In The F.I.V.E. Institute’s recent seminar, psychotherapists Roger Kaufman, LMFT and Dustin Kerrone, LMFT joined The F.I.V.E. Institute co-founders Joel Brierre and Victoria Wueschner for a conversation about the therapeutic potential of 5-MeO-DMT.
Roger and Dustin are co-hosts and co-facilitators of therapeutic 5-MeO-DMT retreats at Sky Mountain in the Sonoran Desert, as well as alumni of The F.I.V.E. Institute’s 9-Month 5-MeO-DMT Facilitator Training Program. Both came to this work after years in psychotherapy, giving them a unique perspective on what changes when psychedelic experiences are held within a broader therapeutic process.
The conversation explores preparation, facilitation, integration, the role of the therapist, and why creating the right container may be just as important as what happens during the experience itself.
*This interview has been edited for length and clarity.
** The experiences discussed reflect the speakers’ clinical observations and should not be interpreted as claims of efficacy or medical advice.
Q: You were both therapists long before you began working with 5-MeO-DMT. What changes when these two worlds come together?
Roger Kaufman: One of the things 5-MeO-DMT can offer is a radically different perspective from our ordinary way of experiencing ourselves and our lives.
There are wonderful benefits to talk therapy, but there are also limits. Sometimes people can understand something intellectually for years without fundamentally changing how they experience themselves. After a profound experience with 5-MeO-DMT, the things that once felt enormous – the worries, anxieties, sadnesses – can suddenly become smaller in relation to something much larger.
What I’ve witnessed is a significant shift in self-acceptance and self-worth. People sometimes come out of an experience and say, “That felt like ten years of therapy.” Recently someone said, “That felt like 54 years of therapy.” Obviously, those are personal descriptions, not clinical measurements. But they capture the scale of perspective shift that people sometimes experience.
Dustin Kerrone: What continues to surprise me is how different that shift can look from person to person. For one person, the experience might bring clarity about the next step in their life. For someone else, it may involve forgiveness.
Someone else may encounter something spiritual or existential. There isn’t one predetermined therapeutic outcome. Part of the work is remaining open to what actually emerges rather than deciding in advance what the person is supposed to experience.
Q: Are there particular psychological struggles or patterns that have stood out to you in this work?
Roger Kaufman: I’ve worked with a client for years who had a long history of treatment-resistant depression and suicidal ideation. His experience was not that every challenge in his life disappeared. What changed was something more fundamental in how he experienced himself.
He described moving from an internal sense of emptiness toward what felt like fullness. That shift became a different center from which he could meet the difficulties that were still present in his life.
Trauma is another area where I’ve witnessed meaningful experiences. Seeing someone encounter aspects of their trauma and relate to them differently can be incredibly powerful. But I want to be careful about making this sound formulaic. It isn’t that a certain diagnosis produces a certain kind of 5-MeO-DMT experience.
Dustin Kerrone: Anxiety is another example that comes to mind. We recently worked with someone who encountered a lot of fear during her experience. Rather than trying to make the fear disappear, we stayed with her in it.
There was something powerful about allowing fear to be present without treating it as something that immediately needed to be fixed or escaped.
That is important therapeutically. Sometimes the reparative experience is not getting rid of an uncomfortable emotion. It is discovering that you can remain present with it in a safe environment.
Q: Are there particular therapeutic approaches that seem especially compatible with 5-MeO-DMT?
Roger Kaufman: There are certainly modalities that lend themselves well to this work—humanistic and existential therapy, Carl Rogers’ client-centered approach, somatic work, and other models that emphasize presence and acceptance.
But for me, the quality of the relationship matters even more than a particular technique.
The underlying idea is that if you create the conditions for growth, there is already something within the person that knows how to grow. The therapist does not always need to direct that process.
That has been a significant change in my own work. Instead of approaching the therapist as the expert who analyzes the client, there can be a much more collaborative relationship. The facilitator or therapist is fully present, but they also have to know how to get out of the way.
Dustin Kerrone: I’ve trained in approaches including Jungian, psychodynamic, psychoanalytic, and Internal Family Systems work, and all of those tools can be useful. But lately I’ve found myself increasingly interested in simply being phenomenologically present: what is actually happening between the client and me right now?
If there is a lot of emotion, I may slow everything down and become much more receptive. When I stop thinking ahead to the next intervention or interpretation, something unexpected often emerges.
The tools are still there. But instead of imposing a tool onto the moment, I let the moment tell me which tool might actually be useful. And I think clients feel the difference. They feel received rather than analyzed.
Q: How much does a person’s history predict what will actually happen during a 5-MeO-DMT experience?
Dustin Kerrone: In our experience, much less than you might expect.
I worked with a client who was a paramedic and had witnessed extraordinarily difficult things over the course of his career. I was anxious about what might emerge for him. Instead, his experience was incredibly peaceful.
Then I’ve had another client going through divorce, struggling with self-worth and fear, and those themes emerged very directly during his experience. We’ve also worked with someone who had a very active mind and complicated interpersonal patterns, and his experience was largely about his mind becoming quiet. He told us it felt like the first time that had ever happened.
So at this point, we prepare ourselves to be present with whatever emerges, including trauma, but we don’t assume trauma is what will appear simply because somebody has a traumatic history.
Roger Kaufman: That unpredictability is important. Sometimes someone with a great deal of trauma has an experience filled with spaciousness or beauty. Someone who appears very high-functioning may encounter something they had successfully kept outside of awareness for years.
We don’t decide what is going to happen. The participant doesn’t entirely decide either. Our responsibility is to create the conditions in which we can safely meet whatever does arise.
Q: What have you had to unlearn as therapists in order to better support people in this work?
Dustin Kerrone: The biggest thing for me has been letting go of the therapist’s agenda.
I think therapists can consciously tell themselves, “I don’t want to impose an agenda,” while still having one. I’ve had to let that go much more completely.
That can actually be frightening at first because therapists are trained to intervene. You can feel like, “I need to do something here.”
But I’ve found tremendous power in trusting the relationship and staying with what is happening rather than constantly trying to move the client somewhere.
When a client feels genuinely met rather than analyzed, something different becomes possible.
Roger Kaufman: My own experiences with 5-MeO-DMT changed the way I see the people sitting across from me. One of my major realizations was that we are all so much bigger than we think we are. People can spend their lives relating to themselves as though they are small, inadequate, or fundamentally lacking.
So part of my work has become seeing something in clients that they may not yet be able to see in themselves – their beauty, their worth, their capacity. That doesn’t mean ignoring suffering or difficulty. It means not reducing somebody to their pathology.
Q: Why do you believe personal experience with 5-MeO-DMT matters for therapists and facilitators working in this space?
Roger Kaufman: I feel very strongly about this. 5-MeO-DMT is often described as ineffable, and I think that is genuinely true. We can try to describe the experience, and trying to put it into words can be useful during integration, but the actual experience can be radically different from anything language can communicate. My experiences completely changed me as a person and changed how I practice therapy.
It is difficult for me to imagine sitting with a client describing an experience of that magnitude without having some experiential frame of reference myself. That includes challenging experiences. I’ve had difficult experiences with 5-MeO-DMT as well. Knowing something about that territory firsthand has been incredibly important to the way I support other people.
Dustin Kerrone: I had an early experience where I felt something like infinity… not as an idea, but as an experience.
Before that, I had been relatively agnostic about spirituality. Suddenly I was encountering something that felt as though it had no beginning and no end, and at first that was existentially terrifying.
I would have had a very difficult time understanding a client describing something like that if I had never encountered that kind of state myself.
At the same time, I think therapists need humility around all of this. Having an experience does not mean we suddenly know exactly what reality is or that we should impose a spiritual interpretation on someone else. It gives us a reference point. It does not make us the authority on somebody else’s experience.
Q: Does someone need to have a “full release” or ego-dissolution experience for the work to be meaningful?
Dustin Kerrone: I think lower-dose and higher-dose experiences can both be valuable, but they may work in very different ways.
At higher doses, someone may move into a state where they are partially or almost completely outside of their ordinary sense of self. That can be extraordinarily significant.
But lower doses can allow someone to remain more conscious of the process as it unfolds. There can be tremendous emotional work there because the person can stay present with what is happening. I don’t think the value of an experience should be reduced to whether somebody reaches a particular threshold.
Roger Kaufman: I agree. Full-release experiences can be deeply transformative, and I think they are significant for many people.
But I have also personally had one of the most important experiences of my life at what would be considered a medium dose. I spent a long time crying, and it was incredibly cathartic. At that point in my own process, stepping back from trying to reach a full release was exactly what I needed.
Most importantly, there should never be pressure placed on somebody to have a certain kind of experience.
The facilitator’s role is not to say, “You need to get here.” It is to create a safe, supportive space in which the person can meet the experience that is actually happening.
That same principle carries into integration. Whether the experience was expansive, frightening, emotional, quiet, or almost impossible to put into words, the work afterward is about allowing its meaning to continue unfolding rather than forcing it into a predetermined story.