585 - Psychedelic Clinics In Our Future

Program Notes

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Guest speaker: Will Siu

Date this lecture was recorded: August 29, 2018.]

Today’s podcast features Dr. Will Siu, an MD and psychiatrist specializing, among other things, in ketamine-assisted psychotherapy. Dr. Siu is also one of the participating researchers in the MAPS MDMA study. In this 2018 Palenque Norte Lecture, he not only provides us with an inside look as some of the issues now arising as the possibility of psychedelic therapy morphs into a reality. For anyone considering a career in the vast field of psychedelic medicine, this thought-provoking talk is not to be missed.

Will Siu MD, DPhil

Capitalism on Psychedelics: The Mainstreaming of an Underground by Eric Davis

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Transcript

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Greetings from cyberdelic space, this is Lorenzo and I’m your host here in the Psychedelic

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Salon.

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This is Lorenzo, and I’m your host here in the Psychedelic Salon.

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And we’re all here together today in part thanks to the generous donations to the salon from Derek K., Jeffrey S., Antoine L., and Samuel G.

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And I thank you one and all for helping to keep these podcasts

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winging their way through cyberspace to our psychedelic friends throughout the world.

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And as another semi-underground group says, we are legion.

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Well, today we’re going to get to listen to one of the Palenque Norte lectures that were recorded at this year’s recent Burning Man Festival.

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Now, there are a lot of people to thank for their work in producing these talks this year. To begin with, there are all of the wonderful burners who make up Camp Soft Landing,

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and who have hosted these lectures for many years now. And, of course, all of the people who work

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directly on the lectures, by putting up the tent, providing a sound system, recruiting the speakers,

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and, well, a dozen other chores that need to take place to pull

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off a major lecture series in the middle of not only a desert, but in the middle of the

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world’s biggest party where there are countless other attractions where they could be spending

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their time.

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In particular, I’d like to thank Frank Nuccio.

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For yet another year, it is Frank who has taken the time and trouble to record these

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talks for us.

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year it is Frank who has taken the time and trouble to record these talks for us. And having done this myself a few times, I have a very good understanding of how difficult it can be to not

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only be present to make these recordings, but also how challenging it can sometimes be to do so in

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the middle of a whiteout or other emergency that happens at Burning Man. Frank, as they say in

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Texas, you’re a good hand. And in Texas,

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where I’m still licensed to practice law, well, there’s no higher praise than that. So thanks a

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million, Frank. And over the years, there will be literally millions of other people who are saying

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the same thing to themselves each time they hear one of your precious Palenque Norte recordings.

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So of the nearly 30 talks that were given this year,

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which one do you think that I selected

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as the first one for us to listen in on today?

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Well, I guess that’s really not much of a challenge

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since you’ve already seen both the title of the talk

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and the name of the speaker.

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And while I’ve never met Dr. Su myself,

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from listening to him in this talk,

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well, I find him to be one of the most forthright and clear-thinking medical professionals that I’ve ever come across.

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My guess is that you’re going to feel the same way after listening to him.

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It isn’t just the work that he’s doing, but it’s also his personal story that has captivated me.

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However, I’ll let you decide that for yourself.

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me. However, I’ll let you decide that for yourself. Now, as you listen to this talk,

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my guess is that there are going to be a few places where you would like to ask a question or add a thought of your own. Well, guess what? Tomorrow night, that’s Monday, October 8th, 2018,

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at 6.30 p.m. Pacific Time, I’m going to begin the first of the weekly live psychedelic salon gatherings,

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and our guest will be Dr. David Nichols, the co-founder of the Hefter Research Institute,

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who will be with us to carry on this discussion about the future of psychedelic clinics.

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So now, coming to us from the dusty playa at the 2018 Burning Man Festival is Dr. Will

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Hsu to pass along a few

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of his ideas about the future of psychedelic clinics.

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Are we all set?

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Cool.

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Thanks for coming.

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So the title of the talk is Psychedelic Clinics on the Horizon, which is really an exciting

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time to talk about

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this let’s put this plane um so it’s an exciting time because you know we really are about a year

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or less away depending uh um you know how you look at things in terms of having a legal psychedelic

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mdma clinics if you consider it mda psychedelic but anyway just a clinic having a new man it’s

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really exciting. And the

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fact that I’m even giving this talk and people are talking about the legal clinics is really,

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really, really cool. So Emily Williams, who is going to give the talk with me, she’s a

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psychiatrist in the Bay Area. Unfortunately, couldn’t make it last minute today. So I’ll

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be doing the talk. And just to give a little bit of a background so you guys know where

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I’m coming from and a little bit about me. My name is Will Hsu. I’m a psychiatrist based in New York

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City. I went both to medical school so I have an MD and I have a PhD in immunology. I was very,

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very interested in science before and so I got that background as well and I’m part of the MDMA for PTSD clinical trials

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at the University of Connecticut so I’m a faculty member a professor at the University of Connecticut

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I also have a faculty appointment at New York University um um through separate interests

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a little bit more about do we happen to have any psychologists here? If you do raise your hand, I’d be curious.

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Okay, cool.

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Great. I think it’ll…

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I hopefully would love your input on some of the items

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that I’m going to talk about.

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So one thing I’d like to talk about

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is a little bit about background,

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about who I am and my education in Yixinghuai.

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So,

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my family’s from Central America,

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from Nicaragua.

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My grandfathers are from China.

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My parents immigrated to the United States in the 70s when the war with the rebels in Contra and the guy who’s become the president and dictator in Nicaragua right now was kind of coming into power.

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There was also a very big earthquake in the 70s, which also led them to flee the country.

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I’m the first in my family to go to college.

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My mom didn’t even finish junior high school in Nicaragua.

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Through that, though, I ended up getting kind of a traditional education.

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I went to college in California.

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I went to medical school at UCLA.

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I ended up getting my Ph.D. from Oxford in England.

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And I ended up doing my psychiatry training at Harvard Medical School.

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And I know that’s a lot of institutions and I the only reason I

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actually like mentioning the institutions is because I think they

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have almost nothing to do what I learned at those institutions have very little

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to do with psychedelic healing and I think real healing and if anything they

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put me behind in many ways and it’s kind of learning through that process to find

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my own healing that I really started understanding what it is to heal from trauma.

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And I use the word trauma very, very broadly.

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But really the Western world requires us right now to really get this training to be involved in for the legal medical Western healing.

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So really, you know, the purpose of this talk is really to talk about, you know, I wanted to share my thoughts and my ideas about these psychedelic clinics that are going to be opening

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up.

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And I wanted to share also my hopes for them.

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But I think the most important part for myself is to talk about my concerns about, you know,

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things that, problems that may come up and perhaps hurdles that we’re going to look at.

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Because even though it’s a relatively tight-knit community and

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everyone’s been in a very generally positive trajectory I mean this is going

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to be real this is going to be work this is going to be organizations and money

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and there’s going to be problems that come up you know the reason I was asking

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if there’s any psychologists in the room is because you know traditionally

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psychologists and psychiatrists don’t work together. We have separate training. We don’t interact

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very much during our training. There’s hierarchy within Western medicine. And a lot of what

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the psychedelic movement is not about. And so since this is going to be new territory,

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I actually want to hear about what are some problems that other people think that we’re

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going to run into. And maybe by learning more this you know we can help prevent some of the issues so obviously part of this is maybe uh doing this

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talk was selfish on my end wanting to hear from people and get better ideas from you all um

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so with that um you know so i’ve kind of basically listed some of the issues that i’ve thought about

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um and i thought there’s about six that I can see up here.

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I’ll talk about each one of them.

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When Emily and I, as I had mentioned to those who were here

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right on time, Emily Williams was supposed to do this talk with me.

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She can’t make it. We were obviously planning

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for about 15 to 20 minutes apiece and then having it be Q&A.

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I’m just going to talk. If you want to

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ask questions in the middle of this, raise your hand. We can have it really Q&A. So I’m just going to talk. If you want to ask questions in the middle

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of this, raise your hand. We can have it really be a discussion. So with that, I’ll start.

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And the other thing I actually want to make sure to be careful and mention is that even

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though I am a psychiatrist on one of the MAPS studies, I am not an employee of MAPS and

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I’m not speaking on behalf of MAPS. I happen to think that the people who work with MAPS,

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Rick is a good friend of mine, would probably agree with many of the things I say,

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but I just want to make it clear that I’m not speaking on behalf of MAPS.

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So yeah, in addition to the MAPS studies, I have a private practice in New York City.

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I’m also an emergency room psychiatrist at Bellevue Hospital in New York.

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I’m a psychiatrist that’s maybe not traditional in many ways,

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and I focused

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really on psychotherapy. I found out very early on in the psychedelic, or sorry, very early on in my

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training as a first-year resident in psychiatry that essentially our medicines don’t work.

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You know, some of the best studies we have is on antidepressants for depression.

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You know, they work about a third of the time time and placebo works about 20% of the time.

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So basically one of our best medicines works about 10% better than placebo. And honestly,

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like it is funny, but the reality is like this was really depressing as a young psychiatrist

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to go into a field. I was feeling really depressed about the situation and I’m like,

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I can’t even get healing from the field that I’m going into.

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And again, I trained at Harvard Medical School and I was really depressed to the point where I was suicidal and I couldn’t even get healing that was helpful to me. And I was like, we’re

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pretty fucked. And it really threw me into a deep depression. I ended up thinking about dropping

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out. I applied to management consulting companies like Bain and McKinsey.

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I got a job, and luckily I decided not to take it.

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But it really threw me into this place of really figuring out

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what the heck I was going to do with my life.

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So at that time, you guys see I’m obviously a burning man,

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and I have long hair, and I have piercings.

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Four years ago, so when I was 34 years old,

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I had smoked pot

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five times in my life. I had not touched a psychedelic. You know, I was raised by Nicaraguan

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immigrants who were Catholic. And then when I was seven, my mom converted to being Jehovah’s Witness.

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So there was no way in hell I was even thinking about taking a drug, even when my friends were

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doing it, because it was ingrained in my mind that I was gonna go to hell if I did

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this so obviously things have changed this is being recorded it’s gonna be

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posted so I’m not gonna admit to any psychedelic illegal psychedelic use

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because I’m not saying I’ve done it we’ve got medical licenses and stuff

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that we have to talk about maybe you know but I have done ayahuasca it was

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done in Peru so it’s legal.

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And I actually got to take MDMA legally about a year ago through the MDMA training that MAPS is doing.

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Legally, they have a side study, a phase two clinical trial that they’re having the therapists undergo so that we can understand the process a little better so that we can also talk about it.

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Because now I can say I took MDMA and not lose my medical license.

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So, the first thing that I think about here, or that I wrote down to talk about, is what happens when these, what are these clinics going to look like?

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Traditionally, I’ve mostly worked at academic institutions, so are these clinics going to be in academia? Are they going to be in the private sector? What happens when things get privatized and capitalism and money moved in?

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Who’s going to be able to afford and pay for this care?

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Especially in the beginning, there’s a limited way, at least with the MDMA clinics, that this is going to open up.

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MAPS had this program called Expanded Access.

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They’re going to be applying for this status of Expanded Access through the FDA,

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They’re going to be applying for this status of expanded access through the FDA,

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which will allow MDMA to be prescribed and perhaps have private clinics open up even before MDMA is rescheduled.

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I won’t go into the details of what expanded access is, but we’re around a year away from that potentially happening.

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But really, these clinics are only going to be able to be opened by psychiatrists and collaborations with psychiatrists who have the training who can prescribe MDMA. And I can’t remember what the exact number is. It’s around 80

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or 90 right now in the nation that are working on these phase two and three clinical trials.

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So really, if you take the 80 people, there’s like 12 different sites or so across the country.

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You’re talking five psychiatrists or so per city at most, like in New York, San Francisco,

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who are going to have this training and a a lot of psychologists right half of them i don’t even know if we’re

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even going to even have the time or the interest to open legal psychedelic clinics and i bring this

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up because all of a sudden you’re going to have a small number of people who are going to be at

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the forefront of the initial clinics and you know in terms of affordability like i’m in new york

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city say there’s three of

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these clinics why wouldn’t i charge a hundred thousand dollars for you know a 12-week treatment

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i’m not saying i’m going to do that but right there’s going to be this temptation of like

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you know you know uh it’s a small market essentially you know i’d see nod like this

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and so that’s one of the things that i think about how are we going to make this treatment

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affordable to a lot of people you know i calculating, I’m a psychiatrist, the New York City rate,

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kind of an entry level psychiatrist in a private practice is going to charge you about $350

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an hour for a treatment hour. A psychologist is going to be more on the level of maybe

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$100,$ 150, but many of them charge $200 an hour. Even the MDMA trial, we’re doing a 12-week trial.

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There’s going to be three MDMA sessions per month.

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Sorry, three MDMA treatments per 12-week session.

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So you’re talking eight three-hour sessions

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plus an hour, hour and a half of therapy every other week.

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And then there’s preparation.

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So if you’re talking about 60 hours or so,

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I’m at, say, $350 an hour.

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The psychologist I work with is, say, at $250.

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That’s somewhere around, depending what people are charging,

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$15, 000 t o$ 20,000 for a 12-week treatment.

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I couldn’t even afford that right now.

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It’s not something a lot of people are talking about.

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But the reality is either a lot of people are going to discount what they’re doing

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or it’s going to be unaffordable to the vast majority of people right now. I’m not saying I have a

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solution to this but again this is supposed to be a discussion if you guys

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have any ideas please share them. The reality is like they don’t train

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doctors are horrible managers of money like they don’t train us how to handle

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money how to start businesses etc and all of a sudden we’re going to be part

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of these group clinics, essentially.

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And so what do we do there?

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Again, I’m hoping no one came here to get answers

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and to think that this is going to be problem-free and it’s going to be great.

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The point is to just encourage discussion and thought around these things.

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And the second point that I wrote down is really one that I talked about in the beginning.

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So all of a sudden you’re going to have medical doctors and psychologists working together. We do not have any

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very, I mean, I literally never worked with a psychologist during my psychiatric training so far.

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And so that’s one thought. And, you know, there’s

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unfortunately in mental health treatment, just like in any other field, there’s a lot of

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hierarchy, there’s a lot of baloney that ends up being a part of

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this. and there is

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tension there are um issues between psychologists and psychiatrists you know one of the ones that we

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often you know that i can think of in terms of psychedelics and psychiatry is that honestly i

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hear walking around here walking around festivals about how horrible western medicine is how we like

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toxify people with our medicines about how you know psychiatrists with expletives

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all the time obviously people look at me they don’t think i’m a psychiatrist but it’s honestly

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kind of tough to hear all these like conversations and i’m honestly um pretty in significant

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agreement with most of them i do think we do some very horrible things and um so so you know

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but it’s tough to like how do we actually integrate psychiatrists into this? How do we work with Western doctors to try to help understand and to work with them, right?

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Psychedelics are really about building bridges and connections.

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How do we continue to keep the good things about Western medicine and psychiatry while getting rid of the things that haven’t worked so well?

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to things that haven’t worked so well.

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The other thing is, you know, I do know,

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just working with a lot of people and a lot of psychologists,

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that I know that there tends to be some animosity around how much psychiatrists make versus psychologists.

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I’m allowed to do psychotherapy, really.

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The first psychoanalyst was Freud, who was a psychiatrist and a doctor.

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But the reality is, you know, I went to, quote,

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the best psychiatry training program in the country at Harvard Medical School.

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And I’ll tell you that because if I only did the training that I was meant to do, which is, you know, we spend rotations at the inpatient unit, the outpatient clinics

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prescribing medicines. If I had only done the psychotherapy training that I was required

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to do by the end of my four-year training, literally when I can go out and open my own office, I would have seen about three or four psychotherapy patients total,

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probably for about a year apiece,

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and that would have been my psychotherapy training.

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All of a sudden now, I can, and I have classmates

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who went out and opened psychotherapy practice

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and charged $250,$ 350, $400 an hour,

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and you can fill a clinic, quite frankly,

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because some people think that just because you have an MD,

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you know what you’re doing.

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And I don’t agree with that.

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And so, versus my colleagues who are psychologists, did, in the number of lectures, I don’t even want to scare you, the number of lectures of psychotherapy that we had, there were not

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many.

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And my colleagues who are psychologists, I mean, that’s all they did, essentially, right?

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There’s tons of didactics, There’s tons of patients that they see.

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Quite honestly, the average psychologist does much, much better psychotherapy than any psychiatrist ever will.

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And all of a sudden, hey, you know, we’re getting paid a whole lot more to do it.

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I’m not going to say it’s below me, but it’s really like I can see why there’s tension.

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It really does not seem fair, even from my end.

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So, yeah. Anyway, I’m seeing some nods also, which I’m happy to see.

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But, you know, again, it’s not like I have a solution to this.

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How do we work with this and with the system that we have?

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The third point that I wanted to talk about is how do we integrate other healing modalities

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with psychology and psychiatry?

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I don’t know how many, how familiar people are here with the MDMA therapy. How do we integrate other healing modalities with psychology and psychiatry?

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I don’t know how familiar people are here with the MDMA therapy.

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One of the things that I found that’s very important, which hit me kind of like a ton of bricks when I first went to the first training for MDMA for PTSD through MAPS,

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was when I saw the therapist on video, Michael Annie Nithofer, put their hands on a patient.

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Like they were doing body work with the patient. I was like what the fuck are these people doing

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you’re touching someone and all of a sudden they’re screaming and releasing

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trauma like it sounds like they could be sued for this like we thought if we

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talked about boundaries and not touching patients and all of a sudden they’re

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putting their hands on people and they’re talking about you know releasing

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energy and you know and I had a very, very traditional education.

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And I was like, what?

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I was like, I maybe made a mistake by coming to this.

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Now, after being involved with MAPS

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and the training for about four or five years,

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it actually seems wrong not to know

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how to touch a patient in the proper way to do healing.

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And I’m saying that because if I’d

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said that to most psychiatrists, they would actually

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probably disagree or they wouldn’t

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see where I’m coming from in terms of really like we need to learn

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how to do this.

00:19:48 ►

You know, and I think that

00:19:49 ►

honestly, I think that, you know,

00:19:51 ►

some amount of healing is going to come through

00:19:53 ►

talk therapy, but really some of the

00:19:55 ►

healing and I know you guys are a crowd

00:19:58 ►

that knows that, you know, the body

00:19:59 ►

keeps, the body holds traumas in a

00:20:02 ►

way that we cannot verbalize. And so

00:20:04 ►

if say you even have a group of therapists who have been trained by MAPS,

00:20:08 ►

for the MDMA work specifically, I think we have all, you know,

00:20:12 ►

the therapists that apply and become therapists through MAPS

00:20:16 ►

at least have interest in body work, but many people don’t have the experience

00:20:19 ►

to actually do body work.

00:20:21 ►

And that’s talking about people who are kind of in on this

00:20:23 ►

and know that this is important, let alone the quicker we spread this amongst

00:20:27 ►

Western psychology and psychiatry we’re just not gonna have a group of people

00:20:30 ►

that knows how to do body work so either a we have to train up a lot more

00:20:33 ►

licensed therapists and psychiatrists to do body work or we need to also work

00:20:38 ►

with body workers I actually prefer the latter I think it would be more fun and

00:20:41 ►

you are collaborative to work with with body workers and other type of healers and i think it also has the benefit of it it can be cheaper per hour which

00:20:49 ►

is something that i’ve kept mindful of if we start working together you know say it probably would

00:20:53 ►

not work with mdma but say uh at least during the mdma session but maybe we can collaborate with

00:20:58 ►

body workers to see the patient after either after the session itself and the weeks after um you know

00:21:04 ►

i do know some people that have opened legal ketamine practices.

00:21:06 ►

I have a ketamine psychotherapy practice in New York City.

00:21:09 ►

Not an infusion clinic with IV, but I give people ketamine lozenges

00:21:12 ►

and we do this stuff legally.

00:21:13 ►

I think most of you know that ketamine is legal right now.

00:21:17 ►

But there are some people who work with ketamine

00:21:18 ►

in that they feel like towards the end of the ketamine experience

00:21:21 ►

or in the days after, the body can be more sensitive

00:21:24 ►

and can be healed with body work. And so we then you know can i as a psychiatrist or a therapist

00:21:28 ►

work with someone with ketamine and then work with a body worker that can see them later in the day

00:21:33 ►

or during the next day you know and again that would be a lot cheaper than having to come

00:21:37 ►

maybe the only like one-stop shop yeah then comes the money issue i mean i talked about that a

00:21:44 ►

little bit in the beginning, right?

00:21:45 ►

We’re really expensive as a healthcare system right now. I don’t see that changing anytime in the near future.

00:21:53 ►

So, again, and is capitalism, is privatization really all bad? I actually don’t think it is.

00:21:58 ►

But again, especially towards the beginning, when we have a limited number of therapists, how do we make sure access is available? And are there other ways to make these things more affordable? You know,

00:22:11 ►

I came from a very poor family. As I mentioned, my family is from, my parents are immigrants from

00:22:18 ►

Nicaragua. We had a family of five. My dad raised us, I was surprised when I looked at his taxes,

00:22:22 ►

like something, he made about $25, 000 t o$ 30,000 a year between when I was growing up and when I left for college.

00:22:29 ►

So even as a doctor with like a nice New York salary, I don’t even know what to do with

00:22:34 ►

the money that I even make right now.

00:22:36 ►

So honestly, like if I open a clinic and I make more money, I actually think I’m going

00:22:39 ►

to hopefully give back to, you know, and have low cost care as well.

00:22:43 ►

Because like the reality is I don’t, you know, i don’t even need all the stuff i make right now so um but i know a lot

00:22:47 ►

of people are not really thinking that same way and you know i was approached by you know there’s

00:22:52 ►

some people who describe themselves as health health care venture capital etc that were getting

00:22:57 ►

prepared to try to open these clinics and you know even when i heard that healthcare venture

00:23:02 ►

capital like that wasn’t even a part of the psychedelic discussion in the last few years.

00:23:05 ►

It kind of scared me a little bit.

00:23:07 ►

It’s like, what’s going to happen to psychedelic medicine?

00:23:10 ►

Is it going to become like these big privatized clinics?

00:23:14 ►

I also had to learn in honor for myself, though, as I heard this, that this is probably inevitable.

00:23:19 ►

And so before when I first entered medicine, I used to think a lot about, well, I’m going

00:23:23 ►

to be a doctor in the rough neighborhoods where I grew up.

00:23:28 ►

But am I doing myself and am I doing other people a disservice by doing only low-cost

00:23:34 ►

care?

00:23:35 ►

Can I be more effective by opening a for-profit clinic that’s going to charge a lot to some

00:23:39 ►

people and I can provide low-cost care to others?

00:23:41 ►

That was really almost like a personal journey that I had to go through because it did not feel

00:23:45 ►

good to think about accumulating wealth.

00:23:48 ►

But I

00:23:49 ►

through more experience,

00:23:51 ►

through more reflection,

00:23:54 ►

through meeting a lot more people in the psychedelic

00:23:56 ►

communities, not just

00:23:57 ►

therapists, but people who are very successful.

00:23:59 ►

Honestly, I’m camped here with

00:24:01 ►

we’re calling it Foam Against the Machine

00:24:03 ►

this year, which is kind

00:24:05 ►

of a camp that was put together by Dave Bronner from Dr. Bronner’s Magic Soaks.

00:24:10 ►

And he’s an example of, you know, which is not a for-profit company, but he’s really,

00:24:15 ►

he pushes, you know, this all one and treat your employees like family, you know.

00:24:20 ►

And some of the things I’ve heard about him and the company is that, you know, there’s

00:24:23 ►

something like where his salary as a CEO is capped at like five or six times the lowest paid person

00:24:28 ►

or something like that and everyone has zero deductible medical dental vision so to me this

00:24:33 ►

is like a company that works extremely well they’re very mindful of the environment so can

00:24:36 ►

capitalism actually be you know can it be really beautiful capitalism that’s helpful to a lot of

00:24:41 ►

people and i actually think the answer to that is yes and so for myself and thinking about opening you know a clinic or a set of clinics myself

00:24:48 ►

you know i hope and i think i can keep this type of ethos you know because again you can have really

00:24:53 ►

really good people with integrity um just stay in the non-profit world but really is it better

00:24:58 ►

for us to actually fill some of these spots and allow ourselves to make some money to kind of give back and that’s kind of where i’m at now um let’s see the other thing and this relates to probably some in terms of income

00:25:13 ►

disparity and socioeconomic status is how to is in treating people of color i’m clearly i’m not white

00:25:20 ►

i’ve told you guys about my background um but it’s no secret that the psychedelic movement, the festival scene, the

00:25:26 ►

Burning Man community is primarily a white community.

00:25:29 ►

And really when we

00:25:30 ►

talk about these plant medicines, especially ayahuasca,

00:25:32 ►

psilocybin, these came from places

00:25:33 ►

that are not white. And we’re essentially going in

00:25:36 ►

and really…

00:25:38 ►

I mean, it’s a very complex topic.

00:25:40 ►

I’m not going to say we’re just going up and screwing

00:25:42 ►

things up in these cultures, but

00:25:44 ►

there are a lot of problems with us going to try to heal with plant medicines and

00:25:49 ►

or other places like that. I think there’s also good things and benefit that happen through these

00:25:54 ►

relationships. But really, again, we’ve been giving the blessing a lot of these plant

00:25:58 ►

medicines from these cultures. If we’re essentially a white community that’s only

00:26:01 ►

treating white people in the Western world, I think, you know, I stay away from saying things are all good or all bad, but at least

00:26:08 ►

we need to, I think, be mindful of trying to let everyone access these medicines.

00:26:14 ►

And, you know, I think that’s not just about financially making this available to more

00:26:20 ►

people.

00:26:21 ►

You know, it’s not simply saying these, you know, even if we could open free clinics that provide psychedelic healing, it doesn’t mean that

00:26:27 ►

people of color are going to be come knocking down the door. The issues

00:26:30 ►

are a lot more complex around what allows someone to come in to do and be

00:26:35 ►

comfortable doing psychedelic healing. So, you know, I mentioned earlier that I’m a

00:26:40 ►

faculty member at the University of Connecticut, which is one of the sites

00:26:43 ►

that MAPS has sponsored for the MDMA for PTSD work.

00:26:48 ►

Before, about a month or two ago, I was able to say

00:26:51 ►

that I’m the only non-white psychiatrist that works with MAPS. Now I’m one of

00:26:56 ►

two. He is also at our site. And our site

00:26:59 ►

has about six therapists, and we are

00:27:03 ►

all people of color.

00:27:06 ►

Outside of our site, I think,

00:27:09 ►

and this is not an exact quote,

00:27:10 ►

I’m not talking about MAPS,

00:27:12 ►

I’m not speaking for MAPS,

00:27:13 ►

is I’m only aware of one of the therapists at MAPS trained

00:27:16 ►

who is not white in the rest of the country.

00:27:19 ►

And the reason I bring that up is because,

00:27:21 ►

you know, again, what do we get to do,

00:27:23 ►

what do we have to do to get a person of color in the door

00:27:26 ►

into a psychedelic clinic? Again, we can put out a sign that says, you’re welcome to come, but A,

00:27:31 ►

once you walk in the door, if your therapist is white, there’s going to be tension around,

00:27:35 ►

potential tension around it. It may be necessary to be able to relate to your therapist on a racial

00:27:40 ►

or ethnic level in order to do good healing work. Set and setting. The setting has to do with the person in front of you.

00:27:46 ►

It has to do with the decor, all of that.

00:27:48 ►

You know, is it going to be culturally sensitive?

00:27:50 ►

And I’m not going to pretend I’m an expert on racial and ethnic issues.

00:27:55 ►

You know, I see some people of color in here.

00:27:56 ►

I know my good friend Nick Powers is much more attuned to those issues.

00:28:00 ►

But they are important issues that we need to address.

00:28:03 ►

Number two, we need to train more

00:28:05 ►

therapists of color. You know, I’ve been talking to Rick in MAPS about how do we increase the number

00:28:10 ►

of therapists who even apply, right? Because Rick has said, hey, you know, MAPS is very well

00:28:15 ►

intentioned. He says, you know, we can maybe have some percentage of, commit to a certain number of

00:28:19 ►

percentage of the next phase of therapists that’s going to be trained to be MDMA therapists and the goal is to train about 300 therapists next year for the next phase of MDMA

00:28:29 ►

therapy and he’s thrown around number like hey well why don’t we do like 50%

00:28:33 ►

which would be great if we can do it but if we can actually get 150 well-trained

00:28:38 ►

people of color who really understand psychotherapy and can do the healing

00:28:41 ►

work in great but how do we even get a hundred I mean I don’t even know 15 right now that we can get across the country let alone 150 so it’s like

00:28:49 ►

how do we get the word out how do we get people of color interested in doing psychedelic training

00:28:54 ►

for their psychotherapy training you know um and because there’s significant issues there and you

00:29:00 ►

and even before that stuff how do we get people or people of

00:29:05 ►

color interested in psychedelics in general because you know one of one of

00:29:10 ►

the many barriers for instance is the legal ramifications for people of color

00:29:14 ►

to get caught using illegal substances in this country right my white friends

00:29:19 ►

but you know my blonde friends deal before recently we’re not going to

00:29:23 ►

probably said they’re not going to prosecute having personal amounts of marijuana in New York City.

00:29:28 ►

But again, if you’re a blonde, white college student getting caught with a little bit of weed, you’re not going to go to jail.

00:29:34 ►

I know many people, and I’m sure people in the room, that if you’re a black man in a park with a small amount of drugs, you could very easily end up going to jail for a long time.

00:29:45 ►

amount of drugs you could very easily end up going to jail for a long time and so you know and meaning i bring that up because in terms of just getting people of color legal psychedelic

00:29:49 ►

experiences or sorry not legal because right now you know doing ayahuasca in the united states isn’t

00:29:55 ►

um legal but even if you got you know a group of black people together that wanted to do an

00:30:00 ►

ayahuasca you know an underground ayahuasca retreat in new York City, I think there could be a barrier just to do that.

00:30:06 ►

Because if you have to worry about, you know, potentially, you know, getting arrested or losing your license, etc.,

00:30:11 ►

that’s going to be a barrier as well.

00:30:13 ►

So that’s kind of one of the issues that I think about.

00:30:17 ►

And, again, please share your thoughts or ask questions at any time.

00:30:25 ►

In terms of…

00:30:26 ►

Yeah, so I mean, one of the things that I’ve thought about

00:30:30 ►

and Nick and I have actually talked about doing together

00:30:32 ►

is say, can we put a video series together,

00:30:34 ►

either with MAPS or Chuck Ruhner

00:30:35 ►

or one of the other big psychedelic publications

00:30:37 ►

where we interview on video a group of black folks

00:30:42 ►

that talk about their psychedelic experiences,

00:30:44 ►

how they got interested, what it’s done for them, or a group of Korean Americans with the same thing, or a group of black folks that talk about their psychedelic experiences, how they got interested,

00:30:45 ►

what it’s done for them, or a group of Korean Americans with the same thing, or a group

00:30:49 ►

of Latino Americans, so that we can put that out there so that people can relate easier

00:30:52 ►

and say, hey, this guy looks like me, this gal reminds me of my family, how do I deal

00:30:57 ►

with these issues within my culture? And so, you know, I think that’s important, and, you

00:31:02 ►

know, I’m saying this also because we need help.

00:31:05 ►

I’m one person.

00:31:06 ►

We have one team in the country that’s supposed to do this.

00:31:08 ►

We don’t have any paid or extra finances to spend time doing this.

00:31:12 ►

It really has to be a group effort with a lot of people.

00:31:18 ►

People of color.

00:31:19 ►

And then really the last major kind of bullet point that I wanted to talk about is integrity, right? And what happens

00:31:26 ►

when people in our community or healers are not acting with integrity? You know, and part of the

00:31:33 ►

things I think about is like sexual abuse with shamans, with underground therapists, that’s

00:31:37 ►

happening. Unfortunately, I’ve heard of it happening and I’ve experienced it actually.

00:31:40 ►

About a year ago, I went to Iquitos to spend time. I was going to spend one-on-one with a shaman the entire time, and it was like, oh my god, he was highly

00:31:47 ►

recommended, and I’m going to do so much learning from this guy. Within five or six days, I

00:31:52 ►

come in at the tail end of a six-week retreat. I found out that he had been sleeping with

00:31:56 ►

two of the female participants, the people in the village who were his family members.

00:32:00 ►

I speak Spanish, so I was chatting with them, and they’re like, yeah, he does this all the

00:32:02 ►

time, and this is normal here, And I left after about a week.

00:32:06 ►

I was supposed to be there for him.

00:32:07 ►

I was like, this is absurd.

00:32:08 ►

But what do we do when this is happening either out there in Iquitos or with legal?

00:32:12 ►

I mean, this happens even with therapists, even in this country.

00:32:15 ►

So we don’t even have to go that far to know that this happens.

00:32:17 ►

What happens when this is happening potentially with psychedelic therapists?

00:32:22 ►

How do we deal with that?

00:32:23 ►

Do we report these people and just get them thrown in jail?

00:32:25 ►

I mean, to me that’s the initial kind of response, but the reality is if we’re about community,

00:32:31 ►

these are healers who are doing healing work that are hurt themselves. How do we deal with these things when they come up in our community?

00:32:37 ►

And that’s another kind of topic that I think about quite often. I know there’s one more thing that I wanted to share

00:32:47 ►

as far as doing the work with integrity.

00:32:54 ►

It’s not coming to mind right now.

00:32:56 ►

So we have plenty of time left, like I said, about 45 minutes.

00:32:59 ►

So really this is the end of what I wanted to talk about

00:33:01 ►

and share with you guys, but I really do want to hear

00:33:04 ►

what you guys think about any of the things that I thought about or these questions or comments

00:33:09 ►

that you have separately. But if you want to move closer, please do. Thank you. So I am a therapist

00:33:20 ►

and a shamanic practitioner. I’m at the beginning of a four-year,

00:33:25 ►

pretty intensive psychotherapy,

00:33:31 ►

psychedelic training program.

00:33:33 ►

And all of us who are being trained in my program

00:33:38 ►

have been through body work training,

00:33:41 ►

have been through energy work training,

00:33:42 ►

have been through somatic psychotherapy training.

00:33:46 ►

And many of us, including myself, or not many, but a number of us, you know, have chosen not to be licensed for a number of reasons.

00:33:55 ►

Mostly so we can put our hands on people, so we can have more options.

00:34:09 ►

more options. And so I guess my question for you is, how do you see the role for those of us who have specifically chosen not to be licensed to collaborate with people who

00:34:16 ►

have focused very much on being more a part of the system and the reality?

00:34:22 ►

Thank you. The Playa provides living when that one item that I didn’t remember was actually talking about underground work.

00:34:28 ►

Thank you very much. I actually just try to think if this would impact my licensing,

00:34:35 ►

but I don’t think it does. I and Rick and I think a lot of the MAPS folks are supportive

00:34:39 ►

of underground therapists. You know, in talking about the cost of this care, again, it’s absurd.

00:34:46 ►

If we’re going to charge $500 or$ 600 an hour

00:34:47 ►

to pay for a therapist care to do 60 hours of clinical work,

00:34:52 ►

it’s unfeasible.

00:34:54 ►

I know Rick would say, really, we’re

00:34:56 ►

thankful to this underground therapist that

00:34:58 ►

have done the work even since before these substances were

00:35:02 ►

made illegal.

00:35:04 ►

There’s tons that I have learned

00:35:06 ►

and that underground therapists have shared

00:35:09 ►

with licensed therapists, thankfully,

00:35:12 ►

that have been doing the work.

00:35:12 ►

Really, if all we had was the people

00:35:14 ►

who had worked with the legal trials,

00:35:19 ►

we’d really be a lot more behind than we already are.

00:35:21 ►

So I actually think that it’s great

00:35:23 ►

to have well-trained

00:35:25 ►

underground therapists doing this work.

00:35:27 ►

I think they’re going to provide a different niche, a different

00:35:29 ►

type of, a different

00:35:32 ►

avenue. So I’m not

00:35:33 ►

saying, even again as a Western psychiatrist,

00:35:36 ►

I think I’ve driven this point home hopefully,

00:35:38 ►

but I’m not a massive fan of

00:35:39 ►

Western medicine. And I don’t think,

00:35:41 ►

I think it’s going to be a way of providing

00:35:43 ►

psychedelic medicine healing work. I do not think it is the only way to do psychedelic healing.

00:35:49 ►

I will also say that I think getting therapist training does not equal being able to provide

00:35:54 ►

good psychedelic healing and being able to hold space for someone. And I also think that doing

00:36:00 ►

lots of psychedelics, going to festivals, to Burning Man and being an underground therapist

00:36:04 ►

doesn’t equal being able to do good healing either.

00:36:07 ►

It’s kind of interesting because I kind of hold this space between you know the

00:36:11 ►

hippie festival Burning Man crowd and I’m also a Western trained psychiatrist

00:36:15 ►

and you know basically I’m kind of saying like no one has it right and you

00:36:19 ►

know it really it’s a combination and you’ll find people within every

00:36:21 ►

community that can provide really good healing work.

00:36:26 ►

Do you think there’s a role for unlicensed practitioners in clinics?

00:36:33 ►

So I think legally for instance, you know, I don’t do underground work. I think

00:36:40 ►

especially early on, you know, I’m 38, in terms of opening a legal psychedelic

00:36:44 ►

clinic,

00:36:45 ►

would I allow an underground therapist to work with me?

00:36:48 ►

Honestly, probably not, and I’m not just saying that because I’m on camera.

00:36:51 ►

The reality is, you know, I think I do really good work.

00:36:54 ►

I deal with integrity.

00:36:55 ►

I have big plans for what I want to do.

00:36:57 ►

It’s a massive risk to be able to, I mean, if I opened one of, say,

00:37:01 ►

three or four clinics in New York City within the next couple of years

00:37:03 ►

of providing MDMA therapy, and I get caught, you get caught working with someone who’s doing the underground work,

00:37:08 ►

I think I would really, you know, this stuff would make the press. We would get these clinics shut

00:37:13 ►

down and I think we have to be very careful about what’s out there right now just because

00:37:19 ►

I think we still are at a timid time and we can see who’s in politics and who’s in office right

00:37:24 ►

now and all they need is, like,

00:37:25 ►

one little excuse to really, you know,

00:37:27 ►

slow down or shut this stuff down again.

00:37:29 ►

So it would not come from a personal space of not wanting

00:37:32 ►

to work with underground therapists.

00:37:33 ►

It would be more, from my end, just

00:37:35 ►

putting things at risk.

00:37:38 ►

Can I ask a further question?

00:37:39 ►

Please. Yeah, yeah.

00:37:41 ►

So I guess I’m curious, you know,

00:37:43 ►

in a doctor’s office, let’s say, there are different levels of people in the office working, you know, there’s a certain kind of practitioner that can give a shot, you know what I’m saying?

00:38:05 ►

in all these different aspects of what goes into this healing process that could really round out the psychiatrist’s perspective that could legally somehow be

00:38:11 ►

collaborated. Yes, I have one. I hesitate to share this, but I’m in the process of opening my own

00:38:18 ►

clinic, and not an MDMA clinic, but a ketamine clinic. Again, I do my solo practice right now

00:38:23 ►

with ketamine, but if someone steals this idea, they actually

00:38:26 ►

think it’s a good one because I think it’s going to provide better care.

00:38:28 ►

So one of my ideas, so there’s four ways of, everyone realizes that ketamine is legal and

00:38:34 ►

we can provide this right now, right?

00:38:36 ►

It’s a prescribable medicine.

00:38:37 ►

There’s four ways of administering ketamine currently that are used relatively regularly

00:38:42 ►

within the psychedelic healing community,

00:38:45 ►

and non-psychedelic.

00:38:46 ►

This really started from anesthesiologists using this

00:38:49 ►

and people being observed getting better after taking ketamine for a procedure.

00:38:55 ►

So the major ketamine work that’s being done out in the Western world right now

00:38:59 ►

is through IV clinics.

00:39:02 ►

So mostly anesthesiologists and non-psychiatrists that have

00:39:05 ►

I mean, some of them are probably really well-intentioned

00:39:09 ►

places, but some of them we call ketamine mills, where you have an anesthesiologist that you never

00:39:13 ►

actually see, and you have a nurse that

00:39:17 ►

they’re full-time. They’re essentially having six people getting

00:39:21 ►

IV infusions with ketamine in New York City. This is anywhere from

00:39:24 ►

750 to 1,250 a pop for about 90 minutes of an IV session.

00:39:30 ►

And this doctor is making a ton of money if you haven’t done that back.

00:39:34 ►

So that’s one way that ketamine is administered.

00:39:36 ►

The other way is through an IM, so like an intramuscular injection just like a shot where it stays in for a certain amount of time.

00:39:43 ►

You have ketamine lozenges, which are dissolvable in the mouth.

00:39:47 ►

Depending on the dose, you can have kind of the peak come up and down,

00:39:49 ►

also for about 90 minutes to two hours.

00:39:52 ►

And the last way is a nasal spray.

00:39:55 ►

One of the ways around, and so there’s the different administrations,

00:39:58 ►

especially the IV route essentially always has to be done with a medical practitioner

00:40:01 ►

because I’m not prescribing IV bottle ketamine in liquid.

00:40:04 ►

I hold it in my office. I administer it. But the rest of them, the nasal spray, the lozenge,

00:40:09 ►

and also the IM, I think, I might be wrong on the intramuscular injection, is written

00:40:14 ►

as a prescription. It’s not picked up at CVS. You have to get it from like a compounding

00:40:17 ►

pharmacy, but the patient goes home and takes it. So one of my ideas is to actually then

00:40:22 ►

work with unlicensed people.

00:40:32 ►

There’s enough to go around, but the reality is I can then, in theory, prescribe this to a group of people who I’ve done a background check, not a background check, like a legal one,

00:40:36 ►

but I know that ketamine is not contraindicated.

00:40:39 ►

They work with me, they do have to come into a session with me,

00:40:42 ►

and then I can provide them a prescription, and perhaps they’re now working with an unlicensed person because once they have the medicine it’s no

00:40:48 ►

longer on my license so if they wanted to take it to a unlicensed person that works really well

00:40:54 ►

again they would have to see me for the first time and you know maybe one or two sessions you know

00:40:59 ►

one or two times I would have to check in on them they would have to come pay me my normal fee

00:41:02 ►

but you know if I’m writing it for them and they choose to go take it to a non-licensed

00:41:06 ►

person and pay them $100 an hour, that’s a hell of a lot cheaper than coming to me

00:41:09 ►

for another person.

00:41:10 ►

That is an idea I have.

00:41:11 ►

So yeah, thanks for clarifying because I think it’s an important thing.

00:41:14 ►

So what city do you live in?

00:41:15 ►

In Oakland.

00:41:17 ►

In Oakland.

00:41:17 ►

I mean, there’s plenty of MDs writing descriptions for

00:41:20 ►

Kennedy in Oakland, so that’s potentially something we may be already doing this.

00:41:24 ►

But that’s an idea that I have that I’m trying to spread a little bit.

00:41:27 ►

That might be a way to get more practitioners to make the point.

00:41:31 ►

Yes, you’re reading it out, this is good, I shouldn’t try to hide anything,

00:41:35 ►

there’s plenty of resources to grab. The other thing that I’m excited about in terms of doing

00:41:38 ►

this is that we can have communities in New York City, in San Francisco, etc., with underground

00:41:43 ►

therapists and legal

00:41:45 ►

therapists that get together and talk about their cases, right? Because it’s interesting,

00:41:49 ►

like, you know, this is more my scientist brain thinking, you know, are certain what

00:41:55 ►

we call diagnoses or illnesses more or less apt to respond to ketamine versus MDMA versus

00:42:02 ►

psilocybin? When that becomes legal, I think we probably

00:42:06 ►

will find that different medicines will respond differently to different, sorry, different

00:42:11 ►

illnesses will respond to different medicine.

00:42:13 ►

And by building kind of a network of underground and above ground therapists who have experience

00:42:18 ►

with this, people can say, hey, I mostly work with PTSD victims of sexual abuse who dissociate,

00:42:24 ►

and my experience with this group of people with ketamine is this,

00:42:28 ►

which is ketamine that dissociates.

00:42:29 ►

Maybe that’ll turn out to be something really good.

00:42:31 ►

Or my experience with working with people with chronic pain with MDMA,

00:42:36 ►

actually I find that that makes them worse and they become more addictive.

00:42:39 ►

But when I work with them with psilocybin, that actually really, really helps.

00:42:42 ►

And so, you know, because right now we’re really thinking,

00:42:47 ►

let’s just legalize, let’s rescheduleule I think as these things become more and more used we’re gonna find that these

00:42:50 ►

subtle differences it’s exciting to kind of be able to now be thinking about how

00:42:55 ►

do they how do we differentiate between the different medicine different

00:42:58 ►

diagnosis it thinks kind of a follow-up question a little bit of a modification

00:43:03 ►

this is kind of more towards the business model angle, because when I heard that question, I was thinking,

00:43:08 ►

okay, well, you know, maybe you touched on it, sorry.

00:43:11 ►

It seems like it would be an opportunity for offering a holistic variety of treatments,

00:43:17 ►

some which require licensing, some which don’t, and it could extend, you know, the relationship with a patient

00:43:22 ►

and treat them over a much longer period of time

00:43:25 ►

for a larger set of conditions.

00:43:28 ►

And I don’t mean to put it necessarily

00:43:30 ►

frame it in the illness,

00:43:32 ►

because it could also be wellness or enhancement.

00:43:35 ►

Absolutely, I’m glad you said that.

00:43:37 ►

And again, that’s why I hesitate

00:43:38 ►

when I say illness diagnosis,

00:43:40 ►

because I’m not a psychiatrist who believes

00:43:42 ►

that certain things, PTSD, depression, is some genetic thing that you’re born with and you won’t have the rest of your life.

00:43:48 ►

My view on what we call illness is that because of someone’s genetic makeup, because of that combination of genetic makeup and environment, they have a psychological stressor that leads to something that we have now called major depression or PTSD or, you know, alcoholism.

00:44:03 ►

And that we will, you, and that through healing the psychological

00:44:06 ►

aspect, we can probably get rid of most things.

00:44:09 ►

But again, that’s not the view of most psychiatrists that you’ll meet.

00:44:13 ►

But it’s interesting what you’re saying, and I 100% think that this is the way I want to

00:44:17 ►

run.

00:44:17 ►

I almost want to have a wellness center, a holistic practice, because I know that I cannot

00:44:23 ►

provide everything for everyone. I can learn

00:44:25 ►

by working with other healers.

00:44:27 ►

Again, I am up here, but I don’t…

00:44:30 ►

I think there’s probably plenty of people

00:44:32 ►

who have no licensing whatsoever

00:44:33 ►

who can probably talk about this more intelligently

00:44:35 ►

than I can. I just happen to be there in part because

00:44:37 ►

I am an MD. But really,

00:44:40 ►

I think that

00:44:40 ►

working with other practitioners, it’s going to be great.

00:44:43 ►

Maybe we can have some people that come in

00:44:45 ►

who are asking for MDMA healing,

00:44:48 ►

but really what might actually work better for them

00:44:50 ►

is to work with a body worker

00:44:51 ►

over the course of time, like you’re saying,

00:44:54 ►

and that might even be any better for them.

00:44:57 ►

So that’s it.

00:44:58 ►

Yeah, in addition, absolutely.

00:45:01 ►

Yeah, completely agree.

00:45:04 ►

Yeah?

00:45:07 ►

Well, thank you so much much that’s been very informative

00:45:09 ►

my question to you is sort of twofold

00:45:11 ►

number one is can you talk about

00:45:13 ►

any of your personal experiences within these trials

00:45:16 ►

with complex PTSD

00:45:17 ►

and MDMA

00:45:18 ►

and some of the numbers we hear out on apps

00:45:21 ►

are extremely reassuring

00:45:23 ►

in treating PTSD

00:45:24 ►

so my thoughts are with some of these tougher cases Some of the numbers we hear on the maps are extremely reassuring in treating PTSD.

00:45:35 ►

So my thoughts are with some of these tougher cases, are you seeing a difference in those responders versus like one incident versus serial incidents that might be experienced in veterans in war?

00:45:46 ►

You’re talking about how bad someone has PTSD or trauma and how they respond to MDMA therapy? Correct.

00:45:48 ►

Correct. Yeah.

00:45:49 ►

So it’s an interesting question because again, there is an entity that, I don’t know if it’s a DSM diagnosis,

00:45:54 ►

whether it’s actually called complex PTSD. There is something that we definitely write about as a field

00:45:59 ►

that we call complex PTSD or, again, anytime know, any time in the Western world, Western medicine,

00:46:06 ►

when we can’t understand something, we kind of try to label it as something else.

00:46:11 ►

And so, again, dissociation or, you know, derealization are a set of symptoms that come

00:46:17 ►

up with some people that have post-traumatic stress disorder, mostly sexual trauma, and

00:46:21 ►

we call that dissociative identity or blah, blah, blah.

00:46:23 ►

Again, I think it’s useful sometimes to think about it this way but i don’t like when the western world

00:46:28 ►

uses it to categorize someone as in this is what you are and i get you um i just think that we run

00:46:34 ►

ourselves into trouble when we do that so in terms of the data i haven’t seen it doesn’t mean it

00:46:38 ►

doesn’t exist that um for me within the maps data someone has said this is complex PTSD versus normal PTSD.

00:46:45 ►

I do know that at least the first studies, because I think there’s been treatment of over 100 people at this point within the MDMA studies in recent times.

00:46:57 ►

I know that especially at the beginning, the first trials were about treatment-resistant PTSD.

00:47:02 ►

So they were pretty bad PTSD, which probably makes sense,

00:47:07 ►

right? It’s not like someone with not bad PTSD would probably be signing up for this experimental

00:47:11 ►

study. So it was lucky in both ways, because people with really bad PTSD were signing up for

00:47:15 ►

the studies and getting a whole lot better. So, you know, meaning I think that I would imagine

00:47:21 ►

that the data is about the same. I think last I heard it’s around 65% because we’re constantly getting more data, right?

00:47:27 ►

So it’s around 65% after three MDMA treatments over three months with normal psychotherapy in between,

00:47:35 ►

no longer have PTSD at the end of the trial, so three months out.

00:47:39 ►

And a lot of that holds even months or years out.

00:47:41 ►

There’s been one study, I think, at four and a half years where essentially people that benefit held

00:47:46 ►

and it got actually a little bit better. I can talk about a little bit better if people are interested.

00:47:51 ►

Just ask why that might be.

00:47:54 ►

So yeah, so I would say there’s a lot of hope that this would be

00:47:59 ►

beneficial for people with more severe PTSD. I’ll bring up another point back to the

00:48:05 ►

for people with more severe PTSD. I’ll bring up another point back to the people of color and racial trauma. So our site, like I said, is focused. It’s not

00:48:09 ►

like formally, we don’t have a separate study, but idealistically we have chosen

00:48:13 ►

to focus on treating people of color with PTSD and race-based trauma, which

00:48:20 ►

are two separate things. So racial trauma could be something like experiencing

00:48:24 ►

chronic racism over

00:48:25 ►

the course of one’s life, probably like every single black American, honestly, and many other

00:48:30 ►

non-white Americans, that we call microaggression. That’s like every single day, you know,

00:48:37 ►

interacting with someone on the street, a police officer, etc., where you’re just feeling racist,

00:48:42 ►

you know, that something about you is being held against you,

00:48:48 ►

that some of that can be associated with losing your life at times or at least having a threat against your life.

00:48:50 ►

I mean, I think even, say, being a black American

00:48:51 ►

and watching a black man on TV getting shot

00:48:53 ►

as he runs away from a police officer, right?

00:48:55 ►

Even the diagnosis of PTSD is not an actual,

00:48:58 ►

necessarily a life-threatening experience for yourself,

00:49:01 ►

but it’s witnessing a life-threatening experience.

00:49:03 ►

I mean, honestly, the first time I saw one of those police videos, sadly, I’d become

00:49:07 ►

numb to it.

00:49:07 ►

That was traumatizing.

00:49:09 ►

It was more like just not being able to focus on anything else, feeling like shaking.

00:49:12 ►

I’m like, how the hell is this happening in the world right now?

00:49:15 ►

The reason I’m bringing this up is because, so, you know, say you can have a point trauma.

00:49:21 ►

And one of the problems with the DSM right now, the DSM, for those who don’t know it,

00:49:24 ►

is a Diagnostic Statistic Manual, something something I don’t even memorize it as a psychiatrist because

00:49:29 ►

I actually don’t like it very much. But we’ve categorized illnesses and said PTSD requires

00:49:33 ►

these three or four or five things. Major depression requires these three, four, or five

00:49:37 ►

things. And really, the DSM diagnosis of PTSD is based on very much a point trauma or a point set of trauma. It is a sexual

00:49:46 ►

assault. It is a, you’re, you’re Humvee being blown up or, you know, three motorcycle accidents,

00:49:52 ►

but it’s meant to be a point trauma. I think the reality of that, we have those, many of us have

00:49:58 ►

those traumas in our life, but we also have chronic trauma that happens every single day to us. I mean,

00:50:04 ►

we could even say that

00:50:05 ►

say physician training of working you know 80 to 100 hours a week really being in a verbally

00:50:10 ►

abusive environment while we do that not getting sleep is traumatic in many ways in a real emotional

00:50:16 ►

way um you know having a society where we’re focused on capitalism and not getting sleep

00:50:21 ►

and working 80 hours a week at a bank on Wall Street is traumatizing.

00:50:26 ►

And then again, back to the people of color thing,

00:50:31 ►

I really think there’s a significant amount of racism that we can call traumatic that has a physiological and psychological impact on certain people

00:50:36 ►

that should be labeled as trauma.

00:50:39 ►

I actually think that, say, a lot of the people in the categories that I was talking about

00:50:44 ►

have not had a point trauma if you actually look at them with the DSM may not fit the criteria for post-traumatic

00:50:51 ►

stress disorder right because it may manifest differently than nightmares and flashbacks and

00:50:56 ►

hypersensitivity right and but is it a trauma or is it not absolutely it’s a trauma but it may not

00:51:02 ►

fit the definition of what we’re calling post-traumatic stress disorder. Many problems with that, right? Funding, insurance-wise,

00:51:08 ►

funding from the VA, etc., honors the DSM diagnosis for something. So if you are having significant

00:51:14 ►

symptoms but they don’t meet the criteria for PTSD, you may not get certain benefits or certain

00:51:18 ►

payments from insurance companies. The other thing is that I think about is in terms of treating, say,

00:51:25 ►

something I’ve talked about a lot with our group,

00:51:28 ►

meaning at the University of Connecticut,

00:51:30 ►

is race-based trauma.

00:51:32 ►

So, yeah.

00:51:34 ►

And meaning, so if, you know,

00:51:37 ►

for example, in a normal white participant

00:51:40 ►

in one of the PTSD studies,

00:51:42 ►

we need to overall make sure

00:51:43 ►

that they’re in a safe environment now

00:51:45 ►

So that they’re not in a physically abusive relationship at home for them to enter our study because if we’re trying to treat a

00:51:52 ►

Physical or sexual trauma that they’ve had ten years ago that they’re symptomatic now

00:51:56 ►

But they have a partner or a boyfriend or they’re in a you know, they’re in a

00:52:01 ►

Poor financial state. So they’re having sex for money like

00:52:05 ►

they’re essentially having trauma happen right now so if we’re trying to treat a

00:52:08 ►

trauma while someone is being traumatized that’s not going to really

00:52:11 ►

work good for a study and it may not even cause relief of the symptoms

00:52:17 ►

because they’re still being traumatized in you know in our site specifically for

00:52:22 ►

racial trauma you know I do again I’m a big believer and I see a lot of heads nodding when I talk about you know

00:52:28 ►

really racism causing chronic trauma to people of color and one of the things

00:52:33 ►

that I am concerned about is so say that we have someone who’s experienced police

00:52:39 ►

shooting or witnessed a police shooting say that’s a black American and we bring

00:52:44 ►

them into our site we treat them with MDMA for PTSD

00:52:48 ►

because we meet criteria for PTSD, but we do a follow-up study.

00:52:52 ►

Say at 12 weeks, we’ve cured them from their PTSD.

00:52:57 ►

But say if we do a 6-month, a 12-month, or a 5-year follow-up,

00:53:00 ►

and they have PTSD symptoms again, it may look like our therapy did not work for them. Is it that they didn’t do good work? Maybe, but it could also be that

00:53:10 ►

perhaps we sent them back out into an environment where the world is racist

00:53:14 ►

and traumatic so that we didn’t really clear them of their PTSD. You know, and one of

00:53:20 ►

the things I worry about more kind of of philosophically is so i trained in

00:53:25 ►

boston again at harvard medical school for my psychotherapy training and i worked a lot with

00:53:30 ►

the boston psychoanalytic institute i mean i was like deep into this show back then i mean i was

00:53:35 ►

like four days a week on the couch doing traditional psychoanalysis for myself you know

00:53:39 ►

you know psychoanalytic society the freudian ones especially, are very much also a white group of people.

00:53:47 ►

I know from my experience in working with a lot of these therapists or working with a lot of these institutions,

00:53:56 ►

and I don’t think these are bad people, but I’ve heard things said like,

00:54:00 ►

you really need, only certain patients do well in psychotherapy.

00:54:04 ►

You have to have a very reflective patient. have to very have a very intelligent patient and they don’t

00:54:09 ►

outright say it but no one will say that usually you know that this is like the wealthier white

00:54:12 ►

people and i know there was people would be people that think oh because you’re poor or because

00:54:17 ►

um you know you’re from a certain ethnic background because you’re an immigrant you’re

00:54:21 ►

probably not made well to be a psychoanalytic patient or a psychotherapy patient. So say if all of a sudden our data, say we do end up,

00:54:28 ►

our site has, say, all people of color as patients. If we don’t do as well, if our data isn’t as good

00:54:35 ►

as the other sites, are people going to say, well, you know, this isn’t a treatment that works well

00:54:38 ►

for people of color? Maybe they’re not good patients versus saying maybe we need to honor

00:54:43 ►

that really we live in a racist country right now and that they’re not doing well because of other factors.

00:54:47 ►

Maybe they’re not doing well.

00:54:48 ►

You know, we are doing pretty well at getting people in the door interested in the study, including once a month for an entire day session, stay overnight and do another session in the morning, and take all that time off of work?

00:55:10 ►

Usually not.

00:55:11 ►

And so we have a lot of barriers that we’re working with right now to try to make this accessible to more people.

00:55:17 ►

Listen, we do have one of the MAPS employees here, so if you have any MAPS-related questions, we can ask Jade.

00:55:22 ►

Who walked in?

00:55:23 ►

Who has the most colorful outfits?

00:55:26 ►

Whether we’re at Burning Man or not.

00:55:27 ►

Welcome, Jade.

00:55:32 ►

I’m a licensed home therapist, and I came in late, so this might be a repeat.

00:55:40 ►

Could you point toward resources just to learn about what the therapeutic benefits of psychedelics are?

00:55:41 ►

Or know them?

00:55:44 ►

Yeah, you said you’re a licensed what? I’m a licensed

00:55:46 ►

clinical social worker. I work as a therapist.

00:55:48 ►

Awesome. But I’m also pretty

00:55:50 ►

naive to all of this. So

00:55:52 ►

where would somebody like me maybe get started

00:55:54 ►

learning more about what research does

00:55:56 ►

exist, what communities are

00:55:58 ►

published in?

00:56:00 ►

Awesome.

00:56:02 ►

Yeah, so I mean,

00:56:04 ►

it’s interesting. So things that I I mean, certainly the MAPS website has, you know, studies and articles written about their own studies.

00:56:12 ►

Let’s see, Chakruna is mostly focused on plant healing. One of my colleagues, Bia Labade from Brazil, she publishes that with a lot of articles on there.

00:56:22 ►

Brazil. She publishes that with a lot of articles on there.

00:56:24 ►

Those are the ones that, I mean, PubMed

00:56:26 ►

is something that we use in the medical community to look

00:56:28 ►

at the data, and a lot of the

00:56:30 ►

MAPS studies have now been published

00:56:32 ►

on PubMed, but those are the major ones

00:56:34 ►

I think about. Is there anyone else that

00:56:36 ►

in terms of

00:56:38 ►

well-controlled, legitimate

00:56:40 ►

studies that we can look at, or places

00:56:42 ►

that we can look for the data for

00:56:44 ►

this work? Actually actually i was about to mention stan so i’m glad you said that so yeah stan groff

00:56:52 ►

a lot of people may not know who yes i’ll mention him um uh so he’s an interesting guy he’s a

00:56:57 ►

psychiatrist from the czech republic he’s still alive which is pretty but i think he’s in his

00:57:00 ►

90s he was friends with albert homan. I think he’s done more legal

00:57:06 ►

LSD therapy work than any human alive right now. I think it’s something like 5,000 LSD

00:57:12 ►

sessions before things became illegal. I think half were in the Czech Republic, half was

00:57:17 ►

in Baltimore when he was recruited to the U.S. He’s written this book. He’s written

00:57:22 ►

many books that are excellent, but one of them is LSD psychotherapy, which I think, unfortunately, long after he’s dead, people are probably going to look at it as probably a giant lion painted by a running man.

00:57:46 ►

But I think it’s going to literally become like a clinical manual for how to really do really great work.

00:57:50 ►

I mean, he puts it into like diagnoses and sorts of beautiful, beautiful things.

00:57:57 ►

I think, you know, as a field, we’re going to be looking and really reading his book to really learn how to do this stuff. Because, again, we’re basically reinventing the wheel in some ways with starting to do this again now, but there’s

00:58:05 ►

many people that came before us that were doing great work.

00:58:08 ►

Anyone else have resources that you really like to use to stay up on the…

00:58:12 ►

Oh, like the MAPS bulletin and the list.

00:58:15 ►

No, so yeah, if you go to MAPS, actually, they have sent out email lists, and Jade can…

00:58:20 ►

Sounds like she’ll sign you up if you want.

00:58:23 ►

And that kind of really keeps up to date on the research.

00:58:27 ►

I’ve been listening to a lot of the podcasts that MAPS puts out.

00:58:30 ►

And I found that by listening to podcasts, you get a lot of information where to go for other stuff.

00:58:36 ►

Like this is going to be on podcasts probably from MAPS.

00:58:39 ►

So anyway, they’ve been really, really useful.

00:58:41 ►

So yeah.

00:58:42 ►

Yeah.

00:58:42 ►

Oh, and actually I know Bia Nabata has now formally,

00:58:45 ►

at least been hired part-time by MAPS.

00:58:47 ►

She’s going to be working a lot

00:58:49 ►

with increasing things available

00:58:51 ►

on social media.

00:58:53 ►

So she’s going to be starting

00:58:54 ►

a series of podcasts or videos

00:58:57 ►

with Brad Burge.

00:58:58 ►

I only know this because

00:58:59 ►

I signed up to do one

00:59:00 ►

where they’re going to be

00:59:01 ►

interviewing people

00:59:02 ►

that are involved in psychedelics

00:59:04 ►

or research and putting those up. So I think MAPS is going to be interviewing people that are involved in psychedelics or research and putting those up.

00:59:07 ►

So I think MAPS is going to be putting out a lot more cool content in the near future.

00:59:11 ►

Yeah, absolutely.

00:59:13 ►

Anyone else?

00:59:13 ►

We’ve got like 20 minutes, but obviously feel free to go anytime.

00:59:18 ►

Or we can end it if no one has any more questions or comments.

00:59:20 ►

I’ll pause today for a bit.

00:59:22 ►

Before you get, we want the microphone, I think, set for the recording.

00:59:24 ►

Actually, one thing that I will

00:59:25 ►

say, because I had on the

00:59:27 ►

information about people of color, so our

00:59:30 ►

professor that works at

00:59:32 ►

our site, who’s in charge of it, Monica

00:59:34 ►

Williams, who, before her involvement in

00:59:35 ►

psychedelics, was already a really

00:59:37 ►

well-known person

00:59:40 ►

working on racial trauma

00:59:41 ►

and a faculty member. We actually put out

00:59:44 ►

a recent publication within the last three or four months or so that looks at all of the

00:59:47 ►

modern studies on legal psychedelic or racial demographics on that population

00:59:55 ►

so she found that about 80% or so of the participants in the modern psychedelic

01:00:02 ►

study meaning like by 90s up until now,

01:00:06 ►

80% were white,

01:00:10 ►

which actually, I mean, I think we could do better,

01:00:11 ►

but it doesn’t sound horrible,

01:00:13 ►

but about 10% of people clicked,

01:00:16 ►

like they basically didn’t give their racial information.

01:00:20 ►

So if we assume that 10% is about the same as the other,

01:00:22 ►

meaning 8% of that 10% were white,

01:00:26 ►

we’re talking 88% of the participants are white.

01:00:28 ►

You know, which again, we live, I tried to crunch numbers.

01:00:35 ►

I think I did like Latinos, Asians, and black Americans make up something like 40% of the United States.

01:00:43 ►

So, you know, we’re nowhere near treating the population that looks like the population of America.

01:00:45 ►

Yes?

01:00:48 ►

I just want to ask about your experience with uncovering other mental illnesses or mental disease states during these trials,

01:00:51 ►

and have you ever come across patients who have suppressed memories

01:00:55 ►

that come out during the ambiening use?

01:01:02 ►

Yeah, so I don’t know that data well.

01:01:05 ►

So I guess the way I hear your question is twofold.

01:01:07 ►

One, you’re saying, could we make stuff worse,

01:01:09 ►

or could we lead someone to having a psychosis

01:01:13 ►

or a bipolar diagnosis or episode after treatment

01:01:16 ►

in one of those studies?

01:01:18 ►

Again, I don’t know the data that well.

01:01:20 ►

I don’t think that that has happened,

01:01:21 ►

at least in the MDMA work,

01:01:22 ►

where we’re causing someone to become psychotic

01:01:24 ►

for the first time or having a manic episode. At least I don’t think that that has happened at least in the MDMA work where we’re causing someone to become psychotic

01:01:29 ►

For the first time or having a manic episode at least I don’t know again, but I

01:01:32 ►

So we also have a pretty extensive

01:01:37 ►

Exclusion criteria so an exclusion set of criteria in any

01:01:44 ►

Study is saying if you have this or a history of this you cannot participate in the study. Most Axis I illness, which the DSM means major depression,

01:01:48 ►

schizophrenia, generalized anxiety, OCD,

01:01:51 ►

are a exclusion from our study.

01:01:54 ►

And so that perhaps prevents a lot of people

01:01:57 ►

from being involved.

01:01:59 ►

Certain, all personality disorders, to my knowledge,

01:02:02 ►

are also an exclusion criteria.

01:02:04 ►

This is not to say that I think that MDMA or other psychedelics

01:02:08 ►

cannot be healing for persons with personality disorders.

01:02:11 ►

I actually do think that there’s a fair and good exclusion criteria

01:02:15 ►

for this study in particular.

01:02:18 ►

So meaning that for a 12-week study where you have just met your therapist,

01:02:22 ►

we’ll only see them for 12 weeks,

01:02:24 ►

and basically give MDMA within three to four weeks of that I actually think is not

01:02:30 ►

good for the participant you know something you know personality disorders

01:02:33 ►

I think are actually something that are going to be very responsive to

01:02:36 ►

psychedelic healing especially MDMA but the study and the process has to look

01:02:40 ►

different I think it’s going to be safe the one thing that gets brought up often

01:02:44 ►

is about a borderline personality should we give this set of patients MDMA? I was actually in one talk when I

01:02:50 ►

first started getting into the research world where actually one of our researchers, who I will

01:02:53 ►

not name, said something to the effect of you should never give patients with borderline

01:02:58 ►

personality. This is like a public talk with about 500 people in it, actually. You should never give

01:03:02 ►

patients with borderline personality disorder MDMA. And someone asked

01:03:07 ►

why and he was like, well,

01:03:09 ►

they have an addictive personality

01:03:12 ►

they’re going to like the high, let’s never give it to them.

01:03:14 ►

I was floored.

01:03:16 ►

Rick was actually at this talk

01:03:17 ►

and we were both like, what are you saying?

01:03:20 ►

Are you mad? Essentially,

01:03:22 ►

again, I’m not going to give any more details, you’ll probably find out

01:03:23 ►

who it is, but the reality is like, A, number one, you’re give any more details, and you’ll probably find out who it is, but the reality is, A, number one,

01:03:26 ►

you’re a mental health person,

01:03:28 ►

so you should know. I know that

01:03:29 ►

the DSM diagnosis for borderline personality, there’s

01:03:31 ►

nothing about addiction in there, so it’s absolutely

01:03:34 ►

absurd to say something like that.

01:03:36 ►

Number two, and I think it’s

01:03:37 ►

essentially a fear of not being able to

01:03:39 ►

understand this patient and being able to help them.

01:03:42 ►

I just think, absolutely, I think we can

01:03:44 ►

treat a lot of personality disorders with psychedelics.

01:03:46 ►

Again, it just has to look different. For something

01:03:47 ►

like borderline personality,

01:03:50 ►

I think it can be something like work with

01:03:52 ►

a therapist that you’ve already been working with

01:03:53 ►

for some amount of time that you have rapport with

01:03:55 ►

and maybe introduce MDMA or another

01:03:58 ►

psychedelic healing modality

01:03:59 ►

at month three or every three months

01:04:02 ►

instead of every four weeks, you know, because it can

01:04:04 ►

be a very intense experience to have mdma or um or another psychedelic so you know i just think

01:04:10 ►

it has to happen over more time with a therapist or therapist that you’ve gotten to know a lot

01:04:13 ►

better um so yeah so that’s about kind of unmasking other things or i think it can cause

01:04:19 ►

problems in in certain patients in the short term and i think because of that they just need a

01:04:23 ►

different container for a different setting um a set and setting to really have more effect.

01:04:29 ►

So okay let me turn it to the sort of question of replicability. Replicability? Yeah so you’re

01:04:36 ►

building your clinic right now around ketamine treatment in New York if I heard correctly yes

01:04:41 ►

and I understand MAPS it has a real interest in spreading these clinics

01:04:46 ►

out around as far as they can.

01:04:49 ►

You know, as far as it can be reached.

01:04:50 ►

I think the galaxy within 10 years

01:04:52 ►

is what Rick is shooting for.

01:04:53 ►

We’ll go bigger.

01:04:55 ►

You know, I’m wondering somewhat

01:04:58 ►

about the practical considerations.

01:04:59 ►

In setting up your clinic,

01:05:02 ►

are you going for outside investors?

01:05:04 ►

What kind of investors are you seeking? How are you structuring the company?

01:05:07 ►

How are you handling liability? Because these are the things that

01:05:12 ►

if there are problems that can be solved, if they’re solved problems

01:05:16 ►

and that information can be transferred, that helps the replication.

01:05:19 ►

Yeah. Great question.

01:05:24 ►

There’s multiple issues in there, I guess, that I’ve thought about.

01:05:27 ►

One is this issue of liability, right?

01:05:31 ►

Because malpractice for a psychiatrist, I think,

01:05:34 ►

is probably the cheapest of any physician.

01:05:36 ►

I think my malpractice right now is like $300 a month,

01:05:41 ►

so like $3, 000 or$ 4,000 a year.

01:05:43 ►

And that’s expensive because it’s New York.

01:05:45 ►

When I was in Boston, my practice was like $150 am o n t h . B u t I ha v e an OBG Y Nt ha t^{'} s l ik e$ 70,000

01:05:53 ►

or $80,000 a year. So it’s relatively low, but that’s just for me as a solo practitioner.

01:05:58 ►

For at least the ketamine work, I’m not that concerned with it because again, I can prescribe

01:06:03 ►

ketamine at least in the lozenge and the nasal spray forms where a person can take it home.

01:06:08 ►

They’re picking it up from a pharmacy.

01:06:11 ►

I haven’t actually talked to a lawyer.

01:06:13 ►

I will at some point soon.

01:06:14 ►

But then I think that’s out of my hands.

01:06:16 ►

Unless I’m bringing them in and doing it in my office, I think there’s probably some liability there.

01:06:21 ►

But if they, again, were to take it to an underground therapist.

01:06:25 ►

there. But if they, again, were to take it to an underground therapist, and I want to make it clear that I’m not saying, and I’m not going to be telling people, I’m giving you this and go to

01:06:29 ►

this underground therapist. That would not be okay on my part. So this is a video here. I’m not saying

01:06:34 ►

that. But what I’m saying is that I think that that’s totally doable. You know, with the MDMA

01:06:40 ►

expanded access clinics and beyond, if people are doing that in-house i have another therapist

01:06:46 ►

that i’m working with i think i will carry much more of the liability and i think i will have to

01:06:50 ►

let my malpractice insurance know and they probably will charge me or say if i have people working

01:06:56 ►

with these participants say in the academy where they are coming into a space that’s

01:07:01 ►

physically mine and say i’m not there I think I will also have to deal

01:07:06 ►

with more liability there.

01:07:08 ►

And replicability is an interesting one, right?

01:07:10 ►

Like, you know, I am a physician, I’m a scientist,

01:07:14 ►

I’m a faculty member right now.

01:07:16 ►

I do honor that Western medicine and research is valuable.

01:07:21 ►

You know, meaning like a lot of the stuff

01:07:23 ►

that we’re talking about right now,

01:07:24 ►

and the successes MAPS has been to be doing this in a legal realm where we’re sharing data. And I think

01:07:30 ►

there’s stuff that’s going to continue to some extent, and I think it’s helpful to a

01:07:34 ►

large extent. But I also think that there’s lots of limits in terms of the cost of some

01:07:40 ►

of these studies is tremendous. And it tends to be slow. Academics do very slow publications.

01:07:45 ►

Essentially, if you’re on PubMed, again,

01:07:47 ►

this is our Google for medical research,

01:07:50 ►

and you’re Googling about studies,

01:07:51 ►

they’re essentially published about a year or more

01:07:53 ►

after they’ve even been done.

01:07:55 ►

So you’re never really up to date

01:07:56 ►

if you’re only looking at the medical research.

01:07:59 ►

So that’s an issue.

01:08:00 ►

And again, just the cost of it.

01:08:01 ►

So, you know, if I were to run some sort of study

01:08:03 ►

within my private clinic,

01:08:06 ►

to put the effort to have that out there

01:08:08 ►

in an academic form is gonna be expensive,

01:08:10 ►

it’s gonna be time consuming.

01:08:12 ►

When I was talking earlier about perhaps then

01:08:14 ►

we can have more collaborations with licensed

01:08:16 ►

and unlicensed therapists that are gonna come in

01:08:20 ►

and say just have informal discussions

01:08:23 ►

about this is what I’m finding with my patients etc.

01:08:25 ►

It can be helpful to share information. It’s not going to be anything that we can publish or hold

01:08:30 ►

on but I do think that this stuff is real. You know I think western medicine and publications

01:08:35 ►

again are very helpful but they’re also limited and I think they’re also based on a western

01:08:40 ►

philosophy of I need to see it to believe it. You know, again, in Eastern philosophy

01:08:46 ►

and Eastern practices don’t really follow that way.

01:08:48 ►

It’s about knowing or feeling something and not knowing it.

01:08:51 ►

And I think you become away from feeling

01:08:54 ►

and being, you know, feeling sure that something is right

01:08:57 ►

and having to have evidence.

01:08:58 ►

Some of this stuff is a waste of time.

01:08:59 ►

For instance, some of these long-term studies,

01:09:02 ►

and the one I was thinking about in talking to someone about today

01:09:04 ►

was a Harvard study that is ongoing.

01:09:08 ►

It’s a 70-year study.

01:09:09 ►

I think it’s one of the oldest research studies ever

01:09:11 ►

where 70 years ago they took a group of Harvard men

01:09:14 ►

because it was a very sexist environment.

01:09:17 ►

It still is a very sexist world that we live in.

01:09:19 ►

They followed them long-term over the course of their life.

01:09:21 ►

They followed their children.

01:09:23 ►

A guy that I…

01:09:24 ►

He was one of

01:09:25 ►

our teachers at Harvard Medical School,

01:09:28 ►

Bob Waldinger, he’s had some

01:09:29 ►

press actually, he took a year off to kind of

01:09:31 ►

talk about this in a TED talk he did.

01:09:33 ►

Where he basically said, after 70 years

01:09:35 ►

in the study, the one thing that correlated

01:09:37 ►

with happiness is the

01:09:39 ►

quality of your interpersonal

01:09:41 ►

relationships. And he did it, he did this really

01:09:43 ►

good TED talk, and he’s been on tour and wrote a book

01:09:46 ►

and he’s become famous

01:09:48 ►

but I’m like, I mean, I think it’s great that he did

01:09:50 ►

this, but the reality is, I don’t think I needed

01:09:52 ►

anyone to do a study and spend millions

01:09:54 ►

and millions of dollars on something like that, right?

01:09:56 ►

I mean, we should know as human beings

01:09:58 ►

that connection and love, etc. is what

01:10:00 ►

we need. I mean, that’s why, I mean, again,

01:10:02 ►

this is the crowd I need to probably convince

01:10:04 ►

of that, right? But again, you know, they’ve done, not they, again, I’m part of

01:10:08 ►

this, the Western medicine, you know, stress increases the chance of someone with heart

01:10:13 ►

disease to have a heart attack. Great that you studied that, but we didn’t need to do

01:10:17 ►

it, again, a very expensive study over the course of time to tell us that. There’s certain

01:10:20 ►

things where I think that Western medicine is going to play a role, and some of these

01:10:24 ►

studies that are more obvious, I think, so we’re more of just like, I think that medicine is going to play a role, and some of these studies that are more obvious, I think it’s going to be great to share some

01:10:29 ►

of this information and how the university is still doing it, but I’ve become a little

01:10:34 ►

more of a believer in just learning from my patient and my experience with patients.

01:10:39 ►

All right, building legs and all these things.

01:10:41 ►

Are there things that you would recommend and what someone should look for

01:10:45 ►

at a ketamine clinic?

01:10:46 ►

Because right now,

01:10:47 ►

like the marketplace is,

01:10:48 ►

it seems really scary

01:10:50 ►

and high by night.

01:10:53 ►

So I’m wondering what you would suggest.

01:10:55 ►

Yeah, I’m glad you brought that up.

01:10:57 ►

Actually, ketamine,

01:10:58 ►

I honestly discovered ketamine

01:11:00 ►

in my personal and private life.

01:11:05 ►

Really, not private, really illegal.

01:11:08 ►

Just personally, I’ve done a legal second LA,

01:11:11 ►

sorry, a legal ketamine infusion myself.

01:11:14 ►

So that’s what I’m going to do.

01:11:16 ►

But before three or four months ago,

01:11:18 ►

I was actually not just anti,

01:11:19 ►

I was a little scared of ketamine, honestly,

01:11:21 ►

because I’m pretty new to the burner festival scene.

01:11:24 ►

Actually, it burned down two years ago, the first time I ever even heard of ketamine, honestly, because I’m pretty new to the burner festival scene. Actually, it burned down two years ago.

01:11:26 ►

It was the first time I ever even heard of ketamine being used.

01:11:29 ►

And, you know, there was a lot of, like, problematic stuff that seemed to come up.

01:11:34 ►

You know, people that seemed to be more, you know, that we would call addicted or had issues currently or in the past with opiates.

01:11:39 ►

Just to where I was, like, a little bit scared of it.

01:11:41 ►

But then in the last few months, it’s really blown my mind how healing ketamine can be.

01:11:46 ►

And that’s when I was like, hey, I’ve got to get out of this because this is really, again, it’s got a lot of benefit.

01:11:50 ►

Shorter acting, cheaper than a full day of MDMA therapy.

01:11:56 ►

That said, I’ve now started really looking into it.

01:11:59 ►

I think in New York, like most cities, most of these ketamine practices are ketamine infusion clinics run by non-mental health providers that are essentially providing ketamine infusions.

01:12:11 ►

I think the setting, they tend to be like white walls.

01:12:14 ►

It’s a very medical-like facility.

01:12:17 ►

And I actually, I’m not saying that infusions are not beneficial.

01:12:20 ►

I just think it’s different than doing ketamine-assisted psychotherapy, which is what I do. I think ketamine infusions can be very helpful to get someone out of a depression,

01:12:28 ►

a suicidal state, which we actually have no alternative to that. So ketamine has its role.

01:12:32 ►

My frustration with ketamine at times is that, you know, so people I think can come off of

01:12:37 ►

antidepressants by getting regular infusion, which I think is good overall, you know, but I also

01:12:43 ►

think it’s unlike MDMA or other

01:12:45 ►

healing where we could potentially get people off of them

01:12:48 ►

much more long-term, perhaps

01:12:49 ►

forever.

01:12:53 ►

So yeah,

01:12:54 ►

I think it’s better, but I think we can do even

01:12:56 ►

better. So that’s why I’m really

01:12:57 ►

focused on doing ketamine-assisted psychotherapy

01:13:00 ►

or working with therapists

01:13:02 ►

that are doing that, because I do think it’s more of a

01:13:03 ►

long-term solution.

01:13:06 ►

But I also

01:13:06 ►

honor that we need ketamine infusion clinics

01:13:08 ►

I think because there are people that can’t

01:13:10 ►

afford the long-term therapy, they don’t have the time,

01:13:13 ►

if they have family, if they have certain jobs,

01:13:15 ►

and perhaps some people just don’t want to do

01:13:16 ►

therapy. I don’t think everyone should have to do

01:13:19 ►

that. And if that, say, down the road

01:13:20 ►

a year or two, they want to do psychotherapy, then they have

01:13:22 ►

that option.

01:13:24 ►

So I think ketamine, that’s kind of what I would think. If you want to do psychotherapy then they have that option um you know so i think ketamine that’s kind of what i would think if you want to do you know

01:13:27 ►

ketamine psychotherapy find practitioners that know what you know really how to work with this

01:13:31 ►

and i don’t know a lot of people that are doing really good ketamine psychotherapy work i mean i

01:13:36 ►

do know some those do exist um marcella one of our maps there says scott shannon both in the

01:13:42 ►

boulder um area do excellent work you know i’m saying like as a whole in the Boulder area, do excellent work.

01:13:45 ►

I’m just saying as a whole in the country, there aren’t a ton of people doing ketamine psychotherapy.

01:13:50 ►

And I think whether it’s MDMA or ketamine-assisted therapy,

01:13:53 ►

I actually like to refer to it as psychotherapy assisted by MDMA or psychotherapy assisted by ketamine

01:14:00 ►

because it’s the psychotherapy that’s doing the healing work.

01:14:04 ►

And again, I don’t know if I can really convince you guys that, you know, plenty

01:14:06 ►

of people doing psychedelics that aren’t being healed.

01:14:10 ►

So I think that, yeah.

01:14:13 ►

Actually, I also want to say that I do think healing work can be done with psychedelics

01:14:17 ►

outside of psychotherapy.

01:14:18 ►

I just think that those chances are much higher of having that happen if it’s combined with

01:14:22 ►

psychotherapy.

01:14:23 ►

All right.

01:14:24 ►

Thanks for listening.

01:14:24 ►

Thanks for listening.

01:14:30 ►

You’re listening to The Psychedelic Salon,

01:14:33 ►

where people are changing their lives one thought at a time.

01:14:37 ►

Well, now that you’ve heard some of these ideas,

01:14:41 ►

my suggestion is for you to go to the program notes for this podcast,

01:14:44 ►

which you can

01:14:45 ►

find at psychedelicsalon.com, and click on the link for the Eric Davis essay that is titled

01:14:51 ►

Capitalism on Psychedelics, the Mainstreaming of an Underground. And if you read that, you’ll get

01:14:57 ►

yet another take on this issue. And then you can join us for the Psychedelic Salon Live, where

01:15:04 ►

you’ll have a chance to join in this conversation

01:15:06 ►

and to ask questions of Dr. David Nichols, should you so desire.

01:15:11 ►

And to do so, of course, you’ll need to first subscribe as a supporter of mine on Patreon,

01:15:16 ►

and that link is on the program notes page as well.

01:15:19 ►

Each week, all of my supporters there receive personal invites with links to the live salon,

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Each week, all of my supporters there receive personal invites with links to the live salon,

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so pledging $1 a month will get you into the live salon and, well, a few other things as well.

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01:15:46 ►

I’ll have more to say about the Salon 3.0 on Patreon in future podcasts, but that should be enough for today. So for now,

01:15:52 ►

this is Lorenzo signing off from Cyberdelic Space. Be well, my friends. Thank you.

⚗️ alembic

Explorer

585 - Psychedelic Clinics In Our Future

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Program Notes

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Transcript

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