This is such important work, Jeremy - I'm here for it. The idea of talk therapy is nonsensical - there is no such thing as talking without a body. Our need to dismiss in order to build up another modality is always suspicious to me. I've been on "both sides" as well - talk therapy, and be trained in the art of it, made me who I am. And I have benefited tremendously from both the somatic and psychedelic fields. But still I come back to conversation that transforms and have been a patient for a long time. There is another piece about talk therapy - it is ongoing in a way that the other modalities rarely are. Trust takes time, unfolding takes time, vulnerability takes time, healing takes time... in recovery I rely on my therapist to be in it for the long term - I'm not looking for a weekly breakthrough, I am slowly but surely coming into relationship in a way I never thought possible. Thanks for this great writing I am looking forward to more.
Hi Alison. Thanks for dropping by. I feel you on time. When I first took psychedelics with a guide some six or seven years ago I remember that the promise was how fast the change would be—and while there's some truth there, it's a lesser one compared to the reality that our unfolding takes time. Curious to hear more about how you're "coming into relationship in a way I never thought possible" if you'd like to share. Thanks for reading and commenting :)
Thanks for responding! I love your question. What's happening is that little by little I am learning to be myself with another human, trusting that they will not leave me. That me being intelligent, giving them my empathy and time... these things are not needed to be safe and loved. I can be loved just by being me. Which may seem obvious to say but is not at all obvious from the inside.
Your reflection on healing captures something profound: it’s not just about processing trauma but about making meaning through relationships. Your critique of talk therapy, particularly structured forms like CBT, raises important points. Some approaches do feel mechanical, prioritizing technique over connection. But research shows that Trauma-Focused CBT consistently outperforms many alternatives in treating PTSD, anxiety, and OCD. Maybe the issue isn’t talk therapy itself, but how it’s practiced—some versions fail, while others succeed through presence, attunement, and real conversation.
Your discussion of trauma and the body is compelling. The idea that trauma is stored and must be somatically released, popularized by Peter Levine and Bessel van der Kolk, has gained traction. But this risks creating a false dichotomy. Your own experience suggests something paradoxical: when words are used with care and precision, they are not weak but profoundly embodied. Maybe healing isn’t about choosing between talk therapy and somatic work, but integrating both.
One of your most striking insights is that we have lost faith in words not because they don’t work, but because real conversation is too dangerous. Perhaps the rise of self-regulation and nervous system healing reflects an avoidance of the rawness of real dialogue. If deep conversation is the key, how should therapy evolve to reclaim that space? How do we step off the self-improvement treadmill and into something deeper?
Appreciate the read and thoughtful response Joshua. Love these questions. Not sure I have answers but will explore them :) Your point about the false dichotomy is part of what I want to point to here, for sure.
Re: trauma-focused PTSD, I prioritize the lived experience of those getting it over any scientific results, so if people feel it's good for them then I'm all for it. One challenge with *scientific results* when it comes to human *experience* is that there is an insurmountable gap between the two. Science can't study experience. It can only create an abstract representation of experience against which it measures results. For that reason I'm very skeptical about what research results really mean for lived experience. On top of that, much of research isn't repeatable and might even be "false." https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
Really appreciated your response and the spirit behind it. There’s a humility and curiosity in what you wrote that’s often missing in discussions about trauma, healing, and what counts as “truth.” I think you’re right to question the authority of science when it overreaches, and right to elevate the dignity of lived experience, especially when it comes to something as intimate and uneven as trauma recovery.
That said, I’d like to challenge (gently) the idea that science and experience are inherently at odds. In my own life, therapy has been hit or miss—some healing, some frustrating, some genuinely helpful, others not. Same with Recovery. I’ve had sponsors who helped me get my feet back under me, and others who, frankly, shook my trust in the process. Sometimes it really does feel like the luck of the draw—who’s available, who clicks, whether you’re even in a place to know what you need or how to ask for it. Most people, when they first walk into a therapist’s office or a 12-Step meeting, don’t have that discernment yet. I sure didn’t.
But that’s why I think shared frameworks—like Cognitive Behavioral Therapy (CBT)—can be so valuable. Not because they replace the uniqueness of our experience, but because they offer tools we can test for ourselves, and share with others. CBT isn’t just theory. It’s been shown to work—in veterans with PTSD, in people with depression, anxiety, insomnia, OCD, binge eating, even psychosis. It doesn’t ask for faith in a guru. It offers methods anyone can try. And the research behind it? Unlike a lot of one-off studies, it has been replicated, adapted, and shown to help across populations and contexts.
You mentioned the Ioannidis article—“Why Most Published Research Findings Are False.” It’s a powerful critique. But it’s not an argument against science—it’s a call for better science. He’s pointing out the flaws in how research is funded, published, and used to chase prestige or policy shortcuts. And ironically, therapies like CBT—with decades of trials, adjustments, and outcome data—are exactly what his critique points us toward: durable, adaptive, and evidence-based practices.
But none of that negates what I think you’re really pointing to: that healing is social. That it’s dangerous to pin all our hopes on a single relationship—whether that’s a therapist, sponsor, pastor, or partner. I’ve come to believe that real healing happens when we integrate what we’ve learned into a self-understanding we can live and share with others. That might be in a church community, a home group, or just a circle of friends who see us whole. No single person can—or should—carry the weight of our healing.
That’s where I see CBT, and science more broadly, as a complement to experience, not a rival to it. Not something to obey or outsource ourselves to, but something to use in community—to test, to adjust, to pass along. The goal isn’t just relief. It’s integration. It’s building a life where our story can be held and heard—not just in a therapist’s office, but at the kitchen table, in a shared prayer, or in the quiet solidarity of people trying to stay sober for one more day.
Would love to hear how you think about that—especially the role of community in discerning what works and what wounds. Who or what has helped you bridge that gap between personal experience and shared healing?
Beautifully said Joshua. Thanks for such a thoughtful reply. This really resonates: "...not just in a therapist’s office, but at the kitchen table, in a shared prayer, or in the quiet solidarity of people trying to stay sober for one more day." When I hear you say "integrate" I take that to mean something like returning from alienation, which is the work of relationships and community (and our relationship with ourselves). One of the challenges seems to be that we're so fragmented and have been out of communities, including our relationship to the earth and all other beings, for so long. I aim to be in community but the reality is my life is also fragmented: work online, school online, etc. I think it was Tara recently who was talking about how the challenge of our time is to live into community and individuation, to bring them together, which seems right to me—and isn't easy. As far as CBT and science: I'm on board with science as one useful epistemology, but is that how it's presented? Science and many scientists claim to be the primary source of truth, which conceals other ways of knowing and revealing that are not just valid but necessary to flourishing. Science and its handmaiden technology dominate. This seems to be the way of science. So it feels important to challenge that view and question what's really happening in so-called evidence-based interventions. They may very well be useful and it's true that there is wider access to them—I'm glad for that. However, these interventions conceal deeper truths and motivations. The philosopher of science Paul Feyerabend writes about this...will try to bring his work into future pieces.
Anyhow, glad to be in dialogue with you and really value your questions.
This is such important work, Jeremy - I'm here for it. The idea of talk therapy is nonsensical - there is no such thing as talking without a body. Our need to dismiss in order to build up another modality is always suspicious to me. I've been on "both sides" as well - talk therapy, and be trained in the art of it, made me who I am. And I have benefited tremendously from both the somatic and psychedelic fields. But still I come back to conversation that transforms and have been a patient for a long time. There is another piece about talk therapy - it is ongoing in a way that the other modalities rarely are. Trust takes time, unfolding takes time, vulnerability takes time, healing takes time... in recovery I rely on my therapist to be in it for the long term - I'm not looking for a weekly breakthrough, I am slowly but surely coming into relationship in a way I never thought possible. Thanks for this great writing I am looking forward to more.
Hi Alison. Thanks for dropping by. I feel you on time. When I first took psychedelics with a guide some six or seven years ago I remember that the promise was how fast the change would be—and while there's some truth there, it's a lesser one compared to the reality that our unfolding takes time. Curious to hear more about how you're "coming into relationship in a way I never thought possible" if you'd like to share. Thanks for reading and commenting :)
Thanks for responding! I love your question. What's happening is that little by little I am learning to be myself with another human, trusting that they will not leave me. That me being intelligent, giving them my empathy and time... these things are not needed to be safe and loved. I can be loved just by being me. Which may seem obvious to say but is not at all obvious from the inside.
Well said. I wrestle with that one. Necessarily true but not at all obvious from the inside.
Your reflection on healing captures something profound: it’s not just about processing trauma but about making meaning through relationships. Your critique of talk therapy, particularly structured forms like CBT, raises important points. Some approaches do feel mechanical, prioritizing technique over connection. But research shows that Trauma-Focused CBT consistently outperforms many alternatives in treating PTSD, anxiety, and OCD. Maybe the issue isn’t talk therapy itself, but how it’s practiced—some versions fail, while others succeed through presence, attunement, and real conversation.
Your discussion of trauma and the body is compelling. The idea that trauma is stored and must be somatically released, popularized by Peter Levine and Bessel van der Kolk, has gained traction. But this risks creating a false dichotomy. Your own experience suggests something paradoxical: when words are used with care and precision, they are not weak but profoundly embodied. Maybe healing isn’t about choosing between talk therapy and somatic work, but integrating both.
One of your most striking insights is that we have lost faith in words not because they don’t work, but because real conversation is too dangerous. Perhaps the rise of self-regulation and nervous system healing reflects an avoidance of the rawness of real dialogue. If deep conversation is the key, how should therapy evolve to reclaim that space? How do we step off the self-improvement treadmill and into something deeper?
Looking forward to your next thoughts.
Appreciate the read and thoughtful response Joshua. Love these questions. Not sure I have answers but will explore them :) Your point about the false dichotomy is part of what I want to point to here, for sure.
Re: trauma-focused PTSD, I prioritize the lived experience of those getting it over any scientific results, so if people feel it's good for them then I'm all for it. One challenge with *scientific results* when it comes to human *experience* is that there is an insurmountable gap between the two. Science can't study experience. It can only create an abstract representation of experience against which it measures results. For that reason I'm very skeptical about what research results really mean for lived experience. On top of that, much of research isn't repeatable and might even be "false." https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
Curious what you think—and about your experience?
Jeremy—
Really appreciated your response and the spirit behind it. There’s a humility and curiosity in what you wrote that’s often missing in discussions about trauma, healing, and what counts as “truth.” I think you’re right to question the authority of science when it overreaches, and right to elevate the dignity of lived experience, especially when it comes to something as intimate and uneven as trauma recovery.
That said, I’d like to challenge (gently) the idea that science and experience are inherently at odds. In my own life, therapy has been hit or miss—some healing, some frustrating, some genuinely helpful, others not. Same with Recovery. I’ve had sponsors who helped me get my feet back under me, and others who, frankly, shook my trust in the process. Sometimes it really does feel like the luck of the draw—who’s available, who clicks, whether you’re even in a place to know what you need or how to ask for it. Most people, when they first walk into a therapist’s office or a 12-Step meeting, don’t have that discernment yet. I sure didn’t.
But that’s why I think shared frameworks—like Cognitive Behavioral Therapy (CBT)—can be so valuable. Not because they replace the uniqueness of our experience, but because they offer tools we can test for ourselves, and share with others. CBT isn’t just theory. It’s been shown to work—in veterans with PTSD, in people with depression, anxiety, insomnia, OCD, binge eating, even psychosis. It doesn’t ask for faith in a guru. It offers methods anyone can try. And the research behind it? Unlike a lot of one-off studies, it has been replicated, adapted, and shown to help across populations and contexts.
You mentioned the Ioannidis article—“Why Most Published Research Findings Are False.” It’s a powerful critique. But it’s not an argument against science—it’s a call for better science. He’s pointing out the flaws in how research is funded, published, and used to chase prestige or policy shortcuts. And ironically, therapies like CBT—with decades of trials, adjustments, and outcome data—are exactly what his critique points us toward: durable, adaptive, and evidence-based practices.
But none of that negates what I think you’re really pointing to: that healing is social. That it’s dangerous to pin all our hopes on a single relationship—whether that’s a therapist, sponsor, pastor, or partner. I’ve come to believe that real healing happens when we integrate what we’ve learned into a self-understanding we can live and share with others. That might be in a church community, a home group, or just a circle of friends who see us whole. No single person can—or should—carry the weight of our healing.
That’s where I see CBT, and science more broadly, as a complement to experience, not a rival to it. Not something to obey or outsource ourselves to, but something to use in community—to test, to adjust, to pass along. The goal isn’t just relief. It’s integration. It’s building a life where our story can be held and heard—not just in a therapist’s office, but at the kitchen table, in a shared prayer, or in the quiet solidarity of people trying to stay sober for one more day.
Would love to hear how you think about that—especially the role of community in discerning what works and what wounds. Who or what has helped you bridge that gap between personal experience and shared healing?
—Joshua
Beautifully said Joshua. Thanks for such a thoughtful reply. This really resonates: "...not just in a therapist’s office, but at the kitchen table, in a shared prayer, or in the quiet solidarity of people trying to stay sober for one more day." When I hear you say "integrate" I take that to mean something like returning from alienation, which is the work of relationships and community (and our relationship with ourselves). One of the challenges seems to be that we're so fragmented and have been out of communities, including our relationship to the earth and all other beings, for so long. I aim to be in community but the reality is my life is also fragmented: work online, school online, etc. I think it was Tara recently who was talking about how the challenge of our time is to live into community and individuation, to bring them together, which seems right to me—and isn't easy. As far as CBT and science: I'm on board with science as one useful epistemology, but is that how it's presented? Science and many scientists claim to be the primary source of truth, which conceals other ways of knowing and revealing that are not just valid but necessary to flourishing. Science and its handmaiden technology dominate. This seems to be the way of science. So it feels important to challenge that view and question what's really happening in so-called evidence-based interventions. They may very well be useful and it's true that there is wider access to them—I'm glad for that. However, these interventions conceal deeper truths and motivations. The philosopher of science Paul Feyerabend writes about this...will try to bring his work into future pieces.
Anyhow, glad to be in dialogue with you and really value your questions.
"Perhaps the rise of self-regulation and nervous system healing reflects an avoidance of the rawness of real dialogue."
Yes. So beautifully said.