Therapist, Trip Sitter Or Guide? A Second-Person Perspective on Psychedelic-Assisted Psychotherapy

In Rob Lovering (ed.), The Palgrave Handbook of Philosophy and Psychoactive Drug Use. New York: Palgrave Macmillan. pp. 513–530 (2024)
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Abstract

Chiara Caporuscio and Adrian Kind argue that psychedelic-assisted therapy is different from traditional therapy in an ethically fraught way and, as a result, arguably require ethical guidelines beyond those constitutive of traditional therapy. The way in question pertains to the therapist’s role as participatory sense-maker of the patient’s experiences and, with it, the balance of power between the therapist and the patient. In both traditional and psychedelic-assisted therapy, the therapist role as sense-maker can give rise to an imbalance of power between the therapist and the patient, such as when the therapist’s attempt at sense-making totally disregards the patient’s attempt at doing so. But in psychedelic-assisted therapy, the possibility of such a power imbalance is exacerbated. For, given her use of a psychedelic drug, the patient’s conscious experience is altered in such a way as to render her much more vulnerable than she otherwise would be. To give just one example, since the therapist is perceived by the patient to be an authoritative sense-making guide, the former’s attempts at making sense of the latter’s experiences can have much more influence on a psychedelically intoxicated patient’s interpretation of her experiences than they otherwise would have. Hence, Caporuscio and Kind’s conclusion that the ethical guidelines constitutive of traditional therapy are probably not sufficient for psychedelic-assisted therapy.

Author Profiles

Chiara Caporuscio
Charité Universitätsmedizin Berlin
Adrian Kind
Charité – Berlin University of Medicine

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