Rerun: 5 Questions for Zach Skiles

In honor of Veterans Day we’re rerunning this interview with Zach Skiles that originally published Nov 29, 2021.

When Zach Skiles was 18, he joined the Marines. A year into his service, the 9/11 attacks took place. At the time, Skiles was stationed in Okinawa, where his unit was under investigation for having the highest suicide rate on the island. Here, Skiles tried psilocybin mushrooms for the first time with others in his platoon, an experience he felt brought them closer together. Then, in 2003, Skiles invaded Iraq, where his unit experienced hundreds of small arms and heavy artillery attacks. Skiles lost several friends, and after returning home to the U.S., he struggled. At first, he thought he could deal with his pain by himself, but after experiencing a period of homelessness, Skiles entered a residential treatment program for veterans. 

Now, Skiles is a clinical psychologist and a postdoctoral researcher working with the University of California at San Francisco’s Translational Psychedelic Research Program (TrPR). He’s one of many veterans helping connect fellow veterans with psychedelic treatment. Studies suggest that psychedelics, including psilocybin, ketamine, LSD, MDMA, and ibogaine could help treat the PTSD, depression, and drug addictions experienced by many veterans. (The VA also says it’s “closely following” this work.) The Microdose spoke with Skiles about his journey from the Marines into clinical psychology, and his work bringing psychedelic therapies to fellow vets.

What led you to pursue psychology, and what do you think your experience as a vet brings to your work?

There were guys in my trauma group that I was able to connect with, and I was told by the director there that I had a knack for psychology. I was like, This feels right, and I'm clearly able to help folks. There are a lot of really great people working at the VA who just don't have personal experience to draw from or any kind of knowledge about the veteran experience. For that, you need somebody who's been there. 

For example, a lot of well-intentioned clinicians want people to engage, to feel coalesced with the group, when in actuality, moving slowly is a cultural mandate in the military. As a new leader or even just as a lower ranking person, you're quiet when you enter a new unit because the cultural mandate is that you keep your mouth shut, you keep your ears open, and just watch how everybody else operates. Then you find your place. It’s one of those things you have to watch: someone's nervous system might go haywire in a crowded room, or somebody’s a little bit more quiet when they come into the room because they're new to the program. 

What aspects of psychedelic therapy might help treat veterans in particular?

In treating PTSD, psychedelics enhance your ability to bring up trauma and simultaneously see it from different angles. Everything feels new, more revelatory and connected. There’s the ability to take a step back and experience something in a totally new way. 

One of the cooler things about psychedelic assisted therapies is you're not only getting those cognitive pieces, but you're also getting somatic, cathartic experiences at the same time. For people who've experienced sexual assault or combat exposure, you cut off a lot of sensation from your body and reconnecting to it is actually one of the main goals of all therapies. Having that experience along with these cognitive pieces is something that they call a codex condensed experience — it’s happening in different constellations of the mind and body. 

Over the last few years, you’ve led groups of vets through psychedelic experiences in Mexico. How do vets hear about this opportunity, and what are the first steps?

It was all word of mouth — it's underground in that sense. I heard about it because I had a friend that I was in treatment with who started going to Burning Man, and he met other guys who were in the special forces. There was a four-month period where I was going to Mexico every weekend; the Mission Within has helped 450 US Special Forces veterans, and I personally have helped 90.

First, we do an intake process with folks, and a needs assessment and demographic assessment of what their life looks like. What are the long standing issues that they're wanting to address practically in their lives? Do they have a safe home place to go to after that experience? 

We would all congregate in San Diego and have a meal together. Then I pack everybody up in our van and drive across the border down into Mexico, usually on a Friday, and we’re down there through Monday. 

What’s the weekend like?  

On Friday night, we talk about intentions and have a group session, and then I administer ibogaine to the group. [Editor’s note: ibogaine is a stimulant found in the West African shrub iboga, which in large doses can produce psychedelic experiences. According to MAPS, there have been at least 30 fatalities associated with ibogaine in the scientific literature, so patients are closely monitored during treatment.] It’s group healing, so things are always in the same room together. Everybody gets hooked up to EKGs and oximeters and gets shown where the bathrooms are. We're usually up all night — ibogaine is a thirty six hour experience — and Saturday is what they call a “gray day.” Then, the medicine is still very much in their system; they're still having conversations with the medicine, so to speak.

In the evening, we prepare them to take 5-MeO-DMT the next morning. [Editor’s note: 5-MeO-DMT is commonly derived from the glands of Bufo alvarius, a toad that lives in the Sonoran Desert, though the compound can also be synthetically derived.] The psychedelic experience is about 15 to 20 minutes, and it's a very physically energetic and intense experience, so we coach them through power poses so that they remain present, doing some breathing exercises. In the morning, we would stay with each person, coaching them through surrendering to the experience, sitting next to them the whole time. A lot of guys who are U.S. Special Forces or Navy SEALs who are trained not to surrender — it’s a challenge. So there's something really powerful when they can feel safe and vulnerable. After the weekend, we have a weekly call-in group — a group therapy session to talk about how integration is going and how to support each other.

These therapies aren’t legal in the U.S. What drove you and other vets to seek out these experiences in Mexico?

There’s a bit of desperation; people have to leave the country to be able to get these therapies. These are folks who have spent careers in the U.S. Special Forces, with blast injuries or lesions on their brain. It's a group of folks who have tried every single therapy that’s offered in the United States and have come up wanting more. They had to leave the country in order to have a therapeutic experience, and not be arrested for it. 

It’s important to give guys an ability to have the most up to date therapeutic access, but in the U.S.; it’s also important for this to become regulated. We operate in the underground because that's the only place we can do this kind of thing. 

This interview has been edited and condensed for clarity and length.