Psychedelics, Death & Understanding

How non-ordinary states of consciousness accessed through psychedelic medicines can help bring understanding and acceptance to our own mortality.

Death.

Perhaps no other word in our mortality-obsessed Western world brings forth such fear. Billions of dollars are spent each year to keep death at bay at all costs. Families burn through financial foundations to delay the inevitable. Countless fortunes flow from delivering tricks and cheats to procedures and systems designed to prop up our aging human suits. It’s as if a youthful appearance will fool death into passing by the house.

To fear death is to fear life. And perhaps no other existential part of being human causes such paralyzing blockage than our fear of death. It is estimated that 3%-10% of human beings have thanatophobia. In a 2022 study, Blomstrom et al. note, “Thanatophobia is synonymous with death anxiety and is defined as the apprehension and fear of annihilation that comes with a physical awareness of the loss of existence”. In a similar vein, a 2021 study by Niles et al. notes that existential distress is a common source of suffering experienced by patients with terminal illnesses. Further studies show that many patients diagnosed with a terminal illness experience significant existential suffering. In their 2019 study, Rosenbaum et al. note that this can lead to a loss of meaning in life. They explain that it can even lead to a desire for an expedited death.

Embracing Death Across Cultures

Despite death being inevitable for all of us, it’s not something most care to discuss. I have tried to bring up my own mortality to my youngest adult daughter. When I do, it’s always met with, “Can we please not talk about this?” What we resist tends to manifest suffering. This aversion to the mere subject of death isn’t evident across various human cultures. In Buddhist traditions, the cycle of rebirth and impermanence brings peace. Hinduism’s beliefs about karma and liberation (moksha) pave life’s path with an understanding of the eternal journey. 

“Natural death…offers the soul an opportunity to exchange a dilapidated, tottering dwelling-place for a new and sturdy one”

— Paramahansa Yogananda

Hamilton Inbadas has stated that “The purpose of human life, according to Indian thought, is to unite with the ultimate Reality, the Divine.” Yoga itself means ‘union’ to the Divine, and therefore moksha or liberation from the cycles of rebirth is the goal of life. Sengupta (2021) notes that the attainment of moksha can only happen through death; therefore, death is essential for a ‘good’ life and not something to fear.

The Spiritual Significance of Death

Christianity and the concepts of heaven, hell, and the afterlife are ripe with promises of a beautiful eternity in heaven. That is—as long as you play by God’s rules. In the Western world, the natural process of death can bring up feelings of fear, uncertainty, and avoidance. In contrast to both human and cultural tendencies within Western society, Paramahansa Yogananda claims, “Natural death is nothing to fear. Natural death is a blessing because it offers the soul an opportunity to exchange a dilapidated, tottering dwelling-place for a new and sturdy one”. The yogic perspective of death as a sacred transition into a more expanded state of consciousness can provide the West with a healthier relationship with death, where it has the potential to be the greatest spiritual teacher.

In Native American traditions, the belief in a deep connection to nature and the circle of life lightens any fear of death or of leaving this world. Meanwhile, in traditional African cultures, rituals, ancestor veneration, and the continuity of life beyond death are leading principles of understanding. 

Psychedelics as a Gateway to Understanding Mortality

So, how do psychedelics fit into the picture? It seems as though plant medicine has been a part of humanity’s connection to the eternal for some time. In Brian Muraresku’s book, “The Immortality Key,” the author investigates entheogens’ role in creating the very foundation of Christianity. His narrative journeys back to times when paganism reigned across cultures. To times when women held space with a variety of concoctions designed to bring forth the deeper, Divine Truth. Following the archeological and historical evidence, Muraresku details how the Ancient Greeks embarked on a ceremonial pilgrimage. These pilgrimages were to partake of the Kykeon, a brew bestowed with the ability to forever change an individual’s life. It does this by enabling them to ‘die before they die.’ The author goes further to claim that the original Christian sacrament was very likely psychedelic, brewed by women practitioners. Male church leaders then ended the practice when they realized the entheogenic sacrament undermined their desire to control the flock. 

In a previous article I wrote for Psychedelic Support entitled, “Ego dissolution during psychedelic experiences,” the parallels between deep non-ordinary states of consciousness via psychedelics and meditation and what comes after this life are explored. Ego dissolution through these consciousness practices delivers common experiences and insights, including feelings of Oneness, expansiveness, peace, and omnipresent love. Many who experience ego dissolution claim to have also dissolved fear of death while developing a deeper appreciation of life. 

The Intersection of Psychedelics and Psychology

The late psychedelics researcher and pioneer Dr. Roland Griffiths ran a study to see how psilocybin would affect cancer patients. As Griffiths notes in an interview with NPR:

“I remember feeling very cautious about what an experience of this sort would do to someone who’s facing the most significant existential threat that they can.

As it turns out, the effects were nothing short of astonishing. This cohort of people, who met criteria for clinical depression or anxiety, after a single dose of psilocybin under our supported conditions, the anxiety and depression dropped markedly – immediately – and markedly and enduringly. That was the most important feature: We followed people up for six months and they remained with very low symptom profiles.”

Dr. Griffiths ended up getting diagnosed with stage 4 colon cancer in November 2021. He died from the disease almost two years later. He maintained that his work with both meditation and psychedelics helped him immeasurably. Not only did it enable him to live his last months to their fullest. Simultaneously, he also campaigned for access to these powerful medicines for those who were diagnosed with terminal illnesses. 

A New Approach to End-of-Life Care

Thanatologist and transpersonal counselor Paul Miner notes how psychedelics align with and support much of his advanced inquiry into the nature of and inherent fears of death. “Psychedelic-assisted therapy (PAT) has been proven to effectively help reduce existential distress amongst patients with terminal illnesses, albeit it is still in its infancy stages, and further studies are necessary. This existential distress and depression make psychological sense when we think about the ego. The ego fears anything that will annihilate or destroy it.”

Studies at NYU, John Hopkins, and UCLA by Bossis (2021) and Rosenbaum et al. (2019) indicate that patients diagnosed with a terminal illness and who have ingested psilocybin have experienced a reduction in depression and anxiety stemming from their approaching death. A quiet ego or humility can act as a buffer against death anxiety. Kesebir provides evidence of this through several studies (2014).  

Might psychedelics do the same for the ego? Psychedelic studies have shown that psilocybin actually quiets the Default Mode Network (DMN). The DMN is an integral network involved in self-referential processing and metacognitive processing. This processing simultaneously increases the activity between the DMN and neural networks that process information about the external world. Changes in neural network processing through ingesting psilocybin are what induce changes in perception. The literature describes these events as hallucinatory or mystical experiences. Moreton et al. note that in these experiences, individuals have a deeply felt sense of becoming one with the entire cosmos (2019).

Navigating the Existential Terrain

Carl Jung (1971) believed that it was psychologically healthy for a person to establish a relationship with death and one’s immortality as they moved from the first half of life to the second half of life. Through work with his patients, Jung saw how those who chose to develop a relationship with death had a more meaningful second half of life and were less psychologically rigid.

Another researcher, Bernard Becker (2022), explains the neurological impact of MDMA in his dissertation entitled, Finding Peace in the Face of Death: A Depth-Psychological Inquiry into MDMA-Assisted Psychotherapy for Anxiety Associated with Life-Threatening Illness.

MDMA impacts the blood flow in the brain by increasing flow to the medial frontal and occipital cortex. Simultaneously, it decreases flow to the motor and somatosensory cortex and the temporal lobe. These neurological changes correlate with the psycho-emotional observations of individuals using MDMA in a therapeutic container. Some examples of these are the reduction of fear and heightened consciousness. This helps explain why individuals have expressed that MDMA allowed various emotions to arise. Becker notes that at the same time, they feel safe and in control rather than fearful and anxious. MDMA also helped foster the therapeutic relationship between the patient and therapist, enabling a greater sense of trust and safety. Becker further reports that this allows them to better explore and share parts of themselves. Specifically, parts of themselves that they typically would not feel comfortable sharing in an ordinary state of consciousness. 

Challenges and Ethical Considerations

Ethical considerations and potential risks are evident in Psychedelic-Assisted Therapy (PAT) for terminally ill patients experiencing thanatophobia. These individuals are experiencing high levels of anxiety around death and are in a vulnerable state. Caution in providing drugs or any substance to people in a vulnerable state of mind must be front and center. Yaden et al.’s (2021) research and anecdotal evidence show how psychedelics can lead a person to an “ego death“. With psychedelics, people can have an experience of ego dissolution. Therefore, there is a good chance that a psychedelic experience might be terrifying for an individual—thus increasing their death anxiety. 

Dosage is a very critical component of this work. Macro doses can lead to significant changes in individuals’ spiritual or religious beliefs. These experiences can be challenging both for someone with a terminal illness and for their friends and family members. Yaden et al. further note it can be difficult to understand and appreciate these experiences during such challenging times. 

Integration for Meaning-Making

From a depth psychological perspective, integration through ongoing therapy or counseling sessions is quite often imperative. It is one thing to have a psychedelic experience. It’s an entire additional level of effort to integrate that experience into one’s consensus reality. If an individual does not integrate and activate that experience into their daily life, then there is less chance of meaning-making and psychospiritual growth for the individual. Additionally, Osterhold & Fernandes-Osterhold (2023) note that there is a good chance these peak experiences can either inflate or deflate the ego. This is another important reason that these psychedelics should be used within the confines of a safe and therapeutic container.

“After a single dose of psilocybin…the anxiety and depression dropped markedly – immediately – and markedly and enduringly.”

— Dr. Roland Griffiths

Many paths exist in our lives, as there are many paths to the end of our human experience. Psychedelics hold tremendous potential to relieve end-of-life depression and anxiety of those with terminal illnesses. And for those of us just living our lives, these non-ordinary states of consciousness can allow us to peek beyond the veil and better understand what a gift this life really is. 

References 

Blomstrom, M., Burns, A., Larriviere, D., & Penberthy, J. K. (2022). Addressing fear of death and dying: traditional and innovative interventions. Mortality, 27(1), 18–37. https://doi.org/10.1080/13576275.2020.1810649

Niles, H., Fogg, C., Kelmendi, B., et al. Palliative care provider attitudes toward existential distress and treatment with psychedelic-assisted therapies. BMC Palliat Care 20, 191 (2021). https://doi.org/10.1186/s12904-021-00889-x

Rosenbaum, D., Boyle, A. B., Rosenblum, A. M., Ziai, S., & Chasen, M. R., (2019). Psychedelics for psychological and existential distress in palliative and cancer care. Current Oncology, 26(4), 225–226. https://doi.org/10.3747/co.26.5009

Embracing Death Across Cultures

Inbadas, H. (2018). Indian philosophical foundations of spirituality at end of life. Mortality, 23(4), 320-333. https://doi.org/10.1080/13576275.2017.1351936 

Yogananda, P. (2000). Man’s Eternal Quest: Collected Talks & Essays on Realizing God in Daily Life: Vol. II (2nd ed.). Self-Realization Fellowship.

A New Approach to End-of-Life Care

Kesebir, P. (2014). A quiet ego quiets death anxiety: humility as an existential anxiety buffer. Journal of personality and social psychology, 106(4), 610–623. https://doi.org/10.1037/a0035814

Navigating the Existential Terrain

Moreton, S. G., Szalla, L., Menzies, R. E., & Arena, A. F. (2020). Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics. Psychopharmacology, 237(1), 21–32. https://doi.org/10.1007/s00213-019-05391-0

Jung, C. G. (1971). The Portable Jung (J. Campbell, Ed.). Viking Press.

Becker, B. (2022). Finding Peace in the Face of Death: A Depth-Psychological Inquiry into MDMA-Assisted Psychotherapy for Anxiety Associated with Life-Threatening Illness (Publication No. 29064295) [Doctoral dissertation, Pacifica Graduate Institute]. ProQuest Dissertations Publishing. https://www.proquest.com/openview/2d88fa6dea2d071b95187663142bf111/1?pq-origsite=gscholar&cbl=18750&diss=y

Challenges and Ethical Considerations

Yaden, D.B., Nayak, S.M., Gukasyan, N., Anderson, B.T., & Griffiths, R.R. (2021). The Potential of Psychedelics for End of Life and Palliative Care. In: Barrett, F.S., Preller, K.H. (eds) Disruptive Psychopharmacology. Current Topics in Behavioral Neurosciences, vol 56. Springer, Cham. https://doi.org/10.1007/7854_2021_278 

Integration for Meaning-Making

Osterhold, H. M., & Fernandes-Osterhold, G. (2023) Chasing the Numinous: Hungry Ghosts in the Shadow of the Psychedelic Renaissance, J Anal Psychol, 68, 638-664. https://doi.org/10.1111/1468-5922.12949