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Psychedelic renaissance: Are LSD and MDMA the future of therapy?

Ketamine nasal spray for chronic anxiety, magic mushrooms for persistent depression, MDMA while holding hands with a therapist to resolve PTSD – is this the future of the psychiatric paradigm?

Image for Psychedelic renaissance: Are LSD and MDMA the future of therapy?

Ketamine nasal spray for chronic anxiety, magic mushrooms for persistent depression, MDMA while holding hands with a therapist to resolve PTSD – is this the future of the psychiatric paradigm? Photo: IMAGO / Science Photo Library

Three years ago, Olivia – a 36-year-old Californian now living in Berlin – was in a really bad place. She was struggling to process a traumatic childhood experience, and her grief had not improved through cognitive behavioural therapy or the several other therapeutic modalities she tried. When her boyfriend eventually recommended a Bay Area therapist who offered underground MDMA-assisted sessions, she decided to give it a try.

After a fairly regular introductory session, she went in for the actual trip. The room was bland, intentionally stripped of visual stimuli: no paintings, no curtains. Given a capsule of MDMA and a pair of blindfolds, in a room with gentle background music on and the therapist by her side, Olivia laid back for what she would remember as “one of the most profound experiences of self-love and healing” in her life.

Mental health issues are nothing new, although the pandemic and the existential threat of climate change have added new urgency to the discussion of them. The quest for effective psychological treatments has a long and storied history, too, from lobotomies to talk therapy and beyond. Today, people both inside and outside the medical establishment are increasingly taking an interest in “psychedelic psychotherapy”, the consumption of psychedelic substances in a therapeutic setting with the goal of healing.

Psychedelics don’t make you a good therapist. You have to be a good therapist to handle psychedelics.

Drugs typically thought of as party gear – tools to mess with the mind – are being investigated as potential medical assets, drawing attention to the sometimes seemingly arbitrary distinction between legal and illegal substances (morphine is used regularly whereas therapeutic MDMA use is still viewed with suspicion).

Over the last few decades, institutional psychedelic research has boomed. World-leading universities such as Johns Hopkins and the Imperial College London have established dedicated research centres, while the number of scientific articles published on the topic has exponentially increased. Germany has recently provided millions of euros in funding to a study on the use of psilocybin for treatment-resistant depression.

The use of brain-imaging software has helped improve scientists’ understanding of the way psychedelics work, with preliminary clinical trials supporting psychedelic-assisted therapy for mood disorders, PTSD, alcohol and nicotine dependence. The research appears to suggest that psychedelic substances have something unique to offer the field of mental health – something psychonauts have been saying for a long time. Indeed, this is a cause that attracts diverse advocates, from academics, psychiatrists and registered doctors to shamans and DIY day-trippers. As the underground sphere begins to collide with the clinical – as party drugs are investigated for their healing potential – how does one guide themselves through the twists and turns of psychedelic-assisted therapy?

A shifting consensus

The counterculture movement of the 1960s opened a psychedelic can of worms, particularly in the US. Initially, psychedelics were considered a promising line of psychological research, which quickly caught on outside the institutional setting as a recreational activity that bolstered anti-authoritarian sentimentality.

In the conservative backlash that followed, most Western nations – who lack the millennia of experience and sophisticated traditions that many indigenous cultures have – responded to these substances with social mistrust and political demonisation. Substances were banned, research was discontinued and users were criminalised across the West. In the US the “summer of love” gave way to a punitive “War on Drugs” that has persisted since the 1970s. Yet the movement didn’t disappear – it went underground, where a vast array of subcultures grew around the countless secretive healers, renegade psychological practitioners and self-experimenters.

But times change, and the taboo on psychedelics appears to be on the wane – thanks, in part, to organisations like the Multidisciplinary Association for Psychedelic Studies (MAPS) in California and the MIND Foundation in Berlin. These scientific and educational organisations are at the forefront of shifting public perception of psychedelics. And once again, researchers from some of the world’s top universities are being given leeway to explore the topic, particularly in the field of mental health. Psychedelic-assisted therapy now seems to be a real possibility.

MIND over matter

The MIND Foundation is a Berlin-based non-profit science and education organisation that promotes psychedelic research and therapy. Alongside a wide variety of educational and harm reduction services, MIND offers a newly developed augmented psychotherapy training programme. This three-year programme qualifies one to become a psychedelic therapist, working with various tools that alter patients’ state of consciousness (personal experience with altered states is a prerequisite). MIND’s co-founder, Dr. Andrea Jungaberle, is eager to emphasise the personal aspect of care: “Psychedelics don’t make you a good therapist,” she says. “You have to be a good therapist to handle psychedelics.”

Last month, MIND’s founders opened an augmented psychotherapy clinic in Friedrichshain. With an airy, light-filled lobby and pleasingly neutral-coloured walls, it looks very much like any other therapy Praxis in town – except, of course, that this team of psychologists and therapists augment their therapy sessions with ketamine alongside other, non-pharmacological methods like breathing techniques and strobe lights. The pharmacological aspects are seen as an addition to treatment, not its core, with the focus firmly on psychological unpacking and on integration of the experience.

Public perception has changed slower in Germany than in North America, Jungaberle observes, but here too “the winds are changing” – thanks in part to the internationalisation of medicine. MIND director of communications Sasha Silberberg is cautious about the public’s fascination. “It’s a sexy topic, people’s ears perk up when you talk about it,” she explains. “But there are also many challenges that come with that: the history of stigmatisation, a focus on urban myths instead of fact-based knowledge and the barriers in communicating something so ineffable. In this sense, we see science and research as a necessary platform for public communication and understanding.”

Truffle trips with experts

Berlinerin Stefana Bosse is involved in a more unconventional form of psychedelic healing. Back in 2016, the founder of the Psychedelic Society UK offered her the chance to begin running psychedelic retreats in the Netherlands. Bosse was delighted: “I felt a deep sense of peace and a re-alignment with my purpose on a profound level.”

What began as Europe’s first organised programme of psilocybin-assisted experiences, marrying psychological support with more spiritual ideas about space holding, has evolved into Alalaho – a healing centre offering multi-day retreats with an emphasis on psychological preparation, not to mention tripping.

Image for Psychedelic renaissance: Are LSD and MDMA the future of therapy?

Olivia, a 36-year-old Californian living in Berlin, called an MDMA-assisted therapy session “one of the most profound experiences of self-love and healing” of her life. IMAGO / Science Photo Library

On a typical post-Corona retreat, guests are welcomed by Bosse and her team of bodyworkers, healers, psychotherapists and clinical psychologists for a multi-day experience of sharing, radical honesty and “magic”. (The price is steep, with a five-day retreat costing up to €2000, although some low-income prices and scholarship options are available.) Participants sip on Tampanensis truffle tea, a derivative of psilocybin mushrooms which is legal in the Netherlands. These retreats stand in contrast to the clinical psychedelic scene, Bosse says, where “the sterile atmosphere and one-on-one dynamic could potentially rob you of the rich social experience you get from group ceremonies in a natural setting”.

Alalaho is proud of its safety measures, including psychological screening for prospective participants via a questionnaire and interview process developed with the help of a psychiatrist at King’s College London; team members are also trained in first aid, although Bosse notes such emergency response has never been necessary and the procedure is fairly low risk. Yet far from these certified retreats and costly clinics, numerous selfmedicators make their own personal calculus of risk and reward.

Going deeper underground

Many people take their psychedelic experiences into their own hands. Jack, a 32-year-old, had his first real LSD experience while backpacking in Burma at 26. He went on to partake in an Iboga circle (using a psychoactive plant bark from western Central Africa) and recently joined an intense sitting with the powerful Bufo Alvarius (a secretion from the sonoran desert toad). His foray into the world of psychedelics started as curiosity, not therapy, but he has found that delving deeper into his own psyche has helped him unpack some of the psychological baggage that was impacting his life. He now enjoys an occasional cocktail of psychedelic substances with meditation, depending on what he needs and when, but no longer considers it recreational. “It’s fun,” Jack says, “but in the way of going to the climbing gym or partaking in other intense activities.” Still, he regrets the “lack of guidance or knowledge” available for such experiences and the risks involved – especially when he first began experimenting.

Alalaho is proud of its safety measures, including psychological screening for prospective participants via a questionnaire and interview process developed with the help of a psychiatrist at King’s College London

Jessica, a 29-year-old from Berlin, started to microdose LSD last summer to manage her mental health. Micro-dosing – the practise of taking sub-perceptual doses of psychedelics, about one-twentieth to one-tenth of a regular dose – is a growing trend, especially in Silicon Valley. It is touted for benefitting creativity, productivity and one’s feeling of presence. Frustrated with therapy and her antidepressants, Jessica turned to microdosing. After one small drop of acid, she recalls, it felt like “someone had opened my head and allowed the world back in”. So far her experiences have been largely positive, but she doesn’t dare tell her therapists that the occasional dose of acid can take her deeper than her talking sessions.

Olivia, too, argues the benefits of her MDMA session – which, though offered by a certified psychologist, was also technically underground. Some of the circumstances were certainly question- able compared to a standardised clinical setting: the dose was 160mg, compared to the 80-120mg at government-regulated research programmes, and official protocols would have prohibited her laying her head in the lap of the therapist. Still, Olivia feels the single session greatly helped her to process the trau- matic childhood event that was weigh- ing on her, giving access to the painful memories with greater ease and allowing her to recolour them in a way that lifted her suffering. “What this experience taught me was that love is presence and therefore self-love is presence with yourself,” she explains. “That is what a psychedelic gives you – you go into this space of profound presence and compassion with yourself and others. It taught me the experience of what it feels like to love yourself, which is something I think talk therapy can’t do.”

No magic cure

PhD candidate Andy Meijer is about to begin work as a researcher on the new psilocybin-depression study conducted by the Central Institute of Mental Health Mannheim and Charité’s university hospital in Berlin. This 144-patient psychedelics study, the first in Europe to be allotted state funding, has received €2.2 million. Meijer is excited to have the opportunity to speak with such a variety of participants, all of whom have treatment-resistant depression, in the hope of uncovering why and how other therapeutic methods have failed them. When he was young, Meijer admits, he occasionally fell victim to wearing rose-coloured glasses regarding the potential of psychedelics.

Now, he is well aware that this is no “unidirectional golden bullet”. “It is a thing that connects neurobiology with psycho- logical understanding of the mind, and something that could allow psychiatry to adopt a more holistic perspective,” he says. “But it is not a cure all, nor should it be seen as such.”

This is a common thread shared by both experts and amateurs who have dabbled in, or are deeply familiar with, these substances. Psychedelics are powerful and potent, but in the end it is up to individuals to do the work, to prepare themselves and to properly integrate the experience afterwards. Stefana Bosse puts the point succinctly: “Psychedelics are not a magic cure,” she says, “you need to do the psychological footwork.”