Light at the End of the Tunnel—Psilocybin Therapy and End of Life Care
Last night, I attended a screening of Linda’s Last Trip, a film that accompanies a 63-year old woman grappling with a terminal cancer diagnosis who turns to psilocybin therapy for solace and perspective. The event—sponsored by the Portland Psychedelic Society— included a panel discussion with active psilocybin facilitators and death doulas.
As you can imagine, the film was harrowing and poignant (If you have a kanopy subscription—which is free with a library card—you can watch it here), as it gave us unrestricted access to a vulnerable human at the crossroads. While Linda’s personal story is the main event, the film does provide a compelling glimpse of actual psilocybin therapy—a rare perspective as cameras and magic mushrooms generally don’t play well together.
End of Life Benefits for Psilocybin Therapy
Linda came away from the journey with a renewed perspective on life. Instead of thinking about death all the time, she found herself immersed and in love with her daily routine. While this seems like a simple pivot from pessimism to optimism, the shift was a monumental one. Because she felt the message so viscerally, it was easy for her to devote her last 8 months of her life to life itself. She pledged to spend as much time as possible with her family. That vacation her sister wanted to take to New Mexico? A hard no before the journey turned into an emphatic, excited HECK YES. While psilocybin therapy didn’t grant Linda a permanent bliss—there is no silver bullet, folks—it alleviated her anxiety and made her more comfortable with death.
One of the most moving parts of the film shows Linda–post psilocybin experience—calmly ripping pages out of her old journals, throwing them into a cardboard box and dragging them outside to burn. While burning old poems may seem like an act of rage and erasure, Linda was actually liberated. She mentioned that the mushrooms gave her permission to start letting go. Did that mean she had to burn everything she ever wrote? Not at all. But the act of sorting, ripping and burning was one of catharsis and gratitude. What a sacred honor to be a custodian of your own estate. What a relief to unburden a loved one from that kind of inheritance.
To review, the mushrooms lifted a stagnant macabre fascination with dying and granted Linda the inspiration to let go of the things she holds so dear, acts that would have likely petrified her just a month earlier. However, these are just pieces of the gigantic lesson that transformed the rest of her life—psilocybin therapy gave her a whole new way to conceptualize death.
Death and the Psilocybin Experience
And yeah, I know—this is where the water gets murky. This is where skeptics say mushrooms are just a drug that distorts reality, a substance that monkeys with our brains to present this holistic vision of existence that has no basis in western medicine and often contradicts some of our most fundamental assumptions about life. But let’s kick this around a little. What do we really know about death? What do we know about consciousness, and what it means to be alive? Why do we label some visions of the afterlife as primitive, animistic or blasphemous when the idea of heaven seems to acutely resemble many of these ancient beliefs? I don’t intend to answer these questions and deliver a philosophical treatise, and I may be preaching to the choir, but I’ve heard folks dismiss these end-of-life revelations too many times to not grumble aloud here.
At any rate, Linda was gifted a new definition of death. Rather than a final descent into nothingness, she learned to see the next 6 months as a necessary and even, beautiful transition; indeed, she was not going away forever, but joining forces with the enchanting world around her. Her death, she believed, was not the book closing but another chapter beginning.
And it’s not just Linda’s story. See this abstract regarding the clinical trials at NYU and Johns Hopkins in which 80% of the Hopkins cancer patients who received psilocybin showed clinically significant reductions in standard measures of anxiety and depression, an effect that endured for at least six months after their session. Read the wonderful chapter in Micheal Pollan’s book where he interviews folks and their loved ones about the effects of the experience on their terminal diagnoses. Or just settle for this recent New York Times piece on this very subject.
The evidence is in. Psilocybin therapy can rid folks of the anguish of a terminal diagnosis and allow them to feel more present and grateful for their time left. That said, end of life psilocybin therapy isn’t for everybody. Folks who already hold sacred beliefs about mortality don’t necessarily need another perspective. Likewise, a mushroom trip might unsettle humans who are already overwhelmed and utterly befuddled by the shock of a diagnosis. Time is a sacred thing any way you spin it, so we need to tread carefully when helping a person toward what we conceive as the sublime.
Scared to Death: Existentialism and Psilocybin Therapy
I want to close here with a thread I’ve been unraveling since watching this film last night. While sitting with Linda’s experience and revisiting the materials I cited in the last paragraph, I’ve fashioned a hasty but poignant (maybe!) hypothesis. Psilocybin therapy tends to deliver core messages and feelings that seem almost agnostic of our intentions. What I mean to say is that maybe it doesn’t matter if we’re arriving at this therapy to alleviate treatment-resistant depression or PTSD or to explore another perspective in the face of a terminal diagnosis.
We seem to always learn to slow down. To appreciate every moment and the finer details of our existence. We sit in gratitude for our friends, family and other creatures in our orbit. We ooh. We ahh. We return to our ordinary state of consciousness with a more poetic and abstract version of the universe. Tragedy seems less bleak. Grief more vibrant.
Moving forward with these feelings leading the way, we repel the darkness and radiate light. Or to really put the hay where the goat can get at it, we wake up intent to live and not afraid to die.