Culture and psychedelic psychotherapy: Ethnic and racial themes from three Black women therapists

Abstract

Psychedelic medicine is an emerging field of research and practice that examines the psychotherapeutic effects of substances classified as hallucinogens on the human mind, body, and spirit. Current research explores the safety and efficacy of these substances for mental health disorders including anxiety, depression, and posttraumatic stress disorder (PTSD). Although current studies explore psychotherapeutic effects from a biomedical perspective, gaps in awareness around cultural issues in the therapeutic process are prominent. African Americans have been absent from psychedelic research as both participants and researchers, and little attention has been paid to the potential of psychedelics to address traumas caused by racialization. This paper examines cultural themes and clinical applications from the one-time use of 3,4-methylenedioxymethamphetamine (MDMA) as part of an US Food and Drug Administration (FDA)-approved clinical trial and training exercise for three African American female therapists. The primary themes that emerged across the varied experiences centered on strength, safety, connection, and managing oppression/racialization. The participants' experiences were found to be personally meaningful and instructive for how Western models of psychedelic-assisted psychotherapy could be more effective and accessible to the Black community. Included is a discussion of the importance of facilitator training to make best use of emerging material when it includes cultural, racial, and spiritual themes. A lack of knowledge and epistemic humility can create barriers to treatment for underserved populations. Implications for future research and practice for marginalized cultural groups are also discussed, including consideration of Functional Analytic Psychotherapy (FAP) as an adjunct to the psychedelic-therapy approaches currently advanced. As women of color are among the most stigmatized groups of people, it is essential to incorporate their perspectives into the literature to expand conversations about health equity.

Full text

Culture and psychedelic psychotherapy: Ethnic
and racial themes from three Black women
therapists
MONNICA T. WILLIAMS
1,2,3*
, SARA REED
1,2
and
JAMILAH GEORGE
1
1
Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
2
Behavioral Wellness Clinic, LLC, Tolland, CT, USA
3
School of Psychology, University of Ottawa, Ottawa, ON, Canada
Received: March 29, 2020 •Accepted: July 5, 2020
Published online: September 8, 2020
ABSTRACT
Psychedelic medicine is an emerging field of research and practice that examines the psychotherapeutic
effects of substances classified as hallucinogens on the human mind, body, and spirit. Current research
explores the safety and efficacy of these substances for mental health disorders including anxiety,
depression, and posttraumatic stress disorder (PTSD). Although current studies explore psychothera-
peutic effects from a biomedical perspective, gaps in awareness around cultural issues in the therapeutic
process are prominent. African Americans have been absent from psychedelic research as both par-
ticipants and researchers, and little attention has been paid to the potential of psychedelics to address
traumas caused by racialization. This paper examines cultural themes and clinical applications from the
one-time use of 3,4-methylenedioxymethamphetamine (MDMA) as part of an US Food and Drug
Administration (FDA)-approved clinical trial and training exercise for three African American female
therapists. The primary themes that emerged across the varied experiences centered on strength, safety,
connection, and managing oppression/racialization. The participants' experiences were found to be
personally meaningful and instructive for how Western models of psychedelic-assisted psychotherapy
could be more effective and accessible to the Black community. Included is a discussion of the
importance of facilitator training to make best use of emerging material when it includes cultural, racial,
and spiritual themes. A lack of knowledge and epistemic humility can create barriers to treatment for
underserved populations. Implications for future research and practice for marginalized cultural groups
are also discussed, including consideration of Functional Analytic Psychotherapy (FAP) as an adjunct to
the psychedelic-therapy approaches currently advanced. As women of color are among the most
stigmatized groups of people, it is essential to incorporate their perspectives into the literature to expand
conversations about health equity.
KEYWORDS
African Americans, hallucinogens, psychedelic medicine, MDMA, psychotherapy, education, race, culture
INTRODUCTION
Psychedelics in Western medicine
Psychedelics have been used in traditional indigenous contexts for centuries for emotional
health, spiritual purposes, and personal growth, but are now re-emerging in Western med-
icine for their potential in reducing symptoms of some of the most disabling mental health
conditions. Therapeutic experimental research of psychedelics dates back to the 20th century,
with drugs like Lysergic acid diethylamide (LSD), psilocybin, mescaline, and 3,4-methyl-
enedioxymethamphetamine (MDMA) being used for a variety of indications (Costandi, 2014;
Passie, 2018). Current clinical research is exploring the safety and efficacy of psychedelics for
Journal of Psychedelic
Studies
4 (2020) 3, 125–138
DOI:
10.1556/2054.2020.00137
© 2020 The Author(s)
RESEARCH ARTICLE
*Corresponding author.
E-mail: monnica.williams@uottawa.ca

mental health disorders, such as posttraumatic stress disor-
der (PTSD), mood disorders, substance use, and end-of-life
anxiety (Brown & Alper, 2018; Ross et al., 2016; Ot'alora G
et al., 2018). These drugs have been explored as stand alone
treatments, such as intravenous ketamine infusion therapies
(Zarate et al., 2006), and as adjuncts to psychotherapy
(Mithoefer et al., 2018; Rodriguez et al., 2016; Wilkinson
et al., 2017). However, very little of this research has focused
on people of color, and there are no accounts that represent
the experience of Black women. The purpose of this paper to
report the personal accounts of three African American fe-
male clinicians who ware administered a psychedelic sub-
stance in a psychotherapeutic clinical setting to help advance
our understanding of the use of psychedelic-assisted psy-
chotherapies in different populations.
In Western clinical paradigms, psychedelic substances
and traditional psychotherapy have been combined to create
mental health treatments that are curative and support
psychic expansion through non-ordinary states of con-
sciousness, where the effect is potentiated by the presence of
an experienced healer, therapist, or guide. For example,
psilocybin is being used in combination with Acceptance
and Commitment Therapy (ACT) for the treatment of
Major Depressive Disorder (Sloshower et al., 2020). Ibogaine
is combined with behavioral therapy in the treatment of
opiate dependency (Brackenridge, 2010). Likewise, MDMA
is being used in combination with psychotherapy for PTSD
to facilitate trauma processing and create a context for
healing within a participant's mind, body, and spirit
(Mithoefer, 2015). Although psychedelic-assisted treatments
are showing promise in Western medicine, researchers and
clinicians must begin to examine the applicability of these
protocols cross-culturally.
Indigenous practices
Most of the existing literature on psychedelic therapy is from
a Eurocentric, medicalized perspective, often omitting
indigenous use or discussing its origins in a detached his-
torical manner (George, Michaels, Sevelius, & Williams,
2020). However, many substances currently used for psy-
chedelic medicine are derived from plants that are consid-
ered to have sacred healing properties by indigenous groups,
and are still being used by those communities today. Even
manufactured psychedelic substances are derived from
plants, some of which have been prized for their health
benefits by indigenous peoples, such as sassafras and similar
spice trees, which produce safrole oil, the source of MDMA
(Kemprai et al., 2020).
Cultural groups around the world make use of psyche-
delic healing traditions, which include the clinical manage-
ment of psychedelic medicines in a spiritual context. These
traditions are repositories of millennia-old medical experi-
ence and knowledge regarding best practices in the use of
these substances. Such indigenous traditions constitute their
own form of clinical science that provides important
guidelines relevant to Western applications of psychedelics
in medicine and therapy (Winkelman, 2007).
There has been much written about the indigenous use of
plant medicines from Mexico and South America, but psy-
chedelics have been used across cultures and eras. The
psychedelic Soma was a central part of ancient Indian
(Vedic) religiosity, and psychedelics appear to have been
used in Biblical times to facilitate divine encounters by
anointing priests and kings (Nemu, 2019). They have also
been used for thousands of years in African culture and
traditions. When Black people were enslaved in North
America, Yorba women from West Africa engaged in heal-
ing practices using their knowledge of plant medicines
derived from Africa (A. Williams, 2018). In Ethiopia, all
plants are believed to possess some degree of medicinal
usefulness, and medicinal plants occupy a central place in
their traditional health care system (Doffana & Yildiz, 2017).
This includes an array of flora for medical purposes and
important psychoactive plant medicines for psychological
problems and more psycho-spiritual problems, such as
warding off evil influences and misfortunes; Çaate (Katha
edulis), buncho (Coffea arabica L.) and t
¸addo (Rhamnus
prinoides) are examples of some of these plant medicines
(Doffana & Yildiz, 2017).
The iboga shrub (Tabernanthe iboga) has been used for
centuries in healing ceremonies and cultural rites by tradi-
tional communities in West Africa, for example among
members of the Bwiti religious groups in Gabon, Cameroon,
Equatorial Guinea and the Congo (Brackenridge, 2010). It is
a mild stimulant in small doses, but in larger doses causes an
intense psychedelic state. Iboga is the source of ibogaine, a
powerful psychoactive alkaloid. Researchers in the West,
found that ibogaine can significantly reduce withdrawal
symptoms from opiate dependency and eliminate cravings
(e.g., Brown & Alper, 2018). This has resulted in several
noteworthy clinical trials and thriving international and
underground ibogaine treatment centers for opiate addiction
(Labate, 2014).
In southern Africa, there is widespread reliance on
ubulawu as psychoactive spiritual medicine among practi-
tioners of traditional medicine in many communities,
including the Xhosa and Zulu, to communicate with their
ancestral spirits and to treat mental disturbances (Sobiecki,
2012). Ubulawu is composed of the roots of a variety of
plants (e.g., Silene and Dianthus species) that are ground and
made into a cold water infusion, churned to produce healing
foam. Further, Bantu traditional healers use the ubulawu as
part of their ritual initiation process and as a training tool
for their shamanic work. It has been noted that factors such
as psychological attitude, familiarization with the process,
correct plant combinations, and a compatible relationship
with the healer are all critical influences in the effectiveness
of ubulawu (Sobiecki, 2012). The Bushmen of Dobe in
Botswana use the hallucinogenic plant kwashi (Pancratium
trianthum) for spiritual and healing purposes (Schultes,
Hofmann, & Ratsch, 2010). As of 2002, over 300 plants with
psychoactive uses have been identified in South Africa alone,
many with psychedelic properties (48 listed as visionary
plants for inducing altered states of consciousness; Sobiecki,
2002).
126 Journal of Psychedelic Studies 4 (2020) 3, 125–138

There are many other psychedelic medicinal traditions in
Africa, but most of these have not yet been sufficiently
researched to enable Westerners to fully understand or
appreciate their potential. What is clear, however, is that
Africans have had a long tradition of healing with psyche-
delic plants, used in accordance with traditional practices
and experienced healers.
Stigma surrounding psychedelics in Black
communities
Despite great public interest in the use of psychedelics for
mental health, and traditional uses among indigenous
groups, people of color in the US have shown less enthu-
siasm for this repopularized modality. In terms of African
Americans specifically, reduced interest is evidenced by the
fact that very few Black people have been included as
research participants in studies of psychedelic therapy (2.5%
worldwide; Michaels, Purdon, Collins, & Williams, 2018)
and our own observations in regards to the small number of
Black researchers involved in psychedelic medicine. Further,
although Black and White people in the US use drugs at
similar rates, recreational use of hallucinogenic drugs is far
lower for African Americans than White Americans (Shalit,
Rehm, & Lev-Ran, 2019).
False stereotypes about African American drug use
causes many to have increased fears about even considering
psychedelics as a mode for healing and growth. Consider
that Black youth use drugs at lower rates than White or
Hispanic youth (Wu, Woody, Yang, Pan, & Blazer, 2011),
and Black Americans are less likely to suffer from substance
use disorders than White Americans (Grant et al., 2016;
Lacey et al., 2016). Nonetheless, Black Americans are 3.5
times as likely to be arrested for drug-related offenses and
are 7 times more likely to be incarcerated for using drugs
compared to White Americans (e.g., US DOJ, 2016;Hinton,
Henderson, & Reed, 2018).
These differential rates of punishment are not an acci-
dent. According to University of Virginia historian, Douglas
Blackmon, the criminal justice system was designed to bring
justice to White people and injustice to people of color
(Anderson, Blackmon, Elzie, L
opez, & Lowery, 2017). Slave
patrols were the forerunners of our police force, hired by
landowners to catch runaway slaves and punish them
(Turner, Giacopassi, & Vandiver, 2006), and law enforce-
ment today continues to carry out a version of its original
mandate. Laws against drug use in the Nixon-era were
intentionally designed to target Black people, as they were
seen as a serious threat due to their push for Civil Rights.
“Hippies”were also targeted as their opposition to the
Vietnam War was attributed to the use of substances like
LSD. However, drug laws were never applied evenly across
racial groups, with Black Americans targeted by law
enforcement and receiving longer and harsher sentences for
identical violations of the law as compared to White
Americans (e.g., Beckett, Nyrop, & Pfingst, 2006). The rising
perception that drugs were a Black problem fueled negative
stereotypes about these communities that Black people were
eager to dispel, resulting in stronger negative attitudes about
drug use overall in Black communities.
The Black Church was motivated to find solutions to
the crack epidemic and aligned itself with the Reagan-era
“War on Drugs”as a potential solution. However, the War
on Drugs became an excuse for long and harsh sentencing
of Black Americans found guilty of drug infractions. Crack
cocaine penalties were much more stringent than penalties
for powdered cocaine use, the only difference being that
Black people were more likely to use crack and White
people were more likely to use cocaine. Through this
process, African Americans became falsely stereotyped as
addicts and dealers who were committing crimes to feed
unconstrained drug habits (Williams, Gooden, & Davis,
2012). So, the War on Drugs became a vehicle for the mass
incarceration of Black Americans accused of drug in-
fractions, and US prisons became filled with Black and
Brown bodies (Alexander, 2012). There was little interest
within the Black community for drugs as a means of
expanding consciousness or personal growth. The focus
was on preventing and reducing drug use to keep people
safe, well, and out of jail.
There is no scientific literature on African Americans
and psychedelics, beyond demographic correlates of usage
and treatment-seeking patterns (e.g., Palamar, Mauro, Han,
& Martins, 2017). The limited research on MDMA among
African Americans indicates that the drug has gained a small
measure of increased popularity among Black youth, amidst
much misinformation and misperception about the benefits
and dangers of use. Rather than facilitating self-discovery or
improving mental health, users believe MDMA can alter the
effects of other drugs or potentiate sexual experiences (Rigg,
2017; Rigg & Lawental, 2017).
African American racial and cultural trauma
Historical trauma refers to the cumulative emotional harm
of an individual or generation caused by a profound trau-
matic experience or event. The trauma experienced by prior
generations continues to result in harm to subsequent gen-
erations. The historical trauma response may include
depression, substance abuse, suicidal ideation, anxiety, low
self-esteem, anger, and emotional constriction (Brave Heart,
2003). Examples of historical trauma include acts of geno-
cide, such as what happened to Native Americans and
Indigenous Canadians, and to Jewish people during the
Holocaust. One of the most salient examples of historical
trauma in the United States is the experience of Black people
in America who were kidnapped from their homes in Africa,
and forced into a lifetime of servitude. These individuals
were subjected to an agonizing Middle Passage, enslavement
of themselves and their children, forced separation of fam-
ilies when children were sold, physical and sexual abuse, and
forced extermination of their culture and languages. Once
slavery was no longer legal, African Americans continued to
experience oppression in the form of segregation, Jim Crow
laws, and the unequal application of the criminal justice,
which included lynchings (Alexander, 2012; DeGruy, 2007).
Journal of Psychedelic Studies 4 (2020) 3, 125–138 127

At every level, the criminal justice system is heavily biased
against Black people compared to White people (e.g.,
Beckett, Nyrop, & Pfingst, 2006;US DOJ, 2016), and
although Black Americans are 13% of the population, they
comprise 35% of male inmates and 44% of female inmates
(Hinton et al., 2018).
Cultural trauma occurs when members of a cultural group
have been subjected to a horrendous event that etches per-
manent marks upon their group consciousness, marking their
memories forever and changing their future identity in
fundamental and irreversible ways (Alexander, Eyerman,
Giesen, Smelser, & Sztompka, 2004). Given the traumatic
history of African Americans, combined with current prob-
lems such as racial profiling, mass incarceration, unchecked
police violence in mass media, and daily discrimination, it
should be unsurprising that cultural trauma persists (Alex-
ander, 2012; Becket, 2006; Bor, Venkataramani, Williams, &
Tsai, 2018; Chou, Asnaani, & Hofmann, 2012). Traumatiza-
tion exists at the intersection of race and gender as well.
African American women experience high rates of PTSD,
which can be explained in part by the high number of
traumas they experience. The National Survey of American
Life found that almost half of all African American women
had been assaulted, which included 17% having been raped,
20% having been sexually assaulted, and 16% having been
stalked; additionally, 17% experienced a life threatening car
accident, 14% had a life threatening illness, and 12% had a
child with a life threatening illness (Ching, Williams, &
Taylor, 2018). Given these grim numbers, it seems clear that
Black women carry a great deal of pain associated with life in
America, from both past and present traumas.
The combination of historical and cultural trauma in
African Americans can lead to what Dr. Joy DeGury (2007)
has termed “Post Traumatic Slave Syndrome”—loss of self-
esteem, anger, and internalized racism. Correspondingly,
current research indicates that the experience of ongoing
racism can indeed result in stress, traumatization, and even a
formal diagnosis of PTSD. When racism causes or contrib-
utes to traumatization, we call it racial trauma (Williams &
Leins, 2016; Williams, Printz, Ching, & Wetterneck, 2018).
African Americans and medical research
African Americans also have these traumas surrounding
medical research, including psychedelic research. There is
evidence that the risks of early era psychedelic research
unduly rested on the backs of African Americans and other
vulnerable populations. In examining these early studies,
comparing the treatment received by White research sub-
jects to what was experienced by people of color, inequities
become evident. The Addiction Research Center (ARC) in
Lexington KY, run by Dr. Harris Isbell, shared the campus
with the Federal Bureau of Prisons. The research subjects
were inmates, one-third White, a third “Negro”and a third
“Mexican.”While most people have some knowledge of the
Tuskegee Syphilis Study of Untreated Syphilis that targeted
Black men, few know about the facility dubbed the “Narco
Farm”in Kentucky (Campbell, Olsen, & Walden, 2008).
One study describes two groups that received LSD, one
was “Negro”males convicted on drug charges who were
recruited from prison and provided coercive incentives to
participate in dubious LSD experiments, and the comparison
group was professional White people at Cold Spring Harbor,
living freely, who were not coerced but given LSD in the
principal investigator's home “under social conditions
designed to reduce anxiety”(Abramson, 1960). Knowing the
profound influence of set, setting, and intention, these two
groups undoubtedly had very different experiences. Ac-
cording to Edward Flowers, an African American subject in
ARC experiments while incarcerated, “They used my ass and
took advantage of me, you know, being a young kid and
all...”(Campbell & Stark, 2017).
There were over 500 published studies that came out of
ARC from 1935 to 1975, testing the limits of human toler-
ance for psychedelics, opiates, and amphetamines on pris-
oners (NIDA, 1978). Dr. Isbell's studies included
dangerously high and prolonged doses of LSD on his sub-
jects. In the 1970s, ARC moved to Baltimore and became the
National Institute on Drug Abuse (NIDA), after a nation-
wide ban on the use of federal prisoners as research subjects.
These studies violated well-established guidelines for the
ethical conduct of biomedical research (e.g., Nuremberg
Code, Declaration of Helsinki, Belmont Report) that has
never been publicly acknowledged. African Americans
individually may not know the details of the crimes
committed against Black communities, but the cultural
memory remains (Suite, La Bril, Primm, & Harrison-Ross,
2007).
Psychedelic experiences for training of therapists
Psychedelic-assisted psychotherapy, as practiced currently in
academic research settings, involves the use of a psychedelic
compound in conjunction with a specified sequence of
therapy sessions that are intended to inform, shape, and
support the psychedelic experience. Studies typically include
three types of sessions: preparatory, medication, and inte-
gration sessions (Bogenschutz & Forcehimes, 2016). These
prepare clients for psychedelic sessions and establish the
therapeutic alliance, to guide them safely during the expe-
rience and assist in the critical process of translating their
experience into lasting change. Sessions generally utilize
medium to high doses of a psychedelic substance during 1–3
sessions, with the intention for the client to have an intense
and insightful experience supported by the therapists and
further explored during integration (Nielson & Guss, 2018).
Therapists and researchers who work with psychedelics
are often questioned regarding their own use of psychedelics,
with a concern that a lack of direct experience might
compromise their effectiveness as therapists (Nielson &
Guss, 2018). Such experiences may be difficult to obtain
given the legal prohibition against psychedelic substances,
and even more so for African Americans for the reasons
described previously. To facilitate instructional psychedelic
experiences, the Multidisciplinary Association for Psyche-
delic Studies (MAPS) received US Food and Drug
128 Journal of Psychedelic Studies 4 (2020) 3, 125–138

Administration (FDA) approval to proceed with a separate
study for healthy volunteers. As part of the training to
become an MDMA therapist, clinicians were able to receive
one dose of MDMA along with psychotherapy in the same
manner in which a participant would. The study was not
designed to investigate the effect of the MDMA experience
on clinicians, but rather to provide the opportunity for
therapists in training to experience MDMA in a therapeutic
setting, while collecting safety data in healthy volunteers.
Some therapists have published their own individual ac-
counts (e.g., Ching, 2020; Halberstadt, 2014), but as previ-
ously noted, there have been no accounts from African
Americans and their corresponding cultural issues published
in the professional literature, making this an important new
area of inquiry. Women of color are among the most stig-
matized groups of people in North America, where much of
this work is taking place, therefore it is essential to incor-
porate these perspectives into the literature to expand con-
versations about psychedelics and health equity.
METHODS
Participants and study procedures
At the University of Connecticut Health Center (UConn),
our team participated in a multisite MAPS-sponsored, FDA
approved, Phase 2 open-label study for PTSD. This work
focused on culturally-sensitive and respectful treatment ap-
proaches for people of color, taking into account the impact
of culture and the possible need to adapt MDMA-assisted
psychotherapy to culturally-specific traumas (Williams et al.,
2018; Williams, Reed, & Aggarwal, 2020).
At the UConn site, most study clinicians participated in
the separate study to further their clinical training, “Phase I
Placebo-Controlled, Double-Blind Crossover Study to
Assess Psychological Effects of MDMA when Administered
to Healthy Volunteers”(MT-1; ClinicalTrials.gov identifier:
NCT01404754). MT-1 was a randomized, double-blind
cross-over study, whereby all participants received MDMA
during one drug session and placebo at a second session.
Three MT-1 participants were Black women. Each partici-
pant had an initial preparatory visit at the investigators'
offices for screening, followed by two day-long drug sessions,
each including an overnight stay with a night attendant in a
nearby room. Participants had an integrative session with
the therapists the next morning after drug sessions, and a
phone call to check in the day after. Each participant worked
with two therapists, a male and a female. Between the three
therapist participants, there were a total of four facilitating
therapists, three of whom were White Americans and one
who was a Columbian American. The study was approved
by the Copernicus Institutional Review Board, and all par-
ticipants provided informed consent.
Methodology
To arrive at critical themes, an iterative thematic analysis
process was utilized (Vaismoradi, Jones, Turunen, &
Snelgrove, 2016). The objective of this approach is to
generate themes related to the phenomena under study that
might point us toward a broader cultural experience as
witnessed through a smaller number of eyes and life expe-
riences (the phenomena-in-context). The goal is to acquire a
felt sense of the experience through accounts described by
different participants. To that end, each participant wrote
about her experience, with a focus on the parts that felt most
salient, and then condensed the accounts to approximately
950 words. An iterative process was utilized to identify
themes, whereby the subjects of the study were themselves
co-creators of the themes. Each participant read each ac-
count and generated themes, revising the final list until there
was agreement.
What follows are the written accounts of three female
African American therapists from the UConn site that
participated in MT-1 in 2017 in Denver, Colorado.
Psychedelic experiences
Therapist 1: Marriage and Family Therapist. Therapist 1 is
a licensed Marriage and Family Therapist and Director of
Psychedelic Studies at an outpatient mental health clinic. She
was also a study therapist for a psilocybin-assisted psycho-
therapy for Major Depressive Disorder at Yale University.
She is a member of the MAPS Advisory Board and member
of the Racial Equity and Access committee for the Chacruna
Institute for Psychedelic Plant Medicines. She also served as
a Sub-Investigator and Study Coordinator for MAPS0Phase
2 MDMA PTSD at UConn. She received her undergraduate
degree in Philosophy with a bioethics concentration from
the University of Louisville in Kentucky, and her M.S. in
Marriage and Family Therapy from Valdosta State Univer-
sity in Georgia. Below she describes her MDMA experience.
“I feel like I'm dying but it's okay,”I say with a smile on my
face. As I lie on the couch with two therapists by my side, I
observe a battle between my mind and body. My body ready
to speak, each cell becoming more energized and attuned to
the drug, ready for a deeper knowing of what it means to be
human; and my mind, stuck, repetitive, looping on narra-
tives of the past making sure that I “keep it together”on my
journey. Soon enough, the drug sneaks past my mind's de-
fenses, past my reflexive tendency towards control and
precision, and catapults me to a place of dissolution. De-
fenses down, I am raw and open, experiencing the world in
its Divine essence, and for the first time in my life I felt free.
Me—a young, Black woman, free. I had transcended the
political realities of my race and gender and ascended to
something greater—I got to be human.
No longer bound by the constraints of my political realities, I
set sail on a journey that allowed me to reconnect to a place
cradled by Love. I'm talking about connecting to the totality
of all Life kinda place; where there is no beginning or end,
where there is no separation from Love. A place I always
knew existed but felt so distant from; I call that place Home.
And my grandmother was the first to greet me. Imparting
her wisdom not only for me, but for my mother, tears of joy
filled my face. This was the first time I had felt her presence
Journal of Psychedelic Studies 4 (2020) 3, 125–138 129

since her passing. “Thank you, grandma; thank you for
bringing me here.”I felt at peace.
After I experienced this sense of freedom and fluidity, I
began to feel a heaviness in my body pulling me down into a
very different story. My breath moved more slowly, a fire of
emotions welling up; my body was slowing me down. Trying
to put my therapist perspective on in this experience, I think
there must be a technique we can do to help my body not
feel so heavy. So I ask my therapists, “What can I do to speed
up my body? My body is slowing me down.”Little did I
know coming back into this Black body, sitting with the
painful internalized stories of not being enough, was the bulk
of my work.
I was not happy. I was not happy at all.
Racial wounds from my past resurfaced and I had to learn
how to sit with these stories in an unfiltered way. Those
defenses that became a necessary part of my social devel-
opment and helped me survive no longer worked. I felt lost,
confused, and tired, not having the skill set to process such
complexities. My personal reality, and mind, told me that I
was beyond my race, gender, and traumas from the past, but
my political reality, or this body, demonstrated something
different. So, there I was, with my two therapists, the drug,
and my wounds, trying to make sense of a new reality; a
culture my body knew in a language my mind did not.
“Some moments of feedback are making me more confused,
angry, and frustrated,”I said to my therapists. “You all don't
understand what I'm really trying to say.”
“Maybe there is a part of you that doesn't want to be un-
derstood,”one of the therapists says.
Silence. My mind trying to process what was said. There is
nothing more than I want in life than to be understood,
especially as a Black woman. Malcolm X once said, “The most
disrespected, unprotected, and neglected person in America is
the Black woman.”I'd like to add misunderstood to that
phrase too. The battle between my mind and body returns.
Moments of connection were replaced by rage. I hated the
parts of myself that said I wasn't enough, the society and
people that reinforced this message too. I know they mean
well when they say “you gotta be twice as good to get ahead,”
but somehow that narrative made me believe that I wasn't
enough. I started to fall apart. I tried to be strong; most of the
mental tricks I knew to help me distract were not working. I
wanted to get back to that space of freedom but I just couldn't.
I normally cope with the stressors of life in isolation; not
confiding in anyone to support me because I don't want to
“burden”others, or I believe I am “strong enough”to handle
it. Talking about my issues made me vulnerable, and I only
knew how to be vulnerable with myself. There is a part of me
that sometimes feels like I am betraying myself if I open up
to others. This MDMA experience was one space where I
couldn't isolate. My therapists and Spirit wouldn't let me. I
had to take off my Super Woman cape and allow others to
care for me –a new skill I had to learn. Love returns and this
tumultuous, relentless, steadfast force did everything to
protect me. And for that, I am forever grateful.
My intention going into my dosing session was that what-
ever happened would be for The Highest good. I believe I am
still discovering what that highest good is. This MDMA
therapy experience showed me –in a very embodied way –
the “two-ness”W.E.B. Dubois, Toni Morrison, and other
writers often talk about in the Black experience. The days,
weeks, and years of processing helped me realize two
important truths: more Black folx deserve to feel human, free
from the oppression and traumas we've endured, and that no
thing can separate me from Divine Love.
Therapist 2: Clinical Psychologist. Therapist 2 is a board-
certified licensed clinical psychologist and academic
researcher. She is also clinical director of an outpatient
mental health facility, where she provides supervision and
training to clinicians for empirically-supported cognitive-
behavioral treatments. She completed her undergraduate
degree from MIT, post-baccalaureate work in psychology at
UCLA, and her doctorate at the University of Virginia. Her
research focuses on African American mental health, cul-
ture, and psychopathology, and she is well-published on
these topics. She feels passionate about improving cultural
competence in the delivery of mental health care services to
reduce barriers to care. She also gives diversity trainings
nationally for clinical psychology programs, scientific con-
ferences, and community organizations. Below she shares
some of the insights she gained during her MT-1 experience.
As the medicine kicked in, my body felt very heavy. My two
therapists suggested I lie down, and I felt myself become an
immovable brick on the couch. I heard myself say it out loud
and slowly, “Everything is about work. Everything I do.”The
words just kept coming, slowly but with purpose. “I have a
schedule of stuff I do, and it's all about ‘check the box.’Even
my family. Even myself. It's like my life is a big to-do list and
everything is check-the-box, done. Take the kids to school,
check. Finish up a paper, check. Self-care, check. I like to
think I am doing that for myself, but it's not, it's all work. So
I can say ‘yeah, I did my self-care, check.’Gym, check.
Friends, check”
My family often posts pictures of me and my sisters to social
media, and I always hated it. If someone had asked why, I
would have said it was because my bangs were frizzy or my
teeth were crooked. I figured it was just because I was a
perfectionist and held myself to a higher standard. In fact, it
never occurred to me that anyone might find their own child
pictures positive in any way. I avoided those pictures, kept
safely tucked away in an ancient photo album, and I don't
show them to anyone. My childhood and my family was a
mess, and these pictures reminded me of that. End of story. I
thought. Until that MDMA session, where we started talking
about that kid that was me. I didn't want to look at her.
I felt wisdom and compassion radiating from my therapist,
as she asked if I could find love in my heart for that little girl.
I said, “No, I hate her.”“Can you try hating a little bit less?”
she asked gently. “No!”I insisted. So why, then did I hate her
so, so much? It wasn't because of anything she had done, but
because of what she couldn't do. This was the key. “Because,”
I said with tears streaming down my face, “because she is so
vulnerable.”I don't know where that came from, but it all
made sense. I knew deep inside that I never wanted to be
that helpless again. The childlike fragility, neediness, and
130 Journal of Psychedelic Studies 4 (2020) 3, 125–138

vulnerability were intolerable. I wanted to be strong all the
time. As Black people, we feel we have to be strong all the
time, and Black women are just strong. You can't be off your
game for a minute or disaster can happen. But no one can be
strong all the time, and no should have to be.
Then I saw an image of the sun. This was the heart of my
experience –though it was bright yellow in the blue sky the
colors stayed completely separate. I said, “The sun is yellow and
the sky is blue, but there's no green.”The colors should be
mixing but they never do. It doesn't make sense, but it's true. I
am sure my therapists thought I had completely lost my mind.
For me this represented the paradox of knowing that people
need people and yet feeling inside that I don't need anyone. The
idea that I might need others for anything triggered intolerable
feelings of brokenness that I desperately wanted to hide. And
often pretending was good enoughas long as I could getby, since
I never thought I could ever be truly repaired. I didn't feel this as
profoundly as I did in the past, but I still didn't see myself as
completely whole. I felt ashamed of my shortcomings, especially
my interpersonal failures, realizing that I expect to be rejected,
and so I'd tell myself I don't need that person. I can't tolerate the
thought of being needy.
I recognized that one of the ways I had dealt with feeling
disempowered and vulnerable was to gain as many compe-
tencies as I could. I had built this big wall of competencies, of
lots of things I could do really, really well to protect myself.
Each glass brick in the wall was another skill or degree or
ability I had mastered –knowledge of the mind, mental illness,
computers, business, math, writing, sex and reproduction, etc.
It also separated me from other people, and that was ok. I was
the expert. Therapeutic relationships were like, “I understand
everything about you while I sit safely behind my wall of
competencies.”Relationships were like, “Iwillfigure out what
you expect of me and I will exceed it –you will find no cracks
in my wall.”If there were going to be any problems, I would
make sure that they were not caused by anything I did or
didn't do. I was safe behind my transparent wall but at the
same time, this wall had cut me off from other people. It had
been a slow process to experiment with being vulnerable.
That child version of myself was so far from everything I had
built. I pictured her in my mind, in a red school dress, long
socks, with black pig-tails and puffy bangs. But as I looked at
the image in my mind, I realized the hate was just gone. She
didn't look ugly to me anymore. In fact, she reminded me of
my two little brothers, who I did care about. “Can you at
least have compassion for her?”the therapist asked me. Yes,
I could have compassion –not love yet, but I was softening.
From hate to compassion –that was a big step.
Therapist 3: Psychiatric researcher. A native of Detroit, MI,
Therapist 3 obtained her Bachelor's degree from the Uni-
versity of Michigan and her Master of Divinity degree from
Yale University at the Yale Institute of Sacred Music. She
received intensive training in the Clinical Neuroscience
Research Unit in the Yale Department of Psychiatry, and she
is currently a doctoral student in clinical psychology. Her
research interests include obsessive-compulsive disorder
(OCD), namely contamination and religious OCD symp-
toms, along with common co-occurring disorders, such as
PTSD and depression, and the neurological underpinnings
of these disorders. She served as a study therapist for MAPS0
Phase 2 MDMA Clinical Study of treatment-resistant PTSD
among people of color at UConn and is passionate about
making such treatments available to underserved pop-
ulations. Below Therapist 3 recounts some of the highlights
of her MT-1 experience:
When I first learned that I would have the opportunity to try
MDMA as part of the MT-1 study protocol, I was so scared.
As a Black woman who grew up watching my communities
torn apart at the hands of gang violence, the street drug
market, mass incarceration, murder, etc., drugs were not a
friend of mine. Not to mention the legacy and lasting impact
of the War on Drugs in the Black community, along with the
over-policing and history of unethical medical practice on
Black bodies, I was petrified. I thought to myself, “You mean
to tell me, they want to bring me, a Black female, into a
clinical setting to receive a psychedelic substance?”It felt like
a set-up. Were the police hiding out somewhere? Would they
bother me (while doing absolutely nothing wrong, like so
many others), find MDMA still in my system, and take me to
jail? I didn't know. I just knew that because of the society in
which we live, I did not (and still do not) feel safe. The
concept was inconceivable.
On the day of my preparation session, the therapists asked,
“What are your concerns or apprehensions?”I told them the
truth –that I was terrified on multiple levels. We worked
through that fear, but I struggled to buy into the journey.
There was an immense resistance on the part of my body
and my brain to trust the co-therapists or the medicine. For
obvious reasons, it is easier to help others through their pain
than to give adequate attention to your own.
My MT-1 experience reminded me of the ways in which I
had been socialized into my own ethnic and racial identity
via the appearance of familiar cultural themes. For example,
I saw a particular lapa (fabric worn like a skirt in West
African countries) which I recognized from my childhood
African dance training. It reappeared a few different times
throughout my experience and served as the most important
element of one of my most impactful visions. At times, I
could see myself draped in it, walking about, other times I
wore it as part of a drum and dance circle, as is customary.
After what seemed like a long stretch of pain-ridden epi-
sodes, I inhaled deeply, closed my eyes, and there was
nothing but darkness for a while. At that moment I felt a
simultaneous terror come over me and my body. I had to
lean into the unknown, which I do not like to do! But once I
did, all of a sudden, I felt peace and it felt easier to breathe
and like I was doing less work to escape the turmoil beneath
me. When I opened my eyes, I watched myself ascend into
the clear blue skies, flying above all the pain and sorrow on
the ground. I didn't die or ascend into a proverbial heaven, I
just started to navigate through life on a higher plane.
I was parallel to the clouds. I was so far above the ground, but I
could see everything below so clearly; it was as if I had a
heightened sense of vision. Beneath me was one of the lapa
from my childhood, carrying me across the sky. It was a
beautifully colorful and thick material. It carried me through
several scenes of my ancestral history, beginning with a
Southern plantation. I saw women who looked like myself and
Journal of Psychedelic Studies 4 (2020) 3, 125–138 131

my mother. I hadn't known them personally, but I felt inex-
tricably connected to them. I was somehow able to reach down
and pull a few of them up with me onto the lapa. The emotions
were so overwhelming that no words needed to be shared. We
sat together in silence as we entered the next “scene”
My MDMA experience was full of powerful themes from my
culture, dancing, music, and celebration, but also painful as-
pects of my past, some of which I knew far too well, others I
hadn't known personally but experienced through an ancestral
view. Having attended an African-centered elementary school,
we were taught many African proverbs and philosophies, one
of which is, “Ubuntu”meaning, “I am because we are, we are,
therefore I am.”I was shown that I exist because my ancestors
existed first. I am also here as a result of my community, my
village. The collective experience is very important in Black
culture and for my experience as well. Though I was alone on
this trip, I felt very much supported by my family and an-
cestors, particularly my Black female ancestors who exhibited
strength, community, and perseverance. As such, the theme of
the “strong Black woman”was prevalent, but I believe it
intended to show me that I am not in this alone and that my
strength comes from being in community.
During integration, I was able to process some of my ex-
periences with the co-therapists in the room with me, but
much of my understanding and processing happened in the
weeks, months, and even years after my dosing session. This
was partly due to needing time to process, but also because I
was nervous to mention some aspects of my culture which
showed up, fearing that I may be misunderstood.
Overall, I have learned so much about myself and the troubled
aspects of my past which I have tucked away so neatly that no
one has known to inquire. I am grateful for the work of
MDMA, my team, and of course, my inner-healer, but trou-
bled by the fact that I still do not feel safe to explore psy-
chedelics in a healing capacity. If this treatment modality is
meant to be effective for Black people, the work is different: all
therapists must become preoccupied with the safety of Black
bodies in these trials, less they permeate even more damage,
perpetuating a vicious cycle of racialized medical trauma.
RESULTS
Major themes
All three of the MDMA-assisted experiences included cul-
tural themes relevant to the experience of Black women in
America. A main theme from Therapist 1 focused on healing
deep, racialized intergenerational wounds. On one hand, she
was able to experience a blissful reality beyond her race and
gender; however, she also had to learn how to sit with these
political realities in an unfiltered way. She notes, “As a Black
woman, I had to learn the language of this White American
world, the mannerisms, and the performance. I've straight-
ened the coils from my hair and denied parts of myself just
to feel like I belonged. Those defenses that became a
necessary part of my social development and helped me
survive in the only world I knew no longer worked.”
The themes from Therapist 2 focused on the paradoxical
need for human connection and dependence, in contrast to
perceived need to be strong, efficient, and self-sufficient to
“survive and thrive in a perilous and often hostile racist
society controlled by White men and women.”She found
the idea of being vulnerable too threatening to tolerate,
which cut her off from the vulnerable parts of her person-
ality and interfered with important relationships.
The themes from Therapist 3 included transcendence,
moving above the oppression and pain of everyday life to a
higher plane, from which she could reach down and help
others to also transcend. She was able to situate herself
simultaneously within her ancestral community and her
current African American experience, and thereby draw
strength from her family, past and present. Nonetheless, she
continued to feel a need to be vigilant and a lack of safety.
She notes, “It has become apparent to me that we must be
preoccupied with helping clients of color, Black clients in
particular, to feel an immense sense of safety.”
The primary themes emerging across the varied experiences
include strength, safety, connection, and managing oppression/
racialization. Challenges with vulnerability also cut across the
narratives. Growth from the experience centered on under-
standing that having needs and experiencing feelings does not
equate to weakness (prominent in narratives 1 and 2), and a
renewed sense of duty to provide help and healing to one's
community (prominent in narrative 3).
Experience as a training exercise
All three therapist participants found the process of having a
session of MDMA-assisted therapy, in the same manner that
a client would experience it, to be helpful for better under-
standing the research protocol and the client experience.
Navigating cultural and racial material during the MDMA
sessions was also an important reminder that all participants
are a product of their culture to various extents, which be-
comes reflected in the psychedelic experience, including past
and present experiences of oppression.
The lived racial experiences and training of the facili-
tating therapists was salient to participant experiences, as it
influenced their ability to respond to material as it was
unfolding. Of the four therapists who facilitated sessions,
two made statements that were culturally insensitive or
microaggressive during the MDMA session, and this directly
impacted two of the three Black therapist participants
(Williams & Halstead, 2019). This underscored the need for
multicultural training and extreme sensitivity on the part of
therapists to refrain from contributing to a participant's
cultural trauma by reenacting social patterns of oppression
that occur in everyday interactions outside of the treatment
space (Williams et al., 2020).
DISCUSSION
Psychedelic-assisted therapy for Black women
The material that emerged from the MDMA-assisted psy-
chotherapy sessions was filled with themes that are particu-
larly salient for Black women in America, including cultural
132 Journal of Psychedelic Studies 4 (2020) 3, 125–138

trauma, spiritual connection to ancestors, care for commu-
nity, and the Strong Black Woman archetype –an intersec-
tional conceptualization of Black womanhood. This archetype
derives from slavery, when Black women had to be strong in
order to survive and protect their children in a brutal envi-
ronment of forced physical, emotional, and sexual servitude.
The Strong Black Woman has become “a cultural ideal that
portrays Black women as strong, self-reliant, nurturing,
resilient, and invulnerable to psychological or physical chal-
lenges”(Baker, Buchanan, Mingo, Roker, & Brown, 2015,p.
53). Black women may struggle with how much to identify
with this ideal due to its conflicting positive and negative and
characteristics. Although a focus on inner strength can be
empowering, adopting this archetype perpetuates problems
such as being overworked, undertreated for mental health
needs, neglectful of self-care, and cut-off from nurturing from
others. It can also interfere with the emotional vulnerability
needed to forge deep, mutually reciprocal relationships.
One important avenue for understanding some of the
other themes may lie in cultural differences in approaches to
understanding the self. The North American concept of the
person centers on individualism, where each person is
considered autonomous and uniquely deserving the free
pursuit of their own private goals; this “egocentric”notion of
the person leads individuals to think about their identity
primarily in terms of personal history and achievements
(Kirmayer, 2007). However African cultures typically have
more of a “cosmocentric”sense of self, and may therefore
narrate their identity in relation to ancestors, spirits, or larger
cosmic forces. Of course, the different ways of construing the
self are not mutually exclusive, as egocentric and cosmocen-
tric views may exist simultaneously (Kirmayer, 2007).
Nonetheless, as noted by Kpanake (2018), African cul-
tures generally have a more spiritual and relational-oriented
perspective of the self, in which an individual manifests
“personhood through connections to three distinct forms of
agency: (a) spiritual agency, including God, ancestors, and
spirits that influence the person; (b) social agency, including
the family, the clan, and the community, with extension to
humanity; and (c) self-agency, which is responsible for the
person's inner experience”(p. 198). These three forms of
agency were all apparent in one or more of the narratives
provided by participants, reflecting their meaningful and
important connection to African culture.
Understanding the self from the perspective of a Black
woman requires consideration of intersectionality as well.
Black women often experience oppression by being both
Black and a woman. They may not be able to separate these
two facets of their identity into distinct pieces, but rather
conceptualize themselves holistically. Without this frame-
work, one can misunderstand or misinterpret important
aspects that are salient to her experience.
Dangers of culturally uninformed therapy
When therapists are unable to make use of cultural material it
can represent a lost opportunity for healing, but it is much
worse when therapists actively cause harm. It has been
recognized for some time that racially charged materials
can provoke violence from clinicians in the form of micro-
aggressions or other harmful actions or inactions, as therapists
struggle to manage their own psychic woundedness around
issues of race (Comaz-Diaz & Jacobsen, 1991; Kanter et al.,
2020). Race relations in the US, Canada, and many other
Western nations operate within a system whereby people of
color are expected to maintain White comfort by remaining
silent about past and present experiences of racial oppression
(DiAngelo, 2011; Kanter et al., 2019). This expectation often
extends into the mental health care frame, and it is thought to
represent a major barrier to treatment for people of color, as
goodtherapyrequiresanopentrustingdialog.Further,ina
typical outpatient mental health setting, if an African Amer-
ican client is harmed by a therapist, the client can use their
generally well-developed defenses against racism and choose
to engage at a superficial level or not at all, or even walk out. In
contrast, when under the influence of a psychedelic, the client
may not leave the session for several hours and may not be
able to access their typical defenses to protect against
emotional harm. Further, the heart-opening properties of
MDMA specifically may make clients who are seeking healing
from racial traumas particularly vulnerable to further
emotional injury. This represents at least two distinct kinds of
abuse, abuse of authority and abuse aided by an intoxicating
substance (Dawson, 2019). This could be compared to the
devastating experience of a client seeking healing from the
trauma of rape only to be subjected to sexual advances from a
therapist while in a physically vulnerable or even helpless state.
Training for therapists and guides
Because of the extreme vulnerability of patients during
psychedelic-assisted psychotherapy, all therapy providers
and supervisors should have basic competencies in working
ethically and skillfully with people of color. As noted by
Williams et al. (2020), essential skills include, the ability to
(1) identify normal cultural variations in the expression of
psychopathology and personality, (2) recognize trauma
related to the experiences of racism and other forms of
oppression, (3) develop good rapport with people of color by
appropriately expressing caring, empathy, and respect, (4)
comfortably engage in discussions about racial topics, and
(5) identify and examine personal biases as they relate to
ethnic and racial differences, with an ongoing action plan to
address any areas of difficulty. All therapy providers con-
ducting psychedelic therapies should be competent in these
areas prior to working with people from different ethnic
groups. Skill in cross-racial work is critical given the very
limited number of psychedelic therapists of color.
Functional Analytic Psychotherapy (FAP) is a therapeutic
approach rooted in the contextual behavioral tradition (Hayes,
Barnes-Holmes, & Wilson, 2012) that focuses on the thera-
peutic relationship as the agent of change to improve re-
lationships (Tsai et al., 2009). FAP promotes intrapersonal
awareness as well as interpersonal awareness between the client
and therapist equally for a strong and authentic connection.
This approach prompts FAP therapists to take interpersonal
Journal of Psychedelic Studies 4 (2020) 3, 125–138 133

risks by experiencing, processing, and disclosing reactions to
the client as they occur in-session in the service of client growth,
and it prompts therapists to encourage their clients to do the
same. When the client engages in courageous self-expression in
FAP sessions, the therapist in turn responds with genuine
feedback to increase the intimacy of the exchange. This
vulnerability and immediacy serves as a model to help the client
improve connections with others, which is an important trans-
diagnostic outcome (Wetterneck & Hart, 2012).
In this context, inadvertent insensitivities and micro-
aggressions committed by therapists present a barrier to
fundamental and necessary intimate, trusting, and safe
transactions. Within FAP this could become an opportunity
for therapist growth around racial anxieties and client growth
in successful assertion of needs, which would ideally lead to a
celebration of a client's expression of their full self as an ethnic
and cultural being. FAP is particularly well-suited for
culturally-sensitive practice because of its focus on the rela-
tionship as a primary change mechanism, and FAP is flexible
enough to be used for understanding behaviors across cul-
turesandethnicities(Vanderburghe, 2008). Therapists are
allowed to admit that they do not have all the answers and
may not fully understand the experience of racial oppression,
which paradoxically bolsters trust and genuine connection
with the client. And, as therapists are able to confront their
own assumptions and biases, they become more culturally
sensitive and attuned to feedback from their diverse clients
(Miller, Williams, Wetterneck, Kanter, & Tsai, 2015). Thus,
FAP may be well-suited for MDMA-assisted psychotherapy
with people of color, given the focus on establishing a quality
emotional connection (Luoma, Sabucedo, Eriksson, Gates, &
Pilecki, 2019; Williams et al., 2020).
Since the accounts described in this paper occurred,
MAPS has made efforts to further the cultural competence
of its therapists, including a series of trainings for inde-
pendent raters, that was recorded and subsequently made
available to study therapists (Reed, 2019; Williams et al.,
2020). Further, in August 2019, two of the authors organized
and co-led a community conference and special training for
therapists of color, which was grant-funded by the Open
Society Foundation and other donors and implemented by
MAPS (Williams & Labate, 2020). These are essential early
steps in improving treatment for people of color, however
important gaps remain. For example, at MAPS there are
almost no approved supervisors able to provide culturally-
informed oversight to new therapists who might require
guidance in this area. Apart from MAPS, we are aware of no
other sponsors or research teams attending to this aspect of
the work (Williams et al., 2020), however one of the only
certified training programs for psychedelic therapies, the
California Institute of Integral Studies, had put some suc-
cessful measures in place to increase admissions for trainees
of color.
Addressing misgivings
Some may be concerned that exposing people to psyche-
delics may be simply introducing a new approach for
escaping from problems as opposed to working through
them in a clinical setting. People may fear this process en-
courages potential drug misuse among patients and clini-
cians by trying psychedelics in a clinical setting. Indeed, the
therapist participants featured here each had private reser-
vations about participating in MT-1 for a variety of reasons.
It is important to understand that all medications have the
potential for healing or abuse, depending on how they are
used, and psychedelics are no exception. That being said, the
data indicate that compared to other substances, psyche-
delics are generally safe, with low addiction potential, and
even recreational use is correlated to few negative outcomes
(Johansen & Krebs, 2015).
Further, psychedelic-assisted therapy is hard work and
should not be considered an escape or shortcut to healing.
All three therapists spent considerable time and effort pro-
cessing their experiences alone and with others to integrate
what was learned into their lives for personal growth and
individual healing from racial stress and trauma.
Reclaiming our cultural birthright
As described previously, there is a rich tradition of plant
medicines and spirituality in Africa, and African spiritual
themes were prominent in two of the three narratives. As
such, people from the African diaspora may especially
benefit from psychedelics within a culturally-appropriate
framework. Two of the participants have started providing
culturally-informed psychedelic-assisted psychotherapy as a
means of treating racial trauma in an outpatient mental
health clinic. In our experience, many African Americans
are fearful of psychedelic medicines and the vulnerability
that comes with being in an altered state. Certainly, these
treatments can be unsafe without skilled providers or caring
therapists to guide clients on their journeys. But these
medicines are part of our cultural birthright, and African
Americans deserve the same access to the healing potential
of psychedelics that our ancestors have benefitted from and
continue to benefit from in Africa today.
Limitations and future directions
Because this study chose to focus on the voices of African
American women, the experiences described cannot be
assumed to generalize to African American males or even
Black people worldwide. More research is needed to amplify
the voices of people from other racial and ethnic groups and
those with other marginalized identities to better understand
psychedelic experiences cross-culturally. As more narratives
become available, it would be interesting and important to
compare them across populations to better understand how
culture influences the psychedelic experience.
CONCLUSION
There is a great potential for psychedelic therapy to address
the mental health needs of people of color, who experience
the same mental health needs as White people, in addition
134 Journal of Psychedelic Studies 4 (2020) 3, 125–138

to the reality of intergenerational cultural trauma for many
ethnic groups and intersectional trauma for women of
color. Barriers to safe and effective psychedelic care include
a lack of clinicians who are able to navigate challenging
racial material in a non-violent matter, and a lack of
awareness surrounding how to optimally utilize cultural,
spiritual, and historical material as it arises. These prob-
lems point to a need for more therapists of color who
understand nuanced cultural issues as they pertain to
specific ethnic groups, as well as better multicultural
training for all therapists, which should include education
about microaggressions and the therapeutic use of FAP
(e.g., Kanter et al., 2020; Williams, Reed, & Aggarwal,
2020). Some important efforts in this area have begun, but
much more is needed and on a larger scale.
There is an urgent need to address many unanswered
questions relevant to people of color. Future studies might
examine the outcomes of psychedelic therapy with and
without the added therapeutic connection provided by
FAP, to explore how it may reduce the prevalence and
impact of covert racism during treatment (e.g., Miller et al.,
2015). Work is needed to better understand and address
the role of culture in set and setting for best outcomes (e.g.,
Neitzke-Spruill, 2020). Although this paper has focused on
the psychotherapeutic experience, future research also
needs to examine how different psychedelic compounds
may differentially affect ethnic groups to help inform
dosing and management of side-effects (e.g., Papaseit,
Torrens, P
erez-Ma~
n
a, Muga, & Farr
e, 2018). Additionally,
more work needs to be done to educate and inform people
of color about psychedelic options for healing, and advo-
cate for inclusion.
The use of psychedelics has not always been safe for
Black Americans, but as psychedelics move into the
mainstream there may be an opportunity for the African
diaspora to come together as a people, create safe spaces,
and become empowered to reclaim psychedelic healing for
Black communities (Williams, 2020). Creation of new rit-
uals and a spiritual path surrounding psychedelic healing
where it is yet undefined and could be an important means
of reconnecting to beneficial ancestral practices in a mod-
ern context, thus paving the way for greater access to
mental health for Black people everywhere as psychedelics
become legal medicines.
Conflict of interest: The authors have no conflicts of interest
to report.
Acknowledgments: The authors wish to thank Marcela
Ot'alora for her therapeutic support and guidance in these
experiences. The author also wishes to thank the non-profit
organization, Multidisciplinary Association for Psychedelic
Studies (MAPS; www.maps.org), who sponsored and funded
“A Phase 1 Placebo-Controlled, Double-Blind, Multi-Site
Crossover Study to Assess Psychological Effects of MDMA
when Administered to Healthy Volunteers”(MT-1; Clin-
icalTrials.gov identifier: NCT01404754).
REFERENCES
Abramson, H. A. (1960) Lysergic Acid Diethylamide (LSD-25).
XXXI. Comparison by questionnaire of psychotomimetic ac-
tivity of congeners on normal subjects and drug addicts. Journal
of Mental Science,106, 1120–1123.
Alexander, M. (2012). The new Jim Crow: Mass incarceration in the
age of colorblindness. The New Press.
Alexander, J., Eyerman, R., Giesen, B., Smelser, N., & Sztompka, P.
(2004). Toward a theory of cultural trauma. In Cultural
Trauma and collective identity (pp. 1–30). Berkeley, Los Angeles
and London: University of California Press. Retrieved February
8, 2020, from www.jstor.org/stable/10.1525/j.ctt1pp9nb.4.
Anderson, C., Blackmon, D. A., Elzie, J. L
opez, I. H, & Lowery, W.
(2017, March 3). Understanding the problem. Policing color:
Black, Brown, and blue forum. Panel, Duke University, School
of Law, NC.
Baker,T.A,Buchanan,N.T.,Mingo,C.A.,Roker,R.,&Brown,C.S.
(2015). Reconceptualizing successful aging among black women
and the relevance of the strong black woman archetype. The
Gerontologist,55(1), 51–57. https://doi.org/10.1093/geront/gnu105.
Beckett, K., Nyrop, K., & Pfingst, L. (2006). Race, drugs, and
policing: Understanding disparities in drug delivery arrests.
Criminology: An Interdisciplinary Journal,44(1), 105–137.
https://doi.org/10.1111/j.1745-9125.2006.00044.x.
Bogenschutz, M. P., & Forcehimes, A. A. (2016). Development of a
psychotherapeutic model for psilocybin-assisted treatment of
alcoholism. Journal of Humanistic Psychology,57(4), 389–414.
https://doi.org/10.1177/0022167816673493.
Bor, J., Venkataramani, A. S., Williams, D. R., & Tsai, A. (2018).
Police killings and their spillover effects on the mental health of
Black Americans: A population-based, quasi-experimental
study. The Lancet,392, 302–310. https://doi.org/10.1016/S0140-
6736(18)31130-9.
Brackenridge, P. (2010). Ibogaine therapy in the treatment of opiate
dependency. Drugs & Alcohol Today,10(4), 20–25. https://doi.
org/10.5042/daat.2010.0724.
Brave Heart, M. (2003). The historical trauma response among
natives and its relationship with substance abuse: A Lakota
illustration. Journal of Psychoactive Drugs,35(1), 7–13.
Brown, T. K., & Alper, K. (2018). Treatment of opioid use disorder
with ibogaine: Detoxification and drug use outcomes. The
American Journal of Drug and Alcohol Abuse,44(1), 24–36.
https://doi.org/10.1080/00952990.2017.1320802.
Campbell, N. D., Olsen, J. P., & Walden, L. (2008). The narcotic
farm: The rise and fall of America’sfirst prison for drug addicts.
London and New York: Abrams.
Campbell, N. D., & Stark, L. (2017). Making up ‘vulnerable’people:
Human subjects and the subjective experience of medical exper-
iment. In K. Brzechczyn (ed.), Towards a revival of analytical
philosophy of history (pp. 225–253). Boston: Brill Rodopi.
Ching, T. H. W., Williams, M. T., & Taylor, R. J. (2018, November).
Gender differences in lifetime trauma exposure among African
Americans and Black Caribbeans. Poster session at the 52nd
annual convention of the association of behavioral and cogni-
tive therapies, Washington, DC.
Journal of Psychedelic Studies 4 (2020) 3, 125–138 135

Chou, T., Asnaani, A., & Hofmann, S. G. (2012). Perception of
racial discrimination and psychopathology across three U.S.
Ethnic minority groups. Cultural Diversity and Ethnic Minority
Psychology,18(1), 74–81.
Comas-Diaz, L., & Jacobsen, F. (1991). Ethnocultural transference
and countertransference in the therapeutic dyad. American
Journal of Orthopsychiatry,61(3), 392–402.
Costandi, M. (2014). A brief history of psychedelic psychiatry. The
Psychologist,27(9), 714–715.
Dawson, A. (2019, May 22). Psychedelics, sex, and consent: A brief
history. Chacruna Institute.Retrieved from https://chacruna.
net/psychedelics-sex-and-consent-a-brief-history/.
DeGruy, J. (2007). Post traumatic slave Syndrome: America's Legacy
of enduring Injury and healing (Revised and Updated Edition).
Joy Degruy Publications, Inc.
DiAngelo, R. (2011). White fragility. The International Journal of
Critical Pedagogy,3(3), 54–70.
Doffana, Z. D., & Yildiz, F. (2017). Sacred natural sites, herbal
medicine, medicinal plants and their conservation in Sidama,
Ethiopia. Cogent Food & Agriculture,3(1). https://doi.org/10.
1080/23311932.2017.1365399.
George, J. R., Michaels, T. I., Sevelius, J., & Williams, M. T. (2020).
The psychedelic renaissance and the limitations of a White-
dominant medical framework: A call for indigenous and ethnic
minority inclusion. Journal of Psychedelic Studies,4(1), 4–15.
https://doi.org/10.1556/2054.2019.015.
Grant, B. F., Saha, T. D., Ruan, W. J., Goldstein, R. B., Chou, S. P.,
Jung, J., et al. (2016). Epidemiology of DSM-5 drug use disor-
der: Results from the National Epidemiologic Survey on alcohol
and related conditions-III. JAMA Psychiatry,73(1), 39–47.
https://doi.org/10.1001/jamapsychiatry.2015.2132.
Halberstadt, N. (2014). MDMA-assisted psychotherapy: A view
from both sides of the couch. MAPS Bulletin (Special Edition),
24(1), 4–6.
Hayes, S. C., Barnes-Holmes, D., & Wilson, K. G. (2012).
Contextual behavioral science: Creating a science more
adequate to the challenge of the human condition. Journal of
Contextual Behavioral Science,1,1–16.
Hinton, E., Henderson, L., & Reed, C. (2018, May). An unjust
burden: The disparate treatment of black Americans in the
criminal justice system. Vera evidence brief. Vera Institute of
Justice. Retrieved from https://www.vera.org/downloads/
publications/for-the-record-unjust-burden-racial-disparities.pdf.
Johansen, P.-Ø., & Krebs, T. S. (2015) Psychedelics not linked to
mental health problems or suicidal behavior: A population
study. Journal of Psychopharmacology,29(3), 270–279. https://
doi.org/10.1177/0269881114568039.
Kanter, J. W., Rosen, D. C., Manbeck, K. E., Branstetter, H., Kuc-
zynski, A., Corey, M. D., et al. (2020). Addressing micro-
aggressions in racially charged patient-provider interactions: A
pilot randomized trial. BMC Medical Education,20(88), 1–14.
https://doi.org/10.1186/s12909-020-02004-9.
Kanter, J. W., Rosen, D. C., Manbeck, K. E., Kuczynski, A. M.,
Corey, M.D., & Branstetter, H. M. L. (2019). Using contextual-
behavioral science to understand racism and bias, chapter 6. In
M. T. Williams, D. C. Rosen, & J. W. Kanter (Eds.), Eliminating
race-based mental health disparities: Promoting equity and
culturally responsive care across settings. Oakland, CA: New
Harbinger Books.
Kemprai, P., Mahanta, B. P., Sut, D., Barman, R., Banik, D., Lal, M.,
et al. (2020). Review on safrole: Identity shift of the “candy
shop”aroma to a carcinogen and deforester. Flavour and
Fragrance Journal,35(1), 5–23. https://doi.org/10.1186/s12909-
020-02004-9.
Kirmayer, L. J. (2007). Psychotherapy and the cultural concept of
the person. Transcultural Psychiatry,44(2), 232–257. https://
doi.org/10.1186/s12909-020-02004-9.
Kpanake, L. (2018). Cultural concepts of the person and mental
health in Africa. Transcultural Psychiatry,55(2), 198–218.
https://doi.org/10.1177/1363461517749435.
Labate, B. (2014). Journey to find iboga. Erowid.Retrieved from
http://erowid.org/plants/iboga/iboga_article1.shtml.
Lacey, K. K., Mouzon, D. M., Govia, I. O., Matusko, N., Forsythe-
Brown, I., Abelson, J. M., et al. (2016). Substance abuse among
blacks across the diaspora. Substance Use & Misuse,51(9),
1147–1158. https://doi.org/10.3109/10826084.2016.1160124.
Luoma, J. B., Sabucedo, P., Eriksson, J., Gates, N., & Pilecki, B. C.
(2019). Toward a contextual psychedelic-assisted therapy:
Perspectives from acceptance and commitment therapy and
contextual behavioral science. Journal of Contextual Behav-
ioral Science,14, 136–145. https://doi.org/10.1016/j.jcbs.2019.
10.003.
Michaels, T. I., Purdon, J., Collins, A., & Williams, M. T. (2018).
Inclusion of people of color in psychedelic-assisted psycho-
therapy: A review of the literature. BMC Psychiatry,18(245), 1–
9. https://doi.org/10.1186/s12888-018-1824-6.
Miller, A., Williams, M. T., Wetterneck, C. T., Kanter, J., & Tsai, M.
(2015). Using functional analytic psychotherapy to improve
awareness and connection in racially diverse client-therapist
dyads. The Behavior Therapist,38(6), 150–156.
Mithoefer, M. C. (2015, August). A manual for MDMA-assisted
psychotherapy in the treatment of posttraumatic stress disor-
der, Version 7: 19. Santa Cruz, CA: Multidisciplinary Asso-
ciation for Psychedelic Studies (MAPS). Retrieved from
https://maps.org/research-archive/mdma/MDMA-Assisted-
Psychotherapy-Treatment-Manual-Version7-19Aug15-
FINAL.pdf.
Mithoefer, M. C., Mithoefer, A. T., Feduccia, A. A., Jerome, L.,
Wagner, M., Wymer, J., et al. (2018). 3,4-Methylenediox-
ymethamphetamine (MDMA)-assisted psychotherapy for post-
traumatic stress disorder in military veterans, firefighters, and
police officers: A randomised, double-blind, dose-response,
phase 2 clinical trial. The Lancet Psychiatry,5(6), 486–497.
https://doi.org/10.1016/S2215-0366(18)30135-4.
National Institute on Drug Abuse (NIDA). (1978). Annotated
Bibliography of Papers from the addiction research center 1935–
75. U.S. Department of Health, Education, and Welfare. Public
Health Service Alcohol, Drug Abuse, and Mental Health
Administration. Rockville, Maryland. Retrieved from https://
www.ncjrs.gov/pdffiles1/Digitization/62807NCJRS.pdf.
Neitzke-Spruill, L. (2020). Race as a component of set and setting:
How experiences of race can influence psychedelic experiences.
Journal of Psychedelic Studies,4(1), 51–60. https://doi.org/10.
1556/2054.2019.022.
136 Journal of Psychedelic Studies 4 (2020) 3, 125–138

Nemu, D. (2019). Getting high with the most high: Entheogens in
the old testament. Journal of Psychedelic Studies,3(2), 117–132.
https://doi.org/10.1556/2054.2019.004.
Nielson, E., & Guess, J. (2018). The influence of therapists’first-
hand experience with psychedelics on psychedelic-assisted
psychotherapy research and therapist training. Journal of Psy-
chedelic Studies,2(2), 64–73. https://doi.org/10.1556/2054.2018.
009.
Ot'alora G, M., Grigsby, J., Poulter, B., Van Derveer, J. W., Giron, S.
G., Jerome, L., et al. (2018). 3,4-Methylenedioxymethamphet-
amine-assisted psychotherapy for treatment of chronic post-
traumatic stress disorder: A randomized phase 2 controlled
trial. Journal of Psychopharmacology,32(12), 1295–1307.
Palamar, J. J., Mauro, P. M., Han, B. H., & Martins, S. S. (2017).
Shifting characteristics of ecstasy users ages 12–34 in the United
States, 2007–2014. Drug and Alcohol Dependence,181,20–24.
https://doi.org/10.1016/j.drugalcdep.2017.09.011.
Papaseit, E., Torrens, M., P
erez-Ma~
n
a, C., Muga, R., & Farr
e, M.
(2018). Key interindividual determinants in MDMA pharmaco-
dynamics. Expert Opinion on Drug Metabolism & Toxicology,
14(2), 183–195. https://doi.org/10.1080/17425255.2018.1424832.
Passie, T. (2018). The early use of MDMA (‘Ecstasy’) in psycho-
therapy (1977–1985). Drug Science, Policy and Law,4,1–19.
https://doi.org/10.1177/2050324518767442.
Reed, S. (2019, Spring). Health equity in psychedelic medicine:
Advancing practices for people of color. MAPS Bulletin,29 (1),
50–51. Retrieved from https://maps.org/news/bulletin/articles/
436-maps-bulletin-spring-2019-vol-29,-no-1/7719-health-
equity-in-psychedelic-medicine-advancing-practices-for-
people-of-color-spring-2019.
Rigg, K. K. (2017). Motivations for using MDMA (Ecstasy/Molly)
among African Americans: Implications for prevention and
harm-reduction programs. Journal of Psychoactive Drugs,49(3),
192–200. https://doi.org/10.1080/02791072.2017.1305518.
Rigg, K. K., & Lawental, M. (2018). Perceived risk associated with
MDMA (Ecstasy/Molly) use among African Americans: What
prevention and treatment providers should know. Substance
Use & Misuse,7(53), 1076–1083. https://doi.org/10.1080/
10826084.2017.1392985.
Rodriguez, C. I., Wheaton, M., Zwerling, J., Steinman, S. A., Son-
nenfeld, D., Galfalvy, H., et al. (2016). Can exposure-based CBT
extend the effects of intravenous ketamine in obsessive-
compulsive disorder? An open-label trial. The Journal of Clin-
ical Psychiatry,77(3), 408–409.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B.,
et al. (2016). Rapid and sustained symptom reduction following
psilocybin treatment for anxiety and depression in patients with
life-threatening cancer: A randomized controlled trial. Journal
of Psychopharmacology,30(12), 1165–1180. https://doi.org/10.
1177/0269881116675512.
Schultes, R. E., Hofmann, A., & Ratsch, C. (2010). Plants of the
gods: Their sacred, healing, and hallucinogenic powers.
Rochester, VT: Healing Arts Press.
Sobiecki, J. F. (2002). A preliminary inventory of plants used for
psychoactive purposes in southern African healing traditions.
Transactions of the Royal Society of South Africa,57(1–2), 1–24.
Shalit, N., Rehm, J., & Lev-Ran, S. (2019). Epidemiology of hallu-
cinogen use in the U.S. results from the National epidemiologic
survey on alcohol and related conditions III. Addictive Behav-
iors,89,35–43. https://doi.org/10.1016/j.addbeh.2018.09.020.
Sloshower, J., Guss, J., Krause, R., Wallace, R., Williams, M., &
Reed, S., et al. (2020). Psilocybin-assisted therapy of major
depressive disorder using Acceptance and Commitment Ther-
apy as a therapeutic frame. Journal of Contextual Behavioral
Science,15,12–19.
Sobiecki, J. (2012). Psychoactive ubulawu spiritual medicines
and healing dynamics in the initiation process of
southern Bantu diviners. Journal of Psychoactive Drugs,
44(3), 216–223.
Suite, D. H., La Bril, R., Primm, A., & Harrison-Ross, P. (2007).
Beyond misdiagnosis, misunderstanding and mistrust: Rele-
vance of the historical perspective in the medical and mental
health treatment of people of color. Journal of the National
Medical Association,99(8), 879.
Tsai, M., Kohlenberg, R. J., Kanter, J. W., Kohlenberg, B., Follette,
W. C., & Callaghan, G. M. (2009). A guide to functional analytic
psychotherapy: Awareness, courage, love, and behaviorism. New
York, NY: Springer.
Turner, K. B., Giacopassi, D., & Vandiver, M. (2006). Ignoring the
past: Coverage of slavery and slave patrols in criminal justice
texts. Journal of Criminal Justice Education,17(1), 181–195.
United States Department of Justice (DOJ). (2016, August 10).
Investigation of Baltimore City Police Dept. DOJ Civil Rights
Division. Retrieved from https://www.justice.gov/crt/file/
883296/download.
Vaismoradi, M., Jones, J., Turunen, H., & Snelgrove, S. (2016). Theme
development in qualitative content analysis and thematic analysis.
Journal of Nursing Education and Practice,6(5), 100–110.
Vandenberghe, L. (2008). Culture-sensitive functional analytic
psychotherapy. The Behavior Analyst,31(1), 67–79.
Wetterneck, C. T. & Hart, J. M. (2012). Intimacy is a trans-
diagnostic problem for cognitive behavior therapy: Func-
tional analytic psychotherapy is a solution. International
Journal of Behavioral Consultation and Therapy,7(2–3),
167–176.
Wilkinson, S. T., Wright, D., Fasula, M. K., Fenton, L., Griepp, M.,
& Ostroff, R. B. (2017). Cognitive behavior therapy may sustain
antidepressant effects of intravenous ketamine in treatment-
resistant depression. Psychotherapy and Psychosomatics,86,
162–167.
Williams, A. (2018). Women, spirituality, and plant-based medi-
cines. Chacruna Institute.Retrieved from https://chacruna.net/
women-spirituality-and-plant-based-medicines/.
Williams, M. T. (2020, March 23). Why black people should
embrace psychedelic healing: Reclaiming our cultural birthright.
Chacruna Institute. Retrieved from https://chacruna.net/why-
black-people-should-embrace-psychedelic-healing-reclaiming-
our-cultural-birthright/.
Williams, M. T., Gooden, A. M., & Davis, D. (2012). African
Americans, European Americans, and pathological stereotypes:
An African-centered perspective. In G. R. Hayes, & M. H.
Bryant (Eds.), Psychology of culture (pp. 25–46). Hauppauge,
NY: Nova Science Publishers. ISBN-13: 978-1-62257-274-8.
Williams, M., & Halstead, M. (2019). Racial microaggressions as
barriers to treatment in clinical care. Directions in Psychiatry,
39(4), 265–280.
Journal of Psychedelic Studies 4 (2020) 3, 125–138 137

Williams, M. T., & Labate, B. (2020). Diversity, equity, and
access in psychedelic medicine. Journal of Psychedelic Studies,
4(1), 1–3. https://doi.org/10.1556/2054.2019.032.
Williams, M. T., & Leins, C. (2016). Race-based trauma: The
challenge and promise of MDMA-assisted psychotherapy.
Multidisciplinary Association for Psychedelic Studies (MAPS)
Bulletin,26(1), 32–37.
Williams, M. T., Printz, D., Ching, T., & Wetterneck, C. T. (2018).
Assessing PTSD in ethnic and racial minorities: Trauma and
racial trauma. Directions in Psychiatry,38(3), 179–196.
Williams, M. T., Reed, S., & Aggarwal, R. (2020). Culturally-
informed research design issues in a study for MDMA-assisted
psychotherapy for posttraumatic stress disorder. Journal of
Psychedelic Studies,4(1), 40–50. https://doi.org/10.1556/2054.
2019.016.
Winkelman, M. J. (2007). Shamanic guidelines for psychedelic
medicine. In M. J. Winkelman, & T. B. Roberts (Eds.), Psy-
chedelic medicine: New evidence for hallucinogenic substances as
treatments,(Vol. 2, pp. 143–167). Praeger Publishers/Green-
wood Publishing Group.
Wu, L. T., Woody, G. E., Yang, C., Pan, J. J., & Blazer, D. G. (2011).
Racial/ethnic variations in substance-related disorders among
adolescents in the United States. Archives of General Psychiatry,
68(11), 1176–1185. https://doi.org/10.1001/archgenpsychiatry.
2011.120.
Zarate,C.A.,Singh,J.B.,Carlson,P.J.,Brutsche,N.E.,
Ameli,R.,Luckenbaugh,D.A.,etal.(2006).Arandomized
trial of an N-Methyl-D-Aspartate antagonist in treatment-
resistant major depression. Archives of General Psychiatry,
63, 856–864.
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