I work out of a second-floor office on Walnut Street in Boulder. The air here is thin. The concentration of somatic therapists is dangerously high. You cannot walk into a coffee shop without overhearing an earnest conversation about microdosing protocols. The psychedelic renaissance is no longer a fringe movement hiding in the shadows of counterculture. It is a heavily funded biopharmaceutical industry. Venture capitalists are patenting specialized ibogaine derivatives. Suburban parents are taking guided psilocybin trips to cure their generalized anxiety. It is all terribly optimistic. We are relying heavily on the clinical model pioneered at Johns Hopkins. You give the patient a high dose of a classic psychedelic. You put eye shades on them. You play choral music through expensive headphones. You hope they experience ego dissolution. The clinical trials show that a single peak experience heavily correlates with a reduction in depressive symptoms. I am not anti-psychedelic. I have seen the utility of these compounds in my own clinical practice. I am fiercely opposed to therapeutic laziness. The current obsession with the single massive dose has a distinct problem. It treats the mystical state as the actual cure.
When I was sixteen I found a battered copy of Alan Watts in my local library. I sat on the dusty carpet reading about the illusion of the separate ego. It blew my adolescent mind. I spent the next decade chasing that intellectual high. I finished a doctorate in philosophy at the University of Chicago. I grew incredibly tired of academic hair-splitting. By twenty-five I was living in Kyoto. I spent two years sitting at Daitoku-ji. I sat zazen until my knees felt like they were filled with broken glass. I learned very quickly that intellectual epiphanies are cheap. Peak states are also incredibly cheap. The monks at Daitoku-ji had a specific word for the fascinating hallucinations that occur during deep meditation. They called it makyo. The literal translation is ghost cave. Makyo is the realm of visions. You might see a golden Buddha weeping tears of light. You might feel a sense of absolute oneness with the universe. The Zen instruction for dealing with makyo is brutal in its simplicity. You are told to ignore it. You are told to return your attention to the physical breath. The visions are a distraction from the actual work of waking up. The modern psychedelic community often sits inside that ghost cave taking notes on the interior decorating.
The history of clinical psychedelic use is split between two camps. European psychiatrists in the mid-twentieth century favored the psycholytic model. They used low doses over a very long period of time to assist with psychoanalysis. The American model favored the single massive dose. Humphry Osmond coined the term psychedelic to describe this mind-manifesting blast of intensity. We have entirely adopted the American model because we are an impatient culture. We want the heroic dose Terence McKenna talked about. We want to swallow five grams of dried fungi and wake up completely healed by Monday morning.
The Prerequisites of Awe
Preparation in the current clinical model mostly consists of a safety screening. A well-meaning clinician checks your family history for bipolar disorder. They take your blood pressure. They tell you to set a positive intention for the session. This passes for rigor in our current clinical environment. It is entirely insufficient. In the Buddhist framework you do not get to touch the infinite until you have stopped lying to your spouse. We begin with Sila. This is the domain of ethics. In the Samaññaphala Sutta King Ajatasattu asks the Buddha about the fruits of the contemplative life. The Buddha does not begin by describing a mystical vision. He begins with a long discourse on ethical behavior. He demands his followers examine their speech. He insists they scrutinize their physical actions. He asks them to look honestly at how they earn their living.
I had a thirty-year-old software engineer come into my office last month. He drove up from Denver in a very expensive electric car. He wanted to do a high-dose session to optimize his creative output. He was sleeping four hours a night. He admitted he routinely lied to his investors to secure funding. He treated his romantic partners like disposable entertainment. I told him I would not sit for him. Giving a massive dose of psilocybin to a person with no ethical foundation is psychiatric malpractice. It might cure his underlying anxiety. It might also make him a highly relaxed sociopath. The drug removes psychological friction. If your daily life is built on exploitation, removing that friction is dangerous. I told him to spend six months doing unglamorous volunteer work and then call me back. He swore at me and walked out.
You cannot bypass the moral inventory. Before anyone encounters a heavy psychedelic state they must examine their actual conduct. When I worked in Vienna at the Viktor Frankl Institute we focused intensely on responsibility. Frankl survived the concentration camps. He watched humanity at its absolute lowest point. He built logotherapy on the premise that meaning is found in how we respond to the unavoidable tragedies of life. Frankl spoke constantly of the tragic triad. He pointed to human pain. He pointed to human guilt. He demanded we face the absolute certainty of our own death. Psychedelics will force you to face these exact three things. If you do not have a philosophical container for pain and guilt the psychedelic experience will simply terrorize you. Meaning is not a warm feeling you get while listening to Samuel Barber on a leather couch. Meaning is an action. My pre-session protocol requires clients to write down a detailed account of their current relationships. We look at where they are causing harm. I make them practice active amends before we even look at a calendar to schedule a dosing day. We spend weeks talking about the people they have ignored. We review the promises they have broken.
The Discipline of the Peak
The clinical guidelines for the dosing session require the patient to lie down and surrender. Surrender is a popular buzzword in the healing community right now. People assume it means going limp. They assume it means letting the drug do all the heavy lifting. Robin Carhart-Harris proposed the entropic brain theory to explain what happens under the influence of these compounds. The brain operates heavily on predictive coding. The default mode network keeps everything orderly and rigid. Psychedelics relax these high-level priors. The brain enters a state of high entropy. The psychic weather becomes highly chaotic. If you do not have concentrative capacity you will simply be thrown around by that chaos. You will latch onto a terrifying memory of your childhood. You will chase a beautiful geometric pattern until you forget your own name. You become a tourist wandering through the chaotic architecture of your own neurochemistry.
This is where Samadhi enters the clinical protocol. Samadhi is concentration. It is the ability to hold the mind steady on a single object. I teach all my clients anapanasati. This is the practice of mindfulness of breathing. The Majjhima Nikaya contains the detailed instructions on this practice. You track the physical sensation of the breath entering the body. You track it leaving the body. You do this when you are completely sober. You build the cognitive muscle over months of boring practice. Then you apply it during the psychedelic session. When the walls of the therapy room start melting you do not panic. You return to the breath. When you are suddenly confronted by a vision of absolute horror you do not scream. You feel the air moving past your nostrils. This is active surrender. It is completely different from passive submission. You are sitting completely still in the middle of a burning room.
At Daitoku-ji the head monk carried a wooden stick called a keisaku. He walked slowly up and down the rows of meditating monks. If he saw you slumping he would strike you sharply on the shoulder. It stung horribly. The sound echoed off the wooden walls. The strike was not a punishment. It was a physical reminder to wake up to the present moment. The breath is your internal keisaku. It cuts right through the makyo. You stop worshipping the vision of the golden Buddha. You anchor yourself in the reality of the physical body. I watch my clients writhing on the couch. I hold their hand. I remind them to breathe. I see the exact moment they stop fighting the terror. The breathing slows down. The facial muscles relax. They stop trying to escape the ghost cave. They just sit down inside it and wait for the storm to pass.
Sweeping the Temple Stairs
Post-session integration is currently a lucrative cottage industry. You can pay a self-appointed coach two hundred dollars an hour to help you decipher your trip. You sit on a Zoom call. You draw pictures with colored pencils. You talk endlessly about the entities you met in the fifth dimension. That is not integration. That is nostalgia. You are reminiscing about a very intense vacation you took inside your own skull. The contemplative value of an altered state is strictly relational. It only matters in relation to how you behave when the drug wears off. If you score a high rating on the Mystical Experience Questionnaire but continue to yell at your barista, the therapy has failed. We need to look closely at Panna. We have to examine wisdom. In the Buddhist tradition wisdom is not secret knowledge regarding the architecture of the cosmos. Wisdom is the severe recognition of impermanence. The Pali word is anicca. It is the recognition of unsatisfactoriness. The word is dukkha. It is the understanding of non-self. The word is anatta. You take a massive dose of medication on Tuesday. You experience the complete interconnectedness of all living beings. The boundary between you and the couch dissolves entirely. You weep tears of joy. On Wednesday morning your toddler throws a bowl of hot oatmeal at your head. The true test of your peak experience happens on Wednesday morning in the kitchen.
The translation of peak states into trait changes requires a community. It requires Sangha. The modern therapeutic model treats the self as an isolated unit undergoing repairs in a clinical garage. You get tuned up by a professional. You get sent back out onto the highway alone. This entire model is deeply flawed. Buddhism understands that the self only exists in relation to others. You cannot integrate a realization of interconnectedness in a vacuum. You need other people to hold you accountable to your own epiphanies. You need people who will call you on your bullshit. My post-session protocol demands that clients engage heavily with their physical community. They must find an avenue for service. I force them to interact with people outside their immediate socioeconomic circle.
I had a client two years ago who worked in corporate logistics. He realized during a high-dose psilocybin session that his supply chain was actively destroying an ecologically sensitive region. He cried about it for two hours in my office. He went through half a box of tissues. He felt spiritually cleansed by the tears. The following week he went right back to the exact same job. He called me a month later and wanted to schedule another session. He wanted to feel that cleansing sadness again. I refused to book him. I told him he was using a sacred medicine as an emotional laxative. I told him he needed to change his career. He called me an arrogant prick and hung up the phone. I drank my cold coffee. I watched the snow falling on Walnut Street. A year later he sent me a brief email. He admitted he had quit his job to teach high school mathematics. He said the pay was terrible but he was finally sleeping through the night. He attached a picture of his new classroom.
The psychedelic boom is going to produce a large number of casualties. We are going to see people chasing higher and higher doses to replicate their initial mystical experiences. They will become spiritual junkies looking for the next hit of ego dissolution. They will read the glowing articles in the legacy media. They will assume the pill itself does the heavy lifting. The pill only opens the door. You still have to sweep the temple stairs. You still have to pay your taxes. You still have to look your children in the eye. The Noble Eightfold Path is brutally mundane. It offers no guarantees of permanent bliss. It promises a method for walking through the fire without burning the house down to the ground. I look out my window at the Flatirons. The afternoon sun hits the rock face. I have another client arriving in ten minutes. I need to wash my coffee mug before he gets here.
