The Therapy Part of Psychedelic Therapy Is a Mess

On touches of a sexual nature, it reads: “Any touch that has sexual connotations or is driven by the therapist’s needs, rather than the participant’s, has no place in therapy and can be counter-therapeutic or even abusive.” But the lack of further description leaves it up to the therapist to interpret the connotations of a touch and whose needs it is serving, Devenot says.

The manual advises that the therapist obtain the individual’s consent before touching them, but whether a patient can give consent in an altered state of consciousness is a point of concern, says Bedi—especially if they’re under the influence of a drug known to enhance suggestibility and sexual feelings. “The idea that people have the capacity to consent when they’re essentially really intoxicated [is] just something that we wouldn’t accept in any other setting,” Bedi says.

McNamee, whose interest in psychedelic therapy led her to seek out training and join communities of clinicians who work with psychedelics, says that she has witnessed insiders “discuss the merits of cuddling clients” in order to repair “wounds of childhood neglect.”

Another commonly used approach involves conducting sessions with two therapists instead of one, generally one female and one male. Sometimes, these therapists are married, as was the case for Meaghan Buisson during her 2015 MAPS clinical trial. MAPS requires only one therapist in its trials to have a license, which, executive director Rick Doblin says, is to reduce costs for patients. This was also the case in Buisson’s situation.

If that unlicensed therapist causes harm, there’s no regulatory board to hold them accountable. Such a scenario is alleged to have happened with Buisson and one of her therapists, Richard Yensen. After active treatment in the 2015 trial had ended, Buisson continued to see the two therapists. During this period, she alleges that Yensen sexually assaulted her.

In response to a civil claim Buisson brought against him, Yensen said that he had entered into a consensual intimate relationship with her. The claim was settled out of court. Buisson later lodged a sexual assault complaint against Yensen with the police over the same events, and the police recommended charges, but the complaint wasn’t pursued by the prosecution services. Neither Yensen nor his co-therapist, Donna Dryer, responded to requests for comment.

MAPS has since barred Yensen and Dryer; Dryer is still a practicing psychiatrist. “The situation with the MAPS trial really highlights the dangers of not having licensed people in the situation, because there is no recourse to regulatory oversight if someone is not licensed,” says Bedi. MAPS did not offer a comment on Buisson’s alleged assault or on its clinical trial guidance. 

The reasoning for co-therapists, as well as how co-therapy should function, is not elaborated on in the MAPS manual. In reality, the concept of a male and female therapist duo in psychedelic therapy was adopted to try to prevent sexual abuse in the wake of reports that Richard Ingrasci, a psychiatrist using MDMA in his practice, had sexually abused his patients in the late 1980s.

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