Psychedelic-assisted psychotherapy and indigenous shamanic healing both use psychoactive substances for healing and gaining knowledge, but they rest on fundamentally different worldviews. Four paradigms are reviewed: standard psychedelic psychotherapy, where the drug amplifies internal self-analysis; shamanic rituals, where the healer takes the medicine to 'see' causes of illness; syncretic folk religious ceremonies focused on community bonding; and hybrid shamanic therapeutic rituals combining elements of both. The shamanic worldview diverges radically from the Western one in two ways: the perception of multiple realities accessible in expanded states of consciousness, and the belief that spirits encountered in dreams and visions are as real as the physical organism.
A new rehabilitation program for prisoners uses consciousness-altering drugs, specifically psilocybin, within a collaborative group setting to produce lasting changes in thinking and behavior, aiming to reduce recidivism. The program avoids traditional doctor-patient roles, is relatively short, and includes built-in evaluation. It is designed to be run by non-professionals with egalitarian wisdom. Recidivism rates are high: 50 to 70 percent of released offenders return within five years, with a national average of 67 percent. The program builds on prior methods such as guided group interaction and psychodrama, but centers on shared insight experiences induced by psilocybin.