How to Deal with Death Using Psychedelic Therapy

We all know how this ends.  We may spend our lives in denial, distracting ourselves from the inevitable but it’s a certainty that, one day, it’ll all be over.  We’re not built to accept death, we’re built to fight against it.  Sometimes, the struggle can grow to the point where our quality of life is impacted by fear around our own mortality.  So, how can we deal with death, and might psychedelics be a useful tool in this challenge?

How to Deal with Death Using Psychedelic Therapy

Confronting death with LSD

During the first wave of psychedelic research in the 50s and 60s, researchers had found that these powerful substances could be used to treat a variety of mental health issues.  In 1973, pioneering LSD researcher Stanislav Grof and his colleagues published the results of their research into using LSD-assisted psychotherapy to help patients suffering with terminal cancer [1].  They found that the death-anxiety that was present in these individuals was significantly reduced, their mood improved and so did their quality of life.  Despite the effectiveness of psychedelic treatments in helping to heal countless people, these substances were banned around this time, preventing research almost entirely for the rest of the century.

Psilocybin and end of life anxiety

Almost half a century later, the renaissance in scientific research into psychedelics was underway and researchers at Johns Hopkins began testing whether these results could be replicated with psilocybin [2].  The researchers gave high doses of psilocybin to individuals with a terminal cancer diagnosis and were suffering from anxiety and depression as a result.  The single dose session resulted in large reductions in depression, anxiety, and fear of death, as well as increases in life meaning, quality of life, and optimism.  In four fifths of the participants, these effects were still observed six months later.  This research showed that psychedelics are potentially the most powerful tool we have for reducing suffering in palliative care, by helping people to deal with death.  There’s no reason to believe these effects are limited to just this population, psychedelics may help many of us come to terms with our own mortality

The Strive for Ego Dissolution

“If you die before you die, then you won’t die when you die”.  This phrase is inscribed over a door at St. Paul's Monastery on Mt. Athos in northeastern Greece.  It captures a core aspect of the mystical experience -- ego death.  How can a psychological dress-rehearsal for death help us overcome our fear of death?  Feeling as if you are about to be obliterated can be a fear inducing experience, but in this situation there’s nothing to do but surrender.  This process requires the individual to confront all of their fears around their mortality and move beyond them.  By feeling the fear, surrendering and then discovering that nothing terrifying occurred on the other side, one can discover that, as Franklin D. Roosevelt famously said, “there’s nothing to fear but fear itself”.  The problem was never really death itself, it was the feelings of fear one held towards it.  Such an experience can reduce this fear and allow people to be more accepting of the inevitable.

Surviving Death

In addition to helping people to work through their fear, an additional aspect of psychedelic-induced mystical experiences can also make death seem less threatening.  It’s not uncommon for people who have undergone such experiences to feel as if they have discovered that what they really are, deep down, is something that will survive death.  Some may interpret this in a supernatural manner and may feel that they have discovered that they are a soul, temporarily inhabiting a mortal body.  There is also a non-supernatural explanation for this insight.  We typically identify with the story we tell about ourselves, our psychological self.  During an ego death experience, we come to see that self for what it is -- a story.  We discover that what we really are, fundamentally, is the same thing as the rest of the universe.  It doesn’t have a name, the theologian Paul Tillich called it “the ground of being”, others describe the energy of the universe.  Whatever you call it, the thing you really are deep down will still be here after the temporary individual self has passed on.  This insight can completely diffuse the fear associated with death.

The Repression of Death Consciousness 

Unless we turn inwards with a psychedelic experience or a practice like meditation, we can spend our entire lives fleeing from parts of our own minds.  It’s very possible to live an entire lifetime with a fear of death that is never confronted directly.  Our minds are masters of keeping us looking into the future and avoiding anything stressful or confronting.  This is not the case in the psychedelic state.  Psychedelics act in the brain by suppressing activity in brain areas that usually rule over the rest of the brain with an iron fist [3].  Without these centers keeping everything under control, the most important issues that we are unconsciously carrying can rise to the surface.  This could be difficult emotional material, traumas or the ultimate fear around which all others are built -- the fear of death.

Psychedelic Substances for Grief Therapy

It’s one thing to struggle with fear around the idea of one’s own death, it’s another to deal with the reality of a loved one dying.  Psychedelics are being found to be of use in both of these cases.

Ayahuasca

Ayahuasca can be powerfully therapeutic when dealing with emotional pain of many kinds.  This therapeutic effect appears to extend to the pain of grief.  The International Center for Ethnobotanical Education, Research & Service (ICEERS) investigated this topic in 2017.  They interviewed grieving individuals who had undergone an ayahuasca experience and found that, compared to individuals who had attended peer-support groups, they had lower levels of grief.  They reported experiences of emotional release, of reliving biographical memories, and of interacting with the person they had lost.  While these results are preliminary, they suggest that ayahuasca may hold great promise as a tool for coping with grief.

Psilocybin Therapy 

In the modern psychedelic renaissance, psilocybin has been leading the charge when it comes to therapies for end-of-life anxiety.  In coming years it may be offered as a treatment in palliative care, for those facing the end of their life.  Once it becomes prescribable for depression in coming years, depressed individuals may be able to use this substance to work through fears around their own mortality.  Many are arguing that, ultimately, psilocybin therapy should be accessible to anyone who is interested, much like conventional psychotherapy.  We may eventually see a situation where psilocybin therapy is the go-to option for anyone who wants to work through their feelings about their own death or the death of a loved one.

MDMA Therapy

The other star substance in the psychedelic renaissance, when it comes to clinical research, is MDMA.  MDMA-assisted psychotherapy has been found to be a powerful treatment for addressing trauma.  Facing one’s death as it approaches can be a traumatic experience, and new research has been recently approved by the Drug Enforcement Administration (DEA) that aims to test whether MDMA might also help those who are terminally ill.  MDMA therapy is also set to be made legal in the coming years, making it another potential tool for helping people deal with death.

Psychedelic death & real death

Near-death experiences are known to be capable of profoundly changing the individuals that experience them.  The psychological death that can occur during a high dose psychedelic experience can also be equally impactful.  Such experiences are ranked as being among the most significant of a person’s life, comparable to the birth of one’s first child or the death of a parent.  Being able to confront our mortality in this way appears to be one of the most powerful tools we have for processing our fears around death, of both ourselves and of others.  So what is the best way to deal with death during the psychedelic experience?  It all comes down to surrender.  Let the experience unfold, don’t resist it and you may have your relationship with death profoundly transformed. 

References

[1] Grof, S, Goodman, LE, Richards, WA. (1973) LSD-assisted psychotherapy in patients with terminal cancer. Int Pharmacopsychiatry 8: 129–144.

[2] Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., ... & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology, 30(12), 1181-1197.

[3] Carhart-Harris, R. L., & Friston, K. J. (2019). REBUS and the anarchic brain: toward a unified model of the brain action of psychedelics. Pharmacological reviews, 71(3), 316-344.


James Cooke