#10 Integration: a conversation with Michelle Baker Jones
An integrative relational therapist's view on psychedelic integration in private practice and as part of Imperial College's psychedelic trials.
|Jul 23, 2020||3||1|
This is part 4/4 on integration. Read part 1 on the meaning-making aspect of integration. Part 2 covers the philosophy and steps of integration, and part 3 is about resistance to integration and techniques to integrate specific types of experiences. This final part is an interview with one of my favourite people in the psychedelic world, Michelle Baker Jones.
Michelle is an integrative relational therapist and a member and lead guide with Imperial College’s Centre for Psychedelic Research on Psilodep 2, a trial comparing psilocybin to the antidepressant Escitalopram in treating depression. She is also the co-founder of one of London’s Psychedelic Integration Groups along with Rosalind Watts.
Her encounter with psychedelic therapy came after about 5 years of private practice, after a friend recommended attending Breaking Convention.
“I was just talking about how inadequate I felt antidepressants were, really.”
She contacted Ben Sessa and David Luke asking if she could volunteer - and, already aware that the shifts that normally happen in therapy are experiential, Michelle became even more convinced about the potential of psychedelics to catalyse therapy. With lots of determination and a clear intention of learning more about psychedelic therapy, Michelle ended up emailing David Nutt and joining as a co-guide on Imperial’s very first clinical trial, Psilodep 1.
“It’s a route I cannot recommend to anyone else apart from being determined and a bit lucky.”
I first met Michelle in the summer of last year, at Breaking Convention. Having already seen her at a previous talk, I awkwardly chased her after her panel to ask if she would see me for integration therapy. Our unusual encounter led to us working together up until my recent move to Romania, integrating a lot of the material that I talk about here. So, naturally, when it came to writing this series on integration, I reached out to ask if she’d be open to an interview. So here we are!
We cover a lot of ground, from her work at Imperial College and how the team’s approach has evolved throughout the years, how she sees integration both in her private practice and on the clinical trials, dealing with trauma, shifting depression, rebuilding our egos, and her vision for the future of legal psychedelic therapy.
I hope you like it.
MARIA: What was it like to be on that first trial? I assume you hadn’t done psychedelic therapy before.
MICHELLE: Yes, I guess in a way I was thrown at the deep end. But I had a basic therapeutic training and I wasn’t the lead guide - that was the psychiatrist James Rucker. When I first sat I just followed his lead. And a lot of it is just about presence, which as a therapist you learn to develop anyway. And then keeping your cool when things might seem a little bit weird.
But I read a great deal, there were lots of books to read. And I do think that in a clinical setting you have the support. It doesn’t feel like you’re alone. You have the drugs should you need them, not that I think we’ve ever used them. But there’s a lot more safety, and people trust you a lot more in a shorter space of time. And that’s probably the role of the expert. That counts for a lot.
But I did find it incredibly interesting to see the transformation of the second participant who was physically quite stiff and uptight and very emotionally reserved. Just seeing how he was in his body after the session, and then the next day, and how much more embodied he seemed. That was quite remarkable. It was quite dramatic to see the changes.
But even with that trial, I think the integration and the after-care was incredibly minimal, which is why Ros (Rosalind Watts) and I set up that group that’s been going for about two years. Because we recognised that in order for the depression to shift substantially more and more integration and support were necessary. It’s not only the experience, but how you embed it in a community where you can talk to other people about it, normalising it. All those elements really help. Very few have the magic bullet idea of two sessions and it’s all good. I think increasingly that’s not how it is. People may shift their depression for six months in that way, but I think you need to work it out in a conscious way.
MARIA: Yes, I remember Ros talking about a psilocybin session being like 10 years of therapy in a TED talk from a while ago. And I think many people took it as oh I’ll just take it once and it’s as if I’d done 10 years of therapy.
MICHELLE: I think that’s originally a Timothy Leary quote. That’s what he said, that it’s like 10 years of therapy. So if that was in the TED talk, it was probably near Psilodep 1. Her perspective would’ve changed quite radically by now.
I think what Timothy Leary said is something about how he learned more taking psychedelics than he did in all his study of psychiatry. And it makes sense because it’s an experiential type of knowing. It’s a different type of knowing, different from intellect and knowledge. But I can’t imagine Ros saying that without massive caveats now.
Michelle guiding at Imperial College’s Centre for Psychedelic Research
MARIA: Have you seen any spiritual emergences or emergencies? How do you integrate them?
MICHELLE: People have definitely had mystical-type experiences. We come from a framework of brilliant - if it helps you feel more connected to yourself and to others. Accepting your pain and connection are really key.
I guess we’re oscillating between whether they get stuck in an archetypal experience and think they’re God - which hasn’t happened - or whether they’re weaving it in their life in a pragmatic way. Oh so you’ve had this really great experience with nature - can you go into nature a little bit more?
“That conditioning, all those beliefs you hold on to so strongly, they get interrupted in the psychedelic experience. This creates that space around what you thought you knew and who you thought you were. That opening makes change possible.”
But it’s how they make meaning of it that’s important, and noticing how they ground themselves. That’s something we’re mindful of. People have struggled with the opening but nobody’s really been at the point of being left in a space where we felt they needed medical intervention, or having a psychotic break. And, you know, the psychotic break usually happens when people having a spiritual emergence are looked at like what the hell is going on with you. If you’re open and you allow it to happen, you allow the process to complete, which you yourself probably know to some degree, it can be a good opening. But it’s about how you allow that process to unfold.
We do say in our prep, if you feel like you’re dying, do die. We encourage you to go into that. So maybe because of the prep, it’s less likely to happen in the conditions of the trial because we are very attentive. And we will give extra integration sessions if we feel like someone is struggling. And we’ve got aftercare with Ashleigh.
I think this trial’s been far more robust in terms of the net of helping people navigate the expansion they have, so the contraction is less painful. And it’s opened our eyes to how important that support is. Because people are vulnerable and open, and that’s a great thing. But it’s also very scary. So that holding is very necessary, to help them gently land rather than it being a painful rebirth experience. It can still be painful, but it’s helpful to have the group of us on hand for extra integration sessions if they need them. We’ve recognised how important that is.
MARIA: So what does integration look like on the trials?
MICHELLE: Often people will stay over at the accommodation. We see them the next day for two hours and go through the experience in as much detail as possible, trying to keep it as open as possible so they’re making their own meanings and we’re just witnessing and hearing about it. And then, nearing the end of that session, we think about how they might take that forward into their life. How they might translate the insights or feelings or whatever revelations they’ve had. It’s like that dance between the mystic and the pragmatist, how can they take that forward.
And then we speak to them a week later on the phone. They have a potential of three Skype calls in between, should they feel the need to or they want to, if they’re struggling or just really want to touch in. And then they have the second session.
“To me integration is like traditional therapy. It’s understanding a person’s history, the split-off parts of themselves.”
So after that, they’ll have the same: the day after, a week follow-up call and then at the six week point they’ll come in for the final follow-up, which will be a final integration session and the big reveal: did they have placebo or did you have a high dose.
MARIA: You said earlier that people can still have a mystical-type experience even on a placebo. Does that still produce the same effect of alleviating depression for a while?
MICHELLE: I think it does definitely help. Interestingly I’ve had someone who only had one session because of COVID-19, because we had to cut it short. She was on a low dose, but she had quite a profound experience. She got in touch with a sense that she was not broken and she felt a real lightness, and 12 weeks on she’s still depression-free.
That was on 1mg. And I wasn’t really sure whether she was on high or low, we couldn’t tell with her. But because she was doing mindfulness and meditation and because she’s had a lot of time to process and integrate, she hasn’t had to go back to work and the busy scheduled life. She’s been really able to really take her time. It makes you wonder. Do you really need psilocybin or do you just need time and space to get in touch with yourself and have lovely caring people be really interested in you and your life?
MICHELLE: I had an email from her recently and she’s still doing incredibly well. She basically reframed it: rather than thinking of herself as someone who’s going to have depression for the rest of her life, like it was always going to be a curse, she’s going to always be like that… she’s now changed her relationship towards it. It doesn’t have to be this cross she’s bearing. Her insomnia lifted after her first microdose. So who knows.
Tiny sidenote This makes me think of a series of studies published in 2018 where researchers found that people who felt their partner or friends were more responsive (that is, kind and understanding) also tended to be more humble and open to other viewpoints. A similar study from 2017 found that people with a more secure attachment style (who feel confident in their relationships) were more open to considering counter arguments to their beliefs. These studies provide a reminder that our relationships can shape how defensive we are about our own knowledge and beliefs. It seems that to be more open-minded, it helps to feel loved and respected.
MARIA: I know people think differently about trauma, but I was recently doing a course on the shadow and someone was talking about how, in order to heal, it’s important to experience your trauma on psychedelics, but this doesn’t mean it goes away afterwards. But then I know Stan Grof said that the full experience of a negative emotion is the funeral pyre of that emotion, and lots of people talk about how once you’ve experienced your trauma it’s gone. But this person was saying that the trauma remains, but what happens is that you change your relationship to it. What do you think about that?
MICHELLE: Well that seems to make sense. That’s the consistent revelation. A lot of people on the trial change their relationship to their depression, and that’s what makes the difference. So it no longer is how they define themselves, it’s something they have to manage. And they manage it a lot better when it’s not like this is who I am, but this is something about me that I need to manage. And then they have space around it.
And obviously sadness, depression are part of the plethora of human emotions. We all have the capacity for these emotions in us. It’s just how we manage it. Which is what psychedelics do so well, they help you reframe your experience. That conditioning, all those beliefs you hold on to so strongly, they get interrupted in the psychedelic experience. This creates that space around what you thought you knew and who you thought you were. That opening makes change possible.
So it’s that insight, but you need to act on it for it to really take root, which is why integration is so important. Insights alone will just evaporate.
MARIA: Speaking of integration, you obviously do integration for Imperial, but you also have your own private practice. Is there any difference in how you approach integration in those cases?
MICHELLE: I use the ACE model at Imperial, although I imagine it’s also seeped into my practice by now. Obviously I do traditional therapy, but people do come to me for integration from psychedelic experiences. Sometimes they come for prep and integration, and I might read the ACE guiding visualisation for them.
To me integration is like traditional therapy. It’s understanding a person’s history, the split-off parts of themselves. You have intentions in psychedelic experiences the same way you have intentions in therapy: what are you hoping to achieve from this, what’s happened and how can we make sense of it? So to me it feels like it’s all the same, it’s all therapy, but with psychedelics you just get very live, experiential material to work with.
I suppose as an integrational relational therapist, the relationship is always really key to me. Being with the person, being alongside the person. And that integrational aspect is about what are those split-off parts, what are the bits of yourself that you’ve been pushing away, and how can we invite them in? How can we know these parts? And obviously working with where the person’s at, what they want, their expectations, and what they’re looking for.
And often I think it’s helping people take the experience not too seriously. People can take the lessons too literally. It’s about helping them reframe things. It’s an unfolding process, and it’s just being curious and being alongside someone as that happens. And I think it’s having that presence so you don’t feel alone with the experience because they can be so intense and so overwhelming. Which you know yourself.
MARIA: Yeah. And I found it really interesting that, regarding that meaning-making part of it, I feel like I’ve actually done more integration in the past few months than right after the experience - just having the space to think, and learning more about this world, helped me realise that this didn’t mean what I thought, this meant a different thing.
MICHELLE: Yes. And it’s holding that unfolding process, keeping that in mind rather than trying to concretise and push it. We are fluid, ongoing, growing human individuals.
I don’t know if you’ve heard of Christopher Bache, the guy who did 73 psychedelic experiences. He’s a professor of religion. And he was saying something like it takes 20 years to process that. The amount of time you need for integration shouldn’t be underestimated. That why, in a way, doing 4 ayahuasca experiences is quite like… really?! How are you going to give yourself the space to integrate that? Just one is quite intense.
So I think that in a way people focus so much on the experience and don’t realise it’s all very well, but what you’re doing is you’re going and disrupting everything, and unless you can bring something tangible, you’re getting fixated on the experience and thinking that is enough. That’s the thing that’s gonna make all things better. But all you’re doing is you’re throwing everything up in the air and seeing how it’s going to land. Which is brilliant if you’re stuck and you’re entrenched, but the landing is equally important. How do you recombobulate and integrate these parts? If you keep throwing them up in the air I think it can become quite messy.
MARIA: I actually still remember, my first piece of advice from Synthesis before I left was “you gotta go home and rebuild your ego”. And my reaction was “wait, but I only just got rid of it!”.
MICHELLE: Yeah, completely. And that’s it, I think people fixate slightly on ego dissolution and they think they can walk around without an ego and that’s not really true. What you want is to have one that’s maybe less rigid. A more flexible, more open ego. But what does look like? No one can figure that out for you.
I’ve had someone come to the integration group who said “I’ve dissolved my ego so many times I really don’t know who I am anymore and it’s really quite distressing”. And I thought why on earth are you trying to dissolve your ego so much? You need it. Whilst you’re in this body, you need it.
“It makes you wonder. Do you really need psilocybin or do you just need time and space to get in touch with yourself and have lovely caring people be really interested in you and your life?”
MARIA: Ha. Do you think people can integrate by themselves, on their own?
MICHELLE: I think if they’re psychologically minded enough, if they have meditation and yoga practices, or if they have community around them, yeah, probably.
MARIA: Before we wrap up, I’m also curious about your vision. At some point, psychedelics are going to make it out of clinical trials and I know what that’s starting to look like in America and Canada, but how do you see it unfolding?
MICHELLE: Well, a group in the Netherlands are setting up the Guild of Guides, out of awareness of all the spiritual narcissism, sexual abuse, and this shadow side of the psychedelic renaissance. It’s about how we make sure that guides are of a certain standard. Because having a psychedelic experience with a guide means you’re in a very vulnerable space. So it’s an attempt to regulate from the inside before external regulation comes: a way to protect and think about which retreats and guides adhere to good practice. And I think it’s absolutely necessary to have standards for psychedelic guides.
It’s not that people are doing things with bad intentions, but if you don’t have a basic psychological understanding or training, and you have especially vulnerable people, where you don’t know whether there’s trauma or sexual abuse or whatever - in those instances I think a psychedelic experience could be extremely damaging and you don’t know if you can trust your guide. And trust is so important, having that safety net and that safe container. For me, this feels like a great start and something that is absolutely necessary if psychedelics are to be an alternative treatment model. So when a person wants to have an experience they can go and check if this person has the seal of approval.
I also think Synthesis want to set up a clinic for depression, and Ros will probably help write the protocol for that, and I might help out with in the future. It’s about how we can make this experience less expensive and more accessible, without diluting the care and attention we were able to give at Imperial.
“This is why the placebo experience is so powerful. Because of all the care, all the time, the listening… that is equally as valuable as the psychedelic experience. If we can get both of them, then the potential is huge.”
For me, I imagine someone suffering from depression potentially might need five or six sessions over a year with therapy and support. And hopefully then they’ll be able to go their merry way or maybe they’ll need a top-up once a year. We don’t really know. But for me it feels like in terms of impact and cost on society: if instead of keeping someone on antidepressants, not feeling for years and kind of muddling along, we can give them an intensive form of treatment, something substantial and solid.
Most people after having these experiences do feel more connected to themselves, more connected to nature, they start yoga and meditation… they do all these new behaviours. But it’s just figuring out how much people need, how much is possible. And I’m awful with finances and money, I’m not much of a capitalist, so it’s all a bit over my head. I’m a dreamy idealist and I’d like to just help people find a way forward.
And I’m sure there will be some compromises, but I’m really hoping we won’t have to dilute what we give and what’s possible. I think that would just be a repetition of what’s happened before, this dilution of expedience, get people through-through-through. This is why the placebo experience is so powerful. Because of all the care, all the time, the listening… that is equally as valuable as the psychedelic experience. If we can get both of them, then the potential is huge. But if it turns out that the psychedelic experience and really minimal care… it’s like the drug becomes the thing and it’s not about the context.
MARIA: It becomes a bit like the Ketamine clinics that only do infusions. You go in, have an infusion and go to work, and I just can’t see that. I don’t get it.
MICHELLE: They’re missing a trick there, aren’t they. Because Ketamine does work, but they could do that with the whole container of the psychedelic experience and I’m sure then it would last a lot longer. The thing is, it’s not just the drug, it’s the combination. And that’s going to be the battle. It’s the care and the drug. It’s the container.
Embedding it in communities is crucially important - getting communities to grow their own mushrooms. Let’s go back to the indigenous tribes, they had the model. It’s about how can we bring some of that into the way we do psychedelics. And if you can grow your own mushrooms, you can bring your own mushrooms, and have the designated guild of guides as sitters... It’s about creating the community and handing the power to the people as well.
I don’t know if you’ve heard of the pollination model by Bennet Zelner. He did a talk at Horizons and he’s very much presenting an alternative to standard capitalism in terms of how the pollination model with small groups and communities could be different. I suppose it’s about sporing the communities, rather than it being in the hands of the big giant corporations who forget about the real people at the end. There are alternatives, it’s just how to make it happen.
Dept. of further investigation
Join this panel coming up in August: Psilocybin-Assisted Psychotherapy Panel Discussion with Dr Rosalind Watts, Ashleigh Murphy-Beiner, Michelle Baker-Jones and Leonie Schneider
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