Ros: Are we ready to hold these medicines well? What I'm really asking is something much bigger. Are we ready to hold birth well, death well, initiation, grief, parenthood, retirement, heartbreak, love? Are we ready to be a culture that knows how to walk each other across the thresholds of being human? Welcome to Stand in the Circle with me, Dr Roslyn Watts. I'm a clinical psychologist, researcher and founder of Acer Integration. This podcast is about how we get connected in a culture that pulls us apart. We talk about the hardest experiences of being human and the circles of care we have needed, couldn't find and are searching for now with stories from people who've lived it and researchers and practitioners. Healing in community is the old way. The work of our time is to rebuild our connectedness to ourselves, to each other and to the living world. This is Stand In The Circle. I'm Dr. Rosalind Watts. Welcome back if you were here last week and welcome if this is your first time. Last week I laid out the foundations of this podcast. That we're not meant to do this alone. That healing has always happened in community and we just need to remember how. that we can learn to stand in the circle, to be honest with ourselves, be witnessed by others, and to remember that we are part of the living world. That kind of connectedness is what gets us through the hard valleys of human life, the places where walking alone is too hard. And it turns out... that this kind of connectedness is exactly what psychedelic medicines, now being researched for so many of these hard places, are pointing us back to. I learnt this through years of research at Imperial College London, listening to people describe what changed for them after a psilocybin session. The word that kept coming up over and over was connectedness, to self, to others, to the world. And so at this first month in the podcast, we are looking at psychedelics for depression, what they can do, what they can't, what's missing from how that care is being built. And here's what I want to do in this episode. I'll tell you the story of a man called John who took psilocybin in one of those trials and about what happened to him afterwards. I'll tell you about a piece of news from this last month that has changed the landscape of psychedelic medicine in the West. and I'll share some of the excitement and also ethical tension that I've been holding around it. I'll look at different responses from other people, different responses to that news, some people celebrating, some quitting their jobs. And a whole country, Gabon, organising to protect a sacred medicine. I'll come back to the three levels of standing in the circle with self, with others and with a living world and what they look like when we scale them up from personal practice to the cultural infrastructure that we need. And I'll end by talking about something I've been thinking about lately, going into the rooms that we might once have refused to enter and what we bring with us when we do. So let me start with the story of John, whose experience made a huge impact on me. I met John about 10 years ago. was a participant in the psilocybin for depression trial that I worked on, which I was a volunteer trip sitter on, which I talked about last week. At the time, John was 45. He had two children. And he told me when I first met him that he felt disconnected from himself, from his family and the farm that they ran. He dearly loved his wife and kids and nature, yet depression had robbed him of the ability to connect to anything. He told me that depression was like all the lights in your house turning off. You're there but you can't see or feel any of the beautiful things inside. He was trapped in a mind telling him negative things all the time and I can relate to that experience. As I mentioned last week I had a condition called PMDD for 30 years which meant that before my period each month just for a few days I was severely depressed. But John, as with so many people with depression, was trapped in the prison of the mind every day for years. So he tried every medicine there was. He had no hope. And he told me when he came in that he was skeptical. Drugs are for mugs. That's what school had taught him. And he didn't really expect anything to change. So John's story appears in the film that was made about the trial, Magic Medicine, which was by Monty Waits, which is on Netflix, I believe. And the film shows John go through two intense psilocybin sessions. The pain he'd been carrying for years was, as he put it, locked in a box and he had to find a way inside it. And he did, he broke through and he received so much insight. And I'll never forget how wonderful it was to see that his depression lifted, to see his smile and to see his sense of connection return. And for a few months after his sessions, he was different. He was on the farm with his wife and children and he was outside in the weather, in the green of it. He told me that the psilocybin experience had felt like the lights coming on in a dark house. It's what so many people describe, that sudden remembering that there is a you inside this ruminating mind box and there are people you love and there's a world out here and you've been away from it for a long time and now you're back. And what's interesting is that neuroscience has been documenting what John was describing. There's a network in the brain called the default mode network. It's the system that lights up when we're not engaged with the outside world, when we're ruminating, planning, replaying, worrying. And depression in brain terms is now understood partly as an overactive default mode network. That self referential loop that traps us keeps us stuck inside our own head. And psychedelic sessions deactivate the default mode network temporarily. So when John says the lights came on, What he's describing isn't just a metaphor, it's the lens of his attention opening away from the narrow loop of his own thoughts out into his life. But many months later, the film caught up with John again. At the time he's feeling great, but he's reflecting that actually when he feels depressed, that he'd rather be in a dark room with no windows and no people than out here in the beautiful natural world. And then at the end of the film, he had retreated from life and is back in his bedroom and we leave his story with the image of a closed door. And I want to be careful here because John's story is not a failure story. He was a pioneer doing something really unprecedented at the time. And the opening was real. It reminded him of what he loved, what he belonged to, who he really was underneath his depression and what he experienced in the months afterwards with his family on the farm was also real. But what I watched with John, I watched with so many of the people in those trials. A profound opening, some months of being more alive than they'd been in years, and then the openness fading, life closing back over the top of it. And it wasn't because the medicine had failed. The medicine had done what these psychedelic medicines can do when they work. And they don't always work, but when they do, they can open a door. What was missing was what comes after the door opens. The circle of people who can hold the opening with you. The practices like breath work to keep that openness, to keep having moments of touching that space beyond the everyday pressures of life. The door that has been shut for decades and then prized open needs to lead to a community and practices for helping keep the lights on day by day in a culture that is constantly turning them off. Because without ongoing community support and regular practices to keep the lights on, It's no surprise that they go out again. And that's the part of the story that I don't think we talk about enough. And that's the work I think that this moment in history is asking us to do to build alongside the medicines, the circles that hold what the medicines can open. And I want to say something here too, because this podcast isn't only going to be about depression and psychedelics. In future months, we will explore other territories where these medicines are showing up. So cancer. where there's growing research on psilocybin for end of life distress and anxiety. Menopause, where some people are using microdosing to help them through. Addiction, where psychedelic assisted treatment has a longer history than most people realize. PTSD, where MDMA has been at the center of decades of work. Anxiety, chronic pain, eating disorders, burnout. Each of those will be at the heart of a month long exploration on this podcast with someone who's lived it and someone who's researched it. So if you're listening because you're interested in psychedelics for one of those reasons, you're in the right place, stay with us. I'm thinking about all of this today because of something that happened in the news a couple of weeks ago that brings these questions right into the open. In April this year, the United States signed an executive order, a piece of policy that fast tracks access to psychedelic medicines for serious mental illness, particularly for veterans. It directs the regulators to speed up approvals and it opens a pathway for patients to access these substances outside of clinical trials. It commits significant funding to scaling the work up. And I want to start with what's hopeful about this, because there is a lot. People who are suffering, people with treatment resistant depression, veterans carrying trauma that nothing else has touched, people with horrendous addictions, people at the end of their lives in great distress. in the US may very soon be able to access medicines that could really help them. I've seen what these medicines can do and the desire to make that available to more people is a good desire. And I am hopeful for so many lives that will be touched by this and excited. And at the same time, something feels worrying. I've spent years grappling with ethical dilemmas in the growing field of psychedelics. Who to work for, who not to work for. I've held a lot of grief about what's being lost, the slow, sacred work being stripped down, and the traditional wisdom being left behind, and the individualization of what has been a deeply communal practice, and the corporatization. And yet, from working with people suffering from depression, I know that for so many of them, They want to see if psychedelics can help and they only want to try it at least for the first time in a hospital with a doctor present and that makes so much sense to me. My own psychedelic experiences have often been really difficult and when I say really difficult I mean viscerally agonizing. And I'm grateful for that because it's given me an insight into what people actually need when it's really tough like that. And actually I really wish that I could have experienced psilocybin as we offered it in the trial 10 years ago there was so much care and there was a doctor present and if I'm having a panic attack because I think I've stopped breathing or I think that I'm dying and these are both thoughts that I have had in the middle of psychedelic sessions then I want a doctor there telling me that I'm fine keep going but instead to experience it I had to go where it was legal which was a ceremony in another country and honestly I didn't feel well enough supported to really let go into my pain. was very intense and there was no one to hold my hand. I wanted someone next to me all the way through to hold my hand. That's what I needed. And I didn't feel safe because I didn't have that, because there weren't enough facilitators. There was a room full of people and there were a few assistants, which meant that we didn't all have somebody by our side the whole way through, which is what I needed to be able to let go. So I think expecting people with depression and trauma to get on a plane and attend a ceremony in a country far away where they will experience psychedelics in a ceremonial group without someone to hold their hand, without a doctor if needed, I don't think that's right for many people. It's also very expensive. And ultimately getting psychedelics into the healthcare systems in the Western world, paid for by health providers and insurance companies, that I think we need. those people deserve, it does mean that they're going to be safe and accessible for people who really need them. And to do that requires medicalization of psychedelics and funding from pharma because it costs millions to get a drug fully researched and to be approved as safe. And I wish that pharma companies were always ethical and put care above profit, but that's not reality. And so the corporatization needed to bring the medicines into our healthcare systems is going to be fought with ethical compromise. And we will see the shape of the work really suffer. And for years I've been confused about what to do, about what the right thing to do is. And you might be feeling some of this too, how to do ethical work in a compromise system. Do we just leave or do we stay and try and make it better? One of the most helpful gifts I've been given in this internal debate of mine is from my mentor, Sophie Banks, who is from the organization Healthy Human Culture. She says, when we consider whether to contribute to something or to step back, we can ask ourselves, what is the source intention of that project or that person? So when I think about the psychedelic project, I am invited to ask, what do the medicines themselves want? What do the mushrooms want? What is their source intention? Because if we know what the medicine is for, we have a way to tell whether what we're building around it is in alignment with it or not. And from everything I've seen in the trials and in the traditions, the medicines have one consistent intention to heal the wounds of disconnection between people and themselves, between people and each other, and between people in the living world. And this executive order is about increasing access to these medicines that can, when offered in careful and appropriate ways, start the process of healing the wounds of disconnection. But what's missing from the executive order is the circle. There's no mention of integration. There is no mention of community. There is no mention of the cultural context that has held these medicines for thousands of years. And maybe that's not surprising. Maybe that's not what they were trying to do. But there is no mention of what happens after the experience, the long, slow work of weaving an opening into a life. The policy is almost entirely about getting people to the medicine faster and silent about what happens once they get there. And so I know that what we are building in the ASA integration community is more important than ever because some of our graduates are starting local integration communities in America and other places. but also just the online community we have. are building a place that will be a way for people accessing psychedelic medicines who don't have any community infrastructure to connect with people who can really support them in that very tender and precious year. The year after a psychedelic session is so tender because people are open. It's a time of great potential for change if people are well supported, but it's a time of real risk if they're not. So I see what's happening now as a moment to recognize. that what we're building right now in this huge moment of expansion needs to be in alignment with what these medicines are for. And Asa's part in that picture is creating accessible integration communities. And many others right now will also be wanting to contribute ways to bridge the gap between what is being built and what the medicines actually require. I think the circle is being built in a thousand places at once by people who will never meet each other and we're all part of it and we have to trust that it's happening. But the field is not of one mind about all this, of course. Some people are celebrating and some are really worried. And I want to tell you about three things happening right now that show the different shapes that the concern is taking that I think are all really important. First is a piece of journalism, a writer called Jules Evans, who runs a sub stack called Ecstatic Integration and directs the Challenging Psychedelic Experiences Project. published a long and very careful piece this week. He interviewed 10 therapists who have worked on psychedelic clinical trials in the US, the UK, Germany and Australia. People who've spent years inside the work, people who really care about the medicines. And what they told him anonymously is that the trials are moving faster than the safety infrastructure can support, that informed consent is being treated as a formality, that therapists are being renamed as monitors. and I'll talk a bit like this with Michelle Baker-Jones in episode four, they're being told not to provide therapy and that participants are sometimes destabilised and left without follow-up. And the companies are telling investors that these medicines don't need therapy at all, that they can be administered like an injection of ketamine by a nurse in a clinic. The therapists raising these concerns are not trying to slow access for its own sake, they are trying to make sure that the people who do get the medicine are protected from the harms that we know can happen. I'll put a link to the piece in the show notes, it's really worth reading. So the second thing is a post I saw on Facebook a few days ago. A therapist in Canada announced that she's closing her psychedelic assisted therapy practice after a year of being open. She wrote that the Canadian system is not ready for this work, that the entire field is going in a dangerous direction. and that she can no longer be complicit. She wrote, medicalization is colonization no matter how you package it. And she said that her dreams of ethical psychedelic assisted therapy died the day she watched Joe Rogan, RFK and others standing in the White House while Trump tried to sound out the word, Ibogaine. She said, at this point, I believe psychedelics are best left in the hands of indigenous wisdom keepers. the rare properly qualified underground therapist and sovereign individuals seeking to explore their own consciousness. I read her post and felt the weight of it. I felt that pull myself, the temptation to walk away, to refuse to be in any room where these medicines are being commodified. And I really respect her decision. There are many ways to respond to this moment. Some people will leave, some will stay, some will build the alternative and we need all three. But when ethical practitioners are walking away from this work, then the field has a problem. The third thing is happening in Gabon in central Africa. For 25 years, Gabon has classified the iboga plant as a national treasure and protected cultural heritage. Iboga is the plant that Ibogaine, currently being fast-tracked in the US for addiction and PTSD, comes from. And it's been carried for centuries by the Bwiti people in a tradition of ceremony. and ancestors and forest and song. And exports of the abogus shrub have been very tightly regulated. As of last year, only one company in Gabon had an active export license. And this year, as the US moves to accelerate Ibogaine access, Gabon is tightening its grip. So new enforcement policies are being introduced against what they're calling biopiracy. So new genetic fingerprinting technology now allows authorities to track exported a boger bark back to the specific village it came from and a national summit was held this year called the Aboge leadership summit asserting bio-cultural sovereignty over the medicine. So the Bwiti are watching the West and what the West does next and they have organised, they are building the infrastructure to make sure that as the medicine travels the money flows back and the cultural knowledge is protected. Now we come back to the story of Maria Sabina who I mentioned last episode. Maria Sabina was a Mazatec healer who lived in a small village in the mountains of southern Mexico, the middle of the last century. She came from a long line of curanderas, women who'd been working with the sacred mushrooms for generations, possibly centuries. And for them, the mushrooms were not a drug, they were a medicine held inside a ceremony called a velada. The medicine woman would sing over the mushrooms through the night. And the mushrooms were embedded in a cosmology and a community. So Maria Sabina knew how to hold them and she held them safely for many years as her relatives and ancestors had. In 1955, an American banker on holiday with a camera persuaded her to let him sit in on her Volada ceremony. She agreed. He took photographs. Two years later, those photographs appeared in Life magazine and the world found out what the Mazatec had known for centuries. And a sample of the mushrooms were sent to Switzerland to Albert Hoffman's lab. The molecule was isolated and then what had been carried so carefully, hand to hand, generation to generation, began a journey into a culture that didn't know how to hold it. Maria Sabina lived for another 28 years. She watched what happened when all these Western seekers began arriving in her village. They were coming from the mushrooms without understanding the ceremony and they were taking the mushrooms and treating them as a recreational substance rather than a sacred one. The culture of her village was disrupted. The ceremonies that had held the medicine for so long were destabilized. And she watched the mushrooms that she'd served her whole life be turned into something that she didn't recognise anymore. She died in poverty, but in the book I read about her, Maria Sabina, her life and chance, that's not what bothered her, not her own poverty. She was devastated most about the loss to the spirit of the mushrooms. And near the end of her life, she said, from the moment the foreigners arrived, the mushrooms lost their meaning. They were profaned. From now on, they will no longer be ours. That's what happened the first time the West encountered a sacred medicine. You could say it happened with peyote and ayahuasca, other psychedelic plants, but what's happening in Gabon right now is such a huge relief because the Breity watched what happened to the others. They saw the pattern and I hope that they're showing us now what a different ending can look like. Where the people who hold the sacred medicine are the ones who decide how it travels. So Gabon is responding to one part of his story, the extraction of sovereign knowledge, but there's another piece we still haven't addressed. The piece that John's story showed us, what happens after the medicine. how we hold what the medicine opens and we still aren't learning the lesson about the importance of communities of support. And given the speed of the executive order, I think we're going to have many more people in that situation, people who walk out of the clinic with the lights on, back into a culture that doesn't offer ways to keep them on and certainly doesn't offer ways to keep the lights on long term. So what would it take to be ready and where do we begin? Because this question isn't just about psychedelics. The psychedelic experience is just one of many powerful thresholds that our culture doesn't know how to hold. The same circle of community and ritual and elders that's missing from psychedelic integration is missing from all the threshold moments where life cracks us open. Birth, death, becoming a parent, coming of age, falling apart, marriage, divorce, grief. This is why our work in ASA and what we're doing on this podcast has reached beyond the psychedelic field. We're not really just trying to build integration infrastructure for psychedelics. We're trying to build integration infrastructure for being human in a culture that's forgotten how to hold the human passages. So when I asked today, are we ready to hold these medicines well? What I'm really asking is something much bigger. Are we ready to hold birth well, death well, initiation, grief, parenthood, retirement, heartbreak, love? Are we ready to be a culture that knows how to walk each other across the thresholds of being human? And I think that the same three things that it takes to hold a psychedelic experience well are the same three things that it takes to hold any of those passages. They're the things that this podcast keeps coming back to. So last week I talked about three principles for sustaining openness after an opening experience. Standing in the circle with yourself, which is honesty. Honesty about how you're feeling. Standing in the circle with each other, which is about being witnessed. And standing in the circle with the living world, which is about belonging to nature. I talked about them as personal practices. But what I want to do today is look at them as something bigger. Because the three things an individual needs to hold an opening are the same three things that a culture needs to hold a passage. They scale up, the shape is the same. So the first principle is honesty. At the personal level, this is telling yourself the truth about what you feel, what you need, what's actually going on. At the cultural level, it's the honesty to admit when something is missing. honesty to say an experience alone is not enough, a retreat alone is not enough, the opening is the beginning of the work not the work itself. The honesty is to say plainly there is something missing here and we need to build it. That's what the Bwiti are doing now, that's what Jules Evans is doing in his journalism, that is what the therapist who closed her practice is also doing. Different forms of honesty, all of them telling the truth about what they are watching even when it's hard for some people to hear. And that honesty is a precondition for everything else. The second principle is being witnessed. At the personal level, this is letting another human being or a group of human beings see you, really see you when you're carrying something hard. Not so they can fix it, but so you don't have to carry it alone. At the cultural level, it's the infrastructure of community, the circles of people who walk you across a threshold and back, the elders who've been there before you. This is the piece that has been most thoroughly stripped from modern life. We don't have circles. We don't have elders. We have therapists sometimes and apps and self-help books and a vague sense that we should be able to figure this out on our own. But most of us are doing the biggest passages of our lives, birth, death, parenthood, grief, almost entirely alone and with nobody around us who has been trained in any meaningful way to hold us through them. And what I learned in the years I worked in the clinical trials is that this gap doesn't go away just because you've added a powerful medicine into the mix. If anything, it gets worse. The medicine has cracked the door. The culture they're returning to needs to know what to do with someone walking through it. And that's why I started ASA. It came directly from that realization. And in episode four, as I mentioned, I'll be talking with my longtime colleague, Michelle Baker Jones, and our conversation will include the moment we had when we suddenly realized that there's such a huge amount of cultural infrastructure needed. And after that, we set up the UK's first psychedelic integration circle in 2018. And then I created ASA in 2020. And they're places of witnessing, they're communities of care. And I think anyone taking psychedelics or having any kind of initiatory experience in life needs access to one of those places long-term. The third principle is belonging to the living world. At the personal level, this is realising that you're not separate from the natural world, you're made of it. Your nervous system was shaped by it over hundreds of thousands of years. The trees and the soil and the river and the sky are not background to your life. They are the life you are inside. At the cultural level, it's the recognition that the medicines that are now being reached for are not separate from the living world that grew them. Foreign administration to fast track psychedelics whilst also stripping back the country's ecological protections is showing just how deeply and dangerously they are missing the point. And I want to say one more thing about this because what I'm describing isn't only about psychedelic medicines, it's about how we stand in a circle with honesty and integrity in a political moment like this one. When I think about the executive order now, I think that there may be rooms I am invited into where I might once have refused to go. and I am going to go into those rooms because I want to see the day that people with depression can access psychedelic sessions and community integration and all the wraparound care that these medicines actually need. I'll be going into any room that I'm invited into with my Acer t-shirt on. I think that when we stand in a circle with honesty and integrity, we can go into any room and speak our truth because the circle goes with us. The circle has our back. So to recap, This week, I told you the story of John, a man whose depression was lifted by psilocybin, but then returned. I told you about the executive order in the United States that's fast-tracking psychedelic access and the need for community infrastructure. I told you about my own ethical dilemma sitting inside that gap and the gift that my mentor, Sophie, gave me, the idea of asking what the medicines themselves want, what their source intention is. I told you about Jules Evans's journalism. therapist closing her practice and Gabon protecting a bogey as a national treasure. I told you about Maria Sabina whose story showed us what happens when a sacred medicine is taken without its container and about Gabon showing us what a different ending might look like. And I mentioned the three things that I think a person needs to hold an opening. Honesty, standing in the circle with yourself. Honesty, standing in the circle with others, being witnessed and standing in the circle with the living world. Remember that you belong to nature. And I think that these are the same three things that culture needs to hold a passage. They scale up. They're what AESA is trying to build and what many others are also trying to build in a thousand places at once. And I told you that for me, this is a moment to go into the rooms that I might once have refused to enter and to bring what we're building in AESA with me. To trust that doing any honest work in service of life is its own form of standing in the circle. If you're new to psychedelics, especially if you're living in the United States, the executive order means that you're going to probably want to know more because these medicines will be becoming part of the healthcare system. There are links in the show notes to where you can find out more about psychedelic therapy. And there are also links to the Jules Evans piece and to information about what's happening in Gabon. And I wanted to say that if you're struggling with depression and psychedelic therapy either doesn't feel right for you or it just feels too far away right now. and you just feel trapped in that mental prison I talked about. Sharing with someone else can really help. And I really trust Samaritan's Volunteers to hold that space anytime you need. In the UK you dial 116 123, in the US you dial 988. And there are more numbers in the show notes for other countries. Thank you for being here. If you want to know what we're up to in ASA, there are links to that in the show notes too. Next week I'll be in conversation with Ruth who participated in that psilocybin for depression trial I've been talking about. and who's been walking the long spiral path of integration since. You'll hear what worked, what didn't, and what she really wished someone had told her. So I hope you can join us for that. I'm Dr Rosalind Watts. Stand in the circle.