🫠 Psychonaut POV

Welcome to Tricycle Day. We’re the psychedelics newsletter that gets inside your head. If you read enough of our emails, your inner monologue starts to include strategic melting smiley emojis. 🫠

Ingmar Gorman has spent his career training therapists to work with psychedelics, but he's not your typical evangelist. While most people in his position are trying to convince everyone and their mom to try these medicines, Ingmar would rather help people decide for themselves.

We asked Ingmar about the misconceptions clinicians have about psychedelic therapy, why his company works behind the scenes with psychedelic drug developers, and whether AI could solve the looming shortage of trained therapists.

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What first drew you to psychedelic research and therapy, and how has your perspective evolved through your work in clinical trials?

I was living in Prague during the second Bush era when I met some American expats who exposed me to psychedelics. I was actively seeking healing and personal growth, but psychedelics were not my first choice. I’d been heavily influenced by the American drug war and was terrified of them. Over time, though, through reading both counter-cultural literature from the 60s and 70s and the scientific work emerging in the early 2000s, my resistance decreased. Trusted relationships with people who had personal experiences helped, too.

Once I tried them, I experienced significant internal changes. They didn't happen overnight, but they were the beginnings of important shifts. At that point, I knew I wanted to be a psychedelic therapist, though I didn't know I wanted to be a researcher. I was 21 years old and had dropped out of the University of Chicago. Part of what attracted me to psychedelics was that they were the underdog—a treatment that was popular in the 50s and 60s before falling out of favor. There was also this rich history of psychedelic research in the Czech Republic. It just felt right, so I dedicated my academic career to it. I went back to college and got a master's and then a PhD in clinical psychology.

Through working with MDMA and psilocybin in clinical trials, I've had the honor of being present and sitting with people who have severe PTSD. It’s one thing to have an experience yourself, but it’s quite another to see what we try to do in regular therapy get supercharged. When you add psychedelics in a therapeutic context, it's genuinely mind-blowing to see the inner healing process unfold.

What gap in the field were you trying to fill when you co-founded Fluence? Has the mission changed since then?

Before Fluence existed, I worked with Katherine MacLean and Andrew Tatarsky to create the Psychedelic Education and Continuing Care Program. This was really the seed of everything that followed.

Katherine had observed that people were having psychedelic experiences, but there wasn't any integration support for them afterward. Andrew had founded Integrative Harm Reduction Psychotherapy, which was a person-centered approach to working with substance misuse. My cofounder at Fluence, Elizabeth Nielsen, and I came in with a strong motivation to bring something meaningful to the world.

We noticed that despite the resurgence in psychedelic research and public interest, therapists and clinicians didn't know anything about these substances. If they did know something, it was only because of their personal interest. Nothing about psychedelics was part of standard training in graduate programs.

So we created educational opportunities through weekend workshops while also operating a clinic that provided integration support and preparation for psychedelic experiences. The goal was to create more therapists knowledgeable about psychedelics who could answer questions and engage with the community seeking help, and the company has stayed true to this mission.

The next phase of Fluence came around 2019 when the market got frothy. We saw lots of money, investors, and new psychedelic companies popping up. Elizabeth and I realized these drug companies had expertise in the molecules and IP, but what pharmaceutical company knows anything about psychotherapy? So we expanded our mission to include helping drug sponsors develop the psychotherapy component of their clinical trials. We now work with eight of the largest drug developers in the space.

After training so many therapists, what's the most common misconception clinicians have when they first engage with psychedelic-assisted therapy?

Therapists with clinical experience—and I include myself here—tend to think we're already skilled in listening and supporting clients in a non-directive way. But after training and especially after doing psychedelic therapy, everyone realizes with humility how wrong they were. There's a much greater appreciation for knowing when to lean forward and be active, and when to sit back a bit, still present, but allowing the client to have their process.

The real distinction is non-directive versus inner-directive therapy. We're not just sitting back passively as therapists. There are moments that call for being actively engaged, but it's in support of the client's inner healer. What we're emphasizing is that the client is directing the process.

For example, if someone on MDMA is revisiting a traumatic memory—not reliving it in a harmful way, but feeling ambivalent about being there—a therapist might ask, "Is it okay to stay with this right now?". They're asking for permission, and if it’s granted, they might encourage the patient to stay a little longer. So it can actually be somewhat directive. There’s an element of guidance. We're trusting that whatever arises for that person in that moment, staying with it will contribute to healing or insight.

You and Elizabeth just released a psychedelic therapy workbook to the public. Why now?

The Psychedelic Therapy Workbook is for both therapists and the public. Therapists can use it with clients, photocopy pages, download worksheets from the publisher's website, and share them freely. And if someone doesn't have a therapist but wants to engage with this material, they can.

Certainly there are already plenty of psychedelic workbooks out there, but I think what makes ours different is our even-handed approach. Our philosophy centers on the client’s agency and their internal recovery processes. I see it as the ultimate patient-centered approach that's valuable whether you're using psychedelics or not.

In fact, we believe even the decision to take a psychedelic should be viewed through this lens of empowering the person's decision-making process. Unlike many other advocates, we don't assume anyone should take a psychedelic. What we really care about is the best interest of the patient, which means providing a broad enough picture that they're empowered to make an informed choice. That empowerment can then seed their whole psychedelic journey if they do choose to proceed.

As more psychedelic therapies move toward approval, how do we solve the shortage of trained mental health professionals who can deliver these treatments?

This is a common question, and honestly, it's hard to know exactly what the landscape will look like given how much has changed in just the last year. One approach we're exploring at Fluence is how technology might augment human therapists.

I believe there's something about human-to-human connection in psychedelic therapy, and therapy in general, that's special. It could be the intuitive element, the authenticity, or the room for spontaneity in the dynamic. Whatever it is, I suspect it will be hard for AI to replicate completely. And even if it could, would it matter? The human element feels inherently important to me.

I want to be clear that I don't underestimate AI's power at all. The practical question is: how much quality are you willing to sacrifice to increase accessibility and scale? What I would love to see, and what we’re striving toward at Fluence, is AI-powered humans. That's how I tend to think about AI—not as a replacement but as an enhancement. If an AI therapist could increase accessibility, and maybe it’s at 75% effectiveness of a human but at a hundredth of the cost, we'd be foolish not to explore that. We'd be doing a tremendous service to those who currently can't access support at all.

I say all this with caution. I love therapy and don’t want to be out of a job, either. But ultimately, we need creative solutions if we want these treatments to reach everyone who could benefit from them.

Want more from Ingmar?

Order a copy of The Psychedelic Therapy Workbook, schedule a 1:1 consult with him, or check out the professional psychedelic therapy courses available through Fluence.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.