Psychedelic-assisted therapy is having a moment. Psilocybin for depression, MDMA for PTSD, both moving from research labs into real clinical frameworks, and the FDA circling closer to approval with every trial. But a new case study published in the Journal of Transpersonal Research points to the therapist’s own relationship with these medicines matters just as much as the protocol they’re running.
The paper, written by psychotherapist Sebastian Salicru, is what’s called a mini-autoethnographic case study, essentially a first-person account of his own experience in a medically supervised MDMA-assisted group therapy session. After more than thirty years in the field and multiple rounds of his own psychotherapy, Salicru assumed an old emotional wound was long since closed. It wasn’t. Under MDMA, it resurfaced with a clarity he hadn’t expected, and the healing that followed came almost entirely through one mechanism: self-compassion.
Why Therapists’ Own Trips Are Becoming Part of the Training
There’s a growing argument in the field that clinicians should have experience with altered states themselves. The reasoning is fairly intuitive. A therapist who has never sat with the disorientation, vulnerability, or emotional intensity of an MDMA or psilocybin session is working from theory alone. Without that lived reference point, there’s a real risk of underestimating how much “set and setting” shapes the outcome, or misreading what a client is actually going through mid-session.
Perhaps you can only take your clients as far as you’ve been yourself. It’s not a new idea in therapy generally, but it carries extra weight in psychedelic work, where the terrain is so much less predictable.
The American Psychological Association named psychedelic treatment one of its top ten trends for psychologists in 2025, which tells you how fast this field is professionalising. Training programmes are scrambling to catch up, and firsthand experience is increasingly treated as a core competency.
What Self-Compassion Does
Self-compassion, in the psychological sense, isn’t a soft or vague concept. It’s usually broken into three overlapping states: kindness toward yourself instead of judgment, a sense of common humanity instead of isolation, and mindful awareness instead of getting swallowed by the feeling. Put simply, it’s the difference between treating yourself like your own worst critic and treating yourself like a loved one.
MDMA seems to be unusually good at making that shift accessible. It’s already FDA-recognised as a breakthrough therapy for PTSD, largely because of its capacity to increase trust and prosocial feeling while keeping the ego intact and cognition clear, unlike some other altered states where a person can lose their footing entirely. That combination appears to lower the emotional guardrails that normally keep self-critical patterns locked in place.
In Salicru’s account, that shift showed up as an encounter with a much younger version of himself, one carrying old, unmet emotional needs. Rather than analysing the memory from a clinical distance, he described meeting it with acceptance and warmth, embracing what he calls the “vulnerable self” – an honest, undefended state that’s normally hard to access. That reframing, done under the emotional safety MDMA seemed to provide, is what he credits with finally resolving something thirty years of standard talk therapy hadn’t fully touched.
The Caveats Worth Repeating
This is one person’s account of one supervised, clinical session, not a green light for anyone to go and recreate it outside a controlled setting. MDMA-assisted therapy remains tightly regulated, and for good reason. But as more of these firsthand accounts surface from within the profession, it’s becoming harder to separate the pharmacology from the psychology. The medicine may do some of the work, but how you meet yourself once it does, that might be the part that actually makes the difference.
