Ali McGhee: Can you tell us a bit about you and your background?
Stephanie Michael Stewart: I am a holistic psychiatrist, and have been totally devoted to psychedelic studies for the last seven years. But I’ve been interested in psychedelics since an embarrassingly young age when I found my first sense of community that was also interested in consciousness.
One of the reasons I became a physician was because I wanted to do deep healing and get at some of the source causes of cultural and ancestral traumas. But some of these deep roots didn’t seem accessible with my Western medical training. Once I found a group of people who were legitimate scientists, therapists, and researchers through MAPS in 2008, it woke up this early calling that I had as a healer. Until then, I hadn’t known any way other than medical school to explore that. Psychiatry felt like the closest Western modality to reach the soul, but after training, I left with more questions than answers.
I did my own exploration through plant medicine healing work, and fortunately, the field blossomed in parallel. There’s so much more awareness, respect, and appreciation, at least for the molecules themselves, and I think there’s real hope that the wisdom that comes with these medicines, from the indigenous teachings and the community settings in which they are used, could transform the medical system.
My work now feels so full circle. For a long time, I felt like I was studying organic chemistry and these nuanced things I wasn’t that interested in in order to get an MD. But this medical model is the way psychedelics are emerging, so it feels convenient that I’m already a psychiatrist. It’s reinvigorated my interest in all of these subjects. I’m geeking out, going back into neuropsychopharmacology and looking at molecular structures. It feels like all of this now has a purpose, if we can properly and legally use these tools.
AM: How did you get interested in psychedelics?
SMS: My mom passed away suddenly and tragically when I was nine years old, but I still felt her presence. She was an identical twin. She and her twin had these uncanny abilities and psychic qualities so I was tuned into her “telepathic ways,” and she was very present with me after her passing.
I also have roots in Blackfoot, Cherokee, and African traditions. Even though I was distanced from those deep cultural roots, the essence still came through. I was living with my grandparents after mom passed, for example, and on Mother’s Day we’d be forced to make cards at school, and I would burn mine. I didn’t know how else to get them to her. My dad was worried about delinquency, but my grandmother said, “She’s sending the smoke. She’s good.”
“I didn’t stumble upon psychedelics. I was always looking for doorways to consciousness.“
Dr. Stephanie Michael Stewart
I didn’t stumble upon psychedelics. I was always looking for doorways to consciousness. I lived in a hippie community in British Columbia at one point, and mushrooms just grew out back of the school. In my first makeshift ceremony with friends, I recognized that the dimension I was accessing, through senses I didn’t normally perceive, was the dimension my mother would come to me on. That place felt familiar and comfortable, and more like a memory than some new territory. It felt like a place of ancestors and allies. I felt a great deal of respect for it and belonging there.
I did go on hiatus from psychedelics when I went to college and medical school. I was trapped in the War on Drugs mentality, that rhetoric of “This is your brain on drugs.” I had no personal safety net. I left home at 15 and put myself through college and medical school, and I knew that my brain was really the only backup plan I had. Those images of an egg in a frying pan were so real. I knew there was so much more to it than I understood, but I also saw that commercial, and went to Spelman College, an HBCU (Historically Black College and University) in the Deep South, and psychedelics were unknown at best and pretty unavailable. So that interest paused until I found MAPS in 2004, during my psychiatric residency.
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AM: When did you found Worldwide Wellness, and what community / health need were you seeking to meet through that?
SMS: I developed Worldwide Wellness in 2010. I was working at L.A. County’s Department of Mental Health in a very marginalized, underserved community – majority Black and brown folks with high rates of trauma and subsequent mental illness. I started a wellness program as an adjunct to the regular mental health department program, to offload the overburdened mental health system.
I helped develop a model of community care that brought patients into contact with some of the resources that already existed in the community, like theatre programs and drama classes, for therapy. This work was informed by asking the patients themselves what they wanted and needed, what was relevant in their communities and their day-to-day lives. That led the charge for what we would do. For example, many said they didn’t have transportation, or they didn’t leave the house other than to come to these appointments.
So we created Urban Explorers. We’d get on a city bus and go for an adventure once a month. Our clinic was located in central Los Angeles, in an area affectionately known as “the Jungle,” just six miles from the Pacific Ocean. One woman in her 60s, born and raised there, had never seen the ocean in her life. There were a lot of complex psychological and social reasons, culminating in feeling like she didn’t belong there. Standing with our bare feet in the sand, witnessing her take it all in, was one of the most beautiful moments of my life. The entire group felt that way.
I began to research the healing effects of nature and found Dr. Ming Kuo’s work. She talked about the healing effects of green spaces. Zoo animals are expensive, and if you just put them in a cage, they’re going to die. So her team studied the natural ecological habitats and found they increased survival rates. Animals and humans need to live in the habitats they evolved in. There’s something in the forests that is really important for our health, and we have effectively put ourselves in cages. They might have granite countertops and stainless steel appliances, but they are, effectively, cages in urban settings.
In another study, they sent people on vacation in either a forest or a nice urban setting. They discovered that natural killer cells stay elevated for 30 days after being in the forest. That’s not the case after an urban getaway weekend. This work is fascinating. Historically maintaining green spaces is expensive, so they get paved over. Crime rates in places with no green spaces are higher. There is all kinds of evidence that is not well known about the mental and physical benefits of being in green spaces. People often unfortunately just think of them as beautiful accessories.
I started taking people on bigger excursions. It was a totally different end of the economic spectrum than at the wellness center. These people could go on therapeutic, global, adventure travel experiences. On the bell curve of happiness, these two extreme ends of the socio-economic spectrum actually have a surprising amount in common.
Travel immersion and movement in nature are medicine. They relocate you from your typical default mode network. Every corner you come around, you operate from pure awareness because it’s not the same path you take every day.
Another important piece was giving back to the communities we would visit. Some of the most profound experiences happened in those little exchanges with people who were so full of joy and had comparatively little compared to these travelers, materially speaking, but they were so connected, and that sense of community and interdependence supported mental health. Integrating all of that with meditation and journaling promoted lasting change in my patients’ lives.
The model was inspired by my own healing journey, my love for travel abroad, and my personal loss, which led to ayahuasca and a vision for healing. Years later, working with UCLA on their Ecological Medicine and Psychedelic Studies Initiative planning committee, I realized that what I was doing was “ecological medicine.” Whether we’re in the plants and/or the plants are in us, it’s medicinal.
AM: How has it been to be a Black woman doing this work, if you identify that way?
SMS: I do identify as a Black woman, and in other ways. But that is the specific way I walk through the world. It’s been very lonely, and my experience has just been so siloed. I have a Black community. I have a medical community. Those two overlap, but lightly. I have a psychedelic community, which historically didn’t really overlap with the others, at least back in the day. I have a queer community. I can be in any one of these spaces, but it hasn’t been until very recently that they have actually really overlapped. Chacruna has been instrumental in that feeling. It’s a homecoming of identities that had been almost completely separate. I couldn’t even dream of the day those could all converge. You’ll find some black physicians, but only 2% of psychiatrists are Black. So now you try to add in a third category or group. How many of them are interested in psychedelics? How many are also queer? It felt very lonely up until recently.
AM: What is the potential of psychedelics to treat racial trauma?
SMS: I think it’s enormous, and it’s just beginning to be studied. I’m so grateful to the people who are doing that work. I think that psychedelics work in a lot of ways by bringing up trauma. And in communities where racial trauma is a daily occurrence, from microaggressions and macroaggressions to communal, ancestral trauma, there are higher rates of PTSD. A lot of that has to be suppressed in order to function, speaking from my own experience. There is an overburdening that happens, and there’s a certain amount of poise that’s required.
If the set and setting are good in psychedelic-assisted therapy, a lot of that is going to come up for a person of color, and a lot of the guards come down. Therapists have to be able to relate to that information in a way that’s helpful. But there is a real inability I’ve seen in therapists to even have conversations about race. I teach about racial bias and have done anti-racist work in therapeutic settings, and I heard from a lot of people – who were great people, but who had lived in “good” neighborhoods, had gone to “good” schools (“good” being synonymous with white) – that many of them hadn’t sat in a room next to a Black person until college or graduate school, or for some, when they had a Black patient for the first time.
So much of the way white supremacy is perpetuated is through this attitude of “We don’t speak of that in polite company.” Speaking about race initially is likely to lead to defensiveness and white fragility. If racial trauma comes up in a psychedelic-assisted therapy session, which inevitably it will, and if that’s foreign or uncomfortable to a therapist, it’s going to be a problem.
“The examination of people’s own biases and the ways racism is real for them, for all of us, even people of color, is essential.”
Dr. Stephanie Michael Stewart
I see antiracist work with therapists being vital. There are some necessary components. Number one is humility, and really caring about people of color. It’s not just showing that you’ve taken some course to be culturally competent. The examination of people’s own biases and the ways racism is real for them, for all of us, even people of color, is essential. It’s in the air we breathe, so taking some of the defensiveness and shame out of it and being able to examine how that shows up for you, and your real willingness to do that work, is crucial.
There is also the potential for healing intergenerational trauma. The roots of racism go so deep, and psychedelics are the only tool I know of to reach that depth and support understanding. Intergenerational trauma isn’t clearly understood in mental healthcare. Psychedelics have the potential to broaden the limited understanding of psychology to include more global Indigenous and spiritual understandings. We would do well to have more humility within academic institutions, and within science as a whole, to be open to learning something new and seemingly impossible, and to take it seriously.
AM: What are the special needs of POC when getting psychedelic therapy? What have you personally learnt about the needs of POC through your own training of becoming a psychedelic therapist?
SMS: There are understandable reasons for the lack of trust in communities of color, generally speaking. The War on Drugs, medical experimentation, psychedelic abuses, etc.
With or without psychedelics, I often worry for the field and for my people. When a person seeking help comes to someone who doesn’t really understand the significance of race, who doesn’t understand systemic racism, they can end up blaming this individual for their problems. Medical training teaches providers to see an individual’s presenting problems as symptoms, but there are layers of systems that create and sustain inequities that show up in a person as symptoms – because how else are they going to show up? It leads to misdiagnosis, mismanagement of medication, and personal rights violations by folks in power who have the ability to lock someone up because of their own lack of understanding. I care passionately about this power differential and its impact on marginalized people.
The quality of the relationship with the therapist given this history is critical. That’s something people of color need to feel trust, a relationship – it’s not assumed that this therapist is representative of a benevolent system that will take care of you. There’s a keen ability to pick up on cues as to whether a therapist really cares, has the capacity to hold a level of complexity, or not, what their blind spots are, any humility or familiarity with the issues we face and why, and their perceptions of people of color. Especially in the context of psychedelic-assisted therapy where there can be more acute awareness as well as more vulnerability and the potential for more harm than good. The ability of all therapists to repair after an inevitable rupture is key.
If racial harm is happening, even amongst the trainees in a psychedelic psychotherapy program who are all credentialed professionals, who have all been accepted into the program, and have all committed time and money to be there – if there’s harm caused to the BIPOC trainees in that space, if they are called threatening, for example, for speaking in a way that is uncomfortable for those with unexamined fragility, I have concerns.
A lot of the work that has been done in the psychedelic field has taken place in academic institutions, and the way most studies are constructed is pretty off-putting and alienating. Some of the language: “investigator,” “investigational drug,” “subject,” and “participant” – I’ve done the MAPS MDMA for PTSD training three times, and it always feels a bit off that they have to identify as an “investigator.” People can’t say they’re therapists because it is “experimental.” The client is a study participant, and they have to use these terms. But thinking about these terms and about the lengthy informed consents, and the time commitment required – there are so many factors working against people of color getting involved. There may be other needs to consider as well, like working and childcare. That’s why so many studies are done on college students on predominantly white campuses. Generally, most have a secure place to live, bills are often paid, they don’t usually have children, and they’re down to make extra money by being in a study. But if most data is based on this population, it’s not exactly applicable to the real world and the medical or psychological complexities of life beyond this privileged group.
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AM: Can you tell me about the psychedelic-assisted therapy training program you’re developing?
SMS: We are working with HBCU medical schools to develop culturally appropriate psychedelic curricula for doctors specializing in psychiatry. We intend to include HBCU psychologist training programs. We’re beginning with Howard University and Charles R. Drew University of Medicine & Science, and then Morehouse School of Medicine (my alma mater), Meharry Medical College, and Xavier Ochsner College of Medicine. My vision is to create a consortium of HBCUs with predominantly Black psychiatrists and patients to coordinate their psychedelic curriculum, training, and research. This education will focus on Indigenous wisdom, reciprocity, and social justice, and will include spirituality. This work begins with community connection and understanding, community building, multidirectional education, and addressing drug and mental health stigma.
There’s so much potential in data from culturally congruent studies, done for BIPOC by BIPOC, to be incorporated for healing in communities of color. It’s important to capture that data in addition to sharing personal stories so information can get out and begin to break down some of the stereotypes that have been deadly since the 1970s, when the War on Drugs started, and through the ‘80s and ‘90s, as well as the subsequent skyrocketing incarceration rates and effects on families torn apart, and the horrible multigenerational impacts of that.
I am hoping to engage community supporters who are already trusted and appropriate for this kind of work, like spiritual centers, chaplains, and churches, as well as other ways of community engagement. I think the model here for communal and relational healing is important, both for witnessing and sharing and for access and cost, so we are keeping those features in mind and also centering the Indigenous wisdom traditions that these medicines come from. There is no reason to extract an active ingredient out of a complex biological system and isolate it in a lab, put it in a capsule, and take it to a sterile office and give this medicine trying to heal an individual. That is so many steps removed from so many layers of healing. And then we say, “We don’t really know how to do this, we’re just winging it,” when there are obviously so many rich cultures who have been learning from and working with these medicines for as long as recorded history. So why are we doing that?
“We really have a worldview that is hierarchical and threatens our entire existence and the existence of every other species on this planet. It’s not just racial superiority we need to undo, it’s human superiority.”
Dr. Stephanie Michael Stewart
People think it’s time to move on from the conversation of racism because they’ve heard enough. We’re watching colonization in action in our beloved field, from some of the most sincere and genuine folks around. If we can’t get it right and listen to the voices of people doing this for thousands of years, why is that? That’s an important question, and it leads right back to unlearning some of our superiority. We really have a worldview that is hierarchical and threatens our entire existence and the existence of every other species on this planet. It’s not just racial superiority we need to undo, it’s human superiority.
AM: Another area of interest you have in women’s health, specifically perinatal and perimenopausal health. How can psychedelics support healing for women in these periods of life?
SMS: I really see these as very important points of a woman’s life. The perinatal and perimenopausal periods are rites of passage. Before childbirth, there is necessary preparation, knowing who you are and what you are capable of. Trusting nature’s capability, and knowing you are nature. There is potential to work with psychedelics in this. Postpartum, there are clear spikes in rates of mental illness where I think psychedelics could be hugely useful. I personally underwent ketamine treatments for postpartum depression, and that was extremely helpful. The journey of labor and delivery is similar to a psychedelic journey in so many ways. That’s something I like to think and talk about.
The preparation for a journey, the intention setting, and the set and setting are important in preparing for childbirth. It’s important that we believe our bodies can do this, that our bodies are designed to handle it. There is a fear instilled and a lack of sharing birth stories and believing in our bodies. I was at a conference and heard doula Latham Thomas [Mamaglow] say, “A woman in a coma can give birth.” That changed my life. Our bodies can do this. It doesn’t really matter what we think; we are capable, and even more powerful than we can know. Preparation is key, for both childbirth and psychedelic journeys.
Set and setting are also crucial in both cases. An animal will only give birth in a setting that’s protected and safe. If exposed to bright lights, disruption, or intruders, labor will stop. In our model of hospital birthing, you’re the star of the show in a brightly lit room filled with strangers. That may naturally stall labor, which leads to pitocin, harder and more prolonged contractions, pain then epidurals, and more C-sections – all these medical interventions often lead to more complications. If the setting were the same as when the baby got in – warm, dark, open, safe, sexy, lubricated, comfortable, unrestrained and unrestricted – that baby will come out much more easily and likely more happily.
The actual journey of childbirth, like a psychedelic journey, is also non-linear. There are phases. An initial onset phase is often slower, with time to adjust. There may be challenging sections: the content that’s coming up, sensations, contractions. There is a peak experience, followed by a resolution and release. The qualities of what happens internally are so similar to a psychedelic journey: the shift to internal focus, the importance of surrender, the soft, shamanic gaze (as opposed to detail-oriented). Your physical gaze gets blurry. The acceptance of what’s coming up for you, the awareness of sensation and pain. Even the language around this is important. Things can start, stop, come, go – it doesn’t necessarily indicate the need for intervention.
There are not many rites of passage and ceremony in our Western culture. Psychedelic journeys can provide that and give us a level of confidence, like, “I’ve been through something, and I know it’s going to be ok. This is doable. It’s safe even though it’s uncomfortable, and I’ll get through this.” And I absolutely believe that can lead to better outcomes in maternal and child morbidity and mortality. What we need to work on is a lot of stigma. “Moms on drugs” is not something a lot of people are celebrating. There’s a lot of work to be done around that.
“During labor and childbirth, the body physically opens to become a channel. This is similar to the emergence of the spiritual experience in psychedelics.”
Dr. Stephanie Michael Stewart
After labor and delivery, integration is crucial. During labor and childbirth, the body physically opens to become a channel. This is similar to the emergence of the spiritual experience in psychedelics. And that literally happens: a spirit emerges from your body. Coming back to a baseline by integrating all of that is really important.
A woman is 20 times more likely postpartum to be psychotic than at any other time in her life. We don’t have a custom of integration for birthing. Birthing can bring up traumas, as can psychedelics. Birth can be traumatizing, so the integration of that and really coming to a place of peace with how your birth went – especially if it didn’t go as planned. Even planning too much can be problematic because it sets up expectations. So, integration for both psychedelics and birth work is key. And what we have been calling postpartum mental illness may be partly due to this spiritual emergence and physical and psychological opening after a legitimate state of altered consciousness that has not been properly closed. We also accept new identities and roles as parents, there is important psychological work to be done to support this huge, magnificent transition.
The perimenopausal period can also be a dramatic shift in identity and role, and there are a lot of physiologic implications that psychedelics can help work through. There is a shift in identity from mothering individual children. Maybe it becomes mothering a community. That grandmotherly role is not celebrated enough, and aging is not celebrated enough in our culture. Psychedelics could really help with that particular aspect as well, in my opinion.
AM: Your bio also mentions you are passionate about gender-affirming care for BIPOC folks – is there an overlap here with the psychedelic-assisted modalities you are using?
SMS: Psychedelics are amazing tools to open into these deeper questions of “Who am I?” Your felt location on the gender spectrum is such an important part of who someone is. How that shifts over a lifetime, how one presents and is received in the world, is important to be in tune with. There is so much marginalization. People can be completely left out my the majority, their needs – and even existence – bringing marginalized groups into focus in psychedelic training for therapists is important if we are to serve everyone, not just the privileged.
Everything I said about BIPOC people as far as training goes here too – humility, education, legitimate care and compassion for all marginalized people. Education is key. Getting language right so you’re not causing harm is crucial. I know there’s a lot of trauma and a lot of hurt and rejection within these communities. I believe in the communal aspect of psychedelic healing. The potential for communal care is one thing, but I’m also talking about the structure of community healing with psychedelics for queer folks. Especially for people with intersecting identities, there is so much need for really making people feel like they’re cared for and cared about, because the medical system is not doing that well.
AM: What is going right in the space of psychedelic healing, especially for people of color? How would you like to see the field evolve?
SMS: There is an awful lot going right. I’m hopeful because I have felt some of these things I’m mentioning begin to shift. There is a new sense of belonging within the community of psychedelic healers. Just getting together at conferences creates community connections, because we’re on the same page.
There’s still work to be done in accepting people of marginalized identities into predominantly white academic institutions and programs. Just because you’re valuing those identities in the selection process, for example, doesn’t mean you’re also creating a safe space for these folks once they get there.
“There’s still work to be done in accepting people of marginalized identities into predominantly white academic institutions and programs. Just because you’re valuing those identities in the selection process, for example, doesn’t mean you’re also creating a safe space for these folks once they get there.”
Dr. Stephanie Michael Stewart
On the training side and the client side, there’s work to be done, but it’s great that people are even talking about things and making mistakes and doing the best that they can to learn about repairing these mistakes. These conversations are happening in the psychedelic circles I exist in. I realize there are still a lot of problems, stigma, and misunderstanding due to the detrimental effects that our structures, systems, and societies have on people, but I am hopeful that psychedelic science and psychedelic global worldviews are being taken more seriously and can help with some of these issues that are really difficult to treat with medications and therapy alone.
AM: Are you working on any publications/scholarship, projects/studies or public appearances now that you’d like to share about?
SMS: The one I’m most excited about is joining Chacruna’s Racial Equity and Access Committee and joining their Board of Directors. That is a true honor. I sit with people whose work I’ve been studying for years and want to do all I can to contribute. The values are so aligned. Ensuring access for marginalized people, making sure Indigenous wisdom and voices are respected, centered, and highlighted, and working to ensure that there are meaningful roles in this so-called psychedelic renaissance – that this wisdom is not being forgotten and the people who have this wisdom are not forgotten.
This year, in March, I participated in a gathering and interactive public dialogue, Cafe Scientifique, with leading researchers in Canada on equity and access. I also spoke at the Psychedelic Culture conference in April on a panel about Queering Psychedelics.
In May at UCLA, I participated in an interdisciplinary symposium on Ecological Medicine and Psychedelic medicine. I’m leading the portion on community locatedness, and what I think of as “place-based wisdom.” I like it because we’re talking about community on many different levels – place-based wisdom, the healing implications of belonging and being in community, the practical aspect of how one can integrate community systems like we did at the wellness center to embellish and support mental healthcare.
In July, I’ll participate in the Canadian Psychedelic Summit. The summit will discuss social justice and its cultural impact, reciprocity and respect, accountability and repair, and the potential of psychedelics for healing, well-being, and growth. My work is done across the border in both Canada and the United States, mostly in California.
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