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.


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.