In recent years we have seen a resurgence in the study of psychedelics' potential for healing. Clinical trials have been under way and the results on healing a wide variety of conditions are being tabulated and reported. In some cases the results are no less than astounding, as in the use of Ibogaine to treat opiate addiction and the use of MDMA to treat drug and therapy resistant post-traumatic stress disorder. These are significant results which can transform the lives of individuals. However, this focus on the individual may miss a strength unique to these substances; the ability to work at the social level.
In considering psychedelic medicine, it is helpful to consider the difference between illness and disease as formulated in medical anthropology. Illness includes signs and symptoms, and how you feel about what’s going on with you. Disease is a structural or functional biological problem. Thus, they tend to overlap at quite a high level, but they are not the same thing and you can have either without the other. Illnesses are social whereas diseases are biological. Psychedelics may not be best understood as traditional pharmaceutical substances, but as reported here - "psychological catalysts which unfold within fields of sociocultural ideas". In other words, a significant part of healing is a function of social expectation or contingency.
By reflection, becoming ill is also a function of social forces. In 1966 Clifford Geertz argued that religion, and by extension other forms of enculturation, promote moods and motivations appropriate to the culture in question. These act as cultural ideals, and whatever falls outside these boundaries is repressed. The aspects of everyone’s personality, as we all exhibit the full range of human emotions, moods and motivations, that fall short of these ideals and are thus repressed can be referred to as the Jungian concept of the Shadow. The shadow is where repressed personality traits fester and they can manifest unexpectedly as pathological behaviour. Neal Goldsmith and Ann Shulgin have both worked extensively on how psychedelics may help us to become aware of our personal shadows in order to reintegrate our full selves and heal psychological traumas; a process known as shadow work.
However, psychedelics are not merely psychological tools. Salutogenesis - the causes of good health - provide us with an interesting model for the effects of the social on the biological. Typically in biomedicine we focus on pathogenesis; the causes of poor health such as viruses, poor diet, bacteria, etc. A focus on pathogenesis leads to addressing biological problems at the expense of social problems. In short, the focus is on repairing us when we are sick but not on supporting health and wellbeing. Salutogenesis, on the other hand, focuses on the ‘sense of coherence’ which appears to underlie the maintenance of good health just as pathogens, or agents of disease, are associated with poor health. Sense of coherence derives from feeling as if one is part of a larger whole and that there is purpose to one’s life. Sense of coherence is also related to a lower incidence of heart attack, fewer sick days from work, and lower mortality in general.
Researchers in fact, invoke salutogenesis when describing ayahuasca as a “generalized resistance resource” that addresses “psychosocial stressors”. This leads to users being more stable and resilient psychologically than controls in sustained psychological testing. By inducing classic mystical experiences, psilocybin also has strong salutogenic qualities, specifically union with a higher power or state of being leaving individuals with a sense of purpose and belonging. The overlaps with ‘sense of coherence’ should be obvious.
‘Sense of coherence’ may be a strong force for combatting illness, but there are social forces that can subvert it. Schismogenesis is the origin of rifts between members of the same community. These rifts develop in a variety of ways, and in traditional tribal level societies they often lead to the splitting of a community into two. However in modern state-level society it is not possible to create autonomous communities so people get caught in a double bind; a damned if you do, damned if you don’t situation.
Citizenship requires engagement in socially defined rules, such as language, paying of taxes, etc. Biological citizenship is the concept that these acts of engagement include biological factors. Through technology biology has ceased to be something fateful, and has become knowable, mutable improvable and manipulable as in plastic surgery or genetic testing. New choices include: prophylactic mastectomy (Preventive Mastectomy) - a body part is removed because it might develop cancer - and whether to go to term if an unborn child tests positive for something like Down’s Syndrome. A modern biological obligation is that women seeking an abortion in some states of the US will now be required to receive a transvaginal sonogram administered via a phallic wand which many women equate with rape. Our bodies are not biological facts, but socially and politically mediated arenas; they become social or anti-social. In current Euro-American culture, psychedelics are seen to be anti-social. They are wrong, not because of any intrinsic properties, but because their use defines someone as either a citizen or not; ‘us’ or ‘them’.
Biological citizenship, in this context is a schismogenic force. Research shows that psychedelics are among the safest psychoactive substances a person can take. Yet, the global community sees these substances as anti-social. Unsubstantiated and fear-inducing media stories on psychedelics in contravention of scientific knowledge lead users to question the integrity of those in power while those without experience accept the message and think the drug community is irrational and falsely justifying their use. This is classic schismogenesis; both sides ultimately see the worst in and can’t trust any communications from the other; on this topic or any other. The double bind is that users must hide or quit that which they find health-enhancing or live a life of criminality. These stressors, in turn, can cause negative health effects which subvert the salutogenic potentials of these substances.
Another example of schismogenisis in action is the phenomenon of disaffected youth. Disaffected youth are young people who drop out of school, don’t care about a career or a future and have disengaged from social values and norms of behaviour.
I have been teaching at a school for disaffected youth for over a year now and have seen the gaping schism between them and mainstream society. The most obvious symptom is the knee jerk reaction to figures of authority, including their treatment of teachers. They regularly treat us with disrespect, often hurling verbal or, rarely, physical abuse. Yet, if we are seen outside of class they are happy to approach us, wave us over to have a chat or sit with us on the train. It is quite clear that the revolt is not against the people who are teaching them, but the role of teacher; an authority figure representing 'the state'. On the other side of the fence is the fact that these kids are often assumed to be up to no good and are occasionally hassled or intimidated by authority figures. I do not wish to argue that they do not get up to no good. It's just that even when they are not, they are expected to be.
Though there is complex multi-agency involvement in trying to help these kids there is very little acknowledgement that their behaviour may be more rational that at first appears. Most of these children come from disrupted if not abusive family situations in a deprived region with no economic prospects. Many of these cases are from several generations of the same. It becomes profoundly evident to a thinking person that there is little chance of getting out. Criminal behaviour, with its attendant risks of harm and incarceration, is an attractive option when compared to living on state support which is under threat of being dismantled. Further, the authorities who are supposed to be helping them out, are at best impotent to make any change in this fundamental state of affairs. Hopeless and angry may be a better description of these young people than disaffected.
My experience with psychedelics has given me, as described above, a holistic perspective which has led me to see these children and the culture in which they live as not separate but as integral to the culture in which I work and live.
In a closed system, as is an economy, the fact that someone has more necessitates that another has less. This is a simple function of limited resources. As in the case of the individual, the Geertzian moods and motivations play a large part in enhancing the cultural predominance of people with certain traits and constraining the cultural predominance of those with others. Those who are able to fit most with the moods and motivations of a culture succeed in education, economy and politics while those who do not fit the mould find it hard to succeed in education and become disengaged as the system does not address, much less meet, their needs. These differences, as in the personal shadow, are segregated and begin to fester creating a social matrix of anger, hopelessness, and disenfranchisement.
In this particular case, children who are unable to sit quietly for an hour, who do not have a family environment that can explain the pertinence of abstract knowledge as opposed to concrete skills training and who have not been clearly shown a pathway to success through culturally appropriate role models have no options at their disposal to become engaged with successful society. In fact, the situation is compounded by the lack of community support and respect, in terms of the current social ideology - monetory success - of those who are on the ground trying to be role models and support these children. At least once a term a student will ask me why I do this job as I don’t get paid enough to deal with the difficulty of working with them. In translation I, as a role model of compassion and the value of education, am not a success story, but a cautionary tale against civic engagement; one probably needs to be a jerk to succeed. This manifests as social pathology; theft, violence, prejudice, etc.
As mentioned above, psychedelics have shown value in healing the psychological traumas of repressed moods and motivations which have been imprisoned in our psyches. Likewise, the use of psychedelics has allowed me to see this same process of repression occurring in the macroscopic level of society. The social disenfranchisement of disaffected individuals can’t be helped by shoving an education down the throats of those who are not prepared, or capable of learning in the standard environment.
Although it is cliché to write of square pegs and round holes - here it is apt. In my experience most of the students in my school are quite intelligent, as evidenced by the complex social relations, obsession with justice with its attendant scorecard, and economic astuteness with regards to ritualised gifting practices. They are also emotionally strong; most having survived situations which I suspect would have reduced me to a gibbering invalid. They are not weak-willed dim individuals who have no intrinsic options but to lead a life of sloth and crime. Instead, they simply do not fit within society’s dictates of what is to be rewarded. Instead of segregating and pathologising them, I argue that a concerted process of integrating this social shadow is necessary to healing society.
Instead of focusing on the problems of disaffected youth - the pathology - the strengths of, for example, non-academically motivated, but highly creative, in the case of ADHD, can be made useful somehow. The impressive memory, auditory and visual cognition and non-verbal intelligence of autism, or the fire and energy of an angry and hopeless child in an economically depressed and abusive environment can be integrated and put to productive use for the good of society. It is simply a matter of becoming aware of the cultural model that drives these individuals to be judged as intrinsically subaltern; to be cognitively or behaviourally different and thus not full biological citizens and modifying it to be more inclusive. This sense of belonging and of having purpose, the sense of coherence, would undermine the pathological associations between this population and criminality - thus healing, to some degree, the social illness of crime.
A more cohesive society
Cultural assumptions are very deeply ingrained and completely hidden. It requires a shift in perspective, often only achieved by a psychological slap in the face, to see that these assumptions are not facts, but just the arbitrary rules of a game that, in this case, leads to behaviour that is damaging to both the mainstream and the disaffected. The remedy to this illness, I believe, can be found in the perspective and creativity afforded by psychedelics. Changes to drug policy should be made along the lines of this integrative thinking, aiming towards a more cohesive society.