“I'm not allowed to touch the mushrooms”: 5 Questions for Oregon-based facilitator Josh Goldstein
Goldstein discusses his role as a licensed facilitator, and how it differs from his work in the underground.
Josh Goldstein grew up in the Reagan era thinking he would never do drugs — and then he went to the University of Oregon. The spring of his freshman year, he took mushrooms for the first time, which made him eager to explore more mind-altering substances. He continued taking psychedelics recreationally, and in 2012, he joined the Church of Santo Daime, where he took ayahuasca two to three times a month. Goldstein became one of the church’s leaders and led ayahuasca ceremonies. He also facilitated ayahuasca experiences for clients as an underground guide. Last year, when Oregon began preparing to launch psilocybin services, Goldstein enrolled in a training program to become a licensed psilocybin facilitator. After graduating from the program, he started working as a facilitator with Bendable, an alternative mental health nonprofit that connects people with psychedelic therapy. Goldstein helps train other facilitators and guides psilocybin sessions with clients in Bend, Oregon. He facilitated one of the state’s first psilocybin sessions with retired builder Jim Carroccio, who we interviewed in July.
We spoke with Goldstein about his role as a licensed facilitator, and how it differs from his work in the underground.
Oregon’s psilocybin services program has been up and running for a few months now. What has demand for psilocybin sessions been like so far?
There’s a pretty lengthy waitlist right now – it’s in the hundreds. We’re starting to work with veterans. Bendable uses a nonprofit model with the intention of taking financials out of the equation so that people who would not otherwise have access can see psilocybin therapy as an option for themselves. It costs $2500 to put someone through a session, and that’s at the low end; the other place in town starts their rates at $3500. We share the service center we use with other groups and facilitators. We only have the space three days a week, which can mean it’s hard to schedule a lot of clients, between preparation, administration, and integration sessions. I try to see at least four clients a month.
Take me through the full psilocybin experience. What do you do with clients, and what it’s like from your perspective?
First, we schedule a full intake session where we talk about their intentions, their life history, and any traumatic experiences they want to share. The more I’m aware of those things, the better I’m able to support them. We also talk about their network outside of the psilocybin experience, like if they’re in therapy, or who their community is. We want to know what places people have to go back to; you don’t want to open up a can of worms in a session and then just say, “Good luck out there!”
We also have an orientation on-site so we can show them what the room looks like, where the bathroom is. Many of our clients are psychedelically naive, meaning they’ve never taken psychedelics. Others may have taken LSD at a concert in the 1960s, so it’s good to have a refresher. I like to encourage them to identify any parts of them that are resistant to the experience, and to ask for those parts to step aside.
On the day of administration, we all arrive at the service center and a representative brings in the mushrooms. As a facilitator I’m not allowed to touch the mushrooms at all; the client takes them of their own accord and I am there to support that process the whole time.
There’s typically not much conversation for the first two-thirds of the session, when they're fully in it. Prior to the session, clients can sign a waiver to have a booster dose about an hour and a half in. If they select that, they self-administer that dose. Again, I’m not able to touch the mushrooms, so if the client is unable to open the package, that’s often a good sign they don’t need it.
Near the end of the session, as they're starting to land, I might engage them in some conversation. They might share what they’ve been going through. We audio record everything as a resource later, but because I did underground work for years, I am used to writing everything down, because I didn’t record those underground sessions. Recordings don’t include a person’s affect, or the tears or laughter that accompanies it. Also, my notes help identify touchstones from the session so I don’t have to listen to the whole six-hour recording if I have to go back to it.
Before their session, they also must outline a transportation plan for who will pick them up and drive them home. We give them some guidance before they leave, like don’t make any big life decisions, be mindful of who you're sharing with about your session and why you're sharing, and to take good care of yourself.
A couple days after, we have a scheduled integration session to unpack what came up. We do offer the ability to arrange additional integration sessions with me, but the base rules of Measure 109 state that we have to include one preparation session and one integration session. I think of the integration session as the beginning of a new process — I’m educating people so they don't think they’ve taken a magic pill. We make plans about how they will implement any lessons they learned in the session into their daily life.
Now you’re a state-licensed psychedelics facilitator in Oregon, the first state in the country to have state-legal psilocybin services. But before that you worked as a psychedelic facilitator in the illegal underground. How is it different for you to be doing this work above ground?
With my underground work, I was going to people’s homes. In that situation, you have to quickly develop a trusting rapport with people so that they know you’re a safe person; they're going to be vulnerable and exposed, and you’ll be in their house.
In a service center, it’s different; you’re both coming to a shared place. My job is to try to make that environment welcoming. The service center I use in my work for Bendable is a separate entity from the non-profit; we rent the space. It’s pretty unassuming, but warm and inviting. There's low lighting, we put a soft playlist on, and there’s interesting artwork on the walls. It’s similar to a therapist’s office; it doesn’t look like a medical setting.
I think of it like this: I’m responsible for the whole 3D environment so the client can let go and go deep. Also, in a service center, there’s another person there as a back-up facilitator if things go off the rails. In underground sessions sometimes people would want to, say, call their family and I’d have to tell them, no, now is not the time. In a service center they don’t come into a session with their phone, or if they do, we take it and put it in the office while they’re in session.
Has anything surprised you about doing above-ground sessions?
The sheer amount of paperwork required. We have to obtain informed consent, of course, and through the process, we have to interact with 20 to 30 forms. It’s not a quick process. Some people think you just go in and take psilocybin, but no, there’s lots of education for the participant. There are also forms for things like taking a psilocybin booster dose; coming up with a transportation plan and emergency plan; information about other medications that the client needs to have administered over the course of the session. These legal frameworks are in place to protect the service center and facilitator, too.
Besides consent forms, what protections are there for facilitators?
Ironically, I am more exposed and at risk doing this legally than I was doing it underground; I have no personal liability insurance. I have a call soon with an organization that might be able to offer it and I’ve been in contact with some insurance agents, but I haven’t been able to find an insurance company that offers the kind of insurance that would work for me. Some offer it to mental health professionals or medical professionals who are also doing psychedelic work, but not for facilitators. Insurance companies are always looking at potential risks and we just don’t have any data for that yet, so it feels like a waiting game.
This interview has been edited and condensed for clarity and length.
