NASW Social Work Talks - EP 116: Psychedelic Assisted Therapy

Episode Date: June 12, 2024

Mary Cosimano, LMSW, has been with the Department of Psychiatry at Johns Hopkins University School of Medicine in the Center for Psychedelic and Consciousness Research since 2000 when they began research with psilocybin. She is currently a Psychedelic Session Facilitator and has served as Director of Clinical Services and as a research coordinator. She has been involved with all the psilocybin studies and has conducted over 500 study sessions including Club Drug studies with Salvia Divinorum and Dextromethorphan. Mary has trained postdoctoral fellows, faculty, clinicians, and research assistants as guides and taught individual and group meditation to breast cancer patients in a Johns Hopkins research study. She completed MAPS MDMA therapy training program. She is a teacher and mentor at California Institute to Integral Studies for their Psychedelic-Assisted Therapies and Research (CPTR) certificate program and conducts training for therapists in psychedelic-assisted psychotherapy. Mary is a Psychedelic Harm Reduction and Integration Coach and leads a Death Awareness/Death and Psychedelics Workshop. In 2003 she started a meditation group for employees in her department. She also has 15 years of experience with direct patient care as a hospice volunteer.

From the National Association of Social Workers, this is Social Work Talks, and I'm your host, Elizabeth Lamott. And today we're going to be talking about psychedelic-assisted psychotherapy. And I am so excited because Mary Cosimano is joining our conversation. She is one of the most experienced psychedelic session facilitators in the field. She has been with the Department of Psychiatry at Johns Hopkins University School of Medicine with their Department of Consciousness and Psychedelic Research since 2000 when they began researching psilocybin.

She is such an inspiring leader in the social work field. Mary Cosimano. Welcome to Social Work Talks. Thank you, Elizabeth. I'm happy to be here. So let's just start from the very beginning. If you could tell our listeners what led you to choose the field of social work? Well, I know we talked a bit before and I wasn't sure you'd want me to share my journey because it may not be the typical one of social workers, maybe. But Honestly, I didn't know what I wanted to do. I know that's not unusual when you begin college. And so I started in accounting because my father said, you're good in math and that's

a good place to start. Always will help you. So after a semester, I realized that is not what I wanted to do in front of a computer. Didn't know what I wanted to do. And honestly, I had a boyfriend in sociology. and I thought sociology sounds more like me and then I get to be in classes so I went into sociology and a couple years later I transferred schools and they got the transcripts mixed up and put social work as opposed to sociology oh my gosh yeah I know but I thought

But you know, that actually sounds more like me and where I'd want to be at. So I kept it at that. And that's how I started my career in social work. And how did you find your way to Johns Hopkins University School of Medicine back in 2000 when the research for psilocybin was beginning? Sure. So that's that could be a very long story, but I'm going to make it shorter. You know, when I kind of always have not known what I wanted to do and just kind of lived in the moment of what felt right at the time.

So I didn't have any specific area of social work I wanted to go into. It turned out it just started gravitating, interestingly, toward the elderly population. One of my first jobs was working in home health care, going into their home and taking care of them, whatever they needed, bathing, shopping, cleaning. And not surprising, if anyone's worked with the elderly or has elderly family members or whatever, this was two of all of them. But I had a 91-year-old, and I would go and I'd say, what can I do? And we had a list because she had to, you know, it was state run and they had to have, you know, needs that they spelled out. And I'd say, well, what about the, oh, Mary, I've already done that. And I said, well, what about this?

Oh, I've done that. And she went through the list and she goes, I just want you to sit down and talk with me. And that was just true with all of them. They just wanted to be listened to. And so that was really, I remember thinking that at that young age, in my early 20s, of that importance. And then I got a job when I moved at a retirement community that was just opening. So I was in on the beginning stage of the development. And so I was the social worker and activities director. And I brought, I was the one who was, who worked with the people that were coming in, which at that, you know, going from, usually it's because they can't stay in their big home or their home they had, or their spouse has died. often they've been together as 50 60 plus years so they're not only coming to this new place downsizing their life often without a partner and again it was the same thing it was just

you know be there for me listen to me um and have present be present exactly so that and then i moved into different areas and um and then my son was born although I went back to graduate school before he was born. I knew I wanted to have my master's when I came out of being home with him, which I wanted to do. And so I got my master's, had my son, was lucky enough to stay home with him for many years. It was one of the greatest joys of my life. And then I worked at his school, and I loved that. I did some school guidance counseling, and i did some teaching substitute teaching but my main role was at his school as a first grade teaching assistant which i loved i loved being with the school the children the

parents it was very much a community and then i was asked by dr bill richards who did this work back in the 60s and 70s who was hired by roland griffiths our principal investigator who got the psilocybin studies approved to start after being dormant for almost 30 years, which was a huge in itself just to have that to be come back because it had been rescheduled to schedule one, which it still is, and had this reputation, as many of us know, such dangerous drugs and et cetera. So it was really because of his reputation and his expertise and years of work at Johns Hopkins that he was able to get it through. And so you always have two guides when you, in our studies, our clinical trials for each person. And so they asked Bill Richards,

they knew he had been in Baltimore, called him. He said, yes, and then you need a second one. and he and I were in a meditation group together and this was probably now what 25 years ago after the classes one of our meditations he said can I talk to you we sat outside I remember the beautiful evening and he told me about it and I didn't know I didn't know I only knew the psychedelics from you know when I was in the college days how it was really more the recreational. And I knew a lot of the fearful myths, you know, that your child could be born with birth defects. And I didn't know any of the studies that had taken place back in the 50s, 60s, 70s, actually a lot. I didn't either until I started researching this topic. It's fascinating.

So as you talk about your early experience working with older people, even when you were quite young, I can't help but imagine that that then prepared you for at Hopkins, the way there have been these groups, both if I understand it correctly, cancer diagnosis often terminal is one, another is smoking cessation, and another is depression. Is that correct? Oh, those are, yes, we've had many others, and you can talk about that later if we want, but those three very much. Those three studied very much at Hopkins. Yes. And what I notice about you as a facilitator or a guide, you could say either, right? Facilitator or guide, they're both appropriate terms. And I guess I'll step back for a moment and say, I first learned who you are from the film that

streams on Netflix, Fantastic Fungi. You are in that film and in that film, which I would certainly encourage our listeners and viewers to watch, you have such a gentle, elegant way of being with the volunteer. And I sense it also reading the chapter that is available in the show notes section of our website about what it takes to become an effective guide. But were you always that way? And can you share with us some about how you have developed your clinical skills in this area over the years? Well, that's a good question. And thank you for that compliment. So I really have to go back to my mid-20s when I started my journey of who am I? Why am I here? What's the meaning of life? I've always been that kind of a thinker, you know, the mind,

and I'm questioning, questioning. And so that has been the most important aspect of my life of what's most important, not necessarily a high paying job or a prestigious job. It's what is right for me and myself to be myself the best I can be. So I've always followed that. And so I think with that, or not think, I know that with that, it's about going inward and how can I be and we can talk about this later if we want it's very much a part of me talking about love and love is our true nature but that my my um what do I say my reason for being um is to be my true self my authentic self which I believe is love, which is connection, which is removing all the barriers that we learn

from our peers, from our parents, from society that block us from that. And when we, the more I can remove those and be in this space of who I really am, the more I can be with you, who you really are without any of the stuff that keeps us from being on that level together so it's this we're we're all here together there's no hierarchy in consciousness which I had been I'd been in this trajectory or this meaningness of my life for 20 years before I started Hopkins so it would just it was so natural for me to be with someone because what the studies are a relationship when we have you know someone who agrees to participate is you're just you're just with them and who are you and why are you here and what do you want that you don't have how do you

want to see your life that's not working and how can we be together yes I mean one of the first things you learn as a social worker is this idea to be where the client's at yes and that has echoes in what you're describing and I want to read one of my I would say many favorite passages from your article about training guides. You write, the ethnobotanist and psychedelic research, Terrence McKenna, said that he believes all of our problems can be boiled down to a single issue, excessive ego. Our work is to shed the ego and come from a place of authenticity, love, connection, presence, and letting go. I strongly believe that a fundamental outcome of the use of psilocybin is for a participant to reconnect to his or her authentic self, to know oneself.

It is that major positive outcome. If that is the major positive outcome of this approach to psilocybin use, it seems that it would also be important for us as guides to be in alignment with that as well. Hence, I am convinced that the desire and willingness to work at knowing one's true authentic self is one of the most important attributes of an effective guide. I'm just telling you, I'm just repeating back what you just said to me, but I wanted to share that. Mary, I want to thank you prior to this interview for both sharing the chapter that is on our show notes section and for encouraging me to read Michael Pollan's incredible book, How to Change Your Mind. There's some concepts in there that I want to talk about that I just think are so interesting. I read the book.

I want to read it again. Um, so to start, um, one of the things that he mentions is that of ego that we were just talking about. Um, can you say more about ego and where you understand that in terms of psilocybin and psychedelic assisted psychotherapy? Mm hmm. So, wow. So that's interesting topic.

Right. So there is, if anyone has read or, you know, read anything or heard talk about psychedelics, psilocybin, one of the things that is often said is that it helps with ego disillusion. And it's interesting being with this, thinking about this over the years, as I've been with so many people. and so so what does that mean you know we know we know the ego is important we know we need it but of course it can come over inflated um and i'm sure you'll ask me but at some point i want to talk about the the side of the things that could go wrong because you know most people hear a lot about only the good but it's really important yeah so ego um so what it seems to the places it can seem to take you the psychedelics is this altered state you know it's not your everyday normal state it like it seems like it opens up it removes these like i was talking about

earlier all of these barriers and these walls that we have put up you know and it it seems to often remove them and so that boom you're left here and this wide open place that is often the experience i mean it can be frightening very much you know it can be joyful it can be all these different things but as far as the ego disillusion um it often is the experience of well here's one little way to say it i know there's others so i talk about fun and play and joy as one of the teachings of the psychedelics there's many teachings love is our true nature the present moment is all there is of different acceptance connection pardon me connection yes one of them is the the joy of life and a nickname for psilocybin is some people may have heard this

as Silly Simon. But what that actually referring to is this place that people can, and it's not unusual to go to, where all they realize that what we thought was important, how we look, how much money we make, how many publications we put out, you know, how the world sees us, All of these things that have been those blocks, they're, they're meaningless, which are all the ego things. How important am I? Those are gone. And there's this knowing that that is not important, that what is important is just being here for each other. And to me, that's the disillusion of the ego. Yeah. Let me just say this quickly, and then I'll let you go. Please, please.

Another important piece that I believe, and everyone does not believe this, but oftentimes, people coming into the studies have often read a lot, heard a lot, and they have these ideas of what it means to have the experience. And it's often very different from what they've read, because everyone's unique. but this they'll they'll say oh i i had the most incredible experience i had the most feeling of oneness and and at peace with myself but i didn't go far enough i didn't have ego disillusion i knew i was still here to me if you go so far out you don't remember anything which we have had that it's not that common you don't remember anything but in the what is to me is what is happening

is you're in that place of being stepping back from the ego right you're the witness you're the observer and and that you want you want that in your experience so yeah it seems like taking psychological space from the ego in terms of unhealthy parts of yourself, it also sounds like, and there's writing about this in the literature, a kind of reclaiming of childlike wonder and curiosity. And I promise we will talk about the risks and the concerns. But while we're on this track. Another topic in this area is brain elasticity, brain flexibility. Can you say something about that in terms of what you observe and how that relates to the experience? Where I believe we're at now is there's so much talk about neuroplasticity

and growing new neurons and new neural pathways and networks. And there is promise of that. But the bottom line is that is still an unknown. The research is all with animal models. So it seems like it could carry over. But there seems like there is this neuroplasticity and this period of time they call the critical period where your brain is more open to allow this to happen.

psychological flexibility is something we have found and that so that is something we've studied and you know one from our lab brought a study of that forward and it's this as you can imagine what that means psychological flexibility you are more open to and that's another thing that often happens is you're more open to oh maybe this and this and i can see why this happened and why that person thought this so it's not just so this narrow focus and the same with themselves maybe i'm you know i have this but i also have this right um it seems that people often describe an insight that sounds obvious but it's something about the process in which they obtain the insight that is so deeply meaningful. I will share just this one quotation that is from

the book, How to Change Your Mind, on this topic. Michael Pollan writes, Mendel Kaelin, a Dutch, in the Dutch postdoc imperial lab, uses a metaphor related to snow. think of the brain as a hill covered in snow and think of thoughts as sleds sliding down that hill as one sled after another goes down the hill a small number of main trails will appear in the snow and every time a new sled or thought goes down the pre-existing trails it's almost like a magnet. Those main trails represent the most well-traveled neural connections in your brain, many of them passing through the default mode network. In time, it becomes more and more difficult to glide down the hill on any other path in a different direction. So think of psychedelics

as temporarily flattening the snow. The deeply worn trails disappear and suddenly the sled can go in other directions exploring new landscapes and literally creating new pathways i i do want to answer that but what you just read i'd like to show this um you know this it's in the book it's in the book but but tell us about it and please describe it for our listeners okay so this is a picture of the brain. Robin Harris came out with this. I forget. It's been quite a number of years now. Then you have a psychedelic, and this is what happens. And this is kind of like that snowfall. This is what we have, the same ones over and over and over and over. And then all of a sudden you have this, and it's like, oh, wait a minute. There's these new pathways, these new

snow trails all of these things and what to me what the difference is because it can sound so simple like you said or has been said and it seems is that often we know these things intellectually that we really are you know here for each other that we really are have this connection with each other we really are love is what the and that's all somewhat to that is cognitive but what happens in the psychedelic experience is this embodiment. One of the mystical, one of the characteristics of the mystical experience is this noetic quality where you know without a doubt that what you experienced is more real than every day. And it's that embodiment of the experience to me that causes the ability to change and to go forward to making change. Yes. And I mean, so many of

our listeners are social workers in private practice, who are, you know, just as with this study, working intensely with human suffering. And yet, I think we've all had the experience of the sense that someone is stuck, or that the thoughts are inflexible, or that the ego seems impenetrable so it's just so interesting to think about this other possibility and of course it then does lead to such excitement and a kind of bubble of expectations of a cure-all and so if you could challenge that here and tell us what the limitations or concerns are as you see them? For sure. So there are many to be aware of. And that's, to me, the beauty of our clinical trials, which, you know, were brought from the way they ran them in the earlier years,

decades, and have followed through with pretty much everyone who does them. And that is this container, this safe container, which is a difference from taking it on your own, taking a party. And what, what we bring forward is, yeah, these experiences can and often are harrowing. And, and you can have experiences of just feeling like, literally feeling like you went crazy, literally feeling like you're going to die, literally feeling like you're never going to come back and you know you can say these things and we do and and to and it does help with the preparation and how to deal with that but it doesn't it doesn't really capture it like anything until you experience and it's real so and it's and i'd like to bring back the ego part

that we were talking about because to me um when people are in those states it's because they haven't been able to allow the ego. It's the ego coming through. You can't, you can't stop me. I'm not going to die. I'm not going to let go. I'm not going to, you know, go crazy. And, and that is where this, you know, holding on and controlling brings this about. So if you're in an environment and we've done studies on that where if you don't have the proper set and setting safety guided sessions, integration, you're much more likely to get in trouble. So that's a piece. I think that our listeners very much understand the setting in terms of the setting being Johns Hopkins or some other research facility. Can you say more about the set? Because that's

such an important piece of it. Sure. And that is your mindset, where you're at. And that, thank you for that, because that really speaks to having this, to me, what, you know, the way we run them as a container, because when you do your, you know, always have preparation sessions before and the preparation set sessions are about setting, putting the set in, you know, it's developing the safety to you feel so safe with us that you can allow yourself to let go. it's that being able to let go and relax and allow the experience and so by having this in place the set that your mind is hey you not only might you experience this but that's a good thing so you're really saying and because i believe it and we do that if this happens it's inside of you it's coming up it wants to come up and so we're here you're safe you're not we're not going anywhere, allow it, dive into it, ask it what can teach you. You'll always come back. So that's one way for the set. I don't know if you want me to talk more. How important do you think it is with

the mindset that some goal be articulated or identified, whether it's I'm afraid the cancer is going to come back or I'm afraid of dying because my cancer is terminal and I am dying or I want to stop smoking like how important is that in this whole journey that's a great question and that's what the preparation is about it's about and I say this I say when we start this is about you telling your story and we're going to go all all over all we're going to touch all the different aspects of your life like your education your upbringing your um you know what's important to your experiences with psychedelics your experiences etc you know about 10 or 12 different things but and and of course you can't share them all in your lifetime but the highlights

and the low lights but what i say is what's what we mostly want you to share are the things that are most fearful, that are most shameful, that are the, you know, grief. And the reason is, is because if you have brought them out, you know, it's like if there's something closed inside and you're able to tell it, it releases this weight on our hearts. It lets our nervous system get back into place. We've had people share with us things that they've never told anyone because I say you want to tell us that and and because if you have that if that comes up if you've shared it you're more likely to let it come about yes there there are several directives about if you see a door open it and walk through it if there's a staircase

climb it which you know is really so brave and without that directive um it could be such a different experience, it seems. I couldn't help but think about personality disorders as I thought about the question of where will this go moving forward? Do you think that if somebody meets the full criteria for a personality disorder, like let's say antisocial personality disorder or narcissistic personality disorder, could this help with that? Or is that too large in scope? Yeah. Well, that's such a good question and unknown. You know, when we started the studies back up again, we were so cautious about who we would take in from all aspects, from the medical to the psychological. And so we would really not, you know, bring in people that, when we started,

we didn't, if someone had high blood pressure, they were automatically out, that's it. After a few years, we realized if it's, you know, if it's under control, they can partake. So that was huge. That right there. Our listeners and viewers would want to know if I have this correct, that because it became such a taboo and all of this promising beginning was halted for decades, that when it started again, it was first with people who had cancer because of an idea that it would be easier to get permission if somebody was already likely to die. that's in the in Michael Pollan's book is that your understanding that that was part of how they were allowed to start studying this again well our first study was with healthy normals that's the term that I like you know who's normal who's healthy you know in the big picture but it was who didn't have any kind of you know mental health diagnoses but our first study was looking at can it bring about a mystical experience, a spiritual experience with healthy volunteers? Our second

study was with healthy volunteers, looking at dose effect, what doses might be most effective. Our third study was with the cancer population and end of life. So in that- Thank you for clarifying that. Yeah, yeah. But it was the first indication other than healthy normal that we were able to go with. there had been a lot of studies back in the 60s with end of life and how helpful it was at that time. So yeah, I think that was the part I was tuning into on that. But when you talk about the kind of experience, there is an interesting, I think, overlay here between the scientific and the psychoanalytic or the psychological in terms of one being

so concrete and research-focused and one being more focused on meaning and deeper psychological roots. And this really is a relationship between the two in terms of who is studying it and how it's being studied. Right. Right. So I'm not sure what your question is. I'm just, that is something that I was particularly taken with in learning about this. But, you know, the more I read about it, especially because Michael Pollan always does take part in his research. So in the book, he writes about LSD, taking LSD, taking psilocybin, taking toad venom and the different experiences there. And I certainly find myself curious about it. Do you think that guides should have had some experience with it to more deeply understand it? Or what is your perspective on that?

Yes, that is a big topic. I would say most people in the psychedelic field think there's no question that you should have experience. I actually am a little bit different in that I'm not necessarily sure. One of the reasons is there's other ways to have altered states. And we know that breath work, that when it was banned, the psychedelics, that's when Stan Groff came out with the holotropic breath work, which very much can mimic. Meditation can. People can have spontaneous. So there are different ways. And many people do have that. This is a more tried and true way to have that. But the thing is, just because someone has had an experience, to me, that can be a block too, because experiences are vastly different.

Yes. That territory of being out of your normal state, but it can be so prejudiced to, oh, this is what I had. So this must be what you're experiencing. And that can really be a block. so that's a that's a really interesting perspective what would you say then are the most important qualities for a guide you certainly train people and have so much experience so you know we can go back to the very first thing it's presence working on yourself and I could I could stop there I mean I could say a lot around that but to me it's being able to It's very simple, which isn't simple to get to, but it's any therapist, any counselor, any guide, whether it's with a psychedelic or with your patient or person, or just with each other, more and more present, meaning more and more focused.

and that means having done work on yourself that has removed as much as you can it's never at least for me it's never removed and never will be in this lifetime for me but you've removed so much that you are able to be fully with them without oh my stuff and this stuff and that stuff that can take you away and being and i say the two things being present and being in love which means in connection. And that's when we can remove that. And that to me is what it's about. Yes. I think it's a big part of why we're here. And I would certainly encourage all of our listeners and viewers to watch your absolutely beautiful TED Talk about love and connection. It's available in our show notes section, and you can Google it.

I would also encourage them to read your chapter on guides, to see the film Fantastic Fungi, and to read Michael Pollan's book, How to Change Your Brain. In addition, for the social workers who want to train and learn more, where would you suggest that they go? in addition to what you said yeah but i mean truly because it has just you know exploded in the past few years you can be get very specific on what you want to you know look at you know do you want to look at the studies with you know cancer end of life do you want to look at it with depression do you want to find out more about the brain just google um do there's YouTube's everywhere. And then there's conferences everywhere and there's talks everywhere. So there's just so much information out there that, you know, what you said was a good start,

but it's just accessible. Yes. And there's training programs. You know, I teach at CIS, which is California Institute of Integral Studies, which in 2016 started the first certificate program for a psychedelic assisted therapist. And so I've been working with them and now there's like 30 or more just by taking, you know, getting that training doesn't mean you're automatically ready to go into the, you know, or you're going to be hired, but it does give you a basis of, you know, so that's another starting point. Can I, can I take a minute only because you asked about personality disorders, I got off track. And in case people were like, wait a minute, that wasn't answered. I can be very brief on that. Where I was going was that

when we first started, we were very cautious. And that was one that, you know, is tricky, personality disorders, and that's beginning to open more. And of course, we hear all kinds of people and anecdotal and, and it's not, you know, there might be more difficult, but that doesn't mean it's not something to look at and to be, you know, not to just automatically cut out. But the whole ego thing, it can increase the ego. And we've seen it many times in many, you know, they take it and say, oh, I'm, you know, I'm special. Interesting. Almost like the reverse. Oh, yes, very much.

so could you share with us the most surprising or some vignette about an experience that has really stayed with you as a guide oh my gosh i know there's so many but there's hundreds and hundreds yeah one that has stood out as as just one of the most beautiful um visuals because, I mean, they have so many that brought the insights that helped him. It was one of our cancer patients, and he was young. He was in his 40s. He had two children, a nine-year-old and a nine-year-old wife, and he was terminal, and he was given six to nine months to live.

and and he was he had been very prominent in his life in his field you know just a very well thought of and educated and helped in his profession and here he was you know in this and he also was physically even though he was so sick he was still physically a big guy and I remember when we did the prep and at first it was real stoic you know I'm this and this is not in an you know ego way just this is who I am and then I remember asking him about his children and he just started crying and so what as you could understand especially if you're children the the thing for him was how can I leave my children my wife too of course but how can I and so he was so tangled and, and focused that nothing else, that was it. And it was all in this very grief

and, um, you know, not wanting to be where he was. So he had one of the longest sessions I've ever had. He was a big guy. And at the time we went by weight, he was 250 pounds and it doesn't always happen their session but his sessions last long so we they write a session report that's something that volunteers do we have them do it before they come in the next day for their integration and they write down as much as they can and then we go over that to integrate so he had three parts his first part was he was laying down you know i shared headphones music and you could just see he wasn't talking but you could just see he was relaxed he was and there's little smiles and he gets up after a couple hours to go to the bathroom and he's like this is great i'm

done i had experience with being one and of course he wasn't he was very far from being done you know very much experience so he laid back down again and this is what he wrote we didn't know at the time except we knew he was in distress so the second part was almost two hours um maybe more of and this is what he wrote after being felt like i was in a trash can being beaten and kicked and and just battered and i mean horrific and we went up to go to the bathroom he said the last thing i wanted to do was to go back down again but I knew he wasn't done and the best way to get through things is to go back under so he said so I encouraged him to and he did so I it was last thing I was so afraid I went back he's laying there this was hours later and all of a sudden

you can see this little relaxing then you see this little bit of a smile then you see this hear this little giggle and so what he and then it was just so here's what the third part which he named it is cosmic gumball machine oh my gosh so he had this experience of a gumball machine that instead of gumballs it was moments and so he takes out a moment what comes in moment a gumball and he's looking at the gumball the moment and he's like of course i'm going to ask about my cancer and you know so that's his this is all happening you know and um and when what he wrote when someone one of those someone in my team that heard that's like a physicist what he wrote he said in order to know what my future is every single

future, every single possibility has to be in this because that's what life is. So we don't know. With that, he had this realization that moment is all there is. The present moment is all there is. What am I going to put into it? So then his next gumball machine is his first son. So he's like, this is this big guy. What do I want to put into my son? And he goes, yellow and sunshine and green grass and then he takes out his other son the next one is his other son and the same thing and then he started he saw this vine and it was the entanglement of his cancer with the sons with his belief and he just saw it untangling you know this separateness that it's all of this and from that moment on he told us because you know we had

integration. And his wife told us he was able to go home and be with his family, be with his boys and see them in this moment and not as I'm dying. And he died. He made the six-month fall. He died shortly after that. But he listened to our playlist, which his wife told us was a way of bringing him back to this session, that place of peace. She said, I will allow whatever you want to say because it was just so transformative. Isn't that amazing? It is amazing. I mean, I'm in awe of what you just shared and that it could be so powerful as it seems to often be. And I'm in awe of you mary for how you are facilitating this journey for people who really really benefit from it um and need it um and i i have one last question uh as far as that goes it's so important

i'm the lucky one and i mean that there's nothing that could bring me more joy or more meaning than to be in these experiences no matter what they are and one of the early researchers very early who did lots of experiences with people like 4 000 they said he did he said someone asked him how he could um what is it like having done so many don't you get tired of it and he said and this is what i believe there's nothing more meaningful more joyful than to see be a part of someone being turned on to themselves and that's what it is when we have that they realize they are okay they are worthy though the rats will take you know the heroin the cocaine the different substances until they die but when they're given the psychedelic they don't they won't they don't

go to it so it's so um it's not addictive i mean it can be abused um there's that that for sure but um it's also um physiologically it's so it's the lowest of almost i think probably any wish i had that chart of any of the drugs um as far as your body goes being harmed and they don't have an ld50 you how much you can take and die. Yeah. I'm not saying you want to, and it could be psychologically blow that mic. Yes. Of course you don't want to, which brings us back to the importance of set and setting, but it is noteworthy that these substances, they're non-addictive and they do not have a threshold of toxicity that many other substances do. Yeah. It's more the psychological where you can get in trouble that is really important to pay attention to. Absolutely. So building on that,

how would you say your work has shaped who you are and how you show up as a person outside of work? Yeah, well, it's just what I said from the beginning. Nothing's been more important to me than to be who I am without, you know, just ordinary, authentic. And that means working on myself. And so the beauty of being in these experiences, it's a continual, just, you know, togetherness of how are we going to do that? And they teach me ways and I share ways I've had. And so I'm constantly learning new ways and immersed in it. So that's my world is how can we be that and so it just continues to unfold again there's nothing more important and it's just in that energy you're always in that space of thinking about it and working towards that

like it's palpable and I imagine it brings a lot to other people not just in your professional sphere but in all spheres I could keep going and going and going and I know that we do have to end. Mary Cosimano, thank you so much for joining us and for the important work that you do. Thank you, and thank you to our listeners. Well, I want to thank you, Elizabeth. You have made this such joyful for me. I just love your interesting questions, and thank you so much. Well, it's been really fun to do this deep dive and learn about this, so maybe we'll have a part two someday. I would certainly be up for that. Very much. Thank you. You have been listening to NASW Social Work Talks, a production of the National Association of Social Workers. We encourage you to visit

NASW's website for more information about our efforts to enhance the professional growth and development of our members, to create and maintain professional standards, and to advance sound social policies. You can learn more at www.socialworkers.org. And don't forget to subscribe to NASW Social Work Talks wherever you get your podcasts. Thanks again for joining us. We look forward to seeing you next episode.