Gosh, 'nerves' have come in a bit sooner than I would have expected.  Lying in bed this morning, early, I felt that hard-to-describe collection of sensations ... quite a full, slightly aching feeling in my chest, and in my belly also a background sense of fullness ... and unease, caution ... and almost like a distant, silent firework display intermittently lighting up the horizon ... a play of slight sensations in my gut that quieten as I internally turn to look at them.  I recognise this feeling.  It's what I experienced at times in the lead-up to my kidney donation operation a bit over two years ago.  OK, in three weeks today I'm due to take my first psychedelic trip for nearly 50 years (I took a dozen or so LSD trips between the ages of 19 and around 24) ... so some 'nerves' are understandable.  But I'm initially surprised these feelings should be emerging so early.  It makes sense though.  I was very focused on the forthcoming 'trip' yesterday.  I've thought and planned extensively for this 'adventure'.  I've just completed an article for the journal "Counselling in Scotland" titled "Psychedelic-enhanced psychotherapy: time for a Scottish special interest group?" and I'm due to send it in this morning.  And although I've set up a couple of 'trip-sitters' who I'll work with in the Netherlands in three weeks time, I have also arranged back-up with a dear therapist who I know well here in Edinburgh ... and yesterday I spent an hour talking about the 'trip' and the next time I'm due to be in touch with her is in just over three weeks, online via Zoom, the day after the first 'trip'.

So interesting watching inner response in a kind of slow motion.  I notice I'm a little 'superstitious' all of a sudden.  Here's the picture that emerged when I opened up Google this morning (it's St David's day):

And the quotation that sprang out when I went to my own website was Rollo May's wonderful wise words: "Without courage other values wither away into mere facsimiles of virtue".  I think I'd be more reassured though if I didn't have David Bowie's words from "Space oddity" running round in my head.  You know the ones that plaintively repeat "Ground control to Major Tom" while he disappears off to float in endless space!  Ah, the mind can be an extraordinary associative machine at times, as no doubt I'll experience in spades in three weeks.  

And now here I am three weeks later ... a first psilocybin trip completed a couple of days ago and a second due tomorrow.  Funnily, I was never as nervous again after that 'tremble' three weeks ago.  I thought of deleting this earlier description, but I guess it illustrates well that it's very normal to feel cautious moving into this territory and that often anxiety is worse in the lead up to an event than it is when the event actually arrives.

There's so much I could say about the trip two days ago.  Choosing the words carefully, I feel it was probably the deepest spiritual experience of my life.  I say deepest rather than most important spiritual experience, because I feel I will only be able to assess its importance after months or years when I have more sense how much it may have actually influenced how I live my life.  The signs are good though.  We can understand the mechanisms of psychedelics at a number of levels ... entropic, neurochemical, via functional magnetic resonance imaging, and by verbal report (to mention just some of the candidates).  I think Robin Carhart-Harris & colleagues are pointing in a helpful direction in their paper from last year "Psychedelics and connectedness" with its abstract commenting "Psychedelic drugs are creating ripples in psychiatry as evidence accumulates of their therapeutic potential. An important question remains unresolved however: how are psychedelics effective? We propose that a sense of connectedness is key, provide some preliminary evidence to support this, and suggest a roadmap for testing it further."  And their emphasis on increasing connectedness to self, others & the environment echoes with the series of papers that have shown that scores on "The mystical experiences questionnaire (MEQ30)" during the psychedelic trip are one of the best predictors we currently have for better long term outcomes with a variety of targets involving both distress symptoms and levels of wellbeing up to a year or more later.  See, for example, the paper "Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin" with its abstract highlighting "scores on the MEQ30 positively predict persisting change in attitudes, behavior, and well-being attributed to experiences with psilocybin". 

See too the deeply interesting work from John Hopkins - "Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors" - with its abstract reading "Psilocybin can occasion mystical-type experiences with participant-attributed increases in well-being. However, little research has examined enduring changes in traits. This study administered psilocybin to participants who undertook a program of meditation/spiritual practices. Healthy participants were randomized to three groups (25 each): (1) very low-dose (1 mg/70 kg on sessions 1 and 2) with moderate-level ("standard") support for spiritual-practice (LD-SS); (2) high-dose (20 and 30 mg/70 kg on sessions 1 and 2, respectively) with standard support (HD-SS); and (3) high-dose (20 and 30 mg/70kg on sessions 1 and 2, respectively) with high support for spiritual practice (HD-HS). Psilocybin was administered double-blind and instructions to participants/staff minimized expectancy confounds. Psilocybin was administered 1 and 2 months after spiritual-practice initiation. Outcomes at 6 months included rates of spiritual practice and persisting effects of psilocybin. Compared with low-dose, high-dose psilocybin produced greater acute and persisting effects. At 6 months, compared with LD-SS, both high-dose groups showed large significant positive changes on longitudinal measures of interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. Determinants of enduring effects were psilocybin-occasioned mystical-type experience and rates of meditation/spiritual practices. Psilocybin can occasion enduring trait-level increases in prosocial attitudes/behaviors and in healthy psychological functioning."   (This paper is available in free full text).  Scoring well on all scales, as I did, bodes well ... scores of over 60% are usually taken as the cut-offs for what the literature calls "complete mystical experiences".

It's important though for me to be clear why I'm writing these descriptive personal posts.  As Pema Chodron has put it "We work on ourselves in order to help others, but also we help others in order to work on ourselves."   I'm confident that these test-runs of where & how one can safely take psychedelics here in the Netherlands will be helpful for me, but even more I hope they will be helpful for other therapists who are interested in the possible benefits for their clients achievable with these approaches, and for people who might be considering exploring these areas for themselves.  I'm not trying to encourage (or discourage) others to take these paths.  What I hope for is that people can make their own decisions based on our current best estimates of risks & benefits - see, for example, the posts "Recent psychedelic research: an introduction",  "Their use in psychotherapy", "What are the risks?", this draft of a paper for the journal "Counselling in Scotland" suggesting the formation of a Scottish psychedelic-enhanced psychotherapy special interest group, and the soon to be completed "Recent psychedelic research: their use in the general population".  As I've repeated many times "It's important to keep an open mind, but not so open that our brains fall out".

And click here for the next post in this three-part sequence.