Saturday, December 9, 2023

Touch during Psychedelic Therapy

Another interesting conversation with my wife this morning.  

We were involved in a study of psilocybin together, developing a training program for guides as well as guiding together.  I was also one of the supervising physicians, my wife was the lead guide and trainer.  

My wife also worked with MDMA therapy and is a certified guide, trained under MAPS.  She is also an RN, certified yoga teacher, body work therapist, certified in massage therapy and has trained and practiced Jin Shin Jyutsu energy medicine.  

We both share a long-term interest in complementary and alternative medicine.  

We are both comfortable with therapeutic touch.    

We both strongly believe that there should be no sexual touch within the practice of psychedelic therapy.  

We started out discussing, the risks and benefits of touch during psychedelic therapy.

So, of course, I started to write an outline for levels of how we might work with the body during therapy.  


1) Body Awareness.  

For instance, such as Gendlin focusing:  “It involves holding a specific kind of open, non-judging attention to an internal knowing which is experienced but is not yet in words. Focusing can, among other things, be used to become clear on what one feels or wants, to obtain new insights about one's situation, and to stimulate change or healing of the situation. Focusing is set apart from other methods of inner awareness by three qualities: something called the "felt sense", a quality of engaged accepting attention, and a researched-based technique that facilitates change.”  

https://en.wikipedia.org/wiki/Focusing_(psychotherapy)

We have also been taught and practiced, for me particularly during meditation, directing our consciousness to any areas of which we become particularly aware, perhaps an area that might feel cold or hot, feel pressure, or might be numb or painful.  

Specific body awareness can also be used in various forms of Guided Imagery.  https://en.wikipedia.org/wiki/Guided_imagery

The guide might ask what it might be like if you touched yourself in a certain, nonsexual, area, or asking what it would be like if someone else touched that nonsexual area.  


2) Self-Touch

Spontaneous Self-Touch.  As a guide we can be aware when someone is spontaneously touching a part of their body.  This may give us information about what is going on either consciously or unconsciously.  We may ask about this at the time we notice the touch or save that questioning for later.  

Directed Self-Touch.  Someone might be experiencing distress, and we might intuit that placing their own hand over a nonsexual area, perhaps, their heart or abdomen, may help to focus or clarify their feelings.  

During Holotropic Breathwork we were shown how to take a rolled-up handkerchief or towel and self-hold it at the front of our neck with some light pressure, to help stimulate the arising of unconscious information. 

Then there are also possible self-touch behaviors that might be disturbing.  For instance, how would you act if a person under the influence of psychedelic medicine started to masturbate?  https://www.counseling.org/resources/library/vistas/vistas06_online-only/McCulloch.pdf



3) Touch by the Guide.  

Here we get into more risky behaviors.  Many therapists have been trained to never touch the client.  

We recommend always obtain consent before, and during, the dose day, and always practice any possible touch before the dose day.  

Within concern for risks, this is also a good reason to have 2 guides present during dose day, and, perhaps, to have consent to videotape sessions.  

We have usually practiced grasping hands to forearms.  This is probably the least risky touch.  

Next level might be to practice the guide touching a client’s shoulder, to see if that is comfortable.  

There can be great comfort and healing with hugs, perhaps feeling cuddled or cradled.  However, this is more likely where sexual boundaries can be crossed.  

It can be even more risky when a client asks you to hold a sensitive, but clearly not a sexual, area such as their neck.  

During Holotropic Breathwork we experienced, with consent, someone applying strong pressure to the back or chest, as a form of resisting body work.  You may wish to use a pillow as part of this kind of therapy.  

You may wish to inquire as to how firm a touch is requested?  A firm touch may be grounding, or a feeling that the guide might be pulling them up from the abyss.  A light touch may be just as helpful and healing.  

As a guide, you may want to contemplate what level of touch is comfortable for you.  Not everyone is comfortable with touch.  Perhaps hugging a client is too much for you.  There are other methods, you could keep a teddy bear or a pillow in the room for hugging.  It might be important to explore your own comfort in depth before entering into this field.  


4) Body Work.

There are many forms of so-called “Body Work.”  Some do not involve touch at all, particularly certain forms of energy work.  https://en.wikipedia.org/wiki/Bodywork_(alternative_medicine)

Non-touch formal types of body work might be Hakomi, somatic experiencing, reiki, qigong.  

Light-touch body work might be craniosacral, Alexander, Feldenkrais.   

Stronger-touch body work might be shiatsu, reflexology, Rolfing, chiropractic, massage.  

These are not complete lists of types of body work.  

One would only contemplate using these techniques with formal training.  

Most would likely use these for integration rather than during a session.  

Again, consent is always required.  


My wife brought up an interesting question of what constitutes “consent” when someone is currently under the influence of psychedelic medicine?  

Drugs such as MDMA, as well as classic psychedelics, may promote a feeling of closeness and warmth for others, this may be a risk for crossing sexual boundaries.  

Also, there is often an increase in emotional sensitivities, perhaps the client might feel they would be causing upset if they refused offered touch.  

Drugs such as Ketamine, at certain doses, may have an effect of damping down skin sensations, your body may feel “wooden.”  How would that effect any possible touch by the guide?  


As always, we do not feel we have the last word on any of these subjects.  

We are most interested in starting and promoting ongoing conversations.    

What we would advocate is attention to touch in any psychedelic training program, attending to risks, benefits, ethics.  

And, as always, we would advocate for further research into the possibilities of using touch during psychedelic therapy.



Namaste