A new study offers promising results for psilocybin-assisted psychotherapy for depression—but these results must be considered preliminary. The data indicated that 54% of those receiving the treatment remitted (no longer met the criteria for depression after four weeks). Still, there was no placebo-controlled group to which the results could be compared. The placebo response rate for depression is usually estimated as falling between 40% and 50%, but some studies have found placebo responses as high as 70%.
The researchers write, “Further studies are needed with active treatment or placebo controls and in larger and more diverse populations.”
Without a placebo-controlled group to which we can compare these results, it is unclear if the findings are due to the drug, the psychotherapy, or a placebo effect. Previous research has indicated that much, if not all, of the improvement in these cases, may be due to all of the aspects surrounding the drug use—preparation, expectation, relationships, a healing setting, an explanation of improvement, and a ritual.
The current study, published in JAMA Psychiatry, was led by Alan K. Davis and Roland R. Griffiths at Johns Hopkins School of Medicine. Psilocybin is a recreationally used psychedelic (hallucinogenic) drug found in certain varieties of mushrooms. Experimental treatments using recreational drugs for depression have been gaining more attention lately, although results are still unclear, and controversies have plagued the therapies.
Davis and Griffiths’ new study was small—including just 13 people randomly assigned to the psychedelic-assisted therapy group, and 11 people randomly assigned to a waitlist control group. Results were measured at multiple time points after the intervention. After 8 weeks, the 11 waitlisted participants also received the drug-assisted therapy, and their results were also included, although there is no comparison group for these participants.
In this study, the intervention included 18 sessions of “supportive psychotherapy,” as well as two-day-long hallucinogenic drug sessions during which two “facilitators were present in the room and available to respond to participants’ physical and emotional needs.”
The primary outcomes were the response to treatment (improvement of at least 50% on the GRID-HAMD) and remission of symptoms (score of less than 8 on the GRID-HAMD). A huge battery of secondary measures was also given to the participants, including multiple other depression rating scales, anxiety scales, scales of mystical experiences, and questions about potential side effects.
The primary results were promising: the average GRID-HAMD score before treatment was 22.9; it was reduced to 8.0 at week 5 and 8.5 at week 8. One week after the intervention, 67% of the participants had improved by at least 50% (response to treatment); this increased to 71% by week 4. Additionally, one week after the intervention, 58% were considered “remitted” (scored less than 8 on the GRID-HAMD); at week 4, it was 54%.
According to the researchers, their results indicate that this intervention may be better than antidepressant prescription:
“The effectiveness of psilocybin therapy after a single or only a few administrations represents another substantial advantage over commonly used antidepressants that require daily administration.”
Again, it is unclear how these results would stack up against psychotherapy alone or placebo drug sessions, as the researchers did not include placebo-controlled or psychotherapy-alone groups. However, women have been found more likely to improve when taking placebo, which could be a factor here, as roughly two-thirds of the participants in this study were women.
Interestingly, during their psychedelic sessions, a wide assortment of potentially frightening or dangerous experiences occurred. Here’s a selection (not a comprehensive list):
92% of the participants felt like crying, 79% felt sadness, 77% felt emotional and/or physical suffering, 60% felt grief, 58% felt isolation and loneliness, 48% felt despair, 40% felt panic, 33% felt that something horrible would happen, and 31% had the profound experience of their own death
Additionally, 29% felt that they were going insane, 17% felt antagonistic toward the people around them, and 8% felt that people were plotting against them. 33% experienced headaches, and one person experienced high blood pressure.
The researchers write that “given that psilocybin was associated with nonserious adverse effects that were frequently reported as mild-to-moderate headache and challenging emotions that were limited to the time of sessions,” this therapy may provide a less dangerous alternative to antidepressants, which have a host of long-term adverse effects.
There were a number of limitations to the study, making these results preliminary, even if promising.
First, the size of the study was very small. 13 participants took part in the initial psilocybin-assisted therapy session, and they were compared with 11 participants who were waitlisted. Small studies like this run the risk of being biased just due to chance, and a difference of one or two participants can considerably shift the results.
For instance, consider a poll of 13 people regarding the US election. If 6 of those people predicted a Biden win, and 7 predicted a Trump win, the statistical conclusion is that Biden would have a 46% chance of winning the election. If a single person changed their mind, this jumps up to a 54% chance, completely changing the outcome. If another person changes their mind, it jumps to 62%.
Likewise, in a small study like this, if one or two people randomly improve, that can considerably change the percentage of people expected to improve due to the treatment.
Having a waitlist control group, as this study did, is a legitimate strategy for mitigating this effect; it is intended to control for the possibility of spontaneous remission. Many people with a diagnosis of depression do improve without any treatment at all. The waitlist group should compare how many people in the study would be expected to do so. However, again, when the study is this small, a difference of one or two people due to chance can considerably alter the results.
The study was single-blinded, which is also a legitimate strategy for preventing one type of bias; this means that the researchers who assessed whether symptoms improved did not know whether the participants belonged to the psilocybin group or the waitlist group. If done well, this effectively controls for the researchers’ biases about the outcome.
However, the participants themselves were not blinded—they were aware of whether they were on a waitlist or receiving a hallucinogenic drug experience. This means that the placebo effect was not controlled at all. Because the researchers did not include a placebo-controlled group, it is unknown whether a placebo drug experience would have resulted in the same improvement—or if psychotherapy alone could have resulted in that improvement.
Each participant had at least 18 in-person psychotherapy visits and at least two drug treatments. 18 therapy appointments alone could result in considerable improvement, as could the placebo effect of two drug treatments.
Both drug treatments were also day-long experiences in which the participants’ physical and emotional needs were cared for by professionals; it is unclear whether two days of having your physical and emotional needs attended to might result in some improvement, even without taking a hallucinogenic drug.
Unfortunately, the waitlist control group doesn’t provide a good comparison for any of these experiences.
Davis, A.K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N.D., Johnson, M. W., . . . & Griffiths, R. R. (2020). Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry. Published online November 4, 2020. DOI:10.1001/jamapsychiatry.2020.3285 (Link)
I just read a summary of this study in Medscape, a website providing medical information to health professionals. The headline stated that Psilocybin provided “remarkable” relief for severe depression, a claim I found inaccurate give the limitations of the study. Your article was far more informative and was a pleasure to read. However, I am suspicious of these preliminary results, given the pharmaceutical industry’s push to cash in on the ingredients in hallucinogens and given the shameful history of so many pharmaceutical-backed psychiatric studies. The overhyping of the results of this study to medical professionals makes me feel even more strongly that caution is warranted
Despite the potentially promising results, I still don’t like the general premise of this research–the idea that some people are “mentally ill” with depression and in need of professional “help.” If drugs are the answer, why not research alcohol and cigarettes? Those drugs make plenty of people feel better, and they don’t need to accept a label of mental illness to use them, or accept whatever abusive treatment psychiatrists come up with for their patients.
I once asked one of my psychiatrists, “Are people supposed to be happy all the time?” She went on to “explain” to me how profoundly mentally ill I was with “depression,” because I had cried when I talked about and remembered my dead sister. And, yes, I did need more drugs. I feel it’s okay, and should be okay, for people to have a full range of emotions, including “depression.” It may be easier to be around people who are always sparkling, happy, and optimistic. On the other hand, those kinds of people can be annoying, insensitive, and lack empathy.
Wow, you’re sad about your sister dying? No WONDER they drugged you! You’re not a complete automaton yet!
Thank you, Steve. I take it you’re not a psychiatrist!!!
You take it right!
The hypotheses for the use of psychedelic drugs to help states of sadness, anxiety, addiction and so on have some significant differences from past drugs marketed for these things.
Having a psychedelic experience by itself is thought to be one reason why using magic mushrooms can help with these things. For this mechanism of action people don’t need to do the drugs daily. One or a few trips on the drugs is suggested. A problem I see is this turning into people taking mushrooms constantly all the time.
Psychedelics have less addiction potential and cause less harm to some ones health compared to any psych drug. Meaning even if they don’t help at all, using them over psych drugs will produce a net benefit by removing the harm from psych drugs.
You’re experience is common. I know people who were put on drugs after a family member attempted suicide or they lost a job. People with negative life events are put on drugs and told they are ill. I wonder how many people don’t even bother mentioning negative life events because they believe they must be “ill” and drugs will help while talking about painful things just causes more pain.
I disapprove this article for the following reasons:
The article presents itself as a measured critique of a valid scientific subject, in so doing it totally misses the point.
There is no such thing as a real illness called “depression” and therefore no cure either.
Psychotherapy is not a real therapy, like oxygen therapy for example, but a cultural relationship similar to the Christian confession or to the exorcism of demons. Psychotherapy is surrounded by the same kind of irrational mystic.
By design it is not scientific, but it can be the object of scientific investigation, like ethnology.
What this study describes is a ritual similar to shamanism, embellished with a scientistic pretension unique to modern culture. Whoever takes these scientistic claims seriously proves that he has not understood anything about what “depression”, “treatment” and “psychotherapy” really are, namely simulation of illness and simulation of medicine: cultural traits. A rational person observe in this experience people who ritualistically indulge in drug addiction, and surround it with a contemporary scientistic and mystical justification: psychiatry.
It is reprehensible to present the “results” of this study as promising or scientific.
Drug addiction is an instrument of the bourgeoisie aimed at stupefying and weakening the proletariat, preventing it from looking for the real causes of its misfortune and paralyzing it with rituals of self-mortification.
The mortification presented here produces an artificial psychosis and a state of psychic vulnerability which, even in the long term, “benevolent” people are sure to exploit.
People who voluntarily place themselves in a state of vulnerability will suffer the consequences. The people who encourage people to weaken themselves are foxes and those who trust in them are baby rabbits. Any auto-intoxication, any drug addiction will have its biological and social consequences.
In short, this kind of research has to be denounced for what it is: a stupid advertisement for narcotics, the level of scientificity of which does not exceed that of a village sorcerer who justifies the use of hallucinogens to hunt demons (today, our neo-shamans hunt “depression”, to seem more modern), and whose social goal is illusion, attrition and submission.
Actually, the village shaman is on a higher ethical plane, because at least s/he is not pretending that s/he is engaged in some kind of objective “science.”
Timothy Leary urged people taking LSD for the first few times to be accompanied by a “guide,” who was familiar with its effects from personal experience, to help them through psychic “ruts” and avoid freaking out at the experience. But Leary, at least after a while, wasn’t advocating LSD as a psychiatric treatment but as a tool for breaking through psychic programming: “turn on, tune in, drop out” was a highly political statement.
Incidentally Leary once wrote to Szasz, calling The Myth of Mental Illness the greatest literary achievement of the 20th Century.
Sadly in our society someone’s actions don’t determine their ethical status. Authority and social status determine if someone is considered ethical in our society. That’s why a psychiatrist is a hero for addicting kids to amphetamines while lying about how meth is a health product.
A meth dealer on the street selling meth to adults lacks authority and social status and therefore should be jailed. This is despite the meth dealer adhering more to the medical ethic of informed consent compared to the psychiatrist.
I agree with Sylvain on pretty much everything except the legitimacy of psychedelics themselves, which are hardly “narcotics” (or stimulants). But putting the psychedelic experience in medical or pseudo-medical trappings is ridiculous.
What a sham! Psychedelics can be incredibly valuable in opening up areas of consciousness that we repress, but they are NOT “therapy”; they are more akin to the sort of awareness “normally” accessed via deep meditation. “Therapists” should be kept a minimum of 100 miles away from anyone going through this process, and it would be inexcusable for any practitioner to portray the results of such a basically spiritual experience as having anything to do with “therapy.”
I pretty much agree with you there oldhead.
OTOH, if psychedelic ‘therapy’ can attract people away from the other options sold as therapies with a bit of fuzzy labeling I don’t see that as a bad thing. Fact is, people will be seeking ‘therapy’ for their socially unacceptable emotional and mental states for a good while yet.
OTOOH it is said that Charles Manson controlled his minions by taking small doses of LSD while giving them mind-blowing amounts and manipulating their vulnerabilities. Sort of like some therapy, I guess, except with LSD added.
Hey, I heard they just legalized mushrooms somewhere? 🙂
All Charlie would have had to do is be sure to use LSD every week. The tolerance it produces is so strong he could then take very large doses for very little effect.
Oregon just voted to legalise. Several cities and counties such as Denver and Oakland have already done so.
Decriminalize, not legalize. But yeah.
Washington state, I believe. Actually, it was foolish to try to outlaw hallucinogenic mushrooms in Washington state in the first place, because there were so many common varieties, some of which grew on lawns and in grassy parks. You would have to dig up and/or apply fungicide to every lawn in the state.
I tried magic mushrooms (psilosibin) while camping in the forest this summer. What a completely underwhelming experience. I had always been told I should avoid psychedelics, that I’m too high strung and I’d have a bad trip. But it was just a very low key and kind of boring feeling of being semi-connected to something very slightly more spiritual. No big revelations or anything. So I honestly don’t see the appeal. But I am very glad I wasn’t stuck in some clinic or psych office during the experience. At least I was able to enjoy my surroundings in nature while I waited for what amounted to nothing to happen.
Firstly it’s dose related. The ‘therapeutic’ dose is meant to bring about mystical experiences and/or ego death and is much higher than a usual recreational dose. Due to emetic chemicals in mushrooms a lot of people will have trouble holding down enough of them to get that sort of dose. In clinical trials the psilocybin is purified or synthesised so you don’t get that problem. You can also moderate the problem by thoroughly drying the shrooms before use; at least if you’re using psilocybe cubensis (gold top) shrooms.
Secondly there’s quite a few things that can moderate the effect due to competition with the 5HT-2A receptors the psychedelic chemicals act upon. These include cannabis and, ironically, antidepressants. So unless they withdraw from their pills first a lot of the people going for these therapies are going to get a reduced effect.
Also, psychedelics produce instant tolerance. If you take a mind bending quantity of shrooms or acid then take a similar dose the next day you will get very little effect. It takes 2-3 weeks for tolerance to get back to normal levels.
And the people doing this ‘therapeutically’ are aware of the importance of setting. It’s not done in a normal lab or office but something set up more like a chill room at a rave. Often the subject is lying down in an eye-mask and headphones listening to music meant to help set the atmosphere.
The ‘therapy’ consists of preparation, which helps the subject approach the trip in a constructive, open manner (often involves learning meditation/relaxation techniques and how to ’embody’ emotional experiences), guiding/sitting during the trip to help them through difficult parts (ego death is often existentially terrifying), and post-trip integration. A strong trip brings about experiences so far outside most people’s prior experience it’s generally impossible to express in words (ineffable) and can’t be incorporated into narrative memory, so it slips away like a dream. Integration is meant to ‘fix’ the insights gained during a trip so they can inform later work the subject does on their issue, whether emotional, psychological, social or spiritual.
It’s not the chemical that does the job. What it does is temporarily knock down your ego defences that can be keeping you locked in a self-defeating mindset. Having hopefully seen through whatever thought patterns are sabotaging her the subject can then, hopefully, ‘cure’ herself. That’s why you don’t need to keep taking it as with psychiatric drugs. One or two experiences will generally be enough for years or a lifetime. Nor do you generally need long term follow-up therapy. A few post-trip integration sessions suffice.
And as oldhead points out, people are hyper-suggestive when their ego defences are down and subject to manipulation, though as the CIA discovered during MKULTRA research, it can be difficult to manipulate them in a predictable way. So unethical or ignorant practitioners can do a lot of harm with this sort of stuff.
And no, what I know about this isn’t just theoretical. I can testify to its effectiveness personally and from the feedback of those I’ve guided. Mostly I’ve used it in addiction work (nicotine and alcohol) but I’ve also seen excellent results in people suffering trauma related anxiety. I also use it with people experiencing spiritual crises or blockages, with more mixed results. The insights gained during a trip can be incompatible with some spiritual outlooks and bring about a crisis of faith, though many people consider their first high-dose trip to be the most spiritually significant event of their lives (even if they’re atheists).
I can testify that they really screwed up my son’s life, too. Testimony is evidence only in the most limited sense. And the process you describe is not a “medical” intervention, but a spiritual/religious ritual, and so does not belong in the realm of “treatment,” even if it does work.
I agree psychedelic ‘therapy’ isn’t a medical intervention. But neither is psychiatry, though it purports to be. And yeah, testimony is anecdote, not data. I’m speaking of my own experience here, not making universalised claims about efficacy. Maybe I’ve just been lucky.
But I’d also assert that few of the problems people receive psychiatric treatment for are medical. They’re mostly social but often have a large spiritual dimension too, so ritual interventions are probably more appropriate than medical ones in many cases.
The Synthesis Institute in the Netherlands calls its psychedelic interventions ‘ceremonies’. I call mine ‘sessions’, not therapy. I definitely *don’t* call myself a therapist, counselor, coach or shaman. I’m just someone with extensive experience of being with people who are tripping.
And I’m sorry to hear about your son. I take as much medical, family and personal history as possible before agreeing to a session – particularly legal and illegal drug use – and reserve the right to refuse if I see any red flags or if it just feels wrong. I start with a low dose test session to see how someone will react but also to give them a better idea of what it’s about before deciding on a high dose session. I also check BP prior to a session because of the hypertensive risks. And because I’m not a professional and don’t see what I’m doing as a commercial service I don’t accept payment. But I’m still not entirely comfortable with the risks of what I do, especially the legal ones. NSW police regularly kill people who are under the influence of psychedelics.
I think there’s ethical questions about representing this as therapy but, as Sami Timimi recently pointed out, psychiatry is more closely aligned with the pseudo-religious ideology of scientism than with medical science and that’s resulted in a society that thinks misnamed ‘therapy’ is the only legitimate way to address many kinds of life crises.
I sincerely think the risk:benefit equations of guided psychedelic sessions are significantly better than those of psychiatric ‘therapies’ for many of those problems, even in jurisdictions that haven’t legalised or decriminalised them.
It sounds like we’re substantially on the same page. He has recently revealed some childhood trauma we did not know about, and he was operating with that inner secret (from himself, too), which no doubt made it difficult to make sense out of things. He also had an emotionally abusive partner he was escaping from, and I think the drugs provided escape for him, too. He was guided at first, but the person guiding him also had some serious issues and told him some very not helpful things. I think certain people just don’t do well with any kind of drug intervention. Nothing works for everyone, and we all have to find our own paths.
“Nothing works for everyone, and we all have to find our own paths.”
I couldn’t agree more.
Definitely dose related. Plus larger doses of LSD put the inner focus at a far deeper level than gulps of mushrooms. But this is not “therapy,” real or imagined.
It is not necessary to have a guide once one is familiar with the new psychic dimensions opened up by the psychedelic agent. Everyone’s experience is unique. As John Lennon said, “there ain’t no guru who can see through your eyes.”
“It is not necessary to have a guide once one is familiar with the new psychic dimensions opened up by the psychedelic agent.”
Agreed. But most of the people I work with have never experienced high dose psychedelics before and, as I’m sure you’re aware, the first time your ego shrivels and dies can be very traumatic. You need someone you trust and have developed rapport with to help you through that.
The biggest single danger with this is that someone will lose it on the way up to the peak and trigger a police response.
And I’m quick to dissuade anyone who starts treating me as a guru, in psychedelics or any other arena. I leave that sort of thing to Charlie and the shrinks.
You need someone you trust and have developed rapport with to help you through that.
It would be a great comfort and I wouldn’t argue against it. But if you’re in a safe place I think it usually works out as ego death is not physical death. Not taking pains ahead of time to prepare an appropriate environment is asking for trouble in terms of consensual reality repercussions, for sure. And cops may not be amused that you find them existentially amusing.
You’re right that the cops are the big danger. Just laughing at them can be ‘threatening behaviour’ and things can go downhill fast from there.
And you’re spot on with setting too. I won’t go into the details online but the participant is expected to have a big input into co-developing a safe space, both physically and in terms of personal boundaries. That’s especially the case after the low dose ‘test run’. If we don’t feel relaxed and safe in each other’s presence in a co-designed safe space then we don’t go ahead unless/until we both feel that way. ‘Safe space’ has always been an important part of how I deal with my own extreme states so I try to be sensitive to the need in others and the various concepts of how it’s ‘constructed’.
And I dunno about you oldhead, but my impression of apparent ego death in both myself and people I think I’ve been with in such states is that it’s usually existentially terrifying the first time (or few times), regardless of the space. The difference with a truly safe space it that it’s easier to push through that without it spiraling out of control from negative sensory and emotional feedback.
Yeah, I’d allow that certain prior experiences – whether spontaneous or the result of some kind of practice – would prepare some people for it. But the fact ego death isn’t physical death is irrelevant at the time. Your ego is where your existential fear of death lives. It’s what you think ‘you’ are until the concept of ‘you’ goes away. And yeah, loads of people think they’ve overcome that but speaking from personal experience, not all of them are right. Not the first time at least.
So unless I’m with some kind of spiritual adept or experienced psychonaut or someone with a long history of learning to deal with extreme states then I’m gonna assume that coming to the peak of an ego-trashing trip is gonna scare the bejesus out of them at first – especially if you use a substance or dosing method that brings it on fast. I don’t *think* my own expectations and prejudices pre-configure those observations; but I wouldn’t, would I?
And that’s the bit where the rubber hits the road. The most important part of my function in this is to get them through that without something happening that imperils either of us physically, psychologically or legally. It’s not necessarily to calm them down or reduce their distress. Depending on prior arrangement and my own gut I might even be encouraging them to go deeper into their fears. But if there’s behavior (or volumes) that are going to breach our agreements regarding mutually safe space then I have to be ready to deal with that. And I need to be mindful of safety, ethics and trust when I do.
It’s generally only the first hour or so that you need to worry about that sort of thing, but some people get flashes of paranoia through most of the trip too. If that happens at low dose it contraindicates a high one, IMHO, though I wouldn’t rule out being convinced that someone had learned to deal with it.
And yeah, it occurs to me that the experience of traumatic entry into the boundless could be a mythic one, configured by our stories of death followed by purified rebirth. And that maybe if we could find something else to viscerally believe in – or not – we could change our myths into something less traumatic or somehow let go of them entirely. But I think that’s beyond my pay grade.
I discontinued my “studies” of this subject matter decades ago, but who knows — the future is a long time. Off the top of my head I would still recommend The Politics of Ecstacy by Timothy Leary. Though maybe some of it is dated by now, don’t know.
No, but it might help to have some 500mg. or 1 gram niacin tablets around the house. Remember, you’re likely to break out in flushing with them unless you take your B3 everyday, although that wouldn’t be a problem with niacinamide, which seldom induces flushing.
“The data indicated that 54% of those receiving the treatment remitted (no longer met the criteria for depression after four weeks). Still, there was no placebo-controlled group to which the results could be compared. The placebo response rate for depression is usually estimated as falling between 40% and 50%, but some studies have found placebo responses as high as 70%.”
Yeah, but check out the change in HAM-D scores for those who’ve had psychedelic treatment for depression compared to those for antidepressants or placebos. It’s chalk and cheese.
Great commentary Cabrogal (a girl from Cabramatta??) – where can I get some! Great conversation old head.
If ego death is a “curative” factor for some using psilocybin (and other entheogens) might there be a non-drug way of achieving this? The philosopher Wittgenstein, was deeply anti-Cartesian; and it was Descartes “I think therefore I am” (‘Cogito, ergo sum’) that has led to the ego being a central assumption in Western culture, especially under neoliberalism which assumes people are isolated monads (& judges you on what you do, and not on your being). Wittgenstein said the task of philosophy was to sort out conceptual confusions that prevent us from thinking clearly, and Descartes error is central to this. Wittgenstein drew our attention to the 2 ways that we use the word “I”. We use “I” to describe ourselves as an object, as in ‘I have grown a centimetre since I last measured myself’, ‘I have broken my arm’, ‘I have a bump on my forehead’. But we also use “I” as a subject. This is done to refer to our mental states and sensations, such as seeing & hearing etc, and feeling pain. This is where Descartes went wrong, he tried to objectify the use of “I” as a subject. Nietzsche drew our attention to the noun-verb structure of our language, and how it creates ghosts in our thinking, like the “it” in ‘It is raining’; or how we break up one thing into two as in “the lightening flashed”. There is of course no lightening apart from the flashing. So there is no “I” who is thinking, seeing, hearing, etc. It is just a convention of language. In his Tractatus, Wittgenstein says that the ‘I’ who is thinking or seeing (etc) is the world (just as the ‘it’ in “It is raining” is the world). He confirms that this egoless subjectivity is the mystical (of the Lao-tsu or Meister Eckhart variety).
Now a number of subsequent Wittgenstein scholars have suggested that we cultivate an imaginary self (or socially construct an imaginary self), but that it has no substance. There is just the narrative of a self. Foucault has one of these in mind when he speaks of the care of the self. However Lao-tsu warns we should drop that readily, with his comment “accept disgrace willingly”. Schopenhauer, who had a strong influence on Wittgenstein, taught that without a self, we were naturally very caring towards each other (cf. Matthew 18:3). Foucault, I think, wants us to cultivate a self based on this more natural way of being.
Now I think, for some cases of so-called “depression”, but not all, ego-death is “naturally” occurring. If you look upon so-called “depression” as the ‘winter of the soul’, it makes some sense to imagine that some of our moods arose with the seasons. In ‘summer’ things are rosy as life blooms and buzzes, but it is followed by ‘autumn’ when it goes from being ‘wet and windy’ to ‘fine’ again, sometimes many times in a day. Then in ‘winter’ I retreat into my ‘heart’s cave’ where things ‘crystallise’ as things become very still. Of course ‘winter’ is followed by ‘spring’, and remember the ice-age even had its ‘thaw’. Nature is prolific in ‘spring’, and not everything arising makes it thru to summer. Although I have consumed my share of entheogens in my younger years, I have also experienced my share of ‘winters’, and now see more clearly.
“a girl from Cabramatta??”
Nah. But I get that a lot. Here’s the explanation.
“If ego death is a “curative” factor for some using psilocybin (and other entheogens) might there be a non-drug way of achieving this? ”
Yes there is, but in my experience the states that bring it about are difficult to predict and maintain. They’re generally very beautiful and rewarding in their own right, but I can’t see how they’d be applied ‘therapeutically’ to a specific task. Nor do I feel it would be appropriate to attempt to do so.
The drugs take care of the altered state for me, freeing me to explore it in a semi-volitional manner. (I’m using language here, which is inherently dualistic and egoistic. I hope you can get around words like ‘I’, ‘me’, ‘attempt’ and ‘volitional’ to what I’m trying to say.)
I’m kinda down on Descartes too, though in my ignorance of Latin I often wonder if ‘cogito ergo sum’ begs the question a little less than ‘I think therefore I am’. But while I agree that linguistic and social conventions reinforce the ego construct I don’t think they cause it, but rather it causes them. IMHO the ego is implied within the fundamental dualism of subject-object and that precedes both language and society.
Schopenhauer was influenced by the anatta of Buddhism and Hinduism’s Tat tvam asi. (I reckon the no-self of Buddhism and the Self=Brahman of Hinduism are the same non-dual thing, though a well known Buddhist scholar has tried hard to disavow me of that notion.) Western philosophers are johnny-come-latelies when it comes to egolessness. And it’s not like you can say much about it. Neti neti …
Learn to collect them yourself, if you have access to pastures. The easily recognizable P. Cubensis only grows in the South, so you’ll have to know your varieties if you’re going to wander northern pastures, where such mushrooms are smaller and less likely to stain blue, the most striking feature of P. Cubensis.