speaker-0: just to see that kind of model of support. And without fail, every single group, they would swap numbers, they would carry on meeting, they would find their own way to keep connected to each other. And I just thought it was just so powerful. And I absolutely think that that is as important as individual therapy.

speaker-1: 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. Welcome back. This is the fourth and last episode of our month of Standing in the Circle with Cancer. This is the one where I answer the questions you submitted via the online form in the show notes. I have four questions. Let me read you all of them now so that you know what's coming. The first three are about community and psychedelics. And the fourth is specific to the experience of cancer. Question one. How can I find a circle? Question two, how does one become part of the psychedelic community or volunteer without paying thousands of dollars? It feels like the space is not equitable and does not have room for those from a different tax bracket. Question three, I want to move out of the triangle and into the circle and reconnect with nature. I'm thinking of going on a retreat somewhere where psychedelics are legal. Do you have any advice about which particular medicine and what dosage? And question four. You've covered psychedelic approaches to the demoralisation that can accompany cancer. What about other non psychedelic therapy approaches? What's available? What's most helpful? So I've enlisted the help of two specialists to help me answer these, Christine Caldwell and Dr. Elika Valley, and you'll meet them as we go. So let's take these questions one at a time. Question one, how can I find a circle? OK, so three different parts to my answer. Part one, there are already more of them. than you probably know about. So look at what already exists near you. Griefs, cafes, death cafes, men's group, women's circles, recovery meetings, quake meetings, which are essentially silent sharing circles and open to anyone and free. Community choirs, which are not really circles, but they kind of do a lot of the same work in the body and the nervous system. Look at your local notice boards. Look at cafes, health food shops. Libraries, village halls, and look at your local Facebook groups. That's often where this stuff gets posted. You can also look for local psychedelic societies. The Global Psychedelic Society has a map showing hundreds of local community groups all over the world. They put on various community events, not just about psychedelics, also things like speed friending or foraging workshops. Part two, AESA. AESA is the year-long circle I run. It's online, which means you can come from anywhere and the sharing circles run at different times so you can find one that fits around your life. We follow 12 trees through 12 months. Each tree has a theme and the whole community works the same one at the same time all over the world. So this month it's the apple. An apple tree on its own will blossom, but it will not fruit. It needs a different variety of apple trees nearby and it needs the bees to carry the pollen between them. So That's the focus of the month. What is my one contribution? Who do I need around me? What is the one thing we could actually create an offer together? Next month is hazel. So that's September. It's when the hazelnuts come. And that one is about gratitude and about harvest. What have I gathered this year? We count our hazelnuts and our pearls that we collected over the last year. Hazelnuts are the sweet things, the gifts. Pearls are the hard-won lessons, the ones that cost you something that you found in the deep dark places. We share stories of our hazelnuts and our pearls with each other, and we store up our gratitude for the winter that's coming. And so every month in Acer works the same way. It's a 10-minute film about that month's tree, and then a tree journey where you go into a mild altered state of consciousness because of a combination of music, guided imagery, and breathing techniques. Now this is a modality that I developed in the psilocybin for depression trials at Imperial College and is really effective for connecting to self and others and nature with no psychedelics required. So after these tree journeys, we have facilitated sharing circles to reflect on what you felt and learned and witness others. And then the rest of the month is more sharing circles, different types of breathwork journeys. dance, art, a whole range of drop-in sessions and getting to know people and making deep connections over the year. So what people say afterwards is that they found people that they could tell the truth to. Come to one of our free live events to hear more about it and see if it's the kind of circle that you're looking for. Our next cohort starts in October this year and we do have assisted places so if money is a barrier please apply and tell us your situation. And then part three of my answer to this question of how do I find a circle? If you can't find a circle and you really want an in-person one, not an online one, start a local circle yourself. So I'm doing this at the moment. I've just started a circle that meets monthly in a yurt, 12 people one Sunday a month for a year. We follow the structure of the 12 trees from Acer. So when we meet, we watch the film. So last month we watched the oak tree film for July, which is about getting to know and accepting all the parts of yourself. Then everyone got cozy and we listened to the oak tree journey. And then we had a sharing circle. And I was amazed actually by how many people applied and they all said the same thing really. They were longing for community of place, meaningful connection with a small group of people long-term to get to know each other deeply, to have a real in-person village and be a villager for others. And I started doing this local group because our vision in ASA is seeding villages like this, giving people the tools to create their own local long-term circles because it's hard to start a group from nothing. But our 12 tree films and tree journeys are all recorded, so it's kind of easy enough to offer them as the basic structure of a 12-month group. And obviously you need to be able to hold a space and have experience with doing so. But this isn't group therapy, it's listening, it's about creating safety. So it's much simpler and much more accessible. And if this appeals to you and you think you could hold a space like this in your community, we train people to do exactly this. So get in touch, links in the show notes. And of course, there are other ways to start your own local circle, other approaches, other focal points, other ways to train. Our approach in Acer is really about connectedness. So we offer this kind of simple way to create an island of connectedness in your own neighbourhood. Question two that was submitted. Now this one I want to read in full. How does one step into the psychedelics? It feels like well-intentioned people don't have the opportunities even after doing the trainings. It feels like the only way to take part is to pay. And that goes against everything I thought this community stood for. How does one become part of the community or volunteer without paying thousands? It feels like the space is not equitable and does not have room for those from a different tax bracket. I am so glad that somebody submitted this. ⁓ The psychedelic field has a problem with equitability and access ⁓ and money and privilege. Trainings cost thousands, retreats cost thousands, and conferences cost hundreds and sometimes thousands. And a lot of the people with the most offer the ones who are steady and kind and can help regulate and calm a frightened person. or hold a beautiful local group are exactly the people who can't afford any of it. Often those of us doing this kind of work, haven't made massive fortunes. This is the kind of work that isn't well paid. Meanwhile, the people who can afford it are not always the people that you would want holding you. And that is the pyramid doing what the pyramid does. I talked about the pyramid in previous episodes. So here is what I know about getting into the field without loads of money. The first door in is about harm reduction. So the Zendo Project and SciCare are amazing organisations and they hold space at festivals and events for people having difficult psychedelic experiences. They train volunteers. You do not pay thousands of pounds. You turn up, you get trained and you sit with people on the hardest night of their year. And I would say that is a better education in holding space than many paid trainings. Although the trainings are great as well and if you can do both, that's amazing. So maybe I shouldn't say that it's better, but it's really valuable. You learn so many valuable things and it's free and it's a great first step. You might find a way to do the more comprehensive training afterwards because it is important if you want to be a psychedelic therapist or guide to do the full training. But you might not know that yet. And so you do the first step of learning what it means to hold space for people in difficult psychedelic experiences from these kind of harm reduction community organizations. It's a really, really good first step and might be the only step. It might be the way you contribute to the psychedelic field and make new friends and have a good time and also feel that you're really giving something back that's important. And you learn what actually helps when someone is terrified, which is, you know, it's not really a technique, it's a kind of calm approach, it's a calm person who's not going anywhere, you learn how to be that person, which is really important, not just in psychedelic festivals, but just in our communities, in our lives in 2026, which is a psychedelic experience all of its own. So the second door into the psychedelic community that's not really expensive is to make the tea. Almost every retreat centre ⁓ training and conference in this field really runs on unpaid hands. So somebody has to cook, drive people from the airport, wash up, set out the chairs, sit on the front desk. Most of the big conferences have volunteer programs where you work for a few shifts and you get a free ticket. Most retreat centers have some version of work trade as well. Very few of them advertise it. You have to write and ask. So write and ask, say what you can do and when you're free. And if a place says yes and then puts you in a room with people who are deep in an experience on your first day with no training and no check on who you are, that's important information. A good organization will be careful about you because they're careful about everybody. The good ones will start you in the kitchen. You stay in the kitchen. You'll learn an enormous amount from the kitchen. Feel safe in that community. Let people trust you. And then, you know, you might move from the kitchen into the therapy room at some point. The door into the psychedelic community for not paying thousands is to get trained somewhere else entirely. this, really want people to hear this because the training you actually need is some of it you can get for free and some of it is not in this field. The best training I ever had was from Samaritans. They will train you really well over months for nothing. Hospices will train you as a volunteer for nothing and then you will sit with people who are dying. When you're ready, crisis text lines will train you online, befriending services can also train you. And none of these will teach you anything about psilocybin, but all of them will teach you the thing that really matters, which is how to be with somebody in the worst hour of their life without flinching, without fixing, without making it about you. Catherine McLean, who you heard from earlier this month, was one of the first scientists in the field, psychedelics. and well from the modern phase of psychedelics, maybe like the second wave of psychedelic research. And she now volunteers in hospice. And that is not a step down. That is going deeper. If you can see it at a deathbed, then you're a safe pair of hands. And safe pairs of hands is what we need in the circle. And of course, I'm going to mention our own ASA training again, specifically about affordability. So this is the ACEs stewardship training offering the 12 trees in your local community. We have had some philanthropically funded places, which means somebody else is paying for someone to do the training and offer the 12 trees to their community. For example, a philanthropist is paying for a group of people from the Global Psychedelic Society to train with us. And we hope to see more of this in the future. And that is the only way I know to make this equitable. And as the person Asking the question to us says, you know, to make it possible for people without huge wealth to be part of the growing psychedelic field. And I think the key thing is not necessarily to go straight to being a trip setter, a psychedelic therapist, because that is a tiny part of the work that this field needs to do to make it solid and safe. We have a whole load of community building, infrastructure building first. And maybe that bit doesn't sound so exciting, but it's really important and you meet like-minded people along the way. Already so many people have done expensive psychedelic therapy trainings and don't have jobs yet. Be part of creating the fabric of care, the community infrastructure that we're going to need if the introduction of psychedelics into Western society is going to be safe and positive. Question three, I want to move out of the triangle and into the circle and reconnect with nature. and I'm thinking of going on a retreat where taking psychedelics is legal. Do you have any advice about which particular medicine and which dosage? I'm so glad to have this question because it's the most common question I get and it really makes so much sense that people ask it because psychedelics are so new and people want to know how they can get involved in the specifics. But I can't really answer it. I can answer it in a particular way, but I can't give the clear answer. that people might want and actually nobody can. I can't give you a medicine or a dose because I don't know you. I don't know your medical history, your medications, your family history, what you're carrying, what you're hoping for. Those things change everything. Two people can take the same substance at the same dose in the same retreat and have completely different weeks, months and years afterwards. And anyone who tells you what you should take without knowing any of that is guessing. And you should be suspicious of that. And actually in the last five years or so psychedelic research has been making the news and it's easy to hear all the stories of how psychedelics have helped people and to really think that psychedelics are a magic cure, but they are extremely powerful and they can cause such harm if used carelessly or without proper screening. You know, we could do a whole month on this podcast on standing in the circle with psychedelic crises or the aftermath of psychedelics going wrong. Another person asking this question is saying that they want to make a safe choice, that they're interested in psychedelics and they're asking a harm reduction question, how to avoid a bad retreat. And there are many of them, sadly. So although I can't answer it, like really specifically anything about the medicine or about the dose, I can offer something. I hope is helpful. So nearly every horror story that I have heard and I have heard a lot of them comes back to the same handful of things. Nobody screened them properly. Nobody prepared them. The person holding the space was not safe or not present or not trained or not there at all. There was nobody to call afterwards. And in the worst cases, somebody took advantage of them at their most open. Shockingly, sexual harm in these spaces happens. So how do you know if the retreat centre in the Netherlands or Portugal, Oregon or Jamaica is any good? Here is what I would ask. Do they screen you properly? And do they screen you before they take your money? A real screening asks about your medical history, your medications, your mental health and your families. Ask about who is holding the room, what is their training and who trained them and how experienced are they? Not what they say about their lineage.

speaker-0: lot.

speaker-1: I need names. Is there integration? And is it more than a single group call the next day or the next week? And what happens if I have a hard time afterwards and I'm struggling? You want a specific answer. Here is who can help, what they do and for how long that's available for. And you can ask, can I speak to people who went last year? Not the testimonials on the website, but actual people. You can ask, what is your policy on touch and on boundaries, boundaries between facilitators and participants. And if you have a prep session and it doesn't feel right, there's often a kind of telephone or an online prep session way ahead of you actually going in person. And if it doesn't feel right, don't go ahead with a retreat. I once had the most appalling prep session for a retreat with someone who is training. in modality of family constellations, if you've heard of that. And instead of listening to me, she unloaded her own spiritual dogma and quite bizarre opinions onto me. She was training and she didn't know how to listen yet, how to get out of the way and stop making about herself. So I wrote her a long email about how the session impacted me. and told her and the retreat leaders that I felt so unsafe that I was cancelling any further participation. So think what we need is a kind of trip advisor for retreats. And I would have written a long review and maybe save someone else from having the experience I had with that facilitator. But we don't have this yet. But people are starting to create directories. One of those people is Christine Caldwell. She's an Acer graduate. She used to run a nursing home and she realized that psychedelics could help people. this stage of life. And I wanted to include her work to link back to the theme of this month because Christine is the founder of End of Life Psychedelic Care. It's a non-profit in Oregon and it's for anybody facing a life threatening or serious illness who has started to suffer spiritual or existential distress. And Christine has created an international directory and that links people to practitioners with experience in both end of life and psychedelic care. And also they're doing a pilot program bringing ketamine therapy and spiritual care into people's homes through palliative care. So I asked Christine the question that you asked me. One of the questions we had submitted this month about, you know, how to find reputable, reliable practitioners. And I suppose it is such a thing with so many different factors, isn't it? There's so many things to consider that it's very difficult to give general advice and it's really a conversation to have really with the person. Would you agree with that, Christine?

speaker-2: Yeah, I I I do, ⁓ because everybody's intention is different. And you know, and of course we all are aware of some of the ⁓ more famous ⁓ retreats and you know and they cater to a different crowd. ⁓ and so it's really important to understand what is it I want I'm wanting to get, what where do I wanna go? and and you know, how do I wanna be supported after? So those are all, you know, factors to take into before you can help somebody decide what's best for them. Or or how how can discuss, you know, options for them.

speaker-1: Thank you. And I'm just wondering, you may or not have an answer for this that you could share on the podcast, but speaking of retreats for people with cancer, are there particular retreats that you know kind of have a special program or really experience with people dealing with cancer and kind of cancer related issues?

speaker-2: ⁓ yes. ⁓ I always always give a big shout out to the Survivorship Collective and they can be found at Survivorship Collective dot org. They organize retreats, group retreats specifically for cancer survivors and cancer thrivers ⁓ in a legal setting ⁓ using psilocybin. So this is right now Oregon and they're branching out into Colorado. They are looking at the Netherlands ⁓ as well as New Mexico. you know, in the future. And then my good friend and colleague Heather Lee ⁓ runs retreats ⁓ as as well. ⁓ she's a longtime ⁓ psilocybin facilitator, cancer survivor herself. And then perhaps near and dear to you all in London is Dr. Lauren McDonald, who has hosted several retreats for individuals with ⁓ cancer. And I I'm pretty sure that's been in the Netherlands and in Spain. Heather works in Portugal, Spain, ⁓ as well as Mexico and Colorado.

speaker-1: So there are some recommendations from Christine. She knows these facilitators personally, but I think names and recommendations are a starting point. It's so important to ask all the vetting questions. You can find more names and more info on Christine's directory for end of life psychedelic care. She also mentioned other directories to guide people towards safe practitioners. So major training organizations have a directory and we've put some of these in the show notes. I want to hold on to what Christine said about all the different factors to consider, especially the one about how do I want to be supported afterwards. Going somewhere legal, having a big opening and then flying home to the same life is just the first bit of the plan and you do need to figure out what holds you when you get back. Who you tell, where you take it. If you're moving out of the triangle and into the circle, the circle is the bit you build at home. The retreat can't do it for you. So find an integration circle before you go on any retreat. Question four. You've covered psychedelic approaches to the demoralization that can accompany cancer, but what about other non-psychedelic therapy approaches? What's available? What's most helpful? This is a good question and it deserved a better answer than I could give. So I spoke to Dr. Eli Kavali. Eli is a clinical psychologist and a cancer specialist. She is the founder and clinical director of After Cancer, which is an online psychology service for people whose cancer is in remission but needs support processing what they've been through and what they want the next chapter to be about. And this focus really speaks to me because it's the same shape as the thing I keep going on about. ACER exists because of the bit after the psychedelic journey. The opening is not the work. What you do in the weeks and months and years afterwards is the work and almost nobody is set up to help with it. after cancer exists because of the bit after the cancer journey. Treatment ends, everybody celebrates and that, Ellie says, is when people often fall apart. So here's our conversation I asked Ellie about non-psychedelic therapy approaches for people walking through cancer.

speaker-0: First of all, the first grouping that I would describe is a group called third wave CBT. So I'm going to explain a bit about what that is because it might not make much sense to people. So CBT is cognitive behavioral therapy. That is quite common. A lot of people have probably heard of CBT. It's been rolled out in quite a big way across the NHS. It definitely has a good evidence base for more mild anxiety and depression. But there's been an evolution of CBT, I think, I guess, work with difficulties that might be more complex. And I think CBT naturally, it's a use of challenge or try to get rid of negative thoughts. Whereas third wave CBT approaches, this development of them is about teaching people to change their relationship and to their negative thoughts. So... There is different types that are used within cancer care. One is called ACT, that is frequently cited as being helpful. So that stands for Acceptance and Commitment Therapy. Now, guiding principle of ACT is about psychological flexibility, and it offers lots of tools to do this. So if we look at the acceptance part of the title, Acceptance and Commitment Therapy, it's about... accepting and tolerating difficult feelings, ⁓ allowing feelings to come and go without trying to fight them or to control them. And this can be a really important part of how to respond to cancer and the anxiety and the difficulties that come about as a result, because there are things that can't be changed. It's how you learn to tolerate these feelings and this position that you find yourself in. And then the commitment aspect of ACT ⁓ is about living in a values driven way. So really thinking about what's important to you and taking proactive and value driven steps to create a meaningful life. So you can kind of see how this tolerating difficult feelings and really thinking about what's important how you want to live your life can be a really important can be really important framework I think for people after cancer, particularly because it throws everything up in the air and people often find themselves thinking you what what's important to me, what do I want to do with my life? It kind of forces that level of reflection. So ACT can be really helpful in that area. Then do stop me any point if you want to ask questions. Then there is CFT, which is compassion focused therapy. Now this... The basic premise, I suppose, CFT is about the brain's threat system and the idea that the brain's threat system is stimulated as a result of the cancer experience leading to overwhelming anxiety and fear. And compassion focused therapy teaches the brain to activate its soothing system. So then it offers tools to do this. It can be particularly helpful, I think, for people where there is high levels of self-blame or self-criticism. And I think, I do think the post-treatment phase is quite a fertile ground really for that. There's huge amounts of pressure that people put on themselves to bounce back, to get back to normal, to get back to work, to get back to their social and family lives. There can be lots of complicated... difficulties relating to how they feel about their body and the changes in their body. There can be lots of feelings of guilt about things that they haven't been able to do while they've been having treatment, things they can't do going forward. So I think particularly where somebody is susceptible to feelings of self-blame and self-criticism, CFT has a really useful place, I think. And then there were mindfulness-based approaches. So mindfulness-based CBT, mindfulness-based stress reduction. They both use mindfulness and mindfulness meditation in a very structured way as an intervention, as a ⁓ tool to help regulate emotions and difficult feelings in the mind and in the body, and helping people to be in the present, which again, it can be very hard when you've had cancer treatment and might be a lot of looking forward to the what ifs and the worries about the cancer coming back. So tools that help to sort of steady you and keep you in the moment. So I think they would be loosely, I think there are the three, the third wave CBT approaches that I say are out there and I think can be easily accessed, I think for people who've had cancer treatment. Then there's the more trauma focused therapies. So this is for people who particularly are struggling with the medical trauma associated to their cancer experience. And I think there's lots of opportunities for trauma. when people are having cancer treatment, there's the point of diagnosis and the shock and the trauma that's associated with that. Then the experience of very invasive and gruelling procedures and treatments. And then there's the side effects of those treatments. know, chemotherapy, for example, can leave people very unwell, very vulnerable, and it can really feel like survival at that point. And I think even just fear of recurrence, living daily with fears of death and dying. these are all just different types of trauma. So there's trauma-focused CBT. So again, that's just using CBT techniques to interrupt the patterns of avoidance and fear and unhelpful beliefs that can come about as a result of treatment. And then there's EMDR, which is eye movement, desensitization and reprocessing. I say on the whole, tends to get used and offered more. is a model that heals trauma by using bilateral stimulation such as side to side eye movement. And this process in itself activates the brain's inflammation processing system and it helps traumatic memories to become unstuck and helps to, I guess, some of the kind of emotional impact of some of those memories gets kind of loosened and it allows the brain to metabolize the experience a bit better. So that's the kind of more trauma focused. And then there is more psychodynamically informed approaches. So these are more exploratory, insight-based, it's less about offering tools and techniques, but more kind of unstructured, open space to explore the experience. I wouldn't say we're talking about a very traditional kind of psychoanalytic therapy where someone's ⁓ on couch, know, kind of Freudian style. probably a slightly more adapted version than that. But the focus is still very much on internal conflicts and how these are contributing to psychological distress. So there's a real focus on unconscious processes and psychological defences and trying to bring to the surface parts of the client's internal world that might not be well understood by themselves. And I think it could be a really helpful approach for people who feel very stuck. know, that have had cancer treatment and just can't quite move on and they don't, they know intellectually that they've had this very difficult experience but the way in which it's getting into the different parts of their lives and they're not able to move on to be really starting to think about what's beyond their conscious awareness can be very helpful. And another central component of psychodynamic approaches is about past experiences and some people might say well what's that got to do with the here and now and my experience of having cancer and cancer treatment. But actually, I think the experience of a cancer diagnosis and treatment really does, it brings the past alive, I think, in ways that people don't always fully understand themselves. And a lot gets reactivated from people's pasts. And I think that just the very, that the experience of being so vulnerable and not being able to rely on your traditional ways of coping. can really kind of expose and bring to the surface unresolved difficulties from the past. So again, psychodynamic psychotherapy gives a framework to work through that. And then I think there's also just non-talking therapies as well. There's art therapy and dance and movement therapies, you know, where there's less of a focus on using language to express and make sense of experiences. worked in settings where I've really seen the benefits of art therapy for some people as well. So, yeah, so I think that's some of the approaches that are available out there in NHS settings, in private setting, in the charity setting as well.

speaker-1: So then thinking ⁓ more towards the after cancer period then. So it's really interesting that you've been focusing on this because I suppose maybe a lot of people think like, ⁓ you know, if you've been through cancer, you're in remission. you're going to be fine now because you're in remission. So talk to us a bit about why do you set up after cancer? Tell us what it is. Yeah. So why you could see the need for it.

speaker-0: Yeah. So after cancer is an online psychology service for people living beyond cancer. And by that, I mean people who've had treatment and they've moved into the post-treatment phase. So that could be a few days after treatment. To be with you, it could even be a few years for some people. I think often the most challenging phase is the first year, but we don't have a kind of upper limit. If you've had cancer treatment and you're still being affected by your cancer experience, then you can come to us. So the reason I set it up is because the post-treatment phase is actually the most vulnerable for people's mental health, more so than diagnosis and more so than treatment. And I think that comes as a huge surprise to people who are having treatment and for those around them. And there's a reason why this happens. If you think about the point of diagnosis, people go into a state of shock. people talk about feeling numb, about it feeling unreal. There's even a level of denial sometimes, you this can't be happening to me. And ⁓ actually, has an evolutionary purpose. It functions to protect our mental wellbeing when things are too much, things are too overwhelming, there is a detachment and a shutdown that happens. So in that phase, people aren't really taking in what this means. They are just in a state of shock. And what is perhaps quite unique about cancer and cancer treatment is you go from that state of shock into treatment. ⁓ And this is often physically very, very gruelling ⁓ for people. ⁓ And it's all the focus is on the physical. It's all about getting rid of the cancer, getting well. And if you've got a very difficult treatment plan, it's about survival at that point and getting to each day. So it's when treatment stops and you're not in that kind of regime of treatment, the mental health takes a real dive. So this is actually when the processing actually occurs. So I think the most common thing I hear in my practice is people saying they are only just beginning to process their experience. And they were only just really taking in what's just happened to them. And, or they say, I don't think I've processed, you know, I don't think I've processed this yet. I don't think I've really been able to process this experience. and they suddenly feel very, very overwhelmed. So that's what's happening in the initial post-treatment phase. And I think it's also when fear of recurrence really kicks in. Not that they weren't aware of this during treatment, but I think the reality of living with that risk and finding a way to cope with the anxiety becomes much more real. And of course, when you've finished active treatment, you're not engaged in doing something that's getting rid of the cancer, you're suddenly kind of on your own a little bit. And that kind of fear that we could just come back at any time is really alive. And I think it's also a time when people feel the most isolated and alone. They don't have the frequent contact and the containment and the monitoring by the medical team. Ironically, people want to get away from it. But when they don't have it anymore, I think it can be really destabilizing. think often the support of family and friends just becomes less available because everybody thinks it's over. And suddenly all that kind of, you know, in a good scenario where you might have had lots of love and lots of support, it just naturally ebbs away because life starts to go back to normal. And I think what's also complicated is that people around somebody who's had cancer, you know, people around them are... celebratory, they're happy, it's over, you you're cancer free, those kind of, you know, words are getting used. And I think that is not the feeling often for somebody who's just finished treatment, they don't feel celebratory. And I think that can kind of compound the isolation and the distress that they're not feeling something, they can't access that feeling, you know, they might feel relieved it's over, but celebratory is not necessarily a word that anyone would. you used to, you know, would use to describe how they're feeling. And I think in the post-traumatic phase is when people really realize that they are forever changed. You know, that's what, know, I hear people say that a lot, that there's a pre-cancer version of themselves and there's a post-cancer version of themselves. And then there's this enormous task of trying to integrate those different parts of themselves. And I think there's lots of grief and... that has to be worked through, to navigate all the changes that their cancer experience has meant for them. You know, it suddenly becomes much more confronting, all the changes when you're trying to get back to your normal life. You really start to realize what's different. So it's emotionally such a complex time. And I think people are really often quite iniquitous and not ready for that. And I think it can feel quite devastating that they've been through all of this. And now they're in this kind of mentally and psychologically, they're in a worse place than they've been throughout the whole experience. And I think at that point, yeah, the physical recovery has started in earnest, but the emotional psychological recovery has really only just begun.

speaker-1: Thank you so much for that. It makes so much sense when you say it, but that's all really feels that feels like really valuable insight because some of that was, yeah, it lands very deeply because of course, but I probably have been one of those people that have greeted friends that have been through cancer and then they get their, you know, they all clear with that celebratory feeling without really stopping to think about the actual nuance and complexity for the person on the other side of that.

speaker-0: Yeah, yeah.

speaker-1: So tell us about After Cancer and what you offer.

speaker-0: Yeah, the, so I guess, the primary aim is to offer support to people in that post-treatment phase. And so that can be any point. So anybody that's had cancer and feels that they need some support with regards to that can come to us. other aim was to offer something that people knew was going to be reliable and high quality. So psychologists who have got doctorate level training, they're registered with the HCPC, which is the Health and Care Professionals Council. And that's, it's kind of a bit like the gold standard, you know what you're getting when somebody is HCP registered. They've, all the psychologists that work for us have worked in NHS settings. So they're not just experienced psychologists, they're experienced oncology psychologists. So there's, think a lot of times when people are out there looking for therapy or looking for support. It's a bit of a minefield. You don't know what you're getting and you don't really know what people's qualifications mean or, you know, who's, you know, what you're going to get. So, taking, taking some of that out of it, you know, what you're getting with us. But also it felt really important to me to provide something that was flexible and accessible. And we've done that through sort of three different pathways. So first of all, we offer a course of six. free sessions for people who are on low incomes and benefits, so completely free of charge. Then we also offer a ⁓ course of short-term therapy that's paid for, for those who can afford it. But the idea is that having six sessions allows you, it's obviously more affordable for only a few sessions, and it allows you a space to focus on the pertinent issues. And sometimes that's enough. People might say, I just need six sessions to really think about how I'm going to manage going back to work, or I need six sessions to really focus on the fear of recurrence and how I can live with this anxiety, or I need six sessions to really think about a relationship that's suffered and struggled during my cancer treatment. So I think there's a lot to be said for that kind of short-term focused work. And it hopefully makes it more accessible for people who can't afford ongoing therapy, but know that they could take something. away from it. And we can also offer those sessions on a fortnightly basis. So again, just spreading them out over time, hopefully makes them more affordable for people. And then we offer them a more traditional offer of open-ended, longer-term therapy. But we just didn't want that to be a barrier for people, that not everybody has got the time or the inclination. to commit to something longer term. So those are the different kind of levels that we offer. Yeah, that hopefully makes us accessible.

speaker-1: That's amazing. What an amazing service. is it available to people in the UK only or could you accept people from other countries?

speaker-0: Yeah, I mean, I think we definitely could accept it from other countries that hasn't happened so far. think sometimes it's just thinking about time differences, isn't it, because it's online. But no, it absolutely wouldn't be an issue if you wanted to get in touch and discuss that. could definitely think it through for sure.

speaker-1: and we'll put links in the show notes of course.

speaker-0: Yeah, see, yeah. Probably just to say that the free sessions would only be available to people in the UK. So if anything else would be available, yeah.

speaker-1: So apart from therapy Ellie, which is obviously your specific focus, what are the other things that you've seen help people in the cancer readjustment phase after they've been through it?

speaker-0: Yes, so I think it really is about community and connection. That's what I've seen. And I absolutely think that it needs to go alongside therapeutic work. I think these two things are needed. And I often encourage people to think about how they might connect to people from the cancer community. And it's definitely something we want to develop as a service as well, as groups as well. But I worked for a cancer charity, we used to run a six week group for people in the post-treatment phase. And there's lots of different elements of it. I would do a week on managing emotions. We had a physio come in to help think about exercise and exercise planning. We had a nutritionist thinking about a diet and food. So lots of helpful things that we were offering, but without wanting to of put ourselves down, it was... peer support and the connection that absolutely made that group special. The sharing of stories, of experience, that you could see the kind of feelings of isolation that just went away for people when they were connecting with other people who got it. That kind of experience of not having to filter themselves or censor themselves, to just speak freely about what had happened and what their fears were. because they were all, people often talk about the they can't talk that open honestly with their loved ones because their loved ones don't want to hear it. It's too dark. It's too difficult. And I think, you know, sort of seeing the power of empathy and compassion, both giving it and receiving it. And it was often deeply moving to be part of that group and to see how they held and contained each other in this group. And there was this really powerful exercise we did in the last week where in their own time. In the last week, they had to write a letter to themselves, just to talk about their experience and their group and where they are now and what they want going forward. And they would then, if they want to, read these letters out. And I mean, there would just be tears all around as people be reading these letters and tears in those and listening to it. And then they would feedback and talk about what spoke to them in the letters. And just to see that kind of model of support. And without fail, every single group, they would swap numbers, they would carry on meeting, they would find their own way to keep connected to each other. And I just thought it was just so powerful. And I absolutely think that that is as important as individual therapy.

speaker-1: And can you think of any kind of, yeah, kind of wider resources for that? So you mentioned about the charity you worked for, but are there other kind of forums or kind of community connectors that you know of that in the UK?

speaker-0: Yeah, so that was a group at Maggie's. It was a group called Where Now? I would absolutely recommend it to everybody in the UK to sort of go to find out where you're nearest Maggie's Centre and find out about that group. I think it's excellent. And I think that definitely, I think there are other charities, I know for sure, but in the UK, there are breast cancer charities, I think Breast Cancer Now, perhaps Future Dreams that offer post-treatment groups as well. I'm trying to think what else there is. think, again, local charities, there's gonna be so many local charities out there that I don't even know about. But I often hear when I'm talking to people in therapy, they went to some group that was local to them. So again, it's about just finding out what your local groups are. And yeah, I do think it's largely in the... in the charity sector, but there may also be NHS psycho-oncology services that are offering groups as well. But with a lot of NHS services, there's a limit to how long after treatment you can access support. And this is part of another reason why I set up After Cancer, because there is sometimes, there's a lot of focus on during treatment and then afterwards, there's not so much available just because, you know, resources are sparse.

speaker-1: And if people listening are wondering about volunteering in some kind of way, if they would like to be supportive to other people that are going through this at any stage of the journey, can you think of any, like where would be a good place for people to kind of as a first port of call to look at? Well, not necessarily had cancer, I guess maybe people that have had cancer and have fully processed it move forward, but just people that would like to volunteer in some way of helping.

speaker-0: people who've had cancer. Yeah, I think a lot of charities offer kind of mentor programs where you can be support an individual who's going through treatment. So they will match you with somebody who's going through a similar, had a similar diagnosis and a similar treatment plan to the one that you had. And again, I've heard lots of people talk about how useful that is to have somebody who's just a few years down the line who can just... offer some, you know, support and advice from a slightly more distance position, but really understanding what that feels like. And then I think there are, you know, various sort of cancer centres like Maggie's and Macmillan Cancer Centres as well, where you can just help out in the centre and make cups of tea, just sit down, have a chat with people when they come in, lots of opportunities for that. But absolutely, you need to have had quite a bit of space, I would say, after your own experience, because that you know, being back in those kind of cancer spaces and talking about cancer can be really challenging. And, you know, you need to also keep yourself safe and not try and go into those things too soon. It can be very tempting to want to give something back. I hear it lots and lots of times people talk about wanting to give something back because people are so grateful for what they've received and the help they've got. But don't do it too soon. That would be my advice. That time will come. But I think another thing that's important to add is as tough as the post-treatment phase can feel. I think it can be a real reckoning for people. It really makes them reassess their lives and they look at what has not been serving them and what they need to change. And I think cancer can really force that change in a positive way and people can go on to live their lives in a more positive way. And this isn't about trying to put a positive spin on it. there is that kind of idea about post-traumatic growth. is, you know, how people come out the other end and live better. So I definitely think that's, you know, I guess I want to say that to people who are in the trenches at the minute.

speaker-1: So there might be that kind of initial phase of expecting to feel really happy because you're in remission and actually feeling quite low and quite processing all of the trauma from the experience and it's very difficult. But then when you're through that period of time, which you're there to support, know, your organization is there to support with, then people actually might really move forward to a really kind of a new place in themselves, a different place, different person, but in many ways more in line with their values and more.

speaker-0: Yes, absolutely.

speaker-1: I was really moved by what Ellie shared that in the cancer journey, the most dangerous point for someone's mental health is not diagnosis and it's not treatment. is afterwards. Shock carries you through the diagnosis, survival carries you through the treatment and then it stops and there's nothing to do and everything you have not felt arrives at once and the people around you are happy and relieved and using words like cancer-free and you can't feel any of it. And also Ellie spoke about the importance. of peer support in cancer care, the importance of the circle. Which brings me back to Christine and to the thing I noticed about this whole month. Catherine lost her sister to cancer and built a sanctuary in the woods. Ellie watched people fall apart after cancer treatment and built a service for them. Christine was deeply immersed in end of life care and could see that psychedelics could help and she built a non-profit. So I asked her about that. I asked her what the Circle had to do with it, how it helped her create this. So Chris, the last time I saw you was when you were in ASA with us years ago. And since then, you've set up this amazing non-profit. And I'm just, yeah, I'm just curious about how this podcast is all about being in a circle and how being part of that community, did it support you developing end of life psychedelic care in any way?

speaker-2: ⁓ definitely. I think it was a perfect complement to following my year-long training with the Psychedelics Today Vital Therapies and Integration program because as a year-long program, and I mean ACER ⁓ in this case, then we really got the opportunity to build that trust, build that bond and share our stories in a safe and non judgmental space. And you know, I mean that that is just tremendous. And as you know, one of the reasons why you founded it is because a lack of connectedness. And have that connection with individuals who are willing to be vulnerable is just priceless, basically. And from that I met a lot of people ⁓ that I still work with today, and that includes Naoko Bishop. She lives here with me in Ashland, Oregon, and she is a psilocybin facilitator. ⁓ Melanie King Vellez, ⁓ who is a has a holds a doctorate in nursing and ⁓ is a psilocybin facilitator also in Oregon. And Andrea Alessandro, ⁓ my gosh, Andrea introduced me to her partner who is funding that ⁓ ketamine pilot I talked about up front. And ⁓ there's several others. There ⁓ there's an amazing woman, Jenny, who does a lot of work in England, outside of Devon, ⁓ dealing with ⁓ end of life, not just with psychedelics, but in terms of helping people understand the ⁓ importance of of building the a relationship, a personal relationship with death and dying.

speaker-1: ⁓ thank you, Chris. So good to hear those names, all those lovely people and to know that you've all got these connections together. Yeah, it's brilliant to hear amazing people you're talking about there and amazing work you're all doing together. And it's great to think of the mycelium connecting you all. And this month on this podcast, we've we've heard from other researchers and clinicians in the space. We've heard from Catherine McLean and Dr. Ellie Cavalli and

speaker-0: is

speaker-1: And like you as well, you've all seen this kind of gap and you've built something. And I'm just wondering whether, do you think there's something about proximity to serious illness that really powers people forward to set things up and build stuff and be really, I guess, brave about it?

speaker-2: ⁓ I love that last bit of your question. And I'm gonna st I'm gonna start my answer by with a story. What I learned from talking to hundreds of, I'll call them psychedelic death workers, is that individuals who are closer to their diagnosis still have that anxiety, like a lot of people feel that you are so well aware of before a psilocybin journey or any psychedelic journey. They don't know what they're going into. There is that fear of the unknown. and then when they get much closer to the end of life, they're basically like, Bring it on, you know, I w I wanna I wanna witness the other side, I wanna see what's going on. And so they they lose their fear of the psychedelic. Now this is a generalization, but you know, that makes a whole lot of sense to me. And you know, it's easy to say, Well, we all die. So, you know, this is a universal sacred journey, and I think this is a big Big reason why all of us have gravitated toward this because of the fact that you know, we all die and we're all facing our mortality and the fears that are associated with that. And in in the Western medical establishment, you know, death is viewed as a failure. So if we, and I love that you mentioned Katherine and Ellie, you know, if we as a as a village, you know, can help people understand. And lose their fear of dying. And also in losing your fear of dying, you also bring meaning and purpose to your life, right? And I know this is what you saw in all the research that you did. So this this is our goal is really to help people overcome that fear. And there's so many lovely stories of psilocybin in particular helping people to go, all right, you know what? It's okay. not to know what's happening next. I'm okay with that. And to say, and as a result, I am going to live a meaningful life in the present. And it also reminds me, I owned a home health care agency for several years, and we supported the individual's physical needs, the activities of daily living. And to some extent we ⁓ supported their social network because Our home healthcare aides were their social network, but we never supported or helped an a client deal with those psychospiritual concerns or existential distress. And this is where psychedelics come in. And it's just such an amazing ⁓ ability. And obviously psychedelics are not for everyone, but you know, the vast stories I've heard is just ⁓ They've helped so many people come to peace with their death and dying.

speaker-1: ⁓ thank you, Chris. It really is. It's a hopeful chapter, isn't it, to think about how much more people can be helped than they have been up till now or in the past.

speaker-2: As I mentioned, there's so many lovely stories, and I'd like to share one with your audience, and that is about ⁓ Thomas Hartle, who was the first Canadian to be approved for psilocybin therapy through Health Canada. And he has this lovely analogy. He talks about a bucket of iron filings. So just visualize a bucket of iron filings. What is that? Not much. You melt down those iron filings and you can fashion a tuning fork. What is that? It's still an object. But when you strike that tuning fork, that vibration you send out into the universe lasts an eternity. And that's how he came to think about his existence, an eternal vibration into the universe.

speaker-1: So something that I learned after speaking with Christine is that Thomas Hartle, who she talked about, died. He died on the 13th of August, 2024, at 56. This was eight years after his diagnosis. He was the first person in Canada to legally receive psilocybin therapy. And then his permission ran out and he spent the last years of his life fighting to be allowed to have it again. And he was refused. There is a bill going through the Canadian Parliament right now with his name on it. So he struck the tuning fork and the vibration is still going. And this brings us full circle to wrap up the month. We started with my auntie and my cousin Tom and how the connection to his vibration is still strong and always will be. And I don't think Thomas Hartle was only describing what happens after a person dies. I think he was describing what a person can do whilst they're still here, when they know their purpose and when they have a circle around them that helps them realise it. You gather up what you're made of, you shape it into one thing and you strike it. Everyone I spoke to this month had struck theirs. They found the thing they needed to do and they did it. Kim and my aunt caring for their children. day and night. Rebecca, choosing to stop fighting for her survival and to belong instead. Catherine creating the place in the woods after her sister died. Ivan and Ellie and Christine setting up their unique and incredible services. Their vibrations are ringing out in harmony and more are coming to make this world a more connected place for people going through cancer and all the other painful terrains of human experience. Next month we begin again. in the territory of perimenopause. So I'll see you there. I'm Ros Watts. Stand in the circle.