Teaching a Graduate Clinical Psychology Course on Psychedelics DAVID LUKOFF, Phd, SOFIA UNIVERSITY

Spring 2013

Teaching A Graduate Clinical Psychology Course on Psychedelics DAVID LUKOFF, PhD, SOFIA UNIVERSITY

David Lukoff, PhD

THE INSPIRATION FOR CREATING A graduate clinical psychol- tial course was !rst o"ered in the fall quarter of 2010 and has ogy course on psychedelics at So!a University (formerly the been well received. Institute of Transpersonal Psychology) came during the MAPS While serving formally !rst as the teaching assistant, and conference in San Jose in 2010. With all of these clinical and later as an instructor for the !rst two years, Alicia Danforth research advances, how could a doctoral psychology program has been the lead instructor. She was especially sensitive to the not provide training in this area? The recent research is beyond necessity for our students to truly understand, not just have compelling that therapy, experientially supported with psyche- read, the core literature. Alicia developed the general scope and delics, helps resolve combat trauma in veterans as well as other framework of the class while Jim and I contributed our special- forms of trauma and reduces anxiety in cancer patients. ized experiences throughout. When space was available, students The tipping point has from other institutions (in- been reached, with millions The tipping point has been reached, with cluding MAPS) and practic- of people who have had such ing clinicians have been ad- experiences bringing them millions of people who have had such mitted into the course. So!a into therapy. Clinical facilities University is currently plan- that are unable to relate to experiences bringing them into therapy. ning the development of an client needs to integrate prior online course for its global drug experiences are no longer fully responsive to the changing students and plans to o"er the class through other institutions. demographics of the clinical population. This is certainly the The class covers clinical research on psychedelic drugs as case in the Bay Area where a signi!cant number of people are adjuncts to psychotherapy for the treatment of addiction, post- having psychedelic-related crises that can be helped without traumatic stress disorder (PTSD), and existential distress at the medication or hospitalization. end of life, as well as approaches to integrate positive psychedel- During a hallway chat (one of the most rewarding parts of ic experiences and to resolve psychedelic crises. Understanding a well-organized conference) with Jim Fadiman, he also won- psychedelic experiences requires knowledge about the interdis- dered why So!a University had never o"ered such a course. ciplinary context, traditional uses, and applications behind the Since I had two teaching units available on my teaching load, I contemporary research on psychedelic drugs for treating trauma proposed a course co-taught by Jim and myself. It was accepted and addiction. into the curriculum as a clinical elective. The two-unit residen- The course begins by establishing a cultural context for

41 MAPS Bulletin Special Edition

psychedelic use among indigenous peoples and throughout hu- work, this inherent connection of psychedelics to spirituality man history. As anthropologist and clinician Marlene Dobkin de should receive increased attention. Rios observed, “The contribution that anthropology can make While not all students intend to be clinicians, clinical to the study of the use of mind-altering plants throughout the considerations are discussed throughout the course. In-class ex- world is to show how cultural variables such as belief systems, periential exercises involve assessing and integrating psychedelic values, attitudes, and expectations experiences in role-played thera- structure one of the most subjec- peutic encounters. Charlie Grob, tive experiences available to hu- A culturally competent clinician M.D., the principal investigator mankind” (de Rios, 1996). Not must know how to address the of the UCLA Harbor Medical understanding the significance Center psilocybin study with and value of psychedelic experi- range of psychedelic experiences that cancer patients, and Anne Shul- ences can be considered a type of gin have been guest presenters cultural insensitivity in contem- clients bring into psychotherapy. as well as So!a doctoral student porary American psychology. A Brito Gonzalo who has worked culturally competent clinician must know how to address the in ayahuasca treatment programs in South America. range of psychedelic experiences that clients bring into psycho- In addition to this course, the increasing interest in psyche- therapy. The weekly topics in our one-quarter course include: delics in higher education is being re$ected in So!a students’ dissertations, research and academic topics that pre-date and 1. De!nitions and History: continue concurrently with our course. Students have found Indigenous (pre-synthetics) ways to apply both conventional and innovative methods to 2. Psychedelics and Spiritual/Mystical Experience explore the topics related to use of psychedelics. Here are some examples: 3. Research: Early (pre-1966), Renaissance (1990–present) r Alicia Danforth is completing her dissertation on the potential of MDMA for helping autistic adults 4. Cannabis: Historical, medical, recreational, increase social adaptability. She is preparing for legal perspectives her job at the Los Angeles Biomedical Research 5. Guidelines and Best Practices for Guiding Institute at UCLA Harbor Medical Center where she was a research associate on their psilocybin 6. Psychosis: “Bad Trips” and Interventions study with cancer patients, and she is the second 7. Uses in Psychotherapy: PTSD, End of Life author on the research published in a leading peer- reviewed journal (Grob, Danforth, Chopra, Hal- 8. Treatment of Addictions: Ayahausca, berstadt, McKay, Greer, Hagerty, 2011). She will Ibogaine, MDMA, LSD present her dissertation !ndings at the Psychedelic 9. Future research areas: Problem-solving, Science 2013 conference in Oakland. creativity, micro-doses r Recent graduate Peter H. Addy, Ph.D. (clinical 10. Integration and student presentations psychology, 2011) is currently a postdoctoral associate in psychiatry at Yale School of Medicine, In particular, the understanding of psychedelic experi- an advanced fellow in medical informatics at the ences requires an appreciation of their relationship to religious/ Veterans A#airs Connecticut Healthcare System, spiritual experiences and to cultural trends toward spirituality and a psychology resident at the Substance Abuse less tied to an organized religious institution. Tom Roberts has Treatment Unit, Connecticut Mental Health termed this democratization of primary religious experience, Center. Peter’s dissertation was a study of the which often occurs during psychedelic drug use. Grinspoon e#ects of administering Salvia Divinorum in a and Bakalar (1986) pointed out over 20 years ago that, “It non-shamanistic setting to healthy volunteers. The should not be necessary to supply more proof that psyche- quantitative data from his dissertation has been delic drugs produce experiences that those who undergo them published in Psychopharmacology (Addy, 2012), and regard as religious in the fullest sense.” More recently, the the qualitative data has been presented at several Johns Hopkins researchers Gri"ths, Richards, McCann, and conferences including Psychedelic Science 2013. Jesse (2006) have done just that by demonstrating that even a Peter also authored a peer-reviewed paper on single psilocybin experience can alter personality and perceived dextromethorphan (DXM), a psychoactive cough meaning among a signi!cant portion of healthy volunteers and medicine ingredient in street use. that the e#ects are substantial and long lasting. As spiritual com- petence becomes more recognized as foundational to clinical r Albert Garcia-Romeu graduated in 2012 with a

42 Spring 2013

Ph.D. in transpersonal psychology, and recently ac- surveying psychedelics’ history from archaeological times to the cepted a position as a post-doctoral research fellow present and by examining their implications for psychotherapy at Johns Hopkins University School of Medicine. and mental health, religion, and various academic disciplines Albert is now manag- and professional interests. ing a study focused Our fondest hope for on treating smoking this course is that it paves addiction through a the way for other universi- combination of cogni- ties, particularly those of- tive behavioral tech- fering graduate training for niques, mindfulness, mental health professionals, and high-dose psilo- to use this precedent at an cybin administration. accredited graduate program to advocate for including r Graduate Michael similar courses in their cur- Cougar (2005) did riculum. To that end, we are his dissertation on making the syllabus available personal transforma- upon request [send request tion and psychoactive to author via email]. In addi- plant use in syncretic tion, the Psychedelic Science Brazilian church cer- A garden pathway at Soﬁa University. 2013 conference in Oakland emonies. in April 2013 will include a r Deborah Quevedo (2009) studied 22 participants presentation going into more detail about the challenges and attending neo-shamanic retreats in Brazil who bene!ts of teaching future therapists to be more sensitive and were given ayahuasca. She administered the Big competent in working with clients who have used or are using Five Personality Inventory before and after taking psychedelic substances. the plant preparation and found statistically signi!cant reductions in Neuroticism and increases REFERENCES in Agreeableness. Addy, P. H. (2012). Acute and post-acute behavioral and psychological e"ects of salvinorin A in humans. Psychopharma- r So!a University faculty member Jim Fadiman has cology, 220(1), 195-204. recently authored The Psychedelic Explorer’s Guide: de Rios, M. D. (1996). Hallucinogens: Cross-Cultural Perspec- Safe, Therapeutic and Sacred Journeys, and is currently tives. Long Grove, IL: Waveland Press. directing two national psychedelic research studies. Gri#ths, R., Richards, W., McCann, U., & Jesse, R. (2006). r Faculty member Arthur Hastings has authored Psilocybin can occasion mystical-type experiences having research papers on hypnosis and MDMA and substantial and sustained personal meaning and spiritual signi!- is also the anonymous author of the chapter on cance. Psychopharmacology. 187(3), 268-8. marijuana in the classic book Altered States of Con- Grinspoon, L., & Bakalar, J. B. (1986). Can drugs be used to sciousness, by faculty colleague Charles T. Tart who enhance psychotherapeutic process? American Journal of Psycho- also wrote On Being Stoned: A Psychological Study of therapy, 40(3), 393-404. Marijuana (2000), a book surveying the early use of Grob, C. S., Danforth, A. L., Chopra, G. S., Halberstadt, A. marijuana in the U. S. culture. So!a U is one of the R., McKay, C. M., Greer, G., Hagerty, M., (2011). A pilot study few schools that provide faculty support for a wide of psilocybin treatment in advanced-stage cancer patients with range of research and scholarship on psychedelics. anxiety. Archives of General Psychiatry, 68(1), 71-78. Roberts, T. B. (2013).The Psychedelic Future of the Mind: How Tom Roberts (2013), who has o"ered an undergraduate Entheogens are Enhancing Cognition, Boosting Intelligence, and Rais- course on psychedelics for over 20 years at Northern Illinois ing Values. Rochester, VT: Park Street Press. University, has stated that, “Psychedelic research may be the !eld with the greatest gap between the information scholars David Luko!, PhD is a Professor at So!a University and a and scientists have discovered and what the general public licensed psychologist in California whose areas of expertise include knows” (from his course syllabus for Foundations of Psychedelic treatment of schizophrenia, transpersonal psychotherapy, spiritual issues Studies). His course syllabus, along with Robert Forte’s course in clinical practice, and case study methodology. He can be reached at syllabus for an online course at CIIS entitled, A Recent History david.luko"@so!a.edu. of Psychedelic Drugs, Their E"ects on Individuals and Society, were both consulted to help bridge that gap for psychologists by