A Call for Retraction: How a Journal Condoned Psychedelic Therapy Abuse

Thanks to Meaghan Buisson for contributions to this essay.

In August of 2024, the US Food and Drug Administration (FDA) rejected the application by Lykos Therapeutics/Multidisciplinary Association for Psychedelic Studies (MAPS) to use MDMA, e.g. “ecstasy,” as a treatment for PTSD. The FDA rejection of psychedelic therapy came for several reasons—questions about efficacy, research integrity of the MDMA clinical trials, unsound psychotherapy methods, and concerns about serious adverse events including documented sexual assault. Yet investigations into MDMA for “therapeutic” purposes remain ongoing, and greater scrutiny of this research warrants revisiting a 2021 study on psychedelic practices published in the Journal of Humanistic Psychology (JHP), and to do so for the purpose of calling for a retraction.

The paper, “A Qualitative Exploration of Relational Ethical Challenges and Practices in Psychedelic Healing,” needs to be retracted for four reasons. First, the 23 therapists who were interviewed described practices that justify sexual assault of patients under the guise that these practices promote healing. Second, the authors withheld information from the interviews that told of sexual mistreatment of patients under the influence of MDMA, and thus published a whitewashed version of their 23 interviews. Third, the lead author failed to disclose that he was a protégé of Aharon Grossbard and Francoise Bourzat, two leading psychedelic therapists facing multiple allegations of sexual abuse widely covered in the media, and that many of the practitioners interviewed for the paper had been trained by Grossbard and Bourzat. Fourth, the paper hid the financial and other conflicts of interests of the principal investigator. (I have previously written for Mad in America about my experiences as a patient and student of Grossbard and Bourzat.)

The Study

As is well known, MDMA increases suggestibility, lowers defenses, impairs cognition, reduces inhibition, and affects memory. It is also gaining attention for its role in sexual assault. As such, the suitability of psychedelics including MDMA for use in psychotherapy raises obvious concerns around safeguarding patients, especially given that MDMA therapy already has produced a record of sexual abuse by therapists. The JHP paper is presented as an effort to investigate these concerns, stating that “psychedelic psychotherapy is rife with unique ethical challenges.”

Principal investigator William Brennan and his co-authors Margo Jackson, Katherine MacLean, and Joseph G. Ponterotto used a qualitative analysis and phenomenological design to derive descriptive and prescriptive themes from the therapists’ interviews, with the purpose of describing “practices [the interviewees] have found most useful in confronting these challenges.” The 23 therapists surveyed had administered MDMA or psilocybin to hundreds of patients. Thirteen of the 23 therapists had graduate psychology degrees; others had therapy training or certificates (including 12 trained in Hakomi therapy). One was a medical doctor.

The paper examined how these practitioners navigated the risk of harming clients under the influence of MDMA and psilocybin, including protection of sexual boundaries, preventing intrusive touch with clients, and avoiding exploitive relationships between therapist and client.

In the interviews, one of the main themes that emerged was that “clients will often relate to their bodies in novel ways during a psychedelic session. This often takes the form of clients experiencing a surge of strong feelings or sensations in their bodies, removing some or all of their clothing, touching their bodies in a sensual or sexual way, or some combination of these phenomena.”

Yet, in the published article, the therapists stated that this behavior of nudity and touching could be “therapeutic for some clients.” Nudity and sexual expression were said to be “likely to arise within a psychedelic session,” with one of the therapists stating that psychedelic therapy “is definitely a type of work that requires a physical contact.”

The JHP article reported that nearly all of the therapists said that “their psychedelic work has required them to eschew rigid professional roles,” and that sessions could include the “exchange of love feelings” between therapist and client. Therapists telling patients they loved them while their patients were under the influence of MDMA “is part of how psychedelics heal.”

In response to a question about possible “problematic” interactions with clients, with clients possibly upset after the session recalling the nudity and touching, the study authors said that one “ethical practice the participants” used to respond to such client upset was “redirecting a client’s attention away from a problematic practitioner–client dynamic toward the possible ways in which this dynamic may inform their healing.”

“Most participants favored restorative justice-based approaches” for dealing with transgressions, the study concluded, and of the 23 therapists interviewed, ‘”All but one reacted negatively to the idea of allowing existing structures, like state licensure boards, to adjudicate transgressions due to concerns about their punitive mechanisms (e.g., revoking licensure).” The therapists spoke of “adjudicating transgressions nonpunitively.”

In the discussion part of the paper, Brennan and his co-authors wrote that nudity, sexual expression, intimate touch, and so forth are “phenomena likely to arise within a psychedelic session.” However, they framed such behavior as “an important part of clients’ healing.” As such, they concluded that “psychedelic work is home to ethical challenges that render existing ethical training and guidelines for psychologists insufficient.” They advocated for dispensing with norms in the field in favor of “alternative guidelines that would better cover the ethical dimensions of psychedelic work.”

Given these sexual elements in psychedelic sessions, the authors stated, “more nuance may be needed in the conceptualization and regulation of what is and is not acceptable in a psychedelic psychotherapy relationship.”

An Initial Critique

Even before any discovery of research malpractice, which has come to the fore since the paper’s publication in 2021, there was reason to be astonished by this paper. It served as an argument for permitting therapists, who weren’t under the influence of psychedelics, to engage in a sexual way with clients who were under the influence of psychedelic drugs. There is a reason MDMA is under scrutiny as having some features of a date-rape drug, and this publication moved that psychedelic dynamic into the therapy room.

Moreover, the “norms” that are presented in this study are at odds with other psychedelic therapy accounts, where nudity and sexual expression are not considered expected. It is well-established that mixing of sexual conduct with therapy is harmful. Survivor advocates, led especially by women survivors, tell of how the unequal power relationship means clients are especially vulnerable to romantic or sexual interaction, which can leave a devastating and lifelong traumatic impact.

Therapists who have sex with clients are often quick to claim their motives are pure. Yet, clients can be so harmed by the realization they’ve been betrayed and used by the therapist, to whom they trusted their innermost secrets with, that they are driven to addiction, self-harm, and suicide.

There is no mention in the JHP paper that abusive behavior by therapists is frequently defended as “healing” and “loving” for the client. None of the behavior described by the therapists interviewed was said to harm clients in any way, or that it even led to allegations of harm. Nor did the study authors ask the therapists why they only recounted their “successes” with intimate touch.

Indeed, no clients were interviewed for this study, which purported to be an inquiry into how to navigate the ethical challenges of psychedelic therapy. If they were truly interested in this question, shouldn’t Brennan and colleagues have sought to learn what clients thought? But instead of hearing from clients, the authors of this paper not only framed the sexual behavior as ethical, they also concluded that such behavior should be presented in training courses and regulatory codes as acceptable.

The premise is that therapists should be held to different standards in the context of the unique healing power of psychedelics, a concept that has been termed “psychedelic exceptionalism” by critics in the field. Instead of expecting psychedelic therapists to follow existing standards for psychotherapists, which of course prohibit romantic involvement, nudity, and intimate touching, this paper called for changing ethical standards.

The Story Since Publication

Although the study could immediately be seen as objectionable in its content and conclusions, that alone might not justify a call for retraction. However, in the four years since the study was published, new details have emerged that together amount to research fraud.

First, the paper states that lead author William Brennan and his co-authors had no conflicts of interest. In fact, Brennan is a clinical consultant to Cybin, a pharmaceutical firm valued at ~$180 million with more than 200 patents pending in the field, where he developed their commercial psychedelic therapist training.

Next, the paper presented the interviewees as a representative sample of therapists engaged in underground psychedelic sessions. This obscures Brennan’s close ties to Grossbard and Bourzat, leading MAPS-affiliated underground trainers worldwide for decades, who have been named in multiple allegations of systematic sexual misconduct and exploiting patients in the media, and in a lawsuit. Many, if not all of the interviewees, had been students of Grossbard and Bourzat.

In his biographic material, Brennan states that he has been invited to the faculty of the School of Consciousness Medicine, which is now known as Gather Well. This school was founded and led by Grossbard and Bourzat; in fact, Brennan trained under Grossbard to practice psychedelic therapy. (Gather Well, now run by their daughter Naama Grossbard, has since also been accused of “ethics washing” to justify its practices.)

Brennan revealed in an Addendum to the paper that possibly a majority or even all of interviewees in his research were also students of Grossbard and Bourzat, and acknowledged the “considerable degree of concordance that the 23 practitioners interviewed showed on most descriptive and prescriptive themes.” Training in Hakomi therapy, used as an adjunct by Grossbard and Bourzat, was reported by more than a third of the study participants. (Bourzat was previously a certified therapist in Hakomi therapy but had her certification removed after sexual contact with clients.)

After the journal article was published, Brennan released an excerpt from his PhD dissertation online. In it, he presented a more complete account of the responses from the 23 therapists, which told of masturbation and what could fairly be described as sexual molestation of clients.

Here are examples of responses that were omitted from the published journal article:

“It’s a very fine line going between physical intimacy to erotic intimacy to sexual intimacy. So, you know, sometimes you can cross it. You have to be careful not to cross it in a way that the client would get hurt. “

“If my shadow stuff or my sexual stuff gets activated, it’s very easy for a part of me to just go with it. To say, ‘just go with it’ and ‘fuck it.’ I’ve even done that. And I was like, ‘I’m not going to tell my supervisor about this.’ […] It’s just sort of my own ego, my own agenda.”

“A transgender woman that I work with, a male-female transsexual, who has been at war with her anatomy for her whole life and kind of attempting to shift that relationship in a way that, you know, involved her looking at her genitals and just exploring what that brings up in her when she sees her penis and testicles and how that doesn’t fit with her identity. And there’s a lot there, you know? And actually being able to be naked and present with her physical anatomy brought up a lot of really useful material that was kind of metabolized in that session.”

“Sometimes the client wants to take their clothes off, and that’s okay. I don’t have any problems with that because that could be very healing for some clients.”

“I’ve had a lot of people disrobe of course, you know, and someone may want to touch themselves. […] Um, I may step out or say, ‘You know, maybe you want to have some time to yourself so you can really explore.’ I’m remembering, a long time ago, someone wanting me to see them touching themselves and to not leave.”

“With my female clients, if they asked me to jump into bed with them and to hug them and spoon them, I don’t think twice about it.”

“In our society and culturally, sex is so charged that it could be messy, which doesn’t mean to say that it wouldn’t be healing… I’m not saying that it wouldn’t be necessarily healing to have sex with a client.”

“Just because a touch and boundary-pushing and eroticism and sexuality are difficult and sometimes taboo doesn’t mean they should be ignored or shuffled off to the side. It should probably be the opposite.”

“When I work with people, I can tell when their system is guarded. You should be able to tell just getting near someone that their system is starting. I’ve never had a client have to tell me to stop because they say no long before then.”

“I wouldn’t be judging people who, you know, clients or others who need to express themselves erotically or to have revelations of that nature, which would appear or present as erotic.”

“I have been in the presence of people who are turned on and randy, and therefore that energy is in there and it’s provocative, regardless of who, you know, regardless of whether it actually conforms to my own interests. It’s provocative. […] I think that’s one place where we can get into trouble. I mean, as people’s boundaries and their self-understanding is transformed by the journey space, they may well discover a sexual desire or something else or, you know, the need to act out.”

“She was someone young, pretty, and, um, she had had some kind of surgery on one of her breasts when she was very young and so had some – she was kind of very perfect everywhere – but there was some kind of deformity, in her experience of it, of this breast. And so, in a session, she wanted me to hold her breast, right? Like, that’s got red flags all over it. But it felt important for me to say yes. […] It felt important to not not do that because of the material that it was about. You know, ‘here’s this thing that I think is repulsive. I just want you to see this, touch it.’”

“I’ve definitely been in sessions where [sexuality] is something they’re really exploring, but it hasn’t been directed at me. Like there are situations that could be seen as sexual, like a woman taking off her shirt and then wanting me to like rub her chest, right? Or her wanting to make contact or something, but it wasn’t ever sexual. It was just, like, safe. Like they felt like they wanted to feel free and to be in their bodies and they felt uninhibited and that’s fine.”

“I had to kind of make myself blank, make myself so that, yes, my hand was on her breast. But there was none of my energy on it. You know, I couldn’t feel it, like there was no energetic transmission.”

“There have been times with individuals where, you know, their process was around healing issues around their sexuality and wanting someone to be present and witnessing and hold space for that, where they were naked and, you know, physical with themselves.”

“Sometimes, I’ll have to kind of shut myself off. Because somebody’s going through intense sexual expressions. I’ll just shut myself off and let them do that, just kinda like block myself off for a while. […] I’m not exchanging anything. So, I’m more like, in the extreme cases [of clients exploring sexual material], I’m more like a rock. I’m not exchanging energy.”

“I’ve had clients certainly in a sexual space, like, having sexual energy really alive for them and writhing around and, you know, whatever is going on. And I’m totally comfortable with them doing that, having that experience. And I’m not going to interact in it. Like, I’m controlling the music and holding a safe space for them to have whatever process they’re going through.”

“I’ve had people wanting me to look at their genitals, for example, if they have trauma there. I’ve had people wanting me to touch their leg in some way that kind of reminds them of some sort of trauma that they had or sexual abuse. So, I won’t get into the specific touch that I won’t do that, but you know, I’ll get to close enough to simulate something so they can feel that I’m addressing it.”

“I’ve had situations where, where a client wanted to sexually touch themselves in a kind of adolescent state, you know, and I’ll kind of stay away from that and I’ll let them do that.”

“Let’s say you’re holding your client and he or she is climbing on you and it’s very intimate and you feel arousal and you have a hard-on. It doesn’t mean I have to do anything about it. I just say, ‘Oh wow, I have a hard-on. That’s okay. I will try to avoid contact between my genitals and their body so they will not feel it. But I will not push them away either because that’s not healthy for them, if to protect them, I become cold and distant.’”

“I’ve had people fully naked, you know, kind of sit on me and I’m not doing, you know, I refrain, I keep boundaries, but I’ll let them do whatever they need to do as long as they’re not going off in some, you know, delusional sexual fantasy.”

“I’m aware of [the APA code of ethics]. I break many of them many times.”

“That’s why there’s all these rules in therapy, you know? Because you have rules when you don’t know how to actually connect with people. So, you have these external controls. And I feel like the external stuff will only get you so far. You know, it’s like the speed limit, you know?”

After the whistle was blown on the abuses of Grossbard and Bourzat and it was revealed Brennan had trained under them, Brennan sought to distance himself from his own study. He wrote: “In the time since the publication of this work, I have come to see it as flawed due to my failure to be sufficiently critical of the participant perspectives it presented. As first author, I did an inadequate job of bracketing the biases I held at the time… I came to regret this and have thus removed the full dissertation from public availability, in part to prevent its uncritical presentation of the data from serving as supportive literature for dubious or abusive practices.”

Brennan’s Addendum version first posted on ResearchGate says “Careful readers should attend to any bias in the analysis or presentation of the results that may reflect Dr. Grossbard’s influence on my thinking and update their inferences accordingly,” but this sentence is missing from the Addendum version later published on the JHP paper page.

Brennan’s removal of his Fordham University dissertation from public view made it impossible for other researchers to better assess the methodology and results from his JHP paper. He also claims the raw interview recordings for the study were deleted.

The Case for Retraction

The concealing of relevant data from a research project is a form of fraud and the grounds for retraction of the JHP study. Omitting relevant data comes under the category of “falsification of data.” Here is the explanation from Elsevier, which is a major publisher of academic research.

Is omitting data falsification?

Falsification is “manipulating research materials, equipment, or processes, or changing or omitting data or results such that the research is not accurately represented in the research record.

The field of MDMA research is already suffering from a crisis of credibility. Three peer-reviewed articles have been withdrawn, and another earned an “expression of concern”, because of unethical conduct at a research site. There is also growing criticism of problematic methodology design at the heart of much psychedelic therapy research.

I and others contacted Sage Journals and JHP Editor Sarah Kamens about the omitted data and Brennan’s conflicts of interest. Kamens attached an “Editor’s Note” to the article, which states that “some practices of underground practitioners are explicitly disallowed by ethical guidelines in the mental health professions,” but to date has not responded to the call for retraction. Sage Journals also did not reply.