Category: Psychodynamics

On the therapist-client relationship, empathy, and the courage it takes to begin therapy

Part of the raw musings of a psychotherapist

When two people relate to each other authentically and humanly, God is the electricity that surges between them.
Martin Buber

I have been revisiting my thoughts on the relationship between therapist and client, and the importance of empathy during the first meeting.

It has been over 30 years now, but I remember the first time I went to therapy. Although I had no prejudice against going to a “shrink,” I still felt a bit funny. I guess the way I dealt with it was by convincing myself that I was not crazy, but only needed some help with certain specific issues. In fact, I prepared a list with the five items that, in my opinion, needed to be addressed.

I do not remember my therapist’s attitude in detail, but I do believe that she made me feel comfortable. She acknowledged my areas of concern, whether she agreed with them or not, I do not know, and also made me feel that my problems were solvable. Had she tried to go another way, for example, trying to convince me not to stick to a specific agenda, or letting me know that there might be other issues to consider, I might have felt like she was trying to sell me something I did not need and most probably would have said, “No thanks,” and walked away.

As therapists, we need to develop, from the first visit, a sincere appreciation for the client. We should acknowledge the client’s courage in being there: taking action, accepting that they need help, and trusting a perfect stranger with their deepest and darkest secrets and struggles. That is a lot! We would do well to provide some assurance that coming to therapy was the right move, that they are not crazy, and that there is hope.

The keyword is sincere. As humans, we can feel when someone is faking appreciation or support. In many ways, beneath such sincere support, authenticity and openness are required.

The other topic that keeps coming back, and that I relate to openness, is the need to remember that, even if the client comes to me looking for magical solutions or to be “fixed,” just as they might go to a priest, a guru, or a tarot reader, I should not receive them with a sense of superiority, but welcome them as an equal. As a fellow traveler on the path.

We therapists first have to clear our own trail (healer, heal thyself!), and then invite others to walk along with us, not as an example to be followed, but more like a traveling companion. Someone who, although they may have already visited this specific “country,” is a traveler nonetheless, still learning and discovering new things.

This means encouraging clients to try their own solutions, and walking together in the therapeutic relationship, where therapist and client meet, relate, and, through this meeting, healing occurs.

Yes, to be fully honest, I often find myself suspended in an inner tension. On the one hand, I notice my desire to present myself as wise, capable, insightful, and worth the money I am being paid. On the other hand, I hold the goal of meeting my client, and everyone, for that matter, as an equal, in an I-Thou way. Yes, we may be playing therapist-client roles right now, but underneath that, we are two human beings trying to figure out this thing called life the best way we can.

I remember attending a lecture a few years ago by Rabbi Michael Lerner, in which he discussed two different visions of the world. The first was the market-based society, where fear is the underlying feeling, and every time I meet someone, I evaluate how he or she may be of use to me. Basically, an I-It world. In such a world, it is clear that I, the evaluator, must assume myself to be better than the “its” to which I relate, the “its” I objectify.

The second was the love-based society, where the criteria for a relationship are love, mutual support, equality, and compassion. An I-Thou world. He seemed to suggest that most of the time we engage with each other in an I-It world, treating others as means to an end rather than acknowledging the miracle of having a living, thinking, feeling, unique human being in front of us.

It is as if, instead of appreciating something, a work of art, a sunset, a flower, a person, we are fixated on figuring out what we can get out of it.

It is sad.

May each of us keep remembering that every human encounter is a unique opportunity and a miracle. May you find, in your own therapy and in all your relationships, the joy of being seen and known, and of seeing the other as they are: radiant.

But then again, what do I know…

Therapy works best when you feel seen, respected, and met as a whole person. If this reflection resonates, we can explore whether working together feels like a good fit.

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Part of the raw musings of a psychotherapist

The Buddha proclaimed that there is no self. Buddhism encourages us to realize that our sense of who we are is an empty construction. There’s even a Ram Dass film called Becoming Nobody.

In contrast, the West wants us to become somebody. That is, to develop a cohesive, functional self, capable of setting boundaries, regulating affect, relating, and working well.

Today I want to focus on the Western side of this equation; on something I habitually see in therapy, though it is often hard to spot: the fear of not existing, which has nothing to do with the Buddhist no-self.

It sounds kind of weird, doesn’t it? Like something out of a fairy tale. Alice fearing that she might be nothing but some sort of figure in the Red King’s dream. But this is no fantasy.

Have you ever met someone constantly needing to be acknowledged or even admired? I’m sure you have. We may even be among them! Some find ways to get it through legitimate means. They find a platform that provides much-needed validation: performing, teaching, helping, creating… Others look for it, or even demand it, from those around them: parents, partners, children, co-workers, lovers…

I often meet them in therapy when their loved ones grow tired of having to prop them up, or, for the most successful among them, when they realize that all the fame, adulation, and acknowledgment are never enough to fill what feels like a hole within.

It is tempting to label them as narcissistic, and some may be, but when we dig deeper, we often find a deeply wounded and scared person facing an unbearable emptiness. A dread that, no matter how successful, funny, accomplished, or accommodating they are, they don’t matter. They feel unsubstantial, lacking matter. Nobody really cares. They could cease to exist, and nobody would even notice.

Although rarely articulated, they seem to fear that, if not noticed, they could dissolve like a dream upon awakening. To be clear, they don’t fear they would literally fade away; but a strange compulsion keeps them demanding attention because the alternative terrifies them.

How can this be?

Psychologically, we develop our sense of being real in relationship. Early on, we need to be seen, recognized, and responded to, not as stars, but simply as beings whose feelings, presence, and existence register in someone else’s mind. This is why young children yell things like, “Look, Mom, no hands!”

When that recognition (known as mirroring) is reliable enough, a person slowly develops an inner sense of solidity: I am here. I count. I remain myself even when no one is looking. But when that kind of acknowledgment is missing, inconsistent, or conditional, the person may continue to depend on outer confirmation to feel real. Then, being noticed starts to feel less like a satisfaction and more like a necessity.

That is why, for some, the hunger to be seen carries such desperation. What they are really fighting is not anonymity, but the old terror of feeling expendable, forgettable, irrelevant, as if they had no psychological weight. In milder forms, this manifests as shame, emptiness, or a chronic sense of not being important. In more serious forms, it feels like a threat to existence itself: If I do not register anywhere, if nobody notices me, do I even exist?

To put it simply, the fear of not mattering can devolve into something primal: the fear of not being, of becoming nothing in the eyes of others and, finally, in one’s own.

How can therapy help?

In a therapeutic relationship, a good-enough therapist offers a new kind of experience: one of being truly seen, perhaps for the first time. Over time, as the client is met by someone who notices them, takes them seriously, and does not reduce them to performance, usefulness, or image, they begin to internalize a steadier sense of being real.

They no longer need quite so much external proof to feel that they exist, count, and have weight. The therapist may also help them develop ways to self-validate, with affirmations such as: “I matter,” “Even when nobody is there, my existence matters,” or, if they are spiritually oriented, “I matter because God sees me, loves me, and cares about me.” 1

It is interesting that, in psychedelic sessions, a recurrent insight is precisely how significant we are, how much we are loved, and how trivial our daily struggles can be. We learn that we are bigger, brighter, and more amazing than we can ever conceive.

Back to the Buddha.

So, should we build the self or see through its illusory nature? Do we matter, or are we empty? As often happens in therapy, the answer is both/and. Jack Engler famously said, “You have to become somebody before you can become nobody.”

Most Western psychotherapy focuses on helping people function in this material world. A healthy ego helps us remember where we parked the car, our Social Security number, and to pay our taxes. Eastern traditions aim toward liberation, toward becoming free from the limitations and illusions of this same world. Their goal is to go beyond the ego. But that’s a topic for a future article.

If you often feel like you need people’s acknowledgment, or if you have been accused of being too needy, insecure, or self-centered, you may have lacked the mirroring every single one of us needs. The good news is that this can be healed.

Remember that you matter and you are loved (and that you should not take yourself too seriously). If you are struggling, therapy can help you heal the fear of being inconsequential and free yourself from the harmful patterns that keep you from seeing who you really are.

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  1. However, it is worth noting that such affirmations alone won’t be enough if the wound from early childhood runs deep, as often happens in these cases. ↩︎

About fifteen years ago, whenever someone invited me to talk about the healing value of meditation, I would start—somewhat mischievously—by saying, “If you’re still wondering whether meditation is healing, you haven’t been paying attention. Its benefits have been proven beyond reasonable doubt.” Even with today’s ever-growing body of research pointing strongly in that direction, when it comes to psychedelics, we’re not there yet.

Psychedelics are being explored for a wide array of purposes: fibromyalgia, dementia, brain injury, Parkinson’s, ALS, Alzheimer’s, and chronic pain. More specifically in mental health (which will be our focus): anxiety, PTSD, depression, anorexia, alcohol and substance use, eating disorders, OCD, bipolar II, smoking, and existential distress. Researchers clearly suspect that these substances hold significant potential across many conditions1.

Not “what”, But “How”.

Although “What can psychedelics heal?” is an important question, there’s another one that’s not asked as often: How do they heal?

Of course, a neuroscientist could answer that psychedelics temporarily loosen rigid brain networks and boost neural plasticity by binding to serotonin receptors—creating a window to reconfigure entrenched pathways into new, more adaptive patterns.

However, I am not a neuroscientist, and I am not sure how many of my readers are, so let’s take a different route.  If we look beyond the brain into current research and what I’ve observed with clients, growing evidence shows that psychedelics and psychotherapy heal through the same core mechanisms—the difference being intensity, not kind. Integrated wisely, each strengthens and completes the other. Let’s unpack it:

Beyond neuropsychological explanations, there are several theories that try to explain the mechanisms involved in psychedelic healing:

  • Set & setting: Mindset, expectations, the quality of the relationship, and the surrounding environment shape and enhance the healing potential of the experience.
  • Network reset: Psychedelics disrupt entrenched neural patterns—and the fixed beliefs they sustain—promoting neural flexibility and the restructuring of pathways.
  • Receptivity: Heightened openness and reduced defensiveness allow for deep exploration, insight, and the learning and retention of new ways of being.
  • Cognitive updating: By widening perspective, old organizing principles are revised into more adaptive meanings, greater agency, and healthier narratives.
  • Emotional release/catharsis: By relaxing the brain’s control systems within a safe relational container, traumatic memories, repressed emotions, and somatic tension trapped in the body can surface, to be completed or reconfigured in an improved emotional context.
  • Mystical insight and self-transcendence: The sense of self expands beyond the wounded ego, merging or identifying with a larger Self or Cosmos, offering a broader perspective and reducing existential fear.

While painted with broad strokes, these ideas form the backbone of how many researchers now understand psychedelic healing.

So, there you have it. That’s how they heal. Now we know… or do we?

Let’s explore it a bit longer. These theories are elegant and plausible, but much of the research is still young. Serious scientific study has only recently resumed, and since the only way to know what’s happening inside someone’s mind is to ask them, researchers usually rely on questionnaires and interviews to access participants’ inner worlds.

Let’s try another approach. Since we already know that psychotherapy works (trust me on that, okay?2), let’s explore how it brings about change and see if we can find some parallels.

How Therapy Works

Even before Freud, this question has been heatedly debated3.  Although we don’t have a definitive answer, decades of research have produced a set of “common factors” that play a part in healing4:

  • A reasonable expectation that therapy, through specific methods, will actually work.
  • A meaningful, safe relationship where the client feels seen, accepted, and understood.
  • The facing, correction, and integration of painful or unresolved emotional experiences, often—but not necessarily- linked to childhood.
  • Insight, meaning-making, and the creation of new personal narratives.
  • Updating of rigid beliefs and practicing new behaviors and ways of thinking.
  • Development of accountability, agency, and self-efficacy.
  • Desidentification beyond limiting self-stories and an expansion of the sense of self.

Although the language differs, it’s easy to spot the parallels. Both emphasize the importance of the relationship (part of the setting), the value of positive expectations (part of the mindset), and the opportunity to face and correct painful past experiences, often through emotional release. Both emphasize insights, updated beliefs, the chance to create new narratives, try new behaviors, expand perspectives, and reclaim agency.

It seems that what helps people change in therapy may be the very same processes at work in psychedelic healing. This would also explain the popular meme that psychedelics are like three (or five, or even ten) years of therapy in one night. But if that were true, why would anyone choose psychotherapy at all?

Old Habits Die Hard

Good question. First, psychedelics are still illegal in most of the world. But even setting legality aside, this isn’t really about choosing one over the other—it’s about understanding their respective strengths and limitations.

The “three years in one night” meme captures only part of the truth. There’s more to it. Over decades, psychotherapists have learned that change is hard. We cling to old—even painful—ways of being. Old beliefs, like habits, die hard.

Psychedelics are intriguing because they seem to produce immediate results. I often hear a version of the meme. This may stem from heightened receptivity, intense emotional release, and powerful, luminous insights—often mystical in nature—that appear to open a broad window of neural plasticity. Psychotherapy, on the other hand, relies on slow, repeated emotional nudges and controlled exposure to unresolved issues. Growth is painstakingly slow and cannot be rushed. It takes time to develop a strong relationship where a person feels safe enough to challenge old patterns and belief systems. Insights must be practiced repeatedly before they become part of who we are.

Therapy, through weekly sessions and the continual revisiting of core themes, consolidates and deepens this process. This slow phase is often frowned upon in a society where “faster” is assumed to mean “better”.

It is misleading to say that psychedelics work faster than psychotherapy. Yes, the openness, catharsis, and insights feel dramatic when compared with regular therapy, but those transient and extraordinary psychedelic states need to be converted into enduring psychological traits. In other words, experience shows that to ensure the jewels gathered in psychedelic sessions aren’t lost, we must develop the necessary structures to help them take root in our lives. This is why, like other experts in the field, I emphasize the importance of preparation and integration as absolutely essential parts of any healing psychedelic process.

Complementary, Not Better

So, how do psychedelics heal? As I explain to my clients, this is not an either/or dilemma but a both/and integration. The change mechanisms of psychotherapy and psychedelics alike foster openness, enhance plasticity, reduce reactivity, facilitate insight, help complete unfinished emotional business, generate new narratives, strengthen agency and responsibility, and expand—or decenter—the sense of self.

Both rely on the same healing principles: psychedelics amplify; psychotherapy stabilizes. Together, they create a more complete path to transformation.

Beyond Psychology

Before ending, it’s worth remembering that it is in the modern West that psychedelics are seen almost exclusively as therapeutic tools, as “psychedelic-assisted therapy”. In contrast, shamanic traditions, which have worked with sacred plants for millennia, the concept of healing includes and transcends the psychological. There, psychedelics are seen as wise teachers in the broadest sense of the word. In my work, I try to honor both approaches.

The West could learn much from these ancient traditions—if only we approach them with respect and humility, but that is a topic for another article…

  1. You’ve probably guessed from the title that this article is ambitious, thus a bit longer than others. Please note that every claim is backed by scientific research, but to avoid making it even longer, I’ve left out the references. If you’re curious, just reach out — I’ll be glad to oblige. ↩︎
  2. Many may question this assertion; however, there is solid evidence that the average therapy client ends up doing better than about 75% of comparable people who receive no treatment. See https://pubmed.ncbi.nlm.nih.gov/921048/ ↩︎
  3. Making the unconscious conscious, reworking old relationship patterns, strengthening the ego, through a corrective emotional experience, catharsis, replacing unhealthy beliefs, taking responsibility, bringing closure to unfinished emotional business, self-transcending egoic patterns, etc. All of these have been advanced as reasons why therapy heals. ↩︎
  4. Of course, beyond these, there are many other alleged factors, but these are generally agreed upon. ↩︎

Why Artificial Empathy Should Not Replace Relationships

We often hear that things are moving faster than ever. The late Joanna Macy used to say that it took us a thousand years to move from hunter-gatherers to agriculture, a hundred to move from there to industrial society, and only ten to reach the information age. It took about ten years for the personal computer and the Internet to reach mainstream use, about eight for the smartphone, and only two for AI 1.

Just 24 months ago, very few people were even aware of AI. Now, almost every week, one of my clients tells me they’ve asked ChatGPT something they might have once asked me. In fact, according to a recent Harvard Business Review article, the most common use of ChatGPT today is for therapy and emotional support 2. Should I be worried? Will AI steal therapy jobs?

Some would say yes. Anthropic’s CEO recently predicted that up to 50% of entry-level white-collar jobs could be automated within five years 3. McKinsey estimates that by 2030, AI could displace up to 800 million jobs 4.  Are psychotherapists, psychologists, and social workers among them?   Optimists argue that since AI lacks emotions, intuition, and empathy, professions that rely on these are less likely to be replaced.

“Did you just say AI doesn’t have emotions, intuition, or empathy? Have you ever asked ChatGPT or Gemini for help? If they don’t have empathy, they sure fake it well.”

Agree. But let’s recall how AI works. 

Believe it or not, AI doesn’t think. It’s more like advanced autocomplete. It was trained on mountains of information and, when prompted, predicts word by word what’s most likely to come next. Its answers are patterns of probability, not insights.  However convincing it may sound, it doesn’t even understand the words it produces. When certain words tend to appear together, they are stitched together, sounding fluent and confident—even when it’s wrong.

I often remind clients that while ChatGPT is a fantastic information resource (though it’s wise to double-check—since it has no problem “hallucinating”), it has never had its heart broken or gone out on a date. Nor does it care for your feelings (since it doesn’t understand them). Its soundest “advice” is just a rehash of what’s already been said. Great for data gathering or quick answers, but not for personal decisions. Regardless of how much we wish for HAL 9000, Samantha, R2-D2, or TARS 5 to give us clarity, the truth is that each of us still has to make our own decisions.

While ChatGPT might be preferable to a bad therapist (hence the importance of finding a good one!), the relationship between client and therapist goes far beyond information. Something subtle and elusive happens in every genuine encounter. And therein lies the real blind spot—or danger—of replacing a competent human therapist with AI.

The importance of a real relationship:

Although efforts are being made to reduce it, most AI interfaces are designed to retain user attention. One way they do this is by being uncritically agreeable—basically sycophancy (who doesn’t like reassurance?), but this creates never-challenging echo chambers, and even delusional spirals—unlike real human relationships. What feels like empathy is just AI mirroring back language patterns to make us feel understood and keep us engaged.

Remember: AI doesn’t understand depression, existential angst, or loneliness. It doesn’t even understand the words you write (it turns them into numbers). This is the biggest risk of AI therapy—artificial relationships replacing real ones.

Psychological pain comes from isolation and disconnection. Attachment injuries happen between people, and trauma is relational rupture. As such, healing can only take place in the context of an authentic, reparative relationship.  Since wounding happens in relationship, healing must also occur in relationship.  

Most clients are unaware of how crucial the relationship itself is. Good therapy goes beyond giving advice or providing “tools.” Our brains are wired for connection. When we’re in contact with someone attuned to our emotional needs—through empathic resonance—our limbic system literally heals and rewires. AI can mimic that pattern but cannot truly reproduce it.

AI “therapy” is like replacing healthy food with junk food; it creates the illusion of nourishment, but it does not do the job. As the “A” in AI indicates, AI empathy is artificial.

“Of course you’d say that, you are a therapist and therefore biased.”

Probably true.  But even someone working at McDonald’s can tell the difference between healthy and unhealthy food.  

Every day I meet clients who are thoroughly “connected” yet lonely.  Among the many crises we face, loneliness ranks high, and social media and AI may be amplifying it. I am not against AI; I think it is fantastic. What concerns me is that the newer generations, surrounded by screens, may have a hard time telling the difference between genuine human relationships and artificial interactions with machines.  They may not know what they’re missing!

It may take generations to fully grasp the potential damage that human relational deprivation can cause.  Plastic empathy may not offer the same neuronal benefits.  Hopefully, we’ll be wise enough to use AI as the powerful tool it is—without letting it replace our shared humanity.  Let us not forget what Martin Buber suggested: when two people genuinely meet, God is the space between them.

But maybe it is just a matter of time… Let’s talk about it.

  1. https://ourworldindata.org/ ↩︎
  2. https://hbr.org/2025/04/how-people-are-really-using-gen-ai-in-2025 ↩︎
  3. https://www.forbes.com/sites/kolawolesamueladebayo/2025/06/04/will-ai-really-take-your-job-experts-reveal-the-true-outlook-today/ ↩︎
  4. https://www.iotforall.com/impact-of-artificial-intelligence-job-losses ↩︎
  5. Some of Hollywood’s almost omniscient and relatable computers. ↩︎

How do therapy and tradition come together in the psychedelic space? Licensed psychotherapist and educator Sergio Castillo invites you into a conversation at the intersection of psychology and spirituality.

PsychedelicTherapy, #TranspersonalPsychology, #MindBodySpirit, #PsychedelicGuideTraining, #PsychologyAndSpirituality, #EntheogenicHealing, #PsychedelicEducation, #PsychotherapyAndPsychedelics, #PsychedelisANDSpirituality,

Why psychedelic guides need training, humility, supervision, and ethical accountability

There is an ongoing discussion in different forums about the problem of abuse in psychedelic circles and the need to train guides better. I could not agree more.

We all need to make a solid commitment to safety, professionalism, and accountability in the field of psychedelic-assisted guiding and psychotherapy, insisting on the importance of comprehensive training for guides. It is my hope that the psychedelic community worldwide, both aboveground and underground, takes notice and keeps this conversation going.

Helping others work with expanded states of consciousness is not an easy job. I’ve been at it for over 20 years now, and I’ve seen a lot. Of course, every profession has its occupational hazards. Still, I am convinced that, due to what it attempts to achieve, being a psychedelic guide is not for the faint-hearted. Aspiring guides should take note of this.

Psychedelics can be understood as nonspecific amplifiers or catalysts that make it possible to take a journey into one’s psyche and explore otherwise inaccessible deep recesses of the unconscious. This means that they can bring whatever is hidden deep in the unconscious to the surface. As any psychotherapist can tell you, this has incredible healing potential and, conceivably, is also a recipe for disaster.

It is common knowledge that the unconscious holds all kinds of repressed and disowned material. Among other things, it includes our darkest impulses, hidden wounds, and private fantasies, often of a sexual or aggressive nature. If that were not enough, we must add archetypal and transgenerational forces dwelling in the collective unconscious.

The psychedelic guide’s job description includes the willingness and ability to work with these wild subterranean currents, operating both in the client and the guide, to facilitate healing and growth. A good guide must be able to engage not only at the mental-emotional level, but also with the body, energetic, archetypal, and spiritual dimensions of experience.

To do this, guides need more than enthusiasm. They need clinical literacy, ethical grounding, relational maturity, somatic awareness, cultural humility, and a respectful understanding of the spiritual and ceremonial traditions they may encounter. Quite an undertaking.

With such a high bar to meet, mistakes are bound to happen. In Mexico, an old proverb says: “In the soap maker’s house, everybody either falls or slips,” meaning that one should not be quick to judge others because, sooner or later, we too will make a blunder.

In a way, guiding happens at the soap maker’s house.

But how can we reduce the risk of making such mistakes? The answer is quite simple: training, training, training. Or, more specifically, learning, doing our inner work, staying humble, and getting plenty of supervision.

Being fully aware of the pitfalls of guiding, any guide training should begin by discussing ethics. Then it should continue talking about ethics throughout and end by reminding trainees again about the value of ethical behavior and their responsibilities toward clients.

When I teach, I spend time talking about transference, including erotic transference, and countertransference; working with shadow material, both the client’s and the guide’s; working with physical touch; respecting boundaries; working with childhood and attachment wounding; and appreciating the power differential in the guiding relationship. I put particular emphasis on reminding students how and why the stakes are even higher when clients are in expanded states of consciousness.

However, talking about ethics is never enough. I help students understand why these ethical principles and healthy boundaries are needed. Experience has shown that ethical principles rarely work when presented as a list of “thou shalt not.” They only function when guides internalize and commit to upholding them.

As is often pointed out, psychedelics are going through a renaissance. Among the many aspiring practitioners who want to become guides, a few always want to do it for personal, often unconscious, reasons. There is often a guru or messiah syndrome somewhere to be found, or old hidden childhood wounds crying for attention.

I see my job as an opportunity to teach them that being a guide requires profound humility, endless openness to learning, and an unwavering commitment to serve others.

As expressed earlier, being a psychedelic guide or a psychedelic-assisted psychotherapist is not for the faint-hearted. It demands standards of care, ethics, and practice well above those in many related professions. The stakes are higher, and the potential for damage, and healing, is formidable.

Let us all reiterate our pledge to continue working to become guides devoted to such standards. Let’s do it together.

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