UC Davis

This dissertation examines psychedelic-assisted therapy (PAT) as an emerging and unsettled field of care in which suffering, meaning, and altered states of consciousness are being organized across clinical, ceremonial, decriminalized, and underground settings. Drawing on sixty in-depth qualitative interviews with facilitators and patients, it argues that psychedelic healing cannot be understood through pharmacology or acute experience alone, but must be situated within the social, relational, and structural conditions that shape whether transformation becomes durable, distorted, or impossible to sustain. Across three empirical chapters, the project develops the concepts of liminal authority and psychedelic careers to explain how facilitators construct legitimacy and how patients learn to interpret and carry forward meanings from altered-state experiences through dispositional and interpretive resources that are themselves unequally distributed, and extends cultural brokerage literature to develop experiential containment and liminal relay as mechanism-centered concepts that specify the conditions under which health transformations succeed or fail to sediment across the boundary between PAT sessions and ordinary life. Together, the concepts across each chapter provide the analytical language necessary to rethink ‘set, setting, and integration’ as social and structural accomplishments rather than individual or pharmacological ones. The dissertation concludes that psychedelic-assisted therapy reveals both an expanding medical jurisdiction over altered states of consciousness and the limits of biomedical and market-driven frameworks for understanding suffering and transformation which exceed the language of symptom reduction alone, and specifies what a critical sociology of psychedelics must entail in order to adequately analyze the field as it continues to develop.