Psychedelic-Assisted Psychotherapy
Traveling Through Another Country: The Landscape of Illness, Healing, and the Thresholds of Life
When you set out for a far-off country, you expect a certain disorientation. The language is unfamiliar, the customs strange, the rules for moving through each day unlike the ones you’ve known. You learn to navigate winding streets, decode maps, and adapt to rhythms that are not your own. You keep a running mental phrasebook of essential expressions: Where is the station? How much does it cost? I need help.
Stepping into the country of medical illness is not so different. You find yourself dropped without warning into a place where the language is dense with acronyms and anatomical terms. There are customs for making appointments, unspoken hierarchies in top teaching hospitals, and rituals for presenting your story to each new specialist. The work is exhausting and absorbing—researching diagnoses, charting treatment options, adjusting to unfamiliar schedules, and learning to read the facial expressions of doctors as carefully as one might read the weather.
Like travel, this journey is both external and internal. You discover yourself in liminal spaces—waiting rooms, corridors, recovery rooms—that feel outside of ordinary time. You learn to hold paradox: fear and gratitude, uncertainty and hope, exhaustion and joy. You begin to see how prayers for strength and moments of awe at the skill of a medical team belong in the same breath.
This territory also has something in common with psychedelic medicine journeys. You leave the ordinary world and cross a threshold into a heightened state. The familiar dissolves; new visions, sensations, and perspectives arise. You may feel untethered at first—then slowly, you learn to trust the unfolding, to let the experience work on you, even when you can’t yet name what’s happening.
Mary Pipher, in her book Another Country, describes aging as its own foreign land. “Elders”, she writes, “live in a cultural space apart from the day-to-day tempo of younger lives, with its own language, customs, and worldview.” Illness and healing, too, bring us into “another country.” In both, you must learn to navigate unfamiliar topography, carry your own history like a passport, and open yourself to the ways this new land will change you.
For me, these maps are not theoretical. As a Marriage and Family Therapist, a doula at both birth and death, and a companion to people through illness, I have spent decades walking in and out of these borderlands. I have been at bedsides where first breaths were taken and where last breaths were released. I have learned that both beginnings and endings are crossings—each with their own language, customs, and sacred tasks.
And now, recently, as I am accompanying my loved ones through the “other country” of medical crisis, I again recognize the terrain. My biographical journey has taught me how to orient when the landscape feels alien, how to find the helpers, how to read the subtle signs of change. I know the value of carrying prayers like provisions, of finding joy in small kindnesses, of holding a steady presence even in uncertainty.
Whether the journey is through illness, aging, birth, or death, the traveler is transformed. You never return exactly as you left. The passport stamps from these crossings are invisible to others, but they mark you forever—proof that you have been somewhere extraordinary, somewhere that required courage, openness, and the Grace to be fully present.
Older Adults & Psychedelic-Assisted Psychotherapy
As a longtime psychotherapist and specialist in the field of aging, it has been exciting to follow the groundbreaking research being conducted by institutions such as the Johns Hopkins Center for Psychedelic and Consciousness Research and the NYU Center for Psychedelic Medicine at the NYU Langone Department of Psychiatry. Many more studies are being conducted and research published throughout the USA, Canada, and Great Britain about the positive results experienced by patients in these studies.
One article, among so many, about the Johns Hopkins research is entitled “Hallucinogenic Drug Psilocybin Eases Existential Anxiety in People With Life-Threatening Cancer“. “In a small double-blind study, Johns Hopkins researchers report that a substantial majority of people suffering cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin — the active compound in hallucinogenic “magic mushrooms.”
In another article, again among so many, is from the biannual print magazine and media company Double Blind which covers the expansion of psychedelics around the globe. The article is entitled “Can Psychedelics Help Us Face Our Fear of Death?”“After coming to a halt in the late 1970s, the study of psychedelic therapy for end-of-life anxiety was eventually resumed by investigators at UCLA, NYU, and Johns Hopkins, among others, and continues to this day. … Even without a fatal illness, every one of us has a terminal diagnosis—death—and anxiety over its inevitability is the ultimate existential crisis. Whether we approach our inevitable demise with fear and angst, spiritual reverence, or simply a healthy curiosity, there is strong evidence that psychedelic therapy can help us reach that milestone with equanimity and grace.”
A few months ago, I was interviewed by the website Psychedelic Support for an article entitled “Older Adults and Psychedelics“. Psychedelic Support is the leading online education and therapeutic platform in the psychedelic space advocating for mental health and well-being worldwide. “How can psychedelics play a role in healing for older adults? Guided and supported psychedelic experiences, with integration, typically create a fluid environment. In this environment individuals are able to soften their ego defenses or “armoring.” They are able to take a look at life experiences, challenges, and/or fears that they have compartmentalized or closed away over the years. We all have those experiences. With the help of a compassionate and competent psychotherapist and guide, many individuals are able to explore parts of themselves and their lives. They begin to develop new, wider perspectives that often include forgiveness of self and forgiveness of others. In older life, a healing process called “Life Review” naturally occurs when encouraged. This process can be greatly facilitated by psychedelic-assisted psychotherapy.”
To summarize, in our midlife and older years, there are many daunting challenges and rich opportunities that arise. We can dive in and explore our inner selves, make changes, and move forward in more balance, or we can lock up, try to resist parts of ourselves, and be in despair. It’s not black and white. But it is this profoundly important, I believe. Accessing altered states – through a variety of paths e.g. meditation, breathwork, vision quests, prayer, fasting, music, art, yoga, dance, and/or, for the right people, psychedelic-assisted psychotherapy – can unlock our hearts and minds and lead to great peace and creativity.