The High Guide Podcast: 135. A Medical Doctor Gives His Opinion on Psychedelics and Grief

Tuesday at 08:10 AM

Can psychedelics help with grief? This is what we explore in the audience Q&A from Psychedelic Salon on grief, recorded live at Town Hall Seattle with Dr. Sunil Aggarwal. It picks up where last week's main conversation left off, and the questions that night ranged far wider than a single loss: grief on scale, watching genocide unfold on a screen, a bereaved parent talking through her own research, a retired nurse asking about her own brain, a psychologist 25 years into practice still figuring out where the guardrails are.

Two threads run through the whole hour. The first is that psychedelics don't reduce grief's pain so much as expand someone's capacity to hold it. A mother who traveled to Jamaica for a psilocybin retreat after losing her son put it more precisely than either of us could: she still misses him every day. What changed was room, for meaning and joy alongside the missing, not instead of it. The second is that the details matter enormously: brain injury history, medical risk factors, whether someone is in a clinical setting or a festival, whether the substance under discussion is MDMA, psilocybin, or ayahuasca, and Sunil is careful never to flatten those distinctions into one answer.

We also get specific: on dosing, on the early and mostly preclinical evidence for psychedelics and brain injury rehabilitation, on how facilitator training is being built in real time with no single accredited path yet, and on whether grief is something science can actually measure (it is, and researchers like Holly Prigerson at Weill Cornell have built the scales to do it).

None of this is medical advice, including the parts where Sunil and I get specific about dosing. If you don't have a Dr. Aggarwal to call, the takeaway that closes this episode is the one to hold onto: start with your hospice's bereavement line if you have one, or a grief-informed therapist if you don't.

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0:00 Introduction and what this Q&A covers2:00 Grief witnessed through a screen: genocide and collective loss4:30 Training the next generation of psychedelic facilitators8:00 Does psilocybin make grief hurt less, or just more bearable?9:00 Grief and psychedelics with a brain injury history15:00 A therapeutic psilocybin dose for grief, and the fear of losing control18:30 Processing grief with psychedelics outside a clinical setting21:30 Choosing between MDMA, psilocybin, and ayahuasca24:30 Is grief scientifically measurable?

Additional Resources

The Wild Edge of Sorrow: Rituals of Renewal and the Sacred Work of Grief, Francis Weller. Referenced by an audience member; lays out the five gates of grief beyond death.
"Psychedelics for Brain Injury," Dr. Aggarwal's 2023 open-access review in Frontiers in Neurology, for anyone who wants the fuller preclinical picture.

Catch the full episode here