by Jason Foster, MA
I originally wrote a slightly-modified version of this article for students enrolled in the InnerTrek Psilocybin Facilitator training program. I hope that by sharing it here others can benefit.
Psychedelic Facilitators need to be able to understand and work with both transpersonal and clinical perspectives.
Let’s start with some loose descriptions of clinical and transpersonal perspectives.
Clinical
In the field of healthcare, including psychology, medicine, and nursing, “clinical” typically refers to activities or practices related to the direct assessment, diagnosis, and treatment of patients or clients. Even though licensed psilocybin facilitators in Oregon are not legally providing medical services, it is important that they are able to understand this perspective.
Here are some examples of how the Clinical lens applies to work as a psilocybin facilitator:
- Consider client readiness and approach to working with clients based on mental health conditions, medical conditions, substance use and pharmaceutical use. If diagnosing a mental health condition is beyond a facilitator’s scope of practice, other professionals should be brought in if such conditions are indicated.
- Assessing when it is appropriate or necessary to bring clinicians on board to work with a client (such as doctors or therapists), either before or after a psilocybin session
- Inviting facilitators to consider how their role power is at play in their professional relationship with their clients
- Encouraging facilitators to get support, such as through a peer or supervised consultation group
- Facilitators must consider client confidentiality
- Facilitators must take an ethical approach to this work
The clinical perspective is rooted in the Western medical model and Western psychological tradition.
Transpersonal
Wikipedia defines transpersonal psychology “as a sub-field or school of psychology that seeks to integrate the spiritual and transcendent aspects of the human experience with the framework of modern psychology.” Because clients sometimes have psychedelic experiences that are outside of the realm of the personal and biographical, the transpersonal psychology perspective is important to understand when supporting clients in this work.
Transpersonal experiences refer to extraordinary states of consciousness that go beyond the individual’s personal identity and involve a connection to something greater than oneself. Here are some examples of transpersonal experiences (this list is not exhaustive):
- Mystical experiences: Profound feelings of unity, interconnectedness, and transcendence, perhaps involving a sense of oneness with the universe, a dissolution of boundaries between self and others, and a deep sense of awe and reverence. One psychonaut describes an encounter with “perfect stillness, being subsumed Into the white light of bliss”.
- Spiritual awakening: Experiences of a profound shift in perception of reality, often accompanied by a deep connection to the divine or spiritual aspects of life.
- Near-death experiences (NDEs): Experiences of moving through a tunnel, traveling to a spiritual realm, or encountering deceased loved ones or spiritual beings.
- Out-of-body experiences (OBEs): An experience of separation from the physical body, often accompanied by the sensation of floating, flying, or observing oneself from an external perspective. Traveling to different locations or dimensions.
- Transcendent states in nature: Deep connections and experiences of awe, beauty, and interconnectedness, perhaps while in natural environments. These experiences can foster a sense of unity with the natural world and a profound appreciation for its wonder and mystery.
- Peak experiences: Intense moments of joy, inspiration, and expanded awareness in which individuals feel a heightened sense of aliveness and connection to something greater than themselves. These experiences often occur during creative endeavors, extreme sports, or moments of deep connection with others.
I want to make a few things clear to start:
- It is not my intention to tell you what to believe. One purpose of this article is to encourage you to become aware of the lenses and biases that you hold and consider how they may show up in your relationship with your client.
- I am going to attempt to avoid getting caught in a discussion of what is “real”, and instead focus on what clients may experience.
- Facilitators are not purveyors of an experience! Clients who take mushrooms will have the experience that they have. It may or may not include transpersonal elements. The work of preparation and interaction with the facilitator during the psilocybin session may influence the direction the experience goes, but it is ultimately beyond the facilitator’s control, and facilitators should be careful to not try to “take the wheel”.
- Both transpersonal and clinical perspectives have their shadow sides, which I will attempt to illuminate at least partially.
- I am aware that some clinicians (therapists) already incorporate a transpersonal approach. For the sake of this article, I will be treating the two as separate perspectives. You might find it useful to think of them as a spectrum and locate yourself along the spectrum.
Limitations of the clinical approach
While the clinical perspective offers psilocybin facilitators a lot to consider in terms of checking the boxes for facilitating a safe-enough psychedelic experience and providing support when the client’s experience is focused on the personal, being rigidly stuck in this perspective may do a client a disservice if the client’s experience is outside the personal.
And in the extreme, the clinical approach only attempts to treat the symptoms of an underlying problem. An obvious example: Antidepressants are frequently prescribed as a treatment for depression. I recognize that antidepressants can really help some people, and I also see how this is rarely a holistic approach to wellness. The limitations of this approach on offering effective healthcare is one of the reasons Measure 109 was created.
In clinical psychology, Cognitive Behavioral Therapy (CBT, a form of talk therapy) is a good example of a modality that tries to fix the problem at a surface level. Challenging negative thoughts, problem-solving and mindfulness have their place, but CBT often doesn’t get to the root of what’s going on with a person. It works fine for some people, and it is often a top-down approach: “if I can think my way out of my depression, I’ll be okay”. Contrast that with psychedelics, which often open users up to parts of themselves that need attention. This is what we call a bottom-up approach: the nervous system and the deep psyche get to express while the cognitive brain takes a back seat.
Add to this “fix the symptom” approach the fact that we live in a Capitalist society, such that systems of medicine are often driven by the edict to “get fixed so you can go back to being productive”. Everyone raised in Western culture is, to some degree, under the spell of these systems. It takes work to decolonize oneself, and bringing awareness to the lens that you see through is the beginning of that work.
So, let’s take a moment to consider why it is important to acknowledge our lenses, our paradigms, and our biases as we prepare to enter this healing/facilitation work.
Psychedelics and Transpersonal Experiences
Psychedelics open us to vast territories inside and beyond ourselves. They give access to the transpersonal. They connect us to something beyond our personal biographical narrative of who we are.
One of the functions of the brain’s Default Mode Network (DMN) is to create a coherent experience of a limited self. A healthy ego requires the ability to discern between me and not me. That allows us to move towards what is nourishing and away from what hurts us.
Psychedelics inhibit the DMN, which breaks down these perceptual walls, perhaps revealing the ego to be a construct, a useful fiction. What is sometimes experienced as “more real” is the interconnectedness of all things – the vast field of Beingness of which “I” am but a small part (the usefulness of the word “part” may be questionable in the experience of non-duality).
Carl Jung suggested that it is our task to relativize the ego in service of the soul. This is not the same as eliminating or “killing” the ego, as certain “spiritual” schools of thought might encourage. Spiritual bypass, which is the tendency to use spiritual ideas to avoid or ignore difficult realities or challenging emotions, is just one shadow of the transpersonal, and facilitators should be aware of the possibility of this tendency showing up within themselves and in their clients.
This relativizing of the sense of self, even temporarily, can have an easing effect on one’s sense of one’s trauma, one’s relationship to one’s story of woundedness or brokenness, or the experience of one’s struggle in life.
Don’t get me wrong: real problems still need attention. Taking a spiritual viewpoint doesn’t mean we shouldn’t strive to fix unjust systems and limit violence in the world. This may be another shadow side of the transpersonal lens: a spiritual bypassing that says “it’s all good, therefore I can ignore this problem”.
On the clinical/personal side of things: Diving into our own unacknowledged pain “at the speed of our slowest parts” and metabolizing it is a very important aspect of healing. When I say “metabolized”, I am pointing to a process of bringing attention to an old experience (or experiences) that got “stuck” in the nervous system (the body-mind) and allowing the nervous system to process that experience on the level of the body, thought and emotions. Crying, sighing, telling a story, and getting angry are just a few examples of metabolizing.
Taking our wounds seriously and being witnessed can be profoundly healing. Psychedelics are great for accessing this material, which is one way that psychedelic healing is very compatible with a non-transpersonal approach (I consider the unconscious parts of ourselves to be personal, not transpersonal).
We know that depression correlates with an overactive DMN. Rumination (dwelling on negative thoughts) is a key feature of some types of depression. The brain may be obsessing over the perceived problem of “what’s wrong with me?”
Depression is sometimes the result of unmetabolized material or exiled inner children (to use the language of Internal Family Systems (IFS)) calling for our attention.
Again, working in the realm of the personal and getting at the pain underlying the self-pitying thoughts can be profoundly healing. The result may look something like: “There’s nothing wrong with me, I’ve just been carrying this burden of grief and negative self-talk since I was a child”.
Another way of thinking about this from the personal/psychological perspective: the DMN projects our beliefs about the world onto the constructs of self and other. A client’s early learning about relationships may have taught them to be small to be safe. They may carry unconscious “ghost images” of a parent with them, which get projected onto people in their life. The unconscious threat activates the learned pattern of shrinking back. When the DMN is inhibited, those patterns may fall away (or they may be brought into consciousness in an uncomfortable way that is ultimately part of healing). In the absence of the DMN’s pattern of keeping the client small, they may feel like they can breathe or be themselves for the first time in their life. It can be profoundly liberating.
And yet, a different level of change can happen when the transpersonal experience provides a shift of focus away from the self that brings about a kind of ontological shock that may shatter the blinders that keep one myopically locked in one’s personal hell.
One may realize that their sense of control was illusory, and they have a feeling of being held by something bigger than them. This allows them to feel safer and “right-size” their sphere of influence. This experience, like many transpersonal experiences, happens on a visceral level that language cannot normally penetrate to.
Encounters with the Sacred
When a psychonaut has a transpersonal experience, it may offer an additional level of healing or resource. For example, a client may experience being a part of the universal tree of life. They experience sitting around a fire with their ancestors, and feel a sense of the perfection of all of life. There is a feeling of remembering something forgotten, something sacred. This fills them with a sense of ease and meaning.
The Sacred is something our culture has very little access to. The dominant forces in Western culture exclude it, ignore it, or attempt to commodify it. The Emerald Podcast episode “When Bread is Not Bread” is a beautiful exploration of the idea that humans inherently hunger for an experience of the numinous (“filled with a sense of the presence of divinity”), the sacred, of feeling part of something bigger than ourselves. The author, Joshua Schrei, shares that trance states are something we all seek out, and that in Western culture the need is only partially met through activities like watching TV or going to a sports game. He states that what is missing from these experiences is contact with the numinous. He uses the analogy of Wonder Bread: it is Western culture’s attempt to provide something that seems like it should be nourishing, but it is so stripped of nutrients that it can hardly be called food.
So many people in Western Culture are starving. We are in a crisis of meaning, and depression and anxiety are symptoms of this. Personal healing work may only go so far, as “depression is a healthy response to living in a sick society.” Not only is systemic change called for, but a shift in the way one relates to life itself may be needed. Spirituality, in all its very personal forms, can be a great resource in a culture that worships money and power. Access to the Sacred, to remembering, can be a balm for living. It can reinvigorate and re-vitalize. It can provide a new lens through which to make sense of the events of one’s life, past, present and future.
An unmediated encounter with the Sacred is a very personal experience – it may not fit into expected forms. It is often ineffable (beyond words), described, perhaps, only by poetry and art. When the experience is shared, talked about, or celebrated, it is reinforced in the psyche as new structures of meaning. When it is danced, it is nourished in the body. When others in community are having their own similar but unique experiences, something blossoms within and without.
Think of the experience of the Sacred like the planting of a seed. If it is not watered, if the soil is not tended, the seed will not sprout.
It is partially the job of the facilitator, mostly when helping with integration, to be the gardener, or at least the gardening consultant. The facilitator’s role is extra important when there is an absence of a community that can support an individual’s developing relationship with their experience of the Sacred (whatever it may be).
It is important for a facilitator to know the territory from the inside. It is those visceral experiences that help loosen ideologies that may limit our ability to support clients in this work.
I want to repeat: not all clients will have a transpersonal experience, and it is not the job of the facilitator to make that happen. Facilitators are not purveyors of experience. We must support clients in whatever experience they are having. If their experience is limited to the biographical realms, be with them in that. It isn’t the job of the facilitator to determine where a client’s problems lie, or where their healing will come from, whether in the realms of the transpersonal or personal (or both). But it is their job to hold both possibilities. Don’t get stuck in either paradigm.
Know thyself
One thing that many therapists were trained to do is to practice self-analysis, to question their own thoughts and beliefs. Psychedelic facilitators will benefit from doing the same. Cultivate an attitude of intellectual humility and beginner’s mind. Be curious. Learn to identify the places inside you that rigidly hold onto ideas. Sometimes there is something in you calling for your attention just beyond those parts that want to firmly plant their feet in the ground (and sometimes standing our ground is the most life-giving thing we can do).
We might call this self-analysis “Doing Your Work”. This idea extends beyond the realm of holding clinical or transpersonal lenses. Your unexamined beliefs and untended wounds are likely to show up in your work with your clients. You don’t need to be 100% healed to do this work, but you and your clients will benefit from the attention that you give to yourself. It’s a lifelong process, so being open to learning is paramount.
You can’t do this alone. Fortunately, we have some excellent tools for this kind of self-work: community and psychedelics. We all have a shadow – things about ourselves we cannot see. That’s where others come in. Colleagues, supervisors, teachers, therapists, and our clients themselves. Be open to letting your clients change you and listen to their feedback.
It’s essential to not do this work alone. Put yourself out there, get trained, and join consult groups so you can get the feedback that helps you grow into those edges of yourself. And ask the mushrooms for help.
Questions
Please ponder these questions:
Beyond just absorbing the “how to” of facilitation, are you open to looking at yourself? What are your personal growth edges?
What lenses do you favor? Do you encounter resistance in yourself to others?
Do you see this path as a journey?
Can you see yourself as an apprentice to the medicine?
I want to offer respect and thanks to Dr. Bill Brennan for his excellent article The Revolution Will Not Be Psychologized, which provided some inspiration for this article, and to Joshua Schrei for the Emerald Podcast, and the podcast episode of the same name as the Dr. Brennan’s article, The Revolution Will Not Be Psychologized.
