In an elegant wooden cabin on the outskirts of Cape Town, Stuart Dodds is preparing for his second psychedelic session, seeking to cope with several mental health issues. He has already tried prescription medications but believes that psychedelics are the key to his recovery.
“My mom died suddenly, and it was awful. Then, a year after her death, I separated from my ex-wife. After that, I started having serious problems,” shares 53-year-old Dodds.
The cost of his session is around $2,000 (£1,500) and includes the use of psychedelics such as psilocybin, known as hallucinogenic mushrooms, and MDMA, also known as ecstasy. The organizers claim that this amount covers accommodation and support.
While research into the effectiveness of psychedelics in treating mental disorders is ongoing, there are many warnings about their use outside of controlled conditions.
Megan Hardy, who is conducting the session for Dodds, also takes a small dose of both substances before the ritual begins. She believes this helps her “tune into the same frequencies” as the patient.
“The shamanic term denotes a connection with different worlds,” she says.
Hardy is aware of the illegality of using these substances but claims it is “righteous civil disobedience.”
When asked about her qualifications to determine dosages, she responds that she has studied the substances on herself for many years, “figuring out what works in various circumstances.”
The growing interest in mental health and the increase in clinical trials of psychedelics have led to heightened interest in their use for treating depression, anxiety, and post-traumatic stress disorder (PTSD).
According to research from Harvard Medical School and the University of Queensland, one in two people worldwide may face a mental disorder in their lifetime, making its treatment a multi-billion dollar business.
Before the ceremony, which Stuart agreed to film for the BBC, Hardy assures him that he can interrupt the session at any time.
“If something feels uncomfortable, just say, ‘Okay, stop.’ That’s important,” she adds.
Her colleague Kate Ferguson has also used microdoses of MDMA and hallucinogenic mushrooms, but neither guide has formal medical training.
Stuart Dodds lies on a thin mattress, covered with a gray blanket and wearing a mask over his eyes. As the effects of the substances begin, he seems to switch between states of calm and twitching.
“Allow yourself to feel it,” whispers Hardy, embracing him.
The women in the room burn herbs and shake shamanic rattles, singing and reciting prayers in a cleansing process known as “smudging.” Hardy wafts a bird wing over Mr. Dodds’ body, trying to cleanse him of “negative energy.”
She offers him another dose of MDMA. Stuart had agreed to this in advance, but when Hardy asks if he wants it, he just shrugs and says, “I don’t know.”
After this, the BBC asks him how one can agree to an additional dose while in an altered state of consciousness.
“I didn’t feel any coercion. At that moment, I was thinking, ‘Do I want this?’ I had complete freedom of choice,” he explains.
Nevertheless, professionals in psychiatry emphasize the risks associated with this unregulated practice.
“To consent, one needs to be in a clear state of mind,” says Dr. Marcel Shtyastni, head of the South African Society of Psychiatrists.
“When a person has already experienced psilocybin and MDMA, they lose touch with reality. They are under the influence of drugs, and this can lead to serious boundary violations,” she adds.
The BBC asks Hardy if her state affected her ability to care for Dodds during the session.
“This is based on the assumption that a sober mind is more preferable,” replies the self-proclaimed healer. “We work within methods that may seem incomprehensible and even frightening to a Western mindset.”
Research continues to explore the potential of psychedelics as an alternative treatment for depression, anxiety, and drug addiction.
In 2022, in one of the largest studies on the therapeutic use of psychedelics, 233 participants were given a synthetic form of psilocybin, leading to reported improvements in depressive symptoms.
However, a review conducted by the European Medicines Agency in 2025 recommended further clinical trials before allowing the drug to be sold.
Additionally, the document emphasizes that the use of psychedelics can cause “increased heart rate, elevated blood pressure, and heightened anxiety,” confirming the need for their use in “controlled conditions.”
Psychedelic substances remain illegal in many countries, yet this does not stop the growth of the industry in South Africa, as evidenced by the increasing number of online offerings.
“I believe this is a serious issue,” says Dr. Shtyastni. “Especially in Cape Town, there is a sharp rise in such practices. People are lost and detached from reality, seeking a ‘pill’ to solve all their problems, but such a pill does not exist.”
Several years ago, Sonette Hill, another self-proclaimed psychedelic guide from Cape Town, gave her patient ibogaine—a powerful psychedelic derived from plants in Central and West Africa.
This led to an unexpected outcome.
“He grabbed me by the throat,” recalls Hill. “He wanted to destroy me. He didn’t like something, and he just wanted to kill me.”
Ibogaine can be used as a powerful detoxification agent for people suffering from drug addiction, but its purchase and use in South Africa are only legal under strict medical supervision.
No criminal charges were brought against Hill, and she stopped using psychedelics, but this did not change her attitude toward the practice.
“Honestly, I believe that psychedelics can change the world. I don’t trust traditional medicine,” she asserts.
In another case, 26-year-old Milo Martinovich came to South Africa seeking help for drug addiction and ended up in an unregistered facility where he was prescribed ibogaine by a dentist.
Six hours later, he died.
The unregistered clinic did not take into account that he was dependent on Xanax—a benzodiazepine that cannot be combined with ibogaine.
In 2024, dentist Anwar Jiva was found guilty on several charges, including manslaughter. This is just one of many cases related to deaths from ibogaine worldwide.
“You cannot call a substance a medicine if it is not,” says Dr. Shtyastni. “I have seen patients who experienced prolonged dissociation after taking psilocybin.”
Data on the medical use of psychedelics is beginning to emerge, but the market for self-proclaimed healers offering organized trips with illegal substances is actively growing.
“Some of them genuinely want to help, but others have developed narcissistic inflation and believe they can do it better than psychiatrists,” notes Dr. Shtyastni.
Returning to the forest cabin, Stuart Dodds begins to feel that his “journey” is coming to an end. He does not feel “healed,” but believes he is moving in the right direction.
“I was striving for greater self-awareness and understanding of myself,” he admits. “I feel that this is a kind of revelation, and perhaps after this, I will embark on another journey.”
