In this episode, Kyle interviews C.J. Spotswood, PMHNP-BC: author and board-certified psychiatric-mental health nurse practitioner currently enrolled in CIIS’ Psychedelic-Assisted Therapies and Research certificate program.
He talks about his introduction to psychedelics and his first patient immediately asking him about microdosing; why he changed his mind on microdosing and why he wrote his book; microdosing studies he’s most excited about; the terms: treatment-resistant depression, risk reduction, and flight nurses; Irving Kirsch’s work uncovering the bad science of research studies; the need for physicians to know enough about psychedelics to be able to meet their patients where they are; the importance of group work; and how, while they’re already so well-versed in caring for patients, using nurses to their full licensure could be the answer to the quickly growing psychedelics and scalability problem.
“When you look at the early research into the 50s in the 60s; they were doing microdosing research, they just didn’t have a title for it. They thought they were using placebo levels but they were actually looking for threshold levels; things like that. Really, it was what by today’s standards [would be an] amount that we would consider as a microdose.”
“I don’t like the term [treatment-resistant depression] when we use that because if you’re using [it] when you’re looking at the standard medications like SSRIs [or] SNRIs, they’re basically all the same. …So when you say that someone’s ‘treatment-resistant’ for three medications, four medications that are all basically working the same pathways and in the same amount; is that truly treatment-resistant, or are we just trying the same thing with just different medications, whereas doing microdosing is a different pathway [and] is a different approach?”
“My first patient I ever saw as a new clinician, like, literally my first patient: I come in and I’m starting to talk to them for the first interview and I got to the point and I’m asking them: ‘Where are we going, what do you need?’ and they said to me, ‘Do you know anything about microdosing?’ …I said to them, I go, ‘Yeah, I know a little bit.’ …So I asked her what she knew, and she knew quite a bit. And she goes, ‘What do you know?’ and I kind of just said to her: ‘I don’t really know how to put this, [but I] wrote a book on it and it’s going to be coming out next year.’ …It reinforced my feeling [that] I’m doing the right thing: this career suicide I’ve thought of, going into working with psychedelics and being open and talking about it, hearing my first patients talking about it – it’s got to be serendipity.”
In this episode, Joe interviews Zach Leary: host of the MAPS podcast, facilitator at Evo Retreats, author, and of course, son of psychedelic legend, Timothy Leary.
Leary was last on the podcast four years ago, so this episode serves as a bit of a check-in and reconnection, and truly goes all over the map. He discusses his relationship with Ram Dass and reconnecting to psychedelics (and himself) after a 13-year spiritually-bankrupt career and not quite understanding his identity outside of his father’s shadow; why the psychedelic facilitation role shouldn’t be standardized; Dave Hodge, Kilindi Iyi, and super high-dose experiences; ancestor work; solo ski trips compared to the Vipassana experience; the ease with which people play Monday Morning Quarterback with the story of his father; floatation tanks and the birth of ketamine; why Ram Dass held a grudge against Dr. Andrew Weil; and critiques of Michael Pollan – how much How to Change Your Mindskipped, how little experience Pollan had before essentially jumpstarting a revolution, and how many people now think they’re ready for a psychedelic experience when they’re likely not.
Leary just recorded with Rick Doblin for the MAPS podcast, he’s finalizing his first book (tentatively titled And Now the Work Begins – Psychedelics in the 21st Century and How to Use Them), and launching an online 8-week course called “Psychedelic Studies Intensive,” which begins February 8. He will also be a guest at our first conference, Convergence (March 30 – April 2).
“I don’t believe that the psychedelic facilitation role or experience should be standardized. There are just so many ways to do it. There’s no one way to do it. Sure, there are some wrong ways to do it, there’s no doubt about that. But it shouldn’t be standardized. It shouldn’t be generic. It shouldn’t be one-size-fits-all. It really doesn’t matter to me if somebody has gone through the MAPS training program or CIIS; that doesn’t make them any more qualified than some of the amazing underground visionaries who are doing healing work as well. …No one psychedelic experience is the same. Why should the facilitation experience be the same?”
“It sort of becomes like a catch 22: If you have to ask if you’re ready for psychedelics… I don’t know, maybe you’re not.”
“If you look at every iteration on the war on drugs; every single one, going back to the late nineteenth century criminalization of opium against Chinese immigrants in the bay area, to African Americans [and] cocaine, to [the] Hispanic population and ‘Reefer Madness’ to white, long-haired, anti-authoritarian hippies dropping LSD, African Americans [and] the crack epidemic – every single time (I mean, this list is endless), it always goes back to a war against people [they] don’t like. And once you do that, you create an inherent system of corruption to fuel that, because it’s a civil war. It’s not a war against the drug. It’s a civil war against behavior [and] against consciousness.”
“This isn’t a political issue. It’s a human rights issue. Like it or not, every single society on the face of the Earth since recorded history has used mind and mood-altering chemicals. And that is never going to change, ever.”
In this week’s episode, Joe and David team up again to discuss what news interested them the most this week: the DA dropping a felony drug charge against a mushroom rabbi in Denver due to the passing of Proposition 122; Numinus Submitting a Clinical Trial Application to Health Canada that would give in-training practitioners the ability to experience psychedelics with their psilocybe-containing EnfiniTea; and a University of Exeter-led trial moving forward with the next step in a study using ketamine for alcohol use disorder (with 2/3 of the money coming from the National Institute for Health and Care Research).
They also review a paper that analyzed the economics of psychedelic-assisted therapies and how insurers come into play; as well as The Journal of the American Medical Association stating that, based on current trajectories compared to cannabis legalization, they believe the majority of states will legalize psychedelics by 2037. So nice to see these continued steps in the right direction!
And if you missed it, we just announced that applications are open for the next edition of Vital. There are incentives to paying in-full by certain dates, so if you missed out on last year’s edition or have been curious, attend one of our upcoming Q+As!
In this episode, Kyle interviews psychologist, psychotherapist, author, and certified Holotropic Breathwork® facilitator: Marc Aixalà.
Aixalà is part of the International Center for Ethnobotanical Education, Research and Service (ICEERS), offering integration psychotherapy sessions, developing theoretical models of intervention, and training and supervising therapists. He is also the writer of the recently released, Psychedelic Integration: Psychotherapy for Non-Ordinary States of Consciousness, of which you can win a copy by entering our giveaway here!
Aixalà wrote the book after receiving more and more emails from people asking for guidance on how they were supposed to process a recent experience, and he realized that so much was unknown around the concept of integration: What exactly does it entail? Has the psychedelic space created a narrative that you need integration when maybe you don’t? When is the work considered integration and when is it psychotherapy?
He talks about some of the metaphors he uses to explain integration; the seven scenarios he typically sees in people seeking integration (and how to respond to each); philosophical constructivism and the importance of working with someone within their preferred cosmology; how the psychedelic hype has created a marketplace full of competition (and why that could be bad); and why he thinks being trained in Holotropic Breathwork is perhaps more important than being trained in facilitating a psychedelic experience.
“One of the things that psychedelics show us (or for me, the main thing) is that somehow, healing is inside of us and growth is inside of us, and they teach us accountability, they teach responsibility, and they teach us that we are the expert of ourselves – that our journey does not depend on an external person. So in my way of practicing integration, I also want to honor that, and do integration when it’s needed, but not create an additional need for people that don’t have it.”
“I think that that’s the richness and the beauty of psychedelics and the psychedelic experience, is that it cannot be understood from just one prism. No, it’s a trans-disciplinary approach that will give us a more subtle understanding of different dimensions included. I don’t think that there’s one way that is better than the other of using psychedelics, [just] as I don’t think that there’s one Shamanic tradition that is better than another Shamanic tradition. Things are there for a reason and we find what resonates more with us.”
“I believe that breathwork can be more effective than psychedelics to deal with certain emotions; things like anger, rage. The body and the somatic part of a traumatic event; that has worked very well with breathwork in my opinion – better than with other substances because it provides some sort of mental clarity that is not distorted by the archetypal aspects of psychedelics.”
Shannon feels that the majority of people who are interested in (and could benefit from) psychedelics would prefer that their experience be as close to a conventional medical setting as possible. And especially with the risks of rogue practitioners, licensing boards want to see predictability, uniformity, regulation, and (perhaps most importantly) that we as a psychedelic culture are placing importance on being accountable and self-governing. He wants to establish a certification process that’s standard enough that which medicine the patient is using will become secondary.
He discusses what the certification process will likely look like; why uniformity is so important; the challenges of respecting and integrating Indigenous traditions into a medical model that’s drastically different; what people should look for in psychedelic education; and the importance of breaking from a siloed and hierarchical model into one that’s cross-disciplinary, where professionals of all types can work together for the betterment of the patient.
“The premise of the certification board is that we’re trying to certify a process …of medication-assisted, psychedelic-assisted psychotherapy that looks at integration [and] prep, that looks at set and setting, that looks at the sacred container of this relationship; and that we build that, and that is the core of it, and the medications become a little bit secondary. We can bring ketamine in, we can bring DMT in, we can bring psilocybin [in], [and] we can bring MDMA in; because these medications, frankly, they’re not really chemically-related or that similar, but what’s similar is the process that patients go through with them.” “There’s always the question of: ‘How do I get training?’ …The Psychedelic Science Funders Collaborative just did a survey of the field of education and found that there are now over 50 providers of psychedelic education, and four years ago, there might have been a handful. But someone coming [up]: What do they do? ‘How much do I need to study?’ These things are expensive. It’s confusing. So we want to create a clear, professional path [where] someone says: ‘I’m going to step into this and do this as a career. Here’s what I need to do? Good. I can do that.’”
Scott has been a student of consciousness since his honor’s thesis on that topic at the University of Arizona in the 1970s. Following medical school, MDMA-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a Psychiatry residency at a Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico. Scott has published four books on holistic and integrative mental health including the first textbook for this field in 2001. He founded Wholeness Center in 2010 with a group of aligned professionals to create innovation in collaborative mental health care.
Scott is a past President of the American Holistic Medical Association and a past President of the American Board of Integrative Holistic Medicine. He serves as a site Principal Investigator and therapist for the Phase III trial of MDMA assisted psychotherapy for PTSD sponsored by Multidisciplinary Association for Psychedelic Studies. He has also published numerous articles about his research on cannabidiol (CBD) in mental health. Scott founded the Psychedelic Research and Training Institute (PRATI) to train professionals in ketamine-assisted psychotherapy and deliver clinically relevant studies. Scott co-founded the Board of Psychedelic Medicine and Therapies in 2021 and currently serves as the CEO for this non-profit public benefit corporation. He lectures all over the world to professional groups interested in a deeper look at mental health issues and a paradigm shifting perspective about transformative care.
In this episode of Vital Psychedelic Conversations, David interviews philosopher, clinical psychologist, Grof-certified Holotropic Breathwork® facilitator, and long-time mentor to Joe and Kyle: Lenny Gibson, Ph.D.
They talk at length about shamanism, Greek mythology, tribal cultures, and the overlapping themes across them. They discuss how religion became but a shadow of the ancient wisdom these cultures held; the commonalities between physics and poetry; how Holotropic Breathwork is a shamanic technique appropriate to 20th century western culture; and the battle between attainable knowledge and the vice of ignorance.
Gibson discusses the “dying before dying” that took place at Eleusis; how practices like meditation and breathwork can help us in recovering what in Zen is called “original mind;” achieving mystical enlightenment by studying mathematics; and the philosophical parallels between Plato, Kurt Vonnegut, Alfred North Whitehead, and the ancient Greeks.
He also shares how LSD has reshaped shamanism along with a fun story from the first time he met Albert Hofmann. When considering the most vital conversations people should be having, Gibson encourages us to return to the origins; to study the lineages that embodied the mystical wisdom discovered through non-ordinary states – something he believes our modern culture is missing. In the words of Leon Russell, “May the sweet baby Jesus shut your mouth and open your mind!”
“Lao Tzu says, ‘The secret awaits the vision of eyes unclouded by longing.’ The secret is in plain sight. All one has to do is step back and pay attention.”
“Conformity and deep understanding don’t go together.”
“I try to discourage the focus on substances because one of the most important means in Greek culture was poetry. Homer may or may not have been a person identifiable, but his poetry survived as a body. …The Greeks gathered in large festivals and they would recite the poems of Homer, The Iliad, and The Odyssey, and get thousands of people together chanting the same poems – a huge rave!”
“The absolutely most impressive thing about Stan Grof’s discovery …that if you empower people in accessing their deepest Self, you will get more than you could get by having a psychoanalyst talk to them about themselves.”
Leonard (Lenny) Gibson, Ph.D., graduated from Williams College and earned doctorates from Claremont Graduate School in philosophy and The University of Texas at Austin in counseling psychology. He has taught at The University of Tulsa, Oklahoma, and Lesley College in Cambridge, Massachusetts. He served a clinical psychology internship at The Veterans Administration Hospital in Boston, Massachusetts, and trained in Holotropic Breathwork with Stanislav Grof. Most recently, he has taught Transpersonal Psychology at Burlington College. Together with his wife Elizabeth, he conducts frequent experiential workshops. He is a founding Board member of the Community Health Centers of the Rutland Region. As a survivor of throat cancer, he has facilitated the Head and Neck Cancer Support Group at Dartmouth-Hitchcock Medical Center. Lenny is President of Dreamshadow Group. He raises vegetables, fruit, and beef cattle on a homestead in Pawlet, Vermont, and plays clarinet in local bands.
This talk covers a lot but really hits home on a few very important topics: the clinical model’s limited perspective; the importance for psychedelic boards to self-organize before government agencies step in; and how cannabis can actually be as powerful a psychedelic as DMT. They mull over where the field of psychedelics is going and wonder: Who gets to do this work? And can psychedelics really fit within our current medical models?
McQueen digs into the non-licensed approach to facilitation; the difference between coaching, counseling, and psychotherapy; and describes valuable harm reduction strategies, vital self-care practices for facilitators, and ways to navigate the (not talked about enough) transformational process of being a guide for others. If you experience anxiety or paranoia from cannabis, you’ll learn how Nano CBD can shut it down almost instantaneously. Last but certainly not least, McQueen shares all about the transformative work and trainings he and his colleagues are doing at both the Center for Medicinal Mindfulness and Psychedelic Sitters School.
“We’ve got to have our boards, we’ve got to become members of those boards, and we’ve got to self-organize and regulate. Otherwise, the government agencies are going to do it for us. It’s going to become super clinical, super medical. It’s going to limit the scope to only people who are really suffering and I think that’s a trap.”
“I’m thinking [cannabis is] probably one of the best psychedelics for trauma resolution work and other things. So I’m way past ‘Is this psychedelic?’ I’m stepping into: ‘This might be one of the best medicines for psychedelic therapy and guiding that we have available.’”
“I just was intuitively drawn from the beginning to do blends – to blend multiple strains [of cannabis] together – and I started to experiment on my friends. …One of my friends …sat up and said, ‘Daniel, if I didn’t trust you, I would swear you put DMT in that.’ And I hadn’t, it was just pot. And that was the moment. I’m like, ‘Okay, maybe there’s something to this.’”
“Sometimes these stories that we hear are the hardest stories to hear from another human being. So there’s an emotional impact to process. I’ve had to really evaluate my existential understanding of reality because of this job, so there’s that whole thing too. It’s not the same as psychotherapy, it’s just not. Professionally speaking, I tell people it’s more like being an emergency medicine doctor. You’ve got to take time off. Self-care is vital.”
In this episode of the podcast, Joe interviews Licensed Chemical Dependency Counselor and Holotropic Breathwork® facilitator, Christine Calvert.
At age 19, Calvert left Los Angeles and found her way to breathwork, spending four years in Grof Transpersonal Training. She quickly discovered that the technique served as a gateway back home to herself – her sacred self. Together, Christine and Joe cut through the many layers of the holotropic paradigm and transpersonal experiences, discussing how willingness for accountability & repair in facilitation are more important than perfection; the role of touch in breathwork sessions and the potential harm in not providing it; how amplification over suppression of symptoms in breathwork can heal; and how doing less as a facilitator can actually do more.
She also talks about the inner healing intelligence we all possess; how celestial nostalgia leads to mystical yearning; the ethics of spaceholding; the excitement and terror in expanded states of consciousness; saying yes to the entire archetypal pool; how Grof was (and still is) decades ahead of psychology; and what it means to die to ourselves.
“There [were], I don’t know, 175 people there. So that was my first big group breathwork. I was sitting first and I remember just looking out at the room which was just absolute pandemonium. It was like the display of the full human experience. I remember just crying because I was both totally intrigued and excited – like ‘Finally, I’ve arrived’ – and then I was also just incredibly terrified. I feel like that’s an interesting and kind of truthful reflection of how expanded state work is for a lot of people. There’s this part of me that feels home and also maybe a little healthy resistance to knowing what that also means for me.”
“One of the greatest gifts we can do for someone is to trust that what is happening for them is exactly what is needing to come through for their healing and that there’s nothing that we necessarily need to do in order to manage that.”
“I can’t imagine that continuing to just treat symptoms and see everything through a pathological lens is really all that fulfilling. Also we’re just the doers in that world. And as much as I think our ego wants that, behind that is always the desire to be a part of something that’s actually truly healing, and to know that we’ve empowered somebody to heal themselves. This is one of the things I love so much about the holotropic paradigm; is that it is about radical self-empowerment.”
“I think we have to stop being afraid to just be vulnerable. We have to stop being afraid of our humanity. As facilitators, as practitioners, as spaceholders, as participants in medicine and breathwork – this is what we have to really be willing to share. …When we’re willing to sort of knock ourselves off the saint pedestal as facilitators and spaceholders, I think then we might be able to hold this.”
Christine Calvert is a teacher and module facilitator for Grof Transpersonal Training and a Licensed Chemical Dependency Counselor. In addition to bringing Holotropic Breathwork® and other experiential workshops to mental health and addiction facilities, she is passionate about the ethics and integrity needed in facilitating expanded-state work; supporting the integration of Holotropic and psychedelic sessions through somatic resourcing; and creative expression, personal ritual, and group support. Her own personal healing journey was greatly influenced by the Holotropic perspective and she feels deeply dedicated to sharing this work with those seeking healing. She enjoys finding ways to weave her personal and professional experience of different therapeutic and spiritual systems such as Shamanism, Somatic Experiencing, Jungian psychology, attachment theory, and mindfulness practices into her work with others. Christine is currently studying to become a Naturopathic Doctor and maintains a private counseling and consulting practice in addition to facilitating Holotropic Breathwork® nationally.
In this episode of Vital Psychedelic Conversations, Kyle interviews clinical psychologist and integration facilitator (and now 3-time guest), Dr. Ido Cohen.
The topic of integration sits center stage for this discussion, as the two peel back all the nitty gritty and nuance of this psychedelic cornerstone, breaking down why integration is so important, where it stands currently, and where it needs to go as psychedelic-assisted therapy grows. They discuss the importance of taking it slow when it comes to exploration of these non-ordinary states – something that can be so difficult for us in our fast-tracked, clock-watching, Western culture, where it’s quite common for people to get blasted into inner-space on a Saturday, be shaken and perplexed by the experience on Sunday, and then have to go back to work and act like it never happened by Monday.
He discusses the value that both individual and group integration holds; what happens when you sit in groups of the same people over time; why Carl Jung never tried psychedelics; and the importance of tolerance, trust, and critical thinking when processing peak experiences.
And he raises some important questions like: What does long-term care in psychedelic-assisted therapy look like? What frameworks can be experimented with and implemented now to offer real movement from peak experiences to sustainable change? What is that bridge between peak experience and long-lasting change which allows us to become the insight? Is every insight true? Where does trauma work fit into this treatment? And what is the difference between symptom reduction and real healing?
“My mission has been: what does that bridge [look like] between experience and the steps that we have to take to really integrate in a deep embodied way to move from, ‘Oh, I can become this thing’ or ‘I have this insight’ to becoming the insight or becoming the thing?”
“I always use this catchphrase because I don’t like it, but it sells the psychedelic science:ten years of therapy in one session. I always say if you get ten years of therapy in one psychedelic session, then you had really bad therapy.”
“The psyche has an organic life. It opens up in the way it opens up. You can bathe yourself in ayahuasca and eat fifty grams of mushrooms per week [but] there are certain processes you can’t rush.”
“It’s funny how when we slow down, things become clearer faster.”
Dr. Ido Cohen, Psy.D, serves individuals, couples, and groups in San Francisco. As part of his practice, Ido works with a diverse range of challenges – childhood trauma, inner critic, relational issues, as well as integration and preparation sessions with individuals and groups. His doctoral dissertation was a 6-year study of the integration process of Ayahuasca ceremonies, while applying Jungian psychology to better understand how to support individuals in their process of change and transformation. He is also the founder of The Integration Circle and facilitates workshops on the different dimensions of integration and the intersection of mental health, spiritual health, and the entheogenic experience. Ido is passionate in supporting individuals to create longterm, sustainable change leading to vibrant, authentic, expressive, and love-filled lives.
In this episode of Vital Psychedelic Conversations, Kyle interviews Dr. Devon Christie: Senior Lead of Psychedelic Programs with Numinus Wellness, clinical instructor, counselor, and Co-Investigator and study therapist for a Canadian MAPS-sponsored trial investigating MDMA-assisted therapy for PTSD.
Christie talks about the importance of biomedical ethics and the unique considerations of psychedelic-assisted therapy: how psychedelics enhance the vulnerability and suggestibility in a well-established power dynamic, and how being aware of your power and biases is of the utmost importance towards not influencing your patient’s experience. They discuss just how much that experience is affected by every detail of preparation, and how it’s a very thin line between scaring someone off, setting impossible expectations, or even giving away too much of the experience (and with limitless possibilities, is that even possible?).
And she talks about the complications of touch and establishing (and honoring) informed consent; how true mindfulness can cultivate a greater capacity for self-regulation; how to handle situations where the client wants to know if a memory is real or not; the idea of psychedelics as a placebo; and many other complicated therapeutic concepts like harm of neglect, undue influence, making pleasure a virtue, cultivating agency, combating physician burnout, and the expectation effect.
“We don’t really know, but there may be aspects of psychedelics and their impacts that may make them ultimately like super placebos.”
“From my training as a relational somatic therapist, it’s actually not about the facts or details of what happened that matter. In fact, we can resolve trauma without even recollection of facts or details because we’re working with how it shows up in the body and how it’s showing up emotionally. …We can assist that process through working with what’s actually emergent in the felt experience and not needing to stay adherent to the narrative around it.”
“I think the yardstick on how far we’re going with this psychedelic work is that, either personally in our own journeys or even in the folks we’re supporting, we’re getting to a place where we don’t need the psychedelics – where the psychedelics have given us a reference, they’ve opened up new vistas of possibility, they’ve helped us to approach our lives differently, such that we are now cultivating the quality of presence and the quality of investigation and curiosity and flexibility and all those things that psychedelics can bring us – in our ordinary lives. …We’ve got these tools and they can help us learn and they can help us connect, and then hopefully we can come full circle and we can drop the tools and just be able to live meaningful lives that are sustaining for ourselves and for each other.”
Dr. Devon Christie is a medical doctor and registered counselor with a focused practice in chronic pain and trauma. She is trained to deliver both MDMA-assisted therapy for PTSD and ketamine-assisted psychotherapy, and she serves as Senior Lead of Psychedelic Programs with Numinus Wellness. Devon is also a certified Mindfulness Based Stress Reduction teacher, Functional Medicine practitioner, and clinical instructor with UBC Family Medicine. She is currently Co-Investigator and study therapist for a Canadian MAPS-sponsored trial investigating MDMA-assisted therapy for PTSD, and co-investigator on a pilot study investigating MDMA-assisted therapy for fibromyalgia.
In this episode of Vital Psychedelic Conversations, Kyle interviews clinical psychologist, author, and researcher, Dr. Adele Lafrance.
Lafrance developed Emotion-Focused Family Therapy, which focuses on the role of the family in psychedelic work. Realizing that the healing process disrupts systems and that dealing with a loved one who is going through a massive shift can be quite challenging for their loved ones, the idea behind EFFT is teaching family and significant others emotion-processing and behavioral support skills, how to make therapeutic apologies, how to recognize defensiveness and not react in a knee-jerk way, and how to find problematic caregiving problems where families accommodate for mental health issues (and therefore perpetuate them). While not typical for adults to involve significant others or family in therapeutic processes, she has found that if done correctly, it can be extremely helpful.
She talks about anger: how we struggle with expressions of anger, the idea of healthy anger, and the ways psychedelics can help us move from rejecting anger to assertion. And she discusses the Hoffman Process; emotion coaching; the power of validation; similarities between EFFT and IFS; rolling with resistance; tips to incorporate family into therapy more; the concept of a shame hangover and checking in on “tomorrow you”; and that even with all the preparation in the world, there’s no way to adequately prepare someone for the vast array of possibilities within (and after) a psychedelic experience.
In addition to being one of the faculty of Vital (reminder that applications close on March 27th), Dr. Lafrance has a 4-Part, CE-approved EFFT Core Clinician Training course that begins April 4th. Click here for details.
“As a culture, we really, really struggle with healthy expressions of anger, both in delivering them and in receiving them, so we end up having these unconscious contracts with our loved ones where there’s this unspoken rule that we don’t …speak up for ourselves when we feel like things aren’t going okay, and both parties can be ‘okay’ with that. And one thing that psychedelics does …is that they help us connect to our healthy assertion, as a byproduct of the cultivation of self-love.”
“The paradox of rolling with resistance is that that’s exactly the most efficient route to releasing resistance.” “There’s actually no way to adequately prepare for what might come. And so I’ve incorporated that – this idea [that] there could be major shifts that are highly disruptive, you might reconnect to old memories that you completely lost connection to that are not pleasant and that will shake your world, or, you can have an experience of self-love that helps clarify your path forward in your career, and anything in between. …We don’t know what can happen. We don’t know. It can be a smooth re-entry, or it can feel like your life blows up, and you need to be prepared for that. What I do know, though, is that it is way more likely that anything that happens will be in the service of creating a more aligned life for you. That, I do feel comfortable saying.”
“Integrity is about doing your ultimate best, being supported, asking for help, and then when you fall down, you pick yourself back up, you learn from your mistakes, and then you teach others.”
Dr. Adele Lafrance is a clinical psychologist, research scientist, author, and co-developer of emotion-focused treatment modalities, including Emotion-Focused Family Therapy. A frequent keynote speaker at professional conferences, Adele has published extensively in the field of emotion and health, including a clinical manual on EFFT published by the American Psychological Association. She is passionate about helping parents to support their kids in a way that is informed by the latest developments in neuroscience. The knowledge and tips in her book, What to Say to Kids When Nothing Seems to Work is an effort to do just that. With colleagues, she also makes a wealth of caregiving resources available at no cost at Mental Health Foundations. Adele is also leader in the research and practice of psychedelic medicine, with a focus on ayahuasca, MDMA, psilocybin and ketamine. Currently, she is the clinical investigator and strategy lead for the MAPS-sponsored MDMA-assisted psychotherapy study for eating disorders and a collaborator/clinical support on the Imperial College study for psilocybin and anorexia nervosa. She is a founding member of the Love Project.
In last week’s blog, Ed Prideaux told us everything we know (and don’t) about Hallucinogen Persisting Perception Disorder (HPPD), visual snow syndrome, and flashbacks. In part 2, he addresses ways to deal with the distress of having HPPD and ways to reduce the risk of developing it in the first place.
The real “problem” with HPPD is distress: anxiety, depression, isolation, panic, and the unhelpful coping mechanisms people can develop to overcome these (alcoholism and drug dependency are sadly common among HPPD patients). Remember, this distress is what technically defines HPPD.
Many people live with significant visual changes and do not find them distressing – rather, they may be sources of enjoyment, “free trips,” artistic inspiration, or purposefully leaned into as part of spiritual or occult practice. The world looking different doesn’t necessarily mean you have a problem.
If you’re currently experiencing HPPD, though, overcoming the distress should probably be your first priority. Speaking crudely, once the distress is overcome, the visuals can more or less “take care of themselves.” With less distress, there is less fixation. With less fixation, there is less noticing. With less noticing, the visuals are less noticeable. They may rapidly normalize, filter in the background, and can disappear unexpectedly with time.
How Can We Address This Distress – and Bring the Visuals Down?
Medication and clinical help: Many in the HPPD community have found relief in the use (especially in the short-term) of medications including Lamotrigine and Klonopin. They can bring visuals and anxiety way down, though some report their symptoms getting worse. They can always bring side effects, too, so some caution is advised.
Healthy lifestyle changes: Many HPPD patients report the decline and resolution of their symptoms – or otherwise acceptance and returning to “normal” life after avoiding further drug-taking, exercising regularly, cutting out processed foods, or trying specific elimination diets.
NotingTriggers: Pay attention to your triggers and act accordingly. Visuals and other HPPD symptoms can surface in response to:
Stimulation, including caffeine
The nature of the environment: visuals are more apparent in the dark, on blank surfaces, in enclosed rooms, and in environments where people had their original psychedelic experiences
Fixation and attention, including staring at blank surfaces and an anxious tendency to look out for visuals
Intoxication with other drugs, especially cannabis
You should also pay special attention to how your condition manifests beyond visuals, in particular, if you are experiencing Depersonalization/Derealization Disorder. More than visuals, it’s often the case that people’s distress comes from DP/DR, and a rich body of literature and therapeutic approaches have been explored for this condition.
Community: You can seek community from others, such as groups on Facebook, or the forums at HPPDOnline.com, r/HPPD, or r/visualsnow. However, tread cautiously around spending too much time on these forums. They can be extremely negative, and cause people to spiral and fixate on their perceptual changes.
Mindfulness meditation: The stress reduction and relaxation effects of meditation are well-established; many report breaking the cycle of visual fixation through learning to hone their attention.
Cognitive techniques: Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) may be useful for accepting and reframing perceptual changes. Challenging the internal beliefs triggered by HPPD could reduce both distress and the visuals – in particular, the beliefs that patients are “brain damaged,” “weird,” “isolated,” or a “casualty.”
Psychedelic integration: Introspection, journaling, and (if you can find and afford it) specialist, psychedelic-informed counseling can be helpful. In particular, you may benefit from exploring the particular details and events of what may have caused HPPD to originally materialize.
Somatic approaches: Certain somatic/bodily therapies have proven helpful for people with Visual Snow Syndrome. This includes the use of acupuncture, muscle relaxation techniques, neck massage, and specific dietary interventions.
Reframing: It may be helpful to learn that many people are not troubled by their perceptual changes. Again, they can be just a “thing” – how one sees now – that’s different, and not necessarily bad. Other people actively enjoy their perceptual changes or view them in a spiritual way, such as glimpsing auras, having broadened the possibility of the mind, or in seeing the intrinsic shakiness of ordinary experience.
Without a deep, embodied grounding for your reframing, though, it can be hazardous. Make sure the frame is not just “in your head,” but truly held across your entire mind and body in a felt way. Don’t gaslight yourself into enjoying your perceptual changes if they are actually disturbing you.
How Can One Reduce the Risk of Developing HPPD When Taking Psychedelics?
There is reason to suspect that the immediate period after a trip – say, one-to-five days – is important.This is because the brain is still neuroplastic and affected by psychedelics for up to a week (or longer) after the trip. And HPPD may be understood as a problem of “resetting” one’s brain back into its ordinary perceptual categories after the shock of a psychedelic experience.
If you want to avoid HPPD, what matters is ensuring that your perception re-transitions to its prior sober state safely. In this one-to-five day period, it may be advised, then, to:
Avoid cannabisand further drug-taking. Some people report that their HPPD was “kicked in” by a subsequent drug experience.
Process the psychedelic experiencethrough dedicated integrationpractices, such as journaling, contemplation, meditation, and inquiry. Speaking very crudely – and because HPPD may well be a “network disorder” involving cross-connected mixtures of perception, emotion and cognition – it may be that failing to integrate the experience may cause the energy to remain and be reactivated, including in cognition and possibly in perception (especially if the right triggers are also hit).
Keep stress and anxiety to a minimum.
Re-embodiment, or reconnecting to body sensations. Practices may be recommended, including through mindfulness meditation. This may help to reduce the risk of dissociative disorders like Depersonalization/Derealization as well.
Reduce screen use. Focusing on screens may cause a disembodying effect, as well as holding back the psychological energies activated by the psychedelic experience.
Avoid triggering environments, such as places that are enclosed or rich in blank surfaces, and try not to self-induce visuals through staring and fixation. If someone wants to be extra careful, they may wish to avoid the place where they had their psychedelic experience. “Training” the brain in hallucinatory ways of seeing while it’s neuroplastic may cause lingering changes once neuroplasticity is reduced and stable categories are reaffirmed.
Important Questions to Ask Before Having an Experience
Have you optimized your set and setting? HPPD seems to be more likely after bad trips or challenging experiences – the likelihood of which strongly depends on how people organize their set and setting. In particular, stress and trauma going into a psychedelic experience may be a trigger for HPPD experiences, even at low dose (and microdose) levels.
Have you experienced some unusual visuals before? HPPD patients may have had a higher-than-normal experience of certainvisual oddities, which are rare parts of normal perception. In particular, phenomena like visual snow, halos, after-images, floaters, and colors in the dark may suggest an underlying tendency in perception that could be triggered by a psychedelic drug to be more intense.
Have you tested your drug? If so, what drug are you taking? HPPD may be more likely with Novel Psychoactive Substances (NPSs) and Research Chemicals (RCs) with more unpredictable, less-researched, and possibly neurotoxic effects. Adulterants in street drugs may also have neurotoxic and other risky properties.
It seems that long-acting psychedelics like LSDare more likely to cause HPPD. While LSD may have certain advantages over other psychedelics subjective to each user, someone very conscious of developing HPPD (at least compared to other risks) may wish to avoid LSD in favor of a shorter-acting psychedelic.
How often are you tripping? Taking lots of psychedelics frequentlyis likely to be correlated with a higher risk of developing HPPD. This can be explained in a number of ways:
A higher likelihood of having a bad trip
Activating a latent genetic susceptibility
More likely to over-excite relevant perceptual circuits
More “re-training” of perception in hallucinatory ways of seeing
Less time in which to integrate properly one’s experiences, and a possibility of a “cascade” of neuroplasticity from taking psychedelics while still in a neuroplastic state
Do you have experience of Obsessive Compulsive Disorder (OCD), Autism Spectrum Disorder (ASD), Complex PTSD, Generalized Anxiety Disorder (GAD), or Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)? While there has not been research on the relationship of HPPD to these conditions, reviews of online forums directly and indirectly suggest a relationship. People with Visual Snow Syndrome seem to experience these conditions more than average based on rough overviews, and people with these conditions may independently report certain visual changes similar to HPPD. Ifthere is a relationship between HPPD and these conditions, the connection may occur through tendencies towards disembodiment, hypersensitivity, overstimulation, and dissociation, all of which may have visual components – and may be amplified by psychedelic experience.
For more, this article’s tips, advice, analysis (and more) is also featured in a more in-depth HPPD Information Guide, which can be freely downloaded from the Perception Restoration Foundation’s website, where a more direct guide for those struggling with HPPD is also hosted. Owing to the tentative nature of our HPPD knowledge base, the PRF invites any and all comments and criticisms for the Guide at firstname.lastname@example.org, and any worthwhile amendments will be quickly published.
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