Death practice

Death practice names a paradox at the center of some high-dose psychedelic experiences: the temporary loss of what ordinarily feels real can feel like dying, yet some participants emerge less afraid of death. The concept describes an experiential rehearsal, not proof of what follows death. Its meaning is shaped by the journey’s preparation and care, by what participants make of the experience afterward, and by the uncertainty that remains around its metaphysical interpretation.

The experience as rehearsal

Katherine MacLean, formerly a psychologist at Johns Hopkins, describes a high-dose psychedelic experience as death practice because participants may lose their familiar sense of reality, ego, and body. That process can feel like dying. The comparison is not simply a metaphor for intensity: the experience may bring a person close to an imagined boundary of death, while leaving them able to return and reflect on what happened.

In trials involving people with cancer, some participants reported that their fear of death had lifted or eased after such experiences. Several described approaching a precipice and looking across it before drawing back. Tammy Burgess, who was diagnosed with ovarian cancer at fifty-five, experienced what she understood as a serene and beautiful plane of consciousness, where she felt able to reach toward people she had known. She imagined that, when her time came, her life would go there, and found that prospect acceptable. These accounts give the rehearsal its emotional force: the participants do not merely contemplate death from a distance; they encounter an experience they interpret in relation to their own mortality.

Interpretation and the afterlife

Some participants understood what they experienced as evidence of a reality beyond the physical body. A New York University volunteer later described having become aware of another reality, an understanding that seemed to set her apart from people who had not undergone the experience. Such reports help explain why the journey could ease death anxiety, but the account presents them as participants’ interpretations rather than verification of an afterlife.

Patrick Mettes’s follow-up conversations with Tony Bossis show how this interpretation could become part of an ongoing process of meaning-making. Patrick understood his journey as a window onto something beyond his physical body and spoke of an infinite plane of existence grounded in love. In later sessions, he discussed his body and cancer as a kind of illusion. The account does not suggest that these convictions changed the course of his illness; it describes a psychological change in how he lived with it. He meditated regularly, felt more able to inhabit the present, and said he loved his wife, Lisa Callaghan, even more. Two months after the journey, while slowly dying of cancer, he told Bossis that he felt the happiest he had ever been.

Preparation, guidance, and care

The death-practice idea belongs to a broader framework for approaching powerful psychedelic experiences. Guidance for participants and guides addresses mental and physical preparation, medication interactions, intention, the stages of a session, frightening material, and post-session integration. Ethical guidance stresses consent, confidentiality, disclosure of risks, and the guide’s responsibility for a participant’s safety. These practices matter because the experience may make participants unusually open to suggestion; care and interpretation are not incidental to the journey.

Patrick’s trial illustrates how that framework could take practical form. After preparatory talking sessions, he was scheduled for two dosing days: one with a high dose of niacin as an active placebo, and one with twenty-five milligrams of psilocybin. For each session, he would spend most of the day lying on a couch with eyeshades and a curated music playlist, accompanied by two sitters, including Bossis. Patrick also received Bill Richards’s Flight instructions. Bossis encouraged him to trust the process and, if he encountered something threatening, to move toward it rather than flee. The arrangement did not determine what Patrick would experience; it supplied a supported setting in which he could meet it.

Ritual, integration, and limits

The account also places guided clinical sessions beside more overtly ceremonial practice. The narrator’s final psychedelic journey took place in an ayahuasca circle with a dozen strangers and a guide trained in the tradition passed through Leo Zeff. Singing, prayers and invocations, bells, rattles, and scented smoke helped establish a ceremonial atmosphere in a yoga studio far from the jungle. The scene shows how ritual can provide a social frame for an intense experience; it does not establish that the narrator’s journey was itself a rehearsal for death.

Across these settings, the central claim remains experiential and qualified. A journey may make the loss of ego and bodily identity feel like dying, and some participants interpret what follows as an encounter with something enduring. For others, the consequential change is less a settled belief about an afterlife than a reduced fear of death, a stronger capacity to live in the present, or a changed relation to loved ones. The concept therefore depends on both the intensity of the session and the work of interpreting and integrating it afterward; it offers no guarantee of a particular vision, belief, or outcome.