Wednesday, October 12, 2011

Drug-Induced Mysticism for the Dying

Dr. Stephen Ross has some interesting and very old ideas about the relationship between medicine and spirituality:
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. . . .

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.”
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?

Via Andrew Sullivan.


Unknown said...

I certainly wouldn't want to take away any sort of comfort that a person with progressing cancer can find, and I don't see in what you've quoted anything that clearly indicates that Ross is starting to preach. But I do think you're a little sweeping in your assertions that there's "no evidence" that faith healing works, or that "the answer" is that people want to talk about their illnesses in a spiritual way, full stop. Of course there's no evidence in any scientifc sense, and I don't believe faith healers can cure people. But there's plenty of the sort of "evidence" that motivates people to do things: anecdote, rumor, half-remembered stories told by parents and neighbors, etc.--the same evidence that convinces people, wrongly, that crime is on the rise. And people follow this evidence about faith healing, partly because they want to talk about their illnesses in a spiritual way, but also because they're looking for real cures: they want their bones to knit, they want to see the lame get up and walk, they want their cancer to get spat out in a bloody gob by some magician. That's why European villagers used to shame the statues of saints that didn't bring rain or keep the plague away.

John said...

You're right, there is lots of folk evidence about faith healing. But evidence like that survives and gets passed around because somebody wants to believe in it. Many people want to believe in spiritual healing. I think Ross's insight explains a big part of why. Many people want to see their lives as having meaning in some cosmic or spiritual sense, so they see threats to their lives as spiritual threats, and they want to approach the seeking of a cure in a spiritual way.