Alicia Danforth worked on the cancer anxiety research study with psilocybin at the Harbor-UCLA Medical Center with psychiatric researcher Charles Grob, M.D. She is currently working on her Ph.D. in clinical psychology at the Institute of Transpersonal Psychology.
David: Have you seen anything in your research that influenced your perspective on death and dying?
Alicia: One of our subjects had been living with cancer for awhile. She had been dealing with a cancer that had gradually become more severe. She was a very optimistic woman who had a lot of deep spiritual beliefs and practices. She hadn’t acknowledged to herself yet that this cancer would eventually take her life, probably sooner rather than later. She was able to talk freely about how that realization had come to her during the psilocybin session. It was really powerful to share that experience with her. She reconciled with the idea that she was going to die from her cancer, and she hadn’t previously come to that conclusion.
As advice to anybody who is going to be doing this kind of research, I would suggest not assuming that you know what people will choose for their intentions, and don’t assume that just because they have a diagnosis of stage-IV cancer that they have accepted the diagnosis as terminal. Journalists will do that sometimes. They’ll describe participants in a study as “terminal cancer patients” or as “cancer victims,” but the participants may not have accepted that prognosis yet. It’s always more appropriate to use the terms advanced-stage cancer or metastatic cancer. Not everyone who participated in the study had concluded that their cancer would be terminal.
This brings up an important point. I had to be mindful about clarifying the purpose of the experimental treatment. There were times—and it was always difficult to accept— when some individuals were unable to conceal harbored desires for a miracle cure for the cancer. I had to be diligent about confirming with them that this was a psychiatric study for anxiety and that we were not attempting to treat the cancer. Some participants would hear that disclaimer and, maybe rightfully so, say something like, “Yes, but if my mood improves I may be able to live a little bit longer. Or I might have a better quality of life that will make my body stronger, so that I can survive a little longer.” I didn’t try to suppress that perspective if someone already had it. Responsible researchers have to be very clear about what they are attempting to influence in experimental cancer anxiety studies with psychedelics.
The only thing that I can attest to is what some participants reported about improved quality of life for their remaining time. A few speculated with questions such as, “Did I outlive my prognosis? Did I live longer than the doctors expected me to because I did this?” We couldn’t draw any conclusions, but we did have participants talk about how the time they did have left was improved in a variety of ways.
Because it was my first time working with this population, I had naively assumed that everybody in the study was signing up because they were scared of dying and that concerns about mortality would be foremost.
I thought that people were afraid of the pain, or that they were afraid because they didn’t know what to expect after death. With people who had accepted that they were going to die, there often were more immediate concerns that they were seeking support for. One example would be improving the quality of their relationship with their significant other.
For some of our participants, the anxiety that they were experiencing with the cancer was having a detrimental effect on their relationships. Because they were so consumed with anxiety, they were tense and agitated all the time—which led to a lot of bickering and friction with their partners. Some subjects attributed improved relationships to the psilocybin experience. They said it helped them to let go of some of that anxiety that was overwhelming every aspect of their personal lives.
I’ve learned that it is possible to have a cancer diagnosis and not fear death. Fearing the dying process, the pain, the saying goodbye… of course, that’s natural. But it is possible to not fear death, at least for periods of time, after a cancer diagnosis. If you’re afraid to go to the dentist, then you’re going to be afraid of dying, but the quality of what is actually frightening when facing death, that perspective is what shifted for me. The insight I gained was that the time between receiving a diagnosis of a terminal illness and the moment of death can be much more than just waiting for death and enduring physical and emotional pain. It does not have to be wasted time. I learned that human beings are capable of finding meaning in their lives and extending love to others until they draw their last breath. That final period, the last chapter in a biography, can be profoundly transformational and have deep, deep meaning, if a person does the work. Or it can be a time full of terror, regret, and distancing from people you’re close to. What I learned was that we have a choice to make meaning as long as we’re alive and that the moment of death can be a peaceful transition. And psychedelics can play a supportive role in finding that deep meaning and sense of peace.