What therapy and ancestral wisdom can learn from each other without destroying what makes each unique 1

Imagine a client who comes to your office after losing her mother. She tells you her mother appeared to her in a dream, clear, luminous, with a message she does not fully understand. Since then, she cannot sleep.

Is this grief? Trauma? Spiritual experience? Psychosis? A call to pay attention?

The honest answer is: it might be all of those things. And the way you respond will depend, more than you might realize, on which shore you are standing.

Two shores. One river. No bridge.

Western psychotherapy and ancestral wisdom traditions have, for most of modern history, operated as if they were on opposite banks of a wide river, occasionally peering at each other with curiosity, suspicion, or misplaced enthusiasm, but rarely building anything solid across the distance.

On one shore: the language of the wounded self. Unconscious patterns, attachment wounds, trauma stored in the body, the slow and careful work of making the implicit explicit. At its best, psychotherapy is a disciplined act of love, witnessing someone’s interior life with rigor, ethics, and presence.

On the other shore: the language of the sacred web of life. Community as medicine, ritual as container, ancestors as living fields of influence, illness as disharmony rather than deficit. Traditions that have never believed the self ends at the skin, or that healing is something you receive alone in a room.

Both shores see something real. Both also have their blind spots. And in our rush to integrate everything, we have often done something that helps neither: we have put it all in a blender.

A blender makes puree. A bridge respects distance.

The wellness industry loves a blender. A little mindfulness from this tradition, a ceremony from that one, a chakra system loosely attached to a somatic protocol, shamanic language grafted onto a trauma model. The result is something that sounds whole but has been stripped of the very thing that made each element powerful: its context, its ecology, its relational and ethical demands.

A bridge works differently. A bridge does not collapse the distance between two shores. It honors the distance. It makes movement possible without pretending the shores are the same place.

This is the question I keep returning to in my clinical and personal life: How do we learn from both traditions without reducing either one?

Not “how do we merge them into a new spiritual product.” But how do we allow psychotherapy to become more soulful, more ritually aware, symbolically alive, culturally humble, without abandoning the rigor that protects clients from harm? And how do we approach ancestral wisdom with enough respect to leave its roots intact?

What each shore actually offers

Psychotherapy, at its core, teaches us to listen to the wounded self. It gives us a language for the unconscious, for developmental wounds, for the patterns that repeat because they were learned before we had words. It shows us that healing often happens through relationship, not technique, and that the body keeps score long after the mind has moved on. It brings ethics, boundaries, evidence, and the kind of careful container that protects the most vulnerable moments in a person’s life.

Ancestral and wisdom traditions teach us to listen to the sacred web of life. They remind us that the human being is not a private ego floating in an indifferent universe, but a relational, ecological, ancestral, and spiritual creature. They remind us that illness can be a form of disharmony, not just pathology. That healing sometimes requires community, not just technique. That some forms of suffering respond not to interpretation but to ritual, to offering, to being witnessed by something larger than the therapeutic dyad.

Where they meet is quietly remarkable: both understand that healing happens in a field, not in isolation. Both know that relationship is medicine. Both work with symbols, one through dreams and transference, the other through ceremony and cosmology. Both recognize the body as essential, not incidental.

Where they do not meet, and why that matters

Here is where most integrative conversations go wrong: they maximize the similarities and minimize the differences. But the differences are real, and pretending otherwise is its own kind of harm.

Psychotherapy generally works within a secular frame: the person, their history, their nervous system, their relationships. Many ancestral traditions operate within a cosmological frame: the person within the community, within the land, within the ancestors, within the spirit world. When a client’s “ancestral vision” gets translated into “part of the psyche” without asking whether that translation fits, something is lost, and something is taken.

The goals also diverge. Therapy often aims to restore function, coherence, and integration. Traditions may aim at liberation, awakening, balance, or right relationship with the sacred. A psychologically healthy person is not automatically an awakened one. A spiritually intense person is not automatically integrated. Conflating these two is one of the more common errors in transpersonal practice.

And the authority structures are entirely different. Therapy protects autonomy, consent, and the right to question. Many traditions involve apprenticeship, lineage, community recognition, and earned surrender. A healer in most Indigenous contexts is not self-appointed. The community recognizes the role, slowly, over time. Modern spiritual culture tends to invert this: brand first, authority claimed second.

Standing in the middle

There is a Nahuatl word that describes what it feels like to stand between two worlds: Nepantla. Gloria Anzaldúa used it to name the liminal space between cultures, identities, and ways of knowing, not a comfortable middle ground, but a living threshold. Uncomfortable, generative, and demanding.

Nepantleros, those who inhabit that in-between space, do not belong entirely to either shore. They are called to hold the tension without resolving it prematurely. To resist the blender.

For therapists and practitioners who move between these worlds, this is the actual work. Not to choose a camp, but to develop what Mi’kmaw Elder Albert Marshall calls “Two-Eyed Seeing”: the capacity to look simultaneously from the strengths of Indigenous ways of knowing and the strengths of Western ways of knowing, using both eyes together, without forcing one to see through the lens of the other.

A different definition of mental health

What would it mean to redefine mental health not as the absence of symptoms, but as restored participation? Participation in your body. In your relationships. In your community. In the natural world. In meaning and mystery.

This definition does not dismiss symptom relief. That matters enormously. But it expands the frame. It asks not only “what is broken?” but “what relationship has been severed?” Not only “how do we reduce suffering?” but “how do we restore belonging?”

How this looks in practice

A bridge-oriented clinician does not try to become a shaman or a guru. That is not the point, and it can be its own form of harm. What shifts is the quality of listening, and the humility with which you hold your own framework.

Before a client’s spiritual or cultural experience gets translated into clinical language, a few questions help:

What world does this experience belong to? Whose lens fits it better, the psychologist’s or the tradition’s? What does healing mean from inside this person’s cosmology? And perhaps most importantly: what is my framework missing that this client’s tradition might supply?

This is not relativism. It is clinical precision. Recognizing that the tools you bring to the room were built for a particular kind of suffering, and that some suffering requires different tools.

A bridge takes two shores

Let me end where I started: with the woman whose mother appeared in her dream.

The most useful thing I can bring to that moment is not a diagnostic category or a spiritual interpretation. It is the willingness to sit with her in the not-yet-knowing, the Nepantla, to listen with what one eye sees as a clinician and what the other eye recognizes as something that exceeds clinical categories.

A bridge is not built so one shore can conquer the other. It is built so that we can move, with care and respect, between worlds.

That, I think, is what good mental health care can look like when it is brave enough to hold the tension.


Interested in a talk or workshop on this theme? I offer presentations and trainings on transpersonal psychotherapy, ancestral wisdom, cultural humility, psychedelic integration, and the bridges between clinical care and spiritual traditions.

  1. This article is a synopsis of my presentation “Wisdom Bridges: Modern Psychotherapy and Ancient Traditions,” presented at FITRA’s 2nd International Transpersonal Conference. ↩︎

What MFTs Need to Know

I just finished teaching a six-month training for Marriage and Family Therapists (MFTs) on Psychedelic-Informed Care, in collaboration with Sacramento Valley CAMFT. These trainings are needed for a simple reason: increasingly, the topic of psychedelics comes up in therapy sessions. Should I do it? Would it help? What are the risks? Can you help me think this through? This is why psychedelic-informed care for MFTs matters.

The fact is that, with a few exceptions, therapists are not trained to answer these questions. If psychedelics are discussed at all, it is usually in a psychopharmacology class as “drugs.” Very few programs address their healing potential, and even fewer teach clinicians how to work skillfully with clients who are curious about them, considering them, or trying to integrate an experience afterward.

As a result, many MFTs are clinically, ethically, and legally underprepared. We may feel curious, nervous, excited, skeptical, or unsure. And yet, the client is already there. Invited or uninvited, psychedelics are finding their way into the therapy hour.

This is why MFTs need to learn Psychedelic-Informed Care (PIC).

To be clear, PIC is not psychedelic-assisted therapy (PAT). PAT refers to clinical work that includes administering a psychedelic substance within a legal, medical, or research structure.

Psychedelics may also come up through underground ceremonies, psychedelic tourism, ketamine clinics, religious practice, or solo use. Regardless of where the client’s interest originates, PIC provides licensed clinicians with tools to discuss, educate, reduce harm, clarify motivation and risk, and support integration, while respecting self-determination and avoiding the encouragement of illegal behavior.

In brief, PIC helps therapists help clients think clearly, make informed decisions, and integrate psychedelic experiences while remaining ethically and legally grounded.

Base Camp, Not Sherpa 1

A useful metaphor for the MFT’s role is that of the Sherpa and the base camp. The Sherpa helps the client climb the mountain. That is not our role. Our job is not to dose, source, guide, or facilitate the psychedelic session. We are base camp: a stable place where clients can prepare thoughtfully, assess risk honestly, and return when the experience needs integration, or if something goes wrong.

This is not a small role. Clients do not need us to be enthusiastic cheerleaders or frightened gatekeepers. An acronym I developed to explain this is that PIC therapists listen to WCIG. We must be:

  • Warm enough that clients tell the truth.
  • Curious enough not to impose our agenda.
  • Informed enough not to minimize risk.
  • Grounded enough not to cross legal or ethical boundaries.

Some questions clients often ask:

“Should I Do It?”

When a client asks whether they should use a psychedelic, the temptation is to answer too quickly. But underneath one question, there are often deeper ones: Can you help me? Will you reject me? Can you hold my uncertainty? Aware of the power differential, we must be careful not to lead the client in either direction. Instead, we can welcome the conversation without judgment and help them explore their assumptions, alternatives, motivations, and risks.

“What Are the Risks?”

MFTs do not need to become physicians, pharmacologists, or attorneys to be helpful. Still, we need enough literacy to know when something may be risky and when to consult or refer. Clinician and educator Kristina Hunter offers a useful concept here: the three mirrors: body, mind, and life context.

  • The body: medical issues, medications, substance interactions, cardiac concerns, pregnancy, neurological factors.
  • The mind: history of psychosis, mania, severe dissociation, suicidality, or current crisis. Is the client sufficiently resourced to handle intense material?
  • The life context: housing stability, relational support, time to recover. Or isolation, impulsivity, secrecy, and the hope that one experience will fix everything.

We should not medically clear clients or encourage use, even if we think it might help. We are helping them think more honestly and, when warranted, inviting them to discuss medical concerns with a qualified professional. And although we should not tell clients what to do, it is part of our duty of care to name our clinical concerns.

“Can You Assist Me?”

A client may ask for our involvement in many ways: “I’d feel safer if you were there.” “Can you talk to the underground guide?” “Can you help me figure out how much to take?” These requests may express attachment needs, fear, hope, or trust and should be explored rather than dismissed. But they also require boundaries.

We must clearly separate preparation and harm reduction, exploring intention, expectations, support systems, and aftercare, from facilitation, dose coaching, procurement, or participation in an unregulated session. The latter falls outside our role and can move dangerously close to ethical and legal transgressions. Being clear about this protects the client, the therapist, and the profession.

The Morning After

Clients may show up the following week and report that they used psychedelics over the weekend and now want, or desperately need, to process the experience. When things go well, they return inspired, tender, and full of insights to propel therapy forward. Other times they return confused, inflated, ashamed, or dysregulated. “I saw God.” “I think I remembered a trauma.” “I haven’t slept for two days.”

Integration is not about forcing the experience into a neat clinical interpretation. It is the slow, vital process of helping raw experience become embodied, relational, and livable, turning psychedelic states into psychological traits.

Sometimes this means supporting meaning-making. Other times, it means grounding or assessing whether consultation, psychiatric evaluation, or medical intervention is required. This is not always easy. Separating a spiritual emergency from a psychotic break requires real care and expertise. Psychedelics do not exempt us from ordinary duty-of-care responsibilities. Safety always comes first. Do not hesitate to reach out for support when needed.

Why PIC Matters for MFTs

MFTs understand relationships, systems, attachment, trauma, and the complicated ways people change and resist change. Psychedelic experiences may open doors, but clients still have to walk through them in real life, with partners, children, parents, and responsibilities.

Every therapist working in this area should be able to say clearly what they do and do not do. Our role is to provide PIC, not PAT: to help clients explore motivations, risks, expectations, meaning, and integration, while avoiding providing, recommending, sourcing, or facilitating psychedelic use.

The psychedelic landscape is changing quickly. Laws differ by jurisdiction, research findings keep emerging, and public enthusiasm often outpaces regulation and training. We need more than opinions. We need ethical steadiness, clinical humility, and a robust consultation network. Part of our role is to help clients separate hype from reality.

As I have said elsewhere, even for experienced guides, psychedelics are terra incognita. Old maps used to warn us that there may be dragons out there. Psychedelics can be powerful, healing, destabilizing, and sacred, sometimes all at once. We need to be prepared.

Psychedelics do not make therapy irrelevant or outdated. They can amplify our impact on a client’s healing process. Our training gives us a reliable compass to keep clients safe within ethical and legal boundaries, helping them think, prepare, integrate, and stay connected to themselves and their relationships. By maintaining solid boundaries, we can support the client’s journey without losing our own way.


I offer talks, workshops, and consultation for MFTs, clinicians, and organizations navigating Psychedelic-Informed Care, integration, ethics, boundaries, and clinical risk.


  1. A note on language: Sherpa refers both to an Indigenous Himalayan ethnic group and, in common usage, to a profession associated with high-altitude mountain guidance. I use the term here in the latter way, with respect and awareness of both meanings. ↩︎

A therapist’s guide to responding without panic, shame, or avoidance

In previous articles, I have written about how AI is being used in connection with therapy, why it should not replace psychotherapy, and where it can safely support the work. Here I want to speak to therapists who are already feeling the presence of AI in their offices. You can find the full series here: AI and Psychotherapy.

Clients are asking chatbots about relationships, symptoms, dreams, diagnoses, attachment patterns, and what they should do about all kinds of personal situations. Some of this may be useful. Some of it may be risky. Most of it is worth talking about.

Professional organizations are trying to catch up. The APA, CAMFT, BACP, and even the WHO have all issued warnings, guidance, or ethics updates. As valuable as that is, warnings do not help us know what to do when a client says, “ChatGPT told me to…” So, what can we do when AI enters the therapy room?

Do not criticize or lecture. Be curious instead.

If clients feel judged, they may simply stop telling us (or stop therapy altogether). Many people are turning to AI because it is available, inexpensive, fast, and seemingly nonjudgmental. Some are lonely. Some are trying to make sense of their pain at 2 a.m. Some may not be able to afford more therapy. From the client’s perspective, it makes sense. Curiosity helps us understand the function of a behavior before we decide what to do about it.

Ask better questions.

Why are they using it? Do they feel heard by it? Is there a rupture in the therapeutic relationship? Is there something they told AI that they have not told us? These are not nosy, but clinical questions. Psychotherapy is not a polite endeavor. Everything is available for exploration. Is AI functioning as a journal? A rehearsal partner? A reassurance machine? A surrogate relationship? An alternate therapist? Depending on the role it is playing, we can begin to consider appropriate clinical interventions.

Bring AI into the room. It is already here anyway.

Why is the client choosing AI instead of the therapist or another supportive relationship? What felt easier to tell a machine than a person? Is the client outsourcing agency to it? If so, is this part of a familiar pattern? All is grist for the mill.

AI-generated material should not be treated as objective truth. Even when it feels empathic or accurate, it is still a complex probabilistic system producing a plausible response based on patterns. Yet it can be treated as material, the same way a dream, a journal entry, or a relational enactment would be. If the response resonates with the client, it can reveal something about their longings, fears, defenses, and assumptions.

Avoid the temptation to compete with AI at the information level. There is no way you can win. Just as you hopefully would not compete with information a client got from a self-help book, your role is to remain grounded, curious, and open. You can offer something the machine cannot: a real human connection. That is where the healing power of therapy lies.

Watch for red flags.

Not every use of AI is dangerous. Still, some uses deserve concern. Pay attention when a client is using AI as their main emotional support, especially during crisis, intense loneliness, paranoia, suicidal thinking, substance relapse risk, or loss of reality testing. Also, be attentive to use that increases isolation, replaces difficult conversations, reinforces a fixed narrative, or becomes a secret part of the client’s life. It is okay to express concern (not disapproval) in these cases. It is part of our duty to care.

Another red flag is certainty. AI can sound confident even when it is hallucinating. It can validate or intensify a client’s interpretation without understanding the larger clinical picture. As Carl Rogers used to say, the client often talks about the thing next to the thing. AI may miss what is not being said.

A useful response might be: “Let’s slow down. What feels true about this? What might be missing? What would happen if we did not treat this as the final word?

There is room for education.

Clients need to understand that AI is not confidential in the way therapy is. Sharing deeply personal material with a chatbot means sharing it with an external technology platform, not with a licensed professional bound by clinical and legal duties.

For therapists, the bar is even higher. When therapists use AI in clinical work, we need to think carefully about informed consent, confidentiality, documentation, vendor policies, legal compliance, and whether identifying client information is being exposed. The basic principle is simple: do not let technological convenience outrun clinical responsibility.

We should also keep reminding clients, and ourselves, that AI does not understand in the human sense. It has never been on a date. It has no children, dreams, fears, body, or even an ego.

The therapist’s role

It is unlikely that AI will stop entering the therapeutic ecosystem. The therapist’s role is neither to panic nor to ignore it, but to help clients use discernment. We can ask better questions, notice when AI is helpful or potentially harmful, and, as with everything else, talk about it.

The task is not to become anti-AI or dazzled by AI, but to remain deeply human when, invited or uninvited, it shows up in the therapy room.

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Want a grounded conversation about AI and psychotherapy for your group? I offer talks, workshops, and consultations for clinicians, organizations, and training programs navigating the ethical and relational implications of AI in therapy. Contact me to keep the conversation going.

How to create a virtuous cycle instead of replacing human care

In previous articles, I have argued that AI should not replace psychotherapy because the relationship itself is healing. You can find the full series here: AI and Psychotherapy.

However, since people are already using AI around therapy, how should we use it?

AI can support preparation, reflection, psychoeducation, and integration. AI can also help you gather information and organize your thoughts, leaving therapy sessions for exploration, connection, introspection, and growth. It becomes risky when it replaces the human relationship, when we ask for its opinions as if it were human, or when it becomes the main source of emotional support, mirroring, and feedback.

Needs context, but be careful what you share

AI only knows what you give it, what it may remember depending on the platform settings, and what may be publicly available. It knows nothing about your life, your relationships, or your inner world unless you tell it. Remember, it does not have an inner life like yours.

So, if you ask, “What have I been avoiding this week?” AI will not be able to answer meaningfully unless you first give it enough information. And if you choose to give it that information, use discretion. Avoid names, addresses, identifying details, or anything you would not want stored or processed by an external technology system. Instead of writing every detail, keep it general. That is usually enough.

Remember that psychotherapists are bound ethically and legally by confidentiality. AI is not. Before sharing personal information, remember that even when advertised as therapy, AI is not, and cannot be confidential in the way therapy is.

Use AI to prepare, not decide

Often people arrive to therapy with a vague sense that something is wrong, but they are not sure how to say it. AI can help you sort through your thoughts before a session.

The key is to give it context and ask it to stay tentative. This is important because AI can sound absolutely certain about what it is saying, even while hallucinating.

For example: “I’m preparing for therapy. This week I felt angry after a conversation with a family member, then guilty for feeling angry. I don’t need advice. Help me identify possible themes or questions I might bring to my therapist. Please keep it tentative.”

This is very different from asking, “What is wrong with me?” or “What should I do?” Do not give AI authority over your decisions.

Allow me to insist on this obvious but easy-to-forget point: AI is not human and does not “know” you. It remembers what you have told it and is brilliant at autocompleting, but it lacks a human perspective and personal experience to compare against. We may say that it is “book-smart,” but lacks hard-earned life experience.

As tempting as it may be, do not relinquish the responsibility and privilege of choosing your life to any person or machine.

Use AI to reflect

A lot can happen in and between therapy sessions. Sometimes you leave with a phrase, image, or realization that feels important and deserves further investigation. AI can help you remember and organize what is emerging.

You might write: “In my last therapy session, we talked about my tendency to avoid conflict. I noticed it again today when I didn’t speak up. Help me reflect on this pattern without turning it into harsh self-criticism.” Or: “Find me information about setting boundaries and speaking up.”

That kind of use can support the work. It helps you stay connected to the process between sessions and deepen it.

Notice that these reflections lead back to therapy, not away from it. If AI gives you something useful, strange, overly certain, or emotionally intense, bring it to therapy. Even, and perhaps especially, when it says something that feels totally right, remember AI’s tendency to agree and flatter. Bring it back to therapy. Use it to strengthen your sessions and deepen your insights.

Use AI for integration

Integration means taking something meaningful and making it part of your life. It is not uncommon to have an “aha!” moment in therapy, only to forget it a few days later.

After a session, AI can help you turn an insight into a small, realistic next step.

For example: “In therapy I realized I often say yes when I mean no. Help me draft three gentle ways to say no that still sound like me.”

This is where AI can be useful. It can offer language, structure, and rehearsal. It can help you prepare for the real conversation.

But real change happens when you have the real conversation in the real world.

A clear boundary

Do not rely on AI as your main support if you are in crisis, feeling unsafe, losing touch with reality, or becoming increasingly isolated.

Ask yourself: Is using AI helping me become more honest, connected, and alive, or am I using it to avoid or replace people?

We need people. You matter. Let your voice be heard by others.

Takeaways

  • Use AI to prepare for and deepen therapy, not to replace it.
  • Use it to organize your thoughts, not to outsource your truth.
  • Use it to gain clarity, not to avoid a conversation.
  • AI can help you prepare for the room. But it should not replace what happens in the room.

And if you are not in therapy, or you have been using AI tools to deal with something heavy, painful, old, or difficult to hold alone, consider therapy. Reach out, you don’t have to do this alone.

The Potential Space

This is part of why I developed The Potential Space.

It is not therapy. It is not crisis care. It is not a replacement for human relationships.

The Potential Space is a bounded AI companion designed to support reflection, psychoeducation, preparation, and integration alongside therapy and life. It is not therapy, not crisis care, and not a replacement for human relationships. You can check it out here.

On the numinous quality of psychedelic work, and why awe and humility belong together.

Psychedelic-Assisted Therapy Essentials | Part 3

In the previous articles in this series, I suggested that psychedelic-assisted therapy (PAT) is not a walk in the park. Old maps warned travelers with the phrase hic sunt dracones, here be dragons. It was a warning suggesting that beyond this point, the map becomes uncertain. Beware. Do not assume you know what you are entering.

That warning applies to psychedelic work.

Psychedelics open fascinating possibilities for healing, insight, grief, forgiveness, and spiritual meaning. They can help people encounter parts of themselves that have been exiled for years, soften rigid defenses, bring forgotten memories into awareness, and reconnect with something larger than the isolated self.

But fascination alone is not enough.

The theologian Rudolf Otto used the phrase mysterium tremendum et fascinans to describe the numinous: that which is simultaneously mysterious, awe-inspiring, frightening, and deeply attractive. This applies to psychedelic work. Often, before a ceremony, people feel both fear and curiosity. This is fitting. Something in us is drawn toward it, while something else trembles before it.

In many ways, psychedelics are like fire. Fire warms us, feeds us, protects us, and illuminates darkness. Around fire, stories are told, meals are shared, rituals are held, and communities are formed. And yet, we remain cautious around it. We do not assume that because fire is good, more fire is always better. We do not hand a torch to someone without preparation. Fire requires knowledge, respect, containment, and care.

Psychedelics do too.

The dragon is also a fitting image. Dragons are powerful, mysterious, unpredictable, and often guard treasures. In many stories, the task is not simply to defeat the dragon but to become worthy of the encounter.

The psychedelic renaissance is full of promise, but also of peril. We may reduce psychedelics to techniques, experiences, or shortcuts. We may oversell them as miracle cures. We may even assume that, since they can bestow so many blessings, nothing can go wrong.

That is simply not the case.

Psychedelics are not silver bullets. They won’t solve our problems for us. In some Indigenous traditions, natural psychedelics are referred to as plant teachers. This makes sense. Good teachers show what needs to be done, but do not do it for us. They reveal, challenge, support, and sometimes confront us.

We still must do the heavy lifting.

This is one of the great misreadings of PAT. Many want to believe that the substance will eliminate their problems just like paracetamol eliminates a headache. But there is more to this story. Psychedelics can make healing more possible. They open the door, but we still have to walk through it.

We may experience unconditional love, but then have to learn how to live from it. A painful memory may be recovered, but still needs to be integrated. A mystical experience may occur, but must be understood without inflation. Insight is not transformation. As Ken Wilber suggests, we need to convert altered states into permanent traits.

This is why preparation and integration are fundamental, not as annoying add-ons, but as part of the work itself. The experience is never separate from the container that holds it. The medicine should not be separated from the person’s mindset, the relationship with the guide, the setting, the boundaries, and the commitment to growth.

The fire needs tending. The dragon asks us to become deserving of the boon.

Enthusiasm without humility can lead to carelessness, inflated claims, naïve expectations, poor boundaries, and even harm to the very people seeking healing. A mature approach must hold awe and discernment together. Awe reminds us that something profound may be taking place. Discernment reminds us that fireworks do not mean healing. Fascination opens the heart. Responsibility keeps the feet on the ground.

Training is crucial.

Psychedelic practitioners require more than information; they require formation. The person preparing, guiding, and integrating these experiences needs more than technical knowledge. They need maturity, self-awareness, ethical clarity, relational skill, cultural humility, and the ability to remain steady when the unexpected appears.

We cannot truly tame the dragon, but we can learn how to work with it. We can approach it, listen to it, respect it, and join forces with it wisely. Not as master, worshipper, or conqueror, but as an ally.

The field does not need hype, panic, dismissal, blind devotion, or pollyannish naïveté, but a grounded orientation. PAT has enormous potential. But if we want this renaissance to mature, we need to remember that what can heal can also harm. We need maps, training, ethics, cultural respect, and honest conversations about risk.

The dragon usually guards a treasure. But it is not given gratuitously. It asks to be approached with humility, preparation, and respect.

Next: Experience Is Not Healing. On why powerful psychedelic experiences do not automatically become transformation.

Want grounded preparation or integration support?
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Psychiatrists are key players and need to stay informed.

Psychedelic-Assisted Therapy Essentials | Part 2

Psychiatrists do not need to support psychedelics. Still, it may be wise to pay attention. The zeitgeist is changing and, soon, if not already, patients will begin asking about them or even stopping their SSRIs in search of a miracle cure. The well-being of patients may depend, in part, on their psychiatrist’s understanding of these historically controversial substances.

To be clear, psychedelics are not the miracle cure the media sometimes announces. However, they have re-entered serious clinical and scientific conversation. Professional psychiatric bodies in the United States1, the United Kingdom, Australia and New Zealand are all taking the field seriously. The American Psychiatric Association supports continued research while withholding endorsement for routine clinical use outside approved investigational settings. The Royal Australian and New Zealand College of Psychiatrists has issued guidance specifically to inform psychiatrists about the potential therapeutic utility of these substances2. The UK Royal College of Psychiatrists has gone further and stated that psychiatrists should be involved in their future therapeutic use and in the clinical leadership of multidisciplinary teams3.

Why should psychiatrists care?

First, patients are increasingly hearing about psychedelics and their potential healing value. As their psychiatrist, you may be the one professional your patients trust most. It is only natural that they may turn to you to make sense of this landscape. What would you say when a patient asks whether psychedelics could help with treatment-resistant depression, or when they ask for your opinion about the Costa Rica retreat they just booked? This is your opportunity to discuss risks, expectations, medication interactions, and contraindications. When the stakes are high, knowing how to respond or who to refer to becomes a form of care.

Second, the research is no longer peripheral. Major psychiatry journals and organizations are engaging the topic seriously. The British Journal of Psychiatry has published guidance and reflections to support psychiatrists as this area evolves. Likewise, in the United States, the APA has issued a Position Statement on the Use of Psychedelic and Empathogenic Agents4. Although the matter is far from settled, the subject has matured enough that informed clinicians can no longer dismiss it as fringe, especially when suffering patients are paying attention.

Third, people interested in using psychedelics need the involvement of their psychiatrists. This area of mental health care should not develop without psychiatric input. Guides, therapists, sitters, and ceremonial practitioners may all benefit from psychiatric expertise. Psychiatrists are especially well-positioned to contribute diagnostic clarity, assessment of comorbidity, medication expertise, adverse-effect monitoring, contraindication screening, harm reduction, and continuity of care.

This matters because psychedelic-assisted therapy is no longer confined to underground or countercultural spaces, and more people are willing to try it to address issues such as depression, anxiety, PTSD, OCD, and fear of death. However, as suggested earlier in this series, what can heal can also harm. That is why psychiatry should join the conversation. Not simply to approve or disapprove, but to bring clinical judgment, patient protection, and a broader view of care to an area that needs all three. The opportunity here is not only for psychiatrists to stay current. It is also for them to better support patients who are curious, hopeful, cautious, or already walking into this territory.

Over the years, I’ve worked with many caring psychiatrists who, while aware of the risks, also recognized the potential benefits of psychedelics and helped make ceremonies safer and more healing. Sadly, I’ve also been called to support people in the aftermath of experiences they pursued on their own, sometimes because they felt they had no place to discuss the issue openly. Of course, patients are responsible for their own decisions, but having informed professionals in their corner can make a huge difference.

Psychiatrists do not need to slay, dismiss, or fear the dragon. But they cannot ignore it either. What is needed is engagement and a better understanding of the territory, if only because more patients are already looking in that direction. Your patients are counting on you.

Next: Fire and the Dragon. On the numinous quality of psychedelic work, and why awe and humility belong together.

If you are a psychiatrist, clinic, or training program curious about this topic, follow this series or reach out for a grounded talk, consultation, or educational offering on the subject.


  1. https://www.psychiatry.org/News-room/News-Releases/Special-Issue-APA-Journal-Psychedelic-Medication ↩︎
  2. https://www.ranzcp.org/getmedia/4cfd1fea-171c-43fc-8dab-7b476b3f706c/cm-therapeutic-use-of-psychedelics.pdf ↩︎
  3. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/position-statement—ps02_25-pars-for-medical-use.pdf ↩︎
  4. https://www.psychiatry.org/getattachment/d5c13619-ca1f-491f-a7a8-b7141c800904/Position-Use-of-Psychedelic-Empathogenic-Agents.pdf ↩︎

…or why AI should not replace human connection

In my earlier article Should ChatGPT Be Your Therapist?, I briefly argued against it. This article further explains my answer.

Many people turn to AI because they are lonely, overwhelmed, or afraid. That is understandable. But if AI becomes a substitute for relationships, something important is lost. Our brains are wired for connection.

Before starting, let me insist that I am not anti-AI. Quite the opposite. I am excited about the possibilities of using it as a companion to therapy (more on this below). Used wisely, it can be genuinely helpful.

Although this is not often emphasized, psychotherapy is not only about providing information. It is a relationship. Good psychotherapy may feel like a simple conversation. Still, there is a lot going on under the hood at psychological and biological levels. Our nervous systems are shaped by contact with other human beings. Our attachment style (basically, the way we relate to others) is formed by how we experienced connection in early life. Who we are is, in large part, the result of our relationships. As it is often said, our wounding happens in relationships and can only be healed in relationship. We do not change only through insight. We change through connection.1

We need to feel safe before we can change

Evolutionarily, our nervous systems are programmed to scan for safety. This is an automatic process that occurs mostly below conscious awareness.2 Tone of voice, pacing, the steadiness of a presence, and the sense that someone understands us and will stay with us without collapsing or attacking. These signals shape how we experience the world and live our lives.

When we feel anxious, shut down, ashamed, or guarded, our whole system contracts. Thinking becomes rigid. Options feel limited. Emotions feel overwhelming. Sometimes we cannot even accept help when it is available. On the other hand, when we feel safe, supported, and accepted, something changes. We relax. We open up. Feelings become tolerable. Reflection becomes possible. We see more clearly and are able to choose. The body must feel safe before the mind can be free.

What the relationship does

It offers co-regulation. Meeting a grounded therapist is not just “nice.” Their steadiness helps settle our system. Over time, we become able to reproduce that steadiness, and it becomes available inside. This is one of the quiet phenomena of good therapy. We borrow regulation until we learn to provide it for ourselves.

It offers a different experience, not just advice. Even when people come to therapy for information, they often stay for something else. The client is constantly sensing the relationship. How does the therapist relate? Are they kind, clear, steady, curious? Can they hold boundaries with care? Can they tolerate strong emotion without collapsing or attacking? Over time, this becomes a living template for how to be with oneself and with others.

It creates a space to explore without shame, guilt, or rejection. After a while, as the client continues to feel accepted by the therapist, they may begin to wonder: “If my therapist accepts me as I am, maybe I can accept myself too.” Again, this relaxes the nervous system and makes room for change. In such an environment, you can explore how you protect yourself, how you handle closeness, how shame organizes your attention, and what you believe you are allowed (or not allowed) to feel. These patterns are often automatic and live below awareness. Over time, a stable relationship helps reorganize these implicit layers and experiment with alternative ways of being. Therapy changes people through lived experience, not simply through insight.3 4

It offers rupture and healthy repair. Therapists are not perfect. Sometimes your therapist does not get it. You may feel misunderstood or even rejected. Often this triggers old experiences of not being seen or accepted, and the conclusion that something is wrong with you. What to do next? Shut down? Capitulate? End the relationship? If the therapist is skillful and navigates this with care and accountability, the nervous system learns something powerful. Conflict does not have to mean abandonment. Misunderstanding does not have to mean danger. This repair, while remaining in connection, is part of how trust is built, and it is difficult to replicate without a real person who can make mistakes, take responsibility, and show up again.

At the risk of oversimplifying, the therapeutic relationship is difficult to replace because healing is not purely cognitive. It is an embodied, relational process that unfolds through attunement, emotional resonance, and real-time interaction.

What AI cannot replace (at least yet)

AI can generate language that sounds empathic. It can reflect feelings. It can offer prompts. It can help you map patterns. You may even feel understood.

But AI is not alive. It does not have a body or a brain. It does not co-regulate in the full human sense. It does not track your breathing, posture, tears, long pauses, or the subtle shifts that guide pacing in real time. Even with voice or video, something central is missing. A real nervous system is not on the other side. AI cannot truly see you, even if it sometimes sounds like it does. And your nervous system knows when something is missing.

AI also lacks accountability in the way a human therapist does. Human therapists are trained to listen not only to words, but to context, tone, and what does not fit. A good therapist does not simply agree. Even a very empathetic therapist may challenge you if something does not make sense, needs clarification or if it make it tingle their -very human- spidey sense. As one of my teachers used to say, therapy is not a polite endeavor. A caring therapist will slow down, double-check, explore hunches, and name what is being said and even name what is not being said. AI cannot feel or care in this very human way. Technically, AI does not understand words the way humans do, and it cannot sense what is implied but unspoken. This always matters, but it matters especially at the edges, when someone is destabilized, overwhelmed, in crisis, paranoid, or losing touch with reality.

There is also the problem of overconfidence and hallucinations. AI can sound certain when it is wrong. That can be harmless in low-stakes settings, harmful in emotionally vulnerable moments, and dangerous in crises. Add privacy concerns, cultural mismatch, and the risk of overdependence, and the picture becomes clearer. AI can be a tool, but it is a risky candidate for replacement.

Where AI can genuinely help

None of this means AI is useless. It means we should understand what it is good for.

AI can support reflection when deep human attunement is not essential. It can help with journaling, psychoeducation, basic skills prompts, and preparing for therapy sessions. It can help you find language for what you are experiencing. It can help you organize a question you want to bring to your therapist. It can offer structure between sessions. I will develop this in more detail in future articles.

Used wisely, AI can even deepen therapy. When it helps with basic learning or clarification, more therapy time can be devoted to what requires human presence. That is meaningful synergy.

A gentle rule of thumb

If what you need is information, conceptual clarity, journaling prompts, or help exploring something already discussed in therapy, AI may help.

If what you need involves attachment wounds, trauma healing, deep grief, relational repair, severe anxiety, existential distress, or you are facing a crisis, a human therapist is usually safer and more effective. Certain kinds of healing require contact with a real person, in real time, over time. And again, since our wounding happened in relationships, it can only be healed in a human relationship.

If you are curious, you can try “The Potential Space” an AI companion designed to support users between sessions with preparation, psychoeducation, and integration.

  1. Lewis, T., Amini, F., & Lannon, R. A General Theory of Love. ↩︎
  2. Porges, S. W. The Polyvagal Theory. ↩︎
  3. Schore, A. N. The Science of the Art of Psychotherapy. ↩︎
  4. Cozolino, L. The Neuroscience of Psychotherapy. ↩︎

Why California LMFTs need psychedelic-informed care1

The relationship between psychedelics and psychotherapy has always been… complicated. In the late 50s and early 60s, LSD was distributed to mental health professionals to explore its therapeutic potential. Sandoz suspected there was something there, but couldn’t quite pin down where it fit. When Tim Leary later “discovered” psilocybin mushrooms, he framed them as psychologically significant. MAPS, from the beginning, assumed therapists would be at the bedside for MDMA experiences. With the 70s, prohibition made the relationship illegal, but it didn’t make it disappear. Many clinicians simply went underground.

Now, in the current psychedelic renaissance, while most psychedelics remain illegal, mental health professionals face a familiar dilemma: how do we support clients without stepping outside legal and ethical boundaries?

With support from CAMFT Sacramento Valley, I’m teaching a six-session series on Psychedelic-Informed Care (PIC)—how clinicians can respond when psychedelics enter the therapy room without fueling hype or reinforcing taboo. Should we lean in? Set boundaries (which ones)? Redirect? The series is designed to help you answer those questions with precision.

The topic will show up.

It arrives in many forms: questions about legality, reactions to a news story, curiosity about a ketamine clinic, plans for a retreat abroad. “Would you recommend it?” “What are the risks?” “Would microdosing help?” And, of course, the therapist’s favorite: “Is it true it’s five years of therapy in one night?” Clients are often confused, and they want orientation from someone they trust—you.

De-mystification

Right now there’s cultural noise, mixed messages, and outright misinformation. As clinicians, we don’t need to endorse or condemn. We need to help clients differentiate—between curiosity and compulsion, hope and inflation, meaningful experience and destabilizing aftermath. PIC begins with demystification: separating evidence from hype, and myth from clinical reality.

The legal landscape patchwork

Part of the surge is legal ambiguity. The picture is no longer a single, clear “no.” It’s a mixed bag: regulated access models in some places, research pathways, tightly controlled international frameworks, religious-use carve-outs, and—closer to home—local reforms and “decriminalization” language.

Even in California, where classic psychedelics remain illegal, several jurisdictions have deprioritized enforcement around entheogenic “plant medicine” (including places like San Francisco, Oakland, and Santa Cruz). But deprioritization is not legalization. It doesn’t change state or federal controlled-substance law—and it doesn’t change LMFT scope.

Why psychedelics? Why now?

The “why now” isn’t mysterious. Psychological suffering keeps rising, and so does the hunger for new solutions (especially when many mainstream antidepressants remain variations on monoamine modulation). Add promising research signals, a primed cultural zeitgeist, and media acceleration—and you get momentum.

But when a society is suffering and hungry for relief, it becomes vulnerable to shortcuts. Psychedelics, when framed as shortcuts, become especially seductive.

Potential benefits—and real risks

It’s hard to deny that psychedelic research is promising. Across trials at different stages, psychedelics have shown potential relevance for trauma-related suffering, depression and anxiety, existential distress and end-of-life fear, relational patterns, and spiritual meaning-making.

At the same time, potential benefits are not guaranteed, and they are not risk-free. Alongside positive outcomes are reports of harm: destabilization and disorientation after experiences, inflation, bypassing, aftercare gaps (no containment, no follow-up, no integration), and boundary/exploitation risks—especially in unregulated contexts.

This isn’t fear-mongering. It’s clinical realism. The psychedelic ecosystem is still maturing. Ethical failures occur. And when they do, the cleanup often lands back in traditional therapy.

So where do LMFTs stand?

Every clinician know to keep this distinction front and center: scope of practice is what California law authorizes; scope of competence is what you personally are trained to do safely.

California’s LMFT scope includes assessing and treating substance use and related mental/behavioral concerns, and explicitly includes client education, consultation, and clinical case management. But legal permission does not equal clinical readiness, and clinical readiness does not grant legal permission. In plain language: just because you can talk about psychedelics doesn’t mean you should, unless you have the training.

PAT vs. PIC (and the underground)

To stay grounded, it helps to separate three different situations:

  • Psychedelic-Assisted Therapy (PAT): administration plus a protocolized, regulated setting.
  • Psychedelic-Informed Care (PIC): what LMFTs can do ethically—discuss, educate, harm-reduce, integrate.
  • Underground work: unregulated and often illegal “guided” psychedelic work, with wide variability in competence and ethics.

Here’s the key takeaway: to remain within ethical and legal grounds, LMFTs must stay in the green zone—discussion, education, case management, referrals (for education, not sourcing) and integration—and avoid the red zone: using, offering, facilitating/administering, or coaching sourcing/dosing for illegal substances. Yes, there are yellow areas and nuance. But clarity protects clients and therapists alike.

Your stance matters

Beyond scope, not every therapist feels the same about psychedelics—and that’s okay. Within professional boundaries, there’s a spectrum of reasonable stances: cautious, curious-but-boundaried, harm-reduction oriented, or integration-focused. The goal isn’t ideological alignment. The goal is ethical, competent care.

The PIC toolkit

PIC is practical. It boils down to three skill areas:

  1. Psychoeducation (balanced, reality-based, myth-correcting)
  2. Preparation (scope-appropriate: intentions, supports, safety planning, consult triggers—without “how-to”)
  3. Integration (meaning-making, relational repair, values-to-action, stabilization)

A simple response flow helps: Discuss → Educate → Harm-reduce → Integrate. If you can remember that loop, you can respond with confidence even when the topic is charged.

And it should go without saying, but it doesn’t: documentation is your shield. When psychedelics come up, chart the discussion, state client goals, document boundaries, note risks reviewed, and record consults/referrals. That’s not bureaucracy—it’s ethical self-respect and license protection.

In closing: your license gives you a clear road to walk with clients, and a reliable compass to stay oriented—so you can support their journey without losing your way.

In future sessions, we’ll cover the state of the art (research/legal/ethics), cultural context and humility, what to do when the client brings it up, what to do when things go sideways, and—finally—a clear vision of the LMFT’s role in the psychedelic landscape.

Now you know. If you have questions or want to explore this topic further, feel free to contact me.

  1. Although many of these principles apply to all LMFTs, note that this article focuses in California law. ↩︎

Clients are bringing psychedelic questions and experiences to therapy. This six-part series gives LMFTs a clinically grounded, culturally informed approach to discussing psychedelics within scope—with tools for education, harm reduction, and integration. It is not a “how to do PAT” course. You’ll learn the current research/ethics/legal context (incl. religious-use carve-outs), cultural considerations, and concrete safeguards around risk and boundaries. Clinicians will leave with clear language for discussing benefits/risks and integration interventions.

Sessions (at a glance – click link for details):

*Please note that you have to register individually for each session

*Education and integration within LMFT scope; no sourcing or dosing guidance.

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