Spring 2013 Vol. 23, No. 1 Special Edition: Psychedelics in Psychology and Psychiatry
The inspiration for creating a graduate clinical psychology course on psychedelics at Sofia University (formerly the Institute of Transpersonal Psychology) came during the MAPS conference in San Jose 2010. With all of these clinical and research advances, how could a doctoral psychology program not provide training in this area? The recent research is beyond compelling that therapy, experientially supported with psychedelics, helps resolve combat trauma in veterans as well as other forms of trauma and reduces anxiety in cancer patients.
The tipping point has been reached, with millions of people who have had such experiences bringing them into therapy. Clinical facilities that are unable to relate to client needs to integrate prior drug experiences are no longer fully responsive to the changing demographics of the clinical population. This is certainly the case in the Bay Area where a significant number of people are having psychedelic-related crises that can be helped without medication or hospitalization.
During a hallway chat (one of the most rewarding parts of a well-organized conference) with Jim Fadiman, he also wondered why Sofia University had never offered such a course. Since I had two teaching units available on my teaching load, I proposed a course co-taught by Jim and myself. It was accepted into the curriculum as a clinical elective. The two-unit residential course was first offered in the fall quarter of 2010 and has been well received.
While serving formally first as the teaching assistant, and later as an instructor for the first two years, Alicia Danforth has been the lead instructor. She was especially sensitive to the necessity for our students to truly understand, not just have read, the core literature. Alicia developed the general scope and framework of the class while Jim and I contributed our specialized experiences throughout. When space was available, students from other institutions (including MAPS) and practicing clinicians have been admitted into the course. Sofia University is currently planning the development of an online course for its global students and plans to offer the class through other institutions.
The class covers clinical research on psychedelic drugs as adjuncts to psychotherapy for the treatment of addiction, post-traumatic stress disorder (PTSD), and existential distress at the end of life, as well as approaches to integrate positive psychedelic experiences and to resolve psychedelic crises. Understanding psychedelic experiences requires knowledge about the interdisciplinary context, traditional uses, and applications behind the contemporary research on psychedelic drugs for treating trauma and addiction.
The course begins by establishing a cultural context for psychedelic use among indigenous peoples and throughout human history. As anthropologist and clinician Marlene Dobkin de Rios observed, “The contribution that anthropology can make to the study of the use of mind-altering plants throughout the world is to show how cultural variables such as belief systems, values, attitudes, and expectations structure one of the most subjective experiences available to humankind” (de Rios, 1996). Not understanding the significance and value of psychedelic experiences can be considered a type of cultural insensitivity in contemporary American psychology. A culturally competent clinician must know how to address the range of psychedelic experiences that clients bring into psychotherapy. The weekly topics in our one-quarter course include:
1. Definitions and History – Indigenous (pre–synthetics)
2. Psychedelics and Spiritual/Mystical Experience
3. Research: Early (pre-1966), Renaissance (1990-present)
4. Cannabis: Historical, medical, recreational, legal perspectives
5. Guidelines and Best Practices for Guiding
6. Psychosis: “Bad Trips” and Interventions
7. Uses in Psychotherapy: PTSD, End of Life
8. Treatment of Addictions: Ayahausca, Ibogaine, MDMA, LSD
9. Future research areas: Problem-solving, creativity, micro-doses
10. Integration and student presentations
In particular, the understanding of psychedelic experiences requires an appreciation of their relationship to religious/spiritual experiences and to cultural trends toward spirituality less tied to an organized religious institution. Tom Roberts has termed this democratization of primary religious experience, which often occurs during psychedelic drug use. Grinspoon and Bakalar (1986) pointed out over 20 years ago that, “It should not be necessary to supply more proof that psychedelic drugs produce experiences that those who undergo them regard as religious in the fullest sense.” More recently, the Johns Hopkins researchers Griffiths, Richards, McCann, and Jesse (2006) have done just that by demonstrating that even a single psilocybin experience can alter personality and perceived meaning among a significant portion of healthy volunteers and that the effects are substantial and long lasting. As spiritual competence becomes more recognized as foundational to clinical work, this inherent connection of psychedelics to spirituality should receive increased attention.
While not all students intend to be clinicians, clinical considerations are discussed throughout the course. In-class experiential exercises involve assessing and integrating psychedelic experiences in role-played therapeutic encounters. Charlie Grob, M.D., the principal investigator of the UCLA Harbor Medical Center psilocybin study with cancer patients, and Anne Shulgin have been guest presenters as well as Sofia doctoral student Brito Gonzalo who has worked in ayahuasca treatment programs in South America.
In addition to this course, the increasing interest in psychedelics in higher education is being reflected in Sofia students’ dissertations, research and academic topics that pre-date and continue concurrently with our course. Students have found ways to apply both conventional and innovative methods to explore the topics related to use of psychedelics. Here are some examples:
Alicia Danforth is completing her dissertation on the potential of MDMA for helping autistic adults increase social adaptability. She is preparing for her job at the Los Angeles Biomedical Research Institute at UCLA Harbor Medical Center where she was a research associate on their psilocybin study with cancer patients, and she is the second author on the research published in a leading peer-reviewed journal (Grob, Danforth, Chopra, Halberstadt, McKay, Greer, Hagerty, 2011). She will present her dissertation findings at the Psychedelic Science 2013 conference in Oakland.
Recent graduate Peter H. Addy, Ph.D. (clinical psychology, 2011) is currently a postdoctoral associate in psychiatry at Yale School of Medicine, an advanced fellow in medical informatics at the Veterans Affairs Connecticut Healthcare System, and a psychology resident at the Substance Abuse Treatment Unit, Connecticut Mental Health Center. Peter’s dissertation was a study of the effects of administering Salvia Divinorum in a non-shamanistic setting to healthy volunteers. The quantitative data from his dissertation has been published in Psychopharmacology (Addy, 2012), and the qualitative data has been presented at several conferences including Psychedelic Science 2013. Peter also authored a peer-reviewed paper on dextromethorphan (DXM), a psychoactive cough medici
ne ingredient in street use.
Albert Garcia-Romeu graduated in 2012 with a Ph.D. in transpersonal psychology, and recently accepted a position as a post-doctoral research fellow at Johns Hopkins University School of Medicine. Albert is now managing a study focused on treating smoking addiction through a combination of cognitive behavioral techniques, mindfulness, and high-dose psilocybin administration.
Graduate Michael Cougar (2005) did his dissertation on personal transformation and psychoactive plant use in syncretic Brazilian church ceremonies.
Deborah Quevedo (2009) studied 22 participants attending neo-shamanic retreats in Brazil who were given ayahuasca. She administered the Big Five Personality Inventory before and after taking the plant preparation and found statistically significant reductions in Neuroticism and increases in Agreeableness.
Sofia University faculty member Jim Fadiman, has recently authored The Psychedelic Explorer’s Guide: Safe, Therapeutic and Sacred Journeys, and is currently directing two national psychedelic research studies.
Faculty member Arthur Hastings has authored research papers on hypnosis and MDMA and is also the anonymous author of the chapter on marijuana in the classic book Altered States of Consciousness, by faculty colleague Charles T. Tart who also wrote On Being Stoned: A Psychological Study of Marijuana (2000), a book surveying the early use of marijuana in the U. S. culture. Sofia U is one of the few schools that provide faculty support for a wide range of research and scholarship on psychedelics.
Tom Roberts (2013), who has offered an undergraduate course on psychedelics for over 20 years at Northern Illinois University, has stated that, “Psychedelic research may be the field with the greatest gap between the information scholars and scientists have discovered and what the general public knows” (from his course syllabus for Foundations of Psychedelic Studies). His course syllabus, along with Robert Forte’s course syllabus for an online course at CIIS entitled, A Recent History of Psychedelic Drugs, Their Effects on Individuals and Society, were both consulted to help bridge that gap for psychologists by surveying psychedelics’ history from archaeological times to the present and by examining their implications for psychotherapy and mental health, religion, and various academic disciplines and professional interests.
Our fondest hope for this course is that it paves the way for other universities, particularly those offering graduate training for mental health professionals, to use this precedent at an accredited graduate program to advocate for including similar courses in their curriculum. To that end, we are making the syllabus available upon request [send request to author via email]. In addition, the Psychedelic Science 2013 conference in Oakland in April 2013 will include a presentation going into more detail about the challenges and benefits of teaching future therapists to be more sensitive and competent in working with clients who have used or are using psychedelic substances.
david.lukoff@sofia.edu
Addy, P. H. (2012). Acute and post-acute behavioral and psychological effects of salvinorin A in humans. Psychopharmacology, 220(1), 195-204.
de Rios, M. D. (1996). Hallucinogens: Cross-Cultural Perspectives. Long Grove, IL: Waveland Press.
Griffiths, R., Richards, W., McCann, U., & Jesse, R. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology. 187(3), 268-8.
Grinspoon, L., & Bakalar, J. B. (1986). Can drugs be used to enhance psychotherapeutic process? American Journal of Psychotherapy, 40(3), 393-404.
Grob, C. S., Danforth, A. L., Chopra, G. S., Halberstadt, A. R., McKay, C. M., Greer, G., Hagerty, M., (2011). A pilot study of psilocybin treatment in advanced-stage cancer patients with anxiety. Archives of General Psychiatry, 68(1), 71-78.
Roberts, T. B. (2013).The psychedelic future of the mind: How entheogens are enhancing cognition, boosting intelligence, and raising values. Rochester, VT: Park Street Press.
