Psychedelics, Psychotherapy, and the Power of Kindness With Dr. Phil Wolfson

As psychedelic-assisted therapies become more mainstream, ketamine treatments are increasingly medicalized, often lacking the integration, connection, and context that can unlock their true healing potential. How can clinicians ensure these therapies are transformative rather than transactional?

Psychedelic psychotherapist Dr. Phil Wolfson advises against separating ketamine from psychotherapy. Instead, he advocates for an integrative, human-centered approach that includes preparatory work, therapist presence, and post-session integration. When determining patient dosage, clinicians should focus on assessing the individual rather than adhering to rigid protocols. Dr. Wolfson also urges clinicians to cultivate compassion, deepen their therapeutic relationships, and consider the spiritual and emotional dimensions of healing, especially when working with trauma and grief. 

In this episode of Living Medicine, Dr. Sandy Newes talks with Dr. Phil Wolfson, the Founder and CEO of the Ketamine Research Foundation, about the art and ethics of ketamine-assisted psychotherapy. Dr. Wolfson shares how his son’s illness led him to pursue psychedelic-assisted psychotherapy, consciousness and death in psychedelic experiences, and the contrast between IV clinics and integrative therapy models.

[1.] Prioritize integration after ketamine sessions: Processing the psychedelic experience with a therapist enhances emotional insight and supports long-term therapeutic gains. Without integration, valuable revelations may be lost or misinterpreted.

[2.] Build strong therapeutic trust: Establishing trust allows clients to feel safe enough to explore deep emotional wounds and vulnerabilities. Healing often begins when clients believe their consciousness is being respected and protected.

[3.] Avoid one-size-fits-all dosing approaches: Sensitivity to ketamine varies widely, and tailoring doses ensures safety and maximizes therapeutic potential. A flexible strategy improves patient outcomes and avoids unnecessary side effects.

[4.] Educate clients on the neuroscience of trauma: Teaching models like Dan Siegel’s “hand model of the brain” empowers clients to understand their stress responses. This knowledge helps them engage more confidently in the therapeutic process.

[5.] Emphasize kindness in clinical practice: Compassion is a powerful catalyst for healing and connection, especially in psychedelic-assisted psychotherapy. A nurturing presence helps clients feel seen, safe, and open to transformation.

This episode is brought to you by the Living Medicine Institute.

LMI is a training, resource, and membership program educating providers about the legal and safe use of psychedelic-assisted psychotherapy.

To learn more or participate, visit https://livingmedicineinstitute.com.

Intro 0:03

Welcome to the Living Medicine podcast, where we talk about ethical medical use of psychedelic psychotherapy, teaching skills, examining the issues and interviewing interesting people. Now let’s start today’s show.

Dr. Sandy Newes 0:18

Hi everyone. This is Sandy Newes of the Living Medicine Institute, and we provide content and resources and training for clinical and medical providers who are interested in either launching a career in Academy and assisted psychotherapy or deepening their existing skills. And we also have a broad interest in psychedelic medicine in general, and psychedelic assisted psychotherapy. And I am thrilled to be with Dr. Phil Wolfson, who is really very clearly one of, if not the kind of identified elder and wisdom keeper in the field. And Dr. Wolfson, actually, I forgot to get your written bio, so I’m just going to wing it so you can fill in if I miss anything. Dr. Wolfson runs a long standing clinic in the North Bay Area where he treats a variety of different clients. He has a group, group practice, and I believe that you offer both ketamine treatment and cap. Is that correct?

Dr. Phil Wolfson 1:15

I don’t differentiate between the two. Okay?

Dr. Sandy Newes 1:18

And also, he wrote, kind of the founding book called The Ketamine Papers, which everybody has on their library, which really, in my opinion, really launched the field into being a field. And he’s also really invested in research, and so runs Ketamine Research Associates. Is that the right way to say it? Normally, I have all this written out

Dr. Phil Wolfson 1:40

organization is the Ketamine Research Foundation, right? We have two groups, Academy, Training Center and the ongoing ketamine psychotherapy associates, of which you have been delightedly a part

Dr. Sandy Newes 1:54

of, right? Yes, and I have had the privilege of being a part of the ketamine psychotherapy associates, which I love and think everybody should be aware of. And it was also able to be with you at Dharma K, which was a kind of retreat style gathering at menla that you all are doing annually. And I’m also aware of the fact that you to also do training so so we are, you know, delighted to have the opportunity to talk with you and to talk about all of those things. So thank you so much. So

Dr. Phil Wolfson 2:27

call me Phil, please. Okay,

Dr. Sandy Newes 2:28

I’ll be happy to All right, well, Phil, so being kind of you know one of the elders, and I mean that as you know the the holders of the wisdom, not just age, but you have certainly ridden this wave, right? Ridden the wave of, you know, psychedelic movement as it came into its inception and where it is now. And so what I thought I’d love to just start with is kind of that like your history in the field. And then let’s move into some of the things about ketamine and cap in general. And you know what makes a good cap therapist? And you know, kind of some of the differences in routes of administration. So how did you get to be here, like, how did, how did you land in this place where you’re so clearly mission driven in this work?

Dr. Phil Wolfson 3:16

Well, you’ve been very complimentary. It’s delightful to be with you and whoever is on your show, and I’m pleased to be here with them, really, as Sandy I am, I wear the cloak of being a psychotherapist, and that’s always been my delight. And so when I was in college at Brandeis, and I had the good fortune of having access to psychotherapy going through my own identity crisis at 17, we skipped a year in New York City, and we were very young coming into college, and it was 1960 and things were just emerging, right? I had the opportunity for 30 sessions for free of psychopathy, and given the severity of my identity crisis and my suicidality and stuff that went along with leaving a very Imperial home with all of its difficulties, abuse, et cetera. Psychotherapy really provoked a sense of a method that enabled me to find myself bit by bit. It went on for a long time after that, but it opened the door to resolution of some of the ways in which I was split and having the difficulty of finding my own path. I I was very interested in history for many different reasons. I decided I was going to go to med school and the psychotherapist. Psychologist at Brandeis, all were complaining that they couldn’t prescribe though they were at the forefront Maslow was my teachers, yeah. They were at the forefront of of progressive psychotherapy. Yeah. Med School. I decided I want to be Che Guevara for a while, and did all kinds of radical stuff, and organized the first health brigade to Cuba in 1968 and did community service in New York against the two standard of class care and racist care and misogynist care that was represented by being in Bellevue Hospital and then alongside University Hospital, and the contrast was horrendous, and the treatment of people who were not able to afford private care was horrendous. So I became very involved in all of the social justice aspects medical Committee for Human Rights the street 60s and in 64 when I started medical school, I and eight other men, young men, all dropped acid in New York City on the roof top of our dormitory, thinking we could fly. No one tried it.

Dr. Sandy Newes 6:25

Nobody can fly. We just need to be really clear, people, humans cannot fly.

Dr. Phil Wolfson 6:34

That was a pretty radical thing to do, and and I don’t know that LSD fully changed me, but it opened certain doors of conception, and what really helped was marijuana, which came in the same year and freed me a bunch of my self consciousness. So while it was really focused on radical ways of developing family therapy, systems therapy as I graduated from med school, and in fact, did therapy while I was in med school. I was devoted to med school into being a doctor, and psychedelics played a small but significant part of that, but it was really the halcyon days of family therapy. Lange and ethos and I ran a small inpatient hospital, an alternative hospital, when I came to California in 77 which was a process. Hospital was called I Ward was funded by the county, and we had a kind of collective of anti racist, very mixed, wonderful people. And the unit tried to show that we could treat first break people, schizophrenia or whatever, without use of significant medicine in a family centered community environment, who were partly successful as a bed hospital in the county system, who was difficult and out of that by 1983 I was looking for some other solutions, and I met Alexander Schulger. Sasha was really the father, the reintroducer of MDMA, and probably the most brilliant creator of psychoactive substances, phenethylamines and tryptamines. And we became very, very close and very close friends and collaborators, etc. And that brought together a lot of the people that you know. So if I’m an elder by age, which I am, plus in part, some of the other elders in Asia, those who are still around, many have passed on, formed an organization called the Rupa, the Association for the responsible use of psychedelic agents that met at Esalen under the umbrella of Dick Price, who was co owner of ES, unfortunately died in an accident up the mountain. We lost that support at us, but for a significant period of time, we were able to go to ES for weeks, out of time, at a time, wow, out of what got, what’s still out there generated then a lot of what we learned, for instance, about MDMA generally, during the legal period. And that

Dr. Sandy Newes 9:50

is so interesting. So let’s So tell me more about that, because I had the privilege of hanging out with Sasha a bit, Sasha and Anne here and there, and the various. Brilliant people who circled them. And I can only imagine that being at Esalen during the time of legality, with what sounds like, was essentially a think tank like our people coming together to explore ideas that must have been really rich.

Dr. Phil Wolfson 10:19

Well, it was an experiential thing. So like Claudio, there are no goblin was part of it. GEORGE Greer, who went on to after Dave Nichols, the secret chief. A lot of people, a lot more people, were really invested. And can will, Ken Block, who did anything to omega around near death experience. It was a very rich experience, and we did a lot of therapy. Of the myths that people are living with now, for example, about psychedelics and MDMA in particular, are just that they’re not based on anything but the illegalization that occurred in 1986 and that led to the truncated, constricted way in which we finally have moved towards prescriptive legalization. But that has all kinds of myths. So a myth, for example, is that you can’t use MDMA more than two or three months apart. No. MDMA is very successfully used a week apart, for example, with integration in between four couples therapy. A lot of what we did was relational, relational issues. We treat depression, PTSD, OCD, families. I wrote a paper on treating families in 1986 It was published. So I know a lot of the methodology, which was revolutionary in its nature, based further on the LSD work, but MDMA as a, really a perfect psychotherapeutic agent, I would argue, along with ketamine in its various ways, especially the low dose, as a perfect psychotherapeutic agent, the revolution was you had to be more alive with your patients. You had more expressive and exposed. You had to spend much more time. And while methodological frameworks were important, what was most important was kind of the integration of the experience that being still probably the most important aspect of a post psychedelic session experience leading to psychotherapy output. And we do, yeah, so

Dr. Sandy Newes 12:57

if you want to finish that thought, go for it. But I want to, I just want to in I want to send just see, like, I’m just sitting here being like, oh my gosh, what a profound personal and professional experience. And I’m just super curious, like, how that influenced like you as a human and how you went on in your professional career. Like to have the opportunity to deep dive like that. Not a lot of us get that like intense

Dr. Phil Wolfson 13:24

I had an intervening, awful difficulty that came at the same time and that my eldest son, Noah, at 12 and three quarters, got a L L cubed for blastic leukemia. Life was threatened and eventually died four years later. So same period where I’m doing all this and my both my kids went to excellent for periods of time. Noah was terribly stricken, and his wife hung on edge much of the time, and eventually it ended so that MDMA was also an important personal part. I wrote a book about it, and we did MDMA sessions. My wife and I, it’s awareness. I wrote a paper for maps in those days on blocking the name, but about being open as parents and not hypocrites, in terms of how we deal with our use, not exposing children to use like an LSD experience, but to use like an MDMA experience. We had family time. They didn’t involve themselves, but there was a centeredness and a cohesion with it that was, you know, part and parcel of what I was doing with other people. So it set me, it set me really into the whole thing about both grief and love and many experience. Answers after that around grief and helping people who losing people or potentially losing people, which I still do, as well as the methodologies of using psychedelics. But of course, it went underground and we lost it for no good reason, for terrible reasons, actually, and we’re only in a very convoluted way, getting back to it. So we talk in this talk, it’s always worthwhile to talk about the defamations of illegalization, which, which is what dominates our lives and and makes our attitudes and views kind of off in some ways, from what they should be. Illegalization makes us think that, for instance, MDMA is only good for PTSD or ketamine is which providers only good for TRD. But psychedelic medicines are about consciousness, and consciousness is enhancing when they work well, and their mind expansion. And they’re about freedom from from uh, obsession and rumination when they’re about freedom to expose oneself to new feelings, ideas and internal recognition of imbalance and to accentuate what we have in us as a guide. So the role of the therapist can be very constricted. Oh, I’m doing CBT, and I’m really locked into that, but in the world of psychedelics, the opportunity is for those things I’ve mentioned, and that’s the excitement of being a psychedelic therapist. Miracles do occur very frequently. They’re not always easy. Some are hard one, but they do occur, and they occur much more rapidly, on average, than conventional therapy. And the life of a therapist doing psychedelic medicine, I think, is much more enhanced, much more exciting and and I think, you know, people like myself are still doing it. I mean, I love still doing it right? 

Dr. Sandy Newes 17:26

I think that is such an interesting thing that you just and we could spend hours on this. So let just, but I just spoke to Dr. Keith heiserling from the trip center. He’s at the Pacific Neuroscience Institute. He’s a psychic researcher. And I spoke to Dr. Ron Siegel, who I know is a friend and collaborator of yours, and we were talking about the same thing that is about this, you know, the relationship between like healing as defined by the scientific methodology, which is largely symptom reduction. And I was trained as a psychotherapy outcome researcher. So, you know, we you have to use symptom reduction kind of as the guide. But you know, within that, you can build in all of these other constructs, but there has to be some objective measurement, which I think is a piece of what you’re talking about, that we then lose. Things can get too mechanistic, but psychedelics have opened up.

Dr. Phil Wolfson 18:17

Why does there have to be objective scientific measurement. Well, in

Dr. Sandy Newes 18:22

order to get something facilitated and re legalized, right? You know,

Dr. Phil Wolfson 18:28

most of it, see, this is the construct I’m talking about. In fact, there are maybe 50 million people, 3 million new users of MDMA. We know from emergency room visits that, you know, it’s very infrequent that people come in panic attacks. They don’t come with safety issues. Why do we always have to show safety issues for 100 people or 300 people, when we have 50 million people who have been safe on multiple users? So the evaluation is unfair. If you did the same evaluation in a legal period without all that scientific mumble jumble, and you extracted what was science, that would be interesting. But most of the issues are covered without the academic you know, stamp of approval. They’re covered, because people are successfully and safely using these medicines. So just, I’m just, you know, hammering at you a little bit around that kind of concept, because while it serves academic medicine and publications, it doesn’t really serve legalization or consciousness raising or the ability of people to obtain these substances.

Dr. Sandy Newes 19:52

Well, I’m with you on that. I’m just, you know, I’m kind of just pretty intrigued at this line, and you know how we do good science. Some good research. Yeah, I did wilderness therapy research for a chunk of time, and there’s very a lot of parallels, but, but the piece I want to kind of zero into here is that the role of, you know, consciousness expansion, the role of shifting consciousness, and then how that relates, you know, like, like, what are your thoughts about that? Like, we all kind of talk about it, but, you know, how can we as clinicians and medical providers, really, you know, do a better job of facilitating that while also kind of holding on to some of the mechanistic pieces that are mandated to us and do good work, right? I mean, how do we do the best healing work that we possibly can or if we go beyond healing, how do we shift consciousness? How do we do

Dr. Phil Wolfson 20:46

remember, we’re really constricted because we only have ketamine as Legal Medicine, okay, right? Yeah, if we take ketamine and the way it’s being applied administered, there are a lot of people who are not interested in going deep into themselves, who just want to seek from cultural, personal and other reasons. You know, a drug experience, like an Academy experience in an IV center, it’s pretty hard for someone to get away with that in an MDMA experience, you can do it. There are a lot of people drop acid, who drop this thing, of that thing, and who really don’t take time to process, or don’t have the opportunity to process with people where they can explain and experience their what happened to them, and have a notion of someone interested in sharing, etc, right? Feel that that integration aspect, the sharing aspect, for most people, is a very important part of healing. And when you look at the statistics for IV ketamine, for example. And you look at McKinney says meta analysis, 29.7% of people in a significant course of IV ketamine have remission. That’s well within placebo. If you look at the approval that bravado just got now for extension into major depression from not only Dr. d, their experience was under 30% with a 7% placebo response. So look at unsupported psychotherapy, non psychotherapy, treatment with substances that are mind expanding, but used in a drug setting, we see very little. Let me put it differently. We see a poor correspondence between outcome and and the drug experience itself, right? And the nature of the drug experience is not just drug so that’s another mythology the nature of the drug experience. Yes, we think ketamine, for example, MDMA for example, are medicines that have experiences on mind. We know that they mess up neural networks. They do all kinds of weird things. They suppress the one network and expand another. They’re all over the map. That’s why they’re different. At the same time, the besides the actual neuro chemical scramble, I call it a scramble of mind and brain. It’s a very various scrambles that occur. If we look at that, we can also see the properties. There’s a psychological properties Academy. There’s a time out. If you don’t get some reduction of who you are, your ego, you don’t get a ketamine antidepressant effect. The psychedelic effect of ketamine is totally linked, and maybe even on the same receptor site is evidence for that, so that there’s a a balance between what may be a drug effect, and what is an actual emotional psychological effect from who you are for a little while, it’s like an ECT, a shock therapy with consciousness. And the reason that shock therapy was explored sleep therapies with and barbiturate sports. Sport was to take people and give them relief from who they were for some time and scramble their brain up with shock. Does including your memory, right, bring you back? So maybe you won’t start at the same place in. Them, yeah, and so with ketamine, that is the essence of what happens. Even in IV settings. You’re you may have psychedelic experiences, most people do, but they’re unprocessed. In most IV settings, you can process them, but anesthesiologists, who run much of it, much of them, don’t do it. So you have this time out, and you have a bit of relief from who you are, from all that nutty concentration, rumination. I need this. I need that. I ate this one. I love that one. Why don’t they love me? All that stuff takes a little break and then come back. And people were very rigid and tight. Will come back often at the same place, but most people come back somewhat different, renewed. There’s a bit of okay, I’m different with MDMA. The process is different. That’s a ketamine process interesting made. The process is watching self and allowing new material to surface more easily. That’s repressed. So MDMA is a wonderful agent for evoking trauma repressed material ketamine does some of that, if you prepare and you work within a low dose, well, did you go from,

Dr. Sandy Newes 26:29

I mean, did you so you know, you’ve done a deep dive into ketamine, and have been in it for a long time, like seemingly as long as almost anyone. And is that because of legality? Or did you think that CLIN that? Or did it kind of capture your attention in other ways? Well,

Dr. Phil Wolfson 26:47

I mean, I first had my ketamine experience in 1990 it was probably even given my history, one of the most powerful things I ever did. People administered it. Didn’t know what they were doing. I was sick for three days, you know, nausea and vomiting, but I had a profound experience like this is great. Do it again? I’m a Buddhist guy, yeah, always looking at non attachment and what I felt in it, and still see, I can still see the experience was my leaving this body and becoming an energy format and the way in which that visually was expressed, because ketamine at high dosages is a visual experience, internal visual experience, not related to external senses, and there’s died, there’s a commentator watching, and you watch the whole thing. If you don’t, if you’re not able to watch it, you’re anesthetized. You’ve gone too far, taken to medicine, but if you watch it, there’s all this stuff. So I thought I had already had encounters with death, lost a child, and I and so many others, parents, etc, and patients. So I felt, well, I had the experience that seemed like death. I think anesthesia is much more a model for death, but I had that experience. I didn’t need to have more. And I think that’s important for people to understand. You don’t have to do it again and again and again. You have to experience and value what you did. Okay, along comes a group of my colleagues, friends. We form a group, and we’ve been together for 25 years, men’s group, and they weren’t ketamine again some 10 years later, amongst others, and it seemed to me to be a profoundly interesting, a profoundly changeful experience, particularly in a good setting. All psychedelics require a good setting where you’re going to have paranoia and get in trouble. I felt that it had clinical merit and began using it slowly in 2013 and then in 2015 we saw we started our clinic the same time Raquel Bennett came up with the first three year conference. And that was interesting, because at that point I was saying publicly that you needed to have a full psychedelic experience for the antidepressant effect. That was really wrong. I once retracted it, and at that conference, kind of a changing event. Was a man who came on zoom from Tasmania, Stephen Hyde, who just self published the second book on ketamine, called ketamine. A depression, and had had the foresight wisdom to use ketamine orally, which is what he could do in Australia. And he said very definitively, there’s no reason to go through the medicalization of putting people with IVs and monitoring them and doing all that stuff. It’s totally safe at will dose. It’s safe. It has an anesthetic, and let’s do it in the office. And he was very explicit in saying, this is an office based practice accompanied by psychotherapy. Was really convincing. We brought him to the states. He’s a wonderful elder that really shifted the practice into two camps, the anesthesiology and academic psychiatry IV camp, who was still in the war on drugs, afraid of psychedelic experience, which they couldn’t control anyway, kept the dosage low. It’s since expanded in amount to be more effective, and the camp of us that saw it as a psychotherapeutic tool, which we’ve been developing, developing, developing over time, with many, many methodologies, nothing that’s totally specific. No one methodology fits everyone, whether it’s internal family systems or self work or psychodynamic The best thing is to be a people worker and know your person and try and try and work with where they’re at and find the good qualities in them that you love and respect. I love

Dr. Sandy Newes 31:38

that. So back to those humanistic roots,

Dr. Phil Wolfson 31:43

yeah, yeah. Why did they weave?

Dr. Sandy Newes 31:45

Well, I’m not saying they left, I’m just saying, like, you know, it’s clear that that’s really foundational in the way that you think about psychotherapy.

Dr. Phil Wolfson 31:52

I think it’s foundational way we think about humans, right, right?

Dr. Sandy Newes 31:56

Agreed. I agree with you. It’s just, it’s sometimes,

Dr. Phil Wolfson 32:01

if we’re not for kindness in this world, what do we have? War, degradation, monsters running countries, nuclear war. What do we got? Let’s be clear, if we don’t foment kindness in our own exploration, in our being in the world as therapists or people, what do we got? Well, it’s

Dr. Sandy Newes 32:22

interesting because in our training program, I actually tell people I did one of the best one of my favorite parts of being a cap clinician, it is I get to just be really sweet to people like it allows me to be just really nurturing and kind and really sweet, like, I’m right in there, in their bubble with them being, like, super nice, you know, and intentional, but I’m like, holding them in this, this bubble of just like I got you in a sweet, loving kind way. And it’s really that’s really transformative for me on a very human level.

Dr. Phil Wolfson 33:02

But I’m sure Sandy within that sweetness that you, you know, slather people with that there’s also an intensity of concentration around, Oh, for sure, issues are and that’s an envelope within which you work, the most successful envelope in psychotherapy by all measures that you know, kindness, sweetness, acceptance and and thoughtfulness towards the human beings we sit with or are within Our treatment is the most successful measure of of outcome, most successful input

Dr. Sandy Newes 33:45

well. And then if you can also be a really good therapist, good clinician with, you know, good assessment skills, and, you know, good understanding of theory, so that you have a sense about where things might emerge next and how to intentionally use the relationship and some good interventions, then all the better. But I think, you know, like the package is really where it’s at, and that’s what appeals to me, on just a human level, is that it allows more of just the kindness and nurturance to just emerge. So I’m curious. I’m

Dr. Phil Wolfson 34:18

saying how interesting it is to be a therapist, and what an amazing learning curve there is to learning about yourself and learning about human beings and social aspects. I mean, it’s, it’s, you know, it’s a scholarship to self awareness. Mm, ever been? There’s never been a profession like our profession. Historically, rabbis, priests sort of come close, but not really.

Dr. Sandy Newes 34:46

I love can I write that down? There’s a scholarship to self awareness. That’s awesome. I love that. I love that. So couple things I want to ask you specifically about cap. One is. Is, and we can kind of go in whichever direction. You keep saying, like low dose versus high dose. And I’m curious. First of all, just ask you that what when you say low dose, what’s the range, and when you say high dose, what’s the range are you? Are you referring to? Because I think people mean different things.

Dr. Phil Wolfson 35:17

I don’t know if you want specific numbers or not.

Dr. Sandy Newes 35:19

I do actually, because, I mean, people are curious about that. Finish the

Dr. Phil Wolfson 35:23

guidelines that we’re going to circulate. Two guidelines. One is for people who are using and getting in trouble and who are contemplating using. It’s very detailed. And yeah, second guidelines for what I view as the standard of care for clinical practice and played out, we’re going to have an online, awesome of large it’s a big pamphlet, good, thorough. I don’t know if I want to put it as numbers, because the hazard of numbers is that it doesn’t speak to your My sensitivity we, you know, classically, we do ketamine, for example, and some other substances as milligrams per kilogram, yeah, you know that was low ball in the initial ketamine IV world, because they were so scared of people having dissociative psychedelic experiences. But it’s really not about milligrams per kilogram. You’re smaller than I am, and you might need more to have an effect. I’m pretty sensitive. And we very small people who need a lot, and very large people who need much less. So the issue with any psychedelic is what it does to your consciousness, what it does in terms of nausea or side effects, but mostly how you receive it and where the sweet spots are. For benefit with ketamine, the sweet spots are all over the map because the dosage is so flexible and you are very low. So some people are using ketamine a very small number of milligrams. We’re going to use it basically as an intramuscular reference. So if you use the intramuscular reference, some people warming people up for conventional therapy with, you know, four to six milligrams, things that hard we feel. There is no micro dosing. So please, if we have anyone listening, don’t bother with micro dose Academy. So that’s not a thing. So then you have what I call psycho revelatory or psycho revelation experience, which I put at 10 to 25 milligrams, where you can do it in wonderfully, in groups where there’s a short period of being under a significant influence, depending on sensitivity, and you can do actual therapy, much like DMA, in which there’s an ability to interact and a softening, which continues after the major metabolism of the doses on and then you go further up, some people are very sensitive and can’t do much more than 35 or 50 milligrams. I just did a group, small group in Malta, of neophytes on the island. And you know, there were, there were people there who had, you know, really sensitive, and then one who went too far, and she came back and did a lower dose again and rectified her difficulty, and was joyous. So, you know, it’s an art for one, and you know what you’re really looking at is the degree in which you’re leaving the room, or you’re dissolving your ego, and you get into a meditative space. So a completely meditative space is when your external sensory inputs are turned off, and what’s going on is your internal visual, mostly visual, somewhat you can you have to do music, but it’s not always appreciated. Where you’ve cut off the outside and you trip it. You’re on a journey. And ketamine journeys are among the most complete in terms of leaving any sort of relationship to this external world, okay, for a short period of time, right? 25 minutes for the major part, 45 to an hour for them coming down and back. So what is the value of that? Many values, one that really takes you out of yourself and leads you, as you integrate, to an understanding of balance. It has very little reference to. Directly to your life, but it can be as you integrate when you come back, of great importance to who you are. If you’re a depressed person and you go through this ketamine reliably has a an impact on emotion that’s neutral to very positive. So we often say to people who come back, who are howlingly Miserable, coming into Academy experience, then they come back, smiling often and joyful, who say to people, don’t think of yourself categorically as a depressed person. You just saw your work. So open that door to not putting you into a box. Well, that’s one of the things that I see a lot. Like,

Dr. Sandy Newes 40:49

people have a felt sense of themselves as different, yeah, like, actually have, like, a lived experience of experiencing themselves, experiencing me in relationship, seeing their lives differently, and people get into this like aha moment, like as if they’re supposed to be just some insight, when really, I think it’s about the felt sense and the like lived experience of having something different actually occur.

Dr. Phil Wolfson 41:12

Well, Said, I agree, like you go on, so there more aspects to it. So the good quality of even before you take that great leap in terms of dosage and experience is really the sense of relaxation, yeah, letting go of obsessional, ruminative, you know, concentration fears. Obsession with fears, where we are always generating obsessions and judgments and they’re in the background, prejudices, attitudes. People carry trauma, see the world through the lenses of their trauma. To various degrees, we created a an acute PTSD trauma program with ketamine for people in war zones, which has been a little bit applied because just the relief from the awfulness to come back to where your executive functions can override a little bit your reactive amygdala, your reactivity functions, is an imperative for people.

Dr. Sandy Newes 42:27

I teach that to every one of my clients, just about kind of hand model the brain, you know, like blanking on Dan Siegel’s model and, you know, teach, teaching people about that I find super useful. And I’ll just put in a plug, like, post disaster. I did that low dose ketamine that you’re talking about, that acute stress protocol, and it was awesome. It just it did exactly that, like suddenly things seemed like, even though it was really hard, we were making it. So I appreciate that.

Dr. Phil Wolfson 42:57

Thank you so much. And that endorsement is important, because we’re not making people go very far into psychedelics. What we’re doing is creating the potential for a bit of relaxation and passiveness with coping functions which are present but overridden by the drama, by the horror show, that those come back a bit, somewhat back, a bit, right?

Dr. Sandy Newes 43:24

Well, and I know we could go on about that, but I mean, personally, I think that is one of the critical mechanisms, and I find it to be even more effective if I’ve educated the client about it beforehand, that we’re looking for that shift in state, right? That like, shift in kind of an awareness that we’re out of the room in a state. Our body is calmer, we see our environment as different, as less threatening, and that helping kind of open the door to that, I think, is really where it’s at, or one of the big pieces. So I love that you said that. So I want to ask you about what do you think are really like best practices if somebody wants to be a good cap person, and again, differentiating ketamine treatment and ketamine assisted psychotherapy. But I also want to put it in there this piece about we started here, like before we started recording, I would do primarily IV, and I love it. And you do all I am, and you feel very strongly about this, so tell me why you hate IV.

Dr. Phil Wolfson 44:28

Let me correct you a bit. I don’t do I do a lot of lozenger work, the rapid dissolving tablets with our formulating pharmacies, which are all over the world. I often begin people with that as a dosage escalation. I use intra nasal but as I said about Steve, I’ve watched a lot of IV. I’ve experienced IV. It’s it’s not that ketamine can’t be experienced well. Of my intravenous. It’s the medicalization of it. I don’t like that at all. I know I watched, just recently, we were in Barcelona doing a training of Europeans and ketamine work, and I watched a whole series of IV sessions run by a psychiatrist, and he had four people in the room all sitting stiffly in a chair with no music and the drip going and they weren’t even communicating. They were just waiting for the experience to occur and get over. Ketamine deserves to be processed. It’s a very powerful experience, and people, as is the common practice, I’m sure not yours being just in a room, a nurse administering an IV, sitting there, lying there, no music, no aftermath. 50 minutes elapsed, or even 40 minutes the drip is over. You have a bit of recovery. You go home, yeah, okay, you may have some benefit, as I said, it’s about under 30% of remission, a little more for having a significant effect, but it’s a powerful psychedelic, and we’re creating a new world, Sandy, the new which we’ve been trying to create now for Many decades, which is not going too well.

Dr. Sandy Newes 46:21

It doesn’t seem to be currently, does it?

Dr. Phil Wolfson 46:26

It’s a world in which people are thoughtful about each other. It’s a world in which people are interested in who they are, how they think their prejudices, intolerances, tolerances, needs, aversions. It’s a world of inquiry and connection and of recognizing the interconnectedness of all of us, and that’s what I see as being the essential work that I want to promote, and that psychedelic medicine promotes, you wouldn’t the same thing about MDMA. You wouldn’t say, oh, let’s put MDMA people in a chair and drip in the MDMA. You would say that’s against the nature of the heartfulness and consciousness, arousal and trauma work that can be done with MDMA. I’m saying Keta means the same.

Dr. Sandy Newes 47:18

Okay, so, just so people know, like, because they, because, just to play, like, agreed, and like, you know, I, because I work in one, and I was trained in one, they can have an IV clinic, like, where you are we, you know, we have one person in a chair, and the therapist is with them. And the, you know, the prescriber, and the, you know, IV person comes in, like once to set it, and then, like, two times to check it, and I’m doing therapy the whole time. And personally, I think it’s great for because the state stays steady, but that’s really different than what you’re talking another

Dr. Phil Wolfson 47:50

myth. Okay, I’m going to argue with you. I agree on your basic supposition, but I can do the same thing with multiple injections, with intramuscular nature. I can start slow. I can add to it. I can do three of them. And then the myth in the IV thing, which I’m going to take you down the road, is that all IV practitioners have complete control of the medicine. That’s baloney. And IV takes 10 minutes before the effect occurs, because it has to drip in. Once the effect occurs and you’re really happy with the effect, you turn off the drift, the person still metabolizing the ketamine for another 10 minutes. The same thing is true with the im, and the advantage of the im is you’re not sitting there stiff with an IV that’s on there. It has to put up you, and you’re dripping in so, yes, you can make IV wonderfully useful to people, if you wish to do that. I’m glad you’re doing that, but I think, I don’t think you would be hurt by switching to im at all. Probably

Dr. Sandy Newes 48:59

not. I will say that my experience, my like, both lived experience and what I have witnessed and seen is that I am goes for the way most people administer it. And again, maybe you have a more sophisticated way of doing it, but it kind of comes on, like a ski jump, right? And then you’re like, you hit full strength, and then it goes down, and then you spend this part of the session, processing this part of the session, whereas with IV, it’s more like this. So that’s just, I’m open. I’m totally open to like, changing my mind. First

Dr. Phil Wolfson 49:30

of all, we have many, many strategies, lozenges, and we do have people go home with lozenges and the supervision, which really supports the work. So I don’t want to maroon myself and I am and the I process, yes, it comes on quick, but if you use a low dosage, it doesn’t matter. And you know, for the IV, you know it takes time to. Shut it off just the same way. Well,

Dr. Sandy Newes 50:02

it’s definitely more resource intensive, so therefore, inherently, often more expensive, like that. That’s a given, right?

Dr. Phil Wolfson 50:09

Actually, psychotherapy, as you know, is much more resource intensive than having a nurse drop an IV into someone, leave the room, and they get dripped, for sure. Thanks very that’s a gold mine for the people who do it that way. Four or six people in rooms, you got the drip, the docks, nowhere to be seen, and they and they’re getting the nurse there, and they leave in 50 minutes. Next batch people are making 10s of 1000s of dollars a day on that kind of stuff, and this bravado thing is taking all the same way people are making fortunes on doing bravado without really any processing. So drug, it’s not it’s not a medicine, it’s not a consciousness tool.

Dr. Sandy Newes 51:01

Yeah, now I’m with you on that. I mean, I share those concerns, just with the idea, with also just the little bit thing like and I think you can do effective cap at an IV clinic, as long as you’re attending to it. But I hear you that that is not usually the way that it’s done, and I share that view like

Dr. Phil Wolfson 51:17

that. I don’t want to attack you, lively, no, no, no,

Dr. Sandy Newes 51:21

no. This is just a conversation. I find it fascinating, like, I don’t feel attacked in the slightest. It’s just a different it’s a different trajectory. And I’m actually, you know,

Dr. Phil Wolfson 51:33

I’m the road. You’re sort of, you’re sort of the middle way, right? Because

Dr. Sandy Newes 51:38

what I do a lot of is the infusion series with cap. So I’ll actually do six sessions over three to four weeks while doing psychotherapy and preparation and integration. So it’s a really intensive model. So So we’re almost out of time. And so I want to just ask you, what do you think? What do people need to know? Like, what are the best practices for cap? And obviously, that’s, you know, that’s a four day training. I mean, I’m just talking about, like, what do you want people to know? Like, if you’re like, Okay, people you want to get into this field, or you’re doing this work, this is what you need to do to treat your patients well.

Dr. Phil Wolfson 52:14

There’s all the administration and technological issues of which are not very complicated of learning how to do ketamine itself, will need to have doctors or people who really know what they’re doing around ketamine to pass it off as an innocent procedure that has no medical consequences, utility or worthwhileness is a mistake, the more people can practice a full psychiatric approach to people knowing what meds are, medical interactions, you know, and the core issues, more importantly, that people bring in in which They’re suffering, which have all the social, personal, relational issues, knowing when to use ketamine as a medicine, knowing about its potential for diversion and its potential for cravings and dependence, which doesn’t occur in the clinical setting, but is occurring obscenely outside the clinical setting. Great, I see that most importantly, since I’m a psychotherapist, emphasizing that getting to know who you’re with, and then being able to relate to it, non judgmentally, ethically, without needs of your own, and being sympathetic to that, and helping the person warn themselves, know themselves, express themselves, are the major points of view. Whether you do that with somatics, which are wonderful in terms of expressive thing, action before and after. You do it with internal family systems, which a lot of people are learning. You do it with psychodynamic psychotherapy, Gestalt therapy. You know, I like to think I’m trying to learn it all. I never will, but I want to be as broadly thoughtful as to what may reach someone better than another, and what really reaches people is that you find with with someone you’re seeing something that you value, and when accentuate that value in them, you Open the door to them, building trust. So the issue of doing any of these kind of experiences, including conventional psychiatry psychotherapy, is the building of trust. And because people are coming to you and having a profound experience to whatever degree they. Are saying to you, I trust you with my consciousness, with my being, with my life, and you as a therapist, practitioner, want to deserve that trust. It’s not easily given. It’s often fraught with defensiveness and a process before someone yields to it. But the core trauma of human beings is the breakage of trust, loss, the grief overall of that and the ways in which we harbor distrust and see the world through lenses that we don’t always recognize as distrust. So what we’re trying to help people do in the best way we can is establish some sense of personal self trust, awareness of how one has been free and how one is responding to that, and being able to become more flexible and develop ways in which you can work with yourself to provide sharing, love connection and a deep experience of learning and appreciating yourself and others.

Dr. Sandy Newes 56:09

Really beautiful translation of some really complex concepts. I can appreciate your skills translator, being able to translate the complexities into just human terms. And I thank you for that well, and that, you know, so I think that’s a lovely place, just to kind of put a pause there. But is what else? What else do you want to share? Like, what do you want to share about yourself? Or what do you want to share with the audience, or the psychedelic world or the clinical world, like, what’s your message? What do you want to get out there?

Dr. Phil Wolfson 56:45

I have only one message. There is only one way forward, whether we call ourselves psychotherapists and we’re reactive to the traumas happening to people and we’re not prophylactic. We need to also be prophylactic against the causation of trauma, whether from misogyny, racism, you know, inequalities, lack of sharing, cruelty, greed, aversion, whatever it is, we need to develop our awareness and our ability to both exemplify and help ourselves and others to share, be kind, love and show concern for others, the only way forward we were living in An increasingly cruel time with true people running lives, and that’s abhorrent, and I don’t know how it’s going to work out, but I do know that the only antidote to that is not being that way, right? Yeah, yeah.

Dr. Sandy Newes 57:56

So let’s earn trust. Let’s not be cruel. Let’s be good humans.

Dr. Phil Wolfson 58:04

Yeah, I hope I quote you about the IV thing. Oh,

Dr. Sandy Newes 58:08

no, I didn’t feel that’s cruel at all. That’s a professional discussion, and it’s useful and interesting. And, you know, I find it quite fascinating, the whole thing. So, yeah, no, that would did not feel cruel in any way that felt like a professional discussion. So all right. Well, anything else you want to

Dr. Phil Wolfson 58:26

share? Yeah, great gratitude to you. Thank you for having me good well,

Dr. Sandy Newes 58:31

and let me also just give it you know, once again, for people who are interested, Phil and his team do training on ketamine through KTC, the Ketamine Training Center. You can also connect with him through Ketamine Psychotherapy Associates, which is an A group that meets every other week where we do some case consultation and discussion. And then there’s the research group, Ketamine Research Associates.

Dr. Phil Wolfson 58:57

The overall umbrella is Ketamine Research Foundation, and you can get to anything that we can, including our clinic, good,

Dr. Sandy Newes 59:06

good, so you can reach him there and the clinic. And I am just really grateful and appreciative, and thank you so much for sharing with us. So all right. Thank you, Phil, welcome,

Dr. Phil Wolfson 59:17

Thanks.

Outro 59:20

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