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Seeing All Sides of Psychedelic-Assisted Therapy: An Interview with PAU Alum Arielle Webb

Arielle Webb

  Acknowledgement from Arielle Webb, PhD   “I want to acknowledge my own privileged identities being white and having a PhD, so I am not here to speak to the experiences of those most affected. I am speaking from the space of what I’ve learned over the last decade during my own studies and in conversations with those most affected, as well as being engaged with several non-profits committed to this work. I would like to apologize in advance for any blind spots associated with my identities and privileges that may arise in this piece… The work of understanding our own privilege and blind spots is a lifelong commitment that I do not shy away from.”    Arielle Webb, newly graduated from PAU’s PhD in Clinical Psychology program, is excited about the potential for psychedelic-assisted therapy but is also concerned about the creation of analogs by pharmaceutical companies and what that means for the indigenous cultures for whom these medicines are considered sacred.   “It’s an exciting time. There is so much promise with this work,” said Webb, who attended the Psychedelic Science 2023 conference in June, along with several other PAU alums. “I work at a community clinic in Oakland, and I’m finding that medication and, at times, traditional psychotherapy, does not work for a lot of people. The research on psychedelic therapy is showing that it’s alleviating symptoms for folks who are resistant to medication and more traditional forms of psychotherapy, which is incredibly inspiring for therapists.”   According to several studies reviewed in a report on the emerging field of psychedelic psychotherapy, the use of psilocybin (hallucinogenic mushrooms), DMT (the hallucinogenic component of Ayahuasca), LSD, and MDMA in clinical settings have shown positive results. This research provides hope particularly for those with treatment-resistant depression, post-traumatic stress disorder (PTSD), substance abuse disorders, in addition to the potential for treating many other mental and physical health disorders.   The report shows psychedelics have a strong impact because of the changes they make in the brain. Due to neural changes that psychedelics induce in patients, researchers have found that psychedelic-assisted therapy results in a “weakening” of strongly held, maladaptive beliefs that inform how the patient perceives themselves and others. After the treatment, therapists offer integration sessions to establish new beliefs and behavior patterns and help restructure how they view themselves in relation to life’s challenges.    “Brain scans have shown that psilocybin reboots the brain’s default mode network and cultivates more cognitive flexibility.” said Webb. “Some patients only need one dose of psilocybin therapy and, along with proper integration, they are symptom-free for the rest of their lives.”   Although many mental health professionals are inspired by the potential for psychedelic therapies, there are several factors to consider that make this field of study controversial.    

Psychedelic-Assisted Therapy and Cultural Appropriation

  Given the immense potential for psychedelics to change the way therapy is offered (along with the potential to make a lot of money) pharmaceutical companies are rapidly creating analogs of natural psychedelic compounds and bringing them to top universities, such as Johns Hopkins, Harvard, and UCLA, for clinical trials.    Although many therapists are excited by the potential of these therapies, Webb has deep concerns about cultural appropriation. “I see value in making these analogs for research purposes, but I want to see our field being respectful of the cultures where they came from,” said Webb. “I want to see researchers giving indigenous elders a voice in the process. Even if someone doesn’t have a PhD next to their name, their contribution and insights are still legitimate if they have been working with these medicines their entire lives. Both perspectives have value and I’d love to see these two worlds come together with mutual respect.”   Webb explained that indigenous cultures have used psychedelics in spiritual and healing ceremonies for thousands of years. For example, psilocybin has been used by natives of Mexico and Central America, including the Aztecs, for more than two thousand years. Ayahuasca (which contains the hallucinogen DMT) is an entheogenic brewed drink traditionally used as ceremonial or shamanic spiritual medicine among indigenous peoples of South America, particularly the Incan culture of Peru.    Many of the sessions that Webb attended at the Psychedelic Science 2023 conference discussed the impact of psychedelic therapy on indigenous cultures. Webb witnessed speakers from indigenous cultures who expressed how important and sacred these medicines are to their culture. Some speakers see the creation of analogs, without reciprocity or being included in the conversation, as a form of colonization of their plant medicine.   

Psychedelic-Assisted Therapy and Accessibility 

  Webb shared that another aspect of cultural injustice involves the issue of accessibility. If the analogs get approved by the FDA for therapeutic use, these will be the only forms of the psychedelic that will be legal, meaning underground use for spiritual purposes will still be deemed illegal.    “It’s a complicated issue because I can see the benefits of someone creating this therapy in a more standardized way that can be backed by research, but it also delegitimizes the current way it’s being used,” said Webb. “Pharmaceutical companies are taking this ancient wisdom, repackaging it, and then saying, ‘the analog is the only way we will acknowledge and approve this medicine,’ while those facilitating healing using the plants in their original form are still getting arrested. It’s not right.”    Webb explains that with any new pharmaceutical, there are many restrictions around who gets access. If psychedelic therapy becomes approved by the FDA, there will be barriers to access for indigenous individuals living in the US who don’t have health insurance or a medical provider. “For individuals who come from cultures where these medicines have been used for thousands of years as part of their spirituality and healing practices, it is currently illegal and risky to engage with their own culture’s spiritual practices. If we only allow psychotherapists and MDs who get approval from a government agency to work with these medicines, we are, in effect, stealing from another culture, dictating how and when they should be used,” Webb argues    “For the marginalized folks, who need this medicine the most, how are they going to have access to these medicines if the pharmaceutical companies have control over them?” asks Webb. “     To address these discrepancies, Webb is a member of Chacruna, a nonprofit organization that works to increase accessibility of these medicines for indigenous populations. Webb also volunteers with The Fireside Project, a psychedelic peer support line that offers affinity group support for veterans, BIPOC, and trans individuals.   

Next Steps

  Due to the hundreds of (and growing) clinical trials demonstrating the efficacy of psychedelic-assisted therapy, MDMA and psilocybin will be considered for approval for therapeutic use by the FDA in the next couple of years, and have already been approved on the state-level, with some limitations, in Oregon and Colorado.     “We have no idea where we will be in this discussion five years from now,” said Webb. “There are so many factors; we don’t know what the FDA will do or how each state will handle approvals and oversight; it can go in so many ways.”    If the FDA grants approval, Webb hopes to open a community clinic offering psychedelic-assisted therapy, ideally covered by Medi-Cal or having a sliding scale structure so that more marginalized individuals can access it. While facilitating the medicines, Webb intends to respect and honor the cultures from which they originated.   “We need to weave the indigenous wisdom into this therapy because there’s a piece that is missing when you just stick to the clinical,” said Webb. “The spiritual and cultural wisdom in the medicine are key ingredients that make it so effective and life-changing.”