Adverse effects

Aixalà's review discussion (in Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness) of adverse effects of psychedelic drugs comes only after almost 200 pages of hagiography (as if of Saint Mushroom, Saint Molly, Saint Ketamine, etc.). Given the context of this book, the adverse effects discussion is surprisingly gruesome.

The other thing that's surprising is that the leading expert on the subject is none other than Sidney Cohen, M.D., who has been dead for 35 years. Cohen was the character who gave LSD to Auldus Huxley and Clare Booth Luce (among other elite socialites) in the 1950's. Later, he debated Timothy Leary and warned about the drug's extensive dangers.

On pages 194-196 of Psychedelic Integration, Aixalà writes:

Sidney Cohen has investigated the adverse effects of psychedelic therapy perhaps more than any other author. Working as a psychedelic therapist over the years, Cohen became quite interested in the adverse reactions, devising a model of description and classification that evolved over the years.

Cohen describes the adverse symptomatology following the use of LSD and classifies it in two main groups: 1) acute reactions and 2) prolonged reactions. However, he does not make such a distinction in all his publications, and some confusion remains regarding the types of adverse events he catalogs. We know (and it will be addressed in the corresponding chapter) that difficult experiences can arise during the acute effects of any psychedelic experience, regardless of the substance or the context. A thorough discussion regarding how to best deal with these acute episodes well surpasses the objectives of this book. Therefore, we will focus on the prolonged reactions that occur and linger after the experience, as they are the ones more closely related to integration. Within this category, Cohen distinguished four different groups of adverse effects: 1) prolonged psychotic decompensation (schizophrenia, intermittent reactions, or flashbacks); 2) depressive and anxious reactions (the most frequent complication, according to Cohen); 3) the activation of psychopathic or anti-social tendencies, anti-social behavior, and letting go of social responsibilities; and 4) paranoid reactions or the confirmation of delusions of greatness in relation to the transcendental aspects of the experience.

While the phenomenological description of the symptoms is extensive, the classification seems to change as his model evolves, with the different categories eventually including many overlapping elements. Cohen affirms that these episodes are infrequent, and most of them may be resolved in the course of a few days or weeks by means of psychiatric medication, but he also reports cases in which the adverse effects persisted for months or years. In this regard, Cohen's approach to the integration and comprehension of these phenomena follows the aforementioned diagnostic line, quite confusing and impractical when trying to prescribe courses of treatment.

Perhaps more interestingly, Cohen further discusses the causes of prolonged psychotic reactions in some subjects. These include: 1)the character structure of the subject; 2) the context; 3) the insecurity and vulnerability entailed by a psychedelic experience; 4) the set and the contagious nature of the group experiences; 5) panic inducing negative experiences; 6) difficulties in "landing" while approaching the end of the experience; 7) dosage; 8) frequent use; 9) previous state of mind and stress levels; and 10) insufficient preparation.

I've quoted these pages at length because it would be difficult to communicate by any secondary description or summary of my own... how unnerving it is, that these people clearly have no clue what they're doing. Aixalà continues with an entire chapter about his very own, "new cartography based on clinical experience," in which he may try to mitigate this horrifying impression.

However... "prolonged psychotic decompensation," "depressive and anxious reactions," psychopathy and anti-social tendencies, plus paranoia... amounts to kind of a lot to mitigate!

Meet the new psychiatry, same as rhe old psychiatry.

Ten more quotes: Part 3

 (The new psychiatry, utilizing psychedelic assisted therapy, is religious, not medical.)

The interpretation of dreams was considered by Freud to be the "royal road to the unconscious," as dreams contain an inexhaustible source of psychic material manifesting itself in our unconscious, albeit in a cryptic way. The psychedelic experience could be considered an even "better" royal road since it can be induced at will and allows a better recollection of the experience. Freud hypothesized in 1940 that if we were ever to discover "specific chemical substances" that influenced the "psychic apparatus," this would result in unsuspected possibilities for therapy. Today, these substances are at our disposal....

 

Jung's analytical psychology is perhaps one of the most useful schools for the analysis of psychedelic content, given its spiritual nature....

 

There are many techniques that use body movement as a tool for introspection or transcendence: Gabrielle Roth's 5Rhythms (1989), trance dance, ecstatic dance, the Sufi dances of the dervishes....

 

Rather sophisticated ways of using song and musical composition are found in traditions such as in the ayahuasca church of the Santo Daime, in which some participants "receive" songs--or hymns--during their sessions and later compile them into a "hymnal," which then becomes part of the doctrine.

 

There is a particular synergy between meditation in all its different varieties and the integration of non-ordinary experiences that makes their combination especially useful. Those with prior meditation experience often find their meditation practice is more effortless and more profound after an experience in non-ordinary states of consciousness. It seems that it becomes easier, after a visionary experience, to remain in states of concentration, mindfulness, and equanimity. In turn, people experienced in non-ordinary states of consciousness often feel that meditation allows them to ground the contents of the experience and remain connected to the higher states they have encountered in their psychedelic experiences.

 

Although the spiritual dimensions of the psychedelic experience are perhaps the best known or at least the most historically emphasized, they are often the most difficult to truly integrate.

 

Although sometimes a spiritual experience manifests so clearly and overwhelmingly that it leaves an indelible mark, it can prove quite difficult to reconcile these states with our baseline physical reality and all its contradictions and painful situations. However, these dimensions hold perhaps the most tremendous therapeutic and evolutionary potential, with the power to help humanity as a whole, beyond our individual intra-psychic conflicts. 

 

The altar becomes a tangible and observable testimony of our experience. It contains elements related to the transcendental dimensions of the experience, reflecting our personal connection with the spiritual dimensions.... For some people, the altar is considered sacred during their integration processes, and it can become a permanent fixture in our homes, dedicated to our relationship with spirituality.

 

Responsibility for our own decisions and actions is a sign of spiritual maturity.

 

Rituals focused on healing have been used in practically all traditions, from shamanic cultures--such as the Andean people--all the way to Christianity, which still carries out exorcisms. Some schools of psychotherapy prescribe ritualized behavioral sequences with therapeutic intentions. Perhaps Alejandro Jodorowsky has come the closest to a new psychological shamanism, articulating and describing his psychomagic (psicomagia) practices--clearly another form of the ritual.... The prescription of rituals in the way we have outlined here requires a skilled and creative therapist who is honest, humble, and sensitive.  

I totally love his phrase, "...a new psychological shamanism." 

Ten more quotes: Part 2

From the textbook of the new psychiatry, Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness by Marc Aixalà (Santa Fe & London: Synergetic Press, 2022):

As we have seen, an enlightening psychedelic experience is often followed by a period of peace and well-being, free of symptoms, free of anxiety or depression.

 

Authors such as Piaget, Kohlberg, Villegas, Maslow, Naranjo, Erickson, Wilber, Nelson, and even Freud have spoken of phases or stages in the evolution of consciousness: from birth to the establishment of an autonomous personality and its subsequent transcendence as we continue our spiritual and moral development. 

 

A good integration, focused on maximizing the benefits of a psychedelic experience, entails using those experiences to hasten our ascension to higher structures by taking advantage of these transitional structures precipitated by a non-ordinary experience.

 

In the transcendent schools, we aspire to climb the mountain of enlightenment and reach powerful non-ordinary states of consciousness that allow us to open ourselves to realities beyond ordinary experience. 

 

Psychedelics can and have been used to induce experiences of the divine in both its immanent and transcendental forms.

 

Psychedelics allow us to achieve, in just a few hours, the same states that we could reach after several years of meditation.

 

If Zen meditation, Tibetan Buddhism, and Eastern philosophies became so popular, it was precisely because of the temporary nature of the psychedelic experience and the desire of many of these seekers to reach the more permanent stages of a higher spiritual development.

 

Many traditions, like Theravada Buddhism, Yoga, and Taoism, speak of the importance of the body as a vehicle of transcendence. In this idea, the body is the temple in which the spirit can dwell and through which we achieve enlightenment. After an experience in non-ordinary states of consciousness, the body is a territory to return to and ground, somewhere we can land, after having navigated across the more subtle dimensions of our psyche. The body is both a tool that allows us to enter the psychedelic dimensions and the anchor that ensures our safe return to the physical dimensions.

 

Although each psychedelic experience is personal and its content is specific to each individual in that particular moment of their lives, some greater universal themes often manifest in one way or another. Issues such as life and death; coming face to face with insanity and the fear of losing control; intense emotions of anger, fear or sadness; and spiritual revelations and ecstatic experiences are all elements that frequently appear in psychedelic experiences.

 

In between the expressive and projective techniques, tarot cards can be a useful tool for interpreting different aspects of the experience and the subsequent states. There are many different decks that can be used, from the classic Marseille tarot to modern reinterpretations, such as the OSHO Zen tarot or cards that represent certain archetypes, deities, or power animals.

Again, the point of these quotes is only to demonstrate how far psychedelic assisted therapy ("PAT" as it is called in the journal JAMA Psychiatry) departs from what we have known as the medical specialty of psychiatry in the mental health profession. I've never heard any member of an EMHC treatment team suggest tarot cards for the treatment plan of an NGRI patient!

(More to follow...)  

Ten quotes from the new psychiatry

I realize that many or most of my readers will say that psychedelic assisted therapy is yet a very long way from being the new psychiatry. But it seems so obvious to me that "PAT" is on the rise, and that 20th Century concepts of medicalized psychiatric mental health have so thoroughly crashed and burned (the simple summary being, "Diagnosis is bullshit and treatment sucks!"), that any aspiring mind doctors will have little choice but to become shamans or priests of some sort. 

I remember rather well the emotion, or the spirit, or the set and setting, of the sixties. When I was seventeen years old, I was quite certain I would never live to be thirty. (People think that's an exaggeration, but it's not at all, I remember.) Now we live in interesting times again, for the second moment since the Civil War, or perhaps the third moment since the French Revolution. After more than half a century, the lessons of my adolescence return to haunt me just a bit.

Readers may or may not know from my earlier articles, what my own opinion is about the "psychedelic renaissance." I'll be clear: I believe it is the single most dangerous and evil thing since nuclear weapons. I believe it will destroy psychiatry as we know it (which is the only silver lining), but the collateral damage may be catastrophic for our entire culture and for human civilization.

Psychedelic drugs scramble the mind. They make an individual human being insane, and they glamorize insanity in society. The religious cult of psychiatry sees this as their opportunity. They will promote psychedelics as a route to salvation, when they are actually the high road to hell.

The following is a simple list of verbatim quotes from Marc B. Aixalà's textbook, Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness. I offer this list merely to demonstrate what a radical departure psychedelic assisted therapy is, from any familiar model of scientific medicine, and to imply that we are absolutely back to zero on mental health. At least, psychiatry is dead.

This decade saw the beginnings of a line of research which was unthinkable just a few years earlier: research on the prosocial effects of MDMA, followed closely by LSD and psilocybin.. Prosocial behavior includes positive social behaviors such as altruism, empathy, cooperation, or the ability to recognize emotions and intentions.

 

The interest in psychedelic plant medicines... is an interest--and a quest--for health systems and knowledge systems that are not limited to the plants, but related to the ontological framework in which they are used. A search for well-being that has to do not so much with pleasure as with self-care, where the people who provide medicine are not the doctors, the psychiatrists, or the psychologists, but representatives whom the larger community has validated as experts, not because of their academic degrees or diplomas, but because of their expertise as technologists of the spiritual world.

 

The fact that hallucinations are a symptom of psychiatric disorders does not mean that they cannot also be a symptom of mental empowerment. The work with these substances consists precisely in taking advantage of the hallucinations in their healing sense.

 

The therapeutic mechanism that was singled out from the multiple studies carried out under the psychedelic paradigm seems to be the mystical experience happening during the LSD session. 

 

Here we see another paradox of the integration process: the multiplicity of interpretation that the same phenomenon or experience can have. The paradoxical nature is inherent in the psychedelic experience and the mystical and transcendent dimensions of the psyche. The integration of paradoxical experiences is only possible through the process of finding higher logical levels, such as metaphors or the "Koan" of the Zen tradition....

 

Psychedelics are also used for their potential to induce mystical and spiritual experiences; they have religious applications; and they are potential tools useful in social conflict resolution.

 

Four levels of reading and interpretation or exegesis exist in the Jewish tradition.... Similarly, a psychedelic experience can be read and interpreted from multiple levels.

 

Spirituality and the psychedelic experience are inseparable. 

 

When faced with our perception of symptoms--be they thoughts, emotions, or behaviors--we tend to mistake human psychological constructs with reality, in this case the so-called "mental illnesses." The psychiatrist or psychologist diagnoses a mental illness as if it were something that really exists, effectively creating a second-order reality that can have devastating effects for the person being diagnosed. Once the construct is accepted by the patient and by his social and family circles, it can turn into a self-fulfilling prophecy.

 

These psychonauts, the navigators of the soul, use non-ordinary states as a tool to know internal and external reality and create their conception of the world. Psychonautics could be understood as a path, a spiritual practice, as is the case for some groups such as the psychedelic festival community or some neo-shamanic communities that routinely organize psychedelic ceremonies.

 (More to follow...)

Go ask Malis when he's ten feet tall

I occasionally try to imagine how psychedelic assisted therapy ("PAT") could ever be implemented anywhere in the forensic mental health plantation system. Jo Neill, a professor of psychopharmacology at the University of Manchester, recently said that such treatments are exactly what psychiatrists should be utilizing. In a paradigm shift, they should emulate shamans rather than continuing to use the same old drugs they have been getting "heartbreaking" results with for the past 70 years. 

It's difficult to justify denying any truly better treatment for mental illness to "patients" who are NGRI because of mental illness. The law says these guys are only held involuntarily in psychiatric "hospitals" to be treated, right? And they are entitled under the law to the least restrictive effective treatment, right? So psilocybin or Ketamine for depression and anxiety, molly for anti-social personality disorder, and LSD for... probably everything, right?

Somehow, it just seems like multiple axe murderers don't deserve good drugs. The guy who strangled his girlfriend in the basement with a clothesline, or the mom who cut her five-year-old's head almost off, should get Haldol or something else that causes really bad side effects. These are not individuals who should be expanding their consciousness: they are bad guys.

Somebody said the bad guys are only bad guys because their brains have chemical imbalances, or their genes are unfortunately mutated. So we try to fix the bad guys with medicine, to help them not be so bad. Psychiatry is medicine, right?

Either that, or maybe psychedelics really aren't good drugs after all? Maybe they're not medicine? But how can that be? There's so much enthusiasm for them everywhere right now! Even at EMHC, a state psychiatrist told me he was very interested in Ketamine. (But maybe he was only interested in Special K for himself, not for his patients?)

It seems like a hard scene to disentangle, unless you understand one principle that has been part of my creed for most of my life: The study of the mind and the healing of mentally caused ills should not be alienated from religion or condoned in non-religious fields.

I briefly mentioned this in the first article I ever wrote for this blog, over 14 years ago. My point was basically just that... the brain, and the mind, and the person... are not identical or inseparable things. Unless one knows something about this, he/she has no chance whatsoever of making a bad guy good. Pretending to "help" people with drugs rapidly degenerates into idiotic confusion.

If mental illness doesn't make people violent or dangerous, why should it excuse violent crime, as it seems to with an NGRI verdict? "Insight" into mental illness as the problem, and Moral Reconation Therapy in the same institution? We don't know what the hell we're doing! When men on the chessboard get up and tell you where to go, and the white knight's talking backwards and the red queen's off with her head....

EMHC is chasing rabbits, and you know they're going to fall.

Psychedelics: psychiatry publicly turns from medicine to religion

The current, much heralded "psychedelic renaissance" signals a darkly ironic evolution of psychiatry away from its long-successful branding as a medical specialty, toward a more explicitly quasi-religious quest for mystical enlightenment to simply override mental disorders as they were previously understood, or to "break on through to the other side."

This is almost certainly prompted by the abject failure of Twentieth Century efforts to raise humanity toward a higher plain through decoding the "secrets" of the brain. The future that Jeffrey Lieberman predicted for his guild in 2014 has not materialized. In fact its prospects now look vanishingly small.

The truth is, psychiatry was always more religion of the brain, than science of the brain. And that's why psychedelics are psychiatry's perfect bridge to oblivion.

Ayahuasca, LSD, psilocybin, MDMA, Ketamine, etc., are used in psychedelic assisted therapy ("PAT") to scramble a person's mind and produce ego death. Then counseling attempts to integrate the terrors and the epiphanies (or the spiritual, existential. religious and theological ("SERT") insights) from the psychedelic trip, into a reconstructed, improved personality capable of functioning better in a practical world. 

There's just no way this is anything but a spiritual quest. When it is attempted by psychiatrists, the quintessential ambassadors of an ultra-materialist, mechanistic view of the human mind, it becomes profoundly dangerous.

A recent leading textbook, Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness, by Marc B. Aixalà (Santa Fe & London: Synergetic Press, 2022) contains a fascinating statement that dramatically illustrates the religious nature of this activity:

The psychedelic induced mystical experience is probably the best corrective emotional experience that can occur.... In some ways, it resembles the resolution in the biblical Book of Job; after suffering countless tragedies, Job asks God the reason for all of it. God's response is transcendental and places Job in front of the greatness of the universe and creation, highlighting the insignificantly significant role that Job plays in all that drama. Thus, psychedelics often give us the same response that God gave to Job. 

(Pages 126-7.)

So after getting nowhere, utterly failing to move the needle despite spending $20 billion in taxpayers' money during the decades of Tom Insel's reign at NIMH; after unsuccessfully bullshitting the public through five editions (including Allen Frances' own) of a "diagnostic manual"; after the proclaimed "Decade of the Brain" and continuous legal authority for most of a century to force the public to be its customers; the guild-cult of psychiatry will now end in the panic of a bad trip, turning on, tuning in and dropping out!

They figure they might just as well play God.

More on Lennon’s breakfast

The high point of this morning’s bike tour in Central Park was a stop at the Strawberry Fields memorial, just steps from the spot where John Lennon was shot dead by Marc David Chapman, as he walked with Yoko Ono outside their Upper West Side home. 

I had never been there before, and for some reason I’d always mistakenly pictured the Dakota as being on the east side of the park. There was a guitarist covering “Imagine” and “No Reply”. It seemed to me that a lot of people walking around had not been born yet on December 8, 1980. 

Chapman, the killer, had no previous record of violent crime. But he had been “treated” by psychiatrists. Our guide on the bicycle tour never uttered his name. She just said Lennon was shot by a maniac.

I wonder what a maniac actually is. It seems like the word must be related to mania, or manic - right? It's kind of ironic, because Marc David Chapman had a long history of depression, which is the opposite of mania, unless he was bipolar and he went back and forth (but I’ve never heard any theory about that - bipolar wasn’t as popular in 1980 as it is now).

There are lots of synonyms for maniac: fanatic, fiend, lunatic, nutcase, madman, and other words, some of which are very casual or pure slang, and some of which might have real meaning, at least historically, in mental health and legal circles. My 10-year-old grandson was the one who remembered what the bike tour guide had called Lennon's killer, so I struck up a conversation with him, about the difference between a maniac and a lunatic.

He knew very little about the incident from 1980, of course. He’d heard something in school about a Beatle who was killed, but nothing about any maniac or lunatic who did it.

I explained to him the roots of the words and what they might mean to mental health professionals, and the irony in Chapman’s being depressed but remembered after the fact as a maniac. He offered the opinion that a maniac was a really dangerous person, whereas a lunatic was just somebody not doing well in life, kind of dumb, and nobody likes him.

That conversation was quite interesting, and I decided to expand the survey to an intergenerational sample. When I asked my wife what the difference is between a maniac and a lunatic, she just held up a thumb and forefinger very close together in a pinching pose, silently saying, “little-teeny (almost no difference),” and probably implying disrespect for my overheard, complex explanation delivered to a 10-year-old. 

Then I asked my daughter what the difference is between a maniac and a lunatic. She cleverly said both her mom and her son were right. She also appeased me (by not implying that I waste my time even being interested in such things).

But the simple fact is, John Lennon was assassinated for never doing anything but making people happy. His killer was a product of psychiatry. A maniac. And 10-year-olds know as much about that as mental health professionals or lawyers.

The Strawberry Fields memorial in Central Park is highly recommended.