Transcrição completa de Psychedelic-Assisted Therapy Explained | The Future of Psychiatry with Dr. Reid Robison

psychiatry, like the 37 00:02:02.760 --> 00:02:03.959 beginning of a new chapter. 38 00:02:04.000 --> 00:02:05.120 I would say. 39 00:02:04.920 --> 00:02:10.719 Because we have these tools, thankfully like SSRISE, prosacs, all 40 00:02:10.759 --> 00:02:17.000 offt et cetera, that help maybe one in three individuals 41 00:02:17.639 --> 00:02:21.199 respond really well to them, and I find them to 42 00:02:21.280 --> 00:02:23.599 be very useful tools to have for a time, like 43 00:02:23.759 --> 00:02:26.479 especially if someone is in a state of depression or 44 00:02:26.479 --> 00:02:31.159 anxiety where therapy hasn't cut it. But they're also they 45 00:02:31.240 --> 00:02:34.360 come with side effects like any medicine. And having to 46 00:02:34.400 --> 00:02:37.120 take a daily pill with a certain percent risk of 47 00:02:37.159 --> 00:02:39.479 side effects or a certain trade off for some people 48 00:02:40.039 --> 00:02:40.879 is not ideal. 49 00:02:41.080 --> 00:02:43.240 And so also the way they work is. 50 00:02:43.280 --> 00:02:46.560 Kind of in an emotional numbing or blunting way out 51 00:02:46.560 --> 00:02:50.319 of necessity to bridge the gap to hopefully do some 52 00:02:51.120 --> 00:02:53.319 deeper work or not need those things and get to 53 00:02:53.360 --> 00:02:56.719 reconnect more fully with one's life. So that brings us 54 00:02:56.719 --> 00:03:00.120 to what's next. And this interesting point we're at is 55 00:03:00.400 --> 00:03:04.759 what some call interventional psychiatry, where you have ketamine being 56 00:03:04.879 --> 00:03:09.080 used while not formally approved for depression, good evidence and 57 00:03:10.520 --> 00:03:13.680 has helped a lot of people respond more quickly at 58 00:03:13.759 --> 00:03:16.800 least as a temporary measure. And then Spravado that came 59 00:03:16.840 --> 00:03:20.199 along in twenty nineteen as a nasal spray es ketamine 60 00:03:20.639 --> 00:03:24.400 for those who don't respond to traditional antidepressants. We have 61 00:03:24.439 --> 00:03:28.360 the first rapid acting medicine approved. And so this is 62 00:03:28.400 --> 00:03:32.639 like a new chapter where we also have TMS transcranial 63 00:03:32.879 --> 00:03:36.879 magnetic stimulation that's not a daily pill. It's like a 64 00:03:36.919 --> 00:03:39.199 big magnet that you come in for and get a 65 00:03:39.240 --> 00:03:42.919 treatment with once a day for like the better part 66 00:03:42.960 --> 00:03:47.919 of a month, and it's really flexing the neuroplasticity pathways 67 00:03:47.960 --> 00:03:52.960 in a positive direction repeatedly, and doesn't work overnight, and 68 00:03:53.080 --> 00:03:55.599 isn't the easiest thing to act, to do and access. 69 00:03:55.680 --> 00:03:59.879 But it's new and it's not and it does help 70 00:04:00.360 --> 00:04:03.520 a fair number of people. And then we may also 71 00:04:03.560 --> 00:04:07.360 talk about psychedelic medicine and what's on the horizon, but 72 00:04:07.439 --> 00:04:10.919 we're entering this era of other options that aren't a 73 00:04:10.960 --> 00:04:15.280 daily pill, like taking a medicine for more quick relief, 74 00:04:15.400 --> 00:04:19.639 and maybe even some other benefits in terms of getting 75 00:04:19.639 --> 00:04:22.199 out the root cause or bringing things to the surface 76 00:04:22.240 --> 00:04:24.040 that need to be addressed to get unstuck. 77 00:04:24.759 --> 00:04:28.199 I love how you couched the SSRI movement, like I 78 00:04:28.199 --> 00:04:30.600 think they came out in like nineteen fifties, and and 79 00:04:31.759 --> 00:04:35.519 really I love how you explain them because this is 80 00:04:35.519 --> 00:04:37.240 how I explain them too. But a lot of my 81 00:04:37.279 --> 00:04:39.920 colleagues don't. They just put them on them and say, 82 00:04:40.120 --> 00:04:42.720 good luck, Well we've got Yeah, it's what we've got, 83 00:04:42.720 --> 00:04:45.040 and you're gonna probably be on this rest of your life. 84 00:04:45.399 --> 00:04:47.480 I love the idea that it's just kind of a 85 00:04:47.519 --> 00:04:49.519 band aid for a minute to kind of stop some 86 00:04:49.639 --> 00:04:52.319 of the i'd say bleeding, but stop some of the 87 00:04:52.360 --> 00:04:54.839 harder things that are going on emotionally with you, and 88 00:04:54.879 --> 00:04:58.480 then as those things get worked on, hopefully with psychotherapy, 89 00:04:58.560 --> 00:05:04.600 with better life style, better social situations, then maybe we're 90 00:05:04.680 --> 00:05:07.040 kind of going to come off of that medicine, especially 91 00:05:07.079 --> 00:05:10.439 the SSRIs at some point, Whereas the academy is a 92 00:05:10.480 --> 00:05:14.279 little different, right because because it like actually grows part 93 00:05:14.319 --> 00:05:17.279 of your brain and spikes some BDNF and some neuroplasticity 94 00:05:17.399 --> 00:05:22.160 and provides a kind of a pathway for maybe maybe 95 00:05:22.199 --> 00:05:23.920 some of the talk therapy to kind of start working 96 00:05:23.920 --> 00:05:25.759 a little bit. Can you speak to just the talk 97 00:05:25.800 --> 00:05:27.800 therapy with regard to ketymene. 98 00:05:27.319 --> 00:05:32.720 And yeah, yeah, So ketamine is what got me into this, 99 00:05:32.720 --> 00:05:35.839 this whole field of psychedelic medicine. I was at the 100 00:05:35.920 --> 00:05:39.360 University of Utah on faculty doing studies, and along came 101 00:05:40.000 --> 00:05:42.720 the study of it was Johnson and Johnson saying, do 102 00:05:42.759 --> 00:05:45.360 you want to be a site for our study of 103 00:05:45.879 --> 00:05:49.800 IVY Academy for depression? And I sat with so many 104 00:05:49.800 --> 00:05:53.360 people as they got their standard infusion then of zero 105 00:05:53.399 --> 00:05:55.759 point five miligrams or kilogram I view over forty minutes, 106 00:05:55.800 --> 00:05:58.199 and you had to ask them questions as part of 107 00:05:58.240 -->

00:06:01.399 the study about the experience and it was fascinating what 108 00:06:01.480 --> 00:06:04.000 they were going through, and some shed tears and it 109 00:06:04.079 --> 00:06:09.600 almost seemed cathartic for individuals, and to see in real 110 00:06:09.680 --> 00:06:15.759 time some relief was really It inspired some hope and curiosity. 111 00:06:15.839 --> 00:06:19.319 So I started working with ketemine, studying it more, and 112 00:06:19.360 --> 00:06:22.399 then it opened the door to these other things. I 113 00:06:22.439 --> 00:06:26.600 started doing psilocybin studies and other psychedelics that I'm mostly 114 00:06:26.639 --> 00:06:28.759 focused on now helping bring those to market. 115 00:06:29.160 --> 00:06:31.639 That is so cool. What is it about the kedymene? 116 00:06:31.680 --> 00:06:33.439 I mean, we'll stay on the keademy for a minute, 117 00:06:33.439 --> 00:06:34.959 but I really want to dive into some of those 118 00:06:34.959 --> 00:06:38.720 other spaces with you. What is it about the ketymene 119 00:06:38.759 --> 00:06:45.160 that creates access better I don't know, better access points 120 00:06:45.240 --> 00:06:48.639 or availability to moving some things for the for maybe 121 00:06:48.639 --> 00:06:49.600 the talk therapy space. 122 00:06:49.800 --> 00:06:52.240 Thank you because I forgot to answer your original question. 123 00:06:52.360 --> 00:06:56.319 I'm realizing so good thing we have a podcast host. 124 00:06:56.519 --> 00:06:59.759 I had to bring us back on track. But so 125 00:07:00.079 --> 00:07:04.120 Ketamine I see working a few different ways. So to 126 00:07:04.120 --> 00:07:06.000 put a pin in a few of them, There's like 127 00:07:06.120 --> 00:07:10.040 one that people don't talk about as much, that ketymine 128 00:07:10.240 --> 00:07:13.920 turns off what's called a lateral hebenular burst mode. There's 129 00:07:13.959 --> 00:07:16.240 this little part of the brain we don't give much attention, 130 00:07:16.360 --> 00:07:19.279 the habenula, And there's a Nature paper maybe five years 131 00:07:19.319 --> 00:07:23.360 ago where they show ketamine kind of flips a switch 132 00:07:23.560 --> 00:07:27.879 and the burst mode is a depressed, stressed out state. 133 00:07:28.079 --> 00:07:32.480 So it's almost It gave me a potential explanation neuroscientifically 134 00:07:32.480 --> 00:07:34.480 at least for what is this cloud lifting? 135 00:07:34.560 --> 00:07:36.319 What is this relief part of. 136 00:07:36.279 --> 00:07:39.399 What lets people come up for air and do the work. 137 00:07:39.439 --> 00:07:44.040 And then you have, like you mentioned, these neuroplasticity pathways 138 00:07:44.079 --> 00:07:47.120 that are activated for a time, at least for ketymine. 139 00:07:47.199 --> 00:07:51.480 Some would estimate it's a couple of days with for psilocybin, 140 00:07:52.240 --> 00:07:54.519 labs that try and estimate this from mouse models and 141 00:07:54.560 --> 00:07:55.439 things might.

142 00:07:55.279 --> 00:07:56.439 Say a couple of weeks. 143 00:07:57.079 --> 00:07:59.759 So you have a window, but it's tighter where the 144 00:08:00.000 --> 00:08:03.560 brain becomes more malleable, where you can, hopefully with the 145 00:08:03.639 --> 00:08:08.680 right kind of intention and therapy and approach, kind of 146 00:08:08.720 --> 00:08:12.639 shift some maladaptive patterns. It could be your depressive patterns, 147 00:08:12.680 --> 00:08:15.360 it could be your anxious loops, it could be addictive 148 00:08:15.720 --> 00:08:19.439 or maladaptive behaviors that aren't serving you, and then you 149 00:08:19.480 --> 00:08:22.839 can work on those in this malleable state and hopefully 150 00:08:23.199 --> 00:08:23.959 they can stick. 151 00:08:25.399 --> 00:08:29.480 Does the m tour BDNF pathway, like, how does that 152 00:08:29.519 --> 00:08:30.319 play into the mix. 153 00:08:31.000 --> 00:08:34.879 It's part of the cascade that turns on this window 154 00:08:34.879 --> 00:08:37.480 of opportunity, if you will. And it's a complicated one. 155 00:08:37.679 --> 00:08:39.840 I just kind of from a big picture see it 156 00:08:39.879 --> 00:08:43.919 as like sprinkling a little brief miracle grow on the 157 00:08:43.919 --> 00:08:48.360 brain and you get an opportunity to use it. And interestingly, 158 00:08:48.440 --> 00:08:50.799 kenymine was not studied initially that study I did did 159 00:08:50.840 --> 00:08:53.600 not have psychotherapy with it. It was studied as a 160 00:08:53.639 --> 00:08:54.600 medicine spravado. 161 00:08:54.799 --> 00:08:55.399 Same thing. 162 00:08:55.919 --> 00:08:59.480 Adding therapy is kind of the next frontier of we 163 00:08:59.559 --> 00:09:03.000 know it's an opportunity, we know there's neuroplasticity opening up, 164 00:09:03.519 --> 00:09:05.919 and what more can we do, especially because we know 165 00:09:06.000 --> 00:09:11.039 that ketamine isn't always durable and some people might get 166 00:09:11.080 --> 00:09:13.159 months of relief, but some people days or weeks. 167 00:09:13.799 --> 00:09:14.399 Do you have. 168 00:09:14.320 --> 00:09:18.360 A form of talk therapy that you like the best 169 00:09:18.840 --> 00:09:20.519 after post psychedelics. 170 00:09:20.600 --> 00:09:26.919 Yeah, it's a really interesting, kind of multifaceted question that 171 00:09:26.960 --> 00:09:31.320 I've pondered for a long time because and I've landed 172 00:09:31.440 --> 00:09:35.279 essentially on the answer. My opinion is that it depends 173 00:09:35.320 --> 00:09:40.360 on what condition, of course, like if you're treating eating disorders, 174 00:09:40.360 --> 00:09:42.720 for example, I work with a lot of eating disorders. 175 00:09:42.720 --> 00:09:46.480 In fact, and the therapy protocols we put into studies of 176 00:09:46.559 --> 00:09:51.720 say ketemine is just psychotherapy there or psychedelics there are 177 00:09:51.759 --> 00:09:55.960 different and we might even have more sessions of dosing sessions, 178 00:09:56.000 --> 00:09:59.200 if you will, because especially for those who have been 179 00:09:59.279 --> 00:10:03.519 chronically affected by a condition, those patterns could be really 180 00:10:04.039 --> 00:10:08.240 deeply entrenched and it might take some more sessions, some 181 00:10:08.279 --> 00:10:12.799 even more intensive psychotherapy than like on the other end 182 00:10:12.799 --> 00:10:17.120 of the spectrum, the early psilocybin studies looked at end 183 00:10:17.120 --> 00:10:20.440 of life anxiety, like the anxiety one gets when they're 184 00:10:20.440 --> 00:10:25.039 faced with like a terminal cancer diagnosis. And you know, 185 00:10:25.120 --> 00:10:28.200 eighty percent of those with the psilocybin dose single dose 186 00:10:28.320 --> 00:10:32.440 had substantial relief and a mystical experience and all that, 187 00:10:32.519 --> 00:10:36.639 but it was it was not the same deeply entrenched 188 00:10:36.639 --> 00:10:40.919 pattern to something to say anorexia or treatments depression, just 189 00:10:41.000 --> 00:10:44.159 to kind of point out that it depends on the condition, 190 00:10:44.720 --> 00:10:50.039 the chronicity. And then but then even with something like depression, 191 00:10:50.440 --> 00:10:53.639 even looking at the same time course, I think my 192 00:10:53.720 --> 00:10:56.600 opinion is you could layer on a lot of different 193 00:10:56.639 --> 00:10:57.240 therapies and. 194 00:10:57.200 --> 00:10:58.120 Get good results. 195 00:10:58.720 --> 00:11:02.720 So the best I've landed on working with a ton 196 00:11:02.759 --> 00:11:08.080 of practitioners helping them do their ketamine therapy work is 197 00:11:08.919 --> 00:11:12.200 leveraging the therapy tools they're good at in the snouroplasticity 198 00:11:12.200 --> 00:11:13.799 window that make the most sense for the. 199 00:11:13.759 --> 00:11:17.960 Patient depending on what the patient is having. Eating disorders 200 00:11:17.960 --> 00:11:20.399 are among the hardest to treat. I understand, like, they're 201 00:11:20.600 --> 00:11:23.000 very entrenched and very difficult many times years and years 202 00:11:23.039 --> 00:11:25.039 and years of therapy and still having a hard time 203 00:11:25.039 --> 00:11:30.080 moving the needle. It where's depression again, sometimes very entrenched, 204 00:11:30.120 --> 00:11:34.000 and trauma and things like that. So so what I'm 205 00:11:34.000 --> 00:11:37.279 hearing is just the modality that the therapist is reasonably 206 00:11:37.279 --> 00:11:40.759 good at, and maybe that's better applied to the current scenario. 207 00:11:41.000 --> 00:11:47.600 Yeah, And the current state of the psychedelic medicine kind 208 00:11:47.600 --> 00:11:52.840 of movement and pathway toward approval is that the therapy 209 00:11:52.879 --> 00:11:59.720 has been somewhat de emphasized or at least more generalized 210 00:12:00.240 --> 00:12:03.120 in preparation for getting in front of the FDA that

211 00:12:03.240 --> 00:12:07.759 doesn't look at doesn't approve therapies right typically, So it's 212 00:12:08.039 --> 00:12:13.039 getting kind of a standard supportive therapeutic approach there that 213 00:12:13.519 --> 00:12:17.759 could be rolled out if something's approved in clinics in 214 00:12:17.799 --> 00:12:21.879 a widespread way. Because interestingly, on these medicines, more so 215 00:12:22.039 --> 00:12:27.559 I think than with ketamine, the healing happens from within 216 00:12:28.240 --> 00:12:31.279 for the most part, and the people the therapists are 217 00:12:31.320 --> 00:12:35.240 there mostly holding space as this like opens up the 218 00:12:35.279 --> 00:12:38.840 window and brings things up to the surface, and so 219 00:12:38.879 --> 00:12:42.200 we create the safety so someone can do the work themselves. 220 00:12:42.639 --> 00:12:45.679 I want to go there because you're right, ketymine kind 221 00:12:45.679 --> 00:12:48.360 of kind of like it's hard to do work under 222 00:12:48.360 --> 00:12:50.120 the influence of ketemy. You're kind of sleeping, and you 223 00:12:50.240 --> 00:12:51.440 kind of a lot of a lot of folks are 224 00:12:51.480 --> 00:12:52.600 kind of out of it, and you don't want to 225 00:12:52.600 --> 00:12:56.799 disrupt that as much, whereas in maybe some of these 226 00:12:56.840 --> 00:12:59.320 other modalities, there's there's I want to I want to 227 00:12:59.320 --> 00:13:01.960 poke into that a little bit because there's a deep 228 00:13:02.000 --> 00:13:05.759 connection and healing space that that that is available through 229 00:13:05.799 --> 00:13:07.519 some of these other modalities. Can we speak to them, 230 00:13:07.759 --> 00:13:10.840 Let's go there, let's Yeah. So we're talking about psychedelic 231 00:13:10.879 --> 00:13:13.120 therapies and some of the research that's going on, and 232 00:13:13.120 --> 00:13:14.519 you're right on the cutting edge of some of that 233 00:13:14.559 --> 00:13:17.600 research right now here in orm Utah. 234 00:13:17.720 --> 00:13:18.639 Yeah, it's exciting. 235 00:13:18.679 --> 00:13:22.440 It's it's exciting what is coming down the pipeline, if 236 00:13:22.440 --> 00:13:22.759 you will. 237 00:13:23.720 --> 00:13:26.879 So Psilocybin, are you allowed to talk about this? Yeah? 238 00:13:27.000 --> 00:13:32.519 Yeah, because and because I'm I'm basically a research site 239 00:13:32.600 --> 00:13:37.399 that does the studies for these companies like MAPS has 240 00:13:37.440 --> 00:13:40.720 been trying to get MDMA approved for PTSD, compass and 241 00:13:40.840 --> 00:13:45.559 USNA psilocybin for depression, and then other things. Mind Mad 242 00:13:45.799 --> 00:13:49.759 they change their name recently to definium mine at LSD 243 00:13:50.120 --> 00:13:53.720 for anxiety, and we did those studies with them, and 244 00:13:53.759 --> 00:13:58.519 now for depression, and uh, there's also a number of others, 245 00:13:58.559 --> 00:14:01.639 like

we're doing a PGD study with a psychedelic. We 246 00:14:01.720 --> 00:14:05.519 have an anxiety study with another psychedelic that people wouldn't 247 00:14:05.600 --> 00:14:07.000 have recognized as much. 248 00:14:08.080 --> 00:14:12.159 And these are in phase three. 249 00:14:12.120 --> 00:14:14.200 Most of them Phase two or three, which is the 250 00:14:14.279 --> 00:14:18.399 last phase before you submitted the FDA for approval. So Psilocybin, 251 00:14:18.480 --> 00:14:22.639 as an example, has just wrapped up its phase three 252 00:14:22.720 --> 00:14:26.519 studies for depression and preparing to submit later this year 253 00:14:27.759 --> 00:14:30.639 is the plan to the FDA. So we may even 254 00:14:30.799 --> 00:14:35.759 have if approved and timelines go well, as early as 255 00:14:35.879 --> 00:14:41.279 next year. Psilocybin prescribable for depression like Spervado came out 256 00:14:41.360 --> 00:14:43.360 for depression under certain parameters. 257 00:14:44.679 --> 00:14:48.840 That's beautiful. Can we speak to why some of these 258 00:14:48.919 --> 00:14:52.879 have a deeper true healing potential rather than rather than 259 00:14:52.919 --> 00:14:55.960 a blunting band aid approach with the SSRIs and things 260 00:14:56.000 --> 00:15:01.799 like that, certcrohibitors, Why do these create such profound experiences 261 00:15:02.080 --> 00:15:07.000 of healing and potential, like deeper level of movement in 262 00:15:07.480 --> 00:15:10.919 our emotional space, in our spiritual spaces, in those spaces 263 00:15:10.960 --> 00:15:13.919 that trauma Like, there's lots of things that are maybe 264 00:15:14.039 --> 00:15:16.799 under the hood that we don't even recognize that maybe. 265 00:15:16.600 --> 00:15:17.559 Need to do a little bit. 266 00:15:18.200 --> 00:15:21.399 Yeah, we didn't realize how much. Like they say, you've 267 00:15:21.399 --> 00:15:22.600 got to feel it to heal it. 268 00:15:22.679 --> 00:15:23.399 In a way. 269 00:15:23.519 --> 00:15:25.799 Now, it's a bit ton in tongue and cheek, but 270 00:15:26.279 --> 00:15:29.840 I think the simple over simple answer is that psychiatry 271 00:15:29.919 --> 00:15:32.919 is finally catching up on the innate healing potential of 272 00:15:32.960 --> 00:15:35.840 the human body. Like you've known for a while as 273 00:15:35.840 --> 00:15:38.519 a family doc that if you get a cut, the 274 00:15:38.519 --> 00:15:41.000 body's going to take care of it right. You might 275 00:15:41.039 --> 00:15:44.879 need to assist with some supports, But you know, I 276 00:15:44.919 --> 00:15:48.200 think this approach we've done too often for too long 277 00:15:48.240 --> 00:15:53.919 in psychiatry. It just kind of throwing these kind of 278 00:15:53.919 --> 00:15:58.240 band aids with consequences at it for long term is 279 00:15:58.879 --> 00:16:02.720 finally kind of getting shaken up. And as these new 280 00:16:02.759 --> 00:16:08.639 modalities present where they give the person the opportunity to 281 00:16:08.679 --> 00:16:12.480 go inward where you may have been in this default 282 00:16:12.519 --> 00:16:15.480 stressed out state and just unable to face your trauma 283 00:16:15.559 --> 00:16:19.080 because it was too system overload, unable to face that, 284 00:16:20.120 --> 00:16:23.080 like that pit of despair of depression, and then you 285 00:16:23.159 --> 00:16:26.960 get a tool like this and and the right support, 286 00:16:27.679 --> 00:16:29.840 and it can melt away some of those defenses bring 287 00:16:29.919 --> 00:16:34.039 up the emotions to the surface, interestingly by another serotonin 288 00:16:34.080 --> 00:16:37.840 receptor five HD two A instead of like the SSRIs 289 00:16:37.879 --> 00:16:41.600 working in a different way on five HT one for example. 290 00:16:41.919 --> 00:16:46.679 Yeah, the five h T two A receptor is amazing. 291 00:16:46.759 --> 00:16:49.159 I've done a deep dive it recently. 292 00:16:49.240 --> 00:16:50.720 Some people get it tattooed on them. 293 00:16:50.799 --> 00:16:56.039 Yeah, I don't blame them. There's there's there's neat stuff there, 294 00:16:56.200 --> 00:17:02.879 and I think can we speak to like the dissolving 295 00:17:02.919 --> 00:17:06.160 of the ego that happens there and maybe the default 296 00:17:06.160 --> 00:17:10.640 mode network silencing and some of those internal dialogues that 297 00:17:11.039 --> 00:17:12.880 some people have hard time shutting them off and they're 298 00:17:12.960 --> 00:17:17.359 driving anxiety or they're driving depression. But but and I'd 299 00:17:17.400 --> 00:17:19.039 love to hear some of your studies that are going 300 00:17:19.079 --> 00:17:21.319 on in these spaces. But why why is it that 301 00:17:21.400 --> 00:17:24.359 these these medicines or I'm gonna call them medicines, but 302 00:17:24.400 --> 00:17:29.119 they're you know, psychedelic therapeutic modality, why they they can 303 00:17:29.200 --> 00:17:31.039 kind of help us silence those spaces? 304 00:17:31.119 --> 00:17:31.480 Is there? 305 00:17:31.759 --> 00:17:35.119 I mean, we can get a little neuroscience therity to it. 306 00:17:35.079 --> 00:17:35.680 For a moment. 307 00:17:36.279 --> 00:17:39.960 And I do like this kind of prevailing theory in 308 00:17:40.279 --> 00:17:44.759 the Psychedelic therapy space by Robin CARRT. 309 00:17:44.839 --> 00:17:46.480 Harris and colleagues. 310 00:17:46.519 --> 00:17:48.319 She was at Imperial College at the time, but he 311 00:17:48.359 --> 00:17:54.039 wrote the entropic Brain Theory based which essentially is based 312 00:17:54.079 --> 00:17:59.920 on this older free energy theory, talking about how hush 313 00:18:00.319 --> 00:18:03.960 we are predicted wired as prediction machines, Like we go 314 00:18:04.039 --> 00:18:06.680 about the world and taking all these sensory inputs and 315 00:18:06.839 --> 00:18:10.960 automatically we're adapting to the world our best prediction of 316 00:18:11.039 --> 00:18:14.839

like don't step in the road with traffic because it'll hurt, 317 00:18:14.960 --> 00:18:19.039 or like don't touch that thing again, and we get 318 00:18:19.079 --> 00:18:22.640 shaped and all these autopilot ways out of necessity by 319 00:18:22.640 --> 00:18:28.559 these magnificent machines were occupying as that is the human body, 320 00:18:28.880 --> 00:18:33.359 but that can also get us into these stuck automatic ruts, 321 00:18:33.440 --> 00:18:36.799 you know, the maladaptive patterns that shape and so along 322 00:18:36.839 --> 00:18:41.920 comes a psychedelic. That one analogy use is that it 323 00:18:42.000 --> 00:18:46.640 kind of heats up these these rigid prediction structures, so 324 00:18:46.680 --> 00:18:51.039 they can be shaped during that window of opportunity, reshaped, 325 00:18:51.319 --> 00:18:54.720 and then as the brain cools and your patterns kind 326 00:18:54.759 --> 00:18:57.799 of take shape again as a window closes, then hopefully 327 00:18:57.799 --> 00:19:01.000 you put in new kind of more adaptive ones and 328 00:19:01.440 --> 00:19:02.799 positive for your life. 329 00:19:03.400 --> 00:19:08.000 And acted expansive and healthy, maybe a little healthier, less 330 00:19:08.000 --> 00:19:10.599 clenched down on rigid thinking. 331 00:19:11.039 --> 00:19:14.079 Yeah, So as as you take a psychedelic, and as 332 00:19:14.200 --> 00:19:18.480 the one of the ways it works is kind of 333 00:19:18.839 --> 00:19:22.119 toning down what you mentioned, the default mode network, that 334 00:19:22.839 --> 00:19:25.480 kind of egoic center of the brain, if you will, 335 00:19:25.559 --> 00:19:30.000 that is just kind of you know, autopilot, not allowing as. 336 00:19:29.960 --> 00:19:34.160 Much of the creative expression or new firing in this. 337 00:19:35.960 --> 00:19:38.799 And then as that melts away, new connections can form 338 00:19:38.880 --> 00:19:46.039 new insights. And because of this serotonergic like medicine effect 339 00:19:46.079 --> 00:19:49.279 and that release of serotonin, some even have like a 340 00:19:49.319 --> 00:19:53.839 mystical experience or connect with their own spirituality in a 341 00:19:53.960 --> 00:19:59.519 deep way, and it's interestingly bringing back spirituality in a 342 00:19:59.559 --> 00:20:01.920 much need way into mental health that was kind of 343 00:20:01.960 --> 00:20:05.119 thrown out with the bathwater in kind of freud eras 344 00:20:05.160 --> 00:20:10.400 and things. But finally we're bringing back into the discussion 345 00:20:10.519 --> 00:20:13.799 because it's an important part of you know, so many 346 00:20:13.799 --> 00:20:15.119 people's lives. 347 00:20:15.640 --> 00:20:19.440 I love how you said in your previous comment, how 348 00:20:20.000 --> 00:20:22.799 the body can heal itself. We just have to give 349 00:20:22.799 --> 00:20:26.200 it the pathways to kind of accomplish that. I remember 350 00:20:26.240 --> 00:20:30.319 in residency, I had a patient in Jacksonville, Florida, and 351 00:20:30.400 --> 00:20:33.599 she had diabetes really bad, and she ended up with 352 00:20:33.640 --> 00:20:37.160 necrotizing fasciatis. It's a really bad infection of the fascia of. 353 00:20:37.119 --> 00:20:40.279 Flesh feeding on the street. 354 00:20:40.400 --> 00:20:43.680 That's all right, that's right. And she got really sick, 355 00:20:43.880 --> 00:20:46.200 ended up in the hospital for a long time. She 356 00:20:46.359 --> 00:20:51.359 had a giant wound on her abdomen. It was twenty 357 00:20:51.400 --> 00:20:55.079 centimeters deep. It was just going to make a psychiatrist ill, 358 00:20:55.119 --> 00:21:00.519 but button g's out, yeah, and he's got But it 359 00:21:00.640 --> 00:21:04.559 was very wide, very deep, and profound. It was profound. 360 00:21:04.599 --> 00:21:08.079 I tried, she didn't have insurance. I tried to get her. 361 00:21:08.640 --> 00:21:10.839 The surgeons had done all of their charity work for 362 00:21:10.880 --> 00:21:13.240 the month. It was the end of the month, and 363 00:21:13.319 --> 00:21:18.440 every evidently those surgery surgery groups have a quota, they 364 00:21:18.480 --> 00:21:20.440 cap it out. They're like, oh, sorry, we've all done 365 00:21:20.440 --> 00:21:23.240 our pro bono work for the month. And and I 366 00:21:23.279 --> 00:21:26.440 begged and pleaded, and they said they followed up with her, 367 00:21:26.720 --> 00:21:29.319 and they said she can heal this. And I said, 368 00:21:29.319 --> 00:21:32.599 are you kidding me? She's type two diabetes, she's overweight, 369 00:21:32.759 --> 00:21:37.240 she's unhealthy. This will kill her. And they said, doctor Sanders, 370 00:21:37.279 --> 00:21:40.319 you young pop ya. I was a resident right and 371 00:21:40.400 --> 00:21:44.880 I was in my you know, post grad probably second 372 00:21:45.000 --> 00:21:49.319 year in my residency, and I was mad. I remember 373 00:21:49.359 --> 00:21:50.920 getting really upset at him, and I was like, you 374 00:21:51.000 --> 00:21:56.279 guys a bunch of chirks. But over the next several 375 00:21:56.279 --> 00:21:59.920 several months, with wet to dry dressing, changes to briding 376 00:22:00.200 --> 00:22:02.559 with went to dry dressing chains. Sometimes we had dacons 377 00:22:02.559 --> 00:22:04.839 because it got in fact with some pseudomonis, because that's 378 00:22:04.839 --> 00:22:10.119 what happens. But we healed that sucker. She healed that sucker, 379 00:22:10.480 --> 00:22:13.920 and it was amazing. I was every time I saw her, 380 00:22:14.359 --> 00:22:16.720 it would get a little smaller, a little smaller, and 381 00:22:16.799 --> 00:22:19.000 a little less deep, a little less deep, and it 382 00:22:19.400 --> 00:22:22.559 was probably I don't know. It was probus sixteen inches 383 00:22:22.680 --> 00:22:27.279 by twelve inches by twenty inches deep. It was deep. 384 00:22:27.480 --> 00:22:30.119 You just stop motion on that looks like superhero stuff 385

00:22:30.119 --> 00:22:31.000 and it's healing it. 386 00:22:31.000 --> 00:22:32.000 It was amazing. 387 00:22:32.119 --> 00:22:35.519 And and I think of that giant crevice and giant 388 00:22:36.039 --> 00:22:39.799 defect and you know, even and the flesh eating pass here. 389 00:22:40.119 --> 00:22:44.759 But there are psychiatric things that are equally as devastating 390 00:22:44.799 --> 00:22:49.119 and difficult to deal with. But how incredible the body 391 00:22:49.240 --> 00:22:52.279 is that it can close down those holes and fill 392 00:22:52.319 --> 00:22:56.119 them up with with live, beautiful tissue and and heal 393 00:22:56.200 --> 00:22:57.079 that super cool? 394 00:22:57.240 --> 00:23:00.799 Yeah, there is there is, because I've I've it play 395 00:23:00.799 --> 00:23:04.480 out time and time again, this innate or interhaling intelligence, 396 00:23:04.480 --> 00:23:08.359 if you will, in the body. And but the challenge is, 397 00:23:09.519 --> 00:23:12.559 you know, kind of activating that or letting it do 398 00:23:12.720 --> 00:23:15.319 its thing and creating the right conditions for healing. 399 00:23:15.759 --> 00:23:18.039 Yeah, turns out it's the five HD two A. 400 00:23:18.960 --> 00:23:25.039 Yeah, that's that's certainly an incredibly useful button to hit 401 00:23:26.400 --> 00:23:30.839 for so many of these conditions to help create that space. 402 00:23:31.119 --> 00:23:33.279 Can you speak to like in Ketamine, I think that 403 00:23:33.359 --> 00:23:35.279 they've done a bunch of data and science on you know, 404 00:23:35.359 --> 00:23:39.440 six sessions or roughly successions with therapy tends to be 405 00:23:39.680 --> 00:23:43.039 a lasting change and some lasting healing to some of 406 00:23:43.039 --> 00:23:46.200 the depression PTSD space. Can you speak to some of 407 00:23:46.200 --> 00:23:48.759 these other modalities and what you're seeing, Let's let's take 408 00:23:48.799 --> 00:23:51.240 them apart. Let's maybe start with zylo cybin, if you will. 409 00:23:51.839 --> 00:23:56.519 So Psilocybin mostly studied for depression. The typical protocol is 410 00:23:57.599 --> 00:24:02.839 two doses. It's been a floored one, two, three, and 411 00:24:02.880 --> 00:24:05.279 they might be separated by a couple of weeks, two, 412 00:24:05.359 --> 00:24:10.279 three weeks and supported by you know, a therapist or 413 00:24:10.319 --> 00:24:13.359 two for holding space for that six hours or so. 414 00:24:13.960 --> 00:24:16.160 And you know, you're meeting with the person before to 415 00:24:16.160 --> 00:24:19.839 help get them ready and and you're following along and 416 00:24:19.960 --> 00:24:25.039 checking in. But the data is showing equal or better 417 00:24:25.279 --> 00:24:29.920 response and remission rates compared to traditional treatments like SSRIs 418 00:24:30.559 --> 00:24:32.559 without We're not talking about a daily pill. 419 00:24:32.599 --> 00:24:33.440 We're talking about. 420 00:24:33.240 -->

00:24:38.559 One or two doses still with benefits still president twelve 421 00:24:38.559 --> 00:24:41.799 weeks out and then there's some long term follow upcoming. 422 00:24:43.000 --> 00:24:44.359 So it does. 423 00:24:44.519 --> 00:24:47.119 I won't say it works for everyone and it stays 424 00:24:47.400 --> 00:24:49.640 and the benefits stay forever, and a lot of that's 425 00:24:49.680 --> 00:24:50.640 still getting figured out. 426 00:24:50.640 --> 00:24:52.160 But but I am. 427 00:24:52.559 --> 00:24:56.319 You know, certainly hopeful and welcoming this as a much 428 00:24:56.359 --> 00:25:00.400 needed option when we can get it into clinics. And 429 00:25:00.440 --> 00:25:03.480 as I've been working with this for the past several years, 430 00:25:03.519 --> 00:25:07.079 I have had to go to far off places sometimes 431 00:25:07.319 --> 00:25:10.920 have been involved in retreats with psychedelic medicine outside of 432 00:25:10.920 --> 00:25:15.240 the country at times to access it for you know, 433 00:25:15.359 --> 00:25:18.279 conditions or people who maybe wouldn't qualify for a study 434 00:25:18.319 --> 00:25:19.119 at this point. 435 00:25:20.599 --> 00:25:25.359 These couple of sessions. That's remarkable that we're having really 436 00:25:25.359 --> 00:25:29.839 positive outcomes just in a couple of sessions. Can we 437 00:25:29.920 --> 00:25:31.799 speak to I mean, I've done some study in this 438 00:25:31.880 --> 00:25:35.480 space of setting and then integration with regard to those 439 00:25:35.599 --> 00:25:38.000 is that being looked at it all or how important 440 00:25:38.039 --> 00:25:39.920 is that to kind of healing sessions. 441 00:25:39.960 --> 00:25:45.680 Yeah, it's an interesting time in the psychedelic therapy world 442 00:25:45.799 --> 00:25:48.519 because these medicines are preparing to go up to the 443 00:25:48.599 --> 00:25:53.759 FDA for approval, starting with psilocybin. And this is following 444 00:25:55.160 --> 00:25:59.200 the attempt to get MDMA approved for PTSD by MAPS 445 00:25:59.640 --> 00:26:02.240 that was not approved by the FDA and created a 446 00:26:02.279 --> 00:26:06.079 lot of debate around how to study these and how 447 00:26:06.119 --> 00:26:09.519 to how the FDA might approve them in this new 448 00:26:09.559 --> 00:26:12.359 era of they were presented with a medicine and therapy 449 00:26:13.079 --> 00:26:17.839 and you know they don't typically approve that kind of thing, right, 450 00:26:18.000 --> 00:26:22.279 a combination like that. And so now I think it's 451 00:26:22.319 --> 00:26:26.759 clear that the model that's been studied and used in 452 00:26:26.759 --> 00:26:29.440 the ketemine world and applied to the psychedelic therapy world 453 00:26:29.640 --> 00:26:33.640 is that you help the individual get ready beforehand by 454 00:26:33.680 --> 00:26:36.960 working with them that you call the preparation phase, and 455 00:26:37.240 --> 00:26:41.759 you get to know you know what

to expect and 456 00:26:41.839 --> 00:26:46.079 also how to surrender to the experience how and you 457 00:26:46.119 --> 00:26:49.720 start to work on like what direction are we going 458 00:26:49.759 --> 00:26:52.839 to point this, what intention perhaps or seed are we 459 00:26:52.880 --> 00:26:55.240 going to plant? As we go in and do some 460 00:26:55.359 --> 00:26:58.279 work and some repeated work in the in the studies 461 00:26:59.160 --> 00:27:02.680 for depression, just doing a session or two and kind 462 00:27:02.680 --> 00:27:05.640 of following along and trying to standardize that. That's why 463 00:27:05.640 --> 00:27:08.640 I say it's an interesting time where you know, it 464 00:27:08.640 --> 00:27:11.519 would be too complicated to layer all the different therapies 465 00:27:11.559 --> 00:27:14.359 and get them in there, or even maybe too risky 466 00:27:14.400 --> 00:27:18.880 to just try one therapy modality. So it's kind of 467 00:27:18.920 --> 00:27:24.000 landed in this supportive dosing session monitor role that is 468 00:27:24.119 --> 00:27:28.920 a psychotherapist in our studies who is working with the 469 00:27:28.920 --> 00:27:33.880 person to repair sitting with them during usually two individuals. 470 00:27:34.079 --> 00:27:35.640 I get to do those on some of our studies, 471 00:27:35.720 --> 00:27:39.759 some they don't let me as the study doc. And 472 00:27:39.799 --> 00:27:42.279 then after usually they'll come in the next day for 473 00:27:42.559 --> 00:27:45.039 a session that we used to call integration, but the 474 00:27:45.039 --> 00:27:48.079 studies aren't calling it that anymore. But it is like 475 00:27:48.119 --> 00:27:51.880 a follow up session. But the whole time you're with 476 00:27:51.920 --> 00:27:55.519 them and they're going inward, coming out and maybe talking 477 00:27:55.559 --> 00:27:58.480 about it or maybe getting some support and how to 478 00:27:58.519 --> 00:28:03.440 move through things. There is the question that comes up 479 00:28:04.079 --> 00:28:09.039 everywhere from the FDA to just like academic circles doing 480 00:28:09.200 --> 00:28:12.759 thought exercises of like how much is the therapy needed, 481 00:28:13.079 --> 00:28:15.960 like for depression if we get out of the way. 482 00:28:16.480 --> 00:28:20.799 There's even some instruction when I trained in the by 483 00:28:20.880 --> 00:28:24.880 maps in the MDMA therapy protocol back when those studies 484 00:28:24.880 --> 00:28:27.640 were going on, there was an acronym that they'd give 485 00:28:27.720 --> 00:28:31.880 us in the therapy manual of like weight, why am 486 00:28:31.960 --> 00:28:34.880 I talking, you know, just like getting out of the 487 00:28:34.880 --> 00:28:40.119 way of that innerhaling intelligence and not over intervening. 488 00:28:40.359 --> 00:28:45.039 We as the therapy or psychiatrist group, because as I thought, 489 00:28:45.079 --> 00:28:46.559 you meant like get out of our own way with 490 00:28:46.599 --> 00:28:47.920 our ego and ourselves yeah. 491 00:28:47.799 --> 00:28:49.960 That too. Probably both of those folks get out of 492 00:28:49.960 --> 00:28:50.640 the way. 493 00:28:50.200 --> 00:28:54.480 But getting out of the way because the individual does 494 00:28:54.599 --> 00:28:57.240 have what they need inside to heal themselves. 495 00:28:57.319 --> 00:29:02.319 And that is so profound, profoundly different than it's a 496 00:29:02.400 --> 00:29:04.720 new It is a new age for psychiatry. 497 00:29:05.039 --> 00:29:05.880 Yeah, yeah, it is. 498 00:29:06.279 --> 00:29:10.160 You can kind of feel the ripple effects, and you know, 499 00:29:10.480 --> 00:29:15.319 there's still widespread kind of mental struggling and suffering out there, 500 00:29:15.400 --> 00:29:17.519 and our world is not an easy place on our 501 00:29:17.519 --> 00:29:18.119 mental health. 502 00:29:18.359 --> 00:29:22.480 Yeah, yeah, that's true. Well, this is super fascinating. The 503 00:29:23.799 --> 00:29:27.519 other studies on I don't know, are there other things 504 00:29:27.559 --> 00:29:29.440 out there to talk about as far as the studies. 505 00:29:29.519 --> 00:29:31.960 I mean, I think we've covered a lot of the 506 00:29:31.960 --> 00:29:34.279 ground of where we're at and what's coming. It is 507 00:29:34.279 --> 00:29:37.759 in this kind of last phase of the research and 508 00:29:37.920 --> 00:29:40.400 roll out, you know, I think we can learn from 509 00:29:40.400 --> 00:29:43.559 what happened with Spravado and how that was delivered with 510 00:29:43.880 --> 00:29:48.039 some new challenges, longer sessions. But I think I can 511 00:29:48.119 --> 00:29:51.440 finally look forward and see the light at the end 512 00:29:51.480 --> 00:29:53.279 of this tunnel of like when we might be able 513 00:29:53.279 --> 00:29:57.799 to prescribe this and it will still have its hoops 514 00:29:57.839 --> 00:30:01.519 to jump through and probably a rem them like spravado 515 00:30:01.599 --> 00:30:02.920 when it's as. 516 00:30:02.799 --> 00:30:03.759 A controlled substance. 517 00:30:03.799 --> 00:30:09.359 But we've come a long way since the complete ban 518 00:30:09.720 --> 00:30:14.279 of psychedelics back in the seventies, including the research labs. 519 00:30:15.440 --> 00:30:18.200 Are there things that clinicians like myself might do in 520 00:30:18.279 --> 00:30:21.519 order to prepare for best practices in this space? I mean, 521 00:30:21.720 --> 00:30:24.759 I would love to be able to get out of 522 00:30:24.839 --> 00:30:28.240 the way to let folks heal in some safe settings 523 00:30:28.279 --> 00:30:31.440 in these spaces, and you know, and I wonder if 524 00:30:31.480 --> 00:30:35.759 there's a way to explore is there additional certifications that 525 00:30:35.799 --> 00:30:39.279 we might need or things just to prepare or is 526 00:30:39.319 --> 00:30:42.599 it just hate prescribe this medicine, give them some rough estimate, 527

00:30:42.599 --> 00:30:43.880 own guidelines and. 528 00:30:43.720 --> 00:30:48.920 It's to be determined. Like, I think, there's so much 529 00:30:49.000 --> 00:30:52.880 we can do to prepare, and most of that is 530 00:30:52.920 --> 00:30:58.000 probably just doing our own work as well tuned individuals 531 00:30:58.039 --> 00:31:01.359 who have walked these tough roads of like facing all 532 00:31:01.400 --> 00:31:06.079 our inner stuff and changing the sticky patterns that have 533 00:31:06.200 --> 00:31:10.240 not been you know, good for our lives and be 534 00:31:10.359 --> 00:31:14.839 able to you know, have the capacity to hold those 535 00:31:14.839 --> 00:31:18.240 big emotions that might come up as people do this work. 536 00:31:18.599 --> 00:31:21.480 And then as these things get closer to proval, we'll 537 00:31:21.480 --> 00:31:24.759 get more guidance on practically speaking, how to prepare and 538 00:31:24.839 --> 00:31:27.200 what you know, who needs to register for what to 539 00:31:27.240 --> 00:31:29.839 be a prescriber, to be a you know, a therapist 540 00:31:29.880 --> 00:31:33.599 in these and whatnot. But many are seeking out trainings 541 00:31:33.640 --> 00:31:39.640 in the meantime and working with ketamine and or psychedelics 542 00:31:39.640 --> 00:31:44.119 in other states even and so I think the field 543 00:31:44.240 --> 00:31:46.480 is progressing on multiple fronts regardless. 544 00:31:46.839 --> 00:31:49.480 I think that's gold. The advice you give tip for 545 00:31:49.599 --> 00:31:51.519 us to just do our own work, do our own 546 00:31:51.599 --> 00:31:55.799 emotional intelligence work, our own your aulasticity work. Are we stuck? 547 00:31:55.880 --> 00:31:58.079 Are there are there things that we're struggling with that 548 00:31:58.079 --> 00:32:00.640 we might need to free up as clinicians so that 549 00:32:00.720 --> 00:32:03.079 we can better show up for these folks as they're 550 00:32:03.319 --> 00:32:06.440 looking to embark on the similar journey. That's really smart, 551 00:32:06.519 --> 00:32:11.920 that's cool, and it relieves us of the hubris of 552 00:32:12.240 --> 00:32:16.200 certifications and additional this and like like, actually, just do 553 00:32:16.319 --> 00:32:17.400 your work. It's fine, Like. 554 00:32:17.880 --> 00:32:20.279 It will it will need to get worked out, but 555 00:32:20.319 --> 00:32:23.200 I can tell you it's not difficult to get like 556 00:32:23.799 --> 00:32:26.720 registered as a spravado provider. It's not going to be 557 00:32:27.319 --> 00:32:31.000 so simple for these other medicines, but you know it's 558 00:32:31.599 --> 00:32:35.119 it's not going to be how the training programs and 559 00:32:35.200 --> 00:32:38.279 things were for the clinical trials five years ago. It's 560 00:32:38.720 --> 00:32:41.680 it's working towards that kind of clarified path. 561 00:32:42.319 --> 00:32:44.200 Can we speak a little bit to the spiritual space, 562 00:32:44.240 -->

00:32:47.160 because if this is introducing kind of this heart opening, 563 00:32:47.319 --> 00:32:51.200 expansive spiritual experience, kind of that that can go in 564 00:32:51.359 --> 00:32:54.640 and heal us deeply some of our broken spaces that 565 00:32:54.680 --> 00:32:58.440 we sometimes don't even see, can we speak to the 566 00:32:58.480 --> 00:33:01.920 spiritual aspect of this and how that is becoming integrated 567 00:33:01.960 --> 00:33:03.279 into the psych space. 568 00:33:04.000 --> 00:33:08.119 Yeah, it's it's interesting if you look at like the 569 00:33:08.160 --> 00:33:14.680 history of mental health treatment and psychedelics during that era 570 00:33:14.759 --> 00:33:17.519 we were just talking about of say the seventies. Like 571 00:33:18.160 --> 00:33:23.039 one example is Bill Wilson, the founder of Alcoholics Anonymous. 572 00:33:23.599 --> 00:33:25.559 And was head of the board of that. 573 00:33:26.920 --> 00:33:32.640 For quite some time, and had an experience himself with 574 00:33:32.960 --> 00:33:36.279 a psychedelic that he attributes his sobriety to and it 575 00:33:36.319 --> 00:33:38.200 was a mystical one and he's written the story and 576 00:33:38.240 --> 00:33:39.839 you can look it up, and he's standing on top 577 00:33:39.880 --> 00:33:43.279 of a mountain and like in this vision experience that 578 00:33:43.359 --> 00:33:46.599 he had on a classic psychedelic and that five AHG 579 00:33:46.720 --> 00:33:51.400 two a receptor and he said, you know, we've got 580 00:33:51.400 --> 00:33:54.480 to he said to his AA colleagues, like we gotta 581 00:33:55.279 --> 00:33:56.759 you know, we got to explore this or whatever. They 582 00:33:56.759 --> 00:33:58.680 would not have it and which he like even had 583 00:33:58.720 --> 00:34:02.720 to leave there. But it's different now. And I think 584 00:34:02.839 --> 00:34:08.760 many people in addiction treatment, in mood disorders, in kind 585 00:34:08.800 --> 00:34:13.880 of eating disorders and all sorts of other things, not all, 586 00:34:13.920 --> 00:34:17.840 but more and more are really kind of sharing and 587 00:34:17.880 --> 00:34:21.239 being able to talk about more freely, like their experience 588 00:34:21.320 --> 00:34:25.599 with connecting with something bigger than themselves, Like that is 589 00:34:25.679 --> 00:34:30.199 outside of this constrained kind of default mode place that 590 00:34:31.119 --> 00:34:35.639 just translates into leaps and bounds of progress, or like 591 00:34:36.199 --> 00:34:40.000 really getting to see the forest from the trees for 592 00:34:40.119 --> 00:34:42.960 a time and putting it in perspective. 593 00:34:43.280 --> 00:34:46.440 Yeah, can we talk about it like in the clinical 594 00:34:46.480 --> 00:34:48.840 setting a little bit, like is therapists and things? 595 00:34:48.880 --> 00:34:49.480 Is that okay? 596 00:34:49.639 --> 00:34:51.159 Or is that still kind of round upon? 597 00:34:51.920 --> 00:34:55.840 No, that's I'd say that's kind of been welcomed with 598 00:34:55.960 --> 00:34:59.199 open arms. And even in the clinical DRIUT protocols people 599 00:34:59.239 --> 00:35:02.800 think it's devoid of spirituality, but no, like people are 600 00:35:02.800 --> 00:35:06.159 having spiritual experiences in a clinical trial and I have 601 00:35:06.199 --> 00:35:08.079 to document it in a chart, you know what I mean, 602 00:35:08.119 --> 00:35:10.800 It's like and you put it in your concise way, 603 00:35:10.840 --> 00:35:15.039 but we are it's an interesting time to do clinical 604 00:35:15.039 --> 00:35:18.679 trials because a side effect of medicine might be like 605 00:35:19.679 --> 00:35:24.800 a visual hallucination, and that could be like a blissful 606 00:35:24.840 --> 00:35:28.639 experience for one, it could be scary for another, but 607 00:35:29.320 --> 00:35:32.519 part of an experience for many that is very different 608 00:35:32.719 --> 00:35:37.639 and unique, and it's it's shaken up. Psychiatrip made us 609 00:35:37.719 --> 00:35:42.079 expand our nomenclature quite a bit, and I'd say it's 610 00:35:42.079 --> 00:35:45.679 also kind of bringing a much needed renewed focus on 611 00:35:46.400 --> 00:35:51.159 emotions in general, which you know, I've always seen are 612 00:35:51.199 --> 00:35:55.119 quite connected to our spirituality and because part of our 613 00:35:56.000 --> 00:35:59.760 emotions exist as signals to tell us how to navigate 614 00:35:59.800 --> 00:36:03.440 the world world like fear warns and anger protects and 615 00:36:03.440 --> 00:36:03.920 things like that. 616 00:36:03.960 --> 00:36:04.920 But also there's. 617 00:36:04.840 --> 00:36:09.079 Meaning making that we as humans really do with those things, 618 00:36:09.199 --> 00:36:14.480 and that's both part of how psychedelics work, kind of 619 00:36:14.480 --> 00:36:18.079 bringing emotions to the surface. You know, you got to 620 00:36:18.360 --> 00:36:20.480 go through it. The only way out is through in 621 00:36:20.519 --> 00:36:26.000 some of those difficult emotions because they exist to kind 622 00:36:26.000 --> 00:36:28.800 of rise and fall and pass, and because we've swatted 623 00:36:28.840 --> 00:36:32.360 them away or numb them out or done something else. 624 00:36:32.400 --> 00:36:36.079 So part of it is kind of bravely going on 625 00:36:36.119 --> 00:36:41.000 that hero's journey to feel the unfelt feelings with the 626 00:36:41.039 --> 00:36:43.360 support so you can get to the other side of it. 627 00:36:44.519 --> 00:36:47.559 Can we talk about like some of the caveates, maybe 628 00:36:47.599 --> 00:36:50.599 some of the contraindications, or maybe some of the maybe 629 00:36:50.599 --> 00:36:54.440 we should pause and consider not doing this where some people, Yeah, 630 00:36:54.480 --> 00:36:58.159 if you are in a certain way, where would be 631 00:36:58.159 --> 00:36:59.400 the cautions that you would give? 632 00:36:59.519 --> 00:37:04.960 I'd

say, like, the big caution is is just these 633 00:37:05.039 --> 00:37:08.800 are not toys, and there is a very real risk 634 00:37:08.960 --> 00:37:13.079 of a difficult experience for many people. If you look 635 00:37:13.079 --> 00:37:18.119 at say the psilocybin studies or the natural survey studies 636 00:37:18.119 --> 00:37:24.159 of people using it outside of clinic settings, it's a 637 00:37:24.239 --> 00:37:28.039 high rate of people having both difficult experiences and even 638 00:37:28.119 --> 00:37:31.559 needing some support like a clinic visit or whatever. But 639 00:37:31.719 --> 00:37:34.639 equally and overlapping with that, a very high rate of 640 00:37:34.719 --> 00:37:36.880 having one of the most meaningful experience of their lives 641 00:37:37.199 --> 00:37:42.679 that they say was profound. But so the bottom line 642 00:37:42.719 --> 00:37:45.400 from that is that you know, doing these in an 643 00:37:45.440 --> 00:37:50.159 unsupported way is considered risky, and there are subpopulations that 644 00:37:50.199 --> 00:37:54.880 are especially at risk, like those with any kind of 645 00:37:55.679 --> 00:37:58.800 history or even family history of psychotic illness. 646 00:37:59.360 --> 00:38:02.400 Where it's it's perhaps a risk. 647 00:38:02.280 --> 00:38:06.119 Of losing touch with reality more substantially and kind of 648 00:38:06.679 --> 00:38:10.159 and losing that grip in a way that you know, 649 00:38:10.239 --> 00:38:14.119 could be you know, not so useful for someone's life. 650 00:38:14.159 --> 00:38:18.840 And same thing with bipolar and active substance use patterns, 651 00:38:18.840 --> 00:38:21.360 perhaps that might interfere. Like there's a lot of data 652 00:38:21.400 --> 00:38:24.840 out on the rate of difficult experiences on psilocybin goes 653 00:38:24.920 --> 00:38:28.320 up quite a bit. There's two main factors, not having 654 00:38:29.400 --> 00:38:32.960 a sober sitter, and two is combined with cannabis, for example, 655 00:38:33.599 --> 00:38:37.159 And so people, you know, take one thing that might 656 00:38:38.079 --> 00:38:39.639 kind of throw them for a loop, but you combine 657 00:38:39.639 --> 00:38:42.400 it with something else and it can be very disorienting. 658 00:38:43.639 --> 00:38:46.000 Addiction potential here with some of these things, I mean, 659 00:38:46.039 --> 00:38:49.079 are we going into a new opiate crisis thing? We're 660 00:38:49.079 --> 00:38:51.960 looking at their thankfully. I think that's the big dogma 661 00:38:52.199 --> 00:38:54.760 right from the sixties, Like folks are like, oh, you 662 00:38:54.800 --> 00:38:55.960 don't want to you know. 663 00:38:56.159 --> 00:38:56.719 You get Yeah. 664 00:38:57.320 --> 00:39:01.480 I was asked by I a group a couple of 665 00:39:01.559 --> 00:39:03.800 years ago to go up to Capitol Hill in Utah 666 00:39:03.880 --> 00:39:07.280 here and testify on behalf of the mushroom if you will, 667 00:39:07.320 --> 00:39:10.880 like psilocybin, to just cite the science and safety, and 668 00:39:10.960 --> 00:39:13.360 so it was because a bill that was trying to 669 00:39:13.400 --> 00:39:16.079 get past at the time that didn't and so I 670 00:39:16.159 --> 00:39:18.840 gave my summary and so do some others. Then they 671 00:39:18.880 --> 00:39:22.679 opened up for comment, and some of the comments were 672 00:39:22.840 --> 00:39:26.079 really energized around how could. 673 00:39:25.840 --> 00:39:28.760 You open these up? The children are. 674 00:39:28.880 --> 00:39:30.880 Going to get them and get addicted or something like that. 675 00:39:30.960 --> 00:39:34.880 But that's grossly misinformed. And I agree with being extremely 676 00:39:34.880 --> 00:39:38.360 cautious with addictive substances, and I agree with being cautious 677 00:39:38.400 --> 00:39:43.079 with ketamine as a substance that some people get addicted to. 678 00:39:44.199 --> 00:39:47.079 But I have not encountered a psilocybinn addiction. I've encountered 679 00:39:47.079 --> 00:39:50.519 a lot of reckless use of it. But thankfully those 680 00:39:50.559 --> 00:39:53.880 medicines tend to come with some inherent anti addictive potential, 681 00:39:54.280 --> 00:39:59.119 and there's another wave of study is looking at them 682 00:39:59.599 --> 00:40:04.920 for addiction, like the first psychedelic to treat it. Yeah, yeah, alcoholism. 683 00:40:05.320 --> 00:40:09.159 Really good data on psilocybin for alcoholism, some data on 684 00:40:09.280 --> 00:40:10.199 opius disorder. 685 00:40:10.559 --> 00:40:12.679 The first study that the US. 686 00:40:12.599 --> 00:40:15.239 Government funded of a psychedelic since they banned them in 687 00:40:15.280 --> 00:40:21.159 the seventies was psilocybin for smoking cessation, like a single 688 00:40:21.199 --> 00:40:26.119 dose and with some really positive response rates. So it's 689 00:40:25.960 --> 00:40:29.000 a it's a very important question. And thankfully on these 690 00:40:29.039 --> 00:40:34.519 ones they don't come with that inherent abuse potential that's 691 00:40:34.519 --> 00:40:39.159 something like ketamine a benzo or opius do And I 692 00:40:39.159 --> 00:40:41.480 don't think. I think ketamine can be used very well 693 00:40:41.760 --> 00:40:45.599 to treat some like addictive disorders at the right phase, 694 00:40:45.599 --> 00:40:48.159 and I've used it that way, and I've used it 695 00:40:48.199 --> 00:40:50.840 a lot in clinic with the right parameters that I 696 00:40:50.880 --> 00:40:53.159 feel comfortable with it. But I just know a lot 697 00:40:53.159 --> 00:40:56.280 of individuals who and have have had a lot of 698 00:40:57.519 --> 00:41:02.199 like encounters with like the smaller subpopulation who is at risk, 699 00:41:02.360 --> 00:41:05.880 and it needs to be extra careful with. 700 00:41:06.639 --> 00:41:09.960 Yeah, very good. And my understanding is like unlike opioids, 701 00:41:10.000 --> 00:41:14.440 these don't hit that MEW

receptor the euphoria space on 702 00:41:14.519 --> 00:41:15.760 a neuroscience standpoint. 703 00:41:16.079 --> 00:41:18.360 Yeah, there, all of this has to. 704 00:41:18.320 --> 00:41:22.440 Be alcohol hits it, opioids hit it strong strongly. 705 00:41:22.800 --> 00:41:27.280 Yeah, So it's it's all w's when any medicine goes 706 00:41:27.280 --> 00:41:30.159 to the FDA to start as trials has to come 707 00:41:30.199 --> 00:41:31.400 with this. 708 00:41:32.840 --> 00:41:33.079 Drug. 709 00:41:33.239 --> 00:41:36.639 This information, this file of all that's known about the 710 00:41:36.760 --> 00:41:40.000 drug ever and a lot of studies on animals and 711 00:41:40.079 --> 00:41:45.679 beyond of its abuse potential and everything else. And so yeah, 712 00:41:45.679 --> 00:41:51.199 thankfully that's really well established as these aren't addictive medicines, 713 00:41:51.239 --> 00:41:53.239 but they will come out in a way that they're 714 00:41:53.280 --> 00:41:56.159 not going to be in people's homes either, Like Spravado. 715 00:41:56.239 --> 00:41:59.239 When I got approved, it was approved to be delivered 716 00:41:59.239 --> 00:42:02.480 in clinics, and so the area that I work in 717 00:42:02.559 --> 00:42:06.079 as a as a physician and a researcher is in 718 00:42:06.119 --> 00:42:09.719 the clinic path. And there are other groups working on 719 00:42:10.320 --> 00:42:16.679 getting these allowed for more psycho spiritual purposes or descheduled politically, 720 00:42:17.320 --> 00:42:22.079 because you know, I'll admit they did get over regulated overscheduled, 721 00:42:22.440 --> 00:42:25.599 but I'm focused on like bringing them to clinic use, 722 00:42:26.880 --> 00:42:28.119 which is safe, you. 723 00:42:28.079 --> 00:42:32.480 Know, controlled environments and not Yeah, I fail you. That's great, 724 00:42:33.360 --> 00:42:35.880 doctor Reed, Thank you so much. This has been so 725 00:42:36.400 --> 00:42:40.559 expansive and enlightening my understanding of some of the psychedelic space, 726 00:42:40.639 --> 00:42:43.559 some of the therapy space, and and even some of 727 00:42:43.800 --> 00:42:46.360 nudging me toward you know, doing some of my own 728 00:42:46.400 --> 00:42:49.039 deeper work in this space. I think it's lovely. Tell 729 00:42:49.119 --> 00:42:52.719 us about your shop, inner space research, yes, tell us 730 00:42:52.760 --> 00:42:54.800 about how one might get a hold of you, and 731 00:42:55.320 --> 00:42:57.480 you know, what are you looking for? As far as 732 00:42:57.599 --> 00:43:00.239 people to enroll in your in your trial and how 733 00:43:00.320 --> 00:43:01.119 might they get hold of you. 734 00:43:01.559 --> 00:43:05.320 So about a year ago I set up this clinic 735 00:43:05.440 --> 00:43:09.239 in Orum with my colleague and friend, doctor Steve Thayer. 736 00:43:09.280 --> 00:43:11.599 He's a psychologist. We've been working together. 737 00:43:11.840 --> 00:43:18.119 On psychedelic studies and working

with helping train clinicians and 738 00:43:18.199 --> 00:43:20.800 ketamine work and et cetera for quite some time, and 739 00:43:20.880 --> 00:43:26.119 so we kind of architected this research site close to 740 00:43:26.159 --> 00:43:30.000 home with everything we've learned in the right. We bought 741 00:43:30.800 --> 00:43:34.079 a former midwiffery, so it's got a lot of cozy 742 00:43:34.119 --> 00:43:37.199 spaces for these psychedelic studies. And we are doing a 743 00:43:37.280 --> 00:43:41.039 number of psychedelic studies all for mental health conditions, and 744 00:43:41.159 --> 00:43:46.800 are currently enrolling for studies of silcybin type medicines for 745 00:43:46.920 --> 00:43:51.760 depression soon for PTSD. We have an LSD study for 746 00:43:52.320 --> 00:43:57.119 depression as well. We have psychedelic study for PTSD and 747 00:43:57.559 --> 00:44:00.639 psychedelic for generalized anxiety disorder. Where people just go to 748 00:44:01.239 --> 00:44:04.920 interspace research dot com, look at the list of studies, 749 00:44:05.440 --> 00:44:09.119 you know, give us a call, submit a form, and 750 00:44:09.159 --> 00:44:10.920 then we just get on the phone and go through 751 00:44:10.960 --> 00:44:12.519 to see if they seem like they might be a 752 00:44:12.519 --> 00:44:14.639 good fit, if they seem like if they come in 753 00:44:14.679 --> 00:44:17.519 and visit and we'll sit down and do the you know, 754 00:44:18.199 --> 00:44:23.320 do the official kind of diagnostic assessments or whatever. And 755 00:44:23.400 --> 00:44:25.920 even if people don't qualify, they get to come in 756 00:44:26.119 --> 00:44:30.679 and learn some things about themselves and contribute to science. 757 00:44:30.719 --> 00:44:33.880 And we even do blood work and EKGs and happily 758 00:44:33.920 --> 00:44:36.400 share those results of people free of charge. I mean, 759 00:44:36.440 --> 00:44:39.760 we actually compensate people for their time and travel and research, 760 00:44:40.199 --> 00:44:46.360 which is nice. So if there are individuals you know 761 00:44:46.519 --> 00:44:50.880 in your circles, anyone listening with depression anxiety PTSD, and 762 00:44:50.920 --> 00:44:52.880 you want to check out the website, we would love 763 00:44:52.920 --> 00:44:54.400 to see if we can help. 764 00:44:54.880 --> 00:44:57.880 And as clinicians, we can refer directly to that website Interspace, 765 00:44:58.440 --> 00:45:02.440 Interspace Research dot com, Space for Sure, dot com. It's awesome. Well, 766 00:45:02.679 --> 00:45:05.239 I have several clients that I'm already thinking about for that. 767 00:45:05.320 --> 00:45:06.920 Would you know, We've been trying to help for a 768 00:45:06.960 --> 00:45:10.480 long time and they're seeking other options and other solutions, 769 00:45:10.519 --> 00:45:12.960 and so I'm excited for your research to be on 770 00:45:13.000 --> 00:45:15.440 the cutting edge of such a new chapter in mental 771 00:45:15.519 --> 00:45:18.320 and emotional wellness. At some point, I'd love to bring 772 00:45:18.360 --> 00:45:20.960 you back and just just talk about ways that we 773 00:45:21.039 --> 00:45:26.360 can maintain emotional wellness and maybe like maybe just recognize 774 00:45:26.400 --> 00:45:29.280 if there is something the matter, Like there were things 775 00:45:29.320 --> 00:45:32.119 in my I've done some work in this space, and 776 00:45:32.159 --> 00:45:35.360 there were some things in my heart that I didn't see. 777 00:45:35.519 --> 00:45:39.559 I just didn't Yeah, and I didn't realize that it 778 00:45:39.639 --> 00:45:43.519 was affecting my default, no network, it was it was 779 00:45:43.719 --> 00:45:47.760 becoming part of the way I showed up. And so 780 00:45:48.159 --> 00:45:49.719 it was. It's been a fun journey for me to 781 00:45:49.840 --> 00:45:53.000 like mostly through foraging in the wilderness and taking deep 782 00:45:53.079 --> 00:45:56.880 breaths of the pine and mushrooms that grow up there, 783 00:45:57.159 --> 00:45:59.039 you know, to being able to dive deeper into my. 784 00:45:59.000 --> 00:46:02.360 Heart and figure out this. Yeah, that's really neat. 785 00:46:02.559 --> 00:46:06.119 Yeah, I would love to talk about you about that 786 00:46:06.239 --> 00:46:09.320 with you more and explore that it's a topic near 787 00:46:09.320 --> 00:46:13.000 and dear to my heart. As like as clinicians especially, 788 00:46:13.000 --> 00:46:17.840 we gotta both practice what we preach and kind of 789 00:46:18.000 --> 00:46:21.599 maintain our capacity to do the work well. Right. 790 00:46:21.679 --> 00:46:24.239 Yeah, So in the meantime, let's take our sixteen year 791 00:46:24.239 --> 00:46:25.760 olds up into the mountains and get them out of 792 00:46:25.760 --> 00:46:28.840 there breathe in the AIRA that would be amazing, Dochory. 793 00:46:28.880 --> 00:46:29.960 Thank you for your time. 794 00:46:30.000 --> 00:46:32.960 Thanks has been really really fun and to our listeners, 795 00:46:32.960 --> 00:46:35.599 I hope you learned some cool stuff today. As always, 796 00:46:35.639 --> 00:46:38.159 our mission is just to expand the knowledge and wisdom 797 00:46:38.199 --> 00:46:40.639 of our community and to bring on really great hosts 798 00:46:40.719 --> 00:46:43.360 or guests. And the host is not bad either, but 799 00:46:44.840 --> 00:46:45.800 it's just really fun. 800 00:46:45.840 --> 00:46:47.760 So yeah, thank you, thanks, I've enjoyed it.