In many ways, treating phantom limb pain is still a guessing game. Doctors often prescribe conventional pain medicine and encourage acupuncture, massage, and virtual reality therapy. Lin is a research scientist at UCSD, so through the whole process he was surrounded by doctors and neuroscientists helping him navigate the ordeal. Lin tried mirror box therapy—using a mirror to reflect his one remaining limb and make it look like there are two legs.
“I would stare at the reflection—as if there was an extension of my original leg. It’s a really simple old trick. You’re doing it in a way to tell your mind that there’s a narrative where the pain that you’re sensing is okay—that it’s healed. But every time the mirror went away the pain would quite quickly start rushing back in. And it makes sense. It’s like, my brain has a story,” he says. “No matter what the new story was, I was still holding onto the old story.”
In an effort to rewrite his reality, Lin tried a number of things beyond what doctors recommended: Kundalini yoga, meditation. But nothing was working. Lin describes the depression that he slipped into as absolute despair. “If you feel excruciating pain nonstop, it’s like gasping for air—you just want some relief.” Pain medicine wasn’t doing much, and fears about addiction and dependence made him wary of opioids.
Lin knew many people involved in scientific research on psychedelics. Through the advocacy of figures like Michael Pollan and Tim Ferris, treating depression and other mental health conditions with guided drug trips is rapidly becoming commonplace. (Last year, Oregon became the first state to legalize psilocybin, the psychoactive compound in magic mushrooms, in a mental health context.) And more recently, research has been done on whether psilocybin can effectively treat various forms of chronic physical pain.
“My partner at the time suggested we go out to the middle of nowhere, with the mirrors and a heavy dose of psilocybin,” Lin said. It worked. “Within 30 minutes I was doing handstands. Literal handstands. I was free of pain. I moved my leg in and out of the sand in a way that I would see the moment when my amputation emerged, and I printed that into my mind and said, it’s okay. Over and over: it’s okay.”
Lin only took psilocybin that one time. He describes his pain going from 10 out of 10 to zero. But he’s also quick to say that it’s not magic. “There are so many things that go into this that are very important—I was in a good, safe setting with a partner who was ready to help me rewrite my story in a way that was focused on positivity.” But he warns that the ability to rapidly re-map your mind—otherwise known as neuroplasticity—comes with dangers, too. “It’s not like psilocybin is this purely positive source. It has so much to do with the setting, the intentions, the community. Neuroplasticity can be used in many ways, like getting people ready to go to war. You have to facilitate the positive outcome.”
Lin’s experience tracks with ongoing experiments that seem to suggest that a one-time use of psilocybin could help patients with chronic pain. Dr. Tim Furnish is the director of inpatient pain consult services at the UCSD Center for Pain Medicine, where he helped treat Lin after his accident. “Albert pretty much tried every drug that we would throw at these kinds of things,” Furnish says. “And nothing really did much of anything.” Lin came to Furnish after he had taken psilocybin and told him that the pain was gone. “That was noteworthy from the standpoint of someone who treats chronic pain. Not much that we do in terms of drugs to treat pain drops it to zero. That’s pretty unusual. We’re generally pretty happy when people have a 50% reduction in their pain.” So they started looking specifically at what psilocybin does in this situation. “We know that it alters these cortical connections in ways that might be similar to mirror box therapy. But is it essentially a supercharging mirror box, or is it doing something completely on its own that’s allowing altered cortical connections to reset themselves?” The answers to these questions could turn Lin’s powerful anecdote into a treatment option for anyone experiencing this kind of pain.