Ketamine psychosynthesis groups (Roquet, historical)

HISTORICAL ACCOUNT — NOT FOR USE. This tab describes a discontinued drug therapy so clinicians can recognise it, evaluate claims about it and support clients who meet its descendants. It deliberately contains no doses, routes, schedules, drug sequences or combinations, or administration details. Nothing here is a protocol.

1. Introduction

Version followed: Salvador Roquet's psicosíntesis as practised in group sessions at his institute in Mexico (1967 to early 1975), as reconstructed from a contemporary observer (Villoldo 1977), a colleague's memoir (Krippner 2017) and the account of his closest US collaborator, Richard Yensen (interview by Wolfson 2014). Roquet's own books (Roquet 1976; Roquet & Favreau 1981) are cited only by title [uncertain].

• What it was. Salvador Roquet (1920–1995), a Mexican psychiatrist and former public-health official, began using hallucinogens as an adjunct to psychotherapy in 1967, first to shorten psychoanalysis along Hanscarl Leuner's psycholytic lines, then developed a group method he called psicosíntesis [source: Villoldo 1977; Erowid; Krippner 2017]. It is unrelated to Roberto Assagioli's Psychosynthesis beyond the name [source: Erowid; Yensen in Wolfson 2014]. A dating to the "1970s" is partly right: drug sessions ran 1967–1974; ketamine entered the method in the early 1970s and is described as among the first therapeutic uses of ketamine [source: Mathai et al. 2022; Yensen in Wolfson 2014].
• Format. Large, deliberately mixed groups went through night-long sessions combining several plant and synthetic hallucinogens (sources list morning-glory seeds, psilocybin mushrooms, peyote, datura, ketamine and LSD) with intense multimedia "sensory overload", readings, personal photographs and family contact, followed by a non-drug integration group [source: Villoldo 1977; Krippner 2017; Yensen in Wolfson 2014].
• Core idea of change (as its proponents put it). Roquet held that anguish about death underlies psychopathology: "At their root all pathological manifestations are symptoms of this inherent problem of humanity" [source: Villoldo 1977, paraphrasing Roquet]. Therapy was a deliberately induced round trip into "madness" and ego-loss and back, followed by synthesis of what surfaced; Yensen describes it as a journey into the world of the madman and the mystic [source: Yensen in Wolfson 2014]. Mathai et al. summarise the aim as "producing, and then processing, extreme psychological experiences" [source: Mathai et al. 2022].
• Why it stopped. In 1974 Roquet was arrested, charged with drug trafficking and crimes against his patients' health, held in Lecumberri prison in Mexico City (five months per Krippner; nine months per Erowid [uncertain]) and released in April 1975 when the charges were dropped; police closed his institute [source: Krippner 2017; Erowid; Villoldo 1977]. Yensen attributes the arrest to a change in political patronage, since Roquet's permission had rested on an informal arrangement with the federal attorney general's office [source: Yensen in Wolfson 2014]. Afterwards Roquet curtailed drug use and ran non-drug "simulated" sessions with light and sound only [source: Krippner 2017].
• What remains today. No regulated programme uses Roquet's method. Richard Yensen presides over a Salvador Roquet Psychosynthesis Association and developed a non-drug "Perceptual Affective Therapy" [source: CIIS abstract of Wolfson 2014]. Echoes appear in contemporary retreat and underground settings that mix substances, multimedia and confrontation [synthesis].
• Current legal and regulatory status of ketamine (as of the sources' dates). USA: ketamine is Schedule III and FDA-approved only as an anaesthetic; "Ketamine is not FDA-approved for the treatment of any psychiatric disorder" (FDA, Feb 2022), so psychiatric use of racemic ketamine is off-label, and compounded products have not been FDA-evaluated [source: FDA 2022]. Esketamine (Spravato) is Schedule III and approved (2019) for treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behaviour; in January 2025 it was approved as monotherapy for treatment-resistant depression. It is available only under a REMS: dispensed and given only in certified health-care settings, never for use at home, with post-administration monitoring by medical staff [source: FDA 2022; Psychopharmacology Institute 2025]. UK: ketamine is a Class B controlled drug; on 28 January 2026 the ACMD advised it remain Class B [source: GOV.UK 2026]. EU approval of esketamine and Mexico's current scheduling of ketamine are not verified here [uncertain].

2. Framework

This is a historical treatment programme, not a manualised therapy; the structure below is reconstructed from observers' accounts and the figures differ between them [source: Villoldo 1977; Krippner 2017; Yensen in Wolfson 2014]. Not for use.

A. The course as a whole

• Population. Mostly neurotic outpatients; occasionally people with antisocial personality, character neuroses and schizophrenia [source: Yensen in Wolfson 2014]. No published screening or exclusion criteria are documented in the sources [uncertain]; Villoldo notes only that groups were "carefully selected" for mix [source: Villoldo 1977].
• Cycle. A repeating cycle of (1) a private meeting with Roquet, (2) a night-long group drug session, (3) a shorter non-drug group session for integration; then the cycle repeated with a differently composed group [source: Villoldo 1977]. Patients near the end of treatment were seen only rarely [source: Villoldo 1977].
• Length. A long series of group drug sessions over months to years; sources disagree on the number and the exact figures are omitted here because they amount to an administration schedule [source: Krippner 2017; Yensen in Wolfson 2014].
• Scale. Roughly 300 patients in treatment at any one time; total case counts range from "over six hundred" (Villoldo) to about 1,700 (Erowid) to about 2,000 case histories (Krippner) [uncertain].
• Criteria for moving on. None formally published in the sources. Progress was judged clinically by Roquet; Villoldo records success with "existential neurosis" and anxiety, mostly within a Freudian frame [source: Villoldo 1977] [uncertain].

B. The experiential stage model (within a session or across a course)

According to Villoldo's account of Roquet's model [source: Villoldo 1977]:

1. Expectancy — anticipation and anxiety before effects begin.
2. Pseudo-visions — imagery that Roquet regarded as a risk of evasion rather than insight.
3. Lucid self-observation with catharsis — seeing one's patterns, emotional discharge.
4. Ego-loss ("madness") — framed as death-rebirth and compared to satori; the "return to the source of sensibility" and recovery of a "lost soul".
5. Synthesis — integrating material into a new personal organisation; the stage that gave the method its name. Villoldo notes Roquet credited datura with breaking down rigid character so that the work shifted from analysis to synthesis.

C. Phases of a single group session (sequence per Villoldo; Yensen and Krippner give similar but not identical orders and durations [uncertain])

Whole drug sessions lasted on the order of a day (Villoldo: about 22 hours) [source: Villoldo 1977; Krippner 2017; Yensen in Wolfson 2014].

3. Guiding principles

These are Roquet's principles as reported by others, given so clinicians can recognise them; the practical meaning is stated historically. Several conflict with current ethical and safety standards (see section 5).

• Death anxiety is the root problem — sessions were built around confronting mortality, with death a central theme of the imagery [source: Villoldo 1977; Yensen in Wolfson 2014].
• Induced madness as a round trip — the therapist aimed to take patients into toxic psychosis and ego-loss and bring them back with insight; Roquet treated the mystical as essential to cure [source: Yensen in Wolfson 2014; Villoldo 1977].
• Difficult experiences are deliberate — the setting was designed to provoke anguish; a participant (Walter Houston Clark) said Roquet deliberately set up "bad trips" [source: Erowid, summarising Clark 1976] and Yensen reports datura-induced anxiety and loss of control were allowed to persist between sessions [source: Yensen in Wolfson 2014].
• Synthesis over analysis — the goal was a new integration rather than interpretation alone [source: Villoldo 1977].
• The group as a social microcosm — groups mixed ages, sexes, classes and "authority figures" (maternal, paternal, youthful) so that transference among members would be activated [source: Villoldo 1977; Yensen in Wolfson 2014].
• Permission for forbidden impulses — patients were told "the expression of both their aggressive and sexual impulses was acceptable in this milieu" [source: Krippner 2017].
• Environmental control — the therapist steered group reactions and intensity through visual and auditory stimuli [source: Villoldo 1977].
• Personalisation — slides, music and materials (family photographs, letters) were chosen for each patient [source: Krippner 2017; Yensen in Wolfson 2014].
• Confrontation — Roquet presented patients with their ongoing life problems and the integration phases were confrontational [source: Yensen in Wolfson 2014].
• Respect for indigenous tradition — Roquet consulted Mexican healers (including María Sabina), held sessions at night as vigils, and framed recovery of the "lost spirit" as central [source: Krippner 2017; Yensen in Wolfson 2014]. Note: this is Roquet's appropriation of ceremonial elements into a clinic; this tab does not describe Mazatec or other ceremony [synthesis].
• Family and life re-entry — relatives and friends were brought in at the end so the experience would carry "into their lives and homes" [source: Villoldo 1977].
• A single charismatic director — one clinician ran a complex multi-element treatment; Yensen calls charisma both the strength and the undoing of Roquet [source: Yensen in Wolfson 2014].
• The drug as launching pad — after prison Roquet said "the psychedelics were nothing more than the launching pad", reporting similar reactions in non-drug simulated sessions (his claim, unverified) [source: Krippner 2017].
• For today's clinician — knowledge of this method serves recognition, history-taking and integration support, never replication [synthesis].

4. Intervention inventory

Part A lists every component of Roquet's method found in the sources, as history: what it was, how it ran in general terms, and why it matters for recognition. Each is not for use. Instead of session scripts, "Example language" gives illustrative wording a present-day clinician can use when a client describes having gone through that component. Part B gives the procedures a clinician uses today; these are [synthesis] built on the regulatory sources cited, because no source on Roquet describes them.

Part A — Historical components (not for use)

A1. Individual consultations with Roquet

• Purpose: Ongoing private psychotherapy that anchored the group cycle; Roquet had psychoanalytic training [source: Villoldo 1977; Yensen in Wolfson 2014].
• Steps (historical, general): a private meeting in each cycle before the group session; frequency fell as treatment neared its end [source: Villoldo 1977].
• Example language (today, illustrative): "Tell me about your one-to-one meetings with the doctor. What did you talk about, and what did he expect of you in the next group?"
• Watch for: intense dependency or idealisation of the director; Yensen describes a deeply transferential bond of his own with Roquet [source: Yensen in Wolfson 2014].

A2. Group composition for heterogeneity

• Purpose: Build a microcosm of society and family so transference among members would surface [source: Villoldo 1977; Yensen in Wolfson 2014].
• Steps (historical, general): groups were assembled to mix ages, sexes, education, social class, time in treatment and "figures of authority"; size ranged from about 6 to 30 (sources differ: 6–30 Villoldo; 10–28 Yensen; about 20 in the session Krippner attended) [source: Villoldo 1977; Yensen in Wolfson 2014; Krippner 2017]. Several assistant therapists and observers were present [source: Villoldo 1977].
• Example language (today, illustrative): "Who else was in the room, and did anyone stand in for someone in your own family?"
• Watch for: shame or guilt about what was seen or done in front of strangers; observers' presence compounds this [synthesis].

A3. Leaderless pre-session group

• Purpose: Air fears and expectations; let newcomers hear veterans; deliberately seed projections and transferences [source: Villoldo 1977; Yensen in Wolfson 2014; Krippner 2017].
• Steps (historical, general): a meeting of about two hours before the session with no therapist present; members talked about expectations, fears and earlier sessions [source: Krippner 2017; Yensen in Wolfson 2014].
• Example language (today, illustrative): "What did people tell you beforehand about what would happen? How did that shape what you expected?"
• Watch for: peer pressure and expectation effects with no professional to contain them [synthesis].

A4. Setting and entry

• Purpose: Create a contained, emotionally charged space under the therapist's control [source: Villoldo 1977].
• Steps (historical, general): a large room without furniture, foam pads or mattresses along the walls, evocative posters (e.g. Emiliano Zapata), projection equipment at the back; patients handed over shoes, watches and cigarettes; staff wore white lab coats [source: Villoldo 1977; Yensen in Wolfson 2014]. Sessions were held at night, after Mexican shamanic practice [source: Yensen in Wolfson 2014].
• Example language (today, illustrative): "You gave up your watch and shoes at the door. What did that feel like — freeing, or like losing control?"
• Watch for: loss of time orientation and personal items as an element of disempowerment [synthesis].

A5. Opening yoga and meditation

• Purpose: Quiet the conscious mind before stimulation [source: Villoldo 1977; Krippner 2017].
• Steps (historical, general): about an hour of yoga and meditation led by an assistant [source: Villoldo 1977].
• Example language (today, illustrative): "Are there practices you learned there, like the yoga, that still help you — or that now bring the session back?"
• Watch for: meditation or yoga cues later acting as trauma reminders [synthesis].

A6. Multimedia "sensory overload"

• Purpose: Evoke personal and universal themes and give the therapist control over intensity and group reactions [source: Villoldo 1977; Krippner 2017].
• Steps (historical, general): multiple slide projectors, a feature film with conflictual themes, two or three stereo systems and coloured floodlights; images often projected in conflicting combinations; themes of death, birth, sexuality, religion, love, pain, destruction and childhood; slides and music personalised, including family photographs [source: Villoldo 1977; Krippner 2017; Yensen in Wolfson 2014]. A brief overload phase also preceded the substances [source: Yensen in Wolfson 2014].
• Example language (today, illustrative): "Which images or sounds stayed with you? Do any still come back uninvited?"
• Watch for: intrusive imagery, startle, sensitivity to flashing light or loud sound. Flashing lights also carry a photosensitive-seizure risk [synthesis].

A7. Administration of hallucinogens (described only as fact)

• Purpose: Roquet's rationale was to open defences and provoke the stage sequence in section 2B [source: Villoldo 1977].
• Steps (historical): sources list morning-glory seeds, psilocybin mushrooms, peyote, datura, ketamine and LSD, used in a planned progression across the course [source: Villoldo 1977; Erowid; Yensen in Wolfson 2014]. Quantities, sequence, combinations and administration are deliberately omitted.
• Example language (today, illustrative): "Do you know what you were given? It's fine if you don't; I'm asking so we can understand what your body and mind went through."
• Watch for: clients often did not know what they received; record what is known and do not speculate on pharmacology [synthesis].

A8. The "madness" period

• Purpose: Deliberately induce anguish and ego-loss, Roquet's "return to the source of sensibility" [source: Villoldo 1977].
• Steps (historical, general): before dawn, films stopped and the sound became chaotic (crashes, strobe lights, car horns, gunfire) before fading to wind; Villoldo reports anguish for many and a pivotal moment for some [source: Villoldo 1977]. Yensen reports that datura-induced anxiety and loss of control were deliberately left unresolved between sessions [source: Yensen in Wolfson 2014].
• Example language (today, illustrative): "That part was designed to be frightening. Whatever you felt then was a response to what was done, not a failing in you."
• Watch for: highest-risk element. Persistent fear, derealisation, intrusive memories, and a belief that one was "mad" [synthesis]. Deliberately provoking toxic psychosis has no place in current practice [synthesis].

A9. Ketamine in the synthesis phase

• Purpose: As Yensen describes Roquet's view, ketamine helped patients find meaning in chaotic datura experiences, acting as a "resolving and grounding" agent and a confrontation that could not be postponed; it was also treated as a major psychedelic experience in itself [source: Yensen in Wolfson 2014]. Roquet learned of its psychological effects through an anaesthetist colleague [source: Yensen in Wolfson 2014]. Mathai et al. say Roquet combined it with psychoanalytic techniques and indigenous healing practices [source: Mathai et al. 2022].
• Steps (historical, general): given to some patients during the synthesis phase. Yensen also describes a later combined approach he developed with Roquet; details are omitted as not for use [source: Villoldo 1977; Yensen in Wolfson 2014].
• Example language (today, illustrative): "Some people describe leaving their body or losing their sense of self. If anything like that happened, we can talk about it at whatever pace suits you."
• Watch for: dissociative after-effects; Yensen's own account describes paranoid thinking at onset and an ego death so convincing he feared toxicity [source: Yensen in Wolfson 2014].

A10. Synthesis work with personal material

• Purpose: Integrate what surfaced by tying it to the person's biography and relationships [source: Villoldo 1977].
• Steps (historical, general): patients reviewed their photographs, letters and journals; heard readings from philosophers; heard playback of earlier sessions; took part in psychodrama; and interacted with Roquet, who moved among them or sat at a table [source: Villoldo 1977; Krippner 2017; Yensen in Wolfson 2014].
• Example language (today, illustrative): "What did you come to understand about your family that night? Does it still feel true now that you're out of that state?"
• Watch for: insights formed under heavy suggestion; test them gently against present life rather than confirming or dismissing them [synthesis].

A11. Confrontation of life problems

• Purpose: Force engagement with ongoing difficulties [source: Yensen in Wolfson 2014].
• Steps (historical, general): Roquet presented patients with problems in their current life situation, in a commanding style, during synthesis and integration [source: Yensen in Wolfson 2014].
• Example language (today, illustrative): "Being confronted while you were that open can leave a mark. How did his words land, and how do they sit with you now?"
• Watch for: shame, internalised criticism, or compliance with views imposed under altered states [synthesis].

A12. Body-oriented and expressive adjuncts

• Purpose: Release "character armour"; Yensen links ketamine's effects to Reich's character analysis [source: Yensen in Wolfson 2014].
• Steps (historical, general): Erowid lists Gestalt therapy, psychodrama, art-making, bioenergetics and Reichian massage among Roquet's techniques; patients were told aggressive and sexual impulses could be expressed [source: Erowid; Krippner 2017]. No touch policy or consent procedure was found in the sources [uncertain].
• Example language (today, illustrative): "Was there any physical contact during the sessions — from staff or other participants? Did you feel able to say no?"
• Watch for: unconsented touch and sexual boundary violations are a recognised risk when touch, permission for sexual expression and altered states combine [synthesis]; ask directly and sensitively.

A13. Rest, breathing and closing practices

• Purpose: Recovery mid-session and closure [source: Villoldo 1977; Krippner 2017].
• Steps (historical, general): an hour of yoga and guided breathing then a nap of a few hours; at the end, roses and open doors [source: Villoldo 1977].
• Example language (today, illustrative): "How did it end for you? Did you feel ready to leave?"
• Watch for: whether the person was fit to go home and who accompanied them [synthesis].

A14. Family visits and calls

• Purpose: Carry the experience "into their lives and homes" [source: Villoldo 1977].
• Steps (historical, general): in the final phase relatives and friends visited or telephoned [source: Villoldo 1977; Yensen in Wolfson 2014].
• Example language (today, illustrative): "What did your family see of you at the end, and how did that change things between you?"
• Watch for: disclosures made to family in an altered state and their consequences [synthesis].

A15. Non-drug integration group

• Purpose: Recount and work through the experience [source: Krippner 2017; Villoldo 1977].
• Steps (historical, general): days later, a group session of several hours without drugs; each patient described the experience, often with abreaction or catharsis [source: Villoldo 1977; Krippner 2017].
• Example language (today, illustrative): "Was there a chance afterwards to make sense of it with others? What was left unfinished?"
• Watch for: unprocessed material; abreaction is not the same as integration [synthesis].

A16. Audiotaping and records

• Purpose: Documentation and playback in later sessions [source: Yensen in Wolfson 2014; Krippner 2017].
• Steps (historical, general): every session was audiotaped; Krippner reports recordings of over 900 group sessions [source: Yensen in Wolfson 2014; Krippner 2017].
• Example language (today, illustrative): "Recordings were made. Would it help to talk about how you feel knowing they exist?"
• Watch for: privacy and consent concerns about recordings made in altered states [synthesis].

A17. Post-1975 "simulated" non-drug sessions

• Purpose: Continue the method legally after prison [source: Krippner 2017].
• Steps (historical, general): workshops using lights and sound alone; Roquet claimed about 90% of participants reacted much as drug patients had (unverified claim) [source: Krippner 2017].
• Example language (today, illustrative): "Even without substances, intense light-and-sound sessions can be overwhelming. How did you feel during and after?"
• Watch for: screen for photosensitive epilepsy, psychosis or bipolar history and unstabilised trauma before any intense sensory method [synthesis].

Part B — What a clinician does today with this knowledge

All of Part B is [synthesis]: present-day clinical practice informed by the history above and by the regulatory sources cited. None of it is attributed to Roquet or his collaborators.

B1. Evaluating historical claims

• Purpose: Respond accurately when a client, colleague or programme cites Roquet as evidence that group ketamine or mixed-psychedelic sessions are proven.
• Steps: (1) Name the sources: Roquet's outcome figures (e.g. 85% "very positive", no one failing to return to sanity) are his own claims as reported by Krippner, with no controls or independent follow-up [source: Krippner 2017]. (2) Note that observers' own figures disagree (patient totals, group sizes, imprisonment length) [source: Villoldo 1977; Erowid; Krippner 2017]. (3) Note Villoldo's observation that true mystical experiences were seldom seen and catharsis was more common [source: Villoldo 1977]. (4) Distinguish this history from current regulated esketamine and off-label ketamine care [source: FDA 2022].
• Example language (illustrative): "Roquet was a real pioneer, but his results were never tested the way we test treatments now, and the people who watched him recorded serious problems as well."
• Watch for: "pioneer" framing used to justify unregulated retreats.

B2. History-taking with someone who took part in Roquet's groups or a similar programme

• Purpose: Understand what happened, its effects and its meaning, without re-traumatising.
• Steps: (1) Ask permission and offer control over pace and depth. (2) Establish the frame: where, when, who led it, legal status, how long, how many sessions. (3) Ask what substances were given only as far as the client knows; do not speculate. (4) Ask about the components in Part A that carry most risk: deliberately frightening periods (A8), confrontation (A11), touch and sexual expression (A12), recordings (A16), family exposure (A14). (5) Screen for current sequelae: PTSD symptoms, panic, persisting perceptual or dissociative symptoms, psychotic symptoms, mood episodes, substance use, shame and moral injury. (6) Ask what was valuable, too; many participants reported benefit [source: Villoldo 1977]. (7) Agree a formulation that holds both.
• Example language (illustrative): "You can tell me as much or as little as you like. I'm interested both in what helped and in anything that harmed you."
• Watch for: rising arousal or dissociation while recounting; switch to grounding (B3).

B3. Stabilisation and grounding for flashback-like or dissociative recall

• Purpose: Restore present-moment orientation when recall of intense altered-state material overwhelms.
• Steps: (1) Slow down and orient to time, place and safety. (2) Use sensory grounding (naming things seen and heard, feet on the floor, temperature). (3) Label the response as a memory, not a present event. (4) Resume only with consent; otherwise close with a stabilising activity. (5) Build a home plan (grounding, sleep, contacts).
• Example language (illustrative): "You're here with me now, in this room. That was then. Let's notice your feet on the floor together."
• Watch for: inability to orient, or persisting perceptual changes outside sessions, which call for medical and psychiatric assessment.

B4. Integration of past altered-state experiences

• Purpose: Help the client make sense of the experience on their own terms, separating insight from induced suggestion.
• Steps: (1) Elicit the narrative and the meanings the client took from it. (2) Distinguish what the client still endorses from what was imposed by the setting, the director or the group. (3) Link endorsed insights to concrete current values and behaviour. (4) Process grief, anger or shame about what was done. (5) Respect spiritual meanings as the client's own, without endorsing or disputing them.
• Example language (illustrative): "Which of the things you understood that night still feel like yours today, and which feel like someone else's voice?"
• Watch for: grandiosity, persisting conviction of special mission, or escalating spiritual crisis, which need psychiatric review.

B5. Harm-reduction conversation with a client who uses ketamine or attends unregulated groups

• Purpose: Reduce risk without facilitating illegal use.
• Steps: (1) Assess what, where and with whom, without judgement. (2) Give general information: unregulated settings lack medical screening and monitoring; mixing substances raises unpredictability; altered states plus confrontation, touch or charismatic leadership raise risk of psychological harm and exploitation. (3) Safety-plan: a trusted sober person, not driving, a way to leave, emergency contacts. (4) Screen for current suicide risk following standard practice, and for psychosis, bipolar disorder, pregnancy, cardiovascular and other medical issues, and refer for medical advice. (5) Offer legal routes (B6). Never give dosing, sourcing or preparation advice.
• Example language (illustrative): "I can't help you get or use it, but I can help you think through the risks and stay as safe as possible."
• Watch for: pressure to act as a session "sitter" or guide; decline, and document.

B6. Referral to regulated care

• Purpose: Route clients interested in ketamine-based treatment to legal, medically supervised care.
• Steps: (1) Explain the US framework: esketamine is approved for specific depressive indications and given only in REMS-certified settings with post-administration monitoring by medical staff; racemic ketamine for psychiatric conditions is off-label; compounded products are not FDA-evaluated [source: FDA 2022; Psychopharmacology Institute 2025]. (2) In the UK, ketamine is Class B; any clinical use is a matter for prescribers [source: GOV.UK 2026]. (3) Refer to a psychiatrist or prescriber for medical decisions; the psychotherapist's role is preparation, support and integration within that team. (4) Check local law where the client lives.
• Example language (illustrative): "If you want to explore this, the safe route is a psychiatrist who can assess whether it's appropriate and provide it in a supervised clinic."
• Watch for: clinics that advertise group sessions, multimedia "journeys" or confrontation as part of ketamine treatment; ask what their protocol is.

B7. Screening a programme or retreat for Roquet-style red flags

• Purpose: Advise clients and colleagues about settings that reproduce the riskiest features.
• Steps: Ask whether the programme: uses deliberate fear induction or "bad trips" as therapy; mixes several substances; runs large groups through altered states with observers; uses confrontation while participants are intoxicated; permits sexual expression or touch without a written consent and boundary policy; centres a single charismatic leader; operates outside regulation or on informal political protection; records participants without clear consent; lacks medical screening and staff responsible for medical monitoring; offers no integration support. Each "yes" warrants caution.
• Example language (illustrative): "Before you go, it's worth asking them a few specific questions. Here's what I would want to know."
• Watch for: claims that Roquet, indigenous tradition or "pioneers" validate these features.

5. Handling problems

Problems documented in the historical sources (what happened; the response column is present-day guidance and is [synthesis] throughout):

• Deliberately prolonged distress. Yensen reports datura-induced severe anxiety and loss of control were left to persist between sessions [source: Yensen in Wolfson 2014]; Clark described deliberately arranged "bad trips" and violent, crude content [source: Erowid summarising Clark 1976]. Response today: treat lingering anxiety, intrusions or derealisation as possible trauma sequelae; assess for PTSD, panic disorder and persisting perceptual symptoms; use evidence-based trauma treatment after stabilisation; refer to psychiatry for persisting perceptual or psychotic symptoms [synthesis].
• Ethical misconduct beyond the clinic. Yensen calls Roquet's participation in psychedelic interrogation by federal police "ethically questionable" and recounts a contested episode involving a student revolutionary in 1968 [source: Yensen in Wolfson 2014]. Response today: if a client describes coerced drug exposure or interrogation, treat it as a potential human-rights and torture-survivor issue; refer to specialist torture-survivor services where available [synthesis].
• Legal fragility and abrupt closure. The method depended on informal political protection; arrest and closure ended treatment for hundreds of patients in mid-course [source: Yensen in Wolfson 2014; Villoldo 1977]. Response today: clients cut off mid-programme may carry unfinished material and abandonment; explore both [synthesis].
• Unresolved theoretical issues. Villoldo listed transference, taking responsibility, facilitating mystical experience and building an ongoing transpersonal process as unresolved [source: Villoldo 1977]. Response today: transference to a charismatic director is a common thread to work through [synthesis].
• Research design. Yensen concedes multi-drug, multi-technique treatment is very hard to evaluate [source: Yensen in Wolfson 2014].

Problems a clinician meets today (all [synthesis]; the sources do not address them):

• Client idealises Roquet and wants to recreate the method. Validate the interest in meaning and transformation; explain that the method is historical, unevaluated and in parts harmful; refer to regulated ketamine/esketamine care or to non-drug experiential therapies; do not facilitate.
• Client asks you to sit with them during ketamine use outside a clinic. Decline clearly; offer B5 and B6; document the discussion; consult your professional body's guidance if unsure.
• Client describes sexual contact or unconsented touch in a group session. Believe and support; assess safety and current contact with the perpetrator; follow mandatory reporting duties for minors or vulnerable adults and explain options for reporting to police or licensing boards; refer to specialist sexual-violence services.
• Overwhelm while recounting. Stop and ground (B3); return later in smaller pieces; consider stabilisation-first trauma work.
• Stuck: client cannot decide whether the experience helped or harmed. Hold both; map specific gains and specific harms separately; avoid persuading them either way.
• Resistance or rupture. If the client hears your caution as dismissing their experience, name the rupture, acknowledge the value they found, and separate their experience from the method's safety.
• Spiritual crisis or persisting conviction of revelation. Respect beliefs as the client's own; assess for mania or psychosis; involve psychiatry if functioning declines; involve the client's own faith or cultural community if they wish.
• Non-adherence to safety plans with ongoing unregulated use. Revisit motivation non-judgementally; reduce to the most important safety steps; keep the door open.
• Suicidal ideation linked to the experience or to depression. Follow standard risk assessment, collaborative safety planning and lethal-means counselling (safe storage and removal); refer urgently where indicated; note that esketamine's approved indications include adults with major depressive disorder and acute suicidal ideation, which is a matter for a psychiatrist to consider [source: FDA 2022].
• Programmes claiming indigenous authority. Roquet borrowed from Mazatec and other traditions [source: Krippner 2017]; indigenous communities hold authority over their own ceremonies. Do not describe or run ceremony; encourage clients to ask who holds cultural authority and how the community itself regards the programme.

Sources

Sources:

• Salvador Roquet Remembered: An Innovative Psychedelic Therapist in 1960s Mexico — Stanley Krippner, Chacruna, 2017
• An Introduction to the Psychedelic Psychotherapy of Salvador Roquet — Alberto Villoldo, Journal of Humanistic Psychology 17(4), 1977 (MAPS bibliography copy)
• Psychedelic Experiential Pharmacology: Pioneering Clinical Explorations with Salvador Roquet — interview with Richard Yensen by Philip E. Wolfson, International Journal of Transpersonal Studies 33(2), 2014 (archived PDF)
• Wolfson 2014, article landing page and abstract — CIIS Digital Commons
• IJTS special topic section page — OPEN Foundation
• Toward Synergies of Ketamine and Psychotherapy — Mathai, Mora & Garcia-Romeu, Frontiers in Psychology, 2022
• Salvador Roquet character vault — Erowid
• FDA alert to health care professionals on risks of compounded ketamine products — FDA, 2022
• 2025 in Review: FDA Approvals, Practice Guidelines and Label Changes in Psychiatry — Psychopharmacology Institute
• ACMD announces decision on the classification of ketamine — GOV.UK, 2026

Further reading (not drawn on) [uncertain]:

• Roquet, S. (1976). The Existential through Psychodisleptics (via Erowid).
• Roquet, S., & Favreau, P. (1981). Los alucinógenos: de la concepción indígena a una nueva psicoterapia. Mexico (via Erowid). Spanish-language primary text not read.
• Clark, W. H. (1976). "Bad trips" may be the best trips. Fate (known only via Erowid's summary).
• Barney (1977), cited by Krippner for the 1967–1974 dates.