Hello Reader,
Years ago, a client came to me after leaving a therapist she'd been seeing for six months.
She had told her previous therapist she was curious about taking psilocybin to help with her PTSD. Not that she had done it. Not that she was planning to. Just that she was curious and wanted to talk about the possibility.
Her therapist's response: "I won't discuss that with you. And if you want to self-medicate with drugs, I won't be able to continue working with you."
So she stopped seeing that therapist, and eventually found me, after losing the place where she tried to ask for help.
I think about that conversation a lot. Not because the therapist was cruel. I don't believe she was. I think she was trained in a system that gave her nothing for that moment, and she filled the gap with an instinct she'd probably have named "clinical boundaries." It landed as a threat. A person in treatment for PTSD had to choose between her curiosity and her therapeutic relationship.
She chose her curiosity. She lost her therapist. She found one who could help, but not before the cost of that first response was clear.
The clinical skill that moment required isn't complicated. It's the capacity to stay in the room with a client's question, take a basic history, and figure out what the conversation is for: whether the client ever takes psilocybin or not, whether the curiosity leads anywhere or not. The job was to be present with the question instead of threatened by it, because that response can either open the door or close it.
That client is the reason I built Psychedelic Affirming Education, and that moment is what the course was designed to make less likely.
Psychedelics and the Therapeutic Frame — 3 CEs, $137 →
— Peter