Psychedelic Research Revival (Second Wave)

Psychedelic Research Revival (Second Wave) names the renewed scientific and therapeutic investigation of psychedelics that began in the late 1990s after sanctioned research had ended decades earlier. The revival reopened questions explored in the 1950s and 1960s, but it also exposed how difficult those questions were to fit within modern medicine: the treatment depended not only on a drug, but on the experience it occasioned and the people and setting through which that experience was guided.

From First Wave to Revival

The new research took up a line of inquiry broken off in the 1970s, when cultural pressures brought sanctioned psychedelic therapy to an end. The return was therefore not a wholly new beginning. Charles Grob, whose 2011 pilot study of psilocybin for cancer anxiety helped clear a path for later trials at New York University and Johns Hopkins University, described the work as picking up a torch earlier researchers had been forced to put down. That continuity also carried a practical implication: historical findings and methods had to be recovered and tested again according to the scientific standards prevailing in the renewed research era.

The revived clinical program explored several kinds of suffering. New York University and Johns Hopkins University investigated whether psychedelics could help people facing death, while other trials examined possible applications to depression and addictions involving alcohol, cocaine, and tobacco. Psilocybin was generally favored over LSD in these studies in part because LSD carried a heavier political burden. The selection of a compound thus reflected more than pharmacology: the history attached to a drug could shape the prospects for studying it and gaining public acceptance.

The Treatment Model and Its Difficult Questions

The return of psychedelic therapy brought back a model that had already challenged psychiatry in the 1950s. Earlier frameworks had been easier to accommodate: the psychotomimetic model treated drug effects as resembling mental illness, while psycholytic treatment could be understood as an adjunct to psychoanalysis. Psychedelic therapy proposed something more disruptive: a single high-dose session intended to produce a conversion-like experience, changing the customary roles of patient and therapist as well as the expected duration and structure of treatment.

That model made the experience itself central. Researchers could not easily separate a drug’s effects from the volunteer’s expectations, the guide’s presence, or the session’s set and setting. Participants and guides could often tell whether psilocybin or a placebo had been administered, making conventional blinding difficult. And if the treatment worked by occasioning a particular kind of experience, it was unclear how to isolate a strictly pharmacological effect from the circumstances that helped shape it. These were not incidental design problems: they challenged the experimental ideal of isolating one variable at a time.

The spiritual dimension sharpened the dispute over what counted as scientific treatment. Charles Grob treated psychedelic therapy as a form of applied mysticism, while other researchers were wary of crossing the boundary between medicine and shamanic practice. Yet the revived field could not simply exclude the extra-pharmacological variables on which its treatment model depended. The argument was therefore not only over whether psychedelics worked, but over whether a medical trial could adequately evaluate a therapy whose context and meaning were part of its operation.

Knowledge Beyond the Clinic

The revival also inherited knowledge from practitioners who continued working outside sanctioned research. The underground guides interviewed by the book’s narrator often traced professional lineages to Timothy Leary, Stanislav Grof, Al Hubbard, or Leo Zeff, sometimes through students and trainees. Zeff, an early underground therapist, said that he had worked with about three thousand patients and trained 150 guides. His methods helped shape a practice that formal clinical settings had not preserved in full.

Myron Stolaroff argued that legitimate research resuming in the late 1990s had developed partly from anecdotal evidence gathered by underground therapists such as Zeff, as well as from the first wave of research. This was not merely an inheritance of ideas. Some underground practitioners were recruited to train guides for university trials, and when the Johns Hopkins team studied music in guided psilocybin sessions, it consulted underground guides about their practices. The boundary between underground and institutional work remained real, but it was permeable: expertise moved across it even when researchers had reason to be cautious about acknowledging that traffic.

The longer prehistory of this knowledge was itself networked. Al Hubbard carried LSD, clinical experience, and therapeutic advice among research centers, from work with Humphry Osmond and Abram Hoffer in Weyburn to sessions and research contacts in Los Angeles and Vancouver. In Menlo Park, he guided Myron Stolaroff and colleagues at Ampex, then helped train them to guide others. Stolaroff later established the International Foundation for Advanced Study with Willis Harman, seeking to investigate LSD’s potential for personality and creativity. These first-wave connections do not erase the gap between eras; they show how methods, personal experience, and practical knowledge could survive the loss of official programs.

Legitimacy, Safeguards, and Public Recognition

By the 2010 MAPS conference in San Jose, the renewed field brought together university scientists, underground guides, experienced psychedelic users, therapists, funders, filmmakers, and entrepreneurs. James Fadiman, who had participated in the earlier research at the International Foundation for Advanced Study, announced a meeting for guides and expected only a handful to attend. A hundred people appeared the next morning. The gathering did not make this disparate group a formal organization, but it made visible a population of practitioners who shared methods and professional concerns across institutional lines.

The conference also displayed a changed relationship with the mental-health establishment. At a panel on the future of psychedelic psychiatry, former American Psychiatric Association head Paul Summergrad sat alongside former National Institute of Mental Health head Tom Insel. Insel recognized the promise of psychedelic-assisted psychotherapy while warning that its integrated model could complicate regulation, which often evaluates drugs in isolation. He and Summergrad stressed safety, rigor, and reputational risk: a poorly conducted study or a disastrous patient experience could undermine confidence in the work as a whole. Their caution recalled the earlier history, when the movement’s public image and research practice had become difficult to separate.

The second wave thus returned to old questions under new conditions. It sought clinical legitimacy through contemporary trials, yet its therapeutic logic depended on a guided experience that resisted reduction to a molecule alone. Its knowledge came from laboratories and from an underground lineage, while its public credibility remained vulnerable to failures of method and judgment. The revival’s defining tension was that the very features that made psychedelic therapy distinctive—context, guidance, and experiences often understood as spiritual—were also the features that made it hardest to contain within conventional medical categories.