A Deep Dive Into the Clinical Process of Psychedelic Psychotherapy

Dr. Sandy Newes 14:40

So when you say corrective experience, are you talking about that witnessing? I know it’s people use different words. So what you just said, the attunement, the witnessing, the mirroring, the noticing what they’re saying, the awareness of their patterns, the it sounds to me like you’re talking about the felt, sense of them being in relationship with you. Is that what you mean by that? A lot

Gita Vaid, MD 15:01

of attachment stuff. So a lot of the things you mentioned, I think, are there, but it also plays out so uniquely for different people. And I’ll give you an example of how it can play out in very unique ways, because we’re all so different. This is a gentleman, an older fellow I’d been working with successfully in psychodynamic psychotherapy for a few years, and he’d done quite well. And when he did his first ketamine session, we had a long history of working together. Well, I was really a bit puzzled, because he listened to the music. And with my office, I kind of liked to have the music be in a speaker, so that we’re both held in the music, so the music is the container within the room. And he actually kind of said, I don’t know if I want you listening to the music. And I was and I said, What do you mean? He said, I think, if you don’t mind, I think I’d like to have my own music. That’s just mine, and I don’t know if I want you to be part of the session. And it was so interesting. This was a man who could not have been more, more of a pleaser. In fact, that yeah, the course of the work was about him learning about His pleasing tendencies, his caregiving tendencies, and to have awareness of that tendency. So this was not him being a pleaser, but what it actually turned out being, and we actually kind of modified it. I didn’t analyze it. We kind of said, well, the next session, you can bring in your own headphones. We’ll have music be your music. And he said, I’d prefer if you don’t talk to me. I don’t want you to touch me. I don’t want you to it was by okay about him feeling what he came to understand was he had felt so intruded upon in terms of boundaries with his mother and a measurement and so much of his pleasing and being an extension of her for safety, was what we talked about, but in a very present, here and now experiential way, he was taking charge and drawing the limit and having his boundaries and telling me, here’s how you’re going to help me. Here’s how you’re not. I want my own space. And really was drawing it. And so I was a little bit shooting the dark. Initially, I could sense a process is happening, but it was fascinating to me to see how, in his case, it was listening, reflecting, responding, but it was almost the inverse of what I was typically used to, but so creative and such an amazing way, he was able to use the session skillfully to listen to his own needs and process to really heal himself. Interesting.

Dr. Sandy Newes 17:21

So how did that unfold? Were you just quiet the whole time, and then you did that work in integration? Or did he eventually take off the headphones? Or, how did that work? And

Gita Vaid, MD 17:32

it was really helpful for him over time, he decided he wanted to take the headphones off, and he was much to share the space, and this corresponded in his outer life, of being able to sort of set limits and not be so inclined to give himself away, which did cause some friction in his relationships, in his everyday which was not easy, but he really felt, I have to be true to myself. I’ve given myself away, and was able to navigate that and get to a place, both in relationships outside in the world, as well as in the session of we can have a shared space, and neither of us have to be tugging at you for you. And so then that was really reflected in being able to share in the same space and loosen up some of the need for his own boundaries and protectiveness. So it was very interesting how it was really a process which we could see mirrored out in the session and outside of

Dr. Sandy Newes 18:26

session. Oh, how interesting. I actually have had a few clients through the years. I talk most of the time. I’m not just me, but you know, we’re engaged, which is one of the things that people don’t always realize. I think more and more people do, but that ketamine assisted psychotherapy, at least the way we do it, and I do it, is that we are talking, but I occasionally, I’ll have somebody who just wants to quietly sit there and that, that the feeling into just the fact that I’m still there and I’m still with them, that, you know, we’re not just sitting there like it’s they’re still feeling, I call it like in The bubble, like we’re still in the bubble with them.

Gita Vaid, MD 19:04

We’re definitely in the bubble with them. And this, I’m not sure why this wonderful patient comes to mind today as I’m talking to you, but it, I think it’s a good example, because this was the person that, as I started off saying, I prided myself on working quite successful with him for several years in psychotherapy. The other thing about the case that was really remarkable to me, and this is one of my earlier patients, I was really amazed that a lot of what we had talked about about his past, and he’d been successfully married for quite a long time with two grown children. He talked a lot to me, initially about the trauma of his first wife, who had made a suicide attempt in front of him, and this was decades earlier, but when he came, you know, he was married for, I think, 20 years wrong. There were other issues that were more prominent. So I was aware of that history and we talked, because it was quite remarkable, but I was shocked that all of that came up in a very. COVID Way, which was, of course, trauma that had been suppressed, but was really suddenly available to be processed and felt together. And it wasn’t that I didn’t know this stuff, but I this time was listening to it and feeling together what the pain was. And it was really a challenging session for me, because he was then burdening himself of the experience and, in a way, recounting exactly what happened in painful detail. I was sitting with him, and it was almost like he was processing it and passing the feelings to me and for me to, in a way, digest what was intolerable for him. Yeah, it was heavy duty work and beautiful work. And I think that’s what’s interesting for a lot of people, is sometimes ketamine can very much mimic how we think of MDMA psychotherapy, I think, and often have these visions that MDMA is for PTSD and ketamine is for depression, and all bets are off when it comes to healing and psychedelics. Oh,

Dr. Sandy Newes 20:58

I’m so glad that you said that, because I, I see MDMA like effects all the time, like, I mean, I do, I do series. I do, like, six sessions over three to four weeks. And so they build on each other, and then we teach from that perspective. And I think when you’re in that, you know, we can bring in, like, gold Dolan’s work about the, you know, critical reward learning period, and what happens there with the neuroplasticity. But, you know, I see this huge relational, you know, trauma processing thing, when the when the container is created in that way. So I love that you said that. So please share more of your thoughts about that.

Gita Vaid, MD 21:37

Well, I just think that I’m really interested in the process, because it’s so remarkable to me how healing is and how you is to each of us. And I would say for me, and I think you just sort of, you know, very much, kind of said, what to me is the most magical about this work, when I can be in a process with someone, where I feel like in session number four, I can look back and see how it arrived from session three or session two. And I could have never, from Session Two predicted where it was going to go. Something is happening, and there’s a real unfolding happening, and that is something I keep an eye on, because if we can achieve that, that to me is, you know, we’re doing, we’re in where we want to be.

Dr. Sandy Newes 22:20

Yeah. So your approach to working with trauma, like, can you say, you know, everybody kind of has a different approach, depending on where they come from and their background and their training. Like, what would, how would you describe your approach? And once again, just, you know, like, just, kind of just name it. It’s like, when I first started in the ketamine field in 2019, people were saying, like, were saying, like, no, not ketamine for trauma. That’s bad, which I think probably comes from the ketamine clinics where there isn’t psychotherapy. So that’s just to kind of inform people as we’re going through it. So you know, what are your thoughts on? How do you work with it, the effectiveness of the use of ketamine specifically for trauma. And you know, what have you seen in the relationship to what you’ve also seen with MDMA?

Gita Vaid, MD 23:04

I would say for me, the way I work with it is, I think I’ve gotten more skilled. Is a never ending process, right? Like, for me, I think if I look back, I feel like I was so much fancier when I first started, and so much more cautious and like, I’m less fancy. When I say fancy, had all of these interesting protocols of how to work with patients.

Dr. Sandy Newes 23:27

Use the word fancy. Like,

Gita Vaid, MD 23:29

what I really am is much more skilled at listening to the process, trusting the process, and following the person’s process, which is way beyond anything I could conceive of, for anything I could imagine. And I think that’s been really helpful. Because I think early on, if someone had a really difficult session or a dark session, I would be a bit concerned, is this helpful? Really useful for the person? And now I have 100% conviction that those are the sessions where the person is really safe enough to grow themselves, yeah, nice. Um, a lot of it has to do with, I think one of the pieces that I value about the work is, for me, healing is, um, really growing ourselves, to be able to to hold both the dark and the light within us. And to, you know, not work it out or metabolize it, sure, but some of it is some of the stuff might be just through life. We have to just ourselves to be able to not suppress it, not to use so much energy to avoid it or to cope with it by evacuating it, instead of being able to grow ourselves to process and right through the feeling states, both internally and then through life, so you can have more of your energy available to be alive. And so I think that’s a big aspect of trauma and healing. And so to your point, what, how do I work with it is I really try and follow the process and open really, I try and open up a process with a person. Can happen then I feel we’re in you. We’re doing something right, and I trust and I’ll follow it, and the person does it as their own pace. Sometimes it’s a lot about building safety. Other times, the person is ready to dive into the work right away.

Dr. Sandy Newes 25:13

So you’ve mentioned attachment, and you know when you’re just you’re talking, and the person feels safe, the person feels like they’re ready to do the work. I mean, that’s, to me, that’s inherently relational, like that you’re building safety with them. And you know, what are, what are your thoughts on working with attachment, which is inherently part of trauma on I mean, I will say that early on, when I started doing this work, I’ve been doing it since 2019 there were some times when what I now think was attachment stuff would come up, and the person would get kind of resistant, or want to kind of pull back, or maybe they wanted to do it on their own. And I think I have also kind of learned different techniques, because that’s not happening anymore, but I do think there’s something about the intensity of the relationship that can read really healing, but may also sometimes people bounce off of that. I’m just curious about your thoughts. You

Gita Vaid, MD 26:00

know, I’m really glad you mentioned I think that psychedelics really allow us to get to the deepest stages of healing and deep attachment work, which I think in some ways is the underpinning, you know, in a way, trauma happens on the matrix in which the person is receiving the trauma. So, you know, two people can have the same traumatic event, and one person could be less scathed by it than someone who had a history of trauma, where to sort of evokes. I was just talking to a new patient yesterday who’s telling me how there was a big betrayal in his business which which would be traumatic. I think for most people to have a big betrayal in a business venture, but for him, it was a bit of a double whammy, because he said he’d been bullied in high school for many years, and suddenly it felt like not only was he being betrayed in a business venture, they were very bullied towards him. And then it opened up this history of being bullied, which then had even earlier roots. So I do feel like attachment, in a certain sense, is the earliest kind of matrix with which all of these later events reside and and the other part of it is, you know, in psychedelic psychotherapy, I think we talk a lot about how we heal ourselves, and I’ve even said that a bunch of times already, how much I like to follow the person’s process so they can do their own healing work. But I think that’s 50% of it. I think we heal us, we heal each other, and that, I really think the balance of that is 5050, which, which, I don’t think too many people in the field think about, I think they think is largely the person. And I think we heal ourselves and we heal each other, because I think we can’t see ourselves, so we need to witness us and and that’s a skill that I can say, that we have to cultivate within ourselves, and so I would say that to me, everything, I think relationships are the crucible for healing. I can’t really heal ourselves, just like we can’t analyze ourselves. Even if we’re really, really sophisticated psychotherapists, we’re going to be a lousy psychotherapist if we think we’re the one who’s going to heal ourselves or analyze ourselves, and I think that is true of psychedelic work or healing work in general. We need each other. We need relationship. And that’s where all of this tough comes alive.

Dr. Sandy Newes 28:12

Nice. I love that so, so you know the piece, what you just said, I want to just highlight that like for because i This work is so nurturing and powerful for me. Like to be able to kind of go into the bubble with a client and and have the trust and the honoring of being in there. And it’s also a very meditative state. You know, we can make light of it and say there’s like a contact high, but it’s, it’s more you’re, you’re in, to use your word you’re in the process with them. And it’s very, very rich on a personal level, and I feel like it impacts me

Gita Vaid, MD 28:48

all the time. It’s a very open field. It’s very undefended. I also think a big aspect of the relationship repair and the work is intimacy. I think the deeper someone can go within themselves, the deeper they’re available to be in relationship with another person. You really see that very, very deeply in the psychedelic space, the person is dropping in, particularly with ketamine work, they’re dropping out of thinking mind. They’re going to deeper places. Feelings are coming up, sensations that they’re holding in their body. They’re going deeper behind the everyday kind of space that they live in, they’re going deeper within themselves, and sometimes you get a hint into why they were blocked from those deeper places. Pain comes up, feelings come up, grief comes up. But the deeper they can go with themselves, the deeper they’re available for the new relationship. And the first one is going to be right there with the therapist in the room to feel. And that’s then very quickly, translates into the person having more of themselves available for relationship in everyday life.

Dr. Sandy Newes 29:46

I love that. I mean that applies with psychedelics and also traditional psychotherapy. You know that it’s just like we can free that up. So you mentioned thoughts and feelings and sensations, which is a great kind of segue into the next thing. I wanted to just check in with you about I’ve been kind of working with this theory on, like, state versus content. Like, is it the processing of the content and then with the relationship being kind of a critical bridge, or are we helping people learn to kind of, you know, to kind of draw from Bessel Van der kolk’s work about just shifting state and being able to, you know, be in wellbeing and to have a more flexible way of being in the world. And I’m just curious, you know, for you, what are your thoughts on the balance of being, you know, the specifics around processing content versus helping somebody shift state and or are those even separate distinctions for you?

Gita Vaid, MD 30:38

Well, the way I would what it brings up for me listening to those two different points, I would say that, you know, I think we get attached to our trauma as human beings. I think we tend to get an identity becomes, what are our problems? What are psychotherapy tends to reinforce that. But even if not, I do think very quickly, once we start healing ourselves and doing some of our processing and having more access to what’s beneath the surface in ourselves, very quickly, I think it shifts away into more of a flourishing and well being, and how much communion rate of having more goodness in our life? Can we let go of some of these negative influences, and can we actually open ourselves up to more. And I think that’s a pivot, and that’s a shift that I think can be really cultivated and reinforced. And those equilibriums and set points, I think shift, and I do see this time that in psychedelic work very quickly after, you know, when I say quickly, I said, after we do enough healing work, it does shift into, how much goodness can you tolerate in your life? Could you tolerate letting go some of those issues? Could you write your own story? Could you life you want instead of replaying those patterns or complaining about what you didn’t get? What if you’re the author of your own life and you self? So I think it shifts a little bit into a very different way of are you ready to let this go now, and yeah, ready to have a different life, the one that you are in charge of or entitled to, and how much can you allow yourself? So I think surprising you would think, well, who wouldn’t be running to do that? But as it turns out, that’s heavy work for all of us. That’s not so in theory. It’s great. In practice, it’s not so easy. And I see this all the time, that the person is trying to provide more for themselves, and they run into a lot of anxiety that I even happened this morning in a session, the person said, my life is going amazingly well, and yet. And I said, and yet what? And they said, I’m waiting for the other shoe to drop. And we talked about how much that anxiety, that it’s all going to fall apart, that she’s not really allowed to have such freedom from anxiety and pain and suffering, including even in herself to herself. She’s like, I’m really quite confident. I’m doing this well. My life is going well. And usually her sense of herself was being, you know, not good enough, not as brilliant. And we could really, and she’s done a lot of amazing work to get herself to this place. But you could see she was pushing back to it’s all going to fall apart. I’m not allowed to much goodness. So that’s one thing about I

Dr. Sandy Newes 33:11

see that a lot, like the fear of, of like, there is a mower out there. So, listener, sorry, yeah, suddenly I’m having this moment where the mower is getting closer and closer. I’m like, closer, and what can we do? But I think that the piece about actually helping people feel safe, feeling at least okay, if not well, is a really big part of this work.

Gita Vaid, MD 33:32

I agree. I think safety is critical. Ketamine and psychedelics oftentimes take someone to the place of safety sometimes, for the first time, yeah, almost just learning and discovering. What is it like to be to be me, or what is it like to be yourself when you’re not when you’re not in survival

Dr. Sandy Newes 33:54

and although that’s a nice that’s a nice phrase, what is it like to be you when you’re not in survival mode?

Gita Vaid, MD 33:59

And for a lot of people, it’s a discovery. Yeah,

Dr. Sandy Newes 34:02

I love that. So, so I want to switch gears a little bit and just, you know, you’re involved in training. I’m involved in training. Like, there’s more and more training programs popping up, and tell me your thoughts on, how do we train people well, like, what do people need to know, and what are the kind of, what’s the mark of a good training program? And those of us who are in it, like, what do we need to be focused on? And if somebody’s looking for good training, like, what, what should they be looking for?

Gita Vaid, MD 34:32

No, I think that’s a really challenging question. I can it’s a huge question. I don’t think it’s interesting. And I like your I like this interview in the podcast focus, because you’re already focusing on process, and I that you understand the process in some ways from my way of thinking. You know, I was a psychiatrist, and I did a lot of training, then became a psychoanalyst. And actually I think it was. Really from my own self work of understanding the process of psychoanalysis. Certainly, I learned a lot from having many patients in psychoanalysis with me and going to supervision and reading the papers. But the critical piece for me was not only the didactics or the supervision, it was really understanding through experience. And that’s what you have to do. You become a psychoanalyst. You have to be in your own analysis, which, for me, went on way too long. It is

Dr. Sandy Newes 35:26

a long time

Gita Vaid, MD 35:28

is it really helped me understand the process. What is early stage psychoanalysis, mid stage all of that. And I think that you don’t have to be a psychoanalyst and go through that to be a psychedelic psychotherapist, but I do think understanding the process, to me, nothing rivals it than understanding an unfolding process. And I’ve done so much training myself, being a psychopharmacologist, a psychiatrist, a psychoanalyst, and I can say, speaking for myself, nothing prepared me for the psychedelic psychotherapy process. I had to go through it myself to understand fully in a way that gave me a sense of how I can best support another person. So that’s one thing that it depends, I think, on how you’re working, but if you’re doing the kind of deep process work, I think that’s, that’s what’s been the most helpful for me. And how do we part what the process looks like? So people can understand it through didactics, through clinical experience, through discussions. But I think there’s nothing that parallels self work and self experience of one’s own unfolding,

Dr. Sandy Newes 36:30

one of the kind of, you know, I don’t know about the training. I mean, I know that ketamine Training Center does a lot of experientials, and we do, we actually do seven medicine sessions in our level, one clinical, intensive. And I’m just so is that sounds like that’s something you would share that people you know should really also be looking for a training program where they get enough experiential to really understand the rhythm of it.

Gita Vaid, MD 36:53

To my mind, if you’re doing this deeper work, I think that’s a critical piece. The other part is, I think that, you know, psychotherapy is such a rewarding field, even with or without medicines, because it’s one that we grow at and we get better at. And I know that most psychotherapists, my colleagues, myself included, I’m always looking for new things. I’m always trying to develop myself, and it’s so gratifying to get better. I mean, I’ve been doing this for 35 years, and I’m so much better than I was five years ago or 20 years ago, and hopefully that continues throughout one’s whole life. But I think self development is a really piece. How do we develop ourselves? And I think psychedelic psychotherapy is unique as it gets to these deeper places within ourselves and with other people. So how do we prepare ourselves to do that really, really depth for work with another person and become really scaled it, and I think it calls for really life, self development, and it actually is a labor of love, because it’s so gratifying to do this work and to be able to it’s almost like being in a archeological site to the person’s oldest experiences and memories and dream work all at once, except that you get to participate in it, but to really, it’s such a magical, very, very unique field, how does one prepare to do that work and really not miss the opportunity with a person, or, even worse, inadvertently not drop the ball, which can ordinarily be not such a big deal because you can repeat in the next session, but In this work, it’s quite unforgiving if you make a blunder, because the person can be very wounded because the field is so open. So I think it’s a really important piece. Is not only doing your own work, but also, how do we develop ourselves, right? I love that.

Dr. Sandy Newes 38:33

Yeah. I mean, that’s the, you know, this is a this, this work can turn you inside out, for the better, for the worse, but knowing that that’s a part of the process. And, you know, I think it’s so important, like, we’re all in this together, you know, like, this is a new thing. So, yeah, so I know that you’re also known as an innovator. And so just anything else that you’d like to say about that innovation in the field, what the potential is, and and then just anything else you’d like to share just in our last couple of minutes here, I’m

Gita Vaid, MD 39:03

really interested in psychotherapy, innovation. I just did an innovation project, which hopefully I’ll be sharing at some conferences, looking at music. And what we did is we had four different skilled facilitators really displaying how they use their own models of the mind and psychotherapy models, and then weave that into music, interesting. So I had, we had Dr. Joe to four, who’s an amazing clinician, and he’s also an Iowa scare, but we can mean and he used his Ikaros, which is really very unique way of healing using sound, and it’s very energetic to access trauma in the body. We had no main ntumai, who’s an amazing facilitator, who used a model, reworking a feminist model of Stan Grof’s birth trauma, where she really invited people to birth themselves through the. Incredible music that really allowed you to journey through the birth passage in your musical experience and to rebirth yourself. So it was wow on breath work, as well as a feminist reworking of Stan Grof’s birth matrices. And then I had Barry Walker, who is an amazing clinician looking at character defenses and using music as an entree into exploring the layers of yourself. And the final one was east forest, who is a who’s an incredible musician, who a lot of facilitators are very familiar with his work, and he has a whole way of thinking about music as facilitator, and has a lot of music that is available and readily available for free on various platforms. And his thinking about how he uses music for people who, you know, don’t have access to treatment, and a lot of people are going to be doing their own work because they can’t afford to go to a doctor’s or a therapist’s office, and how people who are going to be using this, these tools by themselves, how he he thinks of healing and music. So as you can tell from this, I’m a big fan of us having theoretic, new theoretical platforms and a bit more rigorous, not to squash the field, but to actually start building a whole new discipline, which is based because what I’m a little bit dismayed at is a lot of the studies are trying to fall back on evidence based psychotherapies, which which really have, in a way, it’s staying with the old paradigm of healing and not moving forward with what’s possible.

Dr. Sandy Newes 41:35

I mean, I share that I understand from a research methodology perspective, that we need to only change X amount of variables, and yet, it is time for a new paradigm. It is time to do something different. It is time to look at new ways. And this is an entry way to do that. So I love that you said that. So anything else that you want to share with the with the listeners or the audience, or just kind of any other thoughts that you have, um, I guess, for people

Gita Vaid, MD 42:01

who are not so acquainted with this work, what I would say, you know, people oftentimes ask me to describe it, and I can talk endlessly. And oftentimes I’ll ask people, did my explaining it help you understand and prepare you? And they say, not at all. But I would say,

Dr. Sandy Newes 42:17

I personally think you’re quite articulous the therapists

Gita Vaid, MD 42:19

or even patients who are interested in this. The thing that I’ve come to, that I think is really tapped into in this work, is the is the genius and creativity and power of dream work and dreams, dreams are just so magical, and every element is so saturated with significance and meaning and associations. And the dreamer, of course, is ourselves. And I think really that imagination and that creativity is really the piece that blows me away in this work, that the person’s ingenuity in being able to craft together repair and healing is is just phenomenal, and there’s countless examples of it. But I would say, in some ways, we all have access to that, because we’ve all dreamt our dreams, and I think it’s really that’s the I think the piece that this work captures and touches into I

Dr. Sandy Newes 43:11

love that so well. Thank you so much. I appreciate you sharing your wisdom and your clinical expertise and your thoughts and your passion. So I know that you are all in to this work as I am, and many of us are. And so I know that the field has benefited. I personally have benefited. I hope that the listeners benefit. And I just really appreciate all that you know, the way you show up in the world, and all of your knowledge and wisdom. So thank you so so much.

Gita Vaid, MD 43:40

Thank you so much, Sandy, it’s been a pleasure to be in conversation with you. Thank you for having

Dr. Sandy Newes 43:44

me. Let me ask you one more thing, is there a way people can find you? Do you have any upcoming events, any upcoming talks, like, how do people how do people find you and get more opportunities to learn from you?

Gita Vaid, MD 43:56

Thank you. I’ve actually been taking a little bit of a break from teaching. I happy. I will be talking. Hopefully. I’m I’m going to be applying to a few conferences to present this work on the music project, mostly in clinical practice, but I can be my information. There’ll be more information at the website, Center for Natural Intelligence.

Dr. Sandy Newes 44:14

great. All right. Well, thank you so much. Thank you so much.

Outro 44:20

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