Adjunctive Psychedelic Medicines during Dynamic Psychotherapy with Charis Cladouhos, MD (Boston)

Jun 16, 2024

Psychiatrist Charis Cladouhos discusses the integration of psychedelic medicines in psychotherapy, emphasizing the importance of ongoing therapy relationships. She advocates for psychoanalysts to be more involved in the psychedelic field and urges caution and humility in the approach to psychedelic practices. Topics include the use of ketamine, touch, and music in therapy sessions, as well as the challenges and benefits of incorporating psychedelic medicines into psychoanalytic therapy.

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Intro

00:00 • 3min

Incorporating Adjunctive Treatments in Depth Psychotherapy

03:11 • 19min

Exploring Complexities in Dynamic Psychotherapy and Countertransference

22:28 • 2min

Utilizing Adjunctive Psychedelic Medicines in Dynamic Psychotherapy

24:43 • 6min

Administering Ketamine in Psychotherapy Sessions

30:57 • 3min

Exploring Touch and Music in Psychedelic Therapy Sessions

33:52 • 20min

Exploring the Integration of Psychedelic Medicines in Psychoanalytic Therapy

54:21 • 5min

Exploring Thoughtful Medication Use in Psychotherapy

58:52 • 2min

“I would love for the psychoanalytic world to re-embrace some of these adjunctive treatments that get to non-ordinary states of consciousness in order to enhance psychoanalytic treatment, and that includes psychedelics. The other thing I'd like to see is, I think psychoanalysts are extremely well suited to use psychedelic-assisted therapy in a non-harmful way. I really believe that without an ongoing treatment relationship that these medicines are not going to be quick fixes. There’s an article in the Substack blog, Ecstatic Integration, about an Israeli man who had an MDMA treatment for chronic post-traumatic stress disorder and it's a very interesting read, and it really does speak to the crucial aspect of having an ongoing therapy relationship while we use these medicines. I want people who are in the analytic field who are trained right out of the box to provide these containers to be more involved in the psychedelic field. For the psychedelic field I think sometimes I wish they would be a little more humble, a little less zealous about the efficacy, and a little more concerned about what could happen that's harmful. I also think the psychedelic field, for some reason, has not embraced psychoanalysis as a major tool to enhance the medicine."

Episode Description: Charis begins by discussing her inspiration, attributed to Maimonides, for always seeking new understandings to enhance her care of patients. We also begin with a caution - any time we introduce a frame change in clinical work, we must carefully attend to our countertransference to determine the factors that are contributing to our actions. That said, we should be careful to not use our carefulness to rationalize inhibitions to thinking and acting creatively. Charis describes her thinking underlying her decision to introduce ketamine with a particular patient as well as the process of the ongoing psychotherapy. We discuss the practical aspects of this procedure, the risks, the changes in the patient, and the importance of an ongoing psychotherapy to serve as a productive holding and processing space for this work. She concludes with her recommendation to the analytic world to be more open to such adjunctive approaches to therapy and to the psychedelic world to be more modest in their assumptions of its healing ability.

Linked Webinar and Article:

/g/Communications/Ees4tjM0U1lEtzEkVrUmDjgBmH9Vd6wgap_-Z-7BJVXNDw?e=h8Afay&referrer=Outlook.Win32&referrerScenario=email-linkwithembed">https://ipaworld.sharepoint.com//g/Communications/Ees4tjM0U1lEtzEkVrUmDjgBmH9Vd6wgap_-Z-7BJVXNDw?e=h8Afay&referrer=Outlook.Win32&referrerScenario=email-linkwithembed

https://www.ecstaticintegration.org/p/successfully-treating-c-ptsd-with?utm…

Our Guest: Dr. Cladouhos is a child, adolescent, and adult psychiatrist and psychoanalyst practicing in Boston, Massachusetts. She is on the faculty at the Tufts University School of Medicine and in the Boston Psychoanalytic Institute's adult and child analytic training programs. She is the course director of an experiential elective for first-year medical students at Tufts called The Healer's Art: Rekindling the Heart and Soul of Medicine and established a pilot retreat program (First Aid for Physicians) through Tufts Medical Center to address physician burnout. She is trained in EMDR and Deep Brain Reorienting, has completed the first phase of MDMA training through MAPS, and has a certificate in Ketamine Assisted Psychotherapy from the Fluence Center for Psychedelic Training in New York. She is a member of the International Society for the Treatment of Trauma and Dissociation's Special Interest Group on psychoanalytic contributions to the treatment of trauma and dissociation.