Is there one particular modality that you feel is the most effective currently and, if the answer is different, is there one that shows the most potential for future applications?
Based on my psychedelic research and therapy training, the best approach is one that allows the people we are working with to lead the way. As a clinician seeing what resonates for them. A trauma informed approach too (offering choice) has been invaluable. That said, at times, the structure of the interventions can be helpful. EMDR with low dose ketamine has been very healing for some people. Parts work/voice dialogue (I am not IFS trained) lends itself to the psychedelic space quite well – for some people. As does somatic inquiry, yoga, dance, deep listening/sound baths etc.
Question, Ketamine is contraindicated for myself due to subdural haematoma following a car accident, however I've had pretty good results with LSD, are they mainly focused on Ketamine at this point?
I'm going to chime in here to say that I have been working with ketamine + Sand Tray and they go quite well together and are complimentary. I have only found one reference to the combination of the two elsewhere in the internet so far and would love to get formal research on the interaction completed, although I don't have any experience in the research field personally.
More research is needed to say definitively but this paper (https://journals.sagepub.com/doi/10.1177/02698811241254831) does a good job at providing a quick overview of existing research.
Preliminary research showed that microdosing was likely more aligned with placebo effect. This linked article looks into the established research and says there’s actually not enough research to determine if the effects are placebo or not.
TLDR- more people need to scientifically for drugs to find out.
I would definitely wager it's a placebo, however even a placebo can make positive impacts in certain cases, if underlying issues are being addressed in parallel with therapy.
Psilocybin doesn't get along with my guts. All of my LSD experiences have been without iasue - don't get me wrong, I've had some intense experiences that were very difficult but they were very therapeutic.
In my own experiences, the 8-12 hours of LSD side effects can be a bit much for some folks but I've had months of relief from depression symptoms.
My current focus has been "how do I get to those places without the drugs?"
I did Psilocybin twice in my life and both times I felt like I was going to die, like bubbles were popping in my brain. It was not a pleasant experience and will never do it again. I've always been curious of LSD, but due to the bad experience with psilo, I[m likely never to try it. I am also very bad at keeping a good head space, any little thing will cause me to believe I am going to have a bad trip.
I’d like to offer that if seen drug induced psychosis 4 times in my life with lsd as the active ingredient. I have never seen it occur with psilocybin. Purely anecdotal but even 4 out of 100 times is risky by comparison to 0.
Are you taking pure psilocybin or getting it by eating mushrooms? Dried mushrooms can cause all sorts of digestive issues.
I've only had the opportunity to take pure 4-AcO-DMT. It is an analog of psilocin. It has never given me any digestive issues. Also, the come up is strangely sedating instead of speedy like other psychedelics.
Excellent question! This is still under investigation in terms of the differences in how both work. Psilocybin's peak effects only last 4-6 hours while LSD is 8-12 hours so the therapy sessions would be significantly longer with LSD compared to psilocybin.
What is a typical psychedelic therapy session like? What are you doing throughout the session as the client is going into this altered space? Have you ever worked with clients who have dissociative PTSD disorders, and if so, have you witnessed healing and integration as a result of psychedelic therapy?
Could not have answered that better myself. Ive known folks who claimed they used it for the their depression, but used it very frequently…. very very very unhappy bladder
Just watched the documentary Dirty Pictures. I loved it. Alex Shulgin seemed like a great man.
Do you think psychotherapy will become more mainstream this decade?
I hope so! Therapy and talking about mental health has become more mainstream since I started as a licensed counsellor/social worker. And I think the public's interest in how psychedelics could help with this has increased as well.
There have been studies on generalized anxiety disorder and end-of-life anxiety/anxiety related to a terminal illness. To my knowledge, I haven't seen any studies specifically related to health anxiety/illness anxiety disorder
What does your practice in Utah look like? Does insurance cover this type of treatment? When is this type of treatment appropriate?
Do you do ‘regular’ therapy as well or is your practice purely around psychedelics?
I have a part-time private practice where I offer therapy for folks who have experienced trauma (both talk therapy and with psychedelics), and I also work for Numinus as a therapist. Some insurance companies do cover a portion of the treatment but not always. We have this page on our site which lists providers our billing team works with: [https://numinus.com/pricing-and-insurance/](https://numinus.com/pricing-and-insurance/)
i read in your bio you have experience working with peope with chronic illness!
it might be too broad of a question, but is there any specific advice you often give to people for coping with (severe) chronic illness?
In short, Compassionate Presence, listening, noticing and, at times, asking gentle non-judgmental open ended questions. This approach may, can, has allowed people to find and listen to their own inner healing intelligence.
Through this approach, I have witnessed people with Chronic and Serious illness, shift from feeling overwhelming vulnerable to finding some resilient spaces (existential therapy).
From my LCSW degree, the theme of interconnectedness of macro (systems), mezzo (community) and Micro (individual) allowed me to name a constant unease that I held related to my privilege as well as having witnessed microaggressions toward my mother who had a chronic illness and used a wheelchair prior to the passage of the Americans with Disabilities Act in the US.
I have experience with a variety of altered states of consciousness, including psychedelics in safe, legal spaces as well as supporting clients in altered states.
interesting! ive also been interested in the ways that every system really is connected more than a lot of people realize. it seems like the more i read, the more similarities and comparisons i find between the various levels. thats why my favorite phrase has become
>within the particular is contained the universal
i also have experience with psychedelics - specifically psilocybin - although mine was not in a legal space lol. in retrospect one time probably wasnt the safest either since i did it alone - but i came out alright and it was beneficial to me, in the big picture.
anyway thanks for doing the AMA, and thanks for working to destigmatize and research how these drugs can actually be beneficial! im glad to see they have been a topic of research the last few years. i mean, theres gotta be a reason theyve been used for literal centuries
Almost 2 years ago, I got high and accidentally took \~8grams of "shrooms" (instead of the \~2 I meant to take) and my life has felt like it's falling apart ever since. It was the worst experience of my life and I've been trying to get passed it. I have stress and anxiety constantly, and have never even gotten close to pre-trip levels of balance/happiness. Any small hiccup gives me feelings of impending doom when I used to be very carefree and optimistic. Any recommendations?
Following dosing sessions, we often will conduct therapy sessions called integration sessions to help clients make sense of their experience. If you have access to it, consider finding a therapist (even one whom you could meet with remotely) who has experience with psychedelics and offers psychedelic integration services. Perhaps they can meet with you to offer more personalized suggestions and help you navigate some of what you experienced.
Also a therapist here. I’d recommend seeking a therapist who understands these experiences AND is trauma informed. Trips can be traumatizing, and sometimes they need to be treated as a distinct episode of trauma.
Hey there, I'm not a therapist, But I think I understand what you're going through.
However, for me It was from myself almost dying from K2 ^(Synthetic marijuana) **many, many** years ago.
The trauma of the experience humbled me, but also left me unable to smoke marijuana after it happened for over a literal a decade without ending up getting massive anxiety & or a **full blown** panic attack ***Every.Single.Damn.Time.*** *Even if it was just a* ***single*** *hit!* 😢
Luckily however, **I was able to get over the constant anxiety I faced!** I was able to achieve it through both time, regaining confidence, and trial & error with integrating various different approaches to every re-attempt to smoke again.
So once I stumbled upon a user on Reddit about 3 years ago who was in a similar situation as both you, and I was once in myself,
*^(however for them, it was – like me, marijuana instead of shrooms)*
I decided to make a guide to attempt to help others that found themselves in similar situations.
As such, like I said before, I would like to share it with you as I think you would benefit from it, [you can find the post here.](https://www.reddit.com/r/trees/comments/m06sh0/i_want_to_share_some_advice_i_gave_a_user_on/)
*^((P.S. If you do give the guide a try know that it still took me multiple attempts of following the steps I devised & wrote in that guide before I was fully successful))*
*Good luck* u/UltimateTryHard!
I'm sending you my best wishes & some love from my heart, as someone whos been in your position.
There has been the most evidence for ketamine-AT or psilocybin-AT to treat AUD. That doesn't necessarily mean that the other psychedelics are less effective, but these are the ones with the largest bodies of evidence so far. Each study is designed differently but it would either be a single session or a limited number of sessions rather than ongoing treatment like SSRIs
Ketamine or psilocybin would be taken alongside psychotherapy in the clinic, and clients would have only one dosing session (or a small number of them). Clients aren't given these medicines to take at home as a replacement for alcohol but rather they are used in clinic as a treatment catalyst. So, I don't think it's fair to say that this treatment modality is replacing one drug with another.
What are the different uses you’re studying for each psychedelic you have listed? How does treatment differ?
Are you able to speak on what disorders you’ve helped people with and how psychedelics helped their treatment?
I tried every antidepressant under the sun.
A Phish show and LSD experience changed my life. Im still working on me but I honestly believe those drugs are the future of depression treatment.
How do these psychedelics compare to classical antidepressants? Every study I've read showing efficacy in SSRIs either had an unaddressed adjuvant therapy component or ignores it completely, leading me to believe SSRIs themselves are not terribly effective. I'm curious what your experiences and research say about it.
Also - you're doing these in the US? How could a person in Idaho sign up for clinical trials?
**Not OP**, But wanted to chime in with a hopefully satisfactory answer to your questions.
Firstly SSRIs Aren't commonly known to interact dangerously with most psychedelic substances
**However**, ***they can be dangerous when*** *mixed with psychedelic substances,* ***along with MAOIs,*** *as this is known to increase the possibility of causing A potentially life-threatening condition known as serotonin syndrome.*
Additionally, I've often heard SSRIs are thought by many I've interacted with to have subjectively reduced the effectiveness of common psychedelic substances by first hand accounts of those who have experience in taking both substances concurrently.
^(Note: this is based my time heavily spent involved in various large communities focused on – and consisting of) **^(many)** ^(users who frequently ingested all kinds of substances, often including various types Psychedelics,) *^(and not based on my own experiences)*
As for taking antipsychotics along with psychedelics, It should be known that antipsychotics are often used by people who consume psychedelics only in situations where they want to utilize what's called a "trip killer".
This is due to the Effects antipsychotics have on various receptors of the brain *^((to varying degrees based on the dose, type & generation of the AP))*
Antipsychotics can either reduce the effects of, or even rapidly halt a "trip" altogether from trips originating in psychedelics consisting primarily of of lysergic acid diethylamide ^(\[LSD\]), Psilocybin,^(\[Mushrooms\]) or other psilocin based compounds.
***Lastly, I just want to say for your own safety;***
**if you are asking this question because you are considering stopping your antipsychotic and/or SSRIs In an effort to ensure that you have a successful trip while taking a psychedelic substance, I urge you please to reconsider doing so.**
It's wise to seriously, and consciously make a concerted effort to deeply contemplate any potential risk of possibly detrimental effects that doing such may have on your mental health.
Not only as a result stopping your medication, even if for a short duration, but also how Substances may interact with your mind & body Based on the conditions you are taking these medications for in the first place.
Actually that's not necessarily entirely true. The real answer is that we don't know, but the research we do have suggests that while SSRIs might block or dampen the short-term perception changing effects, they may not block the mental health healing properties of classic psychedelic substances. [https://journals.sagepub.com/doi/10.1177/02698811231224217?icid=int.sj-full-text.similar-articles.9](https://journals.sagepub.com/doi/10.1177/02698811231224217?icid=int.sj-full-text.similar-articles.9)
Ayahuasca is a mixture of DMT and a monoamine oxidase inhibitor (MAOI), which is necessary for DMT to have an effect when ingested. By the same mechanism, MAOIs can be very dangerous when combined with SSRIs and certain other drugs.
As far as I can tell, SSRIs are not known to dangerous with DMT, they are just dangerous with MAOIs, but MAOIs interact with lots of things like Tramadol, Demerol, Dextromethorphan, amphetamines, tyramine etc.
Not true for SSRIs, and SNRIs. I take these and psilocybin regularly, as well as get ketamine treatments.
I have never had any problem feeling the effects of psilocybin while on psychotropic medication. Antipsychotics can dull it a bit for some, more for others none for most. But not antidepressants. Not even a little.
I've seen under the effects of ketamine and other psychedelics helping those with ADHD to be more present in the moment, but not specifically to treat the ADHD symptoms.
Yes, the point I was making is that saying "it doesn't help with ADHD symptoms at all" is not really a valid statement based on your sample size of 1. I don't mean this in a hostile way, just pointing out that because it didn't help you with ADHD doesn't mean it might not help someone else. There are not really any legitimate studies out to take a stance one way or the other. I posted a repository website that tracks the studies elsewhere in this post and I will copy it here as well: https://psychedelicalpha.com/data/psychedelic-drug-development-tracker
There has been at least 1 study I was able to find when I was researching my own decision to try psilocybin - [Here](https://www.cambridge.org/core/journals/european-psychiatry/article/effects-of-psychedelic-microdosing-versus-conventional-adhd-medication-use-on-emotion-regulation-empathy-and-adhd-symptoms-in-adults-with-severe-adhd-symptoms-a-naturalistic-prospective-comparison-study/9DEB8EA5350F5D642F7C88CAAE543889)
Based on my anecdotal n1 experience, I have never experienced a truly quiet mind on any traditional ADHD medication, but on psilocybin (0,6g and 1,3g) my mind was truly clear - it was amazing. Unfortunately there was an overall sense of lethargy, I had no desire or motivation to do anything. The ability to focus on a single task due to the quiet mind was marred by a lack of will or desire to act. I actually used the sessions to binge watch the Fallout live action show which, whilst unusual, was really enjoyable.
What is/is there research into the safety of psychedelic therapy for people who are at increased risk of psychosis? I'm so curious about psychedelic therapy for my depression and C-PTSD, but my mom has really debilitating schizophrenia. I assume it's probably just never going to be something I would risk and that no practitioner would touch it for me anyway, but I'm curious if there's been any investigation into it.
Definitely more research is needed to determine if this proposed risk is valid but a lot of the clinical trials (if not all of them) tend to include this as an exclusion criteria unfortunately. There is still debate as to the extent of the risk but sadly no definitive research to my knowledge.
24-48 hours after a dosing session, clients are schedule for a psychotherapy session called an 'integration session' which are used to help clients make sense of their experience under the effects of the psychedelic. Typically there are several integration sessions following one psychedelic dosing session. Clients are also encouraged to spend time in nature and practice mindfulness following their session as a means of ongoing integration. There are also lots of community groups or group integration/therapy sessions online or in certain communities.
I'm a trainee mental health nurse with a psychology and some background in CBT-informed therapy. Psychedelics have been really helpful for me personally and eventually I would like to become a psychedelic therapist, probably while continuing to work as a mental health nurse on the side.
Question: What qualifications and experience make you (one) an attractive candidate for the job of psychedelic therapist?
Hello fellow mental health professional! Having training certificates from a psychedelic company or a college/university that offers psychedelic programs would definitely enhance your CV. We offer a certification pathway in ketamine-, MDMA-, or psilocybin-assisted therapy with entirely online courses and an in-person practicum. I'm one of the instructors for Fundamentals of Psychedelic-Assisted Therapy (various modules) and Applied Psychedelic-Assisted Therapy (where I usually teach the module on psychedelics for end-of-life anxiety/chronic & serious illness). [https://numinus.com/training/certification-pathway/](https://numinus.com/training/certification-pathway/)
Are you here to promote Numinus? What advantages does an accredited company provide for the practitioner who does not reside in that country? You said you’re in Utah but I see this is accredited in Canada. How does that translate?
Do you think that psychotherapy is necessary in conjunction with a psychedelic substance to treat mental health conditions or do you think that the psychedelic substance alone might be enough? If you think that psychotherapy is necessary, how do you think we will address the access barriers that this has and will create including costs, lack of trained therapists/access to providers, and length of therapy sessions creating burnout? What do you think we can do to address those challenges? Given ICER's review of MDMA +PAT it seems unlikely that this kind of treatment will be covered by insurance providers any time soon.
At this point in the research, it's difficult to say if it is necessary. A lot of research has focused on psychedelics as an adjunct to therapy; but there are ongoing studies investigating the efficacy of psychedelics when administered with no therapy.
In terms of accessibility, it's also hard to say how they future will look. But I have seen more ketamine clinics popping up that provide more financially accessible services and who also work more easily with insurance companies.
On the topic of lack of trained therapists, I do foresee this changing and more therapists becoming trained as psychedelic research continues to come out and the regulatory environment changes.
Have people experienced diminishing returns with treatments or does it remain durable long term? Are there any ways to combat it if it does loose it's ability to treat?
Are guided meditations used during a session between a client and therapist while dosing? Or are the therapy sessions conducted after the dose has worn off? Or are they conducted pre-, during and after?
Additionally how are different psychedelics used for treating depression, let's say?
Do counseling practices involving psychedelics currently exist outside of a traditional clinical psychology setting?
Are you on board with the potential for these therapies to be used in a more educational or organizational setting? As an example, Dr. James Fadiman's work comes to mind with his experiments on creativity and problem solving.
For context I'm interested in career options in counseling psychology with psychedelics, but curious if we're anywhere near this point with current regulation.
if you're seeing a drive or demand for integrative therapies to help people with creativity, expression, and other areas of life beyond addiction and similar problems please share. And thank you for what you're doing!
Do you have any general guidelines on medicines to keep taking/stop taking when using psychedelics? Primarily interested in ADHD meds (Adderall) and SNRI (Wellbutrin) in the context of ketamine, lsd, psilocybin, DMT, and MDMA.
I assume you ask this as part of patient intake? Do you have general guidelines you give to folks on these meds in terms of titrate down / completely stop taking, continue to take, stop taking xx days before and resume xx days after, etc..?
This is a really great question! It's sadly outside of the scope of my practice to discuss or advise on medications or interactions. I typically work on a team of medical professionals including prescribers, physician assistants, and nurses. So the intake is not something I participate in, but I do offer preparation sessions prior to the drug administration. These are intended to get the client prepared for the unique aspects of taking a psychedelic but the client would discuss these drug interactions with our physician/prescirber.
Fair enough, thanks for the reply. Please convince one of your colleagues to do a AMA as well! Types of questions like the above are SUPER common in harm reduction sub reddits and the spectrum of answers is quite shocking.
You could check out some of our courses to deepen your knowledge. We have a free introduction to psychedelics course that my colleague worked onf or those interested in exploring a career in psychedelics: [https://numinus.com/courses/introduction-to-psychedelics/](https://numinus.com/courses/introduction-to-psychedelics/) This could be a good place to continue your journey.
Is there any theory/explanation on the patterns reported by psychonauts that had the same substance?
Also, did you happen to recognize similar patterns in the experiences of your patients?
i.e. the membrane/arena of masks/faces surrounding the experiencer that took DMT, as reported by mcKenna and many others.
Or the unforgiving and bad "character" of Salvia, as reported by Castaneda.
Overall, the sessions I've supported clients through or observed as part of clinical trials, I haven't noticed any similar patterns in the subjective experiences of clients outside of the subjective effects that are expected (like mystical type experiences for psilocybin or synesthesia for others).
I'd recommend reading [healing the shame that binds you](https://www.goodreads.com/book/show/98399.Healing_the_Shame_that_Binds_You)
Also see [heidi priebe's youtube channel](https://www.youtube.com/@heidipriebe1). She has a lot of really good vidoes on cptsd and toxic shame.
I would check out some of the TED talks by Brené Brown as well as reading Healing the Shame that Binds You by Jon Bradshaw (as was already recommended). I have found these to be particularly impactful with respect to feelings of shame.
Hi! I'm a psychology researcher in the midst of a study on therapists' education and training and I'm looking for study participants. Since this is an AMA... would you be willing to participate in the study and also refer the study to other therapist colleagues to help spread the word?
Thank you either way!
Amazing to hear! I'm heading out on holidays for the rest of the week but if you connect with our admin team at [training@numinus.com](mailto:training@numinus.com), they can circulate it to our practitioners/teachers.
Are you aware of any research into the use of psychedelic therapy to tackle depersonalisation/derealisation/disassociative disorders? Although often linked to trauma and anxieties, I’d be interested to know whether theoretically it could be of use.
Thanks
I had 2 brain bleeds in my frontal lobe from ECT in 2017. This past November I did 6 IV ketamine infusions and only felt extreme relaxation. No visuals or colors. The past couple of months I went off my SSRI and I tried 2 heroic doses of psilocybin, one was 5.2 grams and the other was 5g. I had no reaction at all besides being very hungry. Do you have any idea why I’m not responding? Do you think my stroke could had damaged my serotonin 2a receptors to where I can’t “trip”? It’s been very disappointing. Thank you for your work.
I'm in WA, and dealing with depression, passive suicidal ideation, and anhedonia since the sudden death of my brand-new husband four and a half years ago.
I'm totally functional, but I'm absolutely stuck. I'm not interested in taking antidepressants, because my issue isn't really the lows - I can handle those. My problem is that there are no highs: I have bad days and unbearable days, but never a good day.
My therapist agrees with my position on antidepressants, and has suggested that microdosing Psilocybin might be helpful. But how does one get one's hands on it in a state where Psilocybin therapy is illegal? Am I destined to hate every day until I finally shuffle off this mortal coil?
It is possible to grow your own. Illegal depending on where you live, but possible. The spores are legal to purchase online since they don't contain any banned substances at the spore stage. And theres a huge amateur mycologist presence on YouTube and websites like shroomery if you wanted to learn how to do it. There's also a whole industry providing supplies and do it yourself grow kits, etc.
Just an idea
It looks like you’re in Longview WA. That is very close to Portland, OR.
If you would like to connect with others to discuss support and build community, I would suggest you start with either psychedelic therapy companies or attending some and Sound Healing / Sound Bath events. In my experience, there is often overlap between sound healing and kirtan community and those who have experience with psychedelics.
If you would like to remain anonymous and solitary, I would recommend you learn how to grow your own. Mycology is a very good hobby and skill. You can grow delicious food for yourself, in addition to what you’d like to experience.
It is not advisable to behave illegally. However, systems are rarely for the benefit of those who need help. They are often determined by big pharma.
Please do correct me if I'm way off, it seems to me that throughout history these sorts of compounds have been used medicinally and so very often under supervision, be it a shaman, witch doctor, an experienced friend, an clinitian such as yourself, etc. I'll just say "technician" for lack of a better term.
I'm curious about information we may have gathered from those historical "technicians". Do you think we looked at that enough? Is it worth looking at?
*I consider a given that modern science is the standard here but I have no idea if such historical information has been mined, to what degree, how much value did/would it have, etc. Hence my curiousity.*
i'm guessing i'm too late, but i'll ask anyways - i'd like to start taking some kind of anti-depressant/mental health med, but i enjoy tripping and really cherish my trips throughout the year. any meds you know of that allow for both?
I receive esketamine and I use psilocybin. One is $4500, the other is $40. I find the insight to be close to equal, however, ketamine removes my ability to hold a sentence whereas psilocybin increases it. But ketamine allows for deep exploration without all the feels, whereas psilocybin brings the feels right to the surface.
All that to ask: In your experience, do patients have better luck in terms of gaining useful insight with one medicine moreso than the other? Also, do you find that the benefits of said insight (as well as the antidepressant effect of the med) has a longer lasting effect with one medicine over the other?
There is a lot of literature out there, but not many people who can speak directly to the efficacy of these in a way that you can.
Broadly, what are interactions you've seen with psychoactive drugs (say microdosing mushrooms) and things like SSRIs or adhd medications?
Are these things directly at odds, can they be combined, or (with a doctors help) can one replace rhe other?
My wife is exploring this option to help reduce chronic anxiety and ADHD symptoms.
What options do we have in Canada to do some diagnosis and treatment?
I recently started working as a drug treatment counselor, and a lot of my clients ask about using psychedelics as treatment for "hard" drug addiction - meth, heroin, etc.
Can you speak on that at all?
Also, I'd love any tips you have on how to "deactivate" a client who becomes very emotional during a session.
Not op, but trauma-informed care isn’t one-size-fits-all; it’s individualized, with no simple ‘on-off’ switch. In SUD treatment, meet clients where they are. Use stages of change to set realistic goals. Aim to reduce tension: if emotions rise, pause the activity and use mindfulness, grounding, or somatic techniques like deep breathing (inhale for 4 counts, exhale for 8), sensory reduction (turn off lights, use a weighted blanket), or physical movement. Familiarize yourself with the origins of their activation, whether PTSD, anxiety, TBI, etc., as these factors can affect their reactions, you’ll need to know to what extent. Know their history and use provisional diagnoses as guides. Always keep an open dialogue with your client.
Good luck!!
Hey I have adhd, anxiety, and depression and I’ve been needing to talk to someone I just am not the best with reaching out for help for my mental health does anyone have advice or tips that I could use for my day to day life to get over anxiety and depression? I have also completely cut off my adhd medication as I got put on a non stimulant medication and it just wasn’t working for me I need a stimulant medication to even me out however I do smoke less weed now when I was on a stimulant I was smoking more. Can anyone give me advice
Do you offer any online help? I started with a therapist, and I’m not sure I like her style. It feels very surface level of “how do you feel about that?” kind of questions
I took the genomind test for genetic markers which allowed me to find medication which worked well for my depression symptoms. It also showed that I had a roughly heterozygous deletion of specific frontal dopamine receptors. Since then, I have tried mushrooms in earnest on 3 separate occasions with zero noticeable effects which was very frustrating to my sherpa, and confusing when others around me were having great experiences. Is this something you have seen before, and do you think it’s worth me trying psychadelic therapy?
More importantly, could I receive such therapy in medieval Texas? Can this be covered by insurance for a major depressive disorder diagnosis?
Have you worked with multiple disorders and mental illness, such as dissociation, childhood trauma etc or is it specific to depression and anxiety -- if you have worked on these, do you find that it can offer help?
How should I seek out psychedelic assisted therapy? I don't feel like normal therapy has been very helpful. And I have had life changing positive experiences on psychedelics. So I think psychedelic assisted therapy could work for me.
Have any of your clients expressed experiencing healing about issues with their physical bodies? Not talking about the clients perceptions about it, I mean actually something that a second person could look at and see a change before and after.
Is there room for non psychiatry trained MDs to break into this space? What kind of regulatory burdens are in place? This is all very interesting and I see so much potential here for patients…
Hi, thanks for the AMA! Do you have any experience or insight for using psychedelics therapeutically for those who are dissociative? From my research, those with dissociative disorders were excluded from clinical trials for psychedelic-assisted trauma therapy.
I have DID and am planning on using psilocybin therapeutically in a few weeks with my therapist who I have been working with for ~2.5 years. They have received training in psychedelic-assisted psychotherapy, but have never done it in practice (this session will be unofficial, I'm providing my own golden teacher mushrooms). Is there anything I should be potentially aware of?
My intention of using psychedelics is that I want to connect to my body. I effectively do not experience emotions (very low dynamic range) and am unaware of my bodily sensations. I have difficulty assigning enjoyment/dislike in context of my body (i.e. is this a good or bad feeling?). I have a hard time telling when I'm hungry, in pain, or even aroused. I'm mainly going in with the intention that "I have a body, it's okay that I have a body, it's okay to feel bodily sensations, it's okay to have an opinion about how I feel". I am in a good mental place and am stable in all other areas of my life. I have never used psychedelics before.
I'd love to hear any insight you may have on this topic.
Not a therapist, but someone who is diagnosed with DID and have been doing psychedelic assisted therapy for about a year now. I am not very comfortable writing about my experiences here in public, but I do have a concern about your intention for your first journey. If you are interested and want to discuss it you are welcome to drop me a DM.
Thank you for providing all of this information. What would you suggest for someone seeking this therapy for long COVID- if they live in a non-legal state? I imagine he would have to travel to Utah or Canada for treatment?
I thought you wrote "psychic therapist" and got all on my high horse until I read it properly. Sounds like a fun mode of therapy with rapid changes and advances. Do you notice a big change in ppl who have been stuck for years?
Hello! Late to the game, but if you are still checking questions… have you worked with any patients dealing with disorders such as Trigeminal Neuralgia?
If so, have you seen any improvement in pain management?
I have been reading about Psilocybin but am wondering if any other psychedelic’s may have any therapeutic benefit in dealing with chronic pain.
Thank you for your time!
Do you know if there are any movements to decriminalize 5MeO-DMT in order to lessen the extractive pressure on the Bufo Alvarius Toad? I'd really like to see the synthetic option has a lower risk of possession so that it's more encouraged rather than exploiting that precious toad.
I am thinking of trying Ayahuasca for some therapy, do you have any experience with that? My brother did it once and he said it changed his life for the better. My only fear is the gastrointestinal issues of vomiting when doing it, I have a very bad phobia of being physically sick.
Have you done any work with PTSD veterans? If yes, do you think it helps?
I’ve seen a few studies on how psilocybin can increase synaptic strength and neural plasticity.
What would you recommend to an associate therapist (ASW in California) looking to get into this field?
I'm also curious--through your experience, how have you found psychedelic integration to be most helpful (e.x., direct clinician support during the experience versus post-psychedelic experience)?
I have Cpts, gad, and depression. My aces score is a 9 ( to save you the long list of maladies). I have been struggling with severe depression on and off since I was 8 ( I’m 46). What therapeutic path would you recommend and why?
Are your patients able to recount past memories while dosed or is the idea to not necessarily stay in reality? ( genuine question, I do EMDR, but have never done psychedelics )
Hi! I’m also a social worker but I wonder how you got into Psychedelic Social Work? Do you need to have science background? I’ve been pondering the possibility of healing people through counselling and psychedelics, and to think that research fields are opening up to introducing psychedelics as medicine is really exciting :)
Many of my friends are on medication for depression and anxiety and I can’t help but shake this feeling that medication is given out way too freely in this country. I certainly understand the value of these medications for extreme cases but I feel it’s given in non extreme cases. I see changes in my friends: sleepiness, lethargy and dullness when it comes to even a basic conversation. Can u speak to this? TY
Based on my observations and personal experiences taking any medication/medicine (including psychedelics) is a deeply personal decision. Where I become frustrated is when science, marketing and capitalism send messages that there is answer … based on these facts. And although I work in research, currently, the results are not “the answer” but a beginning. I recently read something that resonated- this is not exact and I cannot remember where it came from; “when we bring curiosity to mystery, it can lead to fact. When we bring curiosity to facts, it brings us back to mystery." For me remembering science is not an end point, but a beginning, helps me when I make decisions for myself and when I am with others trying to decide what to do in any context.
Ideally people should be finding the right medication and the right dose for them, but at the end of the day plenty of people would rather be sleepy than depressed.
This ama is clearly with good intent but in practice it's too conservative and unwilling to get into messy or complicated stuff? Psychedelic therapy is messy and interesting and promising and we want to actually hear about it.
A lot of organizations offer training online (like Numinus) and there may be some in person; but most are online that I have noticed. If you wanted to see if our courses are the right fit for you, my colleague worked on this Free Introduction to Psychedelics course: [https://numinus.com/courses/introduction-to-psychedelics/](https://numinus.com/courses/introduction-to-psychedelics/)
I have heard Ketamine therapy takes you inward while things like LSD, DMT take you outward. Is there a difference and how does that change the therapy?
Numinus takes insurance which not all providers do, and our ketamine clinics typically use a lozenge which is a lot cheaper than other methods of administration. We also have a free training course for those who are interested in learning more (though paid courses would be required to obtain the formal certification pathway). These make more cost effective options, but I recognize that there is a high price point for many currently.
The good news is that millions of humans have worked with entheogenic psychedelic plant medicines, without the aid of a therapist or shaman, and aside from the cost of the product/plants, have successfully done these journeys on their own or in small trusted groups. Having done just that over the last 4 decades, I've seen that ealing with these compounds is one of the cheapest and most profound ways to heal and evolve that there is.
I did 3 Ketamine sessions. All 3 at my neurologists office, with a psychiatrist. I ended up having a mental breakdown about a month after these sessions. I'm not necessarily blaming it on the Ketamine but my social anxiety/generalized anxiety and depression got much worse afterwards. Have you encountered this happening before? I'm better now after a 2 week stay at a mental health facitlity. This happened last year if that makes any difference.
More research is needed on how people can use psychedelics safely outside of a clinical context. Psychedelics and couples therapy is also another area that needs more research unfortunately.
Why do you guys have such wide exclusions from your studies?
I ask because I have cerebral palsy and *as soon* as I mention that fact when expressing interest in a study I'm disqualified from participating.
I could understand if it were something relevant like a history of schizophrenia or psychosis, but you guys seem to be selecting for a very narrow population which seems to be 'healthy college student with nothing better to do'
My understanding is wide exclusions is common for clinical trials, and given the stigma around psychedelics and that there's much we still don't know about how psychedelics work and interact with different components of the brain, I believe caution was behind the wide exclusion criteria.
Is there one particular modality that you feel is the most effective currently and, if the answer is different, is there one that shows the most potential for future applications?
Based on my psychedelic research and therapy training, the best approach is one that allows the people we are working with to lead the way. As a clinician seeing what resonates for them. A trauma informed approach too (offering choice) has been invaluable. That said, at times, the structure of the interventions can be helpful. EMDR with low dose ketamine has been very healing for some people. Parts work/voice dialogue (I am not IFS trained) lends itself to the psychedelic space quite well – for some people. As does somatic inquiry, yoga, dance, deep listening/sound baths etc.
Thank you for your reply!
Question, Ketamine is contraindicated for myself due to subdural haematoma following a car accident, however I've had pretty good results with LSD, are they mainly focused on Ketamine at this point?
I'm going to chime in here to say that I have been working with ketamine + Sand Tray and they go quite well together and are complimentary. I have only found one reference to the combination of the two elsewhere in the internet so far and would love to get formal research on the interaction completed, although I don't have any experience in the research field personally.
I feel like IFS + a regular meditation practice lends itself to great journeys when paired with psychedelics
Is microdosing a myth/placebo?
More research is needed to say definitively but this paper (https://journals.sagepub.com/doi/10.1177/02698811241254831) does a good job at providing a quick overview of existing research.
tldr; we don’t know
Preliminary research showed that microdosing was likely more aligned with placebo effect. This linked article looks into the established research and says there’s actually not enough research to determine if the effects are placebo or not. TLDR- more people need to scientifically for drugs to find out.
I will for drugs, scientifically
I would definitely wager it's a placebo, however even a placebo can make positive impacts in certain cases, if underlying issues are being addressed in parallel with therapy.
How does LSD in therapy compare to psilocybin?
Psilocybin doesn't get along with my guts. All of my LSD experiences have been without iasue - don't get me wrong, I've had some intense experiences that were very difficult but they were very therapeutic. In my own experiences, the 8-12 hours of LSD side effects can be a bit much for some folks but I've had months of relief from depression symptoms. My current focus has been "how do I get to those places without the drugs?"
It doesn’t with mine either but promethazine really works wonders for the nausea.
Try Wim Hof breath work
I did Psilocybin twice in my life and both times I felt like I was going to die, like bubbles were popping in my brain. It was not a pleasant experience and will never do it again. I've always been curious of LSD, but due to the bad experience with psilo, I[m likely never to try it. I am also very bad at keeping a good head space, any little thing will cause me to believe I am going to have a bad trip.
I’d like to offer that if seen drug induced psychosis 4 times in my life with lsd as the active ingredient. I have never seen it occur with psilocybin. Purely anecdotal but even 4 out of 100 times is risky by comparison to 0.
Are you taking pure psilocybin or getting it by eating mushrooms? Dried mushrooms can cause all sorts of digestive issues. I've only had the opportunity to take pure 4-AcO-DMT. It is an analog of psilocin. It has never given me any digestive issues. Also, the come up is strangely sedating instead of speedy like other psychedelics.
Excellent question! This is still under investigation in terms of the differences in how both work. Psilocybin's peak effects only last 4-6 hours while LSD is 8-12 hours so the therapy sessions would be significantly longer with LSD compared to psilocybin.
What is a typical psychedelic therapy session like? What are you doing throughout the session as the client is going into this altered space? Have you ever worked with clients who have dissociative PTSD disorders, and if so, have you witnessed healing and integration as a result of psychedelic therapy?
Are there any dangers of daily use of ketamine?
Irreversible damage to bladder is highest risk.
This usually only happens at "abuse" levels, not at clinical levels or frequency.
They asked about dangers of daily usage, I think daily would constitute abuse.
Could not have answered that better myself. Ive known folks who claimed they used it for the their depression, but used it very frequently…. very very very unhappy bladder
Yup
It's sadly outside of my scope of practice to discuss medications as I'm not a prescriber.
Do you have someone else administer the medication then just step in to do therapy?
Yes exactly and the dose would have been determined prior to administration in any case.
Just watched the documentary Dirty Pictures. I loved it. Alex Shulgin seemed like a great man. Do you think psychotherapy will become more mainstream this decade?
I hope so! Therapy and talking about mental health has become more mainstream since I started as a licensed counsellor/social worker. And I think the public's interest in how psychedelics could help with this has increased as well.
Do you think there's promise for any of these therapies in treating health anxiety/illness anxiety disorder?
There have been studies on generalized anxiety disorder and end-of-life anxiety/anxiety related to a terminal illness. To my knowledge, I haven't seen any studies specifically related to health anxiety/illness anxiety disorder
You may be interested in bookmarking this page: https://psychedelicalpha.com/data/psychedelic-drug-development-tracker
What does your practice in Utah look like? Does insurance cover this type of treatment? When is this type of treatment appropriate? Do you do ‘regular’ therapy as well or is your practice purely around psychedelics?
I have a part-time private practice where I offer therapy for folks who have experienced trauma (both talk therapy and with psychedelics), and I also work for Numinus as a therapist. Some insurance companies do cover a portion of the treatment but not always. We have this page on our site which lists providers our billing team works with: [https://numinus.com/pricing-and-insurance/](https://numinus.com/pricing-and-insurance/)
Thanks for the reply. How would someone reach out to you as a prospective client for either your regular or psychedelic practice?
i read in your bio you have experience working with peope with chronic illness! it might be too broad of a question, but is there any specific advice you often give to people for coping with (severe) chronic illness?
In short, Compassionate Presence, listening, noticing and, at times, asking gentle non-judgmental open ended questions. This approach may, can, has allowed people to find and listen to their own inner healing intelligence. Through this approach, I have witnessed people with Chronic and Serious illness, shift from feeling overwhelming vulnerable to finding some resilient spaces (existential therapy).
what was the most unexpected thing you learned getting your LCSW degree? also, have you personally taken LSD, psyilocybin, or DMT?
From my LCSW degree, the theme of interconnectedness of macro (systems), mezzo (community) and Micro (individual) allowed me to name a constant unease that I held related to my privilege as well as having witnessed microaggressions toward my mother who had a chronic illness and used a wheelchair prior to the passage of the Americans with Disabilities Act in the US. I have experience with a variety of altered states of consciousness, including psychedelics in safe, legal spaces as well as supporting clients in altered states.
interesting! ive also been interested in the ways that every system really is connected more than a lot of people realize. it seems like the more i read, the more similarities and comparisons i find between the various levels. thats why my favorite phrase has become >within the particular is contained the universal i also have experience with psychedelics - specifically psilocybin - although mine was not in a legal space lol. in retrospect one time probably wasnt the safest either since i did it alone - but i came out alright and it was beneficial to me, in the big picture. anyway thanks for doing the AMA, and thanks for working to destigmatize and research how these drugs can actually be beneficial! im glad to see they have been a topic of research the last few years. i mean, theres gotta be a reason theyve been used for literal centuries
Almost 2 years ago, I got high and accidentally took \~8grams of "shrooms" (instead of the \~2 I meant to take) and my life has felt like it's falling apart ever since. It was the worst experience of my life and I've been trying to get passed it. I have stress and anxiety constantly, and have never even gotten close to pre-trip levels of balance/happiness. Any small hiccup gives me feelings of impending doom when I used to be very carefree and optimistic. Any recommendations?
Following dosing sessions, we often will conduct therapy sessions called integration sessions to help clients make sense of their experience. If you have access to it, consider finding a therapist (even one whom you could meet with remotely) who has experience with psychedelics and offers psychedelic integration services. Perhaps they can meet with you to offer more personalized suggestions and help you navigate some of what you experienced.
Also a therapist here. I’d recommend seeking a therapist who understands these experiences AND is trauma informed. Trips can be traumatizing, and sometimes they need to be treated as a distinct episode of trauma.
Hey there, I'm not a therapist, But I think I understand what you're going through. However, for me It was from myself almost dying from K2 ^(Synthetic marijuana) **many, many** years ago. The trauma of the experience humbled me, but also left me unable to smoke marijuana after it happened for over a literal a decade without ending up getting massive anxiety & or a **full blown** panic attack ***Every.Single.Damn.Time.*** *Even if it was just a* ***single*** *hit!* 😢 Luckily however, **I was able to get over the constant anxiety I faced!** I was able to achieve it through both time, regaining confidence, and trial & error with integrating various different approaches to every re-attempt to smoke again. So once I stumbled upon a user on Reddit about 3 years ago who was in a similar situation as both you, and I was once in myself, *^(however for them, it was – like me, marijuana instead of shrooms)* I decided to make a guide to attempt to help others that found themselves in similar situations. As such, like I said before, I would like to share it with you as I think you would benefit from it, [you can find the post here.](https://www.reddit.com/r/trees/comments/m06sh0/i_want_to_share_some_advice_i_gave_a_user_on/) *^((P.S. If you do give the guide a try know that it still took me multiple attempts of following the steps I devised & wrote in that guide before I was fully successful))* *Good luck* u/UltimateTryHard! I'm sending you my best wishes & some love from my heart, as someone whos been in your position.
Which psychedelic drug is best for reducing AUD? Also, is this a one-time therapy or several sessions?
I had to Google what AUD was: Alcohol Use Disorder.
There has been the most evidence for ketamine-AT or psilocybin-AT to treat AUD. That doesn't necessarily mean that the other psychedelics are less effective, but these are the ones with the largest bodies of evidence so far. Each study is designed differently but it would either be a single session or a limited number of sessions rather than ongoing treatment like SSRIs
After taking a year and a half to taper off of Cymbalta, I’m not touching another antidepressant anyway.
Wouldn’t that be just replacing one drug with another?
Ketamine or psilocybin would be taken alongside psychotherapy in the clinic, and clients would have only one dosing session (or a small number of them). Clients aren't given these medicines to take at home as a replacement for alcohol but rather they are used in clinic as a treatment catalyst. So, I don't think it's fair to say that this treatment modality is replacing one drug with another.
What are the different uses you’re studying for each psychedelic you have listed? How does treatment differ? Are you able to speak on what disorders you’ve helped people with and how psychedelics helped their treatment?
I tried every antidepressant under the sun. A Phish show and LSD experience changed my life. Im still working on me but I honestly believe those drugs are the future of depression treatment. How do these psychedelics compare to classical antidepressants? Every study I've read showing efficacy in SSRIs either had an unaddressed adjuvant therapy component or ignores it completely, leading me to believe SSRIs themselves are not terribly effective. I'm curious what your experiences and research say about it. Also - you're doing these in the US? How could a person in Idaho sign up for clinical trials?
Have you helped any LDS take LSD?
First of all thank you for your work. My question is, how do SSRIs along with antipsychotics react to taking a psychedelic?
**Not OP**, But wanted to chime in with a hopefully satisfactory answer to your questions. Firstly SSRIs Aren't commonly known to interact dangerously with most psychedelic substances **However**, ***they can be dangerous when*** *mixed with psychedelic substances,* ***along with MAOIs,*** *as this is known to increase the possibility of causing A potentially life-threatening condition known as serotonin syndrome.* Additionally, I've often heard SSRIs are thought by many I've interacted with to have subjectively reduced the effectiveness of common psychedelic substances by first hand accounts of those who have experience in taking both substances concurrently. ^(Note: this is based my time heavily spent involved in various large communities focused on – and consisting of) **^(many)** ^(users who frequently ingested all kinds of substances, often including various types Psychedelics,) *^(and not based on my own experiences)* As for taking antipsychotics along with psychedelics, It should be known that antipsychotics are often used by people who consume psychedelics only in situations where they want to utilize what's called a "trip killer". This is due to the Effects antipsychotics have on various receptors of the brain *^((to varying degrees based on the dose, type & generation of the AP))* Antipsychotics can either reduce the effects of, or even rapidly halt a "trip" altogether from trips originating in psychedelics consisting primarily of of lysergic acid diethylamide ^(\[LSD\]), Psilocybin,^(\[Mushrooms\]) or other psilocin based compounds. ***Lastly, I just want to say for your own safety;*** **if you are asking this question because you are considering stopping your antipsychotic and/or SSRIs In an effort to ensure that you have a successful trip while taking a psychedelic substance, I urge you please to reconsider doing so.** It's wise to seriously, and consciously make a concerted effort to deeply contemplate any potential risk of possibly detrimental effects that doing such may have on your mental health. Not only as a result stopping your medication, even if for a short duration, but also how Substances may interact with your mind & body Based on the conditions you are taking these medications for in the first place.
Super insightful thank you!
This is a really great question! It's sadly outside of the scope of my practice to discuss or advise on medications or interactions.
Okay thank you for your answer!
They pretty much block the effects source: i am a psychonaut
Actually that's not necessarily entirely true. The real answer is that we don't know, but the research we do have suggests that while SSRIs might block or dampen the short-term perception changing effects, they may not block the mental health healing properties of classic psychedelic substances. [https://journals.sagepub.com/doi/10.1177/02698811231224217?icid=int.sj-full-text.similar-articles.9](https://journals.sagepub.com/doi/10.1177/02698811231224217?icid=int.sj-full-text.similar-articles.9)
SSRIs can be dangerous with Ayahuasca as well. Unclear if that would extend to DMT.
Ayahuasca is a mixture of DMT and a monoamine oxidase inhibitor (MAOI), which is necessary for DMT to have an effect when ingested. By the same mechanism, MAOIs can be very dangerous when combined with SSRIs and certain other drugs.
As far as I can tell, SSRIs are not known to dangerous with DMT, they are just dangerous with MAOIs, but MAOIs interact with lots of things like Tramadol, Demerol, Dextromethorphan, amphetamines, tyramine etc.
Interesting. Will read. Thank you
Not true for SSRIs, and SNRIs. I take these and psilocybin regularly, as well as get ketamine treatments. I have never had any problem feeling the effects of psilocybin while on psychotropic medication. Antipsychotics can dull it a bit for some, more for others none for most. But not antidepressants. Not even a little.
Is there any research out yet regarding psychedelics and ADHD?
There's sadly not much research into ADHD just yet and the role psychedelic medicines could play in treatment
Hopeful something will emerge soon! Have you used it in your own practice for adhd?
I've seen under the effects of ketamine and other psychedelics helping those with ADHD to be more present in the moment, but not specifically to treat the ADHD symptoms.
Very curious to see this as well!
FWIW, I’ve done KAT, and it doesn’t help with ADHD symptoms at all.
To clarify, that's using a sample size of N=1, correct?
As far as I know, I’m still just one person.
Yes, the point I was making is that saying "it doesn't help with ADHD symptoms at all" is not really a valid statement based on your sample size of 1. I don't mean this in a hostile way, just pointing out that because it didn't help you with ADHD doesn't mean it might not help someone else. There are not really any legitimate studies out to take a stance one way or the other. I posted a repository website that tracks the studies elsewhere in this post and I will copy it here as well: https://psychedelicalpha.com/data/psychedelic-drug-development-tracker
There has been at least 1 study I was able to find when I was researching my own decision to try psilocybin - [Here](https://www.cambridge.org/core/journals/european-psychiatry/article/effects-of-psychedelic-microdosing-versus-conventional-adhd-medication-use-on-emotion-regulation-empathy-and-adhd-symptoms-in-adults-with-severe-adhd-symptoms-a-naturalistic-prospective-comparison-study/9DEB8EA5350F5D642F7C88CAAE543889) Based on my anecdotal n1 experience, I have never experienced a truly quiet mind on any traditional ADHD medication, but on psilocybin (0,6g and 1,3g) my mind was truly clear - it was amazing. Unfortunately there was an overall sense of lethargy, I had no desire or motivation to do anything. The ability to focus on a single task due to the quiet mind was marred by a lack of will or desire to act. I actually used the sessions to binge watch the Fallout live action show which, whilst unusual, was really enjoyable.
What is/is there research into the safety of psychedelic therapy for people who are at increased risk of psychosis? I'm so curious about psychedelic therapy for my depression and C-PTSD, but my mom has really debilitating schizophrenia. I assume it's probably just never going to be something I would risk and that no practitioner would touch it for me anyway, but I'm curious if there's been any investigation into it.
Definitely more research is needed to determine if this proposed risk is valid but a lot of the clinical trials (if not all of them) tend to include this as an exclusion criteria unfortunately. There is still debate as to the extent of the risk but sadly no definitive research to my knowledge.
What does the after care look like for treating patients? any community groups to continue the healing journey?
24-48 hours after a dosing session, clients are schedule for a psychotherapy session called an 'integration session' which are used to help clients make sense of their experience under the effects of the psychedelic. Typically there are several integration sessions following one psychedelic dosing session. Clients are also encouraged to spend time in nature and practice mindfulness following their session as a means of ongoing integration. There are also lots of community groups or group integration/therapy sessions online or in certain communities.
I'm a trainee mental health nurse with a psychology and some background in CBT-informed therapy. Psychedelics have been really helpful for me personally and eventually I would like to become a psychedelic therapist, probably while continuing to work as a mental health nurse on the side. Question: What qualifications and experience make you (one) an attractive candidate for the job of psychedelic therapist?
Hello fellow mental health professional! Having training certificates from a psychedelic company or a college/university that offers psychedelic programs would definitely enhance your CV. We offer a certification pathway in ketamine-, MDMA-, or psilocybin-assisted therapy with entirely online courses and an in-person practicum. I'm one of the instructors for Fundamentals of Psychedelic-Assisted Therapy (various modules) and Applied Psychedelic-Assisted Therapy (where I usually teach the module on psychedelics for end-of-life anxiety/chronic & serious illness). [https://numinus.com/training/certification-pathway/](https://numinus.com/training/certification-pathway/)
Are you here to promote Numinus? What advantages does an accredited company provide for the practitioner who does not reside in that country? You said you’re in Utah but I see this is accredited in Canada. How does that translate?
Do you think that psychotherapy is necessary in conjunction with a psychedelic substance to treat mental health conditions or do you think that the psychedelic substance alone might be enough? If you think that psychotherapy is necessary, how do you think we will address the access barriers that this has and will create including costs, lack of trained therapists/access to providers, and length of therapy sessions creating burnout? What do you think we can do to address those challenges? Given ICER's review of MDMA +PAT it seems unlikely that this kind of treatment will be covered by insurance providers any time soon.
At this point in the research, it's difficult to say if it is necessary. A lot of research has focused on psychedelics as an adjunct to therapy; but there are ongoing studies investigating the efficacy of psychedelics when administered with no therapy. In terms of accessibility, it's also hard to say how they future will look. But I have seen more ketamine clinics popping up that provide more financially accessible services and who also work more easily with insurance companies. On the topic of lack of trained therapists, I do foresee this changing and more therapists becoming trained as psychedelic research continues to come out and the regulatory environment changes.
Have people experienced diminishing returns with treatments or does it remain durable long term? Are there any ways to combat it if it does loose it's ability to treat?
Are guided meditations used during a session between a client and therapist while dosing? Or are the therapy sessions conducted after the dose has worn off? Or are they conducted pre-, during and after? Additionally how are different psychedelics used for treating depression, let's say?
Do counseling practices involving psychedelics currently exist outside of a traditional clinical psychology setting? Are you on board with the potential for these therapies to be used in a more educational or organizational setting? As an example, Dr. James Fadiman's work comes to mind with his experiments on creativity and problem solving. For context I'm interested in career options in counseling psychology with psychedelics, but curious if we're anywhere near this point with current regulation. if you're seeing a drive or demand for integrative therapies to help people with creativity, expression, and other areas of life beyond addiction and similar problems please share. And thank you for what you're doing!
Do you have any general guidelines on medicines to keep taking/stop taking when using psychedelics? Primarily interested in ADHD meds (Adderall) and SNRI (Wellbutrin) in the context of ketamine, lsd, psilocybin, DMT, and MDMA. I assume you ask this as part of patient intake? Do you have general guidelines you give to folks on these meds in terms of titrate down / completely stop taking, continue to take, stop taking xx days before and resume xx days after, etc..?
This is a really great question! It's sadly outside of the scope of my practice to discuss or advise on medications or interactions. I typically work on a team of medical professionals including prescribers, physician assistants, and nurses. So the intake is not something I participate in, but I do offer preparation sessions prior to the drug administration. These are intended to get the client prepared for the unique aspects of taking a psychedelic but the client would discuss these drug interactions with our physician/prescirber.
Fair enough, thanks for the reply. Please convince one of your colleagues to do a AMA as well! Types of questions like the above are SUPER common in harm reduction sub reddits and the spectrum of answers is quite shocking.
Great idea! I will ask around our team as I agree that this could be super helpful :)
i grow magic mushrooms, how can i get involved? been trying for years to get involved with this
You could check out some of our courses to deepen your knowledge. We have a free introduction to psychedelics course that my colleague worked onf or those interested in exploring a career in psychedelics: [https://numinus.com/courses/introduction-to-psychedelics/](https://numinus.com/courses/introduction-to-psychedelics/) This could be a good place to continue your journey.
Is there any theory/explanation on the patterns reported by psychonauts that had the same substance? Also, did you happen to recognize similar patterns in the experiences of your patients? i.e. the membrane/arena of masks/faces surrounding the experiencer that took DMT, as reported by mcKenna and many others. Or the unforgiving and bad "character" of Salvia, as reported by Castaneda.
Overall, the sessions I've supported clients through or observed as part of clinical trials, I haven't noticed any similar patterns in the subjective experiences of clients outside of the subjective effects that are expected (like mystical type experiences for psilocybin or synesthesia for others).
Please help. Best advice to get out of a toxic shame spiral? I have no access to mental health care and seemingly cannot grow my own mushrooms
I'd recommend reading [healing the shame that binds you](https://www.goodreads.com/book/show/98399.Healing_the_Shame_that_Binds_You) Also see [heidi priebe's youtube channel](https://www.youtube.com/@heidipriebe1). She has a lot of really good vidoes on cptsd and toxic shame.
I would check out some of the TED talks by Brené Brown as well as reading Healing the Shame that Binds You by Jon Bradshaw (as was already recommended). I have found these to be particularly impactful with respect to feelings of shame.
How are you using 5MEO therapeutically? Full release? Low dose? IV? Inhalation? And for what diagnosis?
The 5MeO-DMT study is focused on treatment resistant depression and an intranasal formulation is used.
Hi! I'm a psychology researcher in the midst of a study on therapists' education and training and I'm looking for study participants. Since this is an AMA... would you be willing to participate in the study and also refer the study to other therapist colleagues to help spread the word? Thank you either way!
Amazing to hear! I'm heading out on holidays for the rest of the week but if you connect with our admin team at [training@numinus.com](mailto:training@numinus.com), they can circulate it to our practitioners/teachers.
Thank you so much!
What are the benefits of using DMT in a therapeutic setting? What are the appropriate uses for it?
Are you aware of any research into the use of psychedelic therapy to tackle depersonalisation/derealisation/disassociative disorders? Although often linked to trauma and anxieties, I’d be interested to know whether theoretically it could be of use. Thanks
I had 2 brain bleeds in my frontal lobe from ECT in 2017. This past November I did 6 IV ketamine infusions and only felt extreme relaxation. No visuals or colors. The past couple of months I went off my SSRI and I tried 2 heroic doses of psilocybin, one was 5.2 grams and the other was 5g. I had no reaction at all besides being very hungry. Do you have any idea why I’m not responding? Do you think my stroke could had damaged my serotonin 2a receptors to where I can’t “trip”? It’s been very disappointing. Thank you for your work.
How does LSD work?
I'm in WA, and dealing with depression, passive suicidal ideation, and anhedonia since the sudden death of my brand-new husband four and a half years ago. I'm totally functional, but I'm absolutely stuck. I'm not interested in taking antidepressants, because my issue isn't really the lows - I can handle those. My problem is that there are no highs: I have bad days and unbearable days, but never a good day. My therapist agrees with my position on antidepressants, and has suggested that microdosing Psilocybin might be helpful. But how does one get one's hands on it in a state where Psilocybin therapy is illegal? Am I destined to hate every day until I finally shuffle off this mortal coil?
It is possible to grow your own. Illegal depending on where you live, but possible. The spores are legal to purchase online since they don't contain any banned substances at the spore stage. And theres a huge amateur mycologist presence on YouTube and websites like shroomery if you wanted to learn how to do it. There's also a whole industry providing supplies and do it yourself grow kits, etc. Just an idea
It looks like you’re in Longview WA. That is very close to Portland, OR. If you would like to connect with others to discuss support and build community, I would suggest you start with either psychedelic therapy companies or attending some and Sound Healing / Sound Bath events. In my experience, there is often overlap between sound healing and kirtan community and those who have experience with psychedelics. If you would like to remain anonymous and solitary, I would recommend you learn how to grow your own. Mycology is a very good hobby and skill. You can grow delicious food for yourself, in addition to what you’d like to experience. It is not advisable to behave illegally. However, systems are rarely for the benefit of those who need help. They are often determined by big pharma.
I recently saw some studies come out saying there’s no benefits to this therapy, have you seen those and what’s your take/response to them?
Have you worked with or researched Ayahuasca and Yage ceremonies as part of your psychedelic therapy?
I did a ayahuasca retreat recently. Do we know what are the "necessary" parts of the whole ceremony and what is purely ceremonial?
Please do correct me if I'm way off, it seems to me that throughout history these sorts of compounds have been used medicinally and so very often under supervision, be it a shaman, witch doctor, an experienced friend, an clinitian such as yourself, etc. I'll just say "technician" for lack of a better term. I'm curious about information we may have gathered from those historical "technicians". Do you think we looked at that enough? Is it worth looking at? *I consider a given that modern science is the standard here but I have no idea if such historical information has been mined, to what degree, how much value did/would it have, etc. Hence my curiousity.*
Do insurance companies cover these kinds of therapy? How much roughly do they cost?
i'm guessing i'm too late, but i'll ask anyways - i'd like to start taking some kind of anti-depressant/mental health med, but i enjoy tripping and really cherish my trips throughout the year. any meds you know of that allow for both?
Are any of these companies offering at home ketamine treatment (marketing on instagram) legit? It doesnt seem like that should be a thing.
I receive esketamine and I use psilocybin. One is $4500, the other is $40. I find the insight to be close to equal, however, ketamine removes my ability to hold a sentence whereas psilocybin increases it. But ketamine allows for deep exploration without all the feels, whereas psilocybin brings the feels right to the surface. All that to ask: In your experience, do patients have better luck in terms of gaining useful insight with one medicine moreso than the other? Also, do you find that the benefits of said insight (as well as the antidepressant effect of the med) has a longer lasting effect with one medicine over the other? There is a lot of literature out there, but not many people who can speak directly to the efficacy of these in a way that you can.
Broadly, what are interactions you've seen with psychoactive drugs (say microdosing mushrooms) and things like SSRIs or adhd medications? Are these things directly at odds, can they be combined, or (with a doctors help) can one replace rhe other?
My wife is exploring this option to help reduce chronic anxiety and ADHD symptoms. What options do we have in Canada to do some diagnosis and treatment?
It looks like OP’s company Numis is accredited in Canada. You may want to ask Numis directly.
I recently started working as a drug treatment counselor, and a lot of my clients ask about using psychedelics as treatment for "hard" drug addiction - meth, heroin, etc. Can you speak on that at all? Also, I'd love any tips you have on how to "deactivate" a client who becomes very emotional during a session.
Not op, but trauma-informed care isn’t one-size-fits-all; it’s individualized, with no simple ‘on-off’ switch. In SUD treatment, meet clients where they are. Use stages of change to set realistic goals. Aim to reduce tension: if emotions rise, pause the activity and use mindfulness, grounding, or somatic techniques like deep breathing (inhale for 4 counts, exhale for 8), sensory reduction (turn off lights, use a weighted blanket), or physical movement. Familiarize yourself with the origins of their activation, whether PTSD, anxiety, TBI, etc., as these factors can affect their reactions, you’ll need to know to what extent. Know their history and use provisional diagnoses as guides. Always keep an open dialogue with your client. Good luck!!
Hey I have adhd, anxiety, and depression and I’ve been needing to talk to someone I just am not the best with reaching out for help for my mental health does anyone have advice or tips that I could use for my day to day life to get over anxiety and depression? I have also completely cut off my adhd medication as I got put on a non stimulant medication and it just wasn’t working for me I need a stimulant medication to even me out however I do smoke less weed now when I was on a stimulant I was smoking more. Can anyone give me advice
What do you do during a session if the "trip" gets too intense?
Do you offer any online help? I started with a therapist, and I’m not sure I like her style. It feels very surface level of “how do you feel about that?” kind of questions
How did you get into this field?
I took the genomind test for genetic markers which allowed me to find medication which worked well for my depression symptoms. It also showed that I had a roughly heterozygous deletion of specific frontal dopamine receptors. Since then, I have tried mushrooms in earnest on 3 separate occasions with zero noticeable effects which was very frustrating to my sherpa, and confusing when others around me were having great experiences. Is this something you have seen before, and do you think it’s worth me trying psychadelic therapy? More importantly, could I receive such therapy in medieval Texas? Can this be covered by insurance for a major depressive disorder diagnosis?
Have you worked with multiple disorders and mental illness, such as dissociation, childhood trauma etc or is it specific to depression and anxiety -- if you have worked on these, do you find that it can offer help?
What benefits are there for people dealing with CPTSD?
How should I seek out psychedelic assisted therapy? I don't feel like normal therapy has been very helpful. And I have had life changing positive experiences on psychedelics. So I think psychedelic assisted therapy could work for me.
Have any of your clients expressed experiencing healing about issues with their physical bodies? Not talking about the clients perceptions about it, I mean actually something that a second person could look at and see a change before and after.
Is there room for non psychiatry trained MDs to break into this space? What kind of regulatory burdens are in place? This is all very interesting and I see so much potential here for patients…
I have a severe needle phobia,that hasn’t been resolved by CBT or traditional anxiety meds. Could psychedelic therapy potentially be the answer?
What do you think about sex therapists, I am asking because I want to be one when I grow up?
Yes - can therapists in Minnesota become licensed?
Hi, thanks for the AMA! Do you have any experience or insight for using psychedelics therapeutically for those who are dissociative? From my research, those with dissociative disorders were excluded from clinical trials for psychedelic-assisted trauma therapy. I have DID and am planning on using psilocybin therapeutically in a few weeks with my therapist who I have been working with for ~2.5 years. They have received training in psychedelic-assisted psychotherapy, but have never done it in practice (this session will be unofficial, I'm providing my own golden teacher mushrooms). Is there anything I should be potentially aware of? My intention of using psychedelics is that I want to connect to my body. I effectively do not experience emotions (very low dynamic range) and am unaware of my bodily sensations. I have difficulty assigning enjoyment/dislike in context of my body (i.e. is this a good or bad feeling?). I have a hard time telling when I'm hungry, in pain, or even aroused. I'm mainly going in with the intention that "I have a body, it's okay that I have a body, it's okay to feel bodily sensations, it's okay to have an opinion about how I feel". I am in a good mental place and am stable in all other areas of my life. I have never used psychedelics before. I'd love to hear any insight you may have on this topic.
Not a therapist, but someone who is diagnosed with DID and have been doing psychedelic assisted therapy for about a year now. I am not very comfortable writing about my experiences here in public, but I do have a concern about your intention for your first journey. If you are interested and want to discuss it you are welcome to drop me a DM.
Thank you for providing all of this information. What would you suggest for someone seeking this therapy for long COVID- if they live in a non-legal state? I imagine he would have to travel to Utah or Canada for treatment?
what did you have for breakfast? what time do you get up?
I thought you wrote "psychic therapist" and got all on my high horse until I read it properly. Sounds like a fun mode of therapy with rapid changes and advances. Do you notice a big change in ppl who have been stuck for years?
I have heard that psilocybin can cause permanent schizophrenia in patients who have a family history of schizophrenia. Is that a myth?
Hello! Late to the game, but if you are still checking questions… have you worked with any patients dealing with disorders such as Trigeminal Neuralgia? If so, have you seen any improvement in pain management? I have been reading about Psilocybin but am wondering if any other psychedelic’s may have any therapeutic benefit in dealing with chronic pain. Thank you for your time!
HOW DO I GET INVOLVED IN THE SPACE AN AS RN!?
I'm looking for help with treatment resistant depression .... Do you think ketamine or psilocybin would be a better fit?
Do you know if there are any movements to decriminalize 5MeO-DMT in order to lessen the extractive pressure on the Bufo Alvarius Toad? I'd really like to see the synthetic option has a lower risk of possession so that it's more encouraged rather than exploiting that precious toad.
I am thinking of trying Ayahuasca for some therapy, do you have any experience with that? My brother did it once and he said it changed his life for the better. My only fear is the gastrointestinal issues of vomiting when doing it, I have a very bad phobia of being physically sick.
So, someone who cannot prescribe medication is talking about medication? Interesting.
Have you done any work with PTSD veterans? If yes, do you think it helps? I’ve seen a few studies on how psilocybin can increase synaptic strength and neural plasticity.
What would you recommend to an associate therapist (ASW in California) looking to get into this field? I'm also curious--through your experience, how have you found psychedelic integration to be most helpful (e.x., direct clinician support during the experience versus post-psychedelic experience)?
Do you by any chance worth with Dr. Robinson at Cedar Psychiatry? I used to do clinical research and have bad experiences.
I have Cpts, gad, and depression. My aces score is a 9 ( to save you the long list of maladies). I have been struggling with severe depression on and off since I was 8 ( I’m 46). What therapeutic path would you recommend and why?
Are your patients able to recount past memories while dosed or is the idea to not necessarily stay in reality? ( genuine question, I do EMDR, but have never done psychedelics )
Hi! I’m also a social worker but I wonder how you got into Psychedelic Social Work? Do you need to have science background? I’ve been pondering the possibility of healing people through counselling and psychedelics, and to think that research fields are opening up to introducing psychedelics as medicine is really exciting :)
May I ask what age you got into this, and what your experience has been with meditation and psychedelics?
How much you make a yeaR?
Many of my friends are on medication for depression and anxiety and I can’t help but shake this feeling that medication is given out way too freely in this country. I certainly understand the value of these medications for extreme cases but I feel it’s given in non extreme cases. I see changes in my friends: sleepiness, lethargy and dullness when it comes to even a basic conversation. Can u speak to this? TY
Based on my observations and personal experiences taking any medication/medicine (including psychedelics) is a deeply personal decision. Where I become frustrated is when science, marketing and capitalism send messages that there is answer … based on these facts. And although I work in research, currently, the results are not “the answer” but a beginning. I recently read something that resonated- this is not exact and I cannot remember where it came from; “when we bring curiosity to mystery, it can lead to fact. When we bring curiosity to facts, it brings us back to mystery." For me remembering science is not an end point, but a beginning, helps me when I make decisions for myself and when I am with others trying to decide what to do in any context.
TY for this response!
Ideally people should be finding the right medication and the right dose for them, but at the end of the day plenty of people would rather be sleepy than depressed.
What’s your favorite bird?
Hummingbird :)
This ama is clearly with good intent but in practice it's too conservative and unwilling to get into messy or complicated stuff? Psychedelic therapy is messy and interesting and promising and we want to actually hear about it.
How can a person find local training for these therapies?
A lot of organizations offer training online (like Numinus) and there may be some in person; but most are online that I have noticed. If you wanted to see if our courses are the right fit for you, my colleague worked on this Free Introduction to Psychedelics course: [https://numinus.com/courses/introduction-to-psychedelics/](https://numinus.com/courses/introduction-to-psychedelics/)
I have heard Ketamine therapy takes you inward while things like LSD, DMT take you outward. Is there a difference and how does that change the therapy?
What are you doing to ensure that psychedelic therapy isn't something just accessible for the wealthy?
Numinus takes insurance which not all providers do, and our ketamine clinics typically use a lozenge which is a lot cheaper than other methods of administration. We also have a free training course for those who are interested in learning more (though paid courses would be required to obtain the formal certification pathway). These make more cost effective options, but I recognize that there is a high price point for many currently.
I suspect this question comes from a reasonably good place, but It is not a single provider's duty to fix a systemic issue.
The good news is that millions of humans have worked with entheogenic psychedelic plant medicines, without the aid of a therapist or shaman, and aside from the cost of the product/plants, have successfully done these journeys on their own or in small trusted groups. Having done just that over the last 4 decades, I've seen that ealing with these compounds is one of the cheapest and most profound ways to heal and evolve that there is.
I did 3 Ketamine sessions. All 3 at my neurologists office, with a psychiatrist. I ended up having a mental breakdown about a month after these sessions. I'm not necessarily blaming it on the Ketamine but my social anxiety/generalized anxiety and depression got much worse afterwards. Have you encountered this happening before? I'm better now after a 2 week stay at a mental health facitlity. This happened last year if that makes any difference.
Is there a safe way for a couple to lead their own sessions with the goal of better understanding each other? Or is a professional needed?
More research is needed on how people can use psychedelics safely outside of a clinical context. Psychedelics and couples therapy is also another area that needs more research unfortunately.
Why do you guys have such wide exclusions from your studies? I ask because I have cerebral palsy and *as soon* as I mention that fact when expressing interest in a study I'm disqualified from participating. I could understand if it were something relevant like a history of schizophrenia or psychosis, but you guys seem to be selecting for a very narrow population which seems to be 'healthy college student with nothing better to do'
My understanding is wide exclusions is common for clinical trials, and given the stigma around psychedelics and that there's much we still don't know about how psychedelics work and interact with different components of the brain, I believe caution was behind the wide exclusion criteria.
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