Friday, April 29, 2022

Maia Christopher is Leaving ATSA

By David S. Prescott, LICSW

 

Last week, the announcement came that Maia Christopher has resigned from her position as Executive Director of ATSA. It has long been one of my proudest accomplishments to have led the search committee that resulted in her hire during my year as President Elect. With this blog post, I hoped simply to offer some historical reflections on her accomplishments.

 

One can only imagine the challenges of being an Executive Director for ATSA. We wanted a person competent in administration, management, and organizing a conference while also needing someone with not just an understanding of the field, but a deep appreciation for it. Maia was clearly it. With the help of then-President Robin McGinnis and “Dream Team” member Jacque Page, Maia basically saved the 2007 ATSA conference in San Diego. That may seem long ago and far away, but the finances of each conference are naturally a major signpost of ATSA’s health and way forward. The next year, 2008, was the same: Maia and her team managed to pull off an excellent conference at a time (the beginning of the Great Recession in the US) when energy prices had gone through the roof, state agencies were prohibiting travel, and all sorts of things conspired to make it a difficult go. And so it went. Maia was the perfect choice at the perfect time.

 

Tyffani’s description of Maia’s leadership touches on important areas. At the same time, it is difficult to overestimate the amount of effort she has put into making sure that every detail of every conference has worked to our advantage. Some of us use the Hare PCL-R to assess psychopathic traits on a case-by-case basis; Maia was dealing with entire hotel chain managements that seemed to score above the cut-off for psychopathy. Beyond that, Maia has always taken excellent care of her staff. I personally sat in many meetings watching her put the office staff’s needs well ahead of her own. This has long been obvious to outsiders who have seen how well our office staff function as a team.

 

Before stepping into the Executive Director role, Maia co-chaired the committee that produced what were then called the ATSA Standards and Guidelines. That particular round of revisions faced many challenges, and Maia’s ability to thread the needle and get the document past an entire board of individuals who were all quite opinionated in how documents should be edited was impressive. That in itself would have been a remarkable accomplishment for any ATSA member. It seems worthwhile to mention all this today in considering the depth of Maia’s long-term commitment to ATSA.

 

Placed even further into context, Maia followed two other Executive Directors whose tenures were brief and perilous. Their departures left us all with the sense that we could actually hear the bullets that we had just dodged. And before that was another Executive Director who also gave her all to ATSA and, in an unforgettable board meeting, announced that after years of putting ATSA first she had simply run out of vision for the future. It was an amazing high-water mark in the concept of honesty.

 

Why say all of this?

 

·       ATSA members have more reason to be grateful to Maia than we often realize. Being ATSA Executive Director is hard work in the best of times.

 

·       ATSA has also been here before, survived, and emerged stronger thanks to the efforts of a diligent, competent, and effective board.

 

·       This can’t possibly have been easy for anyone involved. Thank you, Maia Christopher, for your service and leadership through all the ups and downs of our organization.

 

Thursday, April 21, 2022

Abuse in Psychedelic Therapy

By David S. Prescott, LICSW and Natalie Villeneuve, MSW

Amended version: Since the publication of this blog, we learned new information. Out of our deepest respect for the people whose harm is referenced below, we have added some important details and observations to this blog post.

Cover Story: Power Trip is a podcast hosted by New York Magazine. It went to #1 on Spotify’s list of True Crime podcasts and consists of nine episodes to date. Featuring Lily Kay Ross, who holds a Ph.D. in Sociology and a Master’s Degree in Divinity, it addresses abuses – sexual and otherwise – that have taken place in treatments incorporating psychedelic medications. These treatments are mostly used for addressing trauma, making these violations even more egregious and noteworthy.

Before delving into the issues covered in the podcast, it’s important to emphasize that whatever one might think about the use of these drugs in therapy, the themes involved are relevant to all who assist those harmed by abuse. They include the willingness of those in authority to dismiss or otherwise turn a blind eye to the experiences of people who trusted, consented to participation in treatment (in some cases within research studies), and found themselves violated and in worse shape than before.

The medications involved (including MDMA, DMT/Ayahuasca, Psilocybin, and others) are certainly not new. In many cases, their use in traditional healing methods, particularly within Indigenous contexts, dates back countless years. In 2018, an entire issue of Psychotherapy Networker focused on their potential use in psychotherapy, with contributors as prominent as Bessel van der Kolk and Rich Simon. In 2019, author Michael Pollan further brought the potential of these drugs to the forefront in his best-selling book How to Change Your Mind. Advocates use terms such as “psychedelic revolution” and “movement” while others recall that drugs such as LSD also have a dark and unfortunate history in CIA attempts at mind control (described in Stephen Kinzer’s “Poisoner in Chief”).

Cover Story: Power Trip provides accounts of individuals whose lives were altered by sexual abuse while using these drugs in a therapeutic context. One tells the story of being pressured into sex by the very person whose job it was to guide her through the experience. She recounts how he told her that all his clients fall in love with him. He was not licensed as a professional in any mental health discipline, and it turns out that he had studied with others who themselves were the subjects of prior allegations of sexual abuse. When the individual who was harmed complained to the people in charge, the only result was an email on which she was blind copied, explaining that he was not to be in contact with her until such time as they could resolve their issues. There was neither validation of her experience nor any consequence from her complaint.

In another case, a woman is guided through a psychedelic experience by two “therapists” (male and female) One of these (the male) had previously been open about having problematic sexual boundaries. During the experience, when she became upset, the guides grabbed her by the wrists and held her down, stuffed part of a towel into her mouth, subdued her, and then lied down next to her. The man spooned her and kissed her on the forehead. As if that wouldn’t be shocking enough, this took place in a small office as part of research by a group called the Multidisciplinary Association for Psychedelic Research (MAPS). Although the incident took place in 2015 and the women subjected to abuse reported it to MAPS, it apparently took them six years to review the video. Even then, their conclusion was that the session had not proceeded in accordance with the protocols. Beyond that, there was never any apology or accountability.

The woman involved in the above incident released the video of this abuse, which is available here. In it, the man can be heard advising his client to lie back and spread her legs. It is very difficult to watch. For those who do wish to see what words can’t adequately describe, it is important to know that it is only a small section of an hours-long video. The edited clip makes it appear that the woman eventually gave up resisting, but she didn’t. In fact, she fought back for hours. Those who know the indomitable spirit of this woman are not surprised by this, but others might not know the full extent of harm caused; the video is brief.

In a separate discussion of the podcast, Lily Kay Ross had this to say about the video:

“In sexual violence resistance education, we talk about the data and the statistics around how […] the use of one active resistance form, like verbal or physical, whether it’s yelling ‘no, get off me’, or trying to punch somebody […] When you use one of those resistance strategies, the chances of rapists advancing and continuing to try to complete the assault, go down a lot. And then you use two strategies, they go down even more. […] The vast majority of people who are intent on committing an act of sexual harm will be deterred if there are forceful resistance strategies deployed against them. And what we see in these videos is this, you know, an hour or so of somebody using what we would teach as resistance strategies to stop something from happening. And they don’t stop, for such a prolonged period of time, they don’t stop. And I don’t understand what kind of person, and what kind of state of mind, a person has to be in, to so clearly see somebody suffering like that and to keep doing what they’re doing.”

Throughout the entire podcast, themes emerge:

·       There is so little accountability – none, really – that any reasonable person would wonder why no one could even say, “that should not have happened” much less apologized. After all, forcing yourself onto a person who by definition is not able to give consent is sexual abuse.

·       Virtually all of those who reported abuse received responses along the lines of gaslighting: Many were told that their reactions to abuse – or their not wanting to have sex with their guide – indicated blockages and resistance in their relationships. Likewise, many were told that their despair in the wake of abuse and attempted abuse were symptoms of other disorders that they needed to come to terms with.

·       In a case in which a woman complains to MAPS about her treatment, describing her condition as being “suicidal every minute,” her response is coded as “lowering of mood” as a side effect and not included in reports to the Food and Drug Administration. By all appearances, the number of the subjects in the studies is surprisingly low for medical trials.

·       Many women felt pressured not to discuss their experiences, so as not to undermine the “psychedelic movement.”

·       Not surprisingly, there is very considerable financial investment in ensuring that these medications are made legal.

·       There are unspoken undertones: It is hard not to notice that the people who are abused are primarily women while the research and professional authorities are (with several surprising exceptions) men. Likewise, it is difficult not to sense an unspoken attitude of victim-blaming in that it is easy to fault women for placing themselves in a vulnerable position.

To be clear, the actual abuse is not the only issue at stake in these scenarios. Very clearly present are those who either don’t notice or care enough to put the brakes on research studies. Following the leads offered in this podcast, one quickly finds responses that are more legalese than actual communication. They add up to an unacceptable betrayal of the vulnerable individuals who trusted them. Again, how hard can it be to apologize? Like the other elements in this podcast, a lack of accountability is something that readers of this blog face every day.

It is tragic that these circumstances have occurred. By most accounts, the proper use of these medications can be enormously helpful, often being the only successful treatment in the lives of some who have experienced trauma. The podcasters, their subjects, and the authors of this post are all in agreement that more research and innovation would be welcome, if it takes place in a space that is truly safe for all involved.

Also frustrating is that beyond the intersection of big money and abuse are many practitioners who use medications as responsibly as possible and take every precaution to provide genuine safety to their clients. We cannot make this point strongly enough.

As an aside, this podcast is not the first to call attention to abuse in this context. Author, therapist, and teacher Will Hall provides a concise and comprehensive review of the issues, as well as his personal experience at the Mad in America website in a 2021 article titled, Ending the Silence Around Psychedelic Therapy Abuse. This article helped to expose apparent abuses by highly influential leaders in the psychedelic therapy arena (Fran├žoise Bourzat and Aharon Grossbard). Their fall from apparent grace has been a difficult experience for many thousands of devotees.

Abuses in similar contexts where charismatic leaders hold enormous power over their vulnerable followers are also not unfamiliar. Yoga legend Pattabhi Jois is alleged to have sexually abused countless numbers of students. The Shambhala meditation tradition has also recently been plagued by sexual assault scandals. While many spiritual movements have emphasized devotion to leaders, it’s nonetheless wise, given these experiences, to be very cautious in how we limit our own autonomy along the way.

What is the best way forward? To start:

·       We can remind one another and ourselves that abuse is abuse, plain and simple.

·       We can recognize that the abuse dynamics in this podcast (and in the article by Will Hall) are similar to those that have occurred elsewhere throughout human history and unite against them.

·       We can be aware that, despite the many potential benefits of these forms of therapy, abuses can and do occur.

·       We can ensure that our professions (and individual practitioners) take action and contribute to the solution instead of tacitly delegating responsibility to outside groups and politicians.

·       We can further work to develop and enforce the most stringent codes of ethics and professionalism to prevent these abuses. This can include advisory committees that include those who have experienced harm as well as experts in trauma. Of course, this will include raising awareness and mobilizing resources, since on their own, ethical codes, like laws, are not enough on their own to prevent abuse.

·       We can revisit what informed consent actually means in the lives of our clients and in our treatment settings, including when one is under the influence of medications that induce ecstatic and suggestible states.

·       We can accept that the Western scientific perspective can be flawed, and that it cannot be our only perspective. We can incorporate Indigenous knowledge into this work and give voice back to those who have a deeper understanding and connection to plant medicines. One area for further reflection can be the colonialist roots of current psychedelic science.

·       We can hold individuals who cause harm accountable while nevertheless regarding them with compassion and supporting opportunities for them to change.

·       We can move beyond the assumption that the criminal justice system will deliver justice, and consider how a restorative justice approach may instead bring healing to those harmed by psychedelic abuse.

·       We can always remember that just as the helping professions are rooted in the idea of doing no harm, we can also focus on ensuring that we do no further harm.

These calls to action are not about vilifying psychedelics, nor is this an attempt to undermine the advancement of psychedelic science, as many stakeholders may fear. Rather, this is a question about how a group of individuals can unite over a common objective. There already exists a community of people who are passionate about psychedelics, and who would largely agree that psychedelic medicines have the power to be life-changing. After a psychedelic experience, many individuals have reported feeling a greater sense of connection to others and the world around them, and they describe leaving the experience with a more open mind.

If we are truly committed to learning from psychedelic medicines, then how can we apply these teachings to address this issue of therapy abuse? How can we proceed with compassion, and how can we bring people together in conversation? Most psychedelic therapists and guides would agree that their goal is to help people, not to further traumatize them. And while justice can look different for every survivor of abuse, a common theme amongst survivors of sexual abuse is that they want to feel validated, and for the person who harmed them to take accountability and admit that they are telling the truth.

It is understandable why anyone would meet accusations of sexual abuse with denial, blame, and even threats of lawsuits (as was the response by Grossbard and Bourzat following allegations of sexual misconduct; for additional legal activity, see here and here). After all, even after having so-called transcendent experiences through psychedelics, these people are still human, and will thus seek to protect themselves in face of fear. If cancel culture has taught us anything, it is that there is no opportunity to recover from your worst mistakes. When fearing punishment, career loss, legal recourse, and ostracization, what would motivate someone to take accountability? How can we expect people to be brave, to take responsibility, and to commit to change if the risks are so great? 

Yet, if we can unite on the common ground that we want psychedelic healing to progress safely, then we have a bridge to connection. If someone communicates (verbally and non-verbally) that they do not feel safe, this must be received with openness and a willingness to learn. If it is true that psychedelics can dissolve the ego, expand one’s consciousness, and increase empathy (as well as suggestibility), then it is fair to believe that we can unite, embrace accountability, learn from our mistakes and harm, and ensure that psychedelic therapy is as free as possible from abuse.

 

(The authors are grateful to Geral Blanchard for his helpful comments on an earlier draft of this blog post.)  


Friday, April 8, 2022

Changes in abuse during the pandemic?

By David S. Prescott, LICSW, & Kasia Uzieblo, Ph.D.

 A recent article in the New York Times compiles data on physical and emotional abuse of teenagers during the pandemic. It is based on research involving 7,705 students conducted in the first half of 2021 and published by the US Centers for Disease Control. Among the findings:

·         44.2 percent described  persistent feelings of sadness or hopelessness that prevented them from participating in normal activities.

·         9 percent reported an attempt at suicide and 20 percent said they had considered it.

·         55.1 percent of teenage respondents said they suffered emotional abuse from a parent or another adult in their house in the preceding year.

·         11.3 percent said they suffered physical abuse.

This contrasts sharply with data from David Finkelhor and his colleagues, published in 2013, finding that (among other things) 13.9 percent of respondents ages 14 to 17 reported emotional abuse during the preceding year, and 5.5 percent reported physical abuse.

Further, in the most recent study, 29% reported that a parent or another adult in the home lost a job, and 24 percent said that they had experienced hunger. One in three high-school students simply reported poor mental health.

In all, it seems that our field is finally starting to see the data we feared we would. Those professionals who have watched the unfolding of the past 25 months or so are very aware that it’s not just the kids; parents and teachers are also experiencing intense stress. It doesn’t end there: a recent survey found that one in five physicians plan to leave their practice in the next two years.

Where do we go from here? Clearly, we have a lot of work to do, and the pandemic is not actually over yet. Setting aside the fact that the world continues to face other crises (such as the war on Ukraine and climate change) there is some good news:

First, we have an opportunity to learn from these data and anticipate cases that will come to our attention. One implication is that developing an appreciation for the context and circumstances in which abuse occurs will be important to consider as well as the characteristics of the person who abuses.

Second, we have a better opportunity to intervene. These data paint a clearer picture than we had before about the nature of suffering behind closed doors. We knew it would be bad, but at least we are better prepared to work with people whose lives have been affected by abuse (including by perpetrating it).

Third, we have expertise that we can share when we work with others in the community. This can include our knowledge of abuse dynamics and trauma as well as our (often hard-won) ability to remain compassionate in the face of the horrific circumstances of our clients.

Importantly, these findings show that times have changed, and we in turn need to adapt our understanding of abuse and neglect. Ultimately, these times – where existential crises unfold on a daily basis – show how important it is that our field shares what we know in order to ease the suffering of others in whatever circumstances we find ourselves.

Friday, April 1, 2022

War, (sexual) exploitation, and rape in Ukraine: A testimony

 By Kasia Uzieblo, PhD

Blogger’s note: Kasia has been in Poland these last weeks, involved in efforts to assist those affected by the war in Ukraine. Her account is presented as the perspective of a colleague working to help others and keenly aware of the role that sexual violence can play in times of war.

Thursday, 24 February, 2022. People from various Ukrainian cities woke up to the piercing roar of the air alert, a sound they hoped they would never have to hear, a sound that made them realize immediately that their lives would never be the same again, a sound that confirmed their biggest fears: President Putin had started the invasion of Ukraine after months of troop deployment at the border, of playing a smoke and mirrors game and of creating diplomatic tension.

Thursday, 31 March, 2022. Just over a month later, at least 1,179 civilian casualties have been reported, at least 1,860 civilians have been wounded, an estimated 6,5 million people are thought to be displaced inside the war-torn country, more than 3,9 million Ukrainians have fled their country. The cost of damage to Ukraine’s infrastructure has reached almost an estimated $63 billion. And let us assume that all these figures are serious underestimates.

What is not included in these numbers, however, are the numbers who fall victim to other brutal acts of violence that are always there, but certainly seem to proliferate during wartime, such as (sexual) exploitation, sex trafficking, and rape.

I could bombard you with figures, but I am not going to do that here. I want to bring you the stories of refugees we have met. Since 11 March, I have been working with a group of volunteers who drive to the Ukrainian border every weekend, on the one hand to deliver basic necessities to local partners and on the other hand to give a safe lift to refugees who want to come to Germany, the Netherlands or Belgium. Since the war, several volunteer groups have started similar initiatives. Although the refugees are allowed to travel through Europe free of charge, such a train journey is anything but a matter of course for many of them. These are mothers with (very young) children who, after days of travelling through war zones of trying to dodge bullets and bombs, arrive exhausted and starved in Poland or elsewhere. They hardly have the energy to continue organizing the journey. These are elderly people who have difficulty walking and who have used up all their strength to cross the border. We are talking about people with mental and/or physical disabilities who need a lot of support in their daily lives and certainly also to get in and out of a vehicle. So, you can imagine that travelling in a van or a car makes their lives a little easier, even if it is for a few hours.

But unfortunately, we do not do this just to offer them comfort. We are also doing this to offer these people a safe passage, in order to protect them from (sexual) exploitation, human trafficking, and other horrors. Many refugees are therefore very fearful and suspicious of any help that is offered, fear of accepting help from someone with bad intentions. This fear can be read in their eyes. It has already happened that the refugees we took along were constantly taking pictures of us, our cars, and our journey, and immediately sent them to the home front, so that there would be some evidence, some clue to the possible culprit(s) if it came to that. It is only after a few hours that they dare to nod off, dare to relax a little, dare to let their guard down, dare to trust us, albeit a little bit.   

This fear is unfortunately well-founded. A few weeks after the invasion, Facebook groups were organized in which people could indicate whether they had a place free in their homes for refugees. This initiative had not yet got off to a good start, when various men offered a place in their house, but they did set some requirements: the woman had to be young, preferably with long hair and long legs, who could also clean and preferably did not yet have a child. These men were 'unmasked', as it were, but many did not bother to post an announcement on a Facebook group and drove straight to the border to find a woman and take her to Belgium or elsewhere. This is certainly possible: rows of cars are waiting for the many refugees at the border, at every train station, …, it is chaos everywhere, despite the efforts of various volunteers. Unfortunately, we can be sure that several women have fallen from one trauma, namely the war, into another terrible traumatic situation. Also, at the train station in Krakau, Poland, we saw several men walking around with signs offering a ride to the refugees. But for the refugees, it is almost impossible to distinguish between those with bad intentions and those with good intentions. All they can do is trust their own intuition, which will sometimes be right, but sometimes not.

Many refugees are a bird for the cat. After all, not everyone will be suspicious and will accept every kind of help they receive, out of desperation, out of necessity. Not all women fully realize the dangers, not to mention the thousands of children wandering unaccompanied in Ukraine itself or in a foreign country. Various bodies, such as the Council of Europe and the UN Refugee Agency, mention these dangers, but the reality is that it is almost impossible to prevent such criminal practices in this chaos. People with bad intentions have more or less free rein. Another horror we are now confronted with is rape. In the last week, more and more stories have reached us of people who have been raped (repeatedly) by (presumably) Russian soldiers, often in front of their children. These men are also given free rein. Moreover, overheard telephone conversations between Russian soldiers and their home front show that these soldiers are quite open about these rapes and that the home front hardly reacts, let alone ostentatiously disapproves. Hearing these tapes and testimonies simply turns your stomach, again and again.

And I realize that these atrocities that we face as volunteers are just the tip of the iceberg. That much remains unspoken, much remains hidden. As a volunteer, you feel powerless so often, and for so many reasons.

We can only do this with the help of sponsorship money, which is not coming in very easily. Even renting a car or a van turns out to be a big challenge every week. Consequently, our places are scarce. The first weekend we helped 13 people, then 24, then 12. Every time I return, it feels as if we have hardly been able to help anyone. Every time, I struggle with the feeling that we still have so many to help, that what we do means nothing. In my now regular nightmares, I see all those faces of those we could not take with us. But then you suddenly get a whatsapp-message, from a female engineer who came with us to Belgium with her 84-year old mother who was moaning of pain all the way and both were completely starving but were too proud to accept any food from us, from a young mother who now has to take care of her 1-year old curly head and her 5-year old daughter who behaved like an adult during the car ride, from a 38-year old woman who now lives safely in a nursing home with her disabled 36-year old brother and 46-year old sister, her own 10-year old daughter and her guinea pig and her 72-year old mother with hardly any luggage. And then you realize for a small moment that you have helped these few people, that these few people can no longer be shot, raped or exploited by soldiers and exploiters, that these few people can still have hope for life.