Psychedelic Medicine Podcast with Dr. Lynn Marie Morski Lynn Marie Morski, MD, JD

In this episode of the Psychedelic Medicine Podcast, Chandra Khalifian, PhD joins to explore ketamine-assisted couples therapy. Dr. Chandra Khalifian is a clinical psychologist, researcher, educator and Co-CEO of Enamory, a clinic and community focused on providing expansive relationship education and therapy including psychedelic-assisted couple-therapy.
In this conversation Dr. Khalifian explores the intricacies of ketamine-assisted couples therapy, sharing why she thinks psychedelics, and ketamine in particular, could be a good fit for couples therapy. She discusses the various contexts where ketamine-assisted therapy may be a good fit for couples pursuing therapy, the therapeutic modalities well-suited to this work, and the different dosing and administration routes of ketamine. In closing, Dr. Khalifian explores situations where couples may be better suited to pursuing this therapy individually and also contexts where ketamine-assisted couples therapy would not be an appropriate intervention.
 
In this episode you'll hear:
How Dr. Khalifian got involved in couples therapy The various models of ketamine-assisted couples therapy, and how to decide what is most appropriate The importance of preparation and integration How to navigate the two people in the couple having very different ketamine experiences When Dr. Khalifian uses intramuscular ketamine infusions versus ketamine lozenges Why Dr. Khalifian leans towards using third-wave cognitive behavioral therapy for ketamine-assisted therapy The tendency for people to make major relationship decisions following intense psychedelic experiences  
Quotes:
“Ketamine is great because—in the same way with individuals—with couples it’s going to pull us out of that pattern so that we can then see the pattern and talk about the pattern from this observer perspective rather than being stuck in the ‘it’s me versus you’ we can look at it together and the couple can say ‘ah, there’s that thing that we do when we feel distressed, and now we can work together on that thing since we can see it from a little more distance.’” [4:43]
“Similar to MDMA, people are less likely to express criticisms in a hurtful way and less likely to receive constructive criticism and be defensive [during ketamine therapy].”  [9:05]
“I had one couple [as patients for ketamine therapy] that the partner was like ‘I just felt this liquid compassion. I finally understood why she was engaging in these behaviors. And so everything made sense and I was able to talk about it in a different way.’” [17:49] 
 
Links:
Enamory website
Enamory on Instagram
Previous episode: MDMA-Assisted Couples Therapy with Kayla Knopp, PhD
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Dr. Evan Cole Lewis joins to explore the topic of psychedelics and seizure disorders. Dr. Lewis is a Canadian Neurologist and holds an appointment as Assistant Professor in the Department of Paediatrics at the University of Toronto. He has special interest in the treatment of neurologic disorders, including functional seizures, with psychedelic therapies.
In this conversation, Dr. Lewis shares his expertise on a number of topics at the intersection of psychedelics and seizure disorders. He discusses the neurology behind psychedelics and functional neurological disorders more broadly, explaining why he thinks this is a very promising area of research. He explains that currently very little is known about the topic of psychedelics and seizure disorders, as almost all studies have had epilepsy as an absolute contraindication, leaving researchers with only case reports. However, there are some promising indications in the preclinical data which warrant further investigation. In closing, Dr. Lewis sheds light on potential seizure risks resulting from interactions between psychedelics and other medications. 
 
In this episode you'll hear:
The different between epileptic seizures and functional seizures How Dr. Lewis started exploring the topic of psychedelics and functional seizures Why Dr. Lewis thinks psychedelic science has the potential to rebuild bridges between neurology and psychiatry Dr. Lewis’ experiences treating epileptic patients with ketamine The potential for co-administered lithium and psychedelics to cause seizures  
Quotes:
“I tell people psychedelics are brain network medicine—they kind of dissolve those networks. If the thinking is that FND [Functional Neurological Disorder] is due to dysfunctional connection or hyperconnectivity in certain networks, what we have to do is we have to repair those networks, but first we have to take them apart and build them back up.” [11:03]
“Regardless, even if there isn’t even a condition in which psychedelics are utilized in neurology, we need the neurologists to be able to indicate that these patients are safe—or at least do the work and be involved in the clinical team.” [21:05]
“Things like drug interactions we pick up with psychedelics again are going to be a big piece of the puzzle that needs to be answered going forward.” [29:17]
 
Links:
Dr. Lewis on LinkedIn
Dr. Lewis on YouTube 
Exploring psychedelic-assisted therapy in the treatment of functional seizures: A review of underlying mechanisms and associated brain networks by Dr. Lewis et al.
Case report: Improvement in refractory functional seizures, depression, and quality of life with ketamine assisted-therapy by Dr. Lewis et al.
Psychedelics, epilepsy, and seizures: a review by Dr. Lewis et al.
Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review by Kelan Thomas, Benjamin Malcolm, et al.
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Dr. Jenna Valentine joins to explore the intersection of psychedelics and somatic therapy. Dr. Valentine is a doctor of Chinese Medicine who incorporates both functional medicine and somatic experiencing within her practice to help achieve optimal wellness.
In this conversation, Dr. Valentine introduces somatic therapy, drawing parallels to psychedelic work and exploring how this modality may support more healthy and holistic psychedelic experiences. She explains how somatic therapy proceeds by tuning into the body, with therapists helping to guide clients’ awareness of the intelligence in their bodies.
Dr. Valentine emphasizes the importance of not forcing things in somatic work - with gentler, slower practices often being best to align with health. In closing, she outlines how somatic therapy can be used for preparation and integration of a psychedelic experience, and also explores the possibilities of somatic modalities being used during psychedelic therapy. 
 
In this episode you'll hear:
The different forms of somatic therapy The overemphasis on the mind in our culture Why there aren’t contraindications for somatic therapy Somatic therapy as a modality for working with patients diagnosed with biploar disorder or schizophrenia The intersection of healing and re-learning to be playful The importance of “doing less” Why glorifying “heroic doses” of psychedelics can be counterproductive to healing Shadow work and somatic therapy  
Quotes:
“There’s many different definitions of [somatic therapy] but the one I love the most is: guiding yourself back to your body as your primary resource.” [4:02]
“A lot of the work is making sure people learn that they don’t have to feel afraid of themselves—no part of you is ‘coming to get you’ … no part of you is trying to trick you or hurt you or surprise you. Sometimes I’ll describe it as I’m helping people guide themselves back to themselves and find a safe home there again.” [13:05]
“We have lost our relationship with discomfort, and a lot of this work is uncomfortable. And the work is being in the discomfort and building a larger capacity for being uncomfortable, and learning the difference between uncomfortable and unhelpful, because that’s not something we’re trained in.” [23:41]
“There’s learning that can happen in everything … The expectation is to have no expectation: we can have a loose intention, and then let the body lead.” [47:18]
 
Links:
Dr. Valentine on Instagram
Dr. Valentine’s website
Psychedelic Medicine Association
Porangui

In this episode of the Psychedelic Medicine Podcast Tommaso Barba joins to explore the topic of psychedelics for sexual functioning and intimacy. Tommaso is a PhD candidate at the Centre for Psychedelic Research at Imperial College London where his research is focused on understanding the potential role of psychedelic drugs for well-being. Tommaso authored the first paper on the effects of psychedelics on sexual functioning.
In this conversation, Tommaso shares results from the multiple studies into psychedelics and sexual functions he has been involved in. He reports that in both a trial comparing psilocybin and escitalopram and a survey of naturalistic psychedelic use, respondents reported positive impacts on sexual functioning following psychedelic experiences. He also speculates about aspects of the psychedelic experience that are interpreted as “erotic” in the midst of the altered state and the reported shifts to experiencing sexual connection as more “spiritual” following psychedelic experiences. In closing, Tommaso discusses the promise of psychedelic journeys for healthy couples and the difficulties of researching this topic since there is no clear pathology being addressed. 
 
In this episode you'll hear:
How Tommaso got interested in the intersection of psychedelics and sexual functioning Why SRRIs often have side effects of inhibiting sexual function How psychedelic neuropharmacology may help explain improved sexual functioning following psychedelic experiences The upcoming studies exploring the effects of psychedelic journeys on couples who undergo the experience together The possible differences between MDMA and classic psychedelics in terms of mechanism and impact when it comes to effects on sexual function  
Quotes:
“When we looked at the positive affect symptoms—like wellbeing, connectedness, ability to feel emotions, and so on… Psilocybin outperformed escitalopram. And given so, we were really curious to investigate further the sex lives of these patients, because an active sex life is a key component of people’s wellbeing, and a very overlooked one.” [7:34]
“What we found was that people treated with psilocybin reported improvements in sexual pleasure, in capacity to communicate sexual desires with their partner, in sexual arousal, sexual satisfaction, and similar components of sexual functioning, while people treated with escitalopram did not report any of these changes and tended to report deterioration in this aspect of functioning.” [11:10]
“[These psychedelic treatments may] work because it disentangles couples and its capable of individuating the two patients into the context of their relationship so that they start to develop a better identity in the context of the relationship instead of being completely fused into each other and not capable of really developing themselves and communicating their desires and what they want.” [31:15]
 
Links:
Tommaso on Twitter
Tommaso on LinkedIn
Imperial College Centre for Psychedelic Research online survey study: psychedelics and couples
Previous episode: Microdosing and the Placebo Effect with Balázs Szigeti, PhD
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast Kayla Knopp joins to explore the topic of MDMA-Assisted Couples Therapy. Dr. Kayla Knopp is a clinical psychologist and researcher specializing in non-traditional couples and relationships. She specializes in making couple therapies more inclusive, accessible, and effective, including MDMA- and ketamine-assisted couple therapy.
In this conversation, Dr. Knopp introduces MDMA-assisted couples therapy, discussing why this entactogen is a good fit for couples therapy. She discusses how MDMA helps couples explore issues by dissolving typical defensive boundaries and encouraging empathy. She emphasizes that not all couples may be a good fit for this therapy, however, and especially cautions against couples therapy in contexts of abuse where connecting with resources for safety and pursuing individual courses of therapy is more appropriate. In closing, Dr. Knopp discusses the importance of screening and the responsibility the psychedelic community has to ensure these substances are being used in safe and effective therapeutic contexts overseen by qualified and caring facilitators.
 
In this episode you'll hear:
The history of MDMA-assisted couples therapy When couple therapy is and is not appropriate Integrating MDMA-assisted therapy with cognitive-behavioral conjoint therapy for PTSD Therapeutic modalities which may be well-suited to MDMA-assisted couples therapy
 
Quotes:
“[MDMA] does so many things that are facilitative of the primary goals of couples therapy, which are to reduce defensiveness, to increase the flexibility that we have in taking our partner’s perspective, increase the empathy and intimacy we feel with other people, increase the reward that we get from positive interpersonal interactions.” [4:33]
“When we treat relationship dysfunction, we know mental health often improves as a result of that and conversely, we also know that sometimes when we do mental health treatments, if we ignore the relational context that somebody is living in, we only give them part of what they need in order to fully heal psychiatrically. So, couple-based interventions for mental health disorders, including PTSD, are up-and-coming as a really effective way to address mental health concerns.” [8:14]
“MDMA tends to increase our window of tolerance for emotional experiences—it makes it safer and easier for us to remain in contact with feelings that might otherwise feel pretty overwhelming.” [23:48]
“I think there’s absolutely a lot of ego and a toxic guru model that can show up in psychedelic-assisted therapy that, as a community, as practitioners, as participants, we need to keep an eye out for and keep ourselves accountable as a community to make sure that we’re not giving folks a pass.” [31:17]
 
Links:
Dr. Knopp on Instagram
Enamory website
Enamory on Instagram
Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)
Psychedelic Medicine Association
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In this episode of the Plant Medicine Podcast, Dr. Mark Braunstein returns to discuss potential concerns surrounding the use of ketamine, especially use which is not overseen by a knowledgeable medical professional. Dr. Braunstein is a whole-health psychiatrist with 22 years of clinical experience. He is the medical director for multiple mental health and psychedelic psychotherapy clinics in Colorado, New Mexico, and Utah and he also runs in-patient and out-patient programs for addiction. Additionally, Dr. Braunstein is involved in multiple projects focused on expanding access, awareness, research, and safety in the field of psychedelics.
To begin this conversation, Dr. Braunstein shares how his original exposure to ketamine wasn’t in a medicinal context, but rather as a recreational drug of abuse. However, since then he has seen the transformative effects this substance can have on patients when used in a physician-directed context and for therapeutic purposes. Nonetheless, Dr. Braunstein stresses that this does not mean ketamine use does not come with certain risks.
Ketamine can be addictive and even carries a risk of overdose, particularly when used recreationally in a context where the purity of the substance is unknown. Dr. Braunstein distinguishes recreational and therapeutic uses of ketamine, explaining that recreational doses are often lower and dosing is more frequent, whereas ketamine is used in high doses in a therapeutic context, with extended periods between sessions.
Dr. Braunstein stresses both the responsibility of physicians and of patients to ensure ketamine is prescribed responsibly and used as directed. Despite the dangers posed by recreational ketamine use Dr. Braunstein describes in this conversation, it is still a medicine he believes can have significant positive impacts for patients. This requires, however, that it not be treated merely as yet another quick fix pill. Instead, Dr. Braunstein emphasizes that ketamine treatment ought to coincide with psychotherapeutic work. This combination, he says, will maximize the therapeutic potential of ketamine while also helping to ensure that the medicine is used responsibly, under the close direction of a medical professional.
 
In this episode:
The addiction and overdose potential with recreational ketamine use How dosage can dramatically change the effects of ketamine Responsible prescribing practices for physicians working with ketamine The psychological and physiological harms of ketamine abuse How Dr. Braunstein talks to his patients about responsible use before prescribing ketamine The importance of combining psychedelic medicines with psychotherapeutic work  
Quotes:
“Part of why ketamine works is because it lights up your brain in all these different ways and when done occasionally, intentionally, it moves you. But if you’re always doing that, it ends up having the reverse effect, causing damage.” [12:56]
“This is a heavy-duty medication that, if you cross the line, can cause you to stop breathing and then die. So there is an actual, real danger to ketamine.” [16:25]
“I think the organ that is most prone to damage from overuse of ketamine is the same organ we are touting it fixing: the mind.” [18:39]
“When we think about these medications, we should think about combining them with therapy and not just taking these medications as medications… So that’s why with ketamine I’m really recommending it with therapy.” [25:04]
 
Links:
Reconscious Medical
Psychedelic Medicine Association
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