Adopting a creative engagement stance can build a generative bridge between regulatory mandates and liberation-centered psychedelic care.
For anyone who knows me, even just a little, it’s pretty clear that I’m here for the good times. I mean, don’t get me wrong, there’s a foundational layer that is seriously committed to collective care and freedom for all, I just tend to gravitate towards the paths to liberation that are paved with glitter. Joy is the nectar of my soul, and cultivating enthusiasm for life has gotten me through unimaginable situations, so I’m sticking with it.
After almost 15 years of practicing psychotherapy in private practice and doing my damnedest to overcome the challenges within the profession, my career trajectory took a sharp turn towards psychedelic care.
I’m now fully immersed in a field that has been re-energizing and exhausting, seductive and heart shattering, unifying and divisive. The psychedelic space has a pattern of engulfing and repelling, but in spite of it all, here I am.
Earning a living while striving to remain authentic is an important part of my integrity practice, whether I am holding space for clients, teaching, consulting, or making art. I do not recommend this strategy if you aren’t ready to have many doors slammed in your face, both literally and figuratively, but mostly literally.
In my case, authentic expression stems directly from my diverse cultural, spiritual, and artistic upbringing, which leads me to question oppressive standards and explore novel, amplified paths. In my approach to psychedelic assisted therapy, creativity drives the work, as I have found it to be a MAJOR ally towards individualized care for the historically marginalized communities I serve.
In examining the role of creative interventions within state-regulated psychedelic therapy settings, this commentary highlights the potential for clients to reclaim their personal narratives and experience a sustained sense of empowerment post-journey.
Developing and sustaining regulated initiatives requires a strong emphasis on structure, ensuring clear boundaries and accountability systems to prioritize ethical care and safety for everyone involved.
While it’s true that the regulated arena has strong Saturnian qualities—emphasizing order and discipline—it’s also important to note that psychedelic facilitators have an opportunity to infuse their practices with a more Neptunian approach, fostering creativity, choice, and connection.
Further, acts of resistance by therapists and facilitators (particularly those holding Indigenous, black, brown, queer, disabled and/or displaced identities) whose anti-oppressive practices are inherently creative and must be uplifted as examples of transformative care.
“…resisting and challenging the mental health industrial complex is rife with complexity when there is so much we need that we don’t yet have.”
Dr. Jennifer Mullan
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Defining Creative Engagement and Defying Colonized Bureaucracy
After reflecting on the various contexts in which psychedelic experiences unfold, and focusing specifically on the newly introduced state regulated programs in Oregon and Colorado, I found that the concept of creative engagement emerged as particularly salient.
Psychedelic Creative Engagement pertains to the ways in which we fully embody the multiplicities within our expressive repertoire in order to amplify the possibilities of altered state experiences.
Many of us who hold liberation centered healing as an anchor for our work with clients are planning to formalize our participation with state regulatory models as licensed providers. This highlights the need for us to be proactive about identifying the ways in which government sanctioned psychedelic initiatives perpetuate features of colonized care.
If we aren’t careful, regulated environments could drain the well of creative potential with pages and pages of safety assessments, intake forms, signature requests, waivers, and more.
When thinking of clinicians like myself becoming trapped in a sea of paper stacks and verbal processing, I am not only horrified, but feel, most importantly, compelled to invite others into dialogue. Mainly, I feel strongly about aligning our offerings to the generative spirit of the medicines we collaborate with.
Adopting creative, affirming, slower, and intuitive approaches to shaping our practices could counteract flat, dismissive, fast, and rigid systemic tendencies. The ideal anti-oppressive framework offers ample space and flexibility for clients to move towards repair. Most importantly, experiencing an anti-oppressive approach within the therapeutic space can amplify and sustain long term empowerment.
In my experience, when clients are invited to explore a fuller range within their expressive potential, from the outset of their relationship with a psychedelic facilitator until its closure, the entire process tends to unfold more smoothly.
Please know that making the case for creative engagement does not by any means absolve a practitioners’ obligation to uphold presence, trust, safety, consistency, and predictability as key features of their care work. Creativity approaches do not equate to chaotic experiences.
The Role of Expressive Arts Therapy
If you are a potential client reading this piece, please remember that our liberatory approaches should never make you feel inadequate, not woke enough, not open-minded enough, or any of that nonsense. Trust yourself and speak your whole truth if something doesn’t feel right.
Exploring the broad applicability of the Expressive Arts as a suitable conduit for preparation and integration processes is a collaborative process between the client and the care provider. As defined by the International Expressive Arts Therapy Association, “the expressive arts combine the visual arts, movement, drama, music, writing and other creative processes to foster deep personal growth and community development.”
In Handbook of Expressive Arts Therapy, psychologist and expressive arts therapist Cathy Malchiodi argues that the integrative nature of expressive arts therapies makes them highly effective for promoting positive change in individuals, groups, and communities, especially when compared to traditional talk therapy. Malchiodi also notes that people tend to prefer self-expression as a healing method when given the choice—I know I do!!
The book highlights the long-standing use of rituals and intentional practices for self-regulation and meaning-making. This concept is vital to our decolonization of care efforts, as we work to reclaim ancestral healing traditions that have been disregarded and replaced by medicalized systems.
In the article Troubling Care: Commentary from the Journal of Arts in Psychotherapy, Karen Estrella highlights how our theory, training, research, and practice are intertwined with systems that, despite promoting “care,” are often inequitable, harmful, and violent.
“We are called to live in contradiction, in multiplicity, to hold ambivalences and to not rush to simplification, to see ourselves and those with whom we work from an intersectional lens that recognizes the many identities and contexts in which we live.”
Karen Estrella
Based on the notion of multiplicity, I’d like to uplift the work of the originators of the Expressive Therapies Continuum, or ETC , Sandra Kagin (Graves) and Vija Lusebrink. The authors propose that human information processing can be understood through a continuum of levels, each contributing to how we engage with and express ourselves in the world:
- At the kinesthetic/sensory level, actions like drumming, stomping, clapping, and dancing, represent movement and physical engagement, while activities such as cooking, eating, and foraging involve all sensory mechanisms.
- Moving up to the perceptual/affective level, creative expressions like clay modeling, sculpture, choreography, and mandalas focus on form and structure, while emotionally evocative mediums such as watercolor painting, singing, and chanting tap into feelings and affect.
- The cognitive/symbolic level involves more representational and some abstract processes: talking, writing, and role-playing help us process information through narrative. Forms like poetry, collage, and altars rely on metaphor and symbolism.
I invite psychedelic practitioners to study ETC and examine it alongside required state mandated procedures (assessments, disclosures, informed consent, intention setting, policies, integration, etc.), reimagining each interaction as having potential for creative expression.
Discover the Indigenous Reciprocity Initiative of the Americas
Expressive Arts Therapy in Action: Touch and Consent
According to Oregon Health Authority (OHA), licensed psilocybin facilitators in Oregon are required to obtain consent before the use of supportive touch during the administration session. Each participant is asked to outline their preferences regarding receiving touch from the facilitator, support staff, or other clients in a group setting. The touch options are: hugs, placing hands on hands, placing hands on feet, placing hands on shoulders, or not touching at all. This particular facet of the preparation process requires care and attention and should not be reduced to a three-question multiple choice document.
Emma Knighton’s essay “Liberating Consent” provides a substantive protocol for understanding touch, power, embodiment, and trauma in psychedelic therapy. They introduce a checklist for creating a consent plan, starting with assessing the client’s relationship to “yes” and “no,” and exploring both the client’s and therapist’s “hard” and “soft” boundaries.
Psychedelic Creative Engagement can be supportive in preparation and integration stages as it offers us a more holistic way of participating in the process. In the case of consent for instance, practitioners can honor the robust wisdom offered to us by authors like Emma Knighton while introducing choice in a dynamic and empowering manner.
The author highlights symbolic pillars that could effectively convey a client’s touch boundaries. Illustrated here are a couple of options for working with the traffic light system (green for go ahead, yellow for proceed with caution, red for no way!) and a couple of additional avenues to explore consent.
As a reminder, the touch options are strictly contained within the following group: hugs, placing hands on hands, placing hands on feet, placing hands on shoulders, or not touching at all.
- The touch options could be added to a circle drawing (like a blank pie chart split in five slices). The practitioner then asks the client to color or paint each section according to their choice (red, yellow, or green).
- A variation of option 1: The touch options are labeled on small jars or placed near small bowls, as the client fills the containers with beads or tinted water with the color corresponding to their preferences.
- For musically inclined clients: The practitioner presents the clients with various musical instrument choices. The client selects an instrument and comes up with a beat, rhythm, or pattern to express their preferences around touch: this could be done by tapping, clapping, beating on a drum, shaking a rattle, etc.
- Writing exercise: The client could write a short poem using rhyme or figurative language, here’s an example:
Hands on hands, a quiet plea
A grounding touch, feet held firmly
As for an embrace, I might need my space.
The above examples offer only a taste on how facilitators could apply creative engagement approaches to their practices, while still meeting state regulatory mandates.
Why Choose Creative Engagement?
Psychedelic practitioners may choose to introduce creative engagement in their offerings for a number of reasons, including:
- To help clients communicate internal challenges/insights (pre and post journeys) without relying exclusively on verbal disclosure.
- To create a space of affirmation of a client’s own resources and wisdom, and how they can be incorporated into their psychedelic work.
- To facilitate rapport building between the client and the practitioner.
- To deepen the relationship to and understanding of the medicine (pre and post-consumption).
- To tap into the flow of integration and its potential for catalyzing change and empowerment far beyond the day of administration.
My hope is that psychedelic practitioners like myself will show up to this new regulatory space in ways that reject the mechanics of one size fits all, prescriptive, sterile, and hurried healing systems.
Perhaps this state mandate moment in time is comparable to the 6-72 hours post journey, the height of systemic neuroplasticity, the sweet spot where historically oppressive structures are most malleable to integrate decolonized approaches, leading to lasting change and furthering collective transformation.
Our willingness to enter the matrix with a creative engagement lens places us in the position to become the systems’ catalysts AND liberators. May we continue to find ways to stay connected to our own generative potential, and may we be inspired by the creative forces all around us.
Feature Art by Alessandra Santos Pye. “Parts of Purpose” Integration, Watercolor and Ink.
References
Estrella, K. (2022). Commentary: Troubling care. The Arts in Psychotherapy, 80, 101946. https://doi.org/10.1016/j.aip.2022.101946
Feng, R., Ching, T. H., Bartlett, A. C., La Torre, J. T., & Williams, M. T. (2023). Healing words: Effects of psychoeducation on likelihood to seek and refer psychedelic-assisted psychotherapy among BIPOC individuals. Journal of Psychoactive Drugs, 56(5), 603–615. https://doi.org/10.1080/02791072.2023.2253535
Girn, M., Mills, C., Roseman, L., Carhart-Harris, R. L., & Christoff, K. (2020). Updating the dynamic framework of thought: Creativity and psychedelics. NeuroImage, 213, 116726. https://doi.org/10.1016/j.neuroimage.2020.116726
Healing Advocacy Fund. (n.d.). https://healingadvocacyfund.org
Herman, J. L. (2015). Trauma and recovery: The aftermath of violence – from domestic abuse to political terror. Basic Books.
Hinz, L. D. (2020). Expressive therapies continuum: A framework for using art in therapy. Routledge.
Knighton, E. (n.d.). Liberating Consent: A Kink-Informed Exploration of Consent in Psychedelic-Assisted Therapy. In Integral Psychedelic Therapy (1st ed.). essay, Routledge.
Malchiodi, C. A. (2023). Handbook of Expressive Arts therapy. The Guilford Press.
Marks, M., Brendel, R. W., Shachar, C., & Cohen, I. G. (2024). Essentials of informed consent to psychedelic medicine. JAMA Psychiatry, 81(6), 611. https://doi.org/10.1001/jamapsychiatry.2024.0184
Mullan, J. (2023). Decolonizing therapy: Oppression, historical trauma, and politicizing your practice. W. W. Norton.
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