Speaker 1: Hi, I'm Ethan Nadelman, and this is Psychoactive, a production
Speaker 1: of I Heart Radio and Protozoa Pictures. Psychoactive is the
Speaker 1: show where we talk about all things drugs. But any
Speaker 1: views expressed here do not represent those of I Heart Media,
Speaker 1: Protozoa Pictures, or their executives and employees. Indeed, heed, as
Speaker 1: an inveterate contrarian, I can tell you they may not
Speaker 1: even represent my own. And nothing contained in this show
Speaker 1: should be used as medical advice or encouragement to use
Speaker 1: any type of thruth. Hello, Psychoactive listeners. Today we returned
Speaker 1: to the subject of kenemine and kenemine assistant psychotherapy. Today's
Speaker 1: guest is Dr Gitavaid. I've known you for a few years.
Speaker 1: I heard her speak at the Horizon Psychedelics conference in
Speaker 1: New York a month ago. She of a brilliant talk,
Speaker 1: really talking about the role of kenamine in psychotherapy and
Speaker 1: how it's changing the way we think about psychoanalysis and
Speaker 1: psychotherapy and psychiatry, and so I wanted to really get
Speaker 1: into this with her about what that's all about, What
Speaker 1: are the benefits, how does it work, how does it
Speaker 1: compare to other psychedelics and I should tell you. I mean,
Speaker 1: she's a key figure nationally in this now, I mean,
Speaker 1: you you google her, you'll see all over the place.
Speaker 1: She's a member of the Mount Sinai Psychedelic Psychotherapy Research Group.
Speaker 1: She's a leader instructor at the Kenemine Training Center. She's
Speaker 1: a co founder of the Center for Natural Intelligence, which
Speaker 1: is a multi disappointed lab that's dedicated to psychedelic psychotherapy,
Speaker 1: innovation and clinical practice. So she is truly one of
Speaker 1: the world's leading experts in this. So, Gita, thank you
Speaker 1: so much for joining me today. Well, thank you for
Speaker 1: inviting me to come and talk and psychoactive with you. Ethan,
Speaker 1: it's a pleasure to be here. Well, I'm really glad
Speaker 1: you're here. So let's just start off by by setting
Speaker 1: this date. So you just explain in Layman's terms as
Speaker 1: best you can, what is kenemine actually what distinguishes it
Speaker 1: from opioids or normally antidepressants or other drugs used for
Speaker 1: an anesthesiology. I mean, what what is it? I think
Speaker 1: that really there's different ways we look at medicines. You
Speaker 1: look at the neurotransmitters they're working on, and in that way,
Speaker 1: kenemine is a little bit of a dirty drug because
Speaker 1: it hits a bunch of different receptors. But I would
Speaker 1: say what's different about it um in high doses you
Speaker 1: can really have anesthetic effects. In lower doses is what
Speaker 1: I'm more interested in is it's kind of has its
Speaker 1: psychedelic properties, which I feel are incredibly important aspect of
Speaker 1: work in psychiatry and psychotherapy for expanded states of consciousness.
Speaker 1: But at lower doses, I oftentimes wonder is dissociation the
Speaker 1: right word, because sometimes I feel like it can be
Speaker 1: at higher doses where you have that disconnect action, but
Speaker 1: also I feel like there's a differentiation almost that happens
Speaker 1: where you can actually have more access to parts of
Speaker 1: yourself and more of almost distinguishing that allows one to
Speaker 1: access more fully different parts of oneself. So it's an
Speaker 1: interesting term, but it has been used as a dissociative anesthetic. Basically,
Speaker 1: if somebody's having surgery, it basically allows that person to
Speaker 1: feel that the part of their body that's being operated
Speaker 1: on is sort of separate from the rest of themselves. Now,
Speaker 1: I think at the high doses you just kind of
Speaker 1: lose consciousness completely, so you're you know, completely outright and
Speaker 1: in you know and lower doses you kind of don't
Speaker 1: feel your body. You feel like sometimes people even have
Speaker 1: the experiences and low doses of not having a body
Speaker 1: or being out at their body or hovering over their
Speaker 1: body until they suddenly have no consciousness at all, you know,
Speaker 1: And you can tailor it to drop out of thinking
Speaker 1: mind and to travel through the different layers of self
Speaker 1: to beyond self until you kind of go further and
Speaker 1: further out to having no awareness. And is it using
Speaker 1: combination with other drugs, whether it's in surgery or pay
Speaker 1: management or treating depression. Oftentimes it is used as a
Speaker 1: cocktail in anesthesia and also even in psychiatry, you know,
Speaker 1: certainly Spravado, which is the only fday proved version of ketamine,
Speaker 1: they use it with other antidepressants as part of their
Speaker 1: protocol for treatment resistant depression. And that's one of the
Speaker 1: nice things about ketamine is that it has very few
Speaker 1: interactions with other antidepressants, so it does allow one to potentially,
Speaker 1: if necessary, combined with other medications. And does that also
Speaker 1: mean when it is being used also illicitly that unlike
Speaker 1: say alcohol or opioids or benzos, where if you combine
Speaker 1: them with one another, some other drugs can be very dangerous.
Speaker 1: That ketamine is maybe more like marijuana in the sense
Speaker 1: that you're not going to be dying from a mixture.
Speaker 1: That's a really good point. Yes, it's it really helps
Speaker 1: with the safety of it because you don't have to
Speaker 1: worry so much about them bumping up other levels with
Speaker 1: most of the compounds or else. What can happen with
Speaker 1: some of the other psychedelics, a blocking effect where you
Speaker 1: have very little efficacy because another drug that's working on
Speaker 1: serotonin is in the air and interferes aciddenly happens with
Speaker 1: the ss rise for example, and psilocybin or some of
Speaker 1: the classic psychedelic medicines. So it's really helpful for being
Speaker 1: able to have much more control over what you're dosing
Speaker 1: and fewer side effects and interactions. It just tell us
Speaker 1: a little something about the diversity of ways in which
Speaker 1: kenemine has been used outside the psychotherapeutic context. I mean
Speaker 1: it used to be describing the media is the animal tranquilizer, right,
Speaker 1: But it's also been used widely around the world, I
Speaker 1: think in pain management. It's been used in medicine on
Speaker 1: the battle fields. Well, kean has an interesting history because
Speaker 1: it did start off being developed as an anesthetic, and
Speaker 1: so it has a really interesting background and that it
Speaker 1: kind of entered into the psychedelic world in medicine through
Speaker 1: a whole different route, which I think makes it very
Speaker 1: unique and has had a lot of implications and how
Speaker 1: it's being practiced in the current moment. It's a very
Speaker 1: powerful anesthetic and it's one that's very unusual because you
Speaker 1: don't have to worry about its cardiovascular effects or its
Speaker 1: respiratory depression, so it makes it very versatile and easy
Speaker 1: to use not only for surgeries, but also in the battlefield,
Speaker 1: almost like the body system because you don't have to
Speaker 1: have such intense monitoring. It's also effective for pain and analgesia,
Speaker 1: so it's used in the emergency room. It's been used
Speaker 1: very safely and studied with children who seem to do
Speaker 1: much better with what they call the emergent phenomena or
Speaker 1: the psychedelic phenomena. So it has, you know, had a
Speaker 1: lot of use in ears operating room around the world,
Speaker 1: and it's in those contexts very widely available and very affordable.
Speaker 1: And remember, you know, there's all the stuff back in
Speaker 1: the nineties, I think in the kind of rave scenes
Speaker 1: and then also in the gay club scene in New York, remember,
Speaker 1: in other places, so it had that other role right
Speaker 1: of being a popular as a kind of you know,
Speaker 1: party drug. And also I think it's gotten a bit
Speaker 1: of a bad reputation even though it's been used a
Speaker 1: lot in the rave scene and as a party drug,
Speaker 1: because you know, in higher doses one can have what's
Speaker 1: called a cahole or kind of actually pass out on
Speaker 1: the floor. It's a very unattractive look, which I think
Speaker 1: hasn't really represented kennemine well because I think it's gotten
Speaker 1: worse reputation and perhaps other recreational drugs. I was watching
Speaker 1: recently Hamilton's Pharmacopeia, the TV show by Hamilton Morris, and
Speaker 1: he has an episode on kenemine, and he's talking with
Speaker 1: somebody who has been deeply committed to kenemine for for decades,
Speaker 1: and one of the points he makes is, you know,
Speaker 1: the odd thing about kennemine is it doesn't have a
Speaker 1: kind of coherent narrative historically in the way to say
Speaker 1: l s D or even mushrooms or peyote do, and
Speaker 1: that maybe there's something about it's incredibly varied uses and
Speaker 1: reputations and context men that somehow it avoided the labeling
Speaker 1: or the stigmatizing to the same degree as other psychedelics
Speaker 1: and and and it's all typically did not become criminalized
Speaker 1: in the same way. What do you think about that.
Speaker 1: I think that's that's true. I think it has kind
Speaker 1: of evaded some of those kind of connotations. On the
Speaker 1: other hand, it has stuck with some of a different
Speaker 1: kind of reputational kind of flavor, such as it being
Speaker 1: an anesthetic or tranquilizer. But it has kind of checkerboard
Speaker 1: past I would say. And when we're talking about different applications,
Speaker 1: I can't resist mentioning how ketamine was also the drug
Speaker 1: used to rescue the tai boys who were trapped in
Speaker 1: the cave. Do you remember that event vaguely? Tell us, Well,
Speaker 1: they were like some kids who were trapped in a
Speaker 1: cave and they had to rescue them, and they used
Speaker 1: ketamine as the anesthetic to be able to get them
Speaker 1: out of these caves that I think had collapsed at
Speaker 1: the time. And once again, you know, it's used really
Speaker 1: well with children as an anesthetic. But that was an
Speaker 1: interesting way. Kenemine also showed up in the news. Uh huh,
Speaker 1: you know you said before their children deal with the
Speaker 1: psychoactive effects maybe better than adults. I get is that
Speaker 1: what was that the point you were saying, and that
Speaker 1: therefore this is one of those ones where there might
Speaker 1: be a lot more latitude for administering kennemine to children
Speaker 1: into teens. I won't know if it's even latitude, as
Speaker 1: much as it's been used really comfortably with children, and
Speaker 1: even now and e os is used because it's so
Speaker 1: safe and shorter acting and well tolerated, and kids don't
Speaker 1: get disturbed by the kind of psychedelic experiences. Maybe because
Speaker 1: their minds and their subjective experiences are much more fluid,
Speaker 1: they seem to roll with it a lot more comfortably
Speaker 1: than adults who are not prepared for it. You can
Speaker 1: have really strange visitations with aliens and get freaked out
Speaker 1: pretty easily, particularly they're not expecting them and they're just
Speaker 1: sort of going in for a procedure. I see, So
Speaker 1: like when kids, he's an Alien's like, hey, like what right? Well,
Speaker 1: so now I guess to to move forward. Then is
Speaker 1: it what ten fifteen years ago, when research really begins
Speaker 1: to emerge that ketamine can be remarkably effective in dealing
Speaker 1: with intractable depression. Yes, it's been really interesting to see
Speaker 1: the studies at Yale where they recognized it for its
Speaker 1: antidepressant property, and I think that's really where this groundbreaking
Speaker 1: research started. And I think that really kind of opened
Speaker 1: up an important movement I think in psychiatry. When there's
Speaker 1: been such a paucity of new antidepressants or treatment approaches
Speaker 1: for such a long time, as depression is escalating at
Speaker 1: a very very unfortunate rate, how did they come up
Speaker 1: with the idea of thinking about kenemine to treat depression.
Speaker 1: Was it that they were seeing that people were giving
Speaker 1: ketamine for other reasons just seemed to benefit in terms
Speaker 1: of mood? I mean where that is that where the
Speaker 1: hints were well, I think it was record noised also
Speaker 1: from anesthesia, the observations of the antidepressant effect in individuals
Speaker 1: who were receiving recognitions, which is where a lot of
Speaker 1: these findings emerge. That you kind of start paying attention
Speaker 1: and taking notes. So for you, Dr Geteraveid, tell me
Speaker 1: about your evolution into this. Is it that you yourself
Speaker 1: were using, you know, experimenting various psychedelics and curious about
Speaker 1: them and tried ketamine. Um, for personal use. Was it
Speaker 1: a professional frustration in what you could accomplish as a
Speaker 1: psychotherapist dealing with your patients through traditional models of analysis?
Speaker 1: I mean, how what brought you to ketamine? Actually it's
Speaker 1: none of those answers. I was working very well in
Speaker 1: my private practice in New York City as a psychiatrist
Speaker 1: and a psychoanalyst, really enjoying my work. So there was
Speaker 1: definitely no frustration and I felt very gratified by the
Speaker 1: work I was doing, but a very interest in the
Speaker 1: research that was, you know, coming out about psychedelics and
Speaker 1: their efficacy, and I think my interest in them really sparked.
Speaker 1: There was some of my colleagues who were also psychoanalysts
Speaker 1: that I were working with who are older, really shared
Speaker 1: with me about their early career experiences. You know, some
Speaker 1: of them had worked in the sixties. One in politicular,
Speaker 1: a really good friend of mine. He talked about working
Speaker 1: with Humphrey Osmond back in the sixties on some of
Speaker 1: his alcohol studies with LSD and Humphrey Husband, as I'm
Speaker 1: sure you know, is the Canadian psychiatrist who coined the
Speaker 1: term psychedelics, and so hearing some of those stories that
Speaker 1: was extraordinary mind blowing and exciting. So to see and
Speaker 1: hear this research emerging got me very interested, and through
Speaker 1: my own work, I met a patient that I saw
Speaker 1: very infrequently, maybe twice a year, for medication management, and
Speaker 1: just sitting with him was so different my experience of
Speaker 1: him that I kept trying to dig around to figure
Speaker 1: out what had aged in his life. And after spending
Speaker 1: quite a lot of time asking a bunch of questions
Speaker 1: and not finding much satisfaction, he finally said, what are
Speaker 1: you trying to get at? And I said to him
Speaker 1: exactly as I'm telling you, how different the experience of
Speaker 1: sitting with him was, and I couldn't account for it
Speaker 1: because nothing seemed to have changed in his life. And
Speaker 1: he sort of said, well, how am I different? And
Speaker 1: I said, I can have emotional contact with you in
Speaker 1: a way I've never experienced you before. And I've known
Speaker 1: this man for several years, even though we saw each
Speaker 1: other relatively and frequently. And he sort of said, well,
Speaker 1: since you've noticed, i'll explain to you. I'm working with
Speaker 1: an underground facilitator. And you know, he was an owner
Speaker 1: gentleman had been also intrigued by the end of life
Speaker 1: studies and found an underground facilitators and and had amazing results.
Speaker 1: So I had asked him, would you mind introducing this
Speaker 1: fellow to me if he's comfortable, And that led to
Speaker 1: a lot of conversations and you know, research on my
Speaker 1: own part. And actually, when I first tried these medicines,
Speaker 1: I had such a huge expansive experience that I was
Speaker 1: vibrating for a month. But I immediately knew from that
Speaker 1: experience just having my own access the therapeutic implications. So
Speaker 1: I immediately was on this path and excited admission to
Speaker 1: find out everything about it, who was working in the underground,
Speaker 1: the overground, the research, and wanted to learn everything and
Speaker 1: get involved with everything. We'll be talking more after we
Speaker 1: hear this ad So Keita, imagine you don't know me
Speaker 1: and I come in. I've been diagnosed with intractable depression.
Speaker 1: What does our interaction look like? And how does that
Speaker 1: lead into the first session? And how do you decide
Speaker 1: whether I'm taking it in? What doose are? How? Just
Speaker 1: walk me through that. I'm happy to do so. So
Speaker 1: usually I meet someone I would just want to get
Speaker 1: to know you. I mean, I have been in practice
Speaker 1: for a long time, so I don't have to go
Speaker 1: through a checklist. We'd have a nice conversation and I
Speaker 1: asked you to tell me about yourself so I could
Speaker 1: understand where you are in your life presently and what's
Speaker 1: going on, and what needs you into seeing me, and
Speaker 1: what are you currently dealing with, And in that way,
Speaker 1: I'm trying to get a comprehensive history. I'm also in
Speaker 1: the moment trying to assess the person's capacities for self reflection, introspection,
Speaker 1: self knowledge. Do they have a sort of sense of
Speaker 1: their own narratives, Do they have a sense of the
Speaker 1: patterns in their life? And so that can pretty much
Speaker 1: inform right away whether the person might need a little
Speaker 1: bit more preparation to set the stage for a psychedelic
Speaker 1: experience or have they already done that. Have they already
Speaker 1: done enough and have enough skills to really go into
Speaker 1: a session. So that sort of sets the stage, and
Speaker 1: that will determine how many sessions we might need. Oftentimes,
Speaker 1: if someone seems to have a lot of knowledge and awareness,
Speaker 1: the issue and I have all my questions answered, which
Speaker 1: sometimes can happen even in the course of the session,
Speaker 1: the issue gets to be about relationship building and safety.
Speaker 1: So I will suggest meeting. However, many times makes sense
Speaker 1: to develop a relationship with a person to let them
Speaker 1: know who I am, how I work, to explain about
Speaker 1: the treatment, to understand what they might imagine would happen,
Speaker 1: to get clear on them, being clear on their obstacles
Speaker 1: and emphasizing them so that we could understand how this
Speaker 1: might be a way of them liberating themselves from those patterns,
Speaker 1: and to sometimes I like to identify them, not even
Speaker 1: so much as to know that's what we're working on,
Speaker 1: to go into it as much as the opposite. It
Speaker 1: sort of turns it upside down to these are the
Speaker 1: patterns that we want to help you break out of.
Speaker 1: So after we have that sorted out, it really is
Speaker 1: about preparing for the session, and on the session itself.
Speaker 1: A person will come to my office for the three
Speaker 1: hour session, fasting beforehand and they will come and we
Speaker 1: will sit and talk. For the first forty five minutes
Speaker 1: or so, we're really just talking about what's on the
Speaker 1: person's mind, what to expect, where they are, what's come
Speaker 1: up for them, and we'll sit with each other so
Speaker 1: that the person feels comfortable before they're invited to lie
Speaker 1: on the couch and I'll play music and have eyeshades,
Speaker 1: and then I will dose them while sharing with them
Speaker 1: what's going to happen. Oftentimes, i'll start with a tiny
Speaker 1: dose because I like to have a testers to know
Speaker 1: how they're going to respond. A low dose, just to
Speaker 1: assess how they're doing. Within three minutes it will come on.
Speaker 1: In that three minutes, I might invite the person to
Speaker 1: go through a body scan, so I will bring their
Speaker 1: awareness to their body so they can start focusing on themselves,
Speaker 1: gather their thoughts, and start the process of really deep
Speaker 1: listening to themselves. And by the time the medicine comes on,
Speaker 1: we'll have gone through the body scan. And I like
Speaker 1: the smaller doses because you can assess how sensitive they
Speaker 1: are so I can tailor it. If someone's really sensitive,
Speaker 1: they'll go quite deep. If it's very mild, it's like
Speaker 1: a bringing themselves into an experience. Their body softens, they
Speaker 1: start relaxing, the chatter of the mind starts dissolving, and
Speaker 1: they start becoming more present to themselves. And also they
Speaker 1: can feel my attention being with them and my presence.
Speaker 1: I'm just breathing with them, I'm just listening to them.
Speaker 1: I'm trying to listen to how they're doing, what it
Speaker 1: feels like. You can really feel the energetic shifts between
Speaker 1: two people, very much like when you have children. You know,
Speaker 1: you can feel when a child is hyper or when
Speaker 1: they're relaxed, and where they are. So it's really nice
Speaker 1: to follow where the person is and the movement of
Speaker 1: the energy between the person, and then I'll check in
Speaker 1: with them. If I send someone's anxious, I might intervene earlier,
Speaker 1: hold their hand, and I'll listen to what the process
Speaker 1: is like. If someone's in a really beautiful space, I
Speaker 1: will let them stay where they are and I will
Speaker 1: check in with them. If they're very mild, I might say,
Speaker 1: would you mind if I give you a little bit more,
Speaker 1: and I will adjust it so we can go deeper,
Speaker 1: but I follow the person's process. If someone's in an
Speaker 1: ecstatic state and doing incredibly well, I will, you know,
Speaker 1: just check in with them or stay with them, and
Speaker 1: when I feel it sort of shifting, I might ask
Speaker 1: them where they are and what they mind if I
Speaker 1: give them more to keep them at that platform. And
Speaker 1: then when the person slowly comes out of the session,
Speaker 1: I'll encourage them to really take their time to linger
Speaker 1: in the experience and to notice as much as possible
Speaker 1: how they start reconstituting, how the anxiety comes back, how
Speaker 1: the chatter comes back. It's a really interesting way of
Speaker 1: discovering from leaving yourself of how you put together. It's
Speaker 1: almost like you start stepping back into yourself and studying
Speaker 1: the whole structure of yourself from experience, and it's really structural.
Speaker 1: You'll sometimes people be like, Wow, the anxiety just suddenly
Speaker 1: lodged back in my chest. It's really shocking how we
Speaker 1: how we don't usually have a chance to notice how
Speaker 1: we're assembled, and this is a really amazing discovery. And
Speaker 1: then at the end of the session, when the person
Speaker 1: comes out slowly, we'll have a lot of time to
Speaker 1: sit together and talk about what they experienced, as well
Speaker 1: as me share with them what I saw happen. We'll
Speaker 1: try and not to put too much into words, because
Speaker 1: sometimes that can really condense and squastion experience that is
Speaker 1: really expensive. But we will cover of the pieces that
Speaker 1: they may want to share with me, or want to
Speaker 1: report to me, or have me remember. And I also
Speaker 1: like to share while we're in that moment, because in
Speaker 1: that space, it's not only an exchange of really trying
Speaker 1: to understand what happened both parties, both the patient themselves
Speaker 1: is in a very open and defended state, as am
Speaker 1: I in residence. So it's just really nice to be
Speaker 1: in each other's presence, and that felt sense of being
Speaker 1: with each other after that experience is incredibly beautiful and
Speaker 1: very healing. I think in and of itself, it's a
Speaker 1: very important part of it. And I won't let a
Speaker 1: person leave my office until they're really safe to leave.
Speaker 1: When you see a minister, is it always intravene as
Speaker 1: trip or is it another form? I either use lozenges
Speaker 1: or intramuscular, But I'm a big fan of intramuscular dosing
Speaker 1: because I can really tailor it. It's very precise, it
Speaker 1: comes on in three minutes and I can really give
Speaker 1: a little bit more or I can't take it away.
Speaker 1: So I like to really no sensitivity engage that so
Speaker 1: I can really guide the person. And on the music,
Speaker 1: is that you determinate or is there a discussion or
Speaker 1: can I say I don't really like that music, or
Speaker 1: how does that happen. I'm very open when it comes
Speaker 1: to music, but I have a playlist that's pretty neutral
Speaker 1: and I go from there and guide it based on
Speaker 1: what the person. Sometimes people don't like the music and
Speaker 1: I'm happy to shift it to what works for them,
Speaker 1: including I had one person say can I have the
Speaker 1: rolling Stones? Which I really thought was a bad idea,
Speaker 1: and it turned out they thought so too. But I
Speaker 1: was happy to say, well, we can try it, and
Speaker 1: if it doesn't work out, can we then move it.
Speaker 1: But I think it's really important to have that be
Speaker 1: a tuned to the person and the person feel heard.
Speaker 1: And usually you can tell when the music it really
Speaker 1: gets into energy and the tone and the quality. If
Speaker 1: you're listening carefully, it's really quite easy to know where
Speaker 1: it goes. One of the things that I always keep
Speaker 1: an eye on is when someone is really open, the
Speaker 1: music is part of the whole experience. It's it's like
Speaker 1: we're all vibration, and so it's really an interesting element.
Speaker 1: And in terms of talking, are some patients talking a
Speaker 1: lot during this session on other people barely talking at all.
Speaker 1: Do you encourage some people to talk more to talk less. Yes,
Speaker 1: it's very varied. I really encourage people to do what
Speaker 1: they feel would be most valuable for them. I do
Speaker 1: start off with saying, you know, I do sometimes find
Speaker 1: then when people talk a lot, it can take them
Speaker 1: out of the session because you know, you're almost in
Speaker 1: two places in one it can actually limit the space
Speaker 1: and the involvement going deeper within themselves. Um So I
Speaker 1: do make that suggestion that if they're comfortable, I'm not
Speaker 1: going to intervene, and feel free not to talk to me.
Speaker 1: But I also let them know if they would prefer
Speaker 1: to talk to me, and that facilitates their presence. Have
Speaker 1: had people want to talk to me because it helps
Speaker 1: them feel safer to listen and feel really free to
Speaker 1: do what feels right to them. And it's so variable.
Speaker 1: I have some people who feel liberated at the chance
Speaker 1: of not having to be bothered to take care of
Speaker 1: me and to just focus on themselves. And one person
Speaker 1: who actually said, I'd prefer you don't talk to me
Speaker 1: at all and really stay there on my treatment as
Speaker 1: other people want to talk the whole time. You know,
Speaker 1: it's standing up can be a little challenging because ketamines
Speaker 1: effect on balance and wobbly legs and all this. But otherwise,
Speaker 1: I mean, do people tend to just lie on their
Speaker 1: back or do they move around, get onto their stomach
Speaker 1: on their side sit up. Most people lie down, although
Speaker 1: I have had some people who have to really move
Speaker 1: and stretch out, so I also keep some mattresses when
Speaker 1: that happens. I oftentimes, when I know that's going to
Speaker 1: be a thing, I have a mattress on the floor
Speaker 1: because it's nice to be able to move for those
Speaker 1: who like to move, and it can be really nice
Speaker 1: to move, and some people get very mobile on it,
Speaker 1: so it's so so variable, and then people who are
Speaker 1: very active the next session, it can be the complete opposite.
Speaker 1: And you learn a lot from observing how their bodies
Speaker 1: move or don't move during the session, absolutely paying really
Speaker 1: close attention to every aspect what they're saying, but also
Speaker 1: the energy in the room, what's happening in their body.
Speaker 1: And oftentimes they're beautiful mood ras. It's almost as a
Speaker 1: communication from their being through their hands and through their
Speaker 1: whole body. But really the hands are very important. In
Speaker 1: Ketamine's sessions. You will oftentimes see expressions moodra's preyful gestures,
Speaker 1: really elegant, almost like prayers from the body, and it's
Speaker 1: really interesting what comes through. It sounds like a lot
Speaker 1: more fun than sitting in a psychotherapist chair. Across from
Speaker 1: somebody on a coult or chair and just having a
Speaker 1: verbal conversation. GETA. Honestly, it really is. It's the most spectacular,
Speaker 1: amazing event. Each one is so unique and so beautifully rich. GETA.
Speaker 1: When you're talking to somebody during this Kereemine session, is
Speaker 1: there something fundamentally different about the quality of that compared
Speaker 1: to ordinary psychotherapy without Kenemine. Yeah, I think pretty much everything.
Speaker 1: It's ways of really being in resonance and in contact
Speaker 1: and support and using all of these different modalities to
Speaker 1: do so, and ideally not words because that puts you
Speaker 1: back into your head, and these people when they're on
Speaker 1: when we're on the couch in that stage, you're not
Speaker 1: really in a thinking place, and it's hard to articulate,
Speaker 1: and it's actually hard to think in that cognitive way.
Speaker 1: You know. The session is so remotely different. If I'm
Speaker 1: talking to someone, it really is based on checking in
Speaker 1: on them or seeing where they are, or if I'm
Speaker 1: noticing they're anxious, and the communication is different. I might
Speaker 1: choose words, sometimes I might choose the piece of music
Speaker 1: just to touch someone. I'll give you an example. I
Speaker 1: had a fellow who got really, really anxious I could
Speaker 1: feel he was so anxious in the session, and actually
Speaker 1: his body started shaking a little bit, so I kind
Speaker 1: of checked in with him and asked him if he
Speaker 1: was okay, and he didn't seem to be responding to that.
Speaker 1: I asked him if I could hold his hand, which
Speaker 1: I could also feel like he couldn't really receive it.
Speaker 1: Even though he let me do it, I didn't feel
Speaker 1: like it was soothing him. So ultimately I shifted the
Speaker 1: music to what was, you know, a very gentle lullaby,
Speaker 1: and he immediately calmed down, and his whole nervous system
Speaker 1: calmed down. At the end of the session, you know,
Speaker 1: I felt that allowed him to make contact. So that's
Speaker 1: an example of ways of communicating with someone. At the
Speaker 1: end of the session, he told me that, you know,
Speaker 1: we talked about it, and he said he got really
Speaker 1: anxious and felt alone and had memories of being abandoned
Speaker 1: in his crib, and he didn't remember me actually reaching
Speaker 1: out to him or retouching him, but he thought I
Speaker 1: was singing to him. He actually thought the lullaby and
Speaker 1: the music was me singing to him as his mother
Speaker 1: or as myself. It was some confused combination and was
Speaker 1: really shocked, and I think so that he disappointed to
Speaker 1: realize I hadn't sung. And so that's in a good
Speaker 1: example of how it varies and what the communication it's
Speaker 1: like in the process itself. It's an art form. It's
Speaker 1: not cookie cut. It's a little bit like having children.
Speaker 1: If you have a parent who's by the book and
Speaker 1: it's just having the person on a schedule that's not
Speaker 1: going to be a great parent. You really have to
Speaker 1: try and listen to someone. And it's really the dance
Speaker 1: between two people. That's where the music is. That's where
Speaker 1: something can happen. And I've always felt this, even when
Speaker 1: I was a regular psychotherapist in New York City with
Speaker 1: none of these psychedelics. I felt we would come together,
Speaker 1: the two people would have this encounter and we would
Speaker 1: talk about, you know, what was going on in a
Speaker 1: person's life, and I would listen, and I would often
Speaker 1: offer some clever ideas or interpretations and try and say
Speaker 1: smart things, show I was listening, come up with some
Speaker 1: clever way of understanding and showing how I understood what
Speaker 1: was happening, or some insights into behavior, recognizing almost that
Speaker 1: that was the that was almost the exchange that had
Speaker 1: to happen for something secret that was going to go
Speaker 1: on between the two of us were real other process
Speaker 1: was happening where we could learn to trust each other,
Speaker 1: learned to know each other, and when there were moments
Speaker 1: when the defenses have both dropped in both parties and
Speaker 1: you could have this strong emotional connection, that's where the
Speaker 1: magic would happen. And so that's always been the kind
Speaker 1: of dance of the practice in my experience, and with psychedelics,
Speaker 1: you're right in that field right away. So it's it's
Speaker 1: a really interesting exciting idea to then just go further
Speaker 1: and feel how can you utilize that space better, how
Speaker 1: can you step into it? And to me, it feels
Speaker 1: like it shifts the field into one of a very
Speaker 1: different quality of work. And I do think one thing
Speaker 1: that you hear a lot about in this field is
Speaker 1: the mystic click experience or the liminal kind of experience
Speaker 1: that happens in these in these sublime experiences, because I
Speaker 1: think that's a very important dimension. It does shift the
Speaker 1: healing work into almost spiritual work, and I think we
Speaker 1: need to get better at conceiving of how to how
Speaker 1: to really have methodologies which are not DSM based only,
Speaker 1: but different structures to really house the process better and
Speaker 1: to take advantage of the field that's at play. I mean,
Speaker 1: it sounds like what's similar with other psycholics, I guess
Speaker 1: in some respects is people can obviously derive enormous benefits
Speaker 1: from using these psychedelics, using them all by themselves right
Speaker 1: or with a friend, without being in psychotherapy of any sort.
Speaker 1: And we know that kenemine is sufficiently powerful that even
Speaker 1: when it's done without any psychotherapy, can still have a
Speaker 1: major positive effect in alleviating depression, at least for some
Speaker 1: period of time thereafter. But that the advantage of integrating
Speaker 1: the use of ketamine or the psychedelic with psychotherapy be
Speaker 1: is that you increase the chances of a positive outcome
Speaker 1: and maybe a positive longer outcome, and you decrease the risk.
Speaker 1: Is that a fair sonation. Yeah, I would say that's
Speaker 1: probably fair. At the same time, I would say, as
Speaker 1: much as I think anyone can have a powerful experience
Speaker 1: with ketamine, and I've certainly seen that without any kind
Speaker 1: of preparation really or guidance or limited guidance, let's just
Speaker 1: say I think that at times I do wonder how
Speaker 1: much of that is a bit of a false friend
Speaker 1: in that, yes, you have an experience, but it's almost
Speaker 1: a lost opportunity or even at times can almost close
Speaker 1: the possibility to make make one almost like a little
Speaker 1: bit dulled to the nuances of what's actually being available
Speaker 1: in an experience. So it's almost moves you further away
Speaker 1: from a deeper inquiry, you know. So I have my
Speaker 1: questions about that, actually, I mean, I do see so
Speaker 1: many people use these medicines recreationally, and you know, I
Speaker 1: don't have any kind of questions about that, but I
Speaker 1: do question of people actually getting relief and are they
Speaker 1: actually more enlightened or healthier or is it more of
Speaker 1: making the unbearable bearable, you know what I mean, and
Speaker 1: helping one cope, which is fine, But that's still a
Speaker 1: little bit different than actually a deeper inquiry that could
Speaker 1: be even more useful or more radical in terms of
Speaker 1: possibilities of growth and openings. I mean, it does appear
Speaker 1: that the effect wears off after a couple of weeks,
Speaker 1: and so therefore people come back in sometimes multiple times.
Speaker 1: Is it just very dramatically person or person? Are there
Speaker 1: times when a single session is enough to cure somebody
Speaker 1: of depression for a very long period of time. It's
Speaker 1: incredibly variable as of just an antidepressant. If we're just
Speaker 1: using it as a pure antidepressant with very limited psychotherapy,
Speaker 1: it is going to have limited effects, even though they
Speaker 1: might be the rare person who's just going to have
Speaker 1: a radical experience that sustained. I think that it gets
Speaker 1: to be very different and enhanced when you augmented with psychotherapy,
Speaker 1: when there really is a psychotherapy process. I've had people
Speaker 1: just have very powerful experiences and then have come back
Speaker 1: and needed a second session several months later. Sometimes, you know,
Speaker 1: one session even is so profound that they need a
Speaker 1: lot of time to integrate it. And so it's really
Speaker 1: very variable. But that's not just employing it as an
Speaker 1: one off administration of medicine. That's with a fuller process,
Speaker 1: which which can take, you know, not that much longer.
Speaker 1: You know, my sessions tend to be three hours, so
Speaker 1: there's plenty of time, but it's a different process where
Speaker 1: you're kind of actually having a little bit more of
Speaker 1: these other threads that are in the experience, not only
Speaker 1: a discovery that is tailored to the individual with some
Speaker 1: tools of knowing how to navigate it and they drawn integrated.
Speaker 1: But I think also the experience of being with the
Speaker 1: person and having being seen and having the certain functions provided,
Speaker 1: which I think is what the psychotherapy shifts are. You
Speaker 1: can suddenly have a much different process which can be
Speaker 1: really quite profound and tailored to the individual. I would
Speaker 1: never have guessed, really how much healing is possible with
Speaker 1: these medicines, the creativity, the mysteries, the poetry of people,
Speaker 1: and the natural healing capacities and the wisdom that's held
Speaker 1: in the bodies. I'm every day blown away. Every day
Speaker 1: I'm blown away. I never thought this would have been
Speaker 1: possible in a million years. I am so shocked and
Speaker 1: so blown away, and so in awe of human beings.
Speaker 1: I have to say, I'm just I'm so grateful to
Speaker 1: do my work because I feel like I learned so
Speaker 1: much from people every day, because the intelligence and the
Speaker 1: creativity is just mind blowing to me. Can you give
Speaker 1: me a few, I'm happy too. There's actually two people
Speaker 1: that come to mind who have very different stories, but
Speaker 1: a little bit of an overlap. One is a young
Speaker 1: woman I saw who was quite brilliant at an Ivy
Speaker 1: League college, who had been in tons and tons of
Speaker 1: therapy because she had had a terrible history of two
Speaker 1: rape experiences, once in high school and once early in
Speaker 1: her college life, and you know, had coped well and
Speaker 1: had done tons of therapy over this and felt she
Speaker 1: dealt with it pretty much, even though she was still
Speaker 1: incredibly traumatized and disturbed by the episode and triggered whenever
Speaker 1: there would be events that would ignite recognition, and she
Speaker 1: was in the same environment so that would happen fairly regularly.
Speaker 1: She had the most moving discovery in the session of
Speaker 1: seeing herself as a kind of a woven fabric, and
Speaker 1: she saw there was a stain on the fabric, which
Speaker 1: is where she had the rape. But she also saw
Speaker 1: this intricate fabric with roidry and so much richness and
Speaker 1: so much stitching, and saw how much that stain had
Speaker 1: become her center of gravity and not all the other
Speaker 1: stitches of the whole unfolding tapestry. And she immediately felt
Speaker 1: almost relieved of having to have that be such a
Speaker 1: big force in her life. And she sort of said
Speaker 1: to me, when she was walking over to my office,
Speaker 1: a fellow had said to her, you know, admired her
Speaker 1: and said, you know, something kind of very flattering to her,
Speaker 1: and hadn't asked for her number, hadn't imposed upon her,
Speaker 1: just had complimented her, And she questioned, why wasn't that
Speaker 1: her center of gravity? This generous you know, appreciation of
Speaker 1: who she was, with no strings attached, and she was,
Speaker 1: you know, just so brilliant in her creative ability to
Speaker 1: take possession of her life and re reframe it for
Speaker 1: herself in this most elegant creative way that really stuck
Speaker 1: with her. Another session, which I think is just as powerful,
Speaker 1: is with an older woman who had done a lot
Speaker 1: of practice with yoga, in fact, that was her profession,
Speaker 1: and when she came and did the session, she actually
Speaker 1: had a lot of vibration in her pelvis and felt
Speaker 1: energy was being released from it and saw for herself
Speaker 1: how early childhood rape of her life that she thought
Speaker 1: she had dealt with and put aside, actually was still
Speaker 1: being held in her body, and she felt she was
Speaker 1: able to release it, along with a recognition in ways
Speaker 1: that she could see somehow revealed to her in her experience,
Speaker 1: not in language, but more in images. She had download
Speaker 1: of understanding of how much that event had in fact
Speaker 1: shaped her life. This is a woman in her sixties
Speaker 1: and how much it had impacted her in a myriad
Speaker 1: of ways, culminating with her recognizing how she had kept
Speaker 1: her self small, how she didn't have a voice, how
Speaker 1: she had been afraid, all of which she had been
Speaker 1: kind of oblivious to. And it wasn't a situation of
Speaker 1: feeling sorry for herself. It was more of deep compassion
Speaker 1: for herself and almost an awakening as well as a
Speaker 1: repair simultaneously with the acknowledgingment and the release of some
Speaker 1: of the trauma in her body energetically, of a reclaiming
Speaker 1: of herself. I have to say, what's really moving about
Speaker 1: working with psychedelic assisted psychotherapy ketamine? But I think all
Speaker 1: of the medicines is. It's so beautiful these stories. But
Speaker 1: actually at the end of the session she even looked
Speaker 1: stronger and more self possessed in her being. It wasn't
Speaker 1: just descriptive or intellectual. It was really embodied. And so
Speaker 1: that's another example. I have many examples. It's very exciting work.
Speaker 1: It really allows one to find the essence of oneself
Speaker 1: as well as a disconnect from these narratives or these
Speaker 1: distractions that hijacked her us or are too dominant in
Speaker 1: our lives, so you can have a balance and a
Speaker 1: chance to really, you know, I think, take possession of
Speaker 1: one's life and responsibility or right the chapter of your
Speaker 1: life that you want, instead of being stuck on these
Speaker 1: earlier narratives. And I think that's very unique about Academy
Speaker 1: and because it really allows, I think, a way of
Speaker 1: really breaking out of some of these patterns and habits
Speaker 1: and conditioning and being able to open up new possibilities
Speaker 1: in a very direct way. And the way you listen
Speaker 1: and observe your patients has that changed in major ways,
Speaker 1: major ways, you know. I've I've been always a psychoanalyst,
Speaker 1: which is a very particular training for those who don't know.
Speaker 1: Aside from being a psychiatrist and residency training and all
Speaker 1: of that fellowship, it's a whole additional training where you
Speaker 1: have to have a lot of didactics, but in addition
Speaker 1: to that, you have to have your own analysis as
Speaker 1: well as treat a bunch of patients and analysis which
Speaker 1: is endless, four or five days a week on the couch,
Speaker 1: and so it's about a ten year additional training. So
Speaker 1: that's always been my orientation and that has changed completely
Speaker 1: because the work that I did in that domain is
Speaker 1: not enough really if you want to do the deeper process.
Speaker 1: It becomes a different mode of listening, which of course
Speaker 1: requires an equivalent kind of knowledge of yourself with these medicines,
Speaker 1: but I really feel like you can listen with your
Speaker 1: whole being, and you can really meditate with another person
Speaker 1: and be in a synchronized state with another person, and
Speaker 1: it's just so exciting the space between two people and
Speaker 1: the knowledge that can come through you. It's a very
Speaker 1: different way of listening. I feel like you can almost
Speaker 1: listen with your soul, or listen with your being and
Speaker 1: here and understand the music of another person, not just
Speaker 1: their mind, which is one thread of what's being communicated
Speaker 1: at any given moment. Let's take a break here and
Speaker 1: go to an ad you know, I mean, my experience
Speaker 1: with ketamine is so limited, but um, you know, last
Speaker 1: year I had an experience with ketamine and it was
Speaker 1: a friend of mine and of yours who's who's also
Speaker 1: doing you know, sket immune sists psychotherapy and offered to
Speaker 1: you know, sit with me for a session. And there
Speaker 1: were a few things that really struck me about it.
Speaker 1: I mean, normally, even when I do say, say mushrooms
Speaker 1: at a very high dose. I mean, where I may
Speaker 1: look psychotic, but even when I do that, I remain
Speaker 1: quite grounded. I know where I am. I don't go
Speaker 1: off into some metisphere or something like that. With ketamine
Speaker 1: was struck me. I mean, after the initial discomfort of
Speaker 1: having to dissolve these lozenges in my mouth because we
Speaker 1: weren't doing I V or I AM administration that when
Speaker 1: I came on. First of all, it came on so
Speaker 1: remarkably gently. That was one of the first things that
Speaker 1: struck me about it, And then parts of it became
Speaker 1: like a sort of mushroom me psychedelic trip was some
Speaker 1: intense focus on some things, But there was this moment
Speaker 1: in my experience when the whole thing I lasted forty
Speaker 1: five minutes. I guess a little bit more. Where I
Speaker 1: found myself in this situation, which I guess is not
Speaker 1: totally uncommon. It was almost like that movie Avatar, the
Speaker 1: imagery of the Avatar, and and in it, I'm in
Speaker 1: this kind of almost underwater, this almost like swab and
Speaker 1: I'm there and I'm thinking I'm underwater. I can't breathe,
Speaker 1: And then I thought, but I'm breathing and then I'm
Speaker 1: kind of, you know, swimming for and it's darkness, murky,
Speaker 1: and I can't see anything, and I'm going, God, this
Speaker 1: is like this should be scary. I mean, there could
Speaker 1: be underwater snakes and things, and I have no idea
Speaker 1: that black would said, but I wasn't scared. And then
Speaker 1: I had this feeling. I said, Oh, my god, so
Speaker 1: this is how I could pass through life into death.
Speaker 1: And it was this first time I've ever had that
Speaker 1: sensation or that thought, or that feeling of moving from
Speaker 1: life into death, and if doing so in a way
Speaker 1: was rather being filled with some sense of fear or
Speaker 1: or horror, just seemed almost gentle and accepting in a way,
Speaker 1: and it was liberating in regard. And so I've since
Speaker 1: read some stuff about ketamine and people's you know, how
Speaker 1: they relate to death. But I wonder in your therapeutic practice,
Speaker 1: you know, how have you have you encounter things like
Speaker 1: this in people in terms of that element of freedom
Speaker 1: or in terms of how they think and approach death. Absolutely,
Speaker 1: and thank you for sharing your account. It's such a
Speaker 1: beautiful description of ketamine that you provide. It isn't very
Speaker 1: gentle medicine, and I think it's really good for those
Speaker 1: of us. And I think both you and I fall
Speaker 1: into this category ethan of being. You know very much
Speaker 1: in our heads a lot of the time, and so
Speaker 1: to actually have a chance to actually drop out of
Speaker 1: your thinking mind and find a lot of the knowledge
Speaker 1: and wisdom and beauty in other sensual realms and other
Speaker 1: kind of ways of knowing and navigating is quite profound
Speaker 1: and a big expansion. And I love your insight about
Speaker 1: transition into death. And there's a lot of work being
Speaker 1: done actually in this area about end of life issues,
Speaker 1: particularly with ketamine. So I'm excited that you bring that up.
Speaker 1: And there's actually even an FDA study that Ketamine Training
Speaker 1: Center had just got a proved for for conscious dying,
Speaker 1: which is very exciting that a bunch of sort of
Speaker 1: sites across the US are going to be really offering
Speaker 1: a protocol with ketamine assisted psychotherapy for end of life.
Speaker 1: And you know, I've had an incredible experience with a
Speaker 1: few patients working with ketamine for end of life issues.
Speaker 1: I'm very interested in weaving it together with meditation. Deepark Chopra,
Speaker 1: who's a partner and a colleague of mine, He and
Speaker 1: I have been working on a protocol looking at ketamine
Speaker 1: assisted psychotherapy for end of life issues with meditation. And
Speaker 1: I'll offer another vignette because this is a person who
Speaker 1: wanted me to share this with the field working with
Speaker 1: her when she was approaching actual death. This was a
Speaker 1: lifelong meditator who had really wanted to die consciously and
Speaker 1: didn't understand why she was encountering so much anxiety since
Speaker 1: she had a really full life and had twenty year
Speaker 1: history of breast cancer, so she had a lot of
Speaker 1: time to prepared for it and felt satisfied by her life,
Speaker 1: but felt really anxious when she was coming down to
Speaker 1: have to decide when to go into hospice, and so
Speaker 1: she reached out to Deep park on me and we
Speaker 1: did a session together. It was one of the most
Speaker 1: beautiful experiences of a guided meditation talking about the nature
Speaker 1: of reality and then actually going into academine experience and she,
Speaker 1: like you kind of felt like she was going into
Speaker 1: a tunnel, and then talked about feeling as if she
Speaker 1: suddenly left her body, which was for her extraordinary because
Speaker 1: she was in so much pain at the time. To
Speaker 1: just not have a body and to be in the
Speaker 1: music was she said, just so freeing of anxiety. But
Speaker 1: what she did teach me, which I thought was really interesting,
Speaker 1: was she actually felt the piece that of her aside
Speaker 1: from having that experience which felt so relieving and the
Speaker 1: transition to death that made her feel hopeful and open
Speaker 1: to to death, was she felt actually the presence of
Speaker 1: having to facilitators supporting her and accompanying her through death
Speaker 1: was perhaps the most single variable that she felt was helpful.
Speaker 1: Even though she was surrounded by people, she felt so
Speaker 1: alone in having to actually take this path towards death
Speaker 1: because she didn't want to upset all her family members
Speaker 1: of sharing what it was like for her, what she
Speaker 1: was encountering, what her fears were. So to have a
Speaker 1: place to really hold hands with people who cared about
Speaker 1: her and were able to almost act as duelers in
Speaker 1: this transition was just as important. You know, I was
Speaker 1: watching recently to talk. You gave a video at the
Speaker 1: Icon School of Medicine in New York, and you're going
Speaker 1: through it talking I think, to people who were in psychiatry.
Speaker 1: But then there was a kind of summing up of
Speaker 1: many of the small points, and the one word you
Speaker 1: wrote next to it all was the word freedom. But
Speaker 1: I think it's really an important concept because I think
Speaker 1: this medicine really makes me aware of freedom, liberation, or
Speaker 1: you know, you can think about it in different ways. Really,
Speaker 1: I think we all imagine we have free choice, but
Speaker 1: how much of our worlds are dominated by our conditioning
Speaker 1: or our habits or calma, however you want to think
Speaker 1: about it. You know, we kind of shape our worlds
Speaker 1: through these particular lenses we're wearing. As a psychiatrist, and
Speaker 1: I think anyone who's been in psychotherapy is very aware
Speaker 1: of how there are certain patterns that one finds throughout
Speaker 1: the course of one life. There's a relationship passion of
Speaker 1: how we tend to the problems we tend to get
Speaker 1: into over and over again. The hope is in psychotherapy,
Speaker 1: if you're aware of them, you're going to stop making
Speaker 1: those patterns. And sometimes that happens. Most often, you know,
Speaker 1: we have more insight and awareness. I really feel psychedelic
Speaker 1: psychotherapy allows one to really have a chance to almost
Speaker 1: find the door out of our prison, which are our patterns,
Speaker 1: our characters are conditioning, and to have new possibilities and
Speaker 1: an emergence into the full aspects of who we are,
Speaker 1: not based on our survival based strategies from childhood and
Speaker 1: the environments we grew in, So I really feel it
Speaker 1: is a process of liberation and growth and new possibilities
Speaker 1: now here you're deeply involved in training others in kenemine
Speaker 1: assisted psychotherapy. What's that like setting up these training programs?
Speaker 1: Do you get people who show up at these things
Speaker 1: and you think they shouldn't be here? And if so,
Speaker 1: how do you deal with that? What is it you're
Speaker 1: trying to convey? Who are these people? They mostly physicians
Speaker 1: or others. Have many of them already been trained in
Speaker 1: m DMA psychotherapy? What can you say about your your trainees?
Speaker 1: It is a really interesting training because it's a retreat
Speaker 1: style training where there's an unfolding process that happens for
Speaker 1: the whole group, and it's very experiential. Everyone experiences a
Speaker 1: low dose and administers a low dose as well as
Speaker 1: the high dose and administers a high dose. So you
Speaker 1: get a lot of knowledge from the sharings, and by
Speaker 1: the end of the five days, you've had so much
Speaker 1: access to different experiences and what people have encountered, as
Speaker 1: well as listening and experiencing yourself and the unfolding safety
Speaker 1: and trust in the emergence within the group, so it's
Speaker 1: a really rich experience, not to mention tons of didactics
Speaker 1: thrown in there, so it's quite quite an intense experience.
Speaker 1: And to your point of who applies, there's so much
Speaker 1: demand for training and knowledge in these new medicines, particularly ketamine.
Speaker 1: It's really open to practitioners, so a lot of them
Speaker 1: are psychiatrists. Sometimes we have and es, thesiologists who even
Speaker 1: have clinics and want to understand more about the process
Speaker 1: or experience it themselves, e R doctors, nurse practitioners, psychotherapists.
Speaker 1: We really are multidisciplinary but now open to healthcare workers
Speaker 1: and medical professionals generally speaking. How much do you all
Speaker 1: need to be worried about the risk? I mean, we
Speaker 1: know that among people using ketamine in an illicit or
Speaker 1: unregulated context that there are issues of dependence and addiction
Speaker 1: and some harms. We know it's not as dangerous as
Speaker 1: opioid addiction, for example, and there aren't the same risks
Speaker 1: of mixing with other drugs, but it is an issue. Um,
Speaker 1: what's your thoughts about that? I think it's it's definitely
Speaker 1: an issue. I think that we have to be much
Speaker 1: wiser about how are we prescribing all of these different
Speaker 1: medicines and ketamine, And I think that's what makes me
Speaker 1: a bit concerned as well about the more biological roots,
Speaker 1: because I think that does push someone more in that
Speaker 1: direction rather than opening up a process which which I
Speaker 1: think is still an accelerated psychotherapy process. But I do
Speaker 1: think we have to be concerned and more knowledgeable and
Speaker 1: responsible about how we're prescribing and what the risks are
Speaker 1: and to identify how to best support individuals who do
Speaker 1: have a wild risk for substance abuse or dependency, because
Speaker 1: this can be an incredibly good treatment in that population too.
Speaker 1: It just has to be handled more thoughtfully and carefully.
Speaker 1: You know, I wonder I mean thinking about the areas
Speaker 1: of methane and booper. I mean methodone is is crazily
Speaker 1: over regulated area in the United States. It has really impeded,
Speaker 1: you know, the effort to make it access as accessible
Speaker 1: as possible. And you know, while we're phrasing an opioid epidemic,
Speaker 1: boupern orphane has required physicians, I think, to get some
Speaker 1: level of training, although maybe some of that is shifting
Speaker 1: in Kenemine right now, there's no requirement right that you
Speaker 1: have any training, Do you think there should be some
Speaker 1: requirement mandated by medical boards or other regulatory agencies. Now
Speaker 1: that's a really good question. I think training would be
Speaker 1: very helpful. Depends on what you've been trained for. I mean,
Speaker 1: that's the thing is that you don't need any training.
Speaker 1: People come to our training because they want to learn,
Speaker 1: not because they're mandated to really learn. And then there's
Speaker 1: so many trainings popping up that you know, it's hard
Speaker 1: for consumers to understand which is the right training to
Speaker 1: go to, because having a beautiful website doesn't really tell
Speaker 1: you very much. So I think training would be really important. Certainly,
Speaker 1: I can speak for myself. I can't imagine just becoming
Speaker 1: academy and provider for psychotherapy without having a lot of
Speaker 1: experience and seeking that out. I tend to be on
Speaker 1: the more very responsible side, so that's my character anyway.
Speaker 1: But I do think some training is really important because
Speaker 1: I think you can really in terms of first do
Speaker 1: no harm, get into trouble if you don't know what
Speaker 1: you're doing or what the doses are, what the concerns are.
Speaker 1: There is such a focus on scaling and access and
Speaker 1: so much commercial gain that's centering into the field, which
Speaker 1: might have its benefits to the problem I see in
Speaker 1: this real mad rush of access and commercial gain. Are
Speaker 1: we going to have a predictable backlash to that so
Speaker 1: instead of actually winding up ahead that everything is going
Speaker 1: to if things get very sloppy and there's casualties popping
Speaker 1: up an addiction and dependency. Are we going to have
Speaker 1: a short lived moment of this growth when everything then
Speaker 1: has to come back and swim to the other direction
Speaker 1: of being regulated and medicalized and shut down and limited,
Speaker 1: which maybe is an important balancing act, But I think
Speaker 1: it would be nice to have a little bit more
Speaker 1: thought in deciding instead of, you know, having the decisions
Speaker 1: made because people are rushing too quickly and carelessly. Well,
Speaker 1: geta listen. I love what you're doing. I love the
Speaker 1: way you think about this, I love the way you
Speaker 1: describe it in the terms of dancing choreography, and I
Speaker 1: love your vision for it. So thank you ever so
Speaker 1: much for being my guest Let's Psychoact. It's been a
Speaker 1: pleasure to be here. Thank you. I'm joy talking to Ethan.
Speaker 1: We love to hear from our listeners. If you'd like
Speaker 1: to share your own stories, comments and ideas. Then leave
Speaker 1: us a message at one eight three three seven seven
Speaker 1: nine sixty that's eight three three psycho zero, or you
Speaker 1: can email us at psychoactive at protozoa dot com or
Speaker 1: find me on Twitter at Ethan natal Man. You can
Speaker 1: also find contact information in our show notes. Next week,
Speaker 1: I'll talk with Hamilton's Morris, the brilliant young journalist, scientific
Speaker 1: researcher and creator of Hamilton's Pharmacopeia. I even would go
Speaker 1: so far as to say I became a journalist as
Speaker 1: a reason to talk to Alexander Shalgan. You know, that
Speaker 1: was that was probably one of the holy motivators, was
Speaker 1: you know, why would he talk to me? Well, maybe
Speaker 1: he talked to me if I were writing an article
Speaker 1: about him, or you know, maybe then that would be
Speaker 1: some incentive. And that was kind of one of the
Speaker 1: main things that interested me about journalism at the beginning,
Speaker 1: was that it was a license to be curious about
Speaker 1: things that otherwise you would have no legitimate reason to
Speaker 1: ask questions about why would somebody talk to and annoying
Speaker 1: college student about their work. They have better things to do,
Speaker 1: they're busy. But if he's working for a magazine, and
Speaker 1: he's writing an article or making a short documentary. Well
Speaker 1: maybe they'll We'll give him a couple of hours. Subscribe
Speaker 1: to Cycleactive now see it, don't miss it. Psychoactive is
Speaker 1: a production of I Heart Radio and Protozoa Pictures. It's
Speaker 1: hosted by me Ethan Nadelman. It's produced by no him
Speaker 1: Osband and Josh Stain. The executive producers are Dylan Golden,
Speaker 1: Ari Handel, Elizabeth Geesus and Darren Aronofsky from Protozoa Pictures,
Speaker 1: Alex Williams and Matt Frederick from My Heart Radio and
Speaker 1: me Ethan Nadelman. Our music is by Ari Blucien and
Speaker 1: a special thanks to Avivi Brioseph Bianca Grimshaw and Robert B.
Speaker 1: B