psychedelics
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.
Boomers and Psychedelic-Assisted Psychotherapy
Boomers and Psychedelic-Assisted Psychotherapy (PAT)
As a longtime Marriage and Family Therapist focused on serving midlife and older adults, I noticed early how few therapists specialize in working with these populations.
This is similar to the medical field where there are very few geriatricians, for various reasons I won’t go into here.
In the last few years, as I began to work in the field of psychedelic-assisted psychotherapy (PAT), I noticed the same phenomenon. That is, a community of practitioners not much interested in older people. At least, not enough to really study aging, with its inherent challenges and opportunities.
Many therapists, doctors, and researchers have mistakenly assumed that older people are the same as younger people – an ageist approach in my opinion. Older folks experience unique developmental tasks – check out Erik and Joan Erikson’s book, “The Life Cycle Completed”, especially the brilliant 9th chapter. Society-based pressures, shifting physiologies and often misdiagnosed and pathologized emotions push on folks in their third season of life.
Fortunately, things appear to be changing. An acknowledgment of how older people have been underacknowledged and invisible in our Western culture for the past decades is beginning to surface.
Here are two articles, one I wrote and one in which I am quoted:
“Older Adults and Psychedelics”
https://psychedelic.support/resources/older-adults-and-psychedelics/
“Older Generations Are Reclaiming Rites of Passage”
A Recent research study out of UCSF called “Effects of Psychedelics in Older Adults: A Prospective Cohort Study” puts it like this:
“Importantly, a recent review found that among 1,400 participants enrolled in 36 psychedelic trials since 1967, only 19 participants (1.4%) were 65 years or older. The safety and efficacy of psychedelic treatments in older populations thus remains largely unknown, although several authors have argued for the potential of psychedelics to loosen cognitive habits in old age generally as well as more formally as treatments for Alzheimer’s disease, including mild cognitive impairment and even health cognitive decline and age-related affective changes.
Other studies are publishing results on the clinical use of psychedelics for existential anxiety and depression at the end of life and in palliative care situations.
Here is one from Johns Hopkins called “Psychedelics May Lessen Fear of Death and Dying, Similar to Feelings Reported by Those Who’ve Had Near Death Experiences”:
My opinion about the growing amount of attention on older adults and research is that it’s about time! And, much more is needed! As usual, boomers are exploring and pushing outdated boundaries.
For the past year, it is my privilege to lead two groups – one for PAT practitioners who are serving this population. We focus on the topics of aging, palliative care, and end-of-life. Our small group includes a psychologist, therapist, social worker, hospice nurse, death doula, somatic sound healer, chaplain, and more.
The second group is called EPIC which stands for Elder Psychedelic Integration Café. Participants’ ages range from 67 to 90. Each individual has experienced PAT and this setting is a place to mutually learn from and support each other’s paths of exploration.
In my private practice I work in connection with a licensed clinic, using ketamine-assisted psychotherapy (KAP). KAP can be very effective in mitigating depression, anxiety, chronic pain, and end-of-life fears. The treatments I provide are given in my home office.
I also help clients to prepare for and integrate sessions with psilocybin and MDMA. I do not provide the substances. When people have solid preparation before and integrative support after an experience, the benefits are often profound.
It is heartening and exciting to see older people finally be included in this burgeoning field of healing!