Final Illumination: The impact and understanding of
psychedelic medicine in end-of-life psychotherapy.

The value of psychedelic medicine in end-of-life care was established (and eclipsed) over 60 years ago in the earlier LSD era. Extensive academic documentation in the past decade, at centers from UCLA to Johns Hopkins, have resurrected and legitimated interest in psychedelic medicine as safe and valuable in the care of the dying. Sophisticated studies have demonstrated the subjective importance of “mystico-spiritual” experiences for psychedelic medicine to be essential components of the care of the dying. Until now there has been sparse discussion of this development in psychodynamic terms.

This 2-day conference will be devoted to explorations of the metapsychology of the “mystico-spiritual” experiences and other transformational processes in psychedelic end-of-life care.

The format of the two-day conference will be a cross-fertilization workshop in which a series of lectures are linked with small and large group study (a Social Dreaming component is built into the group processing). We aim to integrate experiential processing into the clinical competence of psychotherapists and palliative care clinicians. Issues such as death anxiety, ego attachments, and self integrity will be addressed from multiple clinical psychodynamic perspectives.

This workshop is designed to deepen clinical perspectives rather than advocating for one approach. One of the objectives of the workshop is increased competence in managing dying patients’ terror and anxiety; another is to use the intense group processing aspect to facilitate clinicians’ working flexibly with professional colleagues of various types in complex clinical end-of-life situations.

Participation in the Small Groups will offer an experiential demonstration of working comfortably with other professionals whose mindset differ from yours.

By the end of the conference, participants should be able to hold multiple contradictory psychodynamic explanations and to articulate an argument in favor of one or more of those psychological processes.

The conference will be in-person and all attendees will need to show proof of vaccination to enter. Due to the use of small process groups, attendance will be limited 50 licensed clinicians plus faculty.

Registration fee includes Continuing Education certification (11.75CEU/CME hours), Lunch plus

Evening Reception Saturday, June 4, and break-time refreshments.

Faculty

Thomas M Brod MD, DLFAPA (Coordinator) is Associate Clinical Professor of Psychiatry, UCLA Geffen School of Medicine and Senior Faculty at New Center for Psychoanalysis (Los Angeles). He coordinates the Manifest Mind series as well as co-coordinates NCP’s Film & Mind series.

Florian Birkmayer, MD is a holistic psychiatrist and co-founder with his wife Cathy Skipper of AromaGnosis, which combines Jungian depth psychology with aromatic shamanism for personal evolution. He has pioneered the clinical use of essential oils in ketamine and other psychedelic therapies.

Houman Farzin, MD is a Holistic physician, artist, and health technology innovator. He is a palliative care physician at the Jewish General Hospital in Montreal and a lecturer at McGill University medical school. He has a broad range of clinical skills and has spent many years working in remote communities across North America, including the Arctic Circle. He is trained in various psychedelic therapeutic modalities including MDMA, psilocybin, and ketamine. He is the Montreal site physician for the Phase 3 clinical trial of the MDMA-assisted therapy study sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), and on the training committee of TheraPsil, a non-profit organization dedicated to obtaining legal access to psilocybin-assisted psychotherapy.

Pamela Kryskow, MD is a medical doctor widely recognised for her strong interest in psychedelic medicine, mental health and chronic pain. 
She is founding board members of the Canadian Psychedelic Association. She is part of an expert team working to give Canadians access to psilocybin at end of life. Dr Kryskow is actively involved in research related to psilocybin, MDMA, ketamine, mental wellness and neurogenesis. Co-investigator on the largest microdosing study Microdose.me which is ongoing with 14 000+ enrolled participants. A Clinical Instructor at University of British Columbia and Adjunct Professor at Vancouver Island University. 

The medical lead on the Roots To Thrive Ketamine Assisted Therapy program that treats health care providers with PTSD, depression, anxiety, and addiction. 

In real life she loves foraging in the forest, ocean kayaking, growing kale and daydreaming in the hammock. 

Mary Brierre Telliano, founder of the Anam Cara Academy, is an end of life doula. End of life doulas reprocess the death with the friends and family of the departed, holding space for their grieving and lovingly guiding them though the process. A doula does not judge feelings, responses or behaviors. A doula opens the doors for moments of understanding, appreciation, healing and even transformation.

Julane Andries, LMFT directs the Center for Transformational Psychotherapy in San Francisco. She is currently managing a 5-site study of psychedelics and palliative (end-of-life) care.

Leonard Bearne Psy.D. is a psychoanalyst in Los Angeles. Since his first psychedelic experience, over 50 years ago, he has been involved in the study of these substances and their potential use in psychotherapy. One particular area of his interest has been their ability to alleviate the anticipatory fear that people facing life threatening illnesses experience. We all die, but not every death entails suffering.

Julie Michael McCaig, Ph.D. is a training and supervising analyst at the Psychoanalytic Center of California (PCC). She co-founded the THRIVE Infant-Family Program 501c3 -Non- Profit. Thrive therapists observed infants and parents in the NICU (Neonatal Intensive Care Unit) to extend understanding of “perinatal states of mind”. In addition to her practice, training, and supervision, Dr. McCaig is currently studying experiences in Social Dreaming for a deeper understanding of our rhizome-like unconscious creativity.  

Phil Wolfson, MD has extensive post-graduate training in family systems theory and practice, group psychotherapy, psychoanalytic psychotherapy, CBT. He practiced MDMA (Ecstasy) psychotherapy in legal period and published on its use in psychotherapy. Founding Member of Heffter Research Institute. Principle Investigator—MAPS sponsored MDMA and Life Threatening Illness Study.

Gita Vaid, MD is a Board Certified Psychiatrist and psychoanalyst practicing in New York City. Dr. Vaid completed her residency training at NYU Medical Center and psychoanalytic training at the Institute for Psychoanalytic Education affiliated with NYU. She has a rich research and biological background, completing a fellowship in clinical psychopharmacology and neurophysiology at New York Medical College and a research fellowship at NYU Medical Center. Dr. Vaid is currently on faculty and teaches at both IPE and the NYU Department of Psychiatry. She has a special interest in teaching interview technique, psychoanalytic theory and British object relations. Dr. Vaid’s current focus and interest is in psychedelic-assisted psychotherapy.

Dream Mullick is a writer, teacher, producer, death coach and dreamer whose work focuses on the evolution of consciousness and a return to love. She curates programs that combine the world-views of ceremony and science with sacred plant medicines and psychedelics, including the exploration of death as a pathway to liberation. In her practices Dream explores the profound transformative power of death, grief, joy and love. Her latest creation, Entheowheel, launched in collaboration with the Esalen Institute, focuses on the ceremony, science and somatics of sacred plants and psychedelics.

GROUP FACILITATORS

Eva Altobelli, MD started her career working as a filmmaker in New York City while exploring mindfulness, yoga, neuroscience and expanded states of consciousness. Returning to school after a decade in the arts Dr. Altobelli completed a Psychiatric residency and Fellowship in Addiction and is trained in Psychedelic Treatment by California Institute of Integral Studies and MAPS.  Her career evolved working in detox, rehabs and private practice as well as consulting in recovery, psychedelics, addiction and alternative healing arts. During her career Dr. Altobelli came to see psychopharmacology as palliative and has evolved a holistic practice integrating mind, body and spirit into the healing process. With a unique background in addiction, psychiatry, trauma and the arts she specializes in creative ways to help clients find their way to recovery and wholeness.  

Ray Bakaitis, PHD is a clinical psychologist in independent practice in Los Angeles.  He is the President of the A. K. Rice Institute for the Study of Social Systems (AKRI); a Past-President of Grex, the West Coast Affiliate of AKRI; and a Past-President of the Los Angeles Country Psychological Association (LACPA).  He is interested in psychedelics not only as a therapeutic tool but for their contribution toward non-binary thinking that supports transformational social change.  

Leonard Bearne Psy.D. is a psychoanalyst in Los Angeles. Since his first psychedelic experience, over 50 years ago, he has been involved in the study of these substances and their potential use in psychotherapy. One particular area of his interest has been their ability to alleviate the anticipatory fear that people facing life threatening illnesses experience. We all die, but not every death entails suffering.

Houman Farzin, MD is a Holistic physician, artist, and health technology innovator. He is a palliative care physician at the Jewish General Hospital in Montreal and a lecturer at McGill University medical school. He has a broad range of clinical skills and has spent many years working in remote communities across North America, including the Arctic Circle. He is trained in various psychedelic therapeutic modalities including MDMA, psilocybin, and ketamine. He is the Montreal site physician for the Phase 3 clinical trial of the MDMA-assisted therapy study sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), and on the training committee of TheraPsil, a non-profit organization dedicated to obtaining legal access to psilocybin-assisted psychotherapy.

David Laramie, PHD is a health psychologist in private practice in Los Angeles.  He strongly believes in systemic and integrative approaches to healing and wellness and draws on psychoanalytic, emotion focused, and somatic approaches in his psychotherapeutic work.  In both his personal life and professional work, he finds considerable value in mind-body practices such as breath and energy work, biofeedback, meditation, and non-ordinary states of consciousness.  A long time board member and past-president of the Los Angeles County Psychological Association, he currently oversees its Continuing Education programming.  

Pamela Kryskow, MD is a medical doctor widely recognised for her strong interest in psychedelic medicine, mental health and chronic pain. 
She is founding board members of the Canadian Psychedelic Association. She is part of an expert team working to give Canadians access to psilocybin at end of life. Dr Kryskow is actively involved in research related to psilocybin, MDMA, ketamine, mental wellness and neurogenesis. Co-investigator on the largest microdosing study Microdose.me which is ongoing with 14 000+ enrolled participants. A Clinical Instructor at University of British Columbia and Adjunct Professor at Vancouver Island University. 

The medical lead on the Roots To Thrive Ketamine Assisted Therapy program that treats health care providers with PTSD, depression, anxiety, and addiction. 

In real life she loves foraging in the forest, ocean kayaking, growing kale and daydreaming in the hammock. 

John Lundgren, MD is a Training and Supervising Analyst and former President of the Psychoanalytic Center of California. He is on the faculty of UCLA Department of Psychiatry where he co-chaired the development of a leadership group relations training program for psychiatry residents and psychology interns.  As a member of the A.K. Rice Institute and GREX, its local affiliate, he has served as a conference director and staff consultant to Group Relations conferences. 

Joshua Pretsky, MD is an Associate Clinical Professor of Psychiatry at the UCLA David Geffen School of Medicine where he is the founding director of the Concentration in Psychodynamic Psychotherapy and past-president of the Psychiatry Clinical Faculty Association. A senior faculty member at the New Center for Psychoanalysis, Pretsky is an active member of the research committee (past chair) and instructor on empirical research in psychotherapy. On the national level, Pretsky founded and co-directs the Training Advancement Initiative of the American Psychiatric Association Psychotherapy Caucus. In his full time private practice of psychiatry and psychotherapy in Los Angeles, he with a focuses on accelerated experiential psychodynamic psychotherapy and integrative psychiatry, and routinely incorporates somatic experiencing, energy work and ketamine into treatments. Married with three daughters, Pretsky enjoy playing the tImbales with his salsa band and dancing 5 Rhythms. "As a dedicated burner I have journeyed to the playa four times where I have led workshops on authentic experiencing at Anahasana Village."

Learning Objectives for this program

After attending this workshop, participants should be able to:

• Describe or explain how an experienced or trained clinical team can use psychedelic medicine in the management of dying patients’ terror and anxiety; 
• Develop patient-centered criteria for including their dying patients in clinical trials of psychedelic medicine; 
• Discuss multiple (even contradictory) psychodynamic perspectives on the metapsychology of “mystico-spiritual” experiences of dying patients exposed to psychedelic medicine;
• Explain how working comfortably in teams with professions with differing mindset can be of benefit to patients in end-of-life palliative care;
• Discuss the place of music in the psychedelic-integrative process in end-of-life care;
• Explain the concept of the Death Doula and their potential role in the clinical end-of-life team.

The first Manifest Mind Conference at New Center for Psychoanalysis

in November 2019

Focused on Ketamine Assisted Psychotherapy (KAP).

Topics included:

• Do we need a new model of the mind to be able to sit with and “listen” to patients who are under the influence of these medications
• What are useful ways of organizing psychotherapy before, during, and following the drug experiences
• Is the management of expectancy (mental set and physical setting) different with this form of drug-based psychotherapy compared to psychoanalytic psychotherapy
• Is psychological treatment necessary to the successful clinical use of these drugs, and if so, at what point in the treatment are psychotherapies best employed
• Is ketamine-assisted psychotherapy relevant to psychoanalytic and psychodynamic training
• To what extent is a traditional psychodynamic mindset helpful in integrating such experiences into useful insights; to what extent might it interfere
• Since repeated contemporary studies have demonstrated that “mystical” subjective experiences seem to be significantly correlated with clinical success of these drugs, what is the relation of the dynamic therapist to the exploration of such experiences
• Is it possible to use these treatments with Attachment Trauma and severely depressed character disordered patients 
• What are the psychological risks of having ketamine, MDMA, and the classic psychedelic drugs available for wide-spread use
• What are the appropriate ethical safeguards for this kind of drug-assisted psychodynamic treatment? 

Selected References

• Argento E, Christie D, et all (2021), Psychedelic-Assisted Psychotherapy After COVID-19: The Therapeutic Uses of Psilocybin and MDMA for Pandemic-Related Mental Health Problems, Front. Psychiatry, 06 September 2021 https://doi.org/10.3389/fpsyt.2021.716593
• Belser, A. B., Agin-Liebes, G., Swift, T. C., Terrana, S., Devenot, N., Friedman, H. L., . . . Ross, S. (2017). Patient experiences of psilocybin-assisted psychotherapy: An interpretive phenomenological analysis. Journal of Humanistic Psychology, 57, 354-388.
• Blinderman CD (2016) Psycho-existential distress in cancer patients: a return to “entheogens”, Journal of Psychopharmacology, 1-2
• Clare J, Zarbafi A (2009) Social Dreaming in the 21st Century, Routledge
• Davis  AK, Barrett  FS, Griffiths  RR.  Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety.   J Contextual Behav Sci. 2020;15:39-45. doi:10.1016/j.jcbs.2019.11.004
• Dutta, V. 2012. Repression of death consciousness and the psychedelic trip. Journal of Cancer Research and Therapeutics 8 (3):336–42. doi:10.4103/0973-1482.103509.
• Dyck E 2019, Psychedelics and Dying Care: A Historical Look at the Relationship between Psychedelics and Palliative Care, J Psychoactive Drugs. 51-2
• Gasser, P., Holstein, D., Michel, Y., Doblin, R., Yazar-Klosinski, B., Passie, T. & Brenneisen, R. (2014). Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. The Journal of Nervous and Mental Disease, 202(7), 513-20.
• Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D,.Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181-11
• Griffiths, R., W. A. Richards, U. McCann, and R. Jesse. 2006. Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology 187 (3):268–83. doi:10.1007/s00213-006-0457-5.
• Grob  CS, Danforth  AL, Chopra  GS,  et al.  Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer.   Arch Gen Psychiatry. 2011;68(1):71-78. doi:10.1001/archgenpsychiatry.2010.116
• Grob, C., and A. Danforth. 2015. Psychedelic psychotherapy near the end of life. In The psychedelic policy quagmire: Health law, freedom and society, ed. J. H. Ellens and T. B. Roberts, 119–32. Santa Barbara, CA: Praeger. 
• Halifax J, 2005, Being With Dying: cultivating compassionadn fearlessness in the presence of death, Shambhala Publications
• Jenkinson S 2015 Die Wise: A Manifesto for Sanity and the Soul, Noerth Atlantic Books
• JenKast, E. C. 1970. A concept of death. In Psychedelics: The uses and implications of hallucinogenic drugs, ed. B. Aaronson and H. Osmond, 366–81. Garden City, NY: Anchor Books. 
• Johnson  M, Richards  W, Griffiths  R.  Human hallucinogen research: guidelines for safety.   J Psychopharmacol. 2008;22(6):603-620. doi:10.1177/0269881108093587
• Lawrence, W.G. (2005) An Introduction to Social Dreaming, London: Karnac.
• Ostaseski F 2017, The Five Invitations: Discovering What Death can Teach Us about Living Fully, Flatiron Books
• Pollan, M. 2018. How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. New York, NY: Penguin. 
• Richards, W. 2016. Sacred knowledge: Psychedelics and religious experiences, foreword by William Barnard. Baltimore: Johns Hopkins University Press. 
• Rosa, W., & Estes, T. (2016). What end-of-life care needs now: An emerging praxis of the sacred and subtle. Advances in Nursing Science, 39(4), 333-345.
  Rosa, W., Estes, T., Hope, S., & Watson, J. (2019). Conscious dying: Human caring amid pain and suffering. In W. Rosa, S. Horton-Deutsch, & J. Watson (Eds.), A handbook for caring science: Expanding the paradigm (pp. 145-161). New York, NY: Springer Publishing Company.
• Rosa WE, Hope S, Matzo M. 2019 Palliative Nursing and Sacred Medicine: A Holistic Stance on Entheogens, Healing, and Spiritual Care. (2019) Journal of Holistic Nursing.;37(1):100-106. doi:10.1177/0898010118770302
• Roseman  L, Nutt  DJ, Carhart-Harris  RL. 2017 Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression.   Front Pharmacol. 2018;8:974. doi:10.3389/fphar.2017.00974
• Rucker JJ, Young AH (2021)   Psilocybin: From Serendipity to Credibility?, Front. Psychiatry, | https://doi.org/10.3389/fpsyt.2021.659044

©2022 Thomas Brod, M.D.