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Dominique Yarritu, PhD, LMFT in conversation with Kelly Yi, PhD, LCP

A few years ago, at the beginning of my doctoral coursework, I became interested in the work of psychedelic-assisted therapy and have been fascinated by it since. As a student of somatic approaches and theories of healing the ills of humanness, such a work feels the ultimate somatic undertaking. If you have been following the development of this new addition to talk therapy, you may be familiar with the work done with MDMA at Johns Hopkins Center for Psychedelic and Consciousness Research, and you may have heard of psychiatrist Stan Grof’s use of LSD in clinical settings in the 60s, and his immense contribution to the research in the healing potential of various psychedelic compounds. You may also have heard—through the grapevine or from friends or acquaintances—about sessions with Ayahuasca in South America. Psychedelic medicines come in various forms: synthetic, like MDMA or LSD and as plant medicines. Some of the best known plant medicines are psilocybin or mushrooms, Ayahuasca, Ibogaine, San Pedro, and Peyote. And if you find it appealing, you may even experience a psychoactive journey with toad venom.

Among other questions that I will be touch on in this short article, I wondered how the work with one medicine or the other would differ. Would having a session with LSD be very different or produce different results than one with MDMA? What about psilocybin? In Michael Pollan’s book, I learned that the length of each medicine’s effect differs: a few minutes or a couple of hours (with DMT), a little over half a day with MDMA and probably a good full day with LSD. And in this psychedelic treasure trove, which one to choose? To answer these questions, I reached out to Kelly Yi, PhD, who has been practicing psychedelic-assisted therapy with Ketamine for treatment-resistant depression and anxiety at My Doctor Medical Group in San Francisco.  Dr. Yi is experienced and trained in various forms of psychedelic medicine in contexts and countries where it is legal. Our long conversation offered me a new understanding of this therapeutic approach as it took us to various realms of the work with psychoactive agents.  

Dr. Yi says that his view is “a little different than a lot of people in the field” because he puts “less emphasis on the particular agent.” He continues to say though that “there are differences. MDMA and San Pedro are not as challenging to the ego structure. Both of those are going to leave the ego fairly intact but bring up a lot of different aspects [of the person’s current psyche]. However, other medicines like LSD, mushrooms, Ayahuasca typically challenge the ego structure. People have to go through deep ego surrenders, as well as disorientation to reality.”  Therefore, it seems that although the agents or the medicines are different and the effects on various parts of the psyche differ, “the medicine is going to activate what is in the particular person; mostly at the beginning, the biographical material. If there’s a lot of structure around the ego and unprocessed developmental experiences, that’s likely going to be activated more.”  Dr. Yi also emphasized and reminded me that “the dosage is another important aspect” of the work with more intense activation with higher quantities, in particular for new psychonauts.

I would be remiss to tackle the topic of psychedelic-assisted therapy and not mention the transpersonal aspect of this work, what depth psychotherapists, theorists, and Robert Romanyshyn in particular, call soul work or work with soul in mind. Again, Dr. Yi’s “big thing is the metaphysical assumptions around psychedelics because most people will reduce these experiences down to the chemicals and the neurochemistry. That’s a very reductionistic view. I think that once people have worked through their biographical material, their soul shines through. And, in my world view, each person has a very unique soul nature: they’re on this planet to do a very particular thing, unique to them. Beyond this, there can be a lot of mystical oneness experiences and unions [during journeys] that start coming in.” Hearing Dr. Yi speak about the transpersonal aspect of this process reminded me that many of these plant medicines are connected to indigenous traditions, most often used in shamanic journeys, and have been used for millennia by primary peoples. I asked about the cultural aspect of the medicines, and how we can respect the traditions that we are now transferring to the Western model of healing. According to Dr. Yi, “all you can do is have humility. I think that’s the problem for mainstream Western psychology: there’s too much arrogance about their views of other cultures, around knowledge. And yet, if you look at these other cultures, they’re really complex, vast, and profound psychologies. Usually, it’s in the spiritual traditions and often, it is sadly reduced to superficial Western concepts of religion, which it is not. And when I think of psychedelic medicines: they’re profound at illuminating all of this.” In a nutshell, psychedelic journeys are likely to become also transpersonal and mystical experiences if the setting lends itself to it and the psychonaut is ready for the revelation.

The research done with MDMA and other psychedelic medicines promises healing for a wide variety of dis-eases or mental illnesses: from PTSD to depression, end of life anxiety, and other pathologies that are being tested for. The one advantage of using psychedelics in therapy is, at a time when the world pace is ever faster, the speed at which healing can happen could likely be quickened: “this is where I see the power of psychedelics; traditionally, you would have to practice meditation for 10 to 20 years to have the some of the same experiences. But here, you can get this whole reality reorientation. So, that’s very profound. They are indeed very powerful agents” says Dr. Yi. I agree and see these medicines—or agents as Dr. Yi calls them—as conduits, a dynamic link between the outer and inner world and the transpersonal world, an opening to another inner dimension of the Self. Once a psychonaut has experienced the depth of their inner world, Dr. Yi says, it can “lead them to operate differently in the world [of ordinary consciousness]. When you use these agents, you see reality through these different perspectives and lenses experientially: it’s not an intellectual experience but it’s fully experiential.” From the accounts of so many well-known psychonauts, and in particular the accounts of Christopher Bache’s multiple journeys with LSD, it is an extremely somatic experience. It is all about the body, the energetic and subtle body. Therefore, the work itself does not end at the closing of the journey or the ceremony but continues through the integration of the material one has accumulated during the process. To me, says Dr. Yi, psychedelics are “important to open up doorways and then, it’s like ‘how do  you integrate'?

If there is a sequential process associated with the work with psychedelics, does it mean that the journeys follow a strict structure: the sessions focus on developmental issues only until the psychonaut has reached a certain level to access the transpersonal? According to Dr. Yi, that is not necessarily the case and speaks of the “MAPS training, and Rick Doblin, PhD, in particular, founder and CEO of MAPS, who was influenced by Stan Grof, MD, the founder of Transpersonal psychology. One of Grof’s views was the concept of inner healing intelligence. So, basically, we as therapists, from that model of inner intelligence, don’t know the ideal healing sequence. The client has an inner healing intelligence that’s going to guide them to exactly whatever they are ready for. That’s what they’re going to get. That inner intelligence, when you work with the medicine, can start opening up. Maybe one person needs to experience vast oneness in order to process their trauma at 5 years old. Therefore, the experience will not be so linear, it won’t necessarily go directly to the trauma. It’s like a looping fashion: let’s go to the resource of unity consciousness and let’s bring it to your traumatized self, which is very similar to something like IFS and the more transpersonal foundation of that work: access the Self, first, and then relate to the parts like protectors and exiles. There is some kind of iterative loop.”

Psychedelic-assisted therapy is on its way to becoming more mainstream and features increasingly in non-professional media. From my readings and studies, and from Dr. Yi’s experience working with Ketamine and other psychedelic medicines, two things come to mind in closing this article. First and foremost, this type of therapy is not for everyone. There have been cases of extreme self-harm recorded in professional publications and in mainstream media (mostly when using these compounds in a more recreational way). In the introduction to his book, Scott Hill, PhD speaks of his decades long struggle after a bad trip on LSD. And yet, when used within the strict confines of a ceremony and accompanied with a guide who can prepare the psychonaut and help them integrate the experience, psychedelics hold a powerful key to healing. As Dr. Yi says, “psychedelics have the potential to be a major wave to global healing—especially in the industrialized world.”

Kelly Yi, PhD is a licensed clinical psychologist. He currently is the Associate Chair and Director of Clinical Training for the PsyD program at The Institute of Transpersonal Psychology at Sofia University. He is former adjunct clinical faculty and clinical supervisor at Stanford and Palo Alto University. He studied comparative mysticism previously at UC Santa Barbara. He is the chair of a Transpersonal Psychedelic-Assisted Therapy certificate program through The Association of Transpersonal Psychology. He currently is completing a book titled, Multi-Dimensional Psychology, that explores many of these topics. If you would like to be notified when the book is released, feel free to email multidpsych@gmail.com

References:

Bache, C. (2019). LSD and the mind of the universe: Diamonds from heaven. Rochester, VT: Park Street Press.

Grof, S. (2008). LSD psychotherapy: The healing potential of psychedelic medicine. (4th ed.). Ben Lomond, CA: MAPS.

Hill, S. J. (2019). Confrontation with the unconscious: Jungian psychology and psychedelic experience. London, UK: Aeon Books.

Pollan, M. (2019). How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, and transcendence. New York, NY: Penguin RandomHouse. 

Romanyshyn, R. D. (2013). The wounded researcher: Research with soul in mind. New Orleans, LA: Spring Journal.

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