Is the Western medical model about to regulate away the very thing that makes psychedelics transformative? In this episode, I share my three burning questions about where psychedelic therapy is headed — and what we might be losing as we scale it.
Here's what I cover:
🩷 Therapist vs. Guide — The real difference between sitting with a clinical therapist and a traditional ceremonial guide, and why it matters more than most people realize.
🩷 The quality of trust — I think the facilitator's ability to hold uncertainty without flinching is what actually does the deep healing in a psychedelic session. Is that something you can learn from a textbook?
🩷 Apprenticeship vs. credentials — Shamanic traditions apprentice their guides for decades. We're fast-tracking facilitators through clinical trials and certifications. Are those the same thing?
I also get into Robert Carhart-Harris's concept of the entropic brain — how psychedelics push the brain's default mode network (the seat of your sense of self) into a high-entropy state that makes transformation possible. And why the conditions that allow that transformation may be incompatible with a tightly regulated medical environment.
This isn't an anti-therapy take. It's a question about what gets lost when we try to make the unpredictable... predictable.
Drop your thoughts in the comments — I genuinely want to know what you think.
📚 REFERENCES
→ Robert Carhart-Harris — Entropic Brain theory
→ Sara Imari Walker — physicist, "humans are small objects but deep in time."
YOUTUBE + TRANSCRIPT:
(00:00) So psychedelics are really having their moment in the sun and this is the result of psychedelic assisted therapy becoming more and more possible in trying to pursue a medical model for using psychedelics. Are we going to regulate away the very thing that makes psychedelics powerful and transformative? So there are three things that I want to talk about in this episode.
(00:21) I want to talk about the difference between a therapist and a guide. I want to talk about the quality of trust in the psychedelic experience and why I think that’s really important for the transformation and I also want to talk about the idea of apprenticing with psychedelics, not getting PhDs, um not doing more western certifications, but this like idea of apprenticing with these substances that alter your state of consciousness.
(00:51) Um, and the reason that I feel really passionate about this at the moment is because as I steer the channel more in the direction of trying to understand what consciousness is, what is the nature of our experience, not our lived experience, like the things that have happened to us, the content of our lives, but like actual experience like what what is it to even why do we have a subjective experience? Anyway, as I sort of steer the channel more in that direction, I have been reaching out to guests to get them on the podcast and try and unpack some of
(01:23) these questions with me. People way smarter than me, neuroscientists, philosophers, physicists, um, authors of of of books about these topics. But what I have found is the people that are most interested and most enthusiastic about talking to me about consciousness are those who work with or around psychedelics.
(01:44) And I think that’s really awesome and interesting. But what comes up a lot in the conversation around psychedelics is this potential or not even potential but this inevitability that we develop a model for using them um as therapeutic tools. When I say the difference between a therapist and a guide, what I think a therapist is is somebody who works with a patient in a one-to-one capacity.
(02:07) Maybe one to two, one to three if it’s family therapy. That’s besides the point, but somebody that works with a patient or a client in a private um consultation whereby there is a lot of talk, a lot of back and forth about um patterns and um uh life events and personal history and together they come up with a way to um navigate the challenges that are a result of these past experiences.
(02:37) Um, and I think therapy obviously goes deeper than just conversation. It it’s sometimes psychoeducation if the patient is ready for it. I think often um, you know, these days in therapy they use all kinds of different um, techniques and tools like EMDR which don’t really like don’t use as much kind of linear conversation.
(02:57) Um, but ultimately it it is kind of um, yeah, talk therapy is a conversation. A guide is so different to that. A guide is um well in in a lot of traditions um particularly in um parts of Central uh and South America and Africa the guides are musicians. Um they are the ones that sit there and hold the container of the energy.
(03:19) They um do blessings to the land, to the east, to the west, to the south, to the north, um to the elements, and and then yeah, during the the the ceremony after the substance is served, there’s just um yeah, everyone’s just kind of sitting there in the energy and doing their own work.
(03:37) And then the the guide is holding that space, offering some like individual support. um certainly not in like a conversation back and forth kind of let’s figure out this model and what happened to you in your childhood. When we bring this into the context of us here in the west um in places like America and um the UK and Australia where I live bringing about a medical model where we can use these psychedelics it starts to look um more like therapists using psychedelics in therapy.
(04:06) And I know that that’s like what it sounds like and that’s what it is. But I just I’m not sure based on personal experience and research that that works. What works for the experience is is this idea of a guide. this idea of someone that can sit there for many hours, not just a 55 minute Medicare rebated session, but for 5 to 6 to 7 hours um in whatever experience is unfolding without needing to fix problems, without needing to um insert themselves um and whilst also knowing uh what the space needs to kind of like shift whatever blockages
(04:44) might come up. Right? So there’s this British neuroscientist that I really like called Robert Carl Hart Harris and he has this idea um of the entropic brain. And so what he’s doing is he’s taking a a principle of physics or thermodynamics entropy um um which is a measure of disorder or uncertainty just to sort of understand what entropy is.
(05:04) is you could have like a deck of cards. Um, and when the cards are new and in order, there’s only one way that they can be. Um, but when you shuffle them, there’s like a million different possible ways in which the deck can um, uh, fall, you know, or the ways in which the deck can be organized, so to speak.
(05:26) And so when you are on psychedelics, there is this increase in entropy in the brain which means that the brain becomes less ordered, less constrained. But in being less ordered and less constrained, it’s more flexible. And therein lies the opportunity to um create transformation and change.
(05:43) When you are in your normal waking life, you have a low entropy brain like it’s stable, predictable, controlled. You have um repetitive patterns. Your your your body is is tightly regulated by your brain. Um, and you’re efficient and you can get done what you need to do. You know, you can have a job and raise a family and stop at the stop lightss and, you know, say hi to your neighbor, right? But when you are in um so and that’s low entropy.
(06:10) So when you’re in high entropy, you’re more flexible. And what happens is you have this default mode network which is the network of um brain regions that become active when you’re thinking about yourself. This is what becomes entropic, right? So the part of your the the region of networks in your brain that are responsible for your sense of self, your um your sense of self across time.
(06:34) So like your life story, um how you have integrated or made meaning from past events and what meaning you place on future events, all of um the default mode network is responsible for all of that. Sometimes it’s referred to as the ego. Um and so psychedelics push this default mode network into this state of entropy where there is a loosened structure.
(06:57) There is more possible connections that can be made and less filtering like less of the the conditioning and the cultural um and and um yeah the cultural narratives and conditioning that make us um feel the way we feel about ourselves and and contribute to us seeing ourselves in a certain way. There’s less of that.
(07:20) Um, and that’s why these psychedelics work so well. It’s kind of like the setting that says, “Don’t go there. Don’t think about this. Don’t do this. Don’t make that connection because right now everything’s working and let’s just keep doing it how we’re doing it.” Um, that setting is switched off. And I’m not entirely sure if anyone knows how that works.
(07:39) Like I’m sure there are there is like a somebody out there who’s way smarter than I am um and knows the neurochemistry of that. Um, and if that’s you, send me an email. will come on the podcast. Um, but yeah, depending on what you believe about the nature of your consciousness, um, again, which is what I’m interested in, depending on what you believe about how your consciousness is connected to something beyond yourself, there is something that happens in the the room.
(08:05) And and that’s I think the piece that the therapists need to get really good at. And what h it’s it’s often really um unpredictable what happens. you know, you can’t program the psychedelic to give you a particular experience um no matter what you try. And really getting used to that energy and like trusting trusting that that uncertainty is actually part of the process.
(08:33) Um and being able to sit with the discomfort of that is is really the important thing um that needs to happen here. And at least like when I have had experiences, you know, in in more traditional style ceremonies using psychedelics, like that’s really what the the facilitators are doing is they’re holding the space and they are in full trust um because they are in full reverence of of what these um medicines can do.
(09:02) Uh but yeah, I just don’t think that that’s something that you learn from a textbook or something that you learn overnight or something that you learn after one LSD trip at a festival. So yeah, I guess like also my question comes down to here around whether or not it is actually that specific quality of trust um in the unknown and ability to sit with the uh uncertainty and discomfort that is what does the really profound healing in a facilitated psychedelic experience.
(09:32) Um, like that’s what creates the transformation. Almost like the the level of trust that the facilitator can demonstrate when holding the container while the people around them are journeying or while the person in front of them is journeying with substances that completely alter your consciousness and not in a way that you can pre-program.
(09:49) that is like learned um it’s passed on uh by it’s like passed on to the other people in the room and it’s it’s like it’s imprinted onto them and then ultimately that’s what they take out into the world because what so many of us struggle with and the reason why so many of us are in therapy is because we don’t trust in life.
(10:13) We don’t trust in uncertainty like fear of the unknown is the cause of of so much of our suffering and the suffering the chronic suffering is what causes these conditions and and when I say chronic I also mean like intergenerational. So again like back to the whole like what is consciousness like is your your you know your individual consciousness somehow connected to the consciousness of your lineage you know and and we know that humans are um small objects like I love this um this this idea and it’s from a physicist that that I love um called Sarah Am Amari
(10:50) Walker and she says that humans are small objects and they are small comparatively to the object objects in the world but they are deep in time. So the amount of selection and time it has taken um for you to be you for you to have survived and manifested as you is profound and and I and you know what travels what travels along that thread like obviously we have epigenetics that um give us an idea of how DNA and biology is passed on and can genes can express in a certain way given the right environment and that can be um
(11:29) replicated across generations. But I don’t know, I just wonder if there’s something a little bit uh more mysterious about that too, like particularly around um these patterns that form in the default mode network about our sense of self um and about um yeah, the meaning that we attribute to things. Uh so anyway, that was a little bit of a tangent.
(11:56) Um but if you’re interested in this stuff, you should definitely look up Sarah Amari Walker. And if you are Sarah Amari Walker, please get in touch with me. I would love to have you on the podcast. Anyway, um, okay. So, when we look at how the Western medical model approaches these medicines, there isn’t this like let’s just do it and we’re all in it together and we’re going to trust the process and see what happens approach. Like, there can’t be.
(12:17) Uh, it’s tightly regulated. It has to be as predictable as possible. Um, and and things has to have to be tested and controlled. and these these tests and experiments have to be um repeatable and and there’s all these guard rails around like what what you can and you can’t do. And I wonder if in creating um that certainty, I don’t know if it will maybe detract from the quality of the or the part of the psychedelic experience that actually does the deep and permanent transformation.
(12:54) a question. Um the other thing too, uh the the final point that I wanted to make is about an apprenticeship versus a you know a a bunch of study like a you know apprenticeship versus a a master’s degree and a PhD or 10 clinical trials and um you know 50 uh peer-reviewed papers published.
(13:16) I think that with the apprenticeship, the the um the person who is serving the psychedelic is is is is in deep relationship with that substance, not um with the idea of that substance or the information that they have about that substance. They are in deep relationship with the experience of being altered on that substance. And that is what um creates this trust.
(13:41) that is what builds the the thing that the quality that holds the container and and facilitates uh change in people. Um and these apprenticeships are like long uh in in other parts of the world where they work with plant medicines like these apprenticeships they’re from when um when shamans are youths they they get selected and then they get taken through um decades of of apprenticeship and training and they get put in positions where they have to um there’s mishaps and there’s mistakes and they have to experience those in order to learn and I
(14:19) think that that is a natural part of the process and I I I am sure that anyone who else who has worked um in depth and long term with psychedelics uh or has like a deep interest in what they feel like and the uh experience that they produce will say that yeah there’s like there’s mishaps like you have that’s an important part of learning about how to dance with altered consciousness is is when things don’t go well and I I don’t think that that is what is being required of um facilitators and in fact I’m sure that there’s many psychedelic
(14:52) facilitators who are offering this this this service and have never had a psychedelic experience. So how are we going to manage this as this type of therapy becomes more accessible and as the medical model scales it? On one hand we know that this is great. more people need access to this and um you know those people that are very vulnerable should not be doing this at home by themselves or at festivals or at parties.
(15:18) They should be doing it in a space where it is safe and um they are being looked after and cared for. And yet when we when we scale the model does that mean that we risk regulating away the very thing that is going to make these journeys super transformative which is what we want out of the psychedelic medicine. So, how do we strike that balance? My question is really just around a like is this being acknowledged? Is this being addressed? And then how um how is it being approached? So, I’d love to hear your thoughts. Let me know in the comments.
(15:52) I’ll see you next week.
