Dear Reader,

There has been a virtual explosion of interest in psychedelic therapies, from both health practitioners and people in general.

For health practitioners, in particular those who focus on 'mental' or 'behavioral' health, there is enthusiasm because of the promise of a new treatment, which is, on a mostly unconscious level, a reaction to the fact that most of the previously existing treatments, including medications and therapies, don't work for that many people.

On the one hand, practitioners are enthusiastic about this new modality. It's like a shiny new toy. On the other hand, more and more practitioners are realizing that the promises of psychedelic therapy are not always seen. 'Your Milage May Vary' (aka YMMV) is an idiom/meme that can be applied to this.

The other aspect that no one is talking about, one of the shadows of the behavioral health field that is not really being addressed by this new enthusiasm and thus is being carried forward, is that the behavioral health field is really good, albeit unconsciously, at turning people into professional, often life-long patients. A professional patient is someone who has gotten a diagnosis from someone else, meaning their self-identification is no longer up to them, but an expert, and they become part of a system that requires them to be in the patient role for a long time, taking medications, coming to appointments. Their entire identity is often consolidated around this role.

Psychedelic therapy promises quick and deep shifts, which is an inherent contradiction with the role of patients in the system. This can lead to various poor outcomes, such as people staying in, or returning to their long-term patient role, or, if they have profound shifts, these shifts get labeled as problematic by the system. (These themes really need a lengthier exploration and discussion and I attempt this in this post on sustack.)

Conversely, for people in general, who are interested in the promise of psychedelic therapy there are many potential pitfalls. While they are interested, it may be very difficult or impossible to find guides or even basic information. Exploring this modality by themselves can also lead to anxieties and loss of clarity, focus and direction. Also, they may struggle to find anyone to talk to to help integrate their experiences and the subsequent growth and changes they may feel called to make.

What both practitioners and people in general really need is a roadmap, practical information and a sense that this path offers deep transformation and needs to be taken seriously. And in the current environment, in which there's a sense of mandatory enthusiasm, this can be hard to find.

I started offering psychedelic therapy in the form of ketamine in 2011 in my private practice. This was before there was the current wave, where new ketamine clinics are popping up all over, like mushrooms (pun intended). Back then, there were no guidelines, such as the notion of maintenance treatment, which is one of the ways that people are currently being turned into longer-term patients.

I was fortunate, because of my longstanding interest in the work of C. G. Jung, to really be aware of and honor the role of the unconscious, the Shadow, the 'entire' psyche and its role in growth and transformation and this informed my work with ketamine. Many practitioners lack a holistic model of the psyche because it is not taught or discussed. As Jung famously said, "The unconscious is hard to understand, because we are unconscious of it."

The other challenge both for practitioners and people in general, is the power of the ego, the limited sense of 'This is who I am' and its resistance to deep change and to being open to the gifts of the unconscious. The resistances of the ego can limit the benefits of psychedelic therapy, before, during and especially after a session.

Once again, I was fortunate to have cultivated a long-standing deep relationship with aromas in the form of essential oils, which taught me how powerfully they act on the entire psyche. Aromas by-pass the intellect and ego barriers. I know this from personal experience. There is also now research to support this, e.g. that aromas deactivate the Default Mode Network, a brain network that is really the seat of the ego, that tries to keep our mental processes in well-defined ruts.

So, if we want to get the most out of psychedelic therapy, we need a holistic roadmap and powerful allies to bypass the intellect. This was my motivation for writing my new book "Essential Oils for Psychedelic Therapy" (Kindle, print-on-demand)

Don't let the title deceive you. Yes, it gives in-depth information about aromatic allies, but I feel it offers so much more, including a holistic roadmap and a real conviction to take this work seriously, instead of recreationally (or in other ways that are not a risk to the ego).

This book is an important addition to writings about psychedelic therapy, and yet I also know it's just a steppingstone and I feel called, with renewed clarity, to offer a more in-depth, holistic perspective on psychedelic therapy. We all know that's needed.

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Here's a brief synopsis of the book:

Psychedelic Assisted Therapy is getting more popular and showing great promise for a range of psychological and life challenges. Using aromas mindfully is an ancient tradition and offers shifts in awareness and reconnection. In his new book "Essential Oils for Psychedelic Therapy", Florian Birkmayer, MD shares his longstanding experience combing these two modalities in a practical, hands-on way. This appears to be the first book discussing the enhancements that scent can offer to psychedelic assisted therapy. It offers a holistic model of the psyche that is foundational for such work as well as practical suggestions to get started incorporating aromas.

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I also recorded a brief video about the book.

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I'd love to hear what you think.

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Florian

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