MAPS Bulletin Spring 2020: Vol. 30, No. 2
The current cultural moment has exposed for many what people of color knew was always there. The thin veil covering our society’s deep wounds has been removed. What we are seeing is not pretty. It never was.
While psychedelics can often help us see the interconnectedness of our world, it is not hard to see the current duality, and that we have much work toward becoming more connected. Psychedelic research, communities, and spaces remain mostly white, privileged spaces. Communities of color remain on the sidelines. If left alone, this gap will remain and likely widen. To address disparities in access and provide healing support to individuals and communities that need it most, intentional strategies must be developed toward engaging communities of color with psychedelic medicines and treatments.
People of color and indigenous peoples carry the collective trauma from centuries of slavery, colonialism, and oppression inflicted on our ancestors. More recently, here in the United States, violent methods of subordination and segregation have been applied to Blacks and people of color, taking various forms, ranging from lynching to police brutality. Explicit and implicit discrimination, as well as overt and covert acts of racism, are daily occurrences for many. Right now, much attention is being paid to these injustices and racial trauma. But marginalized people have always dealt with this reality, while many others have continued on without much thought to the lived pain all around them. This needs to change.
In many ways, the combination of the COVID-19 pandemic and the death of George Floyd have been a collective retraumatization for Blacks, people of color, and indigenous peoples around the world. The pandemic brought economic disenfranchisement and revealed disparities in health care that people of color know all too well. The knee of a police officer on the neck of George Floyd reminded us that we are still living in a racist and oppressive police state. The officers standing by while not getting involved brought us face to face with the reality that most of society remains complicit in the perpetuation of that system.
There is much work to be done in the way of healing this trauma, and MDMA-assisted psychotherapy is a potentially powerful, yet unexplored, treatment for the long-term racially based trauma that has arisen from the broken American system of policing, health care, justice, and employment. The time for healing is now, and concrete action toward the exploration of this avenue of care must continue.
Bridging the Gaps In Our Work
In the modern psychedelic renaissance, burgeoning psychedelic wellness spaces and communities have inadvertently benefited from a lack of diversity. These spaces might have struggled to develop and grow if more people of color had been a part of their ranks. Research might have failed to launch. Burning Man could not have been started by Black and Brown faces burning effigies on a beach, and an eventual move to the Nevada desert would have been completely out of the question.
But psychedelics have deep cultural roots, from ayahuasca to ibogaine, in native cultures worldwide, and have seen racism and colonization push out tradition and ceremony for research and science.
Most current psychedelic spaces, systems of support, and models of therapy have not been influenced by, or included individuals of color in their research or treatment teams. In a review by Monnica Williams, Ph.D., ABPP, it was found that going back to 1993, more than 80 percent of participants in psychedelic therapy trials have been white (Janikian, 2019). These realities beg for diversification. More inclusion is beginning to happen, and continuing to bring more diverse participants, perspectives, and backgrounds into the fold.
I stood on the sidelines of this movement for years. Much of my inaction was related to not seeing myself represented in research, at conferences, and at festivals. I couldn’t envision myself doing the work. I felt like an imposter. I was avoiding the potential for the psychological injury that I had experienced in attempts to integrate myself into other professional, predominantly white spaces.
Last year, things changed. I was invited to a MAPS-hosted MDMA Therapy Training and Cultural Trauma Workshop (maps.org/mdma-poc-training) for therapists of color desiring to work in the current MDMA-assisted psychotherapy studies, and beyond. Current researchers, therapists, and advocates in the fields of psychedelic medicine, drug policy, and cultural trauma shared the work that is being done and perspectives on moving forward in advancing access to psychedelic medicines for people of color and indigenous peoples.
The experience was humbling, emotional, unforgettable, and career-shifting. This beautifully diverse and dynamic gathering provided space for therapists of color to lean into conversations about intergenerational trauma, racial trauma, indigenous practices, and share cross-cultural wisdom and techniques toward healing our communities with psychedelics and MDMA-assisted psychotherapy.
Voices were present in psychedelic spaces that have long been absent. Therapists of color were empowered in ways they often are not. I found myself among many who share a passion for making psychedelic medicines more accessible to our communities. I began to see myself doing this work.
The path toward our collective liberation from systemic racism depends on the continued development of these spaces and the inclusion of these diverse voices. These multicultural trainings will be essential in empowering the next diverse wave of therapists, including therapists of color in the research and treatment teams, informing our collective approaches, and in the development of greater cultural humility.
Creating Settings of Safety and Support
Individuals begin to heal in settings of safety and support. We often do not have, and struggle to build, safe and supportive environments in our own communities and neighborhoods. MDMA-assisted psychotherapy will help heal people of color impacted by racial trauma by providing these spaces. This model of therapy curates environments in which individuals are heard, supported, assisted in deep processing, and guided toward healing from within.
MAPS’ current clinical trials underway have shown that MDMA-assisted psychotherapy can be extremely efficacious in treating individuals diagnosed with posttraumatic stress disorder (PTSD). In a recently publicized interim analysis from MAPS, this therapy has proven significantly more effective than other treatments currently available (“Press Release: Interim Analysis,” 2020). This same treatment can be administered to people of color with race-based stress and racial trauma. In fact, the symptoms associated with racial trauma are often very similar to the symptom presentation in individuals diagnosed with PTSD. Dismantling the norms of what we define as “trauma,” and bringing down barriers to access, will truly establish this treatment as a breakthrough therapy (“Press Release: FDA Grants Breakthrough Therapy Designation,” 2020).
The war on drugs has left an indelible impression on Blacks and people of color. Psychedelics have become highly stigmatized, and many remain misinformed and afraid. Culturally sensitive education and outreach to communities of color will go a l
ong way toward reversing that trend and contributing to feelings of trust and safety for participants.
The intergenerational trauma from decades of mistreatment in health settings has developed a fear and distrust of therapy and mental health for many people of color. MDMA may help reduce fear, increase positive emotions, and develop trust with therapists. The combination of MDMA and a supportive setting may help an individual safely encounter their traumas so they can move through obstacles or impasses to healing. The therapy will support people of color in a connection to and activation of their internal healing mechanisms, and catalyze a fuller and deeper engagement with their cultural healing practices and methods.
Institutional racism and systemic oppression interfere with the ability of people of color to express their true selves. This stymieing of authentic being often maintains a masked, false self. This repression of true expression creates a culture of low self-esteem. Oppression becomes stored in the body. This therapy will help participants of color express their deeper true selves, connect with their core beings, and liberate their bodies through somatic processing and expression.
There is safety in knowing we are seen, and knowing we are heard. People of color coming into the studies must see themselves represented in the research and therapy teams. Research will remain incomplete if the participants remain disproportionately white, and strategies, sensitivities, and techniques toward healing a diverse population will remain undeveloped.
The Road Ahead, and The Need for Future Research
There is an urgent need to increase our education around these issues, and to lean into research and science for discovery. The current reality is that we know very little about underserved populations, their relationships to psychedelics, and their willingness to participate in novel therapies. This is because these populations have been under-resourced and under-researched. Targeted funding is needed to address these gaps. Funding research into racial trauma and intergenerational trauma by therapists and researchers of color will help fill that void.
Experts in the field of racial trauma and intergenerational trauma must continue to be consulted and invited to develop workshops, training, and ongoing education to expand therapists’ understanding and awareness of the complex challenges experienced by people of color, and provide expertise on best practices and approaches to healing.
Deeper qualitative research and community engagement can support outreach efforts and the development of culturally sensitive education for targeted inclusion of people of color in research studies, and ultimately for treatment when these medicines become more widely available.
Building bridges to spiritual centers will connect to the beacons of safety and trust in these communities. These spaces will also provide safe launching and landing for some participants.
Financial assistance and sliding scales will help support many who live on the margins in accessing MDMA-assisted psychotherapy due to the duration of the studies and the costs of lost time for those who work full time, are unemployed, or living paycheck to paycheck. If we cannot reduce economic barriers to access, we are maintaining the same systems we are striving to dismantle.
Collective racial trauma will begin to heal when complex structural, societal, and environmental causes are addressed. MDMA-assisted psychotherapy is a powerful treatment that is available now, and has proven to heal at the individual level. These treatments may support the collective healing, recovery, and transformation of people of color and indigenous peoples. When we heal, our ancestors heal, and so do all the generations to come.
Throughout its history, MAPS has dedicated its work to taking on structural inequality and drug criminalization as they move toward destigmatizing and increasing access to psychedelics. At the core of their mission is justice and access. In alignment with that mission is a stance against systemic racism and a commitment to racial justice.
The time is now for therapists and researchers of color to deepen our connections, come together more intentionally, support one another, and get actively involved in the outreach, education, research, and treatment of individuals in our communities. The broad cultural lens and expertise we bring to this work is needed to support the great work that has been done by many before us. We must join this powerful movement and help carry the torch toward those who remain in the dark about these medicines.
Trainees from the MDMA Therapy Training for Communities of Color gather during sunset on the Ohio River in Louisville, Kentucky, in August 2019. Credit: Shannon Carlin, M.A., AMFT
References
Cook, B. L., Trinh, N. H., Li, Z., Hou, S. S., & Progovac, A. M. (2017). Trends in racial-ethnic disparities in access to mental health care, 2004-2012. Psychiatric Services, 68(1), 9-16. Retrieved from: https://doi.org/10.1176/appi.ps.201500453
George, J. R., Michaels, T. I., Sevelius, J., & Williams, M. T. (2020). The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and ethnic minority inclusion. Journal of Psychedelic Studies, 4(1), 4-15. Retrieved from: https://doi.org/10.1556/2054.2019.015
Janikian, M. (2019). MDMA for racial trauma. DoubleBlind. Retrieved from: https://doubleblindmag.com/mdma-racial-trauma-monnica-williams/
MDMA Therapy Training for Communities of Color and Psychedelic Medicine and Cultural Trauma Community Workshop. (2019). Multidisciplinary Association for Psychedelic Studies (MAPS). Retrieved from: https://maps.org/mdma-poc-training
Michaels, T. I., Purdon, J., Collins, A., & Williams, M. T. (2018). Inclusion of people of color in psychedelic assisted psychotherapy: A review of the literature. BMC Psychiatry,18:245. Retrieved from: https://doi.org/10.1186/s12888-018-1824-6
Mithoefer, M. (2013). MDMA-assisted psychotherapy: How different is it from other psychotherapy? MAPS Bulletin, 23(1), 10-14. Retrieved from: https://maps.org/news-letters/v23n1/v23n1_p10-14.pdf
Press release: FDA grants breakthrough therapy designation for MDMA-assisted psychotherapy for PTSD, agrees on special protocol assessment for Phase 3 trials. (2017). Multidisciplinary Association for Psychedelic Studies (MAPS). Retrieved from: https://maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials
Press release: Interim analysis shows at least 90% chance of statistically significant difference in PTSD symptoms after MDMA-assisted psychotherapy. (2020). Multidisciplinary Association for Psyche
delic Studies (MAPS). Retrieved from: https://maps.org/news/media/8154-press-release-interim-analysis-shows-at-least-90-chance-of-statistically-significant-difference-in-ptsd-symptoms-after-mdma-assisted-psychotherapy
Williams, M. T. & Leins, C. (2016). Race-based trauma: The challenge and promise of MDMA-assisted psychotherapy. MAPS Bulletin, 26(1), 32-37. Retrieved from: https://maps.org/news/bulletin/articles/407-bulletin-spring-2016/6106-race-based-trauma-the-challenge-and-promise-of-mdma-assisted-psychotherapy
Joseph McCowan, Psy.D., is a licensed clinical psychologist and psychotherapist, currently working with MAPS in Los Angeles as a co-therapist in the Phase 3 clinical trials of MDMA-assisted psychotherapy for PTSD. He is an alumni of MAPS’ MDMA Therapy Training for Communities of Color, held in August 2019. Joseph is deeply passionate about furthering education and awareness of the healing benefits of psychedelics for communities of color and in working to improve mental health outcomes for historically underserved communities. Additionally, Joseph works as a therapist, educator, and clinical supervisor with the non-profit St. Joseph Center in Venice, California, which provides mental health and housing resources to homeless individuals and families across Los Angeles County. There, he provides individual and group supervision, along with ongoing training and education in trauma-informed care, harm reduction, and cultural humility. Joseph received his undergraduate degree in psychology from the University of California, Santa Barbara, and his doctorate in clinical psychology from the Chicago School of Professional Psychology. He can be reached at drjmccowan@gmail.com.
