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Cosmology of belonging: The role of community in the therapeutic use of psychedelics

Published online by Cambridge University Press:  21 January 2025

Caroline Dorsen*
Affiliation:
Rutgers School of Nursing, Newark, NJ, USA
Lola Noero
Affiliation:
Psychotherapist, New York, NY, USA
Michelle Knapp
Affiliation:
Psychiatric Nurse Practitioner, New York, NY, USA
Kristin Arden
Affiliation:
Lead Clinician, Mindbloom, New York, NY, USA
William E Rosa
Affiliation:
Assistant Attending Behavioral Scientist, Memorial Sloan Kettering Cancer Center, New York, NY, USA
*
Corresponding author: Caroline Dorsen; Email: caroline.dorsen@rutgers.edu
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Abstract

Background

The recent wave of clinical trials of psychedelic substances among patients with life-limiting illness has largely focused on individual healing. This most often translates to a single patient receiving an intervention with researchers guiding them. As social isolation and lack of connection are major drivers of current mental health crises and group work is expected to be an important aspect of psychedelic assisted psychotherapy, it is essential that we understand the role of community in psychedelic healing.

Objectives

To explore how psychedelic guides in the United States discuss the role of “community” in naturalistic psychedelic groups.

Methods

This is a secondary qualitative data study of data from a larger modified ethnographic study of psychedelic plant medicine use in the US. Fifteen facilitators of naturalistic psychedelic groups were recruited via snowball sampling. Content analysis was used to identify themes.

Results

Participants viewed the concept of community as essential to every aspect of psychedelic work, from the motivation to use psychedelics, to the psychedelic dosing experience and the integration of lessons learned during psychedelic experiences into everyday life. Themes and subthemes were identified. Theme 1: The arc of healing through community (Subthemes: Community as intention, the group psychedelic journey experience, community and integration); Theme 2: Naturally occurring psychedelic communities as group therapy (Subthemes [as described in Table 2]: Belonging, authenticity, corrective experience, trust, touch).

Significance

Results suggest that existing knowledge about therapeutic group processes may be helpful in structuring and optimizing group psychedelic work. More research is needed on how to leverage the benefit of community connection in the therapeutic psychedelic context, including size and composition of groups, selection and dosing of psychedelic substances in group settings, facilitator training, and role of community integration. Psychedelic groups may provide benefits that individual work does not support.

Information

Type
Original Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press.
Figure 0

Table 1. Yalom therapeutic forces in group therapy (Yalom and Leszcz 2020)

Figure 1

Table 2. Subthemes, exemplar quotes, and corresponding group talk therapy concepts

Figure 2

Table 3. Implications for future palliative care and psychedelic-assisted therapy research