For Emmy Manson, it was a leap of faith. Wearing an eye mask and covered by a blanket, the 47-year-old Snuneymuxw First Nation council member lay on her pillow on one of the mats arranged in a circle in a room at the Ladysmith Community Health Centre. She and the other participants next to her listened on headphones to a playlist designed to accompany the drug ketamine, which they had all just been injected with.
It was the first of three journeys with ketamine, an anaesthetic drug known for its dissociative properties, as part of a 12-week psychedelic-assisted therapy pilot program for health directors run by Roots to Thrive, a non-profit health-care practice. For the next 90 minutes, Manson, who at the time was health director for the Snuneymuxw Hulit Lelum health centre, had a transformative experience.
During the journey, which reminded her of spiritual ceremonies she had experienced with her culture, Manson saw ancestors including her late grandmother, whom she was able to thank for loving and taking care of her. Persistent tension in Manson’s body released, leaving her feeling lighter and looser than she had ever been. And she had a newfound feeling of “self-love.”
“It was life changing,” she recalls. “I’ve been searching for peace in my life since I was a young child … and that’s what I got from it. That was the beginning of me kind of saying ‘I am more than my trauma.’”
Roots to Thrive, in partnership with VIU, launched the Naut sa mawt Centre for Psychedelic Research earlier this year. It is the first of its kind in Canada, and is working with universities across the country to advance the field of psychedelic-assisted therapy.
Psychedelic drugs — such as psilocybin, LSD, ayahuasca, MDMA and ketamine — are growing in popularity. Celebrities including Prince Harry and NFL star Aaron Rodgers are promoting their benefits. But there are concerns that this growing popularity could worsen issues around using psychedelics in a way that appropriates Indigenous cultures, which have been using some of these medicines for generations.
Manson is part of efforts by Roots to Thrive to “decolonize” and “democratize” psychedelic-assisted therapy by making it available, in a supportive and authentic way, to her community. That means building relationships with Indigenous communities to learn from them and find ways to adapt those learnings so they are appropriate for a Western medicine setting.
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Psychedelic-assisted therapy has largely been confined to the underground since a backlash in the 1960s led to a wave of prohibitions that stymied research into the therapeutic benefits of psychedelics. That underground is now flourishing to combat a worsening mental health crisis, says Shannon Dames, co-founder of Roots to Thrive and chair of the psychedelic-assisted therapy education and research program at Vancouver Island University.
Growing acceptance of psychedelic-assisted therapy has also resulted in increased support for clinical trials in jurisdictions such as Alberta, Oregon, Colorado and Australia approving therapeutic use of psychedelics such as psilocybin, the main psychoactive ingredient in so-called magic mushrooms. Dames notes there is a lot of promise in the use of psilocybin to help terminally ill people suffering from end-of-life anxiety and stress, and she says a Roots to Thrive study on this is awaiting final ethics board approval.
Ketamine, she explains, is used in many Roots to Thrive programs because, crucially, it is legal for medical use. As well, ketamine dosages can be precisely measured, the experience doesn’t last for multiple hours like many other psychedelics and there aren’t sustainability and cultural appropriation issues as there are with some plant medicines such as ayahuasca and peyote. She adds that ketamine is conducive to group therapy, where people discuss their fears, expectations and experiences — with peers as a key part of the program.
“Ketamine allows people to find out truly who they are,” Dames says. “It’s a very helpful medicine in terms of pulling away the kind of nervous system and the identities that we tend to attach to, and helping people really feel into what remains when those are pulled away, which is the essence of self, and developing a sense of self compassion and self worth and rebuilding relationship with self.”
Dames co-authored a report in January 2022 that looked at the results of ketamine-assisted therapy for healthcare providers suffering from depression, anxiety and post-traumatic stress disorder that previous treatments had not been able to cure. The study found that 91 per cent of participants saw improvements in generalized anxiety, 79 per cent in depression and 86 per cent no longer screened positive for PTSD. Additionally, 92 per cent reported significant improvement in their life and work functionality, she says.
Dames welcomes psychedelic-assisted therapy moving into the mainstream, as there are a lot of “grey areas” and occasional reports of harm occurring in the underground, she says. But while she sees the need for some oversight, she worries that it will be done using a colonial regulatory model that has historically caused much damage to Indigenous communities, and that an emphasis on the biological components of the therapies could come at the expense of the spiritual and energetic components.
Dames says this is why the Naut sa mawt Centre for Psychedelic Research was created.
“There’s really good work going on in the underground, so I don’t think any of us want to squish that,” she says. “It’s more about bringing the field into the light in a good way, without adding so much bureaucracy that the energetic and spiritual components are lost because we’ve gone to this biomedical framework that has huge blind spots in those areas.”
Because VIU doesn’t have a medical school and is not set up to sponsor clinical trials, the centre is collaborating with service delivery organizations and industry to sponsor trials, aiming to keep the research as pure as possible without conflicts of interest with the pharmaceutical industry, Dames says. Island Health is able to review clinical research on behalf of VIU, she adds.
“We don’t necessarily want patents on everything, going down that very capitalistic, transactional way of moving that isn’t super conducive to what we’re trying to move forward in psychedelic therapy.”
She explains the research centre has three prongs — research, education and service delivery — and is set up to be a collaborating hub where the latest research findings or mistakes made by practitioners are rapidly shared among researchers, practitioners and educators. The idea is to “translate knowledge from what we’re seeing in the research and what we’re seeing in service as quickly as we can so that we are educating providers in the field in a way that recognizes the cultural complexities,” Dames says.
Incorporating Indigenous ways of knowing
Going into it, Manson says she had “a lot of hesitation and fear” about doing psychedelic-assisted therapy. She worried the program would bring up more traumas from her childhood, challenge her 16 years of sobriety and make her uncomfortable as the only Indigenous participant. But none of that happened, she says.
Instead, she says the program has been more effective than years of talk therapy, helping her recover from the burnout of doing mental health work in Indigenous communities over the past 24 years. It really helped, she recalls, that on the program’s first weekly Zoom call to prepare for taking ketamine, she was pleasantly surprised when an opening prayer was led by her aunty Geraldine Manson, elder-in-residence at Vancouver Island University who has been involved with Roots to Thrive since 2019.
The use of psychoactive medicines predates colonization, with Indigenous cultures working with them for thousands of years — not just for healing but also for promoting wellness, Dames says. This includes, she says, traditional uses of psychedelic medicines in Europe that were generally the purview of women. But a lot of these practices were lost through colonization and medicines moving into a more patriarchal model, and are only recently starting to reemerge, she says.
According to Dames, it’s important that psychedelic-assisted therapy incorporates Indigenous ways of knowing, where relationships and connections are centred.
“Most of our sickness, most of our mental distress comes from insecurity and disconnection. And most of our paths back to security and connection is through relationships with other humans that we are not paying,” Dames says.
In contrast, in Western medical research, people and connections may be referenced but the knowledge is separated from the knowledge holder, she explains. She says that a lot of people in the West, including herself, are conditioned to look at knowledge outside of relationships.
Risks of cultural appropriation are mitigated when Indigenous knowledge is received in relationship with the people who are sharing the knowledge, and permission is asked for specific uses, Dames explains. She adds that the centre has been working to “actualize reconciliation” by forging authentic connections with local First Nations. This is why many of the centre’s team members have Indigenous roots or have worked in Indigenous communities.
Jimena Chalchi is the intercultural collaboration leader for the Naut sa mawt Psychedelic Research Centre. She is of Indigenous ancestry — Mayan (Mexico) and Asturian (Spain) — and has spent a lot of time in Indigenous communities in Mexico and the Amazon studying traditional uses of psychoactive medicines such as psilocybin, peyote and ayahuasca.
She learned how these communities developed effective ways of administering and supporting people using psychedelics for healing. She also learned how Western research into the Indigenous use of psychedelics has been extractive, causing problems and making it unsafe for Indigenous people to share knowledge. As a result, the new psychedelic research centre is not interested in replicating Indigenous practices or methodologies, Chalchi explains. Rather, the idea is to understand why these elements are used and then figure out how to achieve their purposes in a Western setting.
“We understand the deeper root of why these elements are important, what function [they have] and then we bridge that, the deeper part,” Chalchi says.
For example, some Indigenous cultures use smudging — the burning of plants such as tobacco, cedar or sage — to clean the energy prior to taking a psychoactive substance. Chalchi says that using smudging in a biomedical setting for psychedelic-assisted therapy would be cultural appropriation. But because cleaning energy before a psychedelic journey serves an important purpose, the takeaway should be to consider how to do this in a Western context through things such as massage or detoxification.
She has been working carefully over the past year with Indigenous communities, researchers and practitioners to deconstruct research methodologies and listen to Indigenous needs to develop a framework that allows for cultural safety. The framework was recently completed and will be posted on the centre’s website in the coming weeks, Chalchi says.
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After her first experiences with psychedelic-assisted therapy, Emmy Manson says she discovered that Snuneymuxw midwives used to give psilocybin mushrooms to women during childbirth. She wants psychedelic medicines to be of use for her people once again.
Despite feeling nauseous after her initial ketamine journeys, Emmy Manson went on to do another 12-week program, this time held at the Snuneymuxw Hulit Lelum health centre with all Indigenous participants. She had made an arrangement with Roots to Thrive for reduced rates for Snuneymuxw members.
About 20 people have taken advantage of this, including her father, who is a residential school survivor, and found the experience beneficial, Manson says. She hopes that psychedelic-assisted therapy can be of use for her father’s generation. “I don’t want my people to die without healing,” she says.
“We have to find space where we’re going to do medicines in our own ways and that we work along with nurses and doctors and psychologists or psychiatrists to disperse the medicine but we bring in elders and ceremony and really get on the land,” Manson says. She envisions incorporating ceremonies such as winter bathing, cedar brushing and prayers as long as they are Indigenous-led.
Manson is enrolled in the year-long Psychedelic-Assisted Therapy Graduate Certificate Program at VIU, which started being offered last fall. Manson has done a practicum with Roots to Thrive, assisting people on their journeys. She was initially worried that non-Indigenous participants wouldn’t accept her, but says “it’s been a gift to see each other,” and hopes that she is breaking down stereotypes.
According to Dames, it’s a challenge getting people trained to lead psychedelic-assisted therapy because post-secondary institutions won’t permit their students to take psychedelic drugs as part of their programs. It’s important not only to know how to support people in a non-ordinary state, but also to know what it’s like to receive support when in a non-ordinary state, she says. Otherwise, “it’s akin to guiding somebody on a scuba diving endeavour without ever having been below the waterline themselves,” she says.
She explains that Roots to Thrive is completing plans and fundraising to lead a psilocybin study for people trained in psilocybin-assisted therapy and a MDMA study for people trained in MDMA-assisted therapy, which will allow trainees to legally have an experience with the medicine before they begin using it therapeutically on people. Also, a study on firefighters using ketamine therapy to cope with their PTSD will begin to roll out in September.