Psychedelic Psychotherapy Is Coming: Who Will Be Included?
Updated: Aug 30, 2018
A new study finds widespread exclusion of minorities in psychedelic research.
Recently, there has been much excitement in the potential of psychedelic-assisted psychotherapy to address a multitude of mental health conditions, including depression, post-traumatic stress disorder, addiction, end-of-life anxiety, and other conditions. The non-profit organization Multidisciplinary Association of Psychedelic Studies (MAPS) has been at the forefront of these efforts, funding studies to demonstrate the efficacy of psychedelics for mental health, including MDMA-assisted psychotherapy for people with PTSD. As a result, FDA approval of MDMA for the treatment of PTSD may soon become a reality. However, not everyone has been included or represented in this momentous process.
The crowd is cheering as the psychedelic train pulls into the station, its inviting doors flung wide open. One by one, people with a multitude of ailments are stepping onboard – people with PTSD, anxiety, depression, and many other conditions. Yet, though there are many who need seats, the only people holding tickets are White.
As noted by Dr. Nicholas Powers, the dominant, pervasive image of the psychedelic community is that of White affluence. This is thought to be rooted in the glorification of 1960s and 70s White hippie drug use as a “counterculture” as opposed to an illicit act. People of color have not been meaningfully included in this community. Other factors uniquely impacting people of color include prohibitive costs and lack of access to substances, negative stereotypes about people of color and drug use, and criminalization of people of color through the War on Drugs.
However, the use of non-ordinary states of consciousness for medicinal purposes is neither novel nor modern, and actually dates back thousands of years to the spiritual practices of indigenous communities all over the world. For many indigenous people, psychedelic use is considered a both a sacred and healing act — something that requires the guidance of a highly trained spiritual leader (shaman), and entails psychoactive rituals that bring humans closer to the spiritual world, in an effort to treat both physical, psychological, and spiritual ills. Understanding the indigenous roots of psychedelic medicine within the historical origins of psychedelic-assisted psychotherapy is an crucial reference point, given that modern psychedelic medicine has struggled to include people of color and is only now beginning to acknowledge the importance of their inclusion.
The psychedelic train is pulling out of the station, and people are giddy with excitement, waving as the train beings to move. The train itself is painted with bright colors, but there is little color within. White faces are pressed against the windows from the inside while everyone else watches from afar. Black and brown people, including the elderly, young people, veterans, and the disabled are left standing on the platform as the train chugs away.
Western medicine’s exploration of psychedelics for treatment purposes can be divided into two distinct periods, the “first wave,” occurring between 1950 and 1985, when synthetic psychedelic compounds were just being discovered, and the “second wave” beginning around the late 1990s and continuing to today, with a renewed focus on high quality research.
The initial “rediscovery” of psychedelics as medicine by Western science first occurred during a period in which biomedical options in psychiatry were limited, as psychopharmacology had not yet become mainstream practice. Newly synthesized psychedelics were not considered controlled substances, and therefore their clinical and research use was fairly unrestrained. Given that psychoanalysis was a mainstay of treatment, initial research on psychedelic medicine examined whether psychedelic drugs could improve the process of psychotherapy, accelerating the treatment of psychological disorders. Yet ultimately, the widespread use of these substances, serious ethical violations (i.e., administration to physically-restrained subjects, sexual abuse between therapists and clients), major methodological flaws in research, and concerns over safety led to defunding of research and eventually the designation of psychedelics as illegal substances. While many researchers and patients continued to espouse the therapeutic benefits of psychedelic-assisted therapy, this area of investigation was shut down for decades.
Several important factors contributed to the resurgence of psychedelic medicine in the late 1990s. Foundational research during the second wave was conducted, consisting of animal and basic science studies. With the creation of MAPS by Dr. Rick Doblin in 1986, researchers were no longer reliant upon government funding and could pursue FDA drug development. The medicinal potential for scheduled substances was also no longer novel, given that research into both cannabis and ketamine had been underway since 1975. Coupled with the fact that many psychiatric illnesses still lacked effective drug treatments, these factors paved the way for today’s second wave of psychedelic research.