Despite the illegality of psychedelic substances in South Africa, a growing number of self-styled healers and shamans in Cape Town openly incorporate them into their treatments. Anyone caught selling or distributing these drugs can face fines, imprisonment for up to 25 years, or both.
Photographer Stuart Dods is one of those seeking psychedelic therapy for mental health challenges. In a secluded wooden cabin on the outskirts of Cape Town, he prepares for his second session involving psilocybin (magic mushrooms) and MDMA (ecstasy), spending approximately $2,000 for the treatment, which includes accommodation and additional support services.
“I lost my mother suddenly, and shortly after, my relationship ended. That period felt like the rug was pulled out from under me,” Dods explains. Dissatisfied with prescription medications, he believes psychedelic therapy may offer relief.
Megan Hardy, who identifies as a “medicine woman,” administers the session. She consumes a smaller dose herself, claiming it aligns her frequency with the participant. Hardy acknowledges the illegality but describes her practice as “righteous civil disobedience.” She bases dosing decisions on personal experimentation rather than formal medical training.
Public interest in psychedelics for conditions such as depression, anxiety, and PTSD has surged amid increasing clinical research. Studies indicate that one in two people worldwide may experience a mental health disorder during their lifetime, highlighting the scale of demand for effective treatments.
Before the session begins, Hardy reassures Dods he can stop at any point. Alongside her colleague Kate Ferguson, who also micro-doses, she guides the ritual, including chanting, smudging, and symbolic purification. Dods alternates between calm and convulsive reactions as the substances take effect.
Concerns remain regarding consent and safety. Psychiatrist Dr. Marcelle Stastny emphasizes, “In order to give consent, you have to be in touch with reality. After ingesting psilocybin or MDMA, individuals are intoxicated and unable to make fully informed decisions.”
Hardy defends her methods, stating, “We are working in ways the Western mind doesn’t understand, which can seem frightening.” While preliminary studies show potential benefits of psychedelics in controlled clinical settings, including reductions in depression symptoms, experts stress the need for supervision. The European Medicines Agency’s 2025 review of eight studies covering 595 participants highlighted risks such as increased heart rate, blood pressure, and anxiety, reinforcing the necessity of a controlled environment.
The underground psychedelic industry in South Africa continues to grow despite legal restrictions, with online advertisements promoting guided sessions. Past incidents illustrate the dangers: Sonette Hill, a former guide, recounts a patient becoming violent under Ibogaine, while in another case, a 26-year-old patient died from a fatal interaction between Ibogaine and Xanax at an unregistered clinic, resulting in the dentist being convicted of culpable homicide.
Dr. Stastny warns, “You cannot call something medicine if it is unregulated. Some patients suffer prolonged dissociation after psilocybin use. The online market is booming, but the risk to vulnerable individuals is significant.”
For Dods, the experience has not provided immediate healing but has opened a path toward self-awareness. “I feel it’s starting to open things up, and I might pursue another journey,” he says, reflecting the cautious optimism many participants express amid the ongoing debate over psychedelic therapy and mental health.
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