MDMA, Ketamine, and Other Tools for Working With Trauma

Veronika Gold 20:57

relational part is that the ketamine is brought into the psychotherapy so the client is coming in, the relationship is creating or supporting the safety that the client will feel. And my colleague Harvey talks a lot about this, like, what does that safety mean? Can we make somebody feel safe? And really it’s can the person feels safe with us to feel unsafe, so that we are creating a space where everything is welcome, so that beautiful, challenging things are welcome into the process, and that then They’re held and healed through that relationship and and then the ketamine work is part of this process. It expands the consciousness and allows, you know, there is a lubrication of the psychotherapy process. And then it also brings kind of access to material that has not been accessed otherwise. And, you know, gives this kind of greater perspective. And so, you know, you can just be there and witness and, you know, keep the person safe, kind of you’re monitoring them and and they’re going through their journey. And, you know, the way we work is we talk about inner directed psychotherapy. And so it is like we, you know, are engaging, and when we, when we use, when the ketamine is on board, the therapist is also, you know, out of bringing in this beginner’s mind, we are there and allowing to for the process to emerge, but then we are engaging as something emerges. And you know, and it might look even as something simple as repeating to the client what they said, or just noting something asking a question. So it looks definitely differently than regular talk therapy when they are under the influence of ketamine, but the therapist is fully present the whole time. And there, there is this back and forth, you know, call and response. So when the client says something, I will, you know, acknowledge it. I will make a make a sound, or I’ll repeat a word and I ask them, and sometimes it’s more active, because they might encounter something what’s challenging, and they need a little bit more support and guidance to move through that. But again, the principle here is a little different, that we are encouraging them to move with what is coming up. So kind of being curious. That’s kind of the biggest, biggest, you know, one of the big principles is to bring curiosity and look at whatever is emerging in that state and the that’s where the relationship is. And then, of course, it continues into the integration process. And, you know, like the preparation for another ketamine session.

Dr. Sandy Newes 24:03

I love that. I kind of, you know, kind of coach my clients on suspend the need to know, like we’re not looking for that moment necessarily. Like we really want to stay just in curiosity, stay in the inquiry, like we’re not actually searching. I mean, the I call that the aha moments can emerge, right? Like, sometimes we’re like, oh my gosh, but really it’s different. Like, I think that’s one of the critical differences. I’m just wondering, do you agree with that, or any thoughts on that,

Veronika Gold 24:35

exactly kind of coming from the mind into the body, you know, having, like, like, the and stone tips talks about is healing through the experience itself. We don’t have to understand what’s happening even, and the shift can happen so kind of coming back being with what is emerging. And of course, it’s difficult for many people, and probably many of us, at times where the mind wants. To understand and wants to figure it out and what it means, but it is a way of moving away from what is actually happening. So how can we be with the process present, curious, and there is time where we kind of invite more, kind of, what are the insights you’re taking away and how it’s emerging in your life, and and that kind of continues to unfold. But during the session, it’s a, it’s a great invitation and practice to kind of go out of the mind and not having to know, not having to understand. That’s

Dr. Sandy Newes 25:33

interesting, because it’s a parallel to mindfulness, right? That you’re like, out there in the world, especially kind of afterwards. Like, you know, can we stay in that curiosity in our lives. Like, of course, you know, we’re just human and we’re doing the best that we can. But I do find the clients want to like button it up, be like, Okay, well, no, this is what I learned about, that when really, what if the learning was actually about the state and was actually about the relational component and being able to stay in curiosity, and it wasn’t so much about realizations, right? I mean, that’s a piece of it, but I think there’s more to it than that,

Veronika Gold 26:09

ourselves, like it’s for the client, for them to know themselves, visit themselves, in a relationship to themselves, in a relationship to another, which will be the therapist, and then then the world. And,

Dr. Sandy Newes 26:24

yeah, yeah. So you, from what I understand, I mean, well, I know because I was there and I’ve heard you talk about it before, but, you know, pretty big advocate for somatic interventions. And somatic interventions don’t always involve touch, but often do. So I’m just kind of curious. You advocate for the use of touch, but that can also be controversial, and you know, so I’m just curious what your thoughts are about using that safely. Where do we need to go with that? Where can that go wrong?

Veronika Gold 26:59

Touch is such a integral part of human development and of who we are, and so that it’s, it’s, it’s just essential for relationships, for and for healing. And you know, in psychedelic therapy, clients sometimes will will go to prove verbal states that prove verbal trauma can come up time when there are no words, and sometimes the touch is really the only way of communicating and and so there is This, this, this great opportunity that working with touch presents, it’s you know, for helping the safety in this session, for creating a new relationship to touch and to really help with attachment and developmental trauma treatment, also to help finish unfinished motor movements, or kind of provide support in those processes. But at the same time, as you’re saying, we have to be very careful when we use touch, and it’s important that the therapist have training in the use of touch, and that includes an extensive consent process, which includes thinking about the power dynamics to kind of bringing in cultural aspects that different people might relate to, the use of touch differently. And then you know, is the person actually able to give consent, not because of the medicine, but maybe because you’re authority. And they, you know, believe that, if this is for the healing, they want to say, yes, so there is, there is, there is kind of an ongoing process of of, you know, consent for, you know, when we when we do use touch. And so I talk about somatic work, I, you know, kind of bring in that idea that the Body Keeps the Score. Bessel van der Kolk book, but it it really kind of helps to understand why the body is so important, and then how the client can feel in their body, kind of how they’re aware of their sensations, emotions, their impulses and and then we are coming to that consent. Can they say yes and no? And sometimes we practice that in the sessions. And then I want them to to understand how touch could be useful in sessions, you know, and just kind of thinking about, you know, the different types of touch, that there is a safety touch, that it’s something like helping the client to go to the bathroom, or if they were moving, and you you want to ensure their safety, and so that is a type of touch. That you know, all my clients will need to agree to in order to move to forward with doing sessions and and then there is a supportive touch, which is something like a, like a, like a holding the client’s hand or putting a hand on their shoulder. And you know, the way, how we think about it is that the touch is in this moment, and any intervention, any words, would be to help the client, to stay with what is and to provide support, not to change something that’s happening. So it’s not to choose them, or to, you know, move them from what is coming up. It’s kind of used as a support, you know. And sometimes clients might ask, you know, can you hold my hand as the medicines coming on and and then they, kind of, you know, go into that, and then touch as a technique that we talk about, where we use different interventions as it emerges in the session.

Dr. Sandy Newes 31:03

Yeah, yeah. I mean, it’s, you know, people now, I’ve been doing cap, full time and teaching and training since 2019 and, you know, people are often surprised when I’m like, I’m actually touching my clients more often than not, like, with consent and with training and wish with intent. But you know, I’m just, like, in the bubble. I mean, I’m putting my hand here, you know, or here. I mean, there’s just a lot of in the reasons for it. I think it’s really, you know, nuance, but it is interesting. And I’ll just say this to people who might be listening like, it’s also okay to get used to it, right? It’s like, you know, you do get used to it, and you do learn a process about how to educate the client and to get client consent to where it really just becomes an integral, and I think it’s an essential part of the process. So, so go ahead, switch a little bit to talking about MDMA and cap and just, you know, not that many people have had the opportunity to do both, like I’ve been to the maps training, but I haven’t seen any actual, actual MDMA clients. What are your thoughts about similarities and differences, you know, and where’s that gonna go?

Veronika Gold 32:13

It always comes up. And, you know, they’re very different medicines, but we are accessing this expanded state of consciousness. And so they can facilitate the healing in, you know, in similar ways. And there is a different signature of ketamine and MDMA, so that there are some characteristics of the work which are different where, you know, one of the easiest one to imagine is that is just a time frame of the session that, you know, the MDMA session, we would be with the participant for six to eight hours, where our ketamine sessions are three hours. And, you know, some some sessions even shorter than our clinics. So there is kind of a less of the time, and the ketamine sessions, you will do more frequently. So there is kind of a different way of the of the treatment plan, and then the signature of the medicine, where the ketamine provides kind of a spaciousness, maybe distance, but, you know, really depending on the dose, so that with ketamine, you can really also modify kind of the dosing you you’re working with, and then MDMA is the empathogenic drug with this some kind of stimulant properties, and really brings the person in this Empath, Empath, empathic, kind of state open heartedness and calming down the amygdala, so that calms down the fight or flight or freeze thre response. So often I talk about kind of expanding the window of tolerance, where clients can access their traumatic memories and experiences without going into the state of feeling overwhelmed, and that allows for greater processing of the of the trauma. So the principles of the work, you know, are similar the way, how, how we do ketamine psychos therapy. It’s an inner, directed approach that’s following the client’s process. And you know, what’s really beautiful is that, you know, there is, this is kind of moving away from the pathology. It’s a, it’s a moving away from the pathologizing the client, pathologizing their disorder. And and kind of stepping away from the role of the expert. Of course, you’re the expert in knowing, you know how the session looks, what the medication can do, what you know, kind of are the interventions. But then you’re following the process, and client is the expert of their experience. And so these guiding principles, you know, are similar in both of these medicines. And so, you know, the process is similar, and, and, you know, there are some of these characteristics that are different,

Dr. Sandy Newes 35:12

yeah, so this is kind of the million dollar question, having done both, like, what is cap? Not

Veronika Gold 35:20

that MDMA, yeah, and, you know, the work I’ve done with MDMA was in the clinical trials, which had very specific protocol, and it has been an integral, you know, really incredible opportunity to work with trauma, and the results of the studies show how effective it has been, and so being able to sit there as a researcher and see the shifts that did happen to our participants has been, you know, really unlike anything else I’ve, I’ve, I’ve done and and, you know, we work with PTSD and trauma with ketamine as well. It the process looks little bit different. And, you know, I think for some clients, is, is that they appreciate the shorter sessions, so that it kind of, you know, is little more titrated.

Dr. Sandy Newes 36:39

But I think both are beautiful into a clinical practice. That’s for sure. You know, people can go about their day and, you know, so it’s just interesting, because I do trauma work with ketamine, and follow similar things with maps protocol, and I’m always just kind of like, you know what you know? Just just just really curious about, about that ongoing conversation, and I really appreciate you for, really, you know, being one of the pioneers of that. Because when I first came into the ketamine field, it was like, No, we don’t do ketamine for trauma. And I was like, kind of, why not, you know. And so, you know, thank you for that. So, yeah, that brings us to just a piece, and we don’t need to spend a ton of time on this, or we could, but, you know, mindful of time. And you know, there was a recent New York Times article in which you were featured and about the MDMA, and it was about some of the controversies, about, you know, some of the criticisms leveraged at the research and groups that had that, that, you know, essentially had a lot of power and really derailed, you know what, in my opinion, I’ll just come right out and say it, because I don’t have to not be biased. Like that was really good research, and in my opinion, it should have been approved, because it was well it was well planned. It was a 20 year type of control. The criticisms that were leveraged are things that are endemic to psychotherapy outcome research, and, you know, that’s a whole nother set of conversation, but, you know, I appreciated your courage in that article for really coming out and speaking to some of that, and, you know, some of the controversies, and I’m just wondering if there’s anything that you want to give voice

Veronika Gold 38:04

to about that, bringing up this, this article that I think has been really important to bring some of what has been happening around the clinical trial and approval process. And, I mean, that

Dr. Sandy Newes 38:24

was just straight up courageous of you to, you know, give that interview and to be in that article, because it, you know, I mean, I just appreciate that, you know, there’s got to be some fear and some nervousness around that, because some of those forces that are against that have been pretty, pretty negative, pretty, pretty harsh

Veronika Gold 38:44

in the interview has been specifically about false allegation you could say, or misrepresentation of what has happened. And I have a chapter in a book where I talk about somatic therapy, consent, the types of interventions, and I am describing one of my client sessions in a ketamine session, and part of that session, taken out of context, was presented in the in the FDA hearing as something that I have supposedly done in in an MDMA session, and it was misrepresented. And so, if it has been very confusing and and so there was this opportunity when New York Times asked about it, to share more about this experience.

Dr. Sandy Newes 39:50

Yeah, great. I mean, thank you for doing that like because it gave, you know, just people like me, a window to even talk to just people in my general community. You know, who came. To me, and they’re like, you know, tell us about this, like, These things seem, you know, because, again, at face value, it’s like, yes, we don’t want to hold people down and, you know, all the different criticisms, but it gives an opportunity to understand that there’s really a lot more of the nuances to the whole process overall. So, you know, thank you for giving birth to that really

Veronika Gold 40:19

difficult thing about it was that there was this misrepresentation, you know, sharing about essentially doing something to a client against their will. The it said that I pinned down a client. And of course, absolutely, that did not happen and and I never described that also that happening, but somebody who reads that might believe that that is true, because they might have no reason. They might not have access to the book where I described a chapter, and they might believe that a therapist who’s been extensively trained and who’s been watched on video and supervised has violated a client in this clinical trial. And you know what violations can happen and have happened, but it was, you know, quite confusing and shocking that this was represented in this way, yeah. And so, you know, as a response to that, Lycos had reviewed all my videos, all my sessions again, because you’re, you know, being watched kind of as decisions are happening. And then there was a record of these sessions, and they acknowledged in a letter that there hasn’t been anything of concern to you know, what was available there. So I, of course, knew that, but it was also good to have you know kind of that there is this process that happens. I just think

Dr. Sandy Newes 42:01

that’s really, really important for people to understand that, you know, the use of pressure is, is a very intensive, you know, it’s a very intentional clinical intervention that is specifically designed, you know, to work through a variety of different clinical issues. And I use it. We use it like it’s very common. And so, you know, that is not holding somebody down, and yet we also need to be really mindful about having, you know, training and awareness and a high degree of intentionality in the way that we utilize such things as well. So I’m just grateful that you gave that some voice. So thank you, and it’s

Veronika Gold 42:39

almost a way of never overpowering the patient, you know. So when you’re putting the the pressure, it’s always to allow them to have the strength. So it’s kind of like a helping, you know. And so in the beginning, the client might just have no strength, because they’re in the freeze response from something that happened. And they kind of like, and so then my hand is very, you know, like there is almost no resistance or no strengths at all. And as they’re getting a little bit more then, then there is a little bit more. And then, you know, it kind of moves from the freeze sometimes, to more of that energy of a fight, where they have the ability to feel their strengths and ability to, you know, self protect, for example, and you know, and then we oftentimes invite a voice, you know, can you make a sound? Are there any words that go with that? Is there something you would like to say? Is there something you, you know, would have like to say to the, to the, to the perpetrator, you know, for example, and so the client might also get back their voice, because part of the trauma is that the clients are oftentimes silenced, and not that they’re frozen in their body, but also in their expression. And so then they’re able to kind of get their voice back. And you know, there is oftentime release that’s connected with that that might be crying, it might be sweating, that might be shaking, and there is a completion of this unfinished motor movement. There is a release of this energy that was held in the body and and so, it’s a, it’s, it’s a such an important part of the of the work, and, you know, and I think it’s important to have a person rather than, for example, pushing a wall, because the wall does not respond, right? It’s, it’s and does not move. And so it’s, it can be helpful as well at certain moments, but if you’re there and you’re able to be with them, and they know you’re the therapist, they’re their client. They’re in a safe space, and they’re getting in touch with something that you know challenging, so that it’s kind of this, this safety of feeling, these difficult feelings and and being able to. Through it and process it is the is a beautiful gift if it’s a non medicine session, or if it’s a medicine session,

Dr. Sandy Newes 45:07

well, that’s, I mean, a beautiful gift is a beautiful way to say that. Because I read that article and I was like, Ooh, you know, like, what if there was a world in which that was somehow made? Like, not okay? Because I personally find it to be a huge part of the clinical work that I do. And so once again, I appreciate you for putting yourself out there and giving us such a great explanation, both in that and also here. So thank you for that. So this is my last question for you. If you What would you like to share with the world? Like, what would you like to, you know, share with people about either about the field or something that people might not know about you. Or, you know, what would you like to share? And you know, if you also want to kind of end and tell us about any upcoming Polaris trainings, that would be awesome as well. Thank you. I think

Veronika Gold 45:59

it’s just so important to be, you know, doing this work, sharing information, getting information, and for therapists to do their work, it’s kind of, there’s always new, new layers, and I think that is the most Important thing. And, you know, my hope is that even with these what I see setbacks in in the process of working with this, the psychedelic medicine that we are learning in the process, and that there is more therapists with proper training offering this work, and I’m excited about the future of the field.

Dr. Sandy Newes 46:47

Good, so am I, you said, beginner’s mind. I love that. Like learning how to stay in beginner’s mind, like, you know, you still have a skill set, you still have an intention, you’re still doing clinical intervention, but can we stay in that place of the inquiry and the curiosity, and in that beginner’s mind like not needing to know. So it’s an interesting dance. So, so where can people find you? How can they find out about Polaris?

Veronika Gold 47:14

polarisinsight.com is our website. There is information on the clinic, on me, or another therapist who work at Polaris and then there is the Polaris training, which also is through Polarisinsight.com and we always have new modules offered. There are the experiential trainings about three times a year. The next one is in August. And we also provide consultation and supervision, so that’s the best way to find us

Dr. Sandy Newes 47:46

good well. Thank you so so much. Veronika. I really appreciate it, and thank you everybody who was listening. And we’ll stop here. Thank you again.

Veronika Gold 47:56

Thank you for having me. Thank you.

Outro 48:01

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