CK's Journal

Psychedelic healing at the end of life (workshop at Unify Festival, Colorado, 2013. Disclaimer at end of post)

Thus shall ye think of all this fleeting world:

A star at dawn, a bubble in a stream;                                                                     

A flash of lightening in a summer cloud;

A flickering lamp, a phantom, and a dream.

From The Buddha’s Diamond Sutra

Introduction

Thoughts from The Bloom video: If these gatherings really are transformational, then we’ll take values and revelations from here to our community, integrating in our lives… for example, community gardens, art, conscious living, right livelihood, gardening, caring for neighbors, friends, and especially family, and so on.

From Evolver Network: These transformational gatherings, festivals, meetings – these scenes feed one another, “inspiring a spiritual underground that is making the connection between visionary experience and social engagement.”

Something about my experience:

I was 13 months in heavy combat. When I came home from the war I turned on. One night, on LSD, lying on the mattress on the floor, I had a healing vision. I knew I could be healed! I lived a hippie lifestyle for ~5 years, but kept feeling like there was more…

I started nursing school in 1973 and later completed several graduate programs. I retired as a family nurse practitioner a couple of years ago. Worked for much of the past 40 years in hospice, primary care, community health (focus on refugees and immigrants), and in education. I’ve studied and I’ve written on end of life, especially in symptom management and other aspects of dying and death, including spiritual care and cultures. I’ve been with a number of people throughout the process of dying and have worked really hard to be good at what I was doing.

The most important ones to me personally were my wife and my mother. All this to say, I have real-world experience and knowledge of dying and death.

Specific to psychedelics, I’ve sat with a few people who have taken these medicines in the context of the end of life – including my Mom. And of course, my own personal history. So I’m at an intersection of psychedelic and mainstream medicine. And I’m also at an intersection of the straight world and this psychedelic, transformative world.

I’m here as a representative of the Multidisciplinary Association for Psychedelic Studies and for Atrium Obscurum.

Here we are, at this transformational gathering, all of us somewhere on a continuum of our own transformational journey, our own becoming. I give thanks for this.

We’ll be talking mostly about the end of life with a focus on psychedelic medicine and on the question of what to do when someone you love is dying.

Every person here will have the opportunity or duty to help care for a loved one who is dying. There is a very good chance that someone here, now is involved with caring for someone at the end of life.

End-of-Life

One of the first people to address the way we die in America said that as a culture we don’t know much about dying and death. He talked about a need for guides, for maps as it were, into this uncharted part of life. I wasn’t consciously thinking about what he said when I wrote this a few weeks ago:

In the early days of hospice we knew we were in uncharted waters.

We were doing something new, something beautiful.

It was visionary.

 We were in the valley of the shadow of death.

 Every day, all day.

It was all a vision – something like hospice as we did it doesn’t emerge from ordinary consciousness.

Like I said earlier, we will ALL have an opportunity to go into that valley with a parent or sibling – some of us will go with a spouse or lover – a few, I’m sorry to say, will go with a child. Our psychedelic experiences help prepare us for this.

Let me tell a story about going with another. Taught courses on hospice and palliative care at several universities and elsewhere. One day a student told about when her sister was terminally ill. They slept in the same room, in twin beds. One night her sister said, “I’m scared.” And my student said, “I am too” and got into bed with her sister. They slept in the same bed for the rest of her sister’s short life.

She didn’t say, Oh, don’t be scared or it’s going to be alright or nobody really dies or any of that rot. She said THE TRUTH. Me too. Her question to me was, did she say and do the right thing? She said she’d worried about it for years. I said, Yes, oh yes. It was The Truth. I’m scared too. Being in the truth gave her sister and her the freedom to not pretend, to not lie, to face the fear – TOGETHER – me too.

I’m going to give you some practical information. Many of the presentations at these gatherings are about changing or realizing or growing consciousness. This isn’t really about that, though if you’ll practice what we talk about today, there will be a change and realization and growth in consciousness.

But really, what I have in mind is a answer to the question that goes something like this: I’ve been high, I’ve had visions and experiences of the Oneness of All, of Infinity, of the darkness and light of my own Soul – So, now what?

One thing is a fuller participation in life, including at the edges of life, like at the end. An ancient thing: Caring for the wounded, for the dying

Process of terminal illness: Suspicion, Dx testing/imaging, Dx cancer or degenerative neurological disease, whatever – and suddenly you’re in a different dimension as surely as if you’d dropped acid. There is treatment, which is often very, very difficult; hopefully remission; recurrence, more treatment. Eventually, for some, BUT not all, further curative or even delaying treatment is futile.

Common physical problems: pain (more on that a little later), N/V, SOB, fatigue, and so on. INTERWOVEN with the physical problems, and sometimes actually driving some of those problems are other problems such as:

Anxiety

Depression

Spiritual distress

Family discord

and so on.

Don’t think that depression or spiritual distress at the end of life are only about dying or being dead. They are also about dying in relation to life. Was my life fulfilled? Was there love? Did my life have meaning?

Early on noticed that often people with the most to lose in terms of loving relationships, rich spiritual lives, and so on often are the ones who have the easiest dying …

Four Tasks – to help in understanding your Mom or Dad or grandparents – remember I talked about having a map, a guide? Well here is a bit of a map – a map to understanding more of what the person is living with – to give us clues about what is going on and what we might do in that confusing matrix of terminal illness.

1. Deal with physical problems. We live in a culture that sees it like this (quoting now): “From what I’ve seen, the final days are not marked by clarity, but endured in a haze of morphine that ineffectively stabs at unbearable, gut-wrenching pain. Sorry if that sounds brutal. My beloved brother is in his final weeks, being eaten alive from the inside out by cancer…” Hear me, please. Mainstream medicine can do very well in pain management, especially at the end of life. Sometimes the patient needs an advocate to remind staff that pain is to be treated preemptively – meds taken on schedule and in sufficient amounts so that pain doesn’t keep coming back – pain is thus prevented.

2. Prepare for separation (life, body, loved ones, hopes, fears, illusions, future…) – it’s so sad, imagine, losing this… dreams unrealized… loves…

3. Manage the prospect of transition to an unknown state (people of faith have answers, but even then we sometimes wonder, what next? What if there’s just nothing)?

4. Look at how life was lived in relation to what might have been – MORE DISCUSS – if you had your life to live over again – if …

Here is a nice tool for the process. Nearly everyone has these three questions in the process of life-threatening illness:

What is it?

What does it mean (suffering, pain, etc.)?

Can I do this?

And we answer the third question with our loving presence, Yes. And I’ll be with you.

The first psychedelic model we had was Aldous Huxley, whose wife gave him several injections of LSD in the last hours of his life. Fine. But the real process started years before, in his journeys on mescaline, psilocybin, and LSD; the process started with a conscious decision to live consciously, changing consciousness, the ongoing work in becoming – just like the people sitting all around us right now.

Aside: Laura Huxley was a pioneer in consciousness in her own right, including related to dying. Did some interesting experiential exercises, some of which remain in use today. Further aside: Since the 1970s Ram Dass was heavily involved in this effort to bring compassion and consciousness into the way we die. In fact, he was still a hospice volunteer, the last I heard two years ago.

The current (medical) model is active in studies at Johns Hopkins, UCLA, and elsewhere. In general, patients who are dying and having significant anxiety and/or depression are given low-moderate doses of LSD or psilocybin. Psilocybin is a mainstay because it combines righteous psychedelic experience with a fairly short duration of action.

Therapy similar to treatment with MDMA, except there is less pre and post work, and the patients all die.

Set & setting important – often in a hospital room with photos of loved ones, holy or inspirational books, wall hangings added, non-sick-room flowers, music, no TV, etc. ALTHOUGH, there are patients in early stages of the disease, which, of course, is a wonderful idea, so these patients would have out-patient session.

Dosing low to moderate doses

Male and female therapists

Patient lying down, eyeshades, music

Non-directive. Everyone knows why we’re here. Let the patient set the pace.

Touching – less than what you might think. Cultural taboo is psychiatry

Body work, such as resistance for patient to push against (Zeff); breathwork (like holotropic)

8-10 hours

Integration afterward

Recall the tasks I noted earlier: deal with physical symptoms, prepare for separation (think in terms of grief and loss), prepare for transition to an unknown state (anticipation or fear; no more me!!!), and integrate how life was lived in relation to what might have been.

Talk about putting catheter in woman and she’s talking about mastectomy 40 years ago.

Sir Galahad dying in his King’s arms: “It’s the old wounds, Arthur.”

Van Morrison sang, “Oh John, the great sadness.” The sadness is so great that we wall it off, put up defenses, act it out… These medicines slash through that. We see our sadness and grief, our ugliness, our dishonesty, our trivialities, all of that stuff – and, MY GOD, our beauty, our trueness, our potential.

Outcomes with psilocybin or LSD are generally about what you and I would expect: decreased anxiety, decreased depression, increased hope and positive outlook, decreased pain, improvement in relations with others, and of course improvement in relations with SELF.

Opening into life, dying as awakening

Many people die as they lived (angry person, trivial person, manipulative, open, loving, and so on)

Some awaken. A few say, I never really lived until I started to die.

What this can be is transforming. That’s what we’re talking about.

With my Mom, all was forgiven, embraced, there was a decrease in pain and an increase in everything good.

Models

It’s never too soon, and seldom too late to start living consciously. So the process would start with living a little more consciously – little kinder to self and others, little less TV, little bit better food, dance, love, and so on.

Rather than start when there is clearly a problem, start in the period around diagnosis (remember that huge change in consciousness) with, FOR THE PATIENT AND LIFE PARTNER, an MDMA session because we do this stuff, living and dying, in relation to others. Imagine, instead of lost in fear and uncertainty, opening into one another, opening into life, facing the grief and fear together, together like never before.

Purpose of life

Reconciliation with God, with others, with self. Born to be healed

Future Directions

Feels like a psychedelic renaissance to me. Who knows what all is happening out there with the medicines we’ve discussed, not to mention medical marijuana, ayahuasca, ibogaine…

We can look for more research and certainly more grass roots or underground efforts. There is an amazing array of research chems out there and the shackles around marijuana use are loosening. Hopefully we’ll see a continuing shift in perception of these substances, and also availability. The Guild of Guides is closer to reality.

So I think individuals will make individual efforts, giving parents and others the opportunity for growth and awakening.

And if parents and others are unwilling, well then, we have ourselves, our insights, our visions and revelations to fall back on.

One reason I got back into psychedelics was that I’m really pretty close to death. And I was thinking I’d better have some psychedelics around for my time of dying. Health event 50-50 chance of living or of dying. And I realized, I’m okay. I don’t have faith; I have experience. What a Revelation!

———————

There are formal programs of study available, such as:

Sofia University, Palo Alto

California Institute of Integral Studies, San Francisco

Heffter Research Institute, Santa Fe

Multidisciplinary Association for Psychedelic Studies (MAPS)

———————

Read

Lord, make me an instrument of your peace.

Where there is hatred, let me sow love.

Where there is injury, pardon.

Where there is doubt, faith.

Where there is despair, hope.

Where there is darkness, light.

Where there is sadness, joy.

 

O Divine Master, O Mother of All, O Great Spirit

grant that I may not so much seek to be consoled, as to console;

to be understood, as to understand;

to be loved, as to love.

For it is in giving that we receive.

It is in pardoning that we are pardoned,

and it is in dying that we are born to Eternal Life.

Amen. (From St. Francis of Assisi, with modifications)

 

 

Disclaimers: I am not suggesting that anyone do anything illegal and I’m not promoting any particular religion.