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Integrative Psychiatry

Psilocybin assisted therapy for existential distress in cancer patients By Jeff Guss, MD

By September 11, 2020December 3rd, 2020No Comments

The delving into the history of psychedelics in our culture, the substances that grow in plants according to studies have been present in nature dating back for thousands of years and are used in indigenous in a variety of context some of which are used in part of a religious process.

The idea of existential crisis in relation to cancer diagnosis contributed on how the study of Psilocybin was constructed and how participants were selected.

Existential crisis in this context is pain that results into questioning the very foundation of life often times us searching for meaning, purpose or value of existence.

A therapist places a minute role in the journey simply put only assisting the patient minimally only when the patient asks and requires.

Integration varies from one therapist to another. Being a psychedelic therapist is not just about what is done during the dosing session but also how to help the person apply and integrate what happened and the changes that happened to them into their day to day lives.

FULL TRANSCRIPT:

Before talking about psychedelic research in academic settings, here are a few words about the history of psychedelics and culture, a small introduction to a vast topic. These substances, these chemical compounds that grow in plants, or that are made out of plants that are cooked together in a variety of ways, have been present in nature and go back thousands, perhaps even 10,000 years in terms of there having been records of them being used in a variety of contexts such as in indigenous and shemona contexts, and are central to some indigenous cultures as a sacrament that is a part of a religious process, but in many indigenous cultures, healing, medicine, healing the body and religion are not separate.

The title of our study at the beginning was a Psilocybin assisted therapy for existential distress in cancer patients. The idea of existential distress or existential crisis in reaction to cancer diagnosis contributed to how we constructed the study, the way we selected participants, the way we prepared them, and the integration that we did afterwards.

What is existential distress? existential distress in this context is pain that results from a questioning the very foundations of life. Whether my life or this life has any meaning, purpose or value. Existential distress is characterized by fear, anger, terror, sadness at the prospect of not existing, a loss of purpose in life and a loss of meaning in life.

The goal of the therapist is to support the medicines effect and the participants immersion in their inner experience. We did not do very much talking with the participants during their journey, unless they really insisted on it. And even then, we try to just talk for a little while, and then have them returned to their inner-directed work with the earphones and an eye shade. We do not give them any encouragement to think about cancer, we encourage them to practice a radical acceptance of all that emerges during the session. When you’re with them, they endure and learn and have a profound experience as a result of going to that edge and you certainly see this in psychoanalytic work.

Integration is really the least well defined varying a lot from therapist to therapist. This is one place where I think being a therapist is so important that being a psychedelic therapist is not just about what to do during the dosing session, but it’s about how to help the person apply, integrate, and bring what happened to them what they learned, the difference, the values that have come up, the changes in relationships that have come up, how to bring those into their real day to day life.

Transpersonal psychology is about helping individuals explore their spiritual side and work with repairing any shattered pieces of their soul. So, if you ask a traditional psychoanalyst the difference between a soul and a psyche, they won’t really have a very coherent answer for you, but a transpersonal psychologist will. A transpersonal psychologist is a specialist in understanding spiritual work, spiritual growth, spiritual illness and malady, spiritual emergence, and integrating this as part of the human being.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.