Avsnitt
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In this episode, Erica Zelfand, ND joins to discuss the important topic of pill shaming in psychedelic communities and how psychedelic medicine and traditional pharmaceuticals can both support healing. Dr. Erica Zelfand specializes in integrative mental health, bridging the gaps between conventional and alternative medicine. In addition to seeing patients in private practice, she also teaches facilitation internationally and leads retreats through Right to Heal.
In this conversation, Dr. Zelfand tackles the issue of pill shaming in psychedelic communities, showing why this rhetoric falls short and ultimately harms patients. She discusses complementary roles for psychedelic and traditional pharmaceutical medicines, suggesting that a medicine like ketamine may be particularly effective in contexts of acute intervention, whereas an SSRI antidepressant may be most effective for maintenance. Dr. Zelfand notes, however, that drug-drug interactions can be a significant concern and stresses the need for medical expertise and supervision in the context of concomitant usage of pharmaceuticals and psychedelics. In closing, she emphasizes that what is ultimately important is that patients are able to progress in healing, and any tools that are able to safely and effectively support this goal have an important role to play and should not be denigrated.
In this episode you'll hear:
The pill shaming rhetoric in psychedelic and cannabis communities Pharmaceutical contraindications to psychedelic therapy and the necessity of medical supervision for tapering off such medications Why comparing traditional antidepressant pharmaceuticals to psychedelic medicines is often an apples to oranges comparison The issues with “no pain, no gain” rhetoric in healing Psychiatric support for processing repressed memories uncovered during psychedelic journeysQuotes:
“When I went into medicine, I actually specifically went into integrative medicine, functional medicine, because I didn’t like that patients were being in this position of having to choose: the conventional route or the alternative medicine route. Both routes have their merits and both routes have their shortcomings and I felt like we all deserve to be able to access both and have it be an integrated model.” [3:06]
“The only form of ketamine that is FDA approved for depression—which is Spravato—is only approved in the context in which the person is also taking an oral antidepressant.” [20:48]
“We have data showing that if you feel really really freaked out and anxious during your [psychedelic] trip, your outcomes aren’t necessarily as good. And the biggest predictor of having a positive experience is actually feeling awe. You don’t have to do the ego death thing, but if you can feel awe, if you can feel inspiration during a trip, your outcomes are better. And there’s even data showing that individuals who are on an SSRI and then trip—they may actually have better outcomes than people who don’t take medication.” [24:12]
“I think part of this trepidation is we don’t want to harm anybody through a dangerous, or potentially lethal, drug-drug interaction. That’s one thing. It’s another thing to be like ‘yeah but if you’re using these [pharmaceutical] drugs you’re doing it wrong and you’re not healing right.’ And I think the one often is used as a camouflage for the other—and they’re two separate things.” [38:59]
Links:
Dr. Zelfan’s website
Dr. Zelfand on Instagram
Dr. Zelfand on Twitter
Dr. Zelfan on LinkedIn
Right to Heal website
Psychedelic pill-shaming article by Jules Evans and Shayam Suseelan
Previous episode: Integrating Challenging Psychedelic Experiences with Keith Kurlander, MA
Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Keith Kurlander, MA, LPC, joins to discuss the important topic of integration practices for challenging psychedelic experiences. Keith is the Co-Founder of the Integrative Psychiatry Institute, the largest professional education company specializing in integrative mental health and psychedelic therapy.
In this conversation, Keith begins by exploring the different types of challenging psychedelic experiences and various lingering effects one may experience following a difficult psychedelic journey. He discusses these from a trauma-informed perspective, explaining how a traumatized nervous system can lead to dissociation on the other side of an intense ego-disrupting experience. Keith also shares practices and insights from internal family systems (IFS) for integrating challenging psychedelic experiences. In closing, he emphasizes that psychedelics are not lazer-targeted therapies, so they do carry inherent risks, but through effective integration practices, patients can make healthy meaning out of even negative experiences.
In this episode you'll hear:
Lingering issues with ego fragmentation and connections to the dissociative disorder spectrum Persisting psychotic disorders following psychedelic experiences The difference between CPTSD and PTSD Uncovering repressed traumatic memories during psychedelic journeys Trauma stemming from difficult psychedelic experiences Challenging spiritual experiencesQuotes:
“The concept of pendulation [is] that we can be more flexible to ease our way into these overwhelming states. So once we are totally overwhelmed, we have to work our way back out gracefully, but as we are doing that, you get a gem as you are coming back… you learn something as you are coming out of that state.” [18:02]
“If people have a psychotic disorder that emerged after their psychedelic use, you need a psychiatrist at that point… If it’s really a psychotic emergence, whether a previous psychotic disorder got triggered or whatever, you need a psychiatrist to work with you on that.” [20:07]
“I believe all these mental health conditions have a trauma process underneath them. I don’t know how you isolate a trauma process from a mental health condition” [25:30]
“It’s about working with a person’s meaning-making structure: is the meaning they’re making creating more psychological flexibility or less psychological flexibility? That’s a really important question to hold as a therapist because people will make all kinds of meaning up from these experiences but if they’re creating meaning that’s creating more rigid structures of how they see the world, then they get disappointed more often.” [34:21]
Links:
Psychiatry Institute website
Keith’s website
Keith on Instagram
Higher Practice podcast
Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans
Psychedelic Medicine Association
Porangui
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Saknas det avsnitt?
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In this episode of the Psychedelic Medicine Podcast, East Forest joins to discuss several aspects at the intersection of music and psychedelics, including how he created the music that so many have used when facilitating psychedelic journeys. East Forest’s latest project, a feature length documentary film called Music For Mushrooms, follows him through the psychedelic renaissance on a mission to pair music with psychedelics to bring about transformative healing to a world in crisis.
In this conversation, East Forest discusses how he first got started making music for psychedelic journeys and the considerations that go into curating the right sound to best support these types of deep inner experiences. He emphasizes the importance of avoiding music that sounds overly sentimental and lacks the depth and richness important for effective psychedelic exploration. He also discusses the importance of maintaining the container, whether in the context of psychedelic facilitation or purely music-focused ceremonies, and suggested that sternness and fortitude have an important function in this context. In closing, East Forest suggests that music is so powerful because of the way it is able to be a point of connection to integrate experiences and bring people together.
In this episode you'll hear:
Composing soundtracks for psychedelic journeys with different substances Integrating nature sounds into compositions Flow states and music Bringing live elements of music and sound into a psychedelic ceremony Singing as a regulating technique during a psychedelic journey The intersection of music, technology, and psychedelicsQuotes:
“If we look at psychedelic experiences and ceremonies from indigenous use, all of them that I know of were guided by music.” [3:16]
“I think it’s more the intention behind the music. I don’t think there’s a particular thing you have to do or not do, but I don’t think you can just play any music. So I think it’s the intention of the music and the intention of the room and the intention of the participants… There has to be an invitation on all of those fronts for that doorway to open.” [16:11]
“I think we’re looking for music and for space that is supportive of that through-line and gives us enough time to be in a process—and that’s another advantage of having these longform, intentional, bespoke songs because they are probably going to give more of that time and space for these processes to occur.” [32:43]
Links:
East Forest’s website
East Forest on Instagram
East Forest on Tik Tok
Music for Mushrooms documentary website
Music for Mushrooms Official Documentary Soundtrack
Winter Solstice Retreat at Esalen
Music for Psychedelic Therapy by Jon Hopkins
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Eric Sienknecht, PsyD joins to discuss the roles of music in psychedelic sessions. Dr. Sienknecht is a licensed clinical psychologist and co-founder and lead trainer at Polaris Insight Center, a ketamine-assisted psychotherapy clinic and training center. He has worked as sub-investigator and study therapist on the Lykos-sponsored MDMA-AT clinical trials for PTSD and currently is also a supervisor and educator in MDMA-AT for various clinical trial sites. Dr. Sienknecht has a deep interest in the role and use of music in ketamine and MDMA sessions and specializes in curating playlists for psychedelic experiences.
In this conversation, Dr. Sienknecht discusses how he first realized the importance of music in psychedelic experiences. He shares insights on how different genres and moods of music may be better suited to certain phases of the psychedelic experience and how he works individually with clients to better tailor a session playlist to their personal taste. Dr. Sienknecht even discusses how to strategically include shadow elements in a playlist to facilitate a client going deeper in their journey. In closing, he emphasizes how the intersection of psychedelic experiences and music remains understudied with only a few book chapters and articles dealing directly with the topic, so there is much yet to learn and explore in this exciting niche.
In this episode you'll hear:
What is universal vs what is individual when it comes to music and psychedelics Why Dr. Sienknecht avoids music with lyrics in a participant’s native language for psychedelic sessions The research on different genres of music for psychedelic journeys Balancing planning music in advance and adapting to the specific pace and mood of the client’s experience Utilizing nature sounds alongside or within music during psychedelic sessions Binaural beats and brainwavesQuotes:
“There’s generally better tracks to use for the opening phase of a [psychedelic] journey, for the peak phase of a journey [etc], and there’s been some research into that as well.” [6:05]
“Taste is so subjective… Knowing your client and talking with them beforehand about their taste and letting that information really inform how you create the playlist is really important.” [27:02]
“One of the benefits of doing psychedelic therapy is that you can surrender control over elements of set and setting—not that those aren’t negotiable and ongoingly negotiable, as they should be—but there’s something about [the fact that the therapist] has got the music taken care of, the room set up, everything is in its right place. All I have to do is fast from food for a few hours, have my intention, and step into the journey—and that can help someone to really just trust and surrender more into the experience.” [30:20]
Links:
Integral Psychedelic Therapy edited by Jason A. Butler, Genesee Herzberg, and Richard Louis Miller
Dr. Sienknecht on LinkedIn
Polaris Insight Center on LinkedIn
Polaris Insight Center website
Music for Ketamine-Assisted Psychotherapy Sessions training with Dr. Sienknecht at Polaris Insight Center
Previous episodes: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Giorgia Caspani, PhD joins to discuss the intersection of psychedelics and the gut microbiome and ramifications for future personalized medicine. Dr. Caspani is a neuroscientist and computational biologist working at the intersection of gut microbiome, psychedelics and personalized medicine.
In this conversation, Dr. Caspani discusses her research published in the article “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis.” She shares what we know about how psychedelics impact the gut microbiome from initial studies and what questions remain unanswered. She draws connections between the way the gut microbiome metabolizes SSRI drugs and how serotonin impacts the gut microbiota to hypothesize the potential ways psychedelics interact with this complex living system. In closing, Dr. Caspani discusses the possibility of predicting responses to psychedelic treatments using data from the microbiota, and the research currently happening to make this possible.
In this episode you'll hear:
How human beings and our gut microbiome co-evolved and the benefits achieved through this symbiotic relationship The correlation between the gut microbiome and stress levels The effects of psychedelics on immune responses Why personalized medicine may be a more effective approach for treating depression How personalized medicine could help make psychedelic therapies more accessible and effectiveQuotes:
“Without our gut microbes… We wouldn't be able to really perform a lot of the metabolic functions that we rely on as humans.” [4:26]
“The gut microbiome is different in every person—it’s very unique. And so every person carries this unique microbial signature that can potentially map out to all of the treatment options that we already have available; it’s just a matter of understanding and identifying markers that can predict which patient will benefit from a specific drug.” [18:22]
“[We hypothesize that] the gut microbiome shapes individual responses to psychedelic treatment. And so if that [hypothesis] is correct, if that is true, we could potentially target the microbiome, change the composition of the gut microbiome like we wanted to, to be able to maximize the effectiveness of these [psychedelic] drugs.” [25:14]
Links:
Dr. Caspani’s article, “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis”
Dr. Caspani on LinkedIn
Dr. Caspani on X
Onaya Science website
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Star Rose Bond, LCSW joins to discuss the topic of using psychedelic-assisted therapy to address intergenerational trauma. As seen in Huffpost, Vice and Psychology Today, Star Rose is a Renegade Psychotherapist, Social Activist, Clinical Supervisor for PEARL Institute and Co-Founder of Life Camp. With a Bachelor’s degree from NYU and a master’s from Columbia, Star brings 15 years of clinical trauma therapeutic services and experience serving marginalized, under-resourced and at risk populations specializing in harm reduction and PTSD recovery.
In this conversation, Star introduces the topic of intergenerational trauma and explores how psychedelic experiences may be leveraged to address this pernicious condition. She begins by explaining what intergenerational trauma means, how it gets passed down, and how it manifests. Star talks about the importance of psychedelic therapists and facilitators having awareness of trauma-informed modalities in order to better serve these populations. She also discusses the complexities of addressing generational trauma, and how it can often be difficult to process sensitive topics within the family unit. However, in conclusion, Star emphasizes that the capacity to heal is an intrinsic aspect of human existence, and that even in particularly dark moments, it is possible to get in touch with this possibility.
In this episode you'll hear:
How the conditions of Capitalism produce and exacerbate chronic stress The profound impact of neglect and abuse in early childhood The unique experience of intergenerational trauma for BIPOC peoples and the recent rekindling of a spirit of connection in these communities due to psychedelic medicines How processing intergenerational trauma can transform familial relationships Ethical and practical considerations for facilitators and therapists guiding clients through psychedelic experiences aimed at resolving deep-seated trauma What to look for in a psychedelic-assisted therapist or facilitatorQuotes:
“Just because you have several students or several clients who’ve experienced the same trauma, don’t make the assumption that they’re all experiencing it the same way. Or maybe you’ll meet a client who has had trauma similar to yours—don’t assume that they have undergone the same emotional impact or psychological impact as you. The truth of the matter is we are complex beings. We have so many different moving variables that go into our psychology and that essentially indicate or play a role in how we respond to things.” [8:43]
“We can’t always express or understand why things happen the way they do. But, we can start to make meaning through a spiritual understanding which in turn lends itself to a sense of ease and comfort.” [22:20]
“When you are going into these experiences as a facilitator—whatever your background is—it is of the utmost importance that you are hyper cognizant and hyper aware of the harms that can be caused by not being aware of the ways in which you can navigate someone else’s trauma as it shows up.” [25:02]
Links:
Star’s website
Star on Instagram
Previous episode: Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD
Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre
My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies by Resmaa Menakem
SHINE Support website
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, L.J. Lumpkin III, MA LMFT joins to discuss the potential of psychedelic medicine in the context of sports psychology. L.J. is a therapist, adjunct professor at Pepperdine University, a coach, author, speaker, and the CEO of Nomad Healing Practices.
In this conversation, L.J. shares his personal experience as an athlete and discusses the difficult transition to a new life once an athlete’s career has concluded. He compares the need to reinvent oneself in this context to ego death and explains how psychedelic-assisted therapy may be helpful for navigating this transition. L.J. also discusses the intense pressure athletes are under to perform, mentioning that the drive to win can often overpower the more basic mode of play at the heart of athleticism. This is an area where he finds ketamine to be a particularly powerful medicine, as its dissociate quality can help athletes tune out the high pressure expectations. L.J. also discusses leveraging the critical learning period provided by psychedelic therapies to institute new healthy habits, something which could benefit athletes both on and off the field.
In this episode you'll hear:
How ketamine-assisted therapy may be able to help athletes with their unique psychological challenges Integrating mindfulness to prepare for psychedelic therapies Leveraging the somatic component of psychedelic therapies to address pain The importance of integration practices and support systems The differences between working with psilocybin versus ketamine Drowning out critics and sports commentary and getting back to basics with the help of psychedelic therapyQuotes:
“If you’ve been paid millions of dollars to hit and be aggressive for so long and that’s how you’ve dealt with your emotions—and it wasn’t a problem because you were being rewarded for it—what do you do when you’re not getting rewarded for that anymore? When you have to actually change how you process emotion—there’s not a playbook for that.” [7:46]
“Just talking about [mental health] and normalizing it—all of a sudden you’re allowed to get help, you’re allowed to heal, you’re allowed to go to practices that have been practiced throughout human civilization. We’re bringing [psychedelics] back and I think that athletes are the ones who are really going to be the ship of normalization.” [22:38]
“Especially if you’re off season, those other medicines [besides ketamine] I think they’re going to be even more helpful because that might encourage the rest, it might encourage being able to connect with family systems. I think for some of the more acute stuff, the ketamine does serve a great purpose in that.” [28:16]
Links:
L.J. on Instagram
L.J. on LinkedIn
Nomad Healing Practices website
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, podcast host Dr. Lynn Marie Morski comes on the mic to provide a five-year update on the podcast and share the changes in the legal landscape of psychedelics in the past half-decade. Lynn Marie Morski, MD, JD is the president of the Psychedelic Medicine Association and host of the Psychedelic Medicine Podcast. She sits on the advisory boards of Psychedelics Today, Cybin, VETS, Inc (Veterans Exploring Treatment Solutions), the Oxenberg Foundation, and the Ketamine Task Force. Dr. Morski is a Mayo Clinic-trained physician in family medicine and sports medicine, as well as an attorney and former adjunct law professor.
In this anniversary episode you’ll hear about the legally-accessible forms of psychedelic therapy which have come to prominence as potential mainstream therapeutics in recent years. Dr. Mroski shares Information on the legal adult use framework for psilocybin in Oregon, including licensing, costs, and exclusion criteria. She also discusses programs in Australia and Canada that will allow certain patients to access psychedelic therapies such as psilocybin- and MDMA-assisted therapy. In addition to classic psychedelic medicines, Dr. Morski also shares information on the medicine which is currently most accessible: ketamine. She discusses the difference between S-ketamine and R-ketamine and on-label and off-label uses of this substance. In closing, Dr. Morski presents some of the finer details of the current landscape of insurance coverage for ketamine.
In this episode you'll hear:
The difference between decriminalization and legalization The FDA decision to deny the Lykos Therapeutics’ new drug application for MDMA-assisted therapy for PTSD The upcoming Colorado psilocybin program Psychiatric licenses to administer MDMA and LSD to patients in Australia The Special Access Program for psychedelic therapies in Canada Legal ketamine access in the United States How the Psychedelic Medicine Podcast chooses guestsQuotes:
“I wanted to focus mostly on what is legal because we know that’s the way things are going to be the most monitored and therefore safely accessible.” [20:45]
“People are in this industry because they want other people to feel better and they want to help and they’re so generous with their time” [25:31]
Links:
clinicaltrials.gov - the place to find information on upcoming clinical trials for psychedelic medicine for which you may qualify
Insurance Coverage for Psychedelic Therapy by Vincent Joralemon
SPRAVATO withMe Patient Support Program
Enthea insurance
Previous episode: How to Choose A Psychedelic Facilitator or Retreat Center with Joël Brierre
Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
Previous episode: Ketamine Scientific Research with Dr. Jason Wallach
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Dr. David Rabin, MD, PhD joins to discuss whether genes can be predictive of one’s response to MDMA Therapy. Dr. Rabin, a board-certified psychiatrist and neuroscientist, is the co-founder & chief medical officer at Apollo Neuroscience. In addition to his clinical psychiatry practice, Dr. Rabin is also the co-founder & executive director of The Board of Medicine, and a psychedelic clinical researcher currently evaluating the mechanism of psychedelic-assisted psychotherapy in treatment-resistant mental illnesses.
In this conversation, Dr. Rabin shares his research into epigenetic responses to MDMA-therapy, exploring topics of trauma, gene expression, and personalized, data-driven medicine. He discusses the seminal discovery that trauma can cause epigenetic changes in the structure and function of the cortical system and his own research findings that uncovered a reversal of these changes associated with MDMA-assisted therapy. Dr. Rabin hopes further research in this area may allow for leveraging epigenetic data to determine which psychedelic medicine a particular patient may be most likely to respond to and track how effective a given treatment has been. In closing, he expresses excitement about bringing objective biological precision to mental health treatment, drawing a parallel to the discovery of antibiotics which allowed for much more tailored treatments of infections which has saved countless lives.
In this episode you'll hear:
Response rates to psychedelic-assisted therapy for PTSD versus conventional therapies The consequences of ineffective treatment for PTSD MDMA-assisted therapy as preventative care and the societal cost savings involved Genetics, epigenetics, and gene expression Using epigenetic data from simple saliva swabs to better gauge response to MDMA-assisted therapy for PTSDQuotes:
“Most of the treatments we have available today for PTSD—that are the FDA-cleared, considered gold standard treatments—only actually induce remission from illness… in about 30% of people. So of the 100% of the millions of people every year that are getting treated for PTSD, with the best treatments that we have that are currently available, only 30%—at best—are getting better long term. Everyone else has a diagnosis of PTSD for life.” [3:55]
“MDMA-assisted therapy for people with PTSD is having an effect that’s similar to what we saw with the discovery of antibiotics for infection.” [8:07]
“Folks with severe PTSD who went through this trial, when they received MDMA-assisted therapy, [the researchers] saw a statistically significant change—in terms of repair—of the cortisol receptor’s epigenetic code which reflects improved structure and function of that receptor site. But not only that—we saw that the amount that people got better… was directly correlated with… the amount of remodeling and repair at the receptor site.” [18:36]
“Epigenetic code is actually something that can be modified by experiences in our environment. And trauma—or PTSD diagnoses, a series of significant traumas over time—can in fact change epigenetic code of the cortisol receptor gene. And that changes how the cortisol receptor gene gets made, and it changes its function.” [29:52]
“PTSD is a disorder of learned fear. How do we treat PTSD? In animals and humans, we provide the same stimulation that they were getting that they are now afraid of in the context of safety. That’s how exposure therapy works, that’s how MDMA therapy works to some extent—all of these tools and techniques work to treat PTSD effectively… in the same way. It’s called safety conditioning.” [36:48]
Links:
Dr. Rabin’s article: Pilot study suggests DNA methylation of the glucocorticoid receptor gene (NR3C1) is associated with MDMA-assisted therapy treatment response for severe PTSD
Dr. Rabin’s website
Dr. Rabin on LinkedIn
Dr. Rabin on Instagram
Dr. Rabin on Twitter
Apollo Neuroscience website
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Mark Braunstein, DO joins to discuss the promise and the peril of ketamine. Dr. Braunstein graduated medical school in 1997 then completed a General Psychiatry Residency at the University of New Mexico and then a fellowship in Child and Adolescent psychiatry at Maine Medical Center in 2002. Upon graduation from his fellowship and becoming board certified in general psychiatry he established a private practice in Durango, Colorado where plant medicine became part of his everyday integrative psychiatric practice.
In this conversation, Dr. Braunstein shares some of the developments in the world of ketamine in the past three years since his previous episode, drawing on his own experience providing ketamine-assisted therapies. He stresses issues of grandiosity that can arise both when working with ketamine and when taking the medicine—issues which in the worst case and fuel ketamine use disorders. Dr. Braunstein stresses the importance of clinicians providing ketamine treatments being realistic and upfront about the potential harms of ketamine when advising prospective patients. In closing, he warns against the dangers of being in an echo chamber which reinforces potentially pathological substance use, especially for clinicians in the ketamine space.
In this episode you'll hear:
Why ketamine has an addictive potential and how ketamine addiction presents Ways to treat ketamine use disorder The importance of informed consent What patients should look for when seeking a ketamine provider The importance of ketamine providers working with multiple modalities and having multiple tools in the toolbox besides ketamineQuotes:
“Here’s what’s scary to me about ketamine: these people that I’ve seen having problems [with ketamine use] are largely lifetime recreational psychedelic/drug users without problems. And these are people who have made it to age fifty, smoking [cannabis], tripping a little bit, their whole life without having a problem—then at fifty years old, find themselves hooked on something for the first time.” [12:30]
“[Ketamine] is not a microdosing medication… There is no such thing as ketamine microdosing. You think of microdosing as sub-perceptual. Everyone that I’ve met that’s abusing ketamine, it was not a sub-perceptual effect—they were very much abusing it to have that perceived effect. Maybe not a psychedelic effect—usually an intoxicated wonky effect is what they’re going for. And people refer to that as microdosing. It’s not microdosing. It’s abusing small doses.” [17:11]
“What do I see that makes me concerned with someone I’m talking to—a clinician or a client? That grandiosity. So that gets me concerned right away when I hear about these ‘downloads’ because that’s where … other psychedelics can have dependency too. You see people … they go for aya ceremonies every week after week after week. So there can be an addiction to the download or to the release.” [34:35]
“The people I know that have been successful in this line of work (from a patient standpoint), whether they’re a clinician or not, have been the ones that have embraced the work. And just knowing that this is going to be a process and I’m in it to win it, for life. I’m working on myself.” [35:40]
Links:
Dr. Braunstein on LinkedIn
Ketamine Research Foundation website
NeuPath Mind Wellness website
Ketamine Training Center website
Previous episode: Ketamine for Alcohol Use Disorder with Steven Mandel, MD
Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)
Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich
Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Steve Rio joins to discuss 5-MeO-DMT for Trauma and PTSD. Steve is a psychedelic facilitator and Co-Founder of Enfold, which offers a groundbreaking psychospiritual model that combines psychedelic intensives, coaching, and community to help individuals heal trauma and reach their full potential.
In this conversation, Steve shares his journey of how he got into facilitating 5-MeO-DMT experiences and insights on working safely and effectively with this medicine over the course of his practice. He discusses the screening procedure he uses before clearing clients for facilitated 5-MeO-DMT experiences to ensure safety as much as possible when working with this powerful psychedelic. Steve also talks about how he tailors his work with clients based on the state of their nervous system and their unique personality. In closing, Steve emphasizes the somatic quality of 5-MeO-DMT experiences, sharing different types of experiences people typically have on the medicine and how these can best be integrated.
In this episode you'll hear:
Preparation for safe and effective 5-MeO-DMT experiences Stories of transformation following 5-MeO-DMT healing for PTSD and focused integration practices How common 5-MeO-DMT reactivations are, and when they typically happen Issues of spiritual bypassing in underground psychedelic facilitation How to navigate informed consent in the context of facilitating psychedelic experiencesQuotes:
“At the peak of the 5-MeO experience, there is no mind… When people talk about the death and the rebirth experience with 5-MeO, what we’re really talking about is relaxing and essentially dissolving the ego entirely so there is no experience of ‘you’ in the experience—you become one with the experience. But… what’s possible there is that we then access the nervous system and we see these very dramatic energetic releases and people often are physically reliving traumatic experiences and physically releasing the fight, flight, freeze response that may have happened or not happened.” [6:52]
“Trauma is complex and for some people it’s not that simple. For some people, they go through a six- to twelve-month process after 5-MeO-DMT that is really challenging.” [22:37]
“So [we’re] helping people… build sensitivity in their nervous system—reconnect with sensitivity and slowing things down and building more awareness and learning how to notice their emotions as sensations in the body before they become thought patterns.” [32:00]
“I think one of the challenges in all of this is that people will lie to you to get to your experience because they’re desperate for the healing. And you have to be really careful about the conversations you have and asking open-ended questions and really listening to your intuition—and really being grounded in that.” [40:28]
“What we’re doing here I would say there’s obviously a psychological component to it, but often that happens in the weeks and months afterwards. What’s happening here is a much more somatic experience and it can be very confusing and challenging for the mind of a person… you’ve paid all this money, you’ve prepared for weeks and months, you’ve been thinking about it, you come have this experience… Right after the ceremony for some people, the thought is ‘what just happened?’ and ‘did anything happen?’ and ‘did it work?’ because there’s very rarely like an immediate insight on ‘here’s how you’re going to make your life better’—that’s not what comes out of this experience. What comes out of this experience is a dramatic shift in how your body feels and often people will report feeling emotionally lighter or that they lost ten pounds. It’s hard to explain, but the way peoples’ eyes light up the day after the ceremony is so different—like they often just look different coming in and leaving.” [42:56]
Links:
Enfold Website
Enfold on Instagram
Enfold on YouTube
Still In It: 5-MeO-DMT Stories
Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT
Previous episode: Psychedelic Adjunct Series: Somatic Therapy with Jenna Valentine, DACM, LAc
Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT
Previous episode: When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Sunny Strasburg joins to open the conversation of leveraging lower doses of psychedelic substances for more effective healing. Sunny Strasburg, LMFT, a licensed psychotherapist, educator, and pioneering author, specializes in psychedelic therapies and training clinicians to be skilled and trauma-informed psychedelic therapists. As the founder and author of The Theradelic Approach, she equips clinicians with trauma-informed psychedelic-assisted therapy methods, blending IFS, EMDR, archetypal psychology, trauma-informed care, and her extensive experience.
In this conversation, Sunny shares insights drawn from Internal Family Systems (IFS) and explores how these perspectives can help inspire more effective psychedelic work, especially with lower doses. She emphasizes the importance of adequate preparation and not over-valorizing intense psychedelic experiences, noting that these therapies themselves can be traumatic if not handled with care. Sunny also discusses how one’s own internal protectors have adaptive rolls and display a lot of compassionate intelligence, so even though these parts may initially provide a barrier to deep trauma work, it is important for therapists to work collaboratively with these parts of a client’s psyche. In closing she talks about how to better set reasonable expectations in group psychedelic therapy and retreat settings, where integration can easily turn into a competition of who had the most intense experience, with things like ego dissolution becoming the barometer for healing.
In this episode you'll hear:
How “protector systems” and “rubber band effects” manifest in high-dose psychedelic therapy sessions Uncovering previously unknown traumas during psychedelic therapies and how therapists can be better prepared for this situation How therapists can skillfully work with symbolic material that arises in psychedelic journeys The importance of slowing down and letting the client guide the pace when addressing serious traumas in particular Differences between ketamine, MDMA, and the classic psychedelics in terms of effects on the fear center of the brain Leveraging critical learning periods in therapy to reprocess traumatic memoriesQuotes:
“Being a trauma therapist, you have to be skilled enough to know what is symbolic in a psychedelic journey, what’s a literal memory… You don’t want to do any kind of leading or prompting the client to fill in anything or directing them to anything—you’re really tracking where they are and letting them uncover their own path. Again, at the speed in which their protector system is ready for that.” [22:43]
“These parts want people to remember. They want to heal, they want to let their stories be told. And so our job as therapists is to clear the clutter so we can really hear the system and trust the system. The system knows.” [28:02]
“Trauma is like a sliver that’s buried in the arm—like in the deep skin of your arm and it’s got an infection around it. And all of your coping mechanisms, all of your protectors (using IFS language), is like building a giant layer of scar tissue on top of that. And you could just go through life with that, and you could just put lotion on the top of that scar and just try to make it look pretty—and that’s okay. But you could go in and surgically remove the sliver that’s been offending your system the whole time. And once you remove that sliver, you will start to heal—your arm will heal, it won’t have an infection anymore, right? But removing that sliver hurts. It’s painful. It’s a process. But you don’t have to deal with that sliver anymore. And that’s kind of how I imagine going through trauma work.” [31:08]
“I’ve had clients that I’ve worked with using EMDR, IFS for years, we’ve made some progress, but then we get ketamine on board and it’s totally helped them and amplified the benefit.” [35:13]
“Trust your protector system. Slow down. I promise, if you slow down and really get curious about what your protectors need, you will go so much further with these medicines. It really is not a race. It’s slow and steady, and you’re going to be able to get more work done.” [40:23]
Links:
Sunny’s website
Sunny on LinkedIn
Sunny on Instagram
Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT
Psychedelic Medicine Association
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This episode of the Plant Medicine Podcast welcomes Dr. Angela Carter (they/them) to discuss the intersection of the LGBTQIA2S+ community and psychedelics. Dr. Carter is a queer, transgender, and genderqueer naturopathic primary care physician who also works as a midwife, sexual assault examiner, and health equity advocate in Portland, Oregon. They also serve as both the vice-chair and the equity in training subcommittees co-chair of the Oregon Psilocybin Advisory Board. In addition to these positions, Dr. Carter serves as the chair of the Transgender Health Program Community Advisory Board at Oregon Health & Science University. They also volunteer with many organizations including the Fireside Project, Black Rock City Emergency Services, and Queerdome.
Dr. Carter begins this conversation by sharing exciting new research currently being conducted which involves LGBTQIA2S+ individuals and psychedelic therapies. While this particular area of research remains small, it is growing and the fruits of these studies will be an important step for better understanding how these new therapies can serve gender and sexuality minorities, and help facilitators understand the unique concerns of people in the LGBTQIA2S+ community. Dr. Carter illustrates these types of concerns by discussing the prevalence of gender binaries within psychedelic spaces. They describe how in a clinical setting it is prevalent to have both a male and a female facilitator, but this leaves no room for gender-nonconforming people to guide experiences—something which could be preferable if the patient themselves shares this identity.
Dr. Carter also discusses this gender binary in traditional contexts. It is common for ayahuasca ceremonies to provide separate spaces for men and women, again leaving no space for gender-nonconforming people. This reification of the gender binary and the often patriarchal organization of the ayahuasca ceremony can have serious impacts on the set and setting, especially for people in the LGBTQIA2S+ community. Dr. Carter emphasizes the importance of making space for folks in the community so that they are able to receive therapy, attend ceremonies, and participate in integration with others who share similar identities. This shared identity, they emphasize, ensures that LGBTQIA2S+ people don’t feel out of place in contexts that ought to be healing. Dr. Carter closes by discussing how members of the LGBTQIA2S+ community experience disproportionate rates of mental illness, further illustrating the crucial importance of equity in accessing psychedelic medicine.
In this episode:
Problems of representation and access for LGBTQIA2S+ individuals in the psychedelic space Current research being done on the intersection between psychedelic therapies and unique issues faced by gender and sexuality minorities Preparations to take before guiding a psychedelic experience for LGBTQIA2S+ people, particularly if you do not come from the community How plant medicines could have unique benefits for the LGBTQIA2S+ community Issues of poverty faced by marginalized peoples and how to support equity of access to emerging psychedelic therapiesQuotes:
“For some people that idea of melding, of becoming one and losing all of those unique pieces of themselves, doesn’t fit their paradigm of a spiritual connecting experience.” [10:47]
“It’s precious, that centering of our community—to be able to sit with people who just understand.” [19:42]
“Psychedelics offer the opportunity for connection of the self to something greater, something outside, a bigger community, spirituality, and really do a huge amount to heal peoples’ relationships with substances.” [25:20]
“Marginalized communities have been really impacted, largely, by the war on drugs, which has put millions of people in jail for drug offenses and stolen their ability to make income, stolen their ability to connect with community and we really need to heal that.” [33:34]
Links:
Chacruna Institute Queering Psychedelics 2019 Conference
Queerdome on Facebook
Portland Psychedelic Society
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Dr. Hans Eriksson joins to discuss the potential of non-dissociative ketamine. Dr. Eriksson, Chief Medical Officer at HMNC Brain Health, is a highly respected drug developer and clinical psychiatrist with over 20 years of pharmaceutical experience. Prior to HMNC Brain Health, Dr. Eriksson served as Chief Medical Officer at COMPASS Pathways and previously as Senior Director of Clinical Research at Lundbeck and Medical Science Director at AstraZeneca.
In this conversation, Dr. Eriksson shares what inspired him to move from clinical practice to drug development, and why he sees so much potential in developing non-dissociative forms of ketamine. He discusses the ways the dissociative effects of ketamine decrease the accessibility of this treatment due to the fact that these changes in perception are undesirable for a significant portion of patients. Dr. Eriksson also shares results from preliminary studies of non-dissociative ketamine which showed efficacy in inducing anti-depressant effects. In closing, Dr. Eriksson discusses why he thinks the experiential element of the classical psychedelics play an important role in their efficacy as mental health treatments, but why this might not be the case when it comes to ketamine.
In this episode you'll hear:
The history of ketamine The pharmacology of ketamine’s dissociative effect The relationship between ketamine dose and antidepressant effect The possibility of bladder issues and addiction with ketamine and whether non-dissociative forms of ketamine would also have these potentials How Dr. Eriksson thinks about combining psychotherapy with ketamine treatmentsQuotes:
“We are aiming for a similar exposure to the drug as you achieve with, for instance, an intravenous administration, but we are achieving a much lower peak concentration, maximum concentration of the compound. So that is one of the characteristics of our formulation.” [10:58]
“Our view is that it's probably better to try to use the metabolism in the body as a tool to achieve very low exposure to ketamine but high exposure to the downstream metabolites.” [23:19]
Links:
Dr. Eriksson on LinkedIn
HMNC Brain Health on LinkedIn
HMNC Brain Health website
Previous episode: Potential Benefits of Non-Hallucinogenic Psychedelics with Kurt Rasmussen, PhD
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Chandra Khalifian, PhD joins to explore ketamine-assisted couples therapy. Dr. Chandra Khalifian is a clinical psychologist, researcher, educator and Co-CEO of Enamory, a clinic and community focused on providing expansive relationship education and therapy including psychedelic-assisted couple-therapy.
In this conversation Dr. Khalifian explores the intricacies of ketamine-assisted couples therapy, sharing why she thinks psychedelics, and ketamine in particular, could be a good fit for couples therapy. She discusses the various contexts where ketamine-assisted therapy may be a good fit for couples pursuing therapy, the therapeutic modalities well-suited to this work, and the different dosing and administration routes of ketamine. In closing, Dr. Khalifian explores situations where couples may be better suited to pursuing this therapy individually and also contexts where ketamine-assisted couples therapy would not be an appropriate intervention.
In this episode you'll hear:
How Dr. Khalifian got involved in couples therapy The various models of ketamine-assisted couples therapy, and how to decide what is most appropriate The importance of preparation and integration How to navigate the two people in the couple having very different ketamine experiences When Dr. Khalifian uses intramuscular ketamine infusions versus ketamine lozenges Why Dr. Khalifian leans towards using third-wave cognitive behavioral therapy for ketamine-assisted therapy The tendency for people to make major relationship decisions following intense psychedelic experiencesQuotes:
“Ketamine is great because—in the same way with individuals—with couples it’s going to pull us out of that pattern so that we can then see the pattern and talk about the pattern from this observer perspective rather than being stuck in the ‘it’s me versus you’ we can look at it together and the couple can say ‘ah, there’s that thing that we do when we feel distressed, and now we can work together on that thing since we can see it from a little more distance.’” [4:43]
“Similar to MDMA, people are less likely to express criticisms in a hurtful way and less likely to receive constructive criticism and be defensive [during ketamine therapy].” [9:05]
“I had one couple [as patients for ketamine therapy] that the partner was like ‘I just felt this liquid compassion. I finally understood why she was engaging in these behaviors. And so everything made sense and I was able to talk about it in a different way.’” [17:49]
Links:
Enamory website
Enamory on Instagram
Previous episode: MDMA-Assisted Couples Therapy with Kayla Knopp, PhD
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Dr. Evan Cole Lewis joins to explore the topic of psychedelics and seizure disorders. Dr. Lewis is a Canadian Neurologist and holds an appointment as Assistant Professor in the Department of Paediatrics at the University of Toronto. He has special interest in the treatment of neurologic disorders, including functional seizures, with psychedelic therapies.
In this conversation, Dr. Lewis shares his expertise on a number of topics at the intersection of psychedelics and seizure disorders. He discusses the neurology behind psychedelics and functional neurological disorders more broadly, explaining why he thinks this is a very promising area of research. He explains that currently very little is known about the topic of psychedelics and seizure disorders, as almost all studies have had epilepsy as an absolute contraindication, leaving researchers with only case reports. However, there are some promising indications in the preclinical data which warrant further investigation. In closing, Dr. Lewis sheds light on potential seizure risks resulting from interactions between psychedelics and other medications.
In this episode you'll hear:
The different between epileptic seizures and functional seizures How Dr. Lewis started exploring the topic of psychedelics and functional seizures Why Dr. Lewis thinks psychedelic science has the potential to rebuild bridges between neurology and psychiatry Dr. Lewis’ experiences treating epileptic patients with ketamine The potential for co-administered lithium and psychedelics to cause seizuresQuotes:
“I tell people psychedelics are brain network medicine—they kind of dissolve those networks. If the thinking is that FND [Functional Neurological Disorder] is due to dysfunctional connection or hyperconnectivity in certain networks, what we have to do is we have to repair those networks, but first we have to take them apart and build them back up.” [11:03]
“Regardless, even if there isn’t even a condition in which psychedelics are utilized in neurology, we need the neurologists to be able to indicate that these patients are safe—or at least do the work and be involved in the clinical team.” [21:05]
“Things like drug interactions we pick up with psychedelics again are going to be a big piece of the puzzle that needs to be answered going forward.” [29:17]
Links:
Dr. Lewis on LinkedIn
Dr. Lewis on YouTube
Exploring psychedelic-assisted therapy in the treatment of functional seizures: A review of underlying mechanisms and associated brain networks by Dr. Lewis et al.
Case report: Improvement in refractory functional seizures, depression, and quality of life with ketamine assisted-therapy by Dr. Lewis et al.
Psychedelics, epilepsy, and seizures: a review by Dr. Lewis et al.
Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review by Kelan Thomas, Benjamin Malcolm, et al.
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast, Dr. Jenna Valentine joins to explore the intersection of psychedelics and somatic therapy. Dr. Valentine is a doctor of Chinese Medicine who incorporates both functional medicine and somatic experiencing within her practice to help achieve optimal wellness.
In this conversation, Dr. Valentine introduces somatic therapy, drawing parallels to psychedelic work and exploring how this modality may support more healthy and holistic psychedelic experiences. She explains how somatic therapy proceeds by tuning into the body, with therapists helping to guide clients’ awareness of the intelligence in their bodies.
Dr. Valentine emphasizes the importance of not forcing things in somatic work - with gentler, slower practices often being best to align with health. In closing, she outlines how somatic therapy can be used for preparation and integration of a psychedelic experience, and also explores the possibilities of somatic modalities being used during psychedelic therapy.
In this episode you'll hear:
The different forms of somatic therapy The overemphasis on the mind in our culture Why there aren’t contraindications for somatic therapy Somatic therapy as a modality for working with patients diagnosed with biploar disorder or schizophrenia The intersection of healing and re-learning to be playful The importance of “doing less” Why glorifying “heroic doses” of psychedelics can be counterproductive to healing Shadow work and somatic therapyQuotes:
“There’s many different definitions of [somatic therapy] but the one I love the most is: guiding yourself back to your body as your primary resource.” [4:02]
“A lot of the work is making sure people learn that they don’t have to feel afraid of themselves—no part of you is ‘coming to get you’ … no part of you is trying to trick you or hurt you or surprise you. Sometimes I’ll describe it as I’m helping people guide themselves back to themselves and find a safe home there again.” [13:05]
“We have lost our relationship with discomfort, and a lot of this work is uncomfortable. And the work is being in the discomfort and building a larger capacity for being uncomfortable, and learning the difference between uncomfortable and unhelpful, because that’s not something we’re trained in.” [23:41]
“There’s learning that can happen in everything … The expectation is to have no expectation: we can have a loose intention, and then let the body lead.” [47:18]
Links:
Dr. Valentine on Instagram
Dr. Valentine’s website
Psychedelic Medicine Association
Porangui
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In this episode of the Psychedelic Medicine Podcast Tommaso Barba joins to explore the topic of psychedelics for sexual functioning and intimacy. Tommaso is a PhD candidate at the Centre for Psychedelic Research at Imperial College London where his research is focused on understanding the potential role of psychedelic drugs for well-being. Tommaso authored the first paper on the effects of psychedelics on sexual functioning.
In this conversation, Tommaso shares results from the multiple studies into psychedelics and sexual functions he has been involved in. He reports that in both a trial comparing psilocybin and escitalopram and a survey of naturalistic psychedelic use, respondents reported positive impacts on sexual functioning following psychedelic experiences. He also speculates about aspects of the psychedelic experience that are interpreted as “erotic” in the midst of the altered state and the reported shifts to experiencing sexual connection as more “spiritual” following psychedelic experiences. In closing, Tommaso discusses the promise of psychedelic journeys for healthy couples and the difficulties of researching this topic since there is no clear pathology being addressed.
In this episode you'll hear:
How Tommaso got interested in the intersection of psychedelics and sexual functioning Why SRRIs often have side effects of inhibiting sexual function How psychedelic neuropharmacology may help explain improved sexual functioning following psychedelic experiences The upcoming studies exploring the effects of psychedelic journeys on couples who undergo the experience together The possible differences between MDMA and classic psychedelics in terms of mechanism and impact when it comes to effects on sexual functionQuotes:
“When we looked at the positive affect symptoms—like wellbeing, connectedness, ability to feel emotions, and so on… Psilocybin outperformed escitalopram. And given so, we were really curious to investigate further the sex lives of these patients, because an active sex life is a key component of people’s wellbeing, and a very overlooked one.” [7:34]
“What we found was that people treated with psilocybin reported improvements in sexual pleasure, in capacity to communicate sexual desires with their partner, in sexual arousal, sexual satisfaction, and similar components of sexual functioning, while people treated with escitalopram did not report any of these changes and tended to report deterioration in this aspect of functioning.” [11:10]
“[These psychedelic treatments may] work because it disentangles couples and its capable of individuating the two patients into the context of their relationship so that they start to develop a better identity in the context of the relationship instead of being completely fused into each other and not capable of really developing themselves and communicating their desires and what they want.” [31:15]
Links:
Tommaso on Twitter
Tommaso on LinkedIn
Imperial College Centre for Psychedelic Research online survey study: psychedelics and couples
Previous episode: Microdosing and the Placebo Effect with Balázs Szigeti, PhD
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast Kayla Knopp joins to explore the topic of MDMA-Assisted Couples Therapy. Dr. Kayla Knopp is a clinical psychologist and researcher specializing in non-traditional couples and relationships. She specializes in making couple therapies more inclusive, accessible, and effective, including MDMA- and ketamine-assisted couple therapy.
In this conversation, Dr. Knopp introduces MDMA-assisted couples therapy, discussing why this entactogen is a good fit for couples therapy. She discusses how MDMA helps couples explore issues by dissolving typical defensive boundaries and encouraging empathy. She emphasizes that not all couples may be a good fit for this therapy, however, and especially cautions against couples therapy in contexts of abuse where connecting with resources for safety and pursuing individual courses of therapy is more appropriate. In closing, Dr. Knopp discusses the importance of screening and the responsibility the psychedelic community has to ensure these substances are being used in safe and effective therapeutic contexts overseen by qualified and caring facilitators.
In this episode you'll hear:
The history of MDMA-assisted couples therapy When couple therapy is and is not appropriate Integrating MDMA-assisted therapy with cognitive-behavioral conjoint therapy for PTSD Therapeutic modalities which may be well-suited to MDMA-assisted couples therapy
Quotes:
“[MDMA] does so many things that are facilitative of the primary goals of couples therapy, which are to reduce defensiveness, to increase the flexibility that we have in taking our partner’s perspective, increase the empathy and intimacy we feel with other people, increase the reward that we get from positive interpersonal interactions.” [4:33]
“When we treat relationship dysfunction, we know mental health often improves as a result of that and conversely, we also know that sometimes when we do mental health treatments, if we ignore the relational context that somebody is living in, we only give them part of what they need in order to fully heal psychiatrically. So, couple-based interventions for mental health disorders, including PTSD, are up-and-coming as a really effective way to address mental health concerns.” [8:14]
“MDMA tends to increase our window of tolerance for emotional experiences—it makes it safer and easier for us to remain in contact with feelings that might otherwise feel pretty overwhelming.” [23:48]
“I think there’s absolutely a lot of ego and a toxic guru model that can show up in psychedelic-assisted therapy that, as a community, as practitioners, as participants, we need to keep an eye out for and keep ourselves accountable as a community to make sure that we’re not giving folks a pass.” [31:17]
Links:
Dr. Knopp on Instagram
Enamory website
Enamory on Instagram
Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)
Psychedelic Medicine Association
Porangui
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In this episode of the Plant Medicine Podcast, Dr. Mark Braunstein returns to discuss potential concerns surrounding the use of ketamine, especially use which is not overseen by a knowledgeable medical professional. Dr. Braunstein is a whole-health psychiatrist with 22 years of clinical experience. He is the medical director for multiple mental health and psychedelic psychotherapy clinics in Colorado, New Mexico, and Utah and he also runs in-patient and out-patient programs for addiction. Additionally, Dr. Braunstein is involved in multiple projects focused on expanding access, awareness, research, and safety in the field of psychedelics.
To begin this conversation, Dr. Braunstein shares how his original exposure to ketamine wasn’t in a medicinal context, but rather as a recreational drug of abuse. However, since then he has seen the transformative effects this substance can have on patients when used in a physician-directed context and for therapeutic purposes. Nonetheless, Dr. Braunstein stresses that this does not mean ketamine use does not come with certain risks.
Ketamine can be addictive and even carries a risk of overdose, particularly when used recreationally in a context where the purity of the substance is unknown. Dr. Braunstein distinguishes recreational and therapeutic uses of ketamine, explaining that recreational doses are often lower and dosing is more frequent, whereas ketamine is used in high doses in a therapeutic context, with extended periods between sessions.
Dr. Braunstein stresses both the responsibility of physicians and of patients to ensure ketamine is prescribed responsibly and used as directed. Despite the dangers posed by recreational ketamine use Dr. Braunstein describes in this conversation, it is still a medicine he believes can have significant positive impacts for patients. This requires, however, that it not be treated merely as yet another quick fix pill. Instead, Dr. Braunstein emphasizes that ketamine treatment ought to coincide with psychotherapeutic work. This combination, he says, will maximize the therapeutic potential of ketamine while also helping to ensure that the medicine is used responsibly, under the close direction of a medical professional.
In this episode:
The addiction and overdose potential with recreational ketamine use How dosage can dramatically change the effects of ketamine Responsible prescribing practices for physicians working with ketamine The psychological and physiological harms of ketamine abuse How Dr. Braunstein talks to his patients about responsible use before prescribing ketamine The importance of combining psychedelic medicines with psychotherapeutic workQuotes:
“Part of why ketamine works is because it lights up your brain in all these different ways and when done occasionally, intentionally, it moves you. But if you’re always doing that, it ends up having the reverse effect, causing damage.” [12:56]
“This is a heavy-duty medication that, if you cross the line, can cause you to stop breathing and then die. So there is an actual, real danger to ketamine.” [16:25]
“I think the organ that is most prone to damage from overuse of ketamine is the same organ we are touting it fixing: the mind.” [18:39]
“When we think about these medications, we should think about combining them with therapy and not just taking these medications as medications… So that’s why with ketamine I’m really recommending it with therapy.” [25:04]
Links:
Reconscious Medical
Psychedelic Medicine Association
Porangui
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