Today, the idea of psychedelic therapists being required to consume the drugs that they prescribe may seem ridiculous. Not so long ago, it was standard practice, and it may be making a resurgence.
Go back about 70 years, and you’ll see that the scientists who were developing pharmaceutical drugs were often the first ones to test them out. In fact, the first hypothesis as to the medical benefits of LSD was that it could help doctors experience psychosis. They believed that taking the drug would allow them to gain insight into the minds of their psychiatric patients.
Fast forward to today, and it is considered malpractice for a doctor of any kind to prescribe themselves drugs. It is widely agreed that drugs used for the treatment of medical conditions, especially highly regulated substances, should only be tested in a strict clinical environment.
Psychedelic medicines, however, may be bringing back the idea that psychiatrists and therapists should be trying the drugs that they are prescribing.
Throughout all of history, up until now, the people facilitating psychedelic experiences experimented with the medicines extensively. In traditional cultures that use psychedelics as part of their medicinal practices, it is often believed that the compound is the primary guide and teacher. In other words, the healers learn from consuming the medicine instead of sitting in a classroom listening to a more experienced healer.
Shamanic apprenticeships often consist of a high volume of psychedelic experiences. On the contrary, the Western practice of psychedelic-assisted therapy will require guides to complete courses that are largely digital. So, the question emerges: Should psychedelic guides be required to have their own psychedelic experiences?
Some would argue that it does not work within the Western medical model. Furthermore, it would be difficult to require anyone to consume psychedelics.
Currently, many of the doctors and scientists supervising psychedelic trips during clinical trials have never consumed the compounds themselves. So, it does appear that these drugs can have profound effects without the guide having intimate knowledge of what a psychedelic experience is like. However, this is completely different than the way it has been done for thousands of years.
Not only are traditional psychedelic healers well accustomed to psychedelics, but they often take the medicine alongside the people they are working with. In Shapibo tradition, the shaman was actually the only one to drink ayahuasca during a ceremony. It was believed that they could energetically heal ailments by dropping into the realm that ayahuasca allows them to enter. Today, due to consumer demand, Shipibo ceremonies now have both the shaman and participants drinking the South American psychedelic brew.
So how do we know if the new way of psychedelic treatment will have unintended consequences? Frankly, we probably won’t until a few decades from now. The question then becomes— How does the industry embrace different approaches while ensuring that people are getting safe and beneficial treatment?
The state legalization laws in Oregon and Colorado attempt to allow these different schools of thought to co-exist. For example, in Colorado, the cultivation, use, and gifting of psychedelic compounds was decriminalized with the passing of Prop 122. Though it is illegal to sell psychedelics, traditional-style healers can charge for their facilitation services. This allows them to practice their craft how they see fit.
The pharmaceutical route to psychedelic access is less likely to be so inclusive. It will be incredibly difficult to convince regulatory bodies, such as the FDA, that therapists administering and supervising psychedelics-assisted therapy should be consuming the drugs themselves. Also, some experts suspect that psychedelic therapy will eventually be something that all therapists will be trained to administer this class of drugs. If this is the case, it is unlikely that training will include a psychedelic experience for all the students.
It is possible to train anyone in harm-reduction techniques, regardless of whether or not they themselves have experienced a psychedelic trip. Harm reduction refers to the reduction of psychological distress and other potential harms that could result from consuming psychedelics. However, there may be limitations to what a guide can help their client accomplish during their trip without having intimate knowledge of the psychedelic experience.
The term itself— psychedelic guide— implies that the person is guiding their client through the experience. In traditional practices, a shaman can guide the trip in a certain direction— perhaps helping the client face difficult emotions or past traumatic experiences that they are trying to avoid. It can be beneficial to have a guide who knows how to do this. That is where the benefit of the Western approach is limited.
Someone who has never had their own psychedelic trip will not be able to guide someone through a trip as intricately as someone who is more experienced. Even someone who has had a few of their own experiences is limited in their ability to do this. As a result, the person undergoing treatment is largely left to navigate the unfamiliar landscape by themselves. This, however, does have some similarities to the shamanic experience.
Some traditional practices allow the person to explore the psychedelic realm with little outside influence. This can prove more challenging but also allows for the person to take responsibility for their own healing, which is a common lesson with psychedelics. Where the shamanic and Western techniques differ is that the shaman is equipped to help if a person does need it. A therapist who is not familiar with the psychedelic experience may have more trouble dealing with these situations, which can occur.
Whichever school of thought you have more faith in, they will both continue to exist in the psychedelic healing space. The Western school of thought, however, will be more widely available. Shamanic healers are, and will continue to be, far and few between in countries like the US, Canada, and England. On the other hand, psychedelic services based on the Western school of thought will be available through insurance companies in the US in the near future.
As mentioned before, the implications of this new psychedelic practice will not be known for some time. Shamanic practices certainly have more history behind them. However, there is little to no empirical data to prove their efficacy.
The debate over best education practices for psychedelic therapists is not likely to end anytime soon. At the end of the day, it should be left up to the individual to decide the specifics of their psychedelic experience. Unfortunately, not everyone is going to have that luxury. The Veteran with PTSD who isn’t able to work or the single working mom won’t have the time and financial resources to access whatever form of treatment that they desire.
How these systems are set up is going to have major implications for the millions of people who could benefit from psychedelic-assisted therapy. Going forward, it is important for the people designing the systems for this new form of healthcare to consider all available routes, even if they are unconventional, to ensure the best experience for everyone.