Dr. Signi Goldman 8:50
Well, it’s a big part of our ethos, because on one hand, we’re medical professionals, and we operate in licensed capacities and mental health clinics. So this is very much a part of mental health treatment in a real sense. But also, whenever you’re altering someone’s state of consciousness, by definition, you’re touching them into a landscape inside of themselves, such as, sort of akin to dreaming, right? So the it’s touching base with the unconscious. And a lot of the powerful metaphors are nature based and have to do with a sort of more indigenous way of living that we all evolved from. And so when you’re working with people in altered states, it’s really important to have some background and training in what we call transpersonal realities, which means, some people would use the word spiritual experiences for that, but a sort of broader connectedness, or something transpersonal that’s bigger than oneself, and a lot of time that comes in through a sense of connection with the natural world or the greater creation, or, you know, a sort of finding a home, or feeling like you’re a sense of a part of that. And so to to work with that in a skilled way, as therapists, you need to be able to you. Know what to do when that sort of content comes up for someone in a psychedelic session, and have a common language for that, and actually have interventions that help them work with that in a way that’s meaningful for them and creates healing or growth and in a training capacity, when Sandy and I are training therapists in our training program, we intentionally work in overt nature, connection activities and training into that, because what happens is, anyone who works a lot with psychedelic altered states can tell you that a sort of common language for feeling in community with the natural world is going to naturally come up when you’re working with states. You know, whether you experience that as spiritual or as like just nature, connection or grounding into, like the created world. And so if you don’t have any, you know, language or skills for working with that, then you’re not going to know what to do when clients find this as a really meaningful part of their healing journey.
Dr. Sandy Newes 10:53
And could I add something to that too, just the piece about nature as resource. So, you know, we live in the natural world, and we are surrounded by that. And so a lot of you know the very tangible pieces of that are building in. You know, connection to the natural world as a resource, because we can all and resource means kind of connecting into something that can help you find a sense of well being, or at least neutrality. So building that in as a really intentional piece, is also a big part of trauma informed care in the way that we work.
Chad Franzen 11:26
Interesting. Have you? Have you found that there are misconceptions about psychedelic assisted therapy and are if so, what are some of the most common ones? Dr Sandy,
Dr. Sandy Newes 11:38
I mean, the most common one is that it’s all about the medicine, right? Then, you know that it’s all about the medicine session, and that the preparation and integration we do is all about getting to the medicine like, as if that’s the end all, be all. And that’s just not the case. Like, you know, there is psychedelic there are psychedelic sessions that don’t happen as part of a therapeutic process, where you might have a therapeutic experience, but that’s not therapy. That’s not psychotherapy. So it’s different. And the other one really is that, well, there’s a couple the other, the other one is that, as if it’s like we’re on the perfect quest for which medicine to use. And I think as we get deeper and deeper into this, that while ketamine has its properties in some ways, it’s really more alike other psychedelics than not. And so we get outcomes and experiences that mirror other types of medicines too. And and then the third is that then this is really kind of more specific to the way that I work. I’m not sure that everybody would agree with this, but that it’s not all about getting to the content. So the content meaning like the experience or the bad thing or the hard thing, that really there’s kind of an emerging hypothesis for me that we might more and more actually be enhancing people’s capacity to experience well being, and just kind of moving into those, those directions.
Chad Franzen 13:07
Yeah, go ahead. I was just saying
Dr. Signi Goldman 13:09
I would add one more that we as a whole, as a field run up against, which is this, what I could call the one and done myth. Just you read this a lot in the media, the idea that, like, if you do a psychedelic, all your problems will be over, you know, and it’s going to just heal you in one fell swoop. And one of the things that Sandy, Sandy, and I do a lot of education around, is that it’s actually a process. It’s a therapy process, and the psychedelic experience is a critical piece of that, and can be really change inducing piece. But, yeah, that’s a myth. We run up against quite a bit.
Chad Franzen 13:45
So how do you address maybe safety concerns in psychedelic assisted therapy?
Dr. Signi Goldman 13:51
Well, we practice this in a medical setting. So for us, this is a clinical intervention like full psychiatric evaluation and a full medical evaluation are part of the vetting process to figure out someone’s appropriateness for this kind of treatment, and anything involving taking a substance is medically monitored. So it’s physician monitored, and they’re tracking your vital signs, and they’re trying, you know, they know your medical history. So there’s a medical piece that’s really important, and that’s part of our model. And then there are psychological safety pieces that are built into the way we work and also the way we train other therapists that have to do with psychological safety in the relationship with the therapist when you’re essentially tripping in an altered state, right? It’s a very vulnerable state. So there’s important pieces around how the therapist conducts themselves and the the contracts and the agreements they make with the client to make sure that it’s very collaborative and CO created and very consent based, and those are built into our training program, and that those really critical pieces, because those that that those are the places where this kind of therapy can go badly or potentially do harm. With therapists that are undereducated on that part.
Chad Franzen 15:03
So it sounds like set and setting is very important in this kind of therapy. Dr Sandy, I
Dr. Sandy Newes 15:10
mean set and setting in a way you could almost say is, is everything, because it really is. You know, set is the mindset that the client comes in with. So they need to feel safe. They need to feel like they have a clear understanding of what the process they need to feel connected to me. They need to feel connected to the team. It’s very jar like, for example, it’s very jarring for a client. When somebody comes into the room that they don’t know, like, even if they’ve got an eye shade on, they can feel it. They actually feel kind of the felt sense of the person and the, you know, the energetic vibe of the team themselves. So, so that’s and that all of that influences how they go into it. And so they need to feel, you know, they might have trepidation, and they might not have nervousness, especially their first time, like, what is this? What’s going to happen? But that’s separate from feeling safe and helped. And so then that’s that setting too, that you know they need to feel from minute one at every interface with the clinic, that they are cared for, that they are seen as an individual, that their approach is going to be individualized to their needs, and also that we got this that they feel like we know what we’re doing. Like in our training program, we teach step into a soft authority like, you know, step into holding that container that containers everything. And soft authority means, you know, with kindness and softness and connection to the client. Because when you’re in that, that non ordinary state, when you’re with the medicine, you know, they’ve got eye shades on, they’re sitting there with a blanket like but yet you feel you feel it. I mean, you’re feeling into the space. And so all of those different things really influence a client’s ability to fully drop into the experience and maximize the therapeutic benefit.
Chad Franzen 17:08
So set and setting are crucial. What role does maybe ceremony and ritual play in your therapeutic approach? Dr Signi,
Dr. Signi Goldman 17:15
wow, that’s actually quite a big topic, and so we have a lot of teaching content around this, because that means different things to different people. Certainly, if you come from an indigenous or indigenous inspired lineage, or you work in that way, you’re going to understand ceremony a certain way, in what we call the quote, underground. So this would be providers that have been doing this in a not legal context for decades. Right ceremony may be understood in a very different way. And then there’s using it in a clinic, in a mental health clinic with people who are coming in under sort of mental health treatment, and how, what does ceremony mean in that context? And in that context, we’re often talking about neuroscience for you know, we know that actually certain aspects of ceremony shift someone’s state of anticipation or their state of awareness or state of consciousness in some measurable ways. And why we may not think of it as ceremony, right? Because it may be something just that the sort of gestures or routines or actions that you and the client develop together to basically say this, we’re moving out of sort of everyday life into this dream, like territory. And it’s not just something we snap our fingers and pivot. We sort of transition in, we settle in. It’s like creating a landing pad for someone to go into an altered state, and that can be very personal to the person. So often, in a clinic, people will bring in photographs or objects that are meaningful to them, sometimes candles or scents. There’s things that you can use, and it really needs to be individualized to your client and CO created with them. But there’s ways that in clinic you use what you could say, the word ceremony, right? This is clinic based ceremony. It is important because it it creates that shift, because most doctors and therapists are not trained to bridge someone from ordinary chit chat consciousness into what is really like a dream, like dialog with your own unconscious. You could think of it like, metaphorically, as a kind of hypnotic state, for example. And so you have, there’s, there’s things you do to bridge into that shift. And we, I would say those are clinical versions of ceremony, and the way that we do that, and Sandy and I do it in the way we train therapists do it is informed by the use of ceremony in these, more these indigenous, or, you know, nature based lineage communities, because there’s a long, long, long amount of knowledge there about the use of ceremony to shift someone’s consciousness. So it is a big topic, but I would say that’s a that’s an overview of the kinds of things that we teach about. Yeah, thank
Chad Franzen 19:46
you. Maybe we can dive into that. Go ahead.
Dr. Sandy Newes 19:50
I think people also get a little bit nervous about that. I know I have at times in my career, like, oh, you know, the ceremony, or this ceremony, or that ceremony, Am I doing it? Right do I have the right elements when really, it can be as simple as beginning a session the same way every single time. And, you know, helping somebody drop in and so that they, you know, they’re cued through the rituals in which you start, and that you kind of come out in a similar way. So it doesn’t have to be really complex, and it can be individually created with the client as well. It could be as simple as it as a sacred object, or perhaps lighting a candle or something that has meaning to them, or even to you as the provider to help you drop in, because you’re also in your own non ordinary state while you’re doing it
Dr. Signi Goldman 20:38
and it, yeah, it is important to differentiate this also from the way that the popular culture often uses the word ceremony, which implies maybe ceremonies that come from specific traditions, like spiritual, religious or tribal traditions. We are. We are not doing that right and that so that that’s a that’s also a very big topic. But so when we say ceremony, we’re, we’re talking about what Sandy just described, like using certain routine rituals to induce and encourage someone into the altered state in a in a way that’s more comfortable.
Chad Franzen 21:11
So once a psychedelic assisted therapy session is over, how do you kind of approach integration? Dr Sandy,
Dr. Sandy Newes 21:21
so integration begins as they’re ending as they’re coming out of the medicine. We take notes throughout. So I write down not everything that they say, but most of what they say, and often kind of word for word that gives them the ability to, just like, not have to track it and and so at the end of a session for me, I might kind of go through some of the the points that I think were the most relevant for them to say. I might, you know, I want to just kind of review some of this. These are some things that came up for you. Just want to invite you to kind of notice what comes up for you as I say them. So I’m already cueing them with memory. And then I say, is there anything else that you want to add, you know, doesn’t need to make a ton of sense, but that you want us to track for integration? So I start that at the end of the medicine session, and then we go back through kind of those notes during integration. So for some clients, I’m literally going like play by play. For others, we’re just visiting it thematically. And then my job is also to kind of help them and cue them to weave in developmental history as well as what it is that they’re there for. You know, one of the things that Signi says in our video training series is, you know, where the I don’t know if you say it exactly like this, Signi, but basically where the rubber meets the road is that this has relevance and meaning for the client’s life, because otherwise, like, you know, we’re they’re just tripping out and having an interesting experience. So we’re really looking for the now, what ultimately, like, how does this help them shift their behavior? How does this help them shift their sense of self? How does this help them shift their felt sense of being in the world? Or what kind of shifts in their felt sense have they had, and how can I help them become aware of that, somatically or in their emotional state, or their cognitive state, or their attentional state, or the way in which they do relationships? So I’m also tracking what I’m noticing and the shifts I’m noticing about how they’re engaging with me as the way as well as the way they’re describing their experiences.
Chad Franzen 23:23
This has been a very interesting episode, as we kind of wrap it up. Dr Signi, what advice would you give to someone considering psychedelic assisted therapy?
Dr. Signi Goldman 23:33
Well, that’s a great ending question, because there’s so much interest out there and also so much confusion and lack of information. That’s a lot of the reason that we’re starting this podcast, because we do speak from experience and authority and an understanding of how to do it safely. So first is make sure that you are someone who’s positioned to do this safely if you want to get into this profession, and that starts with making sure that you really have solid clinical skills. You are a good therapist. You know how to do good therapy, because, like Sandy referenced integration, preparation and integration are huge parts of this work, and you have to do good psychotherapy to help someone land well and really heal from a psychedelic experience, if they’re you know, and target the symptoms they’re struggling with, for example. And you have to be really trained how to be safe around that. So you need to be an experienced therapist that understands relational dynamics and ethics around touch and patient client interactions. So be an experienced therapist is one, and then the second is make sure that you get a training program that allows you to experience the altered state yourself. If you are a therapist that wants to go into this field or a professional, you need to really have spent a significant amount of time in an altered state, a psychedelic state, so you understand what your client is experiencing, and you know how to help them navigate that. So those would be kind of the first two big pieces of advice. And then there’s, there’s other, you know, things in there that that we could definitely talk about. But I would, I would start there. If there’s if people are out there interested in building this into their career.
Chad Franzen 25:03
Okay, sounds good. Sandy, anything you’d like to add to that quickly?
Dr. Sandy Newes 25:07
Yeah, I’d like to speak to the medical professional piece. So, you know. So our training program is for clinicians, therapists and also medical professionals. And you know, they may not be well trained psychotherapists, but if they want to work collaboratively as a team with the therapist, then it is important for them to understand the therapeutic process so that it’s not just all about safety and medical it’s about building that relationship from minute one. It’s about, you know, really partnering with the client and trying to help them understand, you know, their process, and then they too understanding. So I do. I also believe that medical professionals should have their experience with the medicine so that they can, you know, kind of better know how to how to work with those set and settings, so that it’s not just all about like monitoring vitals. It’s about the way in which they enter the space, the way they come in and out of the room, the way that they say hello and goodbye to the client, all of which seem like very small things, but having that level of awareness and an understanding of not only how the medicine works and the physiological aspects, but the therapeutic process, and then the process of being in the state with the medicine itself, I think, is really important for medical professionals as well.
Dr. Signi Goldman 26:18
I think a great summary statement for this for us. And part of why we want to do this podcast is we want more people to get into this field. There’s a huge need and a demand. We want more people to be able to do this well, and we are wary of people jumping in too quickly before it’s safe. So we want to welcome more people to learn more about this and to make sure they learn about it safely, so that they can do it safely. And I think that that’s a good summary of our mission. Yeah,
Chad Franzen 26:44
thanks so much. Great advice. Hey, I really appreciate both of you having me as part of this podcast today. I’ll look forward to hearing future episodes and being a part of future episodes, but I really appreciate it. Thanks so much.
Dr. Signi Goldman 26:56
Thank you. Thanks.
Dr. Sandy Newes 26:56
Yeah, this was really great. We really appreciate it.
Chad Franzen 26:59
So long everybody.
Outro 27:03
Thanks for listening to Living Medicine. We’ll see you again next time, be sure to click Subscribe to get future episodes. You.