The Psychonauts

On 20 February 2020, people around the world are going to share stories of the healing and transformation that they’ve experienced through the use of psychedelic medicine. It’s a bit like a global ‘coming out’ campaign. South African science writer Leonie Joubert of The Psychonauts speaks with the organisers of the Thank You Plant Medicine global campaign.

For some people, depression can be a terminal illness.

American novelist David Foster Wallace was one of its victims. He died of depression in September 2008. A few years before that, he wrote something beautiful that might help a well person better understand the peculiar kind of hell that depression is. He said that a depressed person doesn’t choose this end because they find death suddenly appealing. Someone ends their life, he wrote, in ‘the same way a trapped person will eventually jump from the window of a burning high-rise’. The terror of falling from a great height is easier to face than the terror of the fire’s flames.

Chronic pain - whether it’s emotional, or physical - can be so maddening, so crushing, that it’s easier to jump than to burn.

But what if there’s a medicine that’s proven to relieve the pain of depression, and slow down the headlong plummet into suicide? What if it’s shown to be safe, affordable, and easy to administer? But what if that treatment is illegal, and the state won’t kick into gear the legislative changes that could easily bring it to a hospital near you?

Is there scope, in all of this, for civil disobedience? Why should a potentially terminally ill person have to choose between illegally accessing this lifesaving medicine, or a jail term?

Kalk Bay Books is an independent bookstore outside Cape Town that regularly invites authors to speak about their latest book projects. This month, they hosted science writer Leonie Joubert to speak about her podcast The Psychonauts, a serialised audio-book project which she's release chapter by chapter as the book unfolds. Leonie sat in conversation with medical doctor Rene Usdin to talk about research in the field of psilocybin-therapy, and the changes of mainstreaming it in South Africa.

In South Africa, the underground psilocybin community is relatively new, and from the outside might look more like a religious group than a collective of therapists. These journey guides work by a set of principles for how to facilitate journeys, which, for the most part, try to manage the risks that come with deep-dose sessions. They draw on tried-and-tested shamanic traditions and some good old-fashioned common sense. But a whole lot of New Age gimmickry has crept in, too, which is a bit off-putting for those wanting a more secular or medical approach.

If we want to mainstream psilocybin-assisted therapy into day-to-day medical practice in traumatised, post-apartheid South Africa, the medical sector will need to draw on the accumulated knowledge of the underground community which is still unregulated, self-taught, and largely answerable only to itself.

Human beings are hardwired to ruminate, leading to depression, anxiety, and addictive rituals.

Boosting our emotional wellbeing with techniques like mindfulness and meditation is a bit like good oral hygiene: we need to brush and floss and visit the dentist regularly. But every now and then, we might need something a bit more drastic, like root canal. That’s where a psychedelic session comes in.

A quick update on the status of the podcast after a long silence, and a look at the different legal routes that could see hallucinogenic mushrooms decriminalised or legalised in South Africa. And if, as some argue, we have a constitutional right to access a substance that our laws withhold from us, where is there scope for civil disobedience?

Many South Africans are seeking out psychedelic medicine and retreats, even though it's illegal. In the interests of harm reduction, this Voice Diary looks at how to put medical support in place for those who decide to try this therapy process through the underground community. And it considers how the medical community can prepare itself for when this form of medicine becomes legal and mainstream.

The South African government has already opened the door for psychedelic-assisted therapy: in 2016, it allowed the potent psychedelic, ibogaine, to be prescribed as a medicine. If one psychedelic is legal for medical use, why not all of them? This short voice diary considers what this means for the legal challenge to decriminalise psilocybin mushrooms here in South Africa this year.

Voice Diary 3: The Psychonauts on the PechaKucha platform.

South Africa's Constitution upholds our right to healthcare. Given how unaffordable and inaccessible mental health treatment is in South Africa, having access to a treatment like psilocybin-assisted therapy becomes a Constitutional one.

Early findings from clinical trials show that psilocybin may be more effective for treating some mood disorders and addictions than current methods.

But psilocybin is currently illegal in South Africa, making it impossible for therapists to include it in their treatment methods. A 2018 court bid to legalise the substance may change that. Listen to the audio of Leonie's PechaKucha (Cape Town) talk.

A voice diary insert that lays out how the South African public health care system could roll out this form of therapy to the communities most in need of mental health support.