Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

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 therapy Quotes: "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

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 function Quotes: "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 Porangui

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

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 work Quotes: "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

In this episode of the Psychedelic Medicine Podcast we discuss the topic of psychedelics and postpartum mood disorders. Melissa Whippo is a licensed psychotherapist who specializes in the intersection of women's health and psychedelics. She founded a non-profit, Deva Collective, which has fiscal sponsorship with MAPS, and is currently conducting research about perimenopause and microdosing San Pedro. In this conversation, Melissa shares the details of existing research into psychedelic treatments for postpartum populations. She discusses the findings from her study on "The Pharmacokinetics of Ketamine in the Breast Milk of Lactating Women," reporting that ketamine was not detected at all in breast milk twelve hours after dosing. She also shares information on parents' intentional use of microdosing and what motivates them to take up this practice. In closing, Melissa discusses her upcoming research on microdosing San Pedro among perimenopausal populations and why she decided to focus on San Pedro for this study. In this episode you'll hear: The early research into ketamine for postpartum depression and whether ketamine remains in breast milk The prevalence of mood concerns in the postpartum population Issues of access with ketamine treatments for new mothers Improvements in postpartum mood patients following ketamine treatments that Melissa has seen in her practice Hormone changes after giving birth and how this might relate to mood concerns Ketamine for postpartum pain Quotes: "The reason why ketamine and other psychedelics appeal to me more [than other treatments for postpartum depression], is it's not a medicine you have to take every day and it's not a medicine that's going to cause a significant separation [with the newborn] like a hospital admission would." [5:55] "More SSRI—which is still considered safe by the medical profession—passes through the breastmilk than ketamine. Probably nanograms. And ketamine has such a short half-life in the system, particularly with the intramuscular route of administration, that twelve hours after dosing, the breast milk was completely clear." [14:22] "That's what ketamine does so well—it gives people a different view of some of the things they're really struggling with that they can't quite break through. Some of these more recursive ruminations that seem to befall mothers quite a bit—and they're usually pretty negative. But the medicine space gives them a different view." [18:52] Links: Melissa's study: The Pharmacokinetics of Ketamine in the Breast Milk of Lactating Women: Quantification of Ketamine and Metabolites Melissa's article in the Washington Post: Some moms are microdosing mushrooms for anxiety and depression Melissa's website Deva Collective website Melissa on Instagram Plant Parenthood website Previous episode: Psychedelics and Women's Health with Allison Feduccia, PhD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Hannah Raine-Smith and Jocelyn Rose join to discuss the psychedelic assisted EMDR therapy. Hannah is an integrative psychotherapist and independent researcher specializing in psychedelic integration using EMDR therapy. Jocelyn is a research therapist working on psychedelic clinical trials. She also works in private practice, and has a special interest in exploring the unfolding potential of EMDR as a scalable, trauma focused psychedelic assisted therapy. In this conversation, Hannah and Jocelyn introduce the basics of eye movement desensitization and reprocessing (EMDR) therapy and its possible utility in adjunct to psychedelic assisted therapies. They discuss the overlapping mechanisms between EMDR and psychedelic therapies, with both engaging the serotonin 5-HT2 system and promoting neuroplasticity. Hannah and Jocelyn explain their excitement around integrating EMDR with psychedelic therapy, stressing that this may make these treatments more accessible for the patients who could benefit most from psychedelic therapy. In closing, the researchers call for additional investigation of the intersection of psychedelic therapy and EMDR and invite collaboration from anyone else exploring these promising treatments. You can contact Hannah and Jocelyn at [email protected] In this episode you'll hear: How EMDR works to help people process traumatic memories Similar neurological effects of psychedelic therapies and EMDR Understanding the adaptive information processing (AIP) framework Hannah and Jocelyn's novel hypothesis for the basis of hallucinogen persisting perception disorder (HPPD) Using EMDR as an integration therapy for past psychedelic experiences Making psychedelic treatments more accessible and inclusive Quotes: "Like with indigenous shamanic practices, EMDR uses simple rhythms to alter consciousness. So EMDR is like an ancient healing mechanism that's been adapted to treat the modern soul." [4:56] "When we reprocess these memories using bilateral stimulation of the brain, you start thinking and feeling differently about the same events. So trauma therapy isn't about changing the past, it's about how you think and feel about those experiences." [5:26] "Some of the resistance that would normally be present in an EMDR session is diminished when someone has had a recent psychedelic experience." [12:02] "Research has shown that EMDR taps into the same mechanisms as REM [sleep]. It's like adding the healing benefits of dreaming whilst on psychedelics but being more in control of what gets reprocessed." [14:42] "The people who are most likely to have adverse drug reactions to psychedelics—whether that's HPPD or tolerance—tend to be the people who also have adverse childhood experiences or have traumatic complexity in their biographical content. And so we recognize that there's a need for trauma-focused psychedelic treatments if we're going to make these treatments available to the people who need them most and make them scalable—and we think EMDR is a good enough fit for that work to happen." [25:46] Links: Hannah and Jocelyn's article: "Psychedelic-assisted EMDR therapy (PsyA-EMDR): A memory consolidation approach to psychedelic healing" Bridge to the Matrix: A Memory Consolidation Approach to Psychedelic Healing website Hannah on LinkedIn Jocelyn on LinkedIn Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Steven Radowitz, MD joins to discuss the state of the research into ketamine treatments for PTSD. Dr. Steven Radowitz is the Chief Medical Officer and Co-Founder, Nushama. He believes psychedelic medicine's framework of neuroscience, mystical experience, and integration therapy is the future of mental wellness, and current solutions often fall short, treating symptoms without addressing underlying issues. Dr. Radowitz and the Nushama team have administered thousands of ketamine journeys for mood disorders and are known to be best-in-class and among the most experienced globally. In this conversation, Dr. Radowitz shares the journey of his career in medicine and how he got involved in the treatment of mood disorders with ketamine. He discusses the way he works with patients to determine the best dosing of ketamine for their unique therapeutic needs and the way dosage intersects with the durability of the changes. Dr. Radowitz emphasizes how ketamine promotes neuroplasticity, which allows patients with PTSD to open a critical response window when confronted with triggers and re-code memories of trauma. In closing, Dr. Radowitz discusses the importance of integration and highlights the way psychedelic therapies empower patients to be their own healers. In this episode you'll hear: Using both psycholytic and psychedelic doses of ketamine and how therapeutic approach differs between the two Stories of transformation from Dr. Radowitz's ketamine practice The practices Dr. Radowitz recommends for patients following ketamine infusions How Dr. Radowitz uses music in his ketamine practice Quotes: "As much as we segregate all these mood disorders into separate disease entities… there's actually a common seed for them all—there's just different manifestations. But I say about 95% of the people who come in here [for ketamine treatments] have some type of trauma." [4:56] "The dose doesn't always correlate with the experience—it usually doesn't. I can give people the same dose, with the same music, same everything, and they'll have completely different experiences each time." [13:23] "What we do here is to create a medically safe and an emotionally safe environment for [patients]. But the medicine is them—they're the therapists in the end. … I want them to realize it's all coming from them. They have everything they need within themselves to heal." [32:15] Links: Nushama website Nushama on LinkedIn Nushama on Instagram Nushama on Facebook Nushama on TikTok Dr. Radowitz on Linkedin The Untethered Soul: The Journey Beyond Yourself by Michael A. Singer Letting Go: The Pathway of Surrender by David R. Hawkins Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Rick Strassman, MD joins to discuss the topic of endogenous DMT. Dr. Strassman is adjunct associate professor of psychiatry at the University of New Mexico in Albuquerque and author of DMT: The Spirit Molecule and The Psychedelic Handbook. His DMT and psilocybin studies in the early 1990s initiated the renewal of human research with psychedelics in the U.S. In this conversation, Dr. Strassman discusses the finer details of DMT, from endogenous production in humans and animals, to visionary experiences and theological implications. Dr. Strassman also covers the research that's been done regarding endogenous DMT, clarifying what we do and don't know about the role of the pineal gland and how this might relate to what is reported during near-death experiences. He also discusses the personal and relational quality of psychedelic experiences induced by DMT, mentioning that unitive mystical experiences were actually rare in the trials he conducted, with more experiences having a personal quality, drawing upon the life experiences and interests of the participants. In closing, Dr. Strassman shares his thoughts on the origins of the visions that many report during DMT use. In this episode you'll hear: The overlap between psychedelic experiences and meditation techniques The relationship between fear, self-awareness, and difficult DMT experiences The placebo effect and psychedelic research Dr. Strassman's thoughts on non-hallucinogenic psychedelics DMT as a possible treatment for strokes to prevent damage and speed recovery Effects of microdosing in animals and humans Quotes: "I think the best term for these compounds is psychedelic, which means mind manifesting or mind disclosing, because only one of our fifty-five or so normal volunteers had what one might call a mystical unitive state. … Everybody basically had an experience that was totally dependent on them. It was not inherent in the drug." [9:45] "You could still speculate that to the extent that non-drug states resemble those brought on by giving DMT… that DMT plays a role in the production of those states. But the data aren't there yet. That's why we need more people doing this research." [24:16] "If psychedelics are super placebos and if we have a psychedelic drug in our brain, it's attempting to speculate that normally the placebo effect could be mediated by endogenous DMT." [27:42] "If you starve neurons of oxygen they start dying, but if you add DMT they survive much longer. So there seems to be some neuroprotective effect of DMT on ischemic damage to neurons, at least in the test tube." [32:27] Links: Dr. Strassman's website The Psychedelic Handbook by Dr. Strassman DMT: The Spirit Molecule by Dr. Strassman DMT and the Soul of Prophecy: A New Science of Spiritual Revelation in the Hebrew Bible by Dr. Strassman Dr. Strassman on FacebookPrevious episode: Exploring DMT Entities with Matthew Johnson, PhD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Stephanie Knatz Peck, PhD joins to discuss the research on psilocybin for anorexia nervosa. Dr. Stephanie Knatz Peck is a clinical psychologist and Associate Clinical Professor at the University of California, San Diego with an expertise in eating disorders. She conducts clinical research on novel treatments for eating disorders and has been involved with clinical research evaluating psychedelics across a variety of mental health indications in the capacity of researcher and therapist. She also published the first ever report on a clinical study evaluating psilocybin for anorexia nervosa. In this conversation, Dr. Peck discusses the difficulties of treating eating disorders and the emerging evidence around the safety and efficacy of psychedelic-assisted therapies for these conditions. She discusses the results from a study she conducted on the safety and tolerability of psilocybin therapy for females with anorexia nervosa, finding that the treatment was safe and generally well tolerated amongst the trial group. The study additionally found positive treatment outcomes following the psilocybin therapy in a number of participants. In closing, Dr. Peck discusses how psychedelics are able to open a "behavior change window" following dosing sessions—something which may be crucial to their efficacy in treating eating disorders. In this episode: Dr. Peck's work treating patients with eating disorders The lesser known diagnostic categories orthorexia and eating disorder not otherwise specified (EDNOS) Genetic predisposition for eating disorders Why the participants in Dr. Peck's study thought they could benefit from additional psilocybin dosing sessions How transformative psychedelic experiences can help shift values and identities to promote eating disorder recovery Quotes: "We think that there are specific personality features that predispose someone to engage in dietary restrictive processes or behaviors or actions or modify their lifestyle around exercise and food—and then they fall into anorexia. And the thing that distinguishes those people is that sometimes they have these predisposing factors like a lot of anxiety or preoccupation, an ability to be highly self disciplined… There's a lot of processes in place that can cause a diet to go awry and turn into anorexia." [12:29] "Something that distinguishes anorexia from other psychiatric illnesses is that it is an illness that really results in a lot of physiological vulnerability—across all body systems. And so while it might be fine to just assume that with some other psychiatric illnesses we can reliably assume safety, with this particular population there's cardiac issues, there's serotonergic things that affect cardiac issues that we really needed some safety data on." [19:13] "We really need better treatments [for eating disorders] that treat from the inside out, meaning like what is happening on an underlying psychological level, neuropharmacological level, that's causing someone to want to engage in these behaviors and I think that is the value of these [psychedelic] treatments is that we are treating from a different direction." [27:25] Links: Dr. Peck's study: Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study Current eating disorder studies at UCSD BrightMind Therapy website Dr. Peck on Twitter Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD, MPH joins to discuss why he prefers the term "psychosomatodelics" for psychedelics. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association. In this conversation, Dr. Malcolm shares the meaning of the term psychosomatodelic as well as the history of the different terms used to refer to psychedelics. He emphasizes the ways that these substances manifest mind and body together, rather than only focusing on the mind-altering aspects of the experience. He also suggests that the line between side effects and therapeutic opportunities is blurry in psychedelic therapy, discussing the ways in which nausea and purging in the context of ayahuasca ceremonies can contribute to the sense of healing and psychosomatic catharsis. In closing, Dr. Malcolm suggests some directions for future research regarding serotonergic psychedelics' interaction with the gut-brain axis and the autonomic nervous system. In this episode: The meanings of more newer, more specified terminology such as psychoplastogen, entactogen, and more Trauma-resolving aspects of psychedelic experiences How psychedelics impact transmodal cortices of the brain The somatic side effects of psychedelics Quotes: "The psychedelic experience is inherently larger than either brain or mind, and it's more of a mind-body kind of experience. And it would be worth recognizing the mind-body contribution that is happening as far as the types of experiences persons are having, and maybe even the ways that psychedelics are working to provide a true, felt sense of relief for persons." [3:51] "Why do we wear a blindfold for psychedelic therapy? Well, you're actually trying to limit the sensory input from certain unimodal sensory cortices like vision and you're trying to amplify sensory content—maybe from the body, maybe from the viscera, maybe from inside. It's to heighten the internal landscape. That's why you're actually shutting out these kinds of external sensory inputs." [17:19] "Particularly if you're approaching psychedelics for healing of trauma, then thinking of them as energetic purgatives that have a psychosomatodelic, or full mind-body manifesting type of experience, might allow you to wrap your head around the psychedelic experience or what its doing a little bit easier." [31:53] Links: Spirit Pharmacist website Spirit Pharmacist on Facebook Spirit Pharmacist on Instagram Spirit Pharmacist on YouTube Previous episode: Medical Literature Regarding Psychedelics, Pregnancy, and Breastfeeding with Ben Malcolm, PharmD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Nick Brüss, EdD, LMFT joins to discuss the possibilities of leveraging ketamine-assisted psychotherapy for accelerated growth. Dr. Brüss is a psychedelic therapist licensed in CA, NY and TX. He was a MAPS clinician and supervisor on the historic phase 3 MDMA for PTSD study, and is the director of psychedelic medicine advocacy for the TREAT California ballot initiative. In this conversation, Dr. Brüss explains the intricacies of the internal family systems (IFS) model of therapy which he uses in conjunction with ketamine to help lead clients towards transformation and growth. Dr. Brüss explains how he helps clients work with their various "parts" both leading up to ketamine experiences and while they are under the influence of the dissociative, explaining how the ketamine experience helps to facilitate this work. He emphasizes the non-pathologizing, self-compassion focus of the IFS model and sees this as a natural fit for psychedelic-assisted work. In closing, Dr. Brüss shares details of the TREAT California ballot initiative, which has the potential to provide five billion USD in funding for research and affordable access to mental health treatments using psychedelic medicines. In this episode: Different forms of ketamine-assisted therapy The importance of preparation for both psycholytic and psychedelic forms of ketamine therapy Why Dr. Brüss finds the combination of IFS and ketamine therapy so powerful Working with "parts" using IFS Stories of client healing and transformation following ketamine-assisted therapy with IFS The meaning of "protector parts" and "exile parts" in IFS and how to work with these The mechanisms of ketamine "softening protector parts" and facilitating self-love Quotes: "[Internal family systems] is so synergistic with psychedelic-assisted work because it holds as part of one of its assumptions that we all naturally have this multiplicity of minds… And we also hold this capacity, this inner-knowing that we can open to and relate to and even bring a loving, compassionate embrace to all of our parts." [4:59] "This work is a training for people to get to know themselves, so we work with the biggest pieces, the things that have been holding them down or blocking them in some way—blocking their full expression—and after that, they are now trained to work with any number of parts." [26:52] "One of the things that I wish I could have told my earlier, younger self is to really focus on these areas where if there's a part of myself that I can't love or care for or deeply respect, then that really needs my attention." [33:52] "Even with the most seemingly scary parts, as we get to know them, we can learn from them." [36:00] Links: Dr. Brüss website, A Practice of Freedom TREAT California ballot initiative website Dr. Brüss on Instagram Dr. Brüss on LinkedIn Your Symphony of Selves: Discover and Understand More of Who We Are by James Fadiman and Jordan Gruber Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Erica Siegal, LCSW returns to discuss the important topic of supporting survivors of psychedelic abuse. Erica is a psychedelic-assisted psychotherapist, community organizer, and harm reduction advocate. In 2019 she founded NEST Harm Reduction, a California-based mental health and psychedelic support organization that provides psychotherapy, outreach, education, and integration. Erica also recently founded SHINE Collective to support survivors of psychedelic harm and abuse. In this conversation, Erica unpacks the complexities around various forms of abuse that exist in psychedelic spaces. One major form of abuse she identifies is financial coercion, where clients of psychedelic facilitators come to feel that one's spiritual access has a paywall, or that they are having to make major financial decisions while under altered states of consciousness. Erica also discusses problematic sexual and romantic dynamics that can arise, drawing a clear line in the sand that there should never be any form of sexual contact between psychedelic facilitators and clients. In closing, she shares more about the work SHINE Collective is doing to support survivors of psychedelic abuse, and discusses ways that listeners can help support this important work. In this episode: What inspired Erica to start SHINE Collective Issues of financial coercion in psychedelic spaces Different forms of spiritual abuse Ways identify the dynamics of spiritual abuse and guard against them Why Erica is skeptical of husband-wife teams of psychedelic therapists or facilitators Issues of sexual dynamics between psychedelics facilitators and clients Training and integration needed prior to skillfully and safely facilitating psychedelic experiences What SHINE Collective is doing to support survivors of psychedelic harm Quotes: "You also see people who are like 'oh well if you want to keep working with me it's this price' and then all of a sudden the access to psychedelics—the spiritual access—now becomes 'well I have to be paying this person $1,000 a month to just be on their mailing list because they are the person that is acting as the point between me and my spiritual access.'" [11:19] "If you're facilitating, you should have a consultation group of other facilitators in which you consistently welcome constructive feedback. … And be able to have case consultations, and be able to have reflection." [26:43] "Psychedelic facilitators should not be having sex with people they are facilitating psychedelic ceremonies for." [30:35] Links: NEST Harm Reduction website NEST Harm Reduction on Instagram NEST Harm Reduction on Twitter SHINE Collective website SHINE Collective on Instagram Erica on LinkedIn Erica on Instagram Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c) Article by Jules Evans and Joseph Holcomb Adams: "Blurred Lines: improving the ethics of psychedelic fund-raising" The Emerald Podcast by Joshua Michael Schrei on Spotify Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Kyle Buller and David Drapkin, LCSW of Psychedelics Today join to discuss psychedelic training and education. David is a licensed clinical social worker, the director of education and training at Psychedelics Today, and one of the creators of their 12-month training program, Vital. Kyle is the co-founder of Psychedelics Today and VP of training and education. In this conversation, Kyle and David share an overview of the current state of psychedelic training programs and education. Kyle shares his own background with psychedelic education, discussing how he got involved in this field and what he's found most beneficial and effective in psychedelic training. Kyle and David also discuss the complexities of weighing different programs, considering medicine-specific versus general programs, programs focused on specific modalities, programs geared towards specific professions, and more. They also discuss the details of how they created Psychedelics Today's training program, Vital. In closing, David reiterates the value of diversity in psychedelic education, both in enriching the learning experience and extending the impact of this education. In this episode: The variety of psychedelic education programs The vision behind the Psychedelics Today Vital course What to look for in psychedelic education programs Equity and diversity in training programs Medicine-specific vs. medicine-general programs Dealing with the uncertainties around working with psychedelics as legal landscapes develop Psychedelic training program scholarships Quotes: "Something we put a lot of emphasis on with Vital, is that it be experiential and inner-directed—a process of understanding self and coming out of Vital with more refined questions and a clearer sense of where to go next." [8:31] "If the psychedelic movement is going to continue to grow, we need people to be educated in all realms so that we can help to reduce the stigma." [11:42] "If you want to start working with these medicines, building those foundational elements is so important. Like learning how to work with your body, learning how to use your breath to navigate experience." [31:12] Links: Psychedelics Today website Psychedelics Today Vital course Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Adam Aronovich, PhD(c) returns to discuss issues of psychedelic self-absorption—and how to avoid these traps. According to Adam, he is a PhD candidate in medical anthropology, the creator and curator of Healing from Healing, a trophy husband and dad. In this conversation, Adam revisits his previous discussion of psychedelic narcissism and explains why he's now somewhat more critical of the term. However, Adam still sees issues around cultivating epistemic humility and acknowledging the political dimensions of healing in psychedelic contexts. He explains the issues he takes with forms of New Age, Neoliberal spiritual perspectives he sees as pervasive and typically unacknowledged amongst many engaging with psychedelics. He also discusses how some pop psychology terms have worked their way into the psychedelic realm and what impacts that has had. In this episode: The "spectacle" of filmed psychedelic experiences on social media The intersection of medical and spiritual cultures in psychedelics and how this can create issues of access The cheapening and overuse of the idea of "trauma" in popular discourse and the birth of "traumadelic" culture Why approaches focusing on excavating supposed repressed traumatic memories from childhood should be approached with a degree of skepticism Quotes: "One of the main things with plant medicine—particularly when people are sharing about it—is that people want to be really vulnerable and people want to be very authentic… But at the intersection with the spectacle, that vulnerability and authenticity become part of the spectacle in the sense that they become 100% performative." [19:01] "The people who don't have that modicum of self awareness and epistemic humility to really understand, with intellectual honesty, the scope of their understanding and knowledge, then it is very easy to overdo it. And then we do a disservice, not only to the actual traditions that we purport to be portraying, but also to the people that we're working with." [37:56] "If you don't understand that your healing is political, because individual health, and individual happiness, and individual everything is intrinsically related to collective health, and social health, and cultural health, and environmental health, then you need to go back to square one because you haven't understood anything. " [40:02] "If we can't even fathom that perhaps my own wellbeing is in constant dialogue with the wellbeing of a society, and the wellbeing of a culture, and the wellbeing of an environment—that nobody can be healthy and happy unless everybody else is relatively healthy and happy—then we are in big trouble and we haven't really learned everything." [40:20] Links: Healing from Healing website Healing from Healing on Instagram Healing from Healing on Facebook Adam on Instagram Society Of The Spectacle by Guy Debord Wikipedia entry on the Satanic panic Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich Previous episode: How Western Medicine and Indigenous Traditions Differ in their Approach to Mental Health and Healing with Adam Aronovich Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Michelle Weiner joins to discuss the research on ketamine assisted psychotherapy for chronic pain conditions. Dr. Weiner is Double board-certified in Interventional Pain Medicine, Physical Medicine and Rehabilitation and the Director of Integrative Pain Management at Spine and Wellness Centers of America. She uses a unique personalized approach to treat the root cause of one's pain using a biopsychosocial model including lifestyle and plant medicine to empower her patients to cultivate health, optimize quality of life and decrease pharmaceuticals. In this conversation, Dr. Weiner discusses her recent research into ketamine therapy for chronic pain and comorbid depression, which compared psychedelic and psycholytic doses of the dissociative. She emphasizes the importance of a biopsychosocial approach to pain treatment and sees the psychotherapy aspect of the ketamine treatments as crucial to their efficacy, as this approach allows doctors to have a better understanding of the complex etiology of the patients pain beyond just what shows up on imaging and empowers patients to actively take ownership of their pain management. While the results from Dr. Weiner's study were very encouraging, she mentions that ketamine therapies typically require maintenance and that more longitudinal research is needed to further understand how durable these changes are. In this episode: The issue of central sensitization in chronic pain The difference between psychedelic and psycholytic doses What led Dr. Weiner to study chronic pain and comorbid depression Neuropathic, nociceptive, and nociplastic forms of pain The influence of trauma and stress on chronic pain The intersection of pain and identity Dr. Weiner's biopsychosocial approach to pain treatment The differences between cannabis and ketamine as pain treatment medications Quotes: "A lot of [patients'] pain is really similar to fear—fear in the brain—and… if we're not able to understand where this fear is coming from we're not able to extinguish their pain. So I really changed the way I practice and use ketamine because I started to think more about how the psychiatrists are using it, in terms of preparation and integration." [6:59] "What I've seen is that ketamine does require maintenance in the sense that even if we do six sessions, a lot of patients do need to come back after a few weeks or a few months for maintenance treatment with ketamine as well as therapy." [20:09] "Pain doctors [should try to] be a little bit more aware of the set, setting, and preparation and integration so that we don't need to use benzos and [patients] can actually have this dissociative experience to allow them to have hope or get out of that fight or flight." [33:04] Links: Dr. Weiner's study: Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches Dr. Weiner's website Dr. Weiner on Instagram PMA webinar with Dr. Weiner: Treating Pain and Functional Neurologic Disorders with Psychedelics Spine and Wellness Centers of America Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Jules Evans joins to discuss his work with the Challenging Psychedelic Experiences Project. Jules is a research fellow at the Centre for the History of Emotions at Queen Mary University of London and author of four books including The Art of Losing Control and Breaking Open: Finding a Way Through Spiritual Emergency. He is also the Director of the Challenging Psychedelic Experiences Project and the editor of the substack Ecstatic Integration. In this conversation, Jules shares how he first became interested in psychedelics and the kinds of ecstatic experiences they can produce, as well as what prompted him to turn his attention to the challenging experiences that can result from consuming these substances. He discusses the initial research from the Challenging Psychedelic Experiences Project, sharing the typical ways challenging experiences manifest, as well as the coping strategies people employ to work through these experiences. In closing, Jules reiterates the newness of the psychedelic field, encouraging more research into difficult forms of ecstatic experience and ways to effectively navigate the challenges these pose. In this episode: What got Jules interested in the topic of difficult psychedelic experiences Common impacts of challenging psychedelic experiences Depersonalization vs derealization What helped people integrate challenging psychedelic experiences How people used "cognitive self care" to process challenging experiences The history and meaning of the term "spiritual emergency" Psychedelic "flashbacks" and hallucinogen persisting perception disorder (HPPD) Quotes: "30% of our respondents reported anxiety, panic attacks, social anxiety—and then all these sub-themes related to fear like fear of losing your mind, fear of dying, fear of the experience repeating, fear of being alone." [17:04] "Feeling you don't have anyone to talk to about [a psychedelic experience] will make extended difficulties more likely. Not knowing the dosage that you take seems like it makes extended difficulties more likely." [24:44] "The overwhelming majority [of people who had challenging psychedelic experiences], like more than 85%… still believe in the therapeutic potential of psychedelics." [32:41] "Our culture has a lot of ecstatic illiteracy. We've lost the maps and guides and safe places to having ecstatic experiences, so we're ecstatically naive. And we need to develop ecstatic literacy to learn to get better at having these kinds of experiences." [51:11] Links: Challenging Psychedelic Experiences Project website The first study from the Challenging Psychedelic Experiences Project: Psychedelic integration challenges: Participant experiences after a psilocybin truffle retreat in the Netherlands Ecstatic Integration Substack Jules' book: Breaking Open: Finding a Way Through Spiritual Emergency Jules on LinkedIn Jules on Twitter Jules on Instagram Centre for the History of Emotions at Queen Mary University of London Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Reid Robison joins to discuss managing medical risk in patients seeking psilocybin therapy. Dr. Robison is a board-certified psychiatrist and Chief Clinical Officer at Numinus, overseeing the company's psychedelic and mental health services across the US and Canada. He has led over 200 clinical trials in neuropsychiatry, including the MAPS-sponsored MDMA-assisted therapy for eating disorders study, and several other psychedelic studies with psilocybin, LSD and DMT. In this conversation, Dr. Robison begins by sharing how researchers have been determining guidelines for managing medical risks associated with psilocybin and how this guidance may shift as research continues in real-world settings at larger scales. He also discusses the intricacies of psilocybin's pharmacokinetics and how the substance interacts with common psychiatric medications such as SSRI antidepressants. In closing, Dr. Robison emphasizes the importance of keeping a close eye on potential psychological risks of psilocybin and other psychedelics, especially amid the excitement stemming from the incredible potential of these medicines. In this episode: The emerging medical indications for psilocybin therapy How the research into psilocybin has developed in the past few years The pharmacokinetics of psilocybin Medication interactions with psilocybin Risks of serotonin syndrome Absolute vs relative contraindications Psilocybin's effect on QT interval and heart valves The Psychedelic Medicine Association's "Psilcobyin-Informed Clinicians" database comprised of practitioners who have completed the course Quotes: "There's a lot to learn [about the interaction of psilocybin and SSRIs] and it's a little bit unpredictable. And some people anecdotally would say that their SSRI interfered with their trip or diminished the experience and others would say it did not." [26:22] "Psychological risks are nontrivial, including the risk of a difficult experience—something that may even need some mental health treatment afterwards, something that may be meaningful, nontrivial for the individual for a while, and can coexist with the mystical experience. And having the most meaningful experience of your life can coincide with the most difficult." [40:43] Links: Course: Managing Medical Risk in Patients Seeking Psilocybin Therapy Dr. Robison's website Dr. Robison on Twitter Dr. Robison on Instagram Numinus website Previous episode: Psychedelics for Eating Disorders with Reid Robison Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Kevin Franciotti, MA joins to discuss the intricacies of psychedelic-assisted therapies for substance use disorder. Kevin Franciotti is a Denver-based writer, therapist, advisor, and thought leader in the fields of psychology, psychedelics, and substance abuse counseling. In this conversation, Kevin shares his expertise on the existing research on psychedelic medicines for substance use disorder (SUD) and also discusses the limitations of the results of this research. He talks about the difficulties of designing trials and protocols for psychedelic therapies that target SUD, touching on how this disorder can interact with the neuro-physical and psychological effects of psychedelic medicines. He also contrasts emerging psychedelic treatments for SUD with dominant abstinence-based models and shares where he thinks psychedelic therapies may be a healthier alternative. In closing, Kevin reiterates that it is crucial to continue integrating harm reduction perspectives as psychedelic therapy continues to gain more mainstream traction. In this episode: Contraindications which can arise during detox periods which may require a person to be fully detoxed prior to pursuing any psychedelic-assisted therapy for SUD The neuro-physical effects and the psychological effects of psychedelic substances The role of peer support in psychedelic-assisted therapy for SUD The stigma around psychedelic therapies within traditional recovery programs and communities How psychedelic therapy protocols interface with current guidelines from the American Society of Addiction Medicine The future of insurance coverage for psychedelic therapies Issues of "psychedelic exceptionalism" Quotes: "Ibogaine has somewhat of a miraculous quality of being able to attenuate some of the most painful, acute symptoms of opiate withdrawal—but that is only specific to opiate withdrawal." [11:33] "What's miraculous about a medicine like ibogaine or even psilocybin… is it's designed to enhance somebody's ability to confront their underlying issues." [16:57] "The future of addiction treatment embracing psychedelics is really going to hinge on the treatment industry being willing to construct innovative ideas." [30:37] "Drugs are drugs. Drugs don't have an inherent moral quality around them. [What's important to highlight] is the risk of stratifying people who use drugs as somehow being superior or inferior based on which category of socially accepted drugs that they're doing." [42:39] Links: Kevin's website Kevin on Twitter Kevin on Instagram Kevin on LinkedIn Psychedelics in Recovery Journey Colab All Points North (APN) "Dispelling Lies the Psychedelic Community Believes About Drugs" presentation by Carl Hart, PhD at Horizons 2019 Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Wilhelmina De Castro, LCSW joins to discuss the ways psychedelics may be used to support goals of queer liberation. Wilhelmina is a psychedelic therapist in the San Diego area and serves as a DEI officer for Integrative Psychiatry Institute. She is also lead faculty for the Psychedelic Research and Training Institute and is committed to creating access to psychedelic healing for historically marginalized populations. In this conversation, Wilhelmina discusses the major topics at the intersection of psychedelic healing and queer identities. She shares her own journey of how psychedelics helped with self-discovery and acceptance of her queer identity, discussing the ways these substances can help gender and sexual minorities step outside of forms of normativity that are enforced in the culture. She also discusses creating safe spaces for queer folks where they can access psychedelic healing with facilitators and other participants of a similar background. In closing, Wilhelmina reiterates the continuing issues of access and trust queer people face in the current psychedelic landscape, emphasizing the significant work which must be done to improve this situation. In this episode: How psychedelics can help with self discovery and self exploration What inspired Wilhelmina to begin working professionally with psychedelics Creating spaces for psychedelic healing tailored to queer-identified people Dealing with microaggressions in the context of a psychedelic retreat Working with a therapist or facilitator who shares a queer identity The queerness of psychedelics Quotes: "When I began to explore with psychedelics, there were moments of this connection beyond… the way I was socialized or conditioned to think was normal. I was able to just be myself [and] found that this attraction and this embodiment that I was feeling was actually where I was supposed to be." [4:41] "Psychedelics can be really helpful in challenging, in questioning, in dissolving those oppressive narratives that keep people oppressed, that keep them from accessing their liberation. And so if we can do this consciously, and if we can do this in a safe space where harm is not perpetuated, then we actually have this beautiful opportunity for collective liberation" [14:25] Links: Wilhelmina's practice, Integrate Integrate on Instagram Integrative Psychiatry Institute Psychedelic Research and Training Institute Queering Psychedelics: From Oppression to Liberation in Psychedelic Medicine SoundMind Institute Psychedelics and Identity Initiative Queer Psychedelic Society Psychedelic Liberation Collective Previous episode: Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Joël Brierre joins to discuss the important topic of safety when working with 5-MeO-DMT. Joël is the founder and CEO Tandava Retreats and co-founder of the 5-MeO-DMT education and training platform F.I.V.E. Joël and his team are focused on shepherding 5-MeO into the world in a safe and effective manner. In this conversation, Joël shares his expertise on the screening that should be done prior to 5-MeO-DMT experiences, discussing both physical and psychological considerations. He also talks about synthetic 5-MeO-DMT vs the extract from the Bufo alvarius toad and explains why his retreat center only uses the synthetic version. In closing, he discusses the nuances around drug-drug interactions and how he navigates these with participants, exploring the nuances of the pharmacology involved. In this episode: What inspired Joël to start F.I.V.E. The physical medical considerations when screening patients for 5-MeO-DMT Why it is theorized that 5-MeO-DMT could trigger conditions like multiple sclerosis to recur Psychological red flags for people seeking 5-MeO-DMT experiences Joël's thoughts on navigating psychedelic narcissism Safety considerations working with patients with significant trauma Determining the dosage of 5-MeO-DMT and why Joël thinks there's a lot of value in lower doses Alternative routes of administration for 5-MeO-DMT other than smoking Quotes: "It's very important to us that [5-MeO-DMT] is shepherded out into the world in a safe and effective way, with a good understanding of how it can go wrong—because another bad headline can really harm the progress that it has seen." [7:14] "Where we used to feel you really had to work your way up to 5[MeO-DMT], we found with the right amount of prep and with a good individualized approach it's right for anyone—as long as they're in the right place for it. So if they make it through the screening and intake process, we're good to go." [23:09] "There's no need to turn it into a goal-oriented thing where [the participant] needs to get to a full release. We see plenty of full resolutions happen where we never even have to take a participant to a mystical experience." [29:43] Links: Tandava Retreats website F.I.V.E. website Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the role of peer support in the psychedelic ecosystem. Joshua (he/him) is founder and executive director of Fireside Project and has prior experience as a volunteer counselor on a hotline and as a volunteer at the Zendo Project. He has also practiced law as a deputy city attorney at the San Francisco City Attorney's Office, where he focused on suing business exploiting vulnerable communities. He also co-taught a nationally-renowned clinic at Yale Law School. In this conversation, Joshua shares updates from the first two years of Fireside Project, the psychedelic peer support hotline. He mentions that the hotline has grown nearly 1,000% since their first month, with the number receiving 1,500 calls this past month. Joshua also discusses the intricacies of peer support, sharing why he thinks this form of support is particularly well-suited to psychedelic experiences and how he understands the relationship between psychotherapy and peer support. In closing, Joshua reminds listeners that Fireside Project is available to take calls from anyone working through a psychedelic experience—whether they are in the midst of an altered state of mind or seeking to integrate a past experience. In this episode: When to call the psychedelic peer support hotline The history of peer support and when it may be helpful Why Joshua believes its important for peer support volunteers to have had their own psychedelic experiences The ways peer support and psychotherapy differ The limits of peer support How peer support is similar to the methods used in MDMA-assisted therapy Critiques of peer support Joshua has heard and his responses The relationship between peer support and theoretical frameworks in psychotherapy Quotes: "In non-psychedelic peer support, often the peer-ness starts with a pathology—alcohol use disorder, tobacco use disorder, etc. Psychedelic peer support, the idea is that having had a psychedelic experience by itself is the layer of peer-ness that's needed to go deeper with someone regardless of other aspects of your identity you may have." [8:55] "One of the, I think, key parts of peer support is that we don't interpret a caller's experience for them. We are present with them so that they can interpret their experience and we can create a safe and non-judgmental space for them to engage in that kind of interpretation." [18:32] "I think especially with an experience as vast as the type that can be precipitated by psychedelics, having multiple forms of support is essential." [22:23] Links: Fireside Project website Fireside Project on Instagram Fireside Project on Twitter Previous episode: Insights Gained from the First Year of Fireside Project with Joshua White Previous episode: Fireside Project: The World's First Psychedelic Hotline with Joshua White and Hanifa Nayo Washington Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Hannah Cross, LCSW joins to discuss group ketamine assisted psychotherapy for frontline healthcare workers. Hannah is a licensed clinical social worker and therapist who specializes in trauma healing and psychedelic integration, including work on LSD and psilocybin clinical trials. In this conversation, Hannah shares details from the study exploring group ketamine therapy in a cohort of ten frontline healthcare workers, discussing the study design, the intricacies of group therapy, and the specific dosing protocol and therapy regimen for the patients. She reveals the very promising results of this early study and also shares a number of emotional stories of transformation from the patients. In closing, Hannah discusses the early indicators of the durability of positive effects from this kind of ketamine assisted therapy and lists a number of additional on-going and upcoming studies of group ketamine treatments for other populations. In this episode: The inspiration for this ketamine study How the frontline healthcare workers in the study were chosen What makes a person a good candidate for group therapy The protocol for the ketamine assisted therapy used in the study Why the therapy began with a low, sublingual dose of ketamine How psychotherapy was integrated with ketamine treatments in this study The reductions in PTSD, depression, and anxiety that resulted from the ketamine assisted therapy Why Hannah sometimes sees an increase in anxiety towards the beginning of the therapeutic process Quotes: "Ketamine can help people access more of that self-healing energy and when that's present in a group setting and people are essentially able to shine this healing energy on each other, there's this exponential healing I think can happen." [7:16] "When you wrap a ketamine experience up in experienced and effective therapy, there is this safety in the container that really allows people to have the inward focused journey under ketamine for that forty-five minutes to an hour." [20:03] Links: Full study: Ketamine-Assisted Group Psychotherapy for Frontline Healthcare Workers with COVID-19-Related Burnout and PTSD: A Case Series of Effectiveness/Safety for 10 Participants Numinus website Group ketamine assisted therapy by Numinus Hannah's private practice, Wild Sunflower Counseling Cedar Psychiatry website Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Arsalan Azam joins to discuss the potential of ketamine therapy for helping to address the stress of major life transitions. Dr. Azam is a board-certified Emergency Medicine physician and medical director of Daydream MD. He attended medical school as a Dean's Scholar at Case Western Medical School and completed his clinical rotations at the Cleveland Clinic. He has also worked as an emergency medicine physician around the country, including as a relief physician for hospitals impacted by staffing shortages. In this conversation, Dr. Azam shares patient experiences from his own ketamine practice and discusses the complexities of different approaches to ketamine treatment and different indications, including how some individuals may benefit especially from ketamine assisted therapy, while others may be well served by stand-alone ketamine infusions, especially considering the cost differential of these treatments. Additionally, Dr. Azam explores the role integration and peer support can play in the context of ketamine treatments, mentioning these may be less cost-prohibitive ways for patients to get the most out of their experiences. In this episode: The kinds of life transitions ketamine is helpful with in Dr. Azam's experience What kinds of patients Dr. Azam's practice serves The unique mechanism of ketamine Leveraging ketamine treatment to navigate breakups or professional transitions Ketamine assisted psychotherapy vs stand-alone ketamine infusions, and when having the extra support of therapy may be especially beneficial The role of integration and peer support in ketamine treatments The research into ketamine treatment for suicidal ideation How Dr. Azam sets up treatment programs for different kinds of patients Quotes: "The magic of this neurobiology is that, unlike our existing tools which take weeks to kick in often, this one works within hours. And so it really becomes more of a rescue medication or a supportive medication for these transitions of life that works quickly." [8:32] "Think of our mind and our mental patterns as a piece of cold steel—and it's kind of locked in that structure, in that pattern. Psychedelics, like ketamine and others, can heat that steel up, and make it much more moldable and then when it cools back down it'll maintain a persistent new structure. So ketamine assisted therapy is a tool that helps us leverage that hot piece of steel to mold it into something else." [11:56] "Ketamine works very quickly to reduce suicidal thinking and its degree of effect directly corresponds to the degree of symptoms. So someone who has really severe suicidality is more likely to experience a response to ketamine and is more likely to experience a significant response to ketamine." [18:36] Links: Daydream MD website Daydream MD on Instagram Fireside Project website Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD joins to discuss the research surrounding the intersection of psychedelics with pregnancy and nursing. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association. Dr. Malcolm recently wrote an overview article on the existing research into psychedelics, pregnancy and breastfeeding. In this conversation, Dr. Malcolm shares the current state of research that he explored in his article, highlighting the few points where data does exist while emphasizing that there are still major unknowns. Overall, Dr. Malcolm describes how most are very conservative when it comes to psychedelic use while nursing or pregnant, though pregnancy seems to present more concerns than nursing. Dr. Malcolm also discusses ketamine and the interesting findings in patients who were given this substance as an anesthetic for cesarean sections. In conclusion, Dr. Malcolm suggests moving beyond a black and white perspective on this topic, emphasizing that there are also opportunity costs to not pursuing healing. However, in this area especially, more research is needed before clear guidelines can be developed. In this episode: The lack of treatment options for postpartum depression Why it is likely for a fetus or infant to be exposed to psychedelics if a mother ingests them while pregnant or nursing Psychedelics and the developing brain Ritual use of ayahuasca and mushrooms among pregnant women in traditional ceremonial contexts The research into negative impacts of ecstasy use during pregnancy and the variables that confound the results The unknowns about microdosing while nursing The research into whether LSD is a teratogen The effects of psychedelics on hormones Pregnancy as an aspect of set and setting Quotes: "Psychoactive drugs or psychotropic drugs typically end up in breastmilk more than other types of substances because they are usually more fat-soluble. Usually to get into brain tissue they have to be a little more fat-soluble than drugs that act in the periphery." [10:15] "In the nursing period I think that there's more potential to use psychedelics safely and without really taking much risk as far as exposing the [child], whereas in pregnancy, yeah, you just don't really have that choice—the fetus is going to be exposed." [24:42] Links: Dr. Malcolm's recent article: "Psychedelics, Pregnancy, and Breastfeeding" Spirit Pharmacist website Spirit Pharmacist on Facebook Spirit Pharmacist on Instagram Spirit Pharmacist on YouTube Psychedelic Medicine Association Porangui

In this episode of the psychedelic medicine podcast, Allison Feduccia, PhD joins to discuss the intersection of psychedelic medicine and women's health. Dr. Feduccia is a neuropharmacologist, psychedelic researcher, and builder of virtual and in-person communities. She is cofounder of two prominent organizations, psychedelic.support and Project New Day, and is additionally a scientific advisor for Eastra. Alli has been researching psychedelics since 2004 when she first began studying MDMA and has subsequently been involved in the field through work at numerous universities, the NIH, and MAPS. In this work she seeks to spread evidence-based knowledge, connection to resources, and strategies for individuals to maximize potential therapeutic benefits of psychedelics through safe and responsible practices. In this conversation, Alli responds to questions touching on all areas of women's health and the impact psychedelics could have specifically for female patients. A major theme of the discussion is the interplay between psychedelics and hormones. While this is a topic with little in the way of scientific research, Alli shares some interesting ideas about how the neuromodulation of psychedelics could interact with endocrine systems, and how serotonin receptors within the uterus could explain certain anecdotal reports of various effects of psychedelics on menstrual pains or irregularities. In a similar vein, Alli discusses some of the physiological effects of psychedelics, particularly in relation to blood flow, and how these non-experiential features of these compounds could actually be helpful properties for women with certain conditions. This insight leads to interesting avenues for future drug development and also stresses the importance of studying psychedelics at different doses so that the positive health effects can be isolated. Alli also talks about the potential for psychedelic healing in the context of postpartum depression, sharing an evocative family story which illustrates simply how crucial and overlooked this issue has been in healthcare. The advances in mental healthcare coming out of psychedelic research provide a promising path forward for such conditions, however. In this episode: How psychedelics could help with premenstrual discomfort Concerns about taking psychedelic substances while pregnant Psychedelics and postpartum depression How psychedelics could impact hypoactive sexual desire disorder Psychedelics interactions with menopause Potential role for hormones alongside set and setting for impacting the psychedelic experience Quotes: "It may be that psychedelics could really affect women's moods as they go through these different life stages, and help them feel better." [4:45] "Maybe this concept of neurotransmitter modulation with our sex hormones may be a target for drug development work as well." [23:42] "This is also pertinent to transgender women who may be using hormones. This type of modulation on mood or physiological symptoms—this could be really applicable too for helping to really have the body adjust and be more balanced to changes in hormonal fluctuations in the body." [26:59] Links: Psychedelic.support website Project New Day website Eastra Health Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, PhD candidate and psychedelic science YouTuber Manesh Girn discusses his recent research on psychedelic brain action. Manesh is in the final stages of obtaining his PhD in neuroscience at McGill University and is an author on over a dozen peer-reviewed articles on psychedelics and related topics. He is also chief research officer at EntheoTech Bioscience and runs the YouTube channel the Psychedelic Scientist. In this conversation, Manesh discusses his recent article in Trends in Cognitive Sciences titled "A complex systems perspective on psychedelic brain action." He explains the complexity science approach used in the article, which emphasizes the brain is a holistic, interconnected system, rather than individual component networks that can be isolated. From this standpoint, Manesh critiques some simplistic explanations of the neural mechanisms of psychedelics which focus exclusively on interactions with the default mode network isolated from other brain systems. He also explains how individual some of the neural effects of psychedelics are, citing different findings from different studies and observed variations between brain scans of different people. By better understanding these individual differences, and placing these different responses into a complexity science framework, Manesh believes that more individually-tailored psychedelic therapies are possible once the systems involved are more comprehensively understood. Manesh closes this discussion by explaining the difference between genuine complexity and sheer chaos. Complexity, he explains, is a delicate balance of novelty and order, which is why psychedelic experiences can be both destabilizing and productive of novel insights and personal transformation. In this episode: The research into psychedelics and the default mode network Using frameworks from complexity science in psychedelic research Measuring entropy in the brain Differences in neurological effects from taking between different studies and different individuals How a complexity science approach to neuroscience could better inform precision psychiatry Quotes: "You can't just look at a specific brain region or network [in psychedelic research], you've gotta talk about the brain as a whole, in this sense of seeing the brain as a system of interacting parts." [4:49] "The core idea of this paper is that psychedelics put our brain into this state that is more dynamically flexible, it's more diverse in its activity patterns, and it's more sensitive to inputs that come in." [14:17] "What we find in the brain imaging findings is that different studies disagree, but also if you look at individual people, they can have radically different effects on their brain—almost opposite." [21:37] Links: Manesh' recent article in Trends in Cognitive Sciences: "A complex systems perspective on psychedelic brain action" ​​Psilocybin vs Placebo Brain Connectivity Diagram from Dr. Robin Carhart-Harris The Psychedelic Scientist YouTube Channel The Psychedelic Scientist on Instagram The Psychedelic Scientist on Twitter Manesh on LinkedIn EntheoTech website Psychedelic Medicine Association Porangui

In this episode of the psychedelic medicine podcast, Dr. Johnathan Edwards joins to discuss the potential of ketamine treatments for mental health conditions in adolescent populations. Dr. Edwards is a board-certified anaesthesiologist and author with a key focus on treating mental health conditions with ketamine. He has provided ketamine in his practice for over 20 years and has worked with psychiatrist Dr. Sam Zand to help patients with mental health conditions. In this conversation, Dr. Edwards shares the current state of research exploring ketamine for adolescents, mentioning that there are currently 120 studies of ketamine treatments for mental illness in this population. He shares how he works with these young patients to ensure they are well prepared to experience the effects of the dissociative anesthetic, saying that adolescents typically do very well when adequately prepared. From Dr. Edwards' experience, treatment resistant depression, suicidal ideation, and eating disorders seem to be the conditions where ketamine seems to have the biggest effect for adolescents. In closing, Dr. Edwards emphasizes how significant it is to be able to help kids struggling with these hard to treat conditions, especially as teen suicide remains a significant issue, so he's hopeful that pediatricians, psychiatrists, and anaesthesiologists can continue to collaborate to safely bring ketamine therapy to more patients. In this episode: The existing research on ketamine in adolescent populations The danger of airway obstruction during ketamine infusions among people prone to sleep apnea Preparing adolescents for ketamine journeys Historical and cross-cultural precedents for psychedelic journeys in adolescents and young adults Potential indications for ketamine treatments in adolescents Is there an established protocol for adolescent ketamine therapy? Quotes: "I go through a lot to reassure the parents, to reassure the child, 'Hey, this is gonna be a different voyage for you and you're gonna be in a different place but tell yourself at all times you're safe…' and it goes very well." [5:06] "As long as you have a medical clearance from your pediatrician and a medical clearance from the psychotherapist/psychiatrist/psychologist… and you put those two together, along with parental consent, you're pretty well covered to go ahead and do a ketamine treatment on a child… It's not standard of care but again, you're trying to save a kid's life." [24:39] Links: Dr. Edwards' website Dr. Edwards' forthcoming book: The Revolutionary Ketamine: How a Little-Known Drug Can Cure Depression and Prevent Suicide Previous episode: Psychedelics for Eating Disorders with Dr. Reid Robison Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Paul Thambi, MD joins to discuss insights on the optimal delivery of psychedelic experiences stemming from his recent trial on psilocybin therapy for cancer patients suffering from major depressive disorder. Dr. Thambi is a medical oncologist with nearly 20 years of experience treating patients in a private practice. He now serves as CMO Sunstone Therapies, a company focused on how to best deliver psychedelic therapies. In this conversation, Dr. Thambi shares the details of the design of his recent study, which involved two preparatory sessions, a treatment session, and two integration sessions. He also discusses the efficiency of delivering psychedelic therapy to a group rather than to individuals, allowing the therapist to help more patients at once while still providing focused one-on-one guidance during the psychedelic experience. Additionally, Dr. Thambi discusses the importance of music and space design to provide an optimal state of mind going into the therapy and while under the influence of the psychedelic. Dr. Thambi is happy to report very positive data from this initial trial, with both patients with active cancers and those with no current signs of disease showing great improvement in depression scores. He looks forward to continuing to work to better optimize the delivery of psychedelic therapies, not only for the patients but also for the therapists. Currently, he is pursuing a new "diad trial" of psychedelic therapy for cancer patients and a loved one which may have the potential to ease the suffering caused to a family system by these diseases. In this episode: The design of Dr. Thambi's study of psychedelic therapy for cancer patients struggling with depression Group versus individual forms of psychedelic therapy Crafting an ideal setting for psychedelic therapy with music, artwork, etc. Changes in depression scores, anxiety, and pain amongst the participants in Dr. Thambi's trial Optimizing the experience for psychedelic therapists as well as patients Dr. Thambi's on-going "diad trial" for cancer patients and a loved one Quotes: "What we were trying to do was create something that… could be used when it needed to be for a lot of people—something that was scalable. So something that was efficient, but still had compassion to it. And that's how we came up with the [study design]." [22:16] "80% of [participants] had their MADRS score cut in half or greater within one week of the treatment. And half of those people had what we called a sustained remission, which means a MADRS score of less than or equal to ten on each of the measurements we took, including the last one, which was done at week eight." [23:54] Links: Sunstone Therapist website "Psychedelics may ease cancer patients' depression, anxiety" article by Manish Agrawal California Institute for Integral Studies (CIIS) Certificate in Psychedelic-Assisted Therapies and Research Previous episode: Psychedelics and the Chemistry of Connection with Dr. Julie Holland Previous episode: How Setting Can Affect Psychedelic Journeys with Frederick Barrett, PhD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Joel Castellanos and Jim Harris join to discuss the possibilities of addressing spinal cord injuries using psychedelic medicine. Dr. Castellanos is a board certified physical medicine and rehabilitation and pain management physician and an associate professor in the department of anesthesiology at University of California, San Diego School of Medicine. Jim Harris is a National Geographic photographer who suffered a spinal cord injury during one of his adventures who became notable in the psychedelic space with the article in Outside "Jim Harris Was Paralyzed. Then He Ate Magic Mushrooms." Jim starts off by sharing his own backstory of how he broke nine vertebrae in his spine during a 2014 ski expedition in Patagonia, Chile, leading to significant loss of motion and sensation. After some promising success in traditional rehabilitation and physical therapy settings, Jim details his surprising experience of healing with psilocybin. In this vein, Dr. Castellanos discusses the importance of neuroplasticity in healing for spinal cord injury patients. He talks about how forming new neural pathways can help a patient regain function and sensation in a part of the body that had previously been paralyzed, and leveraging this neuroplasticity using psychedelics and other tools may be a promising way to improve outcomes among these traditionally underserved patients. Considering the unique needs of spinal cord injury patients, Jim wonders whether lower doses of psychedelics may be more beneficial for this population, as it would allow them to maintain a greater degree of sobriety and groundedness to pursue physical therapy and rehabilitation activities while under the influence of the substance. Dr. Castellanos expresses excitement about the possibilities of psychedelic therapies for these patients, as not only does early anecdotal evidence such as Jim's story suggest that these substances may be effective in helping to facilitate regain of function and sensation, but also because of the mental changes brought on by a psychedelic experience. Patients may feel more optimistic and eager to apply themselves following a psychedelic experience, which will facilitate healing beyond just what occurs as a result of the effects of the substance itself. He is also encouraged by current research into different forms of neuroplasticity which have different mechanisms. Dr. Castellanos suggests employing these in combination, such as using psychedelic therapy alongside vagus nerve stimulation, may offer more effective treatment options for spinal cord injury patients. At the end of this conversation, Jim poses Dr. Castellanos a fascinating question: whether there may be any downsides to over-encouraging neuroplasticity. Dr. Castellanos responds that there could be certain risks of increasing pain in patients, as neuroplasticity encourages new connections to be formed in the brain, but it matters what specifically becomes more interconnected. As such, there is reason to proceed with caution even as neuroplasticity offers significant benefits. In closing, Jim shares some hard reduction tips for other spinal cord injury patients interested in exploring psychedelic healing. Both he and Dr. Castellanos are optimistic at the possibilities of psychedelic therapies used in conjunction with other treatments for patients like Jim. In this episode: Leveraging neuroplasticity using psychedelics and other tools to help physical medicine and rehabilitation patients regain function Anecdotes of other spine injury patients who've regained function or sensation following a psychedelic experience The connection between spasticity and psychedelics How the response to psychedelics has changed over time for Jim Connecting physical therapy and psychedelic therapy to improve efficacy of rehabilitation How different mechanisms of neuroplasticity may be used in concert to promote recovery Harm reduction tips Quotes: Jim: "[when I first took psilocybin] all of a sudden I had an ability to contract my hamstring and… lift my heel off the ground, like up toward my butt, and I hadn't been able to do that up until that time." [9:12] Joel: "My primary focus is on neuroplasticity and ways that we can creatively modulate the nervous system to optimize recovery and optimize quality of life, whether that's from a pain perspective or a regaining motor strength perspective." [13:34] Joel: "If we can demonstrate that through psychedelics we can optimize and improve and make recovery more efficient, it is something that will be a huge deal for a great number of patients, and make my job as a rehab physician easier." [14:37] Jim: "The reason I've become interested in psychedelics as medicine has been trying to figure out… what are all the ways that I can have some sort of personal efficacy in my own recovery." [19:22] Jim: "I do know of other anecdotes kinda similar to mine, of people—maybe especially it seems like wi

In this episode of the Psychedelic Medicine Podcast, Agnieszka Sekula joins to discuss her research into the applications of virtual reality in psychedelic-assisted therapy. Agnieszka is a researcher at Swinburne University and co-founder of Enosis Therapeutics. Her research focuses on investigating therapeutic mechanisms in psychedelic treatment that can be strengthened through experience design and translating findings of this research into real-life applications by developing virtual reality scenarios. Additionally, she has recently conducted the first ever case study of VR and psychedelics. In her research, Agnieszka considers many possible uses of virtual reality in the context of psychedelic therapy, as well as potential dangers. The first application she discusses is using VR to promote relaxation prior to a psychedelic journey. Similar to the synergy between psychedelics and meditation, Agnieszka suggests that the immersive experience of VR could be useful in promoting states of calmness which are ideal for a person about to enter into a psychedelic experience. Additionally, she suggests that the otherworldly imagery and soundscapes possible with VR technology can help prime a client for the shifts and intensifications of perception caused by psychedelics. Having the opportunity to explore these states prior to the experience helps the patient to feel more prepared for the experiences, especially since with VR these explorations occur in a context where one maintains a connection with sober consciousness and can easily opt out if things become overstimulating. Next Agnieszka discusses the potential of augmenting peak psychedelic experiences with VR. Considering both psychedelics and virtual reality have the potential to occasion dramatic shifts in consciousness and affect, pairing these together is likely to be synergistic in promoting mystical experiences in the therapeutic process—something which appears to be closely tied to the efficacy of psychedelic-assisted therapy. Though little research currently exists in this area, Agnieszka believes that VR may have the potential to more reliably facilitate experiences of ego dissolution and deep awe during the psychedelic journey. Perhaps one of the most novel proposals in Agnieszka's research is using VR to facilitate greater recollection of the psychedelic journey in order to promote more effective integration. She proposes that by building models of the psychedelic experience in the VR space, a patient can more readily return to the experience in sober consciousness by encountering these same stimuli again in virtual reality. The immersive experience of virtual reality may help facilitate access to feelings, memories, and intuitions which arose during the psychedelic session, leading to an easier process of integration. However, Agnieszka's research also considers potential dangers in combining VR and psychedelics. These include the risk of overstimulation and the potential of a trauma being triggered by certain imagery or auditory input. More mundanely, there is also the possibility of "cyber-sickness" and physical discomfort caused by the VR headset. Despite these potential drawbacks, however, Agnieszka is confident there are powerful applications of VR in psychedelic therapy, particularly in allowing for a more holistic and integrated approach to the altered states of consciousness theorized to be at the center of the efficacy of these new treatments. In this episode: Using VR to induce relaxation in preparation for psychedelic journeys Augmenting peak psychedelic experiences with VR VR as a technology which may promote therapeutic alliance Using VR to store memories of psychedelic experiences to facilitate integration Transitioning between normal consciousness and altered states with the help of VR VR as a "digital diazepam" for decreasing the intensity of a psychedelic experience without pharmacological intervention The potential dangers of overstimulation or triggering traumas with VR and psychedelics Quotes: "VR in itself is just a tool—it's a method of delivery—but in itself it's not the active ingredient. So whenever we speak of VR we think about the way of delivering the content, and the content is that active ingredient." [2:22] "The best way to prepare someone for what an altered state experience feels like is by actually experiencing an altered state, and here again VR can be very helpful in approximating… what that psychedelic experience might feel like." [18:51] "VR is used as a multi-sensory canvas where the patient is building the model of their psychedelic experience so that they can store it for themselves and return to it later." [28:17] "Using VR just as beautiful content, or… contextual design for the entire experience might not be beneficial because it might work more as a distraction than as something that supports the journey." [49:15] "For me the most important thing is to start looking at psychedelic treatment as an experie

In this episode of the Psychedelic Medicine Podcast, Andrew Penn joins to discuss the recent BrainFutures white paper on the elements of psychedelic-assisted therapy which he co-authored. Andrew is a psychiatric nurse practitioner and a professor at UC San Francisco who is also a psychedelic psychotherapy researcher and nationally invited speaker. Additionally, Andrew is the co-founder of the Organization of Psychedelic and Entheogenic Nurses (OPENurses). In this conversation, Andrew discusses his white paper and breaks down the five key elements which need to be present in all psychedelic-assisted psychotherapy to ensure safety and efficacy. These five elements are safety and establishing set & setting; screening and assessment; preparation; the medication session; and integration. In terms of screening and assessment, Andrew mentions the interesting place the field finds itself in currently, as up to this point screening practices have been rather intensive and erring on the exclusionary side since this is the standard when drugs are being tested in clinical trials. However, with psychedelic therapy continuing to become more accessible with patient options outside of these trials on the horizon, the field will need to decide what makes the most sense in terms of balancing accessibility with potential risks, and in doing so more data will be collected which will give a better picture of exclusion criteria. Andrew also stresses the need for psychiatric screening in addition to focusing on medical consideration, mentioning that it's essential for a psychedelic therapist to know a patient's trauma history, as this is something that may come up in a session and the more preparation the better. When it comes to preparation, Andrew suggests that this should include establishing a relationship of trust, educating the patient, obtaining informed consent, and establishing safety measures. On the topic of consent, Andrew discusses the intricacies of dealing with this gracefully in a context where a patient will be undergoing a drug experience where consent cannot be adequately given in that moment. As such, he stresses the importance of explicit conversations between the patient and therapist around topics such as whether or not the patient would want their hand held during an intense moment. Rather than dry, procedural conversations, Andrew thinks discussions of consent are actually crucial moments where the therapist and patient can establish a relationship of trust and also more thoroughly explore the possibilities of what may come up for the patient in the session so that they feel better prepared. In terms of the psychedelic therapy sessions and integration, Andrew suggests that the therapists play different roles in these two contexts, with the medicine sessions being more about supporting the patient in their experience without providing too much direction or prompting so that the experience may unfold naturally and autonomously, whereas in integration the therapist can take a more active role in helping the patient explore what the experiences brought up. One interesting feature about psychedelic therapy, and a reason why integration is so important, is that the intensity of the medicine experiences and the insights triggered during sessions can actually be destabilizing initially. As such, Andrew maintains that integration is a crucial aspect of psychedelic therapy in order to better ensure that these experiences can lead to deep and lasting healing. Andrew hopes that this white paper can introduce the crucial elements of psychedelic therapy to a wider audience and encourage a standard of practice. In this episode: How might screening and assessment change once psychedelic therapies are more widely authorized and not only accessible as clinical trials? Reckoning with the exclusion criteria around psychedelic therapies The importance of thorough preparation in achieving the best patient outcomes The dynamics of consent in preparation versus in the midst of the session and how therapists can more intentionally approach these questions What should therapists do when a patient is not in a calm state of mind at the time of the scheduled psychedelic therapy? Why integration is critical to facilitating healing in psychedelic therapy Quotes: "Trauma is likely to come up during the session and we want to at least know if there's something there then we can anticipate that and also start to create a safer environment for that patient." [7:53] "We're gonna have to figure out what is the right dose of medical screening, and then, certainly, introducing some level of psychological screening will be really important." [10:27] "Informed consent is this ongoing conversation with the patient where the patient can withdraw their consent at any time—they can revoke that—but people really need to know what they're getting into if they're going to make meaningful informed consent." [16:12] "What we've learned from psychedelic t

In this episode of the Psychedelic Medicine Podcast, Dr. Kurt Rasmussen joins to discuss the potential benefits of non-hallucinogenic psychedelic drugs currently in development. Dr. Rasmussen is the Chief Scientific Officer at Delix Therapeutics and was previously at the National Institutes of Health where he led the Division of Therapeutics & Medical Consequences since 2018. Here, he directed the medications development program and played an integral role in evaluating the safety and efficacy of pharmacotherapies, behavioral therapies, and devices to treat substance use disorders. He is also Fellow in the American College of Neuropsychopharmacology and has over 100 publications and patents to his name. Dr. Rasmussen begins by discussing the ways psychedelics can bring out physical changes to brain structure, mentioning that this is an important mechanism for the therapeutic effect of these medicines. He mentions that these structural changes are theorized to be relatively distinct from the experiential, hallucinogenic component of psychedelics, and as such it may be possible to develop new drugs which condition the same cascade of events in neuronal structure without leading to intense subjective experiences and major alterations in perception. But what would the benefits of such drugs be? Dr. Rasmussen explains that the availability of non-hallucinogenic psychedelics could have the potential to significantly increase the accessibility of these substances and their associated therapies—both in populations for whom contraindications exist for traditional psychedelic medicines (such as patients with schizophrenia) and for individuals who may be resistant or fearful of the hallucinogenic experiences that can come with psychedelics. Rather than attempting to replace traditional, hallucinogenic psychedelics, Dr. Rasmussen hopes that these non-hallucinogenic alternatives would be able to serve populations or conditions where current psychedelics are not the best option. In fact, Dr. Rasmussen suggests that perhaps hallucinogenic and non-hallucinogenic psychedelics could be used powerfully in conjunction with one another, hypothesizing that the personally meaningful journeys conditioned by traditional psychedelics may be more effective for kickstarting healing from a condition like depression, but perhaps the non-hallucinogenic substances could be more convenient maintenance, as they would not require regular intense experiences facilitated by specially trained therapists to continue promoting neuroplasticity. Dr. Rasmussen does emphasize, however, that a psychotherapeutic component would still be recommended even with non-hallucinogenic psychedelics, as the combination of medication and therapy leads to greater efficacy. But, this also depends on the particular condition being treated. A patient with a mental health condition will likely benefit from the addition of therapeutic work, but a patient who is exploring psychedelic treatment for something like migraines or cluster headaches may only need the structural changes caused by these substances in the brain in order to feel better—another reason why non-hallucinogenic psychedelics may be preference for certain patients with various conditions. In closing, Dr. Rasmussen reiterates that the exploration of non-hallucinogenic psychedelics is all about increasing patient options and broadening the cools in the psychiatric toolbox to tailor treatments to particular patients and conditions. Whether hallucinogenic on non-hallucinogenic, Dr. Rasmussen sees psychedelic medicine as an important and promising paradigm shift in psychiatry. In this episode: How both hallucinogenic and non-hallucinogenic psychedelics may be used together to reach a greater patient population Why the hallucinogenic component of psychedelics may not be necessary for their efficacy Contraindications involving the hallucinogenic component of psychedelics Potential cardiovascular concerns with regular psychedelic use due to action on serotonin receptor 5-HT2B Why it may be desirable to have a range of psychedelic medications which produce different intensities of subjective effects to treat a wider range of patients Quotes: "There are changes in your brain as a result of administration of these compounds that occur. It's not just a sensory and emotional experience, but actually there are physical changes in your brain, in different circuits, very specific circuits." [5:28] "SSRIs and other antidepressants can have effects by themselves, psychotherapy can have an effect by itself, but the real efficacy, the magic is when you combine the two and I have no doubt that these compounds [non-hallucinogenic psychedelics] will benefit from psychotherapy associated with it." [11:07] "We need more options for patients for sure, and hopefully the psychedelic medications with the hallucinations will help a certain set of patients and hopefully we'll have other non-psychedelic compounds that are neuroplastic

In this episode of the Psychedelic Medicine Podcast, Dr. Max Wolff joins to discuss his 2020 study exploring how psychedelics can facilitate the healing process of "letting go." Dr. Wolff is a psychologist, psychotherapist and head of psychotherapy training and research at the MIND Foundation. He is also therapist and researcher in the EPIsoDE Study, a government funded clinical trial investigating psilocybin-augmented psychotherapy for treatment resistant depression at CIMH Mannheim and Charité Universitätsmedizin Berlin. In this conversation, Dr. Wolff shares insights from his study, "Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance," which appeared in Frontiers in Psychiatry in February 2020. In this paper Dr. Wolff and colleagues explore how psychedelic assisted therapies can help patients work through maladaptive avoidant behaviors at the root of many mental health conditions. Dr. Wolff explains that there are two fundamental motivations systems at work in human beings—the approach system and the avoidance system. In healthy individuals, both of these have important and adaptive roles to play as people work towards goals and seek balance in life. However, adverse experiences in unsafe environments can cause individuals to develop unhealthy avoidance, often leading to mood disorders such as anxiety and depression in more severe cases. One of the goals of psychotherapy—psychedelic or otherwise—is to facilitate a safe container where an individual can work through avoidance, says Dr. Wolff. Psychedelic assisted therapy may be especially effective to this end, as the introspective nature of the experience precludes avoidant thought patterns or behaviors and there is nothing to use as a distraction in the therapeutic context. However, this isn't the only way psychedelics facilitate the process of letting go. Dr. Wolff also discusses the effect of psychedelics on relaxing the beliefs of the patient. This recent theory, called "relaxed beliefs under psychedelics" (REBUS), considers how psychedelics encourage an open mindedness and curiosity around perceptions and ideas that would often be dismissed or ignored in sober states due to rigid structures of beliefs and assumptions. This is important in the context of avoidance, Dr. Wolff explains, as it means that the patient is primed to explore issues where typically an avoidant response would be triggered due to a fixed belief about the stressfulness of the topic at hand. As a result, psychedelic assisted psychotherapy can be particularly effective in empowering patients to revise avoidance-related beliefs at the root of many mental health conditions. By helping patients work through fear and let go of traumas and stress around tender topics, Dr. Wolff thinks psychedelic therapy can make an important contribution to the broader field of psychotherapy. In this episode: The approach and avoidance systems of human motivation How avoidant behaviors can develop into mental illnesses How working through avoidance is crucial for both conventional and psychedelic therapies The experience of avoidance in psychedelic therapy and how this can be conducive to acceptance How the idea of relaxed beliefs under psychedelics intersects with avoidance Different mechanisms for MDMA and classic psychedelics for facilitating letting go Quotes: "The less favorable the environment is, or the conditions in which we develop are, the more likely we are to have interactions with our environment that are threatening to our psychological needs, or even perhaps violating to our psychological needs—that is where a lot of avoidance behaviors or avoidance schemas can develop." [5:43] "Only by withstanding the urge to run away, and only by breaking this vicious circle of avoidance, you get the chance of revising the assumptions that underlie the anxiety." [27:42] "In psychedelic experiences, one factor that may work in concert with this operant conditioning process of learning to let go is the emotional depth and richness that comes with psychedelic experiences and also the increased likelihood of actually encountering deeply felt fears." [30:00] Links: Dr. Wolff's study: "Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance" MIND Foundation website MIND Foundation training for aspiring psychedelic therapists Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Aaron Cherniak joins to discuss the intersection between psychedelic experiences and psychological attachment styles. Aaron is a clinical psychologist and researcher who examines a variety of topics in psychedelic science, including subjective experiences, outcomes, and mechanisms. He is also a Rabbi and the director of the JPSYCH lab of Jewish spirituality and mental health. His recent research looks at how psychedelic experiences are integrated into peoples' narratives of life-long religious and spiritual development and contribute to culturally competent therapeutic models. In this conversation, Aaron shares the science of attachment styles and explores its implications in psychedelic therapeutic contexts. He frames attachment theory as a form of personality psychology, mentioning that someone's attachment style is typically something that stays consistent for long periods of time, though certain traumatic events such as abusive relationships can influence one to develop insecure attachment. The two forms of insecure attachment are avoidant attachment and anxious attachment, which are two different behavioral expressions resulting from an underlying sense of insecurity or lack of safety within a relationship. This is contrasted with a secure attachment style in which a person feels safe in a relationship and does not feel a compulsion to engage in either avoidant or anxious behaviors out of a sense of self-preservation. Aaron explains that there are many potential points of relevance for exploring psychedelic experiences and attachment styles together. For example, it may be the case that therapeutic psychedelic experiences could actually shift a person away from insecure attachment—a finding which would be very significant considering how stable attachment styles typically are. Another idea would be to consider the existing attachment style of a patient entering into psychedelic-assisted psychotherapy, and explore how this could affect the patient-therapist relationship and the efficacy of the therapy. In the context of spirituality and religiosity, Aaron explains that a person's attachment style often influences how they hold spiritual beliefs. In an Abrahamic religious context, a person with a secure attachment style stemming from a healthy home life is more likely to interpret God through lenses that emphasize divine love and God's all-embracing concern, whereas someone with an insecure attachment that developed out of an early childhood experience that was colored by neglect or even abuse is more likely to see God primarily as responsible for bad experiences and potentially even capricious. In the context of spirituality outside of traditional religion, this could be the difference between a person viewing the universe as having a purpose and meaning within it, or seeing the cosmos as only cold and uncaring towards the wellbeing of the creatures within it. Aaron suggests this is relevant for psychedelic research as patients often report transcendent experiences of divine realities during psychedelic experiences, but how such experiences can be integrated may vary significantly based on a person's interpretation of religion and spirituality stemming from their attachment style. Though this work is still in the theoretical stage, Aaron is excited about the potential findings from research into psychedelic experiences and attachment styles. In this episode: What are the different attachment styles? Could attachment style influence the connection between a patient and a psychedelic therapist? How attachment styles impact peoples' interpretations of mystical experiences Psychedelic research as an opportunity to study the psychology of spiritual experiences Quotes: "Attachment theory has provided a very fruitful model of life-long personality development generally, and specifically religion and spirituality." [5:41] "If a psychedelic session can change something that is normally stable over 35 years, that would be a very impressive finding." [14:12] "People talk about the psychedelic substance in attachment terms—people talk about the grandmother or the plant healer… An attachment figure is a stronger, wiser other to whom we seek proximity for closeness, to help us overcome challenges." [19:47] "I think we have a responsibility to develop therapeutic frameworks to help people translate those experiences of safety, of love and all those things into long lasting therapeutic change." [34:55] Links: Aaron's article: Psychedelic Science of Spirituality and Religion: An Attachment-Informed Agenda Proposal Aaron on Twitter JPSYCH Attached: The New Science of Adult Attachment and How It Can Help You Find—and Keep—Love Psychedelic Medicine Association Porangui

In this episode of the Plant Medicine Podcast, Adam Aronovich returns to discuss the phenomenon of psychedelic narcissism. Adam is a doctoral candidate at the Universitat Rovira i Virgili in Spain, focusing on Medical Anthropology and Cultural Psychiatry. He is an active member of the Medical Anthropology Research Center (MARC) and part of the Ayahuasca Community Committee at the Chacruna Institute for Psychedelic Plant Medicines. In the last four years he has conducted extensive fieldwork in the Peruvian Amazon, where he has been doing qualitative research in collaboration with ICEERS, the Beckley Foundation, and, more recently, the Centre for Psychedelic Studies at Imperial College. Beyond his work conducting and coordinating research, Adam regularly facilitates workshops at the Temple of the Way of Light, a prestigious healing center in the Iquitos area. In this wide-ranging conversation, Adam unpacks some of the darker sides of the modern psychedelic movement, discussing the psychosocial dynamics around psychedelic use which can lead to things such as ego inflation, conspiratorial thinking, and narcissism. Adam recalls his own experiences slipping into messianic fantasies during a period of initial enthusiasm around psychedelic experiences. He views issues of alienation and lack of social support as being instrumental in leading to these types of delusions following profound spiritual experiences. While it is difficult to reach people who've slipped into psychedelic narcissism, Adam suggests that communal support is the best safeguard against these dangers and the most effective strategy for grounding people who've lost touch with reality. Drawing on his academic expertise, Adam distinguishes traditional uses of plant medicines from the Western paradigm for approaching psychedelics. He stresses the relational and communal aspects of the spiritual traditions which use psychedelics ceremonially. The pro-social aspects of these wisdom traditions, he claims, help safeguard against the traps of psychedelic narcissism and ego inflation, as there are established mechanisms for keeping people grounded following intense spiritual experiences. Adam closes the discussion with an insightful analysis of modern gurus and self-proclaimed shamans. Adam encourages people to beware of deeply held spiritual fantasies, where a master can appear as more than human. Instead, he emphasizes that even skillful and well-intentioned healers are themselves nothing more than human beings, so there will always be imperfection and messiness. This does not, however, mean that impactful work cannot happen—in fact, this insight helps protect against the idolization of charismatic psychedelic personalities, which can lead to harmful experiences. In this episode: Defining psychedelic narcissism Clinical vs colloquial understandings of narcissism The intersections of the psychedelic movement and conspiracy theories The importance of social and communal support for avoiding ego inflation following psychedelic or spiritual experiences How psychedelic experiences can actually deepen ego attachments and accentuate narcissistic tendencies The importance of humor in combating spiritual narcissism Quotes: "Many of the underlying ideologies upon which Western cultures were built, like hyper-individualism and so on, kind of predispose us and prime us for certain aspects of narcissism." [5:36] "Ego inflation, spiritual narcissism, messianic episodes—all of these are things that are fairly common within both people who are in some sort of spiritual or psychedelic path." [12:17] "In traditional societies for the most part really there isn't such a thing as a self-proclaimed shaman. A person doesn't wake up one morning and is like 'oh, I'm the shaman'—that's a title or a role or a recognition given to that person by the community." [38:03] "The best measure of whether somebody is genuine and helpful is not whatever credentials or titles he assigns to himself, but rather what other people feel. So, you know, you will know a tree by its fruits." [45:08] "Having these experiences by themselves does not necessarily mean spiritual growth or psychological development or any enhanced benefit if we're not constantly, painfully, mindful of how we actually integrate and embody those things in daily life over very long periods of time." [54:29] Links: Adam on Instagram Temple of the Way of Light Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Ben Medrano joins to discuss the intricacies of meaning making in psychedelic healing. Dr. Medrano is the former senior vice president and US medical director of Field Trip Health and has extensive experience in the evolving field of integrated approaches. He is also the current co-medical director of Nue Life Health where he is continuing his efforts in expanding access to ketamine therapies. Dr. Medrano additionally still serves as medical director of Field Trip NYC and DC clinics while continuing his private practice. Dr. Medrano begins this conversation sharing a bit about his background and how he came to be interested in psychedelic medicine and the issues surrounding meaning making. He talks about his experience growing up in a family where mental illness was prevalent and how this planted the seeds for taking an empathetic approach to treating these conditions in his career as a psychiatrist. He also discusses his initial exposure to psychedelics in the Chicago rave scene of the 1990s. It was then that he first realized both the transformative potential of psychedelic-induced altered states and the potential dangers of using these substances without proper precautions or care for set and setting. Following these formative experiences, Dr. Medrano began a practice of meditation within the Tibetan Buddhist tradition. It was through exposure to these spiritual practices and deep teachings that he began to see the importance of this process of meaning making and cultivate various resources suited to this project. Dr. Medrano stresses the importance of self-awareness in realizing one's own approach to meaning making and how this has been shaped by unique personal experiences. This self-awareness helps one realize that a given patient may be approaching their own experiences from a very different angle, but there are still ways in which it is possible to support and encourage this personal meaning making. Dr. Medrano stresses the importance of working with narratives in psychedelic healing. Psychedelic-induced peak experiences can be packed with insights and symbols which may be brimming with significance, but there's a lot of work to be done in understanding this material in light of the personal narratives of a patient's life. Through therapeutic integration, a patient can use their psychedelic experiences to critically examine their narratives and reflect more personally on the potential meanings of given revelations in light of how they understand themselves. Additionally, Dr. Medrano distinguishes the roles a facilitator should play to support meaning making in high dose versus low dose contexts. When a patient is in the midst of a high dose psychedelic experience, Dr. Medrano emphasizes that the facilitator should primarily seek to affirm the experiences of the patient, being a calming and secure presence that doesn't introduce any additional complexity or uncertainty into an already intense experience. On the other hand, in lower dose, "psycholytic" experiences, the facilitator may take a more active role, helping facilitate the patient's meaning making in the midst of the experience through asking questions and engaging with ideas as they arise. In terms of preparation and intentionally building psychedelic experiences more conducive to meaning making, Dr. Medrano emphasizes the importance of ceremony. Through a more ceremonial approach, a psychedelic experience can be given additional structure which may be reassuring for the patient, and additionally this provides an opportunity to more proactively incorporate things which may already be extremely meaningful for a given person. These can be practices such as prayers, or physical objects which have a certain deep personal significance. All of these help to encourage more meaningful content in the psychedelic experience, while also providing something grounding and familiar in the midst of altered consciousness. Because of how effective Dr. Medrano has found various psychedelic therapies to be in helping people make meaning in life, he is primarily focusing his energies on expanding access to these powerful medicines at this stage in his career. In this episode: Dr. Medrano's background and how he got involved in psychedelic medicine and spiritual practices How does Dr. Medrano help clients make meaning out of drug-induced altered states Why Dr. Medrano refers to ketamine as "the great imitator" The importance of understanding a patient's cultural and meaning making background How to work more intentionally with set and setting and incorporate ceremonial practices Shifting away from a "goal-oriented" perspective of psychedelic experiences Quotes: "I think telling our stories is part of this process of healing." [5:20] "Just getting your mind blown by a psychedelic substance is not going to fix things. That's something I had to learn really quick." [11:00] "I think for us to do this work, we

In this episode of the Psychedelic Medicine Podcast, Dr. Ben Sessa joins to share results of his investigation into MDMA-assisted psychotherapy for alcohol use disorder. Dr. Sessa is a trained MDMA and psilocybin therapist and the chief medical officer at Awakn Life Sciences, a biotechnology company researching, developing, and commercializing therapeutics to treat addiction with specific attention on alcohol use disorder in the near-term. Dr. Sessa begins sharing his story of how he got interested in the potential clinical uses of psychedelics as a psychiatrist, discussing his experiences of rave culture and making connections with Rick Doblin and MAPS early in the so-called "psychedelic renaissance," a term he coined. Looking at the work MAPS was doing, he was inspired by the potential of psychedelics to heal trauma and began looking for ways to further contribute to this research. When it came to alcohol use disorder (AUD) specifically, Dr. Sessa mentions how poor the current best treatments are, with relapse rates sometimes being as high as 90%. This being so, there is significant potential for novel treatments to provide better outcomes, and considering the prevalence of AUD, this could be a huge net positive for society. Dr. Sessa explains that AUD is particularly common in individuals with a history of trauma and/or adverse childhood experiences, so considering the potential of MDMA to address these underlying factors, he immediately saw the potential for psychedelic treatments of this condition. Working off of these hypotheses, Dr. Sessa undertook a study of MDMA for alcohol use disorder which showed some extremely promising results. The study found that only 21% of the trial participants returned to previous levels of drinking following MDMA-assisted therapy. In addition to this, about half of the individuals for whom the treatment was effective were actually able to have an occasional drink without relapsing—an outcome that is exceedingly rare with current treatments, hence the insistence on complete abstinence. Though this was only a safety and tolerability study and thus additional research is needed to confirm these initial findings, Dr. Sessa is extremely encouraged by the potential of this novel treatment and he is happy to report that he and his colleagues have just submitted a clinical trials application for a placebo-controlled study of MDMA for AUD, so additional insights into the efficacy of this treatment are hopefully not far off. Dr. Sessa concludes this conversation with an interesting discussion of MDMA "hangovers"—sometimes referred to as "blue Mondays." He mentions that it is an established fact that many recreational ecstasy users experience a rather significant drop in mood and sense of wellbeing following using the drug. However he theorizes that this may be due more to confounding factors rather than the drug itself. Considering the typical contexts of recreational MDMA use, things such as lack of sleep, lack of food, excessive exercise, impure sample, and concomitant drug use could all contribute to negative emotion after a drug experience. And Dr. Sessa's research seems to lend support to this theory, as the MDMA patients in the clinical setting of his study did not experience these side effects, and actually many experienced just the opposite—they felt an "afterglow" following MDMA therapy, where they noted elevated mood for up to a week after the experiences. In this episode: How Dr. Sessa first became interested in MDMA-assisted psychotherapy Why Dr. Sessa decided to focus his work on alcohol use disorder The study design for Dr. Sessa's MDMA for alcohol use disorder trial The types of talk therapy employed in this MDMA therapy trial Does MDMA-assisted therapy have potential for treating other kinds of addiction? Why patients aren't seeing a "blue Monday" hangover after MDMA-assisted psychotherapy Quotes: "In the MDMA state you can work with those forbidden, avoidant memories that normally you wouldn't go to." [5:20] "In fact, most addictions—apart from perhaps nicotine—have this link with childhood adversity and trauma." [8:36] "We didn't just look at drinking outcomes, we looked at mental health, physical health, relationships, quality of life—all these kinds of things… And there were improvements across the board in all of those people who responded well to the MDMA therapy, which was 80% of them." [20:46] "Across 26 MDMA sessions (which was in 13 patients), we found no comedowns. So they all had MDMA and at the end of the day when the MDMA wore off, they didn't feel low, they didn't feel rotten, they felt fine—in fact they felt good." [26:06] "I think if people took MDMA lying in silent darkness like they take mushrooms, I think we'd see a lot more in the way of mystical, spiritual experiences." [32:42] "[Psychedelic-assisted therapy] is much more like surgery than it is psychiatry. It's not daily maintenance treatment with SSRIs for the next sixty years of your life

In this episode of the Psychedelic Medicine Podcast, Rick Doblin joins to discuss the past, present, and future of MDMA-assisted therapy. Rick Doblin is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies. He received his doctorate in public policy from Harvard and has also studied under the father of transpersonal psychology Stanislav Grof. Through MAPS, Rick aspires to develop legal contexts for beneficial uses of psychedelics and marijuana as prescription medicines, but also for self-development and personal growth in otherwise healthy individuals. Rick begins this wide-ranging conversation discussing the early days of MDMA. The compound was originally synthesized by famed chemist Alexander "Sasha" Shulgin and, unlike the classic serotonergic psychedelics, it was not scheduled under the Controlled Substances Act in the early 70s. It was during this period of legality that therapeutic uses of MDMA were first developed and it was only later that the drug became repurposed as a recreational substance to be used in social settings, which consequently led to its emergency scheduling by the DEA. Rick recalls his own initial experiences with the empathogenic compound, stating that he was initially skeptical of its value, prior to gaining first-hand experience. Following this experience, however, he became convinced of its therapeutic potential and he shares some of his own early experiences of using MDMA to help people heal, including a very touching tale of his own grandmother's struggle with depression. From here, Rick discusses the founding of MAPS and his decision to pursue education in policy in order to better understand strategies for furthering MDMA-therapy even while living under prohibition. Since that time, MAPS has gone on to do incredibly impactful work in developing studies researching the safety and efficacy of MDMA-assisted therapy, specifically for post-traumatic stress disorder. Rick shares the progression of these studies, highlighting the results from the most recent phase three investigations which are the last step prior to FDA approval for the therapeutic protocol. These studies show high statistical significance and an amazing effect size resulting from MDMA-assisted therapy, with results being mirrored at all research locations and showing durability over time. Because of this amazing progress, Rick believes we are at the final stretch prior to full FDA approval for MDMA use in a therapeutic context for PTSD, and subsequent rescheduling of the substance by the DEA, which he believes will take place in mid to late 2023. This development will have broad global impacts, spurring other countries to promptly follow suit. Rick closes out this discussion by emphasizing the need for mass mental health in our day and age, and sharing MAPS' lofty goals of training thousands of therapists to hopefully bring psychedelic therapy to millions of patients in the coming decades. In this episode: Rick Doblin's personal journey The history of the MDMA's synthesis and legality Rick's first experiences with MDMA and early experiments with MDMA therapy MAPS' "two-pronged" strategy for mass mental health Early efforts to get an MDMA therapy protocol approved by the FDA following prohibition The politics of concerns about MDMA neurotoxicity and how this impacted MAPS' early approach The results of the first phase three studies of MDMA for PTSD How FDA approval of MDMA will lead to an international cascade of approval and rescheduling Rick's predictions for psychedelic medicine in the years to come Quotes: "What a lot of people don't know is that MDMA was a therapy drug before it was a party drug. And it was the party drug nature of it that really got it criminalized." [7:38] "Seeing what it was like when it was legal and experiencing that, and experiencing situations where people would take it, the kind of experiences and healings, and learnings that people would have, was amazing." [19:12] "What we need is, I believe, legal access to medicinal MDMA, covered by insurance, by trained professionals, and psychedelic clinics. And we also need a whole different kind of drug policy for non-medical use that involves honest drug education, access to pure substances, harm reduction, peer support, and also treatment on demand." [21:08] "The irony here is that the first legal move against MDMA was illegal. The DEA did not have the authority to emergency schedule drugs." [23:43] "FDA is legally bound to approve MDMA for PTSD if these [phase 3] studies generate statistically significant evidence of efficacy, and there are no new safety problems." [40:27] "We think by the third quarter of 2023 we will have FDA approval assuming the second phase 3 study goes well. And then by the fourth quarter, the DEA has to reschedule [MDMA]." [51:18] "What's even greater is the 12-month follow-up data was 67% no longer had PTSD. So people kept getting better—not only was it durable, but they ke

In this episode of the Psychedelic Medicine Podcast, Dr. Steven Mandel returns to discuss ketamine treatments for alcohol use disorder. Dr. Mandel is an internationally recognized expert and pioneer in the use of ketamine-infusion therapy to treat mental health disorders and chronic pain. He is a board-certified anesthesiologist with a masters in psychology and over 40 years of experience working with ketamine. He is the founder and president of Ketamine Clinics Los Angeles and also the Founder and first president of American Society of Ketamine Physicians, Psychotherapists & Practitioners (ASKP3). In this conversation, Dr. Mandel explores the topic of using ketamine to address alcohol use disorder, discussing findings from research and sharing his professional experience with this treatment protocol. He begins by unpacking the specifics of alcohol use disorder before relaying an incredible success story from a client who was able to conquer a very significant alcohol addiction due to ketamine therapy treatment. However, Dr. Mandel notes that actual scientific research for this particular therapeutic use of ketamine is still in the early days, though he notes that the first non-anesthetic use of ketamine was for treating alcoholism in Moscow, and this intervention appeared to be quite effective. He also shares results from animal studies, noting that one study found outcomes of ketamine treatment for alcohol dependent mice was significantly mediated by sex, with the female mice being less responsive to the treatment. However, Dr. Mandel notes that it is too early to know if these same patterns appear in humans. In terms of the theoretical basis for this treatment protocol, Dr. Mandel discusses glutamatergic transmission and the nucleus accumbens as being important in both alcohol use disorder and ketamine treatment. He also mentions that ketamine potentiates the NMDA receptors which are desensitized in the case of chronic alcohol use. But Dr. Mandel insists that these pharmacological mechanisms are not the whole story when it comes to the efficacy of ketamine therapy for alcohol use disorder. At his clinics, treatment consists of a five point model which also addresses things like sleep hygiene and diet to provide a more holistic approach to wellness. He also stresses the importance of including talk therapy in the treatment protocol, as patients are primed for effective therapy following infusions. This is due to the improved neuroplasticity resulting from the neurological effects of ketamine, but since this does not last forever Dr. Mandel maintains there is a sweet spot where therapy will be most effective, which is between a few hours after the ketamine treatment and a few days later. In combination with therapy and other interventions to promote patient wellness, Dr. Mandel is confident ketamine therapy presents a promising treatment option for those struggling with alcohol use disorder, and he thinks it may even be a helpful support for those who've shaken their addictions but still struggle with cravings in abstinence. Ketamine Clinics Los Angeles phone number: (310) 270-0625 In this episode: What is alcohol use disorder? Patient success stories from Dr. Mandel's ketamine treatments The research on ketamine for alcohol use disorder How set and setting differentiates alcohol and ketamine use in important ways The importance of the experiential aspect of ketamine for its clinical efficacy Why Dr. Mandel's clinic focuses on sleep hygiene and diet alongside ketamine therapy to help achieve the best patient outcomes Dr. Mandel's protocol for ketamine infusions The history of AA and psychedelic therapies Quotes: "[Ketamine's] first major use… outside of the operating room for anesthesia was by Krupitsky in Moscow in a government program treating chronic alcoholism. That was the first behavioral use of ketamine! And it was profoundly effective." [9:25] "We're really at a frontier here. Just getting ketamine in people and seeing the transformation is amazing. And trying to sort out how to optimize it—we're not there yet." [20:41] "There's a whole other population of people who are successfully abstinent, but are beginning to have cravings. And those people are so helped by a little experience with ketamine. Ketamine is amazing at helping people to resist cravings." [24:08] Links: Ketamine Clinics Los Angeles American Society of Ketamine Physicians, Psychotherapists & Practitioner Previous Episode: Ketamine Practitioner Methods with Dr. Steven Mandel Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Tomas Frymann joins to discuss his recent paper where he developed scales for measuring dimensions of psychedelic integration. Tomas is a doctoral student at Columbia University's Spirituality and Psychology Lab and the author of the Psychedelic Integration Scales and the Interbeing Identity Scale. He is also a practicing psychedelic integration coach for Veterans Exploring Treatment Solutions (VETS, Inc.). Tomas begins by discussing the context for this research, mentioning that while integration is frequently considered a crucial element of psychedelic healing, the lack of metrics for analyzing it has meant that there has been comparably little attention given to integration in psychedelic research. As such, he hopes that the scales he proposes can both encourage additional research into this dimension of psychedelic therapy and also aid in the implementation of various integration practices and programs through providing a concrete structure from which such things may be developed. Tomas also talks about the research process, mentioning how his team worked with integration experts working in traditional, medical, and independent psychedelic contexts. The team developed initial ideas that they then discussed with the experts in order to identify major patterns and narrow down their selection of relevant criteria. In the end, Tomas realized there are two separate but related aspects of integration: integration engagement and experienced integration. The former refers to specific actions taken in order to facilitate integration. Tomas divides engagement into the categories of reflection and application. Though there are no hard boundaries between the two, reflection generally refers to contemplative attention given to the psychedelic experience after the fact whereas application is implementing lifestyle changes in accordance with the insights gained from the psychedelic experience. Here Tomas discusses his own experience of desiring to change his dietary habits to include less meat following a psychedelic session where he connected deeply with an animal. When it comes to experienced integration, Tomas is seeking to emphasize the psychological feeling of having integrated a psychedelic journey. He divides this aspect into two subsets as well: feeling settled and feeling harmonized. Feeling settled refers to a sense of being at ease in everyday life again following a psychedelic experience, where one is no longer either struggling with integrating a difficult experience nor experiencing dissonance between the revelations of a beautiful experience and the realities of life. Feeling harmonized he explains as a sense of having drawn connections between the insights of a psychedelic journey and conventional existence, so that it feels like these things fit together in a positive way. In closing, Tomas reiterates his excitement that this work may not only lead to additional scientific research into integration, but may also be a useful pragmatic tool for coaches and individuals as they seek to deepen their integration of psychedelic experiences. In this episode: How quantifying integration could help encourage more research into integration and the implementation of these practices in more psychedelic contexts How Tomas researched integration to begin constructing these scales Tomas' seed metaphor for integration What it means to be "settled" in the integration process Using these scales to prompt exploration in integration Quotes: "The purpose of the scales is to have a metric so that we can show that integration is important." [4:32] "When you follow these wisdoms, when you take them into account, when you reflect and apply, the output should be basically an improved wellness" [15:48] "When we were creating the integration scale we were really careful not to say integration has to go in any one direction or not—it's really just about honoring what came up, and working with that." [20:28] Links: Tomas' article: "The Psychedelic Integration Scales: Tools for Measuring Psychedelic Integration Behaviors and Experiences" As We Wake Veterans Exploring Treatment Solutions (VETS, Inc.) Psychedelic Medicine Association Porangui

On this episode of the Psychedelic Medicine Podcast, Juliana Milligan joins to discuss her recent article (co-authored with Joshua White of Fireside Project) on warning signs when selecting a psychedelic facilitator. Juliana is an ibogaine specialist who has been working in the ibogaine treatment community for 10 years. Having been formerly opioid-dependent and incarcerated herself, she currently works at the Center for Optimal Living where she runs the psychedelic education and training program. Juliana additionally works with clients doing preparation and integration of Ibogaine treatments through her business Inner Vision Ibogaine. In this conversation, Juliana discusses each of the 10 red flags she identified in her article. First, she discusses potential issues around sexual misconduct on the part of facilitators, emphasizing that this is a topic which always requires careful and explicit discussion well prior to the psychedelic experience. One ought to also do some individual research, as potential allegations against a facilitator are also a red flag to take seriously. Next, Juliana talks about the importance of facilitators doing a thorough medical intake. This involves getting a medical history from a potential client and checking if there are any contraindications for this person to take a psychedelic, such as dangerous interactions with prescription medications. In a similar vein, Juliana also stresses the necessity of facilitators testing the psychedelics their clients will be consuming whether they themselves provided the psychedelics or if the client brought their own substances. Willingness to test the substances in the presence of the client is definitely a good sign and shows that the facilitator values both transparency and safety. In terms of training, Juliana highly recommends ensuring that a facilitator is trauma-informed before committing to a journey under their guidance. Knowing that a guide will be conscientious and empathetic around issues of trauma helps to ensure that the psychedelic experience doesn't itself turn in a traumatic direction. Similarly, Juliana emphasizes that facilitators should be open about the training they've received—even underground facilitators should ideally have mentors and be involved in a community of practitioners that encourages continued training. In closing, Juliana discusses the dangers of having inflated and unrealistic expectations around the healing potential of psychedelics. Facilitators who use hyperbolic language like "ten years of therapy in one night" may actually be setting up clients for more difficult experiences than they otherwise may have had due to these fantastical claims. Juliana emphasizes that psychedelic healing is a cooperative endeavor, and neither the substance nor the facilitator is solely responsible for any healing that results from the experience. Ultimately, it is the person themselves who does this work, so Juliana highly recommends finding a facilitator who acknowledges their role as primarily supportive of this healing journey, rather than someone who presents themselves as a miracle worker responsible for these positive results. In this episode: Why having a trauma-informed facilitator is important, and what this means The dangers of psychedelic narcissism The importance of the harm reduction practice of chemically testing psychedelics Trusting your intuition and building this capacity Having healthy and reasonable expectations around the healing potential of psychedelics Quotes: "Once you are on a psychedelic, you cannot properly consent to touch—it must be established in advance. And if [a facilitator] is saying 'well no I need freedom in my work, I need to use my intuition' that is a major red flag." [7:19] "It's really important that the facilitator knows exactly what is contraindicated with the medicine they're administering, and if they're not evaluating for this and if they're not familiar with medical conditions and how they interact with the medicine they're giving then they're not properly trained to be giving this medicine." [10:14] "The only person that can really heal you is yourself and a facilitator is just there to help empower you and support you in guiding yourself. It's a collaborative relationship." [13:44] "If a person isn't willing to be receptive to feedback, self-reflective, and take accountability, psychedelics aren't necessarily going to make them do that. And so you give psychedelics to somebody with those kinds of narcissistic traits and it can just make the narcissism worse." [20:15] Links: Juliana's Article with Fireside Project: Warning Signs When Selecting a Psychedelic Facilitator Inner Vision Ibogaine: Guide to Finding an Ibogaine Clinic The Root Ibogaine Collective The Psychedelic Program at The Center for Optimal Living Juliana on Instagram Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich Previous episode: Harm Reduction Through Testing Your Psychedelics with

In this episode of the Psychedelic Medicine Podcast, Balázs Szigeti, PhD, joins to discuss his research on the intersection of microdosing psychedelics and the placebo effect. Dr. Szigeti studied physics at Imperial College, after which he earned a PhD in computational neuroscience from the University of Edinburgh. He has worked as a biomedical software engineer at the Icahn Genomics Institute and he has conducted the largest placebo-controlled study on psychedelics to date. In his research, Dr. Szigeti uses novel statistical and experimental techniques to explore the intersection of psychedelics and placebo effects. Dr. Szigeti begins this conversation by discussing the design of his placebo-controlled microdosing study, "Self-blinding citizen science to explore psychedelic microdosing" which appeared in the journal eLife in March 2021. For this study, Dr. Szigeti and his team employed citizen science to collect placebo-controlled observational data from participants, allowing this experiment to take place outside of a clinical environment. Participants self-blinded by preparing identical psychedelic and placebo microdose capsules and data was submitted using QR codes so that the researchers were knew whether the participant was in the psychedelic group or the control group, while the participants themselves remained in the dark. The results from this study showed a statistically significant improvement of wellbeing among both the microdose and placebo groups, with no statistical significant difference between the two groups in terms of any of the outcomes. Dr. Szigeti talks about the media reception of his research, which tended to present the findings as suggesting microdosing is ineffective since there was no difference between the two groups. However, Dr. Szigeti has a different takeaway. He suggests that the practice of microdosing can indeed lead to improved wellness as the study showed—the takeaway is simply that this effect is harder to distinguish from a placebo than originally anticipated. He emphasizes the very real medical power of this placebo effect, and discusses how triggering one's own placebo effect either through microdosing or some other practice can be transformative. However, beyond what the data may suggest about the impact of microdosing psychedelics, Dr. Szigeti emphasizes the broader takeaways from his study, which bring into question the efficacy of placebo-controlled studies as a gold-standard in the context of psychedelic trials. Because psychedelics cause notable shifts in perception, trial participants will quickly become aware whether they are in placebo or psychedelic groups, particularly in the case of trials exploring doses beyond the microdose range. This causes an immediate unblinding effect, and makes control groups less useful than in other contexts where a participant does not find out which group they were a part of until the trial's conclusion. Dr. Szigeti affirms the methodology of placebo-controlled trials as an essential tool for researchers which deserves its reputation for providing high-quality evidence, but he urges the field of psychedelic studies to pay closer attention to questions of methodology, as there may be yet undiscovered modes of scientific investigation which would be better-suited to psychedelic trials. Dr. Szigeti is currently working on a follow-up blinded study on microdosing which he hopes will address some of the shortcomings of the original investigation. In particular, he mentioned that the participants in the original study had high levels of well-being already at the start of the trial, so improvements may have been less significant than in a population with a lower level of well-being to start. As such, he and his team hope to recruit a more diverse sample in this upcoming trial to further explore the extent of both placebo and microdosing impacts on wellness. Information for the upcoming study can be found at the website: https://selfblinding-microdose.org/ In this episode: How Dr. Szigeti set up his self-blinded placebo-controlled study of microdosing outside of a clinical environment What is "citizen science" and how this differs from other methodologies The issue of tolerance in microdosing and how this may differ between LSD and psilocybin How Dr. Szigeti uses statistical analysis to further interpret data where participants realize which group of the study they are in Quotes: "The results of this microdose trial were mixed because you can make an argument that this change over time is the more important outcome and that was statistically significant, but the comparison of the magnitude of change in the placebo group versus the magnitude of change in the microdose group, that was not significant anymore. It was not significant on any of the scales, I should add." [14:45] "Nobody ever checks whether the placebo control was really working as intended, which is just like—I don't know how it could have happened. There is such a big e

In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the first year of the psychedelic peer-support line, Fireside Project. Joshua (he/him) is founder and executive director of Fireside Project and has prior experience as a volunteer counselor on a hotline and as a volunteer at the Zendo Project. He has also practiced law as a deputy city attorney at the San Francisco City Attorney's Office, where he focused on suing business exploiting vulnerable communities. He also co-taught a nationally-renowned clinic at Yale Law School. Joshua begins this conversation by sharing the success of Fireside Project in its first year of operation. The peer support line has been called over 3,100 times in the 14 months since the launch of Fireside Project, where callers have been able to receive open-ended support from compassionate peers as they navigate a psychedelic experience or attempt to integrate a previous experience. Joshua also shares some details about the kinds of calls the line has received, such as which psychedelic substances were involved in the caller's experience, how callers were describing their experiences, and what mental health conditions callers self-reported. In terms of substances, psilocybin was the most commonly used by callers, though a wide range of different psychedelics were reported. For mental health conditions, PTSD stood out as the most frequently mentioned, though depression and anxiety were also common. Joshua mentions that he's hopeful that this data may be incredibly useful in further developing harm reduction strategies, as the dataset may help uncover previously unknown correlations. Another aspiration for Fireside Project is ensuring equity through their Equity Initiative, which allows callers to process past psychedelic experiences with someone of a similar background. Joshua shares that this initiative will also produce original research on this topic, showing for example the kinds of benefits a caller from the BIPOC community might get through having the opportunity to integrate a past experience with a BIPOC peer. Joshua closes this conversation with powerful words about integration and harm reduction, saying that integration is a form of harm reduction. To that end, Joshua is hopeful Fireside Project can continue offering crucial harm reduction and integration services as the organization grows and reaches beyond the niche of psychedelic enthusiasts. In this episode: Who has been calling the peer-support line and what kind of support they are seeking How Fireside Project could potentially offset the burden on emergency services in the case of negative psychedelic experiences The diversity of Fireside Project volunteers The problems of facilitator abuse and neglect in the psychedelic space The future of Fireside Project Quotes: "Reflective listening—which is the core, the foundation of holding space—this is really a skill that we can continue to cultivate." [8:03] "My hope is that there's no barrier, there's no stigma, and there's no shame to reaching out." [12:53] "All of the lessons we learn, we really just want to share those with the public in the hope that this will lead to less risky and more fulfilling psychedelic experiences." [17:30] "One of the things that I've noticed is—that we've noticed is—even though every single call is different in its own way, especially when someone reaches out to us in a heightened state, really validation, normalization, and reassurance often happen at the very beginning." [25:34] "It's amazing how some of our calls are just so short because someone just wants to know that we are there." [28:44] "As a psychedelic community, people need to stop saying that psychedelics are ten years of therapy in one night. It's just not true, and it sets people up for serious disappointment and can even be really dangerous for that reason." [30:01] Links: Fireside Project website Fireside Project app Fireside Project Instagram Fireside Project Twitter Fireside Project Tik Tok Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Felipe Malacara joins to discuss the safety considerations surrounding ibogaine therapy. Dr. Malacara is the chief clinical operations director for Beond, a Mexico-based Ibogaine clinic. He is also a general practice physician with a medical degree from Universidad Autónoma Metropolitana in Mexico City and has over 17 years of experience treating over 1,200 patients with Ibogaine therapy. In this conversation, Dr. Malacara shares important safety information about ibogaine, starting with major contraindications to using the powerful substance. These contraindications fall into three main groups: heart issues, electrolyte deficiencies, and liver problems. As Dr. Malacara explains, all of these have the potential to make Ibogaine dangerous due to the way it interacts with the heart, particularly if there is a metabolism issue. In terms of negative outcomes, cardiac issues are the most common as ibogaine can cause bradycardia—a dangerous slowing of the heart rate. Due to these potential risks, Dr. Malacara encourages a thorough evaluation prior to ibogaine therapy, including full blood work, an EKG, and occasionally an ultrasound of the heart. Another crucial part of the evaluation is taking an inventory of the patient's prescription medication and drug use. Dr. Malacara explains that patients may need to be weaned off a particular drug or be given a shorter-acting alternative so that they can come into the ibogaine therapy without any substances in their system which could lead to dangerous interactions or render the treatment less effective. In particular, Dr. Malacara notes that SSRIs could interact with ibogaine to produce serotonin syndrome, and while this can be straightforward to treat, diagnosis can be difficult, so avoiding this entirely by weaning off the medication under the direction of a physician is strongly suggested prior to treatment. In closing, Dr. Malacara emphasizes that Ibogaine is not a magic bullet despite its unique efficacy for treating addiction. The will to change on the part of the patient is still crucial, especially as preparation for ibogaine therapy itself requires a lot of commitment and dedication. If that is present, however, Dr. Malacara maintains that the treatment can be extremely effective. In this episode: How Dr. Malacara got involved in Ibogaine therapy The inherent risks of Ibogaine What patients should be evaluated for prior to receiving Ibogaine therapy Weaning patients off drugs or onto different, shorter acting substances in preparation for Ibogaine The types of addictions may be successfully addressed by Ibogaine Monitoring a patient's heart following Ibogaine, and when they can be released Quotes: "In the event [that a patient] is not able to metabolize ibogaine in an appropriate way, the risk of heart toxicity of the Ibogaine increases." [9:25] "Something which is important is drug screening before the treatment. We need to know that the patient has no traces of the drugs that we are going to treat in the system, because otherwise the treatment will be more difficult, the recovery will be more difficult, or it will be even ineffective." [26:48] Links: Beond Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Felipe Malacara joins to discuss the safety considerations surrounding ibogaine therapy. Dr. Malacara is the chief clinical operations director for Beond, a Mexico-based Ibogaine clinic. He is also a general practice physician with a medical degree from Universidad Autónoma Metropolitana in Mexico City and has over 17 years of experience treating over 1,200 patients with Ibogaine therapy. In this conversation, Dr. Malacara shares important safety information about ibogaine, starting with major contraindications to using the powerful substance. These contraindications fall into three main groups: heart issues, electrolyte deficiencies, and liver problems. As Dr. Malacara explains, all of these have the potential to make Ibogaine dangerous due to the way it interacts with the heart, particularly if there is a metabolism issue. In terms of negative outcomes, cardiac issues are the most common as ibogaine can cause bradycardia—a dangerous slowing of the heart rate. Due to these potential risks, Dr. Malacara encourages a thorough evaluation prior to ibogaine therapy, including full blood work, an EKG, and occasionally an ultrasound of the heart. Another crucial part of the evaluation is taking an inventory of the patient's prescription medication and drug use. Dr. Malacara explains that patients may need to be weaned off a particular drug or be given a shorter-acting alternative so that they can come into the ibogaine therapy without any substances in their system which could lead to dangerous interactions or render the treatment less effective. In particular, Dr. Malacara notes that SSRIs could interact with ibogaine to produce serotonin syndrome, and while this can be straightforward to treat, diagnosis can be difficult, so avoiding this entirely by weaning off the medication under the direction of a physician is strongly suggested prior to treatment. In closing, Dr. Malacara emphasizes that Ibogaine is not a magic bullet despite its unique efficacy for treating addiction. The will to change on the part of the patient is still crucial, especially as preparation for ibogaine therapy itself requires a lot of commitment and dedication. If that is present, however, Dr. Malacara maintains that the treatment can be extremely effective. In this episode: How Dr. Malacara got involved in Ibogaine therapy The inherent risks of Ibogaine What patients should be evaluated for prior to receiving Ibogaine therapy Weaning patients off drugs or onto different, shorter acting substances in preparation for Ibogaine The types of addictions may be successfully addressed by Ibogaine Monitoring a patient's heart following Ibogaine, and when they can be released Quotes: "In the event [that a patient] is not able to metabolize ibogaine in an appropriate way, the risk of heart toxicity of the Ibogaine increases." [9:25] "Something which is important is drug screening before the treatment. We need to know that the patient has no traces of the drugs that we are going to treat in the system, because otherwise the treatment will be more difficult, the recovery will be more difficult, or it will be even ineffective." [26:48] Links: Beond Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Wyly Gray and Dr. Andrea Lucie join to discuss the issue of healing military sexual trauma (MST) through ayahuasca. Wyly Gray is a former Marine and founding executive director of Veterans of War, a nonprofit which connects teams of veterans to psychedelic-assisted guided group therapy designed to heal the scars of war in community. Dr. Andrea Lucie is a native of Chile and a third generation healer who has been traditionally and non-traditionally trained in ancient healing practices in the United States and Mexico. She also holds a PhD in mind-body medicine. This conversation begins by discussing the tragic phenomenon of military sexual trauma and the current treatment modalities available for veteran survivors. Wyly explains that the current treatments, which primarily take a talk therapy approach, often fall short of what survivors need as they focus on treating the symptoms as they arise rather than being able to address these conditions at their root causes. Dr. Lucie explains the science behind ayahuasca as a treatment for trauma, highlighting the profound neurological and psychological impacts of this psychedelic medicine. Seeing the particular need for better treatment options among the veteran population, and the potential for ayahuasca to have such a profound positive impact, Wyly founded Veterans of War with the hope of better addressing this need. He shares the details of the six-month fellowship program, which involves a small cohort of veterans who do significant preparatory work together prior to a communal ayahuasca ceremony, followed by many integration sessions after the ceremony. Dr. Lucie explains different forms of mind-body work that may be effective supports before and after ceremony, citing things such as Tai Chi, meditation, and even close relationships with animals. Towards the end of this conversation, Wyly shares some profound stories of transformation he has witnessed first-hand through his work with Veterans of War. He has seen veterans who've struggled profoundly with panic attacks become incredibly joyful people, and others who were on the brink of suicide begin to heal and form deep and meaningful relationships. In closing, Wyly discusses plans to establish a healing center in Oregon for Veterans of War to further increase access to these opportunities without the need for international travel. In this episode: The problems of the civilian service-member divide, and how ayahuasca can help break down these barriers The importance of supportive community in the context of ayahuasca therapy for veterans with MST Mind-body practices that can support veterans working through MST before and after an ayahuasca ceremony How trauma changes the brain and the neurological effects of psychedelics that can help reverse these changes Why tackling issues of sexual assault within the military can be so difficult Quotes: "I think that Ayahuasca is unparalleled in its ability to create a safe and effective path towards recovery, but I deeply believe it also needs bookends on either side, or a structure to get the most out of it." [8:19] "Sometimes we just don't want to talk. We just want to feel and when we feel and we identify where in the body the trauma is stuck—because the trauma gets stuck in the body—then we know how to release it with movement." [27:16] "Our response to trauma has seemed to be very one-dimensional. This is an effort to shift that, to start looking at people as whole units and at the same time, start speaking to the needs of that whole unit. If you are able to heal the trigger point of that trauma, you don't have to heal its expression." [31:18] Links: Veterans of War website Veterans of War on Instagram Veterans of War on Twitter Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Sam Gandy returns to discuss the topic of psychedelic-induced mystical experiences, looking specifically at how to predict and potentiate these experiences. Dr. Gandy holds a PhD in ecological science from the University of Aberdeen and has conducted field research across the globe. He is a researcher and science writer who is also a collaborator with the Centre for Psychedelic Research at Imperial College London, with a research interest in the capacity of psychedelic substances to influence individuals' connection with nature. Dr. Gandy begins this conversation by defining the topic of mystical experiences. He explains that while there are a number of competing terms for how to best address this subject, what is important is that the research has consistently shown that these types of experiences are closely correlated with beneficial therapeutic outcomes. Whether brought on by psychedelics or not, mystical experiences tend to produce positive psychological changes, so it is important for psychedelic researchers to take this topic seriously and thoroughly investigate these experiences and where they come from. However, Dr. Gandy notes that there are a number of hurdles to addressing this topic scientifically. Because of the mystical or spiritual quality of these peak experiences, it can be difficult for researchers to develop sufficiently neutral language in surveys while maintaining accurate descriptions of the qualities of the altered states. Similarly, Dr. Gandy explains that therapists have to walk a fine line between not introducing spiritual or religious bias into the session through decoration or suggestion which may prioritize a certain religious tradition, while also preserving a certain type of spiritual atmosphere which is conducive to mystical experiences and thus beneficial therapeutic outcomes. Dr. Gandy then goes on to explain variables which can be predictive of psychedelic mystical experiences. Set and setting are of course crucial, but there are a number of additional parameters to consider. Dr. Gandy explains that dose, of course, is particularly important, stating that a standard has emerged in the research around psilocybin which has found that 25 milligrams of pure synthetic psilocybin is a sweet spot for encouraging mystical experiences without leading to additional adverse reactions due to the intensity of the experience. Additionally, different psychedelic substances produce mystical experiences at different rates, with 5-MeO-DMT being the most likely to lead to these experiences. Besides dose and substance, Dr. Gandy has also found that intention as well as the personality trait known as absorption are both predictive of mystical experiences in psychedelic therapy. To conclude this conversation, Dr. Gandy shares three possible potentiators of psychedelic mystical experiences: music, meditation and spiritual practice, and nature-based settings. Each of these items, if integrated into the experience intentionally can encourage a more immersive and intense mystical experience. For all of these, Dr. Gandy encourages further research for how they could best be integrated into psychedelic therapy practices. In this episode: The psycho-social changes which often follow mystical experiences The connection between mystical experiences and "spiritual emergencies"The difficulty of working with a spiritual element in the context of psychedelic therapy and research How the typical Western protocols for psychedelic therapy encourage an inward experience Why people who rank highly in the personality trait absorption are more likely to have mystical experiences, both spontaneously and while under the influence of psychedelics Ways to train psychological states of surrender and acceptance prior to high-dose psychedelic therapy which can encourage mystical experiences and prevent adverse reactions Quotes: "What makes psychedelics quite interesting is that they—under the right, appropriate conditions and contexts—they can reliably elicit these [mystical] experiences." [4:39] "The psychedelic 5-methoxy-DMT is definitely an interesting substance to highlight here. … The data that is there shows that when it's used in a supportive context, it can predict mystical experiences—three quarters of cases, over that in two separate studies that have been done so far." [31:22] "Entering the experience with an emotional intent or a spiritual motivation seems to predict greater likelihood of mystical experiences" [34:36] "There's this aspect that negatively predicts mystical experience called mental barriers. And this is where you enter the experience with in some sense an overly rational, analytical way of viewing things, and if you enter the experience like that that's a potential block on mystical experiences happening." [44:21] "People with meditation experience or with an ongoing practice, they seem more liable to report states of oceanic boundlessne

On this episode of the Psychedelic Medicine Podcast, Dr. Pedro Teixeira joins to discuss the emerging research about the effects of psychedelics on health behavior change. Dr. Teixeira is a professor of physical activity and health at the University of Lisbon and the director of research for the Synthesis Institute in the Netherlands. He holds bachelors and masters degrees in exercise science and a PhD in nutritional sciences. As an academic, Pedro's main research interest is health behavior change, a field which he is now trying to put into conversation with the latest psychedelic science. In this conversation, Dr. Teixeira shares the basics of the field of health behavior change, which seeks to study how and why people end up developing positive-health-conscious behaviors. This is a field that is of particular interest to clinicians, as doctors are always looking to encourage healthful behaviors in their patients. When it comes to research on the impact of psychedelics on health behavior change, Dr. Teixeira explains that much of the current data is secondary, though some evidence can be drawn from studies that primarily examined psychedelic therapy for tobacco and alcohol cessation. The data that does exist, however, paints a very promising picture, with many psychedelic users reporting positive changes in diet and exercise following experiences with these mind-altering substances—an effect which Dr. Teixeira notes is often observed even if there was no intent for health behavior change prior to the psychedelic experience. However, more research is needed to substantiate these preliminary results. To that end, Pedro shares the idea of "behavioral psychedelics"—a new methodological paradigm in psychedelic research that will focus more on collecting data on concrete behaviors following psychedelic therapy as opposed to the primarily psychometric data which has dominated the field. Dr. Teixeira also emphasizes that the field of health behavior change could be an important vehicle for emphasizing the role of psychedelics as tools for preventative health, taking the field beyond the current paradigm which sees psychedelics as primarily useful for their potential to address acute mental health conditions. Dr. Teixeira can be reached at ​​[email protected] In this episode: The emerging field of health behavior change Types of health-related behaviors that could be encouraged by psychedelic experiences The new paradigm of "behavioral psychedelics" Possible preventative health roles for psychedelics The evidence from tobacco and alcohol cessation trials for health behavior changes following psychedelic use Quotes: "[Recent observational studies] seem to show that for some reason psychedelic users are not only healthier from a physical health perspective, but there's also indications that that is caused by some of their behaviors." [13:13] "What better way to convince future politicians or policymakers than to show that people are actually improving the quality of their lives and their health habits and saving healthcare costs and eating more sustainable diets perhaps, if indeed the studies in Oregon and in the future in other places are showing that there is a preventative aspect, there is a lifestyle enhancement aspect to these experiences." [21:57] "When you behave from a self-determined perspective, or when you're motivated more internally as opposed to being more externally motivated, your outcomes will be better. Your behavioral outcomes, but also your health outcomes." [26:21] Links: Dr. Teixeira's research group website Dr. Teixeira's paper: Psychedelics and Health Behavior Change Lucid News coverage of Dr. Teixeira's article Study: Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States Article: Behavioral Psychedelics: Integrating Mind and Behavior to Improve Health and Resilience Article: Ayahuasca and Public Health: Health Status, Psychosocial Well-Being, Lifestyle, and Coping Strategies in a Large Sample of Ritual Ayahuasca Users Dr. Teixeira's talk at INSIGHT 2021: Can Psychedelics Improve Diet, Exercise, Meditation, and Weight Control? Self-Determination Theory website Previous episode: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Frederick Barrett joins to discuss setting and the research into how this variable can affect psychedelic experiences. Fred is an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine where he is also the associate center director of the Center for Psychedelic and Consciousness Research. He has been conducting research at Johns Hopkins since 2013 and is currently leading a number of ongoing studies to better understand the psychological, biological, and neurological mechanisms underlying therapeutic efficacy of psychedelics. In this discussion, Fred unpacks his recent article "Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature" which appeared in the February 2022 edition of Current Topics in Behavioral Neurosciences. For this study, Dr. Barrett and colleagues gathered as many studies as they could find which dealt with the topic of the role of setting in psychedelic experiences. While they found over 1,000 articles which discussed the topic in some capacity, the researchers eventually narrowed the selection down to just 43 articles which provided empirical data on this variable. Fred mentions that while ideas of set and setting loom large in psychedelic discussions, this is actually a topic which has received comparably less attention in research contexts. This is beginning to change, however, as researchers have become more certain in the overall efficacy of psychedelic therapies for treating a variety of conditions and are now turning to more specialized investigations, such as looking more closely into the impacts caused by various tweaks to the setting of psychedelic therapies. When it comes to the state of current research on setting, Dr. Barrett reports that music is by far the most studied variable. He discusses different approaches which psychedelic therapists have taken in investigating this topic, with research investigating familiar vs unfamiliar music, or having music vs not having music in a session. He also shares research about expert meditators and how these subjects responded differently to music while under the influence of psychedelics when compared to typical patients. Another variable which Fred discusses is the element of ritual, which is especially prominent in more traditional contexts of psychedelic use. This variable is also interesting because it interacts with participants' expectations, blurring the distinction between set and setting as distinct categories. In closing, Dr. Barrett shares some of his own thoughts about the blurriness of set and setting, suggesting that our understanding of these categories may evolve as empirical research further investigates the roles they play in guiding psychedelic experiences. In this episode: The relationship between ritual and set and setting The difficulties of rigorously studying all the variables of setting in the context of psychedelic experiences The different aspects of setting in traditional, ritualistic contexts for psychedelic experiences versus the context of modern psychedelic therapy Music as an important aspect of setting during psychedelic journeys The blurry distinction between set and setting Quotes: "Out of all of this literature, the one thing that became clear to us was that everybody talks about set and setting, and many papers affirm set and setting are important, but very few actually empirically test an element of set and setting." [6:49] "One of the elements of set and setting in general that we found to be addressed across a number of different studies was the question of specific ritual or ceremonial settings." [15:04] "Music seems to play an overwhelming role in shaping—and some people think driving—their psychedelic experience." [22:25] "Set and setting are both mutable. Your experience at one point in a session, I would argue, is going to influence, or at least has the opportunity to influence the things that happen next." [41:03] Links: Dr. Barrett's paper: Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes Johns Hopkins Center for Psychedelic & Consciousness Research Fred on Twitter Previous episode: Can Ayahuasca Help Promote Palestinian-Israeli Reconciliation? with Dr. Leor Roseman & Antwan Saca Previous episode: The Latest Research on Psilocybin for Depression with Matthew Johnson, PhD Previous episode: Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD Previous episode: LSD Scientific Research with Dr. Katrin Preller Psychedelic Medicine Association Porangui

On this episode of the Psychedelic Medicine Podcast, Dr. Rick Barnett joins to discuss when to not proceed with a planned psychedelic journey. Rick is a licensed clinical psychologist and licensed alcohol and drug counselor, trained in psychedelic therapies and research by the California Institute for Integral Studies. He is the cofounder of the psychedelic society of Vermont while also consulting with patients curious about psychedelic research and therapies, including helping people understand the processes of preparing for, experiencing, and integrating the intentional use of psychedelics for personal growth and healing. Dr. Barnett also works with patients in a traditional psychotherapeutic group practice and has also recently begun offering low-dose ketamine therapy. In this conversation, Rick expounds on his recent LinkedIn article of the same title, exploring the various biological, psychological, and social experiences which provide legitimate reasons for postponing a planned psychedelic experience. On the biological side, Rick explains that sudden illness or injury could absolutely constitute sufficient reason to reschedule a therapy session, and that consulting closely with your therapist or guide is essential if the decision isn't clear cut, as in the case of something which could be a stomach bug or just nervousness manifesting as digestive discomfort. When it comes to the psychological side of things, Rick mentions that it is often a difficult circumstance to navigate, as mental distress is often the reason a patient is pursuing psychedelic therapy in the first place. However, Rick makes a distinction between the typical levels of depression and/or anxiety a patient is accustomed to experiencing, and a much more intense fear which is also qualitatively different that can arise before a session. Again, this is a situation where open communication between patient and therapist or guide is essential in order to help the patient make the best decision, but Rick also stresses that because this is a wholly internal experience, that prudent introspection is ultimately what will guide the decision making.In terms of the social reasons for not proceeding, Rick cites turmoil in personal relationships, traumatic contemporary events, and also recent experiences of death. These can all lead to an individual having a particularly heavy emotional burden going into a session, causing potentially difficult experiences during the psychedelic journey. While sometimes difficult experiences can be very healing in the long term, especially following effective integration, these external stressors have the potential to take people's focus away from the intended inner work, so postponing until the person is confident they aren't bogged down by these social factors could be prudent. With all these factors, Rick stresses that a patient can always return to a psychedelic journey at a later time if they decide not to proceed. A good guide or therapist will accommodate and even proactively support a patient in ensuring they are coming to the experience at the right time. In this episode: The importance of examining refund policies of psychedelic retreats or therapy practices Rick's bio-, psycho-, and social considerations for not proceeding with a psychedelic journey Why these considerations are often molecule-specific What kinds of interpersonal conflicts may warrant postponing a psychedelic journey Distinguishing between overwhelming fear and typical anxiety prior to a psychedelic experience The impacts of traumatic political or social events on mental health and postponing a journey Quotes: "When you speak to a guide, when you speak to a coach, when you speak to a researcher, my hope is and my experience has been that it is always an option on the table at the last minute if you don't feel quite right that you have permission to opt out." [5:24] "Ketamine, when it comes to physical illnesses might be a different judgment call because ketamine—dissociative anesthetic, you kind of lose sense of your body—if there's something going on physically, that might be okay to go ahead with… because you're not with your body as much, but psilocybin, other high dose classic psychedelics and physical illness or physical pain, that could be different." [17:59] "People need permission to say 'you know what, it's gonna happen'—you've done all the preparation, you've done all the work. If it's not going to happen right now, it's still going to happen." [32:57] Links: Psychedelic Society of Vermont Rick's LinkedIn Article: When NOT to Proceed with a Planned Psychedelic Journey Rick on LinkedIn Rick on Twitter Psychedelic Medicine Association Porangui