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

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

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

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

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

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

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

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

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

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