I've been asked to write a short book section on "Psychedelics and dying" and that has nudged me into looking at this territory here on the blog.  It's a fascinating subject in all kinds of ways.  With the limited space I have, I'd like to comment briefly on four overlapping areas.  One is the growing body of research showing that psychedelic-assisted therapy can dramatically ease severe existential distress associated with terminal illness.  A second, less well studied area, is the observation that psychedelic experience reduces death anxiety in the general population.  Thirdly, it's interesting to note the similarities between some descriptions of psychedelic states and reports of near death experiences.  And lastly I'd like to talk about how psychedelics might produce these effects.

“ God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. ” - Reinhold Niebhur (adapted)

Research.  Stages/Tasks.  Vaillant.  Kohlberg.  Adult "maturation tasks".  Retirement.  Death.

Complicated grief is ...

More to follow ...

I watched a very impressive film last night called “How to die in Oregon” (tricky to get as a UK DVD, but easy to download on iTunes).  It’s a 108 minute documentary that was released in 2012.  The plot summary reads “In 1994, Oregon became the first state to legalise physician-assisted suicide.  As a result, any individual whom two physicians diagnose as having less than six months to live can lawfully request a fatal dose of barbiturate to end his or her life.  Since 1994, more than 500 Oregonians have taken their mortality into their own hands.  In How to Die in Oregon, filmmaker Peter Richardson gently enters the lives of the terminally ill as they consider whether, and when, to end their lives by lethal overdose.  Richardson examines both sides of this complex, em

I recently wrote a blog post "Grief is our natural human response to bereavement" where I said that mourning may well involve powerful feelings of yearning, disbelief, anger & depression.  When we have lost someone who has been very important to us, we gradually need to learn to live without them. Reconfiguring our inner emotional lives and our outer activities can be such a challenge.  Mostly though people manage.  It may be hard, but like the body healing after injury, emotional pain also resolves as we hold our loved ones in our hearts but engage more fully again in our lives.  Sometimes though after physical injury, wounds don't heal adequately.  Maybe there is infection or non-union of fractures.  In these situations the healing process may need help.

When we're badly physically injured, there may be horrible pain and loss of ability to function normally. Then though there is typically a gradual recovery.  Scars may be left; there may be some persisting vulnerability, but basically our bodies are wonderful at self-healing.  There are parallels between wounds due to physical injury and wounds due to emotional injury.  For example, when we are bereaved, there may be horrible pain and loss of ability to function normally.  Gradually, over time, our minds & hearts can heal.  Of course, if we have lost someone important to us, we will never be quite the same.  We may always miss them, and remember them with sadness, gratitude and love.  The grief resolves though and we can move on with our lives, even though we continue to carry our loved ones in our hearts ... and this resolution is what they would have wanted for us.

I wrote a blog post yesterday morning setting the scene for a two day workshop I was about to go to with Professor Kathy Shear on her treatment approach for complicated grief.  Well, how did the day go?  It was very interesting, inspiring, and also a little too much "simply sitting listening" for my tastes. It's hard to know what the best design for this kind of two day seminar should be. I strongly suspect though that just sitting taking in, even such excellent information with the opportunity for regular questions, isn't the most effective way of transferring knowledge.  Hard to do it, but more active audience participation would probably serve the workshop's goals even better.  Despite this, the material being shared was great ... really fascinating and important.

I was struck by a couple of papers on grief that I read last year.  One was Kathy Shear & colleagues' "Treatment of complicated grief in elderly persons: a randomized clinical trial" and the other was Bryant et al's "Treating prolonged grief disorder: a randomized clinical trial."   I was impressed because Shear's paper showed clear benefits of one treatment over a valid active comparison treatment.  Trials showing better outcomes of treatments that have been compared with "treatment as usual" (TAU) or "waiting list control" are two a penny.  However an intervention that produces an obviously better outcome than a valid alternative intervention makes me sit up and take notice.