Plant Medicine Podcast
94 episodes
Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
On this episode of the Psychedelic Medicine Podcast, Juliana Milligan joins to discuss her recent article (co-authored with Joshua White of Fireside Project) on warning signs when selecting a psychedelic facilitator. Juliana is an ibogaine specialist who has been working in the ibogaine treatment community for 10 years. Having been formerly opioid-dependent and incarcerated herself, she currently works at the Center for Optimal Living where she runs the psychedelic education and training program. Juliana additionally works with clients doing preparation and integration of Ibogaine treatments through her business Inner Vision Ibogaine.
In this conversation, Juliana discusses each of the 10 red flags she identified in her article. First, she discusses potential issues around sexual misconduct on the part of facilitators, emphasizing that this is a topic which always requires careful and explicit discussion well prior to the psychedelic experience. One ought to also do some individual research, as potential allegations against a facilitator are also a red flag to take seriously.
Next, Juliana talks about the importance of facilitators doing a thorough medical intake. This involves getting a medical history from a potential client and checking if there are any contraindications for this person to take a psychedelic, such as dangerous interactions with prescription medications. In a similar vein, Juliana also stresses the necessity of facilitators testing the psychedelics their clients will be consuming whether they themselves provided the psychedelics or if the client brought their own substances. Willingness to test the substances in the presence of the client is definitely a good sign and shows that the facilitator values both transparency and safety.
In terms of training, Juliana highly recommends ensuring that a facilitator is trauma-informed before committing to a journey under their guidance. Knowing that a guide will be conscientious and empathetic around issues of trauma helps to ensure that the psychedelic experience doesn’t itself turn in a traumatic direction. Similarly, Juliana emphasizes that facilitators should be open about the training they’ve received—even underground facilitators should ideally have mentors and be involved in a community of practitioners that encourages continued training.
In closing, Juliana discusses the dangers of having inflated and unrealistic expectations around the healing potential of psychedelics. Facilitators who use hyperbolic language like “ten years of therapy in one night” may actually be setting up clients for more difficult experiences than they otherwise may have had due to these fantastical claims. Juliana emphasizes that psychedelic healing is a cooperative endeavor, and neither the substance nor the facilitator is solely responsible for any healing that results from the experience. Ultimately, it is the person themselves who does this work, so Juliana highly recommends finding a facilitator who acknowledges their role as primarily supportive of this healing journey, rather than someone who presents themselves as a miracle worker responsible for these positive results.
In this episode:
Why having a trauma-informed facilitator is important, and what this means
The dangers of psychedelic narcissism
The importance of the harm reduction practice of chemically testing psychedelics
Trusting your intuition and building this capacity
Having healthy and reasonable expectations around the healing potential of psychedelics
Quotes:
“Once you are on a psychedelic, you cannot properly consent to touch—it must be established in advance. And if [a facilitator] is saying ‘well no I need freedom in my work, I need to use my intuition’ that is a major red flag.” [7:19]
“It’s really important that the facilitator knows exactly what is contraindicated with the medicine they’re administering, and if they’re not evaluating for this and if they’re not familiar with medical conditions and how they interact with the medicine they’re giving then they’re not properly trained to be giving this medicine.” [10:14]
“The only person that can really heal you is yourself and a facilitator is just there to help empower you and support you in guiding yourself. It’s a collaborative relationship.” [13:44]
“If a person isn’t willing to be receptive to feedback, self-reflective, and take accountability, psychedelics aren’t necessarily going to make them do that. And so you give psychedelics to somebody with those kinds of narcissistic traits and it can just make the narcissism worse.” [20:15]
Links:
Juliana's Article with Fireside Project: Warning Signs When Selecting a Psychedelic Facilitator
Inner Vision Ibogaine: Guide to Finding an Ibogaine Clinic
The Psychedelic Program at The Center for Optimal Living
Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich
Previous episode: Harm Reduction Through Testing Your Psychedelics with Mitchell Gomez
Previous episode: When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD
Previous episode: Insights Gained from the First Year of Fireside Project with Joshua White
Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan
On this episode of the Psychedelic Medicine Podcast, Juliana Milligan joins to discuss her recent article (co-authored with Joshua White of Fireside Project) on warning signs when selecting a psychedelic facilitator. Juliana is an ibogaine specialist who has been working in the ibogaine treatment community for 10 years. Having been formerly opioid-dependent and incarcerated herself, she currently works at the Center for Optimal Living where she runs the psychedelic education and training program. Juliana additionally works with clients doing preparation and integration of Ibogaine treatments through her business Inner Vision Ibogaine.
In this conversation, Juliana discusses each of the 10 red flags she identified in her article. First, she discusses potential issues around sexual misconduct on the part of facilitators, emphasizing that this is a topic which always requires careful and explicit discussion well prior to the psychedelic experience. One ought to also do some individual research, as potential allegations against a facilitator are also a red flag to take seriously.
Next, Juliana talks about the importance of facilitators doing a thorough medical intake. This involves getting a medical history from a potential client and checking if there are any contraindications for this person to take a psychedelic, such as dangerous interactions with prescription medications. In a similar vein, Juliana also stresses the necessity of facilitators testing the psychedelics their clients will be consuming whether they themselves provided the psychedelics or if the client brought their own substances. Willingness to test the substances in the presence of the client is definitely a good sign and shows that the facilitator values both transparency and safety.
In terms of training, Juliana highly recommends ensuring that a facilitator is trauma-informed before committing to a journey under their guidance. Knowing that a guide will be conscientious and empathetic around issues of trauma helps to ensure that the psychedelic experience doesn’t itself turn in a traumatic direction. Similarly, Juliana emphasizes that facilitators should be open about the training they’ve received—even underground facilitators should ideally have mentors and be involved in a community of practitioners that encourages continued training.
In closing, Juliana discusses the dangers of having inflated and unrealistic expectations around the healing potential of psychedelics. Facilitators who use hyperbolic language like “ten years of therapy in one night” may actually be setting up clients for more difficult experiences than they otherwise may have had due to these fantastical claims. Juliana emphasizes that psychedelic healing is a cooperative endeavor, and neither the substance nor the facilitator is solely responsible for any healing that results from the experience. Ultimately, it is the person themselves who does this work, so Juliana highly recommends finding a facilitator who acknowledges their role as primarily supportive of this healing journey, rather than someone who presents themselves as a miracle worker responsible for these positive results.
In this episode:
Why having a trauma-informed facilitator is important, and what this means
The dangers of psychedelic narcissism
The importance of the harm reduction practice of chemically testing psychedelics
Trusting your intuition and building this capacity
Having healthy and reasonable expectations around the healing potential of psychedelics
Quotes:
“Once you are on a psychedelic, you cannot properly consent to touch—it must be established in advance. And if [a facilitator] is saying ‘well no I need freedom in my work, I need to use my intuition’ that is a major red flag.” [7:19]
“It’s really important that the facilitator knows exactly what is contraindicated with the medicine they’re administering, and if they’re not evaluating for this and if they’re not familiar with medical conditions and how they interact with the medicine they’re giving then they’re not properly trained to be giving this medicine.” [10:14]
“The only person that can really heal you is yourself and a facilitator is just there to help empower you and support you in guiding yourself. It’s a collaborative relationship.” [13:44]
“If a person isn’t willing to be receptive to feedback, self-reflective, and take accountability, psychedelics aren’t necessarily going to make them do that. And so you give psychedelics to somebody with those kinds of narcissistic traits and it can just make the narcissism worse.” [20:15]
Links:
Juliana's Article with Fireside Project: Warning Signs When Selecting a Psychedelic Facilitator
Inner Vision Ibogaine: Guide to Finding an Ibogaine Clinic
The Psychedelic Program at The Center for Optimal Living
Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich
Previous episode: Harm Reduction Through Testing Your Psychedelics with Mitchell Gomez
Previous episode: When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD
Previous episode: Insights Gained from the First Year of Fireside Project with Joshua White
Microdosing and the Placebo Effect with Balázs Szigeti, PhD
Microdosing and the Placebo Effect with Balázs Szigeti, PhD
In this episode of the Psychedelic Medicine Podcast, Balázs Szigeti, PhD, joins to discuss his research on the intersection of microdosing psychedelics and the placebo effect. Dr. Szigeti studied physics at Imperial College, after which he earned a PhD in computational neuroscience from the University of Edinburgh. He has worked as a biomedical software engineer at the Icahn Genomics Institute and he has conducted the largest placebo-controlled study on psychedelics to date. In his research, Dr. Szigeti uses novel statistical and experimental techniques to explore the intersection of psychedelics and placebo effects.
Dr. Szigeti begins this conversation by discussing the design of his placebo-controlled microdosing study, “Self-blinding citizen science to explore psychedelic microdosing” which appeared in the journal eLife in March 2021. For this study, Dr. Szigeti and his team employed citizen science to collect placebo-controlled observational data from participants, allowing this experiment to take place outside of a clinical environment. Participants self-blinded by preparing identical psychedelic and placebo microdose capsules and data was submitted using QR codes so that the researchers were knew whether the participant was in the psychedelic group or the control group, while the participants themselves remained in the dark.
The results from this study showed a statistically significant improvement of wellbeing among both the microdose and placebo groups, with no statistical significant difference between the two groups in terms of any of the outcomes. Dr. Szigeti talks about the media reception of his research, which tended to present the findings as suggesting microdosing is ineffective since there was no difference between the two groups. However, Dr. Szigeti has a different takeaway. He suggests that the practice of microdosing can indeed lead to improved wellness as the study showed—the takeaway is simply that this effect is harder to distinguish from a placebo than originally anticipated. He emphasizes the very real medical power of this placebo effect, and discusses how triggering one’s own placebo effect either through microdosing or some other practice can be transformative.
However, beyond what the data may suggest about the impact of microdosing psychedelics, Dr. Szigeti emphasizes the broader takeaways from his study, which bring into question the efficacy of placebo-controlled studies as a gold-standard in the context of psychedelic trials. Because psychedelics cause notable shifts in perception, trial participants will quickly become aware whether they are in placebo or psychedelic groups, particularly in the case of trials exploring doses beyond the microdose range. This causes an immediate unblinding effect, and makes control groups less useful than in other contexts where a participant does not find out which group they were a part of until the trial’s conclusion. Dr. Szigeti affirms the methodology of placebo-controlled trials as an essential tool for researchers which deserves its reputation for providing high-quality evidence, but he urges the field of psychedelic studies to pay closer attention to questions of methodology, as there may be yet undiscovered modes of scientific investigation which would be better-suited to psychedelic trials.
Dr. Szigeti is currently working on a follow-up blinded study on microdosing which he hopes will address some of the shortcomings of the original investigation. In particular, he mentioned that the participants in the original study had high levels of well-being already at the start of the trial, so improvements may have been less significant than in a population with a lower level of well-being to start. As such, he and his team hope to recruit a more diverse sample in this upcoming trial to further explore the extent of both placebo and microdosing impacts on wellness. Information for the upcoming study can be found at the website: https://selfblinding-microdose.org/
In this episode:
How Dr. Szigeti set up his self-blinded placebo-controlled study of microdosing outside of a clinical environment
What is “citizen science” and how this differs from other methodologies
The issue of tolerance in microdosing and how this may differ between LSD and psilocybin
How Dr. Szigeti uses statistical analysis to further interpret data where participants realize which group of the study they are in
Quotes:
“The results of this microdose trial were mixed because you can make an argument that this change over time is the more important outcome and that was statistically significant, but the comparison of the magnitude of change in the placebo group versus the magnitude of change in the microdose group, that was not significant anymore. It was not significant on any of the scales, I should add.” [14:45]
“Nobody ever checks whether the placebo control was really working as intended, which is just like—I don’t know how it could have happened. There is such a big emphasis on the methodological superiority of placebo-controlled trials and then nobody is checking whether its really working or not.” [21:09]
“With psychedelics this issue [of placebo groups] is going to come to the forefront because, yes with microdosing there is some wiggle room in people recognizing their treatment, but when it comes to 200μg of LDS versus placebo, there is zero uncertainty. Everybody will recognize when you’re in the active placebo treatment.” [28:13]
Links:
Dr. Szigeti’s study: “Self-blinding citizen science to explore psychedelic microdosing"
Insights Gained from the First Year of Fireside Project with Joshua White
Insights Gained from the First Year of Fireside Project with Joshua White
In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the first year of the psychedelic peer-support line, Fireside Project. 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.
Joshua begins this conversation by sharing the success of Fireside Project in its first year of operation. The peer support line has been called over 3,100 times in the 14 months since the launch of Fireside Project, where callers have been able to receive open-ended support from compassionate peers as they navigate a psychedelic experience or attempt to integrate a previous experience.
Joshua also shares some details about the kinds of calls the line has received, such as which psychedelic substances were involved in the caller’s experience, how callers were describing their experiences, and what mental health conditions callers self-reported. In terms of substances, psilocybin was the most commonly used by callers, though a wide range of different psychedelics were reported. For mental health conditions, PTSD stood out as the most frequently mentioned, though depression and anxiety were also common. Joshua mentions that he’s hopeful that this data may be incredibly useful in further developing harm reduction strategies, as the dataset may help uncover previously unknown correlations.
Another aspiration for Fireside Project is ensuring equity through their Equity Initiative, which allows callers to process past psychedelic experiences with someone of a similar background. Joshua shares that this initiative will also produce original research on this topic, showing for example the kinds of benefits a caller from the BIPOC community might get through having the opportunity to integrate a past experience with a BIPOC peer.
Joshua closes this conversation with powerful words about integration and harm reduction, saying that integration is a form of harm reduction. To that end, Joshua is hopeful Fireside Project can continue offering crucial harm reduction and integration services as the organization grows and reaches beyond the niche of psychedelic enthusiasts.
In this episode:
Who has been calling the peer-support line and what kind of support they are seeking
How Fireside Project could potentially offset the burden on emergency services in the case of negative psychedelic experiences
The diversity of Fireside Project volunteers
The problems of facilitator abuse and neglect in the psychedelic space
The future of Fireside Project
Quotes:
“Reflective listening—which is the core, the foundation of holding space—this is really a skill that we can continue to cultivate.” [8:03]
“My hope is that there’s no barrier, there’s no stigma, and there’s no shame to reaching out.” [12:53]
“All of the lessons we learn, we really just want to share those with the public in the hope that this will lead to less risky and more fulfilling psychedelic experiences.” [17:30]
“One of the things that I’ve noticed is—that we’ve noticed is—even though every single call is different in its own way, especially when someone reaches out to us in a heightened state, really validation, normalization, and reassurance often happen at the very beginning.” [25:34]
“It’s amazing how some of our calls are just so short because someone just wants to know that we are there.” [28:44]
“As a psychedelic community, people need to stop saying that psychedelics are ten years of therapy in one night. It’s just not true, and it sets people up for serious disappointment and can even be really dangerous for that reason.” [30:01]
Links:
Preparing for Safe Ibogaine Journeys with Felipe Malacara, MD
Preparing for Safe Ibogaine Journeys with Felipe Malacara, MD
In this episode of the Psychedelic Medicine Podcast, Dr. Felipe Malacara joins to discuss the safety considerations surrounding ibogaine therapy. Dr. Malacara is the chief clinical operations director for Beond, a Mexico-based Ibogaine clinic. He is also a general practice physician with a medical degree from Universidad Autónoma Metropolitana in Mexico City and has over 17 years of experience treating over 1,200 patients with Ibogaine therapy.
In this conversation, Dr. Malacara shares important safety information about ibogaine, starting with major contraindications to using the powerful substance. These contraindications fall into three main groups: heart issues, electrolyte deficiencies, and liver problems. As Dr. Malacara explains, all of these have the potential to make Ibogaine dangerous due to the way it interacts with the heart, particularly if there is a metabolism issue. In terms of negative outcomes, cardiac issues are the most common as ibogaine can cause bradycardia—a dangerous slowing of the heart rate.
Due to these potential risks, Dr. Malacara encourages a thorough evaluation prior to ibogaine therapy, including full blood work, an EKG, and occasionally an ultrasound of the heart. Another crucial part of the evaluation is taking an inventory of the patient’s prescription medication and drug use. Dr. Malacara explains that patients may need to be weaned off a particular drug or be given a shorter-acting alternative so that they can come into the ibogaine therapy without any substances in their system which could lead to dangerous interactions or render the treatment less effective. In particular, Dr. Malacara notes that SSRIs could interact with ibogaine to produce serotonin syndrome, and while this can be straightforward to treat, diagnosis can be difficult, so avoiding this entirely by weaning off the medication under the direction of a physician is strongly suggested prior to treatment.
In closing, Dr. Malacara emphasizes that Ibogaine is not a magic bullet despite its unique efficacy for treating addiction. The will to change on the part of the patient is still crucial, especially as preparation for ibogaine therapy itself requires a lot of commitment and dedication. If that is present, however, Dr. Malacara maintains that the treatment can be extremely effective.
In this episode:
How Dr. Malacara got involved in Ibogaine therapy
The inherent risks of Ibogaine
What patients should be evaluated for prior to receiving Ibogaine therapy
Weaning patients off drugs or onto different, shorter acting substances in preparation for Ibogaine
The types of addictions may be successfully addressed by Ibogaine
Monitoring a patient’s heart following Ibogaine, and when they can be released
Quotes:
“In the event [that a patient] is not able to metabolize ibogaine in an appropriate way, the risk of heart toxicity of the Ibogaine increases.” [9:25]
“Something which is important is drug screening before the treatment. We need to know that the patient has no traces of the drugs that we are going to treat in the system, because otherwise the treatment will be more difficult, the recovery will be more difficult, or it will be even ineffective.” [26:48]
Links:
Addressing Military Sexual Trauma through Ayahuasca with Wyly Gray and Andrea Lucie, PhD
Addressing Military Sexual Trauma through Ayahuasca with Wyly Gray and Andrea Lucie, PhD
In this episode of the Psychedelic Medicine Podcast, Wyly Gray and Dr. Andrea Lucie join to discuss the issue of healing military sexual trauma (MST) through ayahuasca. Wyly Gray is a former Marine and founding executive director of Veterans of War, a nonprofit which connects teams of veterans to psychedelic-assisted guided group therapy designed to heal the scars of war in community. Dr. Andrea Lucie is a native of Chile and a third generation healer who has been traditionally and non-traditionally trained in ancient healing practices in the United States and Mexico. She also holds a PhD in mind-body medicine.
This conversation begins by discussing the tragic phenomenon of military sexual trauma and the current treatment modalities available for veteran survivors. Wyly explains that the current treatments, which primarily take a talk therapy approach, often fall short of what survivors need as they focus on treating the symptoms as they arise rather than being able to address these conditions at their root causes. Dr. Lucie explains the science behind ayahuasca as a treatment for trauma, highlighting the profound neurological and psychological impacts of this psychedelic medicine.
Seeing the particular need for better treatment options among the veteran population, and the potential for ayahuasca to have such a profound positive impact, Wyly founded Veterans of War with the hope of better addressing this need. He shares the details of the six-month fellowship program, which involves a small cohort of veterans who do significant preparatory work together prior to a communal ayahuasca ceremony, followed by many integration sessions after the ceremony. Dr. Lucie explains different forms of mind-body work that may be effective supports before and after ceremony, citing things such as Tai Chi, meditation, and even close relationships with animals.
Towards the end of this conversation, Wyly shares some profound stories of transformation he has witnessed first-hand through his work with Veterans of War. He has seen veterans who’ve struggled profoundly with panic attacks become incredibly joyful people, and others who were on the brink of suicide begin to heal and form deep and meaningful relationships. In closing, Wyly discusses plans to establish a healing center in Oregon for Veterans of War to further increase access to these opportunities without the need for international travel.
In this episode:
The problems of the civilian service-member divide, and how ayahuasca can help break down these barriers
The importance of supportive community in the context of ayahuasca therapy for veterans with MST
Mind-body practices that can support veterans working through MST before and after an ayahuasca ceremony
How trauma changes the brain and the neurological effects of psychedelics that can help reverse these changes
Why tackling issues of sexual assault within the military can be so difficult
Quotes:
“I think that Ayahuasca is unparalleled in its ability to create a safe and effective path towards recovery, but I deeply believe it also needs bookends on either side, or a structure to get the most out of it.” [8:19]
“Sometimes we just don’t want to talk. We just want to feel and when we feel and we identify where in the body the trauma is stuck—because the trauma gets stuck in the body—then we know how to release it with movement.” [27:16]
“Our response to trauma has seemed to be very one-dimensional. This is an effort to shift that, to start looking at people as whole units and at the same time, start speaking to the needs of that whole unit. If you are able to heal the trigger point of that trauma, you don’t have to heal its expression.” [31:18]
Links:
Predicting and Potentiating Peak Psychedelic Experiences with Sam Gandy, PhD
Predicting and Potentiating Peak Psychedelic Experiences with Sam Gandy, PhD
In this episode of the Psychedelic Medicine Podcast, Dr. Sam Gandy returns to discuss the topic of psychedelic-induced mystical experiences, looking specifically at how to predict and potentiate these experiences. Dr. Gandy holds a PhD in ecological science from the University of Aberdeen and has conducted field research across the globe. He is a researcher and science writer who is also a collaborator with the Centre for Psychedelic Research at Imperial College London, with a research interest in the capacity of psychedelic substances to influence individuals’ connection with nature.
Dr. Gandy begins this conversation by defining the topic of mystical experiences. He explains that while there are a number of competing terms for how to best address this subject, what is important is that the research has consistently shown that these types of experiences are closely correlated with beneficial therapeutic outcomes. Whether brought on by psychedelics or not, mystical experiences tend to produce positive psychological changes, so it is important for psychedelic researchers to take this topic seriously and thoroughly investigate these experiences and where they come from.
However, Dr. Gandy notes that there are a number of hurdles to addressing this topic scientifically. Because of the mystical or spiritual quality of these peak experiences, it can be difficult for researchers to develop sufficiently neutral language in surveys while maintaining accurate descriptions of the qualities of the altered states. Similarly, Dr. Gandy explains that therapists have to walk a fine line between not introducing spiritual or religious bias into the session through decoration or suggestion which may prioritize a certain religious tradition, while also preserving a certain type of spiritual atmosphere which is conducive to mystical experiences and thus beneficial therapeutic outcomes.
Dr. Gandy then goes on to explain variables which can be predictive of psychedelic mystical experiences. Set and setting are of course crucial, but there are a number of additional parameters to consider. Dr. Gandy explains that dose, of course, is particularly important, stating that a standard has emerged in the research around psilocybin which has found that 25 milligrams of pure synthetic psilocybin is a sweet spot for encouraging mystical experiences without leading to additional adverse reactions due to the intensity of the experience. Additionally, different psychedelic substances produce mystical experiences at different rates, with 5-MeO-DMT being the most likely to lead to these experiences. Besides dose and substance, Dr. Gandy has also found that intention as well as the personality trait known as absorption are both predictive of mystical experiences in psychedelic therapy.
To conclude this conversation, Dr. Gandy shares three possible potentiators of psychedelic mystical experiences: music, meditation and spiritual practice, and nature-based settings. Each of these items, if integrated into the experience intentionally can encourage a more immersive and intense mystical experience. For all of these, Dr. Gandy encourages further research for how they could best be integrated into psychedelic therapy practices.
In this episode:
The psycho-social changes which often follow mystical experiences
The connection between mystical experiences and “spiritual emergencies”
The difficulty of working with a spiritual element in the context of psychedelic therapy and researchHow the typical Western protocols for psychedelic therapy encourage an inward experience
Why people who rank highly in the personality trait absorption are more likely to have mystical experiences, both spontaneously and while under the influence of psychedelics
Ways to train psychological states of surrender and acceptance prior to high-dose psychedelic therapy which can encourage mystical experiences and prevent adverse reactions
Quotes:
“What makes psychedelics quite interesting is that they—under the right, appropriate conditions and contexts—they can reliably elicit these [mystical] experiences.” [4:39]
“The psychedelic 5-methoxy-DMT is definitely an interesting substance to highlight here. … The data that is there shows that when it’s used in a supportive context, it can predict mystical experiences—three quarters of cases, over that in two separate studies that have been done so far.” [31:22]
“Entering the experience with an emotional intent or a spiritual motivation seems to predict greater likelihood of mystical experiences” [34:36]
“There’s this aspect that negatively predicts mystical experience called mental barriers. And this is where you enter the experience with in some sense an overly rational, analytical way of viewing things, and if you enter the experience like that that’s a potential block on mystical experiences happening.” [44:21]
“People with meditation experience or with an ongoing practice, they seem more liable to report states of oceanic boundlessness tied to the mystical experience.” [49:16]
“Nature-based settings seem to be quite conducive to mystical and spiritual states, just inherently.” [57:00]
Links:
Dr. Gandy’s article: predictors and potentiators of psychedelic-occasioned mystical experiences
Dr. Gandy’s Research Gate profile
Centre for Psychedelic Research at Imperial College London
Previous episode: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy
Previous episode: Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
Psychedelics’ Potential to Improve Health Habits with Pedro Teixeira, PhD
Psychedelics’ Potential to Improve Health Habits with Pedro Teixeira, PhD
On this episode of the Psychedelic Medicine Podcast, Dr. Pedro Teixeira joins to discuss the emerging research about the effects of psychedelics on health behavior change. Dr. Teixeira is a professor of physical activity and health at the University of Lisbon and the director of research for the Synthesis Institute in the Netherlands. He holds bachelors and masters degrees in exercise science and a PhD in nutritional sciences. As an academic, Pedro’s main research interest is health behavior change, a field which he is now trying to put into conversation with the latest psychedelic science.
In this conversation, Dr. Teixeira shares the basics of the field of health behavior change, which seeks to study how and why people end up developing positive-health-conscious behaviors. This is a field that is of particular interest to clinicians, as doctors are always looking to encourage healthful behaviors in their patients.
When it comes to research on the impact of psychedelics on health behavior change, Dr. Teixeira explains that much of the current data is anecdotal, though some evidence can be drawn from studies that primarily examined psychedelic therapy for tobacco and alcohol cessation. The data that does exist, however, paints a very promising picture, with many psychedelic users reporting positive changes in diet and exercise following experiences with these mind-altering substances—an effect which Dr. Teixeira notes is often observed even if there was no intent for health behavior change prior to the psychedelic experience.
However, more research is needed to substantiate these preliminary results. To that end, Pedro shares the idea of “behavioral psychedelics”—a new methodological paradigm in psychedelic research that will focus more on collecting data on concrete behaviors following psychedelic therapy as opposed to the primarily psychometric data which has dominated the field.
Dr. Teixeira also emphasizes that the field of health behavior change could be an important vehicle for emphasizing the role of psychedelics as tools for preventative health, taking the field beyond the current paradigm which sees psychedelics as primarily useful for their potential to address acute mental health conditions.
Dr. Teixeira can be reached at pteixeira@fmh.ulisboa.pt
In this episode:
The emerging field of health behavior change
Types of health-related behaviors that could be encouraged by psychedelic experiences
The new paradigm of “behavioral psychedelics”
Possible preventative health roles for psychedelics
The evidence from tobacco and alcohol cessation trials for health behavior changes following psychedelic use
Quotes:
“[Recent observational studies] seem to show that for some reason psychedelic users are not only healthier from a physical health perspective, but there’s also indications that that is caused by some of their behaviors.” [13:13]
“What better way to convince future politicians or policymakers than to show that people are actually improving the quality of their lives and their health habits and saving healthcare costs and eating more sustainable diets perhaps, if indeed the studies in Oregon and in the future in other places are showing that there is a preventative aspect, there is a lifestyle enhancement aspect to these experiences.” [21:57]
“When you behave from a self-determined perspective, or when you’re motivated more internally as opposed to being more externally motivated, your outcomes will be better. Your behavioral outcomes, but also your health outcomes.” [26:21]
Links:
Dr. Teixeira's research group website
Dr. Teixeira's paper: Psychedelics and Health Behavior Change
Lucid News coverage of Dr. Teixeira’s article
Article: Behavioral Psychedelics: Integrating Mind and Behavior to Improve Health and Resilience
Self-Determination Theory website
Previous episode: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy
How Setting Can Affect Psychedelic Journeys with Frederick Barrett, PhD
How Setting Can Affect Psychedelic Journeys with Frederick Barrett, PhD
In this episode of the Psychedelic Medicine Podcast, Frederick Barrett joins to discuss setting and the research into how this variable can affect psychedelic experiences. Fred is an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine where he is also the associate center director of the Center for Psychedelic and Consciousness Research. He has been conducting research at Johns Hopkins since 2013 and is currently leading a number of ongoing studies to better understand the psychological, biological, and neurological mechanisms underlying therapeutic efficacy of psychedelics.
In this discussion, Fred unpacks his recent article “Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature” which appeared in the February 2022 edition of Current Topics in Behavioral Neurosciences. For this study, Dr. Barrett and colleagues gathered as many studies as they could find which dealt with the topic of the role of setting in psychedelic experiences. While they found over 1,000 articles which discussed the topic in some capacity, the researchers eventually narrowed the selection down to just 43 articles which provided empirical data on this variable.
Fred mentions that while ideas of set and setting loom large in psychedelic discussions, this is actually a topic which has received comparably less attention in research contexts. This is beginning to change, however, as researchers have become more certain in the overall efficacy of psychedelic therapies for treating a variety of conditions and are now turning to more specialized investigations, such as looking more closely into the impacts caused by various tweaks to the setting of psychedelic therapies.
When it comes to the state of current research on setting, Dr. Barrett reports that music is by far the most studied variable. He discusses different approaches which psychedelic therapists have taken in investigating this topic, with research investigating familiar vs unfamiliar music, or having music vs not having music in a session. He also shares research about expert meditators and how these subjects responded differently to music while under the influence of psychedelics when compared to typical patients.
Another variable which Fred discusses is the element of ritual, which is especially prominent in more traditional contexts of psychedelic use. This variable is also interesting because it interacts with participants' expectations, blurring the distinction between set and setting as distinct categories. In closing, Dr. Barrett shares some of his own thoughts about the blurriness of set and setting, suggesting that our understanding of these categories may evolve as empirical research further investigates the roles they play in guiding psychedelic experiences.
In this episode:
The relationship between ritual and set and setting
The difficulties of rigorously studying all the variables of setting in the context of psychedelic experiences
The different aspects of setting in traditional, ritualistic contexts for psychedelic experiences versus the context of modern psychedelic therapy
Music as an important aspect of setting during psychedelic journeys
The blurry distinction between set and setting
Quotes:
“Out of all of this literature, the one thing that became clear to us was that everybody talks about set and setting, and many papers affirm set and setting are important, but very few actually empirically test an element of set and setting.” [6:49]
“One of the elements of set and setting in general that we found to be addressed across a number of different studies was the question of specific ritual or ceremonial settings.” [15:04]
“Music seems to play an overwhelming role in shaping—and some people think driving—their psychedelic experience.” [22:25]
“Set and setting are both mutable. Your experience at one point in a session, I would argue, is going to influence, or at least has the opportunity to influence the things that happen next.” [41:03]
Links:
Dr. Barrett’s paper: Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes
Johns Hopkins Center for Psychedelic & Consciousness Research
Previous episode: The Latest Research on Psilocybin for Depression with Matthew Johnson, PhD
Previous episode: Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
Previous episode: LSD Scientific Research with Dr. Katrin Preller
When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD
When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD
On this episode of the Psychedelic Medicine Podcast, Dr. Rick Barnett joins to discuss when to not proceed with a planned psychedelic journey. Rick is a licensed clinical psychologist and licensed alcohol and drug counselor, trained in psychedelic therapies and research by the California Institute for Integral Studies. He is the cofounder of the psychedelic society of Vermont while also consulting with patients curious about psychedelic research and therapies, including helping people understand the processes of preparing for, experiencing, and integrating the intentional use of psychedelics for personal growth and healing. Dr. Barnett also works with patients in a traditional psychotherapeutic group practice and has also recently begun offering low-dose ketamine therapy.
In this conversation, Rick expounds on his recent LinkedIn article of the same title, exploring the various biological, psychological, and social experiences which provide legitimate reasons for postponing a planned psychedelic experience. On the biological side, Rick explains that sudden illness or injury could absolutely constitute sufficient reason to reschedule a therapy session, and that consulting closely with your therapist or guide is essential if the decision isn’t clear cut, as in the case of something which could be a stomach bug or just nervousness manifesting as digestive discomfort.
When it comes to the psychological side of things, Rick mentions that it is often a difficult circumstance to navigate, as mental distress is often the reason a patient is pursuing psychedelic therapy in the first place. However, Rick makes a distinction between the typical levels of depression and/or anxiety a patient is accustomed to experiencing, and a much more intense fear which is also qualitatively different that can arise before a session. Again, this is a situation where open communication between patient and therapist or guide is essential in order to help the patient make the best decision, but Rick also stresses that because this is a wholly internal experience, that prudent introspection is ultimately what will guide the decision making.
In terms of the social reasons for not proceeding, Rick cites turmoil in personal relationships, traumatic contemporary events, and also recent experiences of death. These can all lead to an individual having a particularly heavy emotional burden going into a session, causing potentially difficult experiences during the psychedelic journey. While sometimes difficult experiences can be very healing in the long term, especially following effective integration, these external stressors have the potential to take people’s focus away from the intended inner work, so postponing until the person is confident they aren’t bogged down by these social factors could be prudent.
With all these factors, Rick stresses that a patient can always return to a psychedelic journey at a later time if they decide not to proceed. A good guide or therapist will accommodate and even proactively support a patient in ensuring they are coming to the experience at the right time.
In this episode:
The importance of examining refund policies of psychedelic retreats or therapy practices
Rick’s bio-, psycho-, and social considerations for not proceeding with a psychedelic journey
Why these considerations are often molecule-specific
What kinds of interpersonal conflicts may warrant postponing a psychedelic journey
Distinguishing between overwhelming fear and typical anxiety prior to a psychedelic experience
The impacts of traumatic political or social events on mental health and postponing a journey
Quotes:
“When you speak to a guide, when you speak to a coach, when you speak to a researcher, my hope is and my experience has been that it is always an option on the table at the last minute if you don’t feel quite right that you have permission to opt out.” [5:24]
“Ketamine, when it comes to physical illnesses might be a different judgment call because ketamine—dissociative anesthetic, you kind of lose sense of your body—if there’s something going on physically, that might be okay to go ahead with… because you’re not with your body as much, but psilocybin, other high dose classic psychedelics and physical illness or physical pain, that could be different.” [17:59]
“People need permission to say ‘you know what, it’s gonna happen’—you’ve done all the preparation, you’ve done all the work. If it’s not going to happen right now, it’s still going to happen.” [32:57]
Links:
Psychedelic Society of Vermont
Rick’s LinkedIn Article: When NOT to Proceed with a Planned Psychedelic Journey
When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PhD
When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PhD
On this episode of the Psychedelic Medicine Podcast, Dr. Rick Barnett joins to discuss when to not proceed with a planned psychedelic journey. Rick is a licensed clinical psychologist and licensed alcohol and drug counselor, trained in psychedelic therapies and research by the California Institute for Integral Studies. He is the cofounder of the psychedelic society of Vermont while also consulting with patients curious about psychedelic research and therapies, including helping people understand the processes of preparing for, experiencing, and integrating the intentional use of psychedelics for personal growth and healing. Dr. Barnett also works with patients in a traditional psychotherapeutic group practice and has also recently begun offering low-dose ketamine therapy.
In this conversation, Rick expounds on his recent LinkedIn article of the same title, exploring the various biological, psychological, and social experiences which provide legitimate reasons for postponing a planned psychedelic experience. On the biological side, Rick explains that sudden illness or injury could absolutely constitute sufficient reason to reschedule a therapy session, and that consulting closely with your therapist or guide is essential if the decision isn’t clear cut, as in the case of something which could be a stomach bug or just nervousness manifesting as digestive discomfort.
When it comes to the psychological side of things, Rick mentions that it is often a difficult circumstance to navigate, as mental distress is often the reason a patient is pursuing psychedelic therapy in the first place. However, Rick makes a distinction between the typical levels of depression and/or anxiety a patient is accustomed to experiencing, and a much more intense fear which is also qualitatively different that can arise before a session. Again, this is a situation where open communication between patient and therapist or guide is essential in order to help the patient make the best decision, but Rick also stresses that because this is a wholly internal experience, that prudent introspection is ultimately what will guide the decision making.
In terms of the social reasons for not proceeding, Rick cites turmoil in personal relationships, traumatic contemporary events, and also recent experiences of death. These can all lead to an individual having a particularly heavy emotional burden going into a session, causing potentially difficult experiences during the psychedelic journey. While sometimes difficult experiences can be very healing in the long term, especially following effective integration, these external stressors have the potential to take people’s focus away from the intended inner work, so postponing until the person is confident they aren’t bogged down by these social factors could be prudent.
With all these factors, Rick stresses that a patient can always return to a psychedelic journey at a later time if they decide not to proceed. A good guide or therapist will accommodate and even proactively support a patient in ensuring they are coming to the experience at the right time.
In this episode:
The importance of examining refund policies of psychedelic retreats or therapy practices
Rick’s bio-, psycho-, and social considerations for not proceeding with a psychedelic journey
Why these considerations are often molecule-specific
What kinds of interpersonal conflicts may warrant postponing a psychedelic journey
Distinguishing between overwhelming fear and typical anxiety prior to a psychedelic experience
The impacts of traumatic political or social events on mental health and postponing a journey
Quotes:
“When you speak to a guide, when you speak to a coach, when you speak to a researcher, my hope is and my experience has been that it is always an option on the table at the last minute if you don’t feel quite right that you have permission to opt out.” [5:24]
“Ketamine, when it comes to physical illnesses might be a different judgment call because ketamine—dissociative anesthetic, you kind of lose sense of your body—if there’s something going on physically, that might be okay to go ahead with… because you’re not with your body as much, but psilocybin, other high dose classic psychedelics and physical illness or physical pain, that could be different.” [17:59]
“People need permission to say ‘you know what, it’s gonna happen’—you’ve done all the preparation, you’ve done all the work. If it’s not going to happen right now, it’s still going to happen.” [32:57]
Links:
Psychedelic Society of Vermont
Rick’s LinkedIn Article: When NOT to Proceed with a Planned Psychedelic Journey
Psychedelics and Women’s Health with Allison Feduccia, PhD
Psychedelics and Women’s Health with Allison Feduccia, PhD
In this episode of the psychedelic medicine podcast, Allison Feduccia, PhD joins to discuss the intersection of psychedelic medicine and women’s health. Dr. Feduccia is a neuropharmacologist, psychedelic researcher, and builder of virtual and in-person communities. She is cofounder of two prominent organizations, psychedelic.support and Project New Day, and is additionally a scientific advisor for Eastra. Alli has been researching psychedelics since 2004 when she first began studying MDMA and has subsequently been involved in the field through work at numerous universities, the NIH, and MAPS. In this work she seeks to spread evidence-based knowledge, connection to resources, and strategies for individuals to maximize potential therapeutic benefits of psychedelics through safe and responsible practices.
In this conversation, Alli responds to questions touching on all areas of women's health and the impact psychedelics could have specifically for female patients. A major theme of the discussion is the interplay between psychedelics and hormones. While this is a topic with little in the way of scientific research, Alli shares some interesting ideas about how the neuromodulation of psychedelics could interact with endocrine systems, and how serotonin receptors within the uterus could explain certain anecdotal reports of various effects of psychedelics on menstrual pains or irregularities.
In a similar vein, Alli discusses some of the physiological effects of psychedelics, particularly in relation to blood flow, and how these non-experiential features of these compounds could actually be helpful properties for women with certain conditions. This insight leads to interesting avenues for future drug development and also stresses the importance of studying psychedelics at different doses so that the positive health effects can be isolated.
Alli also talks about the potential for psychedelic healing in the context of postpartum depression, sharing an evocative family story which illustrates simply how crucial and overlooked this issue has been in healthcare. The advances in mental healthcare coming out of psychedelic research provide a promising path forward for such conditions, however.
In this episode:
How psychedelics could help with premenstrual discomfort
Concerns about taking psychedelic substances while pregnant
Psychedelics and postpartum depression
How psychedelics could impact hypoactive sexual desire disorder
Psychedelics interactions with menopause
Potential role for hormones alongside set and setting for impacting the psychedelic experience
Quotes:
“It may be that psychedelics could really affect women’s moods as they go through these different life stages, and help them feel better.” [4:45]
“Maybe this concept of neurotransmitter modulation with our sex hormones may be a target for drug development work as well.” [23:42]
“This is also pertinent to transgender women who may be using hormones. This type of modulation on mood or physiological symptoms—this could be really applicable too for helping to really have the body adjust and be more balanced to changes in hormonal fluctuations in the body.” [26:59]
Links:
Psychedelics and Sexual Trauma with Laura Mae Northrup, MFT
Psychedelics and Sexual Trauma with Laura Mae Northrup, MFT
In this episode of the Psychedelic Medicine Podcast, Laura Mae Northrup, MFT joins to discuss the crucial topic of psychedelics and sexual trauma. Laura is an author, education, and somatic and relational psychotherapist. She brings a spiritual and politicized lens to her therapeutic work and is deeply invested in mentoring healing practitioners and supporting the spiritual integrity of our collective humanity. In addition to her therapeutic practice, Laura is also a podcaster and has addressed the topic of psychedelics and sexual trauma in her show Inside Eyes.
In this wide-ranging conversation, Laura addresses the subject from two angles: first, looking at how psychedelic medicine can be effective in helping survivors of sexual trauma heal; and second, examining how sexual abuse is perpetrated within the context of psychedelic therapy.
To address the topic of psychedelic healing for survivors, Laura explains how sexual trauma has an affective aspect and an aspect related to the nervous system. With that in mind, it’s clear how psychedelics can be a powerful tool in helping survivors encounter difficult feelings and work with their nervous system. Laura also shares an interesting hypothesis regarding why ketamine—a dissociative substance—is actually often very helpful for people who dissociate in their daily lives as a trauma response. She contrasts this daily dissociation with the ketamine experience by explaining that as a trauma response dissociation works by compartmentalizing experiences and feelings, while the ketamine experience softens those boundaries, allowing the survivor to have a more integrated experience of themself.
Laura also emphasizes the necessity to go slow and put in a lot of prep work to ensure any psychedelic healing experiences are as safe and effective as possible for survivors. Because of the dynamics of trauma, it is easy to be eager for an experience of dramatic healing, but because of how powerful psychedelics can be, and because of the power that facilitators and guides have over participants during therapy, these can also be dangerous experiences which could lead to additional traumatic experiences. As such, ensuring a high level of comfort and trust prior to a session is essential, and, if that cannot be achieved, it is safer to pursue other kinds of healing until the right opportunity is available.
Finally, Laura discusses the crucial topic of sexual violence within the context of psychedelic therapy. She mentions that even within the more formal context of conventional therapy—with its checks and balances of professional licenses and credentials—there is a shocking amount of sexual misconduct between therapists and clients. Considering that a lot of psychedelic therapy continues to operate underground due to prohibition, there is serious cause for concern about the prevalence of this issue. Laura explains how, especially in the context of the psychedelic experience, it is impossible to give true sexual consent. This is doubly the case due to the power differential between a client and a psychedelic therapist.
Laura concludes this discussion by emphasizing that healing for those providing psychedelic therapy is absolutely crucial to address this issue, as it is because these guides and facilitators have not properly addressed their own healing that they continue to perpetrate abuse.
In this episode:
The state of research on psychedelic healing for survivors of sexual assault
The relationship between preparatory work and the efficacy of psychedelic therapies for people with PTSD
The difficulty of choosing the right guide or facilitator as a person with trauma
Why there isn’t one best medicine to heal sexual trauma
Why ketamine may be effective for people struggling with dissociation due to traumatic experiences
The importance of the three domains of mind, body, and spirit in psychedelic work
The variety of ethical concerns relating to behavior of guides or facilitators
Quotes:
“I really enjoy supporting survivors to heal, but also we need to be talking about this very, very concerning issue of people sexually abusing their clients.” [6:07]
“When we’re talking about healing from trauma, a lot of times what we’re talking about is growing the capacity to experience and endure very big feelings.” [11:00]
“Being able to work with trauma is like way more than just a little tiny workshop, I mean it's truly something you’re learning to do throughout your career, it involves a lot of extensive training and consultation and guidance from more seasoned practitioners.” [24:21]
“If something is so powerful that it could do that much profound healing for you, man just make it the best it can be. Go with [a facilitator] that you don’t have any reservations about.” [33:00]
“You can always pause a therapy. And there can be such an emphasis on ‘no, move forward’—you can just say ‘that was weird for me, I need time.’ You can go and you can talk to your other people.” [45:29]
“It’s so complicated because the person you would maybe think is the number-one person you would go to to talk about something like this, is your therapist, who is also the person harming you.” [46:54]
“We need to show up to our own healing, because that’s why we abuse people, that’s why we harm people, because we are not doing our own healing work.” [56:48]
Links:
Laura’s forthcoming book Radical Healership: How to Build a Values-Driven Healing Practice in a Profit-Driven World (use code radical35 for 35% off and free shipping)
Psychedelic Survivors website (new resource referenced at the end of the show)
Psychedelic Therapies for Pain with Joel Castellanos, MD
Psychedelic Therapies for Pain with Joel Castellanos, MD
In this episode of the Psychedelic Medicine Podcast, Joel Castellanos joins to discuss the emerging topic of psychedelic therapies for pain-related conditions. Dr. Castellanos is a Board certified physical medicine and rehabilitation and pain management physician and an associate professor in the department of anesthesiology at UC San Diego school of medicine. He earned his medical degree from University of Toledo college of medicine and has since completed a two year program in healthcare administration during his residency at University of Michigan, as well as a fellowship in pain medicine at UC San Diego school of medicine. Most recently he completed the integrative medicine fellowship from the University of Arizona.
In this conversation, Dr. Castellanos introduces the topic of psychedelics as a therapeutic modality for various pain conditions. Dr. Castellanos explains that much of the pain management field focuses on neuromodulation as the basis for particular therapeutic techniques, so psychedelics—which have profound modulating effects within the brain—naturally seem promising.
However, research into this topic is still developing, with studies from the seventies providing some initial data which is now being corroborated and expanded by contemporary research. Dr. Castellanos shares the details of this work, explaining how combined psychedelic treatment and mirror box therapy could prove to be particularly efficacious for individuals suffering from phantom limb pain.
In light of the upcoming trials led by Dr. Castellanos and his colleagues at the Psychedelic Health Research Initiative at UC San Diego, he also discusses certain special considerations for working with amputees as guides or facilitators of psychedelic therapy. The double blind randomized controlled trial investigating the efficacy of psilocybin therapy for phantom limb pain will be conducted first and is currently enrolling. This study seeks to test the efficacy of psilocybin therapy for this condition as well as elucidate its potential mechanism of action through brain imaging. Click here to enroll.
In this episode:
An overview of the literature on psychedelics and pain
Albert Lin’s experience treating his phantom limb pain with combined psychedelic and mirror box therapy
Why psychedelics may be a great alternative to many current treatment options for chronic pain
Stories of healing resulting from psychedelic therapy in patients who have suffered with chronic pain
How to enroll in Dr. Castellanos’ upcoming trial for patients with phantom limb pain
Quotes:
“It’s really interesting to me that neuromodulation - modulating the nervous system - is such a big part of pain medicine—and no one had really looked at psychedelics as an option when they are something that really modulates the nervous system in a profound way.” [4:24]
“I don’t want people to think that this is going to be a panacea, that this is going to be the cure for everything and everyone’s pain because we need to do the research, we need to do the work and really answer the clinical question on who this is going to be most efficacious for.” [7:50]
“Where there has been the most evidence so far and the most work done is in the headache patient population, which is definitely needed. There are so many people who suffer from migraines, from cluster headaches, and it can be really debilitating.” [17:45]
“In the same way that patients who have had PTSD or have severe anxiety or depression it helps to do some talk therapy with those [psychedelic therapy] sessions, maybe some movement therapy during the psychedelic sessions may be beneficial [for treating pain].” [23:26]
Links:
Enroll in Dr. Castellanos’ upcoming study through PHRI at UCSD
Psychedelic Health Research Initiative at UC San Diego
MDMA-Assisted Therapy for PTSD with Rick Doblin, PhD
MDMA-Assisted Therapy for PTSD with Rick Doblin, PhD
In this episode of the Psychedelic Medicine Podcast (formerly the Plant Medicine Podcast), Rick Doblin joins to discuss the past, present, and future of MDMA-assisted therapy. Rick Doblin is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies. He received his doctorate in public policy from Harvard and has also studied under the father of transpersonal psychology Stanislav Grof. Through MAPS, Rick aspires to develop legal contexts for beneficial uses of psychedelics and marijuana as prescription medicines, but also for self-development and personal growth in otherwise healthy individuals.
Rick begins this wide-ranging conversation discussing the early days of MDMA. The compound was originally synthesized by famed chemist Alexander "Sasha" Shulgin and, unlike the classic serotonergic psychedelics, it was not scheduled under the Controlled Substances Act in the early 70s. It was during this period of legality that therapeutic uses of MDMA were first developed and it was only later that the drug became repurposed as a recreational substance to be used in social settings, which consequently led to its emergency scheduling by the DEA.
Rick recalls his own initial experiences with the empathogenic compound, stating that he was initially skeptical of its value, prior to gaining first-hand experience. Following this experience, however, he became convinced of its therapeutic potential and he shares some of his own early experiences of using MDMA to help people heal, including a very touching tale of his own grandmother’s struggle with depression.
From here, Rick discusses the founding of MAPS and his decision to pursue education in policy in order to better understand strategies for furthering MDMA-therapy even while living under prohibition. Since that time, MAPS has gone on to do incredibly impactful work in developing studies researching the safety and efficacy of MDMA-assisted therapy, specifically for post-traumatic stress disorder. Rick shares the progression of these studies, highlighting the results from the most recent phase three investigations which are the last step prior to FDA approval for the therapeutic protocol. These studies show high statistical significance and an amazing effect size resulting from MDMA-assisted therapy, with results being mirrored at all research locations and showing durability over time.
Because of this amazing progress, Rick believes we are at the final stretch prior to full FDA approval for MDMA use in a therapeutic context for PTSD, and subsequent rescheduling of the substance by the DEA, which he believes will take place in mid to late 2023. This development will have broad global impacts, spurring other countries to promptly follow suit.
Rick closes out this discussion by emphasizing the need for mass mental health in our day and age, and sharing MAPS’ lofty goals of training thousands of therapists to hopefully bring psychedelic therapy to millions of patients in the coming decades.
In this episode:
Rick Doblin’s personal journey
The history of the MDMA’s synthesis and legality
Rick’s first experiences with MDMA and early experiments with MDMA therapy
MAPS’ “two-pronged” strategy for mass mental health
Early efforts to get an MDMA therapy protocol approved by the FDA following prohibition
The politics of concerns about MDMA neurotoxicity and how this impacted MAPS’ early approach
The results of the first phase three studies of MDMA for PTSD
How FDA approval of MDMA will lead to an international cascade of approval and rescheduling
Rick’s predictions for psychedelic medicine in the years to come
Quotes:
“What a lot of people don’t know is that MDMA was a therapy drug before it was a party drug. And it was the party drug nature of it that really got it criminalized.” [7:38]
“Seeing what it was like when it was legal and experiencing that, and experiencing situations where people would take it, the kind of experiences and healings, and learnings that people would have, was amazing.” [19:12]
“What we need is, I believe, legal access to medicinal MDMA, covered by insurance, by trained professionals, and psychedelic clinics. And we also need a whole different kind of drug policy for non-medical use that involves honest drug education, access to pure substances, harm reduction, peer support, and also treatment on demand.” [21:08]
“The irony here is that the first legal move against MDMA was illegal. The DEA did not have the authority to emergency schedule drugs.” [23:43]
“FDA is legally bound to approve MDMA for PTSD if these [phase 3] studies generate statistically significant evidence of efficacy, and there are no new safety problems.” [40:27]
“We think by the third quarter of 2023 we will have FDA approval assuming the second phase 3 study goes well. And then by the fourth quarter, the DEA has to reschedule [MDMA].” [51:18]
“What’s even greater is the 12-month follow-up data was 67% no longer had PTSD. So people kept getting better—not only was it durable, but they kept getting better.” [55:00]
“The thing to emphasize here is that MDMA is not the treatment. The treatment is therapy. The MDMA makes the therapy more effective and there can be different kinds of therapy that are used with it.” [1:01:38]
Links:
Trip of Compassion Documentary
The Way of the Psychonaut Books by Stanislav Grof
Upcoming MAPS Psychedelic Science Conference 2023
Becoming an MDMA-Assisted Therapist with Shannon Carlin, MA, LMFT
Psilocin vs. Psilocybin: Differences & Potential Clinical Uses with Josh Woolley, MD, PhD
Psilocin vs. Psilocybin: Differences & Potential Clinical Uses with Josh Woolley, MD, PhD
In this episode of the Plant Medicine Podcast, Dr. Josh Woolley joins to discuss the differences between psilocin and psilocybin, and to share upcoming clinical research which will further clarify the safety profiles, subjective effects, and clinical uses of these psychedelic substances.
Dr. Woolley is an Associate Professor in Residence in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco (UCSF) as well as a staff psychiatrist in Mental Health at the San Francisco Veterans Affairs Medical Center (SFVAMC). He is Board Certified in Psychiatry by the American Board of Psychiatry and Neurology. He is the Director of the Bonding and Attunement in Neuropsychiatric Disorders (BAND) lab at UCSF that focuses on understanding and treating social deficits in neuropsychiatric disorders including schizophrenia, substance use disorders, and mood disorders. He is also the Director of the Translational Psychedelic Research (TrPR) Program at UCSF, which brings together scientists and care providers across disciplines to understand how psilocybin, LSD, ketamine, MDMA, and related compounds impact the brain and other organ systems.
In this conversation, Dr. Woolley begins by sharing a bit about TrPR and the upcoming research they will be conducting on psychedelics as a treatment for depression in individuals living with Parkinson's disease. Dr. Woolley then introduces the main topic of psilocin, psilocybin, and the differences between these two compounds. He explains that psilocybin is a prodrug for psilocin, meaning that the human body metabolizes psilocybin into psilocin, which is the compound responsible for the psychoactive effects produced by psilocybin-containing mushrooms.
Dr. Woolley’s upcoming research will provide more concrete data on the differences between these two compounds, as TrPR will be testing both psilocybin and psilocin in healthy volunteers, giving each participant both substances on different occasions so that effects can be studied both across the sample pool and within individuals. Dr. Woolley hypothesizes that psilocin could have certain clinical advantages over psilocybin: it could produce more consistent effects person-to-person at a given dose as individual differences in metabolism would be less relevant; it may more quickly induce a psychedelic experience, particularly when administering psilocin sublingually; and it is possible there may be fewer side effects related to the gastrointestinal tract.
Dr. Woolley closes out the discussion by sharing other upcoming research to be conducted by TrPR. In addition to the study investigating psilocin and the research into psychedelics for Parkinson's disease, TrPR is also investigating the use of psychedelics to improve quality of life for individuals suffering from chronic pain and they will also be further investigating the interaction between psychedelics and bipolar disorder.
In this episode:
The approach of the Translational Psychedelic Research (TrPR) Program and its upcoming research
The pharmacological differences between psilocybin and psilocin and how the experience induced by the substances may differ
In-subject study design and how it is used in Dr. Woolley’s psilocin trials
The mechanisms for tolerance with using psychedelic drugs
Data on the contraindication of psychedelic use for individuals with bipolar disorder
Quotes:
“For a long time, when you make [psilocin] synthetically—[...]—psilocin wasn’t stable. So, even if you made psilocin synthetically you would then turn it into psilocybin so it would be stable and then people would take it and it would get turned back into psilocin.” [8:39]
“You can’t do sublingual psilocybin because it won’t get broken down easily. But, sublingual psilocin doesn’t need to be metabolized and it can go across your buccal membrane, skipping the gut. That theoretically could be useful because then you might skip the first pass metabolism, it doesn’t have to go to the liver, and it might be faster that way and maybe again more consistent. And fewer side effects—maybe you won’t get any GI side effects if it doesn’t go to the GI tract.” [19:58]
“We think that psychedelics—psilocybin in particular—might be able to change people’s relationship to their [chronic] pain. It might be an analgesic too—it might make the pain go away, that would be great. But even if it doesn’t do that, we think that it should allow people to basically find the pain less impairing.” [41:22]
Links:
The Translational Psychedelic Research (TrPR) Program at UCSF
Delta-8 THC: Your Questions Answered with Dr. Carey Clark
Delta-8 THC: Your Questions Answered with Dr. Carey Clark
This episode of the Plant Medicine Podcast features a conversation with Dr. Carey Clark, discussing delta-8 THC. Dr. Clark is a registered nurse and an expert in cannabis care nursing. She holds a PhD from the California Institute of Integral Studies and is the immediate past president of the American Cannabis Nurses Association. She is also the editor and author of the first nursing textbook on medical cannabis Cannabis: A Handbook for Nurses and has over thirty publications in academic journals. Currently Dr. Clark serves as a professor at Pacific College of Health and Science where she also developed the first college-level, academic certificate in medical cannabis.
In this conversation Dr. Clark introduces delta-8 THC, discussing its chemistry, pharmacology, and legal status. She begins by sharing that delta-8 is a minor cannabinoid which exists naturally in small quantities within cannabis and hemp. Delta-8 THC is chemically very similar to delta-9 THC—the primary cannabinoid within cannabis which is known for its mind-altering and medicinal properties—and in fact, delta-9 naturally degrades into delta-8 under certain conditions. Due to the structural similarities, delta-8 produces similar effects to delta-9, and may have similar medical applications.
Dr. Clark mentions that delta-8 may be synthesized from CBD, allowing for this compound to be readily produced from legal components. However, the delta-8 which results from these synthesis methods contains traces of unknown compounds, perhaps as a result of the particular solvents used in the reaction, so Dr. Clark cautions that consuming these products could have certain risks, though the delta-8 cannabinoid itself is thought to have a similar safety profile to delta-9 THC. Instead. Dr. Clark emphasizes that whole plant medicines are likely the ideal for patients seeking to treat medical conditions with cannabis, but since delta-8 may be more readily available in certain areas due to its murky legal status it may be the best option for some individuals.
While scientific research into delta-8 is currently lacking, Dr. Clark shares the results from a few studies which use animal models and one study looking at the effects of delta-8 in the context of pediatric oncology. In addition to these published studies, Dr. Clark also shares anecdotal reports from patients, saying that these experiences are crucial, preferring to think of these reports as qualitative data which has yet to be systematically studied.
In this episode:
What delta-8 THC is and how it is made
Potential safety concerns with delta-8 products
The current research on delta-8
The legal grey-area of delta-8 THC and states which have banned the cannabinoid
Differences in the doses and effects of delta-8 and delta-9 THC
Quotes:
“My hope as well is that people who are able to access whole-plant medicine can really use whole-plant medicine safely and effectively and they have access to safe, effective medicines. That would be my recommendation—if somebody had a choice—over choosing a really synthesized medicine at this point because of the safety issues.” [15:30]
“[T]there’s still very little research and most of the patient experience we’re hearing is really anecdotal.” [24:52]
Links:
Dr. Clark’s faculty page at Pacific College of Health and Science
Psychedelics and Breathwork with Kyle Buller
Psychedelics and Breathwork with Kyle Buller
This episode of the Plant Medicine Podcast features a conversation with Kyle Buller on psychedelics and breathwork. Kyle is co-founder and host of the Psychedelics Today podcast and he has studied breathwork since October 2010 with Lenny and Elizabeth Gibson of Dreamshadow Transpersonal Breathwork. Kyle earned his BA in transpersonal psychology from Burlington College where he focused on the healthing potential of non-ordinary states of consciousness, exploring topics such as shamanism, reiki, plant medicine, and holotropic breathwork. He has also earned an MS in clinical mental health counseling with emphasis in somatic psychology and has since worked with at-risk teens in crisis and individuals experiencing an early episode of psychosis.
Kyle opens this discussion by providing a basic definition of breathwork and sharing his own journey with this modality. He discusses how breathwork can refer to a wide variety of practices, but what unites these disparate techniques is utilizing the breath to induce specific physiological states and experiences. The holotropic style of breathwork has roots in transpersonal psychology and the work of Stanislav Grof and it is this modality which is often compared to psychedelic experiences.
Kyle discusses how holotropic breathwork can be an incredibly powerful practice for trauma-healing and inducing visceral experiences—similar to the classical psychedelics. He recounts his own experiences with this practice, describing how he was able to relive the experience of being born in the state conditioned by the method of breathing. Due to the synergy with the psychedelic experience, Kyle mentions that there is a lot of potential for breathwork to help individuals integrate or prepare for psychedelic experiences, as well as being a powerful tool for clinicians involved in psychedelic-psychotherapy to better understand the non-ordinary states of consciousness their patients will be experiencing.
Because of the wide variety of breathwork techniques, Kyle discusses the possibilities of tailoring practices to the specific experiences of a client. Everyone has a unique “window of tolerance” depending on their background and constitution, and some people will benefit more from techniques which downregulate the nervous system and allow for peace and relaxation, while others may find more value in techniques which are highly stimulating and provide deeper, emotionally complex experiences that allow for self-exploration.
In this episode:
What breathwork is an how it relates to psychedelics
The origins of holotropic breathwork and Stanislav Grof’s transpersonal framework
Breathwork vs meditation
How to use breathwork to integrate and prepare for psychedelic experiences
The effects of different types of breathing on the nervous system
Quotes:
“[Breathwork] offered a really great tool for training, for understanding how to sit with people in non-ordinary states of consciousness.” [8:49]
“Some breathing techniques, like these more deeply cathartic techniques, they’re bringing up a lot of emotional memory and people are starting to work through a lot of somatic sensations, they are working through trauma.” [13:38]
“We really need to look at somebody’s whole picture, where they’re at, how they could potentially benefit, look at their nervous system, attune to that, and really think about what they could tolerate, what’s going on in somebody’s psyche.” [30:29]
“The breath is this flexible tool, it’s a vehicle—we can help to regulate our nervous system with it and explore it.” [39:38]
Links:
Psychedelics Today Education Center
Dreamshadow Transpersonal Breathwork
Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
In this episode of the Plant Medicine Podcast, Matt Johnson, PhD returns for the final installment to discuss his recent paper “Consciousness, Religion, and Gurus: Pitfalls of Psychedelic Medicine.” Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics.
In his paper, Dr. Johnson explores some concerns around certain norms which have developed in psychedelic therapy, and how these could have potential negative effects. Dr. Johnson raises two main concerns in this conversation. The first is how therapists, guides, and scientific researchers could advance various spiritual or religious beliefs within the therapeutic context or offer metaphysical interpretations of psychedelic experiences beyond what the client suggests.
The second concern involves how psychedelic medicine is presented, both on a cultural level and even materially within therapeutic settings. For example, Dr. Johnson suggests that it is inappropriate to have statues of the Buddha displayed in clinical settings, unless this is something requested by the client. He suggests that if psychedelic therapy embraces a certain “New Age” aesthetic wholesale, it could dissuade people who don’t identify with the subculture from taking advantage of these therapies, especially as these medicines become more widely accessible.
Additionally, Dr. Johnson points out that not all patients would have the same associations with the Buddha statue in the example, and that the inclusion of any particular religious iconography should be something chosen proactively by the client, rather than assumed by the therapist. Dr. Johnson concludes this conversation by again stressing a client-centered approach to psychedelic therapy, suggesting that this approach is best suited to circumvent these concerning pitfalls.
In this episode:
The issue with psychedelic therapists or guides bringing their own metaphysical beliefs into the psychedelic experience or its interpretation
How the current culture around psychedelic medicine subtly presents these therapies as being for specific kinds of people
How a client-centered approach from humanistic psychology can present an effective framework for psychedelic-assisted psychotherapy
Quotes:
“I think it’s critical that therapists—and scientists at this research phase we’re at now—be client-centered in terms of the therapeutic approach. In other words, not making any assumptions for the participants, for the patients, about what the interpretation of these experiences should be.” [4:36]
“You’re there to support them, you’re there to let them lead. If there’s any metaphysical meaning to be made, they are in the driver’s seat. You’re there to create a safe container, to care for their wellbeing, and to allow them to have their experience.” [11:08]
“It’s not that you’re denying any of this stuff—it very well may be that any of these people’s framework is ground truth—it’s just not your role to say and we don’t need to.” [15:06]
Links:
Dr. Johnson’s Paper: Consciousness, Religion, and Gurus: Pitfalls of Psychedelic Medicine
Exploring DMT Entities with Matthew Johnson, PhD
Exploring DMT Entities with Matthew Johnson, PhD
In this episode of the Plant Medicine Podcast, Matt Johnson, PhD returns to discuss previous survey research he conducted regarding DMT entities. Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics.
In this conversation, Dr. Johnson shares findings from his 2020 publication of survey research which investigates peoples’ experiences with DMT entities. To preface these findings, however, Dr. Johnson first lays the groundwork by explaining the limitations of scientific investigation into these kinds of psychic phenomena. He explains that science is unable to answer questions of whether or not DMT entities are ultimately real, or what the fundamental nature of these experiences is. It can, however, employ rigorous methods for analyzing reports of entity encounters in order to document common features of these experiences and the types of effects they can have on individuals.
In the survey, around twenty five hundred respondents shared their experiences of encountering an entity during a DMT experience. From the data collected, Dr. Johnson shares some of the common features of these entities. The beings are typically perceived as benevolent though there was a wide variety of ways the entities were conceptualized, ranging from aliens and machine elves to spirits and angels. Often participants believed the entities revealed metaphysical realities and the presence of these beings was frequently accompanied by extrasensory phenomena such as telepathic communication. Due to the dramatic nature of these experiences, Dr. Johnson’s research found some lasting impacts as reported by respondents, and he concludes by briefly discussing the effects of entity encounters on religious belief.
In this episode:
What questions science can and can’t answer, and the boundaries good scientific research has to take when investigating something such as DMT entities
The findings of Dr. Johnson’s survey research—some general trends regarding the qualities of entities described
Effects of entity encounters on religious belief
Quotes:
“My bet is that if people believe that there’s some sort of reality to these disincarnated entities—that it’s not just in their mind—there are certain people that can hold that experience in a positive way that might benefit them… and probably some of these over 2,000 folks, there’s probably some people that—again, aside from whether we know it’s true or not—believing in things that no one else can prove are there is probably a bad thing.” [12:38]
“The machine elf thing, I mean, that was Terrence McKenna’s trip. And he described it—and I think he was very honest that that was his experience—and I think people who’ve heard his experience, a good number of them have had machine elf experiences because they heard Terrence McKenna’s experience.” [16:17]
“Before the experience, 28% of these people identified as atheist, and then after the encounter that dropped to 10%.” [20:53]
Links: