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username password remember me forgot your password? forgot your username? login psychedelic information you can trust social icons module joomla twitter news experience reports external news knowledge interviews research art e-zine the nexian - issue 2 the nexian - issue 1 presentations dmt-nexus forum wiki faq health & safety about dying to live: the power of transcendence in the treatment of existential anxiety in western society, death is a taboo subject and, from the perspective of medical science, is viewed as a defeat and a failure. medicine is excellent at keeping people alive but is a great deal poorer when it comes to easing the passage of the dying. in a sense, society has actually regressed in terms of the integration of death and dying, as medical science has grown in power and death has become a less common part of our lives. existential anxiety, which includes fear and anxiety centered on death and dying, is something often overlooked and there is a notable lack of effective treatments or therapies, with physicians likely to feel underequipped in treating the psycho-spiritual effects of death anxiety (1, 2). despite the lack of currently integrated treatments, there are a number of avenues worthy of much more attention in this regard. chief among them are the classical psychedelics, a group of substances long-used by humans in the context of healing and divination, which are currently experiencing a scientific research renaissance. psychedelics may have a unique utility in their potential efficacy in the treatment of existential anxiety. while current research has focused on terminally ill patients, with respect to life we are all terminal, and it may likely be that the benefits of these substances are too important to limit to the treatment of sick people only, although this should be made a priority. aldous huxley was a pioneer of this approach of using psychedelics for treatment of the dying, writing to pioneering psychedelic researcher dr. humphry osmond in 1958 about how lysergic acid diethylamide (lsd) could be used to treat terminal cancer patients so their dying could be a “more spiritual, less strictly physiological process” (3). a few years later when huxley—a man who talked the talk and walked the walk—lay dying from laryngeal cancer, he requested and received two 100µg dose injections of lsd from his wife laura, who reported that his death was extremely beautiful and serene in a letter she wrote in 1963 to aldous’s brother julian (4). a pioneering researcher and proponent of using psychedelics to treat the terminally ill was dr. walter pahnke. pahnke joined the maryland psychiatric research center in 1967 and conducted psychedelic therapy with lsd and n,n-dipropyltryptamine (dpt) until his untimely death in 1971 (5). he used lsd in the treatment of terminal cancer patients and wrote a number papers and book chapters with colleagues on his research findings during this time. one chapter published in psi and altered states of consciousness: proceedings of an international conference on hypnosis, drugs, dreams, and psi looked at the effect of the mystical-type experience on terminal cancer patients and the potential implications for psi research (6). a paper published in the journal of psychedelic drugs explored psychedelic therapy utilizing lsd with terminal cancer patients (7). as in the case of huxley, pahnke was motivated in part by his own personal mystical-type experiences catalyzed through his own psychedelic usage (8). in central africa, the oneirogenic (‘dream-inducing’) plant tabernanthe iboga has a long history of use as a spiritual sacrament and medicine and is employed by a number of different groups such as the bwiti in religious ceremonies. the bwiti utilize a single large initiatory dose of the iboga plant, in the form of ingested root bark, consumed by the initiate to induce radical spiritual growth. this induces an experience resembling a near-death experience (nde) in which the initiate is instructed to go beyond the body to the spiritual realms to seek guidance and insight on life issues via communing with their ancestors (9). a number of recent studies have demonstrated both the safety and efficacy of classical psychedelics such as lsd and psilocybin in the treatment of existential anxiety and depression in the terminally ill. a pioneering pilot study by grob et al. (2011) with psilocybin using a dose of 0.2 mg/kg reported safe physiological and psychological responses and no clinically adverse events. a reduction in anxiety was noted 1-3 months after treatment, with a long-term improvement in mood observed at six months (10). a study by gasser et al. (2014) using lsd (at a dose of 200 µg) as a treatment for the anxiety associated with life-threatening diseases reported no lasting adverse reactions from lsd administration, long-term benefits sustained over a 12-month period following a single dose, and highly significant reductions in anxiety (in 77.8% of patients) and a rise in quality of life (in 66.7% of patients) (11). larger scale studies using psilocybin in the treatment of anxiety and depression suffered by patients with life-threatening cancer have built on this previous research. one study conducted by griffiths et al. (2016) at johns hopkins university using doses of 22 and 30 mg/70 kg found that 80% of patients reported lower depression and anxiety at a six-month follow-up including reduced death anxiety and increased quality of life, life meaning, and optimism. study participants reported improved attitudes towards life and self and improved mood, relationships, and spirituality with over 80% of participants describing greater well-being and life satisfaction. it is notable that the mystical-type experiences occurring through psilocybin treatment mediated the long-term therapeutic outcomes (12). a study conducted by ross et al. (2016) at new york university utilizing a psilocybin dose of 0.3 mg/kg reported similar results, with study participants reporting immediate, substantial, and sustained improvements in anxiety and depression, with decreases in cancer-related demoralization and hopelessness, improved spiritual well-being, and increased quality of life. enduring clinically significant reductions in anxiety, sustained reductions in existential distress, increased quality of life, and an improved attitude towards death were each reported by a majority of participants. again, it was noted that the psilocybin-catalyzed mystical experience mediated the long-term therapeutic effect on anxiety and depression (13). it can be seen from these studies that the mystical-type experiences reliably catalyzed through high-dose psilocybin are a core part of their long-term therapeutic effect on depression and anxiety ratings, while enhancing life meaning and outlook. it seems, too, that the mystical experience is of great importance with regard to altering perceptions of death and reducing death anxiety. facets of the mystical experience such as the sense of unity, perceived interconnectedness of all things, a deep sense of love, reverence, sacredness, and noetic quality are very likely contributing to the uplifting attitudinal shifts towards death but also towards self, life, and others. a recently published study by griffiths et al. (2017) utilizing high doses of 20 mg and 30 mg/70 kg psilocybin found that mystical experiences in synergy with spiritual practices produced large significant positive changes for a number of trait measures of prosocial attitudes, behaviors, and perspectives, among them death transcendence (14). this study is notable in that unlike all the aforementioned studies, study participants were physically and mentally healthy and not terminally ill. however, significant numbers of these participants reported death transcendence under high-dose psilocybin, suggesting that such a shift in perspective is something intrinsic to this experience. medicine and psychiatry operate under

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