Between the skyscrapers of Denver and the foothills of the Rocky Mountains, Lilith* is sitting cross-legged on her back porch, near her artificial burbling brook. She is wearing a light, breezy-white shirt and a beaded necklace. She is about to make an enormous life change. The fear and excitement make her hands shake.
Raised in Alabama, her professional life started in corporatized tech. The money was good, she says, but “I felt my soul dying.” She coped with alcohol. At a white-tablecloth dinner with coworkers she guzzled pinot grigio until she collapsed. “I realized I had to get out,” she says. “And I was also asked to leave.”
Since then, the now-43-year-old psychedelic guide has reinvented herself. She got a master’s in somatic psychology and trained formally as a yoga teacher and massage therapist. Then, she trained as a psychedelic guide. She helped in underground plant medicine ceremonies in Colorado, was employed in a ketamine clinic in the Denver area, and guided participants in a psilocybin retreat in Costa Rica.
Now, she is striking out on her own in private psychedelic practice—literally underground. From her back porch, a set of concrete steps descend to Lilith’s therapy room in her basement. Under exposed joists and the occasional cobweb, there are a couple love seats, tarot cards, incense, a shamanic drum, art, and a floor mat with plush pillows where clients sometimes trip. She favors mushroom microdoses over heroic doses, and prefers to work in clients’ homes or a rented cabin in the mountains. On bigger doses, the client might meditate, hike, do yoga, or listen to music. Lilith uses rattles, tuning forks or drums to “attune to the energetic field of what’s happening with the clients—and/or shift it, if necessary,” she says.
Lilith feels so called to help people in these untypical, unsanctioned, psychedelic ways, she’s about to make a decision that is as political as it is personal: She’s walking away from the above-ground therapy world. This August, she let her designation as a “therapist” from Colorado’s Department of Regulatory Agencies lapse.
It was a deliberate renunciation, a conscious break. She doesn’t agree with the state’s regulations for therapists, believing they’re too restrictive and can actually interfere with her ability to support her clients—and, among psychedelic practitioners, she’s not alone. Those rules bar therapists from using touch with their clients, and prevent clients from being friends with or part of the same social circle as their therapist. This state-set boundary, Lilith believes, artificially cuts people off from each other. “I really value relationship as a major healing component,” Lilith says.
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This rule is in place so therapists don’t date or manipulate clients. But while the guides tend to believe in boundaries, some also know many clients need community more than anything. Joseph*, a psychedelic practitioner in the Denver area, sometimes holds events where clients meet each other, seeding connections. “In Indigenous cultures, the shaman will invite you into their home. There are kids running around,” says Joseph.
The cultural and political tides are heading toward the end of psychedelic prohibition, with psilocybin- and MDMA-assisted psychotherapy soon to gain FDA approval— but many underground guides agree with Lilith about state certifications. They balk at the idea of becoming licensed by a government to legally administer these medicines, and want to keep working underground.
State control, says Selena*, a psychedelic therapist who’s treated over 300 clients, “takes away the magic. It just does.” Selena refuses to train with the Multidisciplinary Association for Psychedelic Studies, or MAPS (a psychedelic research and education organization that’s training therapists in psychedelic medicine), believing that it’s more than enough that she was trained by a mentor with more than 50 years of experience. Joseph says the protocols being established by formal training programs are too limiting and will not allow him to do the work that needs to be done. He, too, wants to be able to have deeper relationships with his clients.
To be clear, these guides don’t want the Drug War to persist. Using psychedelics or any drug, they say, should not be a crime. If psychedelic guiding is going to be legal, however, these guides would rather the rules be made by someone other than, say, the DEA, which has barred cannabis use completely for decades, medical bureaucrats who prescribed too many opioids, or the new psychedelic companies who might try to cut corners to make money. Instead, they’d like to see some sort of non-governmental accountability body.
They’re hazy on the specifics of who would make the rules or what those rules might be. But generally, these guides tend to value mentorship, community, and rules made in an organic way, slowly—sort of how traditions have been cultivated by Indigenous cultures who partake in the use of entheogenic plants and fungi in ceremonial contexts. Or how rules developed in the West for scuba diving guides or mountain climbing guides. There is no state-run body for them. Instead, rules tend to be made by guides who have been to the depths and heights, and know the currents and the weather patterns. And certifications are done by nonprofits and private groups, rather than folks in Washington, D.C.
Psychedelics had been illegal for a half-century. Then, in May 2019, Denver made history as county citizens voted for psilocybin mushrooms to be the city’s “lowest law enforcement priority,” barring the district attorney from spending money to go after personal use and grows. Since, more than half a dozen other jurisdictions, including Oakland, Oregon, and Washington, D.C., have also decriminalized psychedelics to varying degrees; meanwhile, government-approved trials to turn psychedelics into pharmaceuticals speed along.
In this new climate, politicians, journalists, academics, regulators, and venture capitalists are contemplating psychedelics’ regulatory future. Some of them, it’s clear, don’t actually know much about tripping.
Many who are already helping people heal, connect, and explore with psychedelics, albeit underground, are left out of the conversation.
Many who are already helping people heal, connect, and explore with psychedelics, albeit underground, are left out of the conversation. Therefore, this demographic, even though it contains some of the most lived experience and practice in the field, is often absent from public discussions with lawmakers or journalists that could threaten their freedom.
In the wake of Denver’s decriminalization initiative, this knowledge gap led a group of academics, therapists, and myself, a journalist, to conduct a formal study, in which we interviewed 16 psilocybin practitioners in Colorado through Colorado State University and a drug education nonprofit called The Nowak Society. Our goal was to learn how these guides operate: how they find mentors and train; select and screen clients; and conduct sessions. We asked how much they charge, the benefits and risks of mushrooms, how their clients get worse or better, how Denver’s decriminalization of psilocybin has affected underground guides, and what future regulations, if any, they’d like to see. Though our study isn’t completed, we’ve been inserting their underground voices into public discussions around the further legalization and decriminalization of psychedelics and other drugs in Colorado.
In August, we presented our preliminary findings at The Nowak Society’s Psychedelic Professionals meetup in Denver, a monthly gathering of clinical researchers and ketamine therapists held at a cozy downtown restaurant. A summary of our research was slated to be included in the official comprehensive report from the city’s Psilocybin Mushroom Policy Review Panel. This panel was mandated by the law that decriminalized psilocybin in 2019 to track decriminalization’s impact. The panel included a harm reductionist, a therapist, a lawyer, police, and the district attorney. It met for a year and, after reviewing the record, “unanimously” agreed mushroom decrim “has not since presented any significant public health or safety risk in the city.” At press time, the panel’s report was being sent to the Denver City Council, and recommended the council start allowing gifting and non-commercial community use: meaning, a friendly mushroom circle.
While much of the discussion about psychedelics centers around therapy, only one of the guides we interviewed was a licensed therapist. Seven called themselves “unlicensed therapists.” The others had diverse backgrounds but felt they were qualified to hold space as psychedelic guides either because they used small doses or had some kind of training, such as the nightclub manager who sold microdoses or the retired movie grip who trained for years with Indigenous Mixtec guides.
For many of these guides, there’s a shift away from using the word “underground,” which conjures up images of dark alleys and police chases. In Colorado, psychedelic guides rarely get in legal trouble, and sometimes they even advertise on social media. Many prefer “community” to “underground,” as in, “community practitioners” or “community guides.”
In a community setting, the guides say that they can do things that might not be FDA- approved, things like using song, prayer, movement, yoga, massage, and other healing modalities that are not currently integrated into the Western medical system.
In a community setting, the guides say that they can do things that might not be FDA- approved, things like using song, prayer, movement, yoga, massage, and other healing modalities that are not currently integrated into the Western medical system. They also, if they feel called and it’s supportive for the client, can incorporate spirituality into psychedelic sessions and be trained in things other than therapy, such as bodywork, divinity, or medicine. Guides also feel it’s important to be able to offer different substances at different doses—or even combine them (especially MDMA with other psychedelics), as opposed to the strict protocols put forth in FDA-approved trials, which define who qualifies for what treatments and at what doses.
A surprising amount of the mushroom work in Colorado is with small doses—microdosing or mini doses—which is an untold number of years away from FDA approval. The current research nearing FDA approval is investigating psilocybin at high doses for people with treatment-resistant depression and major depressive disorder, and we don’t yet know whether people without those indications will qualify. There’s also the issue of setting: Some clients and guides may prefer to work in nature or in their clients’ houses, as opposed to a clinic. And then there’s the desire to control how their medicines are grown or made, including the intentions that went into them—some of these guides grow their own mushrooms and many prefer whole dried mushrooms— and all the alkaloids in them, which may work synergistically, much like they do in cannabis—as opposed to a synthetic version of one compound within the mushroom, psilocybin, which is what will first be available for prescription.
If an unregulated psychedelic landscape sounds like a free-for-all, it sometimes is. While most community guides are ethical and conscientious, some make highly questionable decisions. Three community guides told me that a male guide was addressing women’s trauma using MDMA and a kind of sexual therapy in which the client and the guide got naked together. Accusations of sexual assaults while the client is tripping ripple through the underground community. Cops are almost always excluded, even in extreme scenarios, because the victim doesn’t want to admit to illegal activity, so these crimes rarely end in legal consequences. This leaves clients dangerously exposed and deeply damaged.
And so, calls, even from within the psychedelic community, for official, regulating governmental bodies are loud and clear. “There is nothing to suggest that these guides will regulate themselves,” Los Angeles psychiatrist and addiction specialist Dr. Stephen Scappa tells me. “This group is comprised of humans. And humans, as a group, generally don’t know how to contain themselves. There has got to be a legal backing for accountability for psychedelic psychotherapists. There has to be a regulating body.”
To be clear, these guides are not calling for chaos. “We just don’t want rules made by people who are not doing the work,” Joseph says. “There are a lot of people [who work in policy or government] who want to control the field, without knowing what the field is. And the field is not what they think it is. This is about a deeper truth. It’s about bringing life back to life.”
Under Oregon’s new law allowing psilocybin therapy, the regulating body will be the Oregon Health Authority. It’s unclear which practices currently used by community guides are going to be allowed under regulations laid down by the health authority, and which will remain outlawed.
In Colorado, the regulating body for therapists is the Department of Regulatory Agencies, or DORA. DORA would presumably have a role in future legal schemes. This does not sit well with many guides. “Therapists are terrified of DORA,” says Joseph. “The way they govern is not holistic, it’s not from within a community, it’s more like a set of rules.”
Regulation from DORA will be a “steel wall,” Lilith says. “A steel wall is not comfortable. You can’t really relax into a steel wall.”
Again, there is only a blurry vision among guides for a community-based alternative to DORA, or answers to basic questions like who would set standards for safety and quality control, what qualifies someone to hold space, or what constitutes a breach. Joseph says he is part of a network of guides who are in the process of setting up a system of checks and balances for themselves. But the group has not fully fleshed out the details. It’s more informal. “It’s coming together, sharing difficulties, talking about ethical problems, sharing information, and mentoring each other,” says Joseph. “It’s a mycelial network. I’ve seen it work very well.” Their ethics, he said, are guided by a 1995 book called The Ethics of Caring, written by a student of LSD therapy pioneer Stan Grof.
Many guides use rules handed down from mentors, Indigenous folks from traditions such as the Shipibo or the Mixtec, or, perhaps most provocatively, the mushrooms and medicines themselves. If psychedelic therapy goes legal, guides worry, regulatory control shifts— creating a system for qualifications that might not work, might be too loose or too strict—and, in the words of one guide, “the medicine doesn’t choose who it serves.”
“We have to allow ourselves to develop,” Joseph said. “You start governing us too early and you’re imposing an old system [of healthcare] on us, and you’re preventing us from growing. Either we’ll become like you or we’ll go into hiding and do what we want to do.”
Lilith is worried. In a regulated psychedelic environment, just like her old job in corporatized tech, “my soul would probably still die,” she says. “You have some different content and components, but fundamentally it’s the exact same thing.”
So for now, she’s sticking to her path, off-the-books. And she’s spreading her views. This fall, at a retreat center in the Rocky Mountains, she held a training for 12 professionals in things like mental health, therapy, or body work. Each was considering expanding into psychedelics, off-the-books, too. For five days, Lilith and a co-facilitator taught students how to guide and be guided, using psilocybin. Two of her students booked their first psychedelic clients in the subsequent weeks. Lilith had the feeling her training was just the beginning of something much greater, like planting seeds.
One attendee, Kelly*, tells me Lilith’s immersion changed her life. After two decades working as a psychotherapist, she quit, and now plans to work exclusively as a community psychedelic guide. She marked her exit from the above-ground psychotherapy world with a flourish. A month before Lilith’s retreat, at a full moon ceremony in her home city, Kelly says she burned her copy of the Diagnostic and Statistical Manual a.k.a. the DSM (the textbook of mainstream psychology), her state-issued psychology license, and her baby blanket.
*Names have been changed in this story to protect the anonymity of our sources.
This article originally appeared in DoubleBlind Issue 6, published in December 2021.
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