William Richards on Psychedelic-Assisted Psychotherapy and Mystical Experiences

William Richards on Psychedelic-Assisted Psychotherapy and Mystical Experiences

by David Bullard

Psychologist William Richards discusses his research on psilocybin-assisted psychotherapy for dying cancer patients, and the larger trends to legitimize research and use of psychedelics for alleviating suffering.
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Psychedelic Healing and Research

David Bullard: I’ve enjoyed our several conversations, Bill, heard several of your talks, seen you interact with students and colleagues, and have learned deeply from your recent book, Sacred Knowledge: Psychedelics and Religious Experiences; it filled so many gaps for me in how we see consciousness and psychotherapy. Plus, this has all been augmented with your articles in tribute to Abraham Maslow and on psychedelic psychotherapy published online in September 2016 in the Journal of Humanistic Psychology.

But even more recently, the December 2016 issue of the Journal of Psychopharmacology published the results of your study at Johns Hopkins and of the similar research reported by the NYU team, showing very impressive results in the use of psilocybin for the treatment of people with cancer who were experiencing existential anxiety and depression. These two studies have been described as “the most rigorous controlled trials of psilocybin to date.” The issue also includes penetrating commentaries from ten notable psychiatrists and neurologists. As stated by the issue editor:

“All agree we are now in an exciting new phase of psychedelic psychopharmacology that needs to be encouraged not impeded.”

The re-emerging study of psychedelic research really hit home for many with the beautifully written article in The New Yorker by Michael Pollan, “The Trip Treatment,” giving a historical perspective on the resurgence of research and the therapeutic role of psychedelic medicines. I was astonished at how positive it was for such a mainstream publication. Pollan quoted you in it, concerning whether people get an illusory or “real” experience of mystical consciousness. Citing William James, you suggested “that we judge the mystical experience not by its veracity, which is unknowable, but by its fruits: does it turn someone’s life in a positive direction?”

Can you talk a bit about your research on psychedelic-assisted psychotherapy and the potential entheogens have to accelerate treatment and facilitate transcendental spiritual experiences?
William A. Richards: Well, I’ve been at Johns Hopkins School of Medicine doing research and clinical work for the past 17 years, but I started out in college intending to be a minister. I studied philosophy, psychology and sociology, then completed a first year of graduate studies at Yale Divinity School, followed by a year of studies in both theology and psychiatry at the University of Göttingen. There I naively volunteered to be a research subject and received a drug I had never heard about called psilocybin for the very first time, having heard that it might provide some insights into early childhood. That triggered an awesome and amazing transcendental experience that I wrote about in my recent book.

I then returned to the States, completed the degree at Yale, studied the psychology of religion with Walter Houston Clark at the Andover-Newton Theological School, and then became a research assistant to Abraham Maslow at Brandeis. After that, I accepted a job at the Maryland Psychiatric Research Center doing psychotherapy research with a variety of psychedelics including LSD, DPT, MDA and psilocybin. To further that work I continued my graduate studies at Catholic University to obtain my doctorate and become licensed as a clinical psychologist.

In 2006 our team at Johns Hopkins published our first psilocybin study, utilizing normal volunteers who had no prior experience with psychedelic substances, and the results were impressive.
We found that 58% of the 36 volunteers rated the experience of the psilocybin session as among the five most personally meaningful experiences of their lives.
We found that 58% of the 36 volunteers rated the experience of the psilocybin session as among the five most personally meaningful experiences of their lives, and 67% rated it among the five most spiritually significant experiences of their lives, with 11% and 17%, respectively indicating that it was the single most meaningful experience, and the single most spiritually significant experience. A follow-up study, published in 2008, indicated that attitudinal and behavioral changes were sustained.


Most recently, our study with cancer patients showed psilocybin produced large and significant decreases in clinician-rated and self-rated measures of depression, anxiety or mood disturbance, and increases in measures of quality of life, life meaning, death acceptance, and optimism. These effects were sustained at 6 months. The study at NYU showed similarly robust results.

So what comes to mind is a growing awareness that this field may really become mainstream. In mid-October I was at a conference in Victoria, British Columbia, with 150 really bright, young mental health professionals and boy they are serious about what needs to be done practically to change the laws in Canada so therapists who are properly trained can use psilocybin and other entheogens in their practices. They’re not thinking 50 years from now, they’re thinking five years or sooner. And why not?

And then in early December in San Francisco, you observed the ceremony for 41 therapists and medical personnel who completed an exciting new eight-month training program, the “Certificate in Psychedelic-Assisted Therapies and Research,” directed by Janis Phelps at the California Institute for Integral Studies (CIIS), where I consult and teach as well.

The program is groundbreaking and so important, since multicenter, phase 3 clinical trials are about to be funded for the use of psychotherapy using psilocybin for end-of-life issues and with MDMA for PTSD. Research also continues with psychedelic substances for treatment-resistant depression, alcohol, cocaine, narcotic and nicotine addictions and social anxiety. The CIIS certificate program will provide wonderfully aware and trained personnel to participate as the guides in this important research, both in the US and in other countries. ... Continue Reading Interview >>
DB: I greatly enjoyed witnessing the passion and dedication of the students and faculty at the graduation; it was a beautiful ceremony.
WA: One participant in the program, Dr. Robert Grant, is a physician and a full professor at UCSF who has pursued research with AIDS/HIV and, among other things, is very interested in AIDS survivor syndrome—people who aren’t dying from AIDS now but are often chronically depressed and living with the threat of death over their heads all the time if they don’t take their medication.

There are some very well established clinicians who decided to become students in that program in order to obtain this certificate in case it helps open doors to initiate or contribute to research down the road.
DB: You’ve used a wonderful metaphor of music to describe this profusion of recent events.
WA: Ah, yes! Well, when recently asked how I felt about psychedelic research and clinical work from my historical perspective, I replied, “Most of the time I have music going through my head—and right at the moment it’s the Prelude and ‘Liebestod’ or ‘love death’ from Wagner’s Tristan und Isolde.”

It’s very expressive, romantic, soaring music. And then, as the end of the Prelude approaches, it dies down and gets quieter and quieter. And then there's dead silence. I think there are just a couple plucks of strings, and more silence. And then the theme comes back, very softly at first, and it builds, and it builds, and it builds. And it gets bigger than it ever was in the beginning. It returns even more magnificently than before.

My response was to a question about the way the research has developed: when it started to expand in the 1960s, it was a theme with incredible promise for helping to relieve suffering, and then it became very quiet because of the 1970 legal prohibition and all, and now the research is coming back quite strongly. That music is a metaphor for where the research and the field have been and, following a dormant period of 22 years, where they are right now.
DB: And you’ve even created a playlist for psychedelic studies. It looks like a wonderful compilation to listen to, even without psilocybin!
WA: My son Brian and I had a delightful time putting it together. It is based on many years of experience with an impressive variety of people.
DB: Going back to the just-published psilocybin research: The results are extraordinary for any therapeutic intervention, let alone one that consists of just a few meetings pre and post, and one active psychedelic session with very vulnerable people.

The journal issue includes some excellent supportive commentary on your research that I found very helpful, such as one by Stanford psychiatrist David Spiegel, “Psilocybin-assisted psychotherapy for dying cancer patients—aiding the final trip."
WA: We were very gratified by his and the other commentators’ contributions. It is certainly another milestone in demonstrating the gifts that these experiences facilitated by the skilled use of psychedelics can bring. Everyone involved in this work is dedicated and appreciates how profoundly meaningful these experiences can be for many people.
DB: Do you know how many centers they’re going to need for phase 3 clinical trials to build upon your psilocybin research? Definitions of phase 3 that I’ve seen range from 300 to 3,000 subjects.
WA: We don’t have those numbers yet. We expect to discuss this with colleagues at the FDA soon. But there are countless other research projects that can be done as more and more universities start coming on board. Hopkins may be the beginning, the Mecca, but things are happening far beyond Hopkins.
DB: Including at UC San Francisco; I know that Brian Anderson, MD, had a proposal recently funded to utilize psychedelics in a group therapy format for HIV/AIDS patients.
WA: We keep doing the best-designed research studies we can come up with and it’s spreading. All of a sudden it’s socially respectable to do psychedelic research again, when not long ago many people wouldn’t dare touch it for fear of ruining their careers. Now it’s becoming mainstream and being applied to different populations of patients including “well” people, for that matter. Bob Jesse, who helped to facilitate the initiation of psilocybin research at Johns Hopkins 17 years ago, talks about the use of entheogens in promoting “the betterment of well people.” It looks like these drugs really are fundamentally safe for most people when they’re used responsibly with good preparation and when skilled guidance is provided to facilitate the initial integration of the insights that occur during the period of drug action.

And since it can accelerate and deepen psychotherapy for many people, why should this not be a tool available to the profession? It’s a bit like asking, “Should we allow astronomers to use telescopes or microbiologists to use microscopes?” Well, for the mental health world and perhaps the religious world too, here’s an incredibly effective, powerful tool. And sure, we have to use it skillfully and wisely but why shouldn’t it be legally accessible?
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Awe and Transcendence

DB: You go beyond the psychotherapeutic goal of symptom reduction and restoring someone to a culturally defined “normal” state of mental health. This therapy can increase the capacity for awe and a deeper sense of interpersonal connection, transcendence and feeling at home in the world.
WA:
Normal for some might be drinking beer and watching television. As human beings, it’s not necessarily all that wonderful to only aspire to that.
I suppose that was inevitable after studying with Maslow. He took me on as his research assistant when a dean at Brandeis got cold feet about accepting me as a graduate student with research interests in psychedelics. It was a great opportunity to learn from him. I remember him saying that the early stages of self-acceptance involve coming to terms with grief, guilt and anger, and relationships with parents and siblings and so on. And that’s important, of course.

But that’s kind of the kindergarten. And then you move to coming to terms with your capacity to love, your creativity, your tolerance of different ideas and perspectives on the world—the whole process of self-actualization rather than adjusting to whatever “normal” is. Normal for some might be drinking beer and watching television. As human beings, it’s not necessarily all that wonderful to only aspire to that.
DB: Maslow was even talking about transcending “self actualization.” These are pretty immense subjects to tackle in this brief interview, but you’ve written about Unitive Consciousness and about space and time in the book.
WA: I wrote about transcending time and space as part of the experience of mystical consciousness. It is always a tall order to capture the Divine in language. Immanuel Kant pondered the mysteries of time and space long and hard back in the eighteenth century. Many others, including Huston Smith, have written eloquently about this.

When in some sort of altered state that we describe as mystical or transcendental, what is perplexing is that people often claim not only that they were distracted or unaware of the passing of time, but that the state of consciousness they were experiencing was intuitively felt to be “outside of time.”

Many of our research subjects have reported such experiences, and I’ve explored it in the book over several chapters. These are all extremely exciting and vital topics to pursue.
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Skeptics

DB: You’ve probably had plenty of experience in discussing these issues with skeptics and probably studied the ancient skeptics who classically have been attacked on their major thesis that knowledge is not possible—a rather self-refuting assertion!—but when anyone discusses or writes about mystical experiences, they might be seen as being on pretty thin ice by the more empirical rationalists among us. How do you answer these critiques?
WA: Well, I write extensively about this in the book, but in this discussion I can say that these experiences entail more than emotion—however exalted and elevated the feelings may be. Mystical experiences explored in both the literature of each world religion and in modern psychedelic research, are also claimed to include knowledge.

William James, the Harvard psychologist who published The Varieties of Religious Experience, described it as “beholding truth.” In contrast, Freud had trouble comprehending this aspect of mental functioning and called it “the oceanic feeling,” a term for mystical consciousness that had been coined by a French novelist, poet, and mystic, Romain Rolland.

Freud himself devalued the import of the experience and interpreted it as a memory of union with the mother’s breast before the individual self or ego developed. Yet even he acknowledged “there may be something else behind this, but for the present it is wrapped in obscurity.”

In spite of the apparent efficacy of some visionary and mystical experiences in psychotherapy, I also want to stress that there is also the potential efficacy of psychedelic substances in accelerating psychotherapy within the realm of the ego, often with dosage too low to provide access to mystical forms of consciousness. These experiences are important in their own right, though they may not be described as transcendental, religious or spiritual. In the 1960s a number of European therapists were using psychedelics to accelerate more conventional psychoanalytically-oriented therapy, often administering psychedelics on several occasions during each week of treatment.

Maslow was very interested in my psilocybin experience in Germany as a research subject, but he had a cardiac problem that kept him from pursuing this personally. As noted earlier, I wrote about my time with him in that recent issue of the Journal of Humanistic Psychology. It was a kind of tribute to him and a joy to write and recollect. I’m so grateful for the mentors and other people I’ve been able to know and work with: Huston Smith, Walter Houston Clark, Hanscarl Leuner, Charles Savage, Walter Pahnke, Stanislav Grof, and many others with whom I currently get to interact. Sadly, I just received word that Huston “fully woke up” this morning. I will miss him and find myself grieving—a rich combination of gratitude and sorrow. He was the last of my living mentors. Now we (and an increasingly robust community of other pioneers) are standing on the top of the mountain.
DB: I count 74 colleagues, friends and others who’ve inspired you in the “Acknowledgments” section of your book. So you have found a very meaningful life exploring these understandings with others.
WA: That’s why I can’t retire; it’s too much fun; it’s too meaningful; it’s joyful. And when I look back on my life, I think there were many times when I was wandering academically through sociology and psychology and music and philosophy and comparative religions. People probably looked at me and thought I was just one lost kid. Like, would I ever make a decision of what to commit to?
DB: Yeah, “why don’t you settle down?”
WA: When I look back on it, it was ideal training for becoming a psychedelic therapist or researcher, but I didn’t even know the word “psychedelic” back then. Music really wasn’t a detour at all; it was central to what I was doing. The study of comparative religions was central to it as was the study of depth psychology and it’s like I knew what I was doing unconsciously.

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Psilocybin and Cancer

DB: Back to your point about the old worry that having clinical and research interests in psychedelic medicines could threaten one’s career: Ninety researchers and clinicians from UCSF, UC Berkeley, Stanford, and the California Institute for Integral Studies showed up to hear your talk about psychedelics a few months ago and also for another earlier discussion with Françoise Bourzat, a therapist who’s been doing this work for about 30 years. She takes people to Mexico outside of Oaxaca where she works with a Mazatec elder. She creates therapeutic support and integration for the people, and together with her Mazatec teacher, guides them through the ancient ritual of sacred mushrooms.

But for greater acceptance and legality, there will have to be empirical studies following up yours further validating their safety and efficacy.
WA: Yes. The results of our recent research show some profound effects from the use of psilocybin for a selected group of cancer patients who were experiencing existential anxiety. After several therapy sessions for them to become comfortable with the co-therapy team, they had one session with psilocybin in adequate dosage, followed up by some appointments devoted to the integration of whatever new perspectives they had acquired.
DB: Can you brief us on the research design of your group?
WA: Both Hopkins and NYU utilized double-blind, placebo-controlled crossover designs. At Hopkins the control substance was a very low, placebo-like, dose of psilocybin; at NYU nicotinic acid was administered.
DB: So, were there any particular new perspectives that were commonly attained and helpful across subjects?
WA: Though every person’s experience is unique, many reported new understandings of a religious or philosophical nature as well as helpful insights into their own lives and interpersonal relationships.
Those who encountered mystical forms of consciousness frequently claimed not only reductions in depression and anxiety, but also loss of the fear of death, coupled with increased openness and curiosity about life.
Those who encountered mystical forms of consciousness frequently claimed not only reductions in depression and anxiety, but also loss of the fear of death, coupled with increased openness and curiosity about life.

And there’s work going on in Europe to move towards the legal use of psychedelics, especially in palliative and hospice care. Very bright researchers were recently collaborating at the European Medicines Agency—it’s their equivalent of our FDA—working together to determine which data are needed in order to make a drug like psilocybin accessible. And what training do you need to enable therapists to use it safely and responsibly. They’re involved in very practical considerations. So, things are moving out there.
DB: Definitely. I met recently with a visiting Zen teacher, Vanya Palmers, who helped with a recent University of Zürich double-blind study where, on the 4th day of a 6-day retreat, participants who were long-term meditators got either psilocybin or placebo. Each subject had fMRI imaging before and after and completed follow-up questionnaires. Results haven’t been published yet but are bound to be fascinating.
WA: Here in the States, of course, Dr. Rick Doblin’s group MAPS (Multidisciplinary Association for Psychedelic Studies) has since the mid 1980s been funding research and education in this area with the hope that some of these medicines, like MDMA, might be approved so that medical professionals could prescribe them as early as 2021.
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Enhancing Psychotherapy

DB: Given the apparent effectiveness of a single or just a few of these entheogen sessions in a psychotherapeutic context, how do you see psychotherapy changing to utilize them?
WA: Basically I would say—with no apology—that psychotherapy is an art as well as a science and the being of the therapist is very important as well as the collection of techniques and procedures he or she has memorized and internalized. You can’t do psychotherapy to someone; it’s a process that unfolds in the context of a trust-filled, courageous, committed human relationship; that is, if you want to really accomplish something significant in terms of personality growth or development.

For the clinical use of these medicines, ideally we would have eight hours of preparation. That may be a little more than some people need and a little less than others. But, if in those eight hours you can’t establish an intuitive sense of interpersonal grounding and trust, then I wouldn’t give someone a psychedelic. There’s an intuitive judgement that there’s enough trust here and I’m committed enough to be with this person for the period of drug action whether I’m needed or not. But I can be in a mental space that is completely dedicated, completely accessible, and completely available to that person, especially during the onset for the intense period of drug action.

If the person’s anxious I’m here to provide support; if they just need freedom and privacy and respect I can provide that instead. I’ll make sure they don’t injure themselves physically if they’re off balance and they have to go to the bathroom or something—very practical things. I’ll provide the best supportive music and periods of silence now and then that may be indicated and just let it unfold. It requires evoking and providing the conditions in which the person’s own mind can manifest and heal itself.

And even if there are periods of anxiety or fear to navigate through, we welcome those as well. “In and through, in and through” is the mantra. If an inner dragon, boogeyman, or monster should reveal itself then we go right straight towards it as rapidly as possible and say, “Well, hello. Aren’t you big and scary! What can I learn from you?”

And so instead of running away and getting into panic and paranoia and confusion and even perhaps needing to go to a psychiatric emergency room, you look it straight in the eye and say, “Boy, you’re an ugly part of me but what are you made of?” And when you go towards it, inevitably there’s insight. As you know from psychotherapy in general, the monster turns into the alcoholic father in the middle of the night, or turns into the person who sexually abused you, or turns into some personification of your own guilt or unresolved grief or fears, or deep, dark sources of shame or whatever it is.

But when you go towards it there’s always healing, and insight, and resolution. And what you wanted to run from one moment you can laugh at minutes later. Like, “How could I ever have been afraid of that??!! That was only my drunk father in the middle of the night when I was a little boy,” or whatever it is.
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What Devils Hate the Most is Being Embraced

DB: Well, it’s reassuring to know that voyagers like yourself who have been there with people going through it so many times can, with complete confidence and clarity, make that statement that you can face these demons.
WA: In some psychoanalytic circles there’s this tradition of being afraid of revealing too much too soon. Such that you have to precede very, very slowly and gingerly, four days a week, sometimes for seven years!

But I’m convinced these medicines can be used safely and effectively—having had these clinical research opportunities for decades now, working with several hundred different people—and hardly any of them have been so-called “hippies.” They’re just normal people: cancer patients, or alcoholics, or narcotic addicts, or depressed people, or anxious people, or they have personality disorders. Some have been mental health or religious professionals in an educational context. Generally, they’re people who never would have been interested in psychedelics if the opportunity to receive one hadn’t been offered as part of medical treatment, education or research. Some were eighty-year-olds from the inner city dying of cancer; not the hippie type—not the stereotype of the psychedelic user at all. And I have to say just about all these people have benefited.

I’ve come to believe that if there’s anything they’re not ready to deal with yet it won’t even come up, not even in a psychedelic session.

And if it comes into consciousness, to me that says they’re ready to deal with it—that this is an invitation and if it comes to you, greet it. It may be the uninvited guest but it’s the guest. And you meet it. I always say what devils hate most is being embraced. They’re like kids in Halloween masks—but then the game is up, and you realize the false front of the terror.

When you go towards the fear there’s growth and insight and resolution. But you need to be grounded in a good relationship with a therapist or someone you really trust, or in the depths of your mind perhaps if you’re spiritually developed enough. There’s this courage, there’s this intention to greet, to welcome, to embrace whatever comes into consciousness. And with that there’s a willingness to suffer.

It doesn’t have to be a “good trip,” you know, especially if “good” just means getting high and laughing and feeling that everything’s cool.
It doesn’t have to be a “good trip,” you know, especially if “good” just means getting high and laughing and feeling that everything’s cool. Personal growth is sometimes hard work, and spiritual development takes you through the dark night of the soul sometimes. But with that intention to welcome whatever comes into your field of consciousness and accept it, and wrestle with it, and go through it, people invariably emerge with a feeling of inner strength and confidence, and significantly decreased anxiety at the end of the day.
DB: One mentor of mine, the psychoanalyst and Control Mastery Theory co-developer Hal Sampson, would often say that you can reassure people who have articulated something like, “I’m so ashamed about x, y z, that I’ve never told anyone before,” that their being able to say it out loud to you absolutely means that it’s not as powerful as it was before they could even utter it.

But, you’re taking it a step beyond that by your reassurance that anything that comes up even in a psychedelic session—from your experience—is something that means it’s ready to be dealt with. That’s very useful.

I’m remembering a time with my son when he was 7 years old, and in response to his worrying, I said, “well, whatever goes on in your brain is never going to hurt anybody else and whatever you see or imagine…” He said, “What?? Say it again!” I said it again and he suddenly physically relaxed and went, “Ahhhhhhhhhhhh.”

It’s similar to when I hear you affirming that whatever can come up can be dealt with. And it helped me understand too how we’re used to thinking of traumatic memories coming up and then people being engulfed in them, what some colleagues call a “trauma suck,” but with psychedelics it’s a kaleidoscope, things are going to be shifting and changing.
WA: You triggered a wonderful memory with one of my own sons. On Halloween we were at an amusement park and in one of these rides where you get in a boat and you slowly move through this dimly lit river with dry ice where everything is setup to look spooky. And, as we were going around a curve, there was this girl in a witch’s costume, her back against the wall, just waiting for the moment to jump out and try to frighten us. And Brian must have been six years old and he just jumped up and scared the witch a split second before the witch did her thing. And the poor girl almost fell in the water. But that’s the principle, you know: “If you can scare the witch you’ve got it made!”
DB: There are some therapists and researchers who espouse “exposure and response prevention” and “prolonged exposure” in the treatment of trauma and anxiety. A friend of mine is involved in researching this for the Departments of Defense and Veterans Affairs. But a couple of people I knew just couldn’t tolerate the protocol that they had and so they dropped out, but I have a new appreciation for it in a way by what you’re talking about—of going into it.

The key must be to make sure they have all the tools to make it safe enough—and I think that’s it—an experienced guide who knows it’s safe to go into these psychedelic shifts within consciousness.
WA: I agree. If the relationship is solid and the dosage is adequate so you can tap into what we call transpersonal realms of the mind, beyond the everyday self and at the border between the everyday self and transcendence. One thing we keep discovering, and it’s awesomely beautiful really, is that within the psyche there is wisdom about the way traumas or conflicts are presented to the ego for resolution.
Within the psyche there is wisdom about the way traumas or conflicts are presented to the ego for resolution.
It’s not that it’s just sitting there. But the very way it comes up and presents itself—when you interact with it—the way the mind depicts the process of resolution, it’s like a great novelist writing a very moving and effective story.

And we find these very creative resources within the human body but beyond the ego if you will, perhaps deep within our DNA somewhere. And if you go into the mind with courage, trust, openness, and interpersonal grounding, the experiences that emerge tend to be infinitely more effectively and more artistically designed than anything you could have planned in advance. If you think, “Oh, what this patient needs is to regress to age seven and address her relationship with her father,” you are being unnecessarily controlling and underestimating the resources within your patient. If you just go in with openness and trust, what emerges and what the person writes down after the drug wears off is awesomely effective for many and I suspect most people.

You don’t have to have a doctorate in English Literature, you know; it happens to very ordinary people. And the richness of the imagery and the storylines are very impressive.
DB: And I hear also what you’re saying about the importance of trust by both the person undergoing the experience and the facilitator or therapist, the trust that that’s there.
WA: We’re potentially saying,
“You may feel like you’re dying in this moment and go ahead, let yourself die; you’re going to be okay.”
“You may feel like you’re dying in this moment and go ahead, let yourself die; you’re going to be okay.” Or, “you may feel like you’re going crazy; that’s okay, go ahead, go crazy, we’re going to take good care of you; you’ll be okay.” That certainly takes a lot of trust because when you get into those deep states of consciousness they feel incredibly real, incredibly powerful.
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Transpersonal Psychology

DB: But in everyday life we seldom if ever hear those very powerful, positive, loving, supportive messages that whatever occurs in our own psyche, we’ll be OK.
WA: Right. We’ve got to talk more about these transcendental or mystical states of consciousness. When they occur they seem to be the most powerful factor in attitudinal and behavioral change. They literally change the self-concept. They change who you think you are, who you feel other people are, what you feel the nature of reality is, what the nature of the world is, and your sense of values may shift. That’s powerful stuff, you know? And we’re not used to talking about that; we leave that for the theologians. There’s still this whole reticence in psychology to even acknowledge what we call “transpersonal psychology.” I like to think of “trans” as meaning both “above and beyond” but also “between.” There’s a vertical and horizontal dimension of transpersonal psychology, but they’re both there and they’re both incredibly powerful and important.
DB: That’s something you articulate in the book so well—the sense of oneness, wonder and connectedness. I’ve seen something similar in couples therapy—when they think they’re angry at the other person it’s kind of an illusion because they’ve helped to create the other person who’s there, who is reacting to them as they are reacting to the other. When they see what a system they are in the accusations and guilt can greatly diminish. Many Buddhist concepts come to mind in what you’re talking about also.

Jinpa Thupten, a scholar and the long-time English translator for His Holiness the Dalai Lama, wrote his first book for the general public last year. And when he thought about the numerous Tibetan Buddhist teachings that he had learned, he decided to write about compassion as his main topic. And to me that’s a major part of the whole experience of growing spiritually—developing self- and other- compassion—whether it’s therapy or through transcendental states or other psychedelic experiences or some combination. All of these things merge into self-compassion and compassion for others—and then awe and joy of just being alive.
WA: Yes, and after the great mystical experience, however you want to try to put that into words, you come back to earth and the memory needs to be integrated. You chop wood and carry water. And you try to see the divine in your boss, in your spouse, in your kids, and in the people you disagree with. It’s a lifelong process.
DB: We’ve touched on this a little bit before but I think this thing called “psychotherapy,” at moments joining and looking into all these other human lives, is a counterpoint to meditation that involves looking into your own consciousness and beyond. And I know we’re both grateful we’ve been able to do that. You and I are both celebrating our 40th year of private practice—another synchronicity I enjoyed finding out about, as well as your sense of humor.
WA: I sometimes think of how the Jews, Christians, and Muslims who tend to be excessively serious and somber could benefit from the Hindu appreciation for lila, known as divine playfulness.
DB: Anything you’d like to say more about lila? We could use some of that appreciation for life after this terribly difficult election season.
WA: I’m having trouble myself imagining it. I picture this great beast coming out of the ocean and ask how do we confront it and care for it, and love it, and tame it, and appreciate the energy in it, you know, and not just run in terror.
DB: So, you’re saying that, similar to seeing something terrifying during a psilocybin session, when you would encourage the person to, that great term, embrace the demon who hates to be hugged, we have to find a way to deal with our political realities.
WA:
How do you respectfully stay centered and go towards what we label as bad, evil, or unpredictable, or scary?
How do you respectfully stay centered and go towards what we label as bad, evil, or unpredictable, or scary? It’s a real challenge and an art, I think, and maybe what religions are all about.
DB: And your background in comparative religions and the psychology of religion really informs your writing about the psychotherapeutic experience; it really is the culmination of your whole life’s work.
WA: It is, yeah. The book kind of wrote itself really. Hardly any rewriting, it just kind of flowed out during one year and there it was. Also, I’m more aware that I have a different verbal vocabulary than my written vocabulary. Sometimes I write words that I never say and speak words I never write. It’s just interesting, you know; like another part of the brain is in charge.
DB: So now I’m wondering about your sense of the experience of successfully working with trauma through psychedelic-assisted therapy compared to how we understand either prolonged exposure and response prevention or EMDR and somatic approaches. Any thoughts you’ve got about what happens to a person with trauma when they are in the entheogenic state?
WA: I suspect whenever therapy works there’s stuff in common among these different approaches. It may be labeled differently and be conceptualized differently, but there’s something very important about the courage to confront in a grounded relationship without running away and without panicking and just seeing it for what it is.

And perhaps coupling the intention to trust and confront with some breathing exercises or eye movements or whatever may be helpful. But it would seem to me the main theme is this confidence that in this relationship we call therapy there’s nothing we can’t deal with. You’re not helpless and this can be meaningfully resolved, not just vanquished. And in the big picture the flow of experiences might even enrich your life in some way.
DB: I see the distinction you just made between vanquished versus meaningfully resolved. It’s close to the difference between symptom removal and this transpersonal and even mystical experience that you believe can be or should be a part of psychotherapy for some persons.
WA: That’s right. I mean, you can hide under the bed and you won’t see the tornado coming, but I’m not sure that that’s curative. And it goes deep philosophically. Suffering and tragedy has its place; it’s an integral part of living. The image of the dancing Shiva that’s both destroying and creating comes to mind.
Transformation is not just getting rid of pain but finding meaning in pain.
Transformation is not just getting rid of pain but finding meaning in pain. That’s heavy stuff but it’s profound and it’s intrinsic to being human the way I see it.
DB: Maybe the short version from the Buddha is: out of suffering comes wisdom and out of wisdom comes compassion for yourself and for others.
WA: That’s right.
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Beyond Death Anxiety

DB: Another aspect of all of what we are discussing is the neurobiological studies of the brain with fMRI’s and other sophisticated scanning instruments. A 2014 study in London found that a dose of MDMA occasioned a drop in activity in the limbic system resulting in less fear. Other such exciting work found a quieting of the regions of the brain involved with the sense of self, especially the so-called “default mode network.” It is easy to be very curious about where all that is going. You’ve noted that correlation is not necessarily causation, and that the nature of consciousness still remains a tantalizing enigma.

Is there anything more right now that you think is helpful for the person who clearly has benefited from the depth of their insights, who feels that they have seen a more real reality and then have come back here? Anything you want to say about those experiences?
WA: Just how incredible are the therapeutic and spiritual outcomes for the diverse people who were terminally ill that I’ve given psychedelics to in our research. I recall people who considered themselves agnostics, or atheists, or Jewish or Christian, or those who never went to church or synagogue, or those who were piously there all the time. With all of them when they have this mystical type of experience there’s a change. Instead of fearing death they report something akin to curiosity about it. As in, “this is a new experience I’m going to have that everyone who’s ever been born has eventually had.”

The perceiver and the perceived somehow interact on a subatomic level and everything is perceived as energy and there’s this ultimate insight that we’re all ultimately the same.
Maybe it’ll be, as this one patient of mine expected, “just like a light bulb going out,” you know, or maybe I’ll encounter my ancestors and maybe I’ll visit hell, or purgatory, or heaven or all three. But there’s this kind of almost innocent openness replacing the anxiety. Essentially they say, “something’s going to happen and I wish I could come back and report, but it doesn’t work that way.” And beyond that is this intuitive conviction for those who encounter mystical types of consciousness that it’s not an issue of personal immortality—whether my little ego is going to continue to survive or not. Instead, an intuitive conviction is often expressed that there’s something incredibly magnificent and eternal and trustworthy that’s not going to go away.
DB: It’s so beyond the personal ego.
WA: Yes.
DB: “I don’t have to worry about my little self, there’s this fantastic, beautiful thing out all around us, in us, outside of us.”
WA: “…that is in control. I don’t have to be in control.”
DB: I recently was thinking that when I die, my own personal experiences of joy, awe, excitement will be gone but these human feelings will still be being experienced by others: by my children, and then by their children.” Excitement itself will still continue. It was very comforting.
WA: Yes, especially in Judaism, what we call social immortality is often emphasized: that whatever your contributions are, whatever you stand for in life, it flows on and continues in your children and your children’s children. It’s a beautiful thought, but it doesn’t rule out the energy of consciousness itself being indestructible.
DB: In the book you distinguish between internal and external unity—could you clarify it here?
WA: In the literature and the psychology of religion and in the study of mysticism scholars talk about two different ways to approach unitive consciousness. One, called “internal unity” entails going deeper and deeper through various dimensions of being until finally the ego vanishes, dies or dissolves, like the drop of rainwater in Hinduism that merges with the ocean of Brahman, and all of a sudden there’s awareness of this great oneness.

And then the other approach, called “external unity,” occurs in interaction with the world, often visually through the natural world, a kind of resonating with visual perception to this point where the best way I’ve been able to describe it is—which I think Alfred North Whitehead was trying to state—the perceiver and the perceived somehow interact on a subatomic level and everything is perceived as energy and there’s this ultimate insight that we’re all ultimately the same. There is a great oneness. It boils down to one approach occurring with closed eyes, if you will, and one occurring with open eyes.

But that the same person in the same culture can experience both approaches to unitive consciousness is what the new discovery is. And so this isn’t culturally bound or indicative of different nervous systems, but it appears to be different ways of approaching the same unitive experience. Whether or not it’s the same unity can be debated forever. How many different unities can there be? But, you know, intuitively it feels like it’s ultimate.

Is it the same galaxy or a different galaxy? It’s mighty big and impressive whatever it is.
DB: My own experience with LSD, a few months before hearing a talk by Timothy Leary in the late 1960s, and just before it was made illegal by Federal law, was a strong glimpse into the awareness that I was not just these identifications I carried around with me then: “21 years old,” “college senior,” “English major,” “Middle class,” “Ann Arborite,” “son,” “brother,” or even “male.” These labels all fell off like articles of clothing and what was left of me was pure energy or light—part of a bigger quantity of the Something. Trying to articulate that the next day in an English Literature seminar was not too successful and didn't generate much further class discussion at the time, as I recall!

The descriptions about your own psychedelic experiences and those of the research subjects you’ve heard from are helpful and clarifying in the book. They added a lot for me as a reader.
I also enjoyed the quote in your book from Thomas Roberts about the 500-year blizzard of words triggered by the invention of the printing press. You have written very “illuminatingly” about our limitations in describing and articulating deeper realities using words and concepts. My favorite bumper sticker is “Don't believe everything you think!”

But, back to using your words, can you comment on the impact of faith and religion in these psychedelic studies?
WA: In our first study at Hopkins, published in 2006, the double-blind study with Ritalin and psilocybin demonstrated that psilocybin really does do something; it’s not all suggestion and wishful thinking. For that study we selected people who were religiously inclined, i.e. they went to church or synagogue, or they belonged to a meditation group, sang in a church choir or something. But people who read that study sometimes think it’s only because they were religiously inclined that they had their spiritual experiences. Clearly we know from other studies that people who consider themselves total agnostics also have profound mystical experiences. Perhaps some may even find it easier to allow the occurrence of mystical experiences than those who have studied and practiced specific forms of religion or spirituality.

When there’s a radical openness and they’re not trying to prove anything, mystical and non-ordinary states of consciousness that are claimed to be beneficial seem more likely to occur. People who might have trouble during a psilocybin session would be either the self-defined atheist who wants to prove that there’s no ultimate meaning—
DB: —or the rigid fundamentalist?
WA: If he or she thought that there’s no way except finding Jesus through the Fourteenth Baptist church, he or she might have trouble. But anyone who’s open and willing to explore consciousness and collect new experiences is likely to encounter these really magnificent states.
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Is It Safe?

DB: I wonder if you could again address here what is so well delineated in the book, about the issue of safety?
WA: Gladly. Both my book and the article that Matt Johnson, Roland Griffiths and I published really systematically address it comprehensively. Given the pure drug and the right dose with adequate preparation, the major psychedelics are fundamentally safe for most people. Physiologically they’re safe; psychologically you have to know something about how to navigate well in the internal worlds to benefit. And I make the parallel in my book with learning to ski. It helps to have a few lessons before you do it. And it’s pretty stupid to just throw the drug in your mouth and see what happens, or strap on skis for the first time and jump off the ski lift at a black diamond run.

But given preparation they really are safe for most people. They’re nontoxic and non addictive. They’re not for everyone. For example, persons with psychotic histories, genetic tendencies towards severe mental illness, brain tumors, acute cardiac or renal conditions or dependence on certain medications would incur greater risk and would be screened out of most current research projects with psychedelics. Some persons simply may not be interested in personal or spiritual development, or may prefer other modes of exploration.

Given the pure drug and the right dose with adequate preparation, the major psychedelics are fundamentally safe for most people.
In many studies researchers find that volunteers report little desire to repeat the psychedelic experiences in the near future, even though the therapeutic intervention may be highly valued. One cannot predict the specific phenomenology that’s going to occur, but if you respond to the opportunity of consciousness opening up in an interpersonally grounded style with an intention to accept whatever emerges and explore it, the probability of the experience being beneficial is high. It is not dangerous if it’s handled competently.

Also with psychedelic therapy we’re right up front with volunteers or patients by saying there may be episodes that are scary and painful. One may have to tumble through some grief, guilt, fear or transient somatic discomfort. One may encounter “the dark night of the soul” as part of the spiritual journey, but that’s all good, and it leads towards resolution and transcendence.
DB: In other words, you won’t get stuck in it like the endless dark night...it will turn into daylight.
WA: That’s right, because, whatever comes into consciousness—you can meet it; dive right into it like diving into a swimming pool, and we’re here with you and there’s nothing from which you need to run away. And as we talked about earlier: the principle is that if it arises in consciousness that means you’re ready to deal with it and we’re here with you; let’s meet it.
DB: So, does that imply that it’s necessary for a person who’s a therapist doing psychedelic-assisted therapy to have had the experience?
WA: You have to be comfortable with non-ordinary states of consciousness.
DB: Okay, and you can say that you get there—
WA: Whether with psychedelics or not—
DB: —for example with Stan Grof’s holotropic breathwork.
WA: Yes, or meditation, for some sensory isolation or flooding; then you’re not going to panic if the person expresses something that you might ordinarily label psychotic or fear that the person’s going to get out of control, because that fear can easily become contagious. So, the therapist has to stay centered. “I’m with you and there’s no demon we can’t look straight in the eye.”

“Whether we like it or not the time is coming when we have to put up with being unconditionally loved.”
In a section of my book titled “Movement into the Future,” I wrote that if we take mystical consciousness seriously and accept that it appears to be a potential state of awareness that ultimately awaits all of us, then eventually we may all have to accept that we are spiritual beings, that there is indeed something of god within us, and that “whether we like it or not the time is coming when we have to put up with being unconditionally loved.”
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Cosmic Laughter

DB: Well, I’ll be happy to put up with that! And how much, in your experience, do people in these sessions or journeys get into periods of cosmic laughter?
WA: Quite commonly, you know. And it’s usually after approaching something that feels very heavy and onerous. All of a sudden the belly laugh comes out, and god laughs and the universe goes on.

And humor aside, I wish we could offer safe psychedelic journeys here in the United States, both for persons who may benefit from psychotherapeutic treatment and also for people interested in personal or professional development. I write about the centers for research and retreat that I envisage in the book. And I think that day is coming.
It’s ridiculous that people who want legally to receive psychedelics often have to go to South America and take ayahuasca with sometimes questionable entrepreneurs.
It’s ridiculous that people who want legally to receive psychedelics often have to go to South America and take ayahuasca with sometimes questionable entrepreneurs. That may work out well and it may not work out well. Sometimes there is minimal assistance in facilitating the integration of experiences and not much preparation or thought that goes into the construction of the group.

So why should you have to go to South America to have a legal experience, when we are in the land of the free and the home of the brave? Come on USA, get with it!
DB: We ought to have a Constitutional amendment. We have freedom of speech, why not freedom of consciousness?
WA: Many of us will vote for that!
DB: What would you say to people who are considering doing a journey like this because they have treatment resistant depression, or they have been feeling terribly stuck? You’ve said it many different times, but here is one more opportunity.
WA: It’s tricky because I don’t want to encourage people to break laws and there are dangers of ingesting substances with unknown purity and dosage.

I talk primarily in terms of fostering research, and someday the laws will change. Sometimes I go online to Amazon.com and I read some of the reviews that people have written of my book, and one of them is from a guy who claims to have used drugs and psychedelics in the past but never used them right, and since my book essentially taught him how to use them correctly and safely, he had a marvelous curative experience and he’s deeply thankful for learning how to use psychedelics wisely. And that wasn’t my intent in writing the book, you know, but if it makes for healthier sessions and less trips to the emergency room for the people who choose to use the drug illegally; I can’t regret that.
DB: That’s beautiful.
WA: But it certainly wasn’t my plan in writing the book. Yet, since there are an awful lot of people who are choosing to use psychedelics, if the book helps them learn how to do it safely and wisely, maybe that’s a constructive step.
DB: So as we wrap up this conversation, it might be fun to acknowledge some recent literal “big” news: Astrophysicists reported calculations last month indicating that the universe is from two to ten times as big as was previously thought: they now think there may be up to two trillion galaxies, each with hundreds of billions of stars!
WA: There are no limits to awe! But you can only open your mouth so wide, you know?
DB: And Tibetan Buddhist scholar Robert Thurman suggests that the metaphor of Indra’s Net points toward human consciousness being at least as vast as the universe, if not countless times greater. So it looks like there is still plenty of territory to explore

I want to thank you again for the complete pleasure of our conversations.
WA: Well, good being in the world with you. Enjoy and take care.
DB: Namaste.


*For a full list of all articles cited, please email david@drbullard.com.

© 2017 William A. Richards and David Bullard
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William A. RichardsWilliam (Bill) Richards, PhD, has had a private practice in psychotherapy since 1976, and is a psychologist in the Psychiatry Department of the Johns Hopkins University School of Medicine, Bayview Medical Center, where for the past 17 years he has participated in the design and implementation of research projects with psychedelic medicines. His graduate degrees include a Master of Divinity from Yale Divinity School, a Master of Sacred Theology (S.T.M.) from Andover-Newton Theological School, and a Ph.D. from Catholic University. Richards studied with Abraham Maslow at Brandeis University and with Hanscarl Leuner at Georg-August University in Göttingen, Germany, where his involvement with psilocybin research originated in 1963. Richards first published his findings in the Journal of Religion and Health in 1996 in an article coauthored with Walter Pahnke titled, ‘‘Implications of LSD and Experimental Mysticism.” His highly acclaimed book, Sacred Knowledge: Psychedelics and Religious Experiences, (New York: Columbia University Press, 2016) has been called “…the most comprehensive overview of the actual use of psychedelics in psychotherapy and of the transformative power of mystical experiences” (Torsten Passie, MD, PhD Hannover Medical School). Research results of his most recent studies into psilocybin treatment for existential anxiety in cancer patients was reported in the Journal of Psychopharmacology, December 2016. He has also authored a tribute to Abraham Maslow together with a report of his 25 years of doing psychedelic therapy research for the Journal of Humanistic Psychology, September 2016.
David Bullard, Ph.D., David has had a private practice of individual psychotherapy and couples therapy in San Francisco since 1976. He is a clinical professor in departments of medicine and psychiatry and a member of the professional advisory group of Spiritual Care Services at the University of California, San Francisco, and is a consultant for the Symptom Management Service (outpatient palliative care) at UCSF’s Helen Diller Family Cancer Center. His latest professional publication is the chapter “Sexual Problems” (co-authored with the late Harvey Caplan, M.D., and with Christine Derzko, M.D.) in Behavioral Medicine: A Guide for Clinical Practice, 4th edition (2014; McGraw-Hill). He has previously published interviews for psychotherapy.net with Allan Schore, Ph.D.; Bessel van der Kolk, M.D.; Mark Epstein, M.D.; Ida Gorbis, Ph.D.; George Silberschatz, Ph.D.; and Lonnie Barbach, Ph.D.; and also has written about conversations with Tibetan Buddhist scholar Robert Thurman, Ph.D.
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CE credits: 2
Learning objectives:

  • Describe the research on psilocybin-assisted psychotherapy from the 60s up to the present moment.
  • Understand some of the legal and ethical roadblocks to further research.
  • Learn about the influence of psilocybin sessions on healing in the therapeutic relationship.
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