Tending the Sacred: The Emerging Role of Professional Chaplaincy in Psychedelic-Assisted Therapies

MAPS Bulletin 2021: Vol. 31, No. 2

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Caroline Peacock, Director of Spiritual Health at Emory’s Winship Cancer Institute and Ali John Zarrabi, Palliative Care Physician Scientist are engaged in a ground-breaking psilocybin treatment study and the training of spiritual health guides.

As more and more people turn to guided therapeutic encounters with psychedelics for healing and connection, chaplains are stepping in to tend the gap between these therapies and participants’ spiritual and religious belonging. Professionally trained chaplains mediate a felt sense of compassion and wellbeing that is connected to sources of meaning that are more sustaining than medical and psychological models alone can provide.

Professional chaplains, also referred to as spiritual health practitioners and spiritual care providers, serve in hospitals, hospices, prisons, universities, and military settings. To become a board-certified professional chaplain in a North American context requires three years of graduate theological education and a full-time year of closely-supervised clinical training. To supervise chaplaincy, one must complete an additional 3 to 5 years of education and mentorship. Along with academic and clinical preparation, chaplains are endorsed by our religious or spiritual traditions, placing professional practice within communities of accountability and belonging. Professional chaplaincy training emphasizes theological depth, empathic and non-judgmental presence in the face of emotional, spiritual, and existential distress, and the capacity to offer skilled interventions that prioritize the care-seeker’s spiritual values and guidance as the central ethos of care.

Professional chaplaincy is now expanding beyond the walls of traditional societal institutions. Eco-chaplaincy training programs prioritize tending to the ecological crisis and the human relationship to the natural world, while movement chaplaincy emphasizes accompanying protesters and building resilience in social justice movements. As psychedelic use becomes more mainstream and clinical research progresses, chaplains are beginning to contribute to psychedelic therapies as guides and spiritual caregivers as well.

While some seekers who turn to psychedelic use and psychedelic-assisted therapies are embedded members of traditional communities where plant medicines have long held an important role within the life of the community, many others looking to psychedelics for help or expansion lack a spiritual or religious context to make sense of powerful non-ordinary experiences. Once the therapeutic session is over or the psychedelic retreat comes to a close, psychonauts and participants from non-indigenous contexts may struggle with integration as they return home to their families and communities with religious or spiritual insights that may not be well received or understood. In such instances, chaplains can offer a safe space to explore religious and spiritual experiences and insights in light of previously held beliefs and the culture of family, community, and society.

Consider the following composite case, constructed from the experiences of chaplains in psychedelic therapy settings:

Daniel, a 35-year-old combat veteran, sought MDMA-assisted therapy for PTSD. Daniel’s religious community refrains from all mind-altering substances including alcohol. After a powerful experience of self-forgiveness in his MDMA-assisted therapy session, Daniel expressed dis-ease and shame about the joy and connection he felt in the session. One of Daniel’s guides – a chaplain – wondered if perhaps Daniel was feeling at odds with the beliefs of his community of faith. Daniel shared that he believed God uses many different and unexpected pathways for healing and that God “wants me to feel joy” even if his community and extended family would not understand. In an integration session, Daniel explored ways to share his experience without revealing details about the therapeutic process that might alienate him from his religious community.

Jeannie, a 75-year-old woman with advanced colon cancer scheduled a psilocybin-guided therapy session to work with her fear of death. A long-time member of a Buddhist community, Jeannie regularly attended the sangha as well as her husband’s synagogue during high holy days. In preparing for Jeannie’s psilocybin-assisted therapy session, Jeannie’s guides – a chaplain and a palliative care nurse – met with Jeannie to explore her values, beliefs, and hopes for the experience. Jeannie is a life-long classical musician and choral singer. After assessing her spiritual needs and resources, Jeannie’s chaplain co-created a playlist of classical music and Buddhist mantras and worked with Jeannie to create a ritual to open and close the session that included elements from her daily Buddhist practice. After her medicine session, Jeannie reported feeling less afraid of dying and more connected to her sources of support including family members who had passed on before her. Jeannie shared that the playlist was a profound aspect of her psilocybin journey. Her hospice team had the playlist playing in the background as Jeannie died peacefully at home surrounded by her family.

In addition to deepening the preparation and integration processes, capable professional chaplains offer the following gifts and commitments to the field of psychedelic-assisted therapies:

Empathic Self-Awareness and Presence

In knowing our own inner landscape well, chaplains cultivate a welcoming presence that leaves room for others to be fully themselves. With awareness of the spiritual, religious, and cultural biases and resources we bring into each encounter, professional chaplains guard against unconsciously imposing our own spiritual or religious beliefs and interpretations onto another’s experience. Whether it is our connection with a transcendent deity, a religious community of belonging, a cosmic creative source, or a sense of our place in an intelligent interconnected web of being — when chaplains bring the gift of empathic presence into care encounters, we are mediating something greater than ourselves while inviting the spiritual and religious beliefs and values of the patient or client to guide the healing process. Whatever the source of connection, chaplains know to orient to that which is broader than any one person’s gifts, skills, expertise, and limitations while taking care not to impose our beliefs and convictions onto others.

Compassion-Based Resilience

Chaplains are skilled in guiding meditation, loving-kindness, centering prayer, religious rituals, earth-based practices, and other contemplative approaches that support resilience and wellbeing. Chaplains are committed to our own spiritual health and offer spiritual care interventions that support the wellbeing of our care-seekers and colleagues. A spiritually-integrated approach to care allows us to navigate crises without becoming despairing or burned out over time.

Ritual Care

Chaplains co-create rituals to invite healing, healthy mourning, celebration, and the integration of significant life transitions. Rituals emerge from the collaboration between the chaplain’s expertise and training and the care-seeker’s world of spiritual and/or religious meaning, offered after careful assessment, and always with consent.

Spiritual Assessment and Integration

Models for spiritual and religious assessment and intervention guide the practice of chaplaincy. Inviting reflection on healthy and unhealthy religious coping, spiritual resources for navigating crisis and distress, and the role of community belonging enhances medical and psychotherapeutic approaches to care.

Ethical Accountability

Professional chaplaincy prioritizes ethical practice and accountability through peer review and ongoing professional formation. The right use of power, the importance of spiritual health and wellbeing, and the ethical practice of interreligious and intercultural care are integrated into chaplaincy education and training.

Experience with Non-Ordinary States of Consciousness

Chaplains bring experience with non-ordinary states of consciousness gained from deep spiritual practice, death awareness, and encounters with grief and loss.

As a discipline, professional chaplaincy is not without its limitations. Chaplains may lack experience with psychedelics and plant medicines and creating opportunities for guided experiences will strengthen the field’s capacity to contribute to psychedelic-assisted therapies. Additionally, many chaplains belong to religious communities with strong taboos and prohibitions against the use of mind-altering substances and such taboos will need to be addressed. Finally, the majority of chaplains are endorsed by institutional religious communities, and chaplaincy as a specialized profession within indigenous communities is rare. Inviting dialogues that include input from indigenous spiritual leaders and practitioners with expertise in plant medicines will strengthen the field of professional spiritual care and allow for more sophisticated ethical discourse regarding cultural appropriation and the impact of psychedelic use on indigenous communities.

As psychedelics move further into mainstream settings, professional chaplains can serve as interpreters who build bridges between those turning to psychedelics and their religious and spiritual communities. The important role of chaplains in influencing outcomes for psychedelic therapies is yet to be clearly demonstrated but the values and commitments of the field suggest that chaplains will have an important role to contribute to the interdisciplinary unfolding of these therapies.

Rick Doblin and Jamie Beachy at the Shambhala Mountain Center in Colorado during the 2019 MAPS MDMA-assisted therapy training.

(from left to right) Wael Garas, Study Physician/Study Therapist; Jamie Beachy, Study Therapist; Marcela Ot’alora, Principle Investigator/Clinical Supervisor; and Bruce Poulter, Study Therapist/Clinical Supervisor; at the MAPS MDMA-assisted therapy Phase III study site in Boulder, Colorado.

jamie beachy

Jamie Beachy, MDiv, Ph.D., is Assistant Faculty and Director of the Center for Contemplative Chaplaincy at Naropa University in Boulder, Colorado. Jamie is a certified spiritual care educator (ACPE) and has served as a chaplain and ethics consultant in diverse contexts including hospice, palliative care, and trauma care settings. In addition to her faculty responsibilities with Naropa’s Master of Divinity program, Jamie is a co-therapist for the MAPS-sponsored phase III MDMA-assisted therapy study in Boulder.