Category: Connect

Here’s a guest post by a therapist who has been using ACT for clients with addictions for many years. Jaime highlights core principles using examples from his practice. I follow with a longish comment on aspects of ACT that I find especially important.

 

…by Jaime Booth Jenkins BSW MAPP…

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”  — Viktor E. Frankl

Acceptance and Commitment Therapy (ACT…pronounced “Act”) offers principles and techniques that can enable people to move beyond the addictive cycle…into their future. ACT arose in the ‘third wave’ of cognitive behaviour therapies and shares some fundamental principles with Dialectical Behaviour Therapy (DBT) and Mindfulness Based Cognitive Therapy (MBCT). The advantage of ACT for practitioners is the flexibility both in how it is delivered and the population it can serve. Unlike the prescriptive, manualized nature of DBT and MBCT, ACT has been shown to be effective for both groups and individuals, for a wide range of clinical issues, and it allows the clinician to adapt core techniques as needed.

Addiction, from an ACT perspective, is a result of experiential avoidance — the avoidance of uncomfortable and unwanted thoughts or feelings. Having a few drinks to ease social anxiety, using heroin to ease the pain of failure or trauma, or using methamphetamine to avoid boredom or loneliness are examples of experiential avoidance. Addiction adds an insidious layer of complexity because shame, guilt, self-contempt, and physiological withdrawal become feelings people also try to avoid — sometimes desperately.

ACT is based on 6 core principles:

Acceptance – Uncomfortable thoughts and feelings happen. The goal is not to avoid them, block them out, or pretend they aren’t there, but to accept them, make space for them, and then continue on. When confronting addiction there are plenty of unwanted thoughts and feelings, but one of the most challenging is CRAVING.

William was a young college student who had been using methamphetamine initially to work late — but eventually for the high itself. He had attempted to quit several times but experienced intense cravings that would lead back to using. When he experienced a craving in the session, we practiced breathing into it and visualizing himself as a surfer “surfing the wave” of discomfort. [Note the overlap with Mindfulness-Based Relapse Prevention, coming up later.] The craving dissipated and he was able to continue the session. We practiced this every time cravings arose — and eventually they became less intense.

Cognitive Defusion [sic] – Have you ever repeated a word so often that it begins to sound funny or it completely loses its meaning? This is one way to promote cognitive defusion — to remove the (fused-together) meaning or context from thoughts, words, and feelings. Defusion creates space to regard thoughts and feelings from the perspective of a dispassionate observer, making it easier to let them go and allow more beneficial thoughts and feelings to take their place.

Andy was a high-powered lawyer with a cocaine addiction. He had an extreme reaction to the word “addict” and would go to great lengths to avoid labeling himself that way. The shame of the word itself increased his desire to use. To take the power out of the word we practiced a few different defusion techniques. Changing the words of Happy Birthday to “Happy Addict,” imaging a baby elephant saying the word or repeating it over and over in different tones and voices, it began to lose its meaning and therefore its power.

Being Present – Staying present in the face of uncomfortable internal or external stimuli, without judgement, can be difficult when coming out of an addiction. Painful thoughts and feelings can return without warning and overwhelm the individual.

Every client I see is given a pack of Lifesaver candies (sweet little O’s, multi-coloured, etc). We then run through a simple “lifesaving” meditation in order to practice remaining in the present. Putting a candy in your mouth and focusing on what it looks like, tastes like and feels like allows you to return to the present. If a particularly painful rumination begins, pulling out a lifesaver is a quick and easy way to return to what’s actually happening in the present. Other therapists use other techniques to snap the client out of the “monkey chatter” of cycling thoughts and into the here-and-now.

The Observing Self – This is perhaps where Frankl’s space becomes the most literal, as it requires individuals to distance themselves from their thoughts and feelings and observe them as if they were a separate entity. Having these thoughts and feelings is normal, but this doesn’t make them valid or true.

Emily struggled with the shame associated with some of her actions while drunk. Self-deprecating thoughts about these actions would scream at her and pull her back into drinking. In order to help her regain control we practiced a mindfulness activity in which she was laying on the ground and watching her thoughts float by like clouds. She simply watched, without judging or avoiding. This gave her the opportunity to see her thoughts as separate from herself, and gave her the space to decide whether to grab the thought or let it pass by.

Values – It is not uncommon for an addiction to become the central unifying purpose of an individual’s life. This tends to obscure what is of real importance.

Claire was in my office because her employer noticed her showing up late for work, taking more breaks throughout the day, and taking more “sick days” than others in her position.  She revealed to HR that she regularly drank 1-2 bottles of wine each evening and did not see a reason to stop as she was near retirement. It was not until we came to identify her core values — connecting closely with family and friends — that she was able to see the real impact of her addiction: it was pulling her farther away from them. So now, when she would experience a craving in the session, instead of focusing on not drinking, we would choose an image of interacting with her children as a focal point to move towards. Her value acted as a lighthouse that guided her through the craving. She was willing to experience the discomfort of craving because she knew, on the other side of it, her family was waiting, and she wanted that more than she wanted to avoid the discomfort.

Committed Action – Once a space has been created and values identified we can begin to allow ourselves to be pulled by our future instead of pushed by our past.

Continuing work with Claire involved helping her to set goals that would allow her to live a life more aligned with her values. We set the goal of having interactions with her family or making plans with a friend without wine. Simple — and she much preferred how it felt, once she got used to it.

A silver bullet to “solve” addiction is something I have been searching for throughout my career. But there are likely as many silver bullets as there are individuals. What I have found in ACT is a framework that allows people to regain control, not over their addiction but over their thoughts, feelings, and actions. This control allows them to move in value-led directions — and their addiction can dissipate as a by-product. The work to get there is not easy — but it is certainly worth it.

 

Helpful Links:

Training/books by Russell Harris, an ACT-based practitioner/trainer.

Detailed outline of ACT, principles and practice, also by Russ Harris, from Psychotherapy.net.

Summary and links, Association for Contextual Behavioral Science.

Urge surfing…wrt addiction. From “Mindfulness with Dr. Walsh,” 2016.

Great interview (video) with Steven Hayes, by “Dr. Dave — The Science of Psychotherapy,” 2019.

Last post I said I’d review schools of psychotherapy that promise to target addiction, and ACT and IFS were at the top of my list. I’ll get to these, but I thought I’d spread the net a bit wider. So I’m starting this series with a look at “psychodynamic” or psychoanalytic psychotherapy. I think the underlying concepts of this tradition are crucial for understanding and overcoming addiction.

Psychoanalysis (think Freud and his followers) is the mother of all psychotherapies. No matter what you’ve heard, no matter how much people scoff at penis envy and other outdated concepts, Freud was a genius. He was the first (as far as I know) to develop a “talking cure” for serious emotional difficulties, and he was the first to bring the idea of unconscious wishes and motives into public parlance. Sure, psychoanalysis — on the couch, four times a week, for fifteen years (?!) — hasn’t lived up to expectations, and I believe it’s correctly pushed aside by more focused, present-tense-oriented, and evidence-based treatment models.

But its offspring, psychodynamic psychology, isn’t so easily ignored. So my goal for this post is to tell you how this approach tends to frame addiction and how it can help, directly or indirectly.

The person who first comes to mind (and to Google) when you put “psychoanalytic” and “addiction” in the same search is Lance Dodes. His 2015 book “The Sober Truth” purports to debunk 12-step methods as riding on bad science. I have mixed feelings about this book. If “Science” with a capital S is to be our lodestone, then psychoanalysis doesn’t look so hot either. But, okay, Dodes is inspiring, he’s developed his methods over decades, he’s come down strongly on “resort” rehabs (great video!) like those spawning in Malibu, California. So I want to touch on his perspective.

This is how Dodes conceptualizes addiction, and it captures core features of the psychodynamic insight:

“[E]very addictive act is preceded by a feeling of helplessness or powerlessness (an overwhelming of the capacity to manage [one’s moods or feelings] without feeling emotionally flooded). Addictive behavior functions to repair this underlying feeling of helplessness. It is able to do this because taking the addictive action (or even deciding to take this action) creates a sense of being empowered, of regaining control over one’s emotional experience and one’s life. This reversal of helplessness may be described as the psychological purpose of addiction.”

Of course we know that this temporary “empowerment” leads to further helplessness, but the initial rush of self-determination is not to be denied. More broadly, psychodynamic approaches always look at present problems in the light of one’s early development. A realistic and increasingly popular spin-off of this position is the emphasis on childhood trauma, most famously highlighted by Gabor Maté, as featured in this clip. Whether a specific trauma is discovered or not, psychodynamic psychotherapy works to get people to rediscover and reinterpret their early struggles. The assumption is that addiction is an ineffective resolution to conflicts and defeats that were never fully accepted or resolved.

There are addiction treatment centres (e.g., Caron Treatment Centers) that expressly tap psychodynamic psychology in their approach. Other organizations combine aspects of psychodynamic psychology with other traditions. Andrew Tatarsky’s Center for Optimal Living in New York offers a harm-reduction approach that has psychodynamic psychology (and thus individual psychotherapy) built into it. I particularly like Tatarsky’s model (I spoke there and met him last June) because it is fundamentally empathic and humanistic, honouring individual differences and working with them.

What’s most interesting to me is how psychodynamic ideas provide a foundation underlying many current schools of psychotherapy. With respect to addiction, ACT and IFS (my favourites — see last post) are all about bringing the past into the present and dealing with it. What seems to be missing from our lives? When did that start? Where does the depression come from? What messages do we repeatedly give ourselves that make us feel hopeless or despicable, so there seems little opportunity for relief except our addiction? Where do contradictory self-statements, like yes, this is what I want and I hate doing this! actually come from?

My own training in psychotherapy was entirely psychodynamic. I learned and practiced with children and adolescents, and my mentors were pretty classical by today’s standards. But what I do now, and what I think most psychotherapists do, is blend different approaches, revising and refining our methods until we find what works best. And what works best appears at the interface of our own personality and knowledge base, our style of connecting with others, and the particular problems (in my case, mostly addiction) that come our way.

The problem with “pure” psychodynamic therapy is that it spends too long reinterpreting past events without connecting them intimately and acutely with current issues. As a result, pure psychodynamic therapy can take too long and never really get to the here-and-now. Yet the here-and-now mustn’t be put off when it comes to addiction. Addiction is self-perpetuating and it involves synaptic changes. Psychodynamic therapy ignores the fact that deep habits are neurally encoded and their momentum doesn’t derive from…any one thing. What’s more, people with addictions are truly miserable. They may live their lives on the cliff edge of self-destruction. So, for me, the psychodynamic approach works best as a platform on which to devise and enrich more direct interventions. Yes, we have to understand where we come from, but mostly as a means for understanding where we’re at now and where we’re going next.

 

 

 

 

 

 

 

In my psychotherapy (and chats, consultations, etc) with people in addiction, I combine skills I’ve picked up over 35 years studying clinical psychology, developmental psychology, psychoanalysis, and neuroscience. But it’s not enough. I need retooling.

I’ve developed some good intuitions about how to do psychotherapy…mostly by doing it, putting theory into practice. And I can be effective with people in addiction partly because I’ve been there myself. I know I’ve helped people transform their addictive habits. I’ve had clients who’ve quit, cut down substantially, or who continue to use or drink without a sense of desperation or compulsion. I’ve helped people discover or rediscover how to like themselves, forgive themselves, even love themselves, sometimes despite vast challenges (including abuse of one kind or another) during childhood and/or adolescence. And I’ve helped people devise cognitive tricks to shunt their trajectory away from substance use and toward more satisfying habits.

But I’ve failed a lot too. I’ve had clients I haven’t been able to help, for whom my best instincts amount to little more than a shot in the dark. With drug addiction, every failure is potentially lethal. So I figure I need to retool.

So what’s the best way to do that?

Like so many other “experts” working with people in addiction, I’m still looking for the silver bullet. Or bullets — because I can name ten schools of psychology, psychotherapy and mindfulness training off the top of my head (and some pharmaceutical approaches as well) — most of which aim to help people recover from addiction (as well as other mental health goals). And most of them do help. Some people. Sometimes.

But there seems to be a black hole in the centre of the addiction galaxy that sucks in techniques of every sort and laughingly squishes them to nothing, tosses them back down some wormhole to some parallel universe. And surely that’s because addiction boils down to a unique “thing” which is totally psychological, totally biological, and totally social. A habit in the workings of our cells, our minds, and our interpersonal relations.

(And by the way, when people ask whether addiction is psychological OR biological OR social, they’re asking the wrong question.)

But besides that, the very unique thing about addiction is that when you start to beat it, when you actually start to succeed in your recovery, then instead of a radiant glow of achievement and satisfaction (that may come later) you’re often left with an aching emptiness. And what the hell are we humans supposed to do with that?! (Mindfulness/meditation has some answers, but let’s face it, the solution isn’t obvious.)

So, I want to spend the next few posts examining some of the therapeutic techniques that are potentially effective with addiction, and try to figure out what works best, what works for whom, and how we might nudge some of these techniques so they’ll work even better. I also want to address this issue of “emptiness” head-on. It’s a biggie.

I’ll start by sharing my own plans for retooling.

Acceptance & Commitment Therapy (ACT)

ACT combines techniques from cognitive-behavioural therapy (CBT) with techniques from mindfulness/meditation. It’s oriented toward people’s basic deep-down needs — and the incredible things they do to avoid them, deny them, or satisfy them in ways that just don’t work. It’s also strategic, in that the therapist serves as a coach to try different approaches to recurring negative experiences. ACT is explicitly geared toward conscious change in how we interact with ourselves and with others.

I’ve used some ACT themes in my own work with clients. They help. But I want to get to the details. So I’ve recently enrolled in an online intensive training course. The course is taught by Steven Hayes, the founder, a guy who somehow resembles a martian, totally bald, with sea-shell ears that rise at an odd angle, but who radiates wisdom, compassion and skill. ACT is partly devised to help people with addictions. And other addiction workers (like Matt and Peter Sheath who’ve posted on this blog) see it as effective. So what’s the secret? I’ll tell you what I’m learning as I learn more.

Internal Family Systems (IFS)

IFS is a school of psychotherapy that identifies and listens to the internal voices in our heads — most obvious in addiction through the (sometimes horrendous) conversations or shouting matches between the taking-care self, the addict self, and the internal critic (how they’re often recognized and identified). The founder, a guy named Richard Schwartz, studied family systems therapy back in the 70s and began to realize that all the shit that goes on between family members is actually going on in our own heads. Sometimes almost constantly.

IFS is well-designed for dealing with addiction because addicts so frequently say “there’s a part of me that just says fuck it, I want to use” and ignores the arguments of other “parts” of the self. This division of one part of oneself from other parts just begs to be dealt with head-on. I sometimes focus on clients’ internal dialogue in my own therapy practice, though I’ve never studied IFS seriously. But now I’m reading up on IFS…to get ready. I’ll be attending a 5-day intensive workshop on IFS for people in addiction this March. I’ll let you know what I learn.

I hope visits to these and other psychotherapeutic approaches will be useful for readers who are devoted to helping people in addiction. But I also think they’ll be important for those who are struggling with their own addiction — because they can highlight what’s available from different forms of therapy and introduce powerful techniques you can use on your own.

 

…by April Smith…

What’s HAMS? If you don’t know about it yet, this guest post says it all: HAMS stands for Harm Reduction, Abstinence and Moderation Support. I’ve recognized and admired this organization for years, and I’m delighted to have April tell you more about it.

…………………………

I went to rehab at age 40 after a horrific crash that landed me passed out on a busy street in Philadelphia.  I don’t rehash my story in public, but things were so bad that I was grateful that my parents made the huge financial sacrifice it took to send me to one of the oldest and most respected 12-Step rehabs in the country.

I dutifully did everything I was told, announced to everyone I met that I was an “alcoholic,” and earned the nickname “Recovery Supergirl.” Surprising for a Yale grad who had succeeded at everything? Maybe — until a series of traumatic events and alcohol-fueled relationships eventually landed her facedown on the concrete.

Though outwardly I was the soul of enthusiastic compliance with my treatment, the questions were brewing.  I didn’t think that character defects and self-centeredness had caused my alcohol problems.  I had no interest in spending  my life confessing my sins to strangers.  And I wasn’t convinced that a lifelong abstinence from any mood-altering chemical (except caffeine, sugar and nicotine!) was the only answer.

From reading Marc’s Memoirs of an Addicted Brain, I went on to read the many others who have brought to light real science and common sense about addiction: Johann Hari, Carl Hart, Stanton Peele, and others.  I started writing comments on Marc’s blog, and Marc asked me to turn one comment into a guest post.

A man named Kenneth Anderson found the post and friended me on Facebook.  He is the Founder and Executive Director of a group called Harm Reduction, Abstinence and Moderation Support (HAMS) for Alcohol.   HAMS is a worldwide organization with a vibrant, supportive and non-judgmental Facebook presence, live chats, a forum, and useable, evidence-based tools.

I joined HAMS in a moment of crisis.  After about a year of complete abstinence after rehab, I decided to try drinking moderately.  I sat down at a bar I had once frequented, had a glass of wine, ordered a second and drank only half of it before pushing it away and heading home.

My then-boyfriend freaked out: “You’re drinking again!  You know you can’t drink because you’re an alcoholic!”

The absurdity of it hit me like a bottle of beer smashed over my head.  I had a glass and a half of wine.  Nothing happened.  The world did not end.

In HAMS, I found a community that supported me, no matter what my alcohol choices were.  We support all goals, not just abstinence.  We do not require or recommend that people who have problems with alcohol stop drinking forever.  We don’t require anything, other than that members treat each other with respect and not judgement. We support abstinence (a word we prefer over “sobriety,” as “sober” has moral connotations), moderate drinking, and safe drinking.

It wasn’t long after I started to work with Kenneth that I became the leader of HAMS for Women, a subgroup of women who are trying to change their drinking.  In HAMS for Women, we refer to each other as “ladies,” because women who drink have too often been described by derogatory names — anything but ladies.  We carefully moderate the group to make sure that shaming, blaming, and judgmental comments are kept off.

We don’t just talk about alcohol, though.  We talk about spouses, children, and we post pictures of our pets!  We’ve had extremely sad moments: the day we learned of the death — from cirrhosis — of a woman we had seen through crisis after crisis as her abusive husband kept pushing things just a bit further, all the while keeping her too drunk to work and make a living. We exchange stories we dare not tell in public. In this group we find nothing but love and support.

For me, HAMS has been a critical part of rewriting my identity.  The label “alcoholic” seemed to erase everything I had been before, and everything I might be in the future.  No matter what I did, even when I didn’t drink, I felt shame.  HAMS has taught me that the content of my bloodstream is not the content of my character.  Now my identity is not defined by my relationship to alcohol.  I am not an “alcoholic.”  I am April Wilson Smith.

Many HAMS members learn to successfully moderate, using HAMS tools such as counting your drinks and deciding on a limit in advance. Contrary to the (irrational) idea — promoted by AA and the popular press — that one drink will ruin your life, HAMS members are often able to achieve moderation, even if they had serious problems with alcohol before.  Many choose to abstain altogether, a choice we applaud as well. Our motto is, “Better is Better!”

I recently had the opportunity to interview Kenneth for Filter Magazine.  See the full interview here.

HAMS has just published an e-book, priced at $0.99, relating the stories of our members: their struggles and successes.  We hope you’ll pick it up and check us out on Facebook.  Here’s what Marc has to say about the book — an endorsement that joins praise by Maia Szalavitz, Stanton Peele, Johann Hari, and others.

“Through these moving personal stories, we learn not only how HAMS works but how addiction works. And we learn that overcoming addiction doesn’t have to adhere to a rigid program or philosophy. HAMS succeeds because it connects with people who drink, on their own terms, respects their goals and wishes, recognizes their strengths and supports them where they need and want support. These little memoirs are as varied in style and substance as the individuals who wrote them, but they converge on themes that just don’t go away, including the inadequacy of AA for many who drink, despite its value for some. Intimately told, both raw and articulate, these memoirs reveal how people struggling with addiction can help each other through sensitivity and generosity rather than judgment and dogma.”

I had the pleasure of interviewing HAMS members for the creation of this book, and I saw the full range of improvements in their approach to drinking, without the aid of a Higher Power or even a therapist.  They are living proof that all choices, not just abstinence, can work.

Better is better!

Happy New Year! I’m sure we’re all hoping that this year brings renewed optimism, through the creative, caring, and sensible use of all that’s available in this era of rapid change. In that spirit, I discuss my thoughts about “good drugs” and share my recent experience of DMT.

My twin boys are now thirteen, so they are approaching the age at which they’re likely to be exposed to drugs of all sorts. Like most parents, Isabel and I are concerned. We’re trying to find the right preparation and the right logic to steer them away from drug experiences that will likely be harmful. What can we say that provides guidance, not prohibition? Should we try to persuade the boys to avoid all drugs? Not a very useful strategy, says Carl Hart, and I agree. Not only would they probably dismiss our counsel and ignore our views on drugs completely — after all, we’d simply be displaying our biases. But on this point I follow Sam Harris. Somewhere in his book, Waking Up — A Guide to Spirituality without Religion, he says something like this: (don’t quote me — this is from memory) I hope my kids will never tell me they’ve experimented with meth or heroin. But I also hope they won’t tell me that they’ve avoided the psychedelics with equal fervor. I like Sam Harris. I like his approach to mindfulness, consciousness, and living with awareness. I’ve also just begun his guided meditation app. I highly recommend it.

There are so many kinds of drugs we could talk about with our kids, and the legal system provides almost no help when it comes to sorting them according to potential risk. After all, alcohol and tobacco are the most hazardous of substances, statistically, and they’re both legal. My intuition is to divide non-medical (“recreational”?) drugs into three categories:

1. Those you should never ever touch: methamphetamine, heroin, crack cocaine. Besides the risk of overdose with heroin and psychosis or stroke with psychostimulants, all three drugs are highly addictive. I want to scare my kids appropriately, using my own past experiences for all they’re worth.
2. Those you’d be best to avoid but probably won’t harm you if you explore cautiously, use occasionally, and learn about the risks: nonaddictive party drugs like ecstasy (MDMA) and ketamine.
3. Those that really are okay if used appropriately: including alcohol, an aspect of human social rituals for roughly ten thousand years…but more interestingly, the psychedelics. If you are not vulnerable to psychosis or other severe mental health issues, then psychedelics can be beneficial in the pursuit of self-actualization or just exploring unique aspects of mind, consciousness, and reality. Of course, tread cautiously. Don’t go into these waters without guidance, companionship, and some degree of knowledge. But these drug experiences are among the adventures available to our age.

The psychedelics were epitomized by LSD in my generation. Psilocybin (magic mushrooms) and mescaline were also quite common. For young people in the current era, psilocybin is still frequently used. More recent additions include ayahuasca and other forms of DMT. These DMT compounds might be most attractive (and challenging!) to today’s intrepid psychonaut. And by the way, psychonaut is a real word; it refers to the exploration of altered states, including but not limited to “mind-altering” drugs.

There’s much to say about the ritualistic use of DMT by aboriginal cultures, the shamanic element, the social contexts considered helpful and supportive, and the limited research conducted so far. This Wikipedia page is a good start. It’s also important to note that psilocybin and MDMA are now being used by licensed psychiatrists to help their patients overcome anxiety, depression, addiction, and other unfortunate habits of mind (see Michael Pollan).

But you can read all this on the net. Let me tell you about my own recent experience.

I wrote about my first ayahuasca trip in this blog a few years ago. After five or six ceremonies, I decided that’s enough. The insights were profound, the hallucinations penetrating and beautiful, but running to the toilet every half-hour got old.

More recently, I heard an intriguing description of a trip with The Toad. Bufo Alvarius secretes a substance (5-MeO-DMT) that is dried and then smoked in a glass pipe. The toad is not killed but respectfully released after its DMT is collected. The trip is supposed to be rapid (5-25 minutes) and intense. Efficient, right? So I joined a friend in the UK for my introduction. We had a shaman usher us into this strange world, a short, tough-talking Brit from northern England who’d spent a prolonged period in the Sonoran Desert learning about Bufo from the natives who used it. John was a no-nonsense guy radiating expertise as well as compassion. His Tibetan bowls, drums, and feathers were ready to accompany us into, through, and out of the hallucinatory state.

We met in a church hall, chilly and unadorned. But it was enough. John and his helper arranged two padded bed-rolls which you sat against at first and then lay back on when the DMT hit your nervous system. I’d been feeling afraid of this moment for days. My friend spoke about “ego death” — leaving your personality behind, essentially dying as an individual and becoming connected with the rest of the universe intimately but without control. Sure, I was scared. “Ego death” has the word “death” in it.

For some reason, my fear disappeared the day of the event. I felt ready. By mutual consent, I went first. I was doused in tobacco smoke (an American native ritual) and cleansed of badness with the swoosh of a feather. I sat on the bed-roll. John ordered me to exhale completely, then held the stem of a glass pipe to my lips and lit it from below. Inhale, he said. More, more, keep going! And I did, until it felt like my lungs would burst. And then the room began to dissolve before my eyes. All of its features simply faded to colourful outlines and then…nothing at all. Strong hands helped me to lie back. Close your eyes now — I could still hear his voice. But I wasn’t in the room anymore.

Where was I? Of course it’s nearly impossible to describe. Something like a limitless pink space full of fluctuating colours and…feelings. It was a space of pure emotion. I felt great joy, gratitude that the universe would welcome me so easily. “Marc” meant nothing anymore, but I could still record my experience consciously. And right in the middle of all that joy there was a sort of black hole, called “anguish.” It held the greatest depths of despair, and I recognized a direct trajectory that’s extended through my life, from childhood to the present. The message, if I can call it that, was simple: this is the part of my experience that I thought I could not bear, that has always terrified me. Yet here it is, and it’s just…a feeling. Just loss. This truth seemed incredibly important, and when I came back to the room, smiling up at my companions, groggy and googly-eyed, it was still with me, undiminished.

I don’t want to get into deep speculation as to what I learned from Bufo. But I’m grateful for the awareness it lent me. For weeks I began my day with a simple sense of acceptance. It seemed that nothing in my emotional space needed to be  hidden, or deleted, or modified. It seemed (and often still does) that my sense of reality has no preordained limits, and there is something that can be perceived, something caring and supportive, in the fabric of consciousness itself.

Perhaps in the coming year, the coming years, drugs like DMT will help us discard our preoccupation with our selves and trade our individuality for a connectedness that includes our fellow humans and the planet we share.