The Psychedelic Revival
By Natalie Pompilio
In 1964, the American Journal of Nursing ran an article written by nurse Kay Parley called “Supporting the patient on LSD Day.” Parley described sitting with patients after the psychedelic drug was given as they looked inward and often made life-altering discoveries.
She assured them that she would provide guidance when she saw they needed direction as they lost themselves in internal self-exploration while also serving as their tie to reality.
“You are off on a trip … with no baggage, no destination, and no compass,” she’d tell them. “That’s why I’m here. I can’t go with you, but I can be your anchor. Wherever you go, you’ll always be able to see me.”
Andrew Penn, an associate clinical professor at UC San Francisco’s School of Nursing, described uncovering this article decades after it was in the second episode of Penn Nursing’s Psychedelic Revival series, a free, six-part virtual learning series that drew hundreds of participants when offered live and continues to rack up views online.
“That idea was so ahead of its time,” Penn says. And yet six months later, these substances–including LSD, MDMA (also called “ecstasy” or “Molly”) and psilocybin, which is found in “magic mushrooms”—would be dubbed drugs of abuse, their possession and use criminalized by federal law.
Those who sought to understand the healing properties of psychedelics were ignored or called deviants. Years of promising research on the healing properties of psychedelics for conditions including depression and alcoholism was dismissed.
Until recently. In June 2021, Penn collaborated on a follow-up to that 1964 article that appeared on the cover of the American Journal of Nursing.
“When we told the editors they’d run that article in 1964, I almost think they didn’t believe us until they checked their own archives because it seemed so far away from nursing practice now,” says Penn RN NP CNS PMHNP-BC. “We really wanted to start changing the conversation.”
After decades of neglect, the field of psychedelic research is again quickly building steam. Some say the surge in in- interest in psychedelics stems from Michael Pollan’s 2018 How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, which includes the respected journalist’s own experience with consciousness-expanding substances.
But in truth, psychedelics reemerged years before that. Johns Hopkins University researchers have been exploring the medical potential of so-called hallucinogens since 2000, and in 2019 established the Johns Hopkins Center for Psychedelic and Consciousness Research. In 2020,
UC Berkeley launched its Center for the Science of Psychedelics (BCSP). In late 2021, the National Institutes of Health-funded Matthew Johnson, a Hopkins researcher, to study the use of psilocybin in aiding smoking cessation. The nearly $4 million grant is the first federal funding of classic psychedelic research in more than 50 years.
Penn Nursing’s contribution to the on-going conversation, the Psychedelic Revival series, bubbled up thanks to an idea from former Penn Nursing Board of Advisors member Sandy Samberg Nu’94 GNu’95. Sandy and her husband Joe made a gift that launched the series, which began on Jan. 19, 2022 with an introduction to psychedelic drugs and their uses in medical treatment. It wrapped on March 30 with a discussion around the inequities and barriers to care which included psychotherapist Hannah McLane, founder of the SoundMind Center, a psychedelic therapy center in West Philadelphia.
A post-series in-person event at Claire M. Fagin Hall on April 13 included- ed testimonials from patients who say psychedelics have saved their lives.
“There are common misunderstandings about psychedelics—they’re associated with hippies and tripping, or that people use them to self-medicate and forget their problems—and yet they could be a paradigm shift in how we treat certain medical conditions,” says Kayla Baker, a third-year nursing PhD student, registered nurse, and nurse practitioner who hosted the series’ first episode.
“I’ve never been ‘spiritually-minded’ and this is never something I thought I’d be studying,” Baker continues, “but part of my interest is the mystical experience and how people who have this higher level experience have better outcomes. It’s fascinating.”
Research has shown that psychedelic drugs, when partnered with talk therapy, can help people with historically challenging conditions, including post-traumatic stress disorder (PTSD), substance use disorders and treatment-resistant depression.
Penn Nursing senior lecturer Anita Iyengar DNP RN PMHCNS-BC CNE became familiar with the potential of psychedelic drugs as she helped to organize the series with Associate Professor of Nursing Heath Schmidt PhD and others. The more she learned, the more interested she became in the therapeutic potential of psychedelic-assisted therapy, she says. Now she and other instructors are including psychedelics in their courses.
“STIGMAS ARE STRONG AND THEY’RE TENACIOUS, BUT WHEN YOU GIVE PEOPLE THE CORRECT INFORMATION, THE CONVERSATION CHANGES.”
– Kayla Baker MSN RN
“It’s important to continually explore new therapies that are going to alleviate personal and societal distress,” says Iyengar. “The experts involved in pre- paring for the therapeutic use of psychedelics are passionate and see it as a development that will have healing im- plications for individuals and communities for centuries to come.”
Psychedelic drugs are far from new, and the first episode of the Psychedelic Revival series touched on their long history. Psychedelics have been part of the “sacred medicine” traditions of indigenous peoples for thousands of years, helping users look inward and gain new perspectives. While still being explored by the country’s mainstream scientific community, the therapeutic benefits of psychedelic medicines have long been recognized by many cultures across the world.
“In western medicine specifically, we think a lot about the mind and the body, but sometimes we neglect the injuries to the spirit and the heart,” says Pak Chau MSN CRNP PMHNP-BC GNu’22, a recent graduate who hosted the series’ second episode. “Much of the psychiatry that we practice today does a great job of stabilizing acute conditions but not enough is focused on treating mental illness at its core. With psychedelics, it’s all about what’s happening on the inside and how we can alter our own consciousness and heal within.”
Psychedelics, Chau says, are “ego-dissolving,” allowing people to take a step back and see themselves and their lives more objectively. It also helps them tap into their creativity and curiosity to solve problems buried deep within the human consciousness. Additionally, psychedelics have also had creative outlets to the outside world as well. Two Nobel Laureates—Francis Crick, who discovered the double-helix structure of DNA, and Kary Mullis, developer of the polymerase chain reaction method—have publicly stated that LSD helped them with their scientific breakthroughs.
“I’ve met people who have gone on journeys with psychedelics. They have visions and life-altering experiences, says Chau. “It resets your default mode so your brain can experience things in a new way.”
While most psychedelic drugs remain classified as Schedule 1 substances un- der federal law, individual states and cities are seeking to decriminalize their use. In 2020, Oregon voters approved the country’s first state-licensed, psilocybin-assisted therapy system. Cities including Seattle, Denver, and Washington, DC have decriminalized possession of psychedelics. In June 2021, Texas legislators passed a law allowing for a clinical trial of treating PTSD in veterans with psilocybin.
In 2019, the FDA approved the use of esketamine as a way to address treatment-resistant depression. MDMA- based therapy could receive FDA approval as early as 2023.
But this doesn’t mean a patient will simply receive a prescription for a hal- hallucinogen and then be sent home. There are three parts to the psychedelic therapy model, with the actual drug-taking session sandwiched between psycho-therapy sessions. Penn, the UC San Francisco associate clinical professor, says the patient and therapist/providers are “co-creating a house of healing.”The first part of the treatment, which can be called “tending to the patient,” centers on building a trusting, supportive relationship.
The second phase of treatment involves the patient ingesting the psychedelic of choice under the super-vision. This phase can last for between six to eight hours.
After the second phase is complete, the therapists send the patient home with support. Therapists and patient reconvene the next day to deconstruct what the patient had experienced the day before. While psychedelics aren’t “quick fixes that take away memories or painful experiences, they can change your relationship with how much pain those memories and experiences cause, Penn said. Years ago, he says, a patient with PTSD asked if Penn could make him forget his painful memories.
“I said, ‘Absolutely not. I wouldn’t want to take that away from you even if I could, but I would like to change the relationship … so there’s more space between that painful experience you had as a child and that suffering you experienced and in
that widened orbital there’s room for all the other parts of your life because really so often the suffering really resides in the story,” says Penn.
During the first Psychedelic Revival post-seminar Q&A, Mariavittoria Mangini addressed the stigma once at- tached to psychedelics, recalling that when she began working on her disser- tation in 1995, “I was told I would never get a job, no one was interested in this but me, this was a stigmatized subject, the stigma would stick with me and none of that turned out to be true. … Don’t let historic misperceptions deter you.”
Baker says she thought that strong negative response was a “generational thing,” although she admits she was initially hesitant to talk to her advisors about a dissertation on the use of psychedelics.
“Stigmas are strong and they’re tenacious,” she says, “but when you give people the correct information, the conversation changes.”
Another way to move the conversation forward? Showcase those who credit psychedelics with changing their lives for the better.
The first six Psychedelic Revival seminars each included Stories of Transformation, short videos featuring people who say psychedelics have improved their lives. (The videos were created in partnership with reconsider. org, a non-profit organization that supports the medical uses of psychedelics.)
One such story came from Ethan Abend, a retired New York City police detective, who described years of undergoing different therapies and taking different medications in an effort to deal with his depression, anxiety, and PTSD. Nothing worked without serious side effects.
After years of the status quo, he jumped at the opportunity to be treated with psilocybin, which he says opened his mind and changed his life. “I felt it uncovered the real me. It let my emotions come out instead of covering or having to manage the emotions. It opened the door so I could feel more, even the painful things, but more importantly I feel the everyday good things, too.”
A seventh in-person event held on April 13 featured testimonials from patients. Before the personal stories began, Penn Nursing Dean Antonia M. Villarruel told the crowd that the series had “far exceeded any expectations that we had.”
“We’ve all been inspired by the stories. It’s really worked to humanize and to put in context why this work and why these opportunities are so important,” she says. “There’s no doubt that psy- psychedelic therapy has important use in mental health treatment and I’m happy that Penn Nursing can be part of this.”
One of the final session’s speakers was Jon Kostakopoulos, who in 2016 took part in a clinical trial that used psilocybin to address alcohol use disorder. He hasn’t had an alcoholic beverage, nor has he taken any psychedelic drugs, since his first psilocybin treatment.
“It’s hard to deny the reality that these medicines can help people and alleviate suffering when you hear about a person’s own experience,” Baker says. “Rigorous scientific investigation is needed to understand the risks and benefits of various psychedelic substances and therapeutic modalities, but the power of a personal story always resonates strongly. The path forward will surely involve good science and openness to people’s personal experiences.”
To view the complete Psychedelic Revival series, visit www.nursing.upenn.edu/psychedelicresources.
Penn Nursing will grow its work in psychedelics, expanding the Psychedelic Revival series into a collaborative care initiative with the Columbia School of Social Work (CSSW). This initiative will educate social workers and nurses about psychedelic-assisted therapy in anticipation of FDA approval of this type of treatment—and it will improve access to affordable, safe treatment facilitated by a large workforce of highly qualified practitioners.
Funded by grants from the Joe & Sandy Samberg Foundation and the Steven & Alexandra Cohen Foundation, this pilot will develop an educational training curriculum for Penn Nursing and CSSW, which will then be expanded to Penn’s School of Social Policy & Practice and the Columbia School of Nursing—and beyond.