Who Will Benefit From Psychedelic Medicine?

n a sweaty Sunday morning in August of last year, Jamilah George was on the 16th floor of the historic Brown Hotel in Louisville, leading a spiritual service of sorts. George, a doctoral candidate in clinical psychology at the University of Connecticut who also holds a master’s degree in divinity from Yale University, asked the audience to shout out the names of ancestors or people they admired. With each name, George performed a libation ritual, pouring water into a leafy green plant, stationed at the front of the podium, as a gesture of thanks. “Maya Angelou,” called out one audience member. “Mama Lola,” called another. The names kept coming: Toni Morrison. Audre Lorde. Mahatma Gandhi. Harriet Tubman.

George, who had been part of a team at U-Conn. running the only clinical trial to study the effects of the psychotropic drug MDMA on post-traumatic stress disorder with participants of color, wanted the audience to connect with its cultural lineages before she started her presentation — a bracing call for inclusion and social justice within the burgeoning world of psychedelic healing. It’s a world that holds great promise but is overwhelmingly White and economically privileged. Part of the problem, as George sees it, is that academia has lost its connection to the histories of these consciousness-altering substances (also known as entheogens), many of which have been used by Indigenous cultures for physical and psychological healing for thousands of years.

“It’s up to us to find ways to disseminate resources and stop leaving them at the top, in the most elite research institutions,” she said to the small audience of psychotherapists, who were there to learn how psychotropic substances like methylenedioxymethamphetamine (MDMA) and psilocybin, the active ingredient in hallucinogenic (“magic”) mushrooms, could be used to heal mental and emotional distress. “We have to find ways to take this information and bring it down so it’s accessible,” she continued. “MDMA — you can’t even pronounce it! We have to find ways to make this information translatable. It’s like speaking another language.”

The next day, the public part of the inaugural Psychedelic Medicine & Cultural Trauma Workshop ended and the psychotherapist training began. Fifty therapists of color had been accepted into the week-long training, hosted by MAPS, the Multidisciplinary Association for Psychedelic Studies. In the training, therapists would learn best practices for using the entheogen MDMA to treat PTSD in their patients.

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Meanwhile, in 2017 the FDA granted “breakthrough therapy” status to MDMA-assisted psychotherapy to treat PTSD, after privately funded MAPS studies found that 56 percent of participants experienced significant relief — so much so that they no longer met the requirements for PTSD. (The FDA can’t discuss ongoing trials, a spokesperson told me over email.) Breakthrough status is given to therapies that have shown great promise, with the idea that they will be given priority within the FDA approval process, and MAPS predicts MDMA-assisted psychotherapy will be available sometime in the next few years. I’ve experienced the treatment myself: After editing a story about MDMA-assisted psychotherapy many years ago, I connected with a highly skilled underground therapist to address the lingering effects of my father’s death when I was 14, effects that talk therapy and meditation hadn’t relieved. While it was difficult and painful to face the trauma that I’d buried, I greatly benefited from the work.

But as study after study showed positive outcomes over the years, one thing was constant: There was little diversity among both the study leads and the participants. In 2015, Natalie Ginsberg, MAPS’s director of policy and advocacy, came across the name of Monnica Williams, a clinical psychologist then at the University of Louisville. Williams, who is Black, studied obsessive-compulsive disorder, anxiety and the effects of racism, and her work excited Ginsberg, who wrote Williams to ask if she might be interested in working with MAPS. “Social marginalization compounds trauma,” Ginsberg wrote me via email. Regardless of the origin of their trauma, which could stem from any number of causes, including sexual assault, childhood trauma and military service, “people who experience the highest rates of trauma are those most marginalized from society, which in the U.S. includes people of color.”

Williams had no previous experience with psychedelics. “I had a boyfriend in high school who used LSD once or twice, and I don’t remember any remarkable transformations happening as a result,” she told me. It took some convincing. “It kind of seemed like maybe the fad of the week, you know?” recalls Williams. “Where they say, you know, you drink a glass of water with vinegar and lemon juice and you lose 50 pounds. Like, yeah, right. But actually reading the research, seeing the videos of the participants getting better … when you do this work, you can look at people and you can tell: That person is really ill. And then you see that same person later and they’re smiling and their face is bright. And they’re making eye contact and they’re talking about the future. Seeing that whole progression on a videotape, that’s kind of what convinced me.”

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