Resources
Below you will find multiple topics of interest regarding psychoactive plant medicines and entheogens. Each section includes videos and/or summarized or copied articles that may expand your foundation of knowledge about psilocybin and MDMA. Unfortunately, due to the FDA Advisory Committee, MDMA is not currently being considered for legalized treatment. Until the FDA approves MDMA as a New Drug, it is only being legally administered in studies at the VA and possibly private research institutions or universities.
It’s always a good idea to learn what you can before exploring Psychedelic-Assisted Therapy with a Licensed Psychedelic Facilitator. I believe this information is evidence-based and most of it explains complex situations simply. It will be updated regularly.
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There are two videos in this section. The first one is 31 minutes long from Bioneers. It provides an entertaining introduction to the psychedelic renaissance featuring Michael Pollan, the author of several books, including How to Change Your Mind.
https://www.youtube.com/watch?v=5DrM90dg5t4&ab_channel=Bioneers
The second video is 54 minutes long and is a comprehensive introduction to psychedelics from NOVA. It provides great footage of the history and use in indigenous cultures, information about brain anatomy and several examples of how psilocybin has produced positive effects in Alcohol Use Disorder (AUD); depression and anxiety in terminally ill cancer patients; and PTSD.
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The latest video that explains an amazing study is from Chase Hughes: https://www.youtube.com/watch?v=lZ3_GUilpnk
A 2024 study about how psilocybin affects the brain are described in this NPR episode from 7.18.2024.
The study may be read here: https://www.nature.com/articles/s41586-024-07624-5.
Watch this 1 hour 25 minute video to hear Josh Woolley, MD, PhD discuss the current challenges and future prospects of psilocybin. He is a psychiatrist from the University of California and the Veteran’s Administration Hospital in San Francisco.
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There are two videos in this section that summarize using psilocybin for depression. Additionally there are summaries from RCTs about depression.
The first video is less than 14 minutes and features Dr Rosalind Watts. She completed her clinical psychology training at University College London. After six years of practicing psychotherapy in the NHS, she joined a clinical trial at Imperial College, investigating psilocybin (magic mushrooms) as a treatment for depression. The first study was 7 years ago. It explores patients’ positive experiences of psychedelic-assisted therapy. Dr. Watts has gone on to create the ACER Model of Integration Communities, which I plan to join and use during Integration Sessions.
https://www.youtube.com/watch?v=8kfGaVAXeMY&ab_channel=TEDxTalks
The second video is 1 hour and 20 minutes long. Watch it to learn more about how psilocybin can help with depression. It’s not only informative but also historical and contains personal stories of those who suffered from depression over a period of 2 years. They were participants of the first psilocybin clinical trial at Imperial College in London.
https://www.youtube.com/watch?v=_SbQeZEubv8&ab_channel=BestDocumentary
To read a 2024 systematic review on the effects of psilocybin on depression, anxiety and suicidal ideation, review this article. I copied the Abstract below:
Objectives: The purpose of this systematic review of randomized controlled trials (RCTs) was to evaluate the effectiveness, safety, and tolerability of psilocybin in adult patients with major depressive disorder (MDD).
Methods: A systematic search (up to September 14, 2023) was conducted for RCTs that examined the efficacy, safety, and tolerability of psilocybin in physically healthy adult patients with MDD. Three independent researchers extracted data from publications where the primary outcome was a change in depressive symptoms, and key secondary outcomes were changes in anxiety symptoms and suicidal ideation, discontinuation rates for any reason, and adverse drug reactions (ADRs).
Results: Five RCTs with 472 adult patients with MDD on psilocybin (n = 274) and controls (n = 198) were included. Two of the five RCTs (40%) reported mixed results, while the other three (60%) found that psilocybin had a beneficial effect on MDD treatment. Four RCTs (80%) assessing the anxiolytic effects of psilocybin for treating MDD found that psilocybin was significantly more effective than the control group in improving anxiety symptoms. Psilocybin was more effective than the control group in improving suicidal ideation in one out of five RCTs. Discontinuation rates were similar for any reason between the psilocybin group (2–13%) and the control group (4–21%) (P > 0.05). Four RCTs (80%) reported ADRs in detail. The most common ADR in both groups was headache.
Conclusion: Psilocybin was effective in improving depressive symptoms in over half of the included studies and reduced anxiety symptoms in patients with MDD. The long-term efficacy and safety of psilocybin for MDD treatment needs to be further investigated in large RCTs.
The five RCTs studied for depression used either 25mg or 30mg of psilocybin in either a single dose or 2 doses 3 weeks apart. The length of time that the effects were measured ranged from 3 weeks to 8 weeks.
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1416420/full
Major Depressive Disorder (MDD)
Multiple randomized trials have demonstrated rapid and clinically meaningful antidepressant effects in adults with moderate-to-severe depression.
Significant reductions in depression severity.
Effects often appear within days.
Benefits may persist for months.
References
Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., ... & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry, 78(5), 481-489.
Raison, C. L., Sanacora, G., Woolley, J., Heinzerling, K., et al. (2023). Single-dose psilocybin treatment for major depressive disorder: A randomized clinical trial. JAMA, 330(9), 843-853.
Davis, A. K., et al. (2023). Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up. Journal of Psychopharmacology, 37(5), 479-488. (Follow-up study)
Treatment-Resistant Depression (TRD)
Patients who had not responded to prior antidepressant treatments showed substantial improvements in depressive symptoms.
Key Findings
Rapid symptom reduction.
Some participants achieved remission.
Psilocybin showed at least comparable or greater improvements than standard antidepressant treatment in some trials.
References
Carhart-Harris, R. L., Giribaldi, B., Watts, R., Baker-Jones, M., Murphy-Beiner, A., Murphy, R., ... & Nutt, D. J. (2021). Trial of psilocybin versus escitalopram for depression. The New England Journal of Medicine, 384(15), 1402-1411.
Depression in Frontline Healthcare Workers with Burnout
Larger reductions in depressive symptoms when used with mindfulness
Improvements in emotional exhaustion and demoralization.
No serious adverse events.
References
Stauffer, C. S., et al. (2025). Psilocybin-assisted group psychotherapy plus mindfulness-based stress reduction for frontline healthcare provider COVID-19-related depression and burnout: A randomized clinical trial. Journal of Psychopharmacology.
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There are two videos in this section. and a summary and list of references from RCTs.
The first one is a 17 minute video from TedXMarin. Anthony P. Bossis, MD, PhD, discusses the use of psilocybin for end of life anxiety. He is a respected and well-known FDA-approved researcher at NYU.
https://www.youtube.com/watch?v=U561dQIe6c4&ab_channel=TEDxTalks
In the second video, Anderson Cooper introduced psychedelic assisted therapy on CBS in 2020. Watch the full episode here:
If the above link doesn’t open easily, go to this link and scroll down to WATCH THE FULL EPISODE HERE.
https://psychedelicalpha.com/news/cbs-60-minutes-brings-psychedelic-medicine-to-the-masses
Patients with life-threatening cancer diagnoses experienced rapid and sustained reductions in anxiety, depression, hopelessness, and fear of death.
Large decreases in anxiety and depressive symptoms.
Improved spiritual well-being and quality of life.
Benefits often lasted 6 months or longer.
References
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.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., ... & Schmidt, B. L. (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.
Agin-Liebes, G., Malone, T., Yalch, M. M., et al. (2020). Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in cancer patients. Journal of Psychopharmacology, 34(2), 155-166. (Follow-up study)
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Watch this 1 hour 15 minute video from Aaron Eisen of the Portland Psychedelic Society recorded in 2020.
It covers microdosing of the most readily available psychedelics. While this video only uses information from peer-reviewed sources, there are no double-blind, placebo controlled, randomized trials about microdosing. What that means is that there is no real scientific proof that microdosing has positive effects. However, many people microdose and their anecdotal reports are mostly positive.
https://www.youtube.com/watch?v=yBJWRxIisto&t=1626s&ab_channel=PortlandPsychedelicSociety
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There are two videos in this section.
Watch this 8 minute video for a brief presentation by Dr. Bessel van der Kolk about what trauma does to your brain and body. He is the renown author of The Body Keep the Score published in 2014.
https://www.youtube.com/watch?v=ZKa7V_mV8l8&ab_channel=TheWell
This 11 minute video from TedX Academy features Daisy Peyton’s personal account of PTSD. Her easy to understand explanation of the neurobiology of PTSD. She is in the PhD program at UCSF studying Neuroscience and Psychology.
https://www.youtube.com/watch?v=-BThqIwhqxA&ab_channel=TEDxTalks
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With the situation being uncertain from the new drug application for MDMA by MAPs, it’s reasonable to consider using psilocybin. There are studies that support this consideration. In 2013, a team from the University of South Florida showed that psilocybin led to fear extinction. The researchers found that conditioning of fear extinction may be mediated by actions of low dose psilocybin at sites other than hippocampus such as the amygdala, which is known to mediate the perception of fear. At the low doses of psilocybin that enhanced fear extinction, neurogenesis was not decreased, but rather tended toward an increase. However, the “low doses” used were not published. (1)
Fear conditioning (FC) and fear extinction models in animals can be used to study the biological underpinnings of fear-related disorders, such as PTSD.
Pavlov (1849–1936) first “described extinction as a phenomenon whereby repeated non-reinforced presentation of a conditioned stimulus led to the reduction in the magnitude of the conditioned response(s).” (2) In the case of fear extinction, the conditioned stimulus is typically a previously neutral stimulus that, through conditioning, has come to be associated with an aversive outcome, such that its occurrence alone is capable of eliciting some form(s) of a fear/anxiety/defensive conditioned response. (3)
What is fear extinction? Watch this 5 minute video that explains fear conditioning and fear extinction.
https://www.youtube.com/watch?v=FdulAtk9ES0
In a more recent animal study, A single dose of psilocybin (2.5 mg/kg) facilitated rapid and sustained fear extinction. The researchers believed “this effect might be partially mediated by the promotion of hippocampal neuroplasticity.” (4)
1) Catlow BJ, et al. Effects of psilocybin on hippocampal neurogenesis and extinction of trace fear conditioning. Exp Brain Res 2013; 228: 481–491.
2) Pavlov IP. Conditioned reflexes. London: Oxford UP; 1927.
3)Singewald N, Holmes A. Rodent models of impaired fear extinction. Psychopharmacology (Berl). 2019 Jan;236(1):21-32.
4) Du Y, et al. Psilocybin facilitates fear extinction in mice by promoting hippocampal neuroplasticity. Chin Med J (Engl). 2023 Dec 20;136(24):2983-2992.
The following section is a simplification and summary from:
Dodds C, et al. (2025). Novel psychedelic interventions for post-traumatic stress disorder and their promise for precision medicine. Ther AdvPsychopharmacol.15:20451253251396255.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12681608/
Psychedelic-assisted therapies are emerging as promising treatments for post-traumatic stress disorder (PTSD). Three of the most studied compounds—ketamine, MDMA, and psilocybin—have demonstrated significant reductions in PTSD symptoms over relatively short treatment periods because they can produce rapid therapeutic effects (Feder et al., 2014; Khan et al., 2022; Mithoefer et al., 2018). Researchers believe these benefits occur through unique biological mechanisms that promote neuroplasticity, the brain's ability to reorganize and form new neural connections (Lepow et al., 2021).
Psychedelic-assisted psychotherapy (PAP) combines these medications with structured psychotherapy. The altered states of consciousness produced by psychedelics may help individuals engage more deeply with traumatic memories and emotions, allowing therapeutic work that may otherwise be difficult to access (Elsouri et al., 2022; Lepow et al., 2021). Similar approaches have also demonstrated benefits in the treatment of depression and substance use disorders (Miceli McMillan & Jordens, 2022; Sloshower et al., 2023; Yaden et al., 2021). As evidence for the short-term safety and effectiveness of psychedelic treatments continues to grow, researchers are increasingly focused on understanding their long-term risks and benefits while also exploring ways to improve access to these therapies (Carmi et al., 2016; Lepow et al., 2021).
Psychedelics are sometimes referred to as "psychoplastogens" because they appear to enhance the brain's capacity for change and adaptation (Lepow et al., 2021; Reiff et al., 2020). This increase in neuroplasticity may help weaken maladaptive neural pathways that maintain PTSD symptoms while strengthening healthier patterns of thinking and emotional processing (Lepow et al., 2021; Reiff et al., 2020). The successful processing and extinction of traumatic memories depends on synaptic plasticity, the brain's ability to strengthen or weaken neural connections through processes such as long-term potentiation and long-term depression (He et al., 2018). Psychedelics appear to influence molecular signaling pathways involved in these processes, promoting the neural flexibility necessary for therapeutic change (Ling et al., 2022; Zanos & Gould, 2018). As a result, trauma-related beliefs and emotional responses that sustain PTSD may become more open to modification through psychotherapy.
Although psychedelics share the ability to alter consciousness, they differ substantially in their psychological effects and biological mechanisms.
Ketamine is classified as a dissociative because it can create a sense of detachment from thoughts, emotions, or the environment (Abdallah et al., 2022).
MDMA is considered an empathogen because it promotes feelings of social connection, trust, and emotional openness (Bedi et al., 2010; Nardou et al., 2023).
Classic psychedelics such as psilocybin and LSD are classified as hallucinogens because they primarily alter perception, cognition, and sensory experience (Yao et al., 2024). Researchers increasingly believe that these compounds do not work through a single shared biochemical pathway. Instead, they may converge on a common outcome: the activation of genetic and molecular processes that support neuroplasticity (Nardou et al., 2023).
The psychological effects produced by psychedelic medications may also increase a person's ability to engage in trauma-focused psychotherapy. Studies suggest that these altered states can enhance emotional tolerance and reduce avoidance of difficult material, potentially addressing one of the major challenges in PTSD treatment—the premature discontinuation of therapy (Carhart-Harris et al., 2014; Wells et al., 2023). Unlike currently approved PTSD medications, psychedelic treatments often produce rapid psychological effects and have demonstrated meaningful improvements in depression-related PTSD symptoms and treatment-resistant depression (Feder et al., 2014; Johnston et al., 2023; Khan et al., 2022; Mithoefer et al., 2018).
Psilocybin, the psychoactive compound found in certain mushrooms, has attracted considerable attention because of its effects on perception, emotions, and one's sense of reality (Lowe et al., 2021; Sharma et al., 2023). Depending on the dose, psilocybin may induce experiences such as altered time perception, sensory changes, and "ego dissolution," a temporary reduction in the sense of a separate self (Studerus et al., 2011). These profound subjective effects have led researchers to investigate its therapeutic potential for PTSD, depression, and substance use disorders (Carhart-Harris et al., 2016; Du et al., 2023; Khan et al., 2022; Sloshower et al., 2023; Yaden et al., 2021).
Although the exact mechanisms underlying psilocybin's therapeutic effects remain incompletely understood, current evidence suggests that it acts primarily through stimulation of serotonin receptors, particularly the 5-HT2A receptor. This activation appears to trigger downstream biological processes associated with neuroplasticity, including increased expression of brain-derived neurotrophic factor (BDNF) (Khan et al., 2022; Ling et al., 2022). BDNF plays a critical role in neuronal growth, synaptic remodeling, and learning. Researchers have noted that this mechanism may overlap with ketamine's proposed antidepressant pathway, which also appears to increase neuroplasticity through BDNF-related signaling (Zanos & Gould, 2018).
This overlap suggests that both compounds may promote healing by enhancing the brain's capacity to form new neural connections and revise entrenched patterns of thinking and behavior.
Despite growing interest in psilocybin as a PTSD treatment, no published clinical trials have yet directly evaluated its effectiveness for PTSD. However, substantial evidence supports its use for depression, both as a stand-alone treatment and when combined with psychotherapy.
In a Phase II clinical trial, Goodwin and colleagues (2022) found that psilocybin produced substantial dose-dependent reductions in depression symptoms that persisted for up to three weeks after treatment. However, higher doses were also associated with an increased frequency of adverse effects, including suicidal ideation, intentional self-injury, headaches, and nausea (Goodwin et al., 2022).
These findings highlight both the promise and the potential risks of psilocybin treatment and underscore the importance of further research using advanced methods such as neuroimaging to better understand its therapeutic mechanisms (Carhart-Harris et al., 2017).
In another Phase II study, Carhart-Harris and colleagues (2021) compared psilocybin directly with the SSRI escitalopram over a six-week treatment period. Although the two groups did not differ significantly on the primary measure of depression symptoms, several secondary outcomes favored psilocybin (Carhart-Harris et al., 2021). These results suggest that psilocybin may represent a viable alternative to conventional antidepressants, although larger and longer-duration studies are needed to confirm these findings.
Researchers have also suggested that careful screening, patient education, and a well-supported therapeutic environment can reduce the risk of adverse psychological reactions during psilocybin treatment (Carhart-Harris et al., 2016; Studerus et al., 2011).
Current research continues to explore whether psilocybin can be used safely and effectively for PTSD. While some investigators have expressed concern that the profound alterations in self-perception produced by psilocybin could worsen the sense of fragmentation sometimes experienced by trauma survivors (Whitfield, 2021), others suggest that these same experiences may facilitate healing by helping individuals process traumatic memories and develop new perspectives on their experiences (Calder et al., 2024).
Further research will be needed to determine the balance between these potential risks and benefits.
One thing that stood out to me from this paper is that the authors repeatedly return to a central idea that aligns closely with what I’ve been studying in psilocybin-assisted therapy: the therapeutic benefit may not come primarily from symptom suppression, but from reopening a critical period or “window of opportunity” of enhanced neuroplasticity during which psychotherapy, meaning-making, and integration can reshape trauma-related neural networks.
The authors describe psychedelics as "psychoplastogens" because they appear to create a temporary window in which entrenched trauma pathways become more flexible and responsive to corrective experiences.
References
Abdallah, C. G., Roache, J. D., Gueorguieva, R., Averill, C. L., Young-McCaughan, S., Shiroma, P. R., ... Krystal, J. H. (2022). Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: A double-blind, randomized, placebo-controlled multi-center clinical trial. Neuropsychopharmacology, 47(8), 1574–1581.
Bedi, G., Hyman, D., & de Wit, H. (2010). Is ecstasy an "empathogen"? Effects of ±3,4-methylenedioxymethamphetamine on prosocial feelings and identification of emotional states in others. Biological Psychiatry, 68(12), 1134–1140.
Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day, C. M. J., Erritzoe, D., Kaelen, M., ... Nutt, D. J. (2016). Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. The Lancet Psychiatry, 3(7), 619–627.
Carhart-Harris, R., Giribaldi, B., Watts, R., Baker-Jones, M., Murphy-Beiner, A., Murphy, R., ... Goodwin, G. M. (2021). Trial of psilocybin versus escitalopram for depression. New England Journal of Medicine, 384(15), 1402–1411.
Carhart-Harris, R. L., Roseman, L., Bolstridge, M., Demetriou, L., Pannekoek, J. N., Wall, M. B., ... Nutt, D. J. (2017). Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific Reports, 7, 13187.
Carhart-Harris, R. L., Wall, M. B., Erritzoe, D., Kaelen, M., Ferguson, B., De Meer, I., ... Nutt, D. J. (2014). The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories. International Journal of Neuropsychopharmacology, 17(4), 527–540.
Choi, C., Johnson, D. E., Chen-Li, D., Olson, D. E., & Gerecke, K. M. (2024). Mechanisms of psilocybin on the treatment of posttraumatic stress disorder. Journal of Psychopharmacology.
Du, Y., Li, Y., Zhao, X., Wang, Y., Chen, X., & Li, Y. (2023). Psilocybin facilitates fear extinction in mice by promoting hippocampal neuroplasticity. Chinese Medical Journal, 136(24), 2983–2992.
Elsouri, K. N., Kalhori, S., Colunge, D., & Stokes, P. R. A. (2022). Psychoactive drugs in the management of post traumatic stress disorder: A promising new horizon. Cureus, 14(5), e25235.
Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., ... Charney, D. S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 71(6), 681–688.
Goodwin, G. M., Aaronson, S. T., Alvarez, O., Arden, P. C., Baker, A., Bennett, J. C., ... Malievskaia, E. (2022). Single-dose psilocybin for a treatment-resistant episode of major depression. New England Journal of Medicine, 387(18), 1637–1648.
He, M., Wei, J. X., Mao, M., Wu, H., Jin, M., & Xu, Y. (2018). Synaptic plasticity in PTSD and associated comorbidities: The function and mechanism for diagnostics and therapy. Current Pharmaceutical Design, 24(34), 4051–4059.
Johnston, J. N., Kadriu, B., Allen, J., Henter, I. D., Zarate, C. A., & Murrough, J. W. (2023). Ketamine and serotonergic psychedelics: An update on the mechanisms and biosignatures underlying rapid-acting antidepressant treatment. Neuropharmacology, 226, 109422.
Khan, A. J., Bradley, E., O'Donovan, A., et al. (2022). Psilocybin for trauma-related disorders. Current Topics in Behavioral Neurosciences, 56, 319–332.
Lepow, L., Morishita, H., & Yehuda, R. (2021). Critical period plasticity as a framework for psychedelic-assisted psychotherapy. Frontiers in Neuroscience, 15, 710004.
Ling, S., Ceban, F., Lui, L. M. W., Lee, Y., Gill, H., Teopiz, K. M., ... McIntyre, R. S. (2022). Molecular mechanisms of psilocybin and implications for the treatment of depression. CNS Drugs, 36(1), 17–30.
Miceli McMillan, R., & Jordens, C. (2022). Psychedelic-assisted psychotherapy for the treatment of major depression: A synthesis of phenomenological explanations. Medicine, Health Care and Philosophy, 25(2), 225–237.
Mithoefer, M. C., Mithoefer, A. T., Feduccia, A. A., Jerome, L., Wagner, M., Wymer, J., ... Doblin, R. (2018). 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: A randomised, double-blind, dose-response, phase 2 clinical trial. The Lancet Psychiatry, 5(6), 486–497.
Nardou, R., Sawyer, E., Song, Y. J., et al. (2023). Psychedelics reopen the social reward learning critical period. Nature, 618(7966), 790–798.
Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., Rodriguez, C. I., ... McDonald, W. M. (2020). Psychedelics and psychedelic-assisted psychotherapy. American Journal of Psychiatry, 177(5), 391–410.
Sharma, P., Nguyen, Q. A., Matthews, S. J., et al. (2023). Psilocybin history, action and reaction: A narrative clinical review. Journal of Psychopharmacology, 37(9), 849–865.
Sloshower, J., Skosnik, P. D., Safi-Aghdam, H., et al. (2023). Psilocybin-assisted therapy for major depressive disorder: An exploratory placebo-controlled, fixed-order trial. Journal of Psychopharmacology, 37(7), 698–706.
Studerus, E., Kometer, M., Hasler, F., & Vollenweider, F. X. (2011). Acute, subacute and long-term subjective effects of psilocybin in healthy humans: A pooled analysis of experimental studies. Journal of Psychopharmacology, 25(11), 1434–1452.
Wells, S. Y., Morland, L. A., Hurst, S., et al. (2023). Veterans' reasons for dropping out of prolonged exposure therapy across three delivery modalities: A qualitative examination. Psychological Services, 20(3), 483–495.
Yaden, D. B., Berghella, A. P., Regier, P. S., et al. (2021). Classic psychedelics in the treatment of substance use disorder: Potential synergies with twelve-step programs. International Journal of Drug Policy, 98, 103380.
Yao, Y., Guo, D., Lu, T. S., et al. (2024). Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis. Psychiatry Research, 335, 115886.
Zanos, P., & Gould, T. D. (2018). Mechanisms of ketamine action as an antidepressant. Molecular Psychiatry, 23(4), 801–811.
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There are two videos in this section.
The first video is an introduction to trauma and the treatment for trauma. presentation by Rachel Yehuda, PhD, the Director of the Center for Psychedelic Psychotherapy for Trauma Research at Mt. Sinai in New York. It’s presented by Big Think and was filmed in late 2023.
https://www.youtube.com/watch?v=A3TvqMwgEco&ab_channel=BigThink
The second video, also with Dr. Yehuda, was produced by the European College of Neuropsychopharmacology in 2021. She reviews the history of MDMA up to the creation of MAPS and the FDA breakthrough therapy designation for MDMA. She also highlights some of the findings of the clinical trials with MDMA.
https://www.youtube.com/watch?v=FpAKaqilo6Q&ab_channel=EuropeanCollegeofNeuropsychopharmacology
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Yes, it’s Rick Perry on this video. He is the conservative Republican who was the previous Governor of Texas. He spoke at the Psychedelic Science Conference in Denver in 2023 about PTSD. He is an advocate for the thoughtful, ethical, and well-regulated acceptance of MDMA for the treatment for PTSD. He is also an advocate for Ibogaine.
https://www.youtube.com/watch?v=SSybEJI-vPo&ab_channel=ReasonTV
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There are two videos in this section.
The first video is 2 minutes and 20 seconds and is a simple explanation about neuroplasticity. It is presented by a pleasant MD from the Perth Brain Center in Australia.
https://www.youtube.com/watch?v=1EQ3kAPzVVI&ab_channel=TheBrainCentre
If you are more curious about plasticity, watch this 2 hour video interview with Dr. Gul Dolan about her work on critical periods and metaplasticity.
Her basic question during her education was, “What is the mind?” She approached that question through a combination of neuroscience, linguistics, philosophy, religion and art.
While this is a long video, it details findings that will help you to understand how scientists think that psychedelics work. She explains critical periods in a way that is easy to understand. Creation of a new critical period is how many scientists believe that MDMA provides a ‘window of opportunity’ for therapy.
Be advised, the interview rambles a bit between autism, critical periods, stroke treatment and psychedelics.
https://www.youtube.com/watch?v=Pt9_E4ZR5S0&ab_channel=TimFerriss
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In 2007, Ede Frecska wrote:
"The most common medical side effect of classic psychedelics (LSD, DMT, psilocybin) is an elevation in blood pressure and heart rate. While this effect can be safe for most people to tolerate, it is dangerous for others whose bodies cannot safely handle high blood pressure.
As a result, psychedelics are contraindicated if someone is pregnant, or has a history of epilepsy/other seizure disorder, or severe cardiovascular disease including uncontrolled blood pressure, heart failure, coronary artery disease or previous heart attack or stroke.
Because psychedelics work by activating serotonin receptors in the brain, they can lead to a life threatening condition called Serotonin Syndrome if used in conjunction with other medications or substances that also increase serotonin levels in the brain.
As a result, they are contraindicated in people using medications like Selective Serotonin Receptor Inhibitors (SSRI ) or MonoAmine Oxidizer Inhibitors (MAO-I) antidepressants who are not able to be weaned off of these medications before treatment.
Originally, hallucinogens carried the misnomer of “psychotogenic” (psychosis generating) agents, but the hallucinogenic effect is distinct from psychosis on several accounts; essentially, the two experiences are fundamentally different. Reality control is well maintained after minimal experience with hallucinogens, and the psychedelic effect is actively sought by users. Psychosis is neither voluntary nor desired. It is a disordered mental state over which the subject has no control. Hallucinogenic agents, when taken in appropriate settings in a responsible manner, induce a coherent mental state with feeling of increased internal order and personal growth.
Sporadic anecdotal observations noticed a relationship between the onset of schizophrenia and the hallucinogen use in a vulnerable population. However, when schizophrenic symptoms did persist beyond 24 hours, it appeared that the particular syndrome was a hallucinogen-precipitated event in schizophrenia-prone individuals (e.g., those with relatives with psychiatric problems), rather than a specific and genuine hallucinogen-induced persistent psychosis.
Similarly, psychedelics are contraindicated in people who’ve previously experienced any adverse effect from these substance such as prolonged psychosis or suicidal ideation."
Frecska, Ede. (2007). Therapeutic guidelines: dangers and contraindications in therapeutic applications of hallucinogens. 10.13140/RG.2.1.2364.8888.
Despite its promising therapeutic signal across mental health outcomes, less attention is paid on its potential to provide therapeutic benefits in clients on psychiatric medications, clients with bipolar disorder and across complex medical situations within rehabilitation medicine.
Watch this 11 minute video for a detailed comparison between psychedelics and antidepressants. It also explains why you should consult with your psychiatrist if you are taking antidepressants and would like to explore psychedelics.
https://www.youtube.com/watch?v=497SZVKHnU4&ab_channel=ThePsychedelicScientist
Here are the studies that he talked about in the video:
SSRI/SNRIs appear to weaken psilocybin drug effects relative to a non-serotonergic antidepressant. This dampening effect may last as long as 3 months following antidepressant discontinuation.
Gukasyan N, Griffiths RR, Yaden DB, Antoine DG 2nd, Nayak SM. Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use. J Psychopharmacol. 2023 Jul;37(7):707-716.
Escitalopram did not alter HTR2A or SCL6A4 gene expression before psilocybin administration, QTc intervals, or circulating BDNF levels before or after psilocybin administration. Further studies are needed with a longer antidepressant pretreatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin.
Becker AM, et al. Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects. Clin Pharmacol Ther. 2022 Apr;111(4):886-895.
"There's a huge deficit in the scientific literature (about the use of psychedelics in clients using psychiatric medications)," said lead author Aryan Sarparast, M.D., assistant professor of psychiatry in the OHSU School of Medicine. "There's a major incongruence between the public enthusiasm and exuberance with psychedelic substances for mental health issues -- and what happens when they combine with the existing mental health treatments that we have now."
The researchers decided to conduct the evidence review because they wanted to learn more about interactions between widely prescribed medications such as antidepressants and psychedelics, including MDMA and psilocybin.
They found a total of 40 studies dating back to 1958, including 26 from randomized controlled studies, 11 case reports and three epidemiologic studies.
Researchers found only one study that examined how psilocybin interacts with antidepressant medications. Further, the lead author, Dr. Sarparast noted that all of the clinical trials were conducted with healthy volunteers who were administered a psychiatric medication and a psychedelic at the same time -- a clear sign of the need for further research on the clinical outcomes of combining pharmaceutical medications with psilocybin.
Sarparast said he is concerned that the lack of evidence will lead many providers to direct patients to taper off existing medications before being offered clinical psilocybin therapy.
Patients with mental health conditions may well benefit from psilocybin therapy, but Sarparast said he worries about the implications of stopping existing psychiatric treatment in order to receive psilocybin services. This may force vulnerable people into choosing between their existing medical treatment or psilocybin services.
"That's a very, very tough place to be," Sarparast said.
There's a considerable amount of important data not captured in a literature review related to real-world use, noted co-author Christopher Stauffer, M.D., assistant professor of psychiatry in the OHSU School of Medicine and a physician-scientist at the VA Portland Health Care System.
https://www.sciencedaily.com/releases/2022/03/220318131632.htmI
In a study in 2023, it was found that psilocybin may have potential for treating depressive symptoms, and consequently may be safe for use in Bipolar Disorder (BD). An international web-based survey was used to explore experiences of psilocybin use in people with a self-reported diagnosis of BD.
A total of 541 people completed the survey (46.4% female, mean 34.1 years old). One-third (32.2%; n = 174) of respondents described new/increasing symptoms after psilocybin trips, prominently manic symptoms, difficulties sleeping and anxiety.
No differences in rates of adverse events overall were observed between individuals with BD I compared to BD II. Use of emergency medical services was rare (n = 18; 3.3%), and respondents (even those who experienced adverse effects) indicated that psilocybin use was more helpful than harmful. Quantitative findings elaborated on perceived benefits, as well as the potential for psilocybin trips to contain both positively and negatively received elements.
The subjective benefits of psilocybin use for mental health symptoms reported by survey participants encourage further investigation of psilocybin-based treatments for BD. Clinical trials should incorporate careful monitoring of symptoms, as data suggest that BD symptoms may emerge or intensify following psilocybin use.
Morton E, Sakai K, Ashtari A, Pleet M, Michalak EE, Woolley J. Risks and benefits of psilocybin use in people with bipolar disorder: An international web-based survey on experiences of 'magic mushroom' consumption. J Psychopharmacol. 2023 Jan;37(1):49-60.
American Psychological Association Position (APA): There is currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies. APA supports continued research and therapeutic discovery into psychedelic agents with the same scientific integrity and regulatory standards applied to other promising therapies in medicine. Clinical treatments should be determined by scientific evidence in accordance with applicable regulatory standards and not by ballot initiatives or popular opinion.
Position Statement on the Use of Psychedelic and Empathogenic Agents for Mental Health Conditions Approved by the Board of Trustees, July 2022.
Regarding the use of psilocybin in patients in rehabilitation due to spinal cord injuries: "Persons with spinal cord injury (SCI) have a high prevalence of treatment-resistant mental health comorbidities that compound the extent of their physical disability.
Reports from online discussion forums suggest that those living with SCI are using psychedelics, though the motivation for their use is unknown. These anecdotal reports describe a consistent phenomenon of neuromuscular and autonomic hypersensitivity to classical serotonergic psychedelics, such as psilocybin and lysergic acid diethylamide (LSD). Persons describe intense muscle spasms, sweating, and tremors, with an eventual return to baseline and no reports of worsening of their baseline neurological deficits. The discomfort experienced interferes with the subjective beneficial effects self-reported. This phenomenon has not been described previously in the academic literature.
We aim to provide a descriptive review and explanatory theoretical framework hypothesizing this phenomenon as a peripherally dominant serotonin syndrome-like clinical picture-that should be considered as such when persons with SCI are exposed to classical psychedelics."
Abrams SK, et al. Persons With Spinal Cord Injury Report Peripherally Dominant Serotonin-Like Syndrome After Use of Serotonergic Psychedelics. Neurotrauma Rep. 2023 Aug 22;4(1):543-550.
Read this anecdotal report about Jim Harris, reported on Aspen Public Radio on May 28, 2024: https://www.aspenpublicradio.org/arts-culture/2024-05-28/after-a-life-altering-injury-psychedelics-helped-jim-harris-heal?utm_source=newsletter&utm_medium=email&utm_content=After%20a%20life-altering%20injury%2C%20psychedelics%20helped%20Jim%20Harris%20heal&utm_campaign=Transmitter%2004-12-24
IF YOU HAVE CONCERNS OR QUESTIONS ABOUT USING PSILOCYBIN, PLEASE CONSULT WITH YOUR PRIMARY CARE PROVIDER AND A PSYCHEDELIC FACILITATOR.
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Watch this 1 hour 2 minute video from Abigail Calder, M.Sc. from the University of Fribourg in Switzerland.
She spoke at the 2023 ALPS conference (Awareness Lectures on Psychedelic Science) about the significant negative effects of particular psychedelics.
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The incidence of phantom limb pain after amputation ranges between 60% - 80% according to the NIH. Risk factors for phantom limb pain include persistent pre-operative pain, residual limb pain, and non-painful phantom limb sensations. A small clinical trial of 9 clients out of UC San Diego that psilocybin may effectively treat this stubborn challenge for amputees.
After three preparation sessions, a single dose of 4-5 gram dramatically reduced the severity of their pain — between 50% and 75% — compared to a placebo treatment with niacin. The participants also underwent a month of Integration with psychologists trained in psychedelic facilitation. The group that took niacin reported a brief reduction immediately after the dose, but their reported pain returned to the previous level two weeks and four weeks after the dose.
Psilocybin may do more than just numb the pain—it might also “rewire” the brain’s connectivity processes associated with the traumatic event.
The researchers theorize that phantom limb pain is tied to unresolved trauma from the accident that led to the amputation, and the amputation itself. After the amputation, the body may continue to send pain signals to the brain, indicating that something is wrong and that help is needed.
Brain imaging analysis from the study participants showed that when there was a larger reduction in activity within neural networks associated with self-confidence and personal value, there was a greater reduction in pain relief.
The researchers stated, "The brain is rewiring itself after the dosage, and the more that the rewiring in certain parts of the brain occurs, the greater the pain relief." They are moving to a Phase II trial and are actively seeking participants.
Of interest, the study developed after a case report in Neurocase about Albert Yu-Min Lin, a UCSan Diego researcher and National Geographic explorer, who leg was amputated during an accident. After suffering debilitating pain and failed treatments, including standard nerve pain medications, opioids, antidepressants, ketamine and medical marijuana, he drove to the desert in Joshua Tree, CA and took psilocybin.
His pain was relieved in 30 minutes and although it returned after a few hours, the intensity seemed to have decreased dramatically.
Joel Castellanos used Lin’s case study as the subject for his fellowship research paper, “Chronic Pain and Psychedelics: a review and proposed mechanism of action.” The highly cited paper has helped to galvanize a new era of psychedelic research at UC San Diego.
https://today.ucsd.edu/story/psychedelic-revolution
Castellanos JP, Woolley C, Bruno KA, Zeidan F, Halberstadt A, Furnish T. Chronic pain and psychedelics: a review and proposed mechanism of action. Reg Anesth Pain Med. 2020 Jul;45(7):486-494. doi: 10.1136/rapm-2020-101273. Epub 2020 May 4. PMID: 32371500. https://pubmed.ncbi.nlm.nih.gov/32371500/
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Psilocybin appears to help chronic pain through multiple interacting mechanisms, though the research is still early and evidence quality is modest. When psilocybin is converted into psilocin, it activates the 5-HT2A receptor, which disrupts rigid, over-connected brain networks that maintain chronic pain.
This temporary “disconnection” allows for healthy reconnection as neuroplasticity increases, helping the brain reorganize pain circuits that have become stuck or sensitized. Through this process, many individuals experience sustained reductions in pain intensity or pain-related suffering, even after a single session.
In conditions like cluster headaches and migraines, some of the strongest real-world evidence comes from patient self-reports showing both acute relief and long-term preventive effects from psilocybin or LSD. Randomized controlled trials are now actively studying these effects, especially in cluster headache populations.
Historically, psychedelic-assisted therapy also demonstrated analgesic benefits in cancer and palliative care, where patients experienced improvements in both pain and psychological distress. Modern research is repeating these findings, again showing promising results for emotional and existential suffering associated with cancer pain.
Glynos, et al (2022) found that the perception of benefit of psilocybin was neutral in 59.4% and was positive in 36.8% of patients with fibromyalgia. In a study analyzing effects in fibromyalgia, arthritis, migraine, tension-type headache and sciatica, volunteers reported better pain relief with psilocybin compared to conventional medications, except for sciatica. Micro-doses led to significantly better relief compared to conventional medication in migraines and achieved comparable relief in the remaining three categories. (Cavarra 2024).
Across pain conditions, several biological pathways support these effects. Activation of 5-HT2A triggers glutamate release, BDNF upregulation, and TrkB–CREB–gene transcription cascades, enabling dendritic growth and network flexibility. These neuroplastic shifts reduce chronic pain by dampening overactive circuits, enhancing descending pain inhibition, lowering neuro-inflammation, and improving emotional responses to pain. Psilocybin also reduces anxiety, depression, hypervigilance, and catastrophizing, all of which amplify chronic pain.
In a survey of 466 adults who reported using psychedelics to self-treat a chronic pain condition (46.1% women), the researchers investigated changed substance use patterns and self-reported outcomes on physical and mental health following use of a psychedelic. Most (86.3%) indicated that they ceased or decreased use of one or more non-psychedelic substances "as a result of" psychedelic use, and 21.2% indicated that the decrease in use persisted for more than 26 weeks after psychedelic use. Alcohol (71.1%) and prescription opioids (64.1%) had the highest proportions for ceased/decreased use. Illicit opioids (27.8%) and cannabis (21.5%) had the highest proportions for increased/initiated use. Perceptions of health outcomes following psychedelic use were broadly positive, and psilocybin was reported to be the most effective substance for both physical and mental health symptoms. (Glynos, et al 2025)
Importantly, psychedelics have a favorable safety profile, especially when compared to opioids or long-term analgesics. They do not carry the addictive potential of opioids, and medically supervised use shows low physiological risk and minimal toxicity.
Aday, et al (2025) presented that preliminary clinical trials and case studies report that psilocybin has analgesic effects in migraines, cluster headaches, phantom limb pain and fibromyalgia.
While psilocybin is not a cure for chronic pain, it often helps people change both the neural patterns and the emotional narratives that make pain chronic, providing a meaningful reduction in suffering for many individuals.
Recent study about neuropathy: https://www.zmescience.com/science/neurology-science/a-single-dose-of-psilocybin-eased-nerve-pain-in-mice-for-weeks/
References:
Aday JS, et al (2025) no citation yet.
Cavarra M, et al. (2024). Potential analgesic effects of psychedelics on select chronic pain conditions: A survey study. Eur J Pain. 2024 Jan;28(1):153-165. doi: 10.1002/ejp.2171. Epub 2023 Aug 20. PMID: 37599279.
Glynos NG, et al (2025). Psychedelics and chronic pain: self-reported outcomes on changed substance use patterns and health following naturalistic psychedelic use. Br J Pain. 11:20494637251319497. doi: 10.1177/20494637251319497. Epub ahead of print. PMID: 39944237; PMCID: PMC11811946.
Glynos NG, et al. (2023). Knowledge, Perceptions, and Use of Psychedelics among Individuals with Fibromyalgia. J Psychoactive Drugs. 55(1):73-84. doi: 10.1080/02791072.2021.2022817. Epub 2022 Jan 10. PMID: 35001856.
Kooijman NI, et al. (2023). Are psychedelics the answer to chronic pain: A review of current literature. Pain Pract. 23(4):447-458. doi: 10.1111/papr.13203. Epub 2023 Jan 11. PMID: 36597700.
Video (48 minutes): https://www.youtube.com/watch?v=eKZWlXKgfDY
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Overall Purpose
Ron Cole-Turner seeks to provide a theologically informed, ethically grounded reflection for Christians on the phenomena of psychedelics and the “psychedelic renaissance.” He asks: what is the place of psychedelic-induced experiences within Christian faith, spirituality, and healing? And how should the church respond to the possibility that psychedelics may occasion genuine spiritual or mystical experiences while also raising significant moral, pastoral, and doctrinal challenges.
Key Themes & Structure
Although the book is relatively compact (about 150 pages) it covers several major dimensions:
Scientific/medical context
Cole-Turner reviews how psychedelics are being researched for mental-health and therapeutic uses, and how they also often produce what are called “mystical” or spiritual-type experiences.
He raises the question: if the drug-based experience is phenomenologically similar to classic mystical experiences, then how should theology regard them?
Spiritual/mystical experience and Christian faith
The book explores how Christian tradition understands mystical or unitive experiences (e.g., union with God, transcendence of ego, conversion, surrender).
He considers whether psychedelic experiences might be analogous or bear some kinship to those Christian experiences — and if so, how to interpret and integrate them.
At the same time, he offers caution: such experiences are not automatically “Christian” just because they feel spiritual, and need discernment, grounding, community, and integration.
Ethical, ecclesial and pastoral concerns
Cole-Turner addresses the risks: psychological, physical, legal, and spiritual. He warns about shortcuts to spirituality, the potential for abuse or misuse, and the dangers of bypassing process or community.
He also points out the risk for the church of simply dismissing psychedelic-based spiritual experiences out of hand—doing so may alienate people and ignore meaningful spiritual awakenings.
He calls for pastoral frameworks: how should Christian ministers, congregations, and spiritual directors respond to people who have had such experiences? How to integrate them faithfully into Christian life and community?
Integration and theological reflection
A major thrust is: if psychedelics (when properly used in healing contexts) may occasion significant spiritual transformation, then the Christian community needs to ask: what does this mean for traditional Christian practices (prayer, sacraments, discernment, spiritual formation)?
He advocates for “spiritual formation” rather than simply a pharmacological fix. He suggests that the church might learn from the emerging science-spirituality interface without becoming uncritical or naïve.
He emphasizes that genuine healing and transformation require more than a one-time ‘trip’; they require ongoing community, embodiment, discipleship, accountability, and establishing of “faith, hope, love” (Christian virtues) in one’s life.
Key Conclusions & Insights
Cole-Turner does not argue that psychedelics are the only or preferred way for Christians to have spiritual/mystical encounters. Rather he invites the Christian community to take the phenomena seriously.
He asserts that if psychedelic experiences are phenomenologically similar to historical mystical experiences, then theology cannot simply ignore them. He writes that the church needs “theological and pastoral boldness” to engage with these.
He urges a measured approach: exploring the possibilities (healing, spiritual awakening, expanded consciousness) while maintaining caution about ungrounded use, lack of prayer/community context, legal/regulatory issues, and the risk of bypassing authentic process.
The book challenges the church to ask: how might Christian faith frameworks (sin, redemption, embodiment, community, sacrament) help interpret and integrate these experiences? And conversely: how might the psychedelic renewal challenge the church to revisit neglected dimensions of spirituality (mysticism, embodied practice, inter-connectedness, awe)?
A significant practical implication: those working in psychedelic-facilitation (or integration) and the church need integration work — not only what happens during the session, but what happens after: the meaning-making, the community connection, the transformation of life.
He posits that these developments (psychedelic healing + spiritual experience) may represent an “unexpected pathway” to healing and spirituality — but not a replacement for the Christian faith’s longstanding path of discipleship, community, prayer, service, and love.
Potential Critiques or Limitations
Because the book is relatively short, some readers may feel that it doesn’t delve deeply into technical pharmacology, neuroscience, or the full variety of indigenous/traditional uses of psychedelics. It is more theological/pastoral than scientific/clinical.
Some in the Christian-psychedelic space might feel it remains cautious (which is understandable) and thus may not fully open the door to more radical reinterpretations of spiritual experience in a Christian context.
As with any work bridging faith and psychedelics, the risk remains of simply “glossing over” the risks (psychological, legal, cultural) — though Cole-Turner does raise those.
Because the book is oriented to a Christian audience, some of its theological assumptions may not directly translate to non-Christian or inter-faith contexts (though many of the themes are broadly relevant).
Here’s a reconstructed chapter-by-chapter summary based on verified publisher and reviewer sources:
Chapter 1 – Psychedelics and Spiritual Experience
Cole-Turner introduces the modern “psychedelic renaissance,” noting how psilocybin, LSD, and MDMA research points toward profound mystical-type experiences. He compares these to historic Christian contemplative encounters—union, awe, surrender—and asks whether theology can take them seriously.
Key idea: Christians should neither dismiss nor idolize these experiences, but discern their meaning through prayer, community, and integration.Chapter 2 – Psychedelics and Healing
This chapter reviews clinical evidence for depression, PTSD, addiction, and end-of-life distress. Cole-Turner highlights that therapeutic success often correlates with a sense of the sacred or unity.
Key idea: Healing is not merely chemical; it may point to a restoration of relationship—with self, others, creation, and God.Chapter 3 – The Multiple Levels of Psychedelic Action
Cole-Turner outlines how psychedelics act simultaneously on biology (neuroplasticity and serotonin receptors), psychology (ego dissolution and emotional release), and spirituality (transcendence and meaning).
Key idea: Theology must hold these levels together rather than reducing experience to any single one.Chapter 4 – Mysticism and Spiritual Experience
He surveys Christian mystics—Teresa of Ávila, John of the Cross, Julian of Norwich—and notes phenomenological parallels with psychedelic states: ineffability, timelessness, and self-transcendence.
Key idea: While experiences may look similar, their fruit—humility, compassion, service—determines authenticity in Christian discernment.Chapter 5 – Psychedelics and a Theology
Cole-Turner explores how doctrines like creation, incarnation, and grace inform the interpretation of psychedelic experiences. He argues they may reveal creation’s inherent sacredness rather than manufacture new divinity.
Key idea: God’s presence is mediated through material reality; psychedelics might open awareness to what is always there.Chapter 6 – A Spiritual Home for Psychedelic Seekers
He addresses pastoral and ecclesial questions: How should churches accompany those transformed by psychedelic encounters? He calls for informed compassion, community accountability, and integration practices rooted in faith.
Key idea: The church could become a place of discernment and belonging for seekers, rather than a place of shame or silence.Epilogue – An Unexpected Pathway
Cole-Turner closes by affirming psychedelics are not shortcuts to holiness but can catalyze genuine healing and renewal when approached with humility, preparation, and integration.
Key idea: The Spirit may work through unexpected channels, yet the ultimate goal remains the same—love of God and neighbor.Interview with Ron Cole-Turner:
https://www.youtube.com/watch?v=0J7Ow7-Pido
Recent findings of the Good Friday Experiment:
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MAPS Bulletin 12/2025
Introduction: Illness, Fear, and the Search for Meaning
If you had told me six years ago that I would be running a nonprofit dedicated to psychedelic care for people facing life-threatening illness, I would not have believed you. At the time, I was so consumed with trying not to die, that I had forgotten how to live.
I am an advanced stage breast cancer survivor. Diagnosis, treatment, and recovery were brutal in ways that went far beyond the physical. The surgeries and chemotherapy were harrowing, but what nearly broke me was something people rarely name out loud: existential distress, sometimes described as death anxiety.
I was raised Catholic, with a deep respect for ritual, mystery, and contemplative practice, even when much of it was mediated through institutions. I went on to study philosophy and literature at Notre Dame and Stanford, then earned my law degree from Yale Law School and clerked for a federal judge on the Ninth Circuit. I became both an attorney and a filmmaker. On paper, my life looked solid.
Being diagnosed with advanced-stage cancer as a young adult shattered that narrative.After the hospital lights dimmed and the doctors signed off, I was left alone with questions that echoed like a bell. Am I going to die young? What can I hope for if cancer might come back at any time? What does my life mean now that I have lost so much. That I don’t even recognize myself in the mirror.
On paper, I was a success story. Inside, I was living with a fear I could not outrun. Relationships felt inauthentic. Work lost meaning. Nights were sleepless, filled with panic and a creeping sense that reality had shifted irrecoverably. I tried therapy, meditation, medication, support groups. Some helped a little. The dread kept returning.
Then one morning at my kitchen table, coffee going cold, I read about clinical studies using psilocybin for end-of-life anxiety in cancer patients. At Johns Hopkins and NYU, participants reported large and sustained reductions in depression and anxiety, along with increased quality of life and meaning after a single dose of psilocybin given in a carefully supported setting. You can read two of the landmark studies here: the Johns Hopkins trial by Griffiths and colleagues and the NYU trial by Ross and colleagues.
Participants in these studies described facing mortality with less fear and more peace.
That possibility felt like oxygen.
The single psilocybin session I eventually experienced was one of the most profound experiences of my life. After, the world felt connected again. I was still me. Not just a patient or a survivor, but a whole human being. Later, I discovered that many people in my cancer community were suffering unnecessarily and wanted safe, legal pathways to healing.That is why I founded the Survivorship Collective with other patients and survivors, with palliative care at the heart of everything we do.
Palliative care is often misunderstood as a synonym for hospice or imminent death. In reality it is an approach to relieve suffering at any stage of serious illness and to address physical, psychological, social, and spiritual distress. The World Health Organization defines palliative care as care that improves the quality of life of patients and their families facing life-threatening illness. Psychedelic-assisted care can support this mission by helping people contact meaning, reduce fear, and reconnect with life when cure is uncertain and recurrence is an everyday shadow.Facing Death Without Flinching
In the first year after treatment, I lived with what felt like a split screen in my mind. On one side was the possibility of dying young. On the other was the possibility of living decades more. I did not know which story I was in. The uncertainty was paralyzing. Often I prayed simply to outlive my parents so they would not bury a child.
Psychedelic therapy offered something different. The chance to sit directly with my mortality rather than run from it.
In my session, I watched my body disintegrate and die. My instinct was to resist. But slowly, as my facilitator reminded me to breathe, the fear began to shift. Death was no longer only a shadow waiting to devour me. It was a friend.
There is a strange metamorphosis that happens when you face death directly in a safe, supported environment. Death stops being a phantom at the edge of life and becomes a magnifying glass. Everything becomes more alive. My mother’s voice. The way light falls across a kitchen counter. Birds in the trees. All of it suddenly sacred.
This is what I wanted to share with others. Not only relief from anxiety but a transformation of perspective. Mortality becomes not the enemy but an essential part of life’s depth and beauty. Now, I genuinely believe that serious illness can be a doorway to profound, positive transformation.The Birth of a Collective
The Survivorship Collective began not in a boardroom but in living rooms and hospital waiting rooms. A close friend living with metastatic breast cancer wanted a safe, legal way to access psilocybin to cope with end-of-life fear. A small group of us survivors gathered to try to make it possible.
What began as a circle of friends became a nonprofit led by and for patients and survivors. We saw clearly that people with serious illnesses needed more than medical treatment. They needed community, ritual, meaning-making, and spaces where their emotional and spiritual realities were not afterthoughts.
Today, we run a robust multi-week program that includes an option for a state-regulated psilocybin group ceremony experience with one of our licensed service center partners in Oregon, with expansion underway in Colorado and the Netherlands. These are not recreational experiences. They are carefully designed environments with medical screenings, safety plans, and oversight, where survivors and their loved ones can face fear, process grief, and rediscover joy.The heart of this work is not protocols. It is the voices of people who have walked through illness and emerged changed.
This year alone, we have hosted several retreats in Oregon, and in 2026 that will expand to Colorado and the Netherlands. We will soon publish a study on our outcomes. Survivors deserve more than anecdotes. They deserve data, rigor, and transparency, and we intend to contribute all three.
The stories are extraordinary. One young mother with metastatic breast cancer said her experience gave her “the strength to live with metastatic breast cancer.” Another participant told us that after years of feeling shut down emotionally, she laughed in her sleep for weeks. Families tell us they see their loved ones return more present, more open, and more emotionally available. When one person heals, the entire household changes.The Science and the Sacred
Research reflects what these women describe. In addition to the Johns Hopkins and NYU cancer trials that showed rapid and sustained improvement in mood and anxiety, newer work is building on that foundation. A recent review in Cancers summarizes the use of psilocybin for depression among cancer patients, and a JAMA Oncology paper reviews psilocybin therapy for patients with cancer related distress. There is also emerging work on psilocybin enhanced group psychotherapy in serious illness, which aligns with what we see in our group-based retreats.
Interestingly, psycho-oncology has recently developed interventions explicitly focused on meaning. Meaning-centered group psychotherapy, grounded in the work of Viktor Frankl, has been shown to improve spiritual well-being and reduce despair in patients with advanced cancer. You can read about it in this clinical trial in advanced cancer and its adaptation for cancer survivors after treatment.
The overlap is striking and it reflects a huge need in cancer care. Whether through meaning-centered therapy or carefully supported psilocybin sessions, patients describe a shift from being consumed by fear to being anchored in purpose, connection, and a sense of something larger than the self.
In these meaning-making approaches to healing, preparation and integration are not side notes but core components. Thoughtful guides across the field emphasize that psychedelic sessions work best when embedded in a longer process of intention setting and follow-up support. A concise overview of that logic can be found in this discussion ofpreparation and integration in psychedelic therapy.Building a Movement
Since our first retreat, the Survivorship Collective has grown into a network of survivors, caregivers, clinicians, and allies. We host psilocybin retreats with state-licensed, vetted partners, create individualized safety plans that integrate medical, psychological, and personal history, conduct qualitative research to capture patient experiences, and build community through integration circles and survivor leadership councils. You can watch a short video and learn more about our work on our website.
This is more than a program. It is a movement to reimagine palliative and cancer care. A movement that insists that spiritual and existential suffering deserve the same level of seriousness that we bring to chemotherapy regimens and clinical trial design.A Call to Reimagine Care
The survivors in our community remind me that healing is not only about surviving disease. It is about finding meaning. Reclaiming joy. Rediscovering embodiment. Remembering that even in the midst of illness, life is sacred.
As writer Zadie Smith reflects in her essay on climate grief and the “new normal,” “Elegy for a Country’s Seasons”, there are shifts that reveal what we have taken for granted and what we stand to lose. Serious illness does something similar on the level of a single life. It strips away the illusion of endless time and asks, often quite frankly: What matters now.Where Psychedelic Care Must Go
As access expands, it is becoming clear that medical buildings and therapist’s offices alone are not enough. For survivors, those spaces are often where the trauma happened. Survivors want healing in nature, in community, and in environments that feel grounded and organic rather than clinical. They want evidence-based practice that coexists with ritual, music, and belonging.
My hope is that we evolve toward full ecosystems of care, not isolated interventions. Healing takes time.
The Survivorship Collective began with patients helping one another. Today it is a movement calling for care led by patients, held by community, and grounded in both science and the sacred.
Palliative care is not only about dying well. It is about living fully in the time we have.
Learn more at survivorshipcollective.comWritten by: Anne Hamilton is the founder and executive director of The Survivorship Collective, the first non-profit connecting the cancer community to safe, legal, psychedelic-assisted therapies. After surviving advanced-stage cancer as a young adult, she became an advocate for better mental and spiritual care for cancer patients, survivors, and their loved ones. Hamilton is a former litigator, 9th Circuit Clerk, and a current member of the Psychedelic Bar Association. She has worked in government, with nonprofits, and in higher education as a professor at USC’s School of Cinematic Arts. She is a 2025 Mira Fellow, a certified mediator, holds a J.D. from Yale Law School, a Master’s Degree in Philosophy from Stanford University, and is a graduate of Notre Dame and the American Film Institute.
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Abstract
Methamphetamine use disorder is a chronic relapsing condition associated with substantial mental, physical, and social harms and increasing rates of mortality. Contingency management and psychotherapy interventions are the mainstays of treatment but are modestly effective with high relapse rates, while pharmacological treatments have shown little to no efficacy. Psilocybin-assisted psychotherapy is emerging as a promising treatment for a range of difficult-to-treat conditions, including substance use disorders; however, no studies have yet been published looking at psilocybin-assisted psychotherapy in the treatment of methamphetamine use disorder. Here we review the rationale for psilocybin-assisted psychotherapy as a potential treatment for this indication, and describe practical considerations based on our early experience designing and implementing four separate clinical trials of psilocybin-assisted psychotherapy for methamphetamine use disorder.
Brett J, et al. (2023). Exploring psilocybin-assisted psychotherapy in the treatment of methamphetamine use disorder. Front Psychiatry. 14:1123424.tem description
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Question Does psilocybin combined with psychotherapy elicit abstinence from cocaine in people with cocaine use disorder relative to active placebo plus psychotherapy?
Findings In this randomized clinical trial of 40 adults with cocaine use disorder, a single (25 mg per 70 kg of body weight) dose of psilocybin with manualized psychotherapy resulted in a higher percentage of cocaine abstinent days, a greater likelihood of complete cocaine abstinence, and a reduced risk of cocaine lapse through 180 days after end of treatment as compared with placebo with the same manualized psychotherapy.
Meaning These findings suggest psilocybin shows promise as a novel treatment for cocaine use disorder.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2848757
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Abstract
Opioid-related overdose deaths have reached record high levels, and novel treatments for opioid use disorder (OUD) are needed. The three United States Food and Drug Administration (FDA)-approved medications for OUD function primarily at the mu-opioid receptor. While these remain the gold-standard treatment for OUD, they have shortcomings and treatment options separate from the opioid receptor system deserve attention. Preclinical, clinical, and naturalistic studies of psychedelics have shown some evidence that they may reduce opioid and other substance use. Here, we present the results of a systematic review of clinical studies investigating the therapeutic applications of psychedelics for OUD to describe the current state of the literature and guide future clinical study design in this area. Findings indicate few studies completed using serotonergic psychedelics, with most investigating ibogaine or ketamine. In addition, findings are limited by many studies of weak design focused on opioid withdrawal, and few double-blind or placebo-controlled trials with considerable methodological heterogeneity making comparisons difficult across compounds. Most studies were found to have a high risk of bias mostly related to lack of randomization, blinding, and blinding of assessment outcomes. We outline these limitations and steps towards improving the quality of future studies of psychedelics for OUD.
Weleff J, et al. (2025). The therapeutic effects of psychedelics for opioid use disorder: A systematic review of clinical studies. Psychiatry Research 348:116446.tem description
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This section contains 1) a YouTube video from the Anxiety and Depression Association of America (ADAA), a non-profit organization, leads in education, training, and research for anxiety disorders, depression, PTSD, OCD, and co-occurring disorders. ADAA also provides free evidence-based mental health information and resources to the public. It is 1 hour and 11 minutes; 2) a systematic review and 3) the exciting study findings from Incannex in Australia about the statistically significant findings in their study about psilocybin.
Video from 2024: https://www.youtube.com/watch?v=QEOHec8y-Tc
Systematic Review:
Feulner L, et al. (2023)Efficacy and Safety of Psychedelics in Treating Anxiety Disorders. Ochsner J. 23(4):315-328.
Abstract of systematic review
Background: Anxiety disorders are commonly diagnosed and cause substantial functional impairment. A mixture of pharmacologic and psychosocial treatments currently exists, but these treatments are not always tolerable and effective. For patients with anxiety resistant to standard therapy, psychedelics may be a promising alternative. This review assesses the therapeutic benefits and safety of psychedelics in treating anxiety disorders.
Methods: We searched PubMed, Embase, PsycInfo, and CINAHL for clinical trials investigating psychedelics in patients with clinician-diagnosed generalized anxiety disorder, social anxiety disorder, specific phobia, separation anxiety disorder, selective mutism, panic disorder, agoraphobia, and anxiety attributable to another medical condition. We analyzed data from 9 independent psychedelic-assisted trials testing ayahuasca (1 study), ketamine (4 studies), lysergic acid diethylamide (LSD) (2 studies), 3,4-methylenedioxymethamphetamine (MDMA) (1 study), and psilocybin (1 study). Efficacy was assessed by measuring the change in outcome measures and the quality of life from baseline.
Results: The reviewed studies demonstrated encouraging efficacy in reducing anxiety symptoms, increasing self-perception, and increasing social function in patients with generalized anxiety disorder, social anxiety disorder, or anxiety attributable to another medical condition while establishing feasibility and evidence of safety. For many patients, the therapeutic effects of the psychedelic treatment lasted weeks, and no severe adverse events were reported.
Conclusion: Based on the evidence of symptom reduction and safety, the current literature (2011 to 2021) shows that psychedelics could be considered for treating clinician-diagnosed anxiety disorders. Psychedelics may provide an alternative therapeutic option for patients resistant to current standard treatments.
Incannex Study:
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There are two videos in this section.
Watch the first 7 minute video from MycoMeditations to see the archaeological evidence of use of mushrooms in ancient times at multiple locations.
https://www.youtube.com/watch?v=yFTLMvu19Xs&t=13s&ab_channel=MycoMeditations
Watch this 58 minute video that details the use of psychedelic substances by Indigenous Peoples. It was published by the Portland Psychedelic Society (2021).
The presenter talks fast but the video has interesting information about the ancient use and colonization.
https://www.youtube.com/watch?v=8-Cgxg0QWpU&ab_channel=PortlandPsychedelicSociety
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There are two videos in this section.
The first one is very short video and introduces the Default Mode Network (DMN). The DMN may be the site of action for psilocybin, LSD and DMT. The video discusses the claustrum, which is heavily occupied with 5HT2A receptors.
The second video has an entertaining introduction into the history of psychedelics and also includes helpful information about the DMN.
Dr Stephen Bright is a clinically-trained psychologist. He is a Senior Lecturer of Addiction at Edith Cowan University in Perth and a founding board member of PRISM, an Australian not-for-profit set up to advance the cause of psychedelic research.
https://www.youtube.com/watch?v=Yt35di1e6d4&ab_channel=TEDxTalks
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This 40 minute video explains that new research into psychedelics show promising treatment options for Alzheimer’s and dementia. Dr. Del Potter, PhD – a scientist studying the benefits of psychedelic compounds on brain-related diseases and conditions like dementia, depression and PTSD, shares information on the benefits, availability and future of psychedelic treatment for Alzheimer’s and other dementia related diseases. Potter also discusses the origin of medicinal use of psychedelics. Research shows that psychedelic compounds have positive effects on targets in the brain that may cause Alzheimer’s. As this research becomes more mainstream, more clinical trials and treatment options are becoming available for people predisposed to Alzheimer’s or dementia and those with mild cognitive impairment. Dr. Potter also discusses the treatment options available, including a micro dosing approach that minimizes the psychoactive effects but still shows positive results. This could be a promising option for those with moderate to severe Alzheimer’s. While research is promising, Dr. Potter expresses concerns for the future of medicinal use of psychedelics, as it does become more mainstream and adopted by big pharmaceutical companies. Overall, the outlook on psychedelic treatment for Alzheimer’s and other brain-related diseases is positive. Dr. Potter shares incredible insights that provide hope for the future of Alzheimer’s research.
To read the article mentioned in this Episode, go to: https://doi.org/10.3389/fnsyn.2020.00034To link to the interview with Dr. Potter; go to this link:
https://www.youtube.com/watch?v=cZ8VEzDF0PU
Study about Cognitive Flexibility and Psilocybin
Psilocybin therapy was shown to increase cognitive and neural flexibility in patients with Major Depressive Disorder age 24-59. Cognitive flexibility is broadly defined as the ability to adaptively switch between different cognitive operations in response to changing environmental demands.
Although it is unclear what the enduring effects of psychedelic therapy are on cognitive flexibility in humans, the acute effects of 5-HT2A receptor modulation on cognitive flexibility are mixed. Blockade of 5-HT2A receptors has been found to both impair and enhance cognitive flexibility in animal models. In contrast, activation of 5-HT2A receptors with psychedelic drugs has been found to acutely impair cognitive flexibility in humans.
A moderately high dose (20 mg/70 kg) and a high (30 mg/70 kg) dose of psilocybin were orally consumed at the first and second sessions, respectively. Neural flexibility was measured with the Penn Conditional Exclusion Test (PCET). Errors on the PCET generally decreased from baseline to 1 week post-psilocybin therapy with this effect sustained 4 weeks post-treatment, which indicated an increase in cognitive flexibility.
Doss MK, et al. (2021). Psilocybin therapy increases cognitive and neural flexibility in patients with major depressive disorder. Transl Psychiatry 11(1):574.
Ongoing Clinical Trial
The researchers at Johns Hopkins are currently recruiting participants for a pilot study which will examine whether the hallucinogenic drug, psilocybin, given under supportive conditions, is safe and effective for depression in people with Mild Cognitive Impairment (MCI) or early Alzheimer's Disease (AD). This study will also assess whether psilocybin may improve quality of life in those individuals.
Participants will complete an 8-week course of study treatment including two psilocybin sessions (15 mg/70 kg in week 4) and (15 or 25 mg/70 kg in week 6), with follow-up assessments up to 6 months after the final psilocybin session. The study will assess changes in depressed mood at 1 week after the second psilocybin session compared to pre-treatment, and quality of life in participants from pre- to post-treatment.
Here is a video with Dr Albert Garcia-Romeu, Principle Investigator of this trial:
https://www.youtube.com/watch?v=mALege9vFn8
Here is the link to the trial:
•Animal studies suggest that psilocybin administration can enhance neuroplasticity and improve certain forms of learning and memory loss, but there is no clinical evidence YET that these effects translate into prevention or treatment of cognitive decline or impairment in humans
•2025 conference abstract reported on pilot study of 2 doses of 25mg psilocybin a week apart appeared safe and feasible in small sample of older adults (n = 5) with amnestic Moderate Cognitive Impairment (MCI); it was well tolerated under supervised conditions*
•Johns Hopkins: Psilocybin for Depression in People with Mild Cognitive Impairment or Early Alzheimer's Disease ClinicalTrials.gov identifier: NCT04123314
•Centre for Addiction and Mental Health: Does psilocybin change Synaptic Density in Amnestic Mild Cognitive Impairment? ClinicalTrials.gov identifier: NCT06041152
*Bukovsky D, et al. (2025). Safety, feasibility, and tolerability of psilocybin in older adults with amnestic MCI: Preliminary data from a SV2a PET imaging study. Alzheimer's & Dementia. 21.https://www.researchgate.net/publication/399075992_Safety_feasibility_and_tolerability_of_psilocybin_in_older_adults_with_amnestic_MCI_Preliminary_data_from_a_SV2a_PET_imaging_study
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Watch the 25 minute long TDR Psychedelic Exclusive video, with the former NHLer and advisor of Wake Network, Riley Cote, and Nick Murray, Wake Network’s CEO.
They talk about the ESPN Documentary that was released last year called “Peace of Mind.” It features retired NHL and NFL players, along with professional boxers; all of whom have experienced TBI (Traumatic Brain Injury) during their playing careers.
Cote outlines how the documentary has drawn awareness to many alumni athletes, from professional sports leagues that include the NHL, NFL, NBA, and UFC. Since the release of the documentary, the demand for people wanting to attend the Wake psilocybin retreat in Jamaica has exploded.
Wake Network is a private psychedelic company that focuses primarily on retreats, along with company partnerships that have an existing clinical footprint in the USA.
https://www.youtube.com/watch?v=WsnkNFTZ2po&ab_channel=TheDalesReport
And here is what is available for free online: ‘Peace of Mind’ from ESPN (30 minutes). You have to have a subscription to ESPN to watch it.
https://www.espn.com/watch/catalog/3ddd04cc-82b9-4f84-a32e-8c61d59373c2/peace-of-mind
You can read about it here for FREE:
https://www.espn.com/espn/story/_/id/36226140/magic-mushrooms-psychedelics-pain-hope-science-collide
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This section is "under construction."
Each of us will go through periods of sadness in our life. Unfortunately, happiness does not last forever.
Sadness is a universal emotion that we all will eventually go through. It can be triggered by the death of loved one or a beloved pet or because of losing your job or not getting promoted.
No one will escape sadness; however, grief and sorrow are not necessarily interchangeable terms. According to Ph.D. scholar Robin Dee (a psychologist with more than 30 years of experience) said that sadness is “an emotion we sometimes think about negatively and it actually is not, it’s a very adaptive feeling.” He also said that “Being sad allows us to deal with painful experiences and loss. It can be cathartic and relieve tension. It also aids in empathy for ourselves and what we’re going through, but it’s also an emotion that can help us access other people’s pain and suffering.”
What is Grief?
Grief is a normal part of our human experience here on earth. It is the name of the process your heart goes through when it has been broken.
Broken hearts grieve.
We experience grief.Grief cannot be escaped in this life.
Grief is natural but it is unique to you.
No one else knows how you feel.
Grief hurts.
Grief is not intellectual.
Grief is the price of your love.What is Sorrow?
Sorrow is an emotion, sentiment, or feelings that are more intense than sadness. Sorrow is associated with deep stress due to the loss of someone or something.
Grief and sorrow go together, but there is a slight difference in the two. Grief is the name of the process that your heart goes through when you have experienced a loss. Sorrow is the emotion that your heart is feeling. (Adapted from https://www.healingstartswiththeheart.com/are-grief-and-sorrow-the-same-thing/)
Elisabeth Kubler Ross described the Stages of Grief in 1969 in her book, On Death and Dying. David Kessler and Kubler Ross refined the stages grief in 2014 in their book, On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. Frances Weller’s book published in 2015, The Wild Edge of Sorrow: Rituals of Renewal and the Sacred Work of Grieving. He “reveals the new vitality we encounter when we welcome, rather than fear, the pain of loss.” This section will briefly review the similarities and differences between these three books, but I would recommend reading all three!
More to come…
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Watch this 46 minute video discussion from End Well with Grief therapist, Claire Bidwell Smith, palliative care physician and oncologist Dingle Spence, MD, psychiatrist and teacher Neil Hanon, MD and bereaved parent Allyson Rockwell about psychedelic-assisted grief therapy and how patients and clinicians might benefit from these new modalities of care.
https://www.youtube.com/watch?v=XZ3WM12H2Fs&ab_channel=EndWell
In his book, Spare, Prince Harry describes using psychedelics to help him cope with the death of his mother, Princess Diana. This is a reprint of the article in the New York Times on 1/10/2023. Updated 6/20/2023.
“In the book, he described trying both traditional and unconventional ways to cope with his pain and that using psychedelics was particularly helpful. After one therapist suggested that he suffered from PTSD, Harry started to use mushrooms and ayahuasca “therapeutically, medicinally.” (He had previously experimented with psychedelics recreationally.) “They didn’t simply allow me to escape reality for a while, they let me redefine reality,” he wrote.
Psychedelic therapy has experienced a groundswell of enthusiasm over the past decade as research mounts showing the mind-altering drugs can be useful for treating depression and other mental health disorders. (The therapy is still illegal in most places and is primarily done in underground sessions, abroad or through clinical trials.) However, there is scant evidence about whether psilocybin — the psychoactive ingredient in hallucinogenic mushrooms — and ayahuasca might be helpful for processing grief and trauma specifically.
Dr. Joshua Woolley, director of the Translational Psychedelic Research Program at the University of California, San Francisco, is optimistic about the drugs’ potential. “Can psychedelics help with the experience of grief? I would say probably yes,” he said.
But other experts are less bullish on the idea of using them for trauma. “The actual evidence is really lacking,” said Dr. Shaili Jain, a PTSD specialist at Stanford University and author of “The Unspeakable Mind.” “It’s very early, and we still don’t know the long-term side effects. We are not there yet.”
Grief is not a mental illness; it is a normal human experience that comes after the loss of a loved one. Sadness, anger and disbelief that the person is dead — something that Harry described in his book — are all typical responses to the profound pain of death and can last for months or years. However, if the grief has not improved at all after a year and is affecting a person’s ability to function, a diagnosis of prolonged grief, sometimes called complicated grief, might be warranted.
Grief vs Prolonged Grief
“What we see with prolonged grief is that the grief becomes very entrenched, that things look the same for this person today as they did the day after” the death, said Mary-Frances O’Connor, an associate professor of psychology at the University of Arizona and author of “The Grieving Brain.” “For a person who’s adapting more typically, a year after a loss, they’re still going to have sadness. They’re still going to miss the person who’s gone. But you can see this trajectory of change where they have started to restore a life that feels meaningful to them.”
People with prolonged grief may feel that life has lost its meaning or that a part of themselves has also died; they might have intense emotional pain or feel complete psychological numbness. Harry does not say in his book whether he was ever diagnosed with prolonged grief, but he does describe some of these emotions, and symptoms of PTSD and prolonged grief often overlap. About 10 percent of people mourning a loved one will develop prolonged grief, and the risk is higher if the death happened suddenly or traumatically.
Treatment for prolonged grief often involves cognitive behavioral therapy to help people start to move on and engage in meaningful activities again while they continue to cope with the grief. “It’s not about taking grief away,” Dr. O’Connor said. “It’s about learning how to live with the fact that you are a person who has waves of grief now.”
Using Psychedelics for Grief
Scientists think that psychedelics work in two ways: through their chemical effects on the brain and the subjective experiences a person has while on the drugs. For many people, psychedelics act like “a very intense, fast psychotherapy,” Dr. Woolley said.
Psychedelics “have this potential to induce these transpersonal states of consciousness where people might feel like they are connected” to the deceased relative or friend, added Greg Fonzo, co-director of the Center for Psychedelic Research and Therapy at Dell Medical School, University of Texas at Austin. “That might allow people to move past some of the stuckness that occurs when they’re in this phase of grief.”
In the brain, scientists think that psychedelics induce a “plastic state,” helping to rapidly form new connections between cells. Those new connections may be behind the insights and reprocessing that people can experience when they use the drugs in a therapeutic setting.
There are very few published studies focusing on psychedelics’ effect on people experiencing prolonged grief. In one of the few relevant trials, Dr. Woolley looked at whether psilocybin, combined with group therapy, could help older, long-term AIDS survivors process their depression and survivor’s guilt surrounding their diagnosis, as well as the loss of friends and family to AIDS.
The 2020 study, which included just 18 men, assessed the participants’ levels of demoralization — a therapeutic term for an existential sense of hopelessness and loss of meaning in life. Most of the participants had experienced profound grief and trauma because of the AIDS epidemic; on average, the participants had lost 17 loved ones to the disease.
After one psychedelic therapy session, nearly 90 percent of the men experienced a reduction in demoralization, and many saw a decrease in symptoms of PTSD and complicated grief. In a follow-up paper describing the men’s subjective experiences, the researchers wrote that psilocybin was “a catalyst for reconstructing their identities from rigidly centered on their past traumas to more flexible and growth-oriented life narratives.”
“The people in our study often talked about feeling stuck and detached from people around them and not able to move forward,” Dr. Woolley said. The psilocybin “did seem to help them move forward, to become unstuck and start being more engaged in life.”
Another study published in 2020 by researchers in Spain found that 39 bereaved adults who took part in ayahuasca ceremonies at a retreat center in Peru reported a decrease in the severity of their grief, and those benefits lasted for at least a year. The researchers wrote that people using ayahuasca to process their grief “described emotional confrontations with the reality of the death, the reviewing of biographical memories, and a re-encounter with the deceased.”
While these results are promising, both studies were small and neither included a control arm to compare the effects of the psychedelics against a placebo or another medication. The majority of participants in the ayahuasca study also reported that they expected to benefit from the experience, which may have had an impact on the results.
There is stronger evidence that psilocybin can be useful in treating depression, including in trials comparing the drugs’ efficacy to standard antidepressant medications. Similarly, M.D.M.A, which is sometimes classified as a psychedelic, has been shown to be effective at treating PTSD. Some researchers think that because prolonged grief has many similarities with depression and PTSD, psychedelics could be useful for treating it too.
Dr. O’Connor said that given how scientists think psychedelics work in the brain to treat depression, it’s conceivable that the drugs could also be helpful for people with prolonged grief. However, she cautioned against using the drugs to cope with grief that had not been diagnosed as prolonged or complicated.
“I would not say that it is appropriate to intervene with something as mind-altering, as dramatic, as psychedelic therapy if a person is, in fact, healing in the way that we would expect them to,” Dr. O’Connor said. “Meaning, I would worry that you could do more harm than good and that it just may not be necessary.”
The experts also emphasized that experimenting with the drugs recreationally is not the same as using them in a controlled therapeutic environment. After trying psychedelics in both settings, Prince Harry echoed this sentiment. In an interview with 60 Minutes, he said that he “would never recommend people to do this recreationally,” but that in the right setting the drugs worked “as a medicine” to help him process his grief and trauma.
REFERENCES:
Anderson BT, et al. (2020). Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot study. EClinicalMedicine. 27:100538.
González D, et al. (2020). Therapeutic potential of ayahuasca in grief: a prospective, observational study. Psychopharmacology (Berl). 237(4):1171-1182.
Learn about the End Well: https://www.endwellproject.org/
We believe all people should experience the end of life in a way that matches their values and goals. End Well is a dynamic gathering of individuals committed to generating human-centered, interdisciplinary innovation for the end of life experience.
The retreat in Jamaica link is: https://www.jamaicagriefretreats.org/
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This 18 minute video describes the multiple facets of OCD. It all comes down to anxiety and patterns to avoid anxiety. Psilocybin can treat anxiety via the effects on 5-HT2A receptors and the Default Mode Network.
https://www.youtube.com/watch?v=epDVMBNXsXY&ab_channel=JohnGlanvill-ComplexAnxietySpecialist
Research about psilocybin for OCD
Despite decades of research, first-line pharmacotherapy for anxiety disorders and stress-related disorders still relies on modulation of monoaminergic systems, which on a conceptual level has advanced very little since the first development of monoamine oxidase inhibitors in the 1950s. Early case reports from the late 1980s to 2000 suggested improvement in OCD symptoms after use of psilocybin and LSD but details of these reports are not easily found.
One modified double-blind trial of nine patients found reductions in OCD symptoms following four sessions of psilocybin-assisted psychotherapy in which varying doses of psilocybin were given across a 4-week period. Low (100 microg/kg), medium (200 microg/kg), and high (300 microg/kg) doses were assigned in that order, and a very low dose (25 microg/kg) was inserted randomly and in double-blind fashion at any time after the first dose. Testing days were separated by at least 1 week. Each session was conducted over an 8-hour period in a controlled environment in an outpatient clinic; subjects were then transferred to a psychiatric inpatient unit for overnight observation and testing. Psilocybin was safely used in subjects with OCD and was associated with acute reductions in core OCD symptoms in several subjects.
Moreno FA , et al. (2006). Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry 67 : 1735 – 1740.
Two additional case reports in 2014 and 2021 were published without specific details.
A case report of a patient with refractory OCD treated with psilocybin and followed prospectively for a year, with marked symptomatic improvement. Improvement in OCD symptoms (YBOCS declined from 24 to 0–2) was accompanied by broader changes in his relationship to his emotions, social and work function, and quality of life.
A clinical trial is currently still underway at Yale University comparing Psilocybin (0.25mg/kg) to Niacin (250mg).
Details from one patient in the trial were published - his name is Daniel. At one point during the dosing session, Daniel stated aloud, “This is giving me my life back.” Later on, as the effects wore wearing off, Daniel described the psychedelic experience he'd just been through as “the most intense cascade of emotions he had ever felt.”
Starting with the first integration at 48 hours and onward, Daniel reported a new “space” separating him from his OCD symptoms and a changed relationship with them. Overall, Daniel's reported increased cognitive and emotional flexibility seemed to pervade his everyday life one-month post-dosing. He described a more flexible approach to living, in which he attuned to his body more and adjusted accordingly.
At 12 weeks post-dose, Daniel reported that OCD was no longer a significant part of his life, despite having a persistent “imprint” of obsessions and compulsions in his mind. He felt that if he didn't continue to work at managing this imprint, he could “slip back,” but even if that happened, he now had the “tools” to manage it. Referring to his OCD, he said, “Even if this were to come back, I'm on it.”
Kelmendi B, et al. (2022). Single-dose psilocybin for treatment-resistant obsessive-compulsive disorder: A case report. Heliyon Dec 6;8(12):e12135.
In an online survey of 174 patients with OCD, it was found that psilocybin and LSD reduce symptoms and anxiety.
Among classic psychedelics users, 92% of participants used psilocybin mushrooms, 77% used LSD, 29% used DMT, 11% used mescaline and 9% used ayahuasca. The mean(SD) dose of psilocybin was 20.30 (16.74)mg, ranging from 1 to 88 and the mean(SD) dose of LSD was 131.56 (69.85)μg, ranging from 10 to 250.
When participants were asked whether they had taken the substance again, 23% (n = 21) answered ‘no’. Among the 77% who took it again, 47% (n = 42) reported an intake frequency of at most 3 times a year, 14% (n = 13) reported once a month and 16% (n = 14) at least once a week. The magnitude of OCD improvement was positively associated with both the intensity and the pleasantness of the experience. None of the factors included in the analysis significantly predicted the pleasantness of the acute effects.
The researchers we explored the substance dose used by participants who declared taking the substance at least once a week. Among them, 57% (n = 8) used microdosing with doses lower than 10 µg for LSD and 4 mg for psilocybin, 21% (n = 3) did not provide any information and the remaining 21% (n = 3) reported using regular doses (250 µg for LSD and above 35 mg for psilocybin).
The researchers explored the substance dose used by participants who declared taking the substance at least once a week. Among them, 57% (n = 8) used microdosing with doses lower than 10 µg for LSD and 4 mg for psilocybin, 21% (n = 3) did not provide any information and the remaining 21% (n = 3) reported using regular doses (250 µg for LSD and above 35 mg for psilocybin).
Buot A, et al. (2023). Improvement in OCD symptoms associated with serotonergic psychedelics: a retrospective online survey. Sci Rep 13, 13378 (2023).
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Watch this 4 minute video from NBC about a woman who smoked a pack a day for 40 years. She stopped smoking after one psilocybin session at Johns Hopkins University.
https://www.youtube.com/watch?v=usDWmqn-JCs&ab_channel=NBCNews
Study about psilocybin and smoking:
A recent pilot study in 15 people found that two to three moderate to high doses (20 and 30 mg/70 kg) of psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone.
All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16 – 57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up.
At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At this follow-up, 13 participants (86.7%) rated their psilocybin experiences among the 5 most personally meaningful and spiritually significant experiences of their lives.
At 16-month follow-up, nine participants (60%) were confirmed as smoking abstinent. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence.
Johnson MW, Garcia-Romeu A, Griffiths RR. (2014). Long-term follow-up of psilocybin-facilitated smoking cessation. Am J Drug Alcohol Abuse 43(1):55-60. https://pubmed.ncbi.nlm.nih.gov/27441452/
This RCT at Johns Hopkins confirmed that psilocybin helped in smoking cessation.
Design, Setting, and Participants In this pilot randomized clinical trial, participants and investigators were unblinded to treatment condition, including an optional crossover after completion of the primary end point. Data were collected from psychiatrically healthy adult smokers from January 20, 2015, to May 8, 2023.
Intervention The trial randomized cigarette smokers to receive either 1 high dose (30 mg/70 kg) of psilocybin or initiate 8 to 10 weeks of US Food and Drug Administration–approved nicotine patch treatment on the target quit date. Both groups received a 13-week manualized CBT program for smoking cessation.
Main Outcomes and Measures Biochemically verified prolonged smoking abstinence (primary) and 7-day point prevalence abstinence (secondary) at 6 months after the target quit date were compared between groups using intention-to-treat analysis.
Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R., & others. (2024). Psilocybin-assisted treatment for smoking cessation: A randomized clinical trial. Nature Medicine.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2846155
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There are two videos in this section.
The first video is 3 minutes long and succinctly describes what happens in the brain with moderate to heavy drinking. It was produced by the Ventura Recovery Center.
https://www.youtube.com/watch?v=WXbttnDkp7E&ab_channel=VenturaRecoveryCenter
This 20 minute video from Awakn Life Sciences, a Toronto-based company who focus on the use of psychedelics to treat addiction. It features Dr. David Nutt, a well-respected English neuropsychopharmacologist specializing in the research of drugs that affect the brain.
Studies on psIlocybin:
In this double-blind randomized clinical trial with 93 participants with Alcohol Use Disorder (AUD) were given 2 administrations of high-dose psilocybin (25mg/70kg) vs 50mg diphenhydramine (Benadryl) plus 12 weeks of manualized psychotherapy; the percentage of heavy drinking days during 32 weeks of follow-up was significantly lower in the psilocybin group than in the diphenhydramine group.
Bogenschutz MP, et al. (2022). Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry 79(10):953–962.
Eleven adult patients completed task-based blood oxygen dependent functional magnetic resonance imaging (fMRI) approximately 3 days before and 2 days after receiving 25 mg of psilocybin (n = 5) or 50 mg of diphenhydramine (n = 6). Unique to negative cues, psilocybin increased supramarginal gyrus activity; unique to positive cues, psilocybin increased right hippocampus activity and decreased left hippocampus activity. Greater PFC and caudate engagement and concomitant insula, motor, and cerebellar disengagement suggests enhanced goal-directed action, improved emotional regulation, and diminished craving.
Pagni BA, et al. (2024). Psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder: an fMRI pilot study. Sci Rep 14, 3159.
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“In total, at least 10 studies with over 400 participants have focussed on evaluating the impact of psychedelics on symptoms of anxiety or ‘existential dread’ in response to a cancer diagnosis.”
https://post.parliament.uk/psychedelic-assisted-therapy-to-treat-anxiety-disorders/
“One study examined anxiety in 12 patients with life-threatening diseases. It was found that after two doses of LSD, self-reported anxiety symptoms were reduced after 2 and 12 months when compared with a control group receiving a placebo.
Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart.
The participants received either 200 micrograms of LSD (n = 8) or 20 micro grams of LSD with an open-label crossover to 200 micrograms of LSD after the initial blinded treatment was unmasked (n = 4).”
Gasser P, et al. (2014). Safety and efficacy of LSD-assisted psychotherapy for anxiety associated with life threatening disease. J Nerv Ment Dis 202:513-20.
In one study, “36 healthy volunteers received a high dose (30 mg/70 kg) of psilocybin with no sustained deleterious physiological or psychological effects. The investigators corroborated previous findings that psilocybin could reliably catalyze mystical experiences leading to significant and lasting improvements in quality of life.”
Griffiths R, et al. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology (Berl) 187 (3) 268- 283
“Another trial in 12 patients with advanced-stage cancer and anxiety used psilocybin-assisted therapy (0.2 mg/kg) vs a placebo of niacin (250 mg). All patients received both medicines. The participants had significantly reduced scores of measures of anxiety 1 and 3 months after their second dose.”
Grob CS, et al. (2011). Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer. Arch Gen Psychiatry 68(1):71–78.doi:10.1001/archgenpsychiatry.2010.116
“These positive findings were repeated in another trial using a single-dose of psilocybin (0.3mg/kg) in 29 individuals with cancer-related anxiety in conjunction with psychotherapy. The effects were sustained when participants were followed up after 7 weeks. After 6.5 months, 60-80% of patients had clinically significant reductions in depression or anxiety, demonstrating the long-lasting nature of PAP.”
Ross S, et al. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol 30(12):1165-1180.
“A large trial compared a very low dose of psilocybin with a high dose on anxiety and depression in 51 patients with life-threatening cancer diagnoses. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up.
The study reported significant reductions in anxiety symptoms both immediately after psilocybin-assisted therapy and six months later, demonstrating the effectiveness of this treatment approach in this patient population.”
Griffiths RR, et al. (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.
“To explore the underlying mechanism, researchers subsequently surveyed over 3,000 individuals who had used psychedelics and people who had had near death experiences.
They found similar responses between these groups, indicating psychedelic experiences may fundamentally change one’s attitudes towards death and dying.
However, the methods used in this survey means that is difficult to account for any elements of bias, such as some types of people being more likely to choose to participate. This is a common issue across research relying on survey data.”
Sweeney MM, et al. (2022). Comparison of psychedelic and near-death or other non-ordinary experiences in changing attitudes about death and dying. PLoS One 17(8):e0271926.
Agin-Liebes, G, et al. (2020). Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in cancer patients. Journal of Psychopharmacology, 34(2), 155-166. (Follow-up study)
Together, these studies confirm that patients with life-threatening cancer diagnoses experienced rapid and sustained reductions in anxiety, depression, hopelessness, and fear of death.
Large decreases in anxiety and depressive symptoms.
Improved spiritual well-being and quality of life.
Benefits often lasted 6 months or longer.
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LInk to this site for multiple videos about this topic. There is also a research article linked below.
https://www.autisticpsychedelic.com/video
Before you watch or read any research about autism, I’d recommend watching the Blog on Metaplasticity. Dr. Gul Dolan talks about what is known about the genetic markers of autism and about critical periods. It’s a long video and they ramble a bit, but there is good information there.
Autism: “Recent clinical and preclinical evidence points towards empathogenic and prosocial effects elicited by psychedelic compounds, notably the serotonin 5-HT2A agonists like LSD, psilocybin, DMT. These findings suggest a therapeutic potential of psychedelic compounds for some of the behavioural traits associated with autism spectrum disorder (ASD), a neurodevelopmental condition characterized by atypical social behavior.”
This 2021 article “reviews evidence that suggests that psychedelics may potentially ameliorate some of the behavioural atypicalities of ASD, including reduced social behavior, anxiety and depression. The article also discusses clinical studies from the 1960s and 70s that assessed the use of psychedelics in the treatment of children with ASD.”
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Ego dissolution is a complex concept to understand but it sounds scary. Medium to large doses are usually required to experience this and it may be necessary for new perspectives to emerge.
It seems scary because how do you know what your consciousness would feel like without your sense of who you are – who do you become without you?
Psychedelic drugs, holotropic breathwork and deep meditation are reported to help people focus on something besides themselves. One becomes less of themselves and more like a being in attunement with nature and the universe. Once you enter an altered state of consciousness, what’s left in your mind can be wonderful or terrifying, depending on many factors.
There are two videos in this section.
The first one is 4 minute video from the Mind Foundation for an explanation of ego dissolution.
https://www.facebook.com/watch/?v=3998298733555801
The second video is 4 minutes long and is produced by Sam Harris, PhD describing his experience after taking 5 grams of psilocybin. He is a neuroscientist, philosopher, New York Times best-selling author, host of Making Sense, and creator of Waking Up.
It’s beautiful, it’s mesmerizing, it’s a little bit unsettling. I hope you like it.
https://www.youtube.com/watch?v=zHmg-mYHgLE&ab_channel=SamHarris
The long explanation of his journey can be found here:
https://www.youtube.com/watch?v=yKGddvmU0fA&ab_channel=SamHarris
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There are several studies about psilocybin and mindfulness summarized below. Further on there are two videos in this section.
First Study:
The shared mechanisms between mindfulness training and psychedelic intervention have led to scientists theorizing, and recently demonstrating, positive synergistic effects when both are used in combination. Research findings suggest that these two approaches can complement each other, enhancing the positive effects of both interventions.
Holas P, Kamińska J. Mindfulness meditation and psychedelics: potential synergies and commonalities. Pharmacol Rep. 2023 Dec;75(6):1398-1409. doi: 10.1007/s43440-023-00551-8. Epub 2023 Nov 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661803/
Second Study:
Ten healthy and psychedelic-naïve volunteers underwent PET neuroimaging of 5-HT2A receptors at baseline and one week after a single oral dose of psilocybin (0.2–0.3 mg/kg). Personality (NEO PI-R) and mindfulness (MAAS) questionnaires were completed at baseline and at three-months follow-up.
It was found that there were statistically significant increases in personality openness and as a new finding - the discovery that mindfulness improved.
Madsen MK, et al. (2020). A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding, Europ Neuropsychophar 33:71-80.
Watch this 12 minute video about one young lady’s 6 week transformation after she began her practice of meditation.
https://www.youtube.com/watch?v=pi9Xvh-Dva4&ab_channel=BBCNews
In this 20 minute video, Dr. David Vago provides a scientific explanation about how mindfulness affects the brain. He is the research director at the Osher Center for Integrative Medicine at Vanderbilt University Medical Center and a research associate in the Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School.
https://www.youtube.com/watch?v=1nP5oedmzkM&ab_channel=TEDxTalks
His study stated that they provided some of the participants in mindfulness-based contemplative training. A link to his study: https://cih.ucsd.edu/mbpti/blog/mbsr-fibromyalgia-preliminary-study
A link to a FREE contemplative mindfulness course from Dr. Andrew Weil: https://integrativemedicine.arizona.edu/online_courses/contemplative_care.html
Another website that provides assistance with meditation that has very favorable reviews (but isn’t free):
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This section contains a 12 minute video that explains the mechanism of action, the side effects of both psilocybin and SSRIs.
https://www.youtube.com/watch?v=ec-JXdi4yqI
Psilocybin is a classical psychedelic which has been utilized for healing purposes for millennia. However, with its classification as a Schedule I substance, research into this compound is scarce with few FDA-approved clinical studies. Despite this, profound findings into its antidepressant effects (largely through its action on 5-HT1a receptors) in mental illnesses such as major depressive disorder have rapidly increased interest back into their potential therapeutic benefits.
This systematic review provides an analysis of the studies examining the clinical use of psilocybin for major depressive disorder. In total 6 studies were selected, including 319 participants, with half being randomised controlled trials and half open label trials. In every study psychological support was included as an integral part of the treatment.
It was found that every study significantly favoured the use of psilocybin in reducing depressive symptoms, with few side effects. This gives psilocybin an advantage over commonly prescribed selective serotonin reuptake inhibitors (SSRIs), which carry more risk and cause more adverse effects.
This natural plant medicine therefore shows promise for being used as a clinical treatment for major depressive disorder, however future research should develop a paradigm for its use, with the timing of sessions and type of psychological support specified to allow for more precise analysis of the clinical effects of the drug. Additionally, more studies into its clinical efficacy are needed for appropriate detection of any publication bias.
With this, psilocybin could prove to be revolutionary in treating depression and become an alternative medication to SSRIs.
Watford T, Masood N. Psilocybin, an Effective Treatment for Major Depressive Disorder in Adults - A Systematic Review. Clin Psychopharmacol Neurosci. 2024 Feb 29;22(1):2-12.
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A summary of The Immortality Key written by Brian Murareski:
The book proposes a provocative thesis: that the roots of Western religion (especially early Christianity) involve a psychedelic sacrament inherited from ancient Greek mystery-cult traditions. He argues that ancient rituals, especially the Eleusinian Mysteries in Greece used various psychoactive brews (entheogens), and that the Christian Eucharist (or early versions thereof) may have derived from or supplanted those sacramental practices.
1. Ancient Mysteries Promised Immortality Through Experience
Aristotle once said the initiates came to Eleusis not to learn something, but to experience something.
Eleusis, the spiritual capital. For two thousand years, the Greek sanctuary of Eleusis drew pilgrims seeking life beyond the grave. Unlike traditional worship, the Eleusinian Mysteries offered a direct, transformative experience, promising initiates they would "never die." This profound encounter, shrouded in secrecy under penalty of death, was the core of Western civilization's first major spiritual tradition.
A promise of immortality. Prominent figures like Plato, Pindar, and Sophocles attested to the Mysteries' power, claiming the ritual banished the fear of death and revealed a blessed afterlife. This "beatific vision" was the ultimate goal, achieved after a long initiation culminating in the consumption of a sacred beverage called the kukeon and a night of spectacles in the temple.
The enduring riddle. Despite its immense influence and longevity (from 1500 BC to AD 392), the precise nature of the Eleusinian experience remains history's "best-kept secret." The strict code of silence and the destruction of the site by early Christians left only tantalizing clues about the kukeon and the vision it induced.
2. A Psychedelic Hypothesis Challenged Classical Scholarship
“The Greeks just wouldn’t have done that sort of thing.”
A radical theory emerges. In 1978, ethnomycologist R. Gordon Wasson, chemist Albert Hofmann (discoverer of LSD), and classicist Carl Ruck proposed that the kukeon was a psychedelic brew, likely containing ergot alkaloids derived from barley. This theory suggested the Eleusinian vision was chemically induced, linking ancient Greek religion to mind-altering substances.
Academic and cultural backlash. The hypothesis was met with scorn, dismissed as "perverse" and "unconvincing." In the context of the burgeoning War on Drugs, the idea that the founders of Western civilization used psychedelics was deeply unpopular and seen as a threat to established norms and the perceived rationality of the Greeks.
A scholar's exile. Carl Ruck, the only academic in the trio, paid a heavy price for his association with the controversial theory. He was marginalized within his field, denied opportunities, and largely ignored, demonstrating the powerful resistance to reinterpreting classical history through the lens of psychoactive substances.
3. Prehistoric Brews Hint at Ancient Ritual Intoxication
“In fact, I think they used drugs. Because they wanted to have, eh … how do you say, illusions.”
Drugs were "natural" in antiquity. Despite modern skepticism, ancient sources and archaeological finds suggest a long history of ritual drug use. The Pythia at Delphi may have used ethylene gas or plants like laurel or henbane for her prophecies, and the Homeric epics mention witches like Circe using potent "pharmaka" (drugs) in their potions.
Beer predates bread? The "Beer Revolution" hypothesis suggests that the desire for fermented beverages, not just food, drove the transition from hunting/gathering to agriculture around 10,200 BC. Recent finds support this:
13,000-year-old stone mortars at Raqefet Cave, Israel, show evidence of beer brewing in a burial context.
Göbekli Tepe in Turkey (12,000 years old) features massive stone basins potentially used for large-scale ritual feasting with beer.
Graveyard beer and the afterlife. These early brews appear linked to death cults and ancestor veneration, suggesting a ritual purpose beyond simple intoxication. This tradition of using fermented drinks to commune with the dead may stretch back to the Stone Age, predating the Eleusinian Mysteries by thousands of years.
4. Hard Evidence Links Greek Colonies to Psychedelic Potions
“We should have no trouble with that,” Ruck responds. “It’s time that we acknowledge our heritage.”
The search for the kukeon. With no testable vessels from Eleusis itself, the hunt for a psychedelic kukeon turned to Greek colonies. The Phocaeans, "Vikings of Antiquity" from Anatolia, established settlements across the Mediterranean, including Emporion in Spain, bringing their cults and practices with them.
Mas Castellar de Pontós. Excavations at this Greek farm in Catalonia revealed a "domestic chapel" with evidence of an agrarian cult linked to Demeter and Persephone. Finds included:
Subterranean grain silos used as sacred chambers.
Terra-cotta figures of Demeter/Persephone and their missionary Triptolemus.
Ritual dog sacrifices and funerary banquets.
The smoking gun. A miniature Greek chalice from the chapel tested positive for ergot, the same fungus Ruck hypothesized was in the Eleusinian kukeon. This 2,200-year-old find, along with other nightshade-infused beers in ancient Iberia, provides the first direct evidence of a psychedelic potion used in a Greek-influenced ritual setting, supporting the idea that the Eleusinian sacrament was indeed drugged.
5. Ancient Greek Wine Was a Potent, Drugged Elixir
“It looks like a morel or some kind of mushroom.”
Wine as pharmakon. Ancient Greek literature consistently describes wine as a powerful "pharmakon" (drug), capable of inducing states ranging from healing to madness to death. Unlike modern wine, it was often mixed with various plant additives.
Visual clues on pottery. Red-figure vases like G 408 and G 409 in the Louvre depict Dionysian wine-mixing rituals, showing maenads adding mysterious ingredients to kraters. While damaged, one vase hints at a mushroom or herb being added, suggesting the visual representation of a drugged potion.
Dioscorides' recipes. The first-century pharmacologist Dioscorides documented numerous "wine formulas" in his Materia Medica, detailing how to mix wine with potent and often psychoactive plants like henbane, mandrake, and black nightshade, which he noted produced "not unpleasant visions." This confirms a widespread knowledge of drugging wine in the Greek world.
6. The Gospel of John Cast Jesus as a Dionysian Wine God
“You know … we call the Eucharist the pharmakon athanasian,” he beams, using the Ancient Greek phrase for the “Drug of Immortality.”
Dionysian parallels in John. The Gospel of John uses specific Greek language and imagery to link Jesus to Dionysus, the God of Ecstasy. Examples include:
Jesus's first miracle: turning water into wine at Cana, Dionysus's "signature miracle."
Jesus as the "True Vine," a direct symbol of Dionysus.
Jesus as the "only begotten" Son of God, echoing Dionysus's unique birth.
Jesus's crown of thorns and purple cloak, symbols of Dionysus.
The Eucharist as apotheosis. John's Gospel presents the Eucharist as a means of achieving immortality and becoming one with God, using language ("gnawing" flesh, "True Drink") that mirrors Dionysian rituals of consuming the god's flesh and blood (omophagon charin). This suggests the Christian sacrament was understood as a "Drug of Immortality" (pharmakon athanasias), a concept explicitly used by early Christian writers like Ignatius of Antioch.
A deliberate strategy. By portraying Jesus as the new Dionysus and his Eucharist as a potent pharmakon, John's Gospel appealed to Greek-speaking pagans familiar with the Mysteries, offering Christianity as a continuation and culmination of their own spiritual traditions.
7. Early Christian Eucharist May Have Been a Psychedelic Sacrament
“That’s why … a considerable number of you are dying.”
A different kind of Eucharist. Early Christian communal meals, known as agape or "love feasts," were sometimes marked by excessive drinking. Saint Paul's First Letter to the Corinthians suggests these gatherings could be chaotic, with some getting drunk.
Lethal wine in Corinth? Paul's stark warning in 1 Corinthians 11:30 that "a considerable number" of Corinthians were "dying" from partaking in the Eucharist unworthily suggests the sacrament was more than symbolic. The Greek word used for "dying" (koimontai) is unambiguous, implying the consumption of a potent, potentially lethal substance.
Blending pagan and Christian rites. In Rome, the pagan refrigerium (funerary banquet) tradition, where wine was essential for communing with the dead, merged with the Christian Eucharist. These "chill-outs" in catacombs and cemeteries, sometimes lasting all night, were seen as ways to nourish the deceased and gain access to the afterlife.
Evidence in the catacombs. Frescoes in Roman catacombs like the Hypogeum of the Aurelii depict funerary banquets that resemble the Last Supper, featuring a raised chalice and twelve figures. The presence of pagan motifs like Circe and Dionysian initiation scenes alongside Christian symbols suggests a syncretic period where the Roman cult of the dead and the Christian Eucharist overlapped, potentially involving a shared tradition of potent, perhaps drugged, wine.
8. Women Led Underground Rituals Blending Pagan and Christian Rites
“Whenever Christianity spread,” says the scholar Torjesen, “women were leaders of house churches.”
Women's central role. In ancient mystery cults like those of Demeter and Dionysus, women often held prominent leadership positions and were key to preparing sacred sacraments. This tradition continued in early Christianity, where women like Lydia, Priscilla, and Junia led house churches and played vital roles in the community.
Keepers of the sacrament. Women were traditionally responsible for domestic tasks, including preparing food and beverages. In the context of house churches and catacomb refrigeria, this placed women in charge of the Eucharist, the central ritual meal.
Evidence in Roman catacombs. Frescoes in the Catacombs of Priscilla and Saints Marcellinus and Peter depict women presiding over funerary banquets, raising the Eucharistic cup and directing the mixing of wine. Latin inscriptions like "Misce!" (Mix it up!) and "Da calda!" (Hand over the warm stuff!) suggest women were actively involved in preparing a special, possibly heated or infused, wine for these rituals.
A challenge to patriarchy. The prominence of women in early Christian rituals, particularly their handling of the Eucharist, challenged the patriarchal norms of both Roman society and the emerging male-dominated Church hierarchy. This may have contributed to the later suppression of women's roles.
9. Gnostic Christians Practiced a Visionary, Female-Led Eucharist
“Without visions and revelations, then, the Christian movement would not have begun.”
Gnosis and direct experience. Gnostic Christians sought direct, intuitive knowledge (gnosis) of God, believing the divine spark resided within. They emphasized personal mystical experience over dogma and hierarchy, a perspective that resonated with ancient mystery cults.
Gospel of John and Gnosticism. The Gospel of John, with its emphasis on Jesus as the "True Vine" and the Eucharist as a means of achieving immortality, was particularly favored by Gnostics. They interpreted its "secret symbols and language" as pointing to a hidden doctrine of spiritual transformation.
Female Gnostic leaders. Gnostic texts like the Gospel of Mary Magdalene portray women as key disciples and visionaries, entrusted with secret teachings. Figures like Simon Magus's partner Helena and Valentinus's student Marcus were associated with Gnostic groups in Rome that practiced alternative, often female-led, Eucharists.
A drugged Eucharist? Church Fathers like Irenaeus and Hippolytus accused Gnostic groups like the Marcosians of using "love charms" and "drugs" in their rituals, specifically mentioning women mixing a potent, possibly psychedelic, wine that induced "frenzy" and "ecstasy." This suggests a Gnostic Eucharist may have involved psychoactive substances to facilitate visionary experiences.
10. The Inquisition Targeted Witches for Their Heretical Sacraments
“Although they pretended to be good Catholic Christians,” writes historian Karen Jolly about the many women who attended the Sabbat, “they represented the most dangerous of all enemies of the human race and the Christian Church.”
Survival of alternative practices. Despite the suppression of Gnosticism and the marginalization of women in the mainstream Church, traditions of folk healing, ritual intoxication, and alternative Eucharists persisted, particularly in rural areas and among women.
The Sabbat and its Eucharist. Medieval and Renaissance accounts describe the witches' Sabbat as an alternative Mass, often involving a "wine" or potion mixed with psychoactive ingredients like those found in the witches' ointment (henbane, nightshade, mandrake). Some accounts mention a "toad Eucharist" with potentially psychedelic bufotenine.
Witchcraft as heresy. The Church, particularly through the Inquisition, began to view these practices not just as pagan superstition but as a direct blasphemy of the Christian Eucharist and a pact with the Devil. This elevated witchcraft to a major heresy, justifying brutal persecution.
Targeting women and knowledge. The Inquisition's focus on prosecuting women, often mothers and daughters, suggests an attempt to eradicate a lineage of knowledge about plants, herbs, and potions that had been passed down through generations, potentially including recipes for alternative sacraments.
11. A Renaissance Magus Hinted at a Surviving Psychedelic Tradition
“For a time it was like seeing so many frenzied Bacchanals (tanti furiosi debaccanti), inebriated with that which they saw so plainly.”
Bruno's heretical vision. Giordano Bruno, a Renaissance philosopher from Campania, was burned at the stake for his radical ideas, including a cosmology of infinite worlds and a critique of the Church. His work hinted at a revival of ancient Greek magic and philosophy.
Circe and the beatific vision. In his writings, Bruno used the figure of the Greek witch Circe and her "drugs" (veneficii) as an allegory for achieving the beatific vision, the ultimate mystical experience. He described the resulting state as being "inebriated" like "frenzied Bacchanals," linking his pursuit of enlightenment to Dionysian practices.
Campania's mystical legacy. Bruno's hometown in Campania was part of a region with deep roots in Greek mysticism, home to figures like Pythagoras, Parmenides, and Plotinus, who practiced techniques for dying before dying. This region also had a long history of Dionysian cults and, as suggested by the Villa Vesuvio find, potent, possibly drugged, wine.
Inquisition records. Bruno's trial records, partially preserved in the Vatican archives, show the Inquisition was concerned with his views on the Eucharist. While not explicitly mentioning drugs, his association of mystical vision with ancient Greek "drugs" and his critique of the Christian sacrament suggest he may have been privy to a surviving tradition of alternative, perhaps psychedelic, Eucharists.
12. Modern Science Resurrects the Ancient Beatific Vision
We have tasted of God and our eyes have been opened.
The psychedelic renaissance. Modern research into psilocybin and other psychedelics is revealing their capacity to reliably induce profound mystical experiences, often described as the most meaningful events in a person's life. These experiences closely resemble the "beatific vision" sought in ancient mysteries and by mystics across religions.
Safety, reliability, scalability. Unlike ancient methods, modern science offers controlled, safe, and potentially scalable ways to access these states of consciousness. This addresses the historical limitations that prevented ancient mystical traditions from becoming widespread.
Healing modern crises. Researchers like those at Johns Hopkins suggest these experiences can alleviate anxiety, depression, and fear of death, and may foster increased empathy, connection to nature, and pro-social behavior. This aligns with the ancient idea that such experiences could "hold the entire human race together."
A new Reformation. The potential for widespread access to reliable mystical experiences through regulated psychedelic therapy could lead to a "revival of religion" focused on direct experience rather than dogma. This echoes the ancient religion with no name, which prioritized personal encounter with the divine.
The future of the Eucharist. If the original Christian Eucharist was indeed a psychedelic sacrament, its modern scientific resurrection offers a path to reconnecting with the mystical core of the faith and addressing the spiritual alienation of the modern world.
In essence: The Immortality Key argues that the sacred door to mystical transformation in the West was once an entheogenic sacrament (a ritual drink that induced visionary experience) embedded in the Greek Mysteries; that early Christianity inherited and transformed that sacrament into the Eucharist (losing the entheogenic element and institutionalizing the ritual); and that the revival of psychedelics today invites us to revisit that ancient sacramental model as a pathway to meaning, healing and transcendence.
Critiques & caveats
Important to note: the book is provocative rather than definitive. Muraresku himself acknowledges much of the argument is speculative. Some points to keep in mind:
The evidence for specific psychoactive substances (e.g., ergot, psychedelics in the kykeon) is suggestive rather than conclusive. Some chemical-archaeological work is promising, but the record is fragmentary. cyberdisciple
Some scholars caution that the book’s tone or framing tends to align with contemporary psychedelic-therapy advocacy, which may influence how the history is portrayed. cyberdisciple
The leap from Greek Mystery cult → early Christianity → modern psychedelics is ambitious and contains many inferential steps. As with any grand synthetic thesis, it invites skepticism and further research.
The book is as much about the modern implications of psychedelic spirituality as it is about strict historical proof.
A presentation by Brian Murareski: https://www.youtube.com/watch?v=HYbTXsOtRss
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MAPS Bulletin 12/8/2025
“Observe the varied shades of green.” “Close your eyes and take in the sounds of nature.” “Notice the movement of the leaves.” “Touch a tree as fully as you feel comfortable and embrace it as a fellow being.”
On a temperate weekend morning in the UCLA Botanical Garden, Sylvie Rokab, a forest bathing guide, led a group of healthcare professionals, including myself, in using the senses to connect with nature. The guided experience was peaceful and educational; the ability to move through natural settings more mindfully and intentionally has since become something that I have maintained. These are some basic elements of shinrin-yoku, the Japanese art of forest bathing, and the experience in the UCLA garden was proof that one doesn’t need to be in a vast woodland to reframe one’s relationship with nature.
It’s clear to most of us that Western society’s relationship with nature needs revamping, with humans increasingly separated from nature due to factors such as widespread urbanization and most children favoring electronic devices over playing outdoors, resulting in an “extinction of experience”. In a recently published study, Miles Richardson, a researcher at the University of Derby, cleverly used the frequency of nature-related words in books published since the 1800s to demonstrate a 60% decline in nature-connectedness over time. Earlier, Richard Louv, in his popular 2005 bestseller “Last Child in the Woods”, coined the term “nature-deficit disorder,” reflecting the change in children’s play relationships with nature. In parallel with our separation from the natural world, Western thinking has embraced individualism, materialism, and human exceptionalism (seeing ourselves as distinct and more important non-human elements of nature).This separation from nature is not universal and has not always been so pervasive. Numerous Indigenous cultures place deeper importance on the relationship with nature. One particularly interesting study of First Nations elders in Canada was conducted by Dr. Nicole Redvers of the University of Western Ontario. Some elements of the nature relationship included (some common to numerous North American Indigenous nations) primacy of law coming from nature rather than from people, the inseparability of the health of nature from the health of all species including humans, and recognition of deep inter-connectedness between people and all things of nature (“the plants, rivers, lakes, wind, are all our relatives out there”). Many cultures across the world are more nature-connected than we are, with deeper connection to the land and environment, rich relationships and knowledge of plant medicines and plant allies, a relational approach to environmental stewardship, and recognition that human intelligence is far from the only intelligence out there. There is a wholeness and depth in the natural world, a sense of the sacred, and an understanding of the importance of reciprocity and land stewardship that Western societies have lost.
Western science is beginning to catch on to the benefits of nature connection. Spending time in nature improves physical health, mental health, and general well-being. While the evidence is difficult to dispute, science still doesn’t agree on why being in nature has a positive effect on human well-being. One of the more popular theories, Attention Restoration Theory, was devised by Rachel and Stephen Kaplan in the 1980s. It suggests that being in nature shifts our psychological state to a more effortless mode of attention, lessening the noise bombarding our brain’s attentional system, improving our cognitive functioning, and promoting feelings of calm. Roger Ulrich, famous for demonstrating that hospital patients with views of green spaces recover more quickly from surgery, coined the Stress Recovery Theory, which suggests that nature provides a restorative environment that aids in recovery from emotional and physiological stresses. E.O. Wilson, the evolutionary biologist most famous for his work on group behavior of insects and sociobiology, popularized the term “biophilia” and suggested that humans have a deeply innate affinity for life and the natural world. Another clue to why nature is so beneficial may come from the study of awe, the emotion of reverence and wonder. Dacher Keltner, UC Berkeley’s researcher and world’s expert on awe, notes that the experience of awe is common to both meaningful experiences in nature and to psychedelic experiences.
The current era of Western history may be reaching a watershed moment, as many simultaneous movements aiming to realign our relationship with nature are taking root. To list just a few examples: Japan and South Korea have led other nations in encouraging a national practice of forest bathing (shinrin-yoku) by public campaigns, physician training, and establishing public forest bathing paths within the national park systems. Architecture is starting to incorporate features of biophilic design, an approach that uses nature-inspired design to mimic or integrate natural elements to foster nature connection. Schools are increasingly building green playgrounds with the aim to improve childhood development and attention in school. The number of grassroots and advocacy movements at local and national levels is growing rapidly. If you live in a medium to large city, you have a good chance of seeing urban farms, community gardens, urban greening movements, environmental justice groups, and maybe even a group belonging to the rewilding humans movement.
Within healthcare and scientific research, in addition to established movements such as One Health and Planetary Health, a newer movement emerging from UC Los Angeles is the Ecological Medicine movement. Founded by Helena Hansen, Professor and Chair of Psychiatry, and Landon Pollack, entrepreneur and philanthropist, it is an approach that hopes to counter the trend toward individualism and reductionism in medicine and science. Instead, it argues that understanding the full spectrum of human health requires understanding people’s connections to themselves, to others, to other forms of life, and to the wider environment. In short, health is dependent on inter-connectivity, inter-dependency, and relationality, not just the evaluation of a person in isolation. Two important components are: 1) a better understanding of inter-connectivity and wholeness, inspired and informed by Indigenous wisdom, and 2) bringing nature-based interventions into the healthcare system.There are many paths toward nature-connectedness, such as forest bathing, companion animals and animal-assisted therapy, gardening, urban farming, time spent in parks and other natural settings, and even virtual reality nature experiences (just to name a few). Nature connectedness is built on a foundation of actively noticing and engaging with nature, rather than more passive or superficial interactions. As integral ecologist and nature connectedness researcher, Matthew Zylstra has stated: “it’s not just contact with nature, but the nature of the contact.”
A particularly ancient and powerful path to nature-connectedness comes through the use of psychedelic plants and fungi. Western cultures are beginning to find in Indigenous knowledge rituals and meaning that are missing in their own cultures. The resulting mixing of Westerners and Indigenous knowledge keepers has brought traditional plant and fungal medicine rituals of ayahuasca, mushrooms, and peyote to the West, along with both benefits and harms resulting from this cultural exchange. The West has learned that these psychedelic agents can elicit encounters with the sacred or mystical, contact with nature entities and spirits, and an enhanced sense of connectedness to others or the environment. Some of these experiences encompass elements of animism, a belief system present for most of human history’s relationship with natural world – with a repertoire of greater sacred reverence for the aliveness of all things. It is notable that historical use of psychedelic rituals has been outdoors or in settings with more nature contact (as well as largely being in group settings), perhaps optimized to harness the power of psychedelic medicines to improve relationships with the community and the land (as opposed to the common Western model of individual sessions in closed spaces). There has been research on the power of psychedelic experiences to promote nature-connection, but the field is still in its infancy.
Sam Gandy, an ecologist and psychedelic researcher, is one of the foremost experts in the field. According to Dr. Gandy, a single psychedelic experience is potentially capable of eliciting a rapid and robust increase in nature-connectedness. He also notes that such shifts may be more likely when psychedelics are used in nature-based settings, and there are commonalities between meaningful experiences in nature and psychedelic experiences, such as experiencing awe, occasioning mystical experiences, and loosening the boundaries of the self and readjusting our sense of identity in relation to the natural world. Though more research is needed, an enticing proposition is whether psychedelic experiences might translate into greater pro-environmental behavior. In essence, nature-based reconnection and reciprocity with the land could be viewed as mutual healing and a road to planetary stewardship.
There is reason for hope that despite the planetary crisis, more people are recognizing the urgent importance of reconceptualizing how we interact with nature. A multitude of movements are being fueled by the ethos that our collective health depends on reframing and prioritizing our relationship with nature in a meaningful way. While the “discovery” of the benefits of nature-based interventions in healthcare and the power of psychedelic experiences to connect us to nature are important, they are, in fact, rediscoveries of long-held Indigenous wisdom that has been largely overlooked by Western science. Deeper connection to nature, with humility and reverence, and a renewed sense of stewardship come from this wisdom, along with a sense of rejoining of humanity with the rest of nature (the more than human). There are ecological and environmental wounds and injustices that need healing, and perhaps what we learn from nature-connection, Indigenous wisdom, and psychedelic plants and fungi might help us on the right path of human and planetary health. This may help usher in a shift in perspective, where we see ourselves as existing as a part of nature, instead of apart from nature.
It is apt to conclude with the words of Albert Hofmann, the Swiss chemist and discoverer of LSD, who felt that the capacity of psychedelics to reconnect our species with the natural world was their most fundamental role. Shortly before his death, at the mighty age of 101, he said: “alienation from nature and the loss of the experience of being part of the living creation is the greatest tragedy of our materialistic era. It is the causative reason for ecological devastation and climate change. Therefore, I attribute absolute highest importance to consciousness-change. I regard psychedelics as catalyzers for this.”Written by : Michael Makhinson is Chair of Psychiatry at Harbor-UCLA Medical Center and Clinical Professor in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA. He completed his M.D., and Ph.D. (neuroscience) degrees at UCLA. He then completed his Psychiatry residency, also at UCLA. After residency, Michael then joined the Harbor-UCLA faculty, spending 17 years as co-director of the inpatient psychiatry service before taking the position of Chair. His current interests are in exploring psychedelic-assisted therapy and Ecological Medicine. He is on the Executive Committee of the multi-site Pragmatic Trial of Psilocybin Therapy in Palliative Care (PT2PC) and is on the academic council of Project ReConnect at UCLA, working to explore research, education, and practice in Ecological Medicine. He also enjoys the language of the birds and the sounds of the river and the ocean.
References1. Richardson M. Modelling Nature Connectedness Within Environmental Systems: Human-Nature Relationships from 1800 to 2020 and Beyond. Earth. 2025; 6:82.
https://doi.org/10.3390/earth6030082
2. Redvers N, Lockhart F, Zoe JB, Nashalik R, McDonald D, Norwegian G, et al. Indigenous Elders’ voices on health-systems change informed by planetary health: a qualitative and relational systems mapping inquiry. Lancet Planetary Health. 2024; 8:e1106-e1117.
https://doi.org/doi: 10.1016/S2542-5196(24)00277-8
3. Makhinson, M., Pollack, L., Hallowell, R., Murray, C. H., Maddock, J. E., Stewart, S. M., Basu, A., King, D., Hansen, H., & Ecological Medicine Working Group (2025). A Consensus Statement for Ecological Medicine: Moving Toward Connection-Based Medicine. EcoHealth, 10.1007/s10393-025-01757-3. Advance online publication. https://doi.org/10.1007/s10393-025-01757-3
4. Kettner H, Gandy S, Haijen EC, Carhart-Harris RL. From egoism to ecoism: Psychedelics increase nature relatedness in a state-mediated and context-dependent manner. International journal of environmental research and public health. 2019; 16:5147.https://doi.org/10.3390/ijerph16245147
5. Irvine A, Luke D, Harrild F, Gandy S, Watts R. Transpersonal ecodelia: surveying psychedelically induced biophilia. Psychoactives. 2023;2:174-93.https://doi.org/10.3390/psychoactives2020012
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Clinical conditions for which psilocybin-assisted therapy has demonstrated statistically significant positive outcomes in RCTs and the studies in each category
Major Depressive Disorder (MDD)
Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., ... & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry, 78(5), 481-489.
Raison, C. L., Sanacora, G., Woolley, J., Heinzerling, K., et al. (2023). Single-dose psilocybin treatment for major depressive disorder: A randomized clinical trial. JAMA, 330(9), 843-853.
Davis, A. K., et al. (2023). Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up. Journal of Psychopharmacology, 37(5), 479-488. (Follow-up study)
Treatment Resistant Depression (TRD)
Carhart-Harris, R. L., Giribaldi, B., Watts, R., Baker-Jones, M., Murphy-Beiner, A., Murphy, R., ... & Nutt, D. J. (2021). Trial of psilocybin versus escitalopram for depression. The New England Journal of Medicine, 384(15), 1402-1411.
Existential Depression (Cancer-related Anxiety & Depression)
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.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., ... & Schmidt, B. L. (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.
Agin-Liebes, G., Malone, T., Yalch, M. M., et al. (2020). Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in cancer patients. Journal of Psychopharmacology, 34(2), 155-166. (Follow-up study)Item description
Depression in Frontline Healthcare Workers with Burnout
Stauffer, C. S., et al. (2025). Psilocybin-assisted group psychotherapy plus mindfulness-based stress reduction for frontline healthcare provider COVID-19-related depression and burnout: A randomized clinical trial. Journal of Psychopharmacology.
Alcohol Use Disorder
Bogenschutz, M P, et al. (2015). Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology, 29(3), 289-299.
Bogenschutz, MP, et al. (2022). Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs active placebo in the treatment of adult patients with alcohol use disorder. JAMA Psychiatry, 79(10), 953-962.
Tobacco Use Disorder
Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R., & others. (2024). Psilocybin-assisted treatment for smoking cessation: A randomized clinical trial. Nature Medicine.
Johnson, M. W., Garcia-Romeu, A., & Griffiths, R. R. (2014). Long-term follow-up of psilocybin-facilitated smoking cessation. The American Journal of Drug and Alcohol Abuse, 40(6), 486-491. (Follow-up study)
Obsessive-Compulsive Disorder
Moreno, F. A., Wiegand, C. B., Taitano, E. K., & Delgado, P. L. (2006). Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. Journal of Clinical Psychiatry, 67(11), 1735-1740.
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Clinical conditions for which psilocybin-assisted therapy had early small RCTs or promising preliminary findings, but evidence is small and there are no definitive RCTs yet
Anorexia Nervosa
Spriggs, M. J., et al. (2024). Psilocybin therapy for anorexia nervosa: Feasibility and preliminary outcomes. Nature Medicine.
Peck, S. K., et al. (2023). Psilocybin-assisted psychotherapy for anorexia nervosa: Initial findings. Journal of Eating Disorders.
Chronic Migraine Headaches
Schindler, E. A. D., et al. (2021). Exploratory controlled study of psilocybin for migraine. Neurotherapeutics.
Cluster Headaches
Sewell, R. A., Halpern, J. H., & Pope, H. G. (2006). Response of cluster headache to psilocybin and LSD. Neurology.
Schindler, E. A. D., et al. (ongoing studies).
Demoralization in AIDS Survivors
Stauffer, C. S., et al. (2021). Psilocybin-assisted therapy for demoralization in AIDS survivors. Psychopharmacology.
Anderson, B. T., et al. (2020). Group therapy with psilocybin in older long-term AIDS survivors.
Post-Traumatic Stress Symptoms
Catlow, B. J., et al. (2013). Psilocybin and fear extinction in mice. Experimental Brain Research.
Ongoing ClinicalTrials.gov studies.
Chronic Pain Syndromes
Glynos NG, et al. (2023). Knowledge, Perceptions, and Use of Psychedelics among Individuals with Fibromyalgia. J Psychoactive Drugs. 55(1):73-84.
https://www.axios.com/local/san-diego/2025/03/25/ucsd-study-psilocybin-phantom-limb-pain
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Clinical conditions for which psilocybin-assisted therapy is under active investigation, but published RCTs are not yet available or the results that are available are inconclusive.
Bipolar Depression
Aaronson ST, et al. (2024). Single-Dose Synthetic Psilocybin With Psychotherapy for Treatment-Resistant Bipolar Type II Major Depressive Episodes: A Nonrandomized Open-Label Trial. JAMA Psychiatry. 81(6):555-562.
Generalized Anxiety Disorder
Feulner L, et al. (2023)Efficacy and Safety of Psychedelics in Treating Anxiety Disorders. Ochsner J. 23(4):315-328.
Social Anxiety Disorder
Feulner L, et al. (2023)Efficacy and Safety of Psychedelics in Treating Anxiety Disorders. Ochsner J. 23(4):315-328.
Felsch CL & Kuypers PC. (2022). Don’t be afraid, try to meditate- potential effects on neural activity and connectivity of psilocybin-assisted mindfulness-based intervention for social anxiety disorder: A systematic review, Neuroscience & Biobehavioral Reviews. 139,104724.
Alzheimer’s Disease Related Depression
Zheng S, et al. (2024). Psilocybin for the treatment of Alzheimer's disease. Front Neurosci. 18:1420601.
Parkinson’s Disease Related Depression
Bradley ER, et al. (2025). Psilocybin therapy for mood dysfunction in Parkinson’s disease: an open-label pilot trial. Neuropsychopharmacol. 50, 1200–1209.
Methamphetamine Use Disorder
Brett J, et al. (2023). Exploring psilocybin-assisted psychotherapy in the treatment of methamphetamine use disorder. Front Psychiatry. 14:1123424.
Opioid Use Disorder
Weleff J, et al. (2025). The therapeutic effects of psychedelics for opioid use disorder: A systematic review of clinical studies. Psychiatry Research 348:116446.
Cocaine Use Disorder
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2848
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Chronic pain is recognized as a condition that involves damaged tissues or inflamed nerves, and changes in the brain’s processing of pain, emotion, memory, and stress. Because conventional treatments such as opioids, anti-inflammatory medications, anticonvulsants, and antidepressants often provide incomplete relief, clinicians and researchers have begun exploring psychedelic and dissociative therapies as alternatives.
Two of the most discussed emerging approaches are outpatient treatment with Ketamine and Psilocybin. Although both are sometimes grouped under the broad umbrella of “psychedelic-assisted therapies,” they differ substantially in mechanism, evidence base, accessibility, safety profile, and clinical application for chronic pain.
Ketamine is currently the more established outpatient treatment. Originally developed as an anesthetic, ketamine acts primarily as an N-methyl-D-aspartate (NMDA) receptor antagonist. In chronic pain, this mechanism is important because NMDA receptors are involved in central sensitization, a process in which the nervous system becomes hypersensitive and amplifies pain signals over time. By interrupting these pathways, ketamine may temporarily reduce pain intensity and improve function, especially in neuropathic pain syndromes, fibromyalgia, complex regional pain syndrome (CRPS), and severe centralized pain conditions (Faisco, 2024; Tankha, 2025).
In outpatient settings, ketamine is typically administered through intravenous (IV) infusions, although some clinics use intramuscular, oral, or intranasal formulations. IV and IM routes are more effective due to their bioavailability. Treatment protocols vary widely, but many involve several low-dose infusions over consecutive days followed by maintenance sessions.
One advantage of outpatient ketamine therapy is that it can often be integrated into multidisciplinary pain management programs that include physical therapy, psychotherapy, and behavioral medicine. Some observational studies report improvements not only in pain severity but also in depression, sleep, anxiety, and daily functioning (Tankha, 2025; Faisco, 2024).
Despite growing clinical use, the scientific evidence for ketamine in chronic pain remains mixed. A recent Cochrane review evaluating ketamine and related NMDA antagonists concluded that there is currently no clear high-quality evidence supporting sustained benefit for chronic non-cancer pain. Researchers noted that many studies were small, poorly standardized, or methodologically weak. (Ferraro, 2025). This creates tension in the chronic pain community: Many clinicians and patients report meaningful symptom relief, yet the strongest evidence (RCTs) required for broad clinical consensus is still lacking.
The side-effect profile of ketamine is also troubling. Acute effects can include dissociation, dizziness, nausea, elevated blood pressure, hallucinations, and anxiety. Repeated or high-dose use may carry risks involving cognition, urinary tract injury, dependence, and misuse. Concerns have also emerged regarding inconsistent regulation of outpatient ketamine clinics and variable standards of monitoring and patient selection (Laise, 2025). Nevertheless, ketamine remains legally available in many outpatient clinics because it is already FDA-approved for anesthesia, allowing off-label prescribing for pain.
Psilocybin occupies a very different position. Unlike ketamine, psilocybin remains largely investigational for chronic pain and is usually available only through clinical trials or specialized research programs in the United States. Psilocybin acts primarily through serotonin 5-HT2A receptor agonism and appears to affect brain connectivity, emotional processing, and neuroplasticity. Rather than functioning mainly as a direct analgesic, psilocybin may alter how pain is perceived emotionally and cognitively. Researchers increasingly believe that chronic pain involves learned neural patterns, emotional trauma, catastrophizing, and persistent threat signaling in the brain. Psilocybin-assisted therapy may help disrupt these entrenched patterns (Agnorelli, 2024; Jevotovsky, 2025).
The current evidence for psilocybin in chronic pain is preliminary but intriguing. A recent systematic review found early signs that psilocybin may help conditions such as phantom limb pain, neuropathic pain, migraine and cluster headaches, and fibromyalgia, although most studies were low quality and involved small sample sizes (Gaviria-Castillo, 2025; Jevotovky, 2025).
One especially notable area of investigation involves phantom limb pain. Researchers at the University of California San Diego reported dramatic early findings in a small randomized study in which psilocybin appeared to substantially reduce phantom pain symptoms (Zeiden, 2025). Investigators hypothesized that the treatment may work partly by helping patients process trauma associated with injury and amputation.
Psilocybin therapy also differs from ketamine in how treatment is delivered. Ketamine infusions are often medicalized procedures focused on symptom reduction, whereas psilocybin treatment is usually embedded within extensive psychotherapy preparation and integration sessions.
A psilocybin experience typically lasts several hours and can involve profound emotional or spiritual experiences. Many researchers believe the therapeutic benefits are inseparable from the psychological experience itself. In contrast, ketamine’s benefits may occur even when the dissociative effects are minimized.
The safety considerations for psilocybin are somewhat different as well. Psilocybin does not appear to carry the same addiction potential associated with ketamine, and it is generally considered physiologically safe in medically supervised settings.
However, it may provoke intense anxiety, panic, transient paranoia, or destabilization in vulnerable individuals, particularly those with psychotic disorders or severe psychiatric illness or at “heroic” doses. Because the subjective effects are powerful and unpredictable, psilocybin therapy requires careful screening, supervision, and psychological support (Jevotovsky, 2025).
Another major distinction concerns legality and accessibility. Outpatient ketamine clinics are now widespread across the United States, though insurance coverage for chronic pain treatment is inconsistent because most use is off-label. Psilocybin, by contrast, remains federally classified as a Schedule I substance, although several states (Oregon and Colorado) have moved toward decriminalization or supervised therapeutic access.
As of 2026, psilocybin therapy for chronic pain is still primarily a research intervention rather than a standard outpatient treatment (Lapid, 2026)..
From a clinical perspective, ketamine currently has the advantage of practicality and immediacy. Patients with severe refractory pain may access treatment relatively quickly, and some experience rapid relief within days. Psilocybin, however, may ultimately prove valuable for a different dimension of chronic pain: the emotional suffering, trauma, depression, existential distress, and maladaptive pain processing that often accompany long-term illness.
The two therapies may therefore represent complementary rather than competing paradigms. Ketamine primarily targets neural sensitization and acute symptom reduction, whereas psilocybin may facilitate deeper cognitive and emotional reorganization.
Ketamine and psilocybin may both help chronic pain, but they work through very different mechanisms in the brain.
One important difference involves the NMDA receptor, which plays a major role in central sensitization, a process in which the nervous system becomes overly reactive and continues generating pain signals even after an injury has healed.
Ketamine works primarily by blocking NMDA receptors. This reduces excessive glutamate activity and interrupts abnormal pain signaling pathways. Because of this direct NMDA antagonism, ketamine can produce relatively rapid pain relief, especially in conditions such as neuropathic pain, fibromyalgia, and complex regional pain syndrome (CRPS). However, the effects are often temporary, and repeated treatments may be needed (Faisco, 2024).
Psilocybin works differently. Rather than directly blocking NMDA receptors, psilocybin is converted in the body to psilocin, which primarily activates serotonin receptors, especially 5-HT2A receptors. Activation of 5-HT2A receptors appears to increase neuroplasticity and alter brain connectivity involved in mood, perception, and pain processing. In addition to 5-HT2A, psilocin also interacts with other serotonin receptors, including 5-HT1A, 5-HT2C, and 5-HT1B receptors (Nichols, 2016). These additional receptor effects may contribute to emotional regulation, anxiety reduction, mood improvement, and modulation of pain perception (Vollenweider & Kometer (2010)).
The activity at multiple serotonin receptors may help explain why psilocybin appears to affect the emotional and cognitive dimensions of chronic pain rather than simply reducing pain intensity itself.
Researchers believe psilocybin may help “reset” maladaptive brain networks involved in fear, catastrophizing, depression, and long-term pain conditioning (Agnorelli, 2024; Gaviria-Castillo, 2025).
As a result, psilocybin may eventually be most useful for chronic pain conditions strongly linked with emotional distress, trauma, or altered pain processing.
These differences suggest that ketamine may currently be more effective for immediate symptom reduction because it directly targets NMDA-mediated sensitization.
Psilocybin, by contrast, may offer broader effects on mood, neuroplasticity, and the brain’s interpretation of pain through its actions on multiple serotonin receptor systems. Although ketamine currently has stronger evidence for pain relief, research on psilocybin is growing and may reveal benefits for the long-term psychological and neurological aspects of chronic pain.
There are several healing centers in Colorado that offer both. For example, in clients who may be nervous about a psilocybin journey, a ketamine session is offered a few days to a week before the psilocybin journey.
REFERENCES
Agnorelli, C., Spriggs, M., Godfrey, K., Sawicka, G., Bohl, B., Douglass, H., Fagiolini, A., Parastoo, H., Carhart-Harris, R., Nutt, D., & Erritzoe, D. (2024). Neuroplasticity and psychedelics: A comprehensive examination of classic and non-classic compounds in pre and clinical models. arXiv. https://arxiv.org/abs/2411.19840
Faísco, A., Dinis, R., Seixas, T., & Lopes, L. (2024). Ketamine in chronic pain: A review. Cureus, 16(2), e53365. https://doi.org/10.7759/cureus.53365
Ferraro, M., et al. (2025). Ketamine use in chronic pain unsupported by evidence. Cochrane. https://www.cochrane.org/ja/about-us/news/ketamine-use-chronic-pain-unsupported-evidence
Gaviria-Castillo, A., et al. (2025). Psilocybin and chronic neuropathic pain: A systematic review. Regional Anesthesia & Pain Medicine. https://pubmed.ncbi.nlm.nih.gov/39106989/
Laise E in Marketwatch (4/2024). https://www.marketwatch.com/story/as-ketamine-therapy-booms-industry-insiders-worry-about-patient-safety-5ffd7b89?utm_source=chatgpt.com
Lapid, N in Reuters. (2026, April 21). What to know about psychedelic therapies cited by Trump. Reuters. https://www.reuters.com/business/healthcare-pharmaceuticals/what-know-about-psychedelic-therapies-cited-by-trump-2026-04-21/
Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. https://doi.org/10.1124/pr.115.011478
Tankha, P., & Tankha, H. (2025, October 6). Cleveland Clinic study demonstrates safety, effectiveness of ketamine for chronic pain. Cleveland Clinic Newsroom. https://newsroom.clevelandclinic.org/2025/10/06/cleveland-clinic-study-demonstrates-safety-effectiveness-of-ketamine-for-chronic-pain
Vollenweider, F. X., & Kometer, M. (2010). The neurobiology of psychedelic drugs: Implications for the treatment of mood disorders. Nature Reviews Neuroscience, 11(9), 642–651. https://doi.org/10.1038/nrn2884
Zeidan, F. (2025). UCSD study suggests psilocybin could treat phantom limb pain. Axios San Diego. https://www.axios.com/local/san-diego/2025/03/25/ucsd-study-psilocybin-phantom-limb-pain