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.)  


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