By Mary Carpenter
SPENDING four days at Atman, a Jamaican psilocybin retreat, was emotionally moving, spiritually rewarding and fun for retired D.C. area rabbi L.M. Most important to L.M.’s positive experience were the retreat’s guides, who “provide a ‘container’ for the psilocybin [magic mushroom] experience. You want that to be healthy and good.” (With psychedelic drugs not yet legal in the U.S., retreat organizations offer experiences solely outside the country.)
In his new memoir, Spare, Prince Harry talks about using mushrooms to help with prolonged grief after the death of his mother “therapeutically, medicinally,” writes Dana G. Smith in the New York Times. Smith explains, “Scientists think that psychedelics work in two ways: through their chemical effects on the brain and the subjective experiences a person has while on the drugs.”
With trust a crucial factor for those like L.M. seeking a psychedelic experience—for most people, out of curiosity but also with some hope of having the transcendent experiences described by others—L.M. chose Atman from the site created by How to Change Your Mind author, Michael Pollan.
“The opposite of spiritual is egotistical,” Pollan has explained in interviews. “To the extent that you can diminish the role of the ego, you become a more spiritual person—more connected, less defended.” The ceremonial aspects of Atman’s psilocybin experience impressed L.M., such as when the guides suggested beforehand that participants might want to place an “offering” or meaningful object at the center of the room.
To this “altar,” L.M. added his tefillin, two small leather boxes containing sections of Torah connected by a leather strap, which are worn on the body close to the heart and the brain. For L.M., tefillin “symbolize the human desire…to be One with the intelligence governing the universe, to lose one’s ego and experience the creative intelligence at the basis of all existence.”
Also reassuring to L.M. was that his guide had a PhD in psychology and was involved in clinical research and that the nine participants included four M.D.’s. For each session, the Atman retreat provides three guides plus two other “team members,” with a maximum group size of 12 participants.
Psilocybin and ketamine are the two psychedelics, among a host of those currently being studied, that are “leading the way,” according to Field Trip Health. While the two compounds overlap in their effects and fall under the umbrella term psychedelics, psilocybin belongs in the category of hallucinogens while ketamine originated as a dissociative anesthesia drug.
“Psilocybin and other psychedelics are thought to promote neuroplasticity, a rewiring of the brain that gives patients fresh perspectives on longstanding psychiatric problems,” according to the New York Times. Psilocybin “has shown significant promise for treating severe depression, post-traumatic stress disorder and end-of-life anxiety among the terminally ill” — although long-term benefits remain unclear.
“All of my mom friends are microdosing mushrooms, and I want to try it, too,” a patient told Bay area psychotherapist Melissa Whippo for a Washington Post guest column. Reflecting the expanding enthusiasm for taking small doses of psilocybin, Whippo writes, “my patient lives in the Bay Area — home to one of the epicenters of what is known as the “psychedelic renaissance,” making it more common for moms to discuss microdosing at play dates.”
Meanwhile, some states and cities are moving to loosen legal restrictions on psychedelics. On January 1, Oregon began allowing anyone age 21 and older to “legally access psilocybin services”—although only under the supervision of a state-certified facilitator. The dozens of facilitators currently in training should be ready “sometime later in 2023,” according to Smithsonian magazine.
Colorado, too, has legalized supervised psilocybin use at state-approved centers, which should become available in 2024, while individuals age 21 and up will be able to use, grow and share mushrooms. Neither Colorado nor Oregon allows retail sales of the drugs. Washington D.C. and specific cities in Michigan, California, Massachusetts and Washington State have also decriminalized possession of select psychedelics.
The Pollan site lists a wide variety of psychedelic service providers—including individual “trip sitters” at sites like Psychedelic Passage, who guide personal experiences without supplying the drug. In addition to Atman, several U.S.-based organizations offer psilocybin retreats in the Bahamas, the British Virgin Islands and other countries where the drug is legal.
Another way to experience psychedelic drugs in the U.S. is to participate in research—made possible because of the FDA’s 2018 designation of psilocybin and MDMA (Ecstasy) as “breakthrough therapies” for the treatment of PTSD and depression. Ongoing trials with the Department of Veterans Affairs and at academic research centers, notably the Johns Hopkins Center for Psychedelic and Consciousness Research, generally accept specific groups of people, such as those coping with addiction and terminal cancer, as well as those suffering with PTSD and severe depression.
But outside of research programs, psychedelic experiences can be expensive. The current protocol for MDMA-assisted psychotherapy, for example, includes 42 therapy hours over 12 weeks, with one overnight stay—that could cost $13,000 to $15,000 per treatment. For psilocybin, the Hopkins research protocol calls for about 30 therapy hours, which includes two therapists for lengthy pre- and post-trip sessions, in addition to the eight or so hours of the trip experience.
“The biggest tensions [in efforts to legalize psilocybin have] erupted over the issue of affordability. Psilocybin sessions will not be covered by insurance as long as the federal government lists the drug as a Schedule 1 substance—meaning “no currently accepted medical use,” according to the New York Times.
Of organizations currently offering psilocybin experiences outside the U.S., Atman charges $2,450 for its four-day Jamaica retreats. For Oregon-based Silo Wellness, five-day Jamaican retreats “include 2 separate dosing sessions with reflection time between” at a cost of $4,595 for single occupancy and $3750 for double.
Taking psilocybin at a retreat setting with trustworthy guides makes it possible for some people to consume greater quantities of psilocybin than those who try the drug on their own or with an online guide. While hallucination images can be vivid at any dose, participants taking higher doses seem more likely to report encounters with people—from their past, their present lives and even after death.
For L.M., having his children come to him was “very meaningful,” he said. He talked about having “many conversations, speaking my mind to them.” He felt himself “reaching out” and describes “overwhelming feelings of love toward his kids and other people.” After the experience, L.M. felt “more stillness” in his daily meditations, which became “deeper and more satisfying;” and his prayer life became “enriched.” In the future, he would like to go to Atman or another psychedelic retreat once a year.
An obstacle for some people, however, is the requirement by many retreat organizations that participants stop taking other medications, such as antidepressants. Because both SSRI antidepressants and psychedelics operate on serotonin receptors, experts worry that the combination could cause excess serotonin in the brain, although some researchers have found no such interaction of the two drugs. Others suggest that those taking SSRIs long term need up to 50% more psilocybin to have the same effect.
Stopping antidepressants may be one reason I don’t try a psilocybin retreat. Also, I generally avoid group experiences, and found debriefing sessions at a 50-or so- participant retreat for holotropic breathing to be long and grueling. The Atman maximum of 12 sounds more promising.
Maybe more important, though, the low doses of psilocybin I have tried have gotten me to feel slightly more open to different experiences—even those that previously sounded unappealing. I found L.M.’s account of his Atman experience both intriguing and compelling.
—Mary Carpenter regularly reports on need-to-know topics in health and medicine.