One of my friends has been saying for a while that he would like to try ketamine-assisted therapy. I’d like to try micro-dosing. The research and the case reports sound very interesting. For those with treatment-resistant depression or existential feelings of meaninglessness, I have become convinced that such therapies could well be a game-changer.
What I do wonder about, though, is, well, somewhat complicated… Let me try to set the scene.
Once upon a time I came across some research about a study in which subjects had been provided with a belt, I think it was a belt, that, through tactile stimulation, somehow, indicated true north. So, over the course of a few weeks, these people could ‘feel’ their orientation as they moved about in the world. After the experiment, a good number of them maintained an awareness of the cardinal points, even without the belt. But what was interesting was that the subjects could express their experiences to each other but not to the researchers. Those who had experienced the same thing shared a hermeneutical tool-box: they shared concepts to make sense of a particular experience which they could not share with people who did not have the same experience.
I have been thinking about this in the context of mental health, because much of what ‘counts’ as mental disorder is described ‘from the outside’. However, those who suffer clinical depression or hypomania, for example, experience things ‘from the inside’ which society lacks the conceptual tools to describe. This is one of the agonies of mental illness: people don’t understand fully because they can’t. With depression we can talk about ‘falling into a deep pit’ or ‘black dogs’ or ‘being in a bell jar’ and that offers a glimpse, but there remains something ineffable. How do you describe ‘blueness’ to someone who cannot see colour?
I have experienced a few ‘altered consciousness’ states (not drug induced), which I imagine are maybe not that rare, but as I was interested in them, I thought about them and remembered them. But I cannot properly communicate them. The uncanniness of them is somehow inarticulable. Truly, you ‘had to be there’.
Now, that I cannot communicate these experiences to others is a bit frustrating, but where this can become challenging is if I cannot make sense of it for myself. This is a more severe and more painful agony of mental illness: that one’s own experience is sometimes outside the grasp of one’s ability to conceptualize it.
I feel that my ability to manage some of the challenges I face with my mental health is strengthened by reading psychology, philosophy, literature and so on – all of which provide me with ways of thinking, phrases, concepts, theories. Essentially, I try to create a tool-kit with which to construct an evolving framework that can support some self-understanding. But I am privileged - and such resources may not be available to all.
So, my worry is that is that people who explore therapy with psychedelics may experience something transcendent, transformative or terrifying, but might not have the tools to make sense of that experience. This is why I believe that the role of the therapist is so critical. That person bears a burden of responsibility to assist their clients in finding the resources they need to make sense of what they have experienced.
Of course, therapists are used to doing this, whether they conceive of their role in these terms or not, but where their client is accessing new and often suppressed aspects of themselves, the need to support the search for meaning or the means of articulating will be even more pressing.
Actually, I say that therapists are used to doing this, but I would suggest that there is not enough consideration of the inadequacy of ‘normal’ language to communicate mood and affect, existential feelings, altered consciousness and so on. Once outside a relatively narrow range of experience, there is a dearth of conceptual resources (which may be why, in some cases, art or dance or somatic therapies have an important place in treatment). If we are to open up psychotherapy to a whole new domain of experience that clients will need to process, perhaps it’s time to consider the importance of developing new hermeneutical resources. And not just for these new treatments, but also for existing
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