How to Pick Your Just-Right Bear

Choosing a Therapist/Guide for Psychedelic Journeys

As I trundle down Chicago's Riverwalk in my daily attempt to commune with nature, I find myself hip-hopping through an obstacle course of crap my beloved ducks have deposited. My duckie friends have transitioned from water to land in absolute glee – thrilled to be munching on Spring’s buffet of sprouting grasses. 

Oh, dear. There is excess. Excess eating. Excess excrement. I shake my head at them in exaggerated condemnation, but I don't really mind. I love my duckies and I'm happy to spend time with them regardless of their eccentric and sometimes annoying behaviors. 

I feel the same about bears, though my affection is offered at a greater distance. For safety’s sake, the boundaries need to be clearly defined, to create a protective container. Without that, having a positive experience is left to chance. 

I'm madly in love with this guy and I've spent long days lounging about with him. But the glass barrier between us was definitely required. You don’t want to get between a panda and his bamboo. For reals. And let’s just say this sweetheart can be sweet and can also be touchy. I was never quite sure what inspired which mood. My panda wasn’t safe in any conventional sense. 

So why in the world am I going on about duckies and pandas in an essay on picking a guide for psychedelic-assisted therapy (PAT)? 

Well, I love analogies and these fuzzy friends provide us with a surprisingly coherent framework. Ducks are sweet and, though they can definitely get snappish, they’re not likely to do us much harm. A pissed-off panda, though…oh, man, run for your life! 

When you’re choosing companions, it’s worth considering personality and style. What kind of experience are you hoping for? Feather-light, un-bear-able, or something in between? 

If you’re going to visit an alternate, hallucinogenic universe (in which I’ve met a whole lot of animals, by the way, including a terrifying gigunda tarantula whose job it was to shelter me from harm under its belly), you’d best have a caretaker with whom you feel both safe and resonant. To benefit, you need the right container and guardrails. A psychedelic journey ain’t no duck pond (unless, of course, it is!).

We therapists are humans, may I remind you. We have plenty of crap, just like everyone else. So, it’s essential to pick a guide whose crap you can handle – or, perhaps, even find endearing. But you don’t want a guide whose crap litters the pathway like my duckies’ do. And in no case, should you work with anyone whose boundaries aren’t verbally stated and viscerally embodied. A guide is a bear, not a duck, and the container must be strong. The boundaries must be clear and sacrosanct.*

I’d recommend a panda with glass walls. Someone warm and fuzzy, strong and protective, and totally transparent. 

How to Pick Your Just-Right Bear

In the children’s fairytale The Three Bears, Goldilocks stumbles into the empty cabin of a bear family and tests out their porridge, chairs, and beds, till she finds the ones that are just right for her (not too warm or too cold, not too soft or too hard, not too heady or too basic). In the story, she’s portrayed as a wicked child for exploring in this manner. She was anything but. 

I encourage you to be just as invasive, inquisitive, and investigative as Goldilocks, who was, in fact, an intrepid detective. Be as brash and direct as you want. Ask ALL the questions. State ALL your needs and stand by them. Because your life, healing, and general well-being are on the line. 

To find your just-right bear, you’ll need first to understand the critical factors of Set and Setting and consider every candidate’s qualifications and quirks. 

In textbooks and journals, set and setting are defined as completely distinct terms. But in practice, they’re enmeshed, influencing each other in both obvious and subtle ways. So, if you wind up confused about the difference as you read on, know that you’re in good company. Just relax into the general ideas. The essential point is that your guide impacts both and, in turn, is a key factor in the quality of your journey.

Set

Set refers to your mindset about this venture. So, ostensibly, it’s all about you and your thoughts. But preparation sessions are key to a successful journey. An excellent guide will attempt to support you rather than influence you. Her job is to help as needed in shaping your goals, aspirations, and intentions and to address any concerns and fears you may have. In doing so, your guide will impact your mindset. Pretending it isn’t so is just silly. 

For instance, when I enter a journey feeling frightened of what might arise, my therapist, Geoff, helps me give voice to those fears and then reminds me to “trust, let go, be open” – the psychedelics mantra. 

I’ve been in a different room with a different guide, who shut down any discussion of anxiety and insisted, instead, that I focus on my present-moment safety. In other words, she preferred that I disavow my actual feelings. That’s about as unhelpful as guidance gets. Trying to lock down my psyche while on drugs is futile and the effort often leads to an unpleasant experience, mired in resistance. 

Note the difference: Geoff helps me meet my feelings – remain in relationship to those feelings, comfortable or not – and encourages me to trust that what’s happening is what needs to happen for healing to take place. 

Instead of trying to talk me out of my fears, Geoff often reminds me to face the monsters I meet with curiosity – move toward instead of away. It’s in those frightful situations that the roots of pain are revealed and worked through so that emotional growth occurs. But I’d have trouble taking that tack without guidance.

This exemplifies two tools of a universal just-right bear: equanimous presence and scaffolding. It’s healing to be in a room with someone who calmly listens without adding their own crap to the mix. Someone who lends a hand to make the climb a little less steep. The journey becomes easier, but it’s still your own.

Yes, set is about your mindset, but it’s impacted by the company you keep.

Setting

Setting refers to both the physical and social context of the journey. 

A pleasant, comfortable, safe environment leads to an open and relaxed mindset, so the space has considerable impact. Other aspects of the physical setting include music, aromas, and extraneous sounds. For example, it’s not unusual for me to have visions of a sunrise while a piece of music called ‘Sunrise’ is playing – despite the fact that I’ve never before heard the track and do not know its title. Blows my mind every time.

The social aspect of setting includes other participants in a group journey, medical providers who are present, and, most importantly, the therapist/guide. Note that the physical setting – including playlists – is a reflection of the guide’s personality and preferences. And your guide is the linchpin because she can quite literally mess with your mind. 

This is no metaphor. On psychedelics (and in the days, weeks, and months that follow – long after the medicine has evaporated from your system), your brain is pliable. Multiple studies have demonstrated neuronal growth and the budding of new neural networks. We see the world – our past, present, and future – in novel ways, as if through fresh eyes. In this state of neuroplasticity, unforeseen possibilities emerge. The brain grows. And for most people, new behaviors follow. When things go well, this is precisely how we heal.

If you’re in the room with someone who doesn’t have your best interests at heart, lacks insight into their own impact, or simply isn’t the right fit, harm can result rather than healing. You don’t want that vulnerable brain of yours filled with new problems created by a bumbling bear.

I hope, at this point, you can see that set and setting are inexorably linked. The guide is literally defined as an element of setting but invariably influences mindset as well. This fuzziness is fine, as long as you pick the right bear. 

Qualifications

Qualifications matter. 

If you’re working through a mental health issue like depression or post-traumatic stress disorder, you might want a guide with education, training, and experience specific to that condition. Certainly, it’s wise to work with someone well-trained in psychedelic therapy. There are reputable certification programs that should be on a guide’s resume and some therapists have provided treatment within clinical research trials. 

You’ll also want to be sure that the guide has experience with the particular medicine that you’re requesting. These drugs have different profiles and personalities and navigating each is its own special skill.

But sorting out qualifications is actually the easy part. You can ask directly and do some research to assess the responses. 

Then there’s the touchy-feely, gut-instinct stuff. That requires more insight and finesse.

Quirks

Much more important than qualifications is quirks. You have to be comfortable with your therapist’s style. In fact, as in all good relationships, it's best if you find your therapist’s crap endearing rather than off-putting. 

I enjoy thinking about quirks in Goldilocks terms. 

One type of bear is soft and cuddly and warm. Possibly too soft. You get to decide. 

Here, there’s deep emotional engagement and little substantive guidance. Healing is thought to occur through caring, rather than hard work applying tools and techniques. This can feel comfy and safe. 

But here’s the rub: You're probably not going to all this trouble to simply have your battered soul soothed for a couple of hours. In all likelihood, you're here to seek change. And for that to occur, you need someone who has training, education, skills, and tools that are specific to the psychedelic space. Someone who can transfer this knowledge so that you can do the hard work of healing during and between journeys.

I worked with a soft bear for a time. She did her damnedest to dissuade me from “trying,” insisting that my effort was counterproductive. She was wrong. I didn’t need a hug. I needed hope. And my “trying” was a sign of healing – a sign that hope was present, motivating me to work at my well-being. 

The other type of bear wields his status and authority. You know this person – the god-like doctor whose immense knowledge, skills, and experience are incontrovertible. And he knows it. And he lets you know it, too. This bear’s resume alone can draw people in.

I'm not saying these qualities are bad, but they're problematic in isolation. If a guide is convinced that he knows more about you and what you need than your own system does, he may guide you in ways that are dissonant with your values, hopes, and dreams. And a person like this is likely to push you hard in what he views as the “right”  direction. In such a power dynamic, you may feel compelled to comply, years later realizing that you had conformed to an authority in ways that did not fulfill your own needs.

In all likelihood, Mr. Smarty-Pants bear is not your just-right bear. But, again, you get to decide. 

By now you probably see why my panda with glass walls feels like the best fit for all.

A Brief but Ex-Panda–able Journey to Just Right

I know…I know…I’ve gotta stop with the puns. But, this is a long essay, and finding a guide is serious business that requires some comic relief. Chalk this moment up to self-care.

Ok, I hate the way this story starts: I Googled. Specifically, I Googled “integration therapist Chicago.” Googling for a therapist is the worst idea ever but what can you do? I didn’t have a clue and I had to start somewhere. 

Note that my work with Geoff started off with somatic and integration therapy, so the guide role evolved from the therapist role. After a relationship had developed. This is the most impactful tip I can offer: When possible, get to know your guide before going on a journey. It’s the best way to ensure you’re simpatico and safe.

Qualifications

When I consulted Dr. Google, I was working with an out-of-state guide and needed a local therapist for integration. Geoff’s name came up in my search and I quickly discovered I’d hit the qualifications jackpot. 

Geoff’s a psychologist, a university prof with a large repertoire of publications (which helped me suss out his interests and ethics), and co-founder of Sana Healing Collective, a clinic specializing in ketamine-assisted therapy. At the time, I had no interest in ketamine, but this aspect of his work demonstrated that this dude walks his talk. His clinical work influences his research and vice versa. Geoff’s theoretical orientation (somatic therapy) and areas of expertise (trauma, depression, and mindfulness) also mapped to my needs. This felt like a perfect fit.

Setting

Most settings will have disadvantages, and this was no exception. I’d like to be out in nature – far from a city – when doing this work. But that’s not where I live and it isn’t an option. I found Geoff’s office spacious and comfortable, loved his big, lush, cobalt blue couch, and appreciated little touches like the heaven-scented lavender soap and cosmic, playful paintings in the bathroom. The setting also felt like a fit.

And then there’s the bear himself…

Quirks

What I most remember from our first meeting is feeling calm and grounded, despite discussing difficult material. In nervous system terms, this is called co-regulation: Geoff’s steady-state calm was infectious. That first impression was spot on and this co-regulation continues to this day.

Geoff was also able to track my long-winded monologues (a feat of mental dexterity, as far as I’m concerned), extracting the critical bits, and casually offering some concise insight that would shake my entire worldview. 

In essence, I knew what type of bear was present by his presence. You can’t make someone feel heard and seen without fully showing up yourself. And I deeply respected his skills and commitment to the work from early on. Likewise, I felt his respect for me. Never, never, ever spend a moment with a therapist who doesn’t fit this bi-directional bill. Lack of respect is a non-starter.

I won’t pretend that there’s never been a fly in our honey. As we’ve worked together, we’ve had a few snags. I’m being euphemistic here. Therapy focused on complex post-traumatic stress disorder is like juggling Molotov cocktails: you never know when one will drop and leave a fiery mess in its stead, requiring quite a bit of cleanup. Every time we take a wrong turn, Geoff owns his crap without flinching and gives me the space to work through mine. Like any other solid relationship, we’re both more interested in repairing the connection than being right. 

This is precisely the algorithm to follow. It’s what I wish for you, dear reader. It really should feel this right. 

Wildlife Warnings

None of this is easy or obvious. Take comfort. This is the journey before the journey and it will provide part of the healing you seek. Listening to your inner wisdom and advocating for yourself is good medicine.

I’m asking you to summon your courage before the first call. To reach inside yourself and listen to every small voice – a flutter of the heart, a turn of the stomach, some tension in the brow – and honor that protective cry. 

When you find your just-right bear, you’ll feel it. The roiling ground will steady and your heart will know it’s home. The crap on the path will feel navigable and the container will feel safe. 

I found my just-right bear, and he was worth the wait. We’ve had some kerfuffles and I’ve occasionally slipped on some crap along the path. But my just-right bear (who’s probably appalled to see himself described this way!), picked me up, dusted me off, and we continued on our way. That’s just what a just-right bear does.

Search for and test drive guides till you find one that’s just right. And, if a guide responds poorly to your testing, that calls for immediate dismissal. That person’s crap won’t serve you. 

Never question the legitimacy of your needs. Be your own best advocate on your journey to well-being. And keep on hunting till you find your very own just-right bear.

* NOTE: This essay is not focused on serious or criminal abuses of power within the field of psychedelics, psychedelic-assisted therapy, or psychotherapy. I’ll save that for a future, even more harrowing, discussion. For now, know that such tragedies do occur, frequency unknown due to underreporting, so my words of caution here take on even more importance. Protect yourself as best as you can by honoring your inner signals and contact the authorities if anything untoward occurs. You know where to reach me and I’ll help if I can. ❤️‍🩹