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Based on ethnographic research in Belgium, this paper examines the emergence of psychedelic-assisted therapy by analysing how scientists, therapists, activists, and legislators negotiate knowledges, practices, legitimacy, and authority, and how competing conceptions of mental health are articulated.

Paper long abstract

This paper explores the emergence of psychedelic-assisted therapy as a field of mental health in Belgium through an ethnographic study of the various social groups involved in the definition of the knowledges, techniques, and practices that constitute it. Bringing together a wide range of actors – mainly, scientists, underground and aboveground therapists, as well as activists and lobbyists, legislators, and patients – with diverse knowledges, interests, and understandings of mental health and healing, this new field is marked by tensions and controversies across the medical, economic, social, and political spheres, making it a valuable site for examining broader transformations in the domain of mental health. More specifically, this paper investigates two dimensions. First, it aims to study the different types of knowledges and practices held and enacted by these groups in Belgium, looking at how they are shaped through transnational circulations and through their interactions. It examines how these knowledges and practices are legitimised, as well as the tensions, boundaries, and hierarchies arising from the confrontation of distinct epistemologies and ontologies – asking which types of knowledge and practices are deemed valid, legitimate, and authoritative enough to inform legal and potentially reimbursed therapies. Second, it explores how various conceptions of mental health (biomedical, psychosocial, spiritual, somatic, etc.) and healing are maintained, contested, or transformed across these various groups. Hence, the tensions and contestations in these two dimensions provide a window to study the broader crisis in scientific authority and knowledge production in Global North societies today.

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Drawing on interviews with Western participants engaging with iboga, this paper examines visionary encounters that transform consciousness while resisting biomedical, therapeutic, and spiritual closure. Iboga emerges as a site where polarised epistemologies persist rather than resolve.

Paper long abstract

In the context of the so-called psychedelic renaissance, visionary substances increasingly circulate across therapeutic, spiritual, and informal ritual settings, generating new configurations of meaning, authority, and experience. This paper draws on interviews with Western participants engaging with iboga in ritual and therapeutic contexts linked to Gabon to examine how visionary encounters transform consciousness while resisting stabilisation within any single explanatory framework.

Participants consistently describe iboga as producing profound shifts in perception, memory, ethical orientation, and self-relation. Yet these transformations are rarely articulated as discrete experiences that can be fully integrated or explained. Instead, iboga is described as a persistent presence or agent that exceeds chemical, psychological, and symbolic accounts, continuing to act beyond the moment of ingestion or ceremony. In this sense, healing and belonging emerge not as resolution or closure, but as ongoing processes marked by obligation, discipline, and uncertainty.

Analytically, the paper approaches iboga as a site where polarised epistemologies—biomedical and experiential, therapeutic and visionary, secular and sacred—are not reconciled but held in tension. Rather than treating this indeterminacy as a problem to be solved, I argue that it invites an anthropological stance of epistemic hesitation: a refusal of premature translation that allows multiple, incommensurable ways of knowing to coexist. By attending to visionary experience as an ethnographic and epistemic event, the paper contributes to broader debates on how anthropology might engage polarisation with care, restraint, and methodological openness in a fractured yet interconnected world.

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In recent years, the phenomenon of microdosing psychedelics has gained momentum beyond psychedelic cultures. Drawing on my ethnographic fieldwork, I will examine the cases of Gianmarco and Laura, two young psychedelic facilitators who run microdosing groups and identify themselves as spiritual.

Paper long abstract

In recent years, the phenomenon of microdosing psychedelics has gained momentum beyond psychedelic cultures. While existing literature highlights aspects of cognitive enhancement linked to the practice, microdosing is also embedded in a range of practices and beliefs encompassed by the umbrella of spirituality. Psychedelic spiritualities are diverse, ranging from esoteric knowledge linked to popular occulture, to New Age and entheogenic frameworks. Drawing on ethnographic fieldwork with psychedelic integration circles in Italy and Spain, this article examines two case studies: Gianmarco and Laura, psychedelic facilitators in their thirties who run microdosing groups and identify themselves as spiritual. As young, middle-class psychedelic users, they exemplify a trend of converting subcultural capital—gained from direct psychedelic experience—into economic capital, spurring a new wave of global psychedelic expertise. However, their focus on individual well-being and personal development aligns with a neoliberal spirituality that inculcates an ethic of self-care and self-monitoring. Young people today face a confluence of crises: economic, ecological, and post-pandemic. While the resulting malaise has deep social roots, the responsibility for navigating it is often placed on the individual. Building on Weber’s analysis of the Calvinist ethic’s role in the capitalist pursuit of productivity, I argue that psychedelic spirituality in neoliberal times may similarly serve corporate culture and enhance efficiency through working on resilience. As seen with the co-optation of yoga and mindfulness, the risk is that psychedelic spiritualities become another technique of the self, promoting self-reflexivity while obscuring the social and power dimensions of structural relations.

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Ethnography of a French hospital team who, pre-trial, undertook supervised self-experience with high-dose psilocybin truffles and trip-sitting in the Netherlands. Examines training, safety, tacit knowledge, and care for potentially extraordinary, boundary-testing experiences.

Paper long abstract

This paper reports an ethnography of a French hospital care team preparing for a forthcoming psilocybin clinical trial. Prior to any patient dosing, the clinicians organised an extra-clinical training in the Netherlands—where psilocybin truffles are legally available—combining supervised self-experience with a high dose of psilocybin and trip-sitting, with strictly pedagogical aims. By July 2026, fieldwork will be complete and will include participant observation of the training protocol, ethnographic interviews, and document analysis.

The study traces how personal exposure to psilocybin’s effects is translated into transmissible clinical know-how: preparing set/setting; recognising and accompanying affective transitions; calibrating presence and reassurance; managing music and unforeseen stimuli; arranging follow-up and psychological safety. It also examines how narratives, checklists, and guidance documents mediate the conversion of first-person insights into standardised recommendations that may inform other hospital teams.

Empirically, the case illuminates emerging practices at the interface of institutional medicine and informal, cross-border learning. Conceptually, it addresses the panel’s concerns by showing how psychedelics can reconfigure boundaries between the secular and the exceptional—between regulated therapy and encounters that participants may characterise as extraordinary or noetic, potentially challenging ordinary rationality. The paper interrogates shifting epistemic authority—who counts as “expert” when experiential knowledge becomes part of clinical competence—and surfaces tacit ways of knowing that exceed conventional biomedical frames. Finally, it reflects on ethics and governance: what responsibilities are enacted when clinicians become psychonauts for training purposes?

By following “psychedelics in action,” the paper documents a pivotal moment in the professionalisation of psychedelic care in Europe.

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The paper explores relational and spiritual aspects of iboga/ine’s therapeutic efficacy at a European retreat. Here people are taught to relate with iboga/ine as an animated being. This, I argue, can influence efficacy by working as a more-than-human therapeutic alliance that can facilitate healing

Paper long abstract

The Central-African originating plant iboga and its alkaloid ibogaine are known and revered for both their sacred and psychoactive properties. Historically used within and beyond its region of origin for initiatory, divinatory, medicinal, and stimulatory purposes, iboga/ine is now also employed internationally in the treatment of substance dependence and mental afflictions. While reported therapeutic benefits are largely attributed to (neuro)pharmacological mechanisms, relatively little attention has been given to relational and spiritual factors shaping iboga/ine’s efficacy in such treatments.

Based on six months of ethnographic fieldwork at a European retreat-centre where iboga/ine is offered as part of holistic treatments for substance dependence and psycho-spiritual healing, this paper analyses the efficacious role of spiritual beliefs and ritual practices of animating iboga/ine as a volitional being. At this facility, iboga/ine is framed as a “teacher plant” and “sentient being” which knowingly will “give you what you need, not what you want”. Clients are encouraged to relate to iboga/ine in such ways through therapeutic discourses, ritual activities, and shared interpretations for the treatment to be more efficacious. Drawing lines between perspectives on plant animacy, adorcistic spirit possession, and the psychotherapeutic concept of therapeutic alliance, I argue that the mode of relating with iboga/ine that was socially transmitted and practiced at the retreat, installed the clients in a more-than-human therapeutic alliance with iboga/ine. For some, the cultivation of this alliance with iboga/ine impacted their experiences by providing dialogical engagement for healing and establishing a new relation to themselves and their lives.

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This paper explores the role of suffering in ketamine-assisted psychotherapy, drawing from ethnographic fieldwork conducted in California, USA. It looks at how 'shadow' experiences are supported and integrated within a context of psychedelic spirituality, social inequality and hyper-individualism.

Paper long abstract

This paper is based on fieldwork conducted in California, USA, studying the effects of ketamine assisted psychotherapy. It draws from interviews with patients and practitioners, as well as participant observation in ketamine clinics and psychedelic retreats. The paper explores the role of suffering in different approaches to ketamine therapy, via a critical inquiry into the nature of the "inner healing intelligence", understood to be the mind's innate capacity to heal itself under supportive conditions. In this ideology of healing, all phenomena that arise within the psychedelic experience are the product of the "inner healing intelligence" and are surfacing for processing, release and understanding. This includes ‘shadow’ experiences, which, if handled correctly, can lead to positive healing outcomes. The paper critically explores how practitioners’ spiritual beliefs and practices work to create a safe environment for participants to explore these deeper aspects of psyche, by invoking the reality of the sacred and trust in the "inner healing intelligence". It also looks at case studies of people who have healed from suicidal depression and PTSD with ketamine therapy, where things "get worse before they get better", and how this trajectory of healing may only benefit a privileged class of people with time and space for integration. It places such healing practices within the social context of California, which is marked by hyper-individualism, stark inequality and social issues such as homelessness and addiction, where ketamine clinics are run as businesses whose profit motive may interfere with adequate patient care.

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This paper examines spiritual practices with psychedelic substances in what we term 'ritualised emerging contexts', characterised by their informality. Drawing on ethnographic observations, we analyse variations within these ritual contexts, while considering methodological and ethical challenges.

Paper long abstract

In recent years, there has been a notable increase in research on psychedelic substances in different geographical contexts and scientific domains. This trend is particularly evident in the health sciences, where promising clinical trials have revealed the potential of different substances to address a range of mental health symptoms, fostering a debate about their possible medicalisation. However, in non-clinical fields, such as sociology and anthropology, research remains limited, often overlooking the role of other variables present in real social contexts, which could explain possible therapeutic and transformative benefits. Based on the SPIRECTS research project (funded by FCT, 2023.13311.PEX), which is dedicated to studying spiritual practices and psychedelic substances in light of their therapeutic and socio-cultural implications, we intend to contribute to this debate by examining naturalistic contexts, and specifically what we term ‘ritualised emerging contexts’. These are characterised by their informality and spontaneous nature, existing outside institutional frameworks. What variations do we observe in these informal and self-organised contexts, and how do collective or group dimensions shape expectations and eventual effects, as reported by participants? Methodologically, we have adopted a qualitative, ethnographically inspired research strategy, that involves observing various contexts and conducting in-depth interviews. Studying these informal and underground contexts offers significant epistemological advantages and also presents inherent research challenges. In this paper, we intend to address these challenges by discussing their methodological and ethical implications for understanding psychedelic research.

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The ayahuasca brew has been the focus of research for addressing psychological and spiritual concerns on Global North contexts, leaving a gap regarding indigenous and mestizo populations. I will argue how their experiences are anchored in local notions of spirituality (e.g., visions, dreams).

Paper long abstract

Ayahuasca is an Amazonian psychedelic substance product of the combination of the ayahuasca vine (Banisteriopsis caapi) and the chacruna shrub (Psychotria viridis). It has gained renewed interest in the past 20 years, both in academic spaces and the public sphere, as research in the context of the “psychedelic renaissance” focuses on its potential therapeutic applications -and of other substances- while users from globalized contexts seek it as a solution to a wide array of psychological ailments (e.g., depression, post-traumatic stress disorder), or a gateway for spiritual inquiries.

While relevant research has been done in relation to the ayahuasca tourism scene in Latin American countries, and the circulation of the practice in the Global North, less attention has been placed on how indigenous and mestizo (i.e. people from mixed ethnic and cultural backgrounds often based in urban or peri-urban areas) establish significance of their ayahuasca experiences according to their local notions of spirituality. In this paper, I will explore how the ingestion of ayahuasca and other plants allows indigenous and mestizo people anchor their spiritual realities into concrete forms of relation for human/more-than-human interactions through visions, dreams, and contemplation.

I will argue based on the ethnographic data I gathered among indigenous and mestizo populations during my doctoral fieldwork (January 2022-August 2023; September-November 2024) in the Amazonian region of San Martin, Peru, at two locations: Tarapoto, a city that acts as a gateway to Kichwa-Lamista provinces; and Alto Mayo, a valley accessible by highway from Tarapoto, were the Awajún people are based.