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Sara Reed is a licensed marriage and family therapist and the creative executive of Mind’s iHealth Solutions, a mental health technology and service company committed to changing how we talk about and treat mental illness. As a mental health futurist and former clinical researcher, Sara examines the ways culture informs how we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara is a scientific advisor for Journey Colab and a current board member for the Board of Psychedelic Medicines and Therapies. This is her experience with MDMA-assisted therapy and how the journey sparked her need to advocate for culturally sensitive care in psychedelic medicine.
My journey to becoming a mental health therapist wasn’t an intentional one. The loss of two significant family members after I graduated college ultimately changed the course of my life. I didn’t know how to deal with my grief, so I did what I knew best—I worked it away. With a full schedule, I had little time to think or connect with the pain I was experiencing. But it was during this period that I felt a Divine pull—a spiritual calling—towards clinical training in marriage and family therapy. Despite not knowing much about mental health, I trusted and surrendered to this call. Little did I know that my work over those years was preparing me for something I didn’t even know existed at the time: psychedelic-assisted psychotherapy.
After I finished my master’s program, I had the opportunity to participate in the MDMA-assisted therapy training program sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit and educational organization dedicated to exploring the therapeutic potential of psychedelics. MDMA-assisted therapy has the potential to effectively treat post-traumatic stress disorder (PTSD), but MAPS recognized the need to racially diversify its clinical trial participant pool, and our research site helped to support this objective. During this five-part training program, I got the chance to participate in an optional study in which therapists could take MDMA, a synthetic drug that acts as a stimulant with hallucinogenic effects, in a one-time clinical setting. Knowing that MDMA therapy would be vastly different from any other traditional therapy I had been trained in, it was important for me to experience firsthand what I would be asking others to do.
After completing the required screening for participation, I arrived at the study site prepared for the 8.5-hour session ahead: I wore my comfiest clothes and the bracelets of my grandmother, one of my losses years prior, around my wrists. There were two therapists in the room getting ready for my journey. Soon after I was given the MDMA. With my eyeshades on and music supporting me through my experience, I laid on the cozy couch waiting for the onset effects of the drug to kick in.
About 50 minutes after ingesting the MDMA, which I took via a capsule, I said with a smile to my therapists: “I feel like I’m dying but it’s okay.”
The onset effects of MDMA can be physically and emotionally intense. For me, this intensity felt like an unmasking that was necessary for the journey—an undoing of expectations of what I wanted the experience to be and a surrender to what was happening before me, to me. As the medicine and the music carried me away, my grandmother appeared. Tears flowed down my face and joy filled my heart. It had been years since I had felt her presence like this. Seeing her in this bright, liberating light was an important part of my grieving process.
She took me to a place I knew existed but had never seen. I traveled to what felt like the essence of the universe, a space of Divinity, a place where I belonged. The vision revealed my presence within this enormous Whole—a place that had no beginning or end, where there is no distinction or separation from love. I call that place home. And for the first time in my adult life, I felt freedom. Me, a young Black woman. Free. Human.
Gradually, though, I began to feel a heaviness in my body pulling me into a very different story, a fusion of emotions welling up. My body became more sluggish with each breath. I asked my therapists, “What can I do to speed up my body? My body is slowing me down.”
A teacher once taught me that “You can’t release what you don’t feel.” For this part of my journey I was forced to feel what I had suppressed: stories I carried within my body that are connected to pain, abuse, and violence. Sitting on these stories of my direct and ancestral past revealed a history of suffering and oppression that I had to grapple with in a raw and unfiltered way. I had significantly underestimated the psychological impact of living in a racist and anti-Black society. And I wasn’t prepped on how to navigate between my personal and political worlds during this experience.
As a Black woman, I’ve learned the performance of whiteness in order to survive. Some of y’all know that narrative: I’ve got to be twice as good to get ahead or be noticed, or not be too loud or defensive, and dress in socially acceptable ways. Do you know what that narrative can do to the psyche? Denying parts of yourself to be accepted, respected, and unharmed through the “white gaze”? Living through that distortion is its own kind of suffering. Normally I self-regulate by dismissing or disconnecting from this pain—but those mental reflexes no longer worked in this session. It was like my body was speaking a language that my mind did not know how to understand. And it was difficult for me and my therapists to navigate.
“Some moments of feedback are making me more confused, angry, and frustrated,” I said to my therapists, “You all don’t understand what I’m really trying to say.”
“Maybe there is a part of you that doesn’t want to be understood,” one of the therapists said. Silence. There is nothing more I want in life than to be understood. Malcolm X once said, “The most disrespected, unprotected, and neglected person in America is the Black woman.” I’d like to add misunderstood to that phrase too.
Although the current research exploring MDMA-assisted psychotherapy is promising, my experience revealed to me the need and importance of culturally responsible care in psychedelic-assisted therapy. And in order to provide culturally responsible care, we must integrate culturally sensitive practices within the treatment protocols, while removing oppressive practices that are rooted in colonization and white supremacy, if we are to make this treatment safe and accessible to folks from BIPOC communities. Centering a person’s culture and identity—whether that’s their customs, language, religious beliefs, or simply how they’ve experienced the world—leads to better clinical outcomes. Research supports this fact.
Cultural sensitivity is particularly critical in psychedelic-assisted therapy because participants are in emotionally vulnerable open states. This presents new and potentially increased risks for harm—like retraumatizing people who have lived through traumas—and it is our responsibility as therapists and facilitators to make the experience safe, both physically and mentally. Part of “do no harm” also includes an understanding of personal unconscious biases and not having those biases interfere with a patient’s therapeutic process.
As psychedelics become more medicalized, it’s important to normalize and destigmatize the use of these medicines for mental wellness. Without sensitivity towards these processes, this treatment will remain largely inaccessible to many folks and can result in misconceptions about these drug-assisted therapies. Psychedelics can act as a catalyst or a companion in the treatment; they are not the cure. It’s not just about what drug you use or how much of it you take—it’s about what you do with the experience that produces life-altering changes.
My experience in psychedelic therapy has undoubtedly deepened my understanding of myself and shaped my thoughts on what I’d like to see in the field. Is psychedelic therapy effective? Is it safe? What does the future look like if psychedelic therapy is accessible to those in need? These are just some of the questions experts are attempting to answer. When I envision the future of psychedelics, however, I see a space where people have the resources and protections needed to safely administer this work within their communities, not just in medicalized settings. I see a space where there is more consultation and collaboration with Indigenous people, so that we decrease the risk of misusing and abusing traditional plant medicines and harming people in the process. I envision a future in which someone like me is deeply seen in all of her complexity. A future in which she has the space to safely navigate between the worlds of her humanity and Divinity. A future where her return home is a return to herself.
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