The corpus does not reveal one population or one therapeutic objective. People entered substance-assisted work for markedly different reasons, and the stated purpose of the intervention often depended on its institutional or cultural setting.
Addiction and substance dependence
Addiction is one of the oldest and most geographically dispersed reasons represented in the corpus.
Alcohol dependence
The Russian KPT programme is among the clearest historical examples. By 1997, Evgeny Krupitsky was describing eleven years of ketamine work with alcohol dependence in St Petersburg; later research extended the model to heroin dependence. [1]
In Brazil, religious and community-based programmes approached similar problems from substantially different frameworks. Céu Sagrado in Sorocaba was associated with addiction, alcoholism, depression and spiritual healing rather than operating as a conventional psychiatric clinic. [2]
Opioid and other drug dependence
The early ibogaine ecology was heavily organised around opioid and other drug dependence.
DASH/INTASH in Rotterdam emerged as an informal addict-led self-help and treatment network. Treatments were reportedly conducted from Nico Adriaans's apartment, and the network developed its own intake, psychological and aftercare material. [3]
The Slovenian Iboga Foundation likewise functioned as a loose information and treatment network rather than a single clinic, working primarily with opioid dependence and helping people and their family or social networks construct treatment situations. [4]
Healing Visions Institute, by contrast, represented a medicalised offshore approach. Opened in St Kitts in 1996 under Deborah Mash, it treated people with opioid, cocaine and other chemical dependence under more formal clinical and cardiac monitoring. [5]
The Vancouver Iboga Therapy House, active by the mid-2000s under Sandra Karpetas, described itself in terms of “holistic harm reduction and health promotion,” explicitly widening the stated goal beyond abstinence alone to quality of life and deeper psychospiritual or therapeutic concerns. [6]
In Peru, Takiwasi approached substance dependence through a residential model integrating Amazonian traditional medicine, psychotherapy and community life rather than treating ayahuasca as an isolated anti-addiction drug. [7]
Historical Brazilian programmes also connected dependence with community and social reintegration. Caminho de Luz, founded in 2001, described work around alcohol and drug dependence together with mutual help, individual attention, spirituality, educational and recreational activities, labour or vocational activities and family/community reintegration. [8]
The addiction-related corpus therefore spans detoxification, abstinence, relapse prevention, psychological treatment, quality of life, spiritual healing and social reintegration. Those objectives should remain distinct when the later pattern analysis compares practices.
PTSD, trauma and complex trauma
Trauma becomes more explicit as a named clinical target in later parts of the corpus, although childhood abuse, fear, shame and related problems occur in earlier material without necessarily being labelled “CPTSD.”
PTSD as a formal diagnosis
The MAPS/Lykos research lineage was explicitly organised around PTSD in formal clinical trials. Its treatment model combined preparation, MDMA-assisted sessions and follow-up psychotherapy. [9]
The 2004 Wasatch Front investigation likewise described a pseudonymous psychotherapist using MDMA with a carefully selected patient who had PTSD and histories of childhood physical or sexual abuse. [10]
Roots to Thrive subsequently included healthcare providers with PTSD and depression in a twelve-week ketamine-assisted group programme. [11]
The Stanford observational study conducted with Ambio Life Sciences examined U.S. Special Operations veterans with histories of traumatic brain injury and associated PTSD, depression and anxiety symptoms who received ibogaine-based treatment in Mexico. [12]
These veteran cohorts are only one part of the trauma corpus and should not be treated as representative of trauma-related substance-assisted work overall.
Childhood and developmental trauma
Earlier underground material more often described specific histories and interpersonal problems than a unified diagnosis.
The Wasatch article describes adult psychotherapy clients with childhood physical or sexual abuse histories. [10]
Fischer's underground psycholytic practice did not begin from a single trauma diagnosis; clients entered drug-assisted work only after ordinary psychotherapy and were described as people who had become “stuck” or were not progressing. [13]
The amateur archive similarly contains people explicitly trying to work with trauma outside formal treatment. An Erowid report titled “Healing My Posttraumatic Stress Disorder” describes an experience in 2001 involving close friends and a sober companion, while another report describing childhood trauma and MDMA records a prolonged adverse period and the feeling that traumatic material had arrived “too much … too fast.” These are first-person reports, not clinical outcome evidence. [14]
A 2004 Shroomery participant sought “regressive self-therapy” in the hope of recovering childhood material, while reporting that psychedelics had changed behaviour, emotion and bodily posture without restoring much detailed childhood memory. Again, the ledger preserves this as amateur experiential material, not verified treatment evidence. [15]
Complex trauma and CPTSD
CPTSD becomes more visible in the contemporary provider layer.
Mexico's Instituto de Medicina Intercultural Nierika explicitly describes work with complex trauma and PTSD, particularly in contexts involving systemic violence, organised crime and kidnapping. [16]
The Emerge Clinic in the United Kingdom explicitly treats PTSD/CPTSD and also states that direct evidence for ketamine-assisted psychotherapy in CPTSD remains limited. [17]
Parklands Mindcare Centre in Nairobi describes PTSD among severe treatment-resistant conditions considered within its ketamine programme and lists complex PTSD within its broader trauma services. [18]
Tandava Retreats in Mexico provides a more specific contemporary example: a programme aimed at women recovering from sexual trauma, using a multi-week structure around 5-MeO-DMT, somatic work and what the programme calls “voice & choice.” [19]
The existence of these contemporary CPTSD-oriented sources does not justify relabelling the earlier alcohol, addiction, childhood-abuse, psychospiritual or underground psychotherapy material as CPTSD treatment.
Depression and treatment-resistant psychiatric conditions
Another major reason for substance-assisted treatment in the contemporary corpus is depression or other psychiatric illness that has not responded adequately to conventional treatment.
Psyon operates ketamine-assisted psychotherapy inside a broader psychiatric and psychotherapy clinic in Prague. [20]
OVID Clinics in Berlin uses ketamine-augmented psychotherapy and, under a German compassionate-use framework, psilocybin for treatment-resistant depression. Its broader day-clinic population also includes trauma-related and other psychiatric disorders. [21]
South Island Ketamine Clinic in New Zealand represents a more medically oriented model focused primarily on treatment-resistant mood disorders; its public material also says ketamine may be useful in complex PTSD. [22]
Parklands Mindcare Centre likewise situates ketamine inside ordinary psychiatric care for severe treatment-resistant conditions rather than presenting psychedelic experience as the centre of the practice. [18]
The corpus therefore includes both psychedelic-experience-centred approaches and settings in which the psychoactive drug is used as an adjunct inside conventional psychiatric treatment. The practical differences between those settings belong in the later pattern section, not here.
Psychotherapy that had stalled, relational difficulties and entrenched personal problems
Not every practitioner selected patients because they met a specific diagnostic category.
Fischer's Swiss underground practice is the clearest case. Only about four percent of her ordinary psychotherapy clients reportedly entered drug-assisted work; those who did were generally described as clients who had become “stuck” or had stopped progressing in conventional psychotherapy. [13]
The Utah underground network likewise included practitioners working not only with PTSD and childhood abuse but also with relationship and couple problems. [10]
Vancouver psychotherapist Andrew Feldmár publicly described earlier psychedelic-accompaniment work in terms of psychotherapy clients and repeatedly discussed fear, shame, mistrust and isolation rather than organising his work around one formal diagnosis. [23]
Contemporary retreat and practitioner material also includes intimacy, identity and relational themes. LaWayra's listed integration practitioners describe work involving complex trauma, abuse, addiction recovery, identity, relational patterns and emotional regulation, although these are practitioner biographies rather than evidence that every retreat participant presents with those problems. [24]
These sources are retained because they document substance-assisted work being used in attempts to alter persistent ways of relating, feeling or functioning that did not always map neatly onto a single diagnosis.
Psychospiritual, existential and personal-development aims
A significant portion of the corpus consists of people who were not entering a psychiatric treatment programme at all.
Bwiti House in Gabon describes a retreat and initiation context rather than a diagnostic PTSD clinic. Its participants include people seeking broad healing or initiatory experiences and people training to become iboga providers. [25]
Wasiwaska, created in Brazil in 2003, was an interdisciplinary research and educational centre rather than a trauma-treatment clinic. Historical programme traces describe experiential seminars involving ayahuasca, group sharing, breathwork, artistic or musical expression, body work and other activities. [26]
The historical Silvia Polivoy / Ayahuasca Healing material similarly concerns psychologist-led healing and personal-development retreats rather than a defined psychiatric patient cohort. [27]
Modern retreat providers such as Inwardbound likewise work with broad retreat populations and professional trainees, while explicitly allowing participants to interpret experiences through their own personal, cultural or spiritual perspectives. [28]
These sources need to remain separate from clinical PTSD, addiction or depression cohorts. Their inclusion is useful because the later compilation is concerned with practice forms, but their participants cannot simply be treated as psychiatric patients.
Community, cultural and socially situated suffering
Some projects frame distress partly in relation to community, violence and cultural disruption rather than solely as an individual disorder.
Nierika is the clearest example. Its intercultural work involves Indigenous communities, Western clinicians and researchers, traditional authorities, and community-health training. Its State of Mexico clinic material explicitly lists depression, complicated grief, addiction, anxiety, complex trauma and PTSD associated with systemic violence, organised crime and kidnapping. Its Yaqui work also trains community members as health promoters rather than limiting expertise to outside clinicians. [16]
Historical Brazilian addiction programmes also sometimes framed recovery through family, work and communal reintegration. Caminho de Luz described mutual help, individual care, spirituality, educational and recreational activity, labour or vocational activity, and family/community reintegration alongside ayahuasca-related practice. [8]
The Slovenian ibogaine network similarly involved family and social networks in constructing treatment situations rather than treating intervention as an encounter solely between provider and individual. [4]
Again, this section records what problems and contexts the sources themselves were addressing. Whether these social or communal elements recur as a broader practice pattern belongs to the next stage of the compilation.
Broad or undefined retreat populations
Finally, several organisations in the corpus do not define participants primarily through a diagnosis.
Nihue Rao, the Ayahuasca Foundation, Soltara, ONE Retreats and other contemporary retreat organisations serve broad healing, personal-development or psychospiritual populations. [29] [30] [31] [32]
Some of those organisations discuss trauma in their support material, but that does not mean their participant populations constitute trauma cohorts. This distinction will remain important when the later sections ask whether a practice appears across genuinely different clinical and non-clinical settings.
Where the compilation goes next
At this point, the corpus contains people trying to address different problems, in different eras, under different professional and cultural assumptions.
The next section—Recurring patterns and their origins—will therefore begin from the source material rather than from a predetermined model of psychedelic therapy. It will ask which practices, terms and working assumptions recur across these different settings, which belong mainly to one lineage, where different traditions contradict one another, and how early or independently a practice can be traced.
No recurrence in the next section will be counted merely because one well-documented organisation described the same idea on multiple pages, and direct descendant relationships—such as Russian KPT → Eleusis, Céu Sagrado → Céu da Nova Vida, Silvia Polivoy's early work → Spirit Vine, or MAPS training → later practitioners—will remain visible rather than being counted as independent origins. [33]