Hallucinogenic Healing
When I visited my mother recently, we had a variant of the conversation we have been having for twenty years – about her depression, and the shame she feels surrounding it. “I know my life is worth carrying on with”, she said, “I just don’t feel that it is sometimes.” I thought of the panel discussion I had attended a few days before, which was about the therapeutic benefits of magic mushrooms, and the campaign to reschedule psilocybin, the chemical compound that supplies their “magic”. Along with LSD, MDMA and cannabis, psilocybin is currently Schedule 1, which means that it is thought to have no therapeutic or medicinal value, and researching it is therefore prohibitively expensive. The speakers at the event were Rosalind Watts, a clinical psychologist; James Rucker, a psychiatrist; and David Badcock, the CEO of Drugscience, a charity that aims to provide an evidence-based approach to the harms and values of different drugs. About 200 people had gathered in the basement of a Camden bar to hear them.
“Everyone here has either experienced depression or knows a person who has”, said Rucker. “If current treatments were effective this would not be the case.” Watts talked about a recent pilot study at Imperial College, in which people with treatment-resistant depression experienced a marked reduction in symptoms following psilocybin-assisted psychotherapy. The results, published in Nature, showed that all nineteen participants experienced a significant reduction in symptoms after one week, with 47 per cent still meeting the criteria after five weeks. Brain imaging suggested that a “reset” of participants’ brains was taking place, akin to that elicited by electroconvulsive therapy (though by less traumatic means). All three speakers made clear that they were not advocating legalization (a drug’s schedule is different from its “class”), but expressing their opinion that randomized controlled trials (RCTs) should be made financially possible.
In the US, which is seldom a vanguard of narcotic permissiveness, MDMA-assisted psychotherapy has recently been hailed as a “breakthrough therapy” for post-traumatic stress disorder by the Food and Drug Administration, after some extremely positive early results. The Multidisciplinary Association for Psychedelic Studies (MAPS) administered two to three sessions of MDMA-assisted psychotherapy to 107 people with PTSD. A year after the study, 68 per cent of participants no longer showed symptoms of the disorder, having collectively suffered from it for an average of eighteen years, and no adverse effects were reported. A larger multi-site RCT is now underway. According to MAPS, MDMA enhances psychotherapy by encouraging communication and introspection, reducing fear and defensiveness, and increasing empathy and compassion. This makes it easier for traumatic experiences to be thought through and discussed.
Psilocybin works rather differently. “Connectedness to self, others and environment goes up”, said Watts, “and so does cognitive flexibility. The mind can be a prison sometimes. This treatment allowed people to step out of it”. Cognitive flexibility is defined by the Handbook of Behavioral Neuroscience as “the ability to adapt behaviors in response to changes in the environment” – changes such as trauma, or other psychological setbacks. We were shown a video, voiced by Rucker and promoted by the Psychedelic Society, whose stated goal is “a more compassionate and joyful world”.
David Badcock talked about the surprising, sudden influence that such campaigns can have. He mentioned the case of Billy Caldwell, who garnered public attention this year when his cannabis-based epilepsy medication – procured by his mother in Canada – was confiscated at the UK border, sparking a government review that has led to a change in policy. “More change in a day”, said Badcock, “than David Nutt managed in years”. Nutt is the former chairman of the government’s Advisory Council on the Misuse of Drugs, who was fired for claiming that taking ecstasy was less dangerous than horse riding and that alcohol and tobacco should be Class B substances. The former Home Secretary Jacqui Smith chastised him by saying, “You can’t compare harms from a legal activity with an illegal one”. James Rucker disagrees. “No drug is good or bad”, he said, “we just have to work out who it helps and who it doesn’t.”
I have never experienced psilocybin-assisted therapy myself, but I have experienced psilocybin and therapy separately, and it strikes me that they go together like plant seeds and rain. Magic mushrooms, now beginning to be understood by neuroscience, connect the cognitive and emotional parts of the brain and allow the stock truths of the therapy room to take root. As Michael Pollan stated recently in How to Change Your Mind: The new science of psychedelics, notions such as “Beauty is everywhere” and “I am good enough just as I am” are clichés only until we feel them deeply within ourselves and begin to think and act accordingly.
After seeing my mother, I emailed Rosalind Watts and asked if Imperial were recruiting any more participants for their study. I also enquired how I, as a trainee psychotherapist, could get ready for any changes in the law that might take place. Psilocybin could help democratize therapy by making it briefer and more affordable. My mother has asked whether, should the doors to the laboratories turn out to be closed, she and I could take magic mushrooms together. She has undergone every kind of conventional psychiatric treatment, up to and including multiple rounds of electroconvulsive therapy, alongside years of talking therapy. Might sitting beneath some trees and letting her poor battered brain be loosened up help where conventional treatments have failed? It would be illegal, of course, and I could probably find a hundred people who would say it was a bad idea. But given that she is not young, and psilocybin-assisted therapy will not be authorized any time soon, there’s a growing body of evidence suggesting that it might be worth a try.