Psychedelic Perspectives: Terrance Ching Wants Systemic Change for Equitable Treatment
Esalen Team
April 28, 2021
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Terrance Ching is a US-based Chinese Singaporean who’s currently completing a PhD in clinical psychology at the University of Connecticut; his doctoral work examines the efficacy of MDMA-assisted psychotherapy for white participants and participants of color. 

He’s also a gay man, and his approach to MDMA clinical trials are informed by his cultural and sexual identity, infusing the research process with culturally informed recruitment and assessment. “MDMA, to me, represented something that was inherently queer. It has such stigma in the United States that it became natural that I would gravitate toward MDMA as an option for healing from some of these minority stress processes that I've been going through.”

Terrance sat down with Voices of Esalen’s Sam Stern to talk more about how to build inclusivity into MDMA therapy from the ground up. Read on for the highlights of their conversation, or listen to the podcast for more.

1. Traditional mental health care isn’t accessible to everyone, for cultural reasons as much as financial.

“Where I come from in Singapore, mental illness is very much stigmatized. I lived with a family member with mental illness, and it was hard to see them struggle and understand that function and operate in an environment that wasn't really open to talking about mental illness. So early on my research, I looked at self-help approaches for addressing mental illness: What can we do that doesn't require the person to speak with someone face to face?

MDMA therapy seems to be at the other end of the spectrum; it's really an involved process. But it also brings a sense of hope for people who have struggled for a very long time with mental illness. In its very essence, it represents something that’s against the grain, a little countercultural, a little innovative.”

2. We need inclusive clinical trials to ensure inclusive treatment.

“If you go into the hospital, you see white medical staff and lab coats — it activates some stereotypes about what your experience might be like. Are they going to experiment on me? And these stereotypes are based in reality; there’s an unfortunate history of abuse of patients of color in medical settings, like the Tuskegee syphilis experiment. I did a year of grad school in Kentucky and I didn't know that Kentucky public hospitals had a history of abusing prisoners of color in psychedelic research...

Queer people too: the psychedelic protocol has traditionally had a gender aspect to it. In a co-therapeutic setting, one therapist needs to be the male and one needs to be female so that when transference occurs, you can see the father and the mother and that dynamic could be used for a therapeutic purpose. But when you talk about queer folks, or people who have been raised by same-gender parents, or people who don't feel safe in hetero-normative spaces, would that gender pairing be counterproductive to deeper psychedelic exploration?”

3. Equality and inclusivity require systemic changes.

“I would like for any work to be led by science, and for the science to take place we need more equitable recruitment of diverse populations. A lot of this work has been funded by private organizations that aren’t necessarily holding investigators to the same standards as federally funded trials. Private organizations may have a specific agenda while federal funders operate within a framework that requires X percentage of diverse participants in your clinical trial, and you need to be able to write that into your proposal and deliver that. 

I’d like private organizations to start exerting some pressure on grant applications to reflect the same level of intent about diversity in recruitment. And I would love for there also to be diversification of study staff: so, diversify everything, make sure it's equitable, and make sure that we have enough of a sample size to conduct the analysis that we need to then say MDMA therapy works just as well for people of color, queer folks, differently able folks, et cetera, than folks who are a non-Hispanic white, cisgender male, able-bodied, etc.”

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