Precautions with Underground Psychedelic Therapy

The Multidisciplinary Association for Psychedelic Studies (MAPS) is to be commended for their groundbreaking clinical research, and for obtaining approval from the Food and Drug Administration to conduct scientific trials studying the efficacy of MDMA, LSD, cannabis, and psilocybin mushrooms for the treatment of PTSD, end of life anxiety, depression, social anxiety associated with autism, and personal and spiritual growth—in addition to ibogaine therapy for addiction, and ayahuasca for PTSD. They picked up where the research in the 1950s left off, and the findings are nothing less than astonishing. They have developed a clinical protocol which is freely available on their website.

Underground providers, sitters, and guides may be proficient in providing you with a comfortable and beautiful setting to undergo a psychedelic session. However, without the proper clinical training, it is very probable that they will be “bleeding” into your experience, a term loosely used to mean that their own issues will be activated, possibly contaminating your experience. This could be psychologically harmful to you. At the very least, it could be distracting or annoying—neither of which are desirable.


Belief Systems as a Substitute for Protocol

Although some of the clinical trials being conducted are interested in the possibility of connecting with divine or spiritual energies, such as the trials currently underway at Johns Hopkins University, there is no way to prove that these subjective experiences are an indication of such encounters. These experiences are solely based on belief, although the scientific studies still operate according to clinical protocol.

The same holds true when you seek the assistance of an underground guide. Whatever your personal beliefs are, your guide is going to have their own ideas. If your guide isn’t following some basic guidelines, then things may start to become unclear as you interact with them.

Some of the hallmarks of responsible guiding in psychedelic work:

  • The guide respects your individual process and is not trying to be your “teacher.”
  • The substance is the actual teacher. It provides release, healing, and insight in a way that is unique to you.
  • You and the guide spend time to get to know each other before the session. You are both clear about your intentions and the purpose of the session.

In the aforementioned scientific trials, the protocol is developed so that therapists and sitters undergo a number of psychedelic sessions within the context of safe clinical practice. This is to better empathize with and understand what the subject may be experiencing, and to work on anything that could be a hindrance to the healing process. Medical and personal histories are also taken into account, just like any other medical procedure. Work proceeds accordingly, with the highest level of care and respect for the subjects’ needs.

In underground sessions, you’re taking a huge risk choosing to work with someone who may not have adequately prepared or may have dubious subconscious motivations.

This is most apparent when your guide is triggered in the course of your work together and begins to “bleed” their beliefs or unresolved issues into your experience. This doesn’t mean they’re bad or trying to harm you. It means they are human and may not be properly trained in the correct protocol for facilitating a psychedelic experience.

Therefore, it’s critical to get all of this out in the open in advance; YOU must be the one to set guidelines and boundaries for your work together. Do your due diligence; get a second opinion. Treat this like any interaction that you’d have with a traditional health care provider.



Although I doubt anyone will heed the advice in this section (I could be wrong) a certain level of maturity is recommended for undertaking psychedelic work. It is a commitment to honesty, practice, and ongoing self-development. Aftercare is a must. The point of doing this work is not to be fixed by psychedelics but to use them as a tool whose insights you will integrate and apply ongoing. This takes maturity.


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Safety First–Contraindications

There are several contraindications to be aware of when considering the use of psychedelic drugs. For starters, it’s recommended to avoid these substances entirely if you are diagnosed with schizophrenia, severe depression, or other serious mental health concerns. Bipolar disorder is also reason to tread with caution; though as a sufferer of bipolar disorder myself, I find great relief from my symptoms using psychedelics.

I would recommend having a doctor you can trust and be honest with about your psychedelic drug use. Take the time to become knowledgeable about ongoing psychedelic research, and work with your provider to ensure that your continued use of psychedelics remains a safe and valuable part of your life.


Moving Forward–Legalization of Psychedelic-assisted Therapy

Here in NYC, the Horizons: Perspectives on Psychedelics conference takes place each year and has recently wrapped up its tenth year in a row. I was honored to be a volunteer last year. Every presenter was fascinating; journalists, doctors, and scientists presented their findings on clinical research trials taking place all over the world. Some of the countries that are currently allowing research are Argentina, Israel, Switzerland, Canada, and of course the U.S.A.

The ever-compassionate and entertaining Rick Doblin, Ph.D., assured us that psychedelic therapy was well on its way to becoming legal, and probably will by 2021. That’s only four years away. There is still much work to be done, not only for the legalization of psychedelic-assisted therapy, but for the cognitive freedom to use psychedelics for personal or spiritual healing.

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