Program Notes
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https://www.eventbrite.com/e/psychedelics-101-102-for-clinicians-tickets-43896268922Guest speaker: Ingmar Gorman
Today’s Salon2 podcast features an interview with Dr. Ingmar Gorman about his work at the intersection of MDMA and PTSD.
Ingmar Gorman, Ph.D.
The Psychedelic Education and Continuing Care Program
Psychedelics 101 & 102 for Clinicians’ courses
Announcements
Global Psychedelic Earth Day Cleanup on April 22, 2018
ICEERS survey of psychoactive use
Lightning In A Bottle
Learning and Culture Lineup
Jon Hanna’s video of Bruce Damer’s 2007 Palenque Norte Lecture
A short video clip the Lorenzo took at Bruce’s lecture
Matt Pallamary, Bruce Damer, Jon Hanna, Lorenzo at the 2007 Palenque Norte Lectures
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Transcript
00:00:00 ►
Greetings from cyberdelic space.
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This is Lorenzo and I’m your host here in Psychedelic Salon 2.0.
00:00:25 ►
And before I turn the microphone over to Lex Pelger and his guest,
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there are, well, a couple of things that I want to pass on to you.
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First of all, if you are interested in going to a big festival,
00:00:36 ►
but you’d like to avoid the heat and dust storms that come with a Burning Man experience,
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well, you may want to look into attending the Lightning in a Bottle Festival, which is going to take place this May,
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May 23rd to 28th, 2018, at
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Lake San Antonio in Bradley, California. And in addition
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to a spectacular live music lineup, their Learning and Culture
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track is filled with interesting speakers this year. And I’ll
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post a link to their lineup in today’s
00:01:05 ►
program notes at psychedelicsalon.com. Now, speaking of Burning Man and dust storms,
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well, John Hanna has begun posting some of his massive store of videos to YouTube,
00:01:18 ►
and one of the first recordings that he posted is of Bruce Dahmer’s 2007 Planque Norte lecture, which was given during a major
00:01:26 ►
dust storm. I’ve played a recording of Bruce’s talk in my podcast number 106, which Bruce titled
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How Rare We Are in the Universe. And even if you’ve already listened to this podcast, I think
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that, well, you’ll really enjoy watching at least the beginning of the talk, just to see how difficult the conditions were when Bruce was speaking.
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In addition to John’s video,
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I’ve also posted a very short video segment that I took during that talk,
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where I panned the audience so that you could see that
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most of them had to wear breathing masks while Bruce spoke.
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And if you do watch that little clip,
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well, you may think that my camera was out of focus in the beginning,
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but the problem was with all of the dust that had filled the yurt If you do watch that little clip, well, you may think that my camera was out of focus in the beginning,
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but the problem was with all of the dust that had filled the yurt after the top of it blew out in the storm.
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It made it look a little fuzzy.
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Anyway, now that I’ve had my little festival reverie,
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I think that it’s time for me to turn the program over to Lex Pelger, who also has a couple of announcements himself before he introduces today’s interview.
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It’s just like the sort of knowledge that you’re getting from yourself
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that is what you need to hear to get better.
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I’m Lex Pelger, and this is the Psychedelic Salon 2.0.
00:02:43 ►
Lex Pelger, and this is the Psychedelic Salon 2.0.
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Hello everybody. Today I’m pleased to welcome an old friend from the psychedelic community.
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He came by the Bluebird office to share about his work with MDMA for PTSD. His name is Dr.
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Ingmar Gorman, and as you’ll hear, he’s working in several different directions to learn more about how to integrate these novel psychoactives into therapeutic uses. With a PhD in clinical psychology, he receives funding for his research in the
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National Institute of Health. Ingmar also works with MAPS on their phase three trials that’s
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moving MDMA towards an accepted medicine under the FDA. Working at the intersection of trauma
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and healing, I hope you enjoy hearing from Dr. Ingmar Gorman. But before we get
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to the show, I have a few psychedelic announcements for the community. And the first one comes from
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Ingmar himself. In New York City, he’s helping to lead a two-day training for clinicians about
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psychedelic integration. For any doctors who want to learn about the work, this is a great place to
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check it out. I’ll put a link to this and the rest of the announcements in the episode notes. Also, our friend Kwezi, who founded the Psychedelic
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Society of Western New York, is organizing the Global Psychedelic Earth Day Cleanup.
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On April 22nd, communities around the world will be out doing things for the planet.
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Contact them to find a group to work with or to lead your own cleanup
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project. Finally, if you remember hearing from Ben DeLonen of ICERS, the International Center
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for Ethnobotanical Research, their organization is conducting a survey about people’s drug use.
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Please go and add to the data. And now, on with the show.
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And now, on with the show.
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Thanks for coming on the show.
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Great to be here. Thanks for having me, Lex.
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Yeah. So can you tell us a little bit about how you got into this and what you’re up to now? psychedelic conferences in around 2006, really 2006, and went to a conference and found that I was fascinated by what the people were presenting on. And it became a passion of
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mine where I said, well, I’m going to dedicate my life to this, the study of these substances,
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and particularly the psychotherapy, like that’s what really interests me the intersection of the psychedelic or mdma
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assisted psychotherapy so the question of like so how is it assisting the therapy what is it doing
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so maybe i could say a little bit about mdma therapy for those who don’t or mdma assisted
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psychotherapy for those who aren’t familiar with it. So currently there is research being done for various indications,
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and the one that I focus on is PTSD.
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So using MDMA to enhance psychotherapy to somehow treat PTSD
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maybe you could say more efficiently or potentially more effectively than other modalities for PTSD.
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And this is not to, I’m not making, I want to be clear that I’m not saying that this treatment is
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better because we don’t really have that data at this time, but it may be on par with other
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treatments and it may be helpful for people who don’t respond as well to other existing treatments.
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And so this mode of therapy is still being investigated. MDMA is a Schedule I drug.
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So in order to do this treatment, you have to be doing a study that’s approved by the FDA, the DEA.
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approved by the FDA, the DEA. So maybe to step back for a second, for people who aren’t familiar with PTSD, post-traumatic stress disorder, it’s a psychological disorder that is somehow linked to
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a traumatic event. And there is some debate in the field, and I could speak for a very
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long time about this, but there’s a debate around what constitutes a traumatic event.
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But what seems to be an important piece of it is that a person feels like that their life was
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threatened in some way. It could also extend to the life of a loved one or somebody near them.
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There’s different ways of kind of qualifying this, but someone’s life being threatened is an important piece of that.
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And now people have go through traumatic experiences all the time. Sadly, it is a part
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of life and different people are able to respond and cope with trauma in different ways. And one outcome of trauma is post-traumatic stress disorder, which consists of various cluster of kind of responses to the trauma.
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That can include after a period of time, after the trauma occurred, a person may re-experience the trauma.
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After the trauma occurred, a person may re-experience the trauma, and that can be anything from what people may stereotypically think of like a flashback, sort of the classic idea of the Vietnam veteran who is suddenly back in the jungle or fighting after hearing a car backfire or whatever, that’s often an example.
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But I think that that is maybe overemphasized sometimes too much because re-experiencing, in my mind at least,
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can also be something that is embodied,
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where it’s not as clear-cut as having a nightmare
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or no longer being in the world or the reality that you once were, or were in the present,
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but more so a physical, when I say embodied, meaning, now this is kind of hard to describe,
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but feeling in your body that you’re back in that traumatized place. And so that could be something like a person who
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has PTSD, their boss may walk behind them, and they associate to an abusive partner or parent,
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and they tense up because they’re expecting to get hit, right? And that’s very subtle. And for
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some people that may not be clear that it can be part of a PTSD symptomology. And so this is, that’s, you need in order to meet criteria for PTSD, you need to have various clusters. So there’s like, there’s re-experiencing, there’s changes in mood, changes in cognition.
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There are different kind of symptoms that when you meet a certain number of them, they come together and you can say, okay, well, you’re diagnosed with PTSD.
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There’s a whole other conversation that I want to just touch on that we don’t have to have. But there’s an important question of like, what is the outcome of trauma aside from PTSD?
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Because in the DSM, the only, the diagnostic manual for psychiatry and psychology, the only disorder that really acknowledges trauma is PTSD.
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But trauma leads to so many different kinds of symptoms that aren’t PTSD.
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And there’s this open question, I’m getting ahead of myself, but the open question is, well, could MDMA-assisted psychotherapy also be helpful for different kinds of disorders and symptoms that are related to trauma, but aren’t necessarily PTSD. So to MDMA, what is MDMA?
00:10:12 ►
So MDMA, if my memory is correct, I think it was 1912 was when it was first discovered or
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synthesized by Merck. And they were, I believe, looking for a blood clotting agent, I think.
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I don’t remember what they were looking for.
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But simply that this was an intermediate component in the reaction working towards another drug.
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It wasn’t something of interest.
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It was just a, I guess, almost a waste product along the way.
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So in either case, one misconception to clear up is that a lot of people thought that it was they’re looking for an appetite suppressant because MDMA is a stimulant.
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As I heard Shogun always like to say that you can’t take the A out of MDMA, which is the amphetamine part, which explains its stimulant-like properties.
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explains its stimulant-like properties. But anyway, in 1912, this was first synthesized,
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and it really wasn’t used and studied in humans at all until I think like the 1970s,
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maybe late 70s, when it was first ingested by a human. And then it was really Sasha Shulgin, who then not soon after began to resynthesize it and then gave MDMA and helped it spread through really the mental health community
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at a time where the drug wasn’t yet illegal.
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It wasn’t scheduled yet.
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And so it’s an interesting question if that’s the gray area of the law or not
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because it’s not really recognized by the law.
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I always love the story of somebody told me once that MDMA was first called like Adam or
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Empathy, and it didn’t sell very well. This is how the story goes. And so they rebranded it as
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Ecstasy. And suddenly when dealers began to sell Ecstasy, people were, they wanted Ecstasy.
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Maybe not so much Empathy, but maybe Empathy is a better, maybe a more accurate description of MDMA.
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So as it kind of went through the club scene, I believe like Houston was a big…
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Yeah, Texas was the heart of it.
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Lorenzo of the Psychedelic Salon talks about it a lot.
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Yes.
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Yeah.
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And so then the law became interested in this new drug and why people
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were using it. And I believe it was 1985 that it was scheduled as a schedule one drug, which means
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that it has no, it has a high risk of abuse and no medical value. The community of mental health
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professionals and others who saw the potential for MDMA to assist therapy, particularly for couples counseling and trauma when it was not scheduled yet, they advocated for it remaining unscheduled or at least a lower, a less strict kind of scheduling.
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a less strict kind of scheduling. And unfortunately, it was still scheduled as the most controlled. And that really left MDMA as a prohibited drug. I mean, the research that was
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happening with MDMA from the mid 80s into the 90s was purely looking at the dangers of the drug. And so there’s a ton of research
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on the potential dangers of MDMA, but nobody was examining the clinical utility of it or potential.
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And it wasn’t until the mid 2000s. Well, I should say that MAPS, it’s very important to talk about
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MAPS, the Multidisciplinary Association for Psychedelic Studies, which is the nonprofit organization that is the sponsor of the research that I do. And really, Rick Doblin,
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who heads MAPS and the entire MAPS staff and team have since with Rick starting in 1985,
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till today, and are continuing to fund research for MDMA as a clinical, as a medicine, as a potential
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medicine. And so it’s that kind of dedication, those decades of dedication that brought us here
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today, where we are about to begin a phase three trial, which is means that it’s the last phase
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of research that needs to be done in order to evaluate whether the treatment works
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and whether it could be one day prescribed as a medicine,
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which has significant potential implications for its scheduling because if that were to happen,
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kind of by definition, you would have to reschedule it from one to something that’s
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less strict.
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Yeah, it sounds like it was such an exciting time.
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If anyone out there is interested in the therapy side, there’s one book that I always thought
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was amazing called The Secret Chief.
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And it’s an interview actually with Leo Zeff, who was a friend of Dr. Shulgin.
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And he saw he actually he was doing LSD therapy, taught so many people how to do it, and then LSD became illegal.
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And he tried MDMA, and he came out of retirement to go and start teaching other practitioners how to use this molecule they called ADAM.
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And he helped turn on a lot of people who kept doing it in the underground, but unfortunately got blocked.
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lot of people who kept doing it in the underground, unfortunately got blocked. And thanks to Rick and MAPS, all of a sudden, now we can start looking at this and finding some really significant
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potential for treating veterans and victims of abuse. And so I guess a question for you is,
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what did these sessions look like when you are working with somebody using MDMA and their fears
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around this, you know, thing that’s
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known as a club drug that puts holes in your brain? I have not actually done MDMA therapy as a
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therapist yet. So I’ve been trained. I’ve part of the work that I did as a graduate student was to
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study video recorded sessions of the therapy. So I’ve seen quite a lot of that, um, gone through quite a bit of training.
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So from like a, a very structural perspective, um, in terms of research, we are looking at a
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participant, a potential participant, they’re screened. We’re looking for certain kind of,
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um, inclusion and exclusion criteria. And what exclusion criteria is important?
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What stuff are you watching for the most in terms of safety? Well, so what I can mention is that in terms of
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safety, certainly people currently with a bipolar disorder or a psychotic spectrum disorder
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or even close relationship, a family member that has a psychotic disorder, those are kind of
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important markers for us to look at.
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There are other exclusionary criteria that I won’t go into because we don’t want people
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to know too much in terms of, because this treatment is in so much demand
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that people are willing to, I think,
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bend the truth in order to get the treatment.
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And I do think that there are people
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who would be excluded from our study.
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Again, this is me, I mean, this is a very,
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this is really qualify what I’m saying here because I I see myself as a scientist, and I really take the perspective that if the data is not there, we shouldn’t make any strong claims.
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But what I’m saying here is that I do believe that there are people who are, will be excluded from this research, who could potentially still benefit from the therapy. We have to understand that more fully.
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But in the way research works, you are trying to isolate certain variables,
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and that’s why there’s rather strict inclusion and exclusion criteria.
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So that’s the first process. And then if a person passes this pretty rigorous screening,
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they’ll have three preparation sessions,
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which consists of what we call the building of a therapeutic alliance, which is simply meaning
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trust in a relationship between the therapist and the participant. And there are two therapists,
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male and female, always present throughout the whole treatment. After the three
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prep sessions, there’s the first dosing session or experimental session, test session. There’s
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different words we use for it, but that’s when the participant will get either MDMA or a placebo.
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And then after that, there are three integration sessions. Just to return to the actual dosing session, the participant, that takes six to eight hours.
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So the prep sessions are 90 minutes.
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You could imagine them as if they were like 90-minute therapy sessions.
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But the dosing sessions last anywhere between six to eight hours. And the participant will be either lying down and what we call kind of going inward, blindfolds with music without any kind of vocals in English to not prime the person or bring the person into some sort of intellectual space too much.
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And they are either inward or they’re engaging socially with the two therapists, socially meaning having a conversation about whatever comes up. And it’s a very non-directive kind of treatment. So a person
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is in a very open state when they’re under the influence of MDMA. And as a therapist, it has much
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more to do with not doing than with doing. It’s much more about being very careful about when you are active
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and not being overly active in terms of trying to get the participant to think a certain way or
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to do a certain thing. It’s really more driven by the participant.
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And so that’s kind of that in a nutshell.
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And then there are these integration sessions.
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So there are these three 90-minute sessions that take place.
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One is immediately the morning after the dosing session.
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So the participant stays at the therapy site overnight.
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And then all these sessions, other than that,
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the sessions are pretty much one week apart. So if you had, you know, three weeks of this one 90 minute prep
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session, and then you get the dose, and then you have three integration sessions. So everything’s
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roughly spread out by a week. And that repeats, actually. So there are then after the three
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integration sessions, there’s a dose session, three more integration sessions, another dosing
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session, and then three more integration sessions. So at the end of the day, it’s something like 15-ish 90-minute therapy sessions with these three 6- to 8-hour dosing sessions.
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That’s kind of the model right now.
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That’s a very labor-intensive model.
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kind of the model right now. That’s a very labor intensive model. It might, it’s one of the problems with how this might roll out is how we’re going to have enough people and resources to do
00:21:10 ►
that. Especially if, I mean, just taking care of the veterans who should be getting this treatment
00:21:14 ►
would be a huge investment. Well, yeah. So this treatment unto itself is not like anything else
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that’s out there except for maybe a psilocybin treatment or psilocybin-assisted therapy
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or maybe there’s some comparisons to like EMDR in some ways, but that’s a separate thing.
00:21:33 ►
So the thing about that is, one, it’s a combination of pharmaceutical and a or a drug and therapy and for example the fda does not
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govern or study observe psychotherapy they don’t but they do they do look at right
00:21:59 ►
potential medicines or uh um you know other kinds of products like that, or devices even, right?
00:22:08 ►
Medical devices. So that’s a weird, just that alone is a weird fit, right? So you’re sort of
00:22:13 ►
submitting that the FDA is looking over our protocol for the study, and there’s all this
00:22:19 ►
stuff that they don’t really care about so much. Now, another way that this is sort of a new thing is what you just
00:22:26 ►
mentioned, which is that it’s a lot of therapy kind of front loaded in a way. So it’s resource
00:22:33 ►
intensive, time intensive. But if you think about the number of people who’ve been in PTSD treatment
00:22:38 ►
for many, many, many years, who’ve definitely been through many more hours of treatment than what we’re doing. And it seems like from the data that we’ve collected so far, that when people have their
00:22:52 ►
symptoms reduced, for some people, they don’t even meet criteria for PTSD anymore. That is how
00:23:00 ►
in some participants, the effect is strong. And then that seems to last. In the studies that have
00:23:08 ►
been conducted, the follow-ups are actually pretty lengthy, and it seems like people maintain their
00:23:12 ►
benefits for a longer period of time. So there’s expense associated with that upfront resources,
00:23:22 ►
and there’s a big conversation around insurance coverage and
00:23:26 ►
how can we it’s one thing to find a treatment that works and then there’s another whole part
00:23:30 ►
of it like how do you um how do you make that treatment available it’s another huge problem i
00:23:37 ►
mean this is the amount of effort that’s gone into making making this happen is incredible
00:23:42 ►
it’s a piece of it yeah yeah and especially the model of how it’s getting done.
00:23:48 ►
Normally, pharmaceuticals get approved by a billion dollars or so process,
00:23:53 ►
and there hasn’t been many nonprofits like MAPS pushing through a drug that’s going to get approved.
00:23:59 ►
I think the Plan B birth control was the first nonprofit drug pushed through,
00:24:03 ►
but now MAPS is trying to do that same thing with this old, vile drug.
00:24:09 ►
It’s kind of an amazing process.
00:24:10 ►
I always give my hats off to Rick Doblin for charging ahead.
00:24:14 ►
Under the heart of Reagan’s presidency, he said, let’s start an MDMA treatment.
00:24:21 ►
But the political smarts of it was so good.
00:24:23 ►
I mean, focusing on veterans, it’s a group that everybody cares about. But if I remember correctly, the first studies were on victims of sexual abuse because it was a population that had demonstrated treatment resistance. So they’d been many years, they tried everything else under the sun, and then this showed rather remarkable results. So treatment resistance was defined,
00:24:45 ►
I believe, as at least one, I can’t remember the exact numbers. It was definitely at least
00:24:49 ►
one psychotherapy and one pharmaceutical intervention that didn’t work. It may have
00:24:54 ►
been two psychotherapies in one. I’m not sure. But it was definitely at least, you know, having
00:24:58 ►
tried two different kinds of treatments and not responding. So these were participants,
00:25:06 ►
treatments and not responding. So these were participants, these were people who had chronic long-term PTSD and did not respond to other treatments. And now that’s not the case. You
00:25:13 ►
don’t have to have, you don’t have to be a non-responder to previous treatment to be eligible
00:25:20 ►
for this, the research now. And so can you tell me about the program that enabled you to have
00:25:26 ►
your session yesterday? Sure. Yeah. So MAPS was able to get a study approved that is known as MT1,
00:25:38 ►
which it’s funny, I can’t, I can’t say MT1 anymore without one of the therapists that is on my team in New York likes to say MT1, which, you know, I think of like Buddhism of like emptiness as being a good thing, right?
00:25:57 ►
So he always likes to say that and I can’t now get that out of my mind.
00:26:02 ►
So it’s M, the letter T, letter 1.
00:26:06 ►
And here the participants are therapists.
00:26:11 ►
And the therapists that are in,
00:26:14 ►
who are going to be conducting the Phase 3 research.
00:26:17 ►
And the idea behind it, in part at least,
00:26:21 ►
is to have each therapist have their own experience with the MDMA.
00:26:28 ►
And speaking from my own experience with it, what I found helpful about it was not just
00:26:36 ►
having my own experience with it and knowing what that state is like,
00:26:41 ►
but also to observe how the two therapists were responding
00:26:46 ►
to me or how they were engaged with me in a particular way that really ingrained the
00:26:53 ►
training that I received previously.
00:26:54 ►
Because when you get the training, it’s easy to…
00:27:00 ►
The way that MDMA therapy is designed, that’s also a long conversation, but it’s sort of a mix of a lot of different ways of working.
00:27:08 ►
And therapists are actually invited to bring their own modality a little bit into the mix.
00:27:16 ►
But there is a particular aspect of this non-directive way of working because people are somewhat suggestible in the state, and that’s a strong way of putting it.
00:27:26 ►
I don’t think you could get a person to just obey your commands,
00:27:31 ►
but there’s a way where a person is so open
00:27:34 ►
that what is said really kind of affects you.
00:27:40 ►
You experience what is being said on an emotional level, has a greater emotional resonance.
00:27:48 ►
And so for me to be able to observe how my two therapists who’ve had more experience doing this MDMA therapy,
00:27:59 ►
to hear and see how they responded to me was a real teaching moment.
00:28:06 ►
It was very powerful, and I think I now carry that with me in a different way.
00:28:11 ►
That would be a wonderful way to learn.
00:28:13 ►
It does sound very important.
00:28:16 ►
So often doctors haven’t tried the drugs that they’re giving to patients
00:28:19 ►
because they shouldn’t or they wouldn’t.
00:28:22 ►
But here it just makes so much sense.
00:28:24 ►
Yeah. They shouldn’t or they wouldn’t. But here it just makes so much sense.
00:28:25 ►
Yeah.
00:28:44 ►
There’s, you know, I’m, somebody recently asked me just flat out, like, how important do you think it is that a therapist have their own experiences with MDMA or psilocybin before they do, they provide the treatment themselves.
00:28:48 ►
And my response, I think, you know,
00:28:52 ►
anything that I say I can rethink and reconsider at a later time.
00:28:59 ►
But I still, I think I’m a little bit more open-minded about that than maybe other people in the psychedelic community.
00:29:01 ►
I think there’s a real,
00:29:03 ►
my impression is that there’s a real strong conviction amongst people who are sort of following the psychedelic research
00:29:08 ►
and psychedelic treatment that a therapist has to have their own experience. And I would scale
00:29:16 ►
that back to maybe like, I feel that way, maybe seven, like seven out of 10, you know, because
00:29:21 ►
there are people who are just very, they’re therapists who are just
00:29:25 ►
excellent therapists and get that idea of non-directive treatment and can, I think would
00:29:31 ►
be able to do the treatment well without having their own experience. But I have to say that it
00:29:37 ►
certainly is helpful. And we should maybe even acknowledge some history because when I was an undergraduate, I did some research with speaking to mental health professionals in the former Czechoslovakia when LSD was legal.
00:29:56 ►
And it was interesting there because that was communism.
00:30:12 ►
So the social context in which LSD and psychedelic therapy happened was different than in the United States, where there was also like a parallel cultural movement, social cultural movement.
00:30:25 ►
And what I did in my research was to ask these mental health professionals how important they thought it was that mental health providers had their own experience with the drug before they administered it.
00:30:27 ►
And it was almost like unanimous agreement that they should.
00:30:32 ►
So that was one of the strongest outcomes of our study that we did, actually.
00:30:37 ►
We interviewed and also did surveys with about 20 people,
00:30:42 ►
so it’s not like a huge sample size.
00:30:43 ►
But when you think about the number of people that were doing that work at that time, it’s not that many.
00:30:50 ►
So, yeah, there’s a historical context to this.
00:30:55 ►
The MT1 is really a reemergence of something that was actually considered to be mandatory.
00:31:03 ►
that was actually considered to be mandatory.
00:31:06 ►
Maybe even like it would be unethical to induce a state in somebody else
00:31:09 ►
without really knowing it yourself.
00:31:12 ►
Again, I don’t think that that’s entirely true,
00:31:14 ►
but I think there’s some truth in it.
00:31:17 ►
Yeah, that makes sense.
00:31:18 ►
There are just some therapists who are wonderful.
00:31:20 ►
They already live in an empathetic,
00:31:24 ►
psychedelic state anyway. Jag Davies likes to say that like there’s a
00:31:29 ►
midhoffer effect so Michael and Annie midhoffer were the the therapists who
00:31:32 ►
were sort of leading the MDMA research the first therapists and he’s like
00:31:37 ►
there’s such lovely people like it’s like I don’t know if it’s the MDMA or if
00:31:41 ►
it’s just them what was it like for you yesterday?
00:31:45 ►
After you’ve watched hundreds of hours of other people’s MDMA videos and know so much from the underground and the above ground, what was it like for you?
00:32:06 ►
important part of the, the, what you could call healing or therapeutic aspect of MDMA is what,
00:32:15 ►
um, we refer to as the inner healing intelligence, um, which I’ve, I’ve now like fully embraced that term. I feel like I hadn’t always, I always thought like, Jesus, that’s so much, so hippie.
00:32:20 ►
But, um, I mean, it’s, it’s an accurate description of what it is.
00:32:28 ►
Another way of thinking about it that maybe is less laden is just intuition.
00:32:31 ►
And it’s incredible.
00:32:47 ►
It’s incredible that we actually know there’s a part of us that knows what is best for us or what we, in a way, need to hear.
00:32:52 ►
But it’s coming from our, that comes from within.
00:32:54 ►
So maybe to explain a little bit better,
00:32:57 ►
after when a person is under the influence of MDMA, it seems like, I don’t know how to quite describe it.
00:33:04 ►
It’s like your conscience,
00:33:06 ►
that kind of voice inside you
00:33:08 ►
or that dialogue that you have with yourself,
00:33:10 ►
which is often for most people really critical.
00:33:15 ►
It kind of somehow changes
00:33:18 ►
and you begin to have,
00:33:22 ►
you could maybe call them insights,
00:33:24 ►
but it’s not just logical. It has
00:33:25 ►
this incredible emotional resonance or weight to it where you’re starting to hear yourself,
00:33:34 ►
feel yourself sort of saying things or hearing things. It’s not like voices in your head though.
00:33:39 ►
It’s just like the sort of knowledge that you’re getting from yourself that is what you need to hear to get better, to sort of whether that – to be – whatever that may mean for each person.
00:33:52 ►
And so I’ve like for years sort of knew about this and read about this and was taught this.
00:34:02 ►
And read about this and was taught this.
00:34:07 ►
But it’s not until, and this is what happened to me in my experience yesterday, where it went from that intellectual, like, yes, inner healing intelligence,
00:34:11 ►
to experiencing this intuition, this internal intuition.
00:34:15 ►
And I was like, oh, yeah.
00:34:18 ►
That’s that thing, right?
00:34:21 ►
That’s what it’s about.
00:34:23 ►
And I really do think that that is what, I do think that this is a strong part of what is therapeutic about the, and that’s why the non-directive piece is so important, that it’s not coming from the therapist necessarily.
00:34:34 ►
It may be kind of helping you get there in some ways, but it’s about one’s own internal intelligence that is coming out, that is sort of showing you things. And it’s absolutely
00:34:48 ►
remarkable. I mean, it’s remarkable that we don’t really have contact with that on a daily basis.
00:34:53 ►
And maybe we do and we just sort of ignore it or block it or can’t hear it or whatever. But it’s
00:34:59 ►
there. And it’s probably there all the time. but somehow this drug allows that to kind of shine through.
00:35:07 ►
That’s great.
00:35:07 ►
Now, how much time did you spend with the eye shades on and the music versus out loud talking?
00:35:12 ►
How different did that feel?
00:35:14 ►
Well, I’ll preface this by talking about what I have studied in the videos, which is I’ve seen people talk to the therapist the entire time.
00:35:27 ►
Can’t take the A out of MDMA.
00:35:30 ►
There’s so many feelings.
00:35:32 ►
This is people who’ve observed people use recreationally
00:35:38 ►
or use other stimulants, like talk a lot, or can talk a lot.
00:35:43 ►
But I’ve also seen videos where the participants were
00:35:47 ►
they just went inside the whole time and um i know that i actually i can not that it really
00:35:55 ►
matters but i can demonstrate this quantitatively because what we were doing was transcribing these
00:35:59 ►
videos and uh like i was looking at word count and things like that so like you know some some
00:36:04 ►
i can’t remember what the top one was,
00:36:05 ►
something like 30,000 words or something like that.
00:36:08 ►
And then the bottom was something like maybe 200 words
00:36:12 ►
over the course of eight hours.
00:36:14 ►
And all it consisted of was Michael Mithoffer
00:36:16 ►
going up to the participant and saying,
00:36:17 ►
is everything okay?
00:36:18 ►
And they’re like, yeah, everything is great.
00:36:21 ►
And that was it.
00:36:21 ►
That was basically the exchange that occurred
00:36:24 ►
over checking in, doing the heart rate monitoring and that kind of stuff.
00:36:29 ►
But the, and the thing is that there was no, I mean, it’s hard to conclude just from those
00:36:34 ►
two videos because there’s a lot of other stuff going on, but there wasn’t a difference in their
00:36:38 ►
outcome. Now there may be other factors that may explain that, but in terms of my own experience,
00:36:42 ►
Now, there may be other factors that may explain that. But in terms of my own experience, I did a little bit of both.
00:36:47 ►
I think I was probably more – it’s hard.
00:36:50 ►
Time begins to – your perception of time is altered a little bit.
00:36:54 ►
But my sense from the therapist who spoke to me, I think I was more engaged socially than I was going in.
00:37:02 ►
But the thing is sometimes this is part of the
00:37:06 ►
therapy training. There are times where the therapist may suggest for the participant,
00:37:11 ►
in this case me, to like to go inside to examine a particular feeling or thought or kind of
00:37:21 ►
sticking point to kind of see if going in will help with that.
00:37:25 ►
And there were maybe two occasions where I kind of put my blindfolds on,
00:37:30 ►
put the headphones on, and it was maybe like two minutes.
00:37:33 ►
It’s like, yep, all right.
00:37:34 ►
Like, you know, it came so quickly.
00:37:37 ►
Not always, not always.
00:37:39 ►
But, you know, I like to consider myself to be kind of in tune with that inner voice. Um,
00:37:48 ►
not always obviously, but like, I feel like close to it and it’s something that I, um, I connect
00:37:54 ►
with. You’ve been lecturing about this kind of, uh, work for a long time and out in the circuit,
00:37:59 ►
talking a lot to people. Um, and so, you know, a lot of the issues underlying the, the good sides of this,
00:38:05 ►
the controversies and things like that. If you had your own podcast, what would the topics be
00:38:11 ►
that you would want to focus on that might be more controversial that you think need aired
00:38:15 ►
in the community? Yeah, yeah. So why should I’m going to do another preface, which is we didn’t
00:38:22 ►
even have much of a chance to talk about everything that I do.
00:38:25 ►
And that’s kind of important to kind of contextualize all this.
00:38:29 ►
So one, I’m a co-PI, principal investigator, which means that for the site in New York, what we call the private practice site, because there’s also a New York University site.
00:38:39 ►
So for the private practice site that is doing MDMA for PTSD, I’m kind of like the co-leader of that site with,
00:38:46 ►
along with Casey Pellios, who is an MD.
00:38:49 ►
I’m a PhD clinical psychologist.
00:38:54 ►
Casey is leading that with me.
00:38:56 ►
And so that’s one of my roles in life right now.
00:39:00 ►
The other one is that I’m a NIH-funded postdoctoral fellow at NYU, which is confusing because I’m not doing MDMA work necessarily at NYU.
00:39:11 ►
I’m not part of that team, although I’m very fond of them.
00:39:15 ►
But I have a postdoc position at the university.
00:39:27 ►
And then the other thing that I do, which is related to your question, is that I’m the director of a program called the Psychedelic Education and Continuing Care Program,
00:39:38 ►
which is a private practice that focuses on not providing psychedelics or MDMA to do therapy, but basically everything else around it. So that can include people who have never done a psychedelic, who are interested in their potential risk.
00:39:45 ►
What are the risks that are associated with engaging in psychedelic use?
00:39:50 ►
To people who are psychonauts,
00:39:53 ►
who it could be something as simple as
00:39:56 ►
not really getting where they want to in life,
00:39:59 ►
despite their psychedelic experiences,
00:40:03 ►
needing what we call maybe integration,
00:40:05 ►
and to people who have other kinds of struggles in their life,
00:40:12 ►
other kinds of symptom pathology, to put it clinically,
00:40:16 ►
who are trying to engage in psychedelic use to help themselves,
00:40:20 ►
but aren’t, again, quite getting to where they want to be.
00:40:24 ►
but aren’t, again, quite getting to where they want to be.
00:40:31 ►
And so as the director of this program, I’ve been able to, it’s been very rich for me and probably the greatest learning experience I’ve had so far
00:40:34 ►
in terms of a more broader view of what’s going on in the psychedelic world.
00:40:40 ►
And I’m not going to talk about cases necessarily because I don’t want to, I don’t
00:40:46 ►
have permission from my patients to speak about the particulars, but it really ranges.
00:40:51 ►
And the thing that I like to say, because I think it’s really true that in terms of
00:40:55 ►
the integration work I’ve done, it’s quite rare.
00:40:59 ►
Will somebody, when somebody comes, I think what people think about integration, they think that they have this sort of incredible experience that they can’t quite digest.
00:41:10 ►
And they need help making meaning out of that experience.
00:41:14 ►
And what I found to be more common are people struggling in the day-to-day with very mundane life kind of struggles and not quite getting to where they want to be and kind of focus
00:41:27 ►
on what’s the relationship to psychedelics? What’s the relationship to other things going in their
00:41:31 ►
life? Are psychedelics helpful? Because sometimes they’re not. And kind of supporting a person
00:41:39 ►
through that process. Now, in terms of this podcast, so I’ve had this idea and I don’t know if I’m ever going
00:41:46 ►
to do it, but I would really love to have conversations with people more publicly about
00:41:53 ►
the things in the psychedelic community that the psychedelic community, meaning people who are fans
00:41:59 ►
of this research, who’ve everybody from the researchers to the, I call them fans,
00:42:05 ►
it’s maybe derogatory, but people who really appreciate what we’re doing.
00:42:07 ►
Fellow travelers.
00:42:08 ►
Fellow travelers, yeah.
00:42:08 ►
That’s my favorite.
00:42:09 ►
Yeah.
00:42:12 ►
The things that they don’t want to talk about
00:42:14 ►
or things that maybe they’re afraid to talk about.
00:42:15 ►
And I have to give credit where credit’s due
00:42:17 ►
because this inspiration came from James Kent,
00:42:21 ►
who has this podcast called Dose Nation where he’s kind of concluding it, but
00:42:26 ►
he’s kind of airing all of the things that he’s kept to himself across his decades of
00:42:33 ►
interacting with the psychedelic community. And I think we need to have more conversations around
00:42:39 ►
these topics. And one of them, if I may, is something that a few people have touched on but hasn’t really been catalyzed or formulized yet, which is the potential for psychedelics to be traumatic.
00:42:59 ►
Dare I say, and please don’t hold my word to this, maybe a kind of a psychedelic-induced PTSD.
00:43:08 ►
And now, why do I think that people don’t want to have this conversation?
00:43:14 ►
Well, because there’s so much, well, now there’s a psychedelic renaissance where the media and
00:43:20 ►
the public is willing to engage in this kind of idea that maybe MDMA and psychedelics could potentially be helpful.
00:43:26 ►
But that wasn’t the case, what, like six years ago, seven years ago?
00:43:31 ►
This is relatively new.
00:43:33 ►
And so I think there’s a lot of fear around having a conversation about the potential harmful effects of psychedelics
00:43:39 ►
when used in not ideal or when the conditions aren’t right.
00:43:48 ►
And the reason why I’m saying this and phrasing it in this way
00:43:51 ►
is because I think there is a difference between,
00:43:53 ►
I think most mental health professionals would think of a,
00:43:57 ►
when they hear about these cases,
00:43:59 ►
they would think of a psychotic disorder,
00:44:03 ►
like a substance-induced psychosis
00:44:05 ►
or an acute psychotic disorder
00:44:09 ►
or maybe like a catalyst for schizophrenia.
00:44:12 ►
And that’s not to say that that doesn’t exist.
00:44:15 ►
I think that potential is there too.
00:44:19 ►
I’ve seen that in patient units with cannabis,
00:44:22 ►
but there’s this question of pre-existing,
00:44:26 ►
predisposition to that.
00:44:28 ►
But I think the psychedelic PTSD is different
00:44:32 ►
because it looks different.
00:44:34 ►
It’s very somatic.
00:44:37 ►
People, I’ve been hearing from more women,
00:44:41 ►
and I have a small sample here,
00:44:42 ►
so I’m not making any kind of gender-based conclusions or sex-based conclusions. But for some, they may not have their period anymore.
00:44:57 ►
There’s hair loss. There are certain kind of somatic symptoms. And then coming with that is sort of the intrusive symptoms that you are a part of PTSD,
00:45:06 ►
which is, but they’re psychedelic, you know. So whereas that veteran would return back to Vietnam,
00:45:16 ►
they’re exposed to a stimulus that brings them back to that place. But for them, that can be
00:45:22 ►
concrete, right? It can be the jungle or it can be so many things
00:45:26 ►
depending on what kind of trauma it is. But the thing that I’ve noted in terms of people having
00:45:31 ►
this kind of psychedelic PTSD is that often it’s in response to that kind of, I don’t know if I
00:45:40 ►
could call it ego death or that kind of like intense fear response
00:45:45 ►
where the person under the psychedelic really believes that they’re going to die, right?
00:45:48 ►
Which is one of the kind of criteria connected to PTSD.
00:45:52 ►
They come out of it.
00:45:53 ►
They’re not psychotic.
00:45:55 ►
It’s not like that they’ve had a break with reality in some way, not necessarily delusional,
00:46:01 ►
but say particularly when they’re about to fall asleep or their kind of mind is
00:46:06 ►
maybe a little bit more at ease these sort of intrusive kind of psychedelic things come to like
00:46:12 ►
maybe maybe patterns or just sort of different um reminders of that state that state of being in
00:46:20 ►
like and i really am fond of this word, existential terror. You know, I think that
00:46:25 ►
really captures that state of being an existential terror. And I don’t know, I hope that integration,
00:46:36 ►
the work that I do would be helpful for that. And I haven’t been able to work with those cases yet. And I myself am still learning about how to approach
00:46:48 ►
that kind of picture. You could say symptom picture, because, you know, some level of
00:46:57 ►
PTSD treatment has to include exposure. Well, there’s actually evidence against that. But
00:47:03 ►
a lot of treatments use exposure as
00:47:06 ►
somewhere in there, even the MDMA therapy for PTSD, there’s some aspect of imaginary exposure
00:47:11 ►
where the person when they’re going inward, they often almost always, when they have PTSD,
00:47:17 ►
recollect the trauma in some way and re-relate to it in a new way. But how the heck do you do that
00:47:22 ►
with a psychedelic experience? It’s not like I can,
00:47:25 ►
you know, show you a photo of the Vietnam jungle or like have you write it. I guess maybe they
00:47:30 ►
could write a script about their experience. And, but that’s, that’s very invasive. So there’s this
00:47:34 ►
real conundrum around like, because people talk about how psychedelic experiences themselves are
00:47:39 ►
difficult to express in words. So then how then do you kind of work with that? And I’ve been
00:47:44 ►
receiving some guidance
00:47:45 ►
from one of my mentors, Andrew Totarski, who runs the Center for Optimal Living where the
00:47:50 ►
psychedelic program is housed. So he’s been helping me with that a little bit, but it’s a
00:47:55 ►
challenge and it’s something that we just don’t talk about. Yeah, that would be the idea of
00:48:00 ►
psychedelic trauma. You can just see out on the festival circuit how much that would be a
00:48:06 ►
verboten idea
00:48:08 ►
that they could do that kind of damage.
00:48:10 ►
But the funny part is when I’m out there
00:48:12 ►
asking about people’s stories,
00:48:14 ►
it seems like everybody knows a bad
00:48:16 ►
weed story and a bad psychedelic story
00:48:18 ►
where you have someone who is really harmed
00:48:20 ►
by these things, maybe for a couple weeks
00:48:22 ►
or a couple months and maybe forever.
00:48:24 ►
And it doesn’t get credence. It gets treated as prohibitionistic propaganda when this is a story
00:48:31 ►
of a peer. This is a story of someone who’s into these drugs. They’re not sharing this to
00:48:36 ►
put them down. Because the psychedelic field is kind of neglected generally,
00:48:40 ►
we don’t have the numbers. It would be if like we could say on an epidemiological level, like, okay, these are the number, we do know how many people use
00:48:49 ►
psychedelics roughly, right? But we don’t know how many people have had this kind of experience.
00:48:54 ►
I would still venture to say that it’s rare. It’s a complete guess. But you know, I’m in a position
00:48:59 ►
where I’m directing this program where people are coming. It’s a selection bias.
00:49:06 ►
Like they’re coming to me because they need help.
00:49:07 ►
So I’m hearing these stories.
00:49:10 ►
So I don’t want to overemphasize the danger, right?
00:49:14 ►
I mean, there’s risk, but who knows what the percentage is.
00:49:19 ►
The other thing that I’ve noticed, again, totally anecdotal,
00:49:21 ►
is that this has been, it’s hard to make this claim,
00:49:27 ►
but it seems like ayahuasca and LSD seem to, this seems to have, those are the cases that I’ve heard
00:49:35 ►
of. I haven’t heard. And I think it would, I would venture to say that it again, totally anecdotal
00:49:41 ►
that MDMA due to the way that MDMA, would less likely lead to this kind of experience.
00:49:49 ►
Although, you know, it could maybe.
00:49:52 ►
But I think it’s much less likely.
00:49:54 ►
You know, now my fear, right, is that, like, I’ve said this now.
00:49:59 ►
And there’s going to be some journalist out there who’s going to say, you know, who’s going to turn the tide of, and this is maybe my paranoia, but they’re going to say like headline, like, you know, ayahuasca and
00:50:09 ►
LSD cause, you know, psychedelic PTSD, which is not the, you know, that’s not the take home that
00:50:14 ►
I’m trying to deliver here. It’s more that we need to look at all sides of this, but the media
00:50:19 ►
and sensationalism, particularly today is so intense. Anything for the clicks, right? So that scares me.
00:50:28 ►
Yeah, and it’s a very reasonable fear, but I think this is definitely the right option. I mean,
00:50:32 ►
we can’t let ourselves be guided by lousy journalism when these negative experiences
00:50:38 ►
that last forever do happen. It does seem to be pretty damn rare for the amount of psychedelics
00:50:43 ►
and the amount of bad actors who are giving ayahuasca to people all over the place.
00:50:47 ►
And still the ayahuasca goes okay or is transformative.
00:50:51 ►
That speaks about something.
00:50:53 ►
Yeah.
00:50:53 ►
But the amount of fallout you see from the 60s and from the 80s.
00:51:00 ►
LSD is harder to abuse in a lot of ways, but MDMA is much easier to be doing for a couple of months straight every night.
00:51:11 ►
And, yeah, it’s a pretty safe, non-toxic drug as far as things go.
00:51:16 ►
But you see what happens if you take a thing like that that plays havoc with your serotonin system and all these systems.
00:51:25 ►
The brain can’t take that.
00:51:26 ►
Yeah, I mean, to speak to the MDMA, I had – this seems very rare to me,
00:51:32 ►
but I do actually know of two cases.
00:51:35 ►
And the other thing we should mention about this, this is probably less likely for ayahuasca,
00:51:41 ►
but when people are using MDMA recreationally, there’s also usually alcohol on
00:51:46 ►
board and other substances. And of the cases that I know that I’m thinking about where there was
00:51:53 ►
sort of a negative response to the MDMA, they’re probably, in one case, definitely, and in the
00:51:57 ►
other, most likely that there was other mind-altering substances that were involved along with it. But they both kind of involved an intense sort of social anxious response,
00:52:12 ►
which is curious because to me, I think of MDMA as something
00:52:14 ►
that could potentially even be helpful for social anxiety.
00:52:17 ►
But in this case, for these two individuals,
00:52:21 ►
they became very acutely aware of their surroundings and began to have thoughts
00:52:26 ►
that the people who are around them are laughing at them or critical of them. And it kind of led to
00:52:33 ►
not forever, but a prolonged period of time of kind of increased anxiety.
00:52:40 ►
That really rings true to me. Because my personal experience with MDMA is the first couple of times there was that warm, buttery feeling, but that faded really quickly.
00:52:50 ►
And then the only thing left was an amphetamine-type rush, and that just was so unpleasant.
00:52:55 ►
I have all this energy, and I know I shouldn’t be using it because I sound terrible and stupid, and it really led my brain to thinking faster what a lousy piece of shit I am.
00:53:03 ►
Right.
00:53:04 ►
Well, that’s the – I mean it’s funny because we’re coming back to the – you can’t get the A out of MDMA.
00:53:09 ►
And it’s an important part of – it also connects to how MDMA psychotherapy or MDMA-assisted psychotherapy may be helpful for PTSD.
00:53:17 ►
So PTSD used to be classified as an anxiety disorder.
00:53:21 ►
I don’t think it is anymore.
00:53:23 ►
But – so you could think of trauma and PTSD as related anxiety disorder. I don’t think it is anymore. So you could think of trauma and
00:53:25 ►
PTSD as related to anxiety. And we know that generally for people who have anxiety, it’s not
00:53:32 ►
a good idea to give them an amphetamine because it will generally tends to increase anxiety.
00:53:38 ►
The neat thing about MDMA, and I think an important property of MDMA, and this is based
00:53:42 ►
off of Matthew Baggett’s research with healthy humans.
00:53:46 ►
Just great work.
00:53:47 ►
I just praise it.
00:53:48 ►
I just talk about this wherever I go.
00:53:49 ►
But he, I’m going to skip the sort of the study design
00:53:53 ►
because it’s lengthy.
00:53:54 ►
But essentially what he found was that people report
00:53:57 ►
increased feelings of authenticity.
00:54:02 ►
What were the other sort of positive ones? I’m not recollecting now,
00:54:08 ►
but the important take-home message from that study was that people don’t experience a decrease
00:54:14 ►
in their anxiety. In fact, when people get MDMA, they experience an increase in their anxiety,
00:54:19 ►
right? Which is counterintuitive because people think, and there is some evidence to suggest that MDMA
00:54:25 ►
dampens the fear response in the amygdala, which maybe it does, but it keeps the anxiety intact,
00:54:31 ►
it seems. And that is really important in therapy because why some people argue that
00:54:38 ►
it’s hard to do therapy with individuals who are on benzodiazepines. Benzodiazepines are anti-anxiolytics, anti-anxiety.
00:54:46 ►
And what they do very effectively is they can block that anxiety signal.
00:54:52 ►
But if we’re thinking about exposure or if we’re just thinking about
00:54:55 ►
and being in touch with that kind of signal that’s inside of you
00:54:58 ►
to be able to work with it, you kind of need to access that anxiety
00:55:01 ►
to be able to work with it.
00:55:03 ►
And so I think it’s actually important that MDMA may even contribute to an increase in anxiety.
00:55:10 ►
Yeah, and I think it was Leo Zeff who said,
00:55:13 ►
benzos are putting the feelings underneath the rug,
00:55:18 ►
and MDMA is taking the rug out back and beating the hell out of it.
00:55:22 ►
That was a nice way of looking at it.
00:55:24 ►
rug out back and beating the hell out of it. That was a nice way of looking at it.
00:55:34 ►
And so the last question I’d like to ask is, if we manage to wrangle a big research fund for you, so you could buy a nice property upstate, maybe in Valhalla or something and have your own center,
00:55:39 ►
what would it look like? What are the pieces of that that would be the most important to you
00:55:43 ►
for the kind of work you want to do? There’s one thing that comes to mind is just the setting, right? I mean,
00:55:49 ►
that’s so important. And I mentioned that in my experience in the MT1 study yesterday,
00:55:57 ►
that the therapists, and I think it was mostly Marcella, who did the interior decorating. Nothing super
00:56:06 ►
fancy, but I felt like, I said that while I was under the influence of the MDMA, that I felt like
00:56:11 ►
I was floating in a cloud. And just that, I think having an environment that is, it’s classic set
00:56:19 ►
and setting, but the setting, that’s so important. So it would be something that would be spacious with light
00:56:25 ►
and maybe near nature.
00:56:28 ►
I don’t think that’s absolutely essential, but it could be important.
00:56:33 ►
And then in terms of the work, well,
00:56:36 ►
I have some hypotheses that I’d rather keep to myself,
00:56:40 ►
and they’re not my own.
00:56:43 ►
There are other researchers who I work with who are interested in
00:56:47 ►
testing them. And I think they’re really big ideas that have real potential to show evidence,
00:56:56 ►
further evidence for how MDMA therapy works. It’s a big question that I’m interested in. It’s like,
00:57:00 ►
what is it doing? But one thing that I would be willing to share is I would be really interested in how MDMA or if MDMA could help people with social anxiety.
00:57:15 ►
I think we’d have to connected to the fear of others,
00:57:26 ►
fear of saying the wrong thing or not sort of losing contact with other people socially,
00:57:35 ►
be seen as somebody who’s rejected.
00:57:40 ►
There’s different flavors of social anxiety.
00:57:45 ►
interjected that there’s different ways flavors of social anxiety but to me it just seems like such an obvious potential um treatment because mdma is a stimulant so people are engaged um
00:57:57 ►
and then it comes about i think it would become about, what’s the word?
00:58:13 ►
Not externalizing, but kind of broadening that experience that the participant would have with their therapist
00:58:15 ►
in terms of being socially connected and experiencing that as safe,
00:58:19 ►
and then helping broaden that out to the community outside.
00:58:23 ►
And this is like a totally radical idea. And I don’t,
00:58:26 ►
again, just an idea, but maybe there will be some day in the future where somebody could
00:58:31 ►
be engaged in this therapeutic process. And part of their exposure or the therapy would be to
00:58:37 ►
have the person under the influence of MDMA engage with, they couldn’t be complete strangers. I don’t
00:58:44 ►
think that would be good, but some, maybe you would have some sort of Confederates
00:58:47 ►
or somebody like they would, they would be able to kind of go and, and engage and practice
00:58:51 ►
and see and experience the safety of connecting to others.
00:58:55 ►
Maybe that wouldn’t even be necessary, but you know, it’s a potential.
00:58:58 ►
Yeah.
00:58:59 ►
But this is, we’re talking about, I wouldn’t propose this anytime in the next decade.
00:59:03 ►
But it’s beautiful.
00:59:04 ►
Take it out of the, take it out of the just one-on-one therapy and into something even more practical that relates to real life.
00:59:10 ►
Yeah, because I think that’s what a person really – I think you can still do that internally and do it in the context of the psychotherapy.
00:59:17 ►
But there is something about experiencing it in the real world.
00:59:22 ►
Well, Ingmar, thank you so much. I really hope that you get your giant, beautiful center
00:59:26 ►
upstate or wherever it is that you want it
00:59:28 ►
and get to keep working on these problems.
00:59:31 ►
Thank you so much for your work
00:59:32 ►
and thanks for coming on the show.
00:59:33 ►
Thank you so much for having me, Lex.
00:59:34 ►
I really appreciate it.