In this episode, Joe interviews Dr. Robin Carhart-Harris: founder and head of the Centre for Psychedelic Research at Imperial College London, founding director of the Neuroscape Psychedelics Division at University of California, San Francisco (UCSF), and founder of the Carhart-Harris Lab.
A legendary researcher, he talks about his psychedelic origins: studying Freud, Jung, and eventually Stan Grof and depth psychology to try and better understand the unconscious. He discusses the growth of psychedelics and the cultural shifts he’s noticed (especially in the U.S.), as well as what he’s working on today: researching the influence of psychedelics on set and setting by studying experiences in both enriched and unenriched environments.
He also talks about:
Plasticity: how he defines it, how it relates to critical reopening periods, and how it’s a fundamental thing that transcends the metrics we use to measure it
Early LSD studies, the nervousness surrounding he and David Nutt dosing Ben Sessa, and the youthful energy that kept them going
How plasticity could be exploited to help relieve chronic pain
The potential of psychedelics to help with fibromyalgia and anorexia
How psychedelic-assisted therapy brought care back to health care
UCSF is seeking survey volunteers, so if you’ve had more than three experiences with ketamine, MDMA, and psilocybin (must have experiences with all three) and want to contribute, do so here.
“In my school of thought, that’s not the problem, that’s the opportunity. When something makes sense but it’s abstract, I’m more led by the fact that it makes sense. The abstraction is an opportunity. It’s a richness, a fertility, and we can really dig into that.”
“You notice when people really put mindfulness to the aesthetic, and they lower the lights and with the music: it doesn’t take long and that much effort, really, before it starts to feel like really caring – like actively caring. And it is an intriguing thing to think that that’s absent in the default, you know? That’s a thing that a colleague said to me once; that she loved the fact that psychedelic therapy brought back care. As someone who went into the mental health care profession, she felt like she could care again, for the first time in a long time. And that was not just ok, that was really promoted and made easier in a sense by the paradigm.”
“There’s different hierarchical levels to these assumptions, but the assumptions are often the problem. They guide our experience of the world, but they can entrench us in certain ways, and that entrenchment can be really at the heart of a lot of psychopathology, a lot of mental illness.”
“I guess one thing I’ve discovered, which is fantastic, is just seeing how broad the community is here around psychedelics, and generationally as well. In London, it was really just a young generation, but here, it really transcends generations, and I really appreciate that. There’s something very normalized about psychedelics here that I started noticing very early on; that it was a topic of polite conversation. …That felt like a glimpse of how it will be, not just here, but elsewhere in the future.”
A collection of interviews, peer-reviewed research, and personal story; the book dives deep into the mind-body connection, how to become more embodied, and our need for social connection – which factors into mental and physical health far more than most of us realize. The nod to Michael Pollan’s book is also a challenge: Have we been focusing too much on our minds and now it’s time to pay more attention to our bodies? How much of the benefit of psychedelic experiences is related to truly experiencing our bodies?
How neuroscience is starting to look more at brain-body interactions, and the psychedelic space’s growing interest in somatics
The minimal and narrative selves: Do psychedelics make the minimal self traverse over the narrative self?
Flexible switching and applying interoception to a social context
Her concept of a ‘possibility space’ and new ways of perceiving
The benefit of adding embodiment practices to psychedelic assisted therapy – especially during preparation and integration
“I think people are familiar with the ways in which different compounds can influence the bodily self, so to speak. And it’s a really interesting idea that that, in and of itself (the modulation of your body or your experience of your body or how the body is represented by the brain): if that maps onto therapeutic outcomes, if that’s part of what’s so beneficial about these compounds – not just changing neural pathways in the brain, but actually giving you a different experience of yourself as an embodied organism in the world – I think this is a really interesting area to look into.”
“The minimal self is kind of just your basic feeling of being in a body, not necessarily tied to your identity. And the narrative self is like the story you tell yourself: who you are when you wake up in the morning, all of your memories, and kind of your life story. And it seems that there’s something going on with psychedelics where the minimal self: its influence sort of traverses over the narrative self, and we get an opportunity to be re-embodied in a way.”
“I don’t see a separation between a place of calmness within my body and the peace of the natural world. It’s the same quality to me. So if I’m standing, looking up at the stars at night in some beautiful remote place, that resonates inside me because it’s the same quality, if that makes sense. I feel it in my body so profoundly because it’s a reminder that my body is part of this greater profound stillness.”
In this episode, Joe interviews Christine Calvert: Licensed Chemical Dependency Counselor and certified Holotropic Breathwork® facilitator.
She talks about how addiction led her to breathwork, how breathwork has helped her over the years, how breathwork can be a compliment to other self-work, and how becoming comfortable with breathwork first could be a very important stepping stone towards better understanding the psychedelic experience. She talks about how years of breathwork helped her navigate complicated states of consciousness, and the incredible benefit of learning to trust our body’s capacity to heal itself.
She discusses using bodywork in sessions and the importance of having the experiencer be the one who requests it; how much a facilitator’s past relationship with touch affects how they use touch; the risk in meditation vs. the safety of breathwork; the concept of learning self-awareness; how profound it is to be witnessed in breathwork’s dyad model; and why researching and creating guidelines for this kind of work seems impossible.
“One of the things I love so much about breathwork vs. psychedelics is that it is endogenous medicine; this is coming from within me. And as somebody who had experienced the world in [a way that] felt like I really was surrounded in a culture and a society that was incredibly disempowering – to have a model that turns you back inside yourself over and over again is a true gift and an act of radical self-empowerment.”
“Obviously in counseling we get witnessed, but there is something really profound about the witnessing in the dyad setup model of holotropic breathwork where [we’re] being witnessed by somebody, and their job is only to do that: to literally sit [and] accompany me as I go internal. And then there’s just an immense amount of support. So for these parts that really didn’t have support and are holding a lot of the trauma of omission (the things we needed that we didn’t get); it’s incredibly powerful and poignant to have this kind of relational field surrounding us through that while that material is moving through us.”
“I feel like if we could do a stepping stone program, breathwork would be the first one, because I think if we can’t access and understand what and who we are with our own endogenous medicine; as explorers and facilitators or practitioners, I think we’re missing something.”
Recorded shortly after a week-long philosophy and breathwork conference which they both attended, they mostly dig into the challenging philosophical concepts of Alfred North Whitehead: how everything is made up of a feeling; how everything is relational and we all feel each other’s experiences; how Whitehead defined occasions and how moments of experience are accessing the totality of the past; and how neurology and the mind-brain interaction impacts human experience. This analysis leads to a lot of questions: Is the past constantly present, in that it is an active influencer on all our actions? When we relive a past event, where does that live in our minds vs. bodies? Are we tapping into a universal storehouse of past events, or are we tapping into past lives (or into others past lives)? When we sense that someone is looking at us, what is that?
He also discusses his realization that the experiential element of non-ordinary states of consciousness was the most important; his entry point into breathwork; why breathwork creates a perfect atmosphere for conversation; reincarnation and the idea of being reincarnated into other dimensions; the concept of objective immortality and how ripple effects from a single moment continue onward; and the fallacy of misplaced concreteness and psychoid experiences: Are they real beyond our psyche?
“One of the key moments for my studies was [when] I was tripping, walking through this room. Suddenly, I had this vision of three overlapping circles of psychology, philosophy, and religion, and in the middle was an experiential center that was all of them, where the experience of these questions and mysticism and psychological insight were sort of all flooding in there. And I thought: Wow, this is the insight people are talking about. I’ve got to find out what this is about.”
“Whitehead has a book called Religion in the Making and he says religious experience, a mystical experience is interesting and part of the picture, but you can’t build an entire religion or philosophy based on extraordinary experience of a few great men. But I think with psychedelics, opening up these realms to millions of people; it creates a much better foundation for doing something like that.”
“Everything’s alive, and I think we need to feel that again and to feel the depth dimensions that psychedelics reveal. …I think when we don’t feel the aliveness around us, we don’t feel alive.”
In this episode, Joe interviews Dana Lerman, MD: a decade-long infectious disease consultant who has since been trained in psychedelic-assisted therapy, ecotherapy, and Internal Family Systems, and is the Co-Founder of Skylight Psychedelics, where she prescribes IM ketamine and trains therapists who work with it.
Lerman tells her story: how working with kids with cancer made her want to learn medicine, what it was like working as an infectious disease expert during COVID, and how fascinating it has been to start with modern medicine and then fully embrace the traditional frameworks of ayahuasca ceremonies. She has realized that part of her role is to bring that intention, ceremony, and inner healing intelligence to modern medicine – that that will greatly benefit patients as well as clinicians who naturally want to be healers but are burnt out by the bureaucracy and distractions of the faulty container they find themselves in. Skylight Psychedelics is working on opening a clinical research division, researching psychedelics for Long COVID, and bringing in-person psychedelic peer support services to emergency rooms.
She also discusses intergenerational trauma and how psychedelics have affected her parenting; the impossibility of informed consent in psychedelics and why there should be disclaimers as well as instructions; accessibility, the need for insurance to cover psychedelic-assisted therapy, and why the price of these expensive treatments actually makes sense; why we should be sharing stories of mistakes and things going wrong during ceremonies; and why one of the biggest things we can do to further the cause is to educate our children and parents about psychedelics.
“What’s come to me recently in ayahuasca ceremony is that part of my role in this space is really to bring intention and to bring ceremony and the inner healing intelligence and that concept to the modern medicine space. I mean, there’s so many places for improvement in modern medicine, like even: We have a few minutes for a timeout so you can check to make sure that’s the right patient [and] it’s the right limb you’re going to amputate, but we don’t have a moment to talk about who this person is and the intention of this surgery and what we want for this person. We just have this disconnect, and this disconnect; obviously, it’s not just in medicine. It’s in everywhere. It’s our food. It’s our community. All systems.”
“I have three small children. A lot of why I went to ayahuasca was because I knew [beside wanting] to heal myself of all the stuff that I’ve been carrying around, I wanted to shift my parenting and to be a better parent, and I felt that if I carried my anxiety, my control, all the stuff: It just keeps getting passed down because the kids are just learning from us. But if you can address that, if you can address where does that come from, what is the work that has to be done around it, and do that work, your kids see it. My daughter: When I came home from ayahuasca (she was probably seven); she looked to me and she said, ‘Why didn’t you go there sooner?’”
“Anytime people are using these medicines, I think: There’s a huge disclaimer that should be coming with these medicines, like: ‘Your life will be changed forever. You will never look at anything the same way again, and there’s a possibility that you enter into a space where you are experiencing the vastness of the universe, and that may be very overwhelming for you when the journey is over. You need someone to talk about it with.’ The whole concept of integration is so important.”
This sequel to their fascinating discussion about shadow work earlier this year focuses on dreams, as Amara, while dreaming that she was having an acid trip and coming to the realization that dreams and LSD may be sending her to the same place, is researching the similarities between the odd worlds of dreams and psychedelic experiences: Is it the same place? Do the dreams we have after psychedelic experiences continue those visions and ‘Aha!’ moments? Can they answer questions for us (the concept of “sleep on it”)? Does dream analysis result in a greater feeling of integration? Can we use the dreams we have before experiences to help guide the experience itself?
The conversation goes a lot of places: the many aspects of Jungian psychology; the fluidity of Indigenous perspectives around visible and invisible worlds; how Jung wrote “The Red Book”; the concept of eros and reclaiming our relationship with aliveness; how nature is in constant equilibrium (as are we); how to build a relationship with your dreams; how to work with symbols in dreams; and much more. Ultimately, this episode is about the clash between the conscious and unconscious, the willed and the incidental, and waking life and other realities, and dream analysis and integration work is really tracking vitality in the human psyche: what is alive in us and how does it want to live out in our beings? What makes us come alive? Can our dreams tell us?
“I was inside my dream, analyzing my dream, and having the phenomenological experience of being on LSD, and it was like, ‘Holy shit, is this the same place?’” -Mackenzie
“When you sit with a dream image that maybe scares you or that you avoid: When you sit with it long enough for its purpose to be revealed, it’s like, ‘Man, cool, thank you for sending me that image.’ And you can start to trust that there’s something larger inside of you that has your back. And that level of trust, that level of existential secure attachment (is what I’ve been calling it lately) is un-fuck-with-able. Nobody can take that from you. Once you have that, you’re good. All the chaos can happen around you, but you’ve got something inside of you that nobody can touch.” -Mackenzie
“These are all experiences with the numinous. The numinous wears all the shapes. It’s only our human hubris that searches for it in particular shapes. If we kind of quiet that hubris a little bit and let the self, let the numinous talk in its own language for a second, we can all be humbled to see how vast its language is and how it can find us even in the most ridiculous images.” -Ido
“When we have these experiences, when we’re given this content from our unconscious, it’s an invitation to join the family, to join the life that is living through all things. And that to me, is just really, really hopeful, and I think it’s why I’m so inspired and passionate about psychedelics, is the possibility of them to alleviate that nihilistic thought pattern that says ‘I’m alone in this world.’ When we really, really feel into what’s happening for us, it’s collective. We’re in a collective experience, constantly, all the time. And that’s really beautiful and healing.” -Mackenzie
In this special episode, Melanie Pincus, Ph.D. and Manesh Girn, Ph.D., who joined David in episode 403 to discuss the launch of their new course, essentially interview each other.
As the 2nd edition of their popular course, Psychedelic Neuroscience Demystified, begins on November 1, we wanted to give them a chance to highlight some of the aspects of neuroscience students can expect to learn in the course, and what so many people who are interested in psychedelics don’t fully understand: What does neuroplasticity actually entail? Can one predict if a patient is more apt to have an experience with ego dissolution? How does the amygdala relate to mood disorders? When are critical periods of greater plasticity and socialization at their most beneficial? How does neuroplasticity relate to chronic stress?
They also discuss lessons they’ve received from their own journeys; why they created the course; serotonin; psychological flexibility; body-based versions of self vs. memory-based versions; psychedelics and re-encoding memories (and the potential for false memories); how psychedelic therapy is different from standard drug treatments; psychedelics and the default mode network (is the story oversimplified?), and much more.
For more information on their course, and to sign up, click here!
“A major insight from my psychedelic journeys is just how dense and heavy thoughts and mental content can be. And we often feel the need to overanalyze and think about things and get lost in our concepts and internal dialogue as opposed to experiencing things in the moment, as they are, in a more deeper kind of intimate way – having a greater intimate relationship with our senses, with the immediacy of what’s happening. And my psychedelic experiences, whether it’s with psilocybin or 5-MeO-DMT or what have you, have allowed me to glimpse into states where that stuff is just totally removed, and I’m just immersed in the rawness of experience and just how beautifully vibrant and alive and spontaneously intelligent that is, and how superfluous a lot of our thinking really is, and it just weighs us down. I think my journeys have just allowed me to live with greater ease and hold on to my identity and my narratives much more lightly. So I see them, I acknowledge them, but I’m not totally lost in them. I don’t identify strongly with them.” -Manesh
“Perhaps what’s happening is that MDMA induces a super positive mood where you feel really socially connected, really empathogenic with your therapist or whoever’s around you, you feel so safe and supported. And so if challenging traumatic memories come up, there’s this mismatch between the emotional trace of the traumatic memory and the unique state you’re in with the MDMA on board. And so this mismatch drives the memory reconsolidation process so that your traumatic memory is amended with less fear to be more in line with your current way you’re feeling of being so safe and supported.” -Melanie
She talks about graduating college and going straight to Esalen, where she had little concern over therapy or integration, and how, after 20 years of ayahuasca experiences, she learned to see psychedelic-assisted therapy and ceremonial, transformational experiences as very different things. She discusses her ayahuasca journeys; a surprising MDMA experience; what having an ongoing relationship with the spirit of ayahuasca means; Ann Shulgin’s concerns over going through death’s door while in a journey; what true integration is; how psychedelics can help prepare for death, and more.
And she talks about her new book, Swimming in the Sacred, which collects the stories, unique perspectives, and wisdom of 15 female elders who have been working in the underground for at least 15 years each, and how their experience has led to a somatic-based intuition and ‘know it in their bones’ feeling that so many new practitioners and facilitators need – and can only come with time.
“I kind of want to say to the newly-hatched psychedelic therapists: ‘Well, get this experience,’ but it’s very hard. And they’re not going to wait six years before practicing, so there’s such a need for them, and I can’t, in every podcast, (I mean, you’ll laugh at this), I can’t say, ‘Go do a lot of drugs,’ right? I’m trying to be more elegant about this, but that’s part of the elder women’s experience, is they really know the territory.”
“I know you’ve done a real apprenticeship, and I really respect that. And, yes, it’s very hard to find them, but that is the way people learn. So, what’s the best way to become a psychedelic therapist? It’s to be a patient with someone who’s a very experienced psychedelic therapist.”
“My priority was to work on myself and to grow and evolve. And so I always think of integration as part of a whole life: it’s not something that happens in a couple of sessions. But after these experiences, then what do we do with our lives and how do we live a more integrated life? And how do our lives unfold?”
She shares childhood memories of growing up on her Grandparents’ farm, where she developed a deep appreciation for nature, staring at the stars, and the beauty in stillness, and how coming back to that stillness has been key in her life and psychedelic journeys. The conversation then shifts to all that she’s learned through her work with children on the autism spectrum: the problems of putting people into boxes; how autism affects everyone; the different ways people learn; the connection between autism and the gut microbiome; and how she has learned more from some of these children than any book could teach her – culminating in a story of discovering that a very challenged child people were ready to give up on could actually read and comprehend everything he was hearing.
She discusses her favorite adaptogens; the art of stacking adaptogens and different modalities; her multi-day coaching sessions; Internal Family Systems; quantum biofeedback; the use of supplements in microdosing; and Brilliant Blends, which sells blends of supplements designed to provide benefits as close to what psilocybin can provide (but legally) – inspired by the unique needs of autistic individuals. PT listeners can receive 10% off all purchases with code: PT10.
“If we look at Western medicine, we are masters at saving lives. We’re not so great at quality of life. And looking more toward Eastern medicine, European medicine: where body, mind and soul [is] more brought into play – healing, working on the mind, the emotional, the mind and the body for a complete healing… So that was really why I chose the path of natural integrative medicine because I did see that everything has a place. Everybody brings a talent to the table. …We, many times, need a village for healing.”
“I’ve had some wonderful mentors along the way, but being on the ground, so to speak – not just in a laboratory, formulating things – being hands-on with those children on a day-to-day basis: that was the greatest teacher of: how is this herb working? How is this adaptogen working? So when I went to formulate Brilliant Blends, I just knew it had to honor them because I was using that knowledge base. I use it on a daily basis with everyone. …Autistic children have taught us what we know from autism, and what we know from autism applies to everyone.”
“That’s the end game. That’s the bottom line in all of this work that we’re doing. That’s where the transformation and freedom is: to realize that this medicine is in all of us. Maybe we’re just using psychedelics to open that door to reveal it and show us the path how to anchor it, but this medicine is in all of us and always was. So if we can use these different pathways, these different approaches to lead us back home, then bravo.”
In this episode, Kyle interviews Lisa Wessing: Clinical Psychologist and facilitator specializing in harm reduction at Kiyumí retreats in The Netherlands.
Wessing shares her personal journey and the shift from being uninspired with studying psychology to being a part of space-holding in Mexico and finding her true path. She dives into the world of Kiyumí retreats, discussing their holistic healing approach using psilocybin, somatic movement, dance expression, and other methods supporting their four pillars of embodiment, nature, mindfulness, and art. She discusses their more long-term program with Dr. Gabor Maté integrating his Compassionate Inquiry framework; their Equity Program, which offers partial or full funding for people who may not have the financial resources or who come from marginalized communities (e.g. BIPOC & Queer); and the importance of integration as a continuous process and checking in with people much later to build their “Kiyumíty.”
Much of this discussion covers the challenges of somatic psychology and facilitation in group containers: how most people are somatically illiterate and the challenging journey of becoming more somatic; what to do about someone laughing or singing in a group context; what moving into one’s body really means; and different ways of using art to integrate an experience.
As part of our Vital program, we are running a psilocybin retreat with Kiyumí from September 6-11, and we have some available spots left! If you like what you hear, you’ll be in The Netherlands in September, and want to have an amazing experience with us, click here for more info!
“Something really important is expression: self-expression and expression in community. So seeing and being seen is something also that we value. And that seeing and being seen can create awkwardness and strangeness, and it’s something that we really like to also go into, because once we break through that awkwardness, there’s so much potential of creativity amongst people.” “It’s the fostering of allowing discomfort that is just generally important in this kind of work and in self-work itself. …We live in context in which it’s all about escaping the discomfort. We want to have a really comfortable home and a great job, and our vacation has to be as comfortable as possible. And also in medicine, it’s better to take just a pill that will do the job for me. Psychedelic work is often really uncomfortable, and so the group process reflects that discomfort. So I guess one of the main missions and one of the main challenges is to present that: like, yes, you will be uncomfortable. And let’s work with that.”
In this episode, Joe interviews one of the world’s leading experts on human performance: New York Times bestselling author and Executive Director of the Flow Research Collective, Steven Kotler.
Kotler’s work explores the neurobiology of peak human performance, flow states, and aging, and the concept of getting our biology to work for us rather than against us in our later years, by using the parts of our brains that expand in our 50s, combined with neuroplasticity, learning by play, and the biggest factor: working toward a very difficult – but not impossible – task. His 30-year exploration of the neurobiology behind people accomplishing ‘impossible’ feats led him to test his theories by teaching himself to park ski at 53 with resounding success, then using his protocol with people up to 70 years old the next season. The story is told in his newest book about challenging tired concepts of aging, Gnar Country.
He discusses the power of flow states and how much flow actually amplifies productivity, motivation, wisdom, empathy, and more; why dynamic motion is a key activity for greater longevity and why skiing and similar action sports are some of the best examples; why dynamic activity in novel environments is even better; why changing one’s mindset may be the biggest factor toward change; why corporations are looking at flow training and where these concepts could go in the future; and of course, how this all relates to psychedelics.
“If you study flow science, it turns out that flow is really great at helping us go from zero up to Superman. It’s also really great at helping us go from seriously subpar, ‘I’m completely broken and sick’ back to normal. And it turns out this combination is phenomenal in the second half of our lives. And flow sits at the heart of peak performance aging.”
“The only way I can go [from] A to B with this is to take everything I know about flow science and peak performance and see if I can use it to accomplish this so-called impossible task. So that’s what the book is. And yes, I was obviously very successful. I went 0 to 60, as I said, in a single season. It was the fastest I’ve ever actually learned anything.”
“The place you’ve got to begin is mindset. The mind-body connection gets tighter and tighter and tighter over time, and it plays a significant role in aging and peak performance aging. Mindset is the greatest example. …A positive mindset towards aging – ‘I am thrilled with the second half of my life; my best days are ahead of me’ – translates to an additional eight years of healthy longevity. It’s wild. …You could be morbidly obese and have a shitty mindset towards aging. Change your mindset, you’ll live longer. Don’t lose weight. Change your mindset. It’s more important. In fact, changing your mindset is more important than quitting smoking for healthy longevity.”
When you realize that you’re not who you thought you were, the spiritual leader Ram Dass used to say, the path to enlightenment begins. This is also the beginning of the journey for LGBTQIA+ people.
In either case, self-realization can be prompted by psychedelics. But that transition is a scary one: whether it’s your ego or the gender and sexual orientation you were assigned at birth, it requires the death of the person you’ve known. Ultimately, you break through into a place of beauty, truth, and love. But there’s usually a period of kicking and screaming first, trying to hold on as the known slips through your fingers.
For queer and gender-diverse people, it often isn’t safe to express or connect with who we are, so we learn to suppress this knowledge even from ourselves. Denying one’s authenticity causes trauma that can manifest as depression, anxiety, and PTSD. But LGBTQIA+ researchers, therapists, users, and underground practitioners are finding that psychedelic therapy has immense potential to help their communities heal from internalized queer- and transphobia.
Lxo, a London-based artist and research curator experimented with various medicines in art school when their queer, trans*, and non-binary identities began to surface, deposited by a repressive, religious upbringing and persisting through more than five years of talk therapy.
“Then I did one [dose] of s-ketamine, and something burst forward from the past, like a memory bubble” they say. “I was able to forgive and heal… the version of me that was really crying out for help.”
There Is No “Post-Trauma”
For queer and gender-diverse people, there is no “post-trauma,” says Dr. Jae Sevelius, a clinical psychologist and Professor of Medical Psychology in the Department of Psychiatry at Columbia University Medical Center. Rather, it’s ongoing, and “It’s not just about experiencing violence, it’s about experiencing violence because of who you are.”
Most mainstream therapies, however, treat trauma as an isolated incident. “[In the West,] we don’t have great approaches to offer people,” Sevelius says. “We have medicines that can treat the symptoms… but talk therapies for trauma… can be really challenging, [with] very high dropout and [low] success rates.”
What’s more, these frameworks aren’t built to support the queer experience. On the contrary, they’re often the very sources of the trauma they aim to treat. Homosexuality was still classified as a mental illness in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1973; being transgender, until 2012. These links persist today, with gender-diverse people being required to undergo psychiatric evaluation before receiving supportive healthcare—assuming this is even an option.
I’ve experienced this firsthand: celebrating diagnoses that pathologize your identity because it means you can actually get the care you need, reinforcing cognitive dissonance and negative self-beliefs. It breeds mistrust among queer and especially gender-diverse people, especially those with intersecting underrepresented identities, such as BIPOC and sex workers, who face additional systemic barriers and are most impacted by the drug war.
Patients often have to educate their therapists and doctors in culturally relevant care, emotional labor that can be life-threatening. Even worse, queer and gender-diverse communities have been subjected to so-called conversion therapy, inhumane “treatments” that try to turn people cisgendered and straight, still legal in many places. Methods of administration have included electroconvulsive therapy — and psychedelics.
The fact that substances known as truth agents could be used as tools of oppression speaks to the influence of set and setting – and, perhaps even more, of institutions like medicine, psychotherapy, and the university system, where outcomes must align with conclusions that satisfy funding sources.
Today, the barriers to both gender-affirming treatment and psychedelic healing remain immense. Part of the problem is that LGBTQIA+ people are underrepresented on both sides of psychedelic therapy and research, as well as the sciences more broadly, and largely feel unwelcome in all these arenas.
“We need to recognize that there are specific needs between different people within the community, and those needs arise from systemic failures,” says Alfredo Carpineti, a queer astrophysicist and founder of UK charity Pride in STEM.
Research both reflects and creates the world, as psychologist and Yale researcher Terence Ching and others have observed. Psychedelic clinical trials and research studies don’t even gather data on sexual orientation and gender identity, so there is no way to know how psychedelic therapy impacts LGBTQIA+ communities, yet the message this sends to them is clear.
Existing studies and trials are not designed to capture or accommodate queer experiences, typically using cis-het, male-female therapist dyads that are meant to mimic hetero-normative parenting frameworks. Additionally, therapists are not trained to handle complex gender and sexuality issues that may come up during sessions.
Misgendering or failing to affirm someone’s identity can be particularly wounding, Sevelius warns. Those designing studies need to ask who is training and recruiting the therapists, and where they’re recruiting participants. A study on MDMA therapy for gender-diverse populations that they contributed to found current protocols lacking, calling for explicitly gender-affirming treatment and safer, more inclusive settings.
“I get requests all the time from trans and gender-diverse people asking me how they can be included in clinical trials. And I have to say, I don’t feel comfortable referring people,” Sevelius says. “Psychedelics create a very vulnerable psychological state. When you don’t know whether the therapists are really competent to be working with our communities, it’s very likely someone will get re-traumatized.”
Psychedelic research also needs to more rigorously capture demographic data about sexual and gender identity, but most organizations don’t have the resources, Ching says. Still, it’s crucial to recruit and train more LGBTQIA+ researchers and therapists to support straight ones in building queer-inclusive clinical spaces.
“There are many ways to improve access,” Ching says. “Rethink your eligibility criteria [and] do more than put up fliers. Go to queer organizations, talk to people, … do a town hall. Tell them what PTSD is and actually get savvy with the fact that sexism, racism, homophobia, and transphobia can lead to it.”
You’re Not Who You Thought You Were
Saoirse* spent five years in the military police, presenting masculine as a means of survival. Struggling with “decades of suppression and depression as well as PTSD from growing up in cis-het society and from the military,” she had already done a decade’s worth of talk therapy through the VA, cognitive processing therapy (CPT; a cognitive behavioral therapy for PTSD), and couples counseling. Then she participated in an ayahuasca ceremony.
“Having a safe space to explore my beingness… within a [sacred container and] Peruvian Amazonian lineage… was the key for me in discovering my true essence,” she says. “The masculine persona… dropped away. The other women gathered around me in a group hug, and I felt my true self seen, held, and celebrated for the first time.”
During his own MDMA therapy session, Ching was visited by otherworldly animal entities that helped him reconcile his queer and Asian-American identities, which he describes as “a profound experience of unshackling myself from the confines of internalized homophobia.”
Dee Adams, a research program manager at Johns Hopkins University who studies the impact of psychedelic therapy on gender-diverse people, says, “Psychedelics unlock[ed] those pieces of me that I… didn’t have the courage in mundane reality to approach or be aware of. I don’t know of any [other] medicines that can… be directly attributed to that initial ‘aha’ moment.”
Psilocybin and LSD have huge potential in triggering these insights, Sevelius says, as they’re known to break stuck patterns. MDMA is effective for identity-based trauma because it increases self-compassion and empathy, they add, and can improve gender resiliency when combined with affirming care. Along with a New York-based clinical partner, they’re also developing the first ketamine-assisted group therapy study created by and for trans and gender-diverse people.
Yet the relief goes beyond clinical symptoms. In her ayahuasca journeys, Saoirse connected with not only her own femininity but the feminine archetype, transmitted through the spirit of her mother, who was dying of a brain tumor.
“Spirit gifted me with an experience of the female pain body… and all the feminine has held for the masculine throughout the ages,” she says, including “the damage the masculine has done to itself… in committing violence. I was shown the breadth of our journey as souls through lifetimes and the beautiful and terrible dance of the human story.”
She also experienced reconciling with her mother’s spirit from her painful first coming-out, something antidepressants and talk therapy could never provide. “Healing does not occur in the mind,” Saoirse says. “Especially [when] healing core wounds with identity and gender identity, [it] takes place in the heart, … in belonging, and sacred witnessing of our stories, held in the eyes of love.”
The cure is increasing affirmation while reducing reliance on external validation; psychedelic therapy, they explain, can do both. Affirmation comes from therapists and the sense of connection to larger, mystical forces; the medicines help people validate their own being.
But deconstructing and reconstructing your self-concept is a monumental task; often an entire life’s work. With any psychedelic journey, but especially for LGBTQIA+ users, support before, during, and after the session is essential. Shortcomings of the current clinical framework — not to mention the dubious legal status of most medicines — means many may be better-served by shamanic, Indigenous, and underground providers, something queer researchers confirm.
“Even as a scientist, I don’t necessarily always advocate that the clinical trial is better,” Ching says. “There are some ways of knowing, like gray literature [research published outside formal academic channels] or having your own personal experience, that might be more beneficial than reading it in a scientific journal.”
For Adams, the approaches go hand in hand. Psychotherapy and prescription medication might be additional tools people use for ongoing support after psychedelics bring them the initial realization.
Peer-support networks can be incredibly helpful, providing that essential component for healing: affirmation. Groups such as the Queer Psychedelic Society and Transadelic connect LGBTQIA+ people who use psychedelics through messaging platforms and integration circles. Many trans and gender-diverse people, in particular, find connecting with like-minded others crucial.
“There was a time when our culture was celebrating queerness, but [you had to be] a specific type of queer. I think people are still having and perpetuating that trauma,” says Transadelic member Casey*. “I don’t seek out queer spaces. But I’m really grateful for this one.”
For Saoirse, “hav[ing] my transition journey of self-discovery held… within a conscious spiritual community… has made all the difference for my self-acceptance, self-love, self-confidence, and my quality of life.”
A Queer Medicine
The links between psychedelics, queer culture, and esotericism trace back to spiritual traditions and early LGBTQIA+ rights movements. In the 1960s and ’70s, groups such as the Cockettes and Radical Faeries challenged social norms and blurred counter-cultural boundaries, sprinkled with consciousness-expanding practices.
In fact, the Pride flag was conceived of during an acid trip in the era when the 60’s hippie culture began yielding to ’70s club culture, and queer people found community and catharsis on the dance floor using MDMA and LSD. The myriad colors reflecting off the mirrored disco ball inspired the flag’s late creator, Gilbert Baker, as a symbol that could replace the former logo, the upside-down pink triangle reclaimed from the Nazis.
In the psychedelic state, “the dissolution of ego boundaries becomes the dissolution of binary categories,” Lxo observes, and integration “begins to connect and unify them, bringing all the various different energies, even seemingly binary ones like masculine and feminine, into a kind of relation.”
It’s crucial for the clinical establishment to understand that queer and transness isn’t something that needs to be cured — and tying treatment to disorders and diagnoses echoes of the pathologized past. Sevelius says the focus should be healing past wounds while building coping strategies for facing continual trauma. Meanwhile, Ching wants to see psychedelic therapy “targeted to identity-affirmation processes… fostering the wellbeing and actualization of queer folks.
“Psychedelics have the power to shift the way we see and experience the world, including ourselves, remembering who we were before a traumatized culture had its way with us. As Ching says, “I know I was born this way, but it took MDMA to show it to me, to accept the emotional truth, … and live my life according[ly].”
Editor’s note: Some names have been changed to protect the identity of the source.*
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