Coping Mechanisms: A Journey Through Psychiatry, Alcohol, and Psychedelics

Understanding the Different Approaches to Handling Existential Anxiety and Emotional Distress

A psychiatrist, a drunkard, and a shaman enter a bar. "How are you?" the bartender asks the drinker. "I realized that I live alone and will die alone, and nothing I do will change that," replies the drinker, "so give me something to help me not think about it," and the bartender pours him a double shot of whiskey.

The bartender turns to the psychiatrist and asks, "How are you?" She replies, "I had a hard day. I realized that I live alone and will die alone and nothing I do will change that. So just bring me a glass of water." When he hands her the water, she also swallows an anti-depressant and anti-anxiety pill.

Finally, the bartender turns to the shaman and asks, "What about you?" "I had a great day," answers the shaman. "I realized that there is no difference between me and you, and between them." He points to the psychiatrist, who is already starting to relax with the help of the pills, and to the drinker, who has already started to forget his troubles and orders another double whiskey. "We're all connected," he adds, "so the only thing you can do for me is tell me how you are."

I composed this parable to briefly explain the difference between the answer given by psychiatry to the plight of human existence and the answer given by psychedelia and meditation, and the escapist solution found. The predicament itself, in the conceptualization I use here, is rooted in the feeling that each of us is a unit that moves alone in the world, and that all existential truths apply to it: there will always be an unbridgeable gap between it and other units in the world, nothing will give meaning to its existence, it will die alone, and after death, it will be forgotten, ultimately rendering its life meaningless to those who come after.

Within the framework of the modern worldview, it is difficult to deal with these insights, and they make us depressed and anxious. We deal with this depression and anxiety in a variety of ways, the main ones being escapist suppression and medication. Escapist repression can wear different masks, from drug consumption to building pyramids. Such solutions help us deal with the horror of a private destiny whose bitter end is known in advance by repressing this horror with substances that allow us to put aside what scares us or to delude ourselves that it will not happen.

The traditional drug treatment available today in psychiatry offers us to calm our nervous system in a way that allows us to continue functioning. We still think of ourselves more or less as a crystal glass that stands on the edge of the table and will fall and shatter into hundreds of pieces when something disturbs its delicate balance. However, it no longer makes us want to stay in bed and hide under the covers until this scary part called life passes. Thanks to the drugs, we manage to go to work, start a family, shop, and be ordinary productive citizens.

The third way, however, offers a completely different solution. This path, which can be followed through meditation and also through psychedelia, helps us see the picture in a completely different way. In this picture, the differences between me and another person exist in the way that in my iPhone photo, the pixels that make up my image are different from the pixels that make up the image of the watermelon I'm eating. I mean, they're not really that different. Their color and their position in relation to other pixels are what cause distinct images of a woman and a watermelon to form on the screen.

From this point of view, it makes no sense that the image of the woman in the photograph would be more concerned about its individual fate than the watermelon would be worried about it being smashed on the floor and eaten by ants. There is really no difference between the pixels within the image, and there is no meaning in identifying the image of the woman and the image of the watermelon as separate in terms of pixels.

Of course, this answer solves the predicament from a completely different angle. It actually destroys it to a great extent because it negates the basic premise on which it grows: that we are all disconnected and must face our inevitable destruction alone.

Since all these roads are paved (at least) in our minds, it is interesting to compare the brain processes that occur in each of them. To this end, I would like to outline the differences between them, although in a crude and simplistic way, but nevertheless in a way that can serve as food for thought or further discussion for those who hold the issue close to their hearts.

How Do Anti-Anxiety and Depression Drugs Work and Why Do They Affect Our Mood?

I will briefly explain how drugs belonging to the SSRI family and known as antidepressants work. These drugs work on the neurotransmitter serotonin. If we think of the brain as a party, you can imagine that serotonin is like these cool guests that pick it up. Every such guest has a stage where they go home because their partner is waiting for them, because they have an important day at work tomorrow, or just because they are tired. Antidepressants work by preventing serotonin from being cleared at its normal rate. That is, they are a mechanism that keeps the guests who "lift" longer at your party, and the party manages to lift more easily. Of course, the scientific picture is more complex, and not all psychoactive drugs work in the same way, but this is one of their main avenues.

How Does Alcohol Work and Why Does It Help Us Forget Our Troubles?

Alcohol has many negative effects in the long term, but to explain how it works in the short term, let's now imagine that our brain is a middle-class freelancer who has, for that matter, a shop. Now let's bring another neurotransmitter into the picture called dopamine. You can say that dopamine is the brain's money. In the absence of other really, really (but really) good circumstances, our freelancer will tend to repeat any action that will bring him money. Alcohol is like a rich tourist (it doesn't matter what denomination) who enters a store and pours money without a bill. It is easy for us to understand why such a customer, at the end of a hard day, changes everything for our freelancer.

How Do Meditation and Psychedelics Work?

The existential truth that forms the basis of the common emotional distress I described at the beginning of the article—our existence in the world as a complete, unique, and separate unit—is not based on a fact from the point of view of the mind, but on a hypothesis. In the article where I wrote about the Bayesian model for understanding the brain, I presented the thesis that the brain is a machine whose purpose is to make predictions. The existence of the separate and unique "I" is one such hypothesis. You can call it a hypothesis, but you can also call it a hallucination. I will try to demonstrate this using the following image:

What do we see in this picture? Do you see her face? For sure. Our brains are tuned to recognize faces based on the least amount of information. Can you at the same time see that this is just a big circle that contains two circles, a triangle, and a curved line? Sure. Is one of these descriptions correct? No. In this sense, the face we see when we look at the collection of items placed nearby and in specific locations in this image is an example of the effective hypothesis of our prediction machine. This is also why it can be said that we hallucinate these faces more than we see them with certainty from an unmediated encounter with the sensory information that reaches our brain from the outside. Our experience of "I" is very similar to how we see the face in this picture.

Brain-wise, both meditation and classic psychedelics (such as psilocybin, the active ingredient in hallucinogenic mushrooms, and LSD) stick gum in the projection engine, reducing the activity of the hallucinatory beam that projects the brain's incessant prediction onto the environment.

It can be described a bit like the difference between the way a toddler experiences his home environment and the way an adult experiences the same environment. The toddler will be fascinated by things that, for an adult, are completely banal because his mind does not yet predict them in advance ("Look at that scene, when you pick up a pea and release your grip, it falls to the floor, woowoowoo"). And in the context we are talking about, under the influence of meditation practice (mainly non-dual meditation, which emphasizes the lack of distinction between the person and the environment), and under the influence of psychedelics, the brain's self-delusion weakens.

The effect of this weakening on our mental well-being can be illustrated as follows. In a normal situation, we are like people who receive a small box inside which is placed a delicate decoration that competes with sugar, the kind that is placed next to the ice cream in a luxury restaurant. We are told that this delicate ornament is us and that our destiny is its destiny. Now we have to guard this box from every harm.

We begin to put all of our will into guarding this box, looking for ways to pad it, high shelves to put it on, working on ways to identify people who might shake the box and stay away from them, and so on. Psychedelics and meditation are like a person who convinces us to dare to open the box, and then we discover to our astonishment that it is empty. There is no sugary decoration in it. Never was. We devoted all this energy to keep an empty box. This understanding is the basis of the liberation that comes from this third type of intervention.

By the way, this explanation is also related to the fact that insights acquired under the influence of psychedelics

 are often labeled as an unforgettable truth. They were experienced when the hallucination machine was malfunctioning, so it can be said that they were indeed based on a more direct encounter with reality. That is, to a large extent, they were closer to the truth or reality, just as a child is closer to reality than an adult. It is ironic then that these very substances are called hallucinogens.