Psychedelics For End-of-Life Care, Terminal Illness & Cancer

As the Lo Fidelity Allstars’ song fiercely proclaims “one man’s fear can be another man’s high,” and this could not be more relevant to our topic today—the employment of psychedelic medicines for easing death-related anxiety. A handful of psychedelic researchers have dedicated their studies to understanding the ego-dissolving effects of compounds like psilocybin and LSD, and their findings have attracted the sights of many terminally ill individuals who predict they too, would find comfort in exploring the formless territories that lie beyond this physical, flesh-bound terrain. 

For most, the notion of a foreseeable death painfully dampens our current quality of life, but what if there was a chance to (safely) die before you die, to experience the utter tranquility of infinite awareness without carrying the delirious weight of our human perplexities? Of course…there is a way. 

And our widening psychedelic pharmacopeia is beginning to service our western society with journeys into ‘the beyond’, allowing our transient energetic bodies to detach from the form-bound mental matrices that ground us in an illusion of finity. Today we’ll be looking over some of the most notable studies on the matter, doing our best to verbally transcribe this absolutely intangible experience, while reviewing the anecdotal reports of our own clients and survey respondents.

What is Ego-Death?

Before diving into our extensive bibliotheca of research, it might be helpful to have a general understanding of how these experiences are inwardly sensed. You might’ve heard of the term ‘ego-death’, an admittedly spine-chilling phrase often used to describe this existentially-consoling personal event. First, what is an ‘ego’ and where can we find it? To understand this, we offer a mental exercise that might stimulate your understanding…

Read this silently in your head: Hello, hi, hmm, grrr, pshhh, pft, haha, wowow, meow, woof, wooshhh.

Did you hear that? One more time: Ommmmmm, yaaa…… wiu-wiu…..=====……OUCH!

How is it that we’re able to speak into our vacant spaces of mind and also be the listener on the receiving end? When we really think about it, we are the communicator and message receiver. I’m sure you likely paused during the “=====” part, and this was you, unaware, in the shoes of only the observer, not the responder, edging in anticipatory silence without the interference of lingual interpretation. 

This visualization sheds light on what Carl Jung interprets as the ego, the authentic self, the “I”-ness of ~this~, the central point of our field of consciousness, the inward perspective by which we observe physical life. We feel this ego as a continuing sense of personal identity which is derived from a deeper, more primordial understanding/awareness of simply ~existing~ (consciousness). 

In his perspective, the ego/self is expressed through seven archetypes—one of them being the persona—the personality, the projection we reflect onto our outer world, typically upheld by societal constructs. In our day and age, the practiced ability to perceive as only consciousness/awareness can be somewhat rare, and some would even say it’s the purpose of meditation.

After all, without awareness, how would we know we had a body? Or a thought?

By Jung’s terms, if the ‘ego’ is the ‘self’, then an ‘ego-death’ would translate to ‘self-death’. During a psychedelic-induced ego-death, our focused attention is essentially guided into an inner sense of oneness with ~pure consciousness~, through a sort of innately-guided all-encompassing visual meditation. 

The self/ego dissolves and so do our 5 human senses because they are what holds together a self/identity. Our 5 senses of physicality establish boundaries for differentiating or recognizing a ‘self’ by, through order of relativity. In this experience we stop identifying with the “I” that swims in a larger pool of conscious awareness. 

An ego-death also withdraws our emotional senses. It removes any memory of life experiences, thus conditioning, thus personality, thus… ego/self. This elusive solidity of a ‘self’ that is ‘separate’, is washed away. We no longer feel tightly contained in our form-attributed existence, but rather fluidly at-still in conscious awareness. This relinquishing of physical life is experienced as a sort of coming-to-birth with forces that are greater than a ‘self’.

“Trying to define yourself is like trying to bite your own teeth…It must be obvious that there is a contradiction in wanting to be perfectly secure in a universe whose very nature is momentariness and fluidity.” – Alan Watts

Jung proposes that the collective unconscious is the field of awareness that underpins, surrounds, and thus protrudes the ego. The collective unconscious is like a hand, where egos are its fingers- projecting the illusion of individuality, but being moved, played, and manipulated by the same source. Just as a wave might believe it’s the evoker of its own swell, under the spell of individuality our ego/self behaves as if it were a product of its own making. 

Unaware that we’re a consequence of natural forces greater than ourselves (space, time, gravity, electromagnetism)…that just like waves, we emerge from a deeper, unbounded ocean of action potential—a natural phenomenon that we try to make meaning of through archetypal symbolism—like math, science, history, and language studies. Psychedelics disillusion us out of this concaving search for meaning by letting us briefly exist in a perceptual state of non-being, unrooted in emotion and physicality, thus relinquishing any instincts of desire and suffering.

Feeling no emotion also means we don’t experience happiness or excitement, but this is how psychedelic medicines can help us realize that an absence of physicality does not equal an absence of presence or ‘aloneness’, it just means that we exist in awareness without attachment to form/identity.

This altering of consciousness can be interpreted by the first law of thermodynamics, which states that energy cannot be created nor destroyed, only transferred. The energy level of a closed system (i.e. body) cannot be increased or decreased by creation or destruction, and thus only energy transference can alter levels. In human biofield studies, we observe that after death, the energetic biofield reduces in size and intensity starting from the feet and moving up through the crown of our heads. 

This validates the notion that a closed system, like a body, can only reduce or increase its energy by transference into or out of its container. By these terms, energy departs from the body upon death and is therefore no longer supported with the muscular tools of a brain, eyes, ears, mouth, or fingers. It is pooled into stagnancy until it powers another form. 

I hope that we’re starting to see the parallels between the experience of body-death and ego-death. In physical death, energy quite literally vacates the body and no longer has access to the physical, thus emotional structures for experiencing a sense of self. In an ego-death, our brains chemically recreate the perceptual illusion of having sight, touch, smell, taste, and hearing, removed from the body, eliminating memory and personality, meaning we no longer have access to the physical, thus emotional structures for experiencing a sense of self, a sense of “I

Psychedelics sit our attention in an expansive, non-partisan, timeless, conscious awareness, without the distractions of conceptual reflection. No form = no relativity. We cannot experience disappointment without expectation, or resentment without anger, or fear without love. We cannot experience life without death, but equally, we likely cannot experience death without life—whatever form that life may come in… or not.

An ego-death is said to resemble those nights when we fall into a dreamless pitch-black sleep. While the dream is occurring, we’re not aware of our presence in it, of the time that’s going by, or truly of any identification with a ‘self’. The same goes for an ego-death and because in a psychedelic trip we’re only perceptually experiencing this phenomena, we have a body to come back to, and thus a brain and memory system that allow us to recall what occurred during the trip and place it in a specific point in time, in relative space. 

The same goes for these pitch-black dreams. It’s only upon introspection when we awake, that we become aware of this vacant experience—and oddly enough, we somehow never seem to mind those dreamless nights, because it feels as though nothing occurred, we have no feelings or judgment toward it. 

We’re peacefully accepting of it because the absence of good does not inherently mean bad, it just means that we are aware… and this, this is why so many people are flocking to treat their death-anxiety and end-of-life depression with psychedelics, because these substances can help us take a peek behind the curtains of our everyday ‘ego’ theatrics, unveiling an equally satisfying co-existing reality. 

Experiencing a psychedelic-induced death of self, or ego-death, suggests that when we die, our energy does not die with us, it might just exist somewhere, far out there in the cosmos, as physical or formless conscious awareness. Perhaps the coming and going of consciousness is as natural as the pull and push of tides, as the open and shut of the eye, as the cosmic contraction in and expansion out of a ‘soul’ or ‘ego’. Perhaps there exists a deeper, more intrinsic, and larger, more expansive sleep-wake order to this organic reality.

Realistically, “ego death” is only one of many lexical interpretations that attempt to convey the experience of entering this elemental field of awareness. Other modalities include religious belief. Hinduism calls this moshka, an experience that invites true knowledge of reality’s foundations and unveils an illusion of individuality by letting us swim in this ocean of souls/consciousness (Brahman).

Christians often refer to this as Christ consciousness, a state of awareness in which we achieve perceptual unity with God or Christ or conscious awareness, expanding inside of our awareness to transcend the constructs that ground us in humanity and thus, physicality. Some even believe that ‘heaven’ is not a physical place in space, rather a state of mind that we can tune into and live through as pure consciousness. 

Popular Christian symbology includes references to a ‘hand of God’, which circles back to our comparison of finger-like individuality emerging from a much larger order of nature. This might also explain why the Chritsian Bible says that the “kingdom of God is within you” or “Jesus Christ lives in you.” 

Some believe it’s a reference to conscious awareness existing within us. 1 Corinthians 6:19-20 states “you are not your own, for you were bought with a price. So glorify God in your body.” Some suggest this refers to the fact that our ego is not self-made, but rather is a product of consciousness. The body being the reward, permitting physical connection and expression, the price being an ego that dissipates into excessive individuality and self-constriction, often even keeping out expressive emotions of self love and love for others. 

1 Corinthians 4:7 states “For who makes you different from anyone else? What do you have that you did not receive? And if you did receive it, why do you boast as though you did not?” This may refer to the ego and its desire to embody separateness, similarly expressing that our ego is produced/received by means of consciousness or ‘God’ and that we should stray from recognizing human life through separateness, rather through the observant perception of oneness—by which form/identity primordially emerges from.

In Abrahamic religions, the Sabbath is a day of observance and abstinence from distractions like work. Its purpose is to promote existential contemplation through resting awareness and thus worship. Taoism, as a school of thought and religion, believes that Tao is the fundamental truth of the universe, the cause and force of all, the fingers and the hand, and ultimately the whole corporeal existence—suggesting that what we conceptualize as a ‘self’ is actually part of a much larger fabric of interconnected order (collective consciousness). 

Tao is the nameless which can only be experienced through observance. It is nameless because it exists without the ‘I’. When we try to name it, we can only interpret with the archetypal linguistics that are contained within our personal egos. Thus, to experience it is to accept, to observe, to surrender, to be still ~in~ Tao. Buddhism, Jainism, and Sikhism interpret this as nirvana, a state of transcendence in which suffering, desire, nor a sense of self, exists. This is what monks spend their lives attempting to achieve through meditation…and they do.

Psychedelics essentially catapult us into this state, letting us briefly meet Jung’s interpretation of the collective unconscious. Most pressingly though, for someone with a terminal illness or general fear of death, this experience often sparks a personal practice of non-attachment and acceptance, a sense of knowing that more awaits us post-here.

And though this ‘new’ existence is eternal, it continues to cycle in and out of form, through and sometimes without. An ego-death exposes us to the sleep-wake cycle that’s organically coded into life. In non-being we are formless awareness, in being—as a human does, we are still formless awareness, but now with an attachment to physicality that promotes perceptual division. An ego-death lets us experience the saṃsāra of life (in Sramanic religions, “the cyclicality of all life, matter, existence”)… and feel okay with it.

In medical verbiage, depersonalization/derealization resembles a more toned-down ego-death. This cognitive event provokes a recurring feeling of detachment or absence from one’s outer environment, body, and mental processes. A change in cognitive perception occurs that episodically disconnects our mental awareness from our physical awareness, it’s as if you’re observing yourself from slightly outside of the bounds of your body and may cause a sense that you or the things in your environment are not real. 

This is why psychedelics should always be consumed responsibly, and only if we meet the medical criteria to journey safely. Such abrupt and drastic change in perception can trigger underlying disorders like schizophrenia and depersonalization disorder, to switch on and biochemically animate. For most people, this typically isn’t a problem if their personal and family medical history has no report of predisposition to these brain disorders.

If you get the message, hang up the phone. For psychedelic drugs are simply instruments, like microscopes, telescopes, and telephones. The biologist does not sit with an eye permanently glued to the microscope; he goes away and works on what he has seen.Alan Watts

The Science In Support

Roland R Griffiths et al., conducted a 2016 randomized, double-blind, cross-over trial on the effects of psilocybin on depression and anxiety, in patients with life-threatening cancer. The study recruited 51 cancer patients that displayed symptoms of anxiety and depression. A placebo-like dose of psilocybin (1 or 3 mg/70 kg) was compared to the effects of a larger psilocybin dose (22 or 30 mg/70 kg). 

Doses were spaced 5 weeks apart and participants received follow up check-ins at 6 months. Preparation for treatment took place over the course of one month, where baseline measures were taken and participants were introduced to assisting staff. Abstinence of other drugs was verified through urine samples, and participants were instructed to cease use of cannabis for 24 hours before psilocybin sessions began. 

To ensure study reliability, subjects were exposed to the same music programs and physical environment during both sessions. To minimize expectancy effects, participants were not told the dosage they’d be receiving and were encouraged to focus their thoughts on the ensuing inner events. To measure drug effects, researchers employed standardized assessments, some include the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and the States of Consciousness Questionnaire (SOCQ).

Results of a 5-week follow up indicated that 92% of participants experienced a clinically significant reduction of anxiety and depression on a high dose, and response rates were sustained at 6 months, compared to 32% of participants that experienced similar reductions on the lower dose.

More specifically, average baseline GRID-HAMD (depression) scores dropped from 23 to 6 after the first high dose psilocybin session, and remained intact throughout the 6 months. Average BDI scores dropped from about 17 to 7 after dose 1, and were also sustained. 

The HAM-A (anxiety assessment) produced a baseline average of 26, and mean scores dropped to 17 after session 1, with a further 2-point reduction observed at 6 months. The STAI (anxiety measure) dropped from a baseline average of 45 to 35 after the first high-dose session, and experienced a slight 1-2 point increase at 6 months

The POMS Total Mood Disturbance test dropped from a whopping baseline score of about 57, to a score of 20 post-treatment, and experienced a further 5 point reduction at 6 months. If none of that is enough to satiate your psychedelic curiosities, these next outcomes might just astound you. 

The average baseline score for the McGill Quality of Life Assessment increased from 5 to 7 after the first treatment and rose up to almost 8, at 6 months. Now, getting to the real nuts and bolts of this experiment—the LAP-R Death Acceptance test. Baseline scores for the high-dose group stood at just under 30 in baseline, after the first psilocybin session they rose to a stark 36 point average and this score was sustained at the 6 month follow up, indicating that most people who take a psychedelic trip and are terminally ill, will likely arrive from the experience with a more accepting outlook on death

We’ve included a chart of the outcome measures in this study, below. The results of this experiment serve to scientifically confirm that psilocybin has a high rate of efficacy in treating depression and anxiety associated with terminal illnesses, and proves sustained effects are highly probable. Specifically, the LAP-R Death Acceptance scores demonstrate this medicine’s ability to induce palpable, positive changes in our perceptions of, and our relation to- death. 

Psilocybin Terminal Illness Data

In a 2011 pilot study conducted by Dr. Charles S. Grob and colleagues, researchers explored Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer. The study recruited 12 patients, aged 36 to 58, who complied with the diagnostic criteria of advanced-stage cancer and of an anxiety disorder. 

Subjects were instructed to refrain from supplementing with any medications 24 hours before and 24 hours after the experiment took place. After extensive preparation that involved intention-setting, safety education, and cardiac monitoring, the participants were given 1 psilocybin treatment session (0.2 mg/kg) and 1 randomized placebo session (250 mg of Niacin) over the span of several weeks. 

During each session, participants were given the option to wear eye shades and headphones, with brief, intermittent check-ins occurring every hour. Using several standardized assessments like the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and 5-Dimension Altered States of Consciousness profile (5D-ASC), the participants’ psychological states were measured 2 weeks before treatment and over the course of 6 months. 

Results of the BDI indicated that no significant psychological change had occurred 1 day to 2 weeks after placebo administration. However, following psilocybin administration, the mean BDI (depression) score dropped from 16.1 to 10.0, indicating a clinically significant reduction of depression symptoms. 

In fact, one-month post-treatment BDI scores were sustained at this 30% average reduction of depression symptoms in participants. The mean STAI (anxiety) score was about 43 pre-treatment and dropped to 36, one month after treatment. 

Amazingly, this reduced average was sustained through the 6 month-follow up. The 5D-ASC found that measures of oceanic boundlessness (measuring derealization and depersonalization) were the most affected by psilocybin administration (P<0.001) with anxious ego dissolution (measuring disintegration of the ego) producing less, but still clinically significant effects (p=0.049). 

Scores for facilitated imagination rose by almost 45%. The results of this study indicate a high potential for treatment success, significantly and sustainably reducing symptoms of depression and anxiety while offering exposure to positive depersonalization (ego-death).

Treatment Plans: Who, What, Where, When, How?

If you’ve come to this article because you feel psychedelics may ease depression and/or anxiety related to the terminal illness of a loved one or of yourself– well, first of all… hey there. We are deeply sorry about the corpulent tone of emotional burden that must’ve brought you here, but sincerely, you are exploring the right medicinal territory. We say this with not one drop of self-interest because the true magic and prowess of this journey lies only between you and the psilocybin mushroom itself. 

The power is already within you, psychedelics just help us harness it. Do we highly recommend seeking professional guidance on this trip? If your aim is to address this very specific and vulnerable topic- yes, but only because psychedelic facilitators help us pack tools for the journey, to be safely supported whilst voyaging, and they help us unpack from the trip, to organize and reflect, to evince and exhibit the knowledge reconsolidated from our mental pictures upon return. 

Whoever you choose to guide this journey should help you create a plan of action that embraces the people who are closest to you so that this coming-to-birth experience can be celebrated with community and in vulnerable comfort. Involving family in this process would likely be of immense solace and reassurance, and a facilitator can help you navigate those intimate and fragile, inner and outer conversations, from the comfort of your own home.

A common pitfall that we see with many families and journeyers is that they often use psychedelics as a last resort, exhausting all other possible options first, and waiting until the last possible minute to explore a psychedelic-related option. IT IS NEVER TOO EARLY to come into compassion, understanding, and acceptance of one’s death, or into what some would term as “death positivity”. Don’t wait until the last minute, where health concerns may prohibit an individual from exploring a psychedelic experience. 

For many people facing a terminal illness or end-of-life situation, every single day is full of the same pomp and circumstance. Every day matters. Our only word of caution is that journeyers and their family should both seriously consider whether to proceed with psychedelic-assisted therapy or not if there is any concern that the experience would pose a significant health threat and shorten their already limited time with family, friends, and loved ones. 

Particular consideration should be taken about the journeyer’s energy, endurance levels, mentation, cardiac health, and respiratory health. If there are these concerns, perhaps a microdosing protocol or a moderate level dosage could be a more appropriate option.

Anecdotal Reports

We’ve worked with several clients who were diagnosed with terminal cancer and sought out intentional psychedelic use as a means to ease their inevitable transition to the other side. Alexa has an incurable cancer of the blood that was diagnosed 5 years ago. She takes a pill to control her symptoms and gets an infusion every two weeks. 

Her intention was to get a kernel of truth in regards to her cancer and her fears surrounding death. She took 5 grams of dried psilocybin containing mushrooms with one of our facilitators in a ceremonial setting. Although it didn’t give her the revelation about death she was seeking, she described her experience as “delightful, peaceful, and expansive.” 

She spent time mourning significant memories of the past with the understanding that she was nearing the end of her life. She thought a lot about family, past vacations, and food—all sensory experiences that come with having a human body. Alexa said the experience made her feel brave, because she did the thing she was very afraid of. 

Since her journey, Alexa has been visualizing and telling her body to get rid of her cancer  by repeating “I don’t need you anymore.” Even though she didn’t get exactly what she was looking for out of this experience, she intends to do another journey in the coming months at a higher dose. 

Alexa’s story perfectly illustrates how these journeys give us what we need, not what we want. And even though she couldn’t quite put her finger on what shifted, she’s inspired to go back in for another deep dive. Note that names have been changed to protect the privacy of our clients.

Following the Mushrooms

If we follow the paper trail of psilocybin mushrooms and psychedelics as a whole, we likely find ourselves coming to a common and unified perspective on life after death—there is more to this experience than first meets the human eye, but the human body can strengthen its ability to consciously and positively depersonalize, and experience life without the physical. 

Though much of what we’ve said today seems incredibly promising and downright out-of-this-world, it’s important that you consult someone knowledgeable on psychedelics and that you do your diligent research, to truly understand the life of these compounds, but also, the medical contraindications of this treatment. When done in a safe mental and physical space, with adequate guidance and in a comforting environment, psychedelics can make a world of change in our personal and social lives. We leave you with a question that could hopefully spark some creative interest after the conclusion of your upcoming journey…

Do you prefer to believe that heaven is a physical place, or that it’s a state of mind, and why?

We’d love to chat and ponder this question with you over some ‘magic’ mushroom tea and lots of preparation and integration sessions that ensure a healthy and seamless transition into and out of these altered states of consciousness. We encourage you to book a consultation with us, so you can be better informed on the maintenance practices of these treatments and take the best course of action for your healing journey. We also have a blog page, replete with everything- psychedelic and answers to the most common, and sometimes, not-so-common, healing journey questions. Speak soon, friends.

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nick and jimmy headshot, psychedelic passage co-founders

About Us

We (Nick & Jimmy) are spiritually oriented psychedelic guides who facilitate in-person ceremonial psychedelic experiences with an emphasis on harm reduction all across the U.S. We foster transformational journeys through the exploration of consciousness, which we believe to be a fundamental human right.

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