Where Access to the PAST, is Healing: Enhancing Your Capacity to Live in the Present

Written By Alexandria Jones

– AlexandriaLove @TheSacredSexTherapist


Table of Contents

  • What is Psychedelic Assisted Sex Therapy and its History?

  • Techniques and Uses

  • Benefits- Who can it help?

  • Effectiveness

  • How is it different from traditional psychedelic therapy?

  • How to Get Started as a Client

  • Becoming Psychedelic Sex Therapy Informed 

  • Why Do We Need a Curriculum for Sex Therapists to be Trained and Become More Informed?  







What is Psychedelic-Assisted Sex Therapy and its History?

Psychedelic-Assisted Sex Therapy (PAST) is a therapeutic approach currently being pioneered by the daring few that bear witness and have experienced its benefits in their own sexual healing journey. PAST is a psychotherapeutic approach that combines psychedelic medicine prescribed by a psychiatrist or physician, in a safe and trauma informed therapeutic environment whereby a licensed mental health provider and certified sex therapist offer physical and emotionally consented support for a client before, during, and after their medicine experience. The licensed certified sex therapist fosters a safe and fully consented environment interweaving several traditional therapy approaches, sex therapy approaches, mindfulness, and somatic modalities to best support their client’s needs during all phases of their medicine journey. During the medicine experience with MDMA, psilocybin, LSD, or Ketamine the client and therapist curate specific intentions contoured for supporting the client's sexual healing journey. Under the influence of these medicines, clients sometimes uniquely develop the capacity to move through and experience the depth of their trauma without activating their otherwise traumatic responses. 

PAST by no means is a new modality of therapy. In fact, people have been utilizing sacred medicines and ritualizing around their sacred sexuality through practices of tantra for THOUSANDS of years. It seems that the earliest tantric practice was first discovered in the Hindu framework around the first millennium CE. Tantra primarily focuses on meditative and ritual practices which use tantras, the genre of scripture that acts as the canonical foundation for the many tantric traditions, as its basis. Some have found data that substantiates Tantra originated from India around the 300-400 CE when the Buddhist and Hindu tantric content was first documented as poetic metaphors indicating Divine love and oneness. The sacred rituals and practices, as well as Tantric scripts were guarded and protected by the masters and disciples of these lineages. It is found that the ritualized mixing of sex and psychedelics was forbidden knowledge and ancient secrets to be protected from puritanical colonization and early Tantra initiates (Brown, 2002). 

The major difference between PAST and these practices is, PAST is a therapeutic modality that requires a fully consented, clearly communicated, boundaried, and dynamic medicine space. As the therapist and client/participant relationship is upheld within the utmost respect and requires therapeutic licensing. This licensing honors a relational dynamic in a very particular and careful way. Additionally PAST is held in a container by someone who is a certified sex therapy clinician. Some of those folks have an AASECT certification or a Sexual Health Alliance certification (there are a few other governing bodies that are currently less prominent in the field). Also, to offer deeper clarity for curious individuals, PAST or sex therapy in and of itself,  by no means includes sex work or behaviors that include sex or ongoing physical intimacy. Though, it is worth noting these topics and experiences are heavily explored, discussed, and honored with deep care and reverence in the therapeutic dynamic. 


Psychedelic- Assisted Sex Therapy Techniques, Approaches, and Uses

Researchers are starting to take notice of the potential therapeutic applications of psychedelic medicine for dealing with sexual difficulties and helping enhance intimacy and connection. From what I have come to understand thus far, there are many healing and applicable sex therapy modalities that can be interwoven into the psychedelic therapy journey, whether that is in the preparation phase, the medicine experience, or in the integration phase. 

As for noting folks who are daringly spear-heading this clinical work, in a recent publication "Unfolding Eros - A Journey into Psychedelic-Assisted Sex Therapy,” Jeff Lundgren explores the integration of psychedelics into sex therapy practices and approaches. The book itself, describes the potential of various potent medicines in addressing sexual dysfunctions, sexual trauma, and enhancing intimacy and access to vulnerability in individuals and relationships. He spends time additionally unraveling  the history of psychedelic substances in the United States and their traditional and indigenous practices and applications, and the emergence of scientific research and therapeutic application over the many years. The author is a fellow certified sex therapist, and psychedelic-assisted therapy provider out of Salt Lake City Utah, with a great deal of clinical experience navigating the nuances and traversing the field and legal landscape of psychedelic medicine, traditional psychedelic-assisted therapy, and entangling these practices with sex therapy approaches. 

In the state of Pennsylvania, the state I currently work in under the guise of my mental health licensure, PAST is currently only acceptable within Ketamine-Assisted Psychotherapy and Cannabis-Assisted Psychotherapy. Though, I do have hope for the future, that more medicines (such as MDMA and indigenous medicine rituals) will be safe and accessible above ground with less risk of legal criminalization. We can see in research, decriminalization of medicines is critical for healing, liberation, and equity, especially for sexual liberation, healing, and equity. Also, worth noting, current research indicates there is some concern if Ketamine is misused and not monitored heavily by a medical provider that it can increase the risk of addiction, indicating the use of this medicine is unsafe if not properly cared for and tended to under medical guise (Rogers, 2024).  


Benefits, Who Can PAST Help?

Accessibility to psychedelic sex therapy has the potential to increase someone's capacity to heal the root of their trauma and disconnection, and overall help people improve their lives. The kind of folks psychedelic- assisted sex therapy can support, is a wide range and nondiscriminatory. Besides, people with health risks and a history of schizophrenia, psychosis, bipolar disorder, and borderline personality disorder are generally contraindicated for psychedelic therapy at this time (Jones, 2022). The following are the types of issues people experience that may benefit from psychedelic sex therapy:



  • Sexual communication and relationship difficulties 

  • Intimacy and connection issues

  • Low sexual desire / inhibited sexual desire

  • Sexual dysfunction

  • Religious trauma

  • Sex offending

  • Couple’s desire discrepancy

  • Premature ejaculation

  • Erectile dysfunction

  • Arousal and orgasm difficulties

  • Male and female sexual inhibitions

  • Intimacy after infidelity

  • Intimacy after addiction

  • Concerns about pornography usage

  • STD’S/ STI’s/HIV+

  • Exploring LGBTQ issues

  • Alternative lifestyles

  • Swinging and Open Relationships

  • Polyamory

  • Kink and fetishes

  • BDSM

  • Male sexual health

  • Female sexual health

  • Delayed Ejaculation

  • Pain during sex (Vaginismus, Dyspareunia) or non-medical sexual pain

  • Female anorgasmia: preorgasmic, primary, secondary

  • Sex after pregnancy

  • Sex after cancer or other illnesses

  • Sexual trauma

  • Sex and infertility treatments




Effectiveness

Currently, there is little research on this modality (PAST specifically) and I would like to offer a call for there to be more research conducted. It is mostly anecdotal and ethnographic evidence and oriented around therapeutic and client dynamics without a research component. As the level of interest and funding for research gone into traditional psychedelic therapy approaches has not quite reached PAST yet. Though, I can sense this field will grow rapidly in due time, as in my own hemisphere there is quite the intrigue around this unique modality of psychotherapy and I have been enhancing community awareness in academic realms, in KAP group supervision spaces, and at local festivals. Due to the lack of research, I have recently begun to inquire with other sex therapists who may be interested in developing a curriculum to help other sex therapists train, explore, experience, and learn confidence in approaching this unique modality. It is my greatest hope to help support the enhancement and scaling of this approach, as I have been witness to and had the privilege to walk with many individuals inside of their experience of interweaving sex therapy, Internal Family Systems, somatic mindfulness and meditation, with Ketamine-Assisted Psychotherapy. 

However, there is a great deal of research on the effectiveness of psychedelic psychotherapy. In a recent MDMA trial in 2023 45 of 52 (86.5%) participants were responders with a clinically meaningful improvement at 18 weeks after baseline, defined as a ≥10-point reduction in CAPS-5 total severity score, versus 29 of 42 (69.0%) in the placebo with therapy group (Fig. 3). By the end of the research study 37 of the 52 participants no longer met DSM-5 criteria for PTSD. With that said, PTSD and CPTSD are pervasive in clients who experience sexual-related trauma, whether that is experiencing erectile dysfunction with a partner or being raped, we have come to understand (thanks to Dr. Van Der Kolk's work The Body Keeps A Score) the body and its somatics do not discriminate between traumas. Essentially, trauma doesn't know the difference between big T and little T trauma, or between others’ trauma versus the body's own trauma. The outcomes of this research pose a great deal of promise for survivors of sexual trauma. 

Additionally, there is a great deal of research that suggests psychedelics such as MDMA and psilocybin have significant potential in treating PTSD. For most,  if not all of my clients who experience sexual trauma, also qualify for a C-PTSD or PTSD diagnosis. In recent research, particularly the phase 3 trials conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS) have demonstrated significant efficacy in treating PTSD with MDMA-assisted therapy. These trials showed that participants receiving MDMA alongside therapy experienced a greater reduction in PTSD symptoms compared to those receiving a placebo​ (MAPS)​​ (Mount Sinai Health System)​. The U.S. FDA has granted MDMA-assisted therapy a Breakthrough Therapy designation, highlighting its potential as a significant improvement over existing treatments​ (MAPS)​. These substances help with PTSD  by altering the brain's response to the person's traumatic memories, enhancing emotional regulation, and fostering self-compassion and empathy. Integration is a crucial element in the PAST and is also an important aspect of this research. Integration ensures that insights gained during the medicine sessions are incorporated into everyday life. This involves ongoing therapeutic support and practices such as meditation and journaling to maintain and deepen the healing effects​ (DoubleBlind Mag)​.

Furthermore, many of my clients who experience various different forms of sexual dysfunction or pain, fertility issues, sexual compulsion, also experience anxiety and depression symptoms. In fact, in a recent study of patients with anxiety and depression patients reported that their psychedelic sessions with psilocybin helped them process the intense feelings they repressed without being overwhelmed (White, 2023). While their catharsis was intense, emotional and difficult during their experience,  it helped them achieve acceptance and processing of those emotions, ultimately lessening their feelings of isolation and inner withdrawal from their family and community systems (White, 2023). The power of these medicines is beyond fathomable and demonstrates immense promise, and more promising than traditional approaches. 


How Does PAST Differ From Traditional Psychedelic-Assisted Psychotherapy?

Under a traditional therapy medical model, treatments are focused on the mind and less focused on the spiritual elements, nature-based, psychical and somatic, and community-based and collective elements of healing. Whereas psychedelic medicine experiences traditionally come from community rituals and practices whereby spirituality and human connection are prioritized. Traditional and more well known psychedelic- assisted psychotherapy approaches may include: internal family systems, psychoanalytic, transpersonal, harm-reduction, and jungian psychotherapy (Hasty, 2022). 


Some of the Biggest Differences between PAST and traditional PAT:

  • Nature-Based

  • Decolonizing Approach 

  • Somatic and Body-Based Approach 

  • Consent and Boundaries-Based Approach

  • Sensate Therapeutic Approach 

  • Community-Based Family Systems Approach


In the PAST realm there is a truly unique Leadership Perspective that is embodied, as in the preparation phase for the medicine experience educational space is held and explored whereby an important question is explored. How do we work with someone or a group when sexual energy arises in a psychedelic session? This inquiry leads to open dialogue that truly differentiates PAST from other approaches as well. 


How to Get Started As a Client

Find your local Psychedelic-Assisted Sex Therapy provider or sex therapist that offers integration with medicine journey’s. There are several databases at this point that psychedelic therapy providers are listed on. Currently the options for PAST are very slim, as there is no formal training and there are only a daring few who have capacity to combine both of these modalities. If you do not have a local provider who offers either of those, I recommend traveling to a provider who does offer these services or meeting with a local certified sex therapist who may be able to support you in your exploration and journey without judgment. Finding the right clinician is a process and will require screening. I would like to offer you an invitation to instead of being the one who is only asked questions during the first session, when you first meet a provider to ask them questions and to screen them as well. It is safe and okay to interview your clinician to gain insight and awareness around their expertise and their life curriculum. I personally offer folks a free screening guide on how to find the best psychedelic therapist in this Wild Wild West of a field, as this is important. I have seen and witnessed several unethical things and claims being made, especially by clinicians who have NO experience with medicine themselves. This is absolutely necessary in order to support someone in this terrain and realm. To me it is also dangerous, and is like trying to provide someone instruction for a game or teaching them to ride a bike without ever even riding a bike. It's impossible and misleading. 

If you may have interest in this free screening tool, you're welcome to click the link below to gain access to your FREE journeyer guide. 

https://rooted-healing-sanctuary.mailchimpsites.com -FREE GUIDE



Becoming Psychedelic Sex Therapy Informed


Things to consider as a clinician, if you are not a certified sex therapist or in the process of becoming one. It is imperative that you have awareness and knowledge about scope of practice, when and how to refer to a provider who may be able to offer their expertise. Find your local holistic sex therapist, on psychology today, or google search the AASECT database to find a clinician.  Collaboration for our clients is critical for helping them get the best care they need and it is our responsibility to recognize when it is appropriate and best to refer to another provider to support the clients healing journey. Oftentimes in my local area therapists make little to no effort to find a suitable sex therapist for their clients. In most cases, the therapist never admitted they were not sufficiently trained to help resolve the sexual dilemma presented. From what I have seen in the field many times, counselors pass on their own biases rather than develop a sound treatment plan, given they do not have capacity to do so. This approach ends up harming the clients, and then they come to find me after being traumatized.


Here is what to screen for:

The following are five generalized questions to ask your clients to screen for the need for a sex therapy referral:

Sexual Inventory:

  1. What is your current relationship to sex?

  2. What beliefs around sex did you group up with?

  3. What stories do you tell yourself around sex and sexuality? 

  4. What are your earliest sexual memories and how do you feel about them?

  5. What did your parents and community teach you about sex when you were growing up?


If you receive alarming answers that include any of the following issues. IT IS NECESSARY and appropriate to refer to a sex therapist. 



  • Sexual communication and relationship difficulties 

  • Intimacy and connection issues

  • Low sexual desire / inhibited sexual desire

  • Sexual dysfunction

  • Religious trauma

  • Sex offending

  • Couple’s desire discrepancy

  • Premature ejaculation

  • Erectile dysfunction

  • STD’S/ STI’s/HIV+

  • Arousal and orgasm difficulties

  • Male and female sexual inhibitions

  • Intimacy after infidelity

  • Intimacy after addiction

  • Concerns about pornography usage

  • Exploring LGBTQ issues

  • Alternative lifestyles

  • Swinging and Open Relationships

  • Polyamory

  • Kink and fetishes

  • BDSM

  • Male sexual health

  • Female sexual health

  • Delayed Ejaculation

  • Pain during sex (Vaginismus, Dyspareunia) or non-medical sexual pain

  • Female anorgasmia: preorgasmic, primary, secondary

  • Sex after pregnancy

  • Sex after cancer or other illnesses

  • Sexual trauma history

  • Sex and infertility treatments





Why Do We Need a Curriculum for Sex Therapists to be Trained and Become More Informed?  

We NEED a psychedelic-assisted sex therapy (PAST) curriculum as we begin orienting and specializing with psychedelic medicine as sex therapists. This level of training would cover a number of topics from continued education, to practicum, to ethics and boundaries within the PAST space. I do feel deeply called to be clear In honoring that I do not claim to capture everything that may need to be covered in a curriculum but I can tell you right now, in all of the psychedelic therapy training I have experienced sex and sexuality were NOT a part of them. This standard needs to change as it equips professionals in a way that leaves them ill prepared to orient and work in this realm safely with clients, with clear boundaries and expectations of one another when topics like the ones discussed above are explored. Particularly around sexuality in the psychedelic therapy realm, it differs greatly and requires an open and free dialogue that addresses the potential experiences that may arrive when one sets intentions around healing their sexuality


The following is an example of a PAST curriculum:

Foundations of Psychedelic Therapy

  • History and Ethics: Understanding the historical context and ethical considerations of using psychedelics in therapy.

  • Pharmacology: Study of different psychedelic substances (e.g., MDMA, psilocybin, LSD) and their effects on the brain and body.

  • Legal and Safety Considerations: Current legal status, risk management, and safety protocols for administering psychedelics.

2. Foundations of Sex Therapy

  • Sexual Health Education: Basics of human sexuality, sexual health, and common sexual issues and dysfunctions.

  • Therapeutic Techniques: Methods and approaches used in sex therapy, including cognitive-behavioral techniques, sensate focus exercises, and communication skills.

  • Cultural Sensitivity: Understanding diverse sexual orientations, gender identities, and cultural backgrounds in the context of sex therapy.

3. Integration of Psychedelics and Sex Therapy

  • Therapeutic Models and Approaches: Combining psychedelic experiences with sex therapy practices, including how to prepare clients, facilitate sessions, and integrate insights post-session.

  • Case Studies and Applications: Real-world examples and scenarios where psychedelic sex therapy has been applied, highlighting successes and challenges.

  • Holistic and Somatic Approaches: Incorporating body-centered and holistic methods to address sexual trauma and enhance sexual wellbeing.

  • Consent and Boundaries Exploration: Incorporating boundaries and consent dialogue methods to address and honor sexually explicit conversations and enhance the therapeutic dynamic.


4. Clinical Skills and Practicum

  • Session Planning and Execution: Structuring and conducting psychedelic-assisted sex therapy sessions, including set and setting considerations.

  • Client Assessment and Screening: Evaluating clients’ suitability for psychedelic therapy and identifying contraindications.

  • Ethical Practice: Adhering to ethical guidelines, informed consent, and maintaining professional boundaries.

5. Self-Care and Professional Development

  • Therapist Self-Care Measures and Maintenance: Strategies for therapists to maintain their own mental health and prevent burnout.

  • Supervision and Peer Support: Importance of supervision, group supervision, ongoing training, and peer support networks for continuous professional development and case consultation.

6. Research and Continuing Education

  • Current Research: Review of the latest scientific research on psychedelics and their application in PAT  and PAST.

  • Continuing Education: Encouraging participation in workshops, seminars, and additional certifications to stay updated with advancements in the field.

Practical Components:

  • Role-Playing and Simulations: Practice through role-playing scenarios and simulated PAST therapy sessions.

  • Supervised Practice: Supervised clinical practice with feedback from experienced practitioners.

  • Reflection and Integration: Regular reflection sessions to integrate personal experiences and professional learnings.

This curriculum is an example of what PAST requires to equip therapists with the knowledge, skills, and ethical foundation necessary to effectively and safely incorporate psychedelics into sex therapy practices. This curriculum is not an exhaustive example, and its ever changing and growing .


References:



 

The Author’s Work: 

https://www.rootedhealingsanctuary.com/

Email: alexandrialove@rootedhealingsanctuary.com


Alexandria is currently working on a project Institute for Sexedelics, a non-profit organization fiscally sponsored by the Institute for Sustainable Futures, a 501C3 designated organization. The Institute for Sexedelics is currently looking for funding to support the development of the Institute for Sexedelics organization and its PAST project, as well as a book publication and collaborative authorship for Sexedelics. 


The vision of this project, 

Vision: We envision a world that uplifts and fosters acceptance and access to psychedelic sex therapy and other non-traditional therapy modalities for everybody. 


Alexandria Jones
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