Blog
On Life & Death
Returning home for work, late and exhausted, I retrieved a package from my front door without opening it. It was Wednesday, and I was already drained from the work week. I brought it inside, and decided I would open it later.
Later was in two days. Opening the box, I found a beautiful live plant with instructions on how to care for it and a narrative that felt a little like I was adopting a pet. I will have a relationship with this plant. It was life in a box.
The plant was a thank you gift from a friend. I spent the previous Saturday working with her husband. Upon unpackaging the plant, I vowed I keep this plant alive and healthy, and it would live longer than her husband. I would honor them both with this one, small commitment.
He came to me for a facilitated psychedelic session. I am generally quiet about my work. My social media is sparse and infrequent. I update the blog on my website when I think of it, without notification. The Tao provides. But word gets around. I went to a salon once and the young, eager stylist said “Oh, you’re the m*shroom lady!”
This man had an existing relationship with psychedelic medicine and was an enthusiastic Dead Head. His was an end-of-life diagnosis, no one survives ALS. The life he and his wife built was lovely. They are a human family with trials and tribulations of raising children to adulthood. They are attractive, successful, and gracious. They both had impressive careers and a wide circle of friends. They love and are loved. Death doesn’t care. It comes for everyone. Even an athletic man in his 50s.
We spent some time settling in before he ingested the medicine. He needed assistance unwrapping the medicine for self-administration. His manual dexterity had deteriorated to that point. Three weeks ago, he walked into to my space unaided.
That experience belongs to this man. It is not my story to tell, and I will hold it silently and reverently.
Three months after doing the session with him, I had a dream that he and I were singing the song “Ripple” together. I’m not a Dead Head and have never been to a Grateful Dead concert. I have a casual relationship to the music. I don’t really know what Ripple is about, but it seems like it’s about being here but not here. About always having enough. About a ripple in the water with no apparent cause. A path you take alone. It fit.
This gracious man died five months after our session. He was at peace and surrounded with love. His funeral honored him beautifully. The homily included, like most funerals, aspirational talk of eternal love. A love that survives the earthly life. Most of the time, though comforting, that talk has an “I hope so” quality to it. This didn’t. It had a certainty to it.
Back to the plant that I now have care, custody, and control of. When it arrived, it took two days for me to have the vitality to open the package. Energetically, providing a container for and witnessing the fierce potential of the human spirit to transcend the physical space is a huge endeavor. As much as it fed me, it depleted me. It’s very rare that we get to see such a profound and moving experiences. The contrast of extraordinary beauty and love in the face of so much loss is almost too big to hold. Yet we did, tearfully.
When I’ve cried about this, it’s not that it’s so sad, although it is. It’s that it’s so beautiful. It’s so vast. It’s a human life. That human’s life. When a baby is born, the medical staff handles the experience with professional efficiency, but I wonder if it’s something like that. Are they ever overwhelmed with the enormity of what just happened?
At end of life, it felt even more poignant. This man grew to adulthood. He formed relationships, married the love of his life and they created three remarkable humans. He was not, like an infant, a blank slate of potential. He was potential realized and lost.
I also cry in frustration at my limits. Sure, I can facilitate something for this family. Anecdotal evidence suggested that a positive end of life psychedelic experience not only benefits the person taking the medicine, but their loved ones. Yet, I did not create that experience, his consciousness and the medicine did that. I could provide a safe container and a reflective canvas for him to behold his own enduring, loving consciousness. I could not lengthen his life nor lessen the loss.
And this plant. My attachment to the plant is wrapped up in his life. When the naughty puppy munched on the leaves, I was distressed. When the leaves grew back but became slightly brown around the edges, I felt a helpless sense of urgency. The plant does not have ALS. In the absence of terminal illness, I can keep this plant alive with water and light. Can’t I?
Please, plant. Please grow. Please thrive. The plant connects me to something I don’t want to lose. The gift of the plant is a token gift to me. It represents the gift of bearing witness. The gift of being trusted. The gift of being invited into something so sacred. My attachment to it is outsized. I need it to live.
In the time that I have been doing end of life work, I’ve come to truly understand what it means to be a Ride or Die. Urban Dictionary defines Ride or Die as “when you are willing to do anything for someone you love or someone you really appreciate in your life, the person you will stand by in any problem.”
Your Ride or Die is with you as you accept your death. They will not frame it as a “battle” to be won or lost based on your own heroic efforts and willingness to tolerate any and all medical treatments. They will allow you to speak openly of your death and not need to fill the space with empty platitudes and false hope. They will graciously accept a gift of a material treasure you acquired during your life and have genuine curiosity about what it means to you. They may make you food you both know you won’t be able to eat.
A Ride or Die is patient and sensitive. They will listen deeply and carefully when you repeat yourself, can’t remember the word, or can remember the word but it’s hard for you to say it now. They will sit with you as you cough, spit, doze, choke, leak. They are there for it all. And they will leave when you want them to. You don’t have to entertain your Ride or Die.
Your Ride or Die will hold space for your fear. They will not promote their spiritual practice and will treat yours, if you have one, with reverence. They may cry with you and for you, but you will know it’s not their feelings you need to attend to. Some Ride or Dies will take a risk for you, accommodate an end of life experience you feel you need to have or some you need to avoid. They will not tell you “It’s okay for you to let go” because they know that they may be your Ride or Die, but it’s not up to them to give you permission.
They hold hope for you while you can hope. They will be with you as you create meaning in your life up until your last breath. They were happy to ride with you, as a friend, partner, family member. It was a good ride. And when the end of the ride is near, they will be steadfastly with you as you die. If they are a real a Ride or Die, they are up for both. Ride and Die.
As hard as this is, I’ve seen several Ride or Dies do this with remarkable grace. They put their own pain, fear, and loss aside. They showed up in a way they didn’t know they could, to be what that person needed them be. If that was you, you know who you are.
We should all be so lucky.
Ride or Die
Clinical Research, My Experience
In early 2022, I was contacted by AltaSciences about clinical research on psychedelic medicine starting later that year at their site in Overland Park, KS. There weren’t many details initially provided about this project. I have since learned that clinical trials in pharmaceutical research are very confidential until the data are reviewed and published. (No part of this post violates my non-disclosure agreement). After an interview process with the investigator, AltaSciences, and the study sponsor, Usona, I was hired to be a lead facilitator.
I became part of a team of lead facilitators and co-facilitators. The training and preparation to do this work was extensive. The study sponsor invested heavily in preparing the facilitation team to work with the study subjects and the medicines.
The first medicine that we worked with was psilocybin. Although there is an extensive body of research on psilocybin, this was a phase 1 trial to study pharmacokinetics followed by ADME (absorption, digestion, metabolism, elimination) or what was referred to as “food effects.”
The second medicine we studied was 5-MeO-DMT. This was the first in human study for this molecule, although there is a long history of use of the medicine in naturalistic settings. In those settings and colloquially, it is referred to as “smoking toad.” No toads were harmed in this process.
Both medicines in the study were synthetic opposed to natural products. It should be noted that Usona uses an “open sciences framework” and shares their research in the spirit of collaboration.
There were so many interesting and moving aspects of being part of this. Not the least of which is the fact that it was in Overland Park, KS. When I was trained in ketamine assisted psychotherapy (KAP) in 2019, the clinical landscape for working with psychedelics was limited in the Midwest. I gained insight into the process and all the moving parts of a phase 1 clinical trial. The AltaSciences staff were great to work with. This was a new paradigm for them. We, the facilitators, came into their workplace, unfamiliar with their processes. They were helpful and professional. The sponsor, Usona, was supportive. I had the privilege of meeting and working with some wise and well-informed people from Usona. After a few years in private practice, it was nice to be on a team. Working with the other facilitators became intuitive and we communicated often with only eye contact.
I was particularly moved by the study subjects, yes, that’s what they are called in this setting. They are people that answer those ads: “Are you a healthy adult, ages 18 to 55…” Many of the subjects travel by train, bus, or from neighboring states in the summer with no air conditioning in their car to get to the study. In these studies, they made repeat trips. Many are regular participants in clinical trials. They give their time, bodies, and in the case of psychedelic medicine, their minds, to advance science and medicine. They are paid for this, as they should be. I was amazed and humbled by each of them. There are some that I will never forget.
In the psychedelic space, there is tension between underground and clinical work, natural and synthesized medicines, shamans and licensed clinicians, the past and the future. These are healthy discussions that will continue. However, this process will establish safety and expand access. It was exhausting, challenging, heavy, joyful and awe inspiring.
My first day on the study site was April 19, 2022. My last day will be September 7, 2023. I leave with insight, gratitude, and hope.
You can learn more about these trials at https://clinicaltrials.gov.
Dosed: The Trip of a Lifetime
In March of 2023, I was contacted by directors Tyler Chandler and Nicholas Meyers to participate in a post screening discussion regarding their beautiful movie Dosed: The Trip of a Lifetime at the Kansas City FilmFest International.This documentary follows a mother and wife in Canada who is granted legal access to magic mushrooms as she faces a terminal cancer diagnosis. It tells the moving story of how the medicine, psilocybin, helps her come to terms with her diagnosis and get clarity and peace with her life limiting illness. Her acceptance allows her family to be present and connected as she faces this challenge.Therapeutic and ceremonial use of psilocybin has been used to enhance a sense of wellbeing for a millennia in naturalistic settings. There is a growing and robust body of clinical research supporting the safety and efficacy of psilocybin. I am fortunate to be involved in a phase 1 clinical trial studying psilocybin for over a year. I have traveled to places where magic mushrooms are legal and have had my own experiences of growth and expansion. And I have had the awesome privilege of facilitating therapeutic use of magic mushrooms for a person dealing with their own aggressive, life limiting illness. This was profound, humbling and deeply meaningful.This movie is still being screened at film festivals in the United States and Canada and not yet available for streaming. I have linked the Dosed: The Trip of a Lifetime website for information on when this will be widely available. I encourage you to watch the movie, see the potential of magic mushrooms and be an advocate for therapeutic use of this plant. The Therapeutic Benefits of Companion Animals
A recent article in Time magazine discusses way to be mindful without meditating. By now, everyone knows the benefits of both mindfulness and meditation. Both are helpful to general well being and integrating a ketamine assisted psychotherapy experience. Yet, there are times when neither are easy to do.
The article mentioned paying attention to your pet as a way to be mindful. It suggests focusing on what your senses are experiencing; seeing a tail wag, hearing purring, feeling fur. Pets can help us co-regulate. Our companion animals bring us comfort. At times, they insist that we slow down, shut the computer, lie on the couch. Use that time to be still and present, turning your attention inward with the help of your furry friend.
This is Leo, my mini goldendoodle. He will not be ignored.
Missouri moves forward with a provision for expanded access to psilocybin to treat mental health disorders. House Bill 869 has been introduced in the Missouri House as a life line to those living under the weight of treatment resistant depression, anxiety, PTSD and CPTSD.
This bill is a careful and thoughtful approach to offer treatment in Missouri that is supported by a robust body of clinical research.
As a psychotherapist, the heaviness of intractable depression, anxiety and PTSD, as well as the inaccessibility of effective treatment options, is something I encounter regularly. We can improve the quality of life for so many Missourians when we expand access to psilocybin in a therapeutic setting. We lose far too many people to the hopeless despair of suicide. You can’t change someone’s mind if you can’t change their options. HB 869 provides options. Read more about it below.
Show Me ‘Shrooms
October 21, 2021 ReDiscover’s Annual Fearon Institute gathered subject matter experts to discuss the latest research in co-occurring mental health and substance abuse disorders. There is promising data on ketemine and psychedelic medicines to treat both.
A pressing public health concern is fentanyl overdoses. In Missouri, fentanyl test strips are considered drug paraphernalia and are criminalized. This is counter to a harm reduction model.
I urge everyone to contact elected officials to make fentanyl test strips widely acessable in Missouri. The day these become available, lives will be saved. Find the contact information for your elected officials following the links below.
Missouri Senate Missouri House
I have also linked ReDiscover. Get to know this community asset and the work they do.
Psychedelic Integration
Preparing for your psychedelic experience and integrating the journey afterwards are some of the key ways that Ketamine Assisted Psychotherapy (KAP) differs from recreational use of psychedelics.
Set & Setting
The quality of the psychedelic experience is dependent on set, setting and dosage
Other Psychedelic Options?
Ketamine Assisted Psychotherapy is currently the only legal option to benefit from the expansiveness of psychedelic medicine in a therapeutic setting.