Psychedelic facilitator Steve Rio discusses using 5-MeO-DMT for trauma healing and PTSD. He shares insights on safe practices, tailoring experiences, and integrating somatic qualities. Topics include transformation stories, reactivations, spiritual bypassing, and informed consent in psychedelic facilitation.

In this episode of the Psychedelic Medicine Podcast, Sunny Strasburg joins to open the conversation of leveraging lower doses of psychedelic substances for more effective healing. Sunny Strasburg, LMFT, a licensed psychotherapist, educator, and pioneering author, specializes in psychedelic therapies and training clinicians to be skilled and trauma-informed psychedelic therapists. As the founder and author of The Theradelic Approach, she equips clinicians with trauma-informed psychedelic-assisted therapy methods, blending IFS, EMDR, archetypal psychology, trauma-informed care, and her extensive experience. In this conversation, Sunny shares insights drawn from Internal Family Systems (IFS) and explores how these perspectives can help inspire more effective psychedelic work, especially with lower doses. She emphasizes the importance of adequate preparation and not over-valorizing intense psychedelic experiences, noting that these therapies themselves can be traumatic if not handled with care. Sunny also discusses how one’s own internal protectors have adaptive rolls and display a lot of compassionate intelligence, so even though these parts may initially provide a barrier to deep trauma work, it is important for therapists to work collaboratively with these parts of a client’s psyche. In closing she talks about how to better set reasonable expectations in group psychedelic therapy and retreat settings, where integration can easily turn into a competition of who had the most intense experience, with things like ego dissolution becoming the barometer for healing.    In this episode you'll hear: How “protector systems” and “rubber band effects” manifest in high-dose psychedelic therapy sessions Uncovering previously unknown traumas during psychedelic therapies and how therapists can be better prepared for this situation How therapists can skillfully work with symbolic material that arises in psychedelic journeys  The importance of slowing down and letting the client guide the pace when addressing serious traumas in particular Differences between ketamine, MDMA, and the classic psychedelics in terms of effects on the fear center of the brain Leveraging critical learning periods in therapy to reprocess traumatic memories   Quotes: “Being a trauma therapist, you have to be skilled enough to know what is symbolic in a psychedelic journey, what’s a literal memory… You don’t want to do any kind of leading or prompting the client to fill in anything or directing them to anything—you’re really tracking where they are and letting them uncover their own path. Again, at the speed in which their protector system is ready for that.” [22:43] “These parts want people to remember. They want to heal, they want to let their stories be told. And so our job as therapists is to clear the clutter so we can really hear the system and trust the system. The system knows.” [28:02] “Trauma is like a sliver that’s buried in the arm—like in the deep skin of your arm and it’s got an infection around it. And all of your coping mechanisms, all of your protectors (using IFS language), is like building a giant layer of scar tissue on top of that. And you could just go through life with that, and you could just put lotion on the top of that scar and just try to make it look pretty—and that’s okay. But you could go in and surgically remove the sliver that’s been offending your system the whole time. And once you remove that sliver, you will start to heal—your arm will heal, it won’t have an infection anymore, right? But removing that sliver hurts. It’s painful. It’s a process. But you don’t have to deal with that sliver anymore. And that’s kind of how I imagine going through trauma work.” [31:08] “I’ve had clients that I’ve worked with using EMDR, IFS for years, we’ve made some progress, but then we get ketamine on board and it’s totally helped them and amplified the benefit.” [35:13] “Trust your protector system. Slow down. I promise, if you slow down and really get curious about what your protectors need, you will go so much further with these medicines. It really is not a race. It’s slow and steady, and you’re going to be able to get more work done.” [40:23]   Links: Sunny’s website Sunny on LinkedIn Sunny on Instagram Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT Psychedelic Medicine Association Porangui

This episode of the Plant Medicine Podcast welcomes Dr. Angela Carter (they/them) to discuss the intersection of the LGBTQIA2S+ community and psychedelics. Dr. Carter is a queer, transgender, and genderqueer naturopathic primary care physician who also works as a midwife, sexual assault examiner, and health equity advocate in Portland, Oregon. They also serve as both the vice-chair and the equity in training subcommittees co-chair of the Oregon Psilocybin Advisory Board. In addition to these positions, Dr. Carter serves as the chair of the Transgender Health Program Community Advisory Board at Oregon Health & Science University. They also volunteer with many organizations including the Fireside Project, Black Rock City Emergency Services, and Queerdome.  Dr. Carter begins this conversation by sharing exciting new research currently being conducted which involves LGBTQIA2S+ individuals and psychedelic therapies. While this particular area of research remains small, it is growing and the fruits of these studies will be an important step for better understanding how these new therapies can serve gender and sexuality minorities, and help facilitators understand the unique concerns of people in the LGBTQIA2S+ community. Dr. Carter illustrates these types of concerns by discussing the prevalence of gender binaries within psychedelic spaces. They describe how in a clinical setting it is prevalent to have both a male and a female facilitator, but this leaves no room for gender-nonconforming people to guide experiences—something which could be preferable if the patient themselves shares this identity.  Dr. Carter also discusses this gender binary in traditional contexts. It is common for ayahuasca ceremonies to provide separate spaces for men and women, again leaving no space for gender-nonconforming people. This reification of the gender binary and the often patriarchal organization of the ayahuasca ceremony can have serious impacts on the set and setting, especially for people in the LGBTQIA2S+ community. Dr. Carter emphasizes the importance of making space for folks in the community so that they are able to receive therapy, attend ceremonies, and participate in integration with others who share similar identities. This shared identity, they emphasize, ensures that LGBTQIA2S+ people don’t feel out of place in contexts that ought to be healing. Dr. Carter closes by discussing how members of the LGBTQIA2S+ community experience disproportionate rates of mental illness, further illustrating the crucial importance of equity in accessing psychedelic medicine.    In this episode: Problems of representation and access for LGBTQIA2S+ individuals in the psychedelic space Current research being done on the intersection between psychedelic therapies and unique issues faced by gender and sexuality minorities Preparations to take before guiding a psychedelic experience for LGBTQIA2S+ people, particularly if you do not come from the community How plant medicines could have unique benefits for the LGBTQIA2S+ community Issues of poverty faced by marginalized peoples and how to support equity of access to emerging psychedelic therapies   Quotes: “For some people that idea of melding, of becoming one and losing all of those unique pieces of themselves, doesn’t fit their paradigm of a spiritual connecting experience.” [10:47]  “It’s precious, that centering of our community—to be able to sit with people who just understand.” [19:42]  “Psychedelics offer the opportunity for connection of the self to something greater, something outside, a bigger community, spirituality, and really do a huge amount to heal peoples’ relationships with substances.” [25:20]  “Marginalized communities have been really impacted, largely, by the war on drugs, which has put millions of people in jail for drug offenses and stolen their ability to make income, stolen their ability to connect with community and we really need to heal that.” [33:34]   Links: Chacruna Institute Queering Psychedelics 2019 Conference Queerdome on Facebook  Portland Psychedelic Society Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Hans Eriksson joins to discuss the potential of non-dissociative ketamine. Dr. Eriksson, Chief Medical Officer at HMNC Brain Health, is a highly respected drug developer and clinical psychiatrist with over 20 years of pharmaceutical experience. Prior to HMNC Brain Health, Dr. Eriksson served as Chief Medical Officer at COMPASS Pathways and previously as Senior Director of Clinical Research at Lundbeck and Medical Science Director at AstraZeneca. In this conversation, Dr. Eriksson shares what inspired him to move from clinical practice to drug development, and why he sees so much potential in developing non-dissociative forms of ketamine. He discusses the ways the dissociative effects of ketamine decrease the accessibility of this treatment due to the fact that these changes in perception are undesirable for a significant portion of patients. Dr. Eriksson also shares results from preliminary studies of non-dissociative ketamine which showed efficacy in inducing anti-depressant effects. In closing, Dr. Eriksson discusses why he thinks the experiential element of the classical psychedelics play an important role in their efficacy as mental health treatments, but why this might not be the case when it comes to ketamine.    In this episode you'll hear: The history of ketamine The pharmacology of ketamine’s dissociative effect The relationship between ketamine dose and antidepressant effect  The possibility of bladder issues and addiction with ketamine and whether non-dissociative forms of ketamine would also have these potentials How Dr. Eriksson thinks about combining psychotherapy with ketamine treatments   Quotes: “We are aiming for a similar exposure to the drug as you achieve with, for instance, an intravenous administration, but we are achieving a much lower peak concentration, maximum concentration of the compound. So that is one of the characteristics of our formulation.” [10:58] “Our view is that it's probably better to try to use the metabolism in the body as a tool to achieve very low exposure to ketamine but high exposure to the downstream metabolites.” [23:19]   Links: Dr. Eriksson on LinkedIn HMNC Brain Health on LinkedIn HMNC Brain Health website Previous episode: Potential Benefits of Non-Hallucinogenic Psychedelics with Kurt Rasmussen, PhD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Chandra Khalifian, PhD joins to explore ketamine-assisted couples therapy. Dr. Chandra Khalifian is a clinical psychologist, researcher, educator and Co-CEO of Enamory, a clinic and community focused on providing expansive relationship education and therapy including psychedelic-assisted couple-therapy. In this conversation Dr. Khalifian explores the intricacies of ketamine-assisted couples therapy, sharing why she thinks psychedelics, and ketamine in particular, could be a good fit for couples therapy. She discusses the various contexts where ketamine-assisted therapy may be a good fit for couples pursuing therapy, the therapeutic modalities well-suited to this work, and the different dosing and administration routes of ketamine. In closing, Dr. Khalifian explores situations where couples may be better suited to pursuing this therapy individually and also contexts where ketamine-assisted couples therapy would not be an appropriate intervention.   In this episode you'll hear: How Dr. Khalifian got involved in couples therapy The various models of ketamine-assisted couples therapy, and how to decide what is most appropriate The importance of preparation and integration How to navigate the two people in the couple having very different ketamine experiences When Dr. Khalifian uses intramuscular ketamine infusions versus ketamine lozenges Why Dr. Khalifian leans towards using third-wave cognitive behavioral therapy for ketamine-assisted therapy The tendency for people to make major relationship decisions following intense psychedelic experiences   Quotes: “Ketamine is great because—in the same way with individuals—with couples it’s going to pull us out of that pattern so that we can then see the pattern and talk about the pattern from this observer perspective rather than being stuck in the ‘it’s me versus you’ we can look at it together and the couple can say ‘ah, there’s that thing that we do when we feel distressed, and now we can work together on that thing since we can see it from a little more distance.’” [4:43] “Similar to MDMA, people are less likely to express criticisms in a hurtful way and less likely to receive constructive criticism and be defensive [during ketamine therapy].”  [9:05] “I had one couple [as patients for ketamine therapy] that the partner was like ‘I just felt this liquid compassion. I finally understood why she was engaging in these behaviors. And so everything made sense and I was able to talk about it in a different way.’” [17:49]    Links: Enamory website Enamory on Instagram Previous episode: MDMA-Assisted Couples Therapy with Kayla Knopp, PhD Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Evan Cole Lewis joins to explore the topic of psychedelics and seizure disorders. Dr. Lewis is a Canadian Neurologist and holds an appointment as Assistant Professor in the Department of Paediatrics at the University of Toronto. He has special interest in the treatment of neurologic disorders, including functional seizures, with psychedelic therapies. In this conversation, Dr. Lewis shares his expertise on a number of topics at the intersection of psychedelics and seizure disorders. He discusses the neurology behind psychedelics and functional neurological disorders more broadly, explaining why he thinks this is a very promising area of research. He explains that currently very little is known about the topic of psychedelics and seizure disorders, as almost all studies have had epilepsy as an absolute contraindication, leaving researchers with only case reports. However, there are some promising indications in the preclinical data which warrant further investigation. In closing, Dr. Lewis sheds light on potential seizure risks resulting from interactions between psychedelics and other medications.    In this episode you'll hear: The different between epileptic seizures and functional seizures How Dr. Lewis started exploring the topic of psychedelics and functional seizures Why Dr. Lewis thinks psychedelic science has the potential to rebuild bridges between neurology and psychiatry Dr. Lewis’ experiences treating epileptic patients with ketamine The potential for co-administered lithium and psychedelics to cause seizures   Quotes: “I tell people psychedelics are brain network medicine—they kind of dissolve those networks. If the thinking is that FND [Functional Neurological Disorder] is due to dysfunctional connection or hyperconnectivity in certain networks, what we have to do is we have to repair those networks, but first we have to take them apart and build them back up.” [11:03] “Regardless, even if there isn’t even a condition in which psychedelics are utilized in neurology, we need the neurologists to be able to indicate that these patients are safe—or at least do the work and be involved in the clinical team.” [21:05] “Things like drug interactions we pick up with psychedelics again are going to be a big piece of the puzzle that needs to be answered going forward.” [29:17]   Links: Dr. Lewis on LinkedIn Dr. Lewis on YouTube  Exploring psychedelic-assisted therapy in the treatment of functional seizures: A review of underlying mechanisms and associated brain networks by Dr. Lewis et al. Case report: Improvement in refractory functional seizures, depression, and quality of life with ketamine assisted-therapy by Dr. Lewis et al. Psychedelics, epilepsy, and seizures: a review by Dr. Lewis et al. Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review by Kelan Thomas, Benjamin Malcolm, et al. Psychedelic Medicine Association Porangui

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