Dying well: Meet the psychedelic death doula

Two years ago, a series of events unfolded for death doula Leanne which changed her life forever.

“For me, personally, it all kicked off just before the pandemic because of my grandmother’s death,” she tells me.

“She died in the most perfect scenario that you can imagine: She died with my mother and her son. She was a Catholic woman praying in her home, in her chair. She did plan it, you know, she knew she was reaching the end of her life.”

At 94, Leanne’s grandmother still got the chance to witness Leanne’s wedding three weeks prior to her death. She tells me that inviting everyone to her wedding for a round of final goodbyes, and even sewing her own clothes to be buried in, were all part of her preparations. But despite being a woman of faith and preparing to die despite no signs of illness, completing her last confessions every second day, Leanne was surprised to find out that her grandmother was still terrified of what was to come.

“Even though she had spent her whole life praying, redeeming her sins, she really struggled in the last hour or two to actually die. So, although she had this beautiful death, it got my mind going: What was she really afraid of? We couldn’t have had it any better. What was the fear, if it was so well planned?”

“If we can die before we die, that’s the catalyst to living life.”

Leanne’s grandmother was buried on the same day that her green card interview took place, which would allow her to move to the US with her husband. Being unable to be at her funeral in Ireland triggered a lot of guilt in her, but everything changed when Leanne returned to the yoga practice she had been devoted to for four years at that point.

“I was into my yoga philosophy and not just doing the asanas but wanting to understand. I had always been reading the text and the scriptures and stuff, but at that point, I had joined a yoga studio in Chicago. I just remember my yoga teacher was talking about the eight limbs of  Ashtanga yoga and  Samadhi  being the final limb, which is this pure bliss, and I literally was like, ‘alright, so you’re dead, then. That must mean you’re dead. Because in life, life can’t be that great, right? It can’t always just be that blissful.’”

“This was my internal dialogue and she didn’t shut me down, she was just like ‘no, not necessarily’.”

Leanne tells me this took place at the same time that her grandmother and Ram Dass died. Dass was an American spiritual teacher and author of  Be here now. Reading one of his books gave her a first positive introduction into LSD and other psychedelics and, still guilt-ridden after her grandmother’s death, Leanne decided to give psychedelics a go. On the first of February 2020, she had her first experience with LSD.

“I didn’t pray to anybody; I gave up on my own Catholic faith after my dad died when I was 12. At that point, heaven, hell and purgatory just weren’t cutting it for me. I just couldn’t understand it. And in Ireland at the time, who are you going to question? There was no dialogue, it was just the way it was.”

“Like I said, I wasn’t praying to anybody. So, I didn’t even know where I was putting this intention. But I was like, ‘Okay, well, help me with this guilt. This guilt is really affecting me. I know my grandmother wouldn’t care anyway. So, what is this? Why am I feeling this way?’ So that was my intention.”

Leanne’s husband offered to trip-sit with her – a practice where you hold space for the person embarking on a psychedelic trip to help them stay grounded – taking half a tab of LSD himself.

“They completely shifted my whole perspective on everything. I didn’t have any strong visuals or experience, but my granny was, like, in my mind: Why are you guilty? There’s nothing to be guilty about. And after having read that book Be here now, and having this experience of ‘Oh, my God, really, all I have to do is to be present’ I realised I have to take this more seriously. It’s not just words in a book, it’s literally possible.”

Image representing a psychedelic trip

Ppsychedelic trip are often said to involve bright, coloured lighting and unclear imagery [Unsplash: Jr Korpa] 

Shortly after her grandmother’s passing, the Covid-19 pandemic was in full effect. After watching  The Midnight Gospel on Netflix, Leanne and her husband reflected on the last two episodes of the animated show, which comment on the capitalisation and industrialisation of death and our persistent denial of it. Her husband then made a suggestion that would mark the beginning of Leanne’s psychedelic journey and newfound passion to guide the dying.

“He was like, ‘did you know that you can be a death doula?’ Because literally all I’ve been doing has been talking about death and how we’re not doing death right. And then that was it.”

Originally from a Catholic town in Ireland, Leanne completed her training as a death doula last June and now lives in the US with her husband. While the term ‘doula’ might be more familiar to people, as they are known to support parents throughout pregnancy and through the process of giving birth, death doulas are there to support people as they reach the end of their lives. They’re sometimes called end-of-life guides or death midwives for that reason. Unlike nurses, they hold non-medical roles and are there to serve the dying and their families by cooperating with hospice staff, physicians, pharmacists and caregivers to take care of the dying during their transition in a way that serves them and their spiritual, legal and personal interests best.

Although psychedelics weren’t part of the course, many of her fellow death doulas tried weaving their healing potential into the conversation.

Leanne learned that when we die, DMT, short for N,N-dimethyltryptamine which is found in the South American psychoactive brew ayahuasca, is released in our brains, which could be why some people who have had near-death experiences (NDE) report having seen visuals and even their dead relatives. Leanne tells me that while people might be afraid that they are ‘going insane’, it’s important for doulas to honour their visuals as it becomes part of their dying process.

It’s worth pointing out the ancestral and spiritual connotations of DMT in ayahuasca aya meaning ‘dead person, spirit, soul, or ancestor’ and waska meaning ‘rope or vine’ in the Quechuan language. Shamans who conduct ayahuasca ceremonies and offer spiritual guidance before, during, and after, tell participants to drink the psychoactive brew, made out of hallucinogenic  Psychotria viridis plants and the rainforest’s  Banisteriopsis caapi vine. This is done to connect people to the spirit of their ancestors, which is why sometimes people walk away from the experience having communicated with their deceased loved ones or found closure over their death.

“The society that fears death fears life”

Studies  have shown that the effects of DMT mirror NDE experiences. There are strong associations between NDE scores and what is called the ‘Mystical Factor’, which is what gives people a sense of unity or continuity between the self and the world around them when they’ve taken psychedelics, also known as ‘dissolved ego-boundaries’.

We’ve recently witnessed the launch of the UK’s first  ketamine assisted therapy clinic, biotechnology company AWAKN acquiring exclusive rights to MDMA research, and a study led by psychedelic researcher Robin Carhart-Harris suggesting that we might one day be able to  replace antidepressants with psilocybin. Four years after news outlets started declaring the  beginning of a new psychedelic renaissance in the US, it seems like it has finally travelled overseas.

But while death anxiety is recognised by the fifth version of the Diagnostic and Statistical Manual of Mental Disorders  (DSM- 5)  as a potential phobia, also called  thanatophobia, we don’t usually consider the ability to extend mental health support to help us cope with death.

Last year, the American Psychiatric Association even approved a new diagnosis of  Prolonged Grief Disorder  to be added to the  DSM, recognising the death of a loved one or reaching the end of our own lives as an inevitable threat to our mental wellbeing. As public opinion on the positive effects of plant medicines and psychedelic on our lives is changing, could psychedelic therapy be extended to help us deal with death anxiety and grief? Psychonaut and death doula, Leanne, thinks so.

Close-up of magic mushrooms grown indoor

Close-up of magic mushrooms grown indoors [Unsplash: Marco Allegretti]

One person Leanne works with once ‘flatlined’ for four to six minutes, meaning he was virtually dead for that period of time. But he’s also had psychedelic experiences, and they don’t seem to be all that far away from each other, Leanne tells me.

“If we can die before we die, that’s the catalyst to living life. We don’t have to die physically in order for that to happen.”

“I believe that death in itself is such a liminal space anyway, even without psychedelics present. I think trip-sitting for people going through a really hard trip, for example, is a great preparation to sit with people as they’re dying. That’s where I think the parallels come in. And I really wish that we could maybe bring that more to the forefront of all of the training that people are doing. Can’t we transfer this into allowing people to gain the skills to sit with their loved ones, so that they can die at home, so it’s not this medical event? Because death isn’t a medical event. It’s a natural event, just like birth, that’s also medicalised, but they’re both natural.”

“If you hadn’t reminded me to breathe, I would have quite happily stayed where I was”

Recently, Leanne has had the chance to trip-sit for her mother, with the help of some psychedelic mushrooms she was growing herself in her small town in Ireland. Although her mother is not afraid of death as such, but rather the suffering that could happen around it, Leanne’s intention during the trip was to offer her an opportunity to face the pain she was worried about.

“It was amazing, because for me, having already lost a parent, my biggest fear is losing her. So it was almost like having a preview of it.”

“I gave her a higher dose, and I took a little bit just to be in there with her. We had the room set up beautifully, no music playing, it was just peaceful. And it was so funny because I was massaging her, and she was convinced that I knew exactly where her pain was. Obviously, I didn’t know that. But you know, that’s the way the medicine works, right?”

“At one point, in her mind’s eye, she was dead. I was talking to her afterwards. She was like, ‘if you hadn’t reminded me to breathe, I would have quite happily stayed where I was’. It was beautiful. It was heaven, right? It was her mind’s eye of heaven.”

“We need to start to honour the dead, and the dying, and the living”

The integration after the experience is an important part of the self-care process afterwards, during which the person who had the psychedelic experience and the one who guided them reflect on the visuals, thoughts, and feelings that came up.

“You can’t just go and have this huge trip and then not understand what to do with it.”

Sometimes people are left with a so-called ‘afterglow’, which can leave an inner peace within them and often includes a stronger connection to the world around them. Carhart-Harris has suggested that because psychedelics often remind us of one’s closeness with nature, the afterglow serves as an epistemic reminder of that feeling or fact. In some instances, it obliterates the feeling of being ontologically distinct from others and the world, which can take away the part of death anxiety which is most concerned with the fact that we cease to exist as individuals.

“The society that fears death fears life,” Leanne tells me.

When her dad died, she was convinced that he was gone forever, nowhere to be found. Since her experience with psychedelics and as a death doula, however, she’s started cultivating a relationship with those who have died rather than seeing it merely as something you lose that is gone forever.

“We really need to start to honour the dead, and the dying, and the living. Especially for people who have maybe had a diagnosis and who know that the time is coming, allowing them the time to prepare for how they would like that to go, creating some kind of visual plan so that they are in some sort of sovereignty over that end of their life. It creates an environment where there’s peace, whatever that means for them.”

Many might already be familiar with the story of  Aldous Huxley’s wife injecting him with LSD on his death bed, and we’ve even started offering some people with a terminal illness the option to decrease their depression and death anxiety with the help of a  single dose of psilocybin.

Our mortality has been painfully put under the microscope in the age of Covid-19, and yet we are still surprisingly bad at coping with it. Leanne believes that with the help of psychedelics there is hope for us to catch up on the wisdom which ancient parts of the world knew all along: that death is not a medical failure, but rather a biological fate which will catch up with us all.

“We have to remember how to be communities, again, how to honour both ends of the spectrum again and give people sovereignty over their life. And I think that’s such a root cause of where we are in society. In yoga philosophy,  Abhinivesha is the root of our suffering. It’s the fear of death, the fear of change. So, if we know this, why are we still not doing anything about it?”

Death doulas are often asked to stay with the body after their death. It reminds Leanne of the Irish wake: a tradition during which the deceased body is left out of sight for a short period of time. When her grandmother died, her mum and uncle decided against calling the doctor and just leaving her be for a while.

Shortly after, one of her family members entered the room, looked around, and asked: “Have you let the dog say goodbye?”

“Why should I do that?” her mother asked.

“You should.”

So Leanne’s mother let her sniff her body for a few minutes, trying to pull the dog away after which she would only try to go back in.

“It was as if she was really sniffing every last bit of her. She did it another time a couple hours later and it was as though she was trying to say ‘no, she’s gone’, you know? It’s all good now.”

 


Featured image by Dima Pechurin via Unsplash CC.
Edited by Ana Drula and Sylphia Basak.

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