Pubdate: Sun, 30 Aug 2020
Source: New York Times (NY)
Copyright: 2020 The New York Times Company
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Ernesto Londono

PSYCHEDELIC THERAPY IN THE JUNGLE SOOTHES THE PAIN FOR VETERANS

GIGANTE, Costa Rica - There was a ghostlike quality to Rudy Gonsior,
an American former Special Forces sniper, on the morning he arrived at
a jungle retreat to see if a vomit-inducing psychedelic brew could
undo the damage years of combat had done to his mind.

Glassy-eyed and withdrawn, he barely spoke above a whisper and was
much quieter than the six other veterans who had come to dredge up
painful memories of comrades fallen in battle, thoughts of suicide and
the scar that taking a life leaves on the psyche.

"I have traveled across continents to come to the jungle to do
psychedelics," marveled Mr. Gonsior, who had steered clear from drugs
his whole life. "I guess this is what might be considered a Hail Mary."

They had come to western Costa Rica to try ayahuasca, a substance
people in the Amazon rainforest have imbibed for centuries. Some
Indigenous communities regard the brew, which contains the
hallucinogen DMT, as a powerful medicine that keeps them spiritually
resilient and in harmony with the natural world.

The lodge the Americans visited late last year was a far cry from
that, with a gleaming swimming pool and a sprawling deck that anchors
well-appointed cabanas featuring splendid ocean views. Charging from
$2,875 to $6,900 per person for weeklong retreats, the lodge is among
the newest and priciest additions to a booming alternative healing
sector.

Until relatively recently, only a few botanists, hippies and spiritual
seekers gained access to the world of Amazon shamanism, which
missionaries drove underground during colonization in much of the
Amazon basin as they sought to convert Indigenous groups to
Christianity.

But now, thousands of people from around the world make pilgrimages
each year to the more than 140 ayahuasca retreat centers in Latin
American countries where the substance's use in ceremonial settings is
legal or, as in Costa Rica, not explicitly outlawed.

Besides psychedelic ceremonies, which are often physically and
emotionally draining, retreat organizers offer group therapy sessions,
yoga classes, art therapy, meditation circles and warm floral baths.

Collectively, these centers have become an unlicensed and unregulated
mental health marketplace for people searching for an alternative to
antidepressants and other widely prescribed pharmaceuticals.

The draw of psychedelics has surged amid a growing body of scientific
research that builds on promising studies in the United States and
Europe from the 1960s and 1970s. Much of that earlier research was
shut down after psychoactive substances were outlawed during the
Vietnam War era - a response to concerns over widespread drug use on
college campuses.

But in the last few years, the Food and Drug Administration designated
psilocybin, the psychedelic component in what are commonly called
magic mushrooms, and MDMA, the drug known as ecstasy, as "breakthrough
therapies." That rare designation allows scientists to fast-track
larger studies that could pave the way to administering psychedelics
as medicine.

Drinking ayahuasca can be dangerous, especially while taking certain
pharmaceuticals, including antidepressants and hypertension drugs. It
can also set off psychotic episodes for people with serious mental
health conditions, like schizophrenia.

And while some retreats have strict rules and protocols that have been
developed in consultation with medical professionals, the ayahuasca
boom has sometimes been exploited by scammers and charlatans, and it
has come under scrutiny for instances of sexual assault on vulnerable
or impaired participants, including cases in Peru.

"You have to recognize that there's a Wild West element" to ayahuasca
retreats, said Dr. Matthew Johnson, a professor of psychiatry and
behavioral sciences at Johns Hopkins University who has studied
psychedelics since 2004.

In a controlled setting, he said, unleashing the brain can help
patients revisit repressed trauma and generate new insights. So the
medical establishment, once deeply skeptical of the therapeutic
potential of psychedelics, is embracing "what is essentially a new
area of medicine," he added.

But Dr. Johnson worried that psychedelic retreats in general may be
ill equipped to screen people for whom trips can be dangerous. In
extreme cases, people have tried to commit suicide while high on
psychedelics or experienced psychotic episodes that required
hospitalization.

"These are powerful, powerful tools and they can put people in a very
vulnerable place," Dr. Johnson said. "That is not to be
underestimated."

Still, the growing buzz around psychedelic-assisted healing, which has
been amplified by authors, celebrities and influential podcast hosts,
has put places like the Soltara Healing Center, where the veterans
went, at the forefront of a push to challenge conventional mental
health care.

Melissa Stangl, a co-founder of Soltara, argued that responsibly run
ayahuasca centers could be the seeds of a transformation.

"We are on the cusp of bringing psychoactive medicines into the
mainstream health care system," she said. "Once science really catches
up to just how effective that is for people who aren't being served by
the current medical system, we can become allies."

Before their first ayahuasca ceremony, the veterans met individually
with two Peruvian "maestros," or healers, from the Shipibo community
in Peru.

"Their hearts are hardened," said Teobaldo Ochavano, who helps run the
nighttime ceremonies alongside his wife, Marina Sinti. "They seemed
unable to experience love or joy."

Ms. Sinti said years of interacting with foreigners on retreats had
made it painfully clear why these rituals are in such high demand.

"People in the United States and Europe are very disconnected," she
said. "From each other and from the Earth."

'A Cult of Death'

Like many service members of his generation, Mr. Gonsior said he
enlisted in the Marine Corps to avenge the attacks of Sept. 11, which
happened when he was in high school.

In 2006, he said he deployed to western Iraq for the first of multiple
combat tours. He and his men were constantly ambushed with powerful
roadside bombs and shot at by snipers, he said, and 17 service members
he deployed with returned home in body bags.

The experience, Mr. Gonsior said, turned him into a ruthless
warrior.

"My sole goal was to survive," he said. "I did a lot of things that I
am not particularly proud of."

Instead of relief for surviving, he felt a crushing sense of
shame.

"It was just by dumb luck that I wasn't shot and wasn't blown up," he
said. "Like to the point where, statistically, I should be dead by now
or at least seriously injured."

In 2007, Mr. Gonsior said he joined the Army Special Forces, where he
served as a sniper. It left him feeling that he had joined a "cult of
death," he said.

"The last 17 years of my life, my job in one way or another has
revolved around death," he said. "As I get older, it weighs heavy."

Killing became mundane. But one life he took in Afghanistan in 2012
haunted him for years.

During a routine operation, Mr. Gonsior opened fire on a man on a
motorcycle, believing he was an insurgent. Soon after, Mr. Gonsior
learned he had killed an Afghan intelligence source working with his
unit.

Mr. Gonsior said he didn't allow himself to grieve that death properly
or process the guilt until years later, when he was gripped by
depression and bouts of rage that were sometimes set off by
inconsequential things his children did.

Abstract thoughts about suicide eventually turned chillingly specific,
he said. At the Veterans Affairs hospital where he sought help, Mr.
Gonsior, 35, said he was urged to take antidepressants. He said he
refused, based on the side effects he had seen fellow soldiers suffer.

Last year, after listening to a story about ayahuasca and trauma on
the radio, he became fascinated by the idea that healing deep wounds
requires grappling with their roots.

"There's a lot of emotional wreckage, shipwrecks that are kind of down
there," he said.

By the time he and the other veterans filed into the darkened ceremony
room, with its netted windows and cone-shaped roof, they had signed a
lengthy hold-harmless agreement.

It warned of the "unlikely event of a psychotic episode," the danger
of drinking ayahuasca while taking antidepressants, and that
psychedelic trips leave some people feeling worse "mentally,
physically and emotionally."

Dressed in traditional outfits, the Peruvian maestros blew tobacco
smoke into the candlelit room, known as a maloca. Participants sitting
on cots arranged in a circle stepped up to gulp a shot glass of the
dark brown, sludgy ayahuasca brew.

Chris Sutherland, a 36-year-old Canadian soldier who said he recently
retired on full disability for post-traumatic stress disorder, had
come after years of panic attacks, binge drinking and periods of
taking antidepressants that left him feeling that "I was no longer
human."

David Radband, a British former special forces soldier, said he came
to the jungle hoping to drown out the rage that had consumed his life
after he left the army. He said it had cost him custody of his
children, landed him in prison for assault and pushed him to try to
kill himself twice, once by hanging and once by stabbing himself in
the gut.

"I was blocking emotions with anger," said Mr. Radband, 34. "I was
putting up a wall all the time."

Juliana Mercer, 38, a Marine veteran, said she developed a condition
called caregiver fatigue after spending four years looking after
wounded service members in San Diego. When she deployed to Afghanistan
in 2010, she said she experienced crippling fear every time she saw
young, healthy Marines drive off the base.

"I was just so desperate to keep everybody safe," she
said.

It was quiet in the room when the maestros blew out the candles, save
for the gentle lapping of waves from the nearby beach. But the silence
was short-lived.

As the ayahuasca began taking hold, the Peruvians began pacing across
the room slowly as they sang Icaros, high-pitched songs that the
Shipibo regard as the crux of the healing process.

At times, their rhythm and cadence can be soothing and hypnotic,
lullaby-like. But higher notes and fast-pace sequences can feel
taunting or exasperating.

When ceremonies reach a crescendo, the room often feels like a state
of controlled pandemonium. Bouts of loud vomiting pierce the singing.
There is sometimes audible weeping in one corner and ecstatic laughter
from across the room.

As dawn approaches and the ayahuasca starts wearing off, participants
emerge from the room looking gaunt and dazed as the rational mind
struggles to regain control.

"These experiences have a way of completely blasting people out of the
mental ruts they're stuck in and to look at a broader set of
possibilities," said Dr. Johnson at Johns Hopkins, one of several
universities conducting clinical trials.

Unlike antidepressants, which numb symptoms of distress when
effective, psychedelics appear to turbocharge the kind of healing
process that results from psychotherapy, he added.

But he and other experts who cite the psychiatric promise of
psychedelics worry about their use in retreats or other settings
without adequate controls.

"The room for error is not having adequate medical support" in the
rare instances when people have serious adverse effects, said Collin
Reiff, a psychiatrist at New York University.

Still, Jesse Gould, a former Army Ranger who brought the veterans to
Soltara, says the benefits of the jungle retreat experience outweigh
the risks.

Mr. Gould said he created the Heroic Hearts Project, a nonprofit group
that raises money to send veterans to psychedelic retreats, after
stumbling into one at a low point in his life.

After leaving the Army and traveling a bit, he said he landed a
comfortable job in finance that drove him to drink heavily and left
him with "a feeling of dread about everything."

When he sought help at the Department of Veterans Affairs in Tampa,
where he lived, Mr. Gould said he was encouraged to take
antidepressants, which held no appeal to him. In 2016, he quit his job
and booked a retreat at a center in Peru.

The decision was radically out of character for Mr. Gould, 33, a
strait-laced veteran who said he had avoided drugs his whole life.

"I definitely grew up in the D.A.R.E. generation," he said, referring
to the antidrug advertising campaign that began in the 1980s. "I was
very much into 'Just say no.'"

His first few ceremonies were brutal, Mr. Gould said, calling them "an
all-out war" in which he vomited as many as 20 times in one night and
felt like he was pushed "to the edge of sanity."

But in the months that followed, he said his depression mellowed, his
crippling social anxiety melted away and his mood swings, which had
felt like a "tug of war in my brain," ceased.

"It seemed to almost rewire my brain," Mr. Gould said.

Since then, Mr. Gould and his team have raised more than $250,000 to
pay for psychedelic retreat "scholarships" for dozens of veterans. And
they have infused the movement to decriminalize psychedelics with
testimonies that belie the stereotype of New Age stoners.

"People instantly have the image of a hippie," he said. "But because
of my service, a lot of people that are in a completely different
demographic tend to listen." 'Another Layer of Understanding'

As their weeklong retreat came to an end, Mr. Radband, the British
soldier, said the ceremonies had reignited his desire to live.

"You know, I tried to kill myself twice, but I'm not ready to die," he
said. "I have so much more to give."

Mr. Sutherland, the Canadian, said one of the ceremonies had been "the
most terrifying night of my life, more terrifying than any combat I
have ever been in." But collectively, he said, the trips helped him
overcome a longstanding fear: "I am not a sociopath," he said.

"I was always worried that I was evil, but I was shown where my
compassion lies," he said.

Mr. Gonsior, the American sniper, likened the experience to a "final
surrender" that was grueling but restorative.

"You have so many experiences that run the gamut from absolute terror
to pure joy," he said. "You realize there's another layer of
understanding there."

On the last day, as Mr. Gonsior was waxing poetic about the universe
and how all living beings are connected, Mr. Gould couldn't resist
getting in a little jab.

"There's a hippie inside every veteran," he said.