Why does it (still) feel like a lot of people don’t really care about addressing the problem of exploitative and abusive therapists in psychedelic therapy?
This post discusses medical misconduct, sexual abuse and suicide. I first discuss the media responses of Sessa’s most high-status friends and collaborators: David Nutt, Robin Carhart-Harris, MAPS, Mind Medicine Australia, Emirya and Michael Pollan. At the very end, I note how they could have responded instead.
Yesterday I read a tweet from Emma Tumilty, a bio-ethics researcher. The tweet made me think about why exactly it feels like the top organizations and figures in psychedelics research are not paying attention to the problem of exploitative power dynamics between practitioners and patients.
As I scrolled through Twitter, I noticed a strange silence from those closest to Sessa. While we were all was reading about Sessa’s deplorable misconduct (the courts words, not mine), it was business as usual for Sessa’s most notable collaborators.
The leading figures in this space are extremely PR savvy and understand how to use power. This is (in part) why they are the leading figures. How these figures have decided to (not) react to the tribunal is not an oversight — this is a strategically curated choice.
Sessa’s assessment of his unethical behaviour is worth looking at closely. After performing the song and dance of accountability, Sessa tells us how he really feels about the misconduct that ended in a patient suiciding: “a tragic blip in my otherwise excellent career.”
David Nutt
On February 29th, the day Sessa formally admitted to all allegations against him, David Nutt shared a picture of himself in Las Vegas signing his new book for a fan.
In his new book, Nutt dedicates 13 sentences to the topic of abuse in psychedelic therapy under the heading “What happens if therapy goes wrong?” The title frames abuse and exploitation of power as something outside anyone’s control — it just goes wrong sometimes 🤪! Here is the full section:
“WHAT HAPPENS IF THERAPY GOES WRONG”
There are rules and boundaries that all therapists and mental health professionals should keep in terms of their relationship with a patient or trial subject. On top of this, it’s recognised that someone who’s taken a mind-altering drug is in a unique state of vulnerability, being more open and/or suggestible. During a MAPS MDMA study in 2014, two therapists acted against MAPS guidelines. They were a husband-and-wife therapy team, working with a patient who had PTSD because of sexual assault. Video of one session shows the two therapists pinning the patient to the bed, cuddling and blindfolding her. At the end of the study, the male therapist continued working with the patient, and later started a relationship with her, including having sex. In 2018, the patient made an allegation of sexual assault.
The fact that the therapists acted unethically and unprofessionally doesn’t make the study results invalid. The fact that it happened, though, does highlight a possible risk with all kinds of psychotherapy: that therapists do sometimes have sex with clients. A recent survey found that seven out of ten therapists have found a client sexually attractive and 3 per cent have had sexual relations with their current or former clients.
It’s important that these transgressions came to light. Both during trial and treatments, psychedelic therapists must be held to the highest ethical standards. At Imperial College we film the therapeutic sessions as part of our safeguarding, in case any patient does make a complaint, or if a patient just needs reassurance that professional boundaries were kept.
Let that sink in.
Nutt starts by stating standard boundaries for relationships with patients. He also says that MDMA and psychedelics render people more vulnerable. It is a reasonable enough start.
Then Nutt describes one instance of abuse: Yensen and Dryer in the MAPS Phase II clinical trial. Nutt states the patient “made an allegation of sexual assault” against the male therapist, Richard Yensen, whom Nutt never names.
Yensen never denied sexual contact with the patient. Instead, he denied a basic principle of medical ethics — that the inherent power dynamics, particularly in this situation, meant that the relationship could never be consensual. In Power Trip, Lily K Ross talks about emails Yensen sent to the patient, directly denying her reality:
“Richard [Yensen]’s response begins, “Dear — — — , you are a powerful storyteller. Your stories are full of strife and abuse. You have been telling them for a long time. I’ve sought to comfort and assist you in dealing with the consequences of telling those stories. Now you’re telling them about me. I do not experience them as related to reality.” The way that he denies her sense of reality as though that’s the thing that’s hurting her, rather than the way that he’s treating her. He says in the same email, quote, “Frankly, I feel enticed, rejected, and condemned. Nothing has ever happened between us that wasn’t fully consensual,” which, like, Richard Yensen has admitted to having a — “sexual relationship” is how he frames it. And, as her therapist, there is no such thing as a consensual sexual relationship. That doesn’t exist. That’s not a thing.”
From Nutt’s account, what happened is never clear. He leaves it simply as “an allegation”. He next goes straight to a very defensive argument. I’m repeating this section because I find it so peculiar to make this argument when, just a few sentences before, he states that MDMA increases vulnerability.
“The fact that the therapists acted unethically and unprofessionally doesn’t make the study results invalid. The fact that it happened, though, does highlight a possible risk with all kinds of psychotherapy: that therapists do sometimes have sex with clients. A recent survey found that seven out of ten therapists have found a client sexually attractive and 3 per cent have had sexual relations with their current or former clients.”.
Nutt cites research that says 3% of therapists have had “sexual relations with their current or former clients”. These stats are degendered. According to an anonymous survey, out of 231 male therapists, 21 (9.09%) had had a sexual relationship with a patient. Among the 524 female therapists who responded, 2 (.38%) had a sexual relationship with a patient.
By de-gendering the statistics, Nutt obfuscates the gendered nature of the exploitation of power. Instead, he tries to normalise therapists having sex with patients. If Nutt went back to his first assertion — that psychedelics/MDMA make patients more vulnerable — then the research he cites demonstrates that we should be particularly vigilant about how men exploit power in the therapeutic relationship.
I would suggest that rather than highlight the risk of abuse in psychotherapy in general, the case Nutt describes highlights how the very uppermost senior, experienced researchers in psychedelics hold extremely dubious ethical standards. We’ve now seen this again with Sessa.
Nutt concludes by saying Imperial College upholds the highest ethical standards and films all their sessions. There is no mention of how exactly they will ensure that footage is reviewed, a major failing in the Phase II trial patient. Throughout, it seems like Nutt is communicating a clear message: he’s not listening to any of the reporting and complaints. His narrative remains unchanged.
Overall, the section reads as though Nutt has yet to engage with any significant reporting and research on this issue. He makes points that are easily refuted and fails to even signpost to this being a larger issue. It’s not just incredibly short, but it suggests that this is isolated and normal.
His final words, refering to filming sessions, “…or if a patient just needs reassurance that professional boundaries were kept”, leaves my eyebrows extra raised. Is this an issue that anyone in a clinical trial has had? Genuinely curious, please let me know if anyone has info on this. As far as I am aware, there have been issues with MAPS trial participants being blocked from accessing their trial footage.
The Guardian had a different take.
Robin Carhart-Harris
On March 1st, 14:24 Mountain Standard Time (21:30 London time), several hours after the full details of Sessa’s misconduct/abuse had been released, Robin Carhart-Harris posted a humourous anecdote(?) about his ego.
There is a theme in this anecdote that I’ve seen before in how RCH responds to critique. Defensiveness. A woman makes a reasonable jest about his gloating and RCH frames it as a “take down”. A .gif illustrates his point. He is the innocent victim of a takedown from an errant dog. Yes, I know this is a joke. But at the core, this is what it says.
To recap, RCH tweeted a joke and an update about a new publication on the same night that appalling details came out on the misconduct of his incredibly close collaborator and fellow top leader in psychedelics. This isn’t a hypercritical look at this tweet. It’s not a “you can’t say anything these days”. RCH is an incredibly influential leader in this field with very close ties to Sessa.
RCH didn’t just say nothing about Sessa, he showed us all that he was online, on twitter, and so completely unbothered by the news that he’s joking about his ego.
*Update 5hrs post original post: I’ve been notified the ego tweet from March 1st is gone*
Beyond tweeting “I could care less”, I’m not sure there’s a more clear way for RCH to say “I could care less”.
Many people are devastated and reeling from the news. Yet it doesn’t seem like RCH is very surprised.
As a final note, two days before the tribunal started, Feb 27th, Psychedelics Today published an episode with RCH fondly discussing how Sessa was the first person Nutt dosed with psilocybin at Imperial. Make of that what you will.
Mind Medicine Australia
Here is what MMA posted on March 1st 2024 while we all learned that the patient Sessa abused, suicided.
Congrats, MMA.
In November 2023, Ben Sessa was in Australia teaching students who paid thousands of dollars to Mind Medicine Australia to learn from him. Students not only gave their money, but their trust to Sessa and Mind Medicine Australia. I was in their second training cohort. The training inherently involves personal vulnerability, openess and trust in the trainers and other students. MMA lost my trust with how they handled allegations against Bourzat in 2021, then MAPS in 2022.
I still receive promo emails from MMA. I have received nothing on Sessa. From what I know, they have done nothing to communicate with past/current students on this either. I see no evidence of any growth in this organisation on how they handle allegations of abuse.
Again, it seems the unified PR strategy is to delay any response (if any is coming). There are some valid reasons to delay responding to the tribunal, though I don’t think overtake the need for a timely response. These people and organisations have a responsibilty to everyone impacted by them telling us to trust Sessa.
It’s really hard for me to fathom how anyone thought it was appropriate to post as though nothing at all out of the ordinary was happening.
I checked their page again, just before posting this on March 2nd at 5pm MST. (The 5th bday posts also time stampe as ‘1d’ — I could not get it to timestamp with the date).
MAPS
Grasping at straws here, I’ll say MAPS had the least terrible post on March 1st. But again, if you were searching for info from an organisation who told us all to trust Sessa for years, you would think that nothing is happening.
Another option would be to post info on psychedelic harm support services/resources. I don’t even think they had to mention Sessa directly: just acknowledge that the reality today is a whole lot of people are impacted by news about Sessa.
Update, March 3, 10:20am MST, 2024: Greg Ferenstein, founder of a psychedelics public affairs firm, just happens to post a glowing endorsement of Doblin for no reason at all.
Emyria
Ben Sessa was appointed scientific advisor of Emyria in August 2023 and partnered on their training in April 2023. All of his videos/talks are still on Emyria’s page, though he’s not listed on their Team page.
Despite their very close ties, Emyria have not said anything about Sessa. That means they avoided being in my post about the dismal responses from Mind Medicine Australia and Awakn. That was my oversight — I just didn’t know about Emyria yet. Luckily, someone who didn’t want to say anything about Sessa because they felt he was being subjected to a “trial by media”, tipped me off inadvertently to this. Thanks for that.
On the day Sessa admitted to all allegations, Emirya posted an episode of the “Equity Mates” podcast with the Emyria CEO for everyone to listen to this weekend. As of the time of posting, this is the last thing on their twitter.
Michael Pollan
Michael Pollan said nothing about Sessa. If you’ve read this far, you know that already.
I like a point made by Psychedelic Candor on Pollan. Like most of the mainstream reporting on psychedelics, there was no mention of therapists exploiting/abusing patients in the several hours-long How to Change Your Mind docuseries.
On March 1st, Pollan tweeted “The Microdose” a weekly round up of news in psychedelics. This week the Microdose featured my article on MDMA couples therapy (thank you kindly for sharing my work). Within my article on couples therapy, is a link to my post on the allegations against Sessa. However, Pollan tweets the Microdose every week. I aknowledge the spurious tie, but there was no secret message to Pollan tweeting this. He said nothing about Sessa or any supports/resources for victim-survivors (or for everyone who trusted him as a teacher).
What could they have done?
I understand there are a lot of legal complexities to speaking about this topic. But one thing every single one of these organisations could have done is to make it abundantly clear to their members/followers/students that they acknowledge this is a real thing that is happening; and that people could have strong feelings that impact them in different ways; that there are supports available; that they are open to hearing if anyone has experienced harm from Sessa or anyone else; and to provide options for where people can report or speak to someone about misconduct or their wellbeing.
Saying nothing is a failure to support victim-survivors and everyone who trusted Sessa in part because they endorsed his work. Talking about those options for people impacted should have started yesterday or before. They absolutely should have had responses prepared for different scenarios if they took this seriously. Timing matters.
For supports specific to harms in psychedelic spaces, see:
Links on Alana Roy’s LinkedIn https://www.linkedin.com/feed/update/urn:li:activity:7169043643184480256/
