Tag Archives: mental health

The Support Groups That Help People Process Psychedelic Trips

"How do you come back from a trip?" asks Sherree Godasi, perched on a round cushion in the back room of a Santa Monica boutique that smells of incense and is covered with Tibetan prayer flags and portraits of Buddha. "One way I love integrating is swimming." 

It's a Monday night and there's about ten of us sitting on floor pillows in a circle around Godasi, who is from Israel and wears her long auburn hair in two tight French braids. Godasi is what's known as a psychedelic integration coach, and the bi-monthly, donation-based meetings she leads are intended to provide support and guidance after a psychedelic trip induced by hallucinogenic substances. The aim, she says, is to offer a space for thoughtful integration—or the mental processing of a psychedelic experience long after the effects of a drug have worn off. It's an aspect of psychedelic experimentation that's often overlooked in mainstream culture, but that devotees say is equally as important (if not more important) than the trip itself. 

The concept of integration has been around in some form or another for nearly as long as people have been seeking enlightenment through mind-altering substances. Modern enthusiasts trace the practice back hundreds of years to Amazonian as well as Native American tribes who took psychedelics in ceremonial settings in search of enlightenment. But in Western medicine, it wasn't until the 1960s that integration became a tenet of the psychedelic therapy movement, pioneered by radical California psychologists like Leo Zeff, a Jungian therapist who saw psychedelics as a tool for self-improvement, and James Fadiman, who co-founded the Institute of Transpersonal Psychology in Palo Alto in 1975.

But only recently have coaches, therapists, and healers begun to advertise these services more widely and to the general public. Godasi is one of just a handful of psychedelic integration coaches that openly practices in Los Angeles, but groups like hers have started forming in cities across the country. The rise of so-called integration circles coincides with what many practitioners are calling a psychedelic renaissance, signaled by a new wave of academic research into the possible medicinal benefits of substances like psilocybin (the psychoactive ingredient in mushrooms) and MDMA. Godasi and those who seek her services hope that these above ground meetings will help legitimize psychedelics as real forms of medicine and therapy, rather than just party drugs.

"The field is so new and it's so needed because everyone knows people who drop acid or who roll on molly—right, most of us do—and these people are experimenting with in fact what are considered extremely powerful substances and medicine," Godasi told me in a phone interview. "Why is there a medical system to assist people who take Advil or overdose on sleeping pills, but not one to help someone who felt like they met their own god or became completely in love with their friend while taking MDMA?"

If Godasi today considers herself something of an expert on psychedelics, then it was only recently that she was still taking substances "kind of mindlessly," she says. Then an experience at Coachella three years ago shifted her whole point of view. "I took a huge dose of MDMA that completely changed my life and it was hard to get back into this world, you know, with everything that I understand now," she recalls. "All of the new and incredible universal knowledge and downloads that I received and understandings about the nature of humanity" left her crying the whole drive home, she says. But she had no idea what to make of this experience or how to integrate it into her everyday life. 

It wasn't until the following year that she discovered integration during a psychedelic conference in LA called Visionary Convergence. The idea behind it, presented in a lecture by Berkeley-based clinical psychologist Susana Bustos, immediately clicked with Godasi. But when she and her friend Ashley Booth—the founder of the LA-based psychedelic advocacy group Aware Project—noticed there were few places in the city that offered integration support, they launched their own last year. The result is an organization called InnerSpace Integration, which laid the groundwork for Godasi's integration circles (she has since branched off and now leads them under her own independent brand). 

"Because of prohibition, people don't have the kind of support and education to be able to make good decisions about usage," says Booth, who adds that those who go on ayahuasca retreats in Peru, for example, where it's legal, sometimes arrive home to find there's nobody else to talk about their experiences with. "We really would like to create these sort of gathering spaces for people to be able to continue to talk about their experience and how their integration process is unfolding," she says.

Most psychedelics are still Schedule I drugs, with LSD, MDMA, and Psilocybin listed in the same category for abuse as heroin. Which is why Godassi begins every integration circle with a legal disclaimer: She is in no way encouraging anyone to procure or ingest illegal substances. She also instructs the group to avoid naming any medicine providers—a preferred term in this community for what others might think of as drug dealers—or disclosing the locations where we may have taken hallucinogenic substances like ayahuasca, which in the United States is often administered illegally during group ceremonies in private homes or other underground venues. There's always a chance there could be undercover cops in the room, Godassi says, before alerting everyone to my presence as a journalist. (The members of the group have asked to remain anonymous in this article, many citing potential professional repercussions as a result of their use of psychedelics). 

The integration circle is mostly self-directed, and Godasi says she prefers to sit back and observe rather than guiding the conversation. (She also leads one-on-one sessions that tend to be more intensive.) But getting the group to talk isn't always easy, and even though everyone is presumably here to get something off their chests, the room is frequently punctuated by awkward silences. Godasi scans the room, making eye contact and gently posing open-ended questions to find out who recently had a psychedelic experience they're struggling to make sense of. Once the group finally does start to open up, their anecdotes are sometimes prefaced with notes of caution that they've never told it to anyone before. When one person says he no longer relates to his friends after having done ayahuasca, Godasi jumps in with supportive questions intended to provoke dialgoue. "Our entire life revolves around relationships," she says. "So how do you come back and talk to people?" Think of the experience, she says, as "an invitation to reassess where you are."

"James," a 50-year-old IT recruiter who asked me not to use his real name, is one of the group's more regular members. He says he experimented with psychedelics recreationally when he was in his teens and 20s, but after getting hooked on methamphetamines, he quit drugs altogether and got sober. "I moved away from the area I was in, I just changed my life and led a suburban life for 20 years," he says. "And a couple years ago my life got shaken up and I started looking for myself again." 

That's when he turned to psychedelics—and this time he wasn't just looking to get high. He'd been seeing a psychotherapist for a while, he says, but it wasn't until he started tripping on ayahuasca and DMT that he started to have a breakthrough about who he really was and how to be himself—especially at work, where he felt like he was always pretending to be a more likable, corporate version of himself. "That process of becoming more at ease with myself, becoming less inhibited, being more comfortable with my own skin, all of those things have been helped immensely by psychedelics," he says, cautioning that while his own experiences have been positive, psychedelics aren't for everybody, nor does he advocate that they'll help anyone else in the same way. "That's where the practice of integration comes in because you learn things about yourself but you have to figure out what those things mean to you and how to integrate them into your life."

But it's not as if he can tell his colleagues and clients about the time he hallucinated that humanoids told him the meaning of life during a DMT trip. Those are the kinds of stories he saves for Godasi's integration circle, where it's not uncommon to hear from people who say they spoke to God, saw the afterlife, or communicated with the spirits of deceased loved ones during a psychedelic trip. These are the types of anecdotes that Godasi says could get a person diagnosed with psychosis or mania if they were to tell a doctor or a therapist about them—instead, she says, most people choose to keep quiet. Others, like James, seek out an integration coach. 

As the 90 minute integration circle comes to a close, Godasi presses her palms together in prayer and bows her head down, thanking us all for coming and for sharing our experiences. Most of us just met each other tonight, but nobody is ready to leave yet. We all stand in a circle making small talk, and James asks another member of the group where her accent is from. She says she believes she may have inherited it from a past life. Then, as well all linger in the room, she says she can feel that maybe our spirits have exited our bodies and are now communicating telepathically with one another. Everyone stares at each other in silence.

I Escaped My Manic Demons, but My Jailed Clients Often Can’t

This article was published in collaboration with the Marshall Project.

I met Raheem in an arraignments shift at the Bronx Criminal Court in New York, where I was slated to serve as his social worker.

Raheem had been arrested for stealing lice shampoo from a pharmacy and then getting into a scuffle with the security guard who caught him. As we talked, he fidgeted and scratched at his body while explaining that a lice plague was ravaging the world and only he knew the secret cure. He added that he actually had enough money to buy the shampoo, but couldn't let the store employees know about his plan, so he had tried to sneak out without paying.

At the time, Raheem was on parole, stemming from his record of over 30 arrests, almost all of them minor misdemeanor charges related to his unmanaged schizophrenia. The new arrest meant he would be sent to prison for a year.

The outcome of Raheem's case was hard for me to swallow—and not just because I was part of his defense team. Like Raheem, I too had once shoplifted from a pharmacy while in the grips of a manic episode. For some reason that had felt completely compelling at the time, I needed to stock up on over 20 bottles of nail polish without anyone knowing about it.

As a well-dressed white woman, however, nobody suspected a thing and I had simply walked out of the Chapel Hill, N.C., store without notice. The episode ended in a psychiatric hospitalization, through which I received the treatment I needed to get my symptoms under control.

Even as someone who advocates every day for people with mental health diagnoses, and whose work involves dismantling the stigma that surrounds them, it is still hard for me to disclose my own struggle.

I was diagnosed with bipolar disorder the year I graduated from college. It happened after my first full-blown manic episode, in which I sped on a highway at over 100 miles an hour after buying a $3,000 engagement ring on a whim, planning to surprise my then-boyfriend halfway across the world.

Needless to say, this plan did not come to fruition, and my spontaneity, risk-taking, and impulsivity soon morphed into terrifying psychosis. I was suddenly convinced that my reality was just a big stage and everyone was acting out a script, and I was hospitalized and prescribed anti-psychotics and mood stabilizers.

About four years after my first episode, I pursued a master's degree in social work with the intention of becoming an advocate for those like me. In a mental health policy class, I remember debating the use of physical restraints, and arguing vehemently against the practice. My classmates did not know that I myself had been strapped to ER beds and restrained in seclusion rooms.

But it was in that same class that I learned about the deinstitutionalization and subsequent over-incarceration of people with mental illnesses, and began to slowly comprehend my privilege as a white woman whose circumstances had allowed her to lead a productive and fulfilling life in between episodes.

Now that I am a social worker at the Bronx Defenders, I've met many people like Raheem: men and women of color struggling with mental illness while trying to survive in the South Bronx, one of the poorest districts in America. Many end up ensnared in the criminal justice and immigration systems instead of getting the health care they need.

And I have met many more clients whose experiences are eerily similar to mine, even if their outcomes could not have been more different.

Not too long ago, I had to call a man to inform him that his brother, Jose, my client, had been arrested in a psychiatric hospital for allegedly assaulting a nurse. I heard him weep on the other end of the phone—and I remembered the time that, in the throes of my own psychosis, amid the chaos of a hallway in the ER, I bit a nurse because I thought she was trying to kill me with laser beams.

I was not arrested. Instead, I was admitted to the psychiatric ward and walked out, restored to my sane self, about two weeks later.

I'll never forget Jacob either: a green-card holder from South America whom we represented through an immigration public defense program funded by New York City.

Check out the Motherboard documentary about the strange, troubled fate of smart gun technology in America.

Jacob had been working as a medical professional when he first began experiencing symptoms of schizophrenia. His illness caused him to lose his job, and he fell into homelessness and substance abuse in an effort to self-medicate. He was in and out of hospitals and ended up being arrested as the result of an incident in which he found himself responding to powerful command hallucinations. His convictions landed him in immigration detention, where he continued to deteriorate and even attempted suicide.

Despite our effort to explain his symptoms and need for treatment, an immigration judge denied his application for relief. Jacob was put on a charter plane back to a country he hadn't been to in decades, where he no longer has any family or access to meaningful treatment. I never heard from him again.

It is in moments like these that I feel survivor's guilt most acutely. I have struggled to live with my diagnosis, but how can I reconcile the stark contrast between my experience and those of Raheem, Jose, Jacob, and so many others? Every time I visit my psychiatrist in her Park Avenue office, I feel a pang of guilt accompanied by overwhelming gratitude. Gratitude that I have access to quality care, and gratitude that I respond well to treatment.

My personal experience has been both a blessing and a curse. It has made me more compassionate and patient in working with clients experiencing mental health symptoms, but it also challenges me with painful reminders of past experiences that continue to be shrouded in shame and a feeling of unearned privilege.

So I've learned that to be the best possible social worker for the community I serve, I must understand that vicarious trauma is real—that if I don't try to understand how my own experiences affect my interactions with clients and vice versa, I am doing them a disservice. In the social work profession, we are often in a position of power over our clients, and to some extent, we separate them fully from ourselves.

But I think we should all recognize that many of us share much more in common with our clients than we would readily admit. It is time for people like me to say: I, too, am one of them, but I have been permitted to survive . Survival should not be a luxury.

Kristen Anderson is a social worker at The Bronx Defenders, a public defense office serving low-income communities in New York City.

Why FOMO Is Actually Social Anxiety and What You Should Do About It

You’re probably rolling your eyes at this point when you hear the term FOMO, but bear with me because it turns out that FOMO isn’t about fear of missing information. It’s about feeling anxious that you’re missing out on bonding time with your social group. Here’s what to do about that anxiety.

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Nature Is Not My Safe Space

The ability to want what you already have is kind of everything. When I lived by the beach I thought that I would never get jaded about the ocean, the sunsets, but within a year they became wallpaper to me—some blurry things going on outside the world of the internet. It was as though they were somehow already "mine," or part of me, and I could no longer see or cherish them.

Last week I moved from the beach into a canyon in the mountains. The first day I was here in the canyon I was so enraptured that I swore I would continue to observe nature and remain grateful for living in it. But already I'm looking at my phone more than I'm watching the tall grasses moving in unison in the breeze, the three palm trees swaying outside my window, or the deciduous trees with their cascading leaves glittering in the sun. Also, there's something else inside me saying, "Run! You must compulsively go back and forth to Target, Bed, Bath and Beyond and various other indoor retail hellscapes, to buy things you don't really need and then return them." Instead of simply being with the mountain, I've been buying and returning rugs for three days.

What is it about the going back-and-forth from shitty chain stores that in some ways feels so much more natural to me than just sitting and watching the sky? "Modern man is drinking and drugging himself out of awareness, or he spends his time shopping, which is the same thing," says Ernest Becker in my favorite book, The Denial of Death. "As awareness calls for types of heroic dedication that his culture no longer provides for him, society contrives to help him forget."

When I'm in nature I never forget that I'm going to die.

Certainly, the compulsive buying and returning (or as I like to call it, shopping bulimia) makes me feel as though I have a purpose. It is an ephemeral purpose, a stupid purpose, as the perfect fucking shower caddy isn't going to make me a whole person. When I die I can't take the caddy with me. But I think that is the point, actually: a game of reverse psychology I play with myself, wherein I'm so ensconced in the minutiae of shitty home decor that I can forget about death. After all, what kind of person would spend hours at Ikea when they only have a finite amount of time left to live on Earth? If I'm wasting my time at Ikea, then I can't be about to die, can I?

When I'm in nature I never forget that I'm going to die. This morning, while walking my dog along the incline of the mountain, I remembered something one of my therapists told me about surrendering to anxiety. She was like, "A tree branch that is stiff will snap in the wind, but a reed will bend. You want to be the reed."

This made me feel sad, actually, that nature in its beauty isn't inherently benevolent. It's more neutral. The wind doesn't care whether it breaks the tree branch, it's just doing its wind thing. This doesn't make the wind evil. The tree branch that is ripped off its tree and transformed into a dying stick on the ground can't even blame its killer for cruelty.

I feel bad for the stick, to be honest. I mean, the stick didn't really have a choice as to whether it was born a branch or a reed. The stick never asked to be a fucking stick. It's not like the reed has done a shitload of work on itself in therapy to become more flexible. The reed was born the reed and that's it. I also think, to some extent, the same can be said about mental illness. It's like, bitch, I didn't ask to be born the branch that would be turned into a stick.

While my default mode seems to largely be the stick, sometimes I feel like I am the reed. It's really a question of where I am in terms of factors beyond my control like my neurochemistry and hormonal cycle, as well as elements within my control like antidepressants, therapy, meditation, sleep, nutrition. When I'm charging full speed to Bed, Bath and Beyond, ten minutes before closing, I'm the stick. And the worst part of being a stick is when I don't know I'm a stick. Like, when I'm a stick, that's fine, but it's important for me to be aware of what I'm doing so that I don't hurt myself or others. When I'm speeding in my car with three rugs aimed between my windshield and my back window, binge eating Swedish fish, certainly there is the potential for hurting others. That might be a time to say, "Slow down, this is not urgent, the rugs aren't that important." But it is the urgency of small purpose that creates the distraction from mortality. There is an underlying promise that if I buy the perfect thing, I will be rendered whole, transcendent, somehow immortal.

As Becker wrote:

…man is a worm and food for worms. This is the paradox: he is out of nature and hopelessly in it; he is dual, up in the stars and yet housed in a heart-pumping, breath-gasping body…a material fleshy casing that is alien to him in many ways—the strangest and most repugnant way being that it aches and bleeds and will decay and die. Man is literally split in two: he has an awareness of his own splendid uniqueness in that he sticks out of nature with a towering majesty, and yet he goes back into the ground a few feet in order to blindly and dumbly rot and disappear forever. It is a terrifying dilemma to be in and to have to live with.

The answer, obviously, does not lie at Bed, Bath and Beyond. I know this. And yet, because I sense that there is no "answer" to the paradox of human sentience, I go to Bed, Bath and Beyond, because I do not know where else to go. I am a human who is ultimately afraid to want what I already have, in fear of being reminded of my own impermanence. So I look for new shit and hold onto it until it becomes old shit, and then I look for more.

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Get Over a Micro-Breakup With These Six Slightly Cynical Strategies

When I moved out from the apartment I shared with my husband, two dogs, and a cat, it hurt real bad, but it hurt in a way that I fully expected. There was nothing surprising about the feelings that accompanied the dissolution of a ten-year relationship; I was devastated, but it would be weird if I hadn’t been. Entire…

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Inside the Abandoned Asylum That Was Made Infamous by Geraldo Rivera

Letchworth Village was built specifically for "the segregation of the feeble-minded" over a century ago. It currently rots on roughly 2,000 sylvan acres in Rockland County, New York, about an hour's drive north of Manhattan. Shuttered in 1996, the mammoth decay of the former custodial asylum makes it seem like it's been closed two or three times as long. Vines and branches choke the many battered neoclassical buildings, nearly obscuring some from view. Inside, sickly colors of lead paint slough off walls redecorated with graffiti, while the tile floors are covered in broken glass, rubble from collapsing ceilings, and a host of detritus left behind by former residents and staff or subsequent interlopers. In its brokenness, Letchworth aptly reflects the horror show it became—the rampant neglect and mistreatment of the intellectually and developmentally disabled and the mentally ill.

It was Geraldo Rivera who took millions of TV viewers inside Letchworth as part of his unflinching, award-winning 1972 expose "Willowbrook: The Last Great Disgrace," which is as disturbing a watch now as it was 45 years ago. In it, children lie naked on the floor in their own feces and moaning. Adults wedge together in rooms with no one to care for them. There's a pained incredulity in the voice and face of late Bronx congressman Mario Biaggi as he tells Geraldo during a tour of the facility, "Inside we have housed the children of many of our citizens who are subjected to what appears to be the worst possible conditions I've ever seen in my life. I've visited penal institutions all over the country, I've visited hospitals all over the country, I've visited the worst brigs in the military… I've never seen anything like (this)."

As such, "Willowbrook" nudged public sentiment even further toward "deinstitutionalization" of the disabled and mentally ill back to their families or to smaller, community-based facilities—a process that began in the 1950s with the advent of new medications and approaches to treatment and was fervently championed by President John F. Kennedy before coming to full fruition in the 80s and 90s.

As far as abandoned asylums go, Letchworth is fairly unique. Many other similar facilities are fenced in and heavily patrolled by security to keep out squatters, vandals, and curious urban explorers. Others have been demolished or have been repurposed—including the bullshit "Pennhurst Asylum" haunted house attraction at the former Pennhurst State School and Hospital in southeastern Pennsylvania, which baldly exploits its harrowing history of abuse for Halloween thrills and paints former residents as monsters to be feared. Letchworth Village, however, is essentially a park where you can freely stroll the grounds (it's very popular with dog walkers), and while you're not really supposed to go inside the structurally unsound buildings, there's no one on the premises to insure you don't. Owned by the town of Haverstraw, a few Letchworth structures were turned into a school some years back, but most are too far gone to rehab and too expensive to demolish. So it rots in full view of anyone who cares to go and see.

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A Prison Psychologist Mourns the Patient He Couldn’t Save

This article was published in collaboration with the Marshall Project.

I'd been working for several years as a psychologist for prisoners in Washington state when I was tasked with treating a deeply troubled man in his early 20s. I can't tell you his name, or his mental health diagnosis. I can tell you that treating him was the most significant professional challenge I have ever faced.

Prisons have developed various ways to respond to negative behaviors by prisoners—taking things away, more restrictive environments. These can work, but some of the men I've encountered, because of pain and trauma from earlier in their lives, have never learned positive behavior. The usual tools can make their problems worse; acting out is their way of handling desperation, of seeking help. It is not their fault, or the prison's; society has chosen prisons to be the places that manage these problems, and prisons aren't the right place for them.

But I've learned that the answer is for us to treat them as individuals.

This man had a reputation in the department for constantly harming himself. At first, he used shaving razors to cut himself. When the prison restricted his access to them, he broke his own fingers and swallowed inedible objects like plastic spoons, food wrappers, and batteries. He found ways to harm himself with playing cards, shower shoes, toothbrushes, and books. Even if he was restricted from all these objects, he could bang his head on a door.

At times, officers would place him in a restraint bed for his own safety, so he would not try to reopen his wounds. He often needed observation 24 hours a day. Sometimes he would assault other prisoners and staff.

I can help this person, I thought.

It was an attempted murder that brought him to prison in the first place, and it was clear to me that he had suffered from all kinds of trauma and was carrying around a lot of pain. He could be very social, talking about his fond memories of hunting and fishing and being outside, but then he would get a palpable anxiety over "what was going to happen next." Was he going to be placed in a new cell? Was he going to be allowed outside for recreation? In prison, you can't always answer those questions definitively; sometimes there is a lockdown or an emergency. This would only add to his anxiety.

The traditional way of dealing with his self-harming behavior was to further restrict his environment, but we realized that this might be hurting more than helping. I tried all sorts of special programs to help him manage, including private yoga lessons. Sometimes he would be successful for days, or even weeks. But inevitably he would harm himself again.

I think there were times he actually wanted to end his life, but other times I could tell that he simply hadn't learned how to communicate with words; he communicated with actions. He was so used to being neglected as a child that he saw self-harm as a way to get a big outpouring of emotion from a caregiver. This meant that by giving him lots of attention, we were unintentionally reinforcing the behavior. "The better I do, the less I see people," he told me.

I tried to explain this to the staff, since often his behavior could seem incomprehensible. They all wanted to help him, but there is a dynamic—not just in prisons—where caregivers take self-harm personally. They think I've worked so hard to help you, and then they feel burned by the setback. Part of my work was trying to explain to other staff members that he was doing his best, and to temper their expectations of how quickly he'd get better, if at all.

After harming himself, he would say, "I want to get back on track."

I'd say, "We begin again."

I developed a series of plans for him, collaborating with many other employees at the prison. He was placed in restrictive housing, but was also allowed go to the gym and the yard and spend more time out of restraints, in "medium custody" areas with other prisoners.

Making this work involved a lot of talking to staff in various departments and across the three work shifts, so that some officer wouldn't tell him, "I've never heard of this special plan" and deny him entrance to a class or the rec yard. I was working at two prison units, and developing and implementing these plans, along with providing him with care and programming, was like adding a whole other unit to my workload.

But his life got richer. He got to spend more time out of his cell and have access to objects that had previously been withheld. We'd go on walks. We played Uno. He laughed more. Every chance I could, I'd say: "Look how much better this is than when you were harming yourself." He would say, "People are telling me I'm doing well."

Check out the Motherboard documentary about the strange, troubled history of the smart gun in America.

Then one day last year as I arrived for work and walked from my car toward the facility gate, I saw an ambulance and a police car. That's around the time my cell phone rang.

I was told that he had taken his life.

I found myself sitting down on the sidewalk. Strangely, my mind immediately started trying to formulate a new plan to get him "back on track," as he used to put it. I was sure that I was going to see him again.

I was really touched by the outpouring of support from those I worked with. They all said, "I know how much effort you put into giving him a better life." And I thanked them, too. The medical staff, in particular, had tried so hard to prolong his life.

I later looked at a picture in his file. It must have been from long before, because his face looked very young, free of the scars it would later contain. I wondered what would have happened had I met him, and started working with him, at that moment.

Ryan Quirk is a staff psychologist with the Washington State Department of Corrections. He wrote about the case described here in the November/December 2015 issue of the Correctional Mental Health Report