The Power Dynamics of Psychedelic Therapy

“Healing is the result of love. It is a function of love. Wherever there is love there is healing. And wherever there is no love there is precious little—if any—healing.”
—M. Scott Peck

I write this because I want people who have gone through the process of the clinical trials, or in the grassroots underground psychedelic movement, to not feel alone if they felt silenced, controlled, or interpersonally hurt. I was deeply hurt and so were several people I love. The way we market and consider the narrative around psychedelics is crucially important. In this essay, I critique the MAPS model, because it is the most widely accepted form of psychedelic-assisted therapy. There needs to be a more nuanced discussion of their harms and benefits, as well as more depth of understanding of how they may be best utilized for each particular person. Because these medicines are so potent and vitalizing, they give us a great chance to open our eyes and see what is really going on here in this world, and to grow beyond old ways of relating that keep us disconnected and separated from one another.

Heal Alone

“Here are your eyeshades, Tara. You can lay on this bed and relax. I will bring the medicine to you in a moment.” My eyes scan the room. There is a tapestry of the Buddha in front of the bed, a red hand-knotted rug below my feet, hanging totems, and a wooden statue of mushrooms.

I look at the black Mindfold eyeshades and notice a flash of queasiness. They remind me of being at Disney World as a child and wearing 3D glasses to watch a film, which I never enjoyed. Compared to the aesthetics of the room, they also look ugly and cheesy. But after watching Fantastic Fungi, and listening to many podcasts, I understand this is how psychedelic-assisted therapy is done. I sit down and wait for the medicine. It arrives. I swallow the medicine and lay back and pull the blanket over my body. The eyeshades cover my eyes and everything turns black. The guide sitting for me presses his finger on the power button of the remote to the sound system, and the room is filled with a light sound of peaceful meditation music.

I start to feel pleasure and heat waves course through my limbs. I begin shaking. There is an electric hum thrumming through every cell of me, and I know from reading Waking the Tiger by Peter Levine that I must be shaking the trauma out of my animal body. Yet beneath the surface, layers beneath my conscious self, a small but excruciating doubt about this healing process is taking root.

It took four years to finally let that feeling in my intuition emerge—and what I learned changed my life and what I understand about the role of therapy.

Eye-shaded and inward-focused, this picture shows a method of healing that recreates what most people in this culture feel most of the time: alone. Perhaps unconsciously, that’s how psychedelic journeys are by design. This loneliness is not merely experienced by those who seek healing, but often the healers, too.

The general protocol for psychedelic-assisted therapy as I experienced it, and which is true in many schools and trainings, is the following: the client enters a room that is aesthetically pleasing, with plants, artwork, comfortable furniture, and a bed to lay on either in a house or in a clinical setting. They ingest ketamine, MDMA, or psilocybin. As the medicine begins to take effect, they pull the blanket over their body and put on eye shades, turn inward, and “heal.” The therapist or the guide is there to support the client, often by gently shepherding them inward, and the music serves as a conduit for an emotional experience with their inner healer. This experience lasts between two to six hours.

This process can be beautiful and revelatory, yet it is often recreating a story: that people need to figure out what is wrong with themselves through self-exploration. I’ve gone through this process many times, and it is through my lived experience that I have formed a different opinion about what is happening. I thought I was healing each time I went “in.” I had mystical, profound, somatic insights, downloads, and connections to celestial and underworld realms deeply hidden in corners of my psyche and body. I felt the full range of emotions, experienced grandiose extrasensory perception, and yet I did not truly feel connected to myself, or others. Because I was so convinced that having and integrating these big experiences was in itself healing, I failed to see how wounded I still was in my day-to-day experience.

The psychedelic container is important. The commonly accepted phrase is “set and setting,” aka the people you’re with and place you’re in, as well as the mindstate you’re entering the experience with. And yet what does this model actually tell us about the perspective of healing of those who created it?

Stanislov Grof, a cofounder in transpersonal psychology with Abraham Maslow, developed holotropic breathwork with Christina Grof after LSD became illegal in the ’60s. The psychedelic-assisted therapy model emulates the set-up of holotropic breathwork with the belief that deep self-exploration can be immensely healing. Although I believe there are many benefits to self-exploration, including learning to feel our emotions and senses specifically, many of our human wounds that shape lives of suffering are relational wounds. I am going to say it again. Our most deeply ingrained wounds as humans are relational. Relational wounds cannot be healed through going inside ourselves; they are healed in emotionally intelligent, loving, non-coercive human-to-human relationships.

I went fully into this process for four years; I wore the badge of doing the “work.” There was a lot from my Evangelical background, my history with bulimia nervosa, and abusive relationships that I needed to understand on a deeper level. It was essential to my process as a healer to continue to unwind my own personal emotional, relational traumas, to ensure I was supporting the people I work with out of integrity. And yet I was actually being drawn further and further away from my authentic self, and rather than finding deeper healing, my romantic relationship and community relationships suffered. It is painful to look back now, and see how all the inner work was a sophisticated show that perpetuated my low self-esteem and reinforced relational dynamics that harmed me.

I was in a reenactment of a chronic struggle I had in Evangelical Christianity: needing to say the right prayer to save me from an eternity in hell. Or, my childhood trauma of feeling like at any moment, if I didn’t do what I was supposed to do, I could be shamed or punished according to the rules of obedience training my parents learned from Dr. James Dobson and Focus on the Family. If I set the right intention this time, will I finally be healed? If I do the journey, “right,” will my guide like me? In all of these experiences, the message beneath the message was find out what’s wrong with you and fix yourself, you’re the problem.

This model also harmed others I deeply care about and love, which I briefly discuss in my last essay The Hidden Harms of the Psychedelic Renaissance. There are countless other stories from fellow friends and new acquaintances, who’ve told me about the ways this model re-enforced their inner beliefs and wounds that something must be wrong with them because the experience didn’t heal them. Or because they didn’t live up to the subtle or explicit expectations that their therapist and the model of therapy expressed. As one example, the MAPS protocol manual offers this suggestion in response to a client wanting a change in the music:

“If you want to ask for a change in the music that’s fine, because sometimes a piece of music can be distracting or might not fit well with your process. If you find yourself wanting a change in the music, we encourage you to first reflect on whether this desire is motivated by wanting to move away from an uncomfortable feeling or memory that the music is stimulating. If this is the case then, rather than change the music, we encourage you to experience and explore the uncomfortable feelings or memories, rather than attempt to stop them by removing the music that is stimulating them.”

From a cursory reading, this may seem like a normal way to relate to people in therapeutic spaces. But even if it’s normal, is it okay or actually beneficial? In my reading of this text, the therapists have an agenda for the client to process in a particular way. Although in the end, they are meant to let the client turn the music off if they really don’t want it on, the client’s initial disinterest in the music is met with encouragement from the therapists to check in with themselves and make sure they are not avoiding an uncomfortable feeling or memory. In my view, this creates a power dynamic between the therapist and client. It places the therapist in the seat of an expert. Rather than the therapist innately trusting the initial impulse of the client for the change in music, there is an element of mistrust. This kind of questioning of the client will often reinforce their relational and childhood wounds by making them doubt themselves, something many people with childhood trauma already struggle with.

I also wonder, as the psychologist Andrew Feldmar has suggested, if this setup protects the therapist from having to walk into unknown territory with their client, and if not having a script for what is supposed to happen is scary for them. What if the therapist doesn’t have the answers, or cannot fix their clients? What then is the relationship between therapist and client about? In my experience, agendaless presence from another human being is healing. In a world of therapy that is mostly about tools, techniques, and treatment plans, many therapists themselves have not experienced agendaless presence. If a therapist’s value is based on the treatment plan and successful healing of the client, this places an enormous amount of pressure on the therapist, which then prevents them from being themselves. Therapy can then easily become a performance where the therapist and the client are having to act, rather than connect through the authentic truth between them. I am a therapist, and I’ll tell you honestly from my past experience early on in my career, that many of us therapists hide behind the role of healer. Beneath that role is eons of pain, heartbreak, and feelings of lovelessness.

The MAPS research program reinforces this type of therapist-client relationship that I’m concerned about. Because MAPS needs FDA approval for these medicines, their protocol is scientific. Here I have another fundamental qualm as a woman. As a woman, and a feminist, I am tired of our society only taking things seriously if they are “proven” by science. Feminist, poet, essayist and filmmaker Susan Griffin’s book Woman and Nature: The Roaring Inside Her makes it utterly clear that the progression of science has in many ways been at complete odds with more feminine, intuitive ways of being. She details this in exquisite and painful detail as she maps the history of scientific discoveries alongside the burning of Joan of Arc and other witches beginning in 1383 through 1945 when the atomic bomb destroyed Hiroshima.

It is not that I am against science as an epistemology, but much has been done in the name of science that has catastrophically disconnected us from our humanity.  I believe that the pressure from our cultural systems to convey psychedelic psychotherapy as mostly a scientific endeavor, rather than one focused on poetics, beauty, and human flourishing, is in itself problematic. This is an ethical issue. Science can, and must, be one aspect of our research of psychology, but only with immense discussion, conversation, and nuance on when, how, and in what ways. Otherwise, it becomes another dogma like religion, that makes individuals into a means for the scientific end goal, rather than ends in themselves. Human beings are not science experiments. I do not like being treated like a science experiment. I am not an experiment. I am a living, breathing, human. You are too.

We all long to feel a sense of deep belonging, love and connection to our humanity. Not only did many of us not receive this when we were little and first entered the world, but our human history is also fraught with this interpersonal violence which leaves us isolated and alone. The psychedelic-assisted therapy model fails to accurately apprehend this relational truth, and in fact, often denies it. This is a learning opportunity. From here, we can begin to develop a robust ethic of care in these vulnerable spaces by attuning more to the relational field in psychedelic containers.

The Worship of Experience and Childhood Trauma

I kept going into medicine experiences and received huge insights about my life. I would connect to my body with an incredible increase in my capacity for interoception, as well as a multidimensional connection to Jesus, Mary Magdalene, and other spirits, allies, and guides. I accessed memories that were epigenetically transmitted to me; ancestral traumas that had been hidden. This is all valuable, and I do believe there is a place for reconnecting to these multidimensional planes and embodied experiences. But, I want to be clear that transpersonal experiences and even these embodied experiences did not support me in reclaiming my sovereignty as a human being in this plane of existence, right here and now.

As a psychotherapist, I’ve come to see that many of the people I work with who struggle with OCD, anxiety, depression, complex-post traumatic stress disorder, eating disorders, and addiction have deep childhood and cultural wounds stemming from people and systems that hurt them. Many people with childhood trauma specifically don’t know the experience of what it means to be respected, cared for, and taken seriously by another human being, which makes for very fragile interpersonal territory between them and their therapist. In my personal relationship to my therapists, I too, have traversed this fragile interpersonal terrain.

Many of my revelatory experiences, insights, and connections to celestial realms were all undergirded by a need to “perform,” and do my healing journey “right.” I recognize now that this dynamic was happening in nearly every healer/therapy situation I’d been in, long before I entered the psychedelic renaissance. I believe now that psychedelics accentuated a dynamic that is there in psychotherapy at large, with or without medicines.

Beneath the need to perform and do the journey right, was a deep belief that I was bad and unloveable in relationship to other people. I would never be able to heal this wound inside of myself. I needed to heal it in multiple authentic relationships—romantic, therapeutic, and otherwise. Mature human relationships were not available to me when I first underwent psychedelic-assisted therapy, or before. In fact, the first Counseling Center I worked at after my graduate school was run by leadership that was deeply manipulative, coercive, and emotionally abusive—an all-too-common set-up in mental health clinics.

My Experience

Here is an example of how it often went for me:

I am lying down with eyeshades on.

This music is loud, too loud. I’m too scared to say anything, though. My guide did choose the music, and his choice of music is intentional and is meant to heal me, so I will go along with it. Gosh, I wonder if my guide is bored right now. Am I doing this right?

I can feel that my guide feels that me feeling my repressed anger will heal me. Okay, I guess I’ll start to feel anger.

I can sense that my guide doesn’t like it when I avoid doing “deep” inner work. Okay, I’ll keep feeling rage, sadness, grief, despair. Great. He likes it. He’s supporting me. I can feel he’s satisfied and thinks I’m doing the “work.” I can also tell he doesn’t like when I take the eye shades off. Even though I do not want them on, I’ll keep them on because that is what I am supposed to do. Alright, I guess I’ll keep trying to figure out how to heal on my own, and do what I think my guide wants me to do.

This therapeutic arrangement, the choreography of most psychedelic-assisted therapy, reinforces many people’s earliest wounds. A wound born from being trained to feel their problems are inside them, need to be figured out inside of them, and that relational trauma is something they’re supposed to figure out by themselves rather than

in relationships with people and a culture that supports their flourishing and aliveness. This perspective has deeply unsettling ramifications on a collective social level, including the perpetuation of classism and other social inequalities. Neşe Devenot writes on this extensively.

That quiet voice within me, beneath the outwardly big experiences that seemed healing, longed to just feel loved by another person for who I am. Only later would I come to know that voice as a direct line to my truth, as it was mirrored in a very different type of therapy.

In my next blog, I want to explore how vital connection, love, belonging, and having the space to be our true selves in relationships with other people is to our healing and becoming truly human.

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