Chaplains Contribute to Emerging Psychedelic Care Research
Jamie Beachy, Ph.D
ACPE Educator, Assistant Faculty, Naropa University
Before the early 1960s, psychedelic substances such as LSD (lysergic acid diethylamide), psilocybin (a compound derived from mushrooms), and MDMA (3,4-methylenedioxy-methamphetamine) were researched in medicine as therapeutic agents with positive benefits on mental health and existential suffering. Research in medical psychedelics dramatically halted in the 1960s after problematic recreational psychedelic use was widely publicized. Now, researchers in many well-established health-care institutions are picking up where the former research left off, and some research teams are collaborating with chaplains as co-therapists and investigators in FDA sponsored studies.
Preliminary clinical research is demonstrating promising results for psychedelics in the treatment of a range of conditions that lack effective treatments, notably post-traumatic stress disorder[i], treatment-resistant depression,[ii] and end-of-life anxiety[iii]. As a result of these promising findings, many anticipate that psychedelic substances will become FDA-approved treatments in the United States in the coming years, likely beginning with MDMA for PTSD, followed by psilocybin.[iv] Remarkably, the latest MDMA-assisted therapy data demonstrates that 67% of study participants no longer met PTSD criteria one year after receiving the MDMA-assisted therapy protocol.[v] Although study participants report increased self-compassion, a greater capacity for forgiveness, increased spiritual connection, feelings of belonging, and confidence in post-traumatic growth, only a few chaplains are currently authorized to provide this therapy.
As a recent report by BrainFutures summarizes, psilocybin research is also showing promising results for a variety of conditions.
- Following two doses of psilocybin with therapy, 70 percent of participants diagnosed with cancer-related psychiatric distress showed a reduction in symptoms, in more than one study.
- A Phase 2 trial found psilocybin was efficacious in treating major depressive disorder, with a clinically significant response (defined as a 50 percent or more reduction from their baseline GRID-Hamilton Depression Rating Scale) in 71 percent of participants and remission from depression in 54 percent at four weeks post treatment.
- Psilocybin used for tobacco cessation resulted in significant levels of abstinence at six months (80 percent) and 12 months (67 percent).
- The world’s first Phase 2b trial using a single dose of psilocybin to treat depression found statistically significant and clinically relevant reductions in depressive symptom severity.
- Psilocybin is well-tolerated, with transient effects including mild nausea or headache, as well as altered perceptions, including vivid imagery and auditory experiences, that pass following use.
As research outcomes are further defined, spiritual care professionals could contribute to the development of spiritually integrated protocols, that include spiritual and religious assessment. Chaplaincy has a many gifts and competencies to contribute to psychedelic care and chaplains can advocate for our role in psychedelic care through advocating for the following commitments we bring to the work:
- empathic self-awareness
- a non-reactive and stable presence
- compassion-based resiliency
- spiritual and religious assessment
- ethical accountability
- ritual and ceremonial care
- religious and existential reflection
- capacity to navigate non-ordinary states of consciousness
While chaplains have many gifts to offer this resurgence in research, gaps also exist that will need to be addressed. Chaplains may lack direct experience with psychedelics, for example, and there is currently a need for opportunities for chaplains to experience psychedelic care in safe and legal settings.
In response to the opportunities and gaps present, in April of 2021 professional chaplains, educators and researchers interested in the role of chaplaincy in psychedelic-assisted therapies came together to explore the opportunities and barriers present for chaplaincy with the resurgence of psychedelic research. The event, titled, Towards a Vision for Psychedelic Chaplaincy and Spiritual Care: A Generative Gathering was co-convened by the RiverStyx Foundation, a small, private family foundation that funds psychedelic research, and Naropa University – a Buddhist inspired Divinity program with an onsite accredited ACPE. The goal of the gathering was to clarify the potential contributions of professional chaplaincy to this emerging field, as well as the barriers to access, education, and participation.
The event brought over 40 religious and spiritual care professionals, educators, psychedelic researchers, and practitioners together to discuss education, training, and research pathways for professional chaplains seeking to participate in legal and FDA approved psychedelic care. Present were representatives from the ACPE, Transforming Chaplaincy, the Association for Professional Chaplains, the Graduate Theological Union, Naropa University, Spiritual Health and Emory Healthcare, as well as chaplains, psychologists, and physicians involved in psychedelic research studies. The gathering resulted in a white paper entitled, Chaplaincy and Psychedelic-Assisted Therapy: Opportunities and Barriers included in the 2022 edition of Reflective Practice: Formation and Supervision in Ministry.
The spiritual care professionals present for the gathering decided to continue meeting to discuss possibilities for chaplains to engage research in this emerging field and created the Psychedelic Care Research Network, a Transforming Chaplaincy network. The network meets monthly and is open to spiritual care professionals interested in learning more about research opportunities and sharing insights and strategies for becoming more involved in their institutions. Activities of the network include:
- Discussion of competencies that will be required for chaplains seeking to serve as psychedelic practitioners and guides
- Updates on current training opportunities catered specifically to chaplains
- Report on current research
- Networking and support for those interested in becoming involved in psychedelic-assisted therapies
- Sharing of educational events
Since the time of William James’ investigation into psychedelic experience, scholars of theology have had an interest in psychedelics. In 1962, Harvard professor and Protestant graduate student of theology, Walter Pahnke, explored the benefits of psychedelic substances in the context of religious experience in an unorthodox research study, conducted at Boston University’s Marsh Chapel. Pahnke conducted an experiment to explore whether psilocybin would contribute to mystical experience in religiously predisposed subjects[vi] on Good Friday – a day for observance of Christ’s crucifixion. The group of seminary students convened in the basement of the chapel to participate in the double blinded study received a blessing from the Reverend Howard Thurman, a highly regarded Black minister and Dean of the Chapel. Participants listened to the Good Friday service while under the influence of either psilocybin or, in the case of the control group, a high dose of niacin.[vii] In the end, Pahnke concluded that psilocybin can, in fact, catalyze mystical experiences in religiously inclined people who take it in a religious setting. The study was clearly limited in scope and failed to represent the broader spiritual and religious context. Yet, 80% of the white, male, protestant participants who received psilocybin reported mystical experiences.[viii]
Now, 60 years later, spiritual care practitioners once again have the opportunity to step into this important work to help contribute to study protocols and spiritually integrated approaches to psychedelic care.
[i] Mitchell, Jennifer M., Michael Bogenschutz, Alia Lilienstein, Charlotte Harrison, Sarah Kleiman, Kelly Parker-Guilbert, Wael Garas et al. “MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study.” Nature Medicine 27, no. 6 (2021): 1025-1033.
[ii] Davis, Alan K., Frederick S. Barrett, Darrick G. May, Mary P. Cosimano, Nathan D. Sepeda, Matthew W. Johnson, Patrick H. Finan, and Roland R. Griffiths. 2021. “Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder.” JAMA Psychiatry 78 (5): 1–9.
[iii] Ross, Stephen, Anthony Bossis, Jeffrey Guss, Gabrielle Agin-Liebes, Tara Malone, Barry Cohen, Sarah E Mennenga, et al. 2016. “Rapid and Sustained Symptom Reduction Following Psilocybin Treatment for Anxiety and Depression in Patients with Life-Threatening Cancer: A Randomized Controlled Trial.” Journal of Psychopharmacology 30 (12): 1165–80.
[iv] Beachy, Jamie, and Rachael Petersen. “Chaplaincy and Psychedelic-Assisted Therapy: Opportunities and Barriers.” Reflective Practice: Formation and Supervision in Ministry, 2022, 42:88-103.
[v] Mitchell, Jennifer M., Michael Bogenschutz, Alia Lilienstein, Charlotte Harrison, Sarah Kleiman, Kelly Parker-Guilbert, Wael Garas et al. “MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study.” Nature Medicine 27, no. 6 (2021): 1025-1033.
[vi] Pahnke, Walter N. “Drugs and Mysticism: An Analysis of the Relationship between … Ph.D. dissertation, Harvard University, 1963.
[vii] Doblin, Rick. “Pahnke’s “Good Friday experiment”: A long-term follow-up and methodological critique.” Journal of Transpersonal Psychology 23, no. 1 (1991): 1-28.