The sicker patients get, the more they want their physicians to talk to them about spirituality, meaning, and beliefs. The problem is that physicians aren’t educated to have these discussions; there’s a huge gap between what patients want and what we’re able to provide them. Even among physicians who believe in God, the majority don’t have such discussions with their patients. Whether they don’t have enough time or adequate training, they end up leaving these matters to the chaplaincy. But patients want to have these discussions with their physicians. As for the relationship between religion and spirituality and health outcomes, studies show that it is mostly positive but somewhat inconsistent. Spirituality has been associated with positive outcomes in a variety of medical illnesses and mental illnesses, including substance abuse. As an addiction psychiatrist, I’m used to the construct of spirituality in Alcoholics Anonymous and other spiritually based interventions for addictive disorders.Rationalists sometimes wonder why sick people visit faith healers, since there is no evidence that such people can cure diseases. Here is the answer: sick people visit faith healers because they want to talk about their illnesses in a spiritual way. Coldly rational studies show that people who are optimistic about their lives are more likely to recover from severe illnesses, as are people who have emotionally powerful spiritual or religious lives. Many patients experience illness as a spiritual crisis. Ross wants to offer medicine in a spiritual context, which is exactly what shamans and witch doctors have offered for a hundred thousand years. The purely medical component of modern medicine works better, but that is not the whole picture. Many patients, especially those facing death, want something more.
Ross has begun to study giving psychedelic mushrooms to some of his dying patients. He is excited about the results:
In my fifteen years as a psychiatrist, I’ve seen some profound things. Here I’ve seen decreased death anxiety, decreased depression, greater integration back into daily life, improved family function, and increased spiritual states. Half of our patients had classic mystical experiences, and the other half probably had near-mystical experiences. ... I think psilocybin is a safe treatment modality that can potentially be a paradigm change within psychiatry and very helpful to dying patients. . . .I find this fascinating. Suppose Ross is right, and giving psychobilin to cancer patients causes some of them to have mystical experiences that make them feel better about themselves and less afraid of death. Is that a straight out good thing, or does it smack of manipulating the vulnerable toward certain beliefs?
In another case, we treated a 50-year-old man who worked on Wall Street. Although he was raised Catholic, he had no connection with any meaningful parts of the religion. He was a nonspiritual person. He was diagnosed four years ago with metastatic colon cancer and was told he had fourteen to sixteen months to live. He felt an enormous fear of death and of leaving his wife. He had a birthing experience during his psilocybin session. He was lying down on the couch and reported that something was passing through him. He behaved as if he were in the OB/GYN’s office. Holding the therapist’s hands and putting his legs up as if he were in stirrups, he cried, “Something is passing through me.” And then it came out, and he said, “Oh, it’s beautiful. It’s a cocoon. It’s so warm in here. It’s a cocoon filled with pure love. I’ve never felt anything like it.” Then he had this experience of feeling connected to a transcendental force. Coming out of the experience, he said, “I know I’m going to be okay now. I know I’m going to be okay. I’m ready to go, God. No, no, no—I’m not ready to go. I still have more to do, but now I know it’s going to be okay.” He described an orgasm of the soul and a resolution of his fear of death. Three months later, this nonspiritual man developed a daily mindfulness-based meditation practice, and he reads voraciously about spirituality. He feels better, but unfortunately his disease is progressing. Though he is dying, he continues to say, “I know it’s progressing, but I also know I’m going to be okay.”
Via Andrew Sullivan.