What Working in Psychedelic Therapy Taught Me About Sacred Medicine
When I first tried Ayahuasca, I was 25 miles outside San Jose, the capital of Costa Rica. My partner and I were staying with our facilitator, a kind and genuinely compassionate man who guided us through the experience. It was a single-night ceremony, offered as a gentle introduction to the medicine.
The journey was everything you hear about in Western culture surrounding the sacred vine: intense, profound, life-altering, and almost impossible to put into words, all condensed into a few hours. I had never felt more connected to myself, to others, or to the natural and spiritual world than I did that night.
Before the experience, I had supported the legalization of psychedelics mainly for recreational reasons. My prior encounters with LSD and psilocybin had been just that: recreational. Ayahuasca changed my position entirely. I came out of it believing in legalization for therapeutic purposes, and decided I wanted to pursue a career as a certified psychedelic-assisted therapy practitioner. Yes, it is a bit of a cliché. But the passion was, and still is, genuine.
After finishing school in Manhattan, I moved to Santa Barbara, California and began working at a ketamine therapy clinic. What I have witnessed there has fundamentally changed how I think about the sacred use of psychedelics and their place in modern Western society.
What I keep returning to is this: plant medicines, once revered by indigenous cultures for their spiritual and ceremonial significance, have largely lost that essence in today's secular, science-driven world. What was once used as a bridge between the physical and spiritual realms has been reframed as a set of chemical compounds that rewire the brain for therapeutic outcomes. In a society in the grips of a mental health crisis, these substances have been repurposed as a potential antidote.
This is not necessarily a bad thing.
The potential for psychedelics to treat depression, anxiety, PTSD, OCD, and addiction is one of the most exciting developments in modern mental health. Adaptation is part of human evolution, and there is a reasonable argument that we are simply applying powerful tools to contemporary problems.
And yet, I have real concerns about this model.
Commercialization and What Gets Lost
Psychedelics are not just tools. They are, in many traditions, wisdom-keepers and profound healers. They hold the power to bring a person face to face with the deepest and most difficult parts of themselves, and to help them emerge more whole, more integrated, and more self-aware. My concern is that by imposing a Westernized, commercialized framework onto something so sacred, we risk losing the very wisdom that indigenous traditions have carefully stewarded for centuries.
The controversy is not new. The so-called "discovery" of psilocybin in 1955 by ethnomycologist R. Gordon Wasson is an early and painful example. Wasson and his wife traveled to Mexico to participate in a Mazatec mushroom ritual led by the community shaman, María Sabina. Despite promising not to publicize what he witnessed, he broke that trust entirely, ultimately destroying Sabina's life and exposing her community to exploitation. It set a precedent that the field is still grappling with today.
What followed was the psychedelic renaissance: a cultural revival that brought these once-sacred medicines into the mainstream of science, wellness culture, and recreational use. Indigenous activist Sutton King, co-founder and president of Urban Indigenous Collective, speaks directly to the cost of this trajectory. Even Ayahuasca, arguably the most well-known plant medicine rooted in Central and South American tradition, has become a wellness trend largely accessible to the upper-middle and wealthy classes in the Western world. As King points out, applying the same extractive lens that has long been used to appropriate cultural traditions to plant medicine does not just strip indigenous communities of heritage and meaning. It also opens the door to the misuse of a powerful, psychologically demanding substance that requires reverence, clear intention, and responsible guidance.
This is not a dismissal of Ayahuasca retreat centers. Many operate with genuine care and thoughtfulness. But it points to something broader: the way psychedelics are perceived and framed in contemporary Western culture. Indigenous communities refer to these substances as plant medicines. Western culture tends to call them psychedelics or hallucinogens, centering their neurological effects and distancing them from their spiritual and cultural roots. In pop culture, they are often portrayed as recreational escapes, something to enhance a party or provide a weekend of novelty. Think tech workers microdosing for productivity, or college students dropping acid at festivals.
In clinical research, scientists are now exploring ways to isolate the therapeutic compounds in psychedelics while removing the hallucinogenic effects altogether, intending to package their healing potential as a widely available medical product. That argument deserves its own in-depth piece. But it speaks to the same underlying tension.
This is also where the phrase "bad trip" comes from. These substances were never designed for casual use. They are instruments of inner work and deep transformation, and they demand the right conditions. When used without guidance, intention, and proper context, they can cause more harm than healing.
The Limits of the Clinical Model
On a purely clinical level, psychedelics hold genuine potential to transform mental health treatment. But reducing these medicines to their brain-altering properties, stripped of their sacred origins, concerns me deeply. In traditional ceremonies, participants are held by the community, guided by experienced practitioners, and supported through a meaningful integration process after the experience. That integration is essential to real healing. In most modern therapeutic models, it is an afterthought at best.
I see this in my own work. Clients come in, undergo treatment, and leave two hours later. Some may have a follow-up integration session with a therapist, but it is often days after the fact, not immediately following the experience. There is little space for them to fully process what happened, to reflect, share, or be held in a supportive environment before and after. It raises a question I find myself sitting with often: is this how healing is meant to happen? Can we expect people to access the full transformative potential of these substances under these conditions?
I hope we are not settling for a transactional model of psychedelic healing. These medicines deserve more than that. And so do the people seeking them.
A Turning Point in Psychedelic Medicine
The growing use of psychedelics in mental health treatment is an important and necessary development. But how we approach these medicines matters as much as whether we use them at all. Their origins, and the indigenous peoples who have worked with them for thousands of years, deserve genuine respect and careful consideration.
To commercialize and commodify these plants risks repeating the same patterns Western capitalist societies have enacted before: exploiting, dishonoring, and ultimately erasing the cultural and environmental contexts from which these medicines emerged.
Sutton King points toward a more ethical path: building real dialogue between Western and indigenous experts, combining knowledge systems rather than replacing one with the other. This kind of collaboration would allow us to honor the sacred origins of plant medicines while responsibly exploring their therapeutic potential.
For anyone using these substances, I would offer this: approach them thoughtfully. Use them in safe, intentional environments, with a clear purpose and genuine respect for what they are. And take the time to learn about the indigenous traditions and communities behind these medicines. The wisdom that has been passed down through generations deserves acknowledgment, not just as a footnote, but as the foundation.
