🫠 Ask a Guide Anything

Welcome to Tricycle Day. We're the psychedelics newsletter that almost forgot how we got here. Getting relayed across thousands of servers in a matter of seconds will do that to ya. 😵‍💫

To the average Joe, “psychedelics” used to mean Woodstock and tie-dye. Now it means breakthrough mental health treatment.

(That’s gotta be the biggest rebrand since mayo became aioli.)

Anyway, the excitement around psilocybin for depression and PTSD is definitely warranted. But that story is just as incomplete as the hippie one. The mushrooms contain multitudes.

So for today's issue, we asked our network of licensed psilocybin facilitators: How do you work with people dealing with memory loss or cognitive decline? Does your approach change?

Here’s what they told us.

This experience is designed for men who want to show up fully for their kids and partners, and who have noticed a gap between the husband or father they want to be and the husband or father they are today. Years of experience have taught the facilitator of this experience that psilocybin is a powerful medicine that helps men step into their vision for themselves.

Some facilitators do recommend psilocybin for these issues. Benjamin Dancer is direct: “Microdosing is my recommendation for cognitive decline.” From his perspective, full-dose journeys can be helpful, too, but for a different reason. More on that in a bit.

Clayton Ickes goes further, arguing that cognitive decline might actually remove a barrier: “People with memory loss or cognitive decline may actually be more attuned to some of the most potent, non-cognitive, aspects of this work." He encourages even his sharpest clients to focus on emotions, sensations, and images rather than narrative meaning-making.

That said, Kate Schroeder is clear that the conversation starts with guardrails: “Screening and collaboration with medical providers becomes essential.” In some cases, she says, the conclusion is that psychedelic work simply isn't appropriate.

Cognitive decline almost never exists in a vacuum. It comes with fear, anticipatory grief, and a slow reshaping of every close relationship. Several facilitators say this emotional weight is where psilocybin has the most to offer.

Benjamin draws the line clearly: “Journeys are really good for addressing the fear and anxiety that usually attend the decline.” Jim Hoeffler takes a similar view, and he extends it to the client’s loved ones: “I usually ask the primary caregiver or spouse to consider a journey as well with intentions such as acceptance, patience, gratitude, understanding and compassion.”

Adam O'Neil builds on that same instinct. His practice extends care to the entire support network: “Some say it takes a village to raise a child, but it takes a village to care for our wisdom keepers, too.”

When facilitators do proceed, sessions look a little different. Kate describes an intentional deceleration: “Sessions tend to be simpler, slower, and more structured.” When a client asks the same question three times or needs re-orienting mid-session, she doesn't treat it as a setback: “Repetition isn't a problem; it's part of the work.”

Amy Charlesworth echoes that flexibility. She points out that “every element of the experience can be adjusted, including dosing, strain selection, and environmental factors such as lighting, music, and sensory inputs.” When appropriate, she brings in additional support people and collaborates with the client's medical team and legal guardians.

Integration takes extra planning, too. Adam spends prep sessions mapping out the post-journey environment in advance. That can mean “creating an altar space at home,” so the experience stays physically anchored, and “setting folks up for tasks they love to do,” like walking the dog on a favorite path, so they have “a familiar task they can recognize yet also have an opportunity to experience fresh.”

The facilitators didn’t directly address whether psilocybin is even effective for cognitive decline. (Fair, since we didn’t ask.)

So we’ll chime in on what the research shows.

A 2024 review explained why psilocybin could be effective for Alzheimer’s, but it’s mostly theoretical. Hopkins has a clinical trial underway (which you can apply for), but results aren't in yet.

Another study on repetitive head injuries found psilocybin decreased phosphorylated tau. (That’s the same protein that builds up in Alzheimer's).

And last year, we saw the first published study of psilocybin in any neurodegenerative condition. Even the researchers were surprised to see improvements across mood, cognition, and motor function.

So while there’s no proven protocol yet, the signals are pretty hard to ignore.

For now, if you really want to stay sharp, we know a witty, densely sourced psychedelics newsletter you can read three times a week.

Thanks to Cynthia M. from Cape Cod, MA for submitting this week’s question. 🫠

Reply to this email to shoot your shot. If it’s a juicy one, we may select it for a future issue.

That’s all for today, Cyclists! Whenever you’re ready, here’s how we can help.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.