Michael Pollan and Dr. Robin Carhart-Harris at the Centre for Psychedelic Research at Imperial College.

Everything changed on New Year’s Eve in 2013. Nikita was dancing with dozens of friends on the rooftop of her apartment building in Times Square. Just as the ball was about to drop, she collapsed on the ground, gasping for air.

At the hospital, doctors discovered and removed two tumors in her throat. But the lack of oxygen she experienced at the party that night damaged her brain. It took her two years to begin to recover. This near-death experience, however, pushed her to change the course of her life.

For nearly 20 years, Nikita had worked as an underground psychedelic therapist. Nikita is not her real name, it is the name by which she is known in the underground community. While working for a TV station as a camera assistant and audio engineer, Nikita was administering illegal psychedelic substances to her clients on the low. She arranged secret meet-ups. The healer never charged for her services; she treated her clients out of her one-bedroom Manhattan apartment.

“When you go through an experience like that, you really go deep into: Who am I? What am I doing? Did I really live my life and live it right?” Nikita explained, describing the moment after her near-death experience when she knew her life would change. 

In 2015,  Nikita decided to go back to college to obtain a license that would allow her to practice psychedelic therapy legally. To become a state-certified therapist she has to complete a master’s program and work approximately 3,000 hours. Once licensed, Nikita will be able to assist in clinical psychedelic trials and work as a therapist in other settings. 

Nikita will join a movement of scientists, therapists, and practitioners of alternative medicine who, after decades of operating in the shadows, are driving a resurgence of interest in the use of psychedelics in the treatment of a variety of mental illnesses, from anxiety and depression to post-traumatic stress disorder and addiction. Her fledgling journey comes at a time when universities and federal researchers around the country have begun to conduct numerous psychedelic-assisted clinical trials. 

Over the past 20 years, the US Food and Drug Administration has started to approve clinical psychedelic trials again for the first time since the 1970s, but the number of trials has only been significantly increasing in recent years.

Last year an annual psychedelic conference in New York City drew more than 2,600 from around the world, up from about 250 in 2007. The conference, which started as an afternoon of talks in a church, now boasts two days of classes, parties, exhibitions, film screenings and other events. 

If Nikita’s decision to bring her practice out into the open reflects a growing national interest in psychedelic treatment, it was also intensely personal. After her near-death experience in 2013, Nikita still had problems with speaking and recalling information, as well as spelling, so she thought going back so school would help her brain heal. Even now, she still struggles with some of these issues.

By the time Nikita decided to go back to school, in 2015, the Multidisciplinary Association for Psychedelic Studies was starting a number of clinical trials, marking the perfect time for Nikita to jump in on this journey and contribute her knowledge and experience.

Since this surge in studies has only been resurfacing in recent years, there isn’t yet information about the exact number of participants. However, recently completed trials, according to the institutions that conducted them, show promising results. NYU’s Langone Medical Center completed a clinical trial with psilocybin and cancer patients in 2016. Researchers found that one-time treatment with psilocybin brought relief from anxiety and depression that lasted for more than six months in 80 percent of the 29 study subjects monitored. NYU’s study was published alongside a study conducted by Johns Hopkins University that showed similar results.

Nikita grew up alongside her twin brother, who suffers from schizophrenia. She wanted to understand exactly what hallucinations were, as a way to be able to better understand her brother. When she was about 14, she decided to take psilocybin and LSD for the first time. 

“It was like this whole new world opened up to me,” Nikita recalled. “Not only did I understand myself and the world around me more and feel more connected, but I also felt connected to this spirit world. It was very healing and it helped me understand mental illness.”

Psychedelics helped Nikita work through her own pain and trauma. When she was a teenager, and throughout her 20s, she suffered from post traumatic stress disorder. Her mother’s boyfriend had raped her when she was a child, and later, three boys she thought were her friends drugged her with rohypnol and gang-raped her just after high school. She suffered from anxiety and suicidal thoughts. Psychedelics helped her free herself from these traumas. Whenever she felt bouts of depression coming on, she did a psychedelic session with herself and her depression would subside. 

The World Health Organization estimates that more than 264 million people worldwide suffer from some form of depression, and about one billion have a mental health or substance use disorder. About one third of these individuals suffering from depression do not respond to antidepressants, and are thus treatment resistant. Many of these individuals seek help through clinical psychedelic-assisted trials. 

Seeing how much psychedelics helped her, Nikita started using them to help people around her. “It started me on that journey of doing psychedelic therapy with people,” she said, “because I saw that here we have these drug companies making people addicted to these pills, making money, and here we have this natural and organic matter that can really do so much healing for people and there’s not this addiction where you’re now reliant on them for your functionality or survival.”

People have consumed psychedelic substances for thousands of years. During the 1950s through the early 1970s, which are considered the “golden age” of psychedelic therapy, they found their way into medicine. However, when substances found their way from the labs to broader society, they were condemned and deemed illegal by the government. Psychedelics, and therefore psychedelic therapy, were forced to go underground.

“Many of these studies reported positive results,” said psychiatrist Dr. Alex Dimitriu, the founder of the Menlo Park Psychiatry and Sleep Medicine Center in Menlo Park, California. “But when psychedelics escaped the lab and their uncontrolled recreational use spread, the promise of these substances was supplanted by fear about their effects and concern about abuse and in 1970, their use was prohibited for any purpose. Research came to a halt and the knowledge of what psychedelics could do was all but lost.”

Psychedelics produce radical changes in a person’s consciousness. They work by binding to receptors in the brain, and increase the activity levels of serotonin and other neurotransmitters. Studies by the Multidisciplinary Association for Psychedelic Studies and other research facilities have shown that substances such as psilocybin, ayahuasca, and ibogaine, which are found in fungi and plants, are natural, non-addictive, and can help to overcome addictions to other substances.

The main difference between clinical psychedelic therapy and psychedelic therapy in an underground setting, is that the clinical setting is much more restricted and has to follow narrower scientific research protocols. This, according to Nikita, does not leave a lot of room to individualize the therapy according to each patient’s needs.

It is, however, also the main argument that opponents of underground work emphasize when critiquing this kind of work. Dr. Marc Grifell Guàrdia, who currently does clinical studies with psilocybin and ketamine in Barcelona said that his main concern with underground psychedelic therapy is “that it’s not regulated and everything that is not regulated has some advantages in that it can be tailored to the people, but there are also low regulations.” 

Moreover, he stated that there is a risk that people might be using or administering these substances in an unethical way. This can prove problematic because people who are under the influence of psychedelics are very vulnerable; it’s important that “they take them with people who can really take care of them and do not take advantage of them in that situation,” Grifell Guàrdia said.

In the world of psychedelic therapy, set and setting are the key components to having a successful outcome. “Set” refers to the mental state of mind that individuals bring into their experience — such as their thoughts, moods, and expectations — while “setting” refers to the physical and social environment around an individual, including the person who does the therapy with them. These are the key variables with which Nikita works. 

Nikita was always very aware of the risks involved in doing this illegal work — she could be thrown in jail anytime. But she believes in what she’s doing, and that the benefits outweigh the risks. This has prevented her from ever thinking about quitting. One way she has counteracted this situation is by never charging anyone. This also has to do with her philosophy that “as soon as you charge people for something it becomes a service or commodity and they have certain expectations.” She doesn’t want to create that sort of environment. She wants her patients to get the most out of their experience.

On a typical Friday, Nikita is on call for several New York City hospitals. She provides services that address the needs of trauma survivors who have limited resources or limited access to care. Her work helps victims of rape, sexual assault and intimate partner violence by offering immediate crisis intervention in emergency rooms, follow-ups with psychotherapy, counseling and information, both for past and present survivors and their families and friends. When a call comes in, she gets into an Uber and drives to one of the hospitals.

While she waited on this particular day, she was working on a literature review of psychedelic studies on post traumatic stress disorder conducted with MDMA, LSD, and psilocybin. She sat on a bar stool at a tiny table in the middle of her apartment. Soothing tunes were playing in the background, accompanied by spacey psychedelic screensavers on her TV screen, which she never actually uses to watch TV. 

This space is not only where Nikita lives and does her class work, but also where she holds her assessments and psychedelic therapy sessions. The carefully chosen decorational details — the fairy lights, disco balls and color-changing hula hoops — serve as inspiration and help her stimulate and relax her clients so that the therapy can achieve the best results.

The entire living room wall is covered in heart-shaped Post-it notes. Nikita started putting them up in 2011, because she wanted to test rehabilitation methods for prisoners reentering society– a group she’s particularly interested in working with once she’s licensed. She tested it in her own apartment with her friends to see if these notes, containing encouraging messages, were effective in making people feel more love and safety. 

Her bedroom, adjacent to the living room, contains a special loft area, as well as a handcrafted hammock, both of which serve as safe spaces and places of reflection and relaxation for her patients. Whenever Nikita or her visitors feel like it, they add new notes. Nikita points out one that reads “That God gave me you!!”– she received it from the inmate for whom she initially created the method.

Suddenly, at 4 p.m., her phone rang: it was the hospital. This time Nikita’s patient was a woman. She had been drugged with “roofies” and raped. While Nikita filled out the preliminary papers and determined whether or not she could take this particular case, the woman was sitting in the emergency room with a friend waiting for Nikita to arrive and help her limit her shock, terror, and trauma. Nikita uses trauma-informed care with a client-centered approach to help these traumatized patients at the ERs; these are the same methods she uses with her private clients.

For a typical session, Nikita invites her patient over to her apartment, administers the dose and sits with them and counsels them throughout the entire trip. She tailors her work during the psychedelic therapy sessions specifically to the needs of each individual she works with, but she always creates an electronic music playlist that will play the entire time. This is meant to give her patients a constant, reliable backdrop and help create an atmosphere where they can let go and immerse themselves in an alternate world to dive deep into the issues they want to work through. Similar to a regular therapy setting, she likes to ask her clients questions that trigger them to come to realizations and make breakthroughs themselves rather than telling them what to do or think. She wants to make them feel loved, comfortable and understood in order to create the sort of environment where real transformations can happen — this often entails holding their hand or giving them a hug when emotions overwhelm them. 

Due to the fact that all the individuals Nikita works with have gone through vastly different experiences, she creates a unique approach for each patient, which is also influenced by how their bodies and minds react to the psychedelic substance. Once the substance wears off, Nikita tries to make the transition back to “the normal world” as smooth as possible for her clients — they can stay with her and talk through and reflect on all their experiences as long as they feel the need to. The first few weeks after the session, she makes sure to be available for them on the phone or in person. 

Since starting school Nikita has been using savings from her former job to pay for her tuition and has worked two jobs on the side to be able to pay for her day-to-day living expenses. Because there’s not much time left for her to do her underground work, she usually only works with about two patients over a period of several months, and has to schedule meet-ups with them on the weekends. 

Nikita stopped her work to look up a PowerPoint presentation she did on her self-designed research study in 2018 for her graduate class on research methods. It was supposed to include prisoners and correctional officers, but ended up focusing solely on correctional officers. The goal was to compare traditional therapy sessions, which correctional officers usually go through, with LSD-assisted psychotherapy, ultimately revealing the advantages of psychedelic therapy.

In 2018, Nikita decided to “out” her research interests and her wish to work as a certified psychedelic therapist in her university environment, for the very first time. The occasion was the presentation of the above-mentioned research study and the subsequent dialogue with her class — before that she had only shared this information with her close relations.

“I had spent the whole morning vomiting because I was so nervous,” Nikita recalled.

The college she attends is, Nikita said, “a rather conservative environment” when it comes to unconventional methods like working with illegal substances. That people working in law enforcement were sitting in front of her listening to a presentation on psychedelics didn’t help Nikita’s state of mind. Nikita was taken by surprise when she received overwhelmingly positive feedback.

While Nikita was president of the psychology club at her first college, she organized a talk on the recent developments in psychedelic research. At this time, there hadn’t been a lot of accepted scientific writing and the number of trials was relatively small, so it was still considered a “taboo topic.” Feeling that veterans would benefit from listening to the speaker, Nikita went to the Veterans Affairs Office and invited them to come. When they showed up for the talk, she felt a huge sense of validation.

About a year later, in 2019, while a grad student, she was hired as a speaker by the psychology club at her previous university, to talk about her research and work. This talk required sharing some of her own psychedelic experiences, but she refrained from explicitly talking about the actual therapy she is doing.

That same year, she took a class with a professor who was about to start another psilocybin clinical trial. After finding out that the professor hadn’t ever taken psychedelic substances, she indirectly advised them that it may be best to try to understand psychedelics by taking the substances themselves first, before using them to try to help others. 

A few weeks ago, she suddenly received a call from her former professor. A participant in one of the professor’s studies was in urgent need of care and had unfortunately ended up in the placebo or control group, not in the psilocybin or experimental group. The professor asked Nikita if she knew anyone who would be able to help, because there was nothing that could be done to help this individual within the study anymore.

This marked the final step for Nikita — she was confident enough to reveal the work she’d been doing for over 20 years to this medical professional and offered her services to the participant who had landed in the control group. The doctor’s phone call and patient referral marked the ultimate validation for Nikita and the work she’d been doing for so many years.

Glowing with happiness, Nikita recalled, “Hearing from [them] was like winning the lottery. I was so ecstatic. And it’s simply because the validation of something I’ve dedicated my life and all of this hard work to. Now, I’m in a position to do something about it.”

The validation of Nikita’s work points to the steadily increasing dialogue and popular interest in alternative ways of medicine and treatment. There’s an accelerating amount of published literature, and if research and studies being conducted continue at this pace, it is expected that psychedelic-assisted psychotherapy will be available by 2021, a process in which Nikita will now be able to take an active part.