Shrink Rap: Ask Dr. S

Dr. S. is a clinical-psychologist, former Harvard Medical School academic, serious Buddhist meditator, and Body Electric instructor. Address your questions for Dr. S. to info@ fagrag.com with “ShrinkRap” in the subject line.

Dear Dr. S.: Am I the last person on earth who hasn’t tried ayahuasca or psilocybin? I’m guessing that most of my friends have done psychedelics at least once. I want to, but the snag is that I’m in recovery. I’ve been sober for six years and absolutely don’t want to fuck that up. My program sponsor thinks I’m insane for even considering it, but I feel like I’m missing out. Can I still be sober and make an exception for ayahuasca?

Dear Sober But Curious,

Great question. I’m delighted that sobriety has been beneficial in you life, and fully support you not wanting to jeopardize that. the key question is whether experimenting with psychedelics will jeopardize that. you will find no shortage of people with strong opinions about this.

In many ways, twelve step programs are amazing. Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and similar programs may well be the most effective grassroots healing organizations every devised. Deep bows if you have used a twelve step program to get and keep your life on track. At the same time, the 12-step model is not perfect, and it’s not for everyone. For one thing, it does not recognize non-binary thinking: either you’re an addicr or you’re not. If you’re not an addict, there’s not a problem – it assumes you can engage with moderation. But if you’re an addict, from this perspective all substances could trigger an addictive pull and are to be avoided. Anything non-prescribed is off-limits, regardless of your intent for use or specifics about the substance in question.

Let’s try a different lens. To offer a gross distinction, all substance use can be considered recreational vs. nonrecreational. This includes psychedelics. Recreational use involves partying, getting high, zoning out, seeking thrills, escaping challenges.

Non-recreational possibilities include consciousness expansion, spiritual discovery, and targeted psychological healing (not avoiding or numbing), if your curiosity about psychedelics is mainly recreational, it’s probably not worth it. You risk substituting one high for another and screwing up your sobriety.

But if it’s consciousness expansion or spiritual discovery you’re seeking, you may not be jeopardizing your recovery. You may be enhancing it. If you pursue this path, pay paramount attention to the context, setting, and intention of your exploration. If you’re brand new to this, seek out a structured, guided experience. Work with an experienced person who knows what they’re doing. Be honest with your intentions. Give yourself time to integrate the experience afterwards; walking a psychedelic journey back into daily life is a key component.

Framed another way, are you using psychedelics to avoid or escape something, or to dive more deeply into a new type of knowledge?

Six years into recovery, you’ve hopefully got enough wisdom under your belt to weigh the pros and cons of your choice. If you’ve got other underlying emotional or psychological challenges, consider these in your decision (there’s zero guarantee your psychedelic experience will be happy, easy, or tranquil). For folks whose recovery is newer and not yet stable, you may want to prioritize full sobriety – the option of a psychedelic experience will still be there down the road.

As if this weren’t complicated enough, Bill W., the founder of Alcoholics Anonymous, used LSD years into his sobriety and found it valuable enough to write about its potential in treating alcoholism. Psychedelics such as ketamine, psilocybin, and MDMA are now used in mental health treatment. So why, for example, is Prozac for depression okay but psilocybin for post-traumatic stress disorder not? And what about world cultures that use psychedelics not to foster addiction, but to heal it?

No matter what you decide, you’ll piss someone off. Within the 12-step world, you may feel ostracized or shamed; among psychedelic explorers, you may not find adequate respect for staying abstinent from substances that serve you poorly. Check out psychedelicsinrecovery.org -- an organization of 12-step adherents interested in conscious, intentional psychedelic exploration -- for additional perspectives.

Good luck!