Does Microdosing Work?

Chasing a Therapeutic Silver Bullet

Magazine Issue
May/June 2024
Illustration of a green pill bottle with a smiley face on it | ILLUSTRATION © 2ROGAN

My husband and I have gotten along pretty well for 20 years, but these days, we’ve been more irritable than usual—quick to find fault and slow to forgive. Though I feel passionate about my new writing job, and he’s happily retired, we’ve been getting on each other’s nerves—a lot. He says it’s because I have zero work-life balance and I’m coping poorly with our teenage son’s growing independence and transition into high school. I say it’s because he’s become needier as a partner and I’m tired of doing the emotional labor in our relationship.

“We used to hug,” he laments at dinner one night.

“Initiate hugs, if you want,” I say huffily, even though whenever he does, I grimace and squirm, or make comments about the weight he’s gained—which is mean, I know. I seem to have lost my capacity for offering small kindnesses: for smiling at him in the morning, or thanking him for making coffee, or asking him the types of questions that may seem predictable but ultimately let someone know you care about them. How did you sleep? What are your plans for the day? Want to grab a bite later? Maybe I am sad our son is growing up, but I don’t think it’s that simple. I feel tormented by a vague ennui; sometimes it tips into what feels like a relational existential crisis.

“If I could take a pill and change all this, I would,” I say, gesturing at the air between us. It’s a throwaway comment, but it’s actually what I truly want: a pill that could change things.

At this point, I don’t want more talk therapy or skill-building. Over the course of our two decades together, we’ve gone through many cycles of individual and couples therapy. We’ve read relationship books and taken yearly refresher workshops on communication. Not only that, but I’m a longtime couples therapist: I know how to do the kinds of things I need to do with my husband to feel closer to him, but honestly, I don’t want to. I feel like a five-year-old at mealtime refusing to eat their vegetables. Sometimes it seems like we’ve improved our relational selves to death. I want a pill, one that won’t blunt my emotions or affect my energy level, one that’ll turn me into a less anxious, more embodied, more mindful, less vindictive, more grateful version of myself. My clients have expressed the same desire for a therapeutic silver bullet more times than I can count, and I’ve always been clear with them: it doesn’t exist.

But what if it does?

“Maybe I’ll try microdosing,” I say breezily.

“What?” My husband, who’s begun clearing the table, stops in his tracks. “I thought you were against people taking illegal drugs. What if one of your clients wanted to take an illegal drug to improve their marriage? You’d be seriously worried about their grip on reality!” He laughs. “No offense, Alicia, but I think you’ve finally lost the plot.”

Maybe he’s right. Even just a few years ago, if I’d encountered a client wanting to microdose on my watch, it would’ve sent me running to consult with a supervisor. I’d wonder whether I’d overlooked a substance-abuse diagnosis and how I could work with someone who was ingesting daily doses of psychedelics, no matter how small.

But times have changed.

In the last five years, the collective shift in mental health providers’ attitudes toward psychedelics has been seismic. A mind-blowing journey out of your regular state of consciousness into an alternate one (coupled with integrative therapy, of course) can shift intransigent PTSD, deep depression, even death anxiety. A lot of old research shows this, and a growing cache of new research offers evermore promising results and applications.

But what about taking psychedelics in a way that doesn’t catapult you into an alternate state? When it comes to microdosing, very little research has been done. No credible studies exist proving that it’s better than a placebo. And yet what’s lacking in evidence-based research is made up for in lively anecdotal evidence that’s been exploding into the cultural conversation. On social media, at therapy conferences, on therapist forums and listservs, word is getting around—and the word on the street is that microdosing helps.

In A Really Good Day, writer Ayelet Waldman claims that over the course of her LSD microdosing journey to treat major depression, most of her troubling mental health symptoms decreased. Her friends, children, and spouse had all noted, “Your mood is lighter, even buoyant,” “You seem much happier,” “In situations of conflict, you seem to be able to reset yourself more quickly and easily.” Former hockey player Daniel Carcillo, who suffered seven concussions, took small doses of psilocybin regularly after a single full dose. He says he’s now cured of the previously debilitating symptoms of his traumatic brain injury. Journalist Chryss Cada microdosed psilocybin for eight months to help with longstanding anxiety and depression connected with her brother’s suicide. She writes that it’s improved her mental state by “loosening and releasing tightly held trauma.”

Maybe it can help me like my husband again.

Mycelium

When I recap the details of my prickly dinner conversation with my husband to my friend Po-Hong Yu, a psilocybin integration guide, and tell her that I want to microdose, she says, “Microdosing psylocibin isn’t about ingesting a pill: it’s about cultivating a relationship with an ancient plant medicine that’s alive and intelligent.”

“I’m ready to experience that,” I say. “Will you coach me?”

For a second, she looks ambivalent. We met at a women’s-empowerment retreat several years ago, and since then, we’ve supported each other in our pursuit of deeper satisfaction in our work lives. But I’ve never shared her passion for altered states of consciousness as a path to healing. I’m worried she’ll say she can’t work with skeptics like me.

Illustrated photo of a young woman reaching for a cartoon pill | PHOTO © MASTER1305

“I’d be happy to,” she responds, “if you think we can do it in a way we’re both comfortable with. Keep in mind that the experience is less about fixing and more about surrendering. It’s a spiritual journey.”

As a person, I’m many things, but spiritually inclined isn’t one of them. Still, I’m willing to give spirituality a shot if it means enjoying my marriage and my life more.

Before hanging up, we agree on a fee I can afford and some additional boundaries to avoid dual-relationship issues and preserve the integrity of our friendship, which includes limiting contact between coaching calls and being honest if something feels off between us.

The next day, following Po’s suggestion that I watch the documentary Fantastic Fungi as a first step to cultivating my relationship with psylocibin, I sit on the couch as a single, dew-laden mushroom grows in time-lapse photography on the screen. My husband sits at the opposite end of the couch, yawning. I’ve told him it’s important for him to watch the documentary, too, since I’ll need his support through the process. He’s been acting concerned lately, sending me statistics on opium and fentanyl deaths and articles about model citizens turning into drug abusers. I’m hoping this film will put his fears to rest.

A woman’s voice explains that mushrooms are the visible fruiting bodies of fungi, organisms that thrive nearly everywhere, but mostly underground in the form of filaments known as mycelia. Not only has it been scientifically proven that they communicate with one another, but they function as a network of subterranean routes, like nature’s internet, helping trees and other species absorb nourishment. In one clip, we see tree roots that morph into electrical currents moving along neuronal networks—which quickly fades into a new clip of subterranean strands branching out in all directions, offering a visual illustration of what one expert insists is the mysterious, powerful kinship between mycelia and our brains.

“What do you think?” I ask, scootching closer to my husband on the couch.

He shrugs. “A little creepy.”

He’s not wrong. If it weren’t for the upbeat background music, the wormy strands proliferating through a shadowy underworld might have been lifted from Stranger Things or some other TV series about an evil, faceless creature taking over the world. Only, this faceless creature is benevolent—imbued with the power to heal us.

“Look, if this is too scary, I won’t do it,” I say as the closing credits scroll over the screen. “I don’t want to add more stress to our lives.”

“It’s fine.” He sighs as he rises from the couch. “I’m sorry I’ve been so negative. You should do it. I appreciate that you want to improve things and try something new.”

Psychedelics in Therapy

Flow

A few colleagues have given me recommendations on how to get psilocybin online, but I end up choosing a website a friend used. Their FAQ section is thoughtful and thorough, and I feel myself getting excited as I pick up my phone to chat with a guide I selected from a drop-down menu. She’s reviewed the form I submitted that clarifies my mental health and medical history, so she knows I don’t suffer from schizophrenia, bipolar disorder, or mania. By the end of our conversation, she’ll purportedly be able to recommend the best psilocybin blend for my needs.

“What are you hoping to get out of this?” she asks earnestly, in a soft, lilting voice that makes me wonder if she grew up in California.

“Honestly, I wish my relationship with my husband flowed better. I’ve been overreacting to things. It’s hard to slow down. . . .” I lose my train of thought as I bite off a sliver of thumbnail. She fills the silence with a throaty humming sound.

“Our blends range from moon energy to sun energy,” she says. “We have a moon blend called ‘flow’ that might be a good fit.”

I suppress an impulse to roll my eyes. “When you say ‘moon energy’ and ‘sun energy,’ what do you mean?” I ask politely. Her words have dimmed my excitement. After all, what would happen if I informed a depressed client that they needed more ‘sun energy,’ or encouraged a client struggling with panic attacks to try ‘moon energy’ practices? Energy and celestial body references in adult conversation tend to make me feel deeply uneasy.

“I think about it in terms of the nervous system,” she clarifies. “If we lean toward hyperarousal or vigilance, something on the moon side of the spectrum can help us drop into our bodies. If we lean more toward depression and disorganization, something on the sunnier side can help us be more present and activated.”

“What about legality?” I blurt out. “Is this legal and safe?”

“In the small amounts we work with, it’s low on anyone’s priority list in terms of criminal activity, particularly with all the legislative changes happening now. But there’s a small risk. Our organization focuses on ethical and safe screening, and we ship in confidential packaging. For me, the risk is worth it, because I share the company’s mission to make nature’s medicines safely available to everyone who needs them.”

After our call, I go to the website and type in a backslash, followed by the word “shop,” just as the guide had instructed. It takes me to a new page requiring a password, which I’ve jotted down on a yellow sticky note. Then, as if I’ve pulled a secret lever on a hidden bookcase, a new page loads. It’s full of psilocybin blends with names like Inspiration, Spaciousness, Ease, and Radiant Mind.

I scroll until I find what I’m looking for: Flow. I’ll be doing a 90-day protocol, with five days on and two days off to help mitigate any tolerance I might develop. Po and I have agreed I’ll start with a moderate dose, 100 milligrams, which we’ll adjust as needed depending on how my body responds. After I charge what’s in my cart to my PayPal account, I receive a confirmation number with the words “Thank you for your order,” as if I’d just bought something innocuous, like sunscreen or an immersion blender.

Four days later, I receive a nondescript box in the mail. The psilocybin capsules are in a green glass bottle nestled amid confetti-like shavings. My name has been handwritten in silver magic marker on the label, followed by a smiley face. The bottle is smooth and cool to the touch. Putting it in the refrigerator—on Po’s recommendation—I feel a subtle effervescence radiate through my chest. It touches me to know that somewhere out there, a stranger took the time to handwrite my name on a bottle, and decided, perhaps on a whim, to include a smiley face.

Listening To My Body

Years earlier, a colleague of mine drove her car off a road and almost hit a tree. She’d been microdosing at the time. The doctors said her near-accident was caused by a mini- stroke unrelated to the microdose of the psychedelic she’d ingested, but I’ve decided that if I need to go anywhere, at least at the beginning of my protocol, my husband will be the one to drive. Also, because I still see a few a clients in addition to my writing job, I’ve rearranged my schedule to make sure their sessions fall on off-days, when I’m not microdosing.

My first on-day, I’m so excited that I wake up before the alarm goes off. I slip into a robe, tiptoe out of the bedroom, and make my way downstairs into the kitchen. Carefully, I tip a single capsule out of the green glass bottle onto the palm of my hand. There’s nothing remarkable about the pill. It’s a lozenge-shaped plastic sheath filled with greenish-gray powder that looks like my daily iron supplement. I return the bottle to the refrigerator and carry the capsule and a glass of water into the living room.

Po has encouraged me to get clear on my intention before taking the first capsule, so once I’m settled in a comfortable chair by a window overlooking the wooded area behind our house, I whisper, “My intention is to listen to my body and bring balance to my marriage and life.” Hopefully the psilocybin in the capsule really is alive and intelligent and picks up on what I’m saying. After that, I close my eyes and say, “Thank you,” following another one of Po’s recommendations—to cultivate gratitude for the plant medicine before putting it in my mouth, taking a sip of water, and swallowing. I sense the capsule traveling down my throat, but I don’t feel anything else happen, even after 20 minutes of waiting.

Because the dose I’ve taken is so small, its effects are considered subperceptual. I’m not supposed to notice much, but it’d be nice to feel something—a floaty feeling in my heart center, a hint of euphoria snaking along my spine. I wait another 10 minutes. Nothing happens. For the first time since the idea of microdosing occurred to me, it dawns on me that maybe, after all the debates I’ve had with my husband and the research I’ve done, this little experiment won’t help. I’m disappointed. Maybe I’ve been indulging in a naïve, new-agey rescue fantasy.

The next day—and the day after that—I go through the same process, waking up early, stating my intention out loud, thanking the plant medicine, swallowing it, and sitting in stillness for 20 minutes before going to work in my home office. At night, I take 15 minutes to reflect on the day that’s just passed and write down any moments that felt like shifts, however small—things like, I resisted the impulse to criticize my husband’s driving. I noticed I was tired and I lay down. I ate a snack between meetings at work. I chatted with a cashier at the grocery store. I reached out to my mom and wished her happy birthday. At first, it feels silly to elevate microscopic moments by writing them down—meaningless stuff, in the grand scheme of things. After a while, though, a fluttery lightness in my chest and abdomen accompanies my recognition of these positive micromoments. When I shape them into sentences on a page, the lightness expands into something more full-bodied. Life is good, I think.

By the time I reach the end of the first week, something remarkable has happened. Two days in a row, five minutes after taking the capsule, there’s been a cool, trickling sensation along my arms. On day three, I feel something that reminds me of the sudden pop when you open a vacuum-sealed jar, as if air were rushing in to all the tight spaces between my internal organs. On day five—before my two-day break—I experience something else unusual: myself. I have a sturdy expansiveness I can actually feel. It’s an odd thing to notice, a bit trippy, though I’m not remotely high. My presence feels like a weighted blanket, the kind that can settle jittery children—except it’s inside me, invisible and immaterial, grounding me from within.

Maybe I’m becoming more spiritual.

The Reacher

When Po and I meet on Zoom for our first integration call, we talk about my intention and the shifts I’ve been seeing during week one. I tell her about some physical symptoms I’ve become aware of: headaches, back pain, a little light-headedness, and some difficulty falling asleep. Even just being aware of these things is progress for me, since I tend to ignore my body whenever I feel discomfort, more often than not overmedicating it with Advil.

Po suggests I wean myself off coffee, which I’ve wanted to do for a while, and switch to a drink with less caffeine to help me start sleeping better. She recommends I listen to a Yoga Nidra audio before going to bed. In her opinion as a Chinese medicine practitioner and former acupuncturist, I fit the profile of someone with yin deficiency. She thinks a cup of bone broth daily could help me, too. Despite being a longtime vegan, I give it a try.

Over the next eight weeks, my headaches go away, along with my back pain—which I attribute to the five-minute core workout I’ve started doing every evening. I also sleep better. The biggest improvement, though, is that I feel more openhearted toward my husband. Is this because he’s been supportive of my microdosing project, despite his initial reservations? Because I’m inhabiting my body more? Because I’m getting more sleep?

By week four, when we’re out walking, he puts his hands on my shoulders and gazes into my eyes. “You seem more relaxed,” he says, eyes glistening. “And friendlier. Thank you.”

Somehow, without discussing it, we establish a new ritual right before going to bed at night. Lying on the mattress side by side, one of us reaches for the other’s hand, locates it under the blanket, and holds it tightly. The other one of us allows our hand to be held and sometimes squeezes the reaching hand. My husband is the reacher, some nights; other nights, it’s me.

My microdosing journey has cons, too. As with the pros, causality is hard to pinpoint. A few times over the course of eight weeks, blood vessels pop in one of my eyes, though the redness clears up after a couple of days. Is it my yin deficiency? There’s a week when my digestion is off. Can I blame this on the psilocybin? Or is it the result of a stomach bug, the coffee substitute I’m drinking, or maybe my body’s reaction to a daily cup of bone broth after so many years without ingesting any animal products?

When I fly to Michigan to visit an old friend, a TSA officer pulls me over for a security screening, I start to sweat, and my heart pounds. The officer’s gloved hand brushes against the glass bottle with my name scrawled in silver on the label. Will I go to jail? I wonder. Was this experiment worth the risk? In the end, the officer waves me toward my gate.

Stone Soup

Though I still have a month left before I complete my 90-day protocol, my personal verdict on microdosing is already in: it helps. I feel good, better than I have in a while.

At our last integration session, Po did a check-in where she rescored my presenting symptoms and complaints and compared the new scores to the ones I’d initially given her. All my symptoms—including headaches, back pain, irritability, and anxiety—had gone down.

Today, perched on a windowsill of our living room, I realize that even though I’m sad my son needs me less than he did when he was younger, I’m proud of him. He’s becoming his own person—thoughtful, responsible, and generous. On the floor beside me, I see stacks of old books he’s gathered in boxes to donate to our local library. I pick one up: Stone Soup, which I remember reading to him as a toddler. It’s about three hungry soldiers who ask some villagers to feed them. When the villagers refuse, the soldiers promise they can make a magical soup out of a large stone. All they need is a pot, kindling, and water. Intrigued, the villagers lend them a pot and help them find a stone. Then, offhandedly, the soldiers request other ingredients—a hunk of cabbage, a couple of carrots, potatoes, leftover bones, garlic—until a delicious soup results. In the end, the villagers are amazed at how the soldiers produced such a mouthwatering meal from a stone.

Gazing out the window, I find myself wondering if it’s the psilocybin creating the positive shifts in my marriage, or the other ingredients. Po’s a gifted guide: in our integration sessions, we’re exploring the feelings that arise when I overreact to my husband, and she’s helping me open my mind to a more holistic view of my own physical health. I’ve incorporated pauses into my daily routine, regularly tuning into body sensations and emotional states—which connects me with a paradoxical experience of purposefulness and surrender. Writing down my small personal wins at the end of each day has amplified my faith in my ability to change—which increases my confidence and makes it easier to overcome the urge to criticize my husband’s dietary choices or absentmindedness. The fewer petty conflicts we have, the easier it is to reach out in bed at night and take his hand or remain receptive and available when he takes mine.

One of my colleagues notices the change in my demeanor at a work retreat.

“You’re looking cheerful,” he says during our lunch break.

“I’ve been microdosing,” I say.

He laughs and shakes his head. “Personally, I think microdosing is the new homeopathy. People convince themselves it’ll make a difference and then, because they believe it’s helping them, it actually does. Classic placebo effect.”

“You might be right,” I say. “But I’ll take it anyway.”

Placebo or not, maybe a pinch of psilocybin is the magical ingredient I’ve been needing to turn my stone soup into a nourishing meal.

ILLUSTRATION © 2ROGAN

Alicia Muñoz

Alicia Muñoz, LPC, is a certified couples therapist, and author of four relationship books, including Stop Overthinking Your Relationship: Break the Cycle of Anxious Rumination to Nurture Love, Trust, and Connection With Your Partner (New Harbinger Publications, 2022). Over the past 16 years, she’s provided individual, group, and couples therapy in clinical settings, including Bellevue Hospital in New York, NY. Muñoz currently works as a Senior Writer and Editor at Psychotherapy Networker and as a couples therapist in private practice. She connects with her readers and followers through monthly blogs, newsletters, and podcasts as well as InstagramFacebook, and Twitter. Muñoz is a member of the Washington School of Psychiatry, the American Psychological Association, and the Mid-Atlantic Association of Imago and Relationship Therapists. You can learn more about her at www.aliciamunoz.com.