Who are the psychedelic underground? Meet the 27 facilitators behind this research

Somewhere between the clinical trial and the ceremony, between the legal dispensary and the living room altar, there are people quietly doing some of the most intimate work imaginable - guiding others through the depths of their own minds and souls, one journey at a time. You will not find them on social media or with some sophisticated website. Most won't even tell you what they do. And yet their work is shaping how we might understand healing for generations to come.

This is the population at the heart of my dissertation research.

My study is built on in-depth interviews with 27 psychedelic facilitators operating in the United States - most of them completely underground, all of them doing important work within an important moment in history. As interest in psychedelic therapy explodes into the mainstream, it doesn't seem like many have stopped to ask: what are the people already doing this work actually doing?

Perhaps you haven't noticed (most of us don't), but underground facilitators are almost completely absent from the literature on psychedelic care. There are important reasons for this:

• The field has a longstanding preoccupation with the substances themselves. Neuroscience, pharmacology, and clinical trial design have dominated the conversation - with reason. But unfortunately, the facilitator's influence has often been flattened into a protocol while the molecule gets all the attention.

• In a society where licensure, certification, and institutional affiliation equal legitimacy, underground facilitators are systematically invisible - not because they lack skill or experience, but because there is no legal pathway for them to hold the kind of authority the mainstream recognizes. Someone with sixteen years of apprenticeship in an Amazonian lineage, thousands of ceremonies of experience, and a deep somatic understanding of how trauma moves through the body will not appear in a literature review. They have no degree to cite, no institution to affiliate with, no way to make themselves credible within a system that was not built with them in mind. This keeps out some of the most knowledgeable people in the field.

• Underground facilitators cannot advertise, publish under their own names, present at mainstream conferences, or participate in formal research without exposing themselves to serious legal consequences. Their invisibility is not simply a byproduct of being overlooked. In many cases it is a deliberate and necessary strategy for self-protection. The literature cannot include people who cannot safely be found. And so an entire ecosystem of knowledge - developed over years, sometimes decades, of real-world practice with real people navigating real crises remains largely undocumented. Not because the information isn't important, but because the people who hold it can't afford to be revealed.

• Academic researchers tend to study what they can access through institutional channels - licensed practitioners, clinical trial participants, regulated programs. Reaching underground facilitators requires a different kind of research relationship, one built on trust, confidentiality, genuine community access, and a willingness to meet people on their own terms. That takes time and a particular kind of positionality that most researchers don't have and some don't think to seek. And even when researchers do gain access, the knowledge that underground facilitators carry (i.e. embodied, relational, experiential, accumulated through presence rather than publication) doesn't translate easily into the quantitative outcome measures and standardized protocols that dominate the field's preferred research paradigm.

Nonetheless, to leave underground facilitators out of conversations about psychedelic care seems foolish. Their wisdom is gold: they have the most real-world experience and they understand the nuances of facilitating in our diverse 21st century culture.

So I set out to hear them, to center their voices, their stories, their cautionary tales and wisdom, as the psychedelic renaissance rages on.

What "Underground" Really Means

For many, the word "underground" can bring images of secrecy and recklessness. But the facilitators in this study are neither. They are, in many cases, experienced therapists, trained healers, and long-practicing ceremony holders, some with decades of experience, some with formal clinical licensure, some with deep apprenticeships in Indigenous lineages. What makes them "underground" is simply the legal context they operate within. In most U.S. jurisdictions, psychedelic-assisted healing remains illegal outside of tightly regulated research trials.

It's important to note that these facilitators carry real legal, professional, and reputational risk each and every time they show up to do their work. And yet they keep showing up. To me, that feels important.

Why Study Facilitators?

A growing body of clinical research confirms what many people already know from personal experience: substances like psilocybin, MDMA, and ayahuasca can accelerate profound psychological and emotional healing. But the research is largely focused on the substances themselves - their pharmacology, their efficacy rates, their potential diagnoses.

What's much less studied is the human in the room.

The quality of facilitation can profoundly influence whether the experience becomes a source of transformation, confusion, traumatization, or breakthrough. This is not a minor detail. It's arguably the most important variable of all. After all, a facilitator's main responsibility is to create the set and setting that supports safe and meaningful journeys.

Who Participated in This Research

The 27 facilitators I interviewed came from remarkably diverse backgrounds. Some were licensed clinical social workers and therapists who had integrated psychedelic work after years of conventional practice. Some arrived through spiritual communities and Indigenous ceremony. Some were self-taught through years of personal exploration. A few had stumbled into this work through their own desperate search for healing.

They were - what I like to call - a kaleidoscope of practitioners, from clinical to ceremonial, secular to sacred, highly credentialed to entirely self-taught.

For me, this diversity highlights one of the most important findings of my research: there is no single profile of a psychedelic facilitator. There is no standard training path or singular approach. As I write this, there is no governing body, no licensing exam, no required curriculum. So a standardization of practice doesn't exist (and perhaps never will) - which is a precarious truth that sets the tone of psychedelic care.

What Unites Them

Even with all their differences, the facilitators in this study shared a striking set of core values: humility, integrity, presence, and a deep respect for the participant's autonomy and unique healing process. As my research concludes:

"Facilitators consistently emphasized a shared set of core values: humility, integrity, presence, relational attunement, and a deep respect for the participant's empowerment, autonomy, and unique process."

Most of them did not see themselves as healers. They saw themselves as fellow travelers and companions - people who walk alongside another person through some of the most difficult and beautiful terrain of their inner life, without trying to direct where they go or decide what they find.

The facilitators in my study felt a unified sense of urgency and importance behind their work, especially amidst a mental health crisis. From everything I've learned about their work, I wholeheartedly agree.

What's Coming in This Series

Over the next few articles, I'll share what I learned from these 27 facilitators: their training paths, their philosophies, their practices, and their wisdom. I'll draw directly from the words they shared with me, letting their voices carry the weight of the research.

Whether you're a clinician curious about what's happening outside the lab, a seeker trying to make sense of your own psychedelic experiences, or simply someone paying attention to one of the most fascinating movements in modern mental health, I hope you'll find something here worth knowing.

Next up: the astonishing variety of ways people become psychedelic facilitators in the first place.