From The Antenna: A Professional Blog Series by Dr. Jodie NewDelman

A Path Through Darkness

The bison stands majestic on the vast plains of North America, an enduring emblem of survival against overwhelming odds. Once teetering on the precipice of extinction, these magnificent creatures have resurged through concerted conservation efforts; their thundering return a testament to the power of resilience. This revival narrative is a powerful metaphor for psychedelic medicine. Like these great beasts, psychedelic therapies were nearly extinguished in the long winter of prohibition but now flourish as ongoing research continues to reveal new healing potentials across a spectrum of recalcitrant conditions, each with the central theme of ‘stuckness’.

Facing Storms

When a harsh snowstorm blows across the prairie, rather than flee, bison turn directly into the inclement weather. Beyond a symbol of resurgence, the great beast is a testament to outlandish bravery and the impact of focused attention on the most threatening obstacle in our path. Through the practice of presence in the midst of crisis, like the bison we discover our resources. Each subsequent storm poses new challenges that press growth at the edges of capacity. Courage paired with learning fosters resilience.

This “turning-into” approach builds tolerance for distress while facing discomfort. By reorienting TO, rather than AWAY from pain, we exercise a critical coping muscle in metabolizing life’s inevitable adversities. Bison understand that there will be other storms to weather. Across disciplines, stress physiology is entangled in diagnosis. What our clients need most is NOT shelter from storms, but supportive partnership in facing them directly.

A core tenet of Hayes’ Acceptance and Commitment Therapy (1982) is “psychological flexibility” (e.g. perspective taking, openness, and creative intelligence.) As a cognitive construct that has evolved in synchrony with brain science, it posits that pliancy fosters resourcefulness in braving the “storms.” Bison medicine does not differentiate the mind and the body. Rather, it understands that all physiologic processes are integrally systemic and tether health and emotional self regulation.

Avoiding Storms

Conventional medicine, in its drive for clinical effectiveness, commonly emphasizes a swift dampening of symptoms. On the surface, it is rational to counter pain, sleeplessness, and/or anguish in one form or another, with opiates, benzodiazepines, SSRIs, etc. However, the prescriptive eradication of discomfort is so embedded in western healthcare, that it can unintentionally suppress or distort the body’s natural signaling that a dynamic process has become imbalanced. Medicine practice therefore is actually harmful when psychological, relational, sociological, and cultural factors are inadequately accounted as contributors to physical chief complaints.

By prioritizing approaches that impart temporizing mechanisms when a condition is more chronic than acute, recipients of contemporary western care have speciously learned that turning off pain (or psychologically turning AWAY from obstacles in general) constitutes a solution. What is the trade-off? Why not accept swift, repeated symptom relief, numbing, and distraction? Why not whack-a-mole our dis-ease until we are again a victim in its grip? What’s the harm? Well, by definition, chronic conditions of the body (and rigid patterns of the mind) persist. In fact, chronic conditions are conditioned to be chronic!

The “Stuckness” Problem

Escaping pain is rational! But as an overused default mode, such avoidance, over time, perpetuates illness, deepens fear, and inflames our unique problems. As an example, in a prior context such as childhood abuse, a physically, emotionally, or relationally avoidant response was probably life saving! Learned protective habits for survival of legitimate threats are highly adaptive during an earlier developmental period. In adulthood though, these adaptive avoidance habits tend to distort healthy relational mindsets and behaviors. When applied to chronic physical pain, which is intimately tethered to emotional experience, the same holds true. Soothing a flare without attending to its complex systemic mechanism, is a recipe for symptom return.

Across clinical domains, conventional treatments with good intention may actually reinforce “canalization” — those deeply habitual neural pathways carved reflexively to avoid discomfort, be they mental or physical. Short sighted interventions produce quick relief, while strengthening the recurrence cycle. “Experiential avoidance,” operates progressively, like in the case of phobia. It is learned, over-applied, and behaviorally reinforced in contexts where there is little to no danger. Based on older personal stories of victimhood, new encounters that are of moderate risk or even low risk are perceived as high risk, and provoke habitual worry spirals. Such misapplied safety-seeking patterns coagulate learned distorted thoughts with biochemical mechanisms that paradoxically deepen channels of suffering. Unless we mindfully appreciate and sufficiently value pain and anguish as useful information, we instinctively seek refuge from it.

Psychophysiology and Mindbody Wisdom

In the murky spaces between behavioral neuroscience, sociocultural context, and existentialism lies a web stretched over the relational field. “Stuckness conditioning” is multifactorial, context dependent, and attacks our physiology. In other words, stressors that manifest problems of the mind (like depression, PTSD, and disordered anxiety) have as much impact on the body as stressors that manifest as problems of the body (like autoimmune flares, insomnia, pain syndromes, etc) have on the mind. Thus, the physical conditions that impact our wellbeing and psyche do not efficiently yield to single-mode interventions. Rather, we respond and recover much more readily with prescriptions that un-condition (and accurately re-condition) functional regulation between mind and body.

Yet, the patient with as many needs as specialist appointments is left with the task of reconciling the guidance of disparate, even contradictory expertise. Among the vast majority of medical specialties, stress physiology is rarely featured as central or even significant. Like a stone in the shoe of all clinical disciplines, the underpinnings of stress and psychological orientation are an insidiously vengeful storms when dismissed. It is not metaphoric to define chronicity as recurring bouts of under-treated infection in the “mindbody.”

Attuning Clinical Practice with Neuroscience

Temporizing solutions are, of course, necessary depending on the condition. It would be foolish to dismiss relief measures as a component of care. From a 30-thousand foot view however, outmoded clinical paradigms are a significant culprit in patient disenchantment with the healthcare system at large. Bio-psycho-social care is often hijacked by quick fixes and algorithmic treatment templates that ignore individual differences, fail to collaborate across siloed specialties, and dismiss contextual allostatic contributors to illness. Bison medicine shows us these realities and prompts a deeper, more effective invitation to work with, rather than against the origin of pain, problem, and pattern in both physical and organizational systems.

Examining parallels in the healthcare system itself reveals “entrenched” systemic root causes traced directly to payment models woefully bereft of financial incentive to align medical care with modern behavioral neuroscience. The high cost of systemic impairment is evident in the “body” of the healthcare organization in terms moral injury, burnout, and existential illness in staff. In the patient population, healthcare organizational illness breeds cynicism and mistrust. Those who can afford alternative care, seek unconstrained interventions outside the prevailing care model. Those who cannot afford choice, become increasingly ill with chronic conditions. The demand for disruptive transformation is clear and ethical.

Professional Self-Awareness

The delivery of health and “whole-being” service depends on relational exchanges between people and their providers. In fact, in psychotherapy, therapeutic alliance is the strongest indicator of clinical outcome. As such, the most competent professionals in the healing fields are those who are engaged in their own ongoing personal work. With humility, they know the challenges of walking the same paths as their patients and clients.

A significant difference though, is that even the most client-centered provider has an authoritative or influential role. This power-differential means that safe and effective care depends on a provider’s recognition of potential interactional harm. As such, regulated professions are explicitly tethered to professional ethics practice and are subject to sanctions for exploiting the privilege of licensure. To this end, many (not all) reputable training programs of psychotherapy require students to experience their own psychotherapy as well as supervised experiential education around transference and countertransference. Practiced understanding and active use of these critical constructs are not only central to reducing harm, but foundational to process-oriented treatment. As mental health disciplines learn from our physical medicine colleagues, so ought medical providers grow knowledgable about psychophysiology and expand their edict to “do no harm” to the mindbody. The relational psychodynamics of care for vulnerable healthcare seekers adds both complexity and opportunity.

Experiential Medicine

Harnessing growth and recovery with neuroplasticity is a psychophysiologic process facilitated with non-ordinary (or expanded) states of consciousness. An evolving category of therapies prompt learning through “experience.” These are a wide range of approaches including (but not limited to) therapies assisted by psychedelic molecules. The merging of modalities (psychotherapy + psychedelic compounds) is a catalyzing treatment that reconditions coherence between the “mind” (behavior, mood, thoughts) and the entire central nervous system (including the brain). The approach It is not a cure in the traditional sense, but “makes way” by diffusing resistance and the rigid personal patterning that maintains calcified conditions. Expanded states that are activated in such experientially-assisted therapies support people through their own arduous excavation of core index events in life and help them reckon with the narrative and neural roots of rigidity. Facilitating these treatments in one-on-one or in group settings truly requires foundational experience in clinical self awareness, relational dynamics, and working with stormy abstract content.

Regardless of psychedelics, Bison Medicine is innate to all humans and represents personal agency in disentangling “dis-ease.” Slowly but steadily, integrated paradigms, stress physiology, and context-aware paradigms are quietly finding footing the healthcare ecosystem. Clinical professionals are becoming increasingly adept in the areas of behavioral neuroscience that relate to their disciplines. Deliberate patient engagement approach is potent and yields precious rewards. Beyond more effective health outcomes that reduce chronic suffering, reorientation to psychophysiologic paradigms emphasizes durability and offsets long term care costs.

Paradigm Choice

As humanity and the global therapeutic landscape deepens understanding of stress physiology, experiential care, and psychedelic medicine, the bison reminds us that renewal is possible. Turning into big scary storms grows strength and a much more effective path to resilience and whole-being. Even through the most devastating storms where confusion and doubt reigns, the steadfast beast inspires clarity about entrenched systemic conditions across cultural, organizational, and personal domains. In healthcare specifically, fear and vulnerability transform into a neuromodulating cascade of calm confidence when we choose to pair clinical partnership with mindbody wisdom.