Women’s health is a subject long brushed aside in medical research, from physical to emotional health. Vivian Kanchian sat down with Jennifer Chesak, the author of The Psilocybin Handbook for Women, to discuss Chesak’s journey in opening herself to psychedelics, and how it inspired her writing.
Vivian Kanchian: In your book, you talk about historically how women have been kind of ignored and disregarded. And that even as recently as the 1990s, women were not included in clinical trials, which is very, very recent. Would you say is that one of the things that prompted you to write this book?
Jennifer Chesak: The idea actually was born out of my publisher. They were looking for someone to write a book specifically on psilocybin for women.
And the concept completely resonated with, me simply because I’m so passionate about women’s health and have a history of writing about it. Plus, [as someone] with her own chronic health issues… I related to the topic, right?
And I’ve always been fascinated with psychedelics and really curious how they can benefit people. After there was kind of a research pause. Now, we’ve got this resurgence of research.
It’s just really fascinating all the ways that it can potentially help people. So, I had this light bulb moment that maybe with this new resurgence of research, people are thinking outside the box in terms of not only mental health, but chronic physical health issues. That maybe researchers will finally start looking at women’s health with a new lens.
VK: From your mouth to God’s ears. You mentioned that you’ve always been curious about psychedelics and how they can help people in various ways. So, is that something that you kind of delved into more deeply with this book, with the eye-opening retreat experience that you describe in your book?
JC: I’d grown up around psychedelics because I had friends that frequently used them as teenagers, but I never felt comfortable because I feel like I just didn’t have enough information about it. Plus, I grew up in the Dare Era and I still felt like I’m a teenager, I don’t really know what I’m doing, I’m not going to dive into this right now.
But as an adult, I still had a lot of fear around it. And I think a lot of that is left over from growing up during this era of the War on Drugs. So, even though I hung around people who were on many different substances all the time, and I loved them and thought they were great people, I didn’t trust myself to be able to handle any experience like that as a teenager.
Even into adulthood, that fear perpetuated. But with the book deal, I finally felt like, OK, now I feel like I have enough information to do this in a safe way and controlled way.
You can’t always control your journey on psychedelics, of course. But I felt like I could set myself up for a safe, controlled, healthy experience. And of course, I felt like I could not write the book without having that experience.
Out of all the psychedelics that are out there, psilocybin is the one that has intrigued me the most.
VK: Regarding your comment about control, I remember going to a big psychedelics conference at UCLA, with an expert panel. At one point, I stood up to ask the panelists whether there is something you can do to prepare yourself for the experience you’re about to have… and I think it was Hamilton Morris who basically (and much to my dismay) said, nope.
JC: Well, I think there are some things that you can do to prepare.
So, we have in the psychedelic industry what’s called set and setting. And of course, that does come from Indigenous practices, which is so important to honor and understand. And set and setting is there for a reason.
Set is your mindset going into an experience, and the setting is your environment.
It’s all really important. When you’re going into a journey, I think the most crucial thing (that I learned from experts during my own experience), is that if your mindset focuses on just really being open to the experience rather than resisting it, that will help set you up for a relatively good experience.
And then with the environment, the setting, it’s really about being in a space that you feel safe in, feeling safe around the people who are around you and what is around you. So whether you’re more comfortable outside or inside – all of that plays a role.
There are no guarantees, but at least you’re taking steps to set yourself up for a successful journey.
Even if you have a challenging trip though, it’s possible that it could be really successful based on the fact that the mushroom is forcing you to look at something that maybe gives you a little anxiety or a little stress. And maybe on the other side of that, you can reduce that anxiety and stress.
VK: One of the things that I found interesting in my research is that the larger dose trips that kind of mirror a near-death experience tend to be the ones that spark the most profound and long lasting change in people. And so maybe coming face-to-face with our fears is what activates our ability to recalibrate our lives afterwards… an, “If I could get through that, I can get through anything,” type of feeling.
JC: Yes, absolutely. And I experienced that in my own journey, where the mushroom seemed to be wanting me to look at something that gives me a lot of anxiety in my life. And I didn’t want to look at it.
I was like, no, unsubscribe me from this experience! But you can’t, you have to ride it out. But I was really glad that I just sort of sat with it and let it happen because then on the other side of that was a big reward.
The thing that’s been giving me a lot of anxiety in my life. I’m in middle age, I’m almost 45, and my parents are getting older. So, I know that in the future, not too far down the road, I am eventually going to lose my parents. I know it’s just the cycle of life, right?
But that gives me a lot of anxiety and stress. And part of the reason for that, I suppose, is because I help manage their healthcare. And so, I know all these things. I was constantly thinking about this, and at times I couldn’t sleep.
Before my psilocybin experience, I just had this idea that on the other side of my parents’ eventual deaths, I would only have this unending black hole of grief and I’ll never be happy again. And sure, it’s true that life will never be the same. But the mushroom forced me to look at the fact that I’ve been through really challenging experiences in my life before, and I’ve gotten through them.
That I have tools within me to cope, that I’m resilient. Not only did it show me that I have a great support system around me, but it helped me to actually feel that support system holding me up during this mushroom journey. I learned that I can lean on that support system when I’m going through something really difficult.
So, I now know I have the tools to get through that experience. Yes, it will be extremely hard. It will be full of grief, but I will navigate it. I will be okay on the other side of that.
VK: Isn’t that amazing? Thank you for sharing that.
I remember reading about your moment on the couch where you were wanting to run out of the room, and then talked yourself into sitting with your feelings instead.
JC: Yeah, I mean, the couch was breathing next to me. And I was like, “You are not supposed to be breathing. I don’t want to do this anymore,” ‘cause I was really hitting peak dose at that point.
I think that’s something that people should be aware of. You may get anxious for a minute, but that anxiety will pass. You just have to sit with it even though it’s really hard to do that.
VK: So, getting back to the women’s health piece for a moment. In our initial call together, I mentioned to you something called the Flexner Report. In the 1930s, Rockefeller, Carnegie, J.P. Morgan, all worked together to change the Western medical system to make it more profitable. At the time, our universities had naturopaths, homeopaths, and osteopaths all studying shoulder-to-shoulder in the same institutions.
When the Flexner Report (commissioned by these three men) was published, it promoted a narrative that our more holistic-minded practitioners were quacks and that we need to raise the bar on our medical system.
Additionally, as a direct result of this report, a slew of black medical schools closed down, and women became less likely to be accepted into medical school. Doctors spent more and more time in research and far less time with patients.
So, I see this very much at the root of why women are so disregarded when it comes to health care (at least in the Western world)… which, finally, brings me back to the indigenous piece.
In Mexican culture, for example, María Sabina was a highly regarded medicine woman who was responsible for the Western world’s awakening to psychedelics. Do you think this is one of the reasons it’s so important to infuse indigenous wisdom when it comes to psychedelics?
JC: When I was doing the research on the history of psilocybin, I came across Maria Sabina’s story, and that’s such an important component whenever we discuss psychedelics.
I also learned from talking to a licensed clinical social worker, this concept called “two-eyed-seeing”. I was fascinated by it, and it made so much sense [to blend multiple perspectives for the benefit of all]. The concept was first introduced to mainstream culture by a Mi’kmaq Elder named Albert Marshall from the Eskasoni First Nation.
When we talk about science in general, we need to be bringing in indigenous wisdom and merging the two. Science is a process of doing things over and over again to reproduce the same results, but that’s exactly what indigenous cultures have done, especially with something like psilocybin which is considered a sacred substance.
If we aren’t bringing that in, we’re forgetting that history and why things like set and setting and integration are so important.
Also, the ceremony surrounding psychedelic journeys can really help you keep calm. When my guide was preparing me for my journey, he used a lot of those Indigenous practices to do that. And I think that did really help me feel calm.
There is a lot of information in indigenous culture about women’s health, like working around the menstrual cycle when planning a journey. Then, there’s how we grapple with menopause [in Western culture]. A lot of us think of menopause as this thing that we have to go through in middle age, right? But it’s really a transition period. Indigenous wisdom really helps us reframe what we’re going through, which can change our experience [for the better].
VK: I love that you address all the different phases of life during which women can use psychedelics to improve their wellbeing.
So…potentially during pregnancy, although that’s a little controversial. Then, post-pregnancy, and later during menopause… you mention that about 90% of women consult a doctor when menopause rolls around.
JC: Yes. For example, Mikaela de la Myco (Mama De La Maico on Instagram) used psilocybin while pregnant, and that was simply because she had a problematic relationship with alcohol. And because we have all this information about fetal alcohol syndrome… she used psilocybin to change that relationship during pregnancy.
In cases like that, I think we really need to consider not only the health of the growing fetus, but also the health of the pregnant person too, because psilocybin has been used to help with mental health issues. So, if someone is really struggling, we need to consider that.
The mainstream medical system would say that we don’t have any evidence that it’s safe to use in pregnancy. But we also don’t have any evidence that it is harmful either. And when we look at indigenous practices, they use psychedelics during pregnancy – and specifically, psilocybin.
Hilary Agro is an anthropologist I mention in my book. She’s done the research, and says there is no evidence of harm during pregnancy among indigenous cultures. I’m not saying people should use psilocybin while pregnant. It’s just not an across-the-board, “No.” It’s more about, “What is the right thing for you and your family?”
Hilary talks about using ADHD medication while pregnant, and there is some minor research showing that these medications could lead to birth defects. But she felt like she couldn’t be a good parent or manage her pregnancy without that ADHD medication. So she used it while pregnant in spite of it being somewhat controversial, and felt that overall this had beneficial effects for her and her child over the long run.
VK: So, let’s talk a little bit about the science. You mention the history of psychedelics in your book, and how the scientific research was really taking off in the 1950’s and early 1960’s. Then suddenly, the narrative around them changed and by the mid-60’s they were on their way to being criminalized. Now, there is a research renaissance that points to what appears to be a very safe, non-addictive, and highly effective medicine for all sorts of mental health conditions.
I wonder what kind of a lesson you think we can learn from that today. To maybe keep our minds open, and remember that science is not set in stone, that it is always evolving?
JC: Yeah, I think that’s so important.
So, I think [the reason] the research was halted really stems from that war on drugs [I mentioned earlier]. There was so much misinformation and disinformation spread during that time.
For example, there were studies that came out on MDMA decades ago saying that it will cause you to go crazy. And with the war on drugs in full swing, it was suddenly just off the table without any consideration of its potential health benefits or dosage. (Turns out study participants were using an average of 90 pills per year)!
I think we can learn from that. It could be that someone accidentally misquoted someone, messed up a statistic, or [even] deliberately lied. A lot of that happened during the war on drugs, and it had ramifications – especially for people of color who were incarcerated as a result of these policies.
We need to look at the information we have about psychedelics from indigenous cultures, and we have to stop saying that these medications have no therapeutic or medicinal value and should be classified as Schedule 1 (with no known medical use, and a high risk of abuse).
I think that would help move us forward. Reducing stigma is so important. We need the FDA and DEA to really look at the science. And we need the mainstream medical community, our healthcare practitioners and other medical experts looking at the science and saying, “Yeah, let’s go for this.”
I heard on the news recently that a lot of mental health professionals are worried that people are just going to turn to psychedelics now to solve their mental health problems without going through all the other channels first, like SSRI’s or talk therapy, or meditation. It’s so frustrating.
I think “Well, why are you so hell-bent on getting people on SSRIs instead of letting them try a psychedelic first?” Because the research now shows that you could take psilocybin for depression and get lasting relief for at least a year potentially. We’re still learning exactly how long. And so maybe you could take psilocybin once or twice a year, and manage your depression as opposed to constantly taking a medication that has side effects and is really hard to wean off of.
VK: I love where you took that (laughing)! Not to put you on the spot, but I will say this.
Sometimes science is not unbiased, sometimes it has an agenda. And oftentimes, the foundation of our medical system automatically caters to the drug or the surgery.
I think it’s important to share this quick story of my personal experience. Over a decade ago, I had an inflammatory joint condition that suddenly popped up. And I couldn’t use my dominant hand, it was so painful.
I went to a rheumatologist, because well, that’s what you do. He did like a slew of tests and without being able to provide any clear diagnosis, he said, “You will need to go on a chemotherapeutic drug for the rest of your life,” to the person who won’t so much as take an aspirin for a headache.
I thought to myself, “Wait, you don’t know what I have and you want to give me a chemotherapeutic drug that has all these side effects and is only going to make me worse in the long run?” Luckily, I didn’t take that advice and was able to sort things out for myself through diet and lifestyle changes. But many people will take that advice.
JC: We are so scared into doing what the doctor says, right? I’m not against listening to your doctor. But, you know, every treatment that they recommend is not always going to be the right treatment.
And as women, who’ve been left behind in the medical system, we end up having to do our own research. We always joke about, “Oh, you shouldn’t look at Google MD,” that’s not your doctor. And I get that. There’s lots of misinformation and disinformation out there with medicine.
However, I can’t necessarily just trust that my doctor’s doing the right thing for me because our medical system operates reactively. You’ve got this condition and we’re going to throw every medication that we can at it and you’ll just be out here with all these side effects.
Instead of focusing on the things that we can do to help set our bodies up for the best health possible. We don’t take that holistic approach anymore and that’s really frustrating to me because it does perpetuate a lot of harm – more harm than good in many cases.
There are a lot of great medications out there, and I’m not against medication. I’m on many of them, but I always do a lot of research before I agree to take a medication.
VK: I think that doctors have a certain set of expertise, and they’re working out of a limited toolbox. And then, what we have is living in our bodies on a day-to-day basis. So in some ways, we’re kind of experts of our bodies in that lived-in sense, right?
Moving into your retreat experience a little bit. If somebody wants to do a psychedelics retreat like you did, can you tell us a little bit about some precautions they can take in seeking reputable people in this space to ensure they have the safest and best experience possible?
JC: Yeah, I think it’s so important to consider elements and rules of consent. This is something that I feel really strongly about, and I incorporated a lot of information about this in the book.
But there have been instances of people who have been sexually assaulted in psychedelic sessions, whether that’s with a psychedelic-assisted therapist, with an underground guide, someone claiming they’re a shaman… it’s happening. A really great resource to learn more about this is the podcast “Cover Story: Power Trip” with Dr. Lily Kay Ross.
Sexual assault happens in every industry. I’d love that to not be the case, but it does happen. So the thing that I really emphasize in the book is to make sure that whoever you’re planning to work with is having a conversation about consent with you. Sex should be completely off the table. Obviously, if you’re with your partner and you guys are doing a journey together and you decide to have sex, that’s okay, as long as it’s consensual.
What might be on the table would be therapeutic touch. We know that touch can be very therapeutic. And so if you’re having some anxiety during your journey, you can discuss whether it would be okay for your guide to touch your hand or your shoulder just to help calm you or center you.
The point is that whoever you’re working with should have a conversation with you about those types of things before you go into a session. If the practitioner doesn’t bring [this] up with you, I do think that it’s a red flag if the practitioner doesn’t bring [this] up with you.
Some guides might say, “I will not be touching you at all.” The reason for that is because when you are on a psychedelic, you are in an incredibly vulnerable state, and more open to suggestibility. So, it’s important to cover these concepts while you’re sober.
Then, when you are on the psychedelic, your guide needs to still ask you about that [therapeutic touch] in the moment – you can revoke your consent at any time. You can say, “No, I don’t want you to hold my hand.”
In terms of finding a guide or someone you might wanna work with, obviously look at reviews as much as possible. Talk to friends who’ve maybe had a psychedelic experience and see who they recommend. I can wholeheartedly recommend my guide.
His name is Gabriel Castillo, and his company is called Finally Detached. He brought his mom as a female trip-sitter for me. And so I felt so incredibly safe with them, and they held so much beautiful space for me.
VK: I wanted to hear a little bit more about how you think psilocybin could help women, specifically. I know one of the most reported sexual dysfunctions in women is a lack of sex drive.
And that could relate to all kinds of relationship issues potentially. What are some ways that you think psilocybin directly or indirectly could help?
JC: Back to this topic about how women were largely excluded from early stage clinical trials until the 1990s. This has had dramatic ramifications, especially for female sexual health.
Men got a drug (Viagra) for male sexual dysfunction in 1998. It’s a household name. And at that same point in time, the medical community (let alone anyone that you might have been sleeping with), didn’t have a complete picture of what the clitoris looks like.
There’s all this internal structure to the clitoris, and it’s very important for sexual function and to orgasm. And that didn’t happen until 2005 when a female urologist dug into this research.
Then, it wasn’t until 2015 that women got a drug for female sexual dysfunction, and no one even knows the name of that but it’s not a household name like Viagra. That’s a full 20-year gap.
If we look at the statistics of female sexual dysfunction, it’s alarming that this wasn’t a huge focus in the medical community. At reproductive age, about 40 percent of women have female sexual dysfunction.
And then when you get into that phase of perimenopause and menopause, that number goes up to 80-85 percent. Female sexual dysfunction can range from things like pain with intercourse, to low libido, to not being able to climax – there are all these things that fall under this umbrella term.
I asked a neuroscientist, Dr. Michelle Ross, about this concept of psilocybin and sex… how it can have a positive effect on women’s sex lives. It was interesting to hear her say that it may not necessarily be that it’s a great aphrodisiac, but that it seems to work by boosting confidence. And the research supports this.
Some of the more common barriers to women’s sexual health are lack of intimate partner communication and lack of a positive body image. And psilocybin is being studied for body image, especially in the realm of eating disorders.
There are around 11 types of eating disorders, but most of the focus right now is on anorexia nervosa. Dr. Natalie Gukasyan from Johns Hopkins is studying anorexia nervosa with psilocybin, and we’re learning that it’s likely that psilocybin helps with both body image and eating disorders.
So, perhaps we can use psilocybin to help us become more confident with our bodies, to help us explore our bodies on our own. And then, we can bring that back to the bedroom with our partner, and become better able to really voice our needs.
Intimate partner communication is really where I really see some potential for boosting sexual function, because psilocybin naturally makes us feel more connected to the people that we know and love… and to the universe at large. There’s a concept called oceanic boundlessness
that kind of touches on this. So, you could go off on a retreat or into a therapy session on your own, and you can come back feeling exponentially more intimately connected to your partner.
My husband didn’t go on the journey with me, and he’s not interested in doing so, which is fine.
I’m not forcing it on anyone, but I had my own journey and came back feeling infinitely more connected to him… not that I felt disconnected from him [in the first place], but I couldn’t have imagined having this extra connection. So, the psilocybing journey doesn’t have to be a joint experience, which is such a miraculous and cool thing.
On other thing to consider is that female sexual dysfunction is something that commonly arises during perimenopause and menopause, along with depression (even if you’ve never had depression before).
The first thing that a doctor will do is to stick you on an SSRI. And a common side effect of SSRI’s is sexual dysfunction. Why are we throwing people on SSRIs to combat one symptom of menopause, while exacerbating another? And so there’s potential with psilocybin here.
VK: Huge potential. I love that you say in your book that it is encouraged for women to have a solo journey. Couples are not always on the same page about therapy or how to work out relationship issues. For example, it’s more common for women to suggest therapy, while men are typically more reluctant.
JC: Yeah, sometimes when we do the work on ourselves, we see changes anyways.
VK: Kind of like the butterfly effect. Well, thank you so much. This has been such a pleasure.
Jennifer Chesak is the author of The Psilocybin Handbook for Women: How Magic Mushrooms, Psychedelic Therapy, and Microdosing Can Benefit Your Mental, Physical, and Spiritual Health (Guides to Psychedelics and More). She is an award-winning freelance science and medical journalist, editor, and fact-checker, and her work has appeared in several national publications, including the Washington Post.
Chesak earned her master of science in journalism from Northwestern University’s Medill, and she currently teaches in the journalism and publishing programs at Belmont University. Find her work at jenniferchesak.com, and follow her on Instagram.