Erotic feelings in psychedelic-assisted therapy: What practitioners tell us, and implications for practice
Sexual boundary violations by psychedelic practitioners are a recurring and serious problem. The aim of this psychodynamic study is to identify how erotic transference and countertransference (ETCT) can emerge in psychedelic-assisted therapy (PAT) and how to reduce risk of harms. To this end I have interviewed, thus far, 16 PAT practitioners and participants about their experiences of ETCT.
The case studies richly demonstrate how psychedelics can evoke erotic feelings, material, relational experiences, therapeutic challenges, and transference and countertransference. Several examples will be presented.
For the participant, these medicines can evoke powerful experiences of erotic energy while also decreasing inhibition. If there are unaddressed problems in their intimate primary relationship, the participant can be vulnerable to developing an erotic transference to another in the psychedelic space.
For the practitioner, therapeutic challenges can arise in the form of ETCT driven by developmental or intrapsychic material, powerful relational experiences, and boundary challenges and confusion. In addition the practitioner’s life stressors can lead to increased risk of boundary violations.
Psychedelics can create difficulties for the practitioner providing therapeutic touch, especially if they received inadequate training on how to set boundaries and offer alternatives to touch. Almost all interviewed practitioners felt their training on touch had been insufficient.
The case studies point to urgently needed evolution in practice and training. For example, preparation should include an assessment of the participant’s primary relationship and discussion of possibilities with erotic energy, material, and transference. Training should provide thorough grounding in transference and countertransference, relevant psychodynamic therapy concepts, and management of boundaries and therapeutic touch.