As major research institutions continue to uncover (or really, rediscover) the positive effects of psychedelics in treating a wide range of mental health issues, the need for competent psychedelic therapists is growing.
Here we cover the role of the psychedelic therapist, different types of psychedelic therapy, and how to evaluate a psychedelic therapist when seeking a treatment professional.
The Role of the Psychedelic Therapist
A psychedelic therapist is typically involved in all phases of a therapeutic psychedelic experience, including preparation, during the treatment itself, and afterward during the integration phase which can last anywhere from a number of hours and days to several months or more.
The therapist is charged with creating an ideal set and setting for the entire experience that creates the best possible therapeutic outcomes.
According to the MAPS guide for MDMA-assisted therapy in treating PTSD, “[t]he therapists act as empathic listeners, trustworthy guides, facilitators of deep emotional expression and catharsis, and supporters of the participant’s own inner healing intelligence.”
In many ways, the psychedelic therapist’s job is to follow the patient rather than guide them as they explore previously unrealized self-perceptions. They do provide guidance throughout treatment, but it’s usually in an attempt to provide the patient with more options to choose from rather than attempting to direct them to think or feel a certain way.
Types of Psychedelic Psychotherapies
- Ketamine-Assisted Therapy for Depression. Ketamine is one of the few psychedelics medicines that’s currently legal in the United States, Canada, Europe, and other places around the world. It’s shown amazing promise, with nearly an 85% success rate by some estimations.
- MDMA for Post-Traumatic Stress Disorder (PTSD). Researchers in the United States are currently conducting Phase 3 trials of MDMA-assisted PTSD treatment. Preliminary results are extremely promising and, if approved, could be available to the general public as soon as late 2022 or early 2023.
- Psilocybin for Depression and Anxiety. Preliminary studies at Johns Hopkins University have shown sustained decreases in anxiety and depression in patients with late-stage, terminal cancer after undergoing psilocybin-assisted therapy.
- LSD-Assisted Psychotherapy. Building on the hundreds of studies conducted from the 1950s to the 1970s, researchers are currently in Phase 2 trials with a number of LSD-assisted therapies. These focus primarily on anxiety-related disorders but also include some trials exploring spiritual and creative uses.
- Psychedelic-Assisted Addiction Therapy. A number of psychedelics are proving effective in treating chemical dependence. Ibogaine therapy is a promising addiction treatment, especially for opioid abuse, and a number of clinics around the world have seen wonderful success in recent years. A number of international researchers have also begun to explore the possibility of ayahuasca-assisted therapy to treat dependence.
Evaluating a Psychedelic Therapist
In 2017, Janis Phelps developed a guide outlining the core competencies of a psychedelic therapist:
- An empathetic abiding presence. While empathy is a quality nearly all mental health professionals must have to do their jobs well, a particular kind of empathy is well-suited to psychedelic therapists.The ability to have a clam, abiding empathetic presence throughout the entire process is essential to creating a safe and effective therapeutic environment.This means things like the ability to maintain one’s composure and balanced attention, mindfulness, empathetic listening, “doing by non-doing”, responding with calmness, and equanimity.
- Trust enhancement. A psychedelic therapist should inspire trust in their patients. This means that not only should they view the therapist as a trustworthy guide, they should also inspire trust in the patient’s own inner healing capacity.They should also acknowledge the fact that effective treatment sessions often come with paradoxical and radically unexpected moments that must be trusted as part of the process.
- Spiritual intelligence. Beyond the expertise in psychological principles, psychedelic therapists also have a grasp of mystical experiences and the spiritual power of psychedelics.This includes knowledge of and experience with things like the transcendence of the self, a propensity towards equanimity, fully appreciating impermanence, and experiencing unconditional love both within and far outside oneself.
- Knowledge of the physical and psychological effects of psychedelics. All practitioners of all kinds of medicines should obviously know as much as possible about the substances they use to treat their patients.But beyond the immediate psychological and physiological effects, psychedelic therapists must also be fully competent in screening for eligible patients. This means they should have knowledge of all contraindications of treatment, such as drug interactions and current mental health status among others.They should also be able to create the ideal set and setting for patients based on their individual needs and goals and be fully prepared to assist patients with all the potential challenges they might face before, during, and after a psychedelic experience.
- Therapist self-awareness and ethical integrity. According to Phelps, a psychedelic therapist should exhibit the following qualities:
- Self-awareness of personal motives for this work;
- Integrity in protecting boundaries with the volunteers;
- Well-developed capacities for building therapeutic alliances;
- A capacity for personal self-care, which protects both the therapist guide and the volunteers.
- Proficiency in complementary techniques. Psychedelic therapists are not one-trick ponies. They should be trained in adjacent and complementary techniques, even those outside of their primary training in psychoanalysis as therapists.Some examples include holotropic breathwork, meditation, guided affective imagery, therapeutic touch, shadow work, sensorimotor therapies, stress inoculation, and others.
How to Find a Psychedelic Therapist
At the time of this writing, nearly all psychedelic medicines are not available to the general public without being enrolled in one the ongoing FDA-approved studies. Many therapists who do use psychedelics in their practices are therefore forced to do so at the risk of being caught and losing their licenses and possibly going to prison.
Therefore, we can’t post any names here at this time, but we can offer some guidance on how to find a therapist if you’re exploring psychedelic-assisted treatment.
The best way to do this currently is to enter the psychedelic enthusiast community in some way or another. You can attend a psychedelics-focused conference or event. You can also find psychedelic meetup groups in your city. Many holotropic breathwork practitioners, a completely legal profession, are also familiar with psychedelic therapies and/or are connected to networks of psychedelic therapists as well. You can also check out this thoughtful guide from Psychedelics Today on finding ways to participate in psychedelic therapy through clinical trials, legal alternatives, and legal international retreats.