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Social Media Attacks and Ethical Issues in the Psychedelic Sector – Why can’t we all get on together for the greater good? By Peter Hunt AM

An Open Letter from our Chairman, Peter Hunt AM

 

Tania and I started Mind Medicine Australia three years ago because we wanted to help people who are suffering from mental illness, particularly treatment resistant mental illness. Australia’s mental health statistics are terrible and the level of suffering has become significantly worse during the covid pandemic. Many people who suffer from mental illness have received multiple treatments that have failed often combined with debilitating side effects.

Our mission has always been to expand the treatment options available to practitioners and their patients to reduce the immense suffering in this country.

We chose to work with psychedelic-assisted therapies because the overseas trial results have been so strong. These therapies are curative rather than palliative and the remission rates in overseas trials have been simply stunning. They are also safe and non-addictive when used in appropriate clinical settings by trained practitioners.

We gave ourselves the huge task of developing the ecosystem in this country so that these therapies could become part of our medical system as quickly as possible, and available and affordable to all Australians that could benefit from them.

Over the last three years we have:

Along the way we have met so many outstanding medical and health practitioners and researchers who give of themselves tirelessly every day. They are caring and inspiring people who desperately want to help patients who are suffering from debilitating mental illnesses.

We’ve also met many of the patients. Some of them have received these therapies overseas or though the underground and tell us how much they have been healed from their long-term mental illnesses. Sadly, there are so many more people suffering from long term depression and trauma who reach out to us daily, and tell us about the multiple failed treatments that they have received. They are desperate to be given the opportunity to legally access these therapies. These people just want to be given a chance to lead healthy, happy and meaningful lives.

However, it is with great sadness that I have to say that we have also experienced the dark side of all of this.

There is a small group of people from the psychedelic community that feel threatened by our drive for change. They seem to want things to remain largely the same, with incremental progress subject to ongoing, expensive and time-consuming small research trials which replicate larger trials completed overseas. This group is led by a tiny group of psychologists and young researchers. They operate by making nasty social media attacks on our organisation and highly personal and defamatory attacks on Tania and myself. They send anonymous defamatory and vindictive letters to our advisors and stakeholders. They are too cowardly to speak directly to us or identify themselves on their social media posts. They generally hide behind fake identities or don’t provide any name at all.

Their accusations come under the following headings:

(1) Tania and I are evil capitalists and Mind Medicine Australia is a front for us to make money out of the system. They completely ignore the fact that as a registered charity Mind Medicine Australia’s accounts are audited by external auditors, that we are large funders of its work and that Tania and I work full time for the charity as volunteers and receive zero payment for all the work that we do. They don’t seem to understand that we are simply driven by compassion and a desire to help others.

(2) They attack the quality of the educational courses that we run and don’t appear to realise that the teaching Faculty is led by leading clinicians and educators and includes industry leaders from around the World. Our certificate course was described by Professor David Nutt (one of the leading researchers in this field globally) as the best course of its kind in the World.

(3) They attack the pace of change that we are driving and seem to want people suffering from debilitating mental illnesses to be patient and simply wait until they believe it is time for these therapies to ‘emerge’.

(4) They argue that we don’t believe that research is important and choose to ignore the fact that we are actually funding research trials, have many researchers on our advisory panel and made representations to the Government that led to $15 million of grant funding becoming available for psychedelic research. They do not appear to understand that ongoing research is completely consistent with the use of unregistered medicines in a controlled way on compassionate grounds when circumstances are appropriate, and that this is a normal part of our medical system.

(5) They attack our work environment and ignore the fact that we have an incredible team, some of whom have been with us almost from the start. They point to staff turnover but do not understand that turnover is normal with any organisation especially in its early stages. Sometimes staff members also have to be encouraged to leave because they are disruptive to the culture and/or poor performers. These people have never started or run an entrepreneurial organisation focused on driving change and seem to have no idea of the pressures and work involved.

(6) They justify hiding their identity with the assertion that we would legally attack them if they publicly identified themselves, but ignore the fact that we would have no basis for a legal challenge if their public statements weren’t defamatory and they weren’t engaged in harassment, victimization and bullying.

They particularly attack my wife Tania, an incredibly talented and caring human being who has started three charities to help the disadvantaged and alleviate suffering. Tania works tirelessly to help people, She is deeply compassionate and caring and works as a volunteer for no financial return. Perhaps they find this concept of unpaid service to others challenging and are daunted by her drive and determination to have impact. But that is no excuse. Attacking and trolling any person vindictively on or offline, and particularly a woman, should be unacceptable to all of us. It’s even worse when the perpetrators work in the mental health sector and therefore understand the mental damage that this sort of conduct can cause.

These personal attacks also send a message to the regulators that we are a community divided by pettiness and that we are incapable of coherent and professional discussion of differences. This choice of behaviour is simply self-destructive.

There is a lot of hypocrisy in these people. We know that they are all regular users of the medicines and, indeed, some of them serve the medicines to others. However, they seem to think that it is their right to prevent people suffering from mental illness from accessing these therapies through the medical system until they themselves are ready for this to happen.

They suffer from cowardice and a sense of entitlement. We know who these people are and we have reached out to them on multiple occasions to try to build understanding. These people hold professional qualifications and by their conduct are derogating their professional duties and violating their ethical obligations. Instead, these people keep attacking us and hiding their identity when they send their anonymous letters to third parties and make horrible social media comments.

I am writing this note simply because I want to make you all aware of the unnecessary challenges that we constantly have from a small group of spiteful, selfish and rather sad people. I also want to emphasise that these people will not divert us from our goal of making these therapies accessible to all Australians who need them through our medical system.

What is often referred to as the ‘psychedelic community’ is a broad group of diverse people with many different agendas. Most of the community are decent and caring people who want to see all those who are suffering from relevant classes of mental illness being given the opportunity of accessing these incredible treatments through our medical system. However, the darkness of the small faction that is attacking us needs to be dealt with.

I would therefore ask all of you who know who these people are to insist that they behave decently and in a caring and respectful way. Ask them to consider the importance of the work that we are doing and to consider the implications before posting small-minded and defamatory material. Please ask them to behave as professionals and bring concerns into the clear and open air where we can assess differences and hopefully come to some form of understanding.

It’s fine to have different opinions on how to progress this incredibly important work provided that the discourse is respectful and inquiring. Disagreeing on something can be a feature of a healthy and mature mind if a person remains thoughtful and curious. We welcome anyone with issues with our work to reach out so that we can address them collaboratively.

We should all be working together for the greater good.

Peter Hunt AM

B.Com, LL.B

As an investment banker Peter Hunt AM advised local and multi-national companies and governments in Australia for nearly 35 years.  He co-founded and was Executive Chairman of one of Australia’s leading investment banking advisory firms, Caliburn Partnership (now called Greenhill Australia) and continued as Chairman of the Firm after its sale to Greenhill Inc in 2009. Peter was a member of the Advisory Panel of ASIC and chaired the Vincent Fairfax Family Office.

Peter is an active philanthropist involved in funding, developing and scaling social sector organisations which seek to create a better and fairer world.  He is Chairman of Mind Medicine Australia which he established with his wife, Tania de Jong, in 2018. He founded Women’s Community Shelter in 2011 and remains on the Board. He was previously Chairman of So They Can, Grameen Australia and Grameen Australia Philippines. Peter is a Director of Project Rozana and an Advisory Board member of the Monash Sustainable Development Institute. Peter also acts as a pro bono adviser to Creativity Australia. 

Peter was made a member of the General Division of the Order of Australia in the Queen’s Birthday Honours List in 2010 for services to the philanthropic sector.

The Ethics and Importance of the Role of Therapists in Working in Non-Ordinary States By Dr Traill Dowie and Nigel Denning

Psychedelics

We would like to say something about the ethics and importance of the role of therapists in working in non-ordinary states. Nigel has personally worked in this space for 35 years in various forms including many decades in Holotropic Breathwork. We are often working with patients or clients who carry with them deep personal trauma.

This trauma can manifest in many ways and can express in completely unexpected symptoms. In working with many survivors of complex trauma, including ritual abuse, clergy abuse, intra family abuse, cult abuse, warfare, and other crimes, it is so important that we as therapists and the staff that support therapists, keep a willing and open mind to people’s suffering.

The average report time from first crime to first report for survivors of Institutional sexual abuse, for instance, is 33 years. Often this abuse has been ignored or actively repressed. It is incumbent on us all to hold the importance of the voice of survivors and to give them our belief and support.

Working with non-ordinary states and medicines can raise many deeply buried issues and traumatic experiences can manifest from many different sources, some from biographical memories, others from other symbolic processes. Projection onto therapists in this space during and immediately after sessions is not uncommon. This is one reason why, consistent with world best practice, we recommend 2 therapists always be present during trial and special access sessions, and, when rescheduling occurs, therapy sessions.

It is important that we are making ourselves and our clients safe and maintaining the most ethical and clear containers to allow this work to unfold as we develop greater clinical knowledge and skill.

Therapists who do transgress boundaries and behave in an unethical manner should be appropriately managed under legal and professional codes. Therefore, it is important that anyone working in this field be registered in a professional governance system such as AHPRA or PACFA.

Transgressions against patients in this field, like all others, should not be tolerated or accepted. The only way to create healing is to build trust and safety for all. Working together, openly supporting ethical behaviour and outing all forms of abuse and those who collude with it, it imperative.

Warm regards,

Nigel Denning & Dr. Tra-ill Dowie

Directors, Mind Medicine Training and Education

Nigel Denning

MA, MPsych

Nigel Denning MA, MPsych is a Counselling Psychologist, AHPRA registered supervisor and Managing Director of Integrative Psychology a Psychology/Psychiatry practice in East Melbourne.  He is a former Family Violence Co-ordinator for Relationships Australia and is currently the Former Deputy President of the In Good Faith Foundation, an organisation that supports Institutional Abuse and cult survivors. Nigel is also a registered Neuro-psychotherapy supervisor with IAAN.

Nigel has been involved in Transpersonal Psychology and consciousness studies for over thirty years.  He has studied extensively under Stanislav Grof MD and worked closely with Tav Sparks and Grof Transpersonal Training to develop training approaches to Holotropic breathwork and therapy influenced by this modality. Nigel also conducted one of the few peer reviewed research studies on HB.

Nigel teaches and has presented at numerous national and international conferences on state change technology, including medicine work. Nigel also has an established practice in Tibet Bon Dzogchen meditation under the guidance of Dr Daniel Brown of Harvard Medical School.

Dr Tra-ill Dowie

PhD

Dr Tra-ill Dowie is the Head of the Faculty of Psychotherapy at Ikon Institute Australia. Dr Dowie is the Chair of the Australian Counselling Association (ACA) Panel for Trauma Standards & Practice. Dr Dowie is a practising psychotherapist, supervisor and public speaker. Dr Dowie’s academic life and public lectures cover a broad range of interdisciplinary topics that relate to the human condition: psychiatry, psychotherapy, trauma, continental philosophy, philosophy of mind, anthropology, health and wellbeing, and human optimisation. He holds dual PhDs, receiving a PhD in Psychiatry from Monash University and a PhD in Philosophy from the University of Melbourne.

Psychedelic Hedonism — The Ethics Of Psychedelic Therapy By Riccardo Miceli Mcmillan

Psychedelic trip

INTRODUCTION

Psychedelic-assisted psychotherapy is a novel approach to treating mental illness which has recently been (re)gaining significant public and scientific attention. Current clinical trials are demonstrating promising results which suggest that not only might these medicines be effective at treating a wide array of mental illnesses[1], but in some instances they might be more effective than currently available treatments[2]. However, despite the growing body of empirical work regarding the efficacy of psychedelic-assisted psychotherapy, the socio-cultural history of these compounds along with their unique psychological effects raises a host of normative ethical questions which need to be addressed to ensure that the return of psychedelics to western psychiatry is done in a responsible and ethically sound manner. “Prescribing Meaning: Hedonistic Perspectives on the Therapeutic Use of Psychedelic-Assisted Meaning Enhancement”[3] is a paper which aims to begin the task of addressing the ethics of psychedelic-assisted psychotherapy. The paper does so by applying the moral theory of Hedonism to analyse the ethical justifiability of psychedelic-assisted psychotherapy.

 

HEDONISM

Hedonism is a well-known type of consequentialist moral theory. In other words, Hedonism is a moral theory which places moral value in the outcomes of actions[4]. This means that for an act to be considered moral, said act must produce outcomes which are of moral value. So then, according to Hedonism, what outcomes are of moral value?

Hedonism or Hedonist moral theories are moral theories which place moral value in the outcomes of pain and pleasure[5]. That is to say that according to Hedonism, an act is morally good if it produces more pleasure than pain, or morally bad if it produces more pain than pleasure. There are some nuances of Hedonism which are explored further in the paper, and which subdivide Hedonist moral theory further into Qualitative Hedonism, Quantitative Hedonism, Hedonistic Utilitarianism, and Hedonistic Egoism.

 

PSYCHEDELICS AS MEANING ENHANCERS

It has been suggested that psychedelics exert their effects via a phenomenon known as the meaning-response[6]. The meaning-response refers to the body’s ability to respond physiologically to perceived meaning or symbols in the environment. For example, when someone takes a pill believing it will heal them — even if it has no pharmacologically active component (e.g. a sugar pill) — the body responds in such a manner which is in turn conducive for healing, as the very act of taking a pill is symbolically active[7]. That is to say that even though there are no chemically active ingredients in the pill, the very action of taking a pill carries certain symbolic connotations which lead to physiological changes in the body that change the body in ways which lead to health. This ability of the body to heal itself via mere symbols of healing might initially sound far-fetched, however it is a very well recognised phenomenon, so much so that the scientific community controls for this effect in its research designs — where it is perhaps better known as the placebo effect.

An important thing to note here is that the proposed mechanism of psychedelics as meaning enhancers is not saying that the effects of psychedelic-assisted psychotherapy are merely due to placebo. But rather the same mechanism which gives rise to the placebo effect also underlies the therapeutic effects of psychedelic-assisted psychotherapy. So how is this possible? It is proposed that during psychedelic states of consciousness the perception of meaning is enhanced. That is to say that psychedelics alter the world such that there is a general increase of ‘meaningfulness’ in the things which are experienced. This extra meaningfulness, when experienced in a therapeutic set and setting, results in an increased perception of therapeutic meaning (i.e. symbolically active meaning which is conducive for healing). This enhanced perception of therapeutic meaning leads to a stronger meaning-response, such that the body/mind of the person undergoing psychedelic-assisted psychotherapy will respond with a host of physiological/psychological sequalae conducive for healing. In other words, psychedelic-assisted psychotherapy heals by increasing the ‘meaningfulness’ of experience in such a way that leads to a dramatically increased meaning-response.

 

ETHICS

This is all very academically interesting, but how does this relate to the ethics of psychedelic-assisted psychotherapy? Well, the proposed mechanism of psychedelics as meaning enhancers raises the following ethical question: is it ethically justifiable to pharmacologically enhance the perception of meaning in order to heal patients?[6]. As was explored above, Hedonism would justify pharmacologically increasing the perception of meaning in order to heal patients so long as doing so led to more pleasure than pain. As is explored in greater deal in “Prescribing Meaning: Hedonistic Perspectives on the Therapeutic Use of Psychedelic-Assisted Meaning Enhancement”[3] the current literature on the effectiveness of psychedelic-assisted psychotherapy, its relative safety, as well as the epidemiology and morbidity of mental illness, would suggest that the introduction of psychedelic-assisted psychotherapy to psychiatry would produce more pleasure than pain.

But what if there is more to morality than pain and pleasure? This is the question that Robert Nozick asks people to consider when he presents his famous anti-Hedonist thought experiment: The Experience Machine[8]. To put his thought experiment simply, Nozick invites readers to imagine a machine which creates a completely realistic simulated reality. Before entering the Experience Machine people are allowed to select to kinds of experiences they want to have. Once inside, people become unaware that they have been wired up to the Experience Machine. According to Nozick, if pain and pleasure were the only relevant moral consequences, people would be morally obliged to enter the Experience Machine forever and live a life full of simulated pleasures. Nozick assumes that most readers would find this conclusion unappealing. Hence, Nozick argues that there is more to morality than just pain and pleasure. Nozick suggests that what also matters in determining morality is contact with an actual reality[8].

It has been suggested that psychedelic states of consciousness are analogous to the Experience Machine in Nozick’s thought experiment, and therefore represent a false reality. This analogy of psychedelic states representing a simulated false reality poses a further ethical challenge: are the effects of psychedelic-assisted psychotherapy ethically justifiable if they are produced by contact with a false reality? Two responses are suggested to such a question. Firstly, emerging research on the neuroscience of psychedelic states of consciousness could suggest that psychedelic states do not represent a false reality, but rather a different way of experiencing actual reality. Secondly, even if psychedelic states do represent a false reality, the use of psychedelic-assisted psychotherapy can still be justified in cases of extreme suffering, where concerns about contact with an actual reality are outweighed by extreme reductions in pain — e.g. treatment resistant patients.

 

CONCLUSION

The psychedelic renaissance is providing hope for many who have not responded to currently available psychiatric treatments. However, along with this hope comes a significant burden of responsibility for those researching and advocating for the medicalisation of psychedelics. Those living with mental illness are among some of the most vulnerable patient populations in society. Therefore, it is of utmost importance that the field of psychedelic science proceed with critical reflection to ensure that the work being done is ethically sound and not detrimental to those it is trying to serve. It is hoped that by beginning the process of applying moral theories to the experience of psychedelic-assisted psychotherapy, more discussion will ensue regarding some of the ethical challenges that this promising new paradigm presents.

 

REFERENCES

1. Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM, Work Group on Biomarkers and Novel Treatments, a Division of the American Psychiatric Association Council of Research. Psychedelics and psychedelic-assisted psychotherapy. American Journal of Psychiatry. 2020 May 1;177(5):391–410.

2. Davis AK, Barrett FS, May DG, Cosimano MP, Sepeda ND, Johnson MW, Finan PH, Griffiths RR. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA psychiatry. 2020 Nov 4.

3. Miceli McMillan R. Prescribing meaning: hedonistic perspectives on the therapeutic use of psychedelic-assisted meaning enhancement. Journal of Medical Ethics Published Online First: 04 November 2020. doi: 10.1136/medethics-2020–106619

4. Sinnott-Armstrong W. The Stanford encyclopedia of philosophy: Consequentialism. Available: https://plato.stanford.edu/entries/consequentialism/

5. Moore A. The Stanford encyclopedia of philosophy: Hedonism, 2019. Available: https://plato.stanford.edu/entries/hedonism/

6. Hartogsohn I. The meaning-enhancing properties of psychedelics and their mediator role in psychedelic therapy, spirituality, and creativity. Front Neurosci 2018;12:129.

7. Moerman, D. Meaning, Medicine and the “Placebo Effect”. Cambridge; New York, NY: Cambridge University Press, 2002.

8. Nozick R. Anarchy, state, and utopia. New York: Basic Books, 1974

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