Presence, Trust, and Empathy: Preferred Characteristics of Psychedelic Carers

People who use psychedelics outside of clinical settings value three key characteristics in their carers: presence, trust, and empathy. Analysis of 403 online forum posts showed that these preferences align with existing guidelines for psychedelic-assisted psychotherapy, but also extend them—particularly the ability to “hold space” during the psychedelic experience, which users saw as crucial for positive outcomes. The findings suggest that practice-based evidence from nonclinical contexts can help refine treatment guidelines and point to areas needing more research.

Study at a glance

Abstract

Research into psychedelic-assisted psychotherapy (PAP) is rapidly increasing with best practice guidelines being continuously updated. Yet the key principals of such guidelines are based on evidence accumulated during earlier research into these treatments and trans-disciplinary psychotherapeutic knowledge. One area of practice-based evidence that has not been considered is that accumulated by people who use psychedelics (PWUP) outside of clinical contexts. We conducted a thematic analysis of 403 posts on two online discussion forums with the aim of gathering information regarding the preferences of PWUP for characteristics they value in their carers in nonclinical contexts. We found three key distinct characteristics that PWUP preferred among their carers: presence, trust, and empathy. The characteristics were often consistent with the existing literature on PAP, though at times extended current understandings of key characteristics of PAP therapists, with the notion of carers being able to “hold space” during the psychedelic experience seen as an integral component of effective therapeutic outcomes that deserves more attention. Data obtained from PWUP in nonclinical contexts can be used to triangulate existing principles contained within PAP treatment guidelines and identify areas for further investigation.