“One of the ground rules for any safe and effective treatment is that the therapist performing the act is sufficiently prepared. For psychedelic-supported psychotherapy, this principle involves personal experience with the substances ingestion…While the patients experience non-ordinary states of consciousness, they must be expertly guided and supported by someone intimately familiar with such states. Over the past 60 years, it has been learned and concluded that the therapists gain sufficient familiarity with such states only through personal experience with the substance.”
– Paul Grof, MD, FRCPC
Background
On August 4th, Minister Patty Hajdu granted access to psilocybin for 4 Canadians with end-of-life distress whose applications for exemptions were supported by TheraPsil. Since that day at least 9 more applications have been approved and TheraPsil has been inundated with an influx of patient requests for support.
However, there is an urgent problem: there is an insufficient number of qualified healthcare professionals who are trained in psilocybin therapy and can provide high-quality patient care in this unique modality.
To solve this, starting on June 18th, 2020, doctors, therapists, clinical counselors, nurses, social workers, and other healthcare professionals on the TheraPsil team began submitting their own section 56 exemptions to access psilocybin for professional training.
TheraPsil has been diligently working on a training program to train healthcare professionals in psilocybin-assisted psychotherapy. Psilocybin-assisted psychotherapy is a unique modality which requires a highly specific skill set.
Part of TheraPsil’s training program, in conjunction with lectures, case studies, readings, and discussions, involves ‘experiential learning’, whereby trainees take psilocybin mushrooms themselves.
It is our belief that by experiencing this ‘non-ordinary state of consciousness’ first hand, therapists who will administer and facilitate psilocybin-assisted psychotherapy for their own patients are better able hold space, know when to intervene (and more importantly when not to intervene), and help their patients integrate the psilocybin experience learnings for lasting healing during post-integration sessions.
Unfortunately, to date, we have not heard a response back from Minister Hajdu regarding these applications. In the meantime, patients who are dying and could otherwise benefit from psilocybin therapy to treat their end-of-life distress, are left to suffer without access to a trained therapist.
Letter of Support from Paul Grof to Minister Patty Hajdu
Recently, Paul Groff wrote a letter to Health Minister Patty Hajdu expressing that in their expert opinion “There really is no other way of becoming intimately familiar with non-ordinary states of consciousness than experiencing them.”
Paul Groff has given TheraPsil his blessing that his letter to Minister Hajdu can be made public:
My colleague dr. Sean O’Sullivan asked me to comment on the necessity of having correctly trained therapists performing psilocybin/ psychedelic supported psychotherapy.
One of the ground rules for any safe and effective treatment is that the therapist performing the act is sufficiently prepared. For psychedelic-supported psychotherapy, this principle involves personal experience with the substance’s ingestion. It has been enforced since the early stage.
In the 1960s, when psychedelics were part of regular pharmacopeias in European countries, therapists were allowed to use them in treatment only if they acquired adequate skills through three steps process:
- Taking a therapeutic-size dose of a psychedelic five times under supervision.
- Observing a set of sessions conducted by a senior therapist.
- Conducting five sessions of psychedelic-supported psychotherapy under supervision.
For example, in Europe, these established principles were followed in the National Institute of Mental Health in Prague (Psychiatric Research Institute). In the United States, at the Maryland Psychiatric Research Center, the therapists received three high-dose LSD sessions for training purposes before they could treat patients.
To benefit from the treatment involving psychedelics, the patient needs to experience non-ordinary states of consciousness. Such consciousness states are associated with significant brain function changes, including changes in connectivity, conductivity, oscillatory processes, and default mode network. Such changes appear vital for therapeutic benefits. While the patients experience non-ordinary states of consciousness, they must be expertly guided and supported by someone intimately familiar with such states. Over the past 60 years, it has been learned and concluded that the therapists gain sufficient familiarity with such states only through personal experience with the substance. The therapists also acquire insight into the nature of mental illness in general and their patients.
Ingestion of a psychedelic drug represents an exceptional opportunity for professionals to become intimately familiar with many states of mind that otherwise occur naturally only in the context of mental disorders and high stress. Such states include perceptual distortions in the optical, acoustic, olfactory, and gustatory areas; quantitative and qualitative disturbances of the thought processes and abnormal emotional qualities of extraordinary intensity. It is possible to experience sensory illusions and pseudohallucination, retardation or speeding up of thinking, and an entire gamut of temporary profound mood abnormalities.
There really is no other way of becoming intimately familiar with nonordinary states of consciousness than experiencing them. The requirement that psychotherapists who will treat with psychedelics first have personal, supervised experiences makes their training demanding. This challenge is, however, commeasure with the fact that these therapists are then called on to dealing with the most demanding conditions: such as treatment-resistant depressions, lifethreatening suicidal states, distressed end-of-life situations.
Yours truly,
Paul Grof, MD, FRCPC
Professor University of Toronto
Department of Psychiatry
2020-10-25
