A Mindfulness Expert Talks Psychedelics: Dr. Ron Siegel

Dr. Ron Siegel 10:16

Yeah. So this one is perhaps the most basic because organisms as relatively simple as bacterium, bacteria do do this right? They will retreat from a toxin, and they’ll go for nutrients. And the way this shows up in humans is kind of two, two broad systems that are involved in this. One of them is indeed our fight or flight system, the way in which we, you know, totally recoil from danger and seek safety. And the other is our drive system, the way we seek food when we’re hungry, or we seek, you know, liquids when we’re thirsty, or we seek sexual contact when we have sexual arousal and or we seek to, you know, build a shelter when it starts to get cold out, so so that that one is very basic. And the interesting thing is, it makes total sense. Obviously, we want to flee predators in danger and and get the get our basic needs met, and it works pretty well in the physical realm, but in the emotional realm, it turns out to be a recipe for disaster. And I can perhaps give some examples of

Dr. Sandy Newes 11:31

that. Yeah, if you could, I’d love to hear that just how is it that the emotional realm becomes a recipe for disaster when really it’s a survival need that we’re trying to meet. Well,

Dr. Ron Siegel 11:42

let’s, let’s see. I’ll just ask among our viewers here, I won’t be able to see you, but raise your hand if you drink alcohol, at least occasionally. You know, in some settings, right? Many of us do that, right? And then it’s like, raise your hand if you do it exclusively for the taste. And then the hands go up from the people from Northern California and, you know, and Chile and Italy, but, but a lot of us who aren’t from one of those places say, well, exclusively for the taste, I’m not sure about that. And one of the images I like to think about is imagining our ancestor discovering that, oh yeah, by the bend of the river, there’s this really good fruit tree. And they go there, and they get some yummy fruit one day, and then they go back, you know, a couple of weeks later, and the fruit’s all falling on the ground, and it’s looking kind of punky and but they’re hungry, so, you know, they pick up what piece of fruit, and they taste and doesn’t really taste as good as it did when it was on the tree. But oh, about, you know, 10 minutes later, they get this kind of warm feeling, and they feel kind of more relaxed and less worried about where the next meal is going to come from. They say, where do you get more of that rotten fruit, right? And and after a while, we developed the, you know, the absolute world’s most colorful and tasty drug delivery system, which is like what you see in a bar, right? And we start gravitating toward this. So why do we do it? Well, I think it’s all about changing one state that’s less pleasant into a state that’s more pleasant. So you know, for those of you who are clinicians, you know, it’s a hard day of clinical work, and if you’re anything like me, muscular, skeletally, you look kind of like you know anything. Well, a glass of wine wouldn’t be the worst thing right now, right? Or you’re going to a party, and there are going to be people there you don’t know, or, sometimes worse, people there who you do know. And you think, you know, I think I’ll start with a cocktail. We want to change one state into another, and doing this from time to time. Okay, no, no, no issue. But we know substance use problems, they’re huge, and at the heart of all of them is trying not to feel something painful, trying to feel something more pleasurable. We see this with anxiety, you know, if, if I get nervous before public speaking or flying in an airplane, but I do those things anyway. I don’t have an anxiety disorder. I’m just an anxious guy, but if I start to avoid flying in airplanes or avoid public speaking in order to not feel anxious, well, we know where that leads. You know people, you know, eventually you wind up, you know, in a small room with long fingernails and agoraphobia, right? Trying to get rid of the anxious feeling. And, you know, we see this with insomnia. We see it with erectile dysfunction. We see it with so many different circumstances in which the attempt to control the thing, the attempt to avoid the unpleasant symptom, causes more of it. And this is even what’s going on in depression. You know, if we think about the difference between sadness and depression, and I just invite our viewers to ponder that for a moment, well, maybe I’ll ask you, if you don’t mind, so how in your own experience, are sadness and depression different? Because we’ve all experienced both, to some extent. Yeah.

Dr. Sandy Newes 14:59

Yeah, it’s interesting. I mean, that’s a really interesting question. It’s, you know, sadness feels like a natural state in response to something that would objectively, perhaps make one sad, or is based on our history. But depression is that like crushing weight that it’s always been like this, it’s always going to be this way. There’s a heaviness to it, it and it. And for me, you know, both personally and professionally, I can’t, I mean, I work with trauma in the brain, so I’m always thinking about executive functioning and the role of that, how your thinking is just different. Like with sadness, you might be able to think about the future, about what to do, but with depression, that thinking is so often impaired, like I don’t see the future,

Dr. Ron Siegel 15:43

and in sadness, it may be painful, but it’s quite alive. In fact, it can be poignant, right? You know, when Shakespeare wrote, Parting is such sweet sorrow, we know what he meant. 400 years later, had he said Parting is such sweet depression? We think what what’s he talking about, right? And we probably wouldn’t still be reading them. So one way to understand depression is it’s a kind of shutting down of the nervous system in order not to feel something painful. And in fact, for me, whenever I’ve been depressed, and I start to work with it, there’s a whole mix of other difficult feelings in there. There’s usually sadness, maybe fear, maybe longing, maybe anger. And it’s when I can connect with those underlying feelings, even if they’re painful, and have the courage to really feel them. Then the depression resolves and I’m back alive again, because depression so deadening in a way that sadness is not so so we can see across just use those three examples. Gosh, you know, the things that our mind does, or our brain does to try to avoid pain, the habits we get into, they cause us an awful lot of suffering and so And here’s one where we can really see how the development say of mindfulness practices, which are awareness of present experience, with loving acceptance, opening to whatever is here and feeling it, whether it’s pleasant or whether it’s painful, is a direct antidote to this, as are the psychedelics, because when we you know, you can never tell what’s going to happen in a psychedelic journey. And I’ve been following closely the maps, the Multidisciplinary Association, the Psychedelic Studies. They’re now completed phase three trials of MDMA for PTSD, and you know, one of the modal responses on the part of the participants MDMA is the principal ingredient, or supposed to be the principal ingredient, in the street drug, ecstasy. Um, anyway, the participants say, why do they call this ecstasy? Because, in the context of therapy, people are going inside with the assistance of the medicine, but they’re encountering all sorts of difficulties. And in fact, just add one more perspective on this. You know, if we go back and we look at the Buddha’s history at least as as its report test. You know, there’s this point after he had developed all this expertise and all of these contemplative practices was, you know, a really, really skilled meditator, skilled yogi, and he could be in these concentrated states that were just laser focused on on an object, let’s say, a candle or something like that. And it’s very peaceful when that happens. But he discovered, as soon as I’m not meditating, basically all my old neuroses come back and I’m tortured again. He didn’t use that language, but that’s my understanding what he meant. And then he said, obviously, all right, I gotta figure out what this is all about. And he went out, you know, to sit under this tree that we later came to call the Bodhi tree of the tree of wisdom. He sat there for like 49 days and nights, which in those that air meant a long time. And he was visited. He was visited by every conceivable pleasant or unpleasant phenomena. They say that Mara who was a demon in the mythology of the time, you know, would send these like beautiful maidens. He’d send, you know, like luscious foods and intoxicants, all this stuff. And he also send, you know, monsters and, you know, evil, sadistic soldiers and and all sorts of stuff. And the Buddha learned how to say yes to all of it like that was the key. That’s what he then later came and taught us as mindfulness practices. So clearly that was a direct antidote to this propensity, and it is one of the common features of all of these non ordinary states. That we use for healing, that one of the common features is facing our demons, opening to pain, and really moving with curiosity to toward the things that normally we want to eschew and push out of awareness.

Dr. Sandy Newes 20:14

That’s so interesting, because I really, you know, I really incorporate that in preparation, like more and more the longer that I’ve been doing this. I’ve been doing ketamine work since 2019, at this point, and really just telling people, like, what we’re doing is we’re just cultivating a curiosity. We’re just simply going with it. We’re opening to it, and we’re just learning to be with it. And you know, the parallels to mindfulness practice with that are just, that is mindfulness practice. Yeah,

Dr. Ron Siegel 20:41

my friend Bill Richards, who’s who is the, the last psychologist to legally administer psilocybin in the United States as part of research studied before the War on Drugs shut it down, who’s now in his 80s. And he said, Yeah, you know, we had a formula back then in all the psychedelic assist psychotherapy, and it’s still the formula now, which is instill in people three basic, very interrelated principles, trust, let go and open to whatever unfolds. And those are, it’s a perfect preparation for mindfulness practice. It’s a perfect way to perfect kind of touchstone to come back to for mindfulness practices as well, well.

Dr. Sandy Newes 21:28

And you know, one of the things that I have learned and coming to learn and eternally learning in my life as a mindfulness practitioner and also a psychedelic psychotherapist is, you know, when we’re first learning something, we make it very, very very complicated, like, Am I doing it right? And all these different things and, you know, and coming back to that place of simplicity and trusting, you know, I love what you just said, like trusting, letting go, being open, and just teaching that as a as a way to enter into psychedelic, assisted psychotherapy, yeah. I

Dr. Ron Siegel 22:01

mean, it’s interesting too, in the context of mindfulness practices, so many people, especially when they do intensive retreat practice, will encounter, you know, some state of bliss, some state of concentration, some state of relinquishing ego concerns. And it feels so good to not be so worried about me for a few minutes. And, you know, but then what happens is, oh, how do I reproduce that? How do I keep that going? And it’s like, no, sorry, that’s not it. It’s about trust, let go and open to all the states, including the states of clinging, including the states of self preoccupation and self aggrandizement or self denigration. You know, it’s about opening to to all of it, and it’s the attitude that we learn how to take forward much more than any particular state. Well, it’s interesting.

Dr. Sandy Newes 22:54

I feel like that’s something that people come out of, kind of a surface level study of mindfulness with that they’re supposed to be like, the goal is eternal bliss. And I actually say that in session all the time. I’m like, It’s not eternal bliss. Like, that’s not what we’re going for. It’s not like, a permanent state of happiness. Like, that’s lovely, like you said, if you can stay in a meditative state forever, like on a beautiful mountain and, you know, like, awesome. No, I wish you well with that. But it’s not that’s not realistic. And I don’t even think that’s the, you know, that would that’s not life, yeah,

Dr. Ron Siegel 23:24

that’s not life. I think that, you know, as a householder, they’d call it in Buddhist traditions active in the world, it’s very unlikely that we’re going to stay in those kinds of states. I mean, if you reverse engineer, you know the Buddha early tradition, if you will. You know, he had these monks and nuns, you know, with 500 rules right to try to regulate everything and not owning anything more than a begging bowl and a robe and, you know, not touching money and not having any, you know, sexual relationship and reverse engineering that we can say, Oh, well, so who’s kind of acknowledging that, unless you make it that simple and you’re that focused just on your meditation practice, it’s going to be very, very hard to feel sane. And, you know, I find that actually a comforting take home point, like, okay, so we’ll start with the expectation that I’m going to be nuts here, but let me see. How am I going to work with that? How am I going to change my relationship to that and and that’s what I think we’re doing with all of these different non ordinary states well, and

Dr. Sandy Newes 24:30

it’s funny, because that’s also, you know, a parallel to the psychedelic psychotherapy process, like helping clients understand like this is not linear. This might not even make sense. I’m your scribe. It’s my job as the therapist who’s with you to help you make sense. But, but we’re not doing that right now. We’ll do that later in the integration piece. It’s okay to be a bit insane. It’s okay to have things not make sense. And that, in and of itself, I think, is a really important teaching that everything doesn’t always make linear sense, and it. A given moment, right? So, all right. Well, moving on to the second one, the ability and the propensity to think. And I know that that is obviously all over the mindfulness world, but I wanted to specifically, kind of, you know, dial into this piece that you had said thoughts create suffering and that the real problem is the negativity bias. I really, I’m really interested in this part, the tendency for the brain to remember bad and not good, right? And how that relates to our survival needs and the survival kind of urges within the brain that that’s sort of at the top of the hierarchy. I’m just wondering if you can think to talk to that piece?

Dr. Ron Siegel 25:40

Sure, yeah. It’s I observe it all the time, my own psyche. If you can imagine our ancestor again out there on the African savanna, this time looking at an ambiguous situation. Let’s say there’s a beige or kind of a yellow shape behind some bushes. Well, our ancestor could make one of two types of errors, and they correspond to type one and type two errors in modern scientific research. A type one error would be a false positive, which would either look at the shape and go, Oh my God, it’s a lion, when in reality it was just a beige rock. A type two error would be a false negative, which would be, say, I bet it’s a beige rock, when in reality it was a lion. Now, those of our our ancestors could have made countless type one errors and still live to reproduce, take care of their kids. One type two error. That’s the end of your DNA line. So we might imagine that in the random mutations of the brains back in the day that there were some that were mostly kind of remembering the good stuff and having the positive memory. And they would be, you know, sitting around telling stories about luscious pieces of fruit and dynamite sexual encounters and lovely weather. But they historically were not our ancestors, and the reason was because, statistically, they died before they got to reproduce. Our ancestors were the ones with this negativity bias going around the savanna going, Oh, my God, that could be a line looks like could be one of those poisonous snakes. Oh, no. One of those bushes with those thorns. Remember what happened last time? And as my friend Rick Hansen puts it, the negativity bias is the way in which the brain evolved to be like Velcro for bad experiences and Teflon for good ones. Bad experiences stick. We remember them, we anticipate them, and we imagine them happening again, and good ones slide right off the pan. I was recently interviewed by somebody doing a piece on optimism, and I happen not to be fan of optimism, because I think that both optimism and pessimism are delusional, because they are what we do when we have uncertainty. And by definition, with uncertainty, we don’t know if it’s going to be a good outcome or bad outcome, but the negativity bias certainly predisposes us toward the pessimism, because we’re remembering that bad stuff and anticipating it, and that certainly makes us quite miserable. So we have this, this propensity, and we have the reality that as modern humans, if we’re fortunate enough to live in a sufficiently developed society and to be sufficiently privileged in that society. We’re not actually under acute threat much of the time, but we’re under symbolic threat quite regularly. So if I can ask you know, you and our our viewers, to just take a moment and think of something that upsets you, not not please, not the worst thing ever, but just something that’s a little bit upsetting. And then reflect here and now. If it weren’t for the thought of the thing, would you be having a problem? No, yeah, the answer is almost always no, even if the upsetting thing is like physical discomfort, some kind of pain, it’s usually the thought that it’s going to get worse or less forever, or it portends my death. That’s what really upsets us, the actual physical discomfort. If it’s not too intense, we’re okay with that. So we start to realize that, oh my gosh. You know, almost all the misery we create is created with our thinking, and it’s created because of this negativity bias in the brain, which is, you know, makes perfect sense for survival, but it’s not good for happiness, and it’s not an accident that CBT developed, right? The whole, you know, an entire approach to psychotherapy that’s just about, well, let’s examine the thoughts and see what we can do about the negative ones that are making me miserable. So it turns out that these non ordinary states, the you know, the expanded states that are that are useful for healing and growth and spiritual awakening, they all share this component of learning how to step out of the thought stream with mindfulness practices. We do it quite deliberately. The reason why virtually all mindfulness practices, you. Use as their primary object of attention the breath or sounds or the sensations of the feet on the ground. They use physical sensations, right? And that’s a way to begin to ground consciousness in sensory reality, rather than living in our thought stream as we normally do. And the more we do that, and you see this particularly when you if you do more intensive retreat practice, what starts to happen is instead of consciousness being mostly thinking and then occasionally tasting, seeing and touching, and then thinking about what we’ve tasted, seen and touched, what happens is consciousness becomes predominantly tasting, seeing, touching, feeling the body here and now present, noticing the natural environment around us, or the or the the human made environment, and thoughts start to appear against that backdrop. So the you know, the off, repeated instruction allow thoughts to come and go like clouds in a vast sky. The idea is that the sky remains. Sometimes it’s filled with stars, sometimes with the moon, sometimes with the sun, sometimes with rain or snow with clouds, but the sky somehow awareness remains, and these objects appear and disappear, appear and disappear. And this is a very common feature. We see this in mindfulness practices, and we see it in psychedelic work, right, that there’s this field of consciousness, and you know the constant, constant contents arising and contents passing, arising and passing, and the perspective that we gain on this, that it’s like, okay, whatever arises in the journey I can again, you know, trust, let go and open to it starts to shift our relationship, particularly to the thought contents, where we start to see, oh, there’s one of those scared thoughts, Oh, there’s one of those hungry thoughts, Oh, there’s one of those lonely or inadequate thoughts. And it is so different to have the thought of, oh, yeah, I had one of my inadequacy thoughts. Again, is such a different experience from I’m inadequate? Well, it’s interesting.

Dr. Sandy Newes 32:07

I feel like this is another place where, you know, mindfulness practice meets the neurobiological approaches to, you know, working with trauma like Bessel van der Kolk work and, you know, really, as we move into EMDR and things. And I was just wondering, you know, you I heard you say, I wrote this down it make it hopefully word for word, to get out of the thought stream. We need to repeatedly connect deeply to sensation. And I was just wondering, you know, because I think when our nervous system gets really activated, then our thoughts are going to be more in that negativity bias, and they’re going to have that survival like, Oh, this is something that’s killing or eating me. I have to really get ready and get activated into that fight, flight piece. And so I’m just wondering, you know, do you see that as being the same or different than somatic kind of interventions, like body based interventions to calm the nervous systems? Like, how do those map together? Are they one in the same? Are they different? Well,

Dr. Ron Siegel 33:03

it’s very interesting, and it speaks to an area of a good deal of confusion, because oftentimes people learning these things don’t differentiate between the following. Very often mindfulness practices are confused with relaxation practices, right? That it’s like, well, you know, oh, I practice mindfulness. I do 478, breathing. For example, you know where you breathe into the count of four, and then you hold the breath for seven, and you breathe out to the count of eight. Now, that kind of controlled breathing is designed specifically to energize the sympathetic, the the parasympathetic branch of the autonomic nervous system and to calm us. And it’s great. It works to help to calm us. It is not a mindfulness practice per se, because it is not necessarily inching us toward being more aware and more and have more loving acceptance toward our experience. It’s much more about shifting our experience from one state to another. Now it has its place, right? There are, there are lots of situations where we sense, oh gosh, I’m in a state of arousal, which is not helpful for living this life I’m trying to live. Perhaps it’s very unpleasant, but on top of that, it’s unskillful. It narrows my attention. It makes me irritable, you know, so Absolutely, there’s a role for that, and all sorts of yoga practices. And you know, even the occasional use of a benzodiazepine has its has its place in the world. But that’s not about that. Kind of emotion regulation isn’t the same as mindfulness practice. Now, saying that, excuse me, saying that. I know it’s interesting that Jon Kabat Zinn snuck mindfulness practice as a Trojan horse into medical care by calling it stress reduction. And it is and it isn’t depending. And here’s where this becomes very complicated, because if we’re really interested in mindfulness practice. Just we’re really simply interested in being with whatever’s happening with attention and acceptance. And that could be to be mindful of rage. It could be being mindful of intense states of anxiety. It could be mindful of intense states of sadness. It could be anything, some of which, though, are intense arousal states, and this, this is where you see people having different views toward equanimity, right? Because there’s, there’s the idea, oh, I want to be equanimous. I want to be so zen, so that no matter what happens, no matter what my partner says or does, I’m just peaceful and fine and all that. Well, that’s one model of equanimity. It’s not a terribly realistic one. As a householder. Another model of equanimity is, I want to get to the point where I’m not afraid of my arousal states, where I’m okay if my heart is racing, you know, you know, 1000 beats a minute when I’m on stage about to do public speaking, and I’m going to do it anyway, and I’m okay when I see red. And, you know, I’m ready to kill this other driver, or worse, my family member, you know, and, and I’m all activated, because there’s also a way in which consciousness is holding this with some perspective, allowing it, experiencing it, but not fighting it, nor even identifying with it, but simply experiencing the experience. And here’s where we get into enormous complexity. So let’s say we’ve, we’re, we’re doing mindfulness practice and trying to develop a kind of equanimity, but this kind of equanimity, the the very alive equanimity. Interestingly, when we’re not fighting anger and resisting it, when we’re not fighting fear and resisting it, when we’re not fighting sadness and resisting it, it tends to come. Tends to reach a crescendo, and it tends to pass relatively quickly. Two of my good friends are we’re wonderful guinea pigs for the whole community of meditation meditating clinicians here in Boston, because they did a four year silent meditation retreat. Your names are bill and Susan, not householders, no bill and Susan Morgan and their their couple, and they did that, and the rest of us were really watching this experiment, like, what’s going to happen, right? And when they when they were done, Bill was still very much Bill and Susan was still very much Susan. And in fact, they had pretty similar emotional responses. I happened to have the chance to be teaching with them. They came out of retreat a little bit during the third year to start easing into life and and I had the opportunity to co lead a retreat with them, and it was in New Mexico. And wouldn’t you know it, their flight got canceled, and Bill said, Oh my god. It was just like, I had never gone on the retreat. I was just like, hey, here we are, you know, anxiety, and then other people cutting in line, and, hey, wait a minute. And you know that, how dare you, and all this stuff said, but, but a much shorter tale, like, as soon as the thing was over gone, able to, able to, you know, let it go. So one of the interesting things that happens with these, you know, with mindfulness practice and this whole issue of emotion regulation is when we learn to not fight these different elements, they still come up. The afflictive emotions still arise. But if we’re not fighting them, if we’re not blocking them, if we’re not wrestling with them, they can they can be metabolized. They can come and they can pass, and then the net result is actually an aggregate. We’re less stressed, but not because we tried to calm down, right? We’re less stressed because we gave wide permission. As Suzuki Roshi, the head of the San Francisco Zen Center, posed years ago in Zen Mind, beginner’s mind. He said, You know, if you have a really upset cow or sheep and you want to help it to calm down. What do you think you should do, tie it up or force tell it to calm down, or give it a wide, safe pasture. And you know the right answer is, you give it a wide, you know, safe pasture, and then it calms down by itself. So, so this whole relationship between the mindfulness and motion regulation and and relaxation is is actually quite complex, right? Well,

Dr. Sandy Newes 39:28

it’s super interesting. And I’m aware of the time, and I ask you, like one more specific question about this particular piece, if I can, which is one of the things that I have been tracking is the degree to which the more activated roused people’s nervous system are, the more I believe they have a tendency to focus on what I call the what, or the other, like the problem or the fact what this person did or is doing. And that’s one of the biggest challenges, where I see people having a difficult time. Unplugging and labeling, using observer mind, being able to kind of notice the pattern rise up above it, because it’s so much about the what or the other. I’m just wondering if you can speak to that piece.

Dr. Ron Siegel 40:12

Yeah, no, I think, I think you’re describing something important there. Because when we’re in these aroused states, these arous states are typically variations on fight or flight states. And when we’re in these states, our attention narrows, right? And we don’t see the big picture and we’re focused on survival. And when we’re focused on survival, we’re not great at mentalization, right? We’re not great at taking the perspective of the other, of seeing the big picture and and all of that. So there is a role for learning how to calm down some. It’s just, it’s just, there’s a, there’s a dynamic tension between, okay, I’m going to deliberately relax here, you know, again, using the 478, breathing pattern is just one example. Or I’m going to go for a run to, you know, have the anxiolytic effect of using the the larger muscle groups in the body. There’s that approach, perfectly useful. And then there’s the approach of, no, I’m just going to be with this and allow it to metabolize by not, not trying to control it or fight it or or even change it, but just just deeply accept it, right? So don’t

Dr. Sandy Newes 41:28

do the thing. Just be with it before doing the thing. Yeah,

Dr. Ron Siegel 41:33

yeah. This isn’t, this is not a polemic for going out and like, hitting people and stuff like

Dr. Sandy Newes 41:39

that. Good. Well, so the third one and is we tend to see things that are fixed as being static, yeah,

Dr. Ron Siegel 41:49

well, we tend to see things yeah as fixed or static and not see the fluidity. Yeah. This is here. Well, this is the bill and Susan story. Again, it illustrates it so well that so often when we’re struggling with an emotion, it’s the fantasy that this emotion is going to last forever, that bollocks is us up, you know, oh, I got to get rid of the sadness because I’m afraid that it won’t change by itself. I got to get rid of this fear because I’m afraid it won’t change by itself. I got to do something about the fact that I’m angry and get revenge, because I’m afraid it won’t change by itself. And one things we learn from these expanded states is consciousness is extremely fluid, and particularly if we’re not resisting an element of consciousness, it keeps changing. We see this all the time in the psychedelic assisted work, aided a bit by the music, right? One of the reasons why Stan Groff and others, you know, started using music to help people through the psychedelic journeys, and it’s still done in current research and clinical work a lot, is because the music, as it’s continually changing, sort of signals. Ah, it’s a new stanza. Ah, you know, helps us to see the fluidity, and we certainly see the fluidity of consciousness with mindfulness practice, you know, one minute we’re like, you know, blissed out, enjoying the present moment, feeling one with the universe. The next minute, it’s like, I want to watch TV. I hate this mindfulness crap, you know, and you know, so we see it so, so that’s the, you know. The third one is just getting it that really everything does constantly change, and that includes the elements of consciousness. And the more we see that, the less upset about a given state of consciousness we are in, the less driven to try to change it. We become

Dr. Sandy Newes 43:43

love it all right, so the last, the fourth one then, and I love this. I got a lot out of your teachings with this, just to kind of really map it on, to make it so personal, a tendency to create narratives about ourselves that involve, that involve judgments. And you talked about, it’s evolutionarily beneficial to compare ourselves to others. Yeah,

Dr. Ron Siegel 44:08

yeah, this, and this is, this is a the big enchilada of our affliction, right? It’s, it’s, it’s our, it’s our preoccupation with us and and particularly with the whole realm of social comparison and self esteem. My casual observation of my own consciousness and that of virtually everybody I’ve worked with is that we’re either stressed out trying desperately to keep our self image and self esteem afloat, or we’re bummed out feeling in some way not good enough and inadequate, and looking for a plan of self improvement to be able to feel good about ourselves. And the origins to this as I understand it, are the concern with. Where we rank in the primate troupe. If you go on a so called safari in Africa, which basically means riding in a jeep with a naturalist, the naturalist will point out the same pattern in species after species after species. There’s like a dominant male hanging around with literally a harem of reproductively promising females. And over in the next field, there’s another group of guys, usually a bit younger, doing the species specific equivalent of playing basketball, you know, trying to get the talent and skills together to be able to become dominant. What’s up with that? Why are there species of crickets that, if you put them together in a box inside of a few minutes, have organized themselves into a dominance hierarchy. Why do kids by the age of four establish what are called transitive dominance hierarchies? Transitivity being the principle for math that if a is bigger than b and b is bigger than C, then A is bigger than c. So if Juanita knows that she can dominate George, and George knows that he can lord it over Susie. Susie knows to be afraid of Juanita and to basically give into her wishes. And kids figure this out like right away. Adults, you can just play them the the tonal quality of other people’s voices, and they will predict accurately who will be dominant and who will be subservient. In a group like this stuff is very strongly hard wired. What we have in common is this propensity to compare ourselves to one another, even though different criteria are more salient for one of us than they are for the other. For example, I got hooked at a very early age on intelligence. I discovered I could use big words and and teachers and parents would would like that, and it served to make me feel good about myself. And there’s a great compensation for things like being picked last or close to last on a kickball team, and not being very good at standing up and physically fighting and and that kind of thing. And I’ve kind of been attached to that my whole life, right? Wanting to be seen as as smart, to be able to feel okay about myself. For somebody else, it’s being physically attractive becomes what they put a lot of energy into. For somebody else, it’s being artistically creative. For somebody else, it’s, you know, having a sense of fashion and that kind of thing, or where, knowing what’s, you know, what’s current in in the culture for somebody else, it’s, it’s being seen as the nice one or the kind one or the generous one. And I’m not knocking any of these attributes, you know, whether it’s creativity or intelligence or or kindness, they’re all wonderful. But when we get hooked on needing to see ourselves this way that sets us up for tremendous amount of suffering, because we simply can’t win at this game for two reasons. One is we recalibrate right so whatever used to float our boat doesn’t do it anymore. You know when, when we were really little, and we put together those multi colored wooden or plastic rings on on a pole, and we got in the right order and looked like a cone or a Christmas tree. It was like, hey, look Mommy, look daddy. I can do it. You know, it doesn’t float our boat so much anymore, you know? I mean, it might in the nursing home after a while, but at the moment, it’s not, you know, it’s not doing it right. And similarly, I like to do trainings for mental health professionals. And I’ll often remind everybody, you know what it was like to get our terminal degrees right, and it was a big deal, right? You know, we worked so hard for that and and we’re so proud of it. And then I asked so how many of you woke up this morning feeling good about yourself because you have your terminal degree and exactly your response, cracking up laughing, except sometimes there’s one newly minted clinician, they raise their hand and say, Why is everybody laughing? The problem is, we habituate to all this stuff, and then we look for something else. We need something else to feel good about ourselves. And on top of that, what goes up goes down. So even if we’re an Olympic gold medalist, what are the chances of winning the gold in four years, in eight years, right? So this absolutely doesn’t work, and yet it is so, so built in to us. Clinically. Everybody I work with, struggles with not feeling good about themselves in some way. And they’re either, you know, on the Nazi side of it, and they’re always like, you know, proving themselves, or they’re just E or, and they’re just feeling, well, you know, how, how come everybody else is is good in some way, and, and I’m not. And the really interesting thing is, you know, where the Buddhist practices lead, where mindfulness practices lead, it’s toward seeing all of this as just constructed, seeing that the whole thing, these are narratives that we invent for ourselves. And you know, you know, they’re actually not real. Nobody has more value than anybody else. We’re all going to die. And. Way the whole thing is just, is just nuts. And we can actually get glimpses of this. And with psychedelics, we can get really profound glimpses of this, sometimes where we really see, oh my god, the pain of it. I’ve spent my whole life trying to, like, prove something to me or to others, and the whole thing has been completely and utterly unnecessary and an illusion. People really see this with with psychedelics, and it is profoundly liberating. And I got, I got really interested in this topic a number of years ago, because there I was already in my 60s and spend years doing, you know, Buddhist meditation practice, decades, actually, decades doing psychotherapy, having been in psychotherapy, having experimented with psychedelics. And you’d think by that time, I would have developed something called the secure, stable sense of self, right? Self image? Nope. You know, I was still going up and down, often several times a day, depending on what was in my email inbox, and certainly based on how the last session went. At the last session went well, yeah, you know, all these years of study and practice and introspection, I’m a really talented psychologist, that was a good session. If it went poorly, it was like, you know, I knew I, you know, I was a bright guy. I could have gone into so many fields. This is clearly not my calling, and, you know, and feeling terrible about it. So it was out of that that I became very interested in, are there reliable ways to step off of this roller coaster and actually establish a kind of well being that’s not about boosting self esteem, but that’s that’s embracing the reality of being a human like other humans. And that actually led to a self treatment project, which is a book called The extraordinary gift of being ordinary, finding happiness right where you are. And the book is just methods for maybe doing something about this fourth affliction, if you will, this propensity to compare ourselves with others and be concerned with social rank. It’s a

Dr. Sandy Newes 52:10

great book, by the way. I really enjoy it. I’m glad that you brought it up. I think that it’s so interesting too, that that’s just biological like and I really find that clients just resonate with being told. When you tell somebody, oh, that’s just your biology, like this biological propensity towards distress, right? And that, like, happiness is a learned skill growing the good I’ve been really influenced by Rick Hansen’s work in that area, and this that it’s a biological necessity for you to compare yourself to other people that are up the hierarchy, therefore you will always do it, yeah? That doesn’t mean it’s real, right? I mean, they have to give into it. If it’s biological, then we just notice it, right? And to me, that that, for me, telling, teaching that it’s biological becomes an entry point, yeah, to give people more of a permission like this is why we use mindfulness, because we’re going to do that no matter what.

Dr. Ron Siegel 53:05

And I would just quibble with one word. It’s a biological propensity rather than necessity. Gotcha, because luckily, we have some other instincts, like instincts toward cooperation, instincts toward connection, instincts toward noticing our place in the universe. So it’s a propensity, but the way I like to think of it is that, you know, it’s like the love of fat and sugar, right? That propensity exists because, you know, back in the day, they’re associated with nutrients, right? So we, every culture, has its equivalent of a donut. Yet, we can learn that going for donuts every day, you know, doesn’t actually bring a lot of well being after a while. So it’s the same thing. These are all propensities, but we can learn that they don’t actually serve us, and then we can cultivate the antidotes to them,

Dr. Sandy Newes 53:59

right? I love that, so I want to spend the last chunk of time, if we can, talking about, really, some applied pieces. So I work full time in ketamine assisted psychotherapy, looking forward to the day when other psychedelics are available for legal use, for psychotherapy, but really find tremendous benefit with ketamine, and I’m involved in a training program to live through the living Medicine Institute, teaching therapists how to do clinical practice using psychedelics. And I know you have certainly been involved in that as an educator and a trainer and really driving that movement yourself. And I’m really curious about some of your thoughts about if we’re going to break psychedelic assisted psychotherapy into preparation, the actual psychedelic session and integration, like you know, what are some of the things that you might just starting with the preparation piece in general? What are some things that you might teach and then specific? Fixed skills? Are there things that you might incorporate into preparation when working with clients? Well,

Dr. Ron Siegel 55:06

there’s a lot we don’t know about this. I would start with what Bill Richards, as an elder in this field, says, look for ways to try to to try to help the the client or patient, to cultivate an attitude of trust, let go and open and for a given individual. There, there may be, there may be very different techniques that are going to help that you know, for one person, yeah, teaching mindfulness practice, starting with, you know, an object, such as the breath, staying with it, allowing the mind, when it goes off into the thought stream, to do what it does, see if we can notice it when it goes into the thought stream, and gently and lovingly bring it back. And just doing that over and over and over again, and then having a warm and welcoming attitude toward whatever else comes up, like the longing for love, like the fear of rejection, like the memory of past, small or larger T trauma, and you know, to really Practice saying yes to everything that arise. So that can be done through mindfulness practice. But it can be done through other things too. It can be done through a kind of, you know, Rogerian psychotherapy as a as a preparation, in which the person is simply invited to talk about what happens. And we, we as a therapist, take an attitude of of deep acceptance and curiosity in it or and people are experimenting with this, perhaps something like internal family systems work, where people deliberately allow space for the different parts of us to be recognized, acknowledged and to notice what they all need, because the psychedelic assisted work tends to help us connect with those parts, what my friend Dick’s would call the exiles, the parts of us that we don’t like, and we try to push out of awareness, the those tend to come into awareness and the various protector parts, the things that keep us away from this, they get quieted, maybe even anesthetized a little bit by the the psychedelics, so that we can connect with these, these vulnerable parts. So doing some of that work in that therapy style that could make sense, there are people using act, Acceptance and Commitment Therapy as part of preparation, and act is also a very strongly acceptance based kind of treatment, and it’s a little bit more cognitive in its orientation. But what it does is it helps people to see that, oh, you know, all elements are welcome and all thoughts are welcome, and noticing that all the thoughts that we have arise against this basic backdrop of awareness itself. They call that self in context, if in the ACT system. So that could be a way in and, you know, for somebody who’s theistic, it could be a prayer practice. It could be something about, you know, God in some way or another, divine presence, and working with having them as a benefactor, to feel to feel safe in going into it. But so I think the key is whatever is going to move us in the direction of trusting, letting go and opening we want to do, but that could come from quite a number of different therapeutic or spiritual traditions. I mean, my belly works more mindfulness practice. So that’s, that’s where I would go with my own personal work more most likely, but, but I think it could depend on the person where, which one you’d want to emphasize. Well,

Dr. Sandy Newes 58:56

it’s interesting. I’m just kind of sitting here, just reflecting on just even starting with that. So we’re going to start preparation like, I actually, I’m, you know, I’m an assessment person. That was where I was before, so I do a pretty extensive assessment, but just kind of also beginning with, like, really, the goal of this preparation phase is to help you get to a place where you can trust, let go and be open, right? That might be a really interesting thing, just to put out there, like, and ask them, like, you know, what do you what are you doing already? What can you see that would be helpful for this? I could see that as being a really nice way to actually start in a more like dialog with them, right from minute one, to bring them in to the process.

Dr. Ron Siegel 59:40

Yeah, and it models that this is going to be a cooperative journey that we’re going to take together, in which I can support you, but you know, it’s your own heart and mind is going to be leading the show. I love that.

Dr. Sandy Newes 59:54

So what about during the treatment itself? And by the treatment itself, I’m specifically referencing he. Right now, which is about 60 minutes under the influence, and about a two hour session. I mostly do IV. So that would be IV, and I am particularly other forms last longer. I’m just wondering, you know, if you have thoughts about kind of drawing from mindfulness or kind of this piece is about the four propensities of mine, obviously you don’t know what’s going to come up and end every single session, every single Academy session is different. So certainly we understand that. So it’s not like it’s scripted or per scripted, but just if you kind of reflect on that, just sitting with the client while they’re in the actual altered stage as a provider, what might you what might you suggest?

Dr. Ron Siegel 1:00:39

Well, I’d suggest something like mindfulness practice for us as providers, so that we can be as fully present and as fully accepting of whatever arises as as possible and where it where it morphs into a mindfulness practice where we’re based. The object of our attention is our client or our patient, right where we’re just being with them in as open heart a way as we can, and maybe adding in some compassion practice also to just add some warmth to the presence. But then for the client or the patient, I think much depends on the dose and what kind of work we’re doing at at more modest doses, you can do ketamine assisted mindfulness practice. At least, I’ve done it where you’re where what I’m doing is starting with practice, actually starting with a period of practice without the medicine, adding in the medicine and continuing, for you know, including perhaps on a meditation cushion, continuing the practice and and keeping the same attitude of being grounded in the breath or another object of awareness, but really allowing whatever arises to arise, and investigating what arises. You know, my friend Tara Braxton, a lot to popularize this idea of rain as a mode of inquiry with mindfulness practice, and it involves recognizing whatever’s arising, investigating it, but investigating it, not cognitively and analytically, investigating the way you look at a rare and beautiful flower. I No, I’m sorry, recognizing accepting is next. The A is next. So it’s this attitude of acceptance, then investigating, and then the and is kind of resting in natural awareness, simply allowing it to allowing it to be there, reopening to it very fully. So we can kind of use a mindfulness practice to work with whatever rises in the in the medication into states. And at least my experience with moderate dose of ketamine is it allows kind of wandering in the mind. The hallucination means to wander in the mind. Literally, that’s why some people are advocating that we go back to instead of calling them psychedelics, calling them hallucinogens because they allow us to wander in the mind. And it’s true, the medicine allows for a kind of wandering in the mind with greater greater freedom and less fear than than unassisted mindfulness practice. So at a higher dose, the medicine is going to take over, and there’ll be very little volition in terms of steering the experience. So mindfulness practice is one possibility. One could, at the lower psycholytic doses, do whatever is psychotherapeutic. Certainly, I know that Dick Schwartz has been active in some workshops doing this of of let’s do, ifs work, let’s talk to parts at with low dose of ketamine, and have the active medicine session be a all parts are welcome. Opportunity to talk about parts and unburden them, allow them to to talk about difficulties they’ve had so that they can be healed. So I think there’s a lot of possibilities at the lower dose, at the higher doses, I think it’s about supporting the journey, right?

Dr. Sandy Newes 1:04:17

I’m super. I’m interested, once again, in that piece, just about like, like, I haven’t done this, but, you know, I’m going to experiment with it. But like, what if I taught, what if I teach a client about rain? Like, prior to going in, do they have less fear? Are they more able to drop in with they understand that really, I’m just grabbing hold of that one. There’s, you know, could be many, but like, you know that recognizing and acknowledging and investigating. Just, you know that that is what we’re doing. Yeah, like, think that might be a nice

Dr. Ron Siegel 1:04:47

thing. I’m a big fan. I’m with you. I’m a big fan of psycho education and giving people maps for both what I’m thinking and how this might unfold. Old and what guidelines other people have found useful? Absolutely makes sense to

Dr. Sandy Newes 1:05:04

me. Love that jig, you know, just to hit the last piece. It just, you know, just integration. So integration, for those who don’t know, our sessions that take place shortly after in the ketamine assisted psychotherapy world, shortly after the session where we’re going to go over, review what happened in the session, and find ways to make it meaningful in your life.

Dr. Ron Siegel 1:05:25

I mean, I think, I think that’s wide open in terms of whatever is, however we work, we might work therapeutically with a powerful experience, and it could certainly be spending time with mindfulness practice or, you know, taking walks in the woods and allowing the holding that comes from from nature. We we really want to provide space for whatever needs to surface to surface, and to be able to allow it to come and go freely. So, you know, I’m certainly inclined towards something contemplative that way, but I could easily see it being also a talking therapy that really talked about the different elements and the meaning of them and and, you know, particularly in integration to be exploring. So what was it like to have your typical defenses or your typical modes of coping or navigating to start seeing them coming back after the session. Because very often in psychedelic assisted work, there are these experiences of liberation, right? It was like, I tasted freedom, and then the disappointment that can come in when it’s like Ron’s back, you know? Oh,

Dr. Sandy Newes 1:06:42

no.

Dr. Ron Siegel 1:06:43

That was so nice, you know, so nice. You know, did not have the normal preoccupations. So you know, to also, you know, really be exploring them, and to be open minded about what happens and and, you know, but also, you know, ifs act EMDR, I mean, you know, the list is long of treatment modalities that can help us to integrate material that’s come up. Well, I

Dr. Sandy Newes 1:07:16

wanted to just kind of wrap it up there, but I wanted to, before we do that, I want to just ask you, are there, is there anything else you’d like to share about, or anything else you want to I think

Dr. Ron Siegel 1:07:26

we’ve covered a lot of interesting territory. I really appreciate your your questions and this kind of inquiry of of you know, what’s this interface between contemplative practice, psychedelic exploration and and and psychotherapy is, I think it’s fascinating. And, you know, we’re all anybody involved in exploring this. It’s not like there’s a road map. I don’t know if there ever will be a road map, but, but it’s certainly interesting and fascinating area to explore.

Dr. Sandy Newes 1:07:57

Well, it’s an exciting time to be involved in it, and once again, I’m just really grateful to you for taking the time I’m but I’m also just grateful for you as in your humanity as a teacher and as an educator, and just being so real with all of this and sharing your wisdom and your knowledge, and you’re really making a difference in the world, and I appreciate

Dr. Ron Siegel 1:08:17

that. So thank you so much. Thank you for saying so, and thank you for all that you’re doing in the world and for organizing this and for inviting me.

Outro 1:08:34

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