Can magic mushrooms help us come to terms with death?

For full article: VICE

Promising research suggests psychedelic experiences could be the future of palliative care.

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In 2016, researchers from New York University blindfolded a handful of terminally ill cancer patients and gave them a potent dose of psilocybin—the psychoactive ingredient in magic mushrooms. Each of the 29 patients had volunteered to take part in the medical experiment for somewhat comprehensible reasons: they were unable to handle the certainty of their own deaths.

Around the same time, Johns Hopkins University was conducting a similar experiment. Volunteers would be narcotised with psilocybin, isolated in a room with a purpose-built playlist, and carefully monitored by a pair of psychotherapists. The idea of both studies was that maybe a hallucinogenic could play a positive role in the context of palliative treatment. By giving a terminally ill person just one intense, psychedelic trip, could we maybe alleviate some of that crushing end-of-life anxiety? Anyone who has achieved a sense of clarity and inner peace with recreational drugs will get the idea.

“What we try to do in palliative care at the moment is to relieve the pain and suffering as much as possible by giving people pain medication. But morphine’s not going to take away their anxiety or their depression.”

“This is a completely different way of working with people,” clinical psychologist Dr Stephen Bright tells VICE. “What we try to do in palliative care at the moment is to relieve the pain and suffering as much as possible by giving people pain medication. But morphine’s not going to take away their anxiety or their depression.”

As vice president of Australia’s Psychedelic Research In Science and Medicineassociation, Dr Bright has been keeping a well-trained eye on the progress of these studies overseas. And much to his delight, the results have so far been decisive.

Subjects showed a significant and enduring reduction in anxiety, depression, and existential distress. In a follow-up assessment some six months after the treatment, 70 percent of the patients from the NYU trial later reflected on the psilocybin experience as one of the top five most spiritually significant experiences of their entire lives, while 87 percent reported increased life satisfaction overall.

A research paper published in the Journal of Psychopharmacology attributes a large part of these therapeutic outcomes to the so-called “mystical experience” of psilocybin, which it defines as “encountering a profound sense of unity, transcendence of time and space, [and a] deeply felt positive mood… infused with a renewed sense of purpose and meaning.” That’s one way to put it. But the potential palliative benefits of the drug become slightly less abstract when we consider the effect psilocybin has on the way we see the world.

The “mystical experiences” associated with drugs like psilocybin and LSD most likely stem from their influence on the ‘default mode network’ of the brain—that is, the neural network that allows certain parts of our brain to communicate while simultaneously cancelling out “cross talk” from other parts. The default mode network is important to our everyday functioning, insofar as it keeps us focussed on the things that are immediately relevant—like, say, this article you’re reading—and sidelines those things that aren’t—the overwhelming nausea that comes with impending death, for example.

Dr Bright explains that psilocybin disables the default mode network, thus opening the lines of communication between different parts of the brain that would “never normally cross talk.”

Hence the mystical experience, which he says may provide people with “a completely different perspective on their situation” and bring in to focus those things that humans typically tend to repress or pass over. And counted among those, of course, is the biggest downer of all: our own inescapable demise.

Westerners have a timid relationship with death.

We don’t quite look it in the eye. We pussyfoot around it, bury it in our subconscious and dig for wellsprings of eternal life instead. Which is awkward, really, considering eternal life isn’t an option.

“It’s almost taboo in Western culture to talk about death,” says Dr Bright. “And I think part of the problem that people in these studies are having is coming to grips with the idea of death because of the way it’s treated in society.

“[These patients’] significant others may not want to talk about it, and they may not want to bring it up. But after the psilocybin experience I guess they feel a sense that there’s something else out there, and they’re more likely then to talk heart-to-heart and have that meaningful conversation.”

A not insignificant aspect of psilocybin’s palliative benefits, then, might be the way in which it allows us to reach an understanding of death by facing it head on: to look it in the eye for the very first time and accept it for what it is. As far as psychiatrist Nigel Strauss is concerned, that makes this kind of research invaluable. After all, if we can truly help people come to terms with their own death, then we might just be able to dissuade them from wanting to take their own life.

“One of the things that makes a life good is the acceptance of death,” says Dr Strauss. “In fact we as a society should be thinking about death a hell of a lot more, because it’s an inevitable part of our existence.”

Strauss is well-versed in the subjects of psychedelic research and death. Just last year he had a paper published in the Australian Medical Journal which looked at the relationship between psilocybin-assisted psychotherapy and euthanasia.

“Euthanasia’s such a topical thing in Australia at the moment, there’s been a lot of conversation… and I think it misses the point,” he says bluntly. “For many of these people pain is not the big factor… What the majority of these people are requesting is early death or instant death because they’re not coping with the thought of having to die in the next several months. They just can’t accept that they’re going to die.”

Strauss cites studies conducted in parts of Europe, where assisted dying is legal, which indicate that more people request euthanasia on psychological grounds than physical ones. The way he sees it, palliative psilocybin could assuage the psychological weight that comes with a terminal diagnosis, and give a small flicker of hope to those who might otherwise want to “short-circuit” the process of dying.

“Hopefully a number of people who would have that treatment would then say ‘No, I can see what’s happening. I feel a lot better and more positive about it, and even though I am dying I don’t want to use euthanasia: I want to use the next couple of months to come to terms with everything and everybody.’

“By having the psilocybin experience they can see death in a whole different way and they’re much more comfortable with it.”

Our attitude towards death could probably use a reality check. For centuries we’ve been telling ourselves to “rage, rage against the dying of the light.” But dying doesn’t have to be so dark. If the research so far is anything to go by, there is a more optimistic way to think about the ends of our lives—and psychedelics may well be the key to unlocking it.