In psychedelic therapy, there are no "safe words" for restraint

Some recent reflections on the psychedelic field’s bifurcation. After this summer, the “cultophilic” side has lost power, and critical psychedelic studies is the field’s academic future.

My Everest.

(As a quick content warning, this post contains discussions of sexual abuse and harassment in the psychedelic field.)

I had a hiatus from substack during the end of the summer, while I figured out how to respond to the retaliation and death threats. Although this substack started out as a way to communicate with people who supported my work, it’s now being monitored by people who are opposed to everything I do — which has been an adjustment.

A few weeks ago, I spoke with one of the original physician whistleblowers who helped alert the public to the dangers associated with widespread OxyContin prescribing. His descriptions of his treatment by Purdue Pharma — and the subsequent threats — read like a playbook of my past few months. Purdue Pharma even painted him as an anti-opioid zealot and extremist, just like I’ve been described as someone who doesn’t believe veterans deserve to heal.

While the claims against me have varied, they tend to involve versions of this false narrative: I (and my Psymposia colleagues) lied to the FDA, and those lies torpedoed Lykos’ MDMA-assisted therapy application, which prevented millions from getting access to life-saving care.

On its face, it’s absurd to claim that the FDA rejected Lykos’ application — or that Lykos fired 75% of its staff — because a small nonprofit organization injected “Fear, Uncertainty, and Doubt” into the proceedings. To the contrary, these developments provided corroboration for our contention that there were major problems with Lykos’ clinical trials.

Several individuals and organizations still tried to scapegoat us, however — the most prominent of whom shared funders with Lykos Therapeutics.

The scapegoating began with an open letter from Heroic Hearts and Healing Breakthrough — two veterans organizations that have been funded by the Psychedelic Science Funders Collaborative (PSFC), which was also instrumental in funding Lykos’ Phase 3 clinical trials.

The original Heroic Hearts letter targeted me by name in a false narrative that directed hate my way:

“One of the ‘experts’ ICER relied on in drafting its report is a person named Nese Devenot, the leader of a little-known group called Psymposia. Ms. [sic] Devenot has made it her stated mission to prevent MDMA-AT’s FDA approval due to her personal antipathy towards the therapy’s sponsor, Lykos. After the Advisory Committee’s vote, she publicly claimed victory as the engineer of ICER’s public crusade against MDMA-AT.

“Ms. Devenot and her Psymposia colleagues’ motivation for opposing MDMA-AT lies in their belief that treating veterans suffering from PTSD ‘perpetuates the logic of white supremacism, capitalism, and imperialism.’ They openly refer to veterans as imperialists, white supremacists, and murderers on their website, in public speeches, and on their social media feeds. This hateful, anti-veteran rhetoric infiltrated the media and the Advisory Committee’s psyches through ICER’s draft report....

“As veterans, PTSD advocates, and Americans, it is our responsibility to expose the underlying motives for the carefully coordinated, unscientific, anti-MDMA smear campaign. Ms. Devenot and her colleagues at ICER and Psymposia have successfully manipulated the media and infiltrated the FDA’s regulatory process to the detriment of millions. Psymposia’s involvement in ICER’s report should have rendered its ‘findings’ null and void. Instead, it may single-handedly dash the hopes of thousands of veterans who continue to take their own lives due to their suffering from PTSD.”

This false narrative — to reiterate — is straight out of the playbook of Purdue Pharma. It’s yet more evidence that there’s something deeply wrong about the field’s use of power to achieve predetermined ends at any cost.

Within days of the open letter’s publication, Jules Evans published evidence that this open letter was part of a coordinated PR campaign designed to pressure the FDA to approve Lykos’ application. Almost instantly exposed, the PR campaign effectively tripped over its feet out of the gate. Needless to say, it was not successful.

Evans also identified how the letter’s rhetoric was explicitly dangerous and shouldn’t be acceptable. It was a classic stochastic terrorism campaign: represent your political enemies as a contemptuous out-group standing in the way of the health and safety of an in-group. It’s not technically incitement, but when you broadcast such narratives over the internet, the chances increase that someone will interpret it as a call to violence.

The danger increases when stochastic narratives are widely broadcast. In this case, the letter was shared by then-Presidential candidate RJK Jr., and its claims were translated into a video by Rep. Dan Crenshaw that was subsequently endorsed by Elon Musk. In a message thanking Musk for his support, Crenshaw implicitly advised his followers to direct hate our way, based on inflammatory rhetoric in his video: “So given how they feel about people in the military, maybe it’s no wonder that they're against actually treating veterans with PTSD.”

Compare this false narrative to my real motivations, which Psychedelic Alpha published as a “Letter to the Editor” on July 19:

“During the FDA Psychopharmacologic Drugs Advisory Committee (PDAC) meeting, I served as a proxy for Lykos Therapeutics (formerly MAPS PBC) whistleblowers and participants, because people were already afraid of retaliation by the time they contacted me. The response from Lykos supporters continues a longstanding tendency to portray those who speak up about harms as a threat to the movement.

“This pattern feeds into a climate that is hostile to harm reduction, creating an environment where it is impossible to know the full scale of the harms associated with psychedelic clinical trials. That climate poses a substantial barrier to conducting rigorous research, to creating safer psychedelic cultures, and to communicating effective harm reduction information.

“It is also dangerous to me personally. On June 23, I was targeted by name in a dishonest Heroic Hearts open letter that launched a coordinated PR campaign as political cover for the FDA’s upcoming decision. In a context of increasingly normalized political violence, the decision to contemptuously blame me for jeopardizing the movement is painting the target on my back even brighter.

“The reason we have not shared more information publicly is that we have an obligation to protect the safety of our contacts. We are in touch with 8 contacts with evidence of systemic problems and overlapping abuses across Phase 3 trial sites. This includes Phase 2 and 3 participants, former employees, and clients of Phase 3 therapists and MAPS-trained guides. Collectively, their experiences provide undeniable evidence of widespread corruption and ethical violations that undermined the integrity of data collection and reporting. (Editor’s note: Owing to confidentiality concerns, Psychedelic Alpha is unable to review these claims.)

“Prior to contacting us, our contacts witnessed the field’s treatment of the Phase 2 participant who came forward, and they are seeing how leaders in the field still blame her for assaults that occurred during the trial. As the Phase 2 participant reported to the IRB in 2018 and to the FDA in 2021, those assaults were preventable and predictable consequences of the MAPS therapy protocol. Despite that participant’s requests for an investigation to protect future participants, no such investigation took place, and similar harms from the therapy protocol continued into Phase 3.

“If these incidents had been properly investigated when they were initially reported, I would not have needed to speak to the PDAC on June 4. Patient advocates should not be attacked for engaging in “the democratic arts of education, organizing, and mobilizing people for change,” when change of some kind is clearly necessary.

“The overt contempt by some Lykos supporters is making it harder for that information to become public. Our contacts are still hoping to cooperate with an independent FDA investigation, but no one has yet been contacted.

“While we agree with the votes at both ICER and FDA’s PDAC, we were just as shocked about ICER’s report as everyone else. We were not involved in their draft, and we did not see it coming.

“I am an Indigenous Kurdish scholar and C-PTSD survivor advocating for other victims of trauma. I’ve been a psychedelic researcher since 2010, because psychedelics saved my life. I challenged Lykos’ MDMA-assisted therapy application not because I don’t understand the value of psychedelics, but because they’re so important that we need to get this right. Lykos’ therapy is causing predictable patterns of preventable harm, and I believe it is in the best interest of the field to recognize this and make meaningful changes.

“I was grateful for Jules Evans’ rapid reporting, for Peter Addy’s open letter, for Josh Hardman’s observations, and for everyone who stepped forward to challenge dangerous rhetoric that is demonizing us as political enemies. Building a safer field is a collective responsibility, and it will make for better science.”

As the FDA’s August decision date approached, journalists reached out to ask for my thoughts about possible outcomes. As I reflected on it, I realized that my position was the same regardless of the decision: namely, the FDA needs to investigate what happened during the trials. I sent this message to one journalist:

“Lykos is solely responsible for misconduct and negligence in its clinical trials. In their willingness to target and vilify whistleblowers since the PDAC meeting, Lykos and its funders have corroborated their critics’ concerns: participant safety and open scientific debate are not Lykos’ guiding priorities. There are still many unanswered questions about Lykos’ conduct, and the urgency of investigating that conduct has not been impacted by this decision. Increased safety in the psychedelic industry will require that Lykos and its funders be investigated and held accountable for their actions.”

After the FDA decided against approving Lykos’ application, FDA investigators finally contacted me as part of an investigation into Lykos' clinical trials, and I turned over all of my evidence and contacts to the FDA. I acted in the public interest, on a timeline that was safest for my sources. I accomplished the goal I’d been writing for.

On October 18, Lykos published a short press release that described a recent meeting with the FDA: “The meeting resulted in a path forward, including an additional Phase 3 trial, and a potential independent third-party review of prior Phase 3 clinical data.” Clearly, our calls for an investigation have been taken seriously. 

PSA: Critique is not harassment

Although the “cultophilic” side of the field has been trying to silence me, the field isn’t going back to the way things were before. Academic researchers no longer need to overlook harmful behavior and bend the knee to MAPS. This field will be more curious, more respectful of different perspectives and disciplines, more democratic, more attentive to harms, and more receptive to — even appreciative of — critique.

The inevitability of this change became clear to me at two recent conferences, where my presentations on problems with the MAPS therapy model were appreciatively received. As a plenary speaker for PhilaDelic, I returned to my alma mater — the University of Pennsylvania — where I’d organized the first Psychedemia interdisciplinary psychedelics conference twelve years ago.

Since I joined the field in 2010 (as I mentioned in my presentation), I’ve been encouraging the field to consider the value of humanities methodologies for psychedelic research. During the past summer, one consequence of the incompleteness of this project became clear:

Psychedelic humanities has been so marginalized that the field is struggling to distinguish critique from harassment. That’s a problem! In a mature field, critical perspectives would be seen as valuable interlocutors for identifying areas that might benefit from more attention, research, or communication; for mitigating the risk of groupthink bias by identifying blind spots; and for protecting vulnerable groups from unintentional harm.

Critique is not harassment, malicious, nihilistic, or negative. It’s a caring practice that encourages deeper reflection and greater integrity.

In my critical work — like “TESCREAL hallucinations,” or “MAPS is an MDMA therapy cult” — I construct frameworks for perception. Many folks reached out to me after reading these papers, saying they now see things in a completely new way. They notice details and significance they’d never recognized before — even details that are new to me. The models have explanatory value; they help people make sense of the world in new ways.

This type of critical writing is a fundamentally psychedelic art form: the creation of new conceptual lenses as tools for reshaping consensus reality. A serious field — which would have appreciated the humanities ten years ago — wouldn’t see my work as a threat.

During my doctoral education at the University of Pennsylvania, I was trained in deconstruction by a student of Jacques Derrida’s student. You could say that deconstruction is my lineage.

Deconstruction analyzes central concepts (like “inner healing intelligence”) to reveal contradictions and ambiguities. It challenges foundational assumptions, calling into question purported conclusions that serve to legitimize existing power structures. And it exposes tautologies — identifying how systems of thought reinforce themselves without leaving space for critique or the possibility of updating underlying assumptions.

To accomplish everything I did this summer, I made extensive use of my PhD training with over a decade of postdoc experience. So, no — I don’t deserve to be harassed for doing my job, as the great Chappell Roan also emphasized this summer. It’s a sign of how far off the rails things have gone that many people thought this harassment was justified.

(As a side note: since some people have been reframing their harassment of me as reciprocal “critique,” here’s a handout explaining the difference between harassment and critique. They’re not the same thing.)

Veronika Gold’s “safe words”: Martin Ball 2.0

It’s been five months since I submitted my commentary to the FDA, which helped shift the field’s trajectory. Looking at what MAPS’s therapy actually entailed, half of the field said, “This is totally normal and fine; it’s you who are the problem!” Meanwhile, the other half said, “MAPS therapists were doing what?!! Thank you so much for telling us!”

Until I published my analysis, half of the field didn’t actually know what the other half was doing.

I have yet to see any substantial defense of Veronika Gold’s technique: namely, relying on a “safe word” to determine when a psychedelic therapist should continue physically restraining a client while they are shouting “stop” in escalating distress.

Recently, in a hateful and transparently misogynistic podcast, Hamilton Morris claimed that I lied to the FDA by describing Gold’s advocacy for “pinning down” clients during altered states. (Morris said he hasn’t publicly defended Veronika Gold’s technique because he “was too afraid” of being attacked by my supporters.) Morris’ guest, Casey Paleos (a co-Principal Investigator of a Lykos clinical trial), agreed with this characterization: “When people are just making false accusations or lying about things [like this], there is such a thing as slander and libel.”

(Morris also mocked those who challenged the dangerous rhetoric that targeted me: “If you're so afraid of mentally ill vets coming to kill you, probably a good way to begin would be to not interfere with mental health treatment for veterans.” Paleos — supposedly an expert in healing trauma — responded by laughing out loud: “Right!!”)

The reaction from the “cultophilic” side of the field has clear echoes to previous anger over our critique of Martin Ball’s methodology several years ago — and I think these parallels reveal a lot about the field’s underlying dynamics.

Ball — who wrote the foreword to then-MAPS Canada Executive Director Mark Haden’s Manual for Psychedelic Guides, which recommended Ball’s books as further reading — was widely recognized as a leading expert in 5-MeO-DMT facilitation. In his public writings and lectures, Ball described his facilitation process, which relied on nondual intuition to determine when he needed to vomit on his clients, shove his thumbs down their throats, or touch their genitals (because “that’s what they need”). In one instance, Ball described a session where he discerned that he needed to put his tongue into the mouth of an unresponsive elderly woman who had stopped breathing.

When Psymposia pointed out the dangers of relying on spiritual discernment to justify physical and sexual assault during psychedelic session, Psymposia was framed as the problem. We were described as lying — warping Ball’s statements for sensationalism and “clicks” — just as I’m now being accused of lying about Veronika Gold.

After Morris accused me of lying to the FDA about Gold’s technique, I received messages that devolved into semantic debates about the verb “to pin down” and the client’s angle of recline:

• Example Tweet 2: “I'm genuinely sad & disappointed to need to make this post, but @NeseLSD is doubling down on claiming Gold describes ‘pinning down’ a pt, which is simply & clearly untrue. It’s just 1 detail, but it’s a bad faith willful mischaracterization, which puts their motives in question.”

• Example Tweet 3: “I like your academic work and critical psychedelic studies is really needed atm but you have unfortunately shown yourself up here for this massive and obvious misrepresentation of Veronika Gold. How can we trust anything you say now?”

But as I explained in my original analysis, I found Gold’s technique in a book that was praised by much of MAPS’s leadership, including Rick Doblin and Michael Mithoefer (who designed MAPS’s therapy protocols). Many of the contributors worked on MAPS’s clinical trials. Doblin described it as “a cutting-edge exploration of psychedelic-assisted therapy by some of the top therapists and researchers in the field, providing … essential insights that are foundational to this work. This is a core text for practitioners looking to develop their skills.” In his endorsement, Mithoefer specifically praised the book’s case studies on the ethics of touch, which included this technique from Gold.

“‘Annie began to add her voice, expressing anger and saying, ‘Go away! Get your f***ing hands away from me!’ … There was no confusion in my mind about how to proceed. Over the course of the next several minutes, she pushed my hands with increasing vigor and force.”

It did not matter that this specific example occurred during a ketamine session. This case study revealed a flaw in their underlying model of consent, and it was being used to teach other people about best practices in psychedelic therapy. Separately, I received confirmation that this technique was used in Lykos’ Phase 3 clinical trials.

As I emphasized in my comments to the FDA, it does not matter if this particular individual appreciated this application of focused bodywork. It’s dangerous to establish reliance on a “safe word” as a gold standard for practicing psychedelic therapy.

During my PhD, I was explicitly trained to not rely on the ideological commitments of my source text to determine the criteria for analyzing it. In Cambridge Dictionary, “to pin down someone” is defined as “to limit someone’s ability to move or act, esp. by using force.” I articulated a counternarrative to describe the facts, which is psychedelic humanities. This was not malicious, and I do not deserve to be attacked for doing so.

As I realized even more clearly from these responses, “psychedelic exceptionalism” has gone so unchecked that many people in the field can't see basic ethical problems with Lykos’ therapy that even ChatGPT can easily identify. I posed this question as the prompt:

“Is it safe for a therapist to use Grofian ‘focused bodywork’ with a client on MDMA or ketamine? The method involves applying pressure by pushing against the client. Because the therapist is taught that the client may spontaneously reenact a traumatic memory by struggling with the therapist and shouting for the touch to stop, the therapist and client agreed ahead of dosing to use a ‘safe word’ if the client really wants the touch to stop.”

ChatGPT answered:

• “Using Grofian focused bodywork (or any form of body-based therapy) with clients under the influence of substances like MDMA or ketamine raises significant safety and ethical concerns, particularly when it involves physical touch or applying pressure. The specific scenario you describe, where the therapist and client agree on a ‘safe word’ for when the client really wants the touch to stop, poses both psychological and physical risks.”

• “Even with a prior agreement on a ‘safe word,’ a person under the influence of these substances may struggle to effectively communicate discomfort or a need for boundaries.”

• “The reenactment of traumatic memories during psychedelic therapy is possible and may be exacerbated by physical contact. A client who is reliving trauma may have a fight, flight, or freeze response, and the use of pressure or physical contact can unintentionally trigger re-traumatization, even with the presence of a ‘safe word.’”

• “The client’s emotional and physical responses could be misinterpreted by the therapist as part of the process, leading to further distress without immediate intervention to stop the interaction.”

• “The concept of a ‘safe word’ suggests that the client retains control over the interaction, but in practice, their ability to consent during the altered state may be compromised.”

• “The therapeutic relationship inherently contains a power dynamic. This dynamic may be magnified during a psychedelic experience, where the client is in a vulnerable state. Physical touch, especially if it mirrors trauma, could amplify this imbalance, causing the client to feel pressured (consciously or unconsciously) to endure discomfort or pain without speaking up, even with a pre-established ‘safe word.”

And regarding those debates about the client’s angle of recline? Veronika Gold stated in a 2019 podcast that when she facilitates ketamine-assisted psychotherapy (KAP), her clients “lie down in a bed,” even when she engages in somatic bodywork during lower doses:

“In the lower doses, where people are able to talk more, they’re still lying down on the couch — they have the eyeshades, the music — but they’re sharing about what’s coming up. And sometimes it can be insights, sometimes there are memories that come up that are connected to their struggle. Sometimes they do full trauma processing, so that they might have like a — the memory of what happens comes back, and we are working like I would work in a somatic psychotherapy.”

In a 2020 podcast, Gold also acknowledged that her version of KAP was developed from the MAPS protocol:

“So Polaris [KAP clinic] really came from this deep friendship of five of us who were working on the MAPS clinical trials and, you know, witnessing these transformations, and the healing potential of the medicine, and the desire to begin work with the medicine [ketamine] now, [before MDMA is approved].”

At the end of the day, Gold was describing the same “technique” that Richard Yensen used during the on-camera physical assault that occurred during a MAPS Phase 2 clinical trial, which neither MAPS nor Lykos has acknowledged.

A screenshot involving on-camera abuse of a participant during a MAPS Phase 2 clinical trial. (The Cut)

As with the field’s earlier implementation of male-female therapist dyads — which was widely adopted as a bandaid solution for the widespread problem of sexual assault by MDMA-assisted therapists — the field is now turning to “safe words” as a bandaid solution for therapeutic techniques that are fundamentally flawed and unethical.

PSA: Bioethics exists because we can’t rely on good intentions

It’s worth emphasizing that neither Gold nor Ball were writing memoirs about their personal religious beliefs and practices; they were teaching others about best practices for psychedelic guiding, which raises the stakes. If harmful or dangerous practices are incorporated into explicit pedagogy for other guides to implement, the potential for harm is liable to scale. For those of us who work in psychedelic harm reduction, it’s both an ethical and professional duty to critique harmful practices that are represented as safe and effective.

In a recent episode of Psychedelics Today, Lykos clinical trial co-PI Ingmar Gorman fundamentally misunderstood how ethics works:

“You’re [i.e., Psymposia is] critiquing the integrity of us as therapists...for whom compassion, equanimity, [...] all of these qualities are so important to us. So when you say that we’re a cult member...that completely undermines and attacks our integrity as people who are in a caring profession, and...when you say that there’s allegations of fudging data, that cuts us at the needs of scientists, and so people aren’t...necessarily connecting the dots, right? Like, they think they’re critiquing the organization, but they’re also impacting us as individuals. [...] Coming back to...us clinicians — like me, staff at Lykos...some of whom...have been attacked, and are...actively being attacked right now — they...just got into this to help people. [...] I know some people are really feeling hurt that this is the intention that they went into this work with, and they’re being really viciously attacked for it.”

Given the timeframe, Gorman implied that I was “viciously attack[ing]” Veronika Gold, which demonstrates his ignorance about the nature of systemic critique. 

My analysis of Gold’s writing was never a call-out of an individual person, and I have no doubt that Gold genuinely believes her technique was safe and effective — just as I’m sure that Martin Ball believed in his own techniques. Their writings are symptoms of psychedelic underground’s dominant ideology, wherein guides can cultivate the spiritual capacity to discern when the client needs to suffer for their healing.

Bioethics exists as a field because we can't rely on good intentions. Critiquing dangerous techniques is not accusing therapists of being bad people. There are systemic issues based on fundamental flaws in the underlying healing ideology:

• Intuitive touch and reading energies are vectors for bias that will disproportionately impact the most marginalized demographics.

• Therapists self-monitoring their intentions (“do the work,” “check in with yourself” is not a safe or reliable way to ensure that intuitions are accurate assessments of the client’s own interests.

Systemic critique is not synonymous with “every individual,” and yet it’s common to hear “Not all men!”; “Not all white people!”; and now “Not all MAPS therapists!” I never said it was all MAPS therapists. If the shoe doesn't fit, it’s not about you.

MAPS’s supporters and affiliates have been contemptuously strawmanning my cult analysis, but I was very careful and specific in defining MAPS as a “therapy cult,” as I will elaborate on here.

From the start, MAPS’s therapy model was euphemistic, to the extent that the highest-risk applications of touch in MDMA-assisted therapy have never been discussed in the psychedelic ethics literature. These high-risk applications of touch — many of which emerged from Grofian “focused bodywork,” which Veronika Gold was describing — were outsourced to external workshops and underground practitioners. These uses of touch were not taught as part of MAPS’s formal training.

MAPS’s clinical trial sites were bifurcated between research universities and private clinics, and their clinicians had proportionately disparate backgrounds. Many of the private clinics were selected for their therapists’ experience in the psychedelic underground. Some of the mainstream researchers had no idea that so many MAPS clinicians were underground therapists. This difference in experience between MAPS’s clinicians led to differing perspectives on the therapy model itself.

There was a reasonable, noncontroversial way of reading the MAPS protocol, which is all that conventionally trained researchers and ethicists noticed when they read about it. I’m sure that some of MAPS’s clinicians with conventional research backgrounds maintained rigorous boundaries and respected their clients’ autonomy, and these clinicians were not the focus of my analysis.

After many years of research, I finally discovered that there was a completely different reading of MAPS’s therapy model than the euphemistic version that was acknowledged in the media and in academic articles. This alternative reading was evident to the many MAPS therapists who were trained in the underground, which is where the framework for this therapy model was originally developed.

The underground portion of MAPS’s therapy circle was unquestionably indoctrinating new psychedelic therapists into a system of pseudoscientific beliefs. There is such deep resistance to this idea, in part, because so much of the field has been complicit in normalizing these dangerous ideas. This is evident in a 2021 Psychedelics Today podcast episode with Veronika Gold and her co-therapist Harvey Schwartz, who acknowledged that psychedelic therapists are discovering they have psychic healing powers during retreats, and that they need support adjusting to this new reality:

“I’ve seen this happen on retreats, where [psychedelic] therapists who had previously been more non-transpersonal actually open up to this more intuitive gift, or intuitive ability they have. And then they start going through a big identity crisis around like, ‘Well, what if I go back and tell my [therapist] colleagues back home that I’m, you know...hearing ancestral voices, or, you know, picking up things [telepathically]. And so, I think there’s a lot of support needed for therapists who are going through the transformation to become psychedelic therapists.”

MAPS’s focused bodywork relied on this telepathic ability to discern what the client needs, outside the guardrails of concrete guidelines or fixed boundaries, as the podcast’s host acknowledged:

“It sounds like this [Grofian bodywork] is something that you are trying to teach. Like, how do you pass that on? I feel like it, it is really tricky, and this is something that we’ve actually run into a little bit in, in our breathwork training.... We’ve been trying to figure out, like, some of the bodywork — how do you teach that? Our teacher Lenny's always like, you know, there’s certain techniques, but you really have to tune into the person, and like, follow that process. And sometimes we’ve noticed people getting, just — really wanting to get to know the technique and the protocol, as if there is a protocol when it comes to some of this stuff, and it’s really kind of hard to teach that intuition, that more intuitive process, to follow it and, um, to really trust it at times.”

On that side of the field, it’s easier to demonize me than to acknowledge that it’s always been unethical to promote these practices as evidence-based medicine to vulnerable patients who are desperate to heal.

As introduced by MAPS, the insistence on touch in psychedelic therapy was always a loophole for laundering dangerous, pseudoscientific practices that were never transparently disclosed to the FDA or independent ethicists.

In a Twitter thread earlier this month, other researchers corroborated that MAPS has been omitting details about touch and the associated potential for abuse in its therapy training. As Joar Øveraas Halvorsen mentioned:

“On Wednesday I participated in an interesting panel discussion re. psychedelic-assisted treatments. When the sexual abuse in MP4 was discussed, a psychologist who recently had participated in @MAPS training on MDMA-AT came with an interesting revelation. [...] During recent training in MDMA-AT by @MAPS the sexual abuse in MP4 was never mentioned, not even when focusing on ethical aspects of MDMA-AT. It was the participants themselves that had to thematize this. A clear indication that @MAPS does still not acknowledge the issue."

In response, another researcher added that “I don’t think maps has come out to make clear what kind of touch is and is not ok during mdma-at either which is awful and crazy.”

As I mentioned in my earlier analysis, MAPS used to be more open about its uses of touch — until this caused problems. Even though sexual assault had occurred during its own clinical trials, MAPS stopped including training on touch sometime after the Palo Alto V.A. canceled a planned research collaboration. At the time, V.A. researchers had participated in the training and determined that the recommendations for touch seemed “abusive,” according to Rick Doblin himself. Rather than reconsider whether its approach to touch was actually safe or justified, MAPS became more “discrete” in acknowledging the dangerous practices that were inherent to its therapy model.

Even while Paleos and Morris were trying to debunk me and assure listeners that Lykos’ science was impeccable, Paleos admitted that he did not know how touch was being used at other trial sites in the same Phase 3 clinical trials:

Casey Paleos: “We were taught if you already certified in one of these somatic-oriented psychotherapies, or somatic therapies that — for trauma — that involve touch, and you have proficiency in doing that and that’s part of your scope of practice, that’s okay. Then you can use that. That's within your scope of practice. You already know how to do that ethically and you’re doing it already in your practice, then we were instructed that it’s okay to incorporate that into the work that you're doing.

Hamilton Morris: And what might that entail? 

Casey Paleos: I don't know, because I’m not a somatic therapist. *laughs* But for those of us who weren’t trained as a somatic therapist, what we were taught is you shouldn’t be trying to learn a new skill around touch therapy to be a part of this clinical trial. That was — we were explicitly told not to do that, because this is not the right circumstance for you to be learning this from scratch.

Just prior to that segment, Paleos emphasized that “It almost goes without saying, but it was explicitly stated in our training. Touch is never sexual.”

Since there is never any elaboration from MAPS on this point, this is a dangerous place to leave the basic training. In my research and personal experience with the underground, sexual assault is almost always framed as “for the benefit of the client,” with the guide having spiritually discerned that it was “necessary for healing.”

After I was sexually assaulted by a trusted mentor, my mentor immediately told me that the assault “wasn’t sexual,” and that he did it for me. According to him, the fact that I was upset about what happened showed that “I wasn’t as much of an expert in psychedelics as he thought I was.” This is a recurring consequence of the underlying healing ideology, which means the problem is systemic.

As I’ve been presenting at psychedelic ethics conferences since 2023, Larry Nassar was able to abuse Olympic gymnasts for years by claiming his use of touch was medical, not sexual. By saying that touch is never sexual and relying on the facilitator’s unboundaried intuition in applying touch, the therapy model has enabled abuse that should never have happened.

Ultimately, MAPS’s therapy was premised on a totalizing, pseudoscientific, and non-falsifiable healing ideology that was already associated with a predictable pattern of harm in the underground, long before it was brought into clinical trials. In the cultophilic side of the field, many people believed that this ideology was going to become mainstream and normalized. I’m grateful that’s not happening, and I’m proud of the work that we accomplished over the summer.

“Vulnerability hangovers”: Protecting the lineage with rhetorical shields

Therapy cults promote tautological and non-falsifiable therapeutic ideologies. As in the case of MAPS’s therapy model, these non-falsifiable ideologies make it hard to identify when someone is experiencing an adverse reaction that is not therapeutic. When distress is framed as healing, and the therapist is given the discretion to evaluate the client’s “window” for tolerating distress based on subjective intuition (by “attuning to the relational field”), there is an inherent risk of retraumatization that is magnified by increased vulnerability and suggestibility. 

When clients are told they must “do the work” and are coached to “trust the process” — commonly under media-hyped expectations that psychedelic therapy is a last-resort treatment option — they are primed to endure whatever distress arises. In the most extreme cases, even when clients are clear that they want a therapist’s touch to stop, the ideology endows therapists with the discretion to interpret cries of distress as “actually” directed at the client’s past abusers. And horrifically, in such cases, the therapist is empowered to enact the role of the perpetrator with a struggling client, so long as they “attune” to the client’s inner healing intelligence and ascertain that this struggle is what that intelligence is trying to express.

“One quality of the inner healer that we’ve not talked about is its shadow side. It seems to me that inner healer shows up not just as the supportive element within the client’s experience, but also as the re-creator of the remembered trauma. Here’s what I mean: To process trauma, I think we need the traumatic foe or perpetrator to which we are responding to make an appearance.” — MAPS Bulletin

This is what happened during the horrific abuse that took place in MAPS’s Phase 2 clinical trials.

To this day, neither MAPS nor Lykos has ever acknowledged that the on-camera physical and sexual assault that occurred during Phase 2 was enabled by the therapeutic framework of their MDMA-assisted therapy. MAPS/Lykos never disclosed to the FDA that Donna Dryer and Richard Yensen were following a pseudoscientific methodology that was central to the therapy model used in the clinical trials. These therapists were not statistically inevitable “bad apples”; they were an inevitable consequence of MAPS’s therapeutic ideology. 

I’m not (and have never been) arguing that all of MAPS’s therapists took things this far, but that the MAPS healing ideology leads to and facilitates these outcomes. When things go wrong, people are on their own to deal with the fallout. Since there’s no safety net, people who were harmed find patient advocates like me. And when we try to share that something is wrong, and that people are getting hurt — we receive death threats. Clearly, something is wrong, and there’s more going on in this field than a desire to heal trauma.

When an unfalsifiable lineage is held as spiritually sacrosanct by adherents, the lineage can’t be interrogated as a possible source of emerging harms. In such cases, practitioners develop rhetorical devices that function as “pressure-release valves” by attributing causation to other factors, often at the expense of the clients they claim to serve: “underlying mental illness,” “manipulative tendencies,” or — as I mentioned in my therapy cult analysis — “vulnerability hangover.”

I’ve seen the “vulnerability hangover” script play out in practice, where a MAPS-trained therapist violated a client’s consent, and then chalked up their subsequent distress to the client’s inability to accept responsibility for what “authentically” emerged during the session. When therapists are taught that they can self-monitor their intentions (by “checking in with ourselves”) while cultivating the spiritual capacity to “read” what the client’s inner healing intelligence is expressing, the therapist is positioned to mistake their intuitions for what’s in the client’s best interest. This is a vector for projecting bias that will disproportionately impact the most marginalized demographics.

In a preprint published by MDMA trial therapists after the FDA’s advisory committee meeting, the authors acknowledged that this “vulnerability hangover” is an actual component of their model: “In some cases, a rupture to the therapeutic alliance may emerge after even a ‘positive’ experience in the experimental session. For example, a participant who unexpectedly gave themselves permission to be vulnerable during the session, bypassing standard modes of self-protection, might later experience a ‘rebound’ destabilization.” 

This framing — which does not acknowledge that the therapist might have actually crossed a boundary — functions as a protective screen, shielding the therapist from needing to question the methodology itself.

Beyond the psychedelic field, there have been other instances where totalistic, unfalsifiable lineages have prevented adherents from recognizing nuance in participants’ distress. As an example, I recommend listening to Financial Times’ investigative podcast, “Untold: The Retreat,” which describes uncanny parallels to the problems I’ve been tracking in MAPS’s therapy model. The podcast focuses on intensive Vipassana meditation, from which many people have derived great benefit.

Madison Marriage — the podcast’s host — describes how meditators are prepared to associate distress as part of the process. As a consequence, they are encouraged to endure distress that they would otherwise disengage from. For many, this instruction is described as beneficial, since it encourages them to stick with a process that they might have otherwise given up on. But this orientation has also prevented facilitators from recognizing when participants are experiencing extreme distress that might benefit from stopping the meditation.

The podcast suggests that Vipassana’s overly reductive framing of distress as “part of the process” is driving predictable patterns of harm. These harms are subsequently compounded by institutional betrayal, as facilitators resist any attempts to link these harms with the underlying teachings.

In an interview with Marriage, NPR’s Andrea Muraskin posed a question with obvious parallels to the psychedelic field: “I can imagine you’ve received some pushback from people who’ve really benefited from Vipassana retreats. What’s your response to people who say you’ve painted the Goenka [Vipassana] network too negatively?”

Marriage’s answer perfectly captured my own orientation to my work in the psychedelic field: “We’ve had a couple emails from people who say this is really one-sided, you’re not looking at the positive experiences at all, this has changed my life for the better. But the podcast isn’t about the people for whom this works…. The purpose is to scrutinize the harm that is being done to people and to question why the organization itself [isn’t] doing more to prevent that harm.”

The psychedelic field loves to talk about “shadow work” and taking responsibility, and yet there’s no recognition that this all came to a head during the FDA’s AdComm meeting because the MAPS-centric field had ostracized all of the critical voices who were identifying shortcoming with their methodology. In a healthy field, these critical perspectives would have been sought out as a source of information, with leadership eager to identify potential blind spots in the interest of improving safety and efficacy.

Instead, we were dehumanized, blamed, and pushed to the side. They thought we could be ignored; since they viewed us with contempt, they thought no one else would listen to us either. With so much at stake, we made use of the only options available to us, with the intent of notifying the public and the FDA about our concerns.

The fact that there is so little self-awareness that this was a logical outcome of their own actions emphasizes my point: there is rampant groupthink in the psychedelic field, and that leads to finger-pointing at the “out-group” when any problems arise. Frequently, the out-group is comprised of harmed parties and their advocates.

FIN

I’ll leave you with a summary of our impact from Ars Technica. To all my supporters — thank you so much for your patience and grace through what has been a very challenging year. Now that we’ve done it — let’s make the field better.

“According to a report from The Wall Street Journal, the FDA is now expanding an investigation into clinical trials behind the experimental psychedelic therapy….. Agency investigators reportedly interviewed four additional people last week, asking questions regarding whether the trials underreported side effects. […]

Overall, the MDMA trials faced crushing criticism amid the FDA's review, with outside experts and agency advisers calling out allegations of sexual misconduct at one trial site, as well as flaws in overall trial designs, multiple sources of biases, and claims that the company behind the therapy, Lykos, fostered a cult-like belief in psychedelics. […]

Trial participants and outsiders have levied heavy criticism against the company that will likely be hard to move beyond. […] 

"The prospect of a therapy cult guiding a suggestibility-enhancing drug through clinical trials highlights unique risks that have never been publicly discussed," Neşe Devenot, a Johns Hopkins University senior lecturer in the university’s writing program who focuses on the issue of drugs in society, said in public comments prior to the FDA rejection. "The trials should be scrutinized as if Scientology or NXIVM had submitted a new drug application to the FDA."

Those public comments appeared in a damning report from Institute for Clinical and Economic Review, which concluded that there was insufficient evidence to back MDMA-based therapy. According to the Journal report, Devenot was among the people interviewed by FDA investigators recently.”

(And a final postscript, written during one especially difficult day over the summer:)

I accepted that it would be hard to speak up on behalf of those who weren’t able to. Like my contacts, I had already seen dominant actors in the psychedelic industry — where urgent scaling is premised on claiming solutions for trauma — make examples out of people for drawing attention to abuses.

I had already been one of those examples in a different context, for another time. From that experience, I learned that solidarity is the only antidote for the moral injury of institutional cruelty.

Still, I didn’t anticipate how cruelty can have this many layers and waves — how cruelty can be relentless when you’re speaking the truth. How even in the act of naming the cruelty, in identifying cruelty as it’s happening — how it’s wrong, and how it’s corrosive for the field — it escalates. Identifying cruelty becomes the premise for more abuse.

I didn’t expect the scale of this, because I’d never been such a threat to billionaire investors, whose coordinated PR campaigns could dehumanize me without constraint.

With such a blatant imbalance of power, it’s been hard to watch how many people make excuses, or look the other way, or join in.

It’s important for the field to recognize these dynamics, because it’s not just happening to me. And since this situation is especially egregious, that makes it easier to see.

If we don’t challenge dehumanizing rhetoric while it’s visible, it becomes routine. Where cruelty is tolerated, it disproportionately impacts those with the least power to challenge it.

As with so many other things — because I can see it, I need to say something.