Psychedelic Therapists Must Be Trained to Set Sexual Boundaries
Experiencing sexual energy or memories during psychedelic states can conjure deep wounds creating more trauma or healing as these feelings are brought to light. Sexuality can connect us with the most vulnerable and precious parts of ourselves. It sits at a core layer of our psyches.
Humanistic psychologist Abraham Maslow puts sexuality on the foundational layer of his hierarchy of needs and motivation together with physiological needs that focus on physical survival. Freud assigns the libido as the main force of the unconscious. We cannot underestimate the role that sexuality, or the lack of it, plays in our lives. It’s at the heart of our evolutionary story. An integral part of our wholeness.
Because of the power sexuality can have in someone’s life, we must be ethical and responsible when it arises. This is especially true of someone holding a therapeutic container. Sex and psychedelics are both known for being boundary dissolving experiences. Sexual feelings that arise during therapy can be both liberating and confusing.
Immense trust is placed on therapists that people share these experiences with. When working with psychedelics in a therapeutic environment, there is a range of possible outcomes which can either create scars or heal the ones carried. As a result, this work must be approached with great care. I believe that the first step towards therapeutic providers taking ethical responsibility for setting proper boundaries is education and awareness.
The boundary dissolutions psychedelic medicines provide can increase the number of situations in which sexual boundaries are crossed in professional settings. This can have a major traumatic effect on clients, the field of psychedelic-assisted therapies, and how psychedelics are accepted by the larger culture. I believe that more awareness around the topic, including the development and self-awareness of ourselves as sexual beings, is a part of the solution.
Guides, therapists, and spiritual leaders are primarily humans before their professional roles and humans have deep emotional and sexual needs. This is something that cannot be escaped. It must be accepted, just as our need to eat. It isn’t something to be overcome, but acknowledged, so that therapists can be properly trained to hold boundaries.
The professional space holder must own their own sexual energy and meet their emotional and sexual needs outside of the professional setting. Without this self-awareness, these deep evolutionary impulses might try to resolve themselves with the client or the therapist’s sexual energy may be projected onto the participant.
Why Is Sexuality Not Fully Addressed While Training Psychedelic Therapists?
Before continuing, I want to be transparent about my background. I trained with Francoise Bourzat (author of Consciousness Medicine) and Aharon Grossbard who recently have been the subject of allegations that they crossed sexual boundaries within their past therapeutic practices.
In a post on Medium and an essay on Mad In America, Will Hall alleges that Aharon sexually violated him while he was receiving psychedelic therapy in the 1990s. Another former client says that Francoise engaged in an inappropriate sexual relationship with him.
I trained with Mazatec curanderos in Oaxaca, Mexico with Francoise. Aharon was the external committee member for my doctoral dissertation. I did not experience sexual violations while working with Francoise and Aharon, but these allegations must be taken seriously and addressed. During my work with them we were not trained to engage in sexual contact with clients and I did not witness this behavior.
In my practice as a legal guide working in Jamaica, I have seen sexual energy organically arise in about half the people I see while working with psychedelics in a therapeutic context. Given its immense role in life and how much it shows up in expanded states of awareness, I am surprised that sexuality only played a very small role in the multiple trainings and degrees that I received for holding therapeutic space or in the general field of consciousness.
At most, a day of training had been given to sexuality in any of this training. This isn’t the fault of any instructor or professor, but a larger cultural issue regarding the lack of sexual awareness.
Recent public discussions about sexual boundaries being crossed in psychedelic therapeutic settings is part of a much larger conversation about sexual abuse by different kinds of therapists. It might astound many of us to know that according to researcher Kenneth Pope, one in every twenty therapists will sleep with a client over the course of their career.
For years it’s been known that shamans holding ceremonies have slept with participants— this also happens with priests, gurus, and medical doctors. These are situations in which the participant is being emotionally intimate and vulnerable. In some cases, the experience of closeness can bring up sexuality for both the participant and healer.
In these circumstances, the attachment system of the participant may also be engaged, which can be linked with feelings of abandonment. Prior unresolved experiences of boundaries being crossed also may become activated. The deepest traumas I have seen with clients have been linked with early sexual violations, especially by people that were supposed to protect them. Therapists working with psychedelics must receive better training to address their sexuality and hold professional boundaries.
I believe that psychedelic guides must be ready for sexual energy to arise in the client. That does not mean they should incite it, but that it may organically arise in the process. The practitioner must know that these feelings can be an essential part of the healing process, and be educated to hold strong boundaries and create a container for it.
The issue of sexual energy that emerges in psychedelic states is a complex one and deserves much more breadth and depth than can be covered here. This is meant to merely evolve the conversation forward.
My Journey Through Training
Like almost everyone who trained with Aharon and Francoise, I also have many years of training outside of working with the couple. Very little of it addressed sexuality. I received my Masters in Consciousness and Transformative Studies at John F. Kennedy University and my PhD in the Philosophy, Cosmology, and Consciousness program at the California Institute of Integral Studies (CIIS).
In addition to my academic training, I completed the two year Hakomi somatic psychotherapy comprehensive training, assisted for two years at the Psychedelic-Assisted Psychotherapy Certificate training at CIIS, mentored for a year at the School of Consciousness Medicine, was in the Diamond Approach for four years, and read over 75 books just on psychedelics. I did several trainings in Tantra, a tradition that focuses on sexuality to deepen love and directly experience spirituality.
Sexuality affects us dramatically, but collectively many therapeutic practitioners lack a deep awareness of both sexuality and psychedelics. My interest in the intersection of sex and psychedelics started far before the current discussions in the field of psychedelic therapy were catalyzed by the allegations against Francoise and Aharon.
Psychedelics have been a central part of my life for twenty years now, and over the last ten years I have steadily been in therapy myself to focus on my own growth. Therapists must be prepared to do this interior work to develop a healthy relationship with their own sexuality and not harm others.
Because sexual energy is an essential part of our humanity and at the core of who we are as individuals, Arielle Brown, intimacy coach and founder of Cosmic Tantra, and I created a three hour webinar in August 2021 called “Sex and Psychedelics: The Intersection of Erotic Energy, Space Holding, & Altered States of Consciousness” in collaboration with the San Francisco Psychedelic Society. We created the webinar to fill in some gaps in awareness that we saw concerning sexuality and psychedelic states. 400 people bought tickets for the live online event and a recording can still be purchased on the San Francisco Psychedelic Society website. I also lead legal psilocybin mushroom ceremonies in Jamaica with Atman Retreats and psychedelic integration circles with the San Francisco Psychedelic Society.
My dissertation is now published as “The Psilocybin Connection: Psychedelics, the Transformation of Consciousness, and Evolution on the Planet—An Integral Approach” by North Atlantic Books and distributed by Penguin Random House and across all major platforms.
What I’ve Learned About The Role of Boundaries
I was a physics and math major before a mushroom journey told me to leave physics and focus my work on the development of consciousness. Through all my years of training, I have been working to understand the evolution of matter and consciousness. This has encouraged me to think deeply about the importance of boundaries in psychedelic therapy.
For the safety of both the participant and practitioner, I believe that therapists should not have physical contact with the clients while sexual energy is present for the participant. The boundaries could become too blurred.
In addition to inadequate training and lack of care for a participant’s safety, I believe that one of the reason boundaires are crossed in therapy is because in our culture most people are only emotionally intimate with sexual partners. As this is the only point of reference for many people, they may feel that emotional intimacy or touch must lead to sex. The emotional connection between a therapist and client can be a vehicle for healing the participant without physical contact.
In her New York Times bestseller, “Set Boundaries, Find Peace,” Nedra Glover Tawwab, a long-time therapist and relationship expert, writes: “Boundaries are the gateway to healthy relationships.” This is why boundaries must remain solid and respected so that the relationship remains healthy.
Boundaries within ourselves, just as within relationships, must be honored. Many times, when using psychedelics there is an idea that resistance must be broken through. I argue that is not a loving way forward. Resistance is a boundary within ourselves. Resistance must be honored by the guide and participant. We were taught in Hakomi that honoring the resistance creates safety and trust. Those are the underlying essential ingredients that allow healing.
The resistance arose for a reason. The obstacle is the way. When honored, and the person feels safe, the resistance tends to dissolve. A person must surrender to having resistance before they can genuinely relax. Only then can the wholeness of a person authentically surrender to the process. Asking someone to self-abandon and cross their own boundaries, or the practitioner crossing the boundaries of the participant, will make the participant unconsciously feel violated.
Transference is common in psychotherapy. Transference can be defined as the process of a participant projecting emotions that were originally directed onto someone in their past directly onto the therapist. Countertransference is when the therapist unconsciously and sometimes consciously reacts to the participants transference and plays into the dynamic.
A particularly relevant example of transference is if the participant has had their boundaries crossed in the past and the trauma isn’t resolved, and now the emotions towards the perpetrator can be placed on the practitioner. The transference can happen the day following the session and not be detectable by the guide in the moment. Therefore, it is especially important that the practitioner keeps physical distance when sexual trauma emerges so that there cannot be a misunderstanding of the situation.
It is natural for trauma and repressed sexual energy to arise in psychedelic states. Psychedelic researcher, Stanislav Grof, who co-founded the field of transpersonal psychology and worked with over 50,000 people in expanded states of consciousness, including LSD, over the course of his life, believes that psychedelics can produce “holotropic” states of consciousness, that is, self-organizing states of consciousness that lead towards wholeness. This means the organic emergence of content and energies in the body need integration so one feels whole.
During his six decades of work in the field, Grof created a cartography of the psyche that presents itself in holotropic states of consciousness. He called these the Basic Perinatal Matrices, and sexual energy plays a central role in these archetypal dynamics that describes the development of death-and rebirth commonly experienced in these states. Holotropic states may include repressed sexual energy—whether it be because of trauma or repressed pleasure. It is life force. Often, if integrated, sexual energy leads to a sense of wholeness, confidence, and vitality.
Both sex and psychedelics can create expansive states of consciousness that have the capability to produce healing and wisdom. In addition to the rich practices that Tantra offers, it also offers a complex cosmology, one in which the universe is primarily an interplay of energetic forces that unite in love. This is in resonance with the deep common psychedelic insight that we are all one and love is the purpose of our existence.
What is the Proper Role of Touch in Therapy?
If boundaries need to be set, what is the proper role of touch in therapy? I think there needs to be more examination of the important—and at times controversial—topic of physical contact between therapists and clients. As someone trained in body-based therapeutic practices, there are certain wounds that I believe can’t heal without physical contact. I have found that to be the case in my own personal healing.
Taking touch out of therapy is throwing out the baby with the bath water. There are certain developmental trauma wounds that are caused by neglect of touch as an infant during the first several years of life. For example, regulation for an infant can’t be found through words or content. The nervous system of an infant finds regulation from a stable and nourishing body. Infant mortality and emotional problems as adults arise when infants don’t experience touch.
Touch is how we learn regulation. Developmental trauma can still exist in a person and I believe it is possible to heal. Simple touch by a practitioner, like the holding of a hand or hand on a shoulder (with consent), can dramatically help regulate the nervous system of a person in a traumatic state. Touch in moments of pain is the natural empathic response for one human to another. When working with psychedelics, we can become even more sensitive to touch.
In “Boundaries in Psychotherapy: Ethical and Clinical Explorations,” published by the American Psychological Association and written by Ofer Zur, the author states that “Touch in therapy has probably been the most controversial of all boundary crossings because of the cultural and professional associations of touch with sexuality. The major concern is that nonsexual touch may lead to sexual touch and sexual exploitation… The conflict around the use of touch in therapy arises from a number of sources. There is tension between, on one side, well-established scientific knowledge that says that touch is important for human development and, on the other side, the ethical concerns with exploitative and harmful sexual touching of clients with therapists.”
Zur goes on to note that, “A vast amount of scientific data has been acquired in the past half century on the importance of touch for bonding, human development, healing, and communication. The clinical utility of touch in therapy has also been studied extensively and has determined conclusively that touch enhances therapeutic alliance and increases a sense of trust, calm, and safety. However, there is major concern that nonsexual touch may lead to sexual touch and exploitation of clients.”
According to Zur, most psychotherapists’ surveys paradoxically reveal that 87% of therapists touch their clients, 85% hug their clients, and 65% approve of touch as an adjunct to verbal psychotherapy. They conclude that, “It seems, in spite of a risk management viewpoint that touch is taboo, most therapists do touch their clients, and do so appropriately.”
Part of the work moving forward for everyone, in a therapeutic container and all other settings, regarding touch is to create a culture of consent. In “Creating Consent Culture,” by Marcia Baczynski (sexual communication coach and co-founder of Cuddle Party) and Erica Scott (who leads workshops on consent), the authors state that consent culture “is a culture in which interactions are collaborative, and as mutually agreeable as possible. In consent culture, people feel in control of their own bodily autonomy and boundaries. They feel free to change those boundaries at any time according to their individual desires and needs.”
A problem concerning consent arises when people are under the influence of psychoactive substances. In a professionally held therapeutic container, it is then the guide that must hold the boundaries that were previously set before entering an altered state.
In a professional setting where the participant is coming to the guide for a service, money also helps create a boundary for the energy exchange. The guide is here for the client. The participant is paying for the guide’s talent and presence. Boundaries create the structure of relationships, and it is the responsibility of the guide to maintain this professional relationship. Three boundaries that stand out can be taken from Leo Zeff, perhaps the first underground psychedelic psychotherapist and the person who Alexander Shulgin, who synthesized MDMA, credits for bringing MDMA into psychotherapy.
Zeff trained a hundred guides and worked with several thousand people in the 70’s and 80’s. He taught that the three boundaries that the practitioner sets with the participant are 1) Don’t hurt yourself, me, or the environment; 2) Don’t leave the space; and 3) I won’t touch you sexually. These boundaries can be found in “The Secret Chief Revealed” the Secret Chief being a name Terence McKenna, the entheogenic philosopher, gave to Zeff.
It is also worth noting that these boundaries were also taught by Aharon and Francoise to all their students; we were told to state these boundaries at the beginning of each ceremony. Despite their own role as trainers, if the accusations are true it’s fair to ask whether Aharon and Francoise were conscious of their own boundaries, or fully aware of the pain that the sexual exploitation they are accused of can create for clients. There must be more continuing education for all practitioners of psychedelic therapies and other mental health providers.
After two years of isolation and lack of touch during the pandemic, concerns about therapeutic touch and necessary boundaries will likely emerge with more frequency. Practitioners may encounter situations where the participants, in their expansive state, may sexually approach them. Practitioners must check in with their own needs and hold the ethics of their professional relationships intact.
Because people enter more sensitive states of consciousness that are generally found in traditional therapy, the field of psychedelic psychotherapy brings with it even higher requirements for accountability as it integrates into mental health services. Hopefully, the awareness gained with these medicines will also evolve the ethics of the field in the process.
If it’s true that about one in every twenty therapists sleep with their clients, this exploitation and abuse may undermine the potential of psychedelic therapy unless more awareness and development around sexuality takes place. Psychedelics can potentially bring unparalleled collective healing as they move towards legalization and are integrated into medical and therapeutic institutions. Those who use them for healing must look deeply into the shadow side of their own sexuality to help fulfill this promise.