Reader Series Pt. 2: Modern Healing in the Psychedelic Renaissance

NOTE: This article exceeds the space limits of Substack's email service. To read the full essay, click here.

The second part in this reader series is the following original essay on psychedelic medicine by Vancouver-based psychotherapist Mohit Bassi. It’s incredibly expansive, educational, and well-reasoned. Anyone new to psychedelic therapy may as well start here. This is an excellent introduction.

Subscribe to Mohit’s new newsletter here.

Anyone else interesting in publishing writing on psychedelics or spirituality can email me at rav1033@icloud.com (only a couple slots left before I resume my own writing next week).

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Introduction

Healing is as old as suffering. Before modern-day psychotherapy and the diagnose-and-prescribe medical system all too familiar to us today, people still suffered, and there were ways of managing and alleviating that suffering. The understanding (diagnosing) and healing (treatment/intervention) of mental illness and disorders of various kinds are culturally constrained. The Western system as we know it, is a dominating force in that funding for research, training, and practice is standardized, regulated, and even outsourced to other countries around the world. White Western supremacy?

The inherent problem is that many non-Western cultures do not necessarily prescribe to the same cultural norms, values, and methods of healing that are normalized and practiced in the West, nor do they have funding and institutional power to promote and impose their techniques onto other cultures. In this article, we will deep-dive into what this means for the emergence of the “psychedelic renaissance” (perhaps psychedelic resurgence is more appropriate), as psychedelic medicines bridge methods of traditional healing, with the newer contexts of Western psychotherapy and modern medicine.

Normal or Abnormal?

Before we look at treating the “abnormal”, it is important to understand where the definition of “normal” first comes from. Each of us have our own values, beliefs, personality traits, feelings, thoughts, and behaviours. These generally make up “who we are”. It’s probably understated how much of an influence our cultural upbringing can have on the individual’s development of these traits, but also, how individual traits further enforce and propagate existing cultural norms, creating the definition of what is “normal” or “abnormal” behaviour.

For example, getting caught sleeping on the job at your workplace in the West is a great way to get in trouble and possibly losing your job. However in Japan, the concept of Inemuri is a socially acceptable phenomenon of sleeping on the job.

Sleeping on the subway or at the office is the sign of a hard worker. In fact, your boss might even encourage it. Sleeping in class (while not nearly as acceptable) still carries the subtle suggestion of good intention from staying awake late the previous night to study. The general consensus on inemuri seems to be that, as long you aren’t trespassing, blockading or otherwise disturbing the peace, going to sleep is perfectly acceptable. A good comparison would be an airport. In an airport, people who are tired out from a long night are sprawled out, fast asleep, wherever they can. But the vast majority of people are not. The same is true for inemuri. (Culture Trip)

The same behaviour in the same context (workplace) is perceived very differently between Japanese and Western cultures, and leads to very different outcomes. If you share similar values, experiences, attitudes, and beliefs with those in your social circle (offline or online), are you not embodying a shared cultural experience? It’s easier to drive on the road when you know everyone else is following the same rules of traffic, without having to shout, honk, and become hyper aware of your surroundings as you go from points A > B. It’s easier to understand an internet meme if there’s some shared cutural reference - a memetic device of shared symbolism within the group/audience. Shared implicit cultural norms are powerful, and they naturally guide what the cultural group believes to be “normal” or “abnormal”.

Just as behaviours can be “normal” or “abnormal” within cultural contexts, the presentation of mental illness, its prognosis, treatment, and “return to normal” is also culturally modulated.

As an example, patients diagnosed with schizophrenia have much better mental health outcomes in India than in the United States. Here, the causal mechanism is suggested to be social defeat. That is, the stigmatization of symptoms associated with schizophrenia is so much higher in individualistic/Western countries like the United States, whereas these symptoms are more accepted and understood within a psycho-socio-spiritual context, with greater familial supports provided to the individual suffering from schizophrenia, in collectivist countries like India.

In some sub-cultures of India, having schizophrenia is seen as a gift of the divine, in that the person’s experience is supernaturally different from that of the average person, and their symptoms of schizophrenia are seen more positively, instead of negatively. By contrast, in Canada and USA, persons diagnosed with schizophrenia can be considered to have a legally permanent, severe disability, and are encouraged to apply for disability benefits, which prevent them from living a normal life. Disability benefits typically have clauses and limitations preventing the person from working certain jobs or hours, and engaging in certain activities.

Same disorder, different cultural norms, different definitions of normal and abnormal, different treatment, different outcomes.

Western Healing

Sigmund Freud (father of modern psychotherapy) died in 1939, and the medical model of healing (Assess>Diagnose>Prescribe>Treatment) was coined by psychiatrist Ronald Laing in 1971. Mental healing today is largely influenced by the two: Therapy typically happens in an office, for a set amount of time, approximately once per week, with a professionally trained and licensed healer, using some variation of the medical model of healing. The medical model goes as follows:

Assessment: The healer listens to the client, asks questions, and assesses presenting issues (all Western healers do this in their own way, including counsellors, psychotherapists, psychologists, psychiatrists, psychiatric nurses, and social workers)

Diagnosis: The healer might pick up on symptoms/characteristics of an existing disorder (per the Western DSM), and could formally diagnose the client (if the healer is a psychologist, medical doctor, or psychiatrist)

Prescribe: The healer may prescribe some medication or pill for the presenting issue (if the healer is a medical doctor or psychiatrist), or “prescribe” some routine that can be done outside of therapy (such as worksheets that help identify negative thoughts, prayer, or mindful breathing)

Treatment: The treatment is unique to the type of healer, and the individual healer’s theory of healing. Treatment could include various psychological interventions like cognitive-behavioural therapy (CBT), or medical interventions (ongoing treatment and assessment using prescribed medication)

The diagnose-and-prescribe model works really well for identifying physical or biologically-based disorders (like healing a broken leg, or treating someone with a malignant tumour), since the body heals pretty similarly, regardless of your cultural background. However, this model falls short when it comes to mental health and mental suffering. This is because “normality” and “abnormality” is so culturally constrained, and the manifestation of mental disorder itself is so unique to the individual (lets not forget the medical model assumes that suffering is largely an “imbalance of chemicals” in the brain, that can be fixed with prescribed drugs that were invented in the last 100-or-so years).

Western psychotherapy and mental healing is largely influenced by Freud’s idea of talk therapy in a traditional therapist’s office, and many modern healers follow the medical model of healing that is widely adopted by the West. Thus, Western healing is indigenous (local, or native) to Westerners, and that’s part of what makes it effective in the first place.

Much of Western psychotherapy is used under the guise of it being “evidence-based”. This is a major fallacy, because clearly there were healers and people who were successfully healed, well before modern academia and its “evidence-based” empiricism grounded itself in the observable, measurable, and quantifiable. It is easier to call an intervention or theory empirical when you can measure it, fund it, promote it, and repeatedly administer (scale) it with ease.

For example, in a research setting like in clinical trials, you can assess the utility of a medication (dosage, frequency) pretty easily, since you’re just administering pills and doing follow-ups with the research participant. Treatments like CBT are also very attractive because they can get manualized to the letter, making it easy for the healer/researcher to follow the steps and standardize the healing process. As if healing was as easy as learning to bake a cake from a step-by-step cookbook. Over time, published research in the name of empiricism, gave such treatments more attention and funding because they’re easier to setup/test in research settings under repeated observation, and published treatments show positive results with some reliability (though publication biases exist). It doesn’t mean they’re the only way to heal, or the best way, but they’ve become the Western way.

In short, when healing individuals suffering from some mental illness or disorder, the Western mental health system has been largely developed with a Westernized approach to solving Western problems, and such problems emerge and are worked through, within a Western context. This is largely why they’re deemed effective in the West.

Traditional Healing

Since we’re comparing Western to non-Western healing, the “Traditional Healing” category is extremely broad and all-encompassing, so I won’t be doing a great justice in describing all of the varieties, niches, and sub-categories of traditional healing. Non-Western healing can involve things like ayurvedic medicine, homeopathy, phytotherapy, holistic healing, light therapy, yoga, mindful breathing, nature-based therapy, religious rituals, prayer, shamanistic rituals, plant-based medicines (psycho-active or non-psychoactive), intuitive healing, tonal healing, sensory deprivation, and more.

Essentially, traditional healing can be defined as healing that is indigenous (local, or native) to a given cultural or geographically based group. As mentioned above, the prevailing medical model in the West has made it so that mental healing follows the same formula as physical healing. However, this means that Western healing largely fails when it is being imposed or exported onto other countries and cultures.

Traditional healing is an indigenous (local) solution to the local problems faced by locals in that local culture. Western healing is indigenous to Westerners. So if healing is so culturally contextual, what makes healing, healing?

Common Factors of Healing

In the West, we are very used to taking Tylenol for treating physiological problems like a headache. When it comes to mental health problems, countless studies have shown placebo sugar pills to be equally, if not more effective than psychiatric medication, for helping alleviate mental suffering. Part of this might have to do with the fact that our minds expect to feel better after taking a pill.

Even if we know we’re taking a placebo pill, the motions of opening a pill bottle, taking a pill, swallowing it, drinking water, and expecting to feel better, seems to be a form of therapy, in and of itself.

Amazon sells Zeebo - an honest placebo pill that promotes itself for doing nothing - now available at the same high cost of prescription medication! With Prime Delivery - sans health insurance, of course

Clearly, there’s no one right way to heal, even if the West seemingly has a monopoly on what gets published as “empirical” research in the field. In comes the contextual model of healing.

The contextual model of healing suggests that there are common factors across healers, disciplines, and cultures, that contribute to the overall positive effects of healing. The contextual model argues healing works when:

1. Healing is done in a culturally approved healing setting, such as a counselling office or temple (post-COVID, remote psychotherapy has become “culturally approved”, or normal)

2. There is a trusting and confiding relationship with the healer, such as a therapeutic alliance with a counsellor or emotional attachment to a spiritual healer

3. There is a therapeutic rationale and conceptual framework that provides an explanation for the individual’s presenting complaint, and justification for the efficacy of the proposed methods, such as a psychotherapeutic approach like CBT or the scriptures contained within a holy book. This proposed explanation must be plausible within the broader cultural context and within the individual’s belief structure

4. The proposed rituals/procedures (i.e., proposed mechanisms of change) logically flow from the therapeutic rationale, such as specific psychotherapy procedures, religious rituals, or yoga practices. The specific counselling and psychotherapy techniques (or indigenous healing rituals) are not as important as the engagement of the individual and the healer through shared understanding and affective mutuality

With this framework, whether we look at Western “evidence-based” therapies of healing, pill popping with placebos, or the sample of traditional healing methods mentioned above, it makes sense that someone will heal or feel better if the core ingredients that make up the contextual model are in place, throughout the healing process, regardless of the specific technique or intervention being used. This phenomenon is known as the Dodo bird verdict in psychotherapy, which suggests that all psychotherapies and interventions work mostly similarly, on average, in their overall efficacy. This is a drastic departure from Western theories of healing, which place manualized therapy, pill-prescribing, and other “evidence-based” treatments over all else, dismissing other treatments as pseudo-science.

Benefits of Psychedelic Medicines

Psychedelics have a variety of positive benefits, which I have witnessed first-hand in working with my clients, as well as from personal experience. Within a healing context, psychedelics may help with:

• Experiencing intense mystical and meaningful experiences, leading to a shift in mindset, belief system, and disrupting the default mode network of the brain

• Increasing the personality dimension openness to new experience, which helps break old patterns of thought and habit, disrupting them and helping the person be more receptive to new ways of doing, being, and feeling

• Increased suggestibility - At times, common mental health disorders like depression/anxiety may get in the way of being open to, or trying new things. Not-so-fun-fact, the CIA was known for using LSD as a mind-control substance (major ethical no-no). Increased suggestibility in therapeutic settings may help clients be more open to the therapeutic rationale and proposed rituals/procedures (#3 & #4 of the contextual model). Whatever the proposed treatment, it should be introduced with ethical integrity and a sound proposal for potential positive change in the client

• Changes in neurotransmitters - the brain’s signalling mechanisms are directly affected, leading to changes in brain behaviour and improvement in mood

• Psychedelic drugs are non-addictive, and in fact, have helped people overcome their substance misuse issues (such as alcohol addiction, smoking cessation, and even heroin addiction)

Of course, psychedelics are not all sunshine and rainbows. They can unintentionally bring out unprocessed trauma, ego death, create new triggers in the person, and more. It’s important to recognize that these sacred medicines are not a panacea, and they are not for everyone. Set and setting also highly affect the individual’s experience during the trip.

Institutionalizing the Sacred

Many psychedelic plant medicines, like peyote, psilocybin mushrooms, ayahuasca, and salvia, have a long history of use in rituals of healing across cultures for thousands of years. More recently with advancements in modern medicine, newer synthetic psychedelic compounds have been discovered, sometimes completely by accident.

To this day, the honest psychedelic researcher, practitioner, and recreational user, admits that we know almost nothing about these powerful and life-altering compounds. There are seemingly endless questions surrounding their strong psychological and physiological effects on our bodies. Psychedelics have a deep interaction with the human psyche, and leave lasting effects on human perception and well-being, long after the psycho-active effects of the medicine have subsided.

After the swift and blanket ban on psychedelic research, production, and use in the 1970s, it seems that psychedelic compounds have re-entered the mainstream conscious of the West. However, this time around, there are a growing number of research-based non-profits like MAPS and Johns Hopkins, public companies like Numinus and Field Trip, and even psychedelic integration clinics popping up all around the world, like Thrive Downtown (my workplace).

Following the Western model of healing, there are a growing number of psychedelic training centres, certificate programs, and more, that will continue to prop up as a promised gateway to the world of psychedelic healing through formal education and certification.

What makes this resurgence so undeniable is the amount of PR, corporatization, research, training, media coverage, and major academic and institutional backing that has come with this recent wave of interest in the space. However, the good always brings the bad, and any over-promised blanket cure for mental illness should be scrutinized and carefully studied for the limitations of such substances in Western contexts and healing settings, like a modern therapist’s office.

I’m not suggesting that psychedelics have no place in the therapist’s office, but that there is a time and place for everything, and situational contexts are highly important, especially when working with powerful substances that unlock mental doors that have never been opened before.

Via @D_Nickles

Psymposia is a non-profit media organization that aims to critically analyze systemic issues within the psychedelic space. More recently, they’ve partnered with New York Magazine to do a series of podcasts called Power Tripping. In this series, they dive deeper into recently surfacing ethical issues surrounding the research, training, and clinical use of these substances, which might be brushed over by mainstream media. At the time of writing, there are some articles highlighting severe ethical issues in some of the funded clinical research, but by-and-large, media coverage in this space is overly positive. I’d highly recommend this podcast as a great starting point to learn more about the underbelly of the emerging psychedelic space. This is why I’d call the present movement a psychedelic resurgence, and not necessarily a renaissance.

We don’t fully understand these powerful substances, nor have we properly grappled with their place in our culture at large. There’s a reason why these substances were so swiftly banned in the 1970s, and we should collectively be more careful around their use in both recreational and clinical settings, especially when the latter involves big corporate money, public relations, and abundant conflicts of interest (see podcast above).

Healing is Culturally-Bounded Praxis

The use of psychedelic medicines as part of mental healing is uniquely interesting for many reasons. Firstly, it fits very well within the Western framework of “take this pill and call me in the morning”. The medicines are very potent, and have been studied for their lasting, positive psychological benefits, even in the absence of a healer (although, the integration of a psychedelic experience cannot be understated!).

Additionally, the re-introduction of these medicines is exciting because we have improvements in pharmaceutical technology to uncover new psychedelic molecules that were never before discovered. We have tighter controls surrounding the ethical protocols of psychedelic research studies (not always), and existing therapeutic techniques and the science of healing is improving, if we are to trust the current academic models of knowledge production and dissemination. These substances are being culturally re-introduced at a time when the war on drugs is starting to reverse, and began with the legalization and decriminalization of cannabis in many Western countries. It is an interesting time for the psychonaut to be alive.

Psychedelic plant medicines have been incorporated in rituals dating back to some of the earliest recorded civilizations in human history. By being re-introduced in the West at this time of globalization and cultural hegemony, these sacred medicines are ripe for bridging the gap between modern Western healing, and traditional healing rituals from all over the world. This means, hopefully, that we do not strip the medicine from its contexts. Ideally, the modern shaman (Western therapist) learns to weave traditional healing rituals and practices into their work, with respect, honour, ethical integrity, and grace. This is especially important when such healing rituals include the active use of psychedelic plant medicines. As a collective human conscious, we must tread carefully around the cultural use and reintroduction of these substances.

The Future of Psychedelics

Will psychedelics end all wars, save us all, and bring us world peace? Probably not. Will these powerful substances hold a place in therapeutic settings? They already are, and mostly likely will continue to do so. However, it is vitally important for researchers, organizations, the modern shaman (Western healers), and recreational users, be made aware of the risks, benefits, and limitations that these substances have, and their unique place in our journey through this thing we call life.

As the Western model of healing continues to solidify its cultural presence with the backing of major pharmaceutical and corporate money, there will be many new synthetic variations of psychedelics potentially available for use. These new substances might aim to “heal” and “reset the brain”, without the “tripping” part. A modern anti-depressant of sorts. Some argue it’s foolish to isolate the “good” (healing with psychedelic compounds) from the “bad” (working through ego death, the hero’s journey, lack of integration), since growth requires discomfort and facing the unknown. Others in the field have the wisdom to be on high alert, especially any time major corporations and institutions decide to throw their hat in the ring. We don’t want to medicalize psychedelic medicines to the point where they become “just another prescribed pill”, nor do we want to maximize the quarterly earnings of a public psychedelic company by getting as many people to trip on psychedelics as possible. Did we blink and miss the point when the counter-culture became the mainstream culture? The incentives need to be aligned, for everyone involved in the space.

While the West is known for imposing its perspectives and worldviews on the rest of the world, it can be dangerous for us to assume that the Western way is the only correct way of healing (I’ve argued here why, for example, why the World Health Organization is doing more harm than good). Through the contextual model, healing can be seen as largely culturally defined. Psychedelic substances can act as a powerful bridge and provide a voice for healers from all backgrounds - priests, shamans, physicians, psychotherapists, elders, holistic practitioners, and more. Through this lens, Western healing can introduce these substances, while also acknowledging and opening the doors to the many different ways we can heal and overcome trauma, grief, fear, and other negative emotions. Hopefully, this wider perspective can drive future research into techniques, models, and interventions that are more culturally sensitive, and adaptable to the global cultural heterogeneity of human suffering.

If you get the message, hang up the phone. For psychedelic drugs are simply instruments, like microscopes, telescopes, and telephones. The biologist does not sit with eye permanently glued to the microscope, he goes away and works on what he has seen - Alan Watts

As a Western culture, we have the privilege of pushing advancements in research, training, and outsourcing our theories of healing onto other countries and cultures. There are many ways that we can absolutely screw this up, and psychedelics could just as easily get swiftly banned again, which might further divide traditional healing from Western theories of healing, and hinder further research into the individual, clinical, and societal utility of these sacred medicines. Hopefully, we can learn a thing or two from our past mistakes. This starts with appropriately educating ourselves about the cultural and historical contexts around the use of these plant medicines, and being mindful about where we are treading in the future of this space, be it as a psychedelic corporate executive, investor, researcher, worker, activist, healer, or explorer.