Episode 11

Ep. 11: Ain't all Roses: Risks of Psychedelic Psychotherapy

Published on: 25th October, 2021

During psychedelic experiences people are vulnerable and more at risk to abuses of power in relationships. In this episode we discuss the prevalence of power imbalances in mental health care in general, how the are traditionally dealt with, and the need for greater awareness around the potential for emotional or sexual abuse by therapists in psychedelic-assisted therapy. We highlight a recent study that interviewed underground guides and summarized challenges in working with clients during psychedelic sessions such as increased emotional intensity and attunement to therapist behaviors. We discuss the role of touch in psychedelic-assisted therapy and emphasize the importance of therapists “doing the work” themselves.

For more information about the history of sexual abuse in psychedelic spaces, see:

Ending The Silence Around Psychedelic Therapy Abuse

Psychedelic Therapy Has A Sexual Abuse Problem

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About the Podcast

Altered States of Context

A Podcast about Psychedelics, Science and Psychotherapy

Brian Pilecki and Nathan Gates, two therapists and long-time psychedelic advocates explore the uneasy fit between a medicalized view of individual mental illness and a psychedelic view of suffering and change.

We'll also explore many of the possibilities, opportunities and pitfalls that emerge from this union.

In addition, we'll keep it weird, and talk about some of the aspects of psychedelic experiencing that make it so interesting, fun, and transformative.

This will hold interests for anyone interested in behavior change, cultural trends, and for professionals eager to explore how psychedelics are poised to change many of our therapeutic orientations and approaches.

About your hosts

Nathan Gates

Nathan is a licensed psychotherapist and co-host of Altered States of Context, a podcast about psychedelics, science and psychotherapy. In addition, he serves as president of the board for the Illinois Psychedelic Society and is a board advisor for Entheo Il, a group dedicated to the successful passage of Illinois HB1, the Compassionate Use and Research of Entheogens act. He also practices regenerative ranching and writes from his family's farm in rural west-central Illinois. He is a frequent guest and guest host for the Doomer Optimism podcast, a collective podcast dedicated to promotive creative and humane ways to engage with our social and environmental problems with creativity, hope, and good stewardship.

Brian Pilecki

Dr. Brian Pilecki is a clinical psychologist at the Portland Psychotherapy Clinic that specializes in the treatment of anxiety disorders (OCD, generalized anxiety, social anxiety, panic disorder), trauma and PTSD, and matters related to the use of psychedelics. He completed a post-doctoral fellowship at The Warren Alpert Medical School of Brown University and practices from an orientation based in Acceptance and Commitment Therapy (ACT). Brian also has extensive experience in the areas of mindfulness and meditation, and incorporates them into his therapy with clients. He is an active researcher and has published on topics such as anxiety disorders, mindfulness, and the relationship between theory and practice in psychotherapy. At Portland Psychotherapy, Brian is also involved in research in the use of psychedelics for the treatment of mental health problems.