How do we honor and stay present with others’ pain?

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

It’s been just about a year since we published the first of two blogs, an article, and a conference presentation about sexual and other interpersonal abuses in what is referred to as the psychedelic therapy “community.” These followed a thoroughly sourced podcast by Lily Kay Ross and Dave Nickles, whose work has been featured in media reports throughout much of the world (including this interview).  Still, very little has changed. Some organizations have commented on abuse and floated ethics policies and statements but taken no further action. There is little doubt of the sometimes-transformative power of psychedelic drugs.  The worrisome part is the unacceptable level of risk for trauma outside of ethical practice, which itself is not always carefully defined.

Strikingly absent, however, has been any accountability  at the source of abuse, either the ones who perpetrate it or who are responsible for the environments where it occurs.  Like the #MeToo movement, organizations have made statements  announcing that they do not tolerate abuse, but have done little more. Indeed, those abused are often blamed, or told that they shouldn’t have been allowed into treatment and/or research studies due to the personality characteristics they presented with. Unfortunately, one challenge with trauma is that it can be hard to understand from the outside looking in, and hard to explain from the inside looking out.

Even among trauma experts, there can be a lack of compassionate responses. Some practitioners employing  psychedelics in treatment have openly  minimized those who speak out about and disclose abuse so they “don’t end up derailing the movement.” Other psychedelic proponents have suggested that subjects of abuse, while worthy of support, are not credible commentators since they are still so raw and vulnerable in the wake of their experiences. These subjects rightly point to public perceptions that they can only be taken seriously when they are the “perfect victim.”

Meanwhile, opponents speaking out against these abuses are occasionally surprised at the reactions they get. Some responses come from people with similar experiences of abuse, while others      pose questions that have already been answered in easily available articles and podcasts. For these individuals, disclosing the worst experiences of their lives perpetuates the aftermath of the very discussions they’d hoped would no longer be necessary.

Most recently, Ross and Nickles engaged with the production team of John Oliver’s Last Week Tonight, who were interested in learning more about the potential risks and harms in current psychedelic-assisted therapy. As the Psymposia website describes it, “Last Week Tonight has a history of highlighting the self-serving tactics of unaccountable corporations, the failures of regulatory agencies to act in the public interest, and the complicity of the mainstream media in advancing narratives that serve the powerful.” Even so, the resulting program made no mention of the widely emerging concerns documented, and instead simply bolstered the dangerous hype that is already surrounding psychedelic therapy.            

There is ample cause for concern. Psychedelic-assisted therapy is becoming big business, with numerous media articles addressing the pros and cons of investment in the industry. Entire papers have been published on the legalization of psychedelic drugs, while others address patents for them. How can there be so little consideration for preventing abuse? Especially against a backdrop when so many claim that “there’s no such thing as a bad trip”? One training appeared to minimize the issues by referring to instances of abuse as “erotic transference” in its title.

Perhaps more importantly, how can we ignore the voices of those who have been victimized by the people they trusted, while under the influence of powerful drugs? These survivors could inform prevention efforts as well or better than anyone. In a recent conversation, one person who publicly disclosed abuse while in psychedelic therapy stated, “Maybe it’s because so many people don’t know what to do with it.”

This idea, that most people simply don’t know how to handle accounts of abuse and trauma, is an excellent point. Bearing witness to abuse, suffering, and anguish is not easy, particularly for anyone who never had to. Thinking back on the #MeToo movement, Black Lives Matter (and other) protests, the Jeffrey Epstein abuses, and so many other circumstances, it often seems that most people simply want abuse and exploitation to go away. It can be hard to listen to accounts of abuse; it can be even harder to sit with another’s pain. More challenging still is bearing witness to the aftereffects of prolonged abuse (for example, being abused while on psychedelic drugs in a purportedly therapeutic situation that was supposed to help resolve a history of trauma). Most people who are able to show up and be present with survivors have learned their skills the hard way, through their own victimization.

While many therapists (and friends and allies) show up to this work every day, it’s easy to avoid, forget, or not see the sheer depth of human suffering. The literature provides all sorts of material about effective trauma treatment techniques, protocols, methods, and models. However, few educational programs provide much focus on the simple act of sitting in a room with a person in anguish and remaining clear, compassionate, and present with them.

New approaches to reducing suffering are welcome, although the current hype of the psychedelic movement is reminiscent of many “miracle cures” of the past.  Until we as a society can look at our own suffering and prioritize the needs of people who have been victimized, it is difficult to see how anything will improve. While we rush into the heady promise of new drugs, maybe we can also remember the importance of being an ally to those who suffer.