A Trip to Save a Life: Psychedelics and the Untraveled Road to Recovery
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A Trip to Save a Life: Psychedelics and the Untraveled Road to Recovery For Bobes (05.14.14) Jessica Cadoch Department of Anthropology McGill University, Montreal April 2021 A thesis submitted to McGill University in partial fulfillment of the requirements of the degree of Master of Arts © Jessica Cadoch, 2021 Jessica Cadoch Table of Contents Abstract/Résumé.................................................................................................................... 3 Acknowledgements ................................................................................................................ 4 Acronym Legend ................................................................................................................... 5 Introduction .......................................................................................................................... 7 Questions ........................................................................................................................................................... 12 Context............................................................................................................................................................... 13 History ............................................................................................................................................................... 14 The Existing Game ........................................................................................................................................... 15 Positionality ....................................................................................................................................................... 16 Methods ............................................................................................................................................................. 17 Field ................................................................................................................................................................... 19 Ethics ................................................................................................................................................................. 21 1- Care: Paradigms of Recovery........................................................................................... 24 A Brief Overview of Psychedelic-Assisted Therapy .......................................................................................... 26 Traditional Models of Recovery ......................................................................................................................... 32 New Laboratory Logics and New Narratives .......................................................................................... 35 Excerpts from the Field ...................................................................................................................................... 40 2- Agency: The Gift of an Inner-Healer ............................................................................... 50 Recreational Psychedelic Use ................................................................................................................. 59 The ‘Addict’ as Powerless ....................................................................................................................... 63 The Gift of the Inner-healer..................................................................................................................... 70 Recreation as Therapeutic ....................................................................................................................... 78 3 – Cures? : The Convergence of a Biomedical and Spiritual Fellowship ............................. 81 A Scientific Mystical Experience ............................................................................................................ 84 Psychedelics meet Alcoholics Anonymous ............................................................................................. 90 Lazarus’ Story and the Challenges of AA........................................................................................................... 91 Alcoholics Anonymous meets Psychedelics ........................................................................................... 99 Integration as Conservation ................................................................................................................... 103 Psychedelics as a Bridge ....................................................................................................................... 107 Conclusion ........................................................................................................................ 109 References......................................................................................................................... 112 2 Jessica Cadoch Abstract/Résumé Psychedelic-assisted therapy is a burgeoning approach to managing mental illnesses such as post-traumatic stress disorder, substance-use disorder, end-of-life anxiety, and treatment-resistant depression. This therapeutic approach is currently undergoing FDA-approved clinical trials in the United States and around the globe. The therapeutic practice involves the careful administration of a psychedelic-containing compound such as MDMA, psilocybin mushrooms, LSD, and ketamine, in conjunction with more traditional psychotherapies, including mindfulness and cognitive behavioral therapy. In this thesis, I explore the shift in cultural and mental health narratives around psychedelic substances. This perceptual shift transforms significantly from their use in the 1960s, to their erasure and vilification in the 1970s, to their revival in the 2000s. I trace the historical integration of psychedelics in managing substance use disorders and also outline the controversies and conflicts with more traditional models like twelve-step programs. As psychedelic-assisted therapy shifts older structures in the medical management of addiction, I highlight that psychedelic-assisted-therapy in fact conserves many previous structures and bridges biomedical and spiritual methods in the management of addiction. By demonstrating how this new modality simultaneously displaces and conserves traditional approaches to managing addiction, the thesis argues that the introduction of psychedelic-assisted therapy elicits a paradigm shift in our cultural perspectives toward care and healing in contemporary mental health care. La thérapie assistée par les psychédéliques est une approche en plein essor pour gérer les troubles de santé mentale tels que le syndrome de stress post-traumatique, les troubles de consommation, l'anxiété de fin de vie et la dépression résistante au traitement. Cette approche thérapeutique fait actuellement l'objet d'essais cliniques approuvés par la FDA aux États-Unis et à travers le monde. La pratique thérapeutique implique l'administration prudente d'un composé psychédélique tel que la MDMA, les champignons de psilocybine, la LSD et la kétamine, en conjonction avec des psychothérapies plus traditionnelles, y compris la thérapie cognitivo- comportementale et la pleine conscience. Dans ce mémoire, j'explore le changement dans les récits culturels et de santé mentale autour des substances psychédéliques. Ce changement de perception se traduit par une transformation significative de leur consommation dans les années 1960, leur effacement et leur diffamation dans les années 1970, et leur renaissance dans les années 2000. Je retrace l'intégration historique des psychédéliques dans la gestion des troubles de consommation de substances psychédéliques et je souligne également les controverses et conflits avec des modèles plus traditionnels tels que les programmes en douze étapes. Comme la thérapie assistée par les psychédéliques modifie les structures plus anciennes de la gestion médicale de la dépendance, je souligne que la thérapie assistée par les psychédéliques conserve en fait de nombreuses structures antérieures et fait le pont entre les méthodes biomédicales et spirituelles dans la gestion de la dépendance. En démontrant comment cette nouvelle modalité déplace et conserve simultanément les approches traditionnelles de gestion de la dépendance, ce mémoire soutient que l'introduction de la thérapie assistée par les psychédéliques suscite un changement de paradigme dans nos perspectives culturelles en matière de soins et de guérison dans les soins de santé mentale contemporains. 3 Jessica Cadoch Acknowledgements There are a tremendous number of people who supported the creation of this thesis whom I would like to thank. Academia: First and foremost, Dr. Sandra Hyde. Thank you for not only seeing the value of my work since the beginning, but for supporting me and cheering me on, even in moments of uncertainty. Thank you too, for providing me ample and timely feedback, and for reminding me that everyone struggles with theses, and that I am not alone in those struggles. Without you, my work might never have taken the academic turn it did. I’d also like to thank all the professors and faculty in the anthropology department at McGill University, primarily Dr. Eduardo Kohn for leading me along a path to success. Furthermore, I would like to express gratitude toward all the folks involved in the Transcultural Psychiatry department, and Dr. Laurence Kirmayer’s Culture and Mental Health Research Unit Meeting. You all supported me throughout my degree and taught me how to contribute to academic discussions.