Psychedelic Therapist Training: The Fundamentals

By Julian Bost

So, you’re thinking about becoming a psychedelic therapist? Numinus' goal is to pave the path to certification for folks interested in this profound healing modality. We offer a range of courses to help fully prepare you for work and experiences in this field. Our Fundamentals of Psychedelic-Assisted Therapy course is the first step. Collaborating with the folks over at Healing Maps, we created this blog series to provide both scientific rigour and practical insights into the training journey of a psychedelic-therapist. Whether you're a therapist looking to expand your skillset, or someone curious about the intricacies of this therapeutic field, you're in the right place.

 

The Emergence of Psychedelic Therapy

The undeniable potential of psychedelics, from MDMA's effectiveness in treating severe PTSD to psilocybin's impact on major depression, signals a profound shift. The word 'psychedelics' now echoes in coffee shops, office corridors, and even the National Football League. This cultural shift is evident when highly public figures like Aaron Rodgers discuss their ayahuasca use without repercussions.

 

On a larger scale, philanthropists and institutions are actively backing psychedelic research. The CEO of TOMS pledged $100 million to this cause, while venerable, longstanding institutions like Johns Hopkins University are conducting groundbreaking studies on the link between psychedelics and consciousness. On a global scale, Australia became the first country to legalize MDMA and psilocybin for prescription use.

 

Psychedelics have entered our culture through various avenues, from microdosing to shamanic retreats. However, the most regulated and standardized path may be through therapy. Over the last seven decades, psychedelic-assisted therapy has proven both safe and effective in Europe and North America, with Numinus being at the forefront of today’s movement. As psychedelics gain more approvals globally, the demand for mental healthcare professionals trained in this therapy is set to surge.

 

The Questions That Arise

The growing prominence of psychedelic-assisted therapy prompts crucial questions: How can one become a psychedelic therapist? What is the path, and what does it entail to step into the realm of psychedelic therapy?

 

In being a psychedelic therapist, your job will combine two key elements: The use of a psychedelic substance (such as psilocybin, ketamine, MDMA, etc.) coupled with traditional psychotherapeutic practices. 

 

It's important to note a couple of critical points. Without the therapeutic component, psychedelic use is often considered “recreational.” While recreational or “underground" use has its place, psychedelic therapy is deemed particularly effective due to its professionalism, safety, and therapeutic integration components.

 

The Role of a Psychedelic Therapist 

 

The role of a psychedelic therapist varies based on location but generally requires being a licensed mental healthcare professional. This includes clinical psychologists, psychiatrists, clinical social workers, registered nurses, nurse practitioners, and chaplains who have received specialized training in psychedelic therapy. In essence, a psychedelic therapist is a licensed mental health professional equipped to combine psychotherapeutic practices with guided psychedelic experiences, unlocking individuals' innate healing potential.

 

How to Get Involved

The future holds significant demand for certified psychedelic therapists, and you could be one of them. Explore Numinus' Certification Pathway for more information. As this field continues to evolve, it is vital to ensure our knowledge is rooted in evidence and thoughtful consideration. 

 

Stay tuned for our next article, where we will explore the global legal landscape of psychedelic therapy.

 

The Impact of Psychedelic Harm Reduction In Therapy

3 Benefits of Using a Harm Reduction Framework in Your Therapy Practice

According to a recent study by the National Institute of Health, psychedelic use is on the rise. The percentages of young people who said they used hallucinogens in the past year had been fairly consistent for the past few decades, until 2020 when rates of use began spiking. In 2021, 8% of young adults said they have used a psychedelic drug in the past year, the highest proportion since the survey began in 1988. Reported hallucinogens included LSD, mescaline, peyote, shrooms, PCP and MDMA (aka molly or ecstasy).

With this increase in recreational psychedelic use, there is a growing need for mental health professionals to expand their practices to support harm reduction and psychedelic integration needs. Here are the top 3 reasons practitioners should adopt a harm reduction framework in their therapy practice.

 

1. Builds Trust & Rapport With Clients

By maintaining a non-judgemental, accepting, compassionate, curious, and positive stance when exploring a client’s substance use, as well as other risky or harmful behaviours, you are directly contributing to the trust that client has with you. Being open and curious signals to the client that they are safe to walk through their thought process and current decision-making around psychedelic use, where you can gently advise on any dangers and practices they should take into consideration. When supported in this way, these clients are more likely to stay with you long-term and if you decide to provide psychedelic-assisted therapy in the future, they may feel comfortable turning towards psychedelic care provided by you. 

 

2. Helps Clients To Make Informed Decisions

When psychedelic medicines are used outside of clinical settings, proper education, preparation, and support can mitigate potential harms and increase the likelihood of clients having productive experiences (Gorman et al., 2021).  

Particularly with the medicines used in psychedelic-assisted therapy, clients may start treatment with some inaccurate information about the psychedelic medicine being used. The internet (particularly social media platforms) is full of misinformation about psychedelic medicines, their effects, adverse effects, and anticipated experiences. 

When a client has a more fulsome understanding of experiences and the decisions associated, potential benefits and harms are affected in ways that can enhance and protect their experiences, further contributing to trust this client has with you. 

 

3. Presents A Unique Opportunity To Work With Your Clients

When discussing psychedelic use, an important role you can play with your clients is to help with the integration work. Working on integration is your opportunity to keep the positive changes engendered by psychedelic experiences alive. In this regard, good integration work with your clients will help facilitate lasting changes and could reduce the need for ingesting medicines recreationally outside of a clinical setting. Not only is this an opportunity to work more with your client, but it’s a unique opportunity to really dive into positive and meaningful changes that are important to your client, which can facilitate deeper connection and meaning making as part of your regular appointments. 

 

In Conclusion: 

“Using a harm reduction framework in your clinical practice allows you to support your clients with non-judgmental, compassionate, and acceptance-oriented care. We should expect that clients may choose to use substances outside of the clinical setting, and that providers can play an important role in mitigating any harms associated with that, through building trust and rapport. We teach a harm reduction framework in our Psychedelic-Harm Reduction and Integration course at Numinus, which includes transparent discussions around the legal and ethical responsibilities in doing this work. Psychedelic use is going to continue to rise as more folks seek the healing potential of these medicines, so education in this area is going to become increasingly important.” 

- Amanda Giesler, Director of Training

 

Learn More: 

Join us for a 2-day introductory workshop on the practice of Psychedelic Harm Reduction and Integration (PHRI) and learn the tools needed for educating clients about altered states of consciousness and how to integrate these experiences. Click here to learn more.

 

*The continuing professional development program in no way promotes, condones, or facilitates illegal activity, and is strictly for educational and harm reduction purposes only. Please be aware that certain psychedelic substances still remain illegal in many jurisdictions, including Canada. This program and the contents of this website do not constitute medical advice, and are not a substitute for professional medical advice and treatment.

Pride Month: Fostering Mental Health & Advocacy

Numinus Stands with the LGBTQ2+ Community

June 6th, 2023, the Human Rights Campaign (HRC), a leading LGBTQ+ advocacy group, declared a state of emergency for LGBTQ+ individuals in the United States due to a surge in anti-LGBTQ+ legislation, primarily targeting transgender Americans. In 2023 alone, legislators from 41 US states introduced more than 525 anti-LGBTQ+ bills, with 220 of them specifically aimed at transgender people. These bills encompass a wide range of measures, such as denying transgender students the right to participate in sports, restricting access to gender-affirming healthcare, and prohibiting transgender individuals from using certain bathrooms.

Statistics derived from the Trevor Project's 2023 National Survey on the Mental Health of LGBTQ Young People reveal alarming figures. Within the past year, nearly 50% of transmen, transwomen, and nonbinary/genderqueer youth aged 13-25 seriously contemplated suicide, while over 20% of transgender young individuals attempted suicide. The survey also uncovered that rates of suicidal ideation, suicide attempts, depression, and anxiety among LGBTQ+ youth are two-to-three times higher compared to cisgender, heterosexual peers. The adverse effects of anti-LGBTQ+ legislation directly impact the mental health of queer youth.

We are currently facing an unprecedented mental health crisis within the LGBTQ2+ community. Without decisive and meaningful action, the social and political climate in the United States will continue to jeopardize the health and well-being of queer individuals. As a queer healthcare provider myself, I am devastated and appalled by the ongoing threats to the basic rights of queer people in our country. This Pride Season, it is my hope that mental health providers and organizations will reflect on how we can further advocate for and support the LGBTQ2+ community. Mere symbolic gestures, such as flying flags or posting on social media, will not suffice. We require fundamental and structural changes that permeate every aspect of mental healthcare, including the creation of affirming patient-care spaces and the elevation of queer voices in decision-making processes within institutions. The choices we make today will have a direct impact on the mental health outcomes of LGBTQ2+ individuals for generations to come.

At Numinus, we are committed to fostering a safe and inclusive environment for the LGBTQ2+ community. We prioritize creating a space where individuals of all gender identities and sexual orientations feel respected, affirmed, and free from discrimination. We strive to ensure that our services are accessible, sensitive, and tailored to meet the diverse needs of the LGBTQ2+ community. To our LGBTQ2+ clients and fellow providers, please know that you are seen, valid, and indispensable. Each of you brings unique contributions to this world that no one else can replicate, and together, we collectively enhance the beauty of this world.

 

LGBTQ+ Mental Health Resources

If you require emergency support or assistance, please reach out to the available support networks:

 

Written by Dr. Deven Jennings DNP, PMHNP-BC, APRN

Meet Cory Cooperman: Clinic Director in Montreal

Technology, Tools, and Changing Lives For The Better

 

Meet Cory, Clinic Director for Numinus in Montreal! Cory's dedication as Clinic Director provides transformative psychedelic-assisted therapies to those seeking healing and growth.

We recently sat down with Cory and discuss his role at Numinus, his passion for psychedelics and mental health, and his invaluable advice for anyone considering a career in this groundbreaking field.

What brought you to Numinus?

I came to Numinus as part of the Mindspace acquisition in February 2021. I was eager to join a company so aligned with our mission and values, pushing forward at the cutting edge of mental health care services.


Could you describe your role in 1-2 sentences?

As Clinic Director for Numinus in Montreal, I oversee the day-to-day operations of the clinic spaces in Montreal by managing the Care Coordinators and Personal Health Navigator, recruiting new practitioners (e.g., therapists, nurses, doctors), and administering our electronic medical record, billing and client scheduling system. Ultimately, when it comes to turning new programs into reality, such as our new Group Ketamine-Assisted Therapy pilot project, I am the lead in making sure everything is taken care of.


How do you act in service to yourself to make your mental health a priority?

I am blessed with a partner who happens to be a psychologist, as well as extensive training myself as a therapist, and it all starts with a strong work/life balance. I love to use technology (like Focus Modes in iOS) to help me maintain good work/life balance.


What do you love about Numinus?

I love the feeling of making a difference that comes from being part of Numinus, which is strongly felt when you connect with your co-Numis during meetings and see brilliant, caring people coming together to solve problems.

 

What inspires you the most about the field of psychedelics and mental health? 

I have concretely seen the difference mental health care, provided in a timely and evidence-based fashion, can make. It changes lives for the better, and there’s nothing more rewarding than that.

 

What has been the most transformative experience in your career so far?

I have been lucky to enough to get to transition from being a student therapist to someone who gets to enable practitioners in the field to do their very best for their clients. It brought me full circle, back to my roots in technology and management, while still getting to use my knowledge gained during my clinical training.

 

What advice would you give someone wanting to start a career in your field?

Curiosity is your best tool, and if you approach challenges with a genuine openness to learning something new, even if you don’t solve a particular problem, you’ll come away with something that will help you the next time around.

 

Interested in joining the Numinus team? Check out all of our open roles HERE.

 

--

Technologie, Outils et Changer des Vies

Rencontrez Cory, Directeur de clinique chez Numinus à Montréal ! L'engagement de Cory en tant que directeur de clinique permet de proposer des thérapies assistées par les psychédéliques à ceux qui recherchent la guérison et la croissance.

 

Nous nous sommes récemment entretenus avec Cory pour discuter de son rôle chez Numinus, de sa passion pour les psychédéliques et la santé mentale, ainsi que de ses précieux conseils pour toute personne envisageant une carrière dans ce domaine révolutionnaire.

 

Qu'est-ce qui vous a amené à Numinus ?

J'ai rejoint Numinus dans le cadre de l'acquisition de Mindspace en février 2021. J'étais impatient de rejoindre une entreprise si alignée avec notre mission et nos valeurs, poussant vers l'avant à la pointe des services de soins de santé mentale.

 

Pourriez-vous décrire votre rôle en une ou deux phrases ?

En tant que directeur de clinique pour Numinus à Montréal, je supervise les opérations quotidiennes des espaces cliniques à Montréal en gérant les coordonnatrices de soins et le navigateurs de soins, en recrutant de nouveaux praticiens (p. ex. thérapeutes, infirmières, médecins) et en administrant notre système de dossier médical électronique, de facturation et de prise de rendez-vous. Enfin, lorsqu'il s'agit de concrétiser de nouveaux programmes, comme notre nouveau projet pilote de thérapie de groupe assistée par la kétamine, c'est moi qui veille à ce que tout soit mis en œuvre.

 

Comment se mettre au service de soi-même pour faire de sa santé mentale une priorité ?

J'ai la chance d'avoir un partenaire qui est psychologue, ainsi qu'une formation approfondie en tant que thérapeute, et tout commence par un bon équilibre entre vie professionnelle et vie privée. J'aime utiliser la technologie (comme les modes de concentration dans iOS) pour m'aider à maintenir un bon équilibre entre vie professionnelle et vie privée.

 

Qu'aimez-vous chez Numinus ?

J'aime le sentiment de faire la différence qui découle de mon appartenance à Numinus, sentiment qui est fortement ressenti lorsque vous vous connectez avec vos co-Numis pendant les réunions et que vous voyez des personnes brillantes et bienveillantes se réunir pour résoudre des problèmes.

 

Qu'est-ce qui vous inspire le plus dans le domaine des psychédéliques et de la santé mentale ?

J'ai vu concrètement la différence que peuvent faire des soins de santé mentale fournis en temps opportun et fondés sur des preuves. Cela change des vies pour le mieux, et il n'y a rien de plus gratifiant que cela.

 

Quelle a été l'expérience la plus transformatrice de votre carrière jusqu'à présent ?

J'ai eu la chance de passer du statut d’étudiant au doctorat en psychologie à celui de personne qui permet aux praticiens sur le terrain de donner le meilleur d'eux-mêmes à leurs clients. Cela m'a permis de boucler la boucle, de revenir à mes racines en matière de technologie et de gestion, tout en continuant à utiliser les connaissances que j'ai acquises au cours de ma formation clinique.

 

Quels conseils donneriez-vous à quelqu'un qui souhaite entamer une carrière dans votre domaine ?

La curiosité est votre meilleur outil, et si vous abordez les défis avec une réelle ouverture d'esprit pour apprendre quelque chose de nouveau, même si vous ne résolvez pas un problème particulier, vous repartirez avec quelque chose qui vous aidera la prochaine fois.

Vous êtes intéressé(e) à rejoindre l'équipe de Numinus ? Consultez tous nos postes ouverts ICI.

MAPS Examining the Psychedelic Renaissance - Season 2 Episode 10 with Drs. Reid Robison & Adele Lafrance

Episode 10: Psychedelic-Assisted Psychotherapy for Eating Disorders and Cognitive Behavioural Therapies for PTSD + MDMA

Episode Summary: Hear from the MAPS Researchers. In this episode we will get to hear from some of the leading experts in the field of clinical psychedelic research. Both Dr. Adele Lafrance and Dr. Reid Robison are currently focussed on a study looking at using MDMA to treat PTSD. While Dr. Anne Wagner also has a background investigating Eating Disorders, she will be touching on her work with MDMA + Cognitive Processing Therapy.

Exclusive Post Webinar Sessions:    (Exclusive Post-Webinar Session Details:  Session take place in a private zoom room with the speaker and 6-10 other participants. Limited Capacity. Zoom links sent out the day of the event.  6:30-7:30PM PST, Tuesdays (following the speaker’s episode).  Webinar attendance is not mandatory; however all passes include 1 complimentary ticket to the entire series! 

  • Join Adele and Reid for an Exclusive Q&A. Reid is currently the coordinating investigator for the MAPS-sponsored study MDMA assisted psychotherapy study of eating disorders, and Adele is the clinical investigator and strategy lead for the MAPS-sponsored MDMA-assisted psychotherapy study for eating disorders. This is your chance to meet with the two of them and have all of your questions answered in a semi-private session. To register, see Ep 10Ex: Exclusive w/ Adele & Reid.

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Why Is Therapeutic Integration Important?

Now What?
Picture this: you’ve just had your first ketamine session. It went much better than you planned. You felt uncomfortable at first, but after settling into the experience, you entered a dream-like, euphoric state. As soothing music played in your headphones, you felt your mind disconnecting from your body. All the stuck emotions finally began to unravel themselves.

Now you’re waiting for your ride home. Questions swirl in your head as you begin to think back on what you saw and felt during the ketamine experience. You think about the memories that replayed, odd memories you tried not to think about for years.

At this point, you might be wondering, “Now what?” or “How was that experience productive?” You might even find yourself distressed and burdened by the reintroduction of new ideas and feelings that are uncomfortable and difficult to process.

Therapeutic Integration
This is where therapeutic integration comes in. “It is not often easy for our rational minds to make sense of a psychedelic experience,” says Hannah Cross, one of our Licensed Clinical Social Workers in Utah.

While the ketamine experience has the power to create lasting change, much of the “transforming” is up to you. Working with a trained therapist, therapeutic integration helps you discover actionable insights that can turn an interesting ketamine experience into a transformational one.

“Integration is how one bridges the experience (often associated with transcendence of time and rational thinking) to life outside of the experience. The psychedelic journey doesn’t actually start or end when the medicine’s psychedelic effects start and end.”

Psychedelic Integration Group
At Numinus, we offer a monthly virtual psychedelic integration group. This group utilizes components of various therapy modalities to help clients turn their psychedelic experiences into meaningful change in their lives.

While group therapy might seem intimidating at first, Hannah explains, “Group therapy can provide a powerful opportunity for individuals to connect with others, even those from different backgrounds.

According to Hannah, “this online community is “a game-changer,” especially, “[during] a time [when] many people have felt quite isolated over the last couple of years.”

Of her recent group participants, Hannah says that some have pursued additional work with an individual therapist, while some have built supportive friendships from their connections in the group. In one case, [a] previous participant decided to integrate his psychedelic experiences by outfitting his van and embarking on a cross-country, solo road trip!”

Session Format
The group integration sessions follow a similar pattern. After participants introduce themselves, they discuss their intentions and any examples of integration they found useful, Hannah then proposes a discussion based on a topic related to psychedelic integration.

“A discussion...may follow,” Hannah says, “but more often, there is a guided, more experiential process facilitated by the therapist.” The session is then concluded with discussions in small, 2-3 person break out groups.

This digital first approach to group therapy has been a game changer: “All of this can be done through Zoom and I haven’t found the online platform to jeopardize the effectiveness of the group, at all.”

“In fact, a virtual group has allowed individuals who normally wouldn’t get to connect to do so.”

Psychedelics & Safety Considerations

It’s common for people to have questions about the safety of psychedelic drugs and whether there are risks associated with them. Fortunately, classic psychedelics have little to no abuse potential. In fact, studies suggest they might even be anti-addictive. Even in vulnerable populations, it’s rare for complications like psychosis to arise from the use of psychedelics.

That being said, psychedelics may not be for everyone—which is why we take such great precaution before proceeding down the psychedelic path at our clinics.

 

What screening is done before deciding on psychedelics?

We only use psychedelics when there is a mental health-related diagnosis on record. We also complete thorough medical and psychiatric screening including reviewing pertinent factors such as personal or family history of psychosis and any history of substance abuse. Only after these precautions are in place do we consider psychedelic-assisted therapy.

 

Are these drugs safe?

According to many studies, the short answer is YES. Psychedelics have significantly lower risks than alcohol, cannabis, tobacco, and other drugs. Data from a study of psilocybin found that cases of mental health complications following a psychedelic are rare (<.1%), even in vulnerable populations (<.2%), and rarer still with proper screening. Another notable study, examining the classical (serotonergic, or 5-HT2A receptor agonists) psychedelics, LSD, psilocybin, & mescaline, found that no evidence of increased rates of mental health problems, and psychedelic use has been associated with reduced psychological distress and suicidality. Additionally, studies examining use patterns in humans & self-administration in animals suggest that classic psychedelics possess little or no abuse liability and may even be anti-addictive. These conclusions come from a comprehensive review of several kinds of psychedelic compounds, including classical psychedelics (psilocybin, LSD, &  mescaline), indirect 5-HT agonists, (e.g., MDMA), NMDA antagonists, and κ-opioid receptor agonists (KOAs).

 

Why do some people experience brief psychotic episodes even days after use?

There are several factors that can play into this. As a general guideline, people with cognitive & emotional conditions associated with disorganized or diminished ego strength are not good candidates for psychedelics. Regardless, however, the short-term psychological effects that accompany psychedelic use are profound. Sympathetic nervous system arousal may occur both because of fear, and from direct effects of the drugs--particularly during the initial phase of sessions when barriers between physical senses dissolve; touches, smells, and tastes can take on sounds, shapes and colors. Proper supervision is also important. These drugs’ effects are sufficient to require that professionals skilled in managing adverse effects are present, for safety & to guide patients through their experiences. Additionally, when taken without adequate preparation and when surroundings are anxiety-provoking—either physically uncomfortable or emotionally intimidating—the psychedelic experience predictably results in fear, a prolonged sense of dread, or full panic. Conversely, in controlled settings with elements of soft light, art, and appropriate music, or nature, and gentle, compassionate people, such adverse reactions are rare.

 

What conditions can Ketamine-Assisted Therapy (KAT) treat?

  • Depressive disorders
  • Post-traumatic stress disorder, post-traumatic stress and anxiety
  • Addictive disorders, including substance use and behavioural

 

What conditions are not suited Ketamine-Assisted Therapy at Numinus?

Absolute Contraindications - KAT is not a fit for those with the following conditions: 

  • Allergic reaction to ketamine
  • History of ketamine abuse
  • History of stroke or brain aneurysm
  • Uncontrolled high blood pressure
  • Acute Angle Glaucoma
  • Uncontrolled thyroid disorder
  • History of mania/bipolar 1
  • Age 14 and under
  • Current diagnosis of schizophrenia, schizoaffective disorder, major depressive disorder with psychotic features, psychotic disorder
  • Pregnancy (individuals who can become pregnant must use contraception if sexually active)

 

Relative Contraindications - We can some times treat those with the following conditions, on a case-by-case basis, with additional medical support: 

  • Active or unstable substance use disorder that is not an indication for treatment will be evaluated on a case by case basis by the screening physician
  • History of heart disease
  • Dissociative identity disorder
  • History of psychosis

 

Sources

Byock, Ira. “Taking Psychedelics Seriously.” Journal of palliative medicine vol. 21,4 (2018): 417-421. doi:10.1089/jpm.2017.0684

Heal, David J et al. “Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans.” Neuropharmacology vol. 142 (2018): 89-115. doi:10.1016/j.neuropharm.2018.01.049

Studerus, Erich et al. “Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies.” Journal of psychopharmacology (Oxford, England) vol. 25,11 (2011): 1434-52. doi:10.1177/0269881110382466

Krebs, Teri S, and Pål-Ørjan Johansen. “Psychedelics and mental health: a population study.” PloS one vol. 8,8 e63972. 19 Aug. 2013, doi:10.1371/journal.pone.0063972

Physician Information — Ketamine-Assisted Psychotherapy

What is ketamine-assisted psychotherapy?

As you will likely know, ketamine is an anesthetic and analgesic used widely internationally. Ketamine also has antidepressant and psychedelic effects at certain doses, and international research has increasingly demonstrated that the combination of ketamine with structured psychotherapy can have benefits for a range of mental disorders. The ketamine assisted psychotherapy protocol at Numinus is distributed over approximately 4-6 weeks, depending on the patient’s schedule and how the visits are scheduled. Generally, the therapeutic protocol is expected to include two 50 minute introductory psychotherapy sessions without the use of ketamine, three ketamine dosing sessions of 2.5 hours in duration each followed within 24 hours by 90-minute psychotherapeutic sessions where insights from the ketamine experience are integrated, and a closing 50-minute psychotherapy (non-ketamine) session. Throughout this process, the psychotherapy delivered is focused on support, integrating insights, and identifying and reinforcing change as part of the therapeutic process.

Who is eligible for ketamine assisted psychotherapy?

Though research indicates that ketamine assisted psychotherapy may be effective for a number of mental health indications, Numinus is currently focused on addressing treatment-resistant depression. If you have a patient suffering from treatment-resistant depression that is interested in ketamine assisted psychotherapy, our team will work directly with them to determine whether the patient is a good candidate for treatment by taking a full medical and psychological history. To be eligible for ketamine assisted psychotherapy at Numinus, the patient must be referred by their primary care providers, such as a family physician or nurse practitioner.

What are the contraindications of ketamine assisted psychotherapy?

Those conditions that may make ketamine assisted psychotherapy contraindicated (i.e., potentially unsafe) include, but are not limited to, a history of psychosis (e.g. hallucinations), mania, cerebrovascular or cardiovascular disease, seizure, and severe liver disease. At present, youth, pregnant women and nursing mothers are not eligible for ketamine assisted psychotherapy since the effects of ketamine on pregnancy, nursing children, and youth are unknown. Additionally, the ketamine product monograph lists other risks which will be reviewed with all patients as part of an informed consent process at Numinus.

Episode 41: Jon Hopkins on Music for Psychedelic Therapy

 

“As if in each of us There once was a fire

And for some of us

There seem as if there are only ashes now

But when we dig in the ashes

We find one ember

And very gently we fan that ember

Blow on it

It gets brighter

And from that ember we rebuild the fire

Only thing that’s important is that ember

That’s what you and I are here to celebrate”

– Ram Dass quote, lyrics from “Sit Around the Fire”

Some big news before we get to the episode with Jon Hopkins: This episode of the Numinus podcast will be its last. Joe will be joining the team at the Psychedelic Therapy Frontiers podcast as a co-host. The Psychedelic Therapy Frontiers podcast is hosted by Dr. Steve Thayer and Dr. Reid Robison. It is a “weekly conversation about psychedelics, research and the therapy that makes them so powerful as agents for lasting change in mental health.”

This last episode of the podcast will also be hosted on any of the Psychedelic Therapy Frontiers platforms. You can more information about that here. Joe was also recently interviewed on the Psychedelic Therapy Frontiers podcast. You can find that episode on Apple PodcastsSpotify, and Google Podcasts.

 

In this episode of the Numinus podcast, Dr. Joe speaks with Jon Hopkins, musician and producer. Jon is a prolific musician who specializes in electronic music. He has been playing music for over 20 years. He has written six studio albums and has collaborated and produced albums for Coldplay and Brian Eno. His album, Singularity, received a Grammy nomination for Best Dance/Electronic Album in December 2018.

He also collaborated with Brian Eno to create music for Wavepaths. Wavepaths was founded by Mendel Kaelen and Anna Wakefield. The purpose of Wavepaths is to create therapeutic tools that integrate “psychedelic science, machine learning, music theory, psychotherapies and experience design, in collaboration with artists, therapists and researchers.”

His newest album, Music for Psychedelic Therapy, was specifically written to be used in psychedelic therapy sessions.

In this interview Dr. Joe and Jon explored:

 

Here is more information on subjects mentioned in this episode:

 

More quotes from Jon from the interview:

 

“That core wound, whatever that may be, we all have one, I think, of some kind. And we’re eternally trying to heal. As I got older and more in touch with that, I’m more and more clear that all the music-making is a direct response to that.”

 

“We all share great pain just through the nature of existence, and through the nature of what we witness and experience. We’re also able to share the healing of that and the joy that being alive can also bring. This album, whether consciously or not, has an expression of all those things in it.”

 

“When I hear [Music for Psychedelic Therapy] under the influence, I’m like, ‘Wow, where did that come from? Because it’s not me. It’s everywhere. It’s from everything.”

 

“All I know is that beauty is not an isolated feeling or concept. For me, the most beautiful things have a tinge of sadness or melancholy. Maybe beauty without sadness is meaningless.”

 

“What that ember is–to me–is the divine spark. When you connect to it, whether it’s through meditation or psychedelics, you sink into that place of total oneness or unity. It’s the inherent knowledge that there is a part deep inside of you that is shared by everyone. That is the divine spark.”

 

“The most important thing is daily practice because psychedelics open a door and occasionally you need a reminder that will get you there. It’s what you do everyday that has the biggest chance of fanning that ember.”

 

Here are some highlights from their conversation:

 

I want to actually ask you about the lyrics [of “Sit Around the Fire”]. I was really, really touched again listening to them recently. And if you’ll humor me for a second, I’m just going to read the last section so that the listeners know what we’re talking about.

 

“As if in each of usThere once was a fire

And for some of us

There seem as if there are only ashes now

But when we dig in the ashes

We find one ember

And very gently we fan that ember

Blow on it

It gets brighter

And from that ember we rebuild the fire

Only thing that’s important is that ember

That’s what you and I are here to celebrate”

I’m a little embarrassed hearing my own voice do that because on the track it’s just so beautifully performed by Ram Dass. But I wanted to ask you, from your really, really intimate relationship with those words in the music, what is the fire? What is the ember? What are we celebrating?

Let’s start with the ashes. You know, we often feel isolated, alone. We’ve kind of somehow been persuaded that all of this is meaningless to some degree. Some of us have–

I’m definitely familiar with the ashes, Jon [laughs].

Yes, we know what the ashes are.

Didn’t ask you about those [laughs].

Well, in order to think about the ember, it’s nice to think about the ashes, because I feel like as you said you’re familiar with the ember as well. I would say the stage I’m at is that I found that ember and I’m desperately blowing on it and trying to rebuild the fire. But really what the ember is to me is the divine spark.

When you connect to it, whether it’s through meditation, psychedelics or for me, it’s always the way the two inform each other, you sink into that place of total oneness and unity. And that’s  your inherent knowledge that there is a part deep inside of you that is shared by everyone that is the divine spark. I mean, the words for it don’t really cover it, but that’s there. And I think you touch on that sometimes. People with atheistic views will also touch on that, perhaps just not use the same words.

But, you know, you can feel that infinite oneness through looking at a landscape or gazing at a loved one or being in love or, you know, staring at your newborn child. That magic, that kind of ineffable wonder.

And in psychedelics, you get to spend some time there. You get to spend sometimes a few hours in that state. And when you’re in there, you’re like, ‘how will I ever not be like this again?’  Of course you come out and everything comes back. But in that time, you’re fanning the ember. You’re not forgetting everything. You come out–Okay, you go back to normal, but not quite back to normal. And each time you find it.

For me, the most important thing is daily practice for sure because psychedelics open a door, and on occasion, you need a reminder that they will get you there. But it’s what you do everyday that has the biggest chance of finding that end.

And then as to what the fire is, I like to think of it as the collective, all finding their own embers, and collectively, rebuilding the knowledge of our own innate divinity, that we need in order to make sense of this and also to survive.

And he’s also talking about infinities, talking about the fact that, after all, this is a belief system. It is really after your physical body is no longer with you. Consciousness is just, you know–your spark of consciousness just goes back to join the rest and you’re all one again. That’s what’ll happen in the end anyway. So maybe that’s what the fire is.

 

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Episode 36: Dr. Rosalind Watts on Psilocybin and Depression

“The real medicine is the therapeutic relationship and psychedelics beautifully amplify that.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Rosalind Watts. Dr. Watts is the clinical lead of the Imperial College of London’s Psilocybin for Depression trials. Most recently, she designed the treatment protocol for and served as a guide for participants in a study comparing psilocybin to an antidepressant at the Centre for Psychedelic Research at Imperial College London. This study was published in the New England Journal of Medicine. And she is also a consultant psychologist for Small Pharma who are investigating DMT as a treatment for depression.

(Image: Imperial College London / Thomas Angus)

She is a clinical psychologist for more than 6 years, and now specializes in psychedelic-assisted psychotherapy. She is the clinical director for the Synthesis Institute, an organization dedicated to “training practitioners to safely, ethically and effectively support people on a journey for healing using truffles containing psilocybin.” She co-hosts a monthly Psychedelic Integration group, alongside Michelle Baker Jones for participants of psilocybin clinical trials. And she will be launching Twelve Trees Integration, a new 12 month psychedelic community integration program for anyone who has experience with psychedelics.

More information on this program will be posted on her site in the near future and you sign up for the waitlist there as well: drrosalindwatts.com

She also developed the psychedelic therapy model ‘Accept, Connect, Embody (ACE)’ and an iteration for group-based integration of psychedelic experiences ‘Accept, Connect, Embody, Restore’ (ACER). It is based on the Hexaflex model in Acceptance and Commitment Therapy (ACT).

Dr. Watts and Dr. Joe spoke about:

 

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Here is more information on subjects mentioned in this episode:

 

                                                                                                                                                       ACE Model

                                                                                                                                                    The Hexaflex Model

More quotes from Dr. Watts from the interview:

“The psilocybin experience is kind of a spring or summer opening, and there will inevitably be autumn and winter. You can think of depression as deep rest, and ‘I will allow myself this time of darkness. But I don’t need to get stuck in this winter forever.’

That’s the thing where depression becomes incredibly debilitating when the hope is lost and people feel that they’re not going to be able to move through it. I think that’s where it becomes so painful.”

 

“A lot of people describe antidepressants as numbing them. They’re not going into the depths, and they’re not learning from those places. Psychedelics give us the opportunity for a deep adventure.”

 

“Psilocybin enables people to go to those dark places and go through the cycles. The thing about antidepressants is that people say that it numbs them. It’s cutting off the peaks and the troughs of experience. So they don’t go to the winter. They’re kind of in a limbo land. They’re not going into the depths, and they’re not learning from those places.”

 

Here are some highlights of their conversation:

 

It’s interesting listening to that story because when you said that when the depression comes back, part of me wants to say, ‘well, wait a second. These people did psilocybin and isn’t one session of psilocybin a life-changing mystical experience? Depression is cured. It’s like surgery. Let’s get on with it. Get it into the drinking water so people don’t feel depressed anymore.’ 

That’s not really what happens. Is it?

No. I actually just felt a tear coming to my eye when you said that. I had this real surge of emotion because I remember that narrative and really thinking that was going to be the way forward. The experience of working with people long term showed me that it is absolutely not. We wish it was, but the depression came back for everyone that I was still in touch with. There may be a few people for whom it really, really shifted something and have stayed, but it was just a very small number of people. I’m talking out of like 80 people, maybe three or four. And yeah, for most people, it comes back.

The metaphor that I really started working with and the one that has kind of been the foundation for the work I’ve done since is of the cycles of nature and the seasons in nature and the fact that, you know, starting to think about a psilocybin experience as a kind of spring, summer opening. And then there will inevitably be autumn and there will be winter. And it doesn’t really happen in that linear cycle, but that we all go through the cycles of spring, summer, autumn, and winter.

Trying to hold onto the idea of constant summer is so typical of our culture because we want the never ending sunshine and the kind of consumerist dream of like we can find a way to rig this show and be always happy. But if you think about like the cycle of nature and the course of a day, we go from day to night and the course of the year we go from, you know, well, in the parts of the world where you have seasons.

That cycle of dark and light is so fundamental to nature and to us that rather than lamenting on the fact the psilocybin experience benefits tend to fade, I thought, ‘Well, we can embrace this because there is a time of hibernation. There’s a time of sitting and waiting and resting.’ Thinking about depression as deep rest and allowing that process of ‘I don’t need to get stuck in this winter forever. I can move through this cycle, but I’m going to allow myself this time of darkness. I think it’s just about not getting stuck.

That’s the thing where depression becomes incredibly debilitating, when hope is lost and people feel that they’re not going to be able to move through it. And I think that’s where it becomes so painful.

 

I’m feeling a bit of a need to recalibrate here because if we are just cycling through the seasons in our emotional lives, what the hell is the point of all this? It’s like, maybe, SSRIs are good enough as the New England Journal of Medicine article seems to suggest. Maybe especially if it’s paired with some kind of therapy. There are lots of therapists out there that can provide this work. 

Why do we need the fireworks, the hallucinations, the mystical experiences? Like what’s all the hype about then? What is psilocybin in the context of a therapy actually bringing that’s unique and different and worthy of all the hope and promise?

Very, very good question. And I think it is that it enables people to go to those dark places and go through the cycles because the thing about antidepressants is that what people describe about them is that it’s numbing them. It is cutting off the peaks and troughs of experience, but they didn’t go to the winter. They’re kind of kept in a kind of limbo land and they’re not going into the depths of it and really learning from those places.

And I’d say often with good talking therapy, you can really get down into the shadow. Which is, you know, often the winter, the kind of the underworld, you can get down there. But it’s really hard. And what I’ve learned about depression through this work is that I used to think about depression as like deep grief and sadness, like deep winter. But actually, I think for a lot of people depression is just numbness and stuckness and feeling nothing.

So actually being able to go to grief, being able to go down into that deep, dark cavern of despair that we all have, some people to a much greater degree, and really swim around in those deep dark waters, but also connect. That’s the acceptance: going down into the water. And then there’s the connection to values. So in that cycle of going down and going up, going around, it’s like you can become–you can embrace a cycle of, ‘I will accept my darkest feelings. I’m willing to feel them. I can open up to them. And when I’ve done that, I’m going to connect to the values of what that teaches me. And every time I go through the cycle, I’m learning more. I’m getting more gifts. I’m getting more resilient.’

And as you go through the cycle, you kind of hopefully come out the other side, wise, experienced, able to hold pain, and connect to beauty rather than with other traditional, well, kind of antidepressants. Obviously, for some people, they just work brilliantly, but for a lot of people, antidepressants, you’re not going on these big journeys of acceptance and connection. You’re just kind of staying in numbness.

You’re not going on the adventure. Psychedelics give us the adventure, the opportunity for the deep adventure.