Drawing from ethnographic research with psychedelic therapists and researchers, this talk will explore the political tensions between two sources of efficacy within psychedelic therapy: the self and the chemical. At times researchers and therapists emphasize the specificity of chemical effects in relationship to the neurobiology of particular diagnoses. And at other times they foreground the self as the true source of an experience which is not tied to that same biochemistry. Anthropologists have long emphasized that efficacy is a historically and socially embedded category and practice. Those conversations have new valence in light of recent theorization of the chemicals as material-semiotic structures shaped by their experimental contexts. Drawing from the work of Annmarie Mol, I argue that while the empirical claims embedded in these two efficacies can and do mutually include each other, a fundamental political tension remains between the efficacious ends envisioned by each. As clinical trials develop these drugs as therapeutic agents, they do so through linking the specific effects of the chemical to particular diagnostic populations, which may enfranchise these chemicals, but not all who take them. The fifth speaker in the Centre for Access to Information and Justice (CAIJ) Psychedelics: Past, Present, Future Webinar Series.