In this episode, Jerónimo Mazarrasa joins to discuss how to interpret visions and insights disclosed during ayahuasca journeys more effectively. Jerónimo is Program Director at ICEERS, founder of ICEERS Academy, and creator of AyaSafety, an online course for people interested in increasing the safety of ayahuasca ceremonies.

To start, Jerónimo emphasizes that answering the question of whether ayahuasca visions originate in the plant medicine itself or if these are just disclosures of one’s own subconscious is actually not what's most important. Instead, he suggests that in either case, what is crucial is spending time carefully considering how one should respond to these disclosures. Jerónimo shares insights from expert facilitators on how one can best go about interpreting and responding to such experiences, suggesting that an important aspect of this process is that participants feel comfortable taking personal responsibility for whatever decisions they eventually decide to make rather than thinking of these major life changes as necessary consequences of the psychedelic experience itself. In closing, Jerónimo discusses the tension between externalization and psychologization of psychedelic experiences and why both of these can lead to issues. 

In this episode, you'll hear:

• The common experience of feeling as though the ayahuasca has communicated something to you
• Examples of where taking an ayahuasca vision literally can lead to problematic outcomes 
• The “three confirmations” one should look for before making a major decision based on a psychedelic experience
• The metaphor of ayahuasca as a microscope
• How skilled ayahuasca facilitators ensure proper psychological hygiene with participants
• Judging the validity of potential repressed memories that seem to surface during psychedelic experiences

Quotes:

“The way that ayahuasca becomes useful for people, I think, is that it shows you—it amplifies and shows you—what is already inside of yourself. Now, this is very useful for certain things but one has to understand the nature of the language.”  [9:23]

“Facilitators should instruct their participants that one rule is that you shouldn’t make any decisions during an ayahuasca ceremony—unless they are decisions related to taking yourself out of danger.” [14:42]

“Ayahuasca is not a shortcut for personal development—it’s just a flashlight that can help you shed some light on some darker parts of [your] issues and problems, but it is not a shortcut.” [35:47]

“The main contraindication of psychedelics is not wanting to take psychedelics. You should absolutely never ever ever ever ever take psychedelics if you don’t want to because it is going to be horrible. It’s like a kiss—when you want it, its beautiful, intimate, gorgeous; when you don’t want it, it's the most intrusive, disgusting, blech thing ever.” [50:27]

Links:

Jerónimo on Instagram

Jerónimo on Facebook

ICEERS Academy website

ICEERS Academy on Instagram

AyaSafety course 

Previous episode: Guruism and Cult Dynamics in Psychedelic Practices with Joseph Holcomb Adams

Previous episode: Can Psychedelics Lead to False Beliefs? with Hugh McGovern, PhD

Psychedelic Medicine Association

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In this episode, Hugh McGovern, PhD joins to discuss his research on the impact of psychedelics on beliefs. Dr. McGovern is a Research Fellow at the School of Medicine, Deakin University, Melbourne, Australia.

To start, Dr. McGovern introduces the inference or predictive processing framework utilized in his paper “An Integrated theory of false insights and beliefs under psychedelics”. He explains the role of prediction in cognition, showing how insights occur when our existing perspectives are unable to make sense of our experience. In this vein, Dr. McGovern discusses how the psychedelic experience disrupts our normal modes of prediction and perception, leaving room for greater influence of environmental factors on insight production. In closing, Dr. McGovern shares ideas on further clinical directions for this research that could give guidance for helping patients more effectively integrate insight experiences.

In this episode you'll hear:

• The research into how psychedelics can influence and change beliefs
• The role beliefs and insights can play in psychedelic journeys 
• How false insights can be experimentally induced
• The connection between prediction errors in our cognition and insight experiences
• The hippocampus, memory, and psychedelics
• The association between insight moments and increased mental health following psychedelic experiences

Quotes:

“[In psychedelic experiences] your expectations are no longer helping you make sense of your current sensory experience. And so you’re uniquely susceptible to environmental input under psychedelics—which would account for things like visual hallucinations [and] these novel insight moments.” [18:30]

“When you have really really strong prediction errors or really really strong insight moments, they can have a disproportionately important influence on your worldview going forward.” [20:03]

“Psychedelics, from a few different studies, show they can impair the formation of hippocampally dependent memories but they can perhaps even enhance the formation of cortically dependent memories. So what that means is you come out of the experience with this sense of knowing but it's in some sense lacking in details.” [29:04]

Links:

“An Integrated theory of false insights and beliefs under psychedelics” by Hugh McGovern et al.

Dr. McGovern on Bluesky

Previous episode: Guruism & Cult Dynamics in Psychedelic Practices with Joseph Holcomb Adams

Psychedelic Medicine Association

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In this episode, Heather A. Lee, LCSW joins to discuss the topic of psychedelic healing for grief and loss. Heather is a licensed psychotherapist, educator, speaker, and consultant. With over 30 years of practice in mental health, her focus is on supporting midlife and beyond women as they navigate life transitions.

In this conversation, Heather explores the ways psychedelic healing may have transformative contributions to peoples’ journeys navigating grief and loss. She explains that we live in a culture that doesn’t have a good understanding of grief, how to navigate it, or how to support others who are grieving, so it can be a difficult issue to address. Heather discusses the neuroplasticity-promoting effects of psychedelics and elucidates the ways this can be helpful for processing grief, especially by allowing the person grieving the opportunity to hold their grief in new, productive ways alongside other healthy emotions. In closing, Heather emphasizes how psychedelics can also provide healing for existential distress brought on by the many planetary crises humanity is now facing through providing a broader, life-affirming viewpoint on these issues.

In this episode you'll hear:

• Heather’s journey from working in hospice settings to working with psychedelic therapy
• Navigating the grief of losing others and the grief of realizing the imminent end of one’s own life
• Why Heather thinks psychedelics are particularly useful for grief and loss
• How grief can manifest both mentally and physically
• Client stories from Heather’s practice where patients are able to process grief to achieve a better quality of life
• Neuroplasticity, psychological flexibility, and processing grief
• Psychedelics for end-of-life grief and anxiety
• Physiological impacts of spending quality time in nature

Quotes:

“Psychedelics are a really important and powerful option that are coming into the conversation about how people can take some control of how they navigate that psycho-spiritual-emotional component of coming to end of life.” [3:19]

“There is no right or wrong way to grieve and there is no normal and abnormal. I think it’s just about having markers so that we can know when and how to provide support to people.” [9:27]

“On the [psychedelic] medicine, you experience that grief, that loss—whatever that is—you’re experiencing it while you’re in that [neuroplastic] state so that you have the opportunity to get a fresh perspective. And it’s in that fresh perspective that you create the new patterns of thought around [your grief].” [20:12]

Links:

Heather's website

Medicine Woman Retreats website 

Heather on Instagram 

Heather on LinkedIn

Psychedelic Medicine Association

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In this episode, Thomas Kim, MD joins to discuss ketamine-assisted psychotherapy for anxiety. Dr. Kim is the Chief Medical Officer of Noma Therapy, which is a ketamine-assisted psychotherapy program available via telehealth and in-person with licensed therapists. He has devoted 20 years of his professional life to realizing a value-based approach to healthcare through telehealth.

In this conversation, Dr. Kim shares his journey of working in early telehealth contexts to now working with ketamine. He discusses the research on ketamine treatments for anxiety and explains the significant comorbidity of anxiety, depression, and PTSD, stressing that anxiety is best understood from a more holistic perspective that considers the social determinants of health. Dr. Kim also emphasizes the importance of psychotherapy alongside ketamine dosing sessions, explaining that therapists have a window of opportunity in the days following the ketamine dose to best take advantage of the state of ketamine-induced neuroplasticity the patient is experiencing. In closing, Dr. Kim shares his philosophy of prescribing the least amount of medicine which produces the largest impact for the patient to ensure that side effects are mitigated and financial burdens are reduced. 

In this episode you'll hear:

• Balancing maximal safety and maximal accessibility in medicine
• The research on ketamine treatments for anxiety
• How psychotherapy fits with ketamine treatments
• The neuroscience of why patients can have strong emotional reactions following ketamine sessions
• Stories of success from Dr. Kim’s practice
• The importance of understanding how adverse childhood experiences and social determinants of health significantly contribute to mental health struggles
• Collaborative ketamine-assisted psychotherapy with a patient’s existing therapist

Quotes:

“Over time, continued effort in the field [of telehealth] has led to cost-effective, scalable solutions that can reach more people. I’m really hopeful that we can find solutions in the psychedelic and ketamine landscape to do a similar thing.” [5:36]

“A thing that I say routinely to patients is ‘there is no cure in the bottom of the pill bottle—ketamine included.’ They are all incredibly useful and, when used effectively, can provide you meaningful relief from your psychological distress but make no mistake, there is not a cure—which is why I’m such a huge advocate of therapy and which is why ketamine-assisted psychotherapy also needs to be distinguished from ketamine therapy.”  [14:21]

“[We created] an intentionally time-limited plan which places the emphasis on the fact that, one day, you’re going to drive your own bus and you’re not going to need me. It’s a terrible business model—in fact it’s a wonderful business model because it gives us an opportunity to take care of more people because we set the intention of ‘Ketamine is not forever. You’re not broken. You’re struggling and we’re going to get you to a place where you might not need us.’”  [34:04]

Links:

Dr. Kim on LinkedIn

Noma Therapy website

Psychedelic Medicine Association

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In this episode, Joseph Holcomb Adams joins to discuss the important topic of guruism and cult dynamics in psychedelic communities. Joseph is an ethicist who specializes in issues related to psychedelics, altered states, and transformative experiences.

In this conversation, Joseph introduces the concepts of a guru, guruism, and cult dynamics. He describes the social-psychological mechanisms behind the devotee-guru relationship and the development of ideological conformity in cults, explaining how the heightened states induced by psychedelics can contribute to these dynamics if participants and facilitators are not aware of these dangers and vigilant in guarding against them. Joseph explains that psychedelic experiences can lead to “experiential verification,” where the participant’s sense of the facilitator as a wise spiritual guide can seem to be confirmed through the intense mystical nature of the experience, which in turn can feed into a guru-disciple power dynamic where the participant feels reliant on the facilitator for their healing. In closing, Joseph focuses on the profound importance of education on these topics. He emphasizes that these potentially harmful dynamics will always be present, so raising awareness is crucial as psychedelic healing continues to become more mainstream.

In this episode you'll hear:

• The spectrum of cult dynamics
• How guruism and cult dynamics can become amplified in psychedelic practices 
• How psychedelics influence suggestibility, transference, and projection
• Why it can be easy for psychedelic facilitators to unintentionally fall into guruism
• Ego inflation following psychedelic experiences
• How ecstatic ritual experiences promote group cohesion
• What can be done to address the risks of guruism and cultic dynamics in psychedelic practices
• The importance of informed consent

Quotes:

“[During a psychedelic experience] it can be very easy for the participant to basically associate and identify this mind-opening experience, this earth-shattering spiritual experience, with this person who facilitated it for them, who is right there, who seems to know all about this space of consciousness that they’re experiencing.” [13:22]

“If the facilitator… already has a big, inflated sense of their spiritual knowledge and ability, then that’s already right there, pushing them to step into that guru role and this can happen from their own psychedelic use.” [30:06]

“When we’re engaging in psychedelic-enhanced ecstatic group rituals, what we’re doing here is we’re basically using powerful neuropharmacological tools to help us really powerfully tap into these potentialities that are in our primordial nature as social, instinctively religious beings… That’s what we’re messing around with here.” [38:23]

“The most important risk mitigation factors—really it’s education and the awareness that comes from it.” [43:52]

Links:

Joseph’s website

Joseph on LinkedIn

Joseph’s chapter, “Guruism and Cultic Social Dynamics in Psychedelic Practices and Organisations” co-authored with Jules Evans in Current Topics in Behavioral Neurosciences

“Oxytocin modulates charismatic influence in groups” by Ilanit Gordon and Yair Berson, 2018

Psychedelic Safety Flags: A Color System to Help Assess Practitioner Ethics and Safety

Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans

Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich PhD(c)

Psychedelic Medicine Association

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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

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In this episode, Sorcha O'Connor, PhD(c) joins to discuss the research into the use of psilocybin to address obsessive-compulsive disorder (OCD). Sorcha is completing her neuroscience PhD at Imperial College London, specialising in mental health research. She led PsilOCD, a pioneering study investigating low-dose psilocybin as a treatment for both the clinical symptoms and cognitive features of OCD.

In this conversation, Sorcha introduces obsessive-compulsive disorder and discusses the ways medical professionals are currently thinking about this and other related conditions. She mentions that current therapies for OCD often only minimally improve symptoms, emphasizing the need for better treatment options. This led to studies exploring psilocybin as a treatment for OCD - and Sorcha emphasizes that the early trials have shown positive results, often with significant decreases in OCD symptoms. In conclusion, Sorcha discusses the protocol for the PsilOCD study at Imperial College London, with results from this study soon to be published.  

In this episode you'll hear:

• The features of obsessive-compulsive disorder (OCD) 
• The history and development of treatments for OCD
• The theory behind the hypothesis that psilocybin may be effective for OCD
• Trials exploring the efficacy of psychedelic treatments for OCD
• Why psilocybin has come to the fore more than LSD or ketamine for prospective OCD studies
• How patients are evaluated for OCD

Quotes:

“[OCD] is this complex behavioral pattern and certain medications moderately help and nothing seems to be highly effective yet and that definitely points to the need for novel pharmacotherapy.”  [12:46]

“[By utilizing lower doses of psilocybin], people who maybe fixate on their health and on their mental health and sensations and things can benefit from psilocybin without having to overcome that barrier.” [18:25]

Links:

Sorcha on LinkedIn

PsilOCD Study details on the Imperial College London website

Dr. Michael J. Greenberg’s website

Psychedelic Medicine Association

Porangui

In this episode, Erica Zelfand, ND joins to discuss the important topic of pill shaming in psychedelic communities and how psychedelic medicine and traditional pharmaceuticals can both support healing. Dr. Erica Zelfand specializes in integrative mental health, bridging the gaps between conventional and alternative medicine. In addition to seeing patients in private practice, she also teaches facilitation internationally and leads retreats through Right to Heal.

In this conversation, Dr. Zelfand tackles the issue of pill shaming in psychedelic communities, showing why this rhetoric falls short and ultimately harms patients. She discusses complementary roles for psychedelic and traditional pharmaceutical medicines, suggesting that a medicine like ketamine may be particularly effective in contexts of acute intervention, whereas an SSRI antidepressant may be most effective for maintenance. Dr. Zelfand notes, however, that drug-drug interactions can be a significant concern and stresses the need for medical expertise and supervision in the context of concomitant usage of pharmaceuticals and psychedelics. In closing, she emphasizes that what is ultimately important is that patients are able to progress in healing, and any tools that are able to safely and effectively support this goal have an important role to play and should not be denigrated. 

In this episode you'll hear:

• The pill shaming rhetoric in psychedelic and cannabis communities
• Pharmaceutical contraindications to psychedelic therapy and the necessity of medical supervision for tapering off such medications
• Why comparing traditional antidepressant pharmaceuticals to psychedelic medicines is often an apples to oranges comparison
• The issues with “no pain, no gain” rhetoric in healing
• Psychiatric support for processing repressed memories uncovered during psychedelic journeys

Quotes:

“When I went into medicine, I actually specifically went into integrative medicine, functional medicine, because I didn’t like that patients were being in this position of having to choose: the conventional route or the alternative medicine route. Both routes have their merits and both routes have their shortcomings and I felt like we all deserve to be able to access both and have it be an integrated model.” [3:06]

“The only form of ketamine that is FDA approved for depression—which is Spravato—is only approved in the context in which the person is also taking an oral antidepressant.” [20:48]

“We have data showing that if you feel really really freaked out and anxious during your [psychedelic] trip, your outcomes aren’t necessarily as good. And the biggest predictor of having a positive experience is actually feeling awe. You don’t have to do the ego death thing, but if you can feel awe, if you can feel inspiration during a trip, your outcomes are better. And there’s even data showing that individuals who are on an SSRI and then trip—they may actually have better outcomes than people who don’t take medication.” [24:12]

“I think part of this trepidation is we don’t want to harm anybody through a dangerous, or potentially lethal, drug-drug interaction. That’s one thing. It’s another thing to be like ‘yeah but if you’re using these [pharmaceutical] drugs you’re doing it wrong and you’re not healing right.’ And I think the one often is used as a camouflage for the other—and they’re two separate things.” [38:59]

Links:

Dr. Zelfan’s website

Dr. Zelfand on Instagram

Dr. Zelfand on Twitter

Dr. Zelfan on LinkedIn

Right to Heal website

Psychedelic pill-shaming article by Jules Evans and Shayam Suseelan

Previous episode: Integrating Challenging Psychedelic Experiences with Keith Kurlander, MA

Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan

Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Keith Kurlander, MA, LPC, joins to discuss the important topic of integration practices for challenging psychedelic experiences. Keith is the Co-Founder of the Integrative Psychiatry Institute, the largest professional education company specializing in integrative mental health and psychedelic therapy.

In this conversation, Keith begins by exploring the different types of challenging psychedelic experiences and various lingering effects one may experience following a difficult psychedelic journey. He discusses these from a trauma-informed perspective, explaining how a traumatized nervous system can lead to dissociation on the other side of an intense ego-disrupting experience. Keith also shares practices and insights from internal family systems (IFS) for integrating challenging psychedelic experiences. In closing, he emphasizes that psychedelics are not lazer-targeted therapies, so they do carry inherent risks, but through effective integration practices, patients can make healthy meaning out of even negative experiences. 

In this episode you'll hear:

• Lingering issues with ego fragmentation and connections to the dissociative disorder spectrum
• Persisting psychotic disorders following psychedelic experiences
• The difference between CPTSD and PTSD
• Uncovering repressed traumatic memories during psychedelic journeys
• Trauma stemming from difficult psychedelic experiences 
• Challenging spiritual experiences

Quotes:

“The concept of pendulation [is] that we can be more flexible to ease our way into these overwhelming states. So once we are totally overwhelmed, we have to work our way back out gracefully, but as we are doing that, you get a gem as you are coming back… you learn something as you are coming out of that state.” [18:02]

“If people have a psychotic disorder that emerged after their psychedelic use, you need a psychiatrist at that point… If it’s really a psychotic emergence, whether a previous psychotic disorder got triggered or whatever, you need a psychiatrist to work with you on that.” [20:07]

“I believe all these mental health conditions have a trauma process underneath them. I don’t know how you isolate a trauma process from a mental health condition” [25:30]

“It’s about working with a person’s meaning-making structure: is the meaning they’re making creating more psychological flexibility or less psychological flexibility? That’s a really important question to hold as a therapist because people will make all kinds of meaning up from these experiences but if they’re creating meaning that’s creating more rigid structures of how they see the world, then they get disappointed more often.” [34:21]

Links:

Psychiatry Institute website

Keith’s website

Keith on Instagram

Higher Practice podcast 

Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, East Forest joins to discuss several aspects at the intersection of music and psychedelics, including how he created the music that so many have used when facilitating psychedelic journeys. East Forest’s latest project, a feature length documentary film called Music For Mushrooms, follows him through the psychedelic renaissance on a mission to pair music with psychedelics to bring about transformative healing to a world in crisis.

In this conversation, East Forest discusses how he first got started making music for psychedelic journeys and the considerations that go into curating the right sound to best support these types of deep inner experiences. He emphasizes the importance of avoiding music that sounds overly sentimental and lacks the depth and richness important for effective psychedelic exploration. He also discusses the importance of maintaining the container, whether in the context of psychedelic facilitation or purely music-focused ceremonies, and suggested that sternness and fortitude have an important function in this context. In closing, East Forest suggests that music is so powerful because of the way it is able to be a point of connection to integrate experiences and bring people together.

In this episode you'll hear:

• Composing soundtracks for psychedelic journeys with different substances
• Integrating nature sounds into compositions
• Flow states and music
• Bringing live elements of music and sound into a psychedelic ceremony
• Singing as a regulating technique during a psychedelic journey
• The intersection of music, technology, and psychedelics

Quotes:

“If we look at psychedelic experiences and ceremonies from indigenous use, all of them that I know of were guided by music.” [3:16]

“I think it’s more the intention behind the music. I don’t think there’s a particular thing you have to do or not do, but I don’t think you can just play any music. So I think it’s the intention of the music and the intention of the room and the intention of the participants… There has to be an invitation on all of those fronts for that doorway to open.” [16:11]

“I think we’re looking for music and for space that is supportive of that through-line and gives us enough time to be in a process—and that’s another advantage of having these longform, intentional, bespoke songs because they are probably going to give more of that time and space for these processes to occur.” [32:43]

Links:

East Forest’s website

East Forest on Instagram

East Forest on Tik Tok

Music for Mushrooms documentary website

Music for Mushrooms Official Documentary Soundtrack

Winter Solstice Retreat at Esalen

Music for Psychedelic Therapy by Jon Hopkins

Psychedelic Medicine Association

Porangui