate so patients feel safer in safe settings, for example. MDMA scored strongly on PTSD patients with dissociative symptoms who often prove the toughest to treat. Trial data was consistent across the five test sites spread globally. 

Ecstasy was first named ‘Adam’ then ‘Empathy’

Trial subjects previously suffered severe symptoms that had resisted regular therapeutic treatment for many years.

‘MDMA was invented for shellshocked soldiers’ is a trope I may be guilty of falling for. It wasn’t an appetite suppressant either when patented by Merck in 1914. Forensic research into the German pharmaceutical firm suggests a humbler origins for the love drug as merely a stepping-stone towards developing an alternative to hydrastinine, used to prevent internal bleeding particularly in the uterus.

The military nonetheless had it knocking around for whatever reason in the 1950s around the first time scientists tested MDMA on humans and recorded the results. These soon reached the keen ears of Alexander Shulgin, who says he first synthesised it in 1965. It was originally named ‘Adam’, and also ‘Empathy’. 

Patients during MDMA-AT are given 125mg of what the subculture renamed ‘ecstasy’ with up to 75mg of booster. Apocryphally, a friend who took part in an Imperial MDMA trial said it was hella strong.

Psilocybin for depression with Ashleigh Murphy-Beiner

My unofficial Vital Study Zine #11 with observations from Vital Psychedelic Training and recent happenings in the space

‘White Light’ from Paul Cocksedge Studio

“We have really explicit conversations about sex, about violence, about death and ego death…”

Plus of course, “Paranoia, wanting to go to the toilet, feeling like you're going to the toilet, and the physical bodily experiences,” says Ashley Murphy-Beiner, psychologist and guide at Imperial College’s landmark ‘PsiloDep 2’ trial, which sounds suitably like a Quatermass movie.

Ashleigh Murphy-Beiner is exactly the sort of impressive individual driving the psychedelic renaissance: a mediation coach and Peruvian ceremony facilitator alongside her studies at Imperial College London, she’s noted for her research on ayahuasca for treating depression too. She’s talking about preparing psychedelic novices for their first trip on synthetic psilocybin, the active ingredient in old-fashioned magic mushrooms. It’s used mostly due to stigma around LSD.

“We let them know we’re not going to judge them on anything weird… although they’re not going to do anything like that, because mainly they're worried it’ll really embarrass them or, or cause shame,” she continues, giving a window into life with depression.

Depression is a ‘global burden’. The main cause of disability and the number one reason for taking time off work affects a quarter of a billion people worldwide, and more in The West. One in six Brits are on anti-depressants, and US figures rose by up to 30% during the COVID-19 crisis. Doomongers will be pleased to know there are plenty more sad stats in this week’s ‘zine.

Imperial College psychologist, meditation coach and ayahuasca advocate Asheligh Murphy-Beiner

Can psychedelics cure long term depression where talk therapy and medications failed? Although arguably still spectacular in comparison to existing treatment, results are frankly not as good as those for psychedelic studies on treating trauma, addiction, and end-of-life crisis. That’s partly because depression mostly remains a mystery, with the widely-accepted ‘serotonin imbalance’ theory recently publicly debunked. Ashleigh calls the causes “biopsychosocial” meaning there are biological, psychological and social implications. Many patients have come crashing down to Earth when faced with the cruel reality of life in late capitalism. Preparation and integration are absolutely essential, say trial patient advocates Ian Roullier and Leone Schneider of advocacy group PsyPAN. Dr Rosalind Watts created a treatment model, Acceptance, Connection and Embodiment to cover the ground between secular dystopian life and the psychedelic experience. 

Results of psilocybin for depression trials so far though are certainly optimistic compared to market anti-depressants. A major advantage is that psychedelic treatment opens up the mind, rather than numbing out all feelings, like current anti-depressants are said to. Opportunity and relish can once more be a part of depressive’s mindset. Plus they can dump their daily regime of equally barely-understood serotonin pills with side-effects like a plummeting libido. 

This is one subject for which there is certainly no silver bullet. Here’s Ashleigh talking about ayahuasca, and the ACE therapy model used at the trials with Dr Ros, plus the ethics of the trials and therapy itself, and rounding up the trial results on the Chasing Consciousness podcast, all of which you can see on the New Psychonaut YouTube channel.

This week’s topics arranged along Vital’s core learning pillars are below.

Next issue: MAPS MDMA-AT program designers Michael and Annie Mithoefer.

Freud is dead

Therapy

‘ACE’ is a new therapeutic approach devised by Drs Ros and Richards, with inspo from Stan Grof

‘Icosahedron’ by Anthony James from Unit London

Freud is Dead. And we have killed him.

My loose understanding of the gossip in the ivory towers of psychology is that Freudian psychoanalysis maintains an iron grip on legitimacy. 

This seems to have crumbled almost overnight like empires do. Psychoanalysis’ spiritual home The Tavistock Clinic has been rocked by scandal. And Imperial College didn’t use psychoanalysis as such in PsiloDep 2. Because it’s only been an initial part of psychedelic therapy as documented by Stanislav Grof. 

Indeed Grof’s former colleague, TV’s Dr Bill Richards who’s still kicking it himself at John Hopkins (and on Netflix) advised on Acceptance, Connection and Embodiment (ACE) therapy, the model applied by Imperial College in its landmark trials testing psilocybin against a market SSRI anti-depressant.

“The trials followed a standard psychedelic psychedelic therapy format: preparation, the high dose, and then integration alongside an Acceptance and Commitment Therapy [ACT] adapted model,” relays Ashleigh. 

ACT is a kind-of proactive mindfulness to encourage ‘psychological flexibility’ an adaptive mindset resilient to stressful events. The psychological flexibility model or PFM is referred to in the title of Dr Ros’ stealth bomber of a paper, The use of the psychological flexibility model to support psychedelic assisted therapy which points out the approach is in use in trials at NYU and Yale, too.

And guess what? Everyone prefers it to being told stuff in the past they were doing their best to forget has ruined both their present and future, so it’s going to cost them £200 a week. Plus, ACT’s explanatory infographic is a freaking icosahedron, the sacred geometric form that’s like a 20-sided Dungeons & Dragons dice.

Acceptance and commitment therapy’s ‘hexaflex’ graph

ACT is empirically proven in all of these tests we’re beginning to think will be endless, and approved by EG the NHS.

“It's a very complex experience that people are going through. So we're using lots of different influences”

But because ACT’s not Freudian analysis, it gets crap from the old guard. Seems like nobody cares what they think any more, though, because their way hasn’t worked, except for them. And they gave kids gender reassignment.

That’s not all. “As clinicians, we were drawing on a lot of different psychological theories to support people because it's a very complex experience that people are going through. So we're using lots of different influences,” says Ashleigh.

ACE is Dr Rosalind ‘Ros’ Watts’ remix of ACT. It even has P-ACE (for preparation) and I-ACE (for integration). It includes aspects of polyvagal theory, lived experience and non-dual thinking to name but two.

And there’s even deferral to the inner healer or ‘homeostatic instinct’ to give it its new scientific name in ACE. Metaphors employed for the healing process include ‘diving for pearls’ illustrated by specially prepared visualisers. Plus, let’s not forget, a new ambient John Hopkins’ LP bespoke-made for the trials.

“We're asking people to open up to emotional pain at a pace they may never have experienced”

Stan Grof says psychoanalysis was useful for the earliest stages of treating in-patients, but soon gave way to even more fundamental realms of the psyche – and body – that required knowledge not only of cutting-edge thinkers.

“I wonder how possible it is to grasp”

He names William Reich for perinatal matrix III when the body spasms start (not seen many of those on the course yet) and Jung in his Red Book days, but the ‘transpersonal’ (IE weird), plus theology, literature and philosophy too.

“We invite them to tap into a sense that there may be wisdom and guidance to be learned from emotional pain, and difficult experiences in life,” says Ashleigh. There’s practical considerations that don’t come up in that room your therapist has in Finsbury Park with the knitted throws and knackered dreamcatcher on the ceiling.

“We're asking people to open up to emotional pain, to an extent, and at a pace they may never have experienced before,” says Ashleigh, “I wonder how possible it is to grasp. We wrangled over what we tell people beforehand, so they can make an ethical and informed decision about taking part in a treatment like this.”

‘Must we ourselves become gods simply to appear worthy of it?’ opined Nietzsche upon his most famous line, ‘God is dead.’ The firebrand philosopher meant a sense of shared, guiding ideology rather than the monotheistic biblical concept of God.

He was mostly right, because us stupid normies did come up with a new God – science. The bits of that which considered our relationships to each other, so the only ones that counted, originated from Sigmund Freud, and Richard Dawkins via Charles Darwin.

The new anti-religion preached a mirror image of historical spirituality: humans were essentially chimpanzees, except cleverer, so even more unpleasant to each other.

Arts, achievement, compassion, shared laughter… all just tactics in the game to get ahead. Beneath it all we were just throwing our turds at each other, and pretending not to enjoy getting screwed by the alpha male.

Who hasn’t been seduced by this perverse science at some point? Especially on cocaine, like Sigmund Freud was half the time. 

Eventually though it gets… depressing.