Can magic mushrooms unlock depression? What I’ve learned in the five years since my TEDx talk
Five years ago I stood on the stage at TEDx Oxford and attempted to answer the question: can magic mushrooms unlock depression? I had fifteen minutes to speak from the heart to an audience I assumed to be largely suspicious of psychedelic drugs, which was probably the case at that time.
In the talk I pleaded with the audience, and with the world at large, to take my words and the potential of these substances seriously. However, watching again today, I can’t help but feel as if I unknowingly contributed to a simplistic and potentially dangerous narrative around psychedelics; a narrative I’m trying to correct.
In 2016 I became a volunteer psychedelic trip sitter/ ‘guide’ at Imperial College London’s psilocybin for depression trial. It was with great enthusiasm that I transitioned from my role as an NHS psychologist, where I had been offering talking therapy as a treatment for depression, to ‘guiding’ people through legal magic mushroom sessions. I was thrilled that psychedelic session participants tended to gain important insights and experience a sense of being able to connect to themselves and to connect to the people in their lives, and to feel connected to the natural world despite the sessions taking place in a sanitised hospital room. It surprised and delighted me that even in such a sterile environment the wild wonders of our biosphere often spoke to people in their trips, whispering of an interconnected web of which we are all a part.
The ‘connecting to themselves’ aspect of their trips was often gnarly and painful; long suppressed emotions so raw and overwhelming would wrap their ragged wings around a journeyer lying helplessly in headphones and eyeshades, no choice but to ‘accept, connect and embody’ the visceral teachings of the synthesised encapsulated mushroom. It was often with relief that five hours in, participants would remove the headphones playing the music soundtrack, sit up, and declare themselves to have made it through the gauntlet with diverse gifts to take home: painful realisations and unearthed grief treasured just as much as a newfound feeling of belonging, or a new perspective on what really matters.
Amazed by what I observed, I did a follow-up study, interviewing all the participants six months after the psychedelic session, to learn about their own reflections. The participants described psychedelic therapy as the most effective treatment they had tried, and that it had worked not by targeting their symptoms of depression directly, but by touching something deeper, an underlying sense of disconnectedness that had been keeping them trapped and stuck in numb despair for years.
They described that they had been disconnected from their bodies, senses, emotions, other people, and the world around them, and that the psychedelic session had opened them up to all this, for a few wonderful weeks or months after the session. They said that even after the feelings of connectedness had subsided they were left with hope that this state could be tasted again, one day. This is why, when I was invited to do a TEDx talk about my findings, I so valued this chance to implore a mainstream audience to take psilocybin seriously: not just a recreational hippie drug but a powerful treatment that could provide a lifesaving dose of connectedness.
Five years on, I have many times regretted being so enthusiastic in that TEDx talk. At that time, in 2017, whenever I told people that I was leaving mainstream healthcare to work with magic mushrooms, I was met with a shocked stare and comments about how dangerous psychedelic drugs were. So much of my exuberance on that TEDx stage, extolling the powers of psilocybin, was intended to counter a naysaying world which might never allow its true potential to be explored, because of misinformation and misplaced stigma. Little was I to know that my own optimism might prove to become part of the problem rather than the solution. The backlash to the backlash around psychedelics is underway, and may be just as damaging to the wholesome flourishing of a future that includes psychedelic healing than the first backlash, which occurred in the 60s and 70s.
This current backlash to the backlash of the past I see as a tidal wave of hype, over promising, magical thinking, marketing, sugar-coating, simplistic sound bytes, hopeful shareholders, gold rushing, territory-claiming. This wave has been accompanied by the sidelining of critical voices, like those of the victims of sexual assault in psychedelic contexts turned away by countless respected professionals in the field lest they tarnish the shine. There are so many issues with having a zealous agenda to turn the tides; it comes from a good place originally, but now it all feels a bit like a PR campaign for a celebrity that was wrongfully imprisoned and now needs to be shown to be utterly beyond reproach, sunshine personified, a media onslaught of positivity, positioning them as a superhero. But no superhero acts alone, they are part of a team.
What I have learned in the last five years is that the greatest threat to a healthy psychedelic future is the fetishising of just the drug alone. Whether plant, or synthesised compound of one, there is a narrative that all you need to do to change your mind is eat something. I unknowingly contributed to that narrative in my TEDx talk. I included a quote from a participant who described psilocybin ‘defragging his brain’ and I’ve seen many of these memes about the psychedelic brain reset.
Indeed the psilocybin for depression work at Imperial was done in the context of a neuroscience lab, but none of our team thought we were simply providing a drug to reset the brain. The therapeutic container was always painstakingly and lovingly curated; emphasis placed on the interpersonal bond between guides and participants, on creating a nest of trust and safety for the participant to unravel in, and an understanding that the real work, the real healing, would occur only if the person felt able to ‘let go’ and surrender to the deepest layers of long-suppressed feelings. The effect on the brain was understood as like the opening of a door: once the defences of the ego mind are temporarily deactivated, everything it usually tries to keep out can come in. The drug was a catalyst to the therapeutic process, not the therapeutic process itself. Sadly, this crucial information did not make the headlines as much as the “magic reset button” did.
In 2017 my inbox was piling up with communications from people wanting to access psychedelic therapy, both individuals seeking healing, and business people seeking the next big thing. Michelle Baker Jones and I, after both being volunteer guides in the first Imperial study, set up the UK’s first ‘psychedelic integration group’ because it was clear that lots of people were starting to take psychedelics without a strong therapeutic container. The purpose of the group was to offer a sharing circle for people needing support with integrating trips they had taken in any context, to meet others asking the same questions, for the sharing of harm reduction advice, and passing on information about how to contact ‘psychedelic aware’ therapists for individual integration therapy.
I remember a young man coming to the group who had wanted to reset his brain and so had taken mushrooms alone in the back of his car, and was still shocked by the harrowing experience months later. People were flocking to psychedelic retreats, many had wonderful experiences, but most of them did not receive the kind of aftercare they needed . After such an intense experience they found themselves left alone to understand it, process it, and try and incorporate the teachings into their lives. This is the work of a healing community, but after their brief taste of one they found themselves back home treading the same old pavements and feeling a bit disconnected from their new ‘medicine family’ that they had shared the ceremony with. Now they were left alone with all the emotions, insights and questions the ceremony had revealed.
The other reason we set up the psychedelic integration group, as well as wanting to be a safety net for the wave of DIY trippers and ayahuasca exiles we knew was coming, was to prepare a place for the participants that would take part in Imperial’s second trial, Psilocybin for Depression 2 (Psilodep 2), which was fast approaching. Having been a volunteer in the first study I was the clinical lead of the second. I wrote the therapeutic model, selected the team, and led that team through the 1.5 years of the trial, in which 59 people received a course of psychedelic therapy, including preparation, psilocybin sessions, and integration.
I knew from my ongoing communication with people from the first trial that integration could be complex: one of the participants had been referred for a further 10 sessions with an external specialist, many others had contacted me about a year after it saying their depression had come back with a vengeance and wanted access to psilocybin again. So for Psilodep 2 we created a safety net with more layers: aftercare provision for months after participants finished the trial, and by that time the community integration group was flourishing. We were well prepared. But we could not have anticipated some of the challenges that came our way.
The level of care we took for our participants in all of the clinical trials I have worked on has been similar to the care expectant parents take preparing their spare room for the arrival of a new baby. The teams buzzed around those hospital ‘dosing rooms’ like bees in a beehive, making sure the electric candles have batteries, shopping for the freshest fruit for the first nibble post-psychedelic, maximising a sense of care, connectedness, containment, community. Yet the psychedelic hype sets many participants up for underwhelm, disappointment, and sometimes shock. The ‘resetting your brain’ meme means that many are not prepared enough for what is probably more accurately described as therapy on steroids: they are surprised by how active their role needs to be, and how much professional support and community support they might need to process it all.
During Psilodep 2, our team quickly realised that we needed to spend a lot of time in the prep phase undoing expectations, clearly communicating that this isn’t about a drug, it’s a therapeutic process that the drug can help catalyse. We were also all often shocked by the sheer power of what sometimes got unleashed in sessions: contacting sudden murderous rage, reliving of horrific abuse, shocking ‘discoveries’ about awful things that had (maybe?) happened in childhood. All these experiences, and many more, tested our skills as therapists beyond any training we had received.
In the film Magic Medicine I am shown being a guide in my first, second, fifth and sixth ever sessions. In the BBC documentary ‘The Psychedelic Drug Trial’ I was filmed on my 30th or so; in some ways more confident, but in many ways less.
In my doctoral training as a clinical psychologist, my cohort was taught about the stages we would all pass through: unconscious incompetence, conscious incompetence, conscious competence, unconscious competence. The more you learn, the more you realise you don’t know, until you have been swimming in the discomfort of conscious incompetence (and receiving supervision) long enough to slowly become competent.
I still consider myself a novice guide. I’ve worked in group retreats, three clinical trials (currently as a guide on a DMT for depression trial, where my ACE model is being adapted), and yet I often ask questions to underground guides who have worked with psychedelics for decades longer than I. Many of them still feel the same way, that the more psychedelic sessions you see, the more mysterious it gets.
My final session in Psilodep 2 was with a participant who during the session ‘became’ his grandfather whilst his grandfather was drowning at sea. He was left with murky shock and confusion. I had many more questions than answers; we needed input from the ‘elders’, those who had been through this all before, but as cut off as we are in our culture from a medicine healing tradition we may have once had, we were like parentless children feeling our way in the dark.
The focus on the drug itself means that we neglect all the other aspects of what makes a psychedelic session healing. We isolate this one element, and ignore the rest. We get to where we are now, with the therapeutic elements massively under-explored and pharma companies starting to look at take-home psychedelics without any therapy or guiding at all. We also get to where we got before, in the 60s, with a proclamation to just take the drugs, without there being enough of a cultural container yet to house these experiences.
I am now focusing on building that community container. A place where connectedness to ourselves, each other, and nature can be gently nurtured, in a grounded way. I have written an integration process to cover a twelve month period, which can be repeated annually; it’s based on twelve trees, one for each calendar month.
The twelve trees are based on the CelticTree Calendar, and each tree has a ‘teaching’ : present moment focus, willingness to feel pain, self soothing, emotional resilience, strengthening our bonds with local neighbourhoods, and also like-minded others we find online, forgiveness, compassion for all the different parts of ourselves, cultivating gratitude, recognising patterns of self sabotage, slowing down and resting, and connecting to the wisdom of elders. I want to prepare a safe nest for all of the people who will realise that psychedelic work takes a village, not just a capsule. Five years after that TEDx talk, as I look at the booming blaring psychedelics marketplace, the trees whisper to me of the interconnected web of which we are all a part. A web of reciprocity and cooperation from which we have much to learn.
In the Twelve Trees process, which is the first integration system to be offered as part of the ACER community (Accept, Connect, Embody, Restore) the Douglas Fir is the tree for the month of May. It represents the importance of systems of reciprocity in our local communities, and the importance of honouring indigenous wisdom about how everything is related. The Douglas Fir is a symbol for that because the Canadian ancient Fir forests were sprayed with Monsanto herbicide to prioritise the cash crop (Douglas Firs for timber) and kill all the ‘competitor’ trees and plants. What the timber companies found was that when part of the ecosystem was poisoned, the Firs actually died too: instead of seeing the Firs thrive without the ‘competition’, as they expected, they saw the Firs die because of the lack of community. The incredible mycorrhizal network of tiny fungi under the forest floor, by which all the trees are connected and share resources and warning signals and take care of each other, had been interrupted and cut off. Suzanne Simard writes about these networks in her incredible book, ‘Finding the Mother Tree’, concluding that her decades of scientific study confirmed what indigenous elders had said all along.
Like a dense forest of firs, psychedelic healing requires a complex network consisting of care, community, connection. We need the mother trees, the elders who have been doing this work safely for a long time to take a prominent place in the ecosystem, to share their wisdom and warnings like the wise old Firs, Birches and Pines share information and food. We need a thriving interconnected web involving public education, advocacy groups, therapist training and supervision, outcome sharing, peer-led support groups and community integration networks. We need all of these groups to talk to each other.
We need systems of reciprocity to fairly compensate those whose riches we are extracting, we need to protect psychedelic plants and the communities who have stewarded them from extinction and threat. We need more women, and more people with long roots in psychedelic healing work (the best underground therapists, the best teachers from indigenous medicine communities), and spiritual elders to be given seats at the tables of power, not just people representing science and business.
We need to consciously create a global council of elders from all related disciplines to set guidelines, and oversee their application. We need to nurture an interconnected ecosystem with deep roots around psychedelics, or I believe they will prove to be at best disappointing, at worst dangerous, for a lot of people who have been promised easy transformation. Like the Douglas Fir cash crops, cut off from their root systems, they may ultimately fail.
If I could go back in time, I would not now be so foolish as to suggest that a synthesised capsule, by itself, can unlock depression. It takes a village, it takes community, it takes time. A mushroom is simply the tiny visible tip of a vast interconnected web deep underground.