Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

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

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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

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In this episode of the Psychedelic Medicine Podcast, Eric Sienknecht, PsyD joins to discuss the roles of music in psychedelic sessions. Dr. Sienknecht is a licensed clinical psychologist and co-founder and lead trainer at Polaris Insight Center, a ketamine-assisted psychotherapy clinic and training center. He has worked as sub-investigator and study therapist on the Lykos-sponsored MDMA-AT clinical trials for PTSD and currently is also a supervisor and educator in MDMA-AT for various clinical trial sites. Dr. Sienknecht has a deep interest in the role and use of music in ketamine and MDMA sessions and specializes in curating playlists for psychedelic experiences.

In this conversation, Dr. Sienknecht discusses how he first realized the importance of music in psychedelic experiences. He shares insights on how different genres and moods of music may be better suited to certain phases of the psychedelic experience and how he works individually with clients to better tailor a session playlist to their personal taste. Dr. Sienknecht even discusses how to strategically include shadow elements in a playlist to facilitate a client going deeper in their journey. In closing, he emphasizes how the intersection of psychedelic experiences and music remains understudied with only a few book chapters and articles dealing directly with the topic, so there is much yet to learn and explore in this exciting niche.

In this episode you'll hear:

• What is universal vs what is individual when it comes to music and psychedelics
• Why Dr. Sienknecht avoids music with lyrics in a participant's native language for psychedelic sessions
• The research on different genres of music for psychedelic journeys
• Balancing planning music in advance and adapting to the specific pace and mood of the client's experience
• Utilizing nature sounds alongside or within music during psychedelic sessions
• Binaural beats and brainwaves

Quotes:

"There's generally better tracks to use for the opening phase of a [psychedelic] journey, for the peak phase of a journey [etc], and there's been some research into that as well." [6:05]

"Taste is so subjective… Knowing your client and talking with them beforehand about their taste and letting that information really inform how you create the playlist is really important." [27:02]

"One of the benefits of doing psychedelic therapy is that you can surrender control over elements of set and setting—not that those aren't negotiable and ongoingly negotiable, as they should be—but there's something about [the fact that the therapist] has got the music taken care of, the room set up, everything is in its right place. All I have to do is fast from food for a few hours, have my intention, and step into the journey—and that can help someone to really just trust and surrender more into the experience." [30:20]

Links:

Integral Psychedelic Therapy edited by Jason A. Butler, Genesee Herzberg, and Richard Louis Miller

Dr. Sienknecht on LinkedIn

Polaris Insight Center on LinkedIn

Polaris Insight Center website

Music for Ketamine-Assisted Psychotherapy Sessions training with Dr. Sienknecht at Polaris Insight Center

Previous episodes: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Giorgia Caspani, PhD joins to discuss the intersection of psychedelics and the gut microbiome and ramifications for future personalized medicine. Dr. Caspani is a neuroscientist and computational biologist working at the intersection of gut microbiome, psychedelics and personalized medicine.

In this conversation, Dr. Caspani discusses her research published in the article "Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis." She shares what we know about how psychedelics impact the gut microbiome from initial studies and what questions remain unanswered. She draws connections between the way the gut microbiome metabolizes SSRI drugs and how serotonin impacts the gut microbiota to hypothesize the potential ways psychedelics interact with this complex living system. In closing, Dr. Caspani discusses the possibility of predicting responses to psychedelic treatments using data from the microbiota, and the research currently happening to make this possible.

In this episode you'll hear:

• How human beings and our gut microbiome co-evolved and the benefits achieved through this symbiotic relationship
• The correlation between the gut microbiome and stress levels
• The effects of psychedelics on immune responses
• Why personalized medicine may be a more effective approach for treating depression
• How personalized medicine could help make psychedelic therapies more accessible and effective

Quotes:

"Without our gut microbes… We wouldn't be able to really perform a lot of the metabolic functions that we rely on as humans." [4:26]

"The gut microbiome is different in every person—it's very unique. And so every person carries this unique microbial signature that can potentially map out to all of the treatment options that we already have available; it's just a matter of understanding and identifying markers that can predict which patient will benefit from a specific drug." [18:22]

"[We hypothesize that] the gut microbiome shapes individual responses to psychedelic treatment. And so if that [hypothesis] is correct, if that is true, we could potentially target the microbiome, change the composition of the gut microbiome like we wanted to, to be able to maximize the effectiveness of these [psychedelic] drugs." [25:14]

Links:

Dr. Caspani's article, "Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis"

Dr. Caspani on LinkedIn

Dr. Caspani on X

Onaya Science website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Star Rose Bond, LCSW joins to discuss the topic of using psychedelic-assisted therapy to address intergenerational trauma. As seen in Huffpost, Vice and Psychology Today, Star Rose is a Renegade Psychotherapist, Social Activist, Clinical Supervisor for PEARL Institute and Co-Founder of Life Camp. With a Bachelor's degree from NYU and a master's from Columbia, Star brings 15 years of clinical trauma therapeutic services and experience serving marginalized, under-resourced and at risk populations specializing in harm reduction and PTSD recovery.

In this conversation, Star introduces the topic of intergenerational trauma and explores how psychedelic experiences may be leveraged to address this pernicious condition. She begins by explaining what intergenerational trauma means, how it gets passed down, and how it manifests. Star talks about the importance of psychedelic therapists and facilitators having awareness of trauma-informed modalities in order to better serve these populations. She also discusses the complexities of addressing generational trauma, and how it can often be difficult to process sensitive topics within the family unit. However, in conclusion, Star emphasizes that the capacity to heal is an intrinsic aspect of human existence, and that even in particularly dark moments, it is possible to get in touch with this possibility.

In this episode you'll hear:

• How the conditions of Capitalism produce and exacerbate chronic stress
• The profound impact of neglect and abuse in early childhood
• The unique experience of intergenerational trauma for BIPOC peoples and the recent rekindling of a spirit of connection in these communities due to psychedelic medicines
• How processing intergenerational trauma can transform familial relationships
• Ethical and practical considerations for facilitators and therapists guiding clients through psychedelic experiences aimed at resolving deep-seated trauma
• What to look for in a psychedelic-assisted therapist or facilitator

Quotes:

"Just because you have several students or several clients who've experienced the same trauma, don't make the assumption that they're all experiencing it the same way. Or maybe you'll meet a client who has had trauma similar to yours—don't assume that they have undergone the same emotional impact or psychological impact as you. The truth of the matter is we are complex beings. We have so many different moving variables that go into our psychology and that essentially indicate or play a role in how we respond to things." [8:43]

"We can't always express or understand why things happen the way they do. But, we can start to make meaning through a spiritual understanding which in turn lends itself to a sense of ease and comfort." [22:20]

"When you are going into these experiences as a facilitator—whatever your background is—it is of the utmost importance that you are hyper cognizant and hyper aware of the harms that can be caused by not being aware of the ways in which you can navigate someone else's trauma as it shows up." [25:02]

Links:

Star's website

Star on Instagram

Previous episode: Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD

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

My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies by Resmaa Menakem

SHINE Support website

Psychedelic Medicine Association

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