Episodios

  • Ketamine: The Promise and the Peril with Mark Braunstein, DO

    Ketamine: The Promise and the Peril with Mark Braunstein, DO
    Jul 17 2024

    In this episode of the Psychedelic Medicine Podcast, Mark Braunstein, DO joins to discuss the promise and the peril of ketamine. Dr. Braunstein graduated medical school in 1997 then completed a General Psychiatry Residency at the University of New Mexico and then a fellowship in Child and Adolescent psychiatry at Maine Medical Center in 2002. Upon graduation from his fellowship and becoming board certified in general psychiatry he established a private practice in Durango, Colorado where plant medicine became part of his everyday integrative psychiatric practice.

    In this conversation, Dr. Braunstein shares some of the developments in the world of ketamine in the past three years since his previous episode, drawing on his own experience providing ketamine-assisted therapies. He stresses issues of grandiosity that can arise both when working with ketamine and when taking the medicine—issues which in the worst case and fuel ketamine use disorders. Dr. Braunstein stresses the importance of clinicians providing ketamine treatments being realistic and upfront about the potential harms of ketamine when advising prospective patients. In closing, he warns against the dangers of being in an echo chamber which reinforces potentially pathological substance use, especially for clinicians in the ketamine space.

    In this episode you'll hear:

    • Why ketamine has an addictive potential and how ketamine addiction presents
    • Ways to treat ketamine use disorder
    • The importance of informed consent
    • What patients should look for when seeking a ketamine provider
    • The importance of ketamine providers working with multiple modalities and having multiple tools in the toolbox besides ketamine

    Quotes:

    “Here’s what’s scary to me about ketamine: these people that I’ve seen having problems [with ketamine use] are largely lifetime recreational psychedelic/drug users without problems. And these are people who have made it to age fifty, smoking [cannabis], tripping a little bit, their whole life without having a problem—then at fifty years old, find themselves hooked on something for the first time.” [12:30]

    “[Ketamine] is not a microdosing medication… There is no such thing as ketamine microdosing. You think of microdosing as sub-perceptual. Everyone that I’ve met that’s abusing ketamine, it was not a sub-perceptual effect—they were very much abusing it to have that perceived effect. Maybe not a psychedelic effect—usually an intoxicated wonky effect is what they’re going for. And people refer to that as microdosing. It’s not microdosing. It’s abusing small doses.” [17:11]

    “What do I see that makes me concerned with someone I’m talking to—a clinician or a client? That grandiosity. So that gets me concerned right away when I hear about these ‘downloads’ because that’s where … other psychedelics can have dependency too. You see people … they go for aya ceremonies every week after week after week. So there can be an addiction to the download or to the release.” [34:35]

    “The people I know that have been successful in this line of work (from a patient standpoint), whether they’re a clinician or not, have been the ones that have embraced the work. And just knowing that this is going to be a process and I’m in it to win it, for life. I’m working on myself.” [35:40]

    Links:

    Dr. Braunstein on LinkedIn

    Ketamine Research Foundation website

    NeuPath Mind Wellness website

    Ketamine Training Center website

    Previous episode: Ketamine for Alcohol Use Disorder with Steven Mandel, MD

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

    Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

    Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT

    Psychedelic Medicine Association

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    38 m
  • 5-MeO-DMT for Trauma and PTSD with Steve Rio

    5-MeO-DMT for Trauma and PTSD with Steve Rio
    Jul 3 2024
    In this episode of the Psychedelic Medicine Podcast, Steve Rio joins to discuss 5-MeO-DMT for Trauma and PTSD. Steve is a psychedelic facilitator and Co-Founder of Enfold, which offers a groundbreaking psychospiritual model that combines psychedelic intensives, coaching, and community to help individuals heal trauma and reach their full potential. In this conversation, Steve shares his journey of how he got into facilitating 5-MeO-DMT experiences and insights on working safely and effectively with this medicine over the course of his practice. He discusses the screening procedure he uses before clearing clients for facilitated 5-MeO-DMT experiences to ensure safety as much as possible when working with this powerful psychedelic. Steve also talks about how he tailors his work with clients based on the state of their nervous system and their unique personality. In closing, Steve emphasizes the somatic quality of 5-MeO-DMT experiences, sharing different types of experiences people typically have on the medicine and how these can best be integrated. In this episode you'll hear: Preparation for safe and effective 5-MeO-DMT experiencesStories of transformation following 5-MeO-DMT healing for PTSD and focused integration practicesHow common 5-MeO-DMT reactivations are, and when they typically happenIssues of spiritual bypassing in underground psychedelic facilitationHow to navigate informed consent in the context of facilitating psychedelic experiences Quotes: “At the peak of the 5-MeO experience, there is no mind… When people talk about the death and the rebirth experience with 5-MeO, what we’re really talking about is relaxing and essentially dissolving the ego entirely so there is no experience of ‘you’ in the experience—you become one with the experience. But… what’s possible there is that we then access the nervous system and we see these very dramatic energetic releases and people often are physically reliving traumatic experiences and physically releasing the fight, flight, freeze response that may have happened or not happened.” [6:52] “Trauma is complex and for some people it’s not that simple. For some people, they go through a six- to twelve-month process after 5-MeO-DMT that is really challenging.” [22:37] “So [we’re] helping people… build sensitivity in their nervous system—reconnect with sensitivity and slowing things down and building more awareness and learning how to notice their emotions as sensations in the body before they become thought patterns.” [32:00] “I think one of the challenges in all of this is that people will lie to you to get to your experience because they’re desperate for the healing. And you have to be really careful about the conversations you have and asking open-ended questions and really listening to your intuition—and really being grounded in that.” [40:28] “What we’re doing here I would say there’s obviously a psychological component to it, but often that happens in the weeks and months afterwards. What’s happening here is a much more somatic experience and it can be very confusing and challenging for the mind of a person… you’ve paid all this money, you’ve prepared for weeks and months, you’ve been thinking about it, you come have this experience… Right after the ceremony for some people, the thought is ‘what just happened?’ and ‘did anything happen?’ and ‘did it work?’ because there’s very rarely like an immediate insight on ‘here’s how you’re going to make your life better’—that’s not what comes out of this experience. What comes out of this experience is a dramatic shift in how your body feels and often people will report feeling emotionally lighter or that they lost ten pounds. It’s hard to explain, but the way peoples’ eyes light up the day after the ceremony is so different—like they often just look different coming in and leaving.” [42:56] Links: Enfold Website Enfold on Instagram Enfold on YouTube Still In It: 5-MeO-DMT Stories Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT Previous episode: Psychedelic Adjunct Series: Somatic Therapy with Jenna Valentine, DACM, LAc Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT Previous episode: When *Not* to Proceed with a Planned Psychedelic Journey with Rick Barnett, PsyD Psychedelic Medicine Association Porangui
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    48 m
  • Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT

    Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT
    Jun 19 2024
    In this episode of the Psychedelic Medicine Podcast, Sunny Strasburg joins to open the conversation of leveraging lower doses of psychedelic substances for more effective healing. Sunny Strasburg, LMFT, a licensed psychotherapist, educator, and pioneering author, specializes in psychedelic therapies and training clinicians to be skilled and trauma-informed psychedelic therapists. As the founder and author of The Theradelic Approach, she equips clinicians with trauma-informed psychedelic-assisted therapy methods, blending IFS, EMDR, archetypal psychology, trauma-informed care, and her extensive experience. In this conversation, Sunny shares insights drawn from Internal Family Systems (IFS) and explores how these perspectives can help inspire more effective psychedelic work, especially with lower doses. She emphasizes the importance of adequate preparation and not over-valorizing intense psychedelic experiences, noting that these therapies themselves can be traumatic if not handled with care. Sunny also discusses how one’s own internal protectors have adaptive rolls and display a lot of compassionate intelligence, so even though these parts may initially provide a barrier to deep trauma work, it is important for therapists to work collaboratively with these parts of a client’s psyche. In closing she talks about how to better set reasonable expectations in group psychedelic therapy and retreat settings, where integration can easily turn into a competition of who had the most intense experience, with things like ego dissolution becoming the barometer for healing. In this episode you'll hear: How “protector systems” and “rubber band effects” manifest in high-dose psychedelic therapy sessionsUncovering previously unknown traumas during psychedelic therapies and how therapists can be better prepared for this situationHow therapists can skillfully work with symbolic material that arises in psychedelic journeys The importance of slowing down and letting the client guide the pace when addressing serious traumas in particularDifferences between ketamine, MDMA, and the classic psychedelics in terms of effects on the fear center of the brainLeveraging critical learning periods in therapy to reprocess traumatic memories Quotes: “Being a trauma therapist, you have to be skilled enough to know what is symbolic in a psychedelic journey, what’s a literal memory… You don’t want to do any kind of leading or prompting the client to fill in anything or directing them to anything—you’re really tracking where they are and letting them uncover their own path. Again, at the speed in which their protector system is ready for that.” [22:43] “These parts want people to remember. They want to heal, they want to let their stories be told. And so our job as therapists is to clear the clutter so we can really hear the system and trust the system. The system knows.” [28:02] “Trauma is like a sliver that’s buried in the arm—like in the deep skin of your arm and it’s got an infection around it. And all of your coping mechanisms, all of your protectors (using IFS language), is like building a giant layer of scar tissue on top of that. And you could just go through life with that, and you could just put lotion on the top of that scar and just try to make it look pretty—and that’s okay. But you could go in and surgically remove the sliver that’s been offending your system the whole time. And once you remove that sliver, you will start to heal—your arm will heal, it won’t have an infection anymore, right? But removing that sliver hurts. It’s painful. It’s a process. But you don’t have to deal with that sliver anymore. And that’s kind of how I imagine going through trauma work.” [31:08] “I’ve had clients that I’ve worked with using EMDR, IFS for years, we’ve made some progress, but then we get ketamine on board and it’s totally helped them and amplified the benefit.” [35:13] “Trust your protector system. Slow down. I promise, if you slow down and really get curious about what your protectors need, you will go so much further with these medicines. It really is not a race. It’s slow and steady, and you’re going to be able to get more work done.” [40:23] Links: Sunny’s website Sunny on LinkedIn Sunny on Instagram Previous episode: Ketamine-Assisted Psychotherapy for Accelerated Growth with Nick Brüss, EdD, LMFT Psychedelic Medicine Association Porangui
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    46 m
  • Encore episode: Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter

    Encore episode: Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter
    Jun 5 2024

    This episode of the Plant Medicine Podcast welcomes Dr. Angela Carter (they/them) to discuss the intersection of the LGBTQIA2S+ community and psychedelics. Dr. Carter is a queer, transgender, and genderqueer naturopathic primary care physician who also works as a midwife, sexual assault examiner, and health equity advocate in Portland, Oregon. They also serve as both the vice-chair and the equity in training subcommittees co-chair of the Oregon Psilocybin Advisory Board. In addition to these positions, Dr. Carter serves as the chair of the Transgender Health Program Community Advisory Board at Oregon Health & Science University. They also volunteer with many organizations including the Fireside Project, Black Rock City Emergency Services, and Queerdome.

    Dr. Carter begins this conversation by sharing exciting new research currently being conducted which involves LGBTQIA2S+ individuals and psychedelic therapies. While this particular area of research remains small, it is growing and the fruits of these studies will be an important step for better understanding how these new therapies can serve gender and sexuality minorities, and help facilitators understand the unique concerns of people in the LGBTQIA2S+ community. Dr. Carter illustrates these types of concerns by discussing the prevalence of gender binaries within psychedelic spaces. They describe how in a clinical setting it is prevalent to have both a male and a female facilitator, but this leaves no room for gender-nonconforming people to guide experiences—something which could be preferable if the patient themselves shares this identity.

    Dr. Carter also discusses this gender binary in traditional contexts. It is common for ayahuasca ceremonies to provide separate spaces for men and women, again leaving no space for gender-nonconforming people. This reification of the gender binary and the often patriarchal organization of the ayahuasca ceremony can have serious impacts on the set and setting, especially for people in the LGBTQIA2S+ community. Dr. Carter emphasizes the importance of making space for folks in the community so that they are able to receive therapy, attend ceremonies, and participate in integration with others who share similar identities. This shared identity, they emphasize, ensures that LGBTQIA2S+ people don’t feel out of place in contexts that ought to be healing. Dr. Carter closes by discussing how members of the LGBTQIA2S+ community experience disproportionate rates of mental illness, further illustrating the crucial importance of equity in accessing psychedelic medicine.

    In this episode:

    • Problems of representation and access for LGBTQIA2S+ individuals in the psychedelic space
    • Current research being done on the intersection between psychedelic therapies and unique issues faced by gender and sexuality minorities
    • Preparations to take before guiding a psychedelic experience for LGBTQIA2S+ people, particularly if you do not come from the community
    • How plant medicines could have unique benefits for the LGBTQIA2S+ community
    • Issues of poverty faced by marginalized peoples and how to support equity of access to emerging psychedelic therapies

    Quotes:

    “For some people that idea of melding, of becoming one and losing all of those unique pieces of themselves, doesn’t fit their paradigm of a spiritual connecting experience.” [10:47]

    “It’s precious, that centering of our community—to be able to sit with people who just understand.” [19:42]

    “Psychedelics offer the opportunity for connection of the self to something greater, something outside, a bigger community, spirituality, and really do a huge amount to heal peoples’ relationships with substances.” [25:20]

    “Marginalized communities have been really impacted, largely, by the war on drugs, which has put millions of people in jail for drug offenses and stolen their ability to make income, stolen their ability to connect with community and we really need to heal that.” [33:34]

    Links:

    Chacruna Institute Queering Psychedelics 2019 Conference

    Queerdome on Facebook

    Portland Psychedelic Society

    Psychedelic Medicine Association

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    38 m
  • The Potential of Non-Dissociative Ketamine with Hans Eriksson MD, PhD, MBA

    The Potential of Non-Dissociative Ketamine with Hans Eriksson MD, PhD, MBA
    May 22 2024

    In this episode of the Psychedelic Medicine Podcast, Dr. Hans Eriksson joins to discuss the potential of non-dissociative ketamine. Dr. Eriksson, Chief Medical Officer at HMNC Brain Health, is a highly respected drug developer and clinical psychiatrist with over 20 years of pharmaceutical experience. Prior to HMNC Brain Health, Dr. Eriksson served as Chief Medical Officer at COMPASS Pathways and previously as Senior Director of Clinical Research at Lundbeck and Medical Science Director at AstraZeneca.

    In this conversation, Dr. Eriksson shares what inspired him to move from clinical practice to drug development, and why he sees so much potential in developing non-dissociative forms of ketamine. He discusses the ways the dissociative effects of ketamine decrease the accessibility of this treatment due to the fact that these changes in perception are undesirable for a significant portion of patients. Dr. Eriksson also shares results from preliminary studies of non-dissociative ketamine which showed efficacy in inducing anti-depressant effects. In closing, Dr. Eriksson discusses why he thinks the experiential element of the classical psychedelics play an important role in their efficacy as mental health treatments, but why this might not be the case when it comes to ketamine.

    In this episode you'll hear:

    • The history of ketamine
    • The pharmacology of ketamine’s dissociative effect
    • The relationship between ketamine dose and antidepressant effect
    • The possibility of bladder issues and addiction with ketamine and whether non-dissociative forms of ketamine would also have these potentials
    • How Dr. Eriksson thinks about combining psychotherapy with ketamine treatments

    Quotes:

    “We are aiming for a similar exposure to the drug as you achieve with, for instance, an intravenous administration, but we are achieving a much lower peak concentration, maximum concentration of the compound. So that is one of the characteristics of our formulation.” [10:58]

    “Our view is that it's probably better to try to use the metabolism in the body as a tool to achieve very low exposure to ketamine but high exposure to the downstream metabolites.” [23:19]

    Links:

    Dr. Eriksson on LinkedIn

    HMNC Brain Health on LinkedIn

    HMNC Brain Health website

    Previous episode: Potential Benefits of Non-Hallucinogenic Psychedelics with Kurt Rasmussen, PhD

    Psychedelic Medicine Association

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    31 m
  • Ketamine-Assisted Couples Therapy with Chandra Khalifian, PhD

    Ketamine-Assisted Couples Therapy with Chandra Khalifian, PhD
    May 8 2024

    In this episode of the Psychedelic Medicine Podcast, Chandra Khalifian, PhD joins to explore ketamine-assisted couples therapy. Dr. Chandra Khalifian is a clinical psychologist, researcher, educator and Co-CEO of Enamory, a clinic and community focused on providing expansive relationship education and therapy including psychedelic-assisted couple-therapy.

    In this conversation Dr. Khalifian explores the intricacies of ketamine-assisted couples therapy, sharing why she thinks psychedelics, and ketamine in particular, could be a good fit for couples therapy. She discusses the various contexts where ketamine-assisted therapy may be a good fit for couples pursuing therapy, the therapeutic modalities well-suited to this work, and the different dosing and administration routes of ketamine. In closing, Dr. Khalifian explores situations where couples may be better suited to pursuing this therapy individually and also contexts where ketamine-assisted couples therapy would not be an appropriate intervention.

    In this episode you'll hear:

    • How Dr. Khalifian got involved in couples therapy
    • The various models of ketamine-assisted couples therapy, and how to decide what is most appropriate
    • The importance of preparation and integration
    • How to navigate the two people in the couple having very different ketamine experiences
    • When Dr. Khalifian uses intramuscular ketamine infusions versus ketamine lozenges
    • Why Dr. Khalifian leans towards using third-wave cognitive behavioral therapy for ketamine-assisted therapy
    • The tendency for people to make major relationship decisions following intense psychedelic experiences

    Quotes:

    “Ketamine is great because—in the same way with individuals—with couples it’s going to pull us out of that pattern so that we can then see the pattern and talk about the pattern from this observer perspective rather than being stuck in the ‘it’s me versus you’ we can look at it together and the couple can say ‘ah, there’s that thing that we do when we feel distressed, and now we can work together on that thing since we can see it from a little more distance.’” [4:43]

    “Similar to MDMA, people are less likely to express criticisms in a hurtful way and less likely to receive constructive criticism and be defensive [during ketamine therapy].” [9:05]

    “I had one couple [as patients for ketamine therapy] that the partner was like ‘I just felt this liquid compassion. I finally understood why she was engaging in these behaviors. And so everything made sense and I was able to talk about it in a different way.’” [17:49]

    Links:

    Enamory website

    Enamory on Instagram

    Previous episode: MDMA-Assisted Couples Therapy with Kayla Knopp, PhD

    Psychedelic Medicine Association

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    32 m
  • Psychedelics and Seizure Disorders with Evan Lewis, MD, FRCPC

    Psychedelics and Seizure Disorders with Evan Lewis, MD, FRCPC
    Apr 24 2024

    In this episode of the Psychedelic Medicine Podcast, Dr. Evan Cole Lewis joins to explore the topic of psychedelics and seizure disorders. Dr. Lewis is a Canadian Neurologist and holds an appointment as Assistant Professor in the Department of Paediatrics at the University of Toronto. He has special interest in the treatment of neurologic disorders, including functional seizures, with psychedelic therapies.

    In this conversation, Dr. Lewis shares his expertise on a number of topics at the intersection of psychedelics and seizure disorders. He discusses the neurology behind psychedelics and functional neurological disorders more broadly, explaining why he thinks this is a very promising area of research. He explains that currently very little is known about the topic of psychedelics and seizure disorders, as almost all studies have had epilepsy as an absolute contraindication, leaving researchers with only case reports. However, there are some promising indications in the preclinical data which warrant further investigation. In closing, Dr. Lewis sheds light on potential seizure risks resulting from interactions between psychedelics and other medications.

    In this episode you'll hear:

    • The different between epileptic seizures and functional seizures
    • How Dr. Lewis started exploring the topic of psychedelics and functional seizures
    • Why Dr. Lewis thinks psychedelic science has the potential to rebuild bridges between neurology and psychiatry
    • Dr. Lewis’ experiences treating epileptic patients with ketamine
    • The potential for co-administered lithium and psychedelics to cause seizures

    Quotes:

    “I tell people psychedelics are brain network medicine—they kind of dissolve those networks. If the thinking is that FND [Functional Neurological Disorder] is due to dysfunctional connection or hyperconnectivity in certain networks, what we have to do is we have to repair those networks, but first we have to take them apart and build them back up.” [11:03]

    “Regardless, even if there isn’t even a condition in which psychedelics are utilized in neurology, we need the neurologists to be able to indicate that these patients are safe—or at least do the work and be involved in the clinical team.” [21:05]

    “Things like drug interactions we pick up with psychedelics again are going to be a big piece of the puzzle that needs to be answered going forward.” [29:17]

    Links:

    Dr. Lewis on LinkedIn

    Dr. Lewis on YouTube

    Exploring psychedelic-assisted therapy in the treatment of functional seizures: A review of underlying mechanisms and associated brain networks by Dr. Lewis et al.

    Case report: Improvement in refractory functional seizures, depression, and quality of life with ketamine assisted-therapy by Dr. Lewis et al.

    Psychedelics, epilepsy, and seizures: a review by Dr. Lewis et al.

    Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review by Kelan Thomas, Benjamin Malcolm, et al.

    Psychedelic Medicine Association

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    33 m
  • Psychedelic Adjunct Series: Somatic Therapy with Jenna Valentine, DACM, LAc

    Psychedelic Adjunct Series: Somatic Therapy with Jenna Valentine, DACM, LAc
    Apr 10 2024

    In this episode of the Psychedelic Medicine Podcast, Dr. Jenna Valentine joins to explore the intersection of psychedelics and somatic therapy. Dr. Valentine is a doctor of Chinese Medicine who incorporates both functional medicine and somatic experiencing within her practice to help achieve optimal wellness.

    In this conversation, Dr. Valentine introduces somatic therapy, drawing parallels to psychedelic work and exploring how this modality may support more healthy and holistic psychedelic experiences. She explains how somatic therapy proceeds by tuning into the body, with therapists helping to guide clients’ awareness of the intelligence in their bodies.

    Dr. Valentine emphasizes the importance of not forcing things in somatic work - with gentler, slower practices often being best to align with health. In closing, she outlines how somatic therapy can be used for preparation and integration of a psychedelic experience, and also explores the possibilities of somatic modalities being used during psychedelic therapy.

    In this episode you'll hear:

    • The different forms of somatic therapy
    • The overemphasis on the mind in our culture
    • Why there aren’t contraindications for somatic therapy
    • Somatic therapy as a modality for working with patients diagnosed with biploar disorder or schizophrenia
    • The intersection of healing and re-learning to be playful
    • The importance of “doing less”
    • Why glorifying “heroic doses” of psychedelics can be counterproductive to healing
    • Shadow work and somatic therapy

    Quotes:

    “There’s many different definitions of [somatic therapy] but the one I love the most is: guiding yourself back to your body as your primary resource.” [4:02]

    “A lot of the work is making sure people learn that they don’t have to feel afraid of themselves—no part of you is ‘coming to get you’ … no part of you is trying to trick you or hurt you or surprise you. Sometimes I’ll describe it as I’m helping people guide themselves back to themselves and find a safe home there again.” [13:05]

    “We have lost our relationship with discomfort, and a lot of this work is uncomfortable. And the work is being in the discomfort and building a larger capacity for being uncomfortable, and learning the difference between uncomfortable and unhelpful, because that’s not something we’re trained in.” [23:41]

    “There’s learning that can happen in everything … The expectation is to have no expectation: we can have a loose intention, and then let the body lead.” [47:18]

    Links:

    Dr. Valentine on Instagram

    Dr. Valentine’s website

    Psychedelic Medicine Association

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    57 m