The power of feedback-learning for therapy, writing and everything else

The secret to life is responding to feedback. That’s how biological organisms adapt and evolve. If you fail to respond to feedback and don’t adapt, you die.

That’s true at the level of amoeba, it’s true at the level of society and species, and it’s true for therapists, writers and every other profession.

In societies, if the governing class doesn’t respond to signals from its populace, it doesn’t learn and adapt. The propaganda of the ruling class can become more and more rigid and unmoored from reality, until eventually the bubble bursts and there is some sort of collapse. This is UK policy strategist Dominic Cummings’ prediction of what’s going happening in the UK - he sees the UK governing class / Whitehall as stuck in dogma and blind to reality in a way that’s comparable to the USSR in the 1980s. In his view, the governing class is chronically incapable of responding to the feedback signals from its electorate, so law and order is breaking down.

At the planetary level - can homo sapiens respond to the feedback signal of increasing extreme weather conditions caused by global warming? At the moment, we are failing to respond to the signal, so the thermostat is getting hotter and hotter.

Let’s take psychedelic culture and industry. Does it adapt to signals, learn and evolve, or not?

I spoke at the HOPE psychedelic ethics conference last year on ‘learning from harms’. Psychedelic culture hasn’t learned from harms and adapted, I suggested. There have been warning signals flashing about various risks - sexual assaults, cultishness, adverse events, profit or dogma prioritized over patient-care. But psychedelic culture hadn’t responded to the red lights, mapped the harms, or talked about them, it (sometimes) minimized and silenced them, or (sometimes) attacked the messenger and muffled the signal. Various attempts to introduce standards in the underground and overground failed, like the APPA and the Ethnobotanical Stewardship Council. The culture (which largely means the underground) has not developed regulations or associations to learn from harms or deal with complaints, so it’s like a house with inadequate plumbing - occasionally the house is suddenly flooded with shit (ie public complaints). The Ayahuasca Foundation is an example of this failure to learn from harms - students, clients and employees warned Carlos Tanner for years about serious problems, he didn’t respond to the signals, so eventually the house flooded with shit.

There are signs psychedelic culture is learning, adapting and evolving, to some extent. The conversation has shifted around safety and risks, and there are efforts to better measure adverse events better in clinical trials (although medical use is only a tiny sliver of psychedelic use).

But learning and improvement doesn’t have to be at the systems-level either. Every therapist, guide, retreat centre or church can gather feedback, learn from it and improve their performance and client experience, using the principles of Feedback Learning.

Lack of feedback, evidence and data in therapy

It surprises me how rarely therapists seek feedback from clients. I’ve seen perhaps 12 therapists in my life. None of them ever sought any written feedback from me, not before, during or after the therapy. Isn’t that weird?

Therapists (and, even more, ‘healers’) tend to see what they do as an art, almost akin to magic, deeply relational and guided by intuition, which they may see as the therapeutic superpower. Some of them are offended by quantitative evidence and put off by paperwork, which is seen as somehow soulless and managerial compared to the magic art of therapy. And it’s true this is one of the complaints about the UK NHS’ state-funded therapy program - it’s so obsessed with data, targets and outcomes that therapists end up mired in paperwork and chasing targets rather than trying to help patients.

So there is a balance. But I’ve come to see the ethical importance of seeking feedback, to make sure you’re helping your client, to test your hypotheses and to make extra sure you’re not causing harm. That’s the ethics of the entire scientific process, as Francis Bacon first laid out - you don’t trust blindly in your intuition or dogma, you test it out.

I wrote in this piece on the danger of healers relying only on their intuition, and the value of seeking anonymous feedback, being prepared to change your practice and ditch your sacred cows. That’s the ethical way to offer therapy - seek feedback, seek evidence, make sure you’re not causing harm. Don’t turn client complaints into issues about them and their ‘resistance’.

One study of counsellors and their reliance on intuition found that

an intuitive thinking style was associated with more negative attitudes towards research, less openness to research-based treatments, and less willingness to use evidence-based treatments if required to do so. Furthermore, a tendency to rely on intuition was associated with more positive attitudes towards alternative therapies and the endorsement of erroneous health beliefs.

There’s nothing wrong with intuition per se - it probably is a therapeutic super-strength. But so is learning from feedback and evidence. Imagine if you combined both skills?

I recently learned about an approach to therapy called Feedback Informed Therapy. It doesn’t matter what modality you use (IFS, CBT, psychodynamic, Rogerian, transpersonal, Somatic, whatever!), you just gather feedback from clients using basic forms like this. One reader also suggested having QR codes around the office or even in the toilets whereby clients can leave anonymous feedback - I think anonymity is very important rather than asking a client how it’s going during a session. Then, after one receives feedback, it’s important to try and learn from it through ‘deliberate practice’, where you identify a weak point and consciously practice to improve it, usually guided by a mentor or teacher.

Learning from feedback is even more important when dealing with a powerful experimental medicine like psychedelics, in the underground or overground. If you’re calling something ‘medicine’, seek feedback and data! Make sure you’re not causing harm. Send clients anonymous feedback links after sessions or retreats asking - how was the experience, how was the facilitation, how did you feel afterwards, what could we do better? Legal psychedelic programs like Oregon and Colorado have major issues - particularly cost - but I appreciate that they are gathering data.

Seeking feedback to my own work

I try to seek feedback in my work as well. With the Challenging Psychedelic Experiences Project peer support group, we send out feedback forms after meetings. With the ‘short guide to coping with post-psychedelic difficulties’, we sought feedback from therapists, psychiatrists and people with lived experience of post-psychedelic harms.

I seek feedback in my journalism as well - listening to criticisms and reaching out to readers to find out what they want to read. That’s what I did with the recent EI survey - thanks to the 65 people who responded. You’re all getting an invite to the Founders Club on Saturday September 6, as is anyone else who fills in it.

The survey told me about who you are - the biggest demographics are therapists, psychedelic therapists or guides, academic researchers and spiritual seekers. This is useful for me to know - when I meet readers, very often they are either therapists or people training to be psychedelic therapists, so knowing that helps me focus my work.

I asked what readers look for from EI. They used words like ‘discernment, balanced, risks, ethics, accountability, investigation and information, and critical thinking’ in psychedelic culture and industry. What sort of stories do you want to see? The most popular choices were ‘critical thinking on psychedelics and spirituality’, ‘adverse psychedelic experiences and how to recover from them’, ‘psychedelic business and policy stories’, and ‘the culture and history of ecstatic experiences’. Not so into UFO stories, according to the survey.

This aligns with my intuition that what readers appreciate about my writing is a balance between critical thinking and woo / mystical experiences, between the Socratic and the Dionysiac, trying to steer a course between arid debunking and gushing woo.

Maybe I sometimes err too close to the sceptical / debunking. I got great feedback from a reader this week: ‘Don’t just point out problems but also propose solutions’, for therapists, organisations, industry and society. ‘Make sure you’re not seen purely as an agent of destruction’, the reader advised. ‘If you don’t offer solutions then people will feel cornered and will attack you rather than taking on the feedback’.

Some in psychedelic culture and industry unfortunately do still see me as an ‘agent of destruction’. I heard some negative feedback recently that various people connected to MAPS think I am a part of Psymposia (I’m not) and still believe what Hamilton Morris suggested in various podcasts - that I was secretly paid to attack MAPS by Susie Sarlo (a philanthropist who was one of the funders of CPEP’s work in 2024 and 2025, and who was also previously in a dispute with a MAPS board member ).

As I have previously said, but might as well repeat, Susie Sarlo did not pay me to attack MAPS, I rarely wrote on MAPS or Lykos in the two years she donated to CPEP, and you can see what I did write for yourself, I don’t think any of it is unfair. I hope it’s obvious I wasn’t ‘funded to attack MAPS’ - I didn’t speak at the Lykos Ad-comm hearing, I didn’t ever say Lykos should or shouldn’t be FDA-approved. Susie Sarlo funded a bunch of organisations (NGOs and researchers) in psychedelic harm reduction and safety, because she had seen the harm and dodgy ethics of the field close up and wanted to help it become safer and more ethical. Other organisations she funded also have nothing to do with MAPS. I didn’t know she funded Psymposia last year, and it hasn’t been good for me that she did, because I then got sucked into this intensely acrimonious and polarising fight. But she has the right to spend her money however she wants and Psymposia - which I have nothing to do with, have never written for etc - has the right to critique MAPS and Lykos as well. If you want to know what the Sarlo family funded my organisation to do, check out the CPEP website - we produce research, we share information and we offer peer support and training around post-psychedelic difficulties and what helps people recover from them. It’s important work. Here’s an email we received this week:

I wanted to take a moment to say a heartfelt thank you for your website on challenging post-psychedelic experiences. I am so grateful that someone shared it with me. I took MDMA almost five months ago and have struggled with many difficult after-effects. Until I found your site, especially the symptoms section, I felt so alone and afraid. Reading through it gave me both validation and relief.

That’s affirming and encouraging, but we have to keep seeking feedback, as we too could unintentionally cause harm sometimes, or simply recommend things that aren’t helpful. Negative feedback stings, but it’s a gift. As someone once put it, you can get bitter, or you can get better.

I have also sometimes got negative feedback about my journalism from people I have written about who think I was unfair. Some articles are better than others and when I have made errors I try to hold up my hands, acknowledge mistakes and learn from them. A recent interview I did with Jon Lubecky, for example, included some inflammatory statements which I printed without seeking response from the people or organisations he criticized. My mistake. I had a Zoom with one of these organisations and got an earful - in that instance I deserved it and apologised to the organisation’s founder. It’s not Jon’s job to seek response, it’s mine as the journalist. I continue to learn from feedback to try and spend my energy in a way that is effective and helpful for society. My email letter-box is always open, and you can also leave anonymous comments in the reader survey.

After the paywall, psychedelic and ecstatic links including further news on the police raid against OMMIJ, the biggest ayahuasca retreat company in Europe; more news on AI therapy and AI delusion; some great journal articles on the risk of guruism in psychedelic training courses and researchers’ personal use of psychedelics; and HHS could be set to reschedule psilocybin for compassionate access. Plus, Reverend Hunt Priest of Ligare is removed from the Episcopal Church, and the US government is poised to do military raids on Latin American cartels, while a new book suggests its special services have itself become a drug-running cartel…