Why is nonconsensual, compulsory treatment widely accepted in mental healthcare? Why are many in the medical and bioethics community so certain that the “insane” are undoubtedly unfit to choose for themselves? Who is to say? Who is to decide what is the most whole/beautiful/meaningful/ “right” existence of another?
* Thinking specifically about nonconsensual electroconvulsive therapy (ECT) in schizophrenic patients, some who deny their diagnosis and treatment. See the case PBU & NJE v Mental Health Tribunal from 2018 in Victoria. Essentially, the patients won and were freed from forced treatment. For those on the side of patient advocacy and autonomy, this was good news. However, this ruling upset some psychiatrists and bioethicists.
Can the mentally ill, as certain medical systems see them, make rational, autonomous decisions for themselves? Do certain emotions halt capability to reason? Can anyone make autonomous decisions for themselves? Or are we all embedded in and influenced by altered/unaltered choice/default design?
Fifteen micrograms of acid, on a sliver of paper, washed down with a glass of water. This is my medicine of choice.
I microdosed 1P-LSD from April to December 2017 following a regimen: one day on, threeish days off. It’s been over a year since I stopped that routine and tapered my dosing to as-needed for mood support.
Eight months is a bit longer than most ~microdosing experts~ recommend. Online sources typically suggest six weeks or three months, but that’s mostly speculative. Any recommendations for continued psychedelic use (and all psychiatric medicine?) are relatively inexpert given our still premature understanding of the brain. When it comes to intimate psychological issues, there is no single cure for what has complex—and largely unknown—causes. No one knows which precise treatment or prescription will work for anyone. Especially in people with discreet or hard-to-diagnose issues, who experience difficulty communicating, or who are especially young or old. It’s all an experiment. That’s what the medical community has been doing, as well as a few rogue individuals.
Psychedelic researchers, advocates, and skeptics alike met on February 13th, 2019 in Melbourne for the Mind Medicine Australia launch. Fresh from San Francisco and eager to meet people in this city also interested in psychedelic medicine, I bought an early-bird ticket.
February 13th, 2019, 5:30 PM. At this point in life getting ready to go out involves more time bopping around with acid under my tongue than looking in the mirror. Microdosing quells my zapping nerves and oftentimes overactive mind, especially before larger gatherings.
So I took a small dose before biking to the University of Melbourne for the Mind Medicine launch. The bats weren’t out yet, but they would be soon, and the air was a perfect 23°C. I locked my bike, tried to tame my helmet hair, and entered the Sidney Myer Asia Centre. Immediately greeted, thick lashes ushered me to the left. More smiling eyes appeared around the corner, showing the way upstairs. I entered the full, bustling theater.
There were only a few seats left. Everyone was finding their space, finding their friends. I sat down in the back and observed the crowd. No matter if it’s in Melbourne, London, Berlin, or San Francisco, the general attitude and sense of psychedelic conferences remains the same: compassionate, curious, positive, and present. There’s this shared understanding, communicated with kind and sometimes cheeky glances that say: “We’ve seen a glimpse of the possible. That’s why we’re all here.” It’s usually a clash of characters, buttoned-up scientists, artists. The kind of people you might bond with at a music festival and never see again are there, anticipating a lineup of lectures.
Sound cultish? It really shouldn’t. People from all edges of the earth have been interested in psychedelic medicine and its potential for millennia. Many aboriginal people wonder what took us so long to make the connection. This goes beyond a Reddit thread.
“Hi neighbor,” the man next to me introduced himself. He was wearing a sheen suit and said he wanted a job.
Migration as a bioethics issue — not allowing people to migrate physically (from asylum seeking to relocation for better opportunity and simply travel) and mentally (with psychoactive substance or mind-altering experiences) is a bioethics issue. Regulations on migration, travel, and drug use serve some and harm many.
The ethics of psychiatric diagnosis/prescription vs. self-medication — the current psychiatric system also serves some, but hurts many, and moving from the doctor-patient power imbalance to patient empowerment could be a solution. This research would seek information about people who do not receive psychiatric treatment (for reasons from ability to financial), who do not benefit from current pharmaceuticals, and who already know which drugs they want to try — whether from their psychiatrist or from the street. Do you know people who go to the doctor knowing what they’ll be asking for? Isn’t this doctor-approved self-medication? Do you know people given drugs by doctors that they wouldn’t take on their own, that might even make them seem worse? (Thinking strictly re: psychiatric medicine, not for example, cancer treatment.) Is self-medication really the problem authorities should fight or should they provide wider education and harm reduction instead? Reference: Portugal. Will the information age cut out doctors as the middle men between patients and their preferred medicine? This would reference Our Right to Drugs by Thomas Szasz, among others.
Just one inhale sent me falling backward into my pillow. A phantom in my mirror sat up from my body, then walked away. My eyelids shut, and I shot into space. Flying through vibrant tunnels of geometric patterns and down paths not unlike Mario Kart 64’s Rainbow Road, I eventually landed on “the other side.” Everything was white and black, simultaneously. I seemed to be standing on firm ground in the clouds, with the agency to navigate. I was in the void. There was no distinction between high and low or here and there. Though I’m not religious, Ganesha — Hindu god of beginnings and “remover of obstacles” — appeared. The elephant figure pulsated in the center of my vision as several arms swayed up and down. I was awestruck, eager to explore. I turned and faced a large audience, a sea of young Asian boys. (Don’t ask why. I know it’s specific.) They were all giving me a thumbs-up, cheering me on. Smiling eyes roared in unison: “Keep doing what you’re doing, Erica. You’re doing the right thing.”
At this point, my roommate opened the door, and the visions evaporated. I told her, “I’m on DMT. Please shut the door.” The room returned to silence. The walls seemed to be morphing and dripping with sheen paint. Then, just as suddenly as I’d blasted off, I made a gentle landing back to sober consciousness. I checked the clock. Only 20 minutes had passed. I remember thinking, “That’s it?” But now, several years later, the psychological benefits of that experience continue to crystalize.
That was it. Just one bong rip of DMT — also known as N,N-dimethyltryptamine, a molecule found nearly everywhere in nature and a powerful hallucinogenic — sent me out of this world. I had no idea it would also send me the precise message I needed to hear as a 20-year-old trying to figure out my life.
Like many young people, I went through a period of feeling uncertain about everything. What to do, how to be. I was depressed, skipping class, avoiding responsibilities. (Smoking pot all day didn’t quite ease the existential anxiety.) To escape this inherent developmental discomfort, I used all sorts of substances: alcohol, marijuana, cocaine, sketchy pressed pills, various pharmaceuticals. But psychedelics were always different. Rather than a diversion from reality, they provided a meaningful and direct confrontation with my inner self and this outer space we find ourselves tucked into.
On larger doses of LSD, I’ve seen divine feminine figures in kaleidoscopic vision. All women in one woman, or me. Yoni, apparently. On psilocybin (four grams, a doozy), I once forgot everything about the world, including myself. Even my name. Rediscovering everything as I returned from the fog renewed my appreciation and awe of existence. When you forget that music exists and hear a song for what feels like the first time, even T-Pain on WiLD 94.9 can bring tears to your eyes. On ketamine, the most mundane information transforms into divine comedy. And on MDMA, I’ve connected more deeply with people I love. Once I even saw green energy sparks coming out of my hands after rubbing them together. I was able to see the unseeable.
Each of these seemingly sacred experiences has brought me closer to what feels like my most “authentic self.” And while the psychedelic experience has historically been written from a male perspective, with an emphasis on ego loss as the big shebang, that recurrent theme has been a bit less profound for me and other women I’ve spoken to about psychedelic visions. Maybe ego loss is less focal to the female psychedelic experience because we’re primary caregivers biologically.Maybe it’s neurochemically and socially easier for us to “lose ourselves” in flow states of caregiving, such that becoming aware of a lack of boundaries between ourselves and the world may be a bit less mind-blowing. Instead, reaching an inner state of pure self-compassion, giving my ego a damn hug for once, and being reintroduced to myself sans judgment has been paramount. Some space to say: It’s okay. You’re okay.
Reflecting on all the substances I’ve taken, DMT stands above and beyond the rest. DMT delivered the words of encouragement I desperately needed as a young woman to “find my way.” Not a degree. Not a boyfriend. Not a grade on a paper. Not a like on Instagram. I needed to know within the deepest part of myself that I was okay; I was enough. A very basic human need that comes more naturally to some than others.
That brief message brought me back home within myself. And over time, it made it easier to ignore self-doubt and distractions from my truest goals, dreams, and desires. The things that make me talk too fast. The things that make me write. The things that make me feel full: love and learning. The things in this world that need some editing and rewriting.
I definitely don’t have it all figured out, but that single experience gave me the reassurance I needed to simply be as I am. To stop trying to embody a personality or mimic a state alien to myself. To stop worrying about what others are thinking and feeling at all times. This is not a story of ego loss, but a story of ego restructuring. A moment of solitude that allowed my mind to better prioritize what matters and what doesn’t. What deserves attention. Especially for women, who may exhaust too much mental energy outside of themselves, constantly thinking about how others are feeling, thinking, and perceiving, this return inward can be especially therapeutic.
People familiar with DMT will often ask, “Did you break through?” And I did. After cosmic travel — whether in a spacecraft or within your own mind — your perspective is bound to shift. Anxiety lifts. Everyday trials and tribulations seem more petty than before. Spiraling thoughts of self-doubt become irrelevant, because, according to the laws of universe, it’s going to be okay. Really, you’re doing just fine. For anyone who grew up programmed to think otherwise — that they’re not good enough, that they should conform like this or dress like that, that they deserve less — a psychedelic experience can help send those negative thoughts out of orbit.DMT politely called bullshit on all that disorienting psychosocial conditioning that surrounded me as a young woman, and then said: Keep going.
It’s 7am on the uBahn. Eyes still puffy from the night before. A woman slowly nibbles her morning brötchen while staring into the static on the broken TV above. Everyone is silent. And in this crowd of straight faces, there I am: grinning like an idiot. Why? I have a little secret. There’s acid under my tongue.
This slightly mischievous feeling is familiar to me. I’ve taken 1P-LSD (a legal LSD analog in Germany) over 50 times in the last six months. Most doses have been small. So small that they’ve merely lifted my mood, generally speaking. But somehow each and every time still feels brand new.
These ritual doses have drastically improved my life and reshaped my perception, but what’s really been going on inside my head? It seems my brain has been especially malleable these last few months. I’ve been able to untangle the knots of thought that eclipsed my reality and made everything a little darker.
What type of people decide to become writers? How much self-confidence does it take to decide one day: “I’m going to be a writer.” What level of self-indulgent satisfaction must one reach before they finally hit send; publish.
I imagine them jotting shit down at an elegantly disheveled desk. Writing with feverish intent and concentration. And not on a computer! With a pen. Just like in the movies. But who’s in the picture? Appears to be white dude in his 50s with a dad bod and greying hair. He wears stylish glasses.
Why does this image come most naturally to me?
I can’t compare myself to this portrait. I’m all over the place. But I like to think my mind has more in common with that dude’s desk than him: it’s messy. But full of curiosities and stories that might be worth organizing and sharing someday.
Externally everything seems fine. My appearance manifests itself as a relatively high functioning young adult who lives and works in Berlin.
But I’ve dealt with an unquiet mind all my life, and managing that has proven to be a difficult but beautiful journey. I’ve experienced and still work with anxiety, addiction, mood swings, a strange relationship with food, significant dips in motivation, obsessive tendencies, and self-harm in many intricate fashions. I have trouble admitting this sometimes, but other times, it’s crystal clear.