What Can a Psychedelic Guide Do That a Psychiatrist Can’t?
Hint: the psychiatrist won't tell you
[coordinates: breakfast table in the kitchen in en casa in Oaxaca]
I was just minding my own business one fine Saturday while eating a mushroom frittata and clicking on whichever YouTube video caught my eye.
Let me say first that I have huge respect for the pioneering work Johns Hopkins is doing in legitimizing the field to move towards legalization and decriminalization. This is indispensable.
However, the video posted below, which now has 5 million views misses in the place that nearly every commentary about psychedelics by a scientist or psychiatrist misses. He implicity imposes the limitations of psychiatry on the entire field of psychedelic healing.
In my best Southern accent, I drawl –
“Honey, you do not speak on behalf of everyone.”
He proposes a standard of ethics that may be appropriate for the psychiatric community of practice, but he has zero authority to speak on behalf of others outside that scope. You, however, wouldn’t know it by the way he presents the material.
Dr. Johnson only included white men in his history of psychedelics. I don’t wish to “politely” ignore such a blatant mistelling of a story so dear to my heart. He entirely elided the generations of indigenous practice in every corner of the world stretching back to prehistory. The work done since the 1960s by the scientific community is but a mugful of seawater in the ocean of wisdom that we collectively hold in our minds and bodies about psychedelic experiences.
How is a channel as large as Big Think allowing such an oversight? I reached out to both BT and Dr. Johnson to invite them into this conversation but did not receive any reply.
I’ve run out of patience for innocent ignorance. This isn’t a topic humanity can afford to half-ass at a moment when mental and planetary health has reached crisis levels.
Without further ado, here’s the video in question followed by the comment I left on YouTube. Perhaps it won’t be read by anyone in the sea of the other 11k comments, but I had to do it for my own sake.
Many people wish to be touched physically, emotionally, and spiritually during these profound experiences. If you are considering this work, please don't let Dr. Johnson’s limited presentation of what's possible limit your confidence in choosing guides and priestesses* who possess the capacity to offer these experiences at the highest standard of professionalism.
He says “-We- need to even more tenaciously cling to clinical boundaries. -We- need to limit the use of therapeutic touch. [sic] On the big metaphysical questions -we- have to be silent.” The only -we- he can credibly speak about is psychiatrists. Psychiatrists mustn't touch their clients. Psychiatrists mustn’t offer wisdom on life’s big questions. Ok fair enough, that's their business to decide if they wish.
Many, but not all, people are well-served by this approach. I consider it most suitable for those in the early parts of their healing journey, those raised in Western cultures, or those who have been wounded by religious/spiritual teachers with the guru syndrome he quite rightly points out.
Not all psychiatrists work in this model though. There’s a documentary with Jonah Hill and his psychiatrist called Stutz and the best-selling book The Body Keeps the Score by Dr. Bessel Van der Kolk you can check out to find two of the progressive psychiatrists pushing their field forward.
Dr. Johnson certainly does not possess the credibility to speak on behalf of all psychedelic guides as he does not demonstrate respect for the traditional knowledge which formed the foundation of his own practice or any commitment to telling an accurate, non-colonized history of his profession. Without indigenous healers, there would’ve been no field of psychiatry as humanity would’ve died out long, long ago.
Quite notably absent from the history he presented is that The Beatles were introduced to mushrooms by a curandera named Maria Sabina in the hills of Oaxaca, Mexico. I cannot know for sure what Señora Sabina did or did not do, but I doubt she would've hesitated to answer a big metaphysical question where she had the wisdom to impart.
And regarding the question of touch, many indigenous healers do use touch as an essential piece of their healing process.
White men did not discover this field, and they do not now possess ultimate authority over it.
-We- the psychedelic guides and priestesses cannot be silent on matters of our own authority no matter what anyone with any number of letters after their name claims -we- must or mustn't do.
*If you wanna know more about the systematic suppression of indigenous healing with psychedelics, I recommend The Immortality Key by Brian Muraresku. If you are wondering what I mean by my tiny mention of psychedelic priestesses above, he gives a great introduction.
Cris,
While I don’t by any means entirely disagree with your argument regarding a psychiatrists place in psychedelic healing, I do have some pushback to offer.
In the video by Big Think, Dr Johnson is reviewing the recent and profound effects of psychedelics in clinical settings. While he may have only briefly described the thousands of years of psychedelic use around the world, the point of the video is not to describe indigenous and broader cultural history psychedelic use. Dr. Johnson is describing what we know as a result of the reemergence of this medicine in the West. He describes the psychedelic renaissance of the 60s and 70s, he describes the integration of such into the already developed fields of psychology and psychiatric practice, and he describes the results of such.
In my opinion, what Dr. Johnson is offering the viewer is a lens through which to view psychedelic medicine. A lens which revolves around the times the viewer is likely most familiar with, ie their impact during recent periods on music, scientific understanding, and psychiatric practice. Dr. Johnson refers to the impact psychedelics have had in these moderns times because such is arguably more relevant to the research being conducted today, vs the impact these medicines have had in the more so distant past, or in native populations of today.
In referring to the great pioneers of psychedelic therapy, Dr. Johnson leaves out the healing work indigenous folk like Maria Sabina, not because their work doesn’t have legitimacy or significance, but because the work of individuals like Abram Hoffer is much more quantifiable and arguably more valuable in terms of progress. The “powers that be” (the FDA for example) who control which treatments are available or not, do not care one bit about the countless years of indigenous use, they only care about the data. This is not something I will attempt to justify, as I would personally have it differently. However, that’s just the way it is. Dr. Johnson is, in my opinion, not, “[implicitly] [imposing] the limitations of psychiatry on the entire field of psychedelic healing.” He is simply describing the work that is being done in accordance with authoritative oversight, which does not permit, apart from in religious contexts (ie the Native America church, and others), or see scientific legitimacy in, the use of psychedelics in ceremonies lead by shamanic healers. Not that I agree with this, it’s again just seemingly the way it is at this point in time.
While I 100% agree that, “the work done since the 1960s by the scientific community is but a mugful of seawater in the ocean of wisdom..” the work you want to see acknowledged is not as useful for bringing these medicines back into regulated use. Not to say I think unregulated use of psychedelics should be illegal, but again, in Dr. Johnson’s defense, unregulated use has little merit in the eyes of mainstream academia or in the eyes of lawmakers.
I agree that psychedelics should not be limited to people with chronic or severe mental illness, and I too would encourage people to consider exploring them, and even using them, if they so desire. Dr. Matthew Johnson is undeniably limiting the possibilities in this regard, however, in being a clinician, Dr. Johnson hesitancy is understandable as to promote such, as promoting non-clinical use could deprive him of credibility. Additionally, I agree with you that the hands-off approach many psychiatrists implement most definitely won’t work for everyone, however, the results from numerous clinical trials clearly demonstrate such an approach is certainly not stopping a large body of people from having revolutionary experiences under the influence of these amazing medicines. This is not to downplay the work of shamanic healers, however. Something I don’t think Dr. Johnson is trying to do either, I think he is simply describing what works for clinicians and what standards they practice.
You say, “Dr. Johnson certainly does not possess the credibility to speak on behalf of all psychedelic guides as he does not demonstrate respect for the traditional knowledge,” but I would argue he’s not trying to speak on behalf of all psychedelic guides, and actually has a deep respect for the work of traditional psychedelic healers (something he touches on in longer conversations, such as on the Lex Fridman podcast). Dr. Johnson is only speaking on his own behalf, and the behalf of others conducting similar research; research which is, again, arguably the most valuable in terms of, as you said, “legitimizing the field to move towards legalization and decriminalization.” Something which is necessary if these medicines are ever to return to widespread use in the western world.
To conclude, I do agree that “psychedelic guides and priestesses cannot be silent on matters of [their] own authority,” but if they really want to be accepted and legitimized by the mainstream of science, they must work with academia rather than against it. If a shaman from Peru wishes for their work to become part of the widely accepted scientific narrative, then they must adopt science as an ally, rather than simply claim authority. Anecdotes and personal experiences, while often revealing and moving, are simply not enough. Today’s world is rigorously scientific, and shamanic practices can either remain mainly underground, or can interface with this world. This is what Dr. Matthew Johnson is promoting in my opinion, not a repression of the historical use or significance of psychedelics, but a focus on the profound work being done NOW, work that meets these rigorous scientific standards and is actually bringing psychedelics back into public perception. Something which will ultimately, again - in opinion, lead us down a rabbit hole of what psychedelics are capable of (not just for mentally ill individuals) and what they have offered human civilizations for centuries.
Keep up your work, but perhaps see that Dr. Johnson is an ally, rather than