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Psychedelics and Mental Health
I was recently asked about a piece on psychedelics from the television show, “Last Week Tonight.” The host, John Oliver, did a great job talking about the complicated history around these chemicals in a therapeutic setting. For example, there are places where psychedelics have been considered an integral part of a community (ex: spiritual practices), political policies that have shaped their use, fabricated research used to promote a given stance, and active campaigns to scare people away. So, what do we make of all this?
While I am no expert in this area, I have an opinion (probably a surprise to no one). In the field of psychiatry and psychology, there is definitely growing openness to this form of treatment. Efforts are underway to determine efficacy, particularly in the ability to create relief for those suffering from PTSD. The Daily just aired a podcast that featured a veteran who was haunted by the symptoms of PTSD until she received psychedelic treatment. After her experience, she has become a passionate advocate, hoping more people will find relief.
I look forward to hearing more about the psychological benefits and the sense of calm that some have reported. It will be fascinating to learn about the biological impacts of treatment, established through measurements like brain scans and neurological testing. If research points to noticeable changes in turning off the fight-or-flight response and addressing the structural changes trauma creates, it will show psychedelics to be a potent option for enduring change. Meanwhile, I remain cautious. Here are a few reasons:
- There are training programs that certify therapists in this area. Therapists are not medical providers. Comprehensive coursework around the complexities of biochemistry is not part of a counseling program. We have no ability to assess contra-indicators such as the way psychedelics mix with other medications/drugs or how physical health issues like brain injuries/heart conditions/hypertension could be impacted. I also wonder how therapists are instructed to handle a bad experience. There are no guarantees this treatment will create the healing we hope for. It is important to make damn sure we know the right conditions to promote a positive experience and how to handle a situation should the trip go to unintended places.
- It is important to allow a body of research to emerge that demonstrates statistically significant trends. In undergrad, there was literally a requirement to be a subject of some professor’s research project. I can only imagine what conclusions were drawn based on a bunch of privileged, white, 19-year-olds. Yikes! Good research should include exploring a variety of groupings such as sex, race, age, physical size, diagnoses, etc. That will take some time and careful parameters.
- The treatment has not been approved on a state or national level so there is no mandated, formal protocol. A client experiences a high degree of vulnerability and suggestibility during a trip. John Oliver’s piece mentions a two-person support team, but this is not a standard by any means. I personally know two clinicians who provide this treatment in a one-on-one setting. While I know there are upstanding ethical providers, it is incredibly risky to rely on trust alone.
Although I am excited about the potential benefits, there is a lot of work ahead before this would be a treatment I would recommend. Even though people have access to psychedelics for recreational use and even though it has been used for mystical/transcendental experiences, turning this into a recognized treatment for mental health issues is not a step that should be lightly taken. Scientific research coupled with safe and ethical practices must be our priority when helping people overcome incredible challenges and pain. I stand with the APA on this one:
Sources
- (2023, February 22) Flashbacks after psychedelics. [Audio podcast episode]. In Research Briefing. Blossom. Reportonpsychedelics.com/category/weekly.
- https://www.counseling.org/news/aca-blogs/aca-counseling-corner/aca-member-blogs/2018/09/20/understanding-psychedelics-and-therapy—dose
- https://microdose.buzz/news/apa-issues-position-statement-on-psychedelics/
- https://www.psychiatry.org/getattachment/d5c13619-ca1f-491f-a7a8-b7141c800904/Position-Use-of-Psychedelic-Empathogenic-Agents.pdf
- Oliver, J. (2023, February 19). Psychedelic assisted therapy [Video]. YouTube: Last Week Tonight. https://www.youtube.com/watch?v=a546lxxJIhE
- Barbaro, M. (Host). (2023, February 22) Podcast: The Daily. The Veterans Fight to Legalize Psychedelics. New York Times Company. https://www.nytimes.com/2023/02/22/podcasts/the-daily/veterans-psychedelics-legalization.html
Happy 20th Birthday, Side-By-Side Counseling!!!!
I was in squishy pants, reading something I know was highly intellectual when it suddenly dawned on me- this month is the twentieth anniversary of Side-by-Side Counseling. Twenty Years!!!! While I am in comfortable denial that I’m two decades older than when I started, I can say it has been a compelling ride full of rich stories, hard work, and fabulous people who have and continue to provoke and inspire. After this much time, I thought it might be fun to sit back and contemplate what has evolved over the years.
You know you’ve worked with me if…
- You use food adjectives to describe your experience. For example, something enjoyable is “yummy” while something upsetting is “spicy”.
- To get rid of uncomfortable energy, you have a specific way of moving your body that is a cross between an excited octopus and a seizure.
- Complex internal experiences have been clarified using stuffed animals. My personal favorite animal friend is the new alley cat, “Nibs” but the chicken is a close second. Please note, I do not do puppet shows… yet.
- You know therapy is made better with a nice cup of tea.
- There is no such thing as a typical therapy session. Perhaps you’ve played follow-the-leader across the room. Perhaps you have hit pillows with a martial arts bat coupled with some great four-letter words. Maybe you’ve used a tennis ball to help manage a panic attack. Clients know- healing can come in many forms.
My five favorite life lessons are…
- “I don’t know how to _________ … yet.” “This is hard/painful/confusing/unfamiliar… for now.” These statements highlight that every moment is a chance to create something new. Over time, our efforts can lead to significant change. Relationships can evolve, skills can be learned, and we can let go of worn-out narratives in exchange for a new story.
- It is always my goal to be honest with people, even when it is hard to hear. However, it must be done with great care. As the Dalai Lama stated, “Truth without kindness is cruel.”
- People make sense when we take the time to figure out the context and go deeper than what is on the surface. I’ve learned to trust that someone’s choice/beliefs/feelings/sensations are there for a reason.
- Be curious. It is far richer than being certain. I chose my theoretical orientation partly because of the emphasis on experimentation. In this mindset, we try things out to see what works and what doesn’t. There is no failure, only information to guide us along our path.
- “It is what it is.” Living in denial or a fantasy means figuring out how to cope without full awareness/understanding of what we are dealing with. When moments of acceptance come, there is often relief because the effort required to pretend is finally over.
- Celebrate positives whenever we can. Ex: I am officially the employee of the month. (It helps when you work for yourself)
I am delighted to say that after twenty years of private practice, I would not trade this adventure for anything. Thank you to my parents, teachers, colleagues, mentors, clients, students, friends, hubby, daughter, and cat- all who have helped make this anniversary possible!
Changing Minds: Part 1
I’m outside working in my yard and a neighbor, not known for being friendly, walked up and asked about a yard sign I had out. I was excited to have a chance to engage in a thoughtful discussion but quickly realized this interaction was going to be anything but that. When I gave my answer about the sign, the immediate response was, “But God said….” He had not heard a word I said. I tried to find common ground but no luck. My neighbor had no interest. Instead, he went into a series of Bible quotes and anecdotal experiences that were not even relevant to the topic. Ahhhh- this was about recruitment, not understanding. This was about him proselytizing to me. To no surprise, the conversation fell flat. However, not all was lost. I’m pleased to say that my neighbor now waves when our paths cross.
This underscored a desperate need to find ways to engage in conversations where we can chew on topics together, and “disagreeing without being disagreeable,” (an anonymous quote I found on the internet). Believe me, I am as tempted to avoid these interactions as the next person- they can be uncomfortable, there is potential for escalation, and require a lot of energy. For some reason, my family and friends keep telling me I can’t lock myself indoors, stay in pjs, and binge Netflix specials. They do have a point (don’t tell them that). Avoidance causes critical thinking skills to atrophy. It prevents us from only seeking what is comfortable and we miss out on exploring ideas that challenge us and help us grow. Most importantly, avoiding these conversations has bigger implications. We are seeing the ripple effect certain beliefs and their corresponding voting behaviors have on our daily lives. If we look at Supreme Court decisions such as the reversal of Roe v Wade, upcoming decisions about affirmative action and transgender rights, we cannot afford to pretend all is well. It’s time to engage.
Searching for strategies for civil engagement, I’ve found a ten-step process that has been shown to be a highly effective way to create helpful dialogue and the potential for change. Developed through exhaustive research by a LGBTQ+ organization, “Deep Canvasing” gives us guidance on how to have hard conversations emphasizing respect. I’ve tweaked things slightly, but the essence of the approach remains intact. Hopefully this outline will not only help us talk about uncomfortable topics during election season but can also help us during holiday dinners, offering an alternative to throwing mashed potatoes at our family members.
Deep Canvasing
First: Look Within
Before engaging with others, explore what makes this topic worth discussing. This gives us a chance to have a fuller understanding of ourselves and our position. It promotes awareness about how we think, moving away from superficial talking points and into deeper reflection. In the process, needs and values come to the surface as do life experiences that inform our views. Critically thinking through problems such as confirmation bias or “my-side” bias may also be exposed. This ensures we start from a place of strength and clarity. Consider these questions:
- What do I believe?
- What personal experiences inform my perspective?
- How does this belief align with how I see myself?
- What sources am I using to support my views?
- Why do I trust each of the sources I just listed?
- What parts are facts versus feelings and opinions?
- What needs are being expressed in my views?
- What are the qualities I attribute to those who share my views?
- What are the qualities I attribute to those who disagree with me?
- To what degree can I offer a coherent argument that represents the opposite of my perspective?
- Why is discussing this important to me?
This process is both humbling and enlightening. For example, what if I have not thought things through as much as I had hoped? What if I only had a piece of information taken out of context? Now that I know the bigger picture, it completely changes the information’s meaning. This important exercise will clear away incomplete ideas, faulty reasoning, and unhelpful strategies. Instead, you will be grounded in personal understanding and have practiced the very process we will go through when it’s time to engage with another person.
Upcoming Presentation: Changing Minds: The Art of Conversation and Persuasion
We’ve got Election season in full swing and upcoming holiday gatherings with friends and family. It is inevitable that hard conversations are going to occur where we disagree and may even be tempted to bite one another. For three Sundays, I will guide participants in exploring how to engage while remaining civil and successfully sharing opinions and perspectives. All are welcome!
Location: Arvada United Methodist Church- 6750 Carr St. Arvada, CO 80004
Dates: October 30th, November 6th and November 13th
9-10 a.m. in the Chapel
The Mother of the Fallen Arvada Police Officer’s Call to Action
On 9/11/22, police officer Dillon Vakoff was killed in the line of duty. I had a chance to speak to his mother, Lisa Vakoff, who is responding to this tragedy with a call to action. She has been through many hardships, some which you or someone you know may relate to: being a single parent, dealing with an affair, a family dealing with addiction, a family dealing with the impacts of sexual assault, and homicide, to name a few. With permission, I am sharing a written statement she gave to me, inviting all of us to look around and see how we can push for change.
———–
From Lisa Vakoff
My great, great grandfather, who was from Bulgaria, fought in the Balkan war and proudly on horseback, I might add. My great grandfather immigrated to the United States and became a legal citizen. My grandfather was in the US Army during WWII and if memory serves me at Normandy. My great Uncle was in the US Navy during WWII at Pearl Harbor.
On my mother’s side of the family:
My uncle was in the US Army after the Korean conflict
My father served in the Montana National Guard during Vietnam
My Brother was in the US Navy during the Iran contra affair serving on the USS Nimitz
My ex-husband was in the US Navy during the first Gulf war while I was pregnant with my first son. He also deployed to Somalia as a Seabee during that conflict. His current wife also served in his same unit with the USS navy.
My oldest son was an MP in the US army during the Afghanistan war ( the 2nd Gulf war)
My youngest son was in the US Air Force and deployed to Qatar during the Afghanistan war. His accomplishments and contributions to our country were publicly acknowledged at his memorial service by Major Julian Gluck. Which, I would like to thank the US Air force for personally addressing me to know and understand his service to the country.
I BELIEVE in our military’s service members mission, duty and honor to serve the people of the United States. I BELIEVE in their mission and sworn oath to protect and defend our country’s great and amazing CONSTITUION of our 50 United States. I BELIEVE in our flag (Olde Glory) that represents their duty and sacrifice, and all who proceeded and yet to come, to the people of this great nation and around the world.
That CONSTITUTION is exactly why we are a free and sovereign nation. It is the document that separates us from the rest of the world and affords the American people rights. You know the rights that all of us scream, yell and holler all around the country fighting for our individual causes that we are willing to fight for, even if it is with one another; our friends, family members and neighbors right now. I guess shame on all of us. Maybe that’s how the civil war started. My hope and wish are for all of us American citizens to NEVER forget that all of these service members who volunteered their service and gave the ultimate sacrifice. For those of you who do not comprehend or understand…. They DIED for you!!!! To our great Military “Thank You” There are many that still understand, remember and honor your service!!!
So now I have some questions. Due to the nature of my son’s loss, how many of you have been divorced? I AM- How many of you were hurt and angry? I WAS- Did your spouse cheat on you? MINE DID- How many of you were now single parents? I WAS- How many of you used your children as a pawn for vengeance? I DID NOT! Did you know that the United States ranks #1 worldwide for single parent families? According to PEW Research center the US is the leader worldwide for broken homes!! I guess we should ask ourselves why? Shame on us as American Citizens that we do not value and honor the family unit.
Did all of these single parents move on and start dating someone new? I DID How many of us have been in domestic violent relationships? I WAS- Was drugs and alcohol involved? MINE WAS AN ALCOHOLIC I now became a single mother with 2 children with 2 different fathers. I GOT OUT QUICKLY- How many of you didn’t? I urge you to visit domesticviolencestatistics.org. I urge you to educate yourself.
Did you know that the state of Colorado along with Washington DC rank last in the nation for mental health? According to Mental Health America’s Annual Review Colorado is dead last for mental health care!! So, lets ask why? The people of Colorado on our last ballot voting measure voted NO to have oversight for settlement money coming into Colorado. Why would Colorado NOT want to know about the Oxycontin-Big Pharama-Purdue settlement? What about Big tobacco? Colorado will now receive n millions of dollars from these settlement with no oversight. Maybe ask yourself, are we the people of Colorado complicit in the fact that we are last in the nation for mental health? When you want to complain about homelessness, drug addiction and crime in our streets and communities, maybe we should ask ourselves why did we the people of Colorado not pay attention? Why didn’t we care? Oh, that’s right I forgot Officer Dillon Vakoff will take care of that. Right?
How many of you have been a victim of a sex crime? IT HAPPENED IN MY FAMILY- Please refer to nsvrc.org, or maybe vivtimsofcrime.org to learn more. All the information is out there all you have to do is open your eyes. Do some research. Care!!! That’s all I ask. Did you know that my family violator was an ILLEAGAL citizen? Our violator now bares my families last name legally. How is that even possible. Where is the justice? Trust me when I say “I called everyone from law enforcement to legislators even across state lines only for my story to fall on deaf ears!!! For those of you silently suffering, I hear you!! Seek help
So, at this point of my life all I can do is let go, move on and become a lion. I tried my best to be a productive member of society and raise my boys to have a good soul. This is when my eyes started to open. This is when I started to research and learn to discern information instead of just blindly listening and following all the opinions and trash talk that surrounds us. I started paying attention to my government and what they were doing. At this point I still didn’t quite understand the full capacity of what was happening. How many of you know? How many of you even care. I think that makes us complicit in bad government policy when we don’t care or know.
How many of you have experienced drug addiction? I HAVE- the rollercoaster ride that is addiction is the most horrific thing anyone, attached to it, can go through in this life. For the families and friends of an addict I understand. For the drug addict I understand. My son became addicted to pain killers recovering and injury in the military. It was scary to send my son into a war zone, after 9/11 I put on my cheerleading outfit and flew my flag. My duty was to support my son’s efforts to protect the constitution and our freedoms. He was Dillon’s hero and our family’s hero. Protocols, I’m hoping were changed after a meeting with CID. How many other veterans suffered the same fate? I’m sure the numbers are in the thousands. Drug addiction is the leading cause of death ages 18-45 in the United States according to CDC.gov. FYI I have tried to fight back, however the laws in Colorado are designed to protect the pharmaceutical companies, the rehabilitation centers and their insurers. I know from personal action. There is no justice and there is no remedy for the average person. Beware Colorado. Twenty-two other states practice in law comparative negligence. For those of you trying to recover when you are offered the miracle drug vivitrol, make sure the people administering this drug have protocol and procedures in place. I DID NOT- I am not a doctor or a nurse but was expected to be in my situation. According to a 9news source here in Colorado thousands, if not higher, have been injured or resulted in death from administering vivitrol because protocol of the manufacturer was not followed.
How many of you feel powerless? Want to fix what is broken in our systems. My son Officer Dillon Vakoff felt that way. He was set in motion to fix this broken world. He did everything in his power to be a positive light in everything he did and everyone who crossed his path. I am asking you to please hear me…..
My son gave to his country, he gave to his state, and he gave to his community everything he could to make a difference. He gave to the human condition….his LIFE!!!
I beg of you fellow Americans…. Please don’t fight with each other. Fight for the cause of good. Fight for what is broken. Do something meaningful and with purpose in whatever capacity you have to give. Again, ask yourself…how am I complicit, what can I do to help the human condition for the GOOD and ask what would Dillon do?
Part 8: The Fear of Disappointing- The Final Reflection
Thank you for joining me on this ten-month dive into the pervasive tendency to avoid disappointing others. The journey has been illuminating for me, allowing a window into some of the complex ways we maneuver through relationships. I can honestly say that I have so much more appreciation for what people must overcome to stay loyal to themselves and speak up. As we discovered, there are potent messages to confront, inherent risks to face, and a lot of pain to sift through in the process. Here’s what we explored:
Potent Myths
Risking disappointing others requires challenging numerous myths about relationships that we may not have recognized or thought through before. These emphasize caretaking, self-sacrifice, and loyalty. To upset someone means something has gone horribly wrong. Rather than challenge the myths, the assumption is that going against the grain is somehow a character flaw. Stepping out of this mess means realizing that shame-induced obedience is harmful. It means figuring out that the healthy alternative is to do exactly what you are told is wrong. These messages can be deeply embedded and heavily reinforced by friends and loved ones.
Being Different is Risky
Most times, these myths have grown out of experience. Those who have avoided disappointing others will have good reasons for doing so. Speaking up may have evoked angry cascades of insults, tears that evoke a sense of obligation and guilt, hostile silences, withdrawal of affection, and punishment. Some have dealt with people who are so cruel and dangerous that speaking up can be literally life-threatening. Whether subtle or overt, all of these experiences send a strong message that to being an independent person means risking the loss of love, acceptance, and safety. I want to reiterate, consider the context, determine benefits and risks, seek wise counsel, and trust your intuition. Whatever direction makes sense, rest assured that you have made the best choice available to you.
Grieving What Has Been Lost
Between the experiences themselves and the messages that have been embedded in the psyche, exposing all of this is painful. There is huge discomfort when it becomes apparent just how much these myths/expectations have cost. Authenticity has been sacrificed to make sure no one was made uncomfortable by your differences. Honesty has been compromised, creating a barrier to greater emotional depth and connection. It becomes harder and harder to know what is personally important or someone else’s expectation. If self-esteem and self-awareness are intact, resentment is highly likely. Even health can be impacted. Going along to get along will eventually whittle away physical health (disease is really dis-ease) and emotional well-being.
Needed Skills
Given life-experience, it is understandable if there is minimal foundation for how to proceed in a new, empowered way. If the myths are inaccurate, what is the healthy way? How does one formulate a strong response? If running out of the room screaming is not an option, what does it feel like to be centered and strong? What can be done when the relationship becomes fragile or distant? How can sanity be retained?
The good news is that this habitual dynamic of avoiding disappointing others can change with awareness, intention, skills, and support. One can unlearn what has been learned (did I just quote Yoda?) The very losses that have been painful to face can turn into powerful motivators for moving into new territory. Skills can be developed to weather the emotional and relational storms, and over time, success will quiet the anxiety and grow confidence. With the new goal, you can work towards building relationships based in honesty, respect, and a celebration of individuality.
“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.”
Anais Nin
** Please feel free to utilize the reflections, information, and strategies presented in previous articles:
- Part 1: The Quest: Determining What is So Terrifying About Disappointment
- Part 2: Fear of Disappointing Others- Disappointment Defined
- Part 3: Fear of Disappointing Others- When Helping is Harmful
- Part 4: Fear of Disappointing Others- Hoping the Problem Will Just Go Away
- Part 5: Fear of Disappointing Others- Dealing with the Consequences
- Part 6: Fear of Disappointing Others- Misplaced Responsibility
- Part 7: Fear of Disappointing Others- Insufficient Ways to Deal with Distress
Great Local Resource for Medications
I was introduced to a pharmacy that is almost too good to be true. The company is located in Denver and comes across like a family business with personable, capable staff and a delivery service that will bring the medication(s) to the location of your choice. The delivery window is usually within two hours and the driver will notify you when in route. (Please note that this information does not benefit me in any way. I share this with the hope of removing the hurdle around picking up medications)
Company: Capsule
Contact info: 303.223-2502 capsule.com