The risk for abuse exists in every possible therapeutic setting, from a comfortable office to a ... [+] colorful underground ceremonybut the stakes are considerably higher when a client is under the influence of a psychedelic.
Psychedelic therapy is everywhere: on the covers ofmagazinesandnewspapers, the subject of recentbest-selling books, inTV showsanddocumentaries, and in the pitch decks and business plans of dozens of public companies keen to hawk it as the solution to the worlds mental health woes.
If youre in the echo chamber, it can be easy to get lost in the noise.
There is no doubt that psychedelic therapy can have a profound impact on individuals suffering from mental health issues like depression and PTSD, but while research on the subject has never been so eagerly pursued, its not a panacea, and it doesnt come without risks.
One of the risks currentlybeing discussed more openlywithin the psychedelic community is therapy abuse, afterallegationsof sexual misconduct were recently brought against Aharon Grossbard and Francoise Bourzat in an essay inMad In America.
[Psychedelic] therapyabuseincluding therapists and doctors having sex with clientshas a history that reaches back to the early days of LSD, but you wouldnt know that reading [Michael] Pollans account or listening to todays psychedelic proselytizer, writes Will Hall, therapist and therapy abuse survivor in the piece.
To be clear, the risk for abuse, whether mental, verbal, physical, or sexual, exists in every possible therapeutic setting, from a comfortable office to a colorful underground ceremonybut the stakes are considerably higher when a client is under the influence of a psychedelic.
Even where mistreatment doesnt include sexual contact, harm from emotional betrayal can be just as devastating, writes Hall, who was contacted for this piece but didnt provide a comment.
Therapists have an enormous special duty to protect their clients from that betrayal, he writes. When you add psychedelics, the risks only get magnified.
How safe will a client feel in the hands of a therapist, guide, or shaman when theyre opened up by a powerful psychedelic drug, especially if they are navigating intense trauma? The answer to that question will determine whether they leave the session feeling better or worse than when they arrived.
Psychedelics can be, literally, incapacitating, says Dr. Clancy Cavnar, a clinical psychologist and co-founder at the non-profitChacruna Institute. This means that the therapist must take full responsibility for how the session proceeds, as the client is too intoxicated to make rational choices.
For people who have been traumatized by authority figures, being highly dependent on an authority figure during psychedelic therapy could be frightening, and potentially re-traumatizing, she says.
If a therapist is aware and caring, these issues can be mitigated, clarifies Cavnar, but for therapists with unexplored shadows and no supervising body to sanction them, the power differential could lead to an abusive relationship.
The outcome could be devastating for the client: They may cease their quest to heal if they are abused in the healing domain. They may be frightened away from plant medicines or other healing modalities because they are associated with the abuser. They may suffer PTSD from the treatment they received, necessitating healing on top of their original complaint.
While Cavnar says its impossible to say how common psychedelic therapy abuse is, survey data self-reported by therapists suggestsnine to 12 percentof mental health professionals have had sexual contact with their patients, however data on the subjectis scarce, and estimates vary. That number does not account for abuse that might take place in underground psychedelic communities and groups, where one cant exactly file a complaint.
Due to high levels of shame and guilt, victims dont come forward, says Bia Labate, PhD, co-founder, and executive director at Chacruna and the public education and culture specialist for the Multidisciplinary Association for Psychedelic Studies (MAPS).
Labate says there are several misconceptions about psychedelic therapy, including the idea that a licensed practitioner is less likely to commit abuse because they hold a license.
Its also an illusion to think that that abuse is something that is related only to medicalization and corporatization of psychedelics, and that it does not happen among Indigenous people and in traditional contexts.
While its hard to measure these things, Labate says 25 years of fieldwork and anecdotal evidence obtained by Chacruna on ayahuasca ceremonies shows that sexual misconduct is pretty prevalent in those settings.
Another misconception about psychedelic therapy, according to Cavnar, is that abusive behavior would be reported and dealt with accordingly in such a woke community. That, she says, is rarely the case.
In an emerging industry trying to avoid negative press, the open discussion of an issue like abuse is seen as a potential threat to the advancement of approved psychedelic medicine, and could potentially bring legal attention and repression to underground communities.
Fear aside, the psychedelic community needs to be aware of bad actors and use its own informal system to get the word out about providers who are abusive, says Cavnar.
Since Halls essay has been published, some members of the psychedelic community have responded with statements, includingMAPS, theCenter for Consciousness Medicine, andDr. Phil Wolfsonof the Ketamine Research Foundation. Anopen lettercalling for added measures to prevent harm and abuse within psychedelic communities was also published and is signed by more than 200 therapists and practitioners.
Independent of how abuse occurs in the psychedelic community, Labate says its important to consider each case while doing everything to protect victims and survivors"and, of course, do all we can to prevent such abuse from happening in the first place.
MAPS has published a code of ethics for psychedelic psychotherapy, while Chacruna offers several resources on the subject, including a guide to raising awareness aroundsexual abuse in ayahuasca circles, as well aslegal resourcesfor victims and survivors. Labate says it has operated as an informal hub for complaints and support for victims, but the organization is not really well structured this way.
We think that raising the conversations around these topics is fundamental, and we must collectively address it andengage in discussions to identify how cultural mechanisms can be developed, she says.
We must find a way to foremost tend to the needs of survivors, and when appropriate and possible, offer pathways of repair for repentant abusers who are reformed and wish to return to the community. Knowing where that balance is, is the million-dollar question.
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