My exact comment was “MDMA has potential-and… overwhelmingly unresolved risks”
That is not a pro-MDMA. That is a balanced perspective.
I feel troubled by your fictitious sequelae of MDMA clinical trial assault. The inference that individuals assaulted after taking psychedelics are blind to the influence of psychedelics and in fact continue to support their use is an extremely broad statement.
Putting vulnerable individuals in overwhelmingly vulnerable situations is not a good idea. Psychedelics highlight the power schema inherent to any patient/therapist dyad… and in that circumstance, acts of abuse can and do occur.
That someone turns to a given modality for healing and is assaulted by his/her therapist however, is an indictment upon the therapists and the institution allowing such perpetrations to occur. Inferring anything less is an extremely shallow reduction of the egregious acts of abusers and thinly veiled victim-blaming. I trust that is not what you intended.
Thank you for your open-minded reply. I agree with you that MDMA has potential-and strongly continue to believe it has overhwhelmingly unresolved risks requiring address for it to ever, truly, be an evidence-based and safe option. You wrote, “Also, please note that MAPS is a non-profit organization, and MDMA is not pattentable. This is really not about greed or profit. These people may turn out to be wrong, but they are not part of the pharma-industrial complex, far from it.”
With respect, while MAPS is indeed a non-profit, the organization has set up a for-profit B-corp strictly for the purposes of marketing and monetizing MDMA. In doing so, while optically continuing to appear (and benefit from public opinion) as a not-for-profit, they have indeed become a pharmaceutical corporation.
The FDA’s approval provided MAPS with a binding agreement guaranteeing the therapeutic legalization of MDMA should Phase 3 trials obtain two statistically significant results with no emergent safety concerns (NOTE: A sexual assault in the Phase 2 clinical trial-the LAST place it should have occurred, with both MAPS and MDMA under far more scrutiny than either will ever face again-should most definitely be considered a safety concern, in my opinion).
Upon legalization, MAPS will be granted drug exclusivity, making the company the sole source of therapeutic MDMA for at least the first five years after legalization. Granted, as you pointed out, MDMA is already widely available: It’s not patentable. But only MDMA produced by MAPS’ for-profit B-corp-the sales arm of MAPS i.e. MAPS-as-Big-Pharma-will be legalized for prescription use. In addition to actual drug sales, MAPS stands to benefit through the training and certification of therapists. All future therapists and clinics will require MAPS’ approval. Finally, MAPS anticipates rolling out “thousands of psychedelic centres” of its own over the next decade. (Again, can I mention that MAPS is doing nothing of significance to mitigate the risk of sexual abuse, and is instead actively setting the lowest-not highest-possible bar in the certification of its “psychedelic therapists”) With the company recently valued at $100 million, MAPS’ CEO, Rick Doblin estimates profits over first five years post legalization will be around $36 million.
While I remain hopeful for the future and use of MDMA, in the absence of any external oversight; positing of MDMA as benign cure; MAPS’ calculated marketing initiatives; and multiple examples of MAPS placing profit over patients, I am deeply concerned on many fronts by its impending legalization within the current framework.
Where I am wholeheartedly in agreement with you (if I may paraphrase what I understood from your comments) however is in the need for continued, informed and thoughtful dialogue. That’s the only way safe, viable, evidence-based options will ever truly be part of mental health care-giving individuals the opportunity to choose what’s best for them, knowing the options are evidence-based and backed by objective research, not for-profit corporations or non-profit organizations masquerading as the same.
I suspect the patient who was repeated sexually assaulted by her therapists during the Phase II clinical trial might beg to differ. The full statement is available on MAPS’ website, here: https://bit.ly/2VZuJOC
Any drug that increases empathy, enhances trust and extinguishes fear is not benign. To its own financial benefit, MAPS is marketing MDMA through both general media and peer-reviewed journals. Publications-written and researched by MAPS-are overwhelmingly positive. There is little to no truly objective outside analysis; and no mention of the overwhelming evidence that sexual abuse was, is and remains a serious concern in the mind-altering realities of psychedelic psychotherapy. This article is not unbiased research; rather a repeat of what Big Pharma drug companies have been doing for years… selling a drug before it has been fully clinically tested and highlighting just how concerning that “clinical testing” truly is.
“it can potentially help the person change the way they see the world and relate to it.”
Yup.
Unfortunately, that doesn’t fit neatly into some kind of biological paradigm of “drug changes X in brain and patient is cured!” simplicity.
In my (completely biased) opinion, I think one of the biggest risks regarding the impending legalization of any psychedelics is the positioning of such substances as quick-fix miracle drugs.
Carl Jung said it best, “It is a mistake when you think that only the authority in this field could help you. You have a mind just as well as any other human being and you can use it if you only know how to apply it.”
(Carl Jung, Letters Vol 1. Page 127)
Psychedelics can HELP (with the proper support, integration, etc…) with the process of finding a way through the mind’s wounds and how they manifest externally. That’s very different than saying they (or any psychiatric drug, really) is a CURE.
This sentence intended to convey the limitation of talk therapy (trauma lodged in the limbic system lies beyond the reaches of talk therapy – see Bessel van der Kolk’s “The Body Keeps the Score”) that can be addressed through psychedelics.
The healing process, I agree, comes not through resolution of some physical wounding; rather the awareness of the deeper (unconscious) emotional/psychological insults leading to the symptoms (or character development) and ensuing devastation.
I’m not sure how I could have made that clearer in the essay, given general length-constrictions, but I’ll keep note of your comment for if/when I turn this whole experience into a book (someday… 🙂 Thanks for being a keen-eye editor!
It’s actually supported but not guided. The structure (of the clinical trial) was outlined in a specific manner (spanning over 3 days, middle day being 8-hour session, day 3 being integration, however long that takes. Patients stayed overnight on site post MDMA… you can find the exact protocol online, MAPS.org
The actual therapy, at least during the trial, was generally non-guided, i.e. NOT directive. Rather, allowing the client to go into the experience with the psychedelic, with the therapists using their skill and training to amplify the experience. An example of this: using music to match the intensity and what’s manifesting somatically (e.g. non-stop shaking in fear for several hours = non-stop African drumming). Guidance is applied only in instances where therapists notice avoidance of certain topics/experiences, and even then, asking rather than directive.
There is still considerable debate over (translation: they don’t know) the specific brain mechanisms / changes associated with psychedelics. That said, what is known – and unique – is their mind manifesting properties.
Basically, psychiatric drugs work by numbing DOWN emotions… you feel less.
Psychedelics do the opposite… they open you up = feeling more, more deeply, or what’s going on in the unconscious. (Hence intensity, also a deep spiritual component – not in any religious sense, but well beyond the realm of Western medicine). MDMA research is being conducted for PTSD, etc. in part because it has empathogenic properties – it increases oxytocin and bonding, also decreases fear… so subjects taking MDMA are able to feel safe and connected while exploring difficult experiences (e.g. talking about a rape)
A very different approach than psychiatric drugs just trying to knock down symptoms. Psychedelics can increase symptoms – everything comes up, “bad trips”, etc – but can also bring awareness of the underlying origins… and thus, ability to find new perspectives and ways through.
There is much to be said for actually experiencing a substance prior to inflicting (or using it therapeutically) on the other. The same should go for psychiatrists, too… a weekend on Seroquel would do wonders for curbing over-exhuberent prescribing practices…
Correction: “I’m sorry that you felt some of the clinicians involved in your treatment were not qualified to lead you up the mountain ala Bill Richards’ analogy.”
That is totally NOT what I meant. The folks I worked with who were clinicians were – and are – impeccable in their training, self-awareness and commitment. The grossly incompetent and unconscious facilitators were in the underground (ayahuasca) community. The difference lay in their training, not in their first-hand experience working with their selected medicine.
In terms of credible training programs for psychedelic psychotherapists, there are currently only three:
a) The Orenda Institute’s psychedelic psychotherapy program
b) MAPS’ therapist training
c ) CIIS’ psychedelic therapist program and
ORENDA (British Columbia, Canada)
Of the three courses, the Orenda provides the most solid foundation of self-work, in breath, depth and scope. The first week takes participants deeply into their process, using a heuristic method that takes participants into and through a safe vessel, culminating with a 24-hour (legal) experience. The second week breaks down the format of the first, i.e. going through what was done and why, building understanding set/setting, training therapists how to form the vessel (stimuli, music, images, etc.) The final week focuses on human development, including character armouring and the development of personality as an adaptation through childhood. The Orenda students form a conscious ‘pod’ upon completion of their training – a tightly knit, highly trained group capable of providing and engaging in peer support for one another to ensure maximal safety and appropriate care of themselves and their clients.
Orenda is run by Dr. Richard Yensen and Dr. Donna Dryer – Acting Principle Investigator and Therapist for the Canadian MAPS Phase II clinical trial, in addition to associate faculty. The Orenda accepts 10 students/class, running in three one-week intensives over the summer.
CIIS (California)
CIIS provides aspects of the above in terms of content, but in a much less intensive manner, e.g. a weekend course in breath work, etc. Multiple faculty, currently accepts 35 students, but increasing numbers (60? – can’t remember if this is the actual figure or the current wait list, so don’t quote me on that) next year.
MAPS (USA, California/Other)
MAPS is the least experiential, some work on the therapist but more on methodology with an eye to standardizing treatment as required for FDA approval for Phase III trials. One of the good things re. the MAPS training is that therapists selected for the Phase III will actually undergo their own MDMA session, something the other 2 can’t provide at this point in time.
To give a sense of the training hours:
a) MAPS: ?
b) CIIS: 180 hours over 9 months
c) Orenda: 180 hours over three-7 day intensives
Challenge is, there is no real “certificate”, i.e. graduating from any one of the three doesn’t provide anything beyond a sheet of paper saying one has gone through that particular course. So it comes down to desire of methodology, really. The folks who drop out of the Orenda Institute in the first week are those who don’t think they need to do any work on themselves prior to trying to “fix” someone else.
Again, just my own opinion, but having been on the receiving end of wayyyyyy more unconscious therapists than the handful of truly stellar ones met along the way, that single factor alone – i.e. self-selection in the first week through actually experiencing what it means/feels like to be put into as close to a psychedelic experience as possible (and seeing who can actually deal with it, and who turns and bolts) – puts the Orenda 1st in my books.
If I’m not willing to trust someone with my LIFE – to be born with them, to die with them, to be certain that they’re not going to break, crack or drop me when I’m at my most absolute vulnerable – and to believe at the most visceral level of connection that they have the competency and training to be aware enough of what’s going on within that they’re not going to project their issues on me because they’re triggered – it’s a no brainer: There is NO WAY I want them anywhere near me in any therapeutic context, let alone with a psychedelic.
In terms of what works vs. doesn’t, my own experience and belief is in total agreement with the most experienced therapists I’ve ever met, on this one: #1 thing anyone incoming can do, is work on themselves and get the absolute best training possible. Anything less is a disservice – and arguably hostile – to future clients.
(That said, it can be a daunting prospect, with the difference up here in Canada ranging from a quick-and-easy non-thesis 30-month degree without any foundational psychology required all the way up to a 9-year trek through a Masters + PhD. I’m still trying to figure out the “hows” of my own journey, so this strikes a chord. From starting a BSc. to graduating with a PhD., my own university career could very well span 30 years. Slight hiatus for trauma 🙂 I’m calling it “experiential learning”)
“One of the reasons psychiatrists and psychotherapists might be destabilizing is that the treatment is illegal”
Which leads to a challenging paradox… as long as psychedelics are illegal, it’s impossible to train therapists how to competently use them. Doing so, itself, would break any number of laws.
This creates two potential situations if/when psychedelics are legalized (with MDMA and Psilocybin both nearing that mark):
a) non-trained non-professional individuals providing “therapy” with little to no formal training in psychotherapeutic/analytic foundations and zero experience using psychedelics in a professional psychotherapeutic setting OR
b) professional therapists becoming “certified” to use psychedelics despite having minimal to no actual first-hand experience prior to believing themselves competent to doing so.
Of the need for therapists to actually have training AND experience in what they believe themselves capable of successfully using, senior psychedelic researcher/therapist Bill Richards (one of the investigators in the Spring Grove trials, currently at John Hopkins University) put it best. At the recent Psychedelic Psychotherapy Forum in Victoria, BC: “if you’re climbing a mountain with a Sherpa as a guide, you want someone who’s actually been up that mountain – and hasn’t just read about it in some book!”
The current MAPS training program, while limited in many ways, acknowledges and seeks to address this gap. Part of the approved Phase III protocol will see trained therapists administer MDMA to incoming therapist teams – i.e. having the therapists themselves receive psychedelic-assisted psychotherapy – prior to those teams then providing therapy to Phase 3 patients.
All of which is a basic and critical, in my opinion, first step… but one that doesn’t in any way negate the need for therapists to first DO THEIR OWN WORK ON THEMSELVES, above and beyond any work with psychedelics. Otherwise, psychedelics are a disaster waiting to happen: All the power and ego associated with psychiatric/Big Pharma drugs combined with poorly trained and/or unconscious therapists lacking awareness of their own stuff coming up and taking it out on the subject… or believing that using a psychedelic provides a “chemical cure” and thus requires less, not more, training.
That which makes psychedelics so potent – their tremendous capacity to heal – can equally be turned to abuse… even if not obviously intended as such, i.e. through their use by poorly trained, ill-prepared and unconscious therapists who get in over their incompetent or ego-swollen heads.
I, for one, am all for any regulation, prior to legalizing these substances, that mandates their use as as psychotherapeutic adjunct ONLY by trained psychotherapistswho have (at the very least) undergone professional clinical training combined with extensive and competent personal therapy. A cautious, judicious approach to how this is all unfolding may take longer but in the end – what’s the true cost? What’s the true risk? How do we figure out how to do this properly? While I doubt this approach will occur, I just can’t see many negatives to taking the time to really look deeply at all facets of their use, including whether and how our society is ready to deal with this.
Ayahuasca is an entheogenic brew indigenous to South America. It’s made from combining Banisteriopsis caapi vine and the Psychotria viridian leaf, generally with other admixtures. Individually, the leaf and vine are quite benign. The potency and psychedelic properties of ayahuasca occur through the combination: Psychotria contains DMT, while B.Caapi is a MAO inhibitor. Highly hallucinogenic, tends to be used in a group setting, the effects last 4-8 hours and are generally accompanied by vomiting (both from the brew itself and the fact it tastes like something you’d scrape out of the bottom of a garbage can).
It’s illegal in North America, except when imported for legal use by members of the Santo Diame church. Illegally or abroad, it’s popular in the realm of psychedelic tourism.
Your comment made me think of quote pinned to a bulletin board I once knew well: “I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.” (Mandela). (Amusingly, this was next to an RD Laing quote eviscerating psychiatry!)
I learned courage in that office. In large part, from witnessing a therapist with the courage to stand up for what he believed in – the ability of this patients to heal from severe trauma, free of psychiatric meds – against incredible adversity.
If courage is connected to fear, there is truth to the adage, “I stand on the back of giants”.
Reply to Oldhead’s post October 9, 2016 at 5:27 pm
(MiA staff-how come I can’t reply directly underneath Oldhead’s reply?)
“There are people who are good at exploring reality and consciousness with others, and there are people with degrees who get paid to reinforce the parameters of this system.”
Challenge being, figuring out who HAS the skills and training to provide full spectrum of care from ceremony through integration, regardless of whether scope of training came from a degree or lived experience.
In my experience at least, one of the biggest risks (both in using psychedelics and psychedelic therapy in general) surrounds the aura of the ‘instant expert’ – individuals in the psychedelic field providing services without due diligence or formal training in even the basics of psychology. (Again, regardless of actual degree and convinced they are both capable and competent.)
This is certainly an issue in ayahuasca; made all the most worrisome by it’s lucrative nature (350-475$ CDN/per person/ceremony) and lack of regulation if/when something does go wrong.
Interesting point re. the CIA, I hadn’t thought about that, i.e. how the response would be too varied and unpredictable to standard (thank goodness) as a weapon of war.
Hmmm… for some reason, I couldn’t “reply” to you Oct 8, 2016 7:55 pm post below. Hence, posting here.
This thread touches on something I keep trying to turn over in my head: Simply, how can something as psychospiritual as a psychedelic FIT into a system that looks at anything beyond cogent boundaries as delusional? Or, if it doesn’t and can’t (and frankly, probably shouldn’t), what needs to be implement – training, or environment, or ??? – such that psychedelics can be offered and used in a safe manner?
From this end, this split between biological / psychospiritual was most apparently in the diagnostic standards and measures used during the clinical trial. For FDA approval, any psychedelic study has to fit into the box of being randomized, double-blinded, controlled and measurable.
All of which is highly problematic. Case in point: how do you truly double-blind a psychedelic vs. placebo??? How about standardize a psychedelic treatment? Or use psychometrics to somehow quantify the fact that appreciate that sometimes, deeply psychospiritual insights can indeed emerge from a radiator? 🙂
Curiously, Osmond picked its location because he felt England was too conservative and he wanted someplace rural and remote (which, as anyone who has ever driven through SE Saskatchewan can attest, it definitely is…). At the time, though, Saskatchewan was also the epicentre of activism, thanks to Tommy Douglas being elected post-Depression with a radical socialist agenda. (He’s the reason Canadians have universal health care, albeit currently being massacred).
Osmond’s approach was equally radical. Opposed to the power relations in psychiatry, his decisions included
– having an architect take LSD, to understand how the patients would react to the structure of the building, and design the space.
– putting authority with ward nurses rather with doctors
– welcoming family to the hospital
– incorporating art and music therapy
– encouraging patients to get involved within the community
– insisting workers also took LSD (so they understood what it was like for the patients… wouldn’t it be great if psychiatrists today had to do the same prior to prescribing anything?!)
Basically, Osmond created a environment in the middle-of-nowhere that employed most of the town, attracted world-class medical professionals, and got patients OUT of the hospital and IN to community. The clinical outcomes were unprecedented (to this day…) Using LSD for generate insight/awareness underlying the need to drink, of the 2000 subjects treated for alcoholism from 1954-1960, 40% hadn’t returned to drink at least a year after treatment. (Kaplan, 2013.) (DOI:10.1177/0967772013479520)
Unfortunately, this threatened the conservative medical profession, which attacked the data (which was, admittedly, heavily anecdotal and not gold-standard RCT). Tim Leary’s indiscriminate drug promotion didn’t help. The CIA also got interested (MK-Ultra, testing mind-control). The DEA blocked import of LSD in 1965 and a series of articles blaming LSD from everything from foetal abnormalities to psychosis a year later was the final nail in the coffin… at least, for the next 41 years. The Phase II psychedelic trial that took place in Vancouver last year was the first legal psychedelic therapy in Canada since the Weyburn experiments.
All of which is fascinating. Also, hard to believe, in light of the conservative and “bio-bio-bio” belief system that so plagues the current mental health system.
(Weyburn is actually a bit of a personal curiosity. My great grandparents homesteaded near Weyburn.)
I agree that there is a need for political activism. However, I don’t see “Therapy, Recovery and Healing” as necessarily distinct and separate from justice, much less an either-or proposition.
For any rape survivor, I think what’s ultimately important is finding his/her voice and ability to reclaim that which is most violently ripped asunder. It’s not the physical damage that leaves the deepest wounds; rather those to the psyche and the soul.
For some, a reclamation of power might mean activism. For others, it comes in finding whatever compassionate individual, or a group (aka. “therapy”) offers a sense of not being alone.
There is no one ‘right’ way to heal, as your comments clearly elucidate. Is that not in itself the first step of establishing legitimacy and the reclamation of power? – the ability to make a choice for oneself about oneself. To each their own.
“I don’t see how there could ever be a line between “professional” and “client” that wouldn’t dissolve during a psychedelic experience.”
No kidding.
There’s a conference next weekend in Victoria, BC (http://www.psychedelicpsychotherapy.ca) that will (hopefully) address this, with at least one expert panel discussing how to appropriately train therapists such that they can provide a safe and healing, if not “controlled”, environment. The word “controlled” to me, sounds more like a mechanicized therapy, i.e. give the client the drug and pretend environment or human interaction doesn’t have an impact…
By set and setting, I was alluding to the mindset (“set”) and physical/social environment (“setting”), both of which are directly linked to the healer’s ability to establish and maintain a deep and safe healing vessel. It’s hard to see how that can be generated in our current mental health system.
(Absurd and ironic are definitely words that come to mind when thinking about our current mental health system… because how absurd and ironic is it, to try to treat something as psychosocially interconnected as trauma with substances or therapies or beliefs as isolating and inhumane as those which turn a suffering being into nothing more than the sum of her/his broken bits?!)
It was shocking to me (if not surprising) when a recent exploration of Canadian psychology grad programs possibilities revealed not a single one requiring its students to have personally undergone psychotherapy prior to believing themselves capacity of possessing the skills and insight to do the same on another! (This is the case in at least 4 provinces… I haven’t checked out the others yet…)
As the adage goes, “People don’t know what they don’t know.”
Perhaps that’s why the mere concept of equality between client/therapist- rather than some kind of paternalistic model-is so threatening to health care providers unconscious of how they are using “being in charge” or “being the expert” to avoid their own unresolved traumas.
“you feel that the benefits of this kind of therapy cut to the chase quicker (for you personally) than years of drug treatments and talk therapy”
My foray into psychedelics was far more one of desperation than conviction… At the time of going into the trial, I’d literally maxed out the medical system. I had no alternatives beyond conventional treatment (i.e. drugged to death). The only option, according to my then-case worker was, “accept that you are permanently disabled and stop trying to recover.”
The frustrating thing I found, over nearly 20+ years of therapy, was just never being able to get past my own trauma enough to actually go INTO and deal WITH the trauma… Healing was so painfully slow, and the container available within the medical system (while at times deeply supportive) was simply not suffice for the severity of trauma and how it manifested.
I left an awful lot of psychiatric appointments over the years looking seemingly “fine” but in truth triggered and dissociating… which lead to car accidents on the way home, or falling and winding up with yet another concussion.
That, for me, was the key difference with this trial, indeed any credible psychedelic psychotherapy… it had nothing to do with the chemical, rather, the incredible support/safety/set and setting that allowed for deep work to occur. It was the first time I didn’t have the fear I’d be “too much”, either for myself or the therapists I was working with. But it took a long, long time to get to that point…
Sound plays a significant role in psychedelic psychotherapy, with music being used to amplify/deepen/modulate emotion.
(Actually, there’s research now too, talking about its use for traumatic brain injury, stimulating regeneration at a cellular level…)
You are correct, this is the first of a planned series… the subject of psychedelics is simply too big and complex for a single post. The next few will be exploring some of the more contentious issues surrounding contemporary psychedelics.
The points you raised about vulnerability are definitely on the agenda for a future, extended, post. The use of psychedelics to venture deeper into trauma to revisit and integrate its experiences creates a situation that is tremendously vulnerable (both for therapist and client). Not just externally (risk of sexual abuse, ego, projection/transference that isn’t managed appropriately, etc.) but internally.
As you put it,
“for some people dealing with past trauma and their own armored emotional defenses, psychedelic drugs (in a safe environment) might break down those defenses in a helpful way, thus allowing some people to more completely explore and reconstruct new memories of past trauma events in a therapeutic way.”
Totally true… but the latter can also happen, i.e. Difficult material coming up in an unsupported environment. Having one’s “armor” blown apart without the support of skilled healers to hold the vessel until the fragments come together again can, itself, be traumatic.
Given the vulnerability inherent to this work, therapists need to do their own inner work – and have cogent awareness of their own issues – prior to entering any psychedelic healing realm. This is simply to hold themselves and the client in safety, regardless of what comes up.
(The difficulty of this, of course, being “people don’t know what they don’t know.” Personally, I think it’s nothing shy of unethical for post-graduate training programs in psychology – let alone psychiatry residencies! – not to require all students undergo extensive personal psychotherapy prior to believing themselves capable of inflicting the same on someone else!)
Regarding vulnerability and how scary psychedelics can feel, a comment that resonated in my own work during the clinical trial was, “a difficult trip isn’t necessarily a bad trip.” This was true; some of the hardest and “worst” experiences were ultimately the most insightful. But for them to be so required an awful lot of integration, support, and a solid, stable and safe vessel in which to do the work.
That’s not something readily available in our current medicine system, much less the countless ways that trauma survivors are placated (“oh, it’s not your fault, you were a child, etc…”)
As a friend recently commented to me, “Trauma isn’t like a zit – you can’t just pop it, squeeze all the pus out and then pretend it never happened.” It’s life changing.
I loved your paragraph, that touched on this: “It is here where a deeper self acceptance and self love is finally achieved and the person can put these events in the proper perspective. NOT FORGETTING THEIR PAST, BUT NO LONGER ALLOWING THE PAST TO DICTATE OR CONTROL future thoughts, feelings, and behaviours.” [emphasis added]
If something like EMDR can provide that for some, it is wonderful resource. Thank you, Richard, for sharing your insights about this modality and the deeper journey of healing. I look forwards to a continued dialogue and your insights about therapy/vulnerability in a future post exploring this subject in greater detail.
“I think detaching from social expectations and ‘the way things are done,’ in order to take our soul journey and feel who we are as creative spirits–the characteristics and purpose of which are unique to each of us– is healing in and of itself…”
YES!!!
And yet, paradoxically, SO difficult to do-particularly in moments when the “box” or expectations of self from others (or from self for others) maintains or serves some purpose.
Perhaps that’s why it’s so hard to navigate family dynamics… The process of sifting through the automatic roles and patterns of behaviour to a place of truth threatens the very things our lives depended on as children: acceptance, acceptability and approval.
“Mutual support” is essential. Otherwise it’s a long, hard and painful journey through the opposition.
Thankfully, there are places like here and dialogues like these that can provide a sense of community, even as we navigate our, deeply personal, lives.
Dear A_truentic, Gratitude flows both ways… your beautiful words reminded me, that for all the isolation and misunderstandings associated around trauma, “you are not alone” (to borrow a motto from the Icarus Project!). Thank you for your feedback.
Thank you for catching the editorial error. You are, of course, absolutely correct. It’s Donald Ewan Cameron of MCGILL University. No excuses, a mental blip that amalgamated the two. I’m sorry I didn’t catch it on the read-through… thanks for allowing the correction here!
Are you familiar with any good books on Cameron?? The best I’ve read was “Father, son and CIA” by Harvey Weinstein… I was thinking today, I would love to read more on this topic. The fact that was going on concurrent to the (far more positive outcomes of 1950s) LSD work in Weyburn, SK, really speaks about the polarity surrounding psychedelic use – ie. tremendous good can from their (appropriate) use, but so too, can they be wielded with terrible evil.
Thanks again for your editorial eye, Rossa!
(I can’t correct it on the website, but have made the appropriate change in my hard draft)
“I never took psychedelics trying to treat anything but I can imagine how it could help hit the thinking reset button…”
I’ve been in/out of therapy for almost 20 years. Figured I’d been through and tried everything, lots of rough years and hard work. My view going into the clinical trial was “nothing can be harder than anything I’ve been though”. Right. Nope. Those months were-without question-the hardest, deepest, most difficult therapeutic experiences of my life. Each psychedelic session felt like the equivalent of at least five years of conventional therapy. (But they each packed the exhaustion and emotional punch of five years’ worth of therapy into every one of those those (non-stop) 8+ hour sessions!)
A point about your comment on marijuana. I’m no expert in the field, but am familiar with the distinction between THC and CBD. Both THC and CBD are cannabinoids found in cannabis (“marijuana”); with different levels found in different strains of plant. Recreational-use plants, aka. “pot”, tend to have a high THC content.
THC is psychoactive – that’s what gives the “high”, paranoid, anxiety, etc. associated with marijuana.
CBD, on the other hand, is NON-psychoactive. There is no “high” that comes with ingesting a 100% CBD strain, despite it still seeming to provide therapeutic benefits. Much of the research that’s now ongoing about the potential therapeutic capacities of cannabis-e.g. neuroprotective properties in post-concussion syndrome, anti-seizure, anti-inflammatory, etc.-focuses on high CBD/low THC strains… which means not getting high.
Thank you for your comments. Your thoughtful analysis touched on many key issues surrounding psychedelics. I totally agree with your remarks, particularly, the challenge of how (or if) psychedelics fit into our current “mental health” paradigm… and what the consequences are of such approach. Any efforts to reduce psychedelics to mere chemical compounds fails to acknowledge their psychospiritual properties, set and setting-i.e. all that surrounds and ultimately helps form a healing or harming psychedelic experience. For me, that’s one of the most concerning issue around psychedelic use in any treatment capacity, simply, their being framed as some kind of potent medicine akin to psychiatric drugs and treated as such-rather than an adjunct, or as you put it, a tool to open into the unconscious. Psychiatric drugs numb emotions. Psychedelic drugs, on the other hand, do the opposite… Your comments offer scope for potential of many future essays. There are many conversations to be had, wherever we are along our respective trails! Thanks so much for joining the journey! 🙂
Beautifully written, Alex. Thanks for clarifying what you meant about “embodying Spirit”. Literally “in-body”-ing.
Bessel van der Kolk is purported to have said, “the butt beats the breath”; that meditation, etc. are critical, yet that absolute “ground point” remains IN (and getting back into) one’s body.
Your thoughts about linking to gratitude/trust to somatic makes a lot of sense. Trauma is so utterly contractive, it’s a great reminder to start with consciously relaxing (no matter how forced or fake or futile it feels, ugh!) to remind the body that the PNS does actually still exist, underneath the chronic flood of cortisol…
On that note, time to stop looking for work and get to yoga!
Call me an optimist (or naive… or any number of adjectives), but I find it hard to abandon hope in the human race, i.e. that there’s NO safety or possibility of whole trust.
Maybe it’s because I just don’t want to believe that the human race is entirely focused on individual gain at the cost of exploitation of another (although I’d totally agree with any hypothesis stating that is very much the focus of a Western-influenced capitalistic society… )
In the experiences of my life, I could sway either way. There are absolute and egregious breeches of trust – and those more insidious (and frankly, far more devastating). Even so, this is weighed against the goodness that just keeps showing up, drops of goodness, one person at a time. And somehow, those good moments – no matter how small – are impossible to ignore.
Don’t know. Maybe that’s just me… There’s just something that doesn’t sit right within me, though, to think of the human race as thuggish and suspicious (at least, outside a capitalistic mindset!)
“Sometimes one has to escape in order to find oneself again.”
An interesting comment. There was radio documentary recently on “Ideas” on CBC that explored this – i.e. the belief that leaving, or relocating geographically, doesn’t actually help… versus the belief that it DOES.
I would love to hear others’ experiences in this realm. What relocations (physical or mental) worked?… Which didn’t?… Any thoughts/guesses why???
Wreck Beach… good to know. Perhaps someday we could connect for a chat on a rare and beautifully balmy winter day?
I’m over in East Van (just past DTES) but do travel on occasion to Kitsilano (although it’s actually probably a good thing I don’t live I close proximity to Banyan Books – that place is like crack cocaine for a bibliophile!)
Finding a meditation community – or at the very least, an affordable yoga studio – is high on the ‘priority’ list for grounding.
I appreciate your words of encouragement. Even holding trust in Spirit, those old patterns, fears and dark energies can be hard to release. As a friend reminded me recently, all we can do is “notice it, notice it, notice it” – and keep walking the path.
it sounds like you’ve been through a lot. Thank you for sharing your process of discovery.
Is it that there is NO safe place, or no safe place externally in an ever-shifting impermanent environment… and if that’s the case, one must find safety within?
I love the mental pictures conjured up by your words, by the way…there is power in drops of water – one by one, they erode stone.
Curiously, one of the most wonderful discoveries about Vancouver is that it actually doesn’t rain ALL the time in the winter. (it just rains a lot…)
The desire for, yet fear of, community seems to resonate… myself, your son, others on this site… It really speaks to the dislocation of our current society – and the desperate isolation that can come even whilst surrounded by many.
Any ideas regarding what works to break down these barriers, whether tangible or in one’s mind???
What a wonderful discovery after years of NOT knowing where to call home through all the moves. Thank you for this beautiful reminder, that even when a place doesn’t ‘feel’ like home in the moment, a little piece (or peace?!) is added to the mosaic.
Community is elusive… and yet, all around. All best to you, along your own journey of turning fantasies to realities!
“Remember that there is meaning beyond absurdity. Know that every deed counts, that every word is power…Above all, remember that you must build your life as if it were a work of art.” — Abraham Joshua Herschel
For whatever vital spark managed to stay alive, I am grateful.. Given the general state and functioning of my pre-frontal cortex however, I’m not sure it was as much self-discipline as utter desperation and despair that got me off meds (and then just sheer stubbornness for the rest.)
Actually, I had NO IDEA it was a two year process until going through my notes for this essay (and in doing so, finally talking with my family, at least in part, about it…). Most of the withdrawal period for me, as with being on medication, is lost in fog.
There’s irony about racing with the national team though… Courtesy of random drug testing, I/my coach (more him than me, we were worried enough about ramifications if anyone found out what I was ‘diagnosed’ with – which later experiences proved wasn’t at all paranoia – he’d call anonymously on my behalf) had to put a call into WADA/CCES (World Anti-Doping Agency/Canadian Centre for Ethics in Sport – they hire the suits that show up on one’s door step and don’t leave until you pee in a cup. Makes for awkward moments. (And really awkward first dates! E.g. “Oh. Darn. Hey, sorry about this, but they need to follow me around for the next couple hours, because I’m too anxious to pee in front of them. Do you still want to go for dinner?”) prior to filling any script to ensure it wasn’t on the ever-changing banned substance list. Several cough formulations, for instance = banned. As are Beta-blockers (pending sport). As are, curiously, some formulations of tea. Risperdal, on the other hand, is most definitely not considered performance enhancing… but we had to check all the same and document it. Anyhow, that’s how I was able to go back and figure out what I was on, when.
Good point about calling it “medication”. A future post will discuss psychiatric drugs v/ plant medicine v/ psychedelics. I used to be quite militant against medication, but then realized the best treatment option is whatever works for the individual. From this end, mindfulness, diet, exercise, eastern-based approaches, etc., are way more effective. In my own dance of exploration, I’ve gotten to a point where I honestly cannot fathom taking a pharma-drug. I’ll sit on a meditation cushion and regrow my hippocampus one neuron at a time, thanks, rather than take something that will numb the immediate distress but kill grey matter. But with that determination also comes the responsibility of figuring out alternatives (and doing them!)… and respecting that others might and do make difference choices, pending their situation. To each their own. That said, particularly given recent findings correlating gut dysbiosis with emotional turmoil, it’s baffling – and I think, increasingly and utterly unacceptable – that clinical pharmacology remains a full year course in medical school but lifestyle modulators (nutrition, exercise, meditation, etc.) aren’t covered in any detail…
Many thanks for your positive feedback. In terms of becoming an author on MiA, I’m not sure if there’s any ‘formal’ protocol… best start with an inquiry email to the web administrator.
Thank you for sharing your website. The splash page – i.e. the photograph of 2 hands reaching towards each other – is gorgeous, lucid and chilling. As is your writing on the site.
In terms of my own health, I continue to battle the beasts. Self-discovery leads to increased moments of stability, but it’s a hard-fought journey with much that derails me still. Such moments of derailment *always* come from disconnect, i.e. when I shut myself off from the mind/body/SPIRIT realm of life. Thankfully, so too lies the way out. With awareness of this now generally limiting ‘crashes’ to periods of days – no longer weeks or months – that which needs to be (re)engaged to get back to stable ground is that much closer at hand… and thus the journey continues…
Thanks Mary! I’m not familiar with Monica’s site in any great depth but am curious to check it out!
Will Hall’s “Harm Reduction Guide to Coming Off Psychiatric Meds”(available for free download online) is also a fantastic resource. Rxisk.org can be helpful for figuring out what symptoms are being caused by one’s meds…
“I’m merely a patient advocate, and so have no traction within the system”
If I may offer a correction, that’s exactly who GETS traction in the system. The whole system isn’t going to change until we, as consumers/survivors/ex-patients and allied supporters, request and increasingly demands those necessary shifts the only way we can – one person, one voice, one conversation at a time. Until we – first individually, then through such determination, collectively – stop accepting status quo. The work you’re doing, regardless of its extent, capacity or outward perception of “success” DOES matter, because it’s doing exactly that. It’s one more voice, one more person, saying “this isn’t right.” THAT is traction, one determined toe-hold at a time.
I hear the frustration in your post, regarding how medication remains front line treatment, despite the reality it does little (or with more accuracy, NOTHING) to resolve the underlying issues… and that the things that do help are sadly unattainable for many who need them most.
All best to you in your support and advocacy. I’ve been in that role also, trying to get help for a loved one who was drugged then told “that’s it”. Sometimes, you just have to keep fighting. For whatever resources, options, doctors, hope there is. There ARE resources out there, pending location (at least in Canada)… It’s unfortunate that they’re hard to access and one quite literally has to fight the dual battle of justifying and making a case for oneself whilst simultaneously stepping away from the biological paradigm (difficult to do at the best of times, let alone in the crises of emotional turmoil)- but they do exist. And thank goodness for advocates such as yourself, creating the support necessary to do so. As a dear friend once said to me, “illigitimus nil carborundum.” Don’t let the bastards grind you down.
Am grateful for your words, and thankful if something I’ve written or provided can hep in any way.
Best, MB
p.s. An earlier piece I wrote for Mad in America was actually initially written at the request of a psychiatrist to give to a fellow patient contemplating coming off meds. You may be interested in it as well… “Letter to a Patient”
After writing this piece, I went back and looked through my notes regarding coming off medication:
I went off meds in the fall of 2003. Had a number of issues in withdrawal that resulted in going back ON meds (Prozac, in particular, was quite awful to break off). Was on again/off again throughout 2003/4, no guidance just fighting through the withdrawal and titrating up again when I couldn’t. Raced the 2004 season on meds… fractured my skull in August 2004. Finally pulled myself off everything that winter, 2004/2005.
Basically, I consider myself GOING off medication Fall of 2003, GETTING off medication (withdrawal hell) from that point on until early 2005 and then finally FEELING as though I was starting to see snippets of “me” by February 2005.
Since then, I’ve stayed mostly clear of psychiatric drugs barring a couple instances when I’ve totally derailed, or just not able to function. It’s been pretty minimal though – my body is just so hypersensitive now to any kind of input, I’m really chary about meds. To be honest, exercise, nutrition and the like do far more for my mental health than any chemical or endogenous aid ever did…
I really appreciated the sensitive acuity with which you broached an immensely loaded topic. Personally, I can’t think of ANY diagnosis or label more difficult to hold in open conversation than that of “borderline personality disorder”. As Judith Herman so aptly wrote, borderline personality disorder, in many ways, has become “a sophisticated insult”. The fact that certain sequelae of experiences can lead to a collection of symptoms that, when clustered together, lead to an entirely subjective diagnoses isn’t what’s loaded. Where it gets loaded is with is everything that goes along with the cultural, societal, medical perception of someone labelled “borderline”.
When I read your paragraph – “Trauma does not explain the need to inflict pain. Trauma does not explain a display of entitlement to reduce another person to subhuman status– nor is the pervasive attitude of one’s superiority a right of passage for a victim of abuse… graphic recounting of their abuse histories is often the first sign that the *listener* is being scrutinized for his/her potential to satisfy their predatory cravings.” – I felt chilled. I thought of my own experiences with and around this label.
It’s so rare to find a piece of writing that brings together the challenges of navigating trauma (one’s own or another) AND YET simultaneously speaks to the pain that renders it seemingly impossible to stay with such pain. Of the need for both listener and sufferer to, somehow, find ability to remain present as required for healing to occur. To recognize the human in the other… and the humanity and humaneness of oneself.
I’m going to save your post, and reread it many, many times over… Wow. My own words aren’t doing justice to what I’m trying to write… Thank you. Great work.
Upon reading your bio, I visited the website you’ve created – http://www.recoverystories.info. Sites such as yours are such a gift, providing people opportunity to speak, listen, share and learn. There is something truly healing that comes from the lessons and teachings of others’ experiences. While everyone’s journey is unique, there is much that resonates at a deeply human level regarding “what it means to be called crazy in a crazy world” (to quote Will Hall).
Hi CatNight, You made a great point about how disparaging comments and judgment can come from outside… and how easy it is to internalize those beliefs that what one is doing is ‘wrong’. You are very right, it IS to our own detriment. Kudos to you for sticking with your creativity – and congratulations regarding your museum piece!
“Call it arrogant, I don’t care, they must prove to me that they’re worth being my doctor. ”
YES!!! And yet, really, is that “arrogance” or simply one’s right to self-determination of the best fit?
An analogy comes to mind: If an auto mechanic doesn’t know squat about the car he’s about to work on, would it be arrogant to tell him “you’re not touching my car?” or would that simply be, a very wise choice?
Why trust one’s body/mind/spirit with anything less?
Are you talking about the study cited in Healy’s “Let Them Eat Prozac?” (or is my brain equally foggy). If we’re thinking of the same study – antipsychotics given to clinical researchers and physicians – here’s an anecdotal account:
I shuddered when I read your words – and then started laughing, because I’d never actually realized what you’d so accurately nailed. Holy paternalism… right down to the wagging finger. I would *love* someday to see a mandatory class for all psychiatric residents; perhaps a week-long stay in a psych ward to experience life on the flip side of the proverbial couch? Could you imagine what that would do for the industry, if every doctor who wanted to prescribe a drug (or ECT) had to first have experienced it, themselves??!!
Thank you for your email. You’ve asked a question I’ve often reflected upon myself. Studies from Buchanan and Barker-Buchanan have correlated the degree of therapeutic success to be determined not on the therapist’s training or methodology; rather, the patient’s perception of the therapeutic relationship – that is, whether the patient believes his or her therapist to be supportive and empathetic.
Logically, that makes sense. If I don’t trust a therapist, there’s no way in h*ll I’ll work with them. It’s hard to explain, that immediate instinct – but it’s pretty accurate. I think the perception of those in the medical field as somehow being infallible or god-like, the paternalism of a system that posits patients as ‘lesser than’ is outright detrimental. If a doctor’s not willing to see and work with me as an equal, if different, member of the team, they’ve got NO RIGHT to having a say in my medical care. Period. As a society, I think we tend to accept that doctors are hard to find, so “take what you can get and don’t complain”. Garbage. Incompetent drug-happy doctors don’t deserve good patients. We are all good patients.
Beyond that simple criteria – is this individual educated and competent and do I feel even remotely safe around them? – for me, the three things that have made the most difference are: support, education, advocacy. In terms of support, I’d be dead if it wasn’t for individuals in my life who somehow saw ME beyond the ego, personality, all I thought I was(n’t) supposed to be – and believed that someday I’d see the same, someone worth caring about and fighting for.
This included a physiotherapist, followed by a coach and, finally, the psychiatrist whom I wrote about in my first blog, “Farewell”. The one thing they all had in common, I suppose, was Rogerian unconditional positive regard – and incredible support. They saw me less as a pathology and more of a person. They fought for the person.
Education was critical. Particularly when one is labelled as “mentally ill”, it’s so easy – and utterly demeaning, devaluing and frankly dehumanizing – to be written off as “lacking insight”. I come from a family of (biologically oriented) physicians, one of whom frequently reminds me I’m “mentally ill” and it’s “my fault” because I’ve gone off meds. To that point, we’re on polar ends of the medical paradigm, and we’ll never likely agree. A major (and admittedly recent) turning point in my life was – I don’t care. She’s got her opinion. And I’m equally welcome to my own. What an insight – not everyone has to accept what I’m doing?! (Hello, health). I’ll go head to head with any doctor in the country when it comes to evidence-based research and challenging the biological paradigm. I recognize part of that comes from simply being discounted so many times, I’ve developed an incessant need for evidence to state my case and back-up whatever I write or say… but doing so has also given me a platform off which to make evidence-based decisions… and fight for myself. Or keep going, when faced with countless people who’s understanding of “mental illness” comes from t.v. ads and the like. Critical for stepping beyond the prison of self and/or societally limited perception.
That leads to the third component of what’s helped me – Advocacy. Fighting for myself. Refusing to quit. Constantly making a commitment to doing whatever I can – and increasingly, looking for others doing the same. From a lifetime of isolation, the discovery of how healing it is to actually BE in a community remains frequent and profound. We are social beings; recovery doesn’t happen in a vacuum. Finding – and keeping – good people in my (very close and tightly contained) circle of support has been instrumental. However, I see that also as a responsibility; if they’re willing to help me, I’m accountable to helping myself. This commitment is an ongoing battle, and one that daily takes me to new places. Efforts to bring awareness to spontaneous desires to numb or drug myself means looking at all the addictive patterns arising to do just that. From there, it means looking at nutrition, physio, exercise, mindfulness, alternative treatment modalities in order to retrain my brain to better cope… and the countless times I crash and burn. Basically, I see recovery more as DIScovery, i.e. doing anything and everything that might be able to help. Most of all, it means increasingly learning to listen to the very intuition I shut off in order to function and survive though incredibly overwhelming experiences and episodes of early childhood trauma and abuse. As far as I’m concerned, so long as it’s not immoral or hurting any one else – and it helps my mental health – I’ll try it. Plant medicine as been a relatively new, and incredibly positive, part of my journey. I am blessed with teachers and mentors such as Dr. Gabor Mate, and his teachers, in particular A.H. Alamaas. Reading – and implementing – the works of Schwartz, Hanson, Tolle, etc. also helps.
Finally, at least for me, a critical component of my own health is simply appreciating that everyone’s healing path is different. It’s easy to experience envy when I see others seemingly moving faster or quicker through recovery, dating, functioning, etc; or giving in to that voice in my head whispering “others recover, but I can’t…” Learning to let go of that lends space to see the beauty of being precisely where I am at, on whatever step of the journey I’m on. This doesn’t mean I have to like any given situation or experience. Nor does it mean immediate perfection. It just means the focus shifts to learning from wherever I find myself, recognizing the suffering comes from not from said situation but my wanting to be elsewhere – and establishing the resources to regroup and keep going.
Healing can ONLY occur in the present. It can also only come from within. Not in the future, not in the past. Not from anyone else. Others can support; but they can’t do all the work.
The latter is something I was reminded of again, quite recently in the retirement of my psychiatrist. After eight years together, ending this relationship was destabilizing, to say the least… but going through that process, I realized my reliance on him had resulted (entirely unwittingly) on avoiding the necessary step of standing on my own. Consequently, when he ‘maxed out’, so too did I. Ultimately, his retirement was a gift, a parting and painful gift, but one I needed none-the-less. It doesn’t mean life is perfect, or tomorrow morning’s going to be any easier. It just means I’m on the next step, of a continuing journey.
Anyhow, that’s how I see it from this end. Support. Education. Advocacy. Responsibility. The latter, not as any kind of judgment or means of beating oneself up in negatively narcissistic ego; rather, simply, recognizing, that healing can only come from within… and that means doing whatever it takes to keep the relentless forwards progress.
Antoine de Saint-Exupery writes, “what saves a (wo)man is to take a step. And then another step. It is always the same step, but (s)he still must take it.” When I think about dealing with trauma, that’s really it. There’s no easy way around the pain. There’s only through. One step, one breath, one stumble, one relapse, one moment at a time. And along THAT path, finding again the self that exists, always, underneath and despite the pain.
I’d love to hear what others think, in particular, about finding balance on reaching outwards for support whilst finding the awareness within…
“We are judging people who have sensitive dispositions and absorb the world around them; people who are essentially struggling with basic life issues. And as a system – the mental health system – that sort of prides itself on exploring human behavior without judgment, this is a failure — not on our client’s part, but on the part of professionals and systems that are supposed to be caring for them.”
THANK YOU. THANK YOU. THANK YOU for this essay.
As Judith Herman said, “Borderline personality disorder is… little more than a sophisticated insult.” A well-written piece that speaks of the damage done to already wounded and fragile souls, when slapped with incredibly pejorative label.
Great points about a touchy topic, ie personal responsibility. As you alluded, the situation is far more complex than ‘just’ Big Pharma.
While writing the project from which this letter emerged (link: https://docs.google.com/file/d/0B5cLaT3gdm9NNDZQb3Zscl82RDA/edit ), I was surprised by how many times the realization “it’s patients/families seeking the meds” came up. Your observation of how we live in a society geared towards instant gratification (and also the expectation thereof – leading to the generation of intense suffering when reality proves far different) is readily apparent. But you think it goes deeper than that? Is not society a reflection of the preferred values of he collective?… In which case, we create our own society, by saying ‘yes’ and accepting much that is woefully wrong, indeed abnormal to a level never before seen at a mass scale of humanity.
This goes beyond medication obviously (although the fact a substantial percentage of our population is heavily medicated and deemed ‘mentally ill’ is itself alarming); but also, destruction of the environment, election of governments that focus more on economic growth than acknowledging a country’s GDP actually improves the LESS healthy its citizens/environment are (inefficient health care spending & infrastructure = more monetary stimuli), etc…
A common thread is the cutting oneself off from the world in which we all live, both internally and the collective external. What other species tends towards self destruction, both internally and of the very resources in which their lives depend? Only humans. Bruce Alexander ‘s work, The Globalization of Addiction, posited disconnection from self and others as the primary factor in addiction and poor mental health. We are living in such an unnatural, disconnected state, it goes to follow that artificial “quick fixes” seem natural – particularly when the alternative is taking a clear look at one’s life and questioning how did this come to be, what need to change and HOW?
Which takes time, commitment, having resorces to do so, spending of resources on things that can’t be measured in the current monetary value system of our society, going against family systems (ie stepping out of generated roles that are easier/comfortable for others if maintained-no matte how unhealthy)… And most of all realizing that nothing external can truly take the responsibility to save us. Resolution is endogenous – it comes from deep within.
In terms of polypharmacy, I can only speak to my own experiences but for me, it was a combination of 1) doctors (and myself admittedly – trained and brainwashed as I was to cow to authority and believe someone willing to ‘take care of me’ gave them sufficient ability to do so…) not being aware of the science or risks – ie assuming the pills were benign, 2) patently irresponsible physicians who took the easy road out, 3) the interpretation of side effects as further proof of ”mental illness”, 4) absence of other alternatives in the medical sector, 5) family pressure, 6) desperation/fear/shame, 7) the power of being labelled and hence ostracized if/when NOT medicated (and blamed ie because then it was ‘my fault’), 8) the fact a ten-minute doctors appointment can’t even begin to address a lifetime of complexities, and 9) frankly being perceived/labelled as a “difficult patient”.
There is no easy solution for crises of emotional distress. But a good start, whether individually or as a society, is recognizing them as just that – and not a pathology. The world we have created that enables the continuation of a broken system is what’s mad about all this… Anything within is a normal response to overwhelming, entirely abnormal stressors…
Thanks again for sharing your experiences, as well as this dialogue.
Absolutely, a “blanket approach” to saying “no medication for anyone,” can be as polemic and limited as the opposing paradigm of medication as front line treatment. As expressed in this letter however, the question isn’t whether anyone should or shouldn’t be on medication; rather, the right of that individual to an INFORMED, EDUCATED decision. A right which – in our current system – is largely co-opted.
An advocacy for the right to medical self-determination requires appreciating the use of psychiatric medication is not black and white. For some, positing emotional distress as a biochemical imbalance in the brain can present as far less painful than acknowledging – and facing – the alternative… namely, looking at history of trauma and ramifications therein.
Alternately, come times when a drug – with awareness – can help “take off the edge,” at least enough to regain functionality to then move forwards; for example, managing a couple hours of sleep when trauma had negated any such ability for days on end and no other realistic alternative is viable. The same could be argued for individuals for whom taking the time and space to deal with all the underlying ‘stuff’ just isn’t possible – or who just need, as a dear friend recently said to me, “to give their brain a bit of a rest, to turn down the volume,” in order to regroup, return, keep going.
That kind of mindful, conscious use of medication however – which sounds like your situation as well – is vastly different than psychotrophic drugs being used as some kind of ‘cure’, under the false pretences of how they’re ‘supposed’ to be working, as a means of social/individual control, or as a form of avoidance.
In the end, the realities of life and suffering are only fully known to the individual therein, and ultimately, the decision to use (or avoid) medication comes down to what is best – feels best – for said individual.
What I believe is that every individual deserves the right to ethical, evidenced-based medical information, to know and understand the choices they are making, and to be able to make that choice in regards to what they feel is best for their body. That we as a society have the right to know the best practices available, and they be made available – and supported by our government. That our governments and service providers made decisions not under the partisan influence of Big Pharma and corporations but from the moral and ethical stance of true integration of the mind/body/spirit realm. And for those still locked in the biological paradigm, to have options beyond simply “shut up and swallow” – to quote one of my own physicians.
And finally, that we, patients as much as physicians and other care providers, desperately need support – and connections with like-minded individuals because it’s really hard place to go alone to create and access services focused on what works.
I’m really glad you seem to have found a combination of something that works for you. In the end, that’s what really matter.
“… when we dull, avoid, or separate from our emotions, we have lost touch with a vital part of ourselves that serves to guide us, so it’s easy to feel either with lost in direction or dependent on others,”
That’s so true, and certainly my experience as well. The ability to listen (and hear) the intuitive within seems to be one of the first things that goes with trauma, which makes sense… i.e. literally, cutting oneself off from overwhelming emotion – which serves a purpose… but also comes at the cost of being able to FEEL in the present, the only place possible for healing to occur.
I was away last week and didn’t have a chance to read the replies until now.
WOW. I am in awe of this community; the strength, compassion, insight, wisdom and support of its members therein. Thank you all who have contributed to the dialogue following ‘Child’s Pose’. I feel humbled and inspired by the stories, struggles, suggestions and spirit shown here. Thank you for sharing your words.
I’m grateful to a lot of teachers of my own… many have dealt with freaked-out panic stricken bolting from the classroom. It’s amazing how much energy is stored, literally, in the body… emotions coming up and out in various poses. Speaks to the power of yoga.
There does seem to be a paucity of trauma-centric yoga, at least outside specific centres. The best resource I’ve found so far in terms of yoga/trauma is Bessel van der Kolk’s program:
Thank you for your comments. I wholly agree with your observation, that the successful therapist-client relation has to be a human one. In my experience at least, the only doctors I’ve seen as even remotely helpful as those willing to engage in a collaborative – and hence, client-centric/empowering – approach. Unfortunately, this isn’t (or doesn’t appear to be) the standard model of our medical system.
In terms of loss, absolutely, it may be more painful at the start to lose a relationship that is actual based in respect and care… but in the long-term, I suspect one with false divisions – the psychiatrist, priest, authority figure, whoever being in “control” – would be far more difficult to lose. When there is collaboration, there is a sense of client autonomy, a decreased dependency (if still present) on the dyadic partner. Conversely, when there is authority – being told, whether implicitly or explicitly – that the client is “lesser than” – it’s a huge step from that state into the void of figuring out “now what?!” (i.e. independence)… or devastation.
That said, “devastation” implies a complete and utter inability to recover. Is pain – or loss – always devastating? If the therapist/client related to each other in a human, hermeneutical manner… could not an imminent loss ALSO be seen as (and mutually explored) as part of the natural course of progression? That’s not to say it isn’t still painful, awful, gut-wrenching, upsetting… simply, perhaps not as devastating as an abrupt rupture of whatever unequal, ego-driven division lead to an alternate interaction of superiority/inferiority? The latter, to me, suggests more imbalance, and hence, more scope for devastation through loss of the role as well as the person.
Thanks again for your insight and observation about the power dichotomy that does exist in many therapist-client/religious/political, etc… relationships…
You nailed it, in your words”helping someone overcome a traumatic and difficult upbringing in a traumatic and difficult society.” It’s not just a matter of dealing with one’s own past trauma but also, the trauma of being in a society increasingly devoid of meaningful human connection.
One of the things I’ve really turned to in the past few years has been this site – also Will Hall’s great radio program, Madness Radio. To hear of others’ experiences and struggles, opinions and thoughts brings a sense of community oft-times so lacking. As Bessel van der Kolk observed, “working with trauma is as much about remembering how we survived, as it is about what is broken.”
Thank you for your comments and sharing your own painful experience. I appreciate your Sri Nisargadatta Maharaj quote. Regarding the split between what we are TOLD we are and who we truly ARE, the words of R.W. Emerson come to mind, “to be yourself in a world desperately trying to make you someone else, is the greatest accomplishment.”
Stephen-
Please refrain from identifying me as “pro MDMA”.
My exact comment was “MDMA has potential-and… overwhelmingly unresolved risks”
That is not a pro-MDMA. That is a balanced perspective.
I feel troubled by your fictitious sequelae of MDMA clinical trial assault. The inference that individuals assaulted after taking psychedelics are blind to the influence of psychedelics and in fact continue to support their use is an extremely broad statement.
Putting vulnerable individuals in overwhelmingly vulnerable situations is not a good idea. Psychedelics highlight the power schema inherent to any patient/therapist dyad… and in that circumstance, acts of abuse can and do occur.
That someone turns to a given modality for healing and is assaulted by his/her therapist however, is an indictment upon the therapists and the institution allowing such perpetrations to occur. Inferring anything less is an extremely shallow reduction of the egregious acts of abusers and thinly veiled victim-blaming. I trust that is not what you intended.
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Daniel-
Thank you for your open-minded reply. I agree with you that MDMA has potential-and strongly continue to believe it has overhwhelmingly unresolved risks requiring address for it to ever, truly, be an evidence-based and safe option. You wrote, “Also, please note that MAPS is a non-profit organization, and MDMA is not pattentable. This is really not about greed or profit. These people may turn out to be wrong, but they are not part of the pharma-industrial complex, far from it.”
With respect, while MAPS is indeed a non-profit, the organization has set up a for-profit B-corp strictly for the purposes of marketing and monetizing MDMA. In doing so, while optically continuing to appear (and benefit from public opinion) as a not-for-profit, they have indeed become a pharmaceutical corporation.
The FDA’s approval provided MAPS with a binding agreement guaranteeing the therapeutic legalization of MDMA should Phase 3 trials obtain two statistically significant results with no emergent safety concerns (NOTE: A sexual assault in the Phase 2 clinical trial-the LAST place it should have occurred, with both MAPS and MDMA under far more scrutiny than either will ever face again-should most definitely be considered a safety concern, in my opinion).
Upon legalization, MAPS will be granted drug exclusivity, making the company the sole source of therapeutic MDMA for at least the first five years after legalization. Granted, as you pointed out, MDMA is already widely available: It’s not patentable. But only MDMA produced by MAPS’ for-profit B-corp-the sales arm of MAPS i.e. MAPS-as-Big-Pharma-will be legalized for prescription use. In addition to actual drug sales, MAPS stands to benefit through the training and certification of therapists. All future therapists and clinics will require MAPS’ approval. Finally, MAPS anticipates rolling out “thousands of psychedelic centres” of its own over the next decade. (Again, can I mention that MAPS is doing nothing of significance to mitigate the risk of sexual abuse, and is instead actively setting the lowest-not highest-possible bar in the certification of its “psychedelic therapists”) With the company recently valued at $100 million, MAPS’ CEO, Rick Doblin estimates profits over first five years post legalization will be around $36 million.
While I remain hopeful for the future and use of MDMA, in the absence of any external oversight; positing of MDMA as benign cure; MAPS’ calculated marketing initiatives; and multiple examples of MAPS placing profit over patients, I am deeply concerned on many fronts by its impending legalization within the current framework.
Where I am wholeheartedly in agreement with you (if I may paraphrase what I understood from your comments) however is in the need for continued, informed and thoughtful dialogue. That’s the only way safe, viable, evidence-based options will ever truly be part of mental health care-giving individuals the opportunity to choose what’s best for them, knowing the options are evidence-based and backed by objective research, not for-profit corporations or non-profit organizations masquerading as the same.
Thanks for your comments.
Meaghan
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“No harmful effects on social functioning”
I suspect the patient who was repeated sexually assaulted by her therapists during the Phase II clinical trial might beg to differ. The full statement is available on MAPS’ website, here: https://bit.ly/2VZuJOC
Any drug that increases empathy, enhances trust and extinguishes fear is not benign. To its own financial benefit, MAPS is marketing MDMA through both general media and peer-reviewed journals. Publications-written and researched by MAPS-are overwhelmingly positive. There is little to no truly objective outside analysis; and no mention of the overwhelming evidence that sexual abuse was, is and remains a serious concern in the mind-altering realities of psychedelic psychotherapy. This article is not unbiased research; rather a repeat of what Big Pharma drug companies have been doing for years… selling a drug before it has been fully clinically tested and highlighting just how concerning that “clinical testing” truly is.
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“it can potentially help the person change the way they see the world and relate to it.”
Yup.
Unfortunately, that doesn’t fit neatly into some kind of biological paradigm of “drug changes X in brain and patient is cured!” simplicity.
In my (completely biased) opinion, I think one of the biggest risks regarding the impending legalization of any psychedelics is the positioning of such substances as quick-fix miracle drugs.
Carl Jung said it best, “It is a mistake when you think that only the authority in this field could help you. You have a mind just as well as any other human being and you can use it if you only know how to apply it.”
(Carl Jung, Letters Vol 1. Page 127)
Psychedelics can HELP (with the proper support, integration, etc…) with the process of finding a way through the mind’s wounds and how they manifest externally. That’s very different than saying they (or any psychiatric drug, really) is a CURE.
Thanks for your comment, Explorer86!
MB
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Hi Oldhead,
Thanks for your comment.
This sentence intended to convey the limitation of talk therapy (trauma lodged in the limbic system lies beyond the reaches of talk therapy – see Bessel van der Kolk’s “The Body Keeps the Score”) that can be addressed through psychedelics.
The healing process, I agree, comes not through resolution of some physical wounding; rather the awareness of the deeper (unconscious) emotional/psychological insults leading to the symptoms (or character development) and ensuing devastation.
I’m not sure how I could have made that clearer in the essay, given general length-constrictions, but I’ll keep note of your comment for if/when I turn this whole experience into a book (someday… 🙂 Thanks for being a keen-eye editor!
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Hi The_cat
Yes, it’s cool.
Re. guided…
It’s actually supported but not guided. The structure (of the clinical trial) was outlined in a specific manner (spanning over 3 days, middle day being 8-hour session, day 3 being integration, however long that takes. Patients stayed overnight on site post MDMA… you can find the exact protocol online, MAPS.org
The actual therapy, at least during the trial, was generally non-guided, i.e. NOT directive. Rather, allowing the client to go into the experience with the psychedelic, with the therapists using their skill and training to amplify the experience. An example of this: using music to match the intensity and what’s manifesting somatically (e.g. non-stop shaking in fear for several hours = non-stop African drumming). Guidance is applied only in instances where therapists notice avoidance of certain topics/experiences, and even then, asking rather than directive.
There is still considerable debate over (translation: they don’t know) the specific brain mechanisms / changes associated with psychedelics. That said, what is known – and unique – is their mind manifesting properties.
Basically, psychiatric drugs work by numbing DOWN emotions… you feel less.
Psychedelics do the opposite… they open you up = feeling more, more deeply, or what’s going on in the unconscious. (Hence intensity, also a deep spiritual component – not in any religious sense, but well beyond the realm of Western medicine). MDMA research is being conducted for PTSD, etc. in part because it has empathogenic properties – it increases oxytocin and bonding, also decreases fear… so subjects taking MDMA are able to feel safe and connected while exploring difficult experiences (e.g. talking about a rape)
A very different approach than psychiatric drugs just trying to knock down symptoms. Psychedelics can increase symptoms – everything comes up, “bad trips”, etc – but can also bring awareness of the underlying origins… and thus, ability to find new perspectives and ways through.
Mind numbing vs. mind manifesting.
Very cool.
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Hi Oldhead,
I’m with you on this one.
There is much to be said for actually experiencing a substance prior to inflicting (or using it therapeutically) on the other. The same should go for psychiatrists, too… a weekend on Seroquel would do wonders for curbing over-exhuberent prescribing practices…
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Hi Jane
Correction: “I’m sorry that you felt some of the clinicians involved in your treatment were not qualified to lead you up the mountain ala Bill Richards’ analogy.”
That is totally NOT what I meant. The folks I worked with who were clinicians were – and are – impeccable in their training, self-awareness and commitment. The grossly incompetent and unconscious facilitators were in the underground (ayahuasca) community. The difference lay in their training, not in their first-hand experience working with their selected medicine.
In terms of credible training programs for psychedelic psychotherapists, there are currently only three:
a) The Orenda Institute’s psychedelic psychotherapy program
b) MAPS’ therapist training
c ) CIIS’ psychedelic therapist program and
ORENDA (British Columbia, Canada)
Of the three courses, the Orenda provides the most solid foundation of self-work, in breath, depth and scope. The first week takes participants deeply into their process, using a heuristic method that takes participants into and through a safe vessel, culminating with a 24-hour (legal) experience. The second week breaks down the format of the first, i.e. going through what was done and why, building understanding set/setting, training therapists how to form the vessel (stimuli, music, images, etc.) The final week focuses on human development, including character armouring and the development of personality as an adaptation through childhood. The Orenda students form a conscious ‘pod’ upon completion of their training – a tightly knit, highly trained group capable of providing and engaging in peer support for one another to ensure maximal safety and appropriate care of themselves and their clients.
Orenda is run by Dr. Richard Yensen and Dr. Donna Dryer – Acting Principle Investigator and Therapist for the Canadian MAPS Phase II clinical trial, in addition to associate faculty. The Orenda accepts 10 students/class, running in three one-week intensives over the summer.
CIIS (California)
CIIS provides aspects of the above in terms of content, but in a much less intensive manner, e.g. a weekend course in breath work, etc. Multiple faculty, currently accepts 35 students, but increasing numbers (60? – can’t remember if this is the actual figure or the current wait list, so don’t quote me on that) next year.
MAPS (USA, California/Other)
MAPS is the least experiential, some work on the therapist but more on methodology with an eye to standardizing treatment as required for FDA approval for Phase III trials. One of the good things re. the MAPS training is that therapists selected for the Phase III will actually undergo their own MDMA session, something the other 2 can’t provide at this point in time.
To give a sense of the training hours:
a) MAPS: ?
b) CIIS: 180 hours over 9 months
c) Orenda: 180 hours over three-7 day intensives
Challenge is, there is no real “certificate”, i.e. graduating from any one of the three doesn’t provide anything beyond a sheet of paper saying one has gone through that particular course. So it comes down to desire of methodology, really. The folks who drop out of the Orenda Institute in the first week are those who don’t think they need to do any work on themselves prior to trying to “fix” someone else.
Again, just my own opinion, but having been on the receiving end of wayyyyyy more unconscious therapists than the handful of truly stellar ones met along the way, that single factor alone – i.e. self-selection in the first week through actually experiencing what it means/feels like to be put into as close to a psychedelic experience as possible (and seeing who can actually deal with it, and who turns and bolts) – puts the Orenda 1st in my books.
If I’m not willing to trust someone with my LIFE – to be born with them, to die with them, to be certain that they’re not going to break, crack or drop me when I’m at my most absolute vulnerable – and to believe at the most visceral level of connection that they have the competency and training to be aware enough of what’s going on within that they’re not going to project their issues on me because they’re triggered – it’s a no brainer: There is NO WAY I want them anywhere near me in any therapeutic context, let alone with a psychedelic.
In terms of what works vs. doesn’t, my own experience and belief is in total agreement with the most experienced therapists I’ve ever met, on this one: #1 thing anyone incoming can do, is work on themselves and get the absolute best training possible. Anything less is a disservice – and arguably hostile – to future clients.
(That said, it can be a daunting prospect, with the difference up here in Canada ranging from a quick-and-easy non-thesis 30-month degree without any foundational psychology required all the way up to a 9-year trek through a Masters + PhD. I’m still trying to figure out the “hows” of my own journey, so this strikes a chord. From starting a BSc. to graduating with a PhD., my own university career could very well span 30 years. Slight hiatus for trauma 🙂 I’m calling it “experiential learning”)
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“One of the reasons psychiatrists and psychotherapists might be destabilizing is that the treatment is illegal”
Which leads to a challenging paradox… as long as psychedelics are illegal, it’s impossible to train therapists how to competently use them. Doing so, itself, would break any number of laws.
This creates two potential situations if/when psychedelics are legalized (with MDMA and Psilocybin both nearing that mark):
a) non-trained non-professional individuals providing “therapy” with little to no formal training in psychotherapeutic/analytic foundations and zero experience using psychedelics in a professional psychotherapeutic setting OR
b) professional therapists becoming “certified” to use psychedelics despite having minimal to no actual first-hand experience prior to believing themselves competent to doing so.
Of the need for therapists to actually have training AND experience in what they believe themselves capable of successfully using, senior psychedelic researcher/therapist Bill Richards (one of the investigators in the Spring Grove trials, currently at John Hopkins University) put it best. At the recent Psychedelic Psychotherapy Forum in Victoria, BC: “if you’re climbing a mountain with a Sherpa as a guide, you want someone who’s actually been up that mountain – and hasn’t just read about it in some book!”
The current MAPS training program, while limited in many ways, acknowledges and seeks to address this gap. Part of the approved Phase III protocol will see trained therapists administer MDMA to incoming therapist teams – i.e. having the therapists themselves receive psychedelic-assisted psychotherapy – prior to those teams then providing therapy to Phase 3 patients.
All of which is a basic and critical, in my opinion, first step… but one that doesn’t in any way negate the need for therapists to first DO THEIR OWN WORK ON THEMSELVES, above and beyond any work with psychedelics. Otherwise, psychedelics are a disaster waiting to happen: All the power and ego associated with psychiatric/Big Pharma drugs combined with poorly trained and/or unconscious therapists lacking awareness of their own stuff coming up and taking it out on the subject… or believing that using a psychedelic provides a “chemical cure” and thus requires less, not more, training.
That which makes psychedelics so potent – their tremendous capacity to heal – can equally be turned to abuse… even if not obviously intended as such, i.e. through their use by poorly trained, ill-prepared and unconscious therapists who get in over their incompetent or ego-swollen heads.
I, for one, am all for any regulation, prior to legalizing these substances, that mandates their use as as psychotherapeutic adjunct ONLY by trained psychotherapistswho have (at the very least) undergone professional clinical training combined with extensive and competent personal therapy. A cautious, judicious approach to how this is all unfolding may take longer but in the end – what’s the true cost? What’s the true risk? How do we figure out how to do this properly? While I doubt this approach will occur, I just can’t see many negatives to taking the time to really look deeply at all facets of their use, including whether and how our society is ready to deal with this.
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Hi Oldhead,
Ayahuasca is an entheogenic brew indigenous to South America. It’s made from combining Banisteriopsis caapi vine and the Psychotria viridian leaf, generally with other admixtures. Individually, the leaf and vine are quite benign. The potency and psychedelic properties of ayahuasca occur through the combination: Psychotria contains DMT, while B.Caapi is a MAO inhibitor. Highly hallucinogenic, tends to be used in a group setting, the effects last 4-8 hours and are generally accompanied by vomiting (both from the brew itself and the fact it tastes like something you’d scrape out of the bottom of a garbage can).
It’s illegal in North America, except when imported for legal use by members of the Santo Diame church. Illegally or abroad, it’s popular in the realm of psychedelic tourism.
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Thanks, Planxty,
Your comment made me think of quote pinned to a bulletin board I once knew well: “I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.” (Mandela). (Amusingly, this was next to an RD Laing quote eviscerating psychiatry!)
I learned courage in that office. In large part, from witnessing a therapist with the courage to stand up for what he believed in – the ability of this patients to heal from severe trauma, free of psychiatric meds – against incredible adversity.
If courage is connected to fear, there is truth to the adage, “I stand on the back of giants”.
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Great, thanks.
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Reply to Oldhead’s post October 9, 2016 at 5:27 pm
(MiA staff-how come I can’t reply directly underneath Oldhead’s reply?)
“There are people who are good at exploring reality and consciousness with others, and there are people with degrees who get paid to reinforce the parameters of this system.”
Challenge being, figuring out who HAS the skills and training to provide full spectrum of care from ceremony through integration, regardless of whether scope of training came from a degree or lived experience.
In my experience at least, one of the biggest risks (both in using psychedelics and psychedelic therapy in general) surrounds the aura of the ‘instant expert’ – individuals in the psychedelic field providing services without due diligence or formal training in even the basics of psychology. (Again, regardless of actual degree and convinced they are both capable and competent.)
This is certainly an issue in ayahuasca; made all the most worrisome by it’s lucrative nature (350-475$ CDN/per person/ceremony) and lack of regulation if/when something does go wrong.
Interesting point re. the CIA, I hadn’t thought about that, i.e. how the response would be too varied and unpredictable to standard (thank goodness) as a weapon of war.
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Hmmm… for some reason, I couldn’t “reply” to you Oct 8, 2016 7:55 pm post below. Hence, posting here.
This thread touches on something I keep trying to turn over in my head: Simply, how can something as psychospiritual as a psychedelic FIT into a system that looks at anything beyond cogent boundaries as delusional? Or, if it doesn’t and can’t (and frankly, probably shouldn’t), what needs to be implement – training, or environment, or ??? – such that psychedelics can be offered and used in a safe manner?
From this end, this split between biological / psychospiritual was most apparently in the diagnostic standards and measures used during the clinical trial. For FDA approval, any psychedelic study has to fit into the box of being randomized, double-blinded, controlled and measurable.
All of which is highly problematic. Case in point: how do you truly double-blind a psychedelic vs. placebo??? How about standardize a psychedelic treatment? Or use psychometrics to somehow quantify the fact that appreciate that sometimes, deeply psychospiritual insights can indeed emerge from a radiator? 🙂
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Weyburn Hospital isn’t on many peoples’ radars 🙂
Curiously, Osmond picked its location because he felt England was too conservative and he wanted someplace rural and remote (which, as anyone who has ever driven through SE Saskatchewan can attest, it definitely is…). At the time, though, Saskatchewan was also the epicentre of activism, thanks to Tommy Douglas being elected post-Depression with a radical socialist agenda. (He’s the reason Canadians have universal health care, albeit currently being massacred).
Osmond’s approach was equally radical. Opposed to the power relations in psychiatry, his decisions included
– having an architect take LSD, to understand how the patients would react to the structure of the building, and design the space.
– putting authority with ward nurses rather with doctors
– welcoming family to the hospital
– incorporating art and music therapy
– encouraging patients to get involved within the community
– insisting workers also took LSD (so they understood what it was like for the patients… wouldn’t it be great if psychiatrists today had to do the same prior to prescribing anything?!)
Basically, Osmond created a environment in the middle-of-nowhere that employed most of the town, attracted world-class medical professionals, and got patients OUT of the hospital and IN to community. The clinical outcomes were unprecedented (to this day…) Using LSD for generate insight/awareness underlying the need to drink, of the 2000 subjects treated for alcoholism from 1954-1960, 40% hadn’t returned to drink at least a year after treatment. (Kaplan, 2013.) (DOI:10.1177/0967772013479520)
Unfortunately, this threatened the conservative medical profession, which attacked the data (which was, admittedly, heavily anecdotal and not gold-standard RCT). Tim Leary’s indiscriminate drug promotion didn’t help. The CIA also got interested (MK-Ultra, testing mind-control). The DEA blocked import of LSD in 1965 and a series of articles blaming LSD from everything from foetal abnormalities to psychosis a year later was the final nail in the coffin… at least, for the next 41 years. The Phase II psychedelic trial that took place in Vancouver last year was the first legal psychedelic therapy in Canada since the Weyburn experiments.
All of which is fascinating. Also, hard to believe, in light of the conservative and “bio-bio-bio” belief system that so plagues the current mental health system.
(Weyburn is actually a bit of a personal curiosity. My great grandparents homesteaded near Weyburn.)
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Hi Nomadic,
I agree that there is a need for political activism. However, I don’t see “Therapy, Recovery and Healing” as necessarily distinct and separate from justice, much less an either-or proposition.
For any rape survivor, I think what’s ultimately important is finding his/her voice and ability to reclaim that which is most violently ripped asunder. It’s not the physical damage that leaves the deepest wounds; rather those to the psyche and the soul.
For some, a reclamation of power might mean activism. For others, it comes in finding whatever compassionate individual, or a group (aka. “therapy”) offers a sense of not being alone.
There is no one ‘right’ way to heal, as your comments clearly elucidate. Is that not in itself the first step of establishing legitimacy and the reclamation of power? – the ability to make a choice for oneself about oneself. To each their own.
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“I don’t see how there could ever be a line between “professional” and “client” that wouldn’t dissolve during a psychedelic experience.”
No kidding.
There’s a conference next weekend in Victoria, BC (http://www.psychedelicpsychotherapy.ca) that will (hopefully) address this, with at least one expert panel discussing how to appropriately train therapists such that they can provide a safe and healing, if not “controlled”, environment. The word “controlled” to me, sounds more like a mechanicized therapy, i.e. give the client the drug and pretend environment or human interaction doesn’t have an impact…
By set and setting, I was alluding to the mindset (“set”) and physical/social environment (“setting”), both of which are directly linked to the healer’s ability to establish and maintain a deep and safe healing vessel. It’s hard to see how that can be generated in our current mental health system.
(Absurd and ironic are definitely words that come to mind when thinking about our current mental health system… because how absurd and ironic is it, to try to treat something as psychosocially interconnected as trauma with substances or therapies or beliefs as isolating and inhumane as those which turn a suffering being into nothing more than the sum of her/his broken bits?!)
It was shocking to me (if not surprising) when a recent exploration of Canadian psychology grad programs possibilities revealed not a single one requiring its students to have personally undergone psychotherapy prior to believing themselves capacity of possessing the skills and insight to do the same on another! (This is the case in at least 4 provinces… I haven’t checked out the others yet…)
As the adage goes, “People don’t know what they don’t know.”
Perhaps that’s why the mere concept of equality between client/therapist- rather than some kind of paternalistic model-is so threatening to health care providers unconscious of how they are using “being in charge” or “being the expert” to avoid their own unresolved traumas.
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Apologies accepted… I suspect “Rossa” is also equally prone to frequent consonant amputation! 🙂
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Hi Rossa,
“you feel that the benefits of this kind of therapy cut to the chase quicker (for you personally) than years of drug treatments and talk therapy”
My foray into psychedelics was far more one of desperation than conviction… At the time of going into the trial, I’d literally maxed out the medical system. I had no alternatives beyond conventional treatment (i.e. drugged to death). The only option, according to my then-case worker was, “accept that you are permanently disabled and stop trying to recover.”
The frustrating thing I found, over nearly 20+ years of therapy, was just never being able to get past my own trauma enough to actually go INTO and deal WITH the trauma… Healing was so painfully slow, and the container available within the medical system (while at times deeply supportive) was simply not suffice for the severity of trauma and how it manifested.
I left an awful lot of psychiatric appointments over the years looking seemingly “fine” but in truth triggered and dissociating… which lead to car accidents on the way home, or falling and winding up with yet another concussion.
That, for me, was the key difference with this trial, indeed any credible psychedelic psychotherapy… it had nothing to do with the chemical, rather, the incredible support/safety/set and setting that allowed for deep work to occur. It was the first time I didn’t have the fear I’d be “too much”, either for myself or the therapists I was working with. But it took a long, long time to get to that point…
Sound plays a significant role in psychedelic psychotherapy, with music being used to amplify/deepen/modulate emotion.
(Actually, there’s research now too, talking about its use for traumatic brain injury, stimulating regeneration at a cellular level…)
A few weeks ago, I had a chance to attend a workshop with Peter & Heike Hess: http://www.soundtrance.com/en/sound-trance-formation-3/
It was fascinating, both the theory behind sound and trance healing, and the instruments they used.
You are right, many, many exciting possibilities on the horizon!!
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Hi Richard,
You are correct, this is the first of a planned series… the subject of psychedelics is simply too big and complex for a single post. The next few will be exploring some of the more contentious issues surrounding contemporary psychedelics.
The points you raised about vulnerability are definitely on the agenda for a future, extended, post. The use of psychedelics to venture deeper into trauma to revisit and integrate its experiences creates a situation that is tremendously vulnerable (both for therapist and client). Not just externally (risk of sexual abuse, ego, projection/transference that isn’t managed appropriately, etc.) but internally.
As you put it,
“for some people dealing with past trauma and their own armored emotional defenses, psychedelic drugs (in a safe environment) might break down those defenses in a helpful way, thus allowing some people to more completely explore and reconstruct new memories of past trauma events in a therapeutic way.”
Totally true… but the latter can also happen, i.e. Difficult material coming up in an unsupported environment. Having one’s “armor” blown apart without the support of skilled healers to hold the vessel until the fragments come together again can, itself, be traumatic.
Given the vulnerability inherent to this work, therapists need to do their own inner work – and have cogent awareness of their own issues – prior to entering any psychedelic healing realm. This is simply to hold themselves and the client in safety, regardless of what comes up.
(The difficulty of this, of course, being “people don’t know what they don’t know.” Personally, I think it’s nothing shy of unethical for post-graduate training programs in psychology – let alone psychiatry residencies! – not to require all students undergo extensive personal psychotherapy prior to believing themselves capable of inflicting the same on someone else!)
Regarding vulnerability and how scary psychedelics can feel, a comment that resonated in my own work during the clinical trial was, “a difficult trip isn’t necessarily a bad trip.” This was true; some of the hardest and “worst” experiences were ultimately the most insightful. But for them to be so required an awful lot of integration, support, and a solid, stable and safe vessel in which to do the work.
That’s not something readily available in our current medicine system, much less the countless ways that trauma survivors are placated (“oh, it’s not your fault, you were a child, etc…”)
As a friend recently commented to me, “Trauma isn’t like a zit – you can’t just pop it, squeeze all the pus out and then pretend it never happened.” It’s life changing.
I loved your paragraph, that touched on this: “It is here where a deeper self acceptance and self love is finally achieved and the person can put these events in the proper perspective. NOT FORGETTING THEIR PAST, BUT NO LONGER ALLOWING THE PAST TO DICTATE OR CONTROL future thoughts, feelings, and behaviours.” [emphasis added]
If something like EMDR can provide that for some, it is wonderful resource. Thank you, Richard, for sharing your insights about this modality and the deeper journey of healing. I look forwards to a continued dialogue and your insights about therapy/vulnerability in a future post exploring this subject in greater detail.
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“I think detaching from social expectations and ‘the way things are done,’ in order to take our soul journey and feel who we are as creative spirits–the characteristics and purpose of which are unique to each of us– is healing in and of itself…”
YES!!!
And yet, paradoxically, SO difficult to do-particularly in moments when the “box” or expectations of self from others (or from self for others) maintains or serves some purpose.
Perhaps that’s why it’s so hard to navigate family dynamics… The process of sifting through the automatic roles and patterns of behaviour to a place of truth threatens the very things our lives depended on as children: acceptance, acceptability and approval.
“Mutual support” is essential. Otherwise it’s a long, hard and painful journey through the opposition.
Thankfully, there are places like here and dialogues like these that can provide a sense of community, even as we navigate our, deeply personal, lives.
Thanks for sage perspective, Alex!
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Dear A_truentic, Gratitude flows both ways… your beautiful words reminded me, that for all the isolation and misunderstandings associated around trauma, “you are not alone” (to borrow a motto from the Icarus Project!). Thank you for your feedback.
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Dear Rossa,
Thank you for catching the editorial error. You are, of course, absolutely correct. It’s Donald Ewan Cameron of MCGILL University. No excuses, a mental blip that amalgamated the two. I’m sorry I didn’t catch it on the read-through… thanks for allowing the correction here!
Are you familiar with any good books on Cameron?? The best I’ve read was “Father, son and CIA” by Harvey Weinstein… I was thinking today, I would love to read more on this topic. The fact that was going on concurrent to the (far more positive outcomes of 1950s) LSD work in Weyburn, SK, really speaks about the polarity surrounding psychedelic use – ie. tremendous good can from their (appropriate) use, but so too, can they be wielded with terrible evil.
Thanks again for your editorial eye, Rossa!
(I can’t correct it on the website, but have made the appropriate change in my hard draft)
MB
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Hi The_cat,
“I never took psychedelics trying to treat anything but I can imagine how it could help hit the thinking reset button…”
I’ve been in/out of therapy for almost 20 years. Figured I’d been through and tried everything, lots of rough years and hard work. My view going into the clinical trial was “nothing can be harder than anything I’ve been though”. Right. Nope. Those months were-without question-the hardest, deepest, most difficult therapeutic experiences of my life. Each psychedelic session felt like the equivalent of at least five years of conventional therapy. (But they each packed the exhaustion and emotional punch of five years’ worth of therapy into every one of those those (non-stop) 8+ hour sessions!)
A point about your comment on marijuana. I’m no expert in the field, but am familiar with the distinction between THC and CBD. Both THC and CBD are cannabinoids found in cannabis (“marijuana”); with different levels found in different strains of plant. Recreational-use plants, aka. “pot”, tend to have a high THC content.
THC is psychoactive – that’s what gives the “high”, paranoid, anxiety, etc. associated with marijuana.
CBD, on the other hand, is NON-psychoactive. There is no “high” that comes with ingesting a 100% CBD strain, despite it still seeming to provide therapeutic benefits. Much of the research that’s now ongoing about the potential therapeutic capacities of cannabis-e.g. neuroprotective properties in post-concussion syndrome, anti-seizure, anti-inflammatory, etc.-focuses on high CBD/low THC strains… which means not getting high.
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Hello Oldhead,
Thank you for your comments. Your thoughtful analysis touched on many key issues surrounding psychedelics. I totally agree with your remarks, particularly, the challenge of how (or if) psychedelics fit into our current “mental health” paradigm… and what the consequences are of such approach. Any efforts to reduce psychedelics to mere chemical compounds fails to acknowledge their psychospiritual properties, set and setting-i.e. all that surrounds and ultimately helps form a healing or harming psychedelic experience. For me, that’s one of the most concerning issue around psychedelic use in any treatment capacity, simply, their being framed as some kind of potent medicine akin to psychiatric drugs and treated as such-rather than an adjunct, or as you put it, a tool to open into the unconscious. Psychiatric drugs numb emotions. Psychedelic drugs, on the other hand, do the opposite… Your comments offer scope for potential of many future essays. There are many conversations to be had, wherever we are along our respective trails! Thanks so much for joining the journey! 🙂
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Beautifully written, Alex. Thanks for clarifying what you meant about “embodying Spirit”. Literally “in-body”-ing.
Bessel van der Kolk is purported to have said, “the butt beats the breath”; that meditation, etc. are critical, yet that absolute “ground point” remains IN (and getting back into) one’s body.
Your thoughts about linking to gratitude/trust to somatic makes a lot of sense. Trauma is so utterly contractive, it’s a great reminder to start with consciously relaxing (no matter how forced or fake or futile it feels, ugh!) to remind the body that the PNS does actually still exist, underneath the chronic flood of cortisol…
On that note, time to stop looking for work and get to yoga!
MB
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Hi Boans,
Thanks for clarification.
Call me an optimist (or naive… or any number of adjectives), but I find it hard to abandon hope in the human race, i.e. that there’s NO safety or possibility of whole trust.
Maybe it’s because I just don’t want to believe that the human race is entirely focused on individual gain at the cost of exploitation of another (although I’d totally agree with any hypothesis stating that is very much the focus of a Western-influenced capitalistic society… )
In the experiences of my life, I could sway either way. There are absolute and egregious breeches of trust – and those more insidious (and frankly, far more devastating). Even so, this is weighed against the goodness that just keeps showing up, drops of goodness, one person at a time. And somehow, those good moments – no matter how small – are impossible to ignore.
Don’t know. Maybe that’s just me… There’s just something that doesn’t sit right within me, though, to think of the human race as thuggish and suspicious (at least, outside a capitalistic mindset!)
???
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“Sometimes one has to escape in order to find oneself again.”
An interesting comment. There was radio documentary recently on “Ideas” on CBC that explored this – i.e. the belief that leaving, or relocating geographically, doesn’t actually help… versus the belief that it DOES.
I would love to hear others’ experiences in this realm. What relocations (physical or mental) worked?… Which didn’t?… Any thoughts/guesses why???
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Rest assured… “Finding Rat Park” will have sequels… 😉
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Hi Diana!
Wreck Beach… good to know. Perhaps someday we could connect for a chat on a rare and beautifully balmy winter day?
I’m over in East Van (just past DTES) but do travel on occasion to Kitsilano (although it’s actually probably a good thing I don’t live I close proximity to Banyan Books – that place is like crack cocaine for a bibliophile!)
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Thank you Alex!
Finding a meditation community – or at the very least, an affordable yoga studio – is high on the ‘priority’ list for grounding.
I appreciate your words of encouragement. Even holding trust in Spirit, those old patterns, fears and dark energies can be hard to release. As a friend reminded me recently, all we can do is “notice it, notice it, notice it” – and keep walking the path.
Thanks.
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Hello Boans,
it sounds like you’ve been through a lot. Thank you for sharing your process of discovery.
Is it that there is NO safe place, or no safe place externally in an ever-shifting impermanent environment… and if that’s the case, one must find safety within?
I love the mental pictures conjured up by your words, by the way…there is power in drops of water – one by one, they erode stone.
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Curiously, one of the most wonderful discoveries about Vancouver is that it actually doesn’t rain ALL the time in the winter. (it just rains a lot…)
The desire for, yet fear of, community seems to resonate… myself, your son, others on this site… It really speaks to the dislocation of our current society – and the desperate isolation that can come even whilst surrounded by many.
Any ideas regarding what works to break down these barriers, whether tangible or in one’s mind???
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“I guess they’re all my home.”
What a wonderful discovery after years of NOT knowing where to call home through all the moves. Thank you for this beautiful reminder, that even when a place doesn’t ‘feel’ like home in the moment, a little piece (or peace?!) is added to the mosaic.
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Community is elusive… and yet, all around. All best to you, along your own journey of turning fantasies to realities!
“Remember that there is meaning beyond absurdity. Know that every deed counts, that every word is power…Above all, remember that you must build your life as if it were a work of art.” — Abraham Joshua Herschel
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Thanks, Oldhead,
For whatever vital spark managed to stay alive, I am grateful.. Given the general state and functioning of my pre-frontal cortex however, I’m not sure it was as much self-discipline as utter desperation and despair that got me off meds (and then just sheer stubbornness for the rest.)
Actually, I had NO IDEA it was a two year process until going through my notes for this essay (and in doing so, finally talking with my family, at least in part, about it…). Most of the withdrawal period for me, as with being on medication, is lost in fog.
There’s irony about racing with the national team though… Courtesy of random drug testing, I/my coach (more him than me, we were worried enough about ramifications if anyone found out what I was ‘diagnosed’ with – which later experiences proved wasn’t at all paranoia – he’d call anonymously on my behalf) had to put a call into WADA/CCES (World Anti-Doping Agency/Canadian Centre for Ethics in Sport – they hire the suits that show up on one’s door step and don’t leave until you pee in a cup. Makes for awkward moments. (And really awkward first dates! E.g. “Oh. Darn. Hey, sorry about this, but they need to follow me around for the next couple hours, because I’m too anxious to pee in front of them. Do you still want to go for dinner?”) prior to filling any script to ensure it wasn’t on the ever-changing banned substance list. Several cough formulations, for instance = banned. As are Beta-blockers (pending sport). As are, curiously, some formulations of tea. Risperdal, on the other hand, is most definitely not considered performance enhancing… but we had to check all the same and document it. Anyhow, that’s how I was able to go back and figure out what I was on, when.
Good point about calling it “medication”. A future post will discuss psychiatric drugs v/ plant medicine v/ psychedelics. I used to be quite militant against medication, but then realized the best treatment option is whatever works for the individual. From this end, mindfulness, diet, exercise, eastern-based approaches, etc., are way more effective. In my own dance of exploration, I’ve gotten to a point where I honestly cannot fathom taking a pharma-drug. I’ll sit on a meditation cushion and regrow my hippocampus one neuron at a time, thanks, rather than take something that will numb the immediate distress but kill grey matter. But with that determination also comes the responsibility of figuring out alternatives (and doing them!)… and respecting that others might and do make difference choices, pending their situation. To each their own. That said, particularly given recent findings correlating gut dysbiosis with emotional turmoil, it’s baffling – and I think, increasingly and utterly unacceptable – that clinical pharmacology remains a full year course in medical school but lifestyle modulators (nutrition, exercise, meditation, etc.) aren’t covered in any detail…
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Hi Slaying_the_Dragon_of_Psychiatry,
Many thanks for your positive feedback. In terms of becoming an author on MiA, I’m not sure if there’s any ‘formal’ protocol… best start with an inquiry email to the web administrator.
Thank you for sharing your website. The splash page – i.e. the photograph of 2 hands reaching towards each other – is gorgeous, lucid and chilling. As is your writing on the site.
In terms of my own health, I continue to battle the beasts. Self-discovery leads to increased moments of stability, but it’s a hard-fought journey with much that derails me still. Such moments of derailment *always* come from disconnect, i.e. when I shut myself off from the mind/body/SPIRIT realm of life. Thankfully, so too lies the way out. With awareness of this now generally limiting ‘crashes’ to periods of days – no longer weeks or months – that which needs to be (re)engaged to get back to stable ground is that much closer at hand… and thus the journey continues…
Warmly,
MB
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Thanks Mary! I’m not familiar with Monica’s site in any great depth but am curious to check it out!
Will Hall’s “Harm Reduction Guide to Coming Off Psychiatric Meds”(available for free download online) is also a fantastic resource. Rxisk.org can be helpful for figuring out what symptoms are being caused by one’s meds…
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p.s.
“I’m merely a patient advocate, and so have no traction within the system”
If I may offer a correction, that’s exactly who GETS traction in the system. The whole system isn’t going to change until we, as consumers/survivors/ex-patients and allied supporters, request and increasingly demands those necessary shifts the only way we can – one person, one voice, one conversation at a time. Until we – first individually, then through such determination, collectively – stop accepting status quo. The work you’re doing, regardless of its extent, capacity or outward perception of “success” DOES matter, because it’s doing exactly that. It’s one more voice, one more person, saying “this isn’t right.” THAT is traction, one determined toe-hold at a time.
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Hi GwynOlwyn,
I hear the frustration in your post, regarding how medication remains front line treatment, despite the reality it does little (or with more accuracy, NOTHING) to resolve the underlying issues… and that the things that do help are sadly unattainable for many who need them most.
All best to you in your support and advocacy. I’ve been in that role also, trying to get help for a loved one who was drugged then told “that’s it”. Sometimes, you just have to keep fighting. For whatever resources, options, doctors, hope there is. There ARE resources out there, pending location (at least in Canada)… It’s unfortunate that they’re hard to access and one quite literally has to fight the dual battle of justifying and making a case for oneself whilst simultaneously stepping away from the biological paradigm (difficult to do at the best of times, let alone in the crises of emotional turmoil)- but they do exist. And thank goodness for advocates such as yourself, creating the support necessary to do so. As a dear friend once said to me, “illigitimus nil carborundum.” Don’t let the bastards grind you down.
Am grateful for your words, and thankful if something I’ve written or provided can hep in any way.
Best, MB
p.s. An earlier piece I wrote for Mad in America was actually initially written at the request of a psychiatrist to give to a fellow patient contemplating coming off meds. You may be interested in it as well… “Letter to a Patient”
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Hi elocin,
After writing this piece, I went back and looked through my notes regarding coming off medication:
I went off meds in the fall of 2003. Had a number of issues in withdrawal that resulted in going back ON meds (Prozac, in particular, was quite awful to break off). Was on again/off again throughout 2003/4, no guidance just fighting through the withdrawal and titrating up again when I couldn’t. Raced the 2004 season on meds… fractured my skull in August 2004. Finally pulled myself off everything that winter, 2004/2005.
Basically, I consider myself GOING off medication Fall of 2003, GETTING off medication (withdrawal hell) from that point on until early 2005 and then finally FEELING as though I was starting to see snippets of “me” by February 2005.
Since then, I’ve stayed mostly clear of psychiatric drugs barring a couple instances when I’ve totally derailed, or just not able to function. It’s been pretty minimal though – my body is just so hypersensitive now to any kind of input, I’m really chary about meds. To be honest, exercise, nutrition and the like do far more for my mental health than any chemical or endogenous aid ever did…
Hope that helps!
Best,
MB
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Sinead,
I really appreciated the sensitive acuity with which you broached an immensely loaded topic. Personally, I can’t think of ANY diagnosis or label more difficult to hold in open conversation than that of “borderline personality disorder”. As Judith Herman so aptly wrote, borderline personality disorder, in many ways, has become “a sophisticated insult”. The fact that certain sequelae of experiences can lead to a collection of symptoms that, when clustered together, lead to an entirely subjective diagnoses isn’t what’s loaded. Where it gets loaded is with is everything that goes along with the cultural, societal, medical perception of someone labelled “borderline”.
When I read your paragraph – “Trauma does not explain the need to inflict pain. Trauma does not explain a display of entitlement to reduce another person to subhuman status– nor is the pervasive attitude of one’s superiority a right of passage for a victim of abuse… graphic recounting of their abuse histories is often the first sign that the *listener* is being scrutinized for his/her potential to satisfy their predatory cravings.” – I felt chilled. I thought of my own experiences with and around this label.
It’s so rare to find a piece of writing that brings together the challenges of navigating trauma (one’s own or another) AND YET simultaneously speaks to the pain that renders it seemingly impossible to stay with such pain. Of the need for both listener and sufferer to, somehow, find ability to remain present as required for healing to occur. To recognize the human in the other… and the humanity and humaneness of oneself.
I’m going to save your post, and reread it many, many times over… Wow. My own words aren’t doing justice to what I’m trying to write… Thank you. Great work.
MB
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Thank you, David,
Upon reading your bio, I visited the website you’ve created – http://www.recoverystories.info. Sites such as yours are such a gift, providing people opportunity to speak, listen, share and learn. There is something truly healing that comes from the lessons and teachings of others’ experiences. While everyone’s journey is unique, there is much that resonates at a deeply human level regarding “what it means to be called crazy in a crazy world” (to quote Will Hall).
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Hi CatNight, You made a great point about how disparaging comments and judgment can come from outside… and how easy it is to internalize those beliefs that what one is doing is ‘wrong’. You are very right, it IS to our own detriment. Kudos to you for sticking with your creativity – and congratulations regarding your museum piece!
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“Call it arrogant, I don’t care, they must prove to me that they’re worth being my doctor. ”
YES!!! And yet, really, is that “arrogance” or simply one’s right to self-determination of the best fit?
An analogy comes to mind: If an auto mechanic doesn’t know squat about the car he’s about to work on, would it be arrogant to tell him “you’re not touching my car?” or would that simply be, a very wise choice?
Why trust one’s body/mind/spirit with anything less?
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Hi John,
Are you talking about the study cited in Healy’s “Let Them Eat Prozac?” (or is my brain equally foggy). If we’re thinking of the same study – antipsychotics given to clinical researchers and physicians – here’s an anecdotal account:
https://invinciblesummers.wordpress.com/2009/04/16/a-doctor-voluntarily-took-an-antipsychotic-drug/
Alternately, here’s a report off Healy’s website, regarding SSRI healthy patient studies:
http://davidhealy.org/mystery-in-leeds/
Best,
MB
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Thanks 🙂 The poem was written while sitting in a doctor’s office…
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Hi John,
I shuddered when I read your words – and then started laughing, because I’d never actually realized what you’d so accurately nailed. Holy paternalism… right down to the wagging finger. I would *love* someday to see a mandatory class for all psychiatric residents; perhaps a week-long stay in a psych ward to experience life on the flip side of the proverbial couch? Could you imagine what that would do for the industry, if every doctor who wanted to prescribe a drug (or ECT) had to first have experienced it, themselves??!!
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Hi Mary,
Thank you for your email. You’ve asked a question I’ve often reflected upon myself. Studies from Buchanan and Barker-Buchanan have correlated the degree of therapeutic success to be determined not on the therapist’s training or methodology; rather, the patient’s perception of the therapeutic relationship – that is, whether the patient believes his or her therapist to be supportive and empathetic.
Logically, that makes sense. If I don’t trust a therapist, there’s no way in h*ll I’ll work with them. It’s hard to explain, that immediate instinct – but it’s pretty accurate. I think the perception of those in the medical field as somehow being infallible or god-like, the paternalism of a system that posits patients as ‘lesser than’ is outright detrimental. If a doctor’s not willing to see and work with me as an equal, if different, member of the team, they’ve got NO RIGHT to having a say in my medical care. Period. As a society, I think we tend to accept that doctors are hard to find, so “take what you can get and don’t complain”. Garbage. Incompetent drug-happy doctors don’t deserve good patients. We are all good patients.
Beyond that simple criteria – is this individual educated and competent and do I feel even remotely safe around them? – for me, the three things that have made the most difference are: support, education, advocacy. In terms of support, I’d be dead if it wasn’t for individuals in my life who somehow saw ME beyond the ego, personality, all I thought I was(n’t) supposed to be – and believed that someday I’d see the same, someone worth caring about and fighting for.
This included a physiotherapist, followed by a coach and, finally, the psychiatrist whom I wrote about in my first blog, “Farewell”. The one thing they all had in common, I suppose, was Rogerian unconditional positive regard – and incredible support. They saw me less as a pathology and more of a person. They fought for the person.
Education was critical. Particularly when one is labelled as “mentally ill”, it’s so easy – and utterly demeaning, devaluing and frankly dehumanizing – to be written off as “lacking insight”. I come from a family of (biologically oriented) physicians, one of whom frequently reminds me I’m “mentally ill” and it’s “my fault” because I’ve gone off meds. To that point, we’re on polar ends of the medical paradigm, and we’ll never likely agree. A major (and admittedly recent) turning point in my life was – I don’t care. She’s got her opinion. And I’m equally welcome to my own. What an insight – not everyone has to accept what I’m doing?! (Hello, health). I’ll go head to head with any doctor in the country when it comes to evidence-based research and challenging the biological paradigm. I recognize part of that comes from simply being discounted so many times, I’ve developed an incessant need for evidence to state my case and back-up whatever I write or say… but doing so has also given me a platform off which to make evidence-based decisions… and fight for myself. Or keep going, when faced with countless people who’s understanding of “mental illness” comes from t.v. ads and the like. Critical for stepping beyond the prison of self and/or societally limited perception.
That leads to the third component of what’s helped me – Advocacy. Fighting for myself. Refusing to quit. Constantly making a commitment to doing whatever I can – and increasingly, looking for others doing the same. From a lifetime of isolation, the discovery of how healing it is to actually BE in a community remains frequent and profound. We are social beings; recovery doesn’t happen in a vacuum. Finding – and keeping – good people in my (very close and tightly contained) circle of support has been instrumental. However, I see that also as a responsibility; if they’re willing to help me, I’m accountable to helping myself. This commitment is an ongoing battle, and one that daily takes me to new places. Efforts to bring awareness to spontaneous desires to numb or drug myself means looking at all the addictive patterns arising to do just that. From there, it means looking at nutrition, physio, exercise, mindfulness, alternative treatment modalities in order to retrain my brain to better cope… and the countless times I crash and burn. Basically, I see recovery more as DIScovery, i.e. doing anything and everything that might be able to help. Most of all, it means increasingly learning to listen to the very intuition I shut off in order to function and survive though incredibly overwhelming experiences and episodes of early childhood trauma and abuse. As far as I’m concerned, so long as it’s not immoral or hurting any one else – and it helps my mental health – I’ll try it. Plant medicine as been a relatively new, and incredibly positive, part of my journey. I am blessed with teachers and mentors such as Dr. Gabor Mate, and his teachers, in particular A.H. Alamaas. Reading – and implementing – the works of Schwartz, Hanson, Tolle, etc. also helps.
Finally, at least for me, a critical component of my own health is simply appreciating that everyone’s healing path is different. It’s easy to experience envy when I see others seemingly moving faster or quicker through recovery, dating, functioning, etc; or giving in to that voice in my head whispering “others recover, but I can’t…” Learning to let go of that lends space to see the beauty of being precisely where I am at, on whatever step of the journey I’m on. This doesn’t mean I have to like any given situation or experience. Nor does it mean immediate perfection. It just means the focus shifts to learning from wherever I find myself, recognizing the suffering comes from not from said situation but my wanting to be elsewhere – and establishing the resources to regroup and keep going.
Healing can ONLY occur in the present. It can also only come from within. Not in the future, not in the past. Not from anyone else. Others can support; but they can’t do all the work.
The latter is something I was reminded of again, quite recently in the retirement of my psychiatrist. After eight years together, ending this relationship was destabilizing, to say the least… but going through that process, I realized my reliance on him had resulted (entirely unwittingly) on avoiding the necessary step of standing on my own. Consequently, when he ‘maxed out’, so too did I. Ultimately, his retirement was a gift, a parting and painful gift, but one I needed none-the-less. It doesn’t mean life is perfect, or tomorrow morning’s going to be any easier. It just means I’m on the next step, of a continuing journey.
Anyhow, that’s how I see it from this end. Support. Education. Advocacy. Responsibility. The latter, not as any kind of judgment or means of beating oneself up in negatively narcissistic ego; rather, simply, recognizing, that healing can only come from within… and that means doing whatever it takes to keep the relentless forwards progress.
Antoine de Saint-Exupery writes, “what saves a (wo)man is to take a step. And then another step. It is always the same step, but (s)he still must take it.” When I think about dealing with trauma, that’s really it. There’s no easy way around the pain. There’s only through. One step, one breath, one stumble, one relapse, one moment at a time. And along THAT path, finding again the self that exists, always, underneath and despite the pain.
I’d love to hear what others think, in particular, about finding balance on reaching outwards for support whilst finding the awareness within…
Best,
MB
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“We are judging people who have sensitive dispositions and absorb the world around them; people who are essentially struggling with basic life issues. And as a system – the mental health system – that sort of prides itself on exploring human behavior without judgment, this is a failure — not on our client’s part, but on the part of professionals and systems that are supposed to be caring for them.”
THANK YOU. THANK YOU. THANK YOU for this essay.
As Judith Herman said, “Borderline personality disorder is… little more than a sophisticated insult.” A well-written piece that speaks of the damage done to already wounded and fragile souls, when slapped with incredibly pejorative label.
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Hello AJD13,
Great points about a touchy topic, ie personal responsibility. As you alluded, the situation is far more complex than ‘just’ Big Pharma.
While writing the project from which this letter emerged (link: https://docs.google.com/file/d/0B5cLaT3gdm9NNDZQb3Zscl82RDA/edit ), I was surprised by how many times the realization “it’s patients/families seeking the meds” came up. Your observation of how we live in a society geared towards instant gratification (and also the expectation thereof – leading to the generation of intense suffering when reality proves far different) is readily apparent. But you think it goes deeper than that? Is not society a reflection of the preferred values of he collective?… In which case, we create our own society, by saying ‘yes’ and accepting much that is woefully wrong, indeed abnormal to a level never before seen at a mass scale of humanity.
This goes beyond medication obviously (although the fact a substantial percentage of our population is heavily medicated and deemed ‘mentally ill’ is itself alarming); but also, destruction of the environment, election of governments that focus more on economic growth than acknowledging a country’s GDP actually improves the LESS healthy its citizens/environment are (inefficient health care spending & infrastructure = more monetary stimuli), etc…
A common thread is the cutting oneself off from the world in which we all live, both internally and the collective external. What other species tends towards self destruction, both internally and of the very resources in which their lives depend? Only humans. Bruce Alexander ‘s work, The Globalization of Addiction, posited disconnection from self and others as the primary factor in addiction and poor mental health. We are living in such an unnatural, disconnected state, it goes to follow that artificial “quick fixes” seem natural – particularly when the alternative is taking a clear look at one’s life and questioning how did this come to be, what need to change and HOW?
Which takes time, commitment, having resorces to do so, spending of resources on things that can’t be measured in the current monetary value system of our society, going against family systems (ie stepping out of generated roles that are easier/comfortable for others if maintained-no matte how unhealthy)… And most of all realizing that nothing external can truly take the responsibility to save us. Resolution is endogenous – it comes from deep within.
In terms of polypharmacy, I can only speak to my own experiences but for me, it was a combination of 1) doctors (and myself admittedly – trained and brainwashed as I was to cow to authority and believe someone willing to ‘take care of me’ gave them sufficient ability to do so…) not being aware of the science or risks – ie assuming the pills were benign, 2) patently irresponsible physicians who took the easy road out, 3) the interpretation of side effects as further proof of ”mental illness”, 4) absence of other alternatives in the medical sector, 5) family pressure, 6) desperation/fear/shame, 7) the power of being labelled and hence ostracized if/when NOT medicated (and blamed ie because then it was ‘my fault’), 8) the fact a ten-minute doctors appointment can’t even begin to address a lifetime of complexities, and 9) frankly being perceived/labelled as a “difficult patient”.
There is no easy solution for crises of emotional distress. But a good start, whether individually or as a society, is recognizing them as just that – and not a pathology. The world we have created that enables the continuation of a broken system is what’s mad about all this… Anything within is a normal response to overwhelming, entirely abnormal stressors…
Thanks again for sharing your experiences, as well as this dialogue.
Best,
MB
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Absolutely, a “blanket approach” to saying “no medication for anyone,” can be as polemic and limited as the opposing paradigm of medication as front line treatment. As expressed in this letter however, the question isn’t whether anyone should or shouldn’t be on medication; rather, the right of that individual to an INFORMED, EDUCATED decision. A right which – in our current system – is largely co-opted.
An advocacy for the right to medical self-determination requires appreciating the use of psychiatric medication is not black and white. For some, positing emotional distress as a biochemical imbalance in the brain can present as far less painful than acknowledging – and facing – the alternative… namely, looking at history of trauma and ramifications therein.
Alternately, come times when a drug – with awareness – can help “take off the edge,” at least enough to regain functionality to then move forwards; for example, managing a couple hours of sleep when trauma had negated any such ability for days on end and no other realistic alternative is viable. The same could be argued for individuals for whom taking the time and space to deal with all the underlying ‘stuff’ just isn’t possible – or who just need, as a dear friend recently said to me, “to give their brain a bit of a rest, to turn down the volume,” in order to regroup, return, keep going.
That kind of mindful, conscious use of medication however – which sounds like your situation as well – is vastly different than psychotrophic drugs being used as some kind of ‘cure’, under the false pretences of how they’re ‘supposed’ to be working, as a means of social/individual control, or as a form of avoidance.
In the end, the realities of life and suffering are only fully known to the individual therein, and ultimately, the decision to use (or avoid) medication comes down to what is best – feels best – for said individual.
What I believe is that every individual deserves the right to ethical, evidenced-based medical information, to know and understand the choices they are making, and to be able to make that choice in regards to what they feel is best for their body. That we as a society have the right to know the best practices available, and they be made available – and supported by our government. That our governments and service providers made decisions not under the partisan influence of Big Pharma and corporations but from the moral and ethical stance of true integration of the mind/body/spirit realm. And for those still locked in the biological paradigm, to have options beyond simply “shut up and swallow” – to quote one of my own physicians.
And finally, that we, patients as much as physicians and other care providers, desperately need support – and connections with like-minded individuals because it’s really hard place to go alone to create and access services focused on what works.
I’m really glad you seem to have found a combination of something that works for you. In the end, that’s what really matter.
MB
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Hi AxqiY,
The complete citations and background body of research is available online here:
https://docs.google.com/file/d/0B5cLaT3gdm9NNDZQb3Zscl82RDA/edit
Reference #4 should read “T. Watson,” not “D. Watson.”
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Hi Alex,
“… when we dull, avoid, or separate from our emotions, we have lost touch with a vital part of ourselves that serves to guide us, so it’s easy to feel either with lost in direction or dependent on others,”
That’s so true, and certainly my experience as well. The ability to listen (and hear) the intuitive within seems to be one of the first things that goes with trauma, which makes sense… i.e. literally, cutting oneself off from overwhelming emotion – which serves a purpose… but also comes at the cost of being able to FEEL in the present, the only place possible for healing to occur.
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I was away last week and didn’t have a chance to read the replies until now.
WOW. I am in awe of this community; the strength, compassion, insight, wisdom and support of its members therein. Thank you all who have contributed to the dialogue following ‘Child’s Pose’. I feel humbled and inspired by the stories, struggles, suggestions and spirit shown here. Thank you for sharing your words.
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Thanks Vanessa,
I’m grateful to a lot of teachers of my own… many have dealt with freaked-out panic stricken bolting from the classroom. It’s amazing how much energy is stored, literally, in the body… emotions coming up and out in various poses. Speaks to the power of yoga.
There does seem to be a paucity of trauma-centric yoga, at least outside specific centres. The best resource I’ve found so far in terms of yoga/trauma is Bessel van der Kolk’s program:
http://www.traumacenter.org/products/..%5Cclients%5Cyoga_articles.php
If anyone knows of others (especially in Canada!!!)… please do share!
MB
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Hi Oldhead,
Thank you for your comments. I wholly agree with your observation, that the successful therapist-client relation has to be a human one. In my experience at least, the only doctors I’ve seen as even remotely helpful as those willing to engage in a collaborative – and hence, client-centric/empowering – approach. Unfortunately, this isn’t (or doesn’t appear to be) the standard model of our medical system.
In terms of loss, absolutely, it may be more painful at the start to lose a relationship that is actual based in respect and care… but in the long-term, I suspect one with false divisions – the psychiatrist, priest, authority figure, whoever being in “control” – would be far more difficult to lose. When there is collaboration, there is a sense of client autonomy, a decreased dependency (if still present) on the dyadic partner. Conversely, when there is authority – being told, whether implicitly or explicitly – that the client is “lesser than” – it’s a huge step from that state into the void of figuring out “now what?!” (i.e. independence)… or devastation.
That said, “devastation” implies a complete and utter inability to recover. Is pain – or loss – always devastating? If the therapist/client related to each other in a human, hermeneutical manner… could not an imminent loss ALSO be seen as (and mutually explored) as part of the natural course of progression? That’s not to say it isn’t still painful, awful, gut-wrenching, upsetting… simply, perhaps not as devastating as an abrupt rupture of whatever unequal, ego-driven division lead to an alternate interaction of superiority/inferiority? The latter, to me, suggests more imbalance, and hence, more scope for devastation through loss of the role as well as the person.
Thanks again for your insight and observation about the power dichotomy that does exist in many therapist-client/religious/political, etc… relationships…
MB
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Great to hear, thanks.
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Hi Steve,
You nailed it, in your words”helping someone overcome a traumatic and difficult upbringing in a traumatic and difficult society.” It’s not just a matter of dealing with one’s own past trauma but also, the trauma of being in a society increasingly devoid of meaningful human connection.
One of the things I’ve really turned to in the past few years has been this site – also Will Hall’s great radio program, Madness Radio. To hear of others’ experiences and struggles, opinions and thoughts brings a sense of community oft-times so lacking. As Bessel van der Kolk observed, “working with trauma is as much about remembering how we survived, as it is about what is broken.”
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Hi Duane,
Thank you for your warm welcome! Many more missives to come…
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Hi Fred
Thank you for your comments and sharing your own painful experience. I appreciate your Sri Nisargadatta Maharaj quote. Regarding the split between what we are TOLD we are and who we truly ARE, the words of R.W. Emerson come to mind, “to be yourself in a world desperately trying to make you someone else, is the greatest accomplishment.”
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