I've been practicing independently for a bit over 5 years. I refer to it as independent (as opposed to private practice) as a nod to my arts background and the important role of independent (indie) film as an adjunct to the primary industry (mainstream). Lower budgets and simpler organizational structures permit certain freedoms, in responsiveness, niche appeal, creativity and experimentation.
My practice as a narrative and expressive arts therapist is community centered, collaborative, secular, contemporary and urban. It takes liberties in response to client needs and preferences, and squeezes a lot out of limited resources. It sits in a space that I don’t consider 'underground' where many psychedelic practitioners situate themselves, It does not encourage secrecy (while still respecting privacy), or ask people to compromise standards of care or accountability in order to participate. It’s not exactly above ground either, as to date it has not been legitimized or endorsed by any of the major players currently scrambling to organise themselves into accredited (institutionalized) bastions of best and evidence based practice. So perhaps in this binary of above and below, I’m somewhere in the middle, on the ground as opposed to under it. Grassroots, DIY-ing, aspiring to thrive, supported by rich resources that are largely unseen and unrecognized.
Richard Sears writing for Mad In America notes what I hope is a shift in acknowledgement of the value substance users with and without formal education bring to this work. I am fortunate to have both. To have worked with substances in contexts most sacred and most profane, and been equally illuminated. Sears points to Magdalena Harris and Nicole Luongo introducing a special issue of The International Journal of Drug Policy, “dedicated to exploring academics and researchers that have lived experience of illicit drug use... In addition, they argue that knowledge around illegal drug use must include voices of people who use illicit drugs, voices that are often silenced due to the epistemic violence and stigma that accompanies drug use.” It's time for functional substance users to speak up where they can. Particularly in psychedelic spaces that are increasingly populated by clinical mental professionals with recent accredited training in this area that have never achieved a non-ordinary state of consciousness via a psychoactive substance. Not even a puff on a joint in college in some cases...
I’ve learned to improvise in my practice, to make do with what’s on hand, to navigate obstacles through will and imagination. The flexibility and agility of this response based approach is largely what led me as a therapist with experience in substance use and altered states of consciousness to revisit ideas about 'self-medicating' as tap in to the considerable knowledge and skill some substance users bring to this task.
When cannabis became legal in Canada in 2017 and CBD products widely available, a shift took place. Public and private shame cast a slightly smaller shadow over many of my clients, and how I was supposed to respond (clinically) to such behaviors. I have identified as a ‘high functioning stoner’ for about 15 years and began sharing this where appropriate with the people I worked with, with the understanding we were all learning about the nuances of 'recreational' versus therapeutic applications. This was an extension of practices of transparency common to postmodern therapeutic modalities (Cheon & Murphy, 2007) that promotes alliances in shared experience and solidarity in shared values.
I learned about the ways individuals attend to themselves with what they have, to reduce the considerable suffering that can accumulate just from being a person in the world. A person perhaps caught on the wheel of productivity and busy-ness, where reflection is a luxury superseded by overthinking, where rest does not equal peace, and access to affordable modalities of care are few and 2-24months on a waitlist away. The increase in toxicity of current drug supply, positioned alcohol, along with cannabis as convenient state and socially sanctioned options to mitigate the grand scale of social suffering that would increase exponentially with the onset of COVID a couple of years later. I think about how readily day drinking and living room zoomba classes were normalized as a reasonable response to being cloistered at home by my peers.
I’m not supposed to take a position on drugs as a therapist. My profession doesn’t want me to condone illicit drug use, or have an opinion on pharmaceuticals (though in practice this seems to be perfectly ok). Clients don’t want to feel judged. The only way I can satisfy everyone is to remain silent, neutral and enigmatic, (as an analysand I can't stand it when therapists employ this). It’s too hard for me, my face won't let me be neutral, and clients have a keen sense of judgement about judgement. Instead, I’ve developed a set of questions for discussion informed by the following general line of enquiry:
If drugs are tools, how do we find the right tool for the right job? Taking into account your skills and experience in using them and what it is you hope they'll do for you.
These discussions have led to rich understandings of the ways we might evaluate the things we turn to for support.
