What's the Difference? Psychedelic Therapists vs. Psychedelic Guides
In recent years, there has been a resurgence of interest in the therapeutic potential of psychedelics. From psilocybin mushrooms to MDMA to ketamine, these substances are being explored as tools for healing mental health conditions such as depression, PTSD, and addiction, as well as for personal growth and spiritual exploration. However, embarking on a psychedelic journey requires careful consideration and preparation. One crucial decision is whether to work with a psychedelic therapist or a psychedelic sitter (or guide…or coach…etc). Both play distinct roles in supporting individuals during their experiences. So who are all these psychedelic people that keep popping up all over the place?!
Pictured: Me reacting to the idea of psychedelic-assisted therapy in 2018-ish
What is a Psychedelic Therapist?
A psychedelic therapist is a licensed mental health professional who has undergone specialized training in psychedelic-assisted therapy. They possess a deep understanding of the psychological, emotional, and spiritual aspects of the psychedelic experience. Psychedelic therapists typically work within a therapeutic framework, integrating talk therapy techniques with the use of psychedelics to facilitate healing and transformation. In the case of ketamine-assisted psychotherapy, research differentiates the process from other formats by focusing on the inclusion of psychotherapy before, during and after the medicine session.
Psychedelic therapy sessions are structured and intentional, often involving a series of preparatory sessions before the psychedelic experience itself. During the session, the therapist provides a safe and supportive environment for the individual to explore their inner landscape. They offer guidance, insight, and emotional support as the individual navigates the psychedelic experience, helping them process and integrate their insights afterward.
Red Flags in a Psychedelic Therapist
I’m going to be pretty blunt and it might cost me some popularity among my colleagues in the psychedelic community, but if a psychedelic therapist is too nonchalant about the process and the legality of the situation, I would not trust that therapist. Psychedelic therapy is still for the most part illegal. I would ask a prospective therapist how they provide this service legally, and if the answer is really simple I would run! Therapists can legally help people prepare for and integrate psychedelic experiences, but they are not currently allowed to be there for the psychedelic experience itself. This can also vary from state to state depending on the local laws. So if the answer is pretty simple, my reflex is that particular therapist is currently engaged in a practice that could cost them their license. Whether that is intentional or due to ignorance, it still will let you know whether that is someone you would like to trust with your personal growth and healing. (And I would also start with those who provide ketamine-assisted psychotherapy as that IS currently a legal avenue for integrating psychedelic experiences in therapy).
Going along with that, I would not trust a psychedelic therapist that does not work with a medical provider. Point blank, the influence of medicines and their impact on biology is out of the scope of practice for psychotherapists (The exception being medical providers who also have training and experience with psychotherapy). If a therapist does not work with someone who can provide medical screening, then your physical safety cannot ACTUALLY be ensured in that process
What is a Psychedelic Sitter?
A psychedelic sitter, on the other hand, is a supportive companion who is present during a psychedelic experience but does not necessarily have formal training in therapy or mental health. Sitters may be friends, trusted individuals, or experienced guides who offer a reassuring presence and ensure the physical safety of the person undergoing the experience.
While psychedelic sitters do not provide therapeutic interventions in the same way therapists do, they play a vital role in creating a conducive setting for the experience. They maintain a calm and compassionate presence, offer reassurance during challenging moments, and assist with practical needs such as providing water or adjusting the environment for comfort.
Red Flags in a Psychedelic Sitter (or guide…or…coach)
So I keep referring to them as sitters, guides, or coaches. You might also see words like “healer” as well. The range of qualification for these folks is extremely broad because we are now talking about people who do not have any form of organizing body. And while I am no fan of the ways that bureaucracy tends to shape healthcare in the U.S., I am also not a fan of people not having a clear path to hold practitioners accountable. There are documented cases from the underground psychedelic therapy movement which detail abuses by those with power. This podcast even references multiple abusive psychedelic therapists who’s trainees (including guides/non-clinicians) and followers went on to perpetuate the same abuses and violations of their clients. So with this group, I encourage people to ask about the person’s formal training. Then do some researching about wherever it is they got that experience to see if there’s any documented controversies.
Personally, I would not trust a sitter without formal training. While I know that people have gained wonderful experience in the years that practices have been underground, my own opinion and comfort if I would engage with a sitter is still that I do not really trust practitioners who do not believe they have anything to learn from someone else. Further, cultural appropriation will let you know that you do not want to work with someone. If you are looking to pursue healing through a practice which is tied with a certain culture, I believe that finding someone who comes from that culture is the best place to start. Otherwise, I think we sometimes run the risk of finding the practitioners who are only after a quick buck.
Choosing Between a Psychedelic Therapist and a Psychedelic Sitter**
When deciding between working with a psychedelic therapist or a psychedelic sitter, there are several factors to consider:
1. **Purpose of the Experience**: If the primary goal of the psychedelic journey is therapeutic healing or personal growth, working with a psychedelic therapist may be more suitable. Therapists can provide the necessary psychological support and facilitate deeper exploration of underlying issues. However, if the focus is on spiritual exploration or self-discovery without specific therapeutic goals, a psychedelic sitter may suffice.
2. **Level of Support Needed**: Individuals with mental health issues or trauma may benefit from the expertise of a trained therapist who can navigate potential psychological challenges during the experience. Conversely, those seeking a less intensive experience or who feel confident in managing their emotions may find the presence of a sitter sufficient.
3. **Legal and Ethical Considerations**: In many jurisdictions, psychedelic therapy is still in the experimental stage and may not be legally accessible. In such cases, working with a psychedelic sitter within the bounds of the law may be the only option. Therapists in some cases are able to help with integration even when they are uninvolved with the clients psychedelic experience.
4. **Personal Comfort and Trust**: Ultimately, the decision should be guided by personal comfort and trust. Whether working with a therapist or a sitter, it's essential to establish a rapport and feel confident in their ability to support you through the experience. Open communication and mutual respect are key elements of a successful psychedelic journey.
In conclusion, both psychedelic therapists and psychedelic sitters play valuable roles in supporting individuals during their psychedelic experiences. The choice between the two depends on factors such as the purpose of the experience, the level of support needed, legal considerations, and personal comfort. By carefully considering these factors, individuals can make informed decisions that enhance the safety, efficacy, and transformative potential of their psychedelic journeys.
Best,
Ryan
