There is a missing piece in the psychedelic renaissance, and I keep seeing it everywhere.
We are talking about molecules, access, clinical trials, legislation and treatment protocols. We are asking whether ketamine can relieve depression, whether MDMA-assisted therapy can help people living with PTSD, whether psilocybin should become available through regulated programs, and how quickly we can get promising interventions to veterans and others who have spent far too long suffering.
Those are important questions. Some of the research is genuinely encouraging. In a 2023 randomized Phase 3 trial of 104 people with moderate to severe PTSD, MDMA-assisted therapy produced significantly greater reductions in PTSD symptoms and functional impairment than placebo with the same therapy. By the end of the study, 71.2 percent of participants in the MDMA group no longer met DSM-5 criteria for PTSD, compared with 47.6 percent in the placebo-with-therapy group. Those results deserve attention, alongside the study's limitations and the continuing regulatory debate around MDMA-assisted therapy.
And when someone is in acute distress, I am not interested in making relief wait for a philosophical discussion about the meaning of healing. Get people help. Reduce suffering. Keep people alive. We do not need another name added to the suicide column while we debate the perfect model of care.
But relief and healing are not necessarily the same thing.
That distinction is at the heart of why we are now training facilitators at Plant Medicine University, and why I believe the emerging psychedelic profession has to become much larger than expertise in psychedelic substances. I have been saddened and disappointed to see such a lack of proper philosophy and knowledge about how lasting change works, and so much revolving door activity.
Medicine Requires a Dance
After more than 25 years studying holistic health, traditional knowledge, consciousness, stress and the mind-body relationship — including my doctoral work in Transpersonal Psychology and years of field experience in New Mexico and Colorado — I have come to understand healing as a relationship rather than an event.
Traditional Medicine taught me that long before I had sophisticated language for it.
The human organism is rhythmic. We breathe in cycles. Hearts beat in rhythm. Sleep and waking follow biological patterns. The nervous system continually responds to information from inside and outside the body. We regulate in relationship with other people and with our environment. Our thoughts, emotions, physiology and behavior are not four separate corporations that occasionally exchange emails. They belong to the same living system.
This is where I believe modern psychedelic care can learn something profound from Indigenous and traditional approaches without pretending that ancient traditions and contemporary clinical medicine are interchangeable.
Medicine requires participation. You can be given a substance. Healing asks something from you.
Ayahuasca taught me this particularly clearly. In my experience, you do not simply take the Medicine and wait for it to repair you. You enter a relationship with it, and the capacity of your nervous system profoundly influences what you can encounter, process and eventually integrate. It fundamentally changes you forever, each time. And it is a dance — like weaving a fractal tapestry with quantum consciousness, reweaving your mind and body to better resemble what you came here for. Healing. But never passive. With proper preparation and practice, this comes much easier.
My teacher, Don Patricio Dominguez, was extraordinarily clear about this principle. Over the years I began describing it with a much less mystical metaphor: a road trip cannot exceed the capacity of the vehicle.
The Vehicle Matters
You can know exactly where you want to go and still have a vehicle incapable of making the trip. You can press the accelerator harder, but speed does not repair alignment. You can cover the warning lights, but the engine remains overheated. You can demand another hundred miles from an empty tank, but determination is not fuel.
The same principle matters enormously when we enter altered states.
A psychedelic experience can be physiologically and psychologically demanding. It can bring emotion, memory, fear, insight, grief, beauty and questions of identity or meaning into consciousness with extraordinary intensity. The purpose of preparation is not to guarantee what someone will experience. It is to help develop the capacity to meet experience without unnecessarily overwhelming the system.
That is why I believe your experience is only as useful as your capacity to work with what it brings forward.
This is also why the preparation and integration surrounding psychedelic experiences deserve at least as much attention as the experience itself.
Indigenous Knowledge Does Not Need to Become Museum Glass
I spent years learning from Native elders, medicine people and traditional communities, including seven years of direct study with Patricio. I sat at gatherings of tribal elders associated with the Eagle and Condor traditions. I listened to songs, participated in ceremony, learned oral traditions and asked questions.
At first, they were embarrassingly large and simple questions: What is life for? Why am I here? What is a human being supposed to be doing?
Over time, the questions became more informed. I studied stress, consciousness, mind-body relationships and the nervous system. I watched what happened with retreat participants. I watched what happened with executives, veterans and people who had already received conventional treatment. I began to recognize that some principles I had encountered through traditional teachings could be translated into language accessible to people who would never enter a Native ceremony.
That became part of the foundation of COMPASS Keys.
COMPASS Keys is not an attempt to reproduce Indigenous ceremony for non-Indigenous practitioners. That would miss the point. It is an effort to translate some of the relational wisdom I was taught into a contemporary framework that can coexist with neuroscience, trauma-informed practice, professional ethics and the regulatory systems now emerging around psychedelic care.
The COMPASS Keys, in that sense, are the arms of the Medicine Wheel translated for contemporary life: Mind, Body, Emotion and Purpose.
The traditions remain worthy of respect in their own right. Translation allows some of their underlying wisdom to travel without pretending that everyone using the framework has inherited the traditions from which parts of that wisdom emerged.
Modern Regulation Is Beginning to Recognize the Facilitator Problem
The emerging legal systems are already telling us something important: the person accompanying the experience matters.
Oregon, for example, requires prospective licensed psilocybin facilitators to complete core training, practicum and a comprehensive examination through a qualifying training program before applying for a facilitator license. The state describes facilitators as people who support clients through a non-directive approach and specifically emphasizes client safety, scope of practice and awareness of one's own limitations.
That is an important beginning. But regulation establishes a floor. Education has the opportunity to build upward from it.
At Plant Medicine University, we believe facilitator development must include the terrain surrounding the medicine: nervous-system literacy, preparation, trauma awareness, ethics, boundaries, set and setting, somatic awareness, cultural responsibility, non-directive presence, crisis recognition, integration, community reintegration and, critically, knowing when something is outside your scope and another professional needs to enter the room.
Sometimes the Best Medicine Happens Before the Medicine
Some of my former clients came to me while receiving ketamine treatment because they wanted additional practices they could use themselves. They wanted to understand their bodies better, regulate anxiety and tension, work with breath and rhythm, and develop tools that did not disappear when a treatment session ended.
That experience reinforced something I had been seeing for years.
We underestimate the medicine of practice. Breath. Rhythm. Presence. Movement. Sound. Relationship. Rest. Nature. Community. Repetition. Love.
None is as glamorous as a breakthrough psychedelic experience. That may be precisely why they are so easily overlooked.
Yet these are the practices through which people can learn to recognize and influence their own state. They can be practiced before an altered-state experience, during ordinary life and throughout integration afterward.
At Plant Medicine University, our training therefore includes practices that do not require psychedelic substances at all. We use breath, nervous-system regulation, sound and simulated journey experiences so facilitators can develop their own capacity and learn how altered-state principles operate before they are responsible for supporting somebody else.
I sometimes call it push-ups for the soul.
The Practitioner Is Part of the Medicine
Perhaps the greatest mistake the emerging field could make would be to create beautifully regulated access to powerful substances while underinvesting in the human beings entrusted to accompany them.
The facilitator brings a nervous system into the room too.
They bring assumptions, wounds, ambitions, beliefs and blind spots. They need emotional hygiene. They need boundaries. They need enough self-awareness to recognize when their own material is entering someone else's experience. They need the humility to understand that supporting an experience does not give them ownership of its meaning.
And they need a toolkit.
That is what we are building through Plant Medicine University Facilitator Training: not simply a curriculum to complete, but an immersive professional education practitioners can bring into their own lives, practices, organizations and communities.
There is a tremendous need for competent, good-hearted practitioners from many walks of life. Some will come from healthcare. Others from veteran and first-responder communities, coaching, wellness, education, recovery, traditional practice, somatic disciplines or entirely different professions. The emerging field will be stronger if those people learn both the rigor of contemporary professional practice and the humility that comes from realizing human beings were working with altered states long before anyone invented the phrase 'psychedelic industry.'
"The medicine may open a door. The deeper work is developing the human capacity to walk through it, return, integrate what was found, and live differently afterward."
That is the work we are training facilitators to understand.