How Psychedelic Science Privileges Some, Neglects Others, and Limits Us All

By Jae Sevelius|September 20, 2017

There is an urgent need for cultural humility in psychedelic science in order to prevent it from falling into the same limiting, and often unethical, traps that we see in Western science and medicine.

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This article was originally published on Chacruna

Promises of psychedelic science include the opportunity to transform consciousness itself, to creatively generate new solutions to old problems, and to elicit deep healing through self-reflection. In Western psychedelic science and culture, there is a tendency to believe we are on the precipice of healing the world, transcending our traumas and our harmful conditioning, about to discover and unleash the answer to suffering itself. However, current psychedelic science is driven by a Western medicalized framework, and thus reflects all of the same limitations. The lack of cultural humility that pervades so much of Western science is just as prevalent in psychedelic science.

Cultural humility is the acknowledgment that we are all bound by the limitations of our socialization and are often ignorant of our own privileges. Psychedelics can potentially be powerful tools for overcoming oppressive social programming, yet the psychedelic science framework has, so far, been replicating existing power structures. Many of us may hesitate to critique the paradigm that psychedelic science is replicating because we are invested in its success. However, until we are willing to admit that we all have much healing to do, we cannot heal our movement. This lack of humility will be Western psychedelic science’s primary barrier to achieving one of its ultimate goals, which is to develop medicines and therapies that are available and generalizable to as many people as possible.

There are very few people of color, let alone women of color, leading psychedelic science, especially in the United States. The boards of the primary funding organizations, as well as the scientific teams, are comprised primarily of white men. In seeking to diversify our movement, we also must consider the difference between true collaboration and tokenization. Avoiding tokenization means going beyond inviting women and people of color in order to merely create demographic diversity. We must also be willing to make the changes necessary to allow new perspectives, knowledge, and ideas to actually be expressed, welcomed, and acted upon. When women and people of color participate on advisory boards and scientific teams, they must also have a powerful voice in the agenda, the decisions, and the outcomes in order to truly benefit the science.

The tremendous benefit of diversity on teams has been well-established scientifically. Research has shown that it is a limiting factor to only have one kind of perspective represented when making important decisions and building new paradigms. Diverse perspectives are critical in order to generate innovative insights. However, change requires true commitment to go beyond superficial tokenization of voices that are often excluded or silenced. Purposeful effort is required to resist cultural norms that dismiss the voices of marginalized people and reinforces the paradigm of dominance and oppression.

Currently, indigenous people who have been studying these medicines for many generations receive little if any respect in Western science for their extensive expertise. Furthermore, underground therapists, often women, have been putting their lives, livelihoods, and reputations on the line in the name of healing without institutional protections or recognition for their work. These are people who have been doing the work on the ground for generations, studying and developing these profound tools for healing. In Western science, the men who lead the boards and the research are the ones who receive the funding, the credit, and the accolades for bringing about the current “psychedelic renaissance.” They also receive the protection and the respect of our governmental, scientific, and cultural institutions. Despite claims to the contrary, “set and setting” was not a recent discovery of modern science. Indigenous peoples have emphasized the importance of intention, ritual, and sacredness in the use of plant medicines since the virtual beginning of time.

Despite their minority status, there are several female and indigenous leaders and organizations in psychedelic community. Vice recently published an article about several women fighting sexism in psychedelic science. The 2017 Psychedelic Science conference included a plant medicine track that raised the profile of women and indigenous people due to the leadership of Bia Labate, an anthropologist, who saw the need for and benefit of more diverse perspectives. The conference also included an interdisciplinary panel entitled “Injustice, Intersectional Trauma, and Psychedelics.” The Women’s Visionary Congress has spent many years organizing around the topic of power and privilege in psychedelic communities. Janis Phelps, Ph.D., is pioneering the first certificate program in psychedelic-assisted therapies and research at the California Institute for Integral Studies. Alicia Danforth, PhD, has been pioneering MDMA-assisted psychotherapy for social anxiety among autistic adults, and demonstrating how psychedelic research can be done with community engagement and humility.

There is movement and willingness; this is apparent in the response to some of the sessions and ongoing discussions around the Psychedelic Science conference. For example, LisaNa Red Bear demonstrated tremendous courage in speaking her truth about the fraught relationship of psychedelic science to indigenous peoples to Gabor Maté during the question and answer period at his plenary session at the conference. Maté’s initial dismissive response and subsequent apology to Red Bear is an example of how we can begin to acknowledge and apologize for the mistakes that we make, and will continue to make, as a movement. This is not personal; this is a societal experience and phenomenon. We are all socialized into a paradigm that privileges some ways of knowing over others. We all need to do the work of reexamining this cultural programming. This is not about any particular white people or men. This is about the need for psychedelic science as a movement to acknowledge and resist the replication of existing structures of power and oppression, especially in the name of “science.”

Lack of diverse expertise informing study designs and therapy models can result in narrow frameworks that unnecessarily limit the generalizability of our findings and reflect unfounded and outdated assumptions. We need to be willing to question how we use power and privilege; not just because it is ethical—although that it is clearly a standalone reason—but also because it is holding back the science. In order to be generalizable, we must be able to demonstrate that these therapies are applicable to different types of people. Otherwise, we are merely testing a highly specific therapy on an exclusive subpopulation under narrow conditions. We know that there is a serious problem with lack of diversity in the recruitment of participants in studies of psychedelic therapies. We do not know what the barriers to participation are for different groups because those voices are not at the table. We can infer from other clinical trials in medicine that distrust is likely a factor, given that communities of color have long histories of being abused, manipulated, and treated unethically within the context of medical research. We also know that communities of color have been devastated by the War on Drugs and subsequent mass incarceration, and thus have much more at stake when asked by researchers to participate in studies that involve illegal substances.

Another example of this limitation is the long-standing requirement that psychedelic-assisted therapy teams must be comprised of one man and one woman. The assumption is that clients have a therapeutic need for symbolic representation of their biological parents reflected by the therapy team. However, there is absolutely no empirical evidence supporting this assumption, which does not account for people who are raised by gay couples, transgender people, or single parents. Furthermore, presumably, the required male/female therapist pairs are cisgender (i.e. not transgender), so is there space in this model for transgender people as therapists? In a public talk, one well-known male psychedelic therapist/researcher described a session where a participant was projecting “mother issues” onto him. Clearly, this is an indication that therapists do not necessarily need to be female to be the object of mother-related projections. Family dynamics in psychedelic-assisted therapy are evidently more complex and profound than just the presenting gender of the therapist.

There is an urgent need for cultural humility in psychedelic science in order to prevent it from falling into the same limiting, and often unethical, traps that we see in Western science and medicine. Cultural humility requires sharing and even giving up the podium to make space for diverse voices and contributions. Healing happens in community. I believe our movement wants collective healing for all of us, not just some. This discussion is timely, as the United States is currently embroiled in debates about the value of health equity: the importance of health being accessible to all, not just the privileged few. We would like to believe that psychedelic science has the potential to undo these systems of power such that we all have safe access to the cognitive liberties promised by this movement. To achieve this potential, we need to begin to broaden our framework of healing to include a cultural focus.

A genuinely accessible psychedelic therapy paradigm would be built in true community and collaboration. It would include integrity, humility, and deep listening. It would include diverse voices, including the people who have been hurt by the current paradigm. These voices would help lead us to new ways of being in community together. Building this community would require moving at the speed of trust.

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Jae Sevelius

Jae Sevelius, Ph.D., is Associate Professor of Medicine at University of California, San Francisco, and holds a Certificate in Psychedelic Therapies and Research from the California Institute of Integral Studies.