Integrating ayahuasca into western healthcare (part 2)

Here is part 2 of my interview with pioneering researcher Milan Scheidegger, who works in the psychedelics lab at University of Zurich. You can read part 1 here. In this half of the interview, we discuss how to translate aspects of indigenous ayahuasca rituals - such as the shaman or sacred plant songs - into the context of western healthcare. We also discuss Milan's plans to establish a psychedelic healing clinic in Switzerland.

In terms of translating the elements of indigenous psychedelic rituals into a western context, the role of the shaman is taken by a therapist. The therapist becomes a spiritual guide, not just someone you talk to. They acquire a sort of vatic standing. What do you think of the scientist as shaman?

It's a controversial topic. In Switzerland, we had a psychiatrist called Samuel Widmer, who offered psycholytic therapy with substances like LSD and MDMA with special regulatory permission. During his work, he moved from being a clinical psychiatrist to being a spiritual guru, offering tantra retreats with substances. He acquired many followers dressed in white, who lived in a commune. [He also had two wives and preached free love.]

Similar to what happened with Timothy Leary and Ram Dass? Timothy Leary tried to set up a religion after he was fired from Harvard...

Yes somewhat. These things can happen also in other parts of society, it is not solely related to psychedelics. It can be dangerous of course, this change in social role and dynamic. That’s why this type of work poses ethical challenges in terms of the personal integrity of the facilitator. What is their motivation in doing this work? Is it just a narcissistic, histrionic motivation to become a guru, or is it a humble motivation to reduce human suffering? Responsible use of psychedelics is related to the ability of the therapists to question their own role, providing a safe space for the transformation to happen, rather than strongly guiding the role. Yeah, it's a problem we can't get rid of. There are also guru-type personalities in other realms of society.

Indeed, and in other realms of therapy and psychiatry too. Then there's the role of nature in the psychedelic healing process. You did a masters on deep ecology, didn't you? Most psychedelic research is done in the lab, rather than deep in nature.

Yes. Our psilocybin meditation study is the only study that took place in an aesthetically pleasing retreat centre in nature. Obviously this type of setting has a huge influence on the experience of participants. I remember my own ayahuasca experience in the jungle, where one's ego boundaries dissolve and you can't distinguish anymore if the sounds from the animals are out there or in here. That’s why I believe that the widespread use of psychoactive plants in human cultures must have some deep ecological function. My colleague Matthias Forstmann recently published an interesting study on how lifetime experience with psychedelics predicts pro-environmental behavior through an increase in nature-relatedness. They argue that the mechanism is that, through dissolving our ego boundaries, we start to self-identify with nature. When the distinction between self and nature becomes more permeable, we incorporate nature into our self-concept and start to behave more responsibly. That is very similar to taking a non-dual perspective, then hurting somebody out there is actually damaging yourself. There are huge ethical implications in deep ecological thinking.

So you'd prefer the psychedelic clinic of the future to be in some beautiful natural setting?

Yes, the ideal setting would be a retreat centre in nature, offering inpatient treatments for 1-3 weeks with followup outpatient care. The retreat facilitates transformation because it takes patients out of their habitual dysfunctional settings, offering psychotherapy, body-work, music therapy, nature-exposures, consciousness-altering rituals, psycho-education and integration. When psychotherapy becomes more experiential, than just cognitive, people are more likely to change.

What about the importance of the group. Psychedelic research tends to study individuals. Do you think groups are the best setting?

From our experience with the psilocybin meditation study and my participation in indigenous rituals, a group seems to be an ideal setting for psychedelic therapy. The level of solidarity can be very deep and therapeutic, especially when participants share their experience in a group. We are all part of a life process, creating an interpersonal conscious field together through our relationships, you get to see that others' experiences can mirror your own, to listen to similar stories which can also reveal your own patterns and struggles. It’s not different from other types of group psychotherapy. However, it's difficult to get regulatory permission to work with psychedelic substances in groups because it’s not yet established within the biomedical treatment paradigm. The Swiss Society for Psycholytic Therapy had special permission from 1988-1993 to work in groups of patients, but most of the clinical studies are of individuals.

How about the role of music? Could you tell me about your work with the Sound Trance Institute.

At the World Ayahuasca Conference 2014 in Ibiza, Joel Olivé – an ethnomusician from Spain - was giving a concert with archaic instruments. I was very touched by the resonance field and collective space of consciousness that opened up in the conference hall just through Joel's playing of the archaic instruments.

What are archaic instruments?

The oldest archaic instrument of course is our own voice. Other instruments include didgeridoos, monochord, drums, cymbals, rattles, kalimbas, singing bowls, and symphonic gongs. It's acoustic instruments that have been used by tribal societies from all over the world to create sound vibrations that feel very organic, and which facilitate entrance into trance states. When archaic instruments are used in a specific sequence, they induce states of consciousness that are very similar to psychedelic therapy and shamanic rituals. Peter Hess, a German psychiatrist and music therapist developed the so-called Gong Therapy, a new form of receptive sound therapy, that can be better integrated in our culture and society. As a musician, I became very inspired and passionate about this approach. Now I am training with Peter and Joel and my vision is to combine music therapy with psychedelic-assisted therapy in the future.

You've also done research into psychedelics and meditation. Can you tell me about that, and how meditation and psychedelics can work together?

Our primary interest was to research the neurobiology of the self and its alteration through psychedelics. Since long-term meditators are trained experts in self-regulation and in navigatingconsciousness, we were interested in how they will deal with psychedelic experiences. As study participants, they spent 5 days in a silent meditation retreat, and we compared how psilocybin affected their meditation experience compared to a placebo group. We were particularly interested how psilocybin affects meditation depth, the occurrence of mystical experiences, and quality of life afterwards. Some participants have been meditating for 20 years, so you'd expect perhaps there is not much room to go deeper. But it was quite surprising to see that the psilocybin group not only reached higher levels of meditation depth and mystical-type experiences, but also truly improved on follow-up measures of mindfulness, self-acceptance, sense of purpose and appreciation for life, and less fear of death.

I feel the ayahuasca retreat I went on in October has helped my meditation practice since then. First of all, meditation practice is so useful during the psychedelic experience. Things like staying in the moment, following your breath, connecting to your body, reminding yourself things will pass, self-acceptance - these are such useful tools during psychedelic experience, that it really gives you a sense of the efficacy of those tools, which motivates you to work harder on meditation in the weeks and months afterwards.

As you mention, it's a mutual relationship. On the one hand, exploring deeper states of consciousness through psychedelics can motivate a daily mindfulness practice. Psychedelic experiences can refresh the meaning behind your practice and be revealing even after sitting on a meditation cushion for 20 years. When you return to the madness of everyday dual existence and the polarities of life, having had a psychedelic experience can broaden your flexibility and courage in coping with difficult experiences. On the other hand, there are these other mindfulness capabilities that you mention – where psychedelics can support processes such as dis-identification from self-limiting beliefs or developing radical acceptance towards things you cannot change in life.

And meditation helps with the integration, with turning altered states into altered traits.

Yes, and it helps with the preparation too. In our study we found that long-term meditators had much less fear response to the psychedelic experience than non-meditators. Meditation can increase your conscious competence, going from narrow-minded consciousness to a broader perspective, and feeling more accepting of what happens.

There should be a masters degree in conscious competence.

You put yourself through a lot of conscious competence practices for your last book [The Art of Losing Control]!

Well…conscious incompetence maybe. Tell me about the Reconnect project.

The Reconnect Foundation is a non-profit organisation based in Switzerland, with the mission to establish a novel approach to transformational and sustainable healthcare with a focus on mental health and holistic well-being. It's proposing a new paradigm of transformation-based psychotherapy, which means moving from the biomedical substitution-oriented model, for example giving anti-depressants every day for depression, towards more of a transformation-based approach, inspired by consciousness-altering techniques, to provide a sense of re-connection, to self, others and nature. The foundation also supports research into the therapeutic potential of psychointegrative plant medicines like ayahuasca. 

Will this potentially also be a psychedelic therapy centre?

Yes, we would like to offer evidence-based psychedelic-assisted therapy in the future.

What are the chances of psychedelic therapy being legalized in Switzerland?

It's the perfect place because Switzerland has a long history with psychedelics, including Albert Hofmann’s discovery of LSD, and the long-standing psychedelic research at the University of Zurich over the last 20-30 years. The Swiss Society for Psycholytic Therapy received special permissions for psychedelic-assisted therapy in the past. And regulatory authorities are quite pragmatic, as long as we can proof the safety and efficacy of our approach. So I assume we have a good chance.

Where would Reconnect be based? In the Alps?

Currently, most of our researchers and clinicians are based in Zurich, but indeed the Swiss Alps would be a perfect setting to set up a mental health centre.

Finally, what are the questions not being sufficiently explored in psychedelic or ecstatic research? And what are the biggest challenges for the field?

Well, I see big challenges and dangers with respect to exposing the general public to psychedelics. The studies that have been published in the last few years are quite enthusiastic about the usefulness of psychedelics to treat various mental health disorders. It's always dangerous to hop on trends because you can lose your critical perspective. I've often asked myself during my clinical practice, which of my patients would probably benefit from psychedelic therapy? We have no idea or data to estimate the costs and benefits and risks of psychedelic therapy for an individual patient. If we want to arrive there, a lot of research has to be done. I see a danger that clinicians who have no experience with psychedelics themselves, who haven't gone through psychedelic training or haven't had the chance to learn in indigenous or other legal contexts, will just administer these drugs in a setting that isn't safe or effective enough. Psychedelics are like a surgeon's knife, you need to be well trained to use this powerful tool purposefully, it’s not enough to watch how to do proper surgery on a YouTube channel. Similarly, the level of depth of a psychoanalysis varies with the reflective capacity and self-experience of your therapist. In my opinion, the same standards should apply to the responsible use of psychedelics in medical practice.

As for other frontiers, I have a special interest in non-dual experiences. Psychedelics are exciting molecular tools to systematically research this frontier of consciousness. Non-dual experiences were reported by mystics from various religious backgrounds, but they are also found among users of psychedelics, and they are the most challenging from a philosophical, phenomenological and naturalistic point of view. How can we make sense of a non-dual experience in terms of brain dynamics? If we understand how the brain mediates these two states – the dual and the non-dual mode of information processing – it could greatly advance our understanding of consciousness. There is also some ontological doubt about these experiences - what do they teach us about the nature of consciousness and the fabric of reality? We cross an epistemological boundary here that is very exciting for me, because non-dual experiences pose a challenge on integrating both scientific and spiritual perspectives on life.

One of the things that I feel could be more studied is the nature of the imagination. Psychedelics obviously open up the imaginative faculty in the subconscious - metaphors, symbols, stories, myths, our connection to art and music. When we're asking about the value or validity of our experiences, that's also a question of the value and validity of the imagination. The 17th-century materialist view of the imagination, in Thomas Hobbes for example, is that is just creates sandcastles in the sky, empty chimeras. But then you have the idea in medieval Christianity or Romanticism that the imagination can be a visionary, prophetic faculty. I don't see that discussed much in psychedelic research.

Absolutely, that's a new frontier. Imagination plays an important role in psychotherapy, you can work on your self-image through various imagination exercises. We can use our imagination to build up compassion to ourselves and others, and to review our self-limiting narratives and to transform them, to liberate ourselves from dysfunctional patterns. We know that psychedelics increase our imaginative capabilities, so that could be a great paradigm.

Indeed.In Stephan Beyer's book Singing with Plants, he talks about medicine and theatre, and of helping a person to a story about their illness and their recovery. He calls it 'emplotment' - 'the activity of making sense of the story'. He writes: 'to heal is to rebuild the shattered lifeworld of the sick person'. Psychedelic medicine really does that, it helps people to new narratives: 'I was broken, then I went to the jungle to take ayahuasca, now I'm better'. Or the opposite: 'I was well, then I did LSD, now I'm fucked'.

So, as a final frontier, your work looks at nature, music and psychedelics. It's interesting to think about how music connects us to nature. We don't think about that much in the West. But Amazon shamans say the plants teach them their songs, and their songs call in the plant spirits. I think about Renaissance songs, like in Shakespeare, or Beatles songs like Blackbird, or Romantic odes to mountains, flowers and birds - how many western poems are songs that connect us to birds, or flowers, or mountains. So in that sense music and poetry deepen our connection to the spirits of nature.

Yes, the connection of life and nature through rhythm and music is very exciting. Since the 1970s, the Damanhur community in Italy has researched plant intelligence and communication. They created an instrument able to perceive the electromagnetic variations from the surface of plant leaves to the root system and translated them into sound. It's incredible, it sounds like composed music, as if there is an innate ability or intelligence in nature to communicate intentionally. Our brain does not seem to be the only interface, where mind and nature meet.