A Journey Through the Psychedelic Revival: What Happens in Psychedelic Therapy?

hello um welcome to the second session of a journey through the psychedelic revival sponsored by penn nursing um my name is pak and i'm a psychiatric mental health nurse practitioner student here at penn nursing at the start of my nursing career i worked in the emergency department for three years where i specialized in patching up bullet holes and infusing copious amounts of blood products in order to reanimate lifeless bodies the trauma room was where i flourished and i loved working with the drama team but little did i know i would become a trauma patient myself but not exactly the physical trauma i was used to mental trauma is something that cuts much deeper after witnessing so much depth and despair throughout the kobit 19 pandemic it's hard even now to process the reality that was these last three years without a doubt the unseen trauma is the hardest one to treat i now look forward to my training as a mental health trauma nurse at penn nursing one that helps treat the pain and the suffering within psychiatric mental health field isn't an easy one and we'll need every tool in our arsenal to help us in the aftermath of this pandemic as of recently psychedelics have found their way into the toolkits of many clinicians looking to help individuals overcome trauma there's still a lot to learn about psychedelics but i'm excited to be part of this learning series where we hear from both people who have benefited from this therapy and from the leaders in the fields who have extensive experience with psychedelic medicines we'd like to thank dean villarreal for supporting this event the dean's support for innovation here at penn foster's learning experiences such as these we hope this series will spark critical discussions across disciplines in attendance tonight our nurses physicians researchers therapists and many others from a variety of professions who are eager to learn more about innovative approaches to modern day health challenges uh to begin this conversation on psychedelic medicines uh we're first going to start each session with a short video to humanize this type of healing tonight caroline nelson will be sharing her story about how psychedelic assisted therapy helped her heal from the trauma she experienced afterwards our speaker for tonight andrew penn um will be talking about psychedelic medicines they'll be talking about it for about 45 minutes while he'll have plenty of time for q a at the end this is a unique opportunity to have a leader in the field answer your questions we invite you to engage with us please use the q a function rather than the chat for any questions that you would like to ask andrew you'll be able to like your favorite questions which will help us identify which questions should be prioritized we'll do our best to make sure that our speaker answers as many questions as possible tonight if you have any questions that aren't specifically directed at andrew tonight please post them in the chat and we'll do our best to answer those questions separately and now for our video my name is carolyn nelson i am from charleston south carolina and i am an emergency room nurse so i am the baby of four and the only girl three older brothers the oldest brother was six years older than me and he was kind of my end-all be all like he just was the most amazing individual he and i just had a connection like no other and he my brother committed suicide and he didn't die from the incident eventually though had to make the decision to take him off life support and that was probably the hardest decision i've ever made my entire life thinking if i had to say goodbye i mean i was really saying goodbye i was really struggling with not being able to sleep well not feeling super happy not wanting to be around certain people also headaches were just horrible because every time i close my eyes i mean i could just see the same scene you know over and over and over i knew it was necessary to meet with someone and so that was kind of the turning point [Music] the mdma study is patient-centered with professionals that know what they're doing this was obviously something i'd never experienced before where i was going to have therapy and really digging in to trauma and and learning more and figuring out how to move forward and that was a big thing to be able to share in these experiences with basically two strangers i was just glad to feel comfortable with them and to take this [Music] sounds wrong to call it a drug because sometimes drug you know i would say therapy to take this therapy and they are some of the most amazing people and i would not be where i am without them in this therapy my experience with psychedelics it softened me a lot and not that i'm a harsh person or a hard person i'm very loving but it it just soft and softened the edges it's been 13 to 14 years and so i feel like it was just yesterday i feel like i always joke i say oh my gosh can i pretend like i haven't done it can i please go back in because i know what it did for me and and i want it to be for others as well i think that there are so many people out there that deserve to have this type of therapy to help them kind of get out of the box or their internal jail or however you want to call it gosh it can make the world a better place [Music] thank you caroline for sharing your experience with us um your story is incredibly touching and it inspires hope to those still actively seeking innovative treatment options uh for their trauma this learning series is designed to explain psychedelic assisted therapies over a course of six sessions during the first session we learned about the history of psychedelics and the most common substances used tonight we'll discuss what's involved in the preparation for therapy using psychedelics and what happens during and after each session after tonight our next sessions will take you through the pharmacology and neuroscience behind psychedelics please note this will be held on tuesday february 15th at 6 30 pm this will be followed by information about burnt research being conducted as well as clinical applications which will be held on march 2nd at 6 30 pm these presentations will be followed by our last two sessions which will be panels with experts in the field discussing the future of psychedelics and how people will gain access to them going forward please note that you will need to register for each session separately without further ado it is my pleasure to introduce tonight's speaker andrew penn is a university of california san francisco trained psychiatric mental health nurse practitioner he serves as an associate clinical professor in the ucsf school of nursing and practices in san francisco va where he works with nurse practitioner residents and students he has completed the ciis maps and usona trainings in psychedelic assisted therapy and has worked as a study therapist on a phase 3 mdma assisted therapy protocol for ptsd additionally he is a co-investigator to the usona sponsored study of psilocybin assisted therapy for major depression he's the co-chair of the sinus symposium and co-founder of the organization of psychedelic and and theogenic nurses an organization focused on advocating for the perspective of nurses in psychedelic therapy andrew has published on psychedelics in both american journal of nursing and the journal of humanistic psychotherapy before we move on to the presentation this is a reminder to please keep in mind that the information shared here is for educational purposes only penn nursing and the speakers in this learning series do not endorse or encourage the use of illegal substances with that i offer a warm welcome to andrew penn we appreciate your time with us tonight to talk about such an interesting topic thank you pak for that introduction let me just get my slides up here all right i hope everyone can see that and thank you again for that introduction um so yes my name is andrew penn and um i want to acknowledge before we get started here tonight that i live and work on unseated elony rami tushland here in san francisco which is important to note uh especially when we talk about this work much of which has origins in uh ancestral uh indigenous practice so i think it's important to to make that acknowledgement at the beginning i also want to thank the u penn school of nursing for the innovation and invitation especially to sandy sandberg and quasi odessi for their tireless leadership in putting this series together and also for reconsiders uh sponsorship of this series i do want to acknowledge that i did receive salary support from maps and usona for the work that i've done on their respective clinical trials but i have no other commercial conflicts of interest nor do the sponsors of this series and if it wasn't obvious already mdma and psilocybin remain schedule one drugs are not fda approved and there's nothing in this presentation intended to encourage illegal drug use what i would like to do tonight is to present a qualitative and theoretically driven presentation that i am hoping will inspire those listening to think about how to describe and study the care that we deliver as psychedelic therapists and this presentation is centered in my training as a nurse but the skills that i'm going to describe in guiding a psychedelic session are not exclusive to nursing although they do align with the native sensibilities and ethos of our profession you know one of the things that i really love about psychedelic therapies is the way that they decrease the differences between the varied professionals within healthcare and encourage cross-disciplinary collaboration so if you are a psychotherapist or physician this presentation will have relevancy to your work and i hope that you'll be reaching out to your nursing colleagues to improve your studies and your clinical practice and as such i will use the terms nurse and therapist interchangeably tonight if you are requesting continuing education units for this event do keep an eye on your email box the one that you registered with as they'll be sent out to you so without any further ado let's talk about what happens in a psychedelic session that's our objective tonight so here is the fundamental problem that matthew johnson our colleague at hopkins captured very nicely in this tweet he said psychedelic therapy is more psychotherapy than most pharma companies and i would add ant psychopharmacologists and neuroscientists know how to deal with and more pharmacology than most psychotherapists know how to deal with and i think he's really onto something here because what is really not being captured in a lot of the conversation is about the care that we deliver in these therapies in fact most really most psychopharmacologic studies are really kind of a black box you know we put we have a person who's suffering from a condition let's say depression we give them a medication and six weeks later out comes this outcome do we really know what happens inside the black box between the beginning of the study and the end of the study often we really don't and i would posit that with psychedelic therapies that what happens in the black box is critical to the outcome that this is not your standard psychopharmacologic study where it really doesn't matter what happens between those two points but that really what happens in that in between space is critical because if we take that out of the condition we have one way that we look at at healthcare right now which is that you know in in medicine often we think of a disease uh first we think of you know you even if you spend some time in an er you'll hear somebody talk about the mi and curtain three and in this case the disease really takes center stage and the person can often get an eclipsed by by the pathology now this objectivity has led to some incredible treatments you know things that we might call curative based care um but the problem is especially when we apply these to some of the more nebulous pathologies that we work with in psychiatry or say in palliative care is that we have have gotten this idea that perhaps we can take something like pain in psychiatry and that might be the emotional pain of having a difficult childhood and that there is there's suffering and so often we kind of conflate the two things together you know attorneys will talk about this in a in one sentence of pain and suffering right but there's this old idea i believe it's based in buddhism that pain and suffering are not the same thing that the pain may not be negotiable but suffering we have some uh we have some agency over and that suffering often takes a form of either avoiding the painful experience or being overly attached to it but this idea that we can just sort of knock this out as a as an ailment has led us to these kind of lytic treatments in psychiatry you know we talk about anxiolytic drugs for treatment of anxiety and this is an idea that's borrowed from microbiology that we can just kind of poke a hole in that new in that cell and it will die and the problem will go away but you know those of us who work in this field know that it's often not that simple and i would i would suggest that at least up until now most of psychiatric interventions i this may not be the truth the case for psychotherapy but that a lot of psychiatric interventions are palliative and that's okay that there's that's no knock on on palliative as an orientation but really we're mostly reducing symptoms and hopefully by doing so improving quality of life now let's bring nursing into this conversation so we have florence nightingale here somewhere in crimea now nursing looks at illness in a different way so we look at a disease sure but we think about that disease as embedded in a person the person is what comes first the disease comes second and that that person with their disease exists on a wide field of their own their possibilities their existence if you will and also existing on this field are things such as their family and the people that care about them their important ideas and work and relationships these are all parts of what make us who we are now sure we as as health care professionals may be part of this landscape but you see we're not uh we're really not the main attraction here we're just one small part of helping this person in that their wide field of existence and this is what gene watson who i'll speak about in a moment has called curative proper curative processes or a curative process in the psychedelic therapy model it's really important to understand that there are three parts to it and a lot of times when the popular press gets a hold of of this story they really focus on the medication they focus on the drug session but i really want to emphasize that the drug session is bookended on both sides by periods of psychotherapy now it depends on the therapy model that we're using the protocol but it may be anywhere between six eight hours may even be more than that and for some people it probably should be and in that therapy session the preparation therapy so no drug is involved this is where we begin to establish trust and safety and it's important to understand that this is not a one size fits all right now in the in the controlled trials it's being we're sort of forcing it to be a one size fits all because we have to in order to have a consistent uh model for for comparing outcomes but when we get this to hopefully a point in the future where this can be done clinically it's very clear that some people are going to need more time to develop this sense of trust and safety and this may be informed by trauma this may be informed by cultural um considerations this may be historical um there are some people who feel less comfortable in medical settings than others and so we need to we need to keep that in mind and during that time we're providing psychoeducation we're getting to know the patient we're hopefully setting some intentions for the psychedelic session um while at the same time holding our expectations loosely and the reason for that is because there's an old adage in psychedelics that you don't always get what you want but you'll get what you need and so sometimes if people hold on to what they're hoping for too tightly they can be disappointed and they can actually lose sight of the other things that might be available to them during the session we're also creating what we are calling set and setting and support so the set refers to the mindset though that the things that the person is thinking about when they come into the session the setting is all of the physical aspects and also the relational aspects between the patient or subject and the therapist and the the external support system so that's essential that we set that up before they come into the drug dosing day which generally is an all day long session depends on the drug but it can go anywhere between six to ten hours maybe shorter if it's something like ketamine now during that time after the drug is ingested may not be a lot of interaction that takes place the person may be having a largely internal experience and that's fine that because we're going to plenty of time to talk about it after the therapy is over we don't forcefully direct people into talking about particular things we don't have specific exercises we're not doing cbt for example in that session we're not doing thought records or something like that um mostly what we're encouraging people to do is to direct their attention inward is a sort of a mantra of trust let go and be open and there's music playing in the background and music helps to set sort of an emotional tone for the day and it also creates kind of a current in which the person can follow because music is usually kind of flowing from a beginning point to an end point and sometimes psychedelic sessions can feel sort of frozen in time there can be something called time dilation so this music helps to create this this current for the person to follow and then starting the next day after the drug session is over so we've usually sent the person home with a support person they're going to come back or we're going to meet on zoom and we're going to begin integration and integration is the therapy that happens afterwards and during that time we're going to first we're going to talk about what happened the day before sometimes people had strange experiences or bewildering experiences it can be a little bit like talking about a dream you know as you're saying it it's like well this sounds sort of silly but i think it was important um and so we try and make sense out of the experience we explore it we interpret it we also look for opportunities for change in the day-to-day so a lot of times there's this period of a few days maybe even a few weeks afterwards sometimes referred to as an afterglow where people are really thinking about their lives and they're really thinking about how they might like to make changes to their lives to help themselves feel better and we want to encourage people to make those changes in a thoughtful way and we talk about bringing this back into what betty eisner referred to as the matrix of their life so so this is the larger setting in which they live so this is not only their family but this is also their work it's also the way we think about these kind of non-ordinary states of consciousness within our culture that's all part of the matrix so we're bringing this back to their day-to-day life and as i started thinking more and more about this i thought you know nursing is so naturally aligned with this model so this is to the right this is bruce poulter who's a nurse in boulder colorado and his partner marcela ocholora and they were they are maps therapists sort of a mock-up of one of their sessions and i thought you know this is a lot like midwifery the nurse midwifery it's not necessarily about curing an ailment because pregnancy is certainly not an illness but it's something that needs guidance it needs care it needs support you might need somebody to help you out if you get a little stuck you might need somebody to tell you what to expect um reassurance is is powerful medicine in those moments and i think about this is sort of the icu it's like the intensive caring unit and we talk about health care but that word care often gets kind of lost in the shuffle but i want to re-centralize air and i am not an original thinker on this so this is a fantastic find that i found uh some years ago in the maps archive so this is cape harley she was a nurse in saskatchewan canada um she was working with humphrey osmond so if you know a little bit about psychedelic history you may remember that humphrey osmond was the psychiatrist in canada who is working with lsd and patients with what we would now call having out having alcohol use disorder and i found this remarkable article in the 1964 issue of the american journal of nursing called supporting the patient on lsd day which was really just astonishing to me and in it were these gems like the nurse patient relationship during lsd treatment is i suspect like that between partners on a mountain climbing team warm cooperative intimate and yet objective i mean you that that was so ahead of its time um kay is to that's my knowledge is still alive she's i think about 99 years old and living in it's still there in uh regina canada and um she's written an amazing memoir which i wish i had time to get into but you should definitely uh take uh take a look at that called inside the mental she has an amazing story of her own and of course kay is one of many women who have carried medicine over the millennia you know we know in in many traditions uh women were the medicine carriers and this is just really a contemporary example of that so we wanted to continue this story so we were so astonished that we found this in the american journal of nursing that working with my colleagues caroline dorsen stephanie hope who spoke at the last penn nursing session and billy rosa we wrote the follow-up article to this 57 years later in last year's cover story of the american journal of nursing and i you know when we told the editors that they had run this article in 1964 they almost i don't i i almost think they didn't believe this until they checked their their own archive because it seems so far away from from nursing practice now and re we really wanted to start to change the conversation around that and i think um i think we've been i think this this series that upenn has been very pioneering to put on is a great example of how that conversation is changing so i started thinking about what kind of qualities does a psychedelic guide need and of course timothy leary had opinions on many things and and no surprise he had opinions on this too uh in this sort of whimsical um description of uh of a psychedelic guide would need to have uh these these skills of being a patient as a first grade teacher as wise as a guru um the sensitivity of a poet as creative as a science fiction writer fantastic gesture a little hard to quantify a little hard to set into a formal praxis so janice phelps fortunately who's a colleague of mine she's the director of the california institute for integral studies certificate in psychedelic therapies and research which is really the uh the original program to train people to be psychedelic therapists wrote an article back in 2017 talking about these qualities of a psychedelic therapist being that of empathic abiding presence trust enhancement spiritual intelligence understanding how psychedelics affect both the physical and the psyche being self-aware and having ethical integrity and being proficient in complementary techniques and so as i read this i also started thinking a lot about nursing now wait a second this sounds like a lot of what we do just naturally in nursing and then i remembered back to my nursing theory class and somebody who is very well known in the nursing field is gene watson and jean has spent the 50-plus years of her career really describing what the what it means care for another human being and to really describe this ineffable quality that we have in nursing and while when i approached her about co-writing this this this article she was um only somewhat peripherally aware of what was happening with psychedelics this is her book from i believe 1996 which those of you who are familiar with alex gray's psychedelic painting work you'll see is on the cover of his of her book so you know she really was um quite prescient about these ideas um well before this field of psychedelic therapy had emerged in its more contemporary form so i i approached her and i said would you be willing to to co-write this paper and very graciously she said yes so we wanted to fuse these two ideas that of janice phelps and that of gene watson into something that i'm calling psychedelic caritas nursing peritos is the the greek word for care that gene watson uses as part of her theoretical work and really at the heart of this keratos process is the relationship so the the the central idea here is that we alleviate suffering through the caring relationship between two or more human beings and my hope is that if we can do that then what we are actually doing is we are widening that nucleus of of suffering that orbits around pain so what do i mean by that so you know i i once years ago had a patient with ptsd asked me in my practice he said if i take medicine will i forget about the trauma that i had as a child and i said absolutely not i wouldn't want you to do that or actually they asked me if they went through therapy if they would forget that what the they had experienced and i said absolutely not i wouldn't want to take that away from you even if i could but what i would like to do is to change the relationship that you have with it so that there is more space between that painful experience that you had as a child and the suffering you experience and in that in that widened orbital there is room for all the other parts of your life because really so often the suffering really resides in the story that we have about our experience so we we formalized this into an article that was uh graciously published in the journal of humanistic psychology um happy to send you a copy of this or it's on my website if you want to download it um so this is this presentation tonight is really an adaptation of that that article and my hope is that as we begin to establish these therapeutic models for psychedelic therapy and there are many proposed models many of which are are complementary of each other to things such as adapting internal family systems or holotropic breath work or acceptance and commitment therapy that this idea of psychedelic keratosis can can be complementary to all of them because it's really not a it's really not a theoretical framework uh in the same way that a psychological theory is this is really a a map for a way of being with patients uh that i think that nurses are very well suited to doing quite naturally and that we can certainly teach our non-nursing colleagues so what does this look like here's an overview so really you can sort of divide it up into two rough categories so there's tending to the patient and tending to the self and the world and so this tending to the patient is based on a trusting relationship in which we learn and teach we learn from and we get to teach our patients they teach us we teach them um that we are authentically present for the patient and supporting the inner world and supporting that with loving kindness and equanimity for with both positive and negative things that may emerge during the psychedelic session uh additionally we we get to have some fun here we get to play a little bit we get to be creative in the way that we do this and then tending to the self and the world that we as therapists as nurses are cultivating our own spiritual practice so that we are more able to be attendant to suffering help people make meaning out of difficult things in their lives um this may be um making whatever we need to do in order to feel comfortable with the parts of life that are maybe a little more non-ordinary maybe the more spiritual mysterious aspects of life particularly those that might around might attend to illness and death that we create the healing environment in all ways so that's the physical environment setting and we take care of the physical body because while this may be a emotional process for the patient this may be a psychological process for the patient we mustn't forget that it takes place in a physical body and that we want to help people not only support the physical body but really incorporate that into their therapeutic process we'll talk more about each of these in turn the image that i like to think about as we're beginning this process is that the the patient and i the patient and the therapist we are co-creating this sort of house of healing if you will together and this is a remodeling project of the patient's internal world and so the therapist in this job in this role has the job of being both a collaborator and somebody who knows how to help build things and the container we're building is comprised of both physical so it's the physical setting it's a safe um and hopefully pleasant place to be in for the duration of the therapy but it's also psychological and interpersonal but by that i mean that the therapists know the subject well enough they know the patient well enough that they know what kind of themes might emerge and that the patient feels trusting of those therapists so those three parts comprise this container that the psychedelic therapy takes place this vessel if you will now if you've ever gone through a remodeling process you know that this can be kind of messy so this was my my place here in san francisco um very 19 1985 vintage kitchen with complete with appealing laminate and all sorts of unpleasant things that we decided a few years ago we were going to tear out and remodel and that was going to be a messy process because in order to get to here we had to go through this and it was a messy process because we were living here too so it was kind of like a big game of construction tetris and in order to get from this kitchen on the left to this kitchen on the right from which is where i'm i'm sitting today we needed a guide this wasn't something we were going to be able to do ourselves and this was pascal our wonderful contractor and so he really was our our transformative guide couldn't have done it without him now a lot of people have this imagination if you will call it a fantasy that psychedelic therapy is going to be this quick fix you know this the media really encourages this narrative that people have been suffering for a long time they join one of these studies and boom they're cured um in our study we call this the pollen effect from michael pollan's writing and as much as i appreciate what michael pollan has done in really translating a lot of this work to the general public it really has kind of created this idea that this is going to be a curative process for people and while it may be for some people there's there's a lot that happens between a and b uh and and that the the reality of this can be it can be somewhat non-linear and somewhat recursive and sometimes really quite frankly a struggle there's also been a lot of sort of uh innovation might be one way of putting it on imagination that maybe this could be streamlined down to doing this with an app you know heck we order our groceries with the phone we do a lot we hail rides with a phone why not do psychedelic therapy with a phone i worry about this quite honestly because what i hope to convey here tonight is that at the core of this this treatment work is based in a human caring relationship and i think that's a difficult thing to convey through a screen so let's walk through this so before we can begin any kind of therapeutic process we have to be invited in so we can't just impose ourselves on to a patient they have to be willing to let us in just like i had to be willing to let pascal in to tear down my walls and this is going to require different levels of sensibility from different with different patients um you know one of the the problems that we've run into in psychedelic research is that our subject pools tend to be very white they tend to be uh upper middle class white people uh who are our subjects which is a problem because it doesn't represent the populations that are going to need it's not inclusive of all the populations that are going to need this treatment and the reasons for that are many and they they really go beyond this conversation tonight but we really need to be thinking about are we developing a meaningful relationship with the communities that we are treating or are we just hoping that they come into our studies so that we can get data and publish papers because that's really an extractive and exploitative model so we really need to think about how do we create meaningful and enduring relationships with the communities who are helping us to create this to do this research who are essential for us to be able to successfully do this research once that once the relationship begins we then begin to learn from the patient and hopefully the patient begins to learn from us and this is a process of building trust and i also want to point out that this is all therapy is time limited now some therapy might be one session some therapy might some therapies might be 10 years but they're always inherently time limited and so the same is true for psychedelic therapy when our work is done we end the relationship and and go forward so um so this this trust begins at the beginning and so once we have this trust then that allows for something that's sometimes referred to as the inner healing intelligence to emerge and inner healing ability inner healing intelligence is probably one of the more nebulous terms that is uh thrown about in in psychedelic therapy and different people define it differently one of the ways that i define it is is is nature it really is you know this is this resonates with something that florence nightingale said about healing you know this is over 150 years ago she said that really it's nature that heals the wound and what we do as nurses is we put the patient in the best condition for nature to act upon that patient and this was echoed by annie mithoffer who many of you know as one of the pis in the maps mdma studies and she said something very similar that really it's this trust that is developed between the patient and the therapist bidirectional trust so it's not just one way it has to go both ways is what allows for the participants inner healer to emerge i was fortunate to be able to look through some transcripts from qualitative studies that were done by alex belser and cody swift at the nyu study of psilocybin for cancer anxiety and looked for examples of what this looked like and and this was a this was it from a subject in that study names have been changed but talked about feeling so protected and couldn't have felt more protected that real sense of trust and safety and that that was created by these kind of recursive loops of the therapist getting to know the patient and then stating that back stating in a way in a clarifying way and that really communicates that that we've understood each other and that that is foundational for this to work um once that trust is established we have to behave in an impeccable way because our patients are going to be in a very vulnerable state in these psychedelic spaces and it's that impeccable behavior and that presence that continues to deepen and maintain that trust once we have that trust we can begin to see the world as they see it um and the the patient to some extent sees the world as we see it and it's that it's that exchange that happens in the preparatory therapy which is really critical and part of what we're learning during that time is very much like what we had to do here in remodeling the house we we constructed this together the part before we took any tools to the to the to the walls um our contractor wanted to know how we lived in our house where do you put your dishes how do you cook um it's really about learning how somebody lives in their own case a house but the therapy how they live in their own skin we also get a sense of what kind of complexities might await us because as we know some houses are really simple and others you tear down the walls and oh my gosh there's wiring there from 1900 and who knows what it does so we need to start to understand what might be tucked away in the basement because that stuff is likely to come up in the psychedelic therapy session and we want to communicate to the patient that no matter what comes up we are there for them and this this process of our presence engenders trust as people trust us they can learn from us we can learn from them this is what martin buber referred to as the difference between an i it relationship which is one person looking at another as if they are an object which is objectifying and dehumanizing and moving that to what we would now call an i thou relationship and it is in this inner subjective space that we really get to understand the world through somebody else's eyes and they get to understand our world through our eyes it is different than losing our boundaries and this is really important to emphasize because this space can be a little bit seductive it can be a little bit intoxicating for both patients and for therapists and so this is where our impeccable behavior is critical because in order for people to feel safe with that inner subjective space they need to know that our boundaries are appropriate and um and solid this is that supporting that inner world of the patient through the the helping trusting caring relationship how did that feel like what did that inner subjectivity how was that experienced you know they talked about the sensitivity that you have in that state that everything the way they looked at them their choice of words all of that really mattered in those moments um and and noticing where people's attempts at healing themselves might be emerging so this was the subject talked about how the subject had had breast cancer and the therapist pointed out that when she would talk about the breast cancer she would touch her chest where the cancer had been and he pointed that out and he asked about it in a very thoughtful way which allowed the patient to reflect the subject to reflect that maybe what they were really trying to do was to rub out the cancer to to heal themselves now psychedelic therapists therapies can get a little intense sometimes quite honestly um you know anybody who's spent 12 hours in an icu with a patient with delirium uh knows that uh non-ordinary states of consciousness can be kind of intense um that's not to say that everyone in a psychedelic state would be in a state of delirium but definitely people can have very intense emotional experiences and that's fine we we don't discourage that and part of the way that we make space for that is to really hold this empathic abiding presence with a sense of loving kindness with something called equanimity so whatever emerges we can sit with it uh in buddhism this idea of a bodhisattva somebody who has foregone their own enlightenment in service of other people this sort of calm quiet presence that we can be present to whatever emerges during that time without feeling like we have to rush in and intervene and that's and that's the um that's the tricky part because so often in therapy you know we feel our own anxiety bubbling up and we feel like we need to do something and so what this is an invitation to do is can we do as the old bumper sticker said don't just do something get there can we wait an extra beat before we speak can we take an extra breath and see what emerges because often the right action as the the dao de ching talks about will arise by itself if we allow it to what should we be doing during this time um in taoism there's this idea of wu way which is doing not doing my dog here we got him during kovid and he's very good at doing not doing when he's doing he's really doing he's an australian cattle dog he's got a lot of energy but he has these moments where he's just quite content doing not doing uh and and so this this idea of being able to respond uh without having to force a response and that we don't always have to do something and the music that we have in these sessions that we should really think about choosing thoughtfully and hopefully in the future when we get out of the need to standardize this for everyone for research purposes we can really maybe even make co-creation of the music list part of the preparatory therapy um so that it reflects the the what's important and the background of the patient but that music creates this kind of current that when things get challenging you kind of ride that current but really the the the message i want to leave here is that often less is more in these settings that often the right the the right answer will emerge naturally if we don't force it and you know florence nightingale had ideas about this too i mean she was really a visionary you gotta hand it to florence nightingale because she this the sensibilities that she taught her nurses are so applicable to what we're doing now 160 years later you know of course they're kind of wound up in these 19th century uh this 19th century language but she talked about how um we often talk at patients to make ourselves feel better and she called it chattering hopes she said we think you know we basically think we're making the patient feel better but really what we're trying to do is make ourselves feel better and what we end up doing is making the patient feel worse and so i was taught by one of my uh teachers my guiding teachers this acronym of weight which is why am i talking and as you can tell i have no problem talking so this is often an important uh reflection for me as i'm about to say something to say you know is what i'm about to say going to add anything to the beautiful silence that is currently present in the room the answer is no i try not to say it and a lot of times we uh we say things because we're we're trying to be helpful but a lot of times we're sometimes colluding in the avoidance that a patient might be experiencing so by distracting them themselves from their emotions by talking um we're actually kind of colluding in that i'm not saying we need to be silent stoics the whole time but you know i'm thinking about a patient that that we had in one of our studies a lot of times would discharge his anxiety by talking all the time and at one point i encouraged him to to really just go inward and see what emerged as if he was kind of lying in bed on a sunday morning and just woken up from a pleasant dream to see what would emerge he spent hours in that state that quiet state so it definitely can be done we may we may need to invite our patients into it and a lot of times when they are having a difficult experience the natural tendency might be like this dog biting our hand so my coven dog loved to bite us when we first got him he's a puppy and i learned very quickly that if you try and pull your hand out of a dog's mouth that's biting you you will succeed in tearing up your hand because their little teeth are hooked in there to get you if you try and pull out the trick to getting out of a difficult experience in this case the dog biting you is to actually go into it to push your hand into the mouth of the dog that is biting you and what happens is the mouth releases and this is often the case with with these kind of uh difficult moments in psychedelic therapy is that we need to encourage people to stay with it or maybe even to go deeper into it rather than rushing away from it now what might happen if we make this kind of space occur so there is one of the things i love about a psychedelic dosing session is that we've got all day we get there at 8 in the morning 7 30 in the morning subject gets there at 8 8 30 we dose by 9 9 30 and we're there till 5 or 6 and you know peak drug effects if they if the person was randomized to drug and not placebo probably going to happen about an hour and a half into it two hours in and then you've got this last long coast until mid afternoon and the beautiful thing about it is you know it's that's so different than most of my days most of my days my calendar tells me where i got to be and what i got to do i'm always doing something i'm always thinking what i need to be doing and this is such a beautiful experience as a therapist to have nowhere to go and nothing and it's the same for our subjects and even we always tell them in preparation because it is a placebo-controlled trial there's a 50-50 chance that they may not they may not get the drug they may get the active placebo um and when that happens we encourage them to still make use of the time to enjoy the music to enjoy the tooth you know to make use of the two therapists who will be there all day so the same two therapists that have been with them through the preparation but often when people do that what one of the things that can emerge is grief i love this excerpt from a poem by pablo neruda that if we were not so single-minded about keeping our lives moving and for once could do nothing perhaps a huge silence might interrupt this sadness of never understanding ourselves and of threatening ourselves with death and what often does emerge in psychedelic sessions at least at parts is grief and this grief can be released when the ego goes offline so we talk a lot about egolitic drugs so you know our ego is a part of ourselves that sort of watches our our internal and external process or narrates what's happening for us and you know it's it's probably in part what keeps us civilized and other times makes us suffer from some of the ailments that we do um but one of the things that often holds back are things that we don't want to think about so when that goes down sometimes there can be this whole lake of unmetabolized grief that lies behind that dam and that grief can be personal losses um but i'm also seeing that it can be ancestral too so these are these are experiences that people had um in their family but maybe even before they were born or maybe happened to their parents that they're experiencing the grief of other generations i think that's a very deep experience that in our individualistic culture we often don't make a lot of room for but have definitely been present in our culture in recent years as we've seen through me too and black lives matter that there is a lot of a lot of pent-up ancestral grief that can emerge various forms but certainly in psychedelic sessions many of us did not get a lot of guidance in how to grieve in our professional training and probably in our lives which is one of the reasons why i've found um this is a teacher of mine named francis weller who's a psychotherapist here in northern california and he's written this beautiful compact little book called the wild edge of sorrow which i cannot recommend highly enough but he talks about that we can enter into uh the into grief through one of five gates and there may be more than one that applies and these gates are one is the obvious one which is that we will lose everything that we love eventually but we also grieve the places that have not known love the parts of us that have not been appreciated or loved and that we grieve the sorrows of the world which have certainly been in no short supply in the last few years but we also grieve what we expected but did not receive in our lives and that finally as i mentioned before we carry ancestral grief and i found this to be a really helpful map to navigate some of these less obvious forms of grief you know the first one is what most of us are familiar with but there's a lot to be said about the other areas of grief as well now how did patients and their therapists experience uh receiving uh having their grief received with loving kindness and presence and and really you know it's it's about being seen and this this um the subject talked about the transformation and losses that they had experienced through their cancer diagnosis and how things change but nobody tells you how it's going to change but that in talking with the therapist there was this sense of kind of a common humanity for being and being received as just another traveler on the path k parley talked about how that really when you are this in this role that you are really their anchor you are the subject's anchor and that they they absolutely need you in order to uh to find their way back um and she would describe that you and you will go on a journey today for eight hours and i will be here the whole time and i will make sure that you you come right back to where you started of course um in these experiences of of grief and psychedelic spaces not only grief but there can be bliss as well that the spiritual practices of a therapist are important as well now i want to be clear this is not saying that that clinicians need to be adherents to a certain religion or even have a specific practice but what they do need to do is find a way that they can be comfortable with suffering and for many people this is a spiritual practice because in this work uh psychedelic or not we are witness to uh incredible amount of suffering and so we need to be able to fortify ourselves in order to absorb that and to to be a conduit for people to pass that suffering um hopefully out into a larger ocean where we are where they are not holding it and we are not holding it either and that um perhaps we help people find meaning in that suffering which allows for some alleviation from what people are going through and of course you might imagine this was important in the cancer anxiety study that we looked at and a lot of times it was really confu communicated non-verbally um that this subject said you know there was just something about peter they had a look on his face like he understood like maybe he'd experienced it himself but it was just more than that there was just this of noetic quality of being understood um and that really being able to relate human to human this subject talked about how the cancer diagnosis had made him realize how much we take for granted and get caught up in our lives and forget the meaning of it we forget what's important we get caught up with paying bills and making money and that really just being is a simple pleasure in life that we often overlook and that the therapist could appreciate that you know that really this is about being co-travelers on a path together of being human and then of course many of you in the audience are nurses and so we know that we also take care of the physical body of a patient and so the this is really important right because um we're not just brains going around with fingers you know we have a whole body that that is part of our human experience and has often been where our traumas have been received and so we need to be thoughtful about how we care for that body but also just simple things such as helping somebody get to the bathroom or taking blood pressure taking vital signs those are opportunities for us what gene watson would call a sacred act of tending to basic human needs and i think this is something that nurses just do naturally you know we just naturally touch our patients appropriately of course but this is just something that comes normally to us and it's a really important part of healing it's something we always talk about in the preparatory sessions we talk about the possibility of touch would person be okay with that are there how would they like that to be delivered we talk about how they can gesture out with a hand if they would like to have their hand held and if they if they can't find words in that moment they can just pull it back and we'll read that cue as as that they would like to not be not have touch um but this is something we talk about very close very carefully and explicitly before the session and how did that feel to the patients well you know they talked about how the sense of being well prepared made them feel safer and that things like going to the bathroom with the with the study therapist you know because they felt safe with the person because they knew them um that was not a big deal you know we walked to the bathroom with the subject make sure they go in there and of course we're right outside the door if they need us but you know it's entirely possible a patient could have an episode of incontinence during one of these sessions and you know we would just help them clean we'd help them get cleaned up we have people bring an extra set of clothes you know and as nurses we're not really bothered by that that is something that that really is very comfortable in her wheelhouse um this is the physical setting so we we need to understand how people are experience these drugs as therapists and there are some training programs historically that would actually have therapists go through their own psychedelic experience which might seem kind of kind of transgressive but really i would say that's no different than a psychotherapy program that asks its uh students to go through their own psychotherapy it's a way of understanding the landscape through which the patient will be transiting um this is so we talk about having a safe environment of care this is our um this is before we decorated it again but this is our space at ucsf um very comfortable living room type environment um you would really not know that you were in a hospital building by looking at this room it's only when you leave our room and you go past the tms machine which is kind of eerie and sci-fi looking that you realize that you are in a medical setting but when you're in this room you could be in a living room anywhere and we need to think about what sort of techniques might be helpful in complementing the therapy so um you know there will be opportunities for things like aromatherapy or movement perhaps yoga might be a useful complement to these treatments to incorporate more of the somatic component these are all things that can be explored as time goes on once the basic research is done of course nurses are very familiar with the idea of creating a healing environment you know this idea goes back to the greeks because hygiena who was the daughter of the healing goddess squeaplius was the goddess of the healing environment and of course florence nightingale talked about this in her environmental theory of nursing he said we need to use the environment as a way of helping people and the first thing she did when she got to crimea was to open up the windows get some fresh air in there get some sunlight in there and scrub the place down so she knew and and by doing that she drastically reduced infections which were killing more pete more soldiers than bullets um so she knew that the environment played a role and so did timothy leary you know so timothy leary talked about the setting is is not only the physical but it's also the things that are going on in the world the chemistry between the two therapists in the room all of that is going to be part of the setting which will amplify or influence the psychedelic experience and you know patients come to love this space subjects we have in the room they really like the space because i think they they have such warm associations as this subject did here and then finally when this is all over we have to come back to something we call integration the integration as i mentioned before is really where we make sense of these experiences and i think about this as a kind of homecoming to our to our community of where we are from what matters to us who we are as a person really our sense of self um i want to i want to close out with the last part of a wonderful poem which you should treat yourself and listen to the listen to david white uh reading it himself it's uh you can find it online if you search for the audio but he says at the end of this poem which is called everything is waiting for you he says put down the weight of your aloneness and ease into the conversation the kettle is singing even as it pours you a drink the cooking pots have left their arrogant aloofness and seen the good in you at last all the birds and creatures of the world are unutterably themselves everything everything everything is waiting for you oftentimes when we get to integration people feel a real sense of awareness of where they are in their lives and irving yalum the great existential therapist sometimes would do this exercise with patients where he would take a piece of paper and on the left you'd make an accident say this is your birth you draw a line across and on the right side you'd make an x and say this is when you die and he said where are you on this line and david white that same poet talks about how we live in this liminal frontier between that which is disappearing and that which is emerging and oftentimes these psychedelic experiences can really amplify the poignancy of that reality and that what they often result in is people really taking stock in what matters to them how they're living their lives and who they're doing that with and so this integration piece is really critical it's what differentiates a meaningful psychedelic experience from a novelty then finally once the construction is done we get to live in our home again we get to live in this newly refurbished sense of ourselves this is our home after we finished remodeling this was our re housewarming party and you know this home is sacred this is where you meet with your family this is where you entertain your friends and the beautiful thing is now that the house has been remodeled it can be reopened to guests we want to invite people in and we see the world differently it's like um you know my windows look out i can see far out to on the pacific ocean off in the distance but on a clear day i can see the farallon islands which are 20 miles offshore san francisco and you know a lot of times these windows they get dirty and i don't see as much anymore but if i go out there and i clean the windows wow it's a it's the same world outside but i'm seeing it very differently i think you know that's sort of like what william blake talked about if the window he called the doors of perception but if the windows of perception could be clean everything would appear as it is infinite so here's the organization that um i was very fortunate to help co-found with um my uh cis colleagues angela ward wendy murusic and liz willis open nurses encourage you to if this has been interesting to you to join us there you can sign up for our mailings on our webpage there and that's my email address if you'd like to contact me but with that i'd like to go ahead and stop sharing and take any questions that you might have wow that was such an interesting presentation um i think it's really beautiful the way you framed how nurses uh served such a unique role in this type of um and also really like the way you compare your house to the whole therapy process and it's such an amazing metaphor um and i personally have my questions and i'm excited to see what the audience also wants to know as well um so just start um i guess where do you see uh this therapy going towards you know in the next five years and 10 years and moving forward as well how do you think it's going to be developing um in the near future yeah it's it's we're in a fascinating point in time right now because though the research landscape as as we'll be talked about in some of the later sessions so mdma is in what's called phase three late phase three so it it you know if everything continues to go well it could be fda approved by 2023 so very soon philosophy is a little further behind probably a couple of maybe two or three years behind that date you know there's a lot of unknowns in research obviously nobody expected a respiratory pandemic that would shut down a lot of research for for almost two years so um 2021 was being batted around for a while for mdma and clearly that that got interrupted but it's soon it's closer than we think um and you know i think a lot of times people think about that as the end of the story and i would say it's just the beginning really because what that will establish is that there is a safe way to use these medications and that they can be used in a particular way for particular treatments once you have that approval then you can start branching out and thinking about other ways that they can be used doing other studies and it'll be a lot easier because it won't be schedule one substances at that point they'll be you know schedule two or schedule three i mean depends uh how the dea decides to reclassify them but that will allow for a lot of creativity and what are called investigator initiated studies those studies where a researcher says hey you know i wonder if this might be helpful for say eating disorders or for methamphetamine use disorder you know so there's there's lots of opportunities to look at this and and then i think we can start also looking at different ways to deliver this care um you know we're really building the plane as we're flying it right now and i don't think anybody is exactly sure what this therapy is going to look like in 10 years from now it's all very speculative but it does appear that it is it is going to be available now one of the challenges is going to be having enough people who are trained in doing this in order to deliver it and i think this is where nurses are really important because we are a ready-made workforce there are 3.5 million of us i think in the united states and if if my hypothesis is true that a lot of what nurses already know how to do can be adapted to psychedelic therapy um then it would probably take only a re only a modest amount of retrain of additional training for nurses to be able to deliver this care safely and thoughtfully and so i think nurses are going to be a critical part of the provider bottleneck which we are going to face um if this if when and if this is uh available for for for prime time you know because the my my other big fear is that um we're going to get the stuff fda approved but nobody's going to be able to access it because there's not going to be enough people who know how to deliver it or that the regulations are going to be so ods that it'll be like buprenorphine where you know many people have you know an x-waver for example to prescribe buprenorphine for opiate use disorder but they don't use it because the restrictions are so complicated so we have to be really careful that we don't create a new set of problems as we solve the current problems absolutely absolutely i remember you talking also about um you know having the psychedelics over the delivered the therapy part delivered over the phone and so that's going to be a whole different kind of can of worms that i guess we would be dealing with um in terms of you know how well it's regulated and if it's actually effective and things like that as well um so we actually have i have uh some questions regarding um you know nurses that do want to um you know use psychedelics in their assisted therapy um so what is the criteria to becoming a psychedelic therapist in the united states what does it look like in terms of you know like certifications or credentialing yeah it's a great question um well that's part of the plan that we're building as we're flying it right now because right now the term psychedelic therapist is really um it's it hasn't really been defined so um so one of the questions that's going to need to be answered as this goes through fda approval is what what psychotherapy will be required to be delivered with the drug and this is where it gets kind of difficult because the fda is used to regulating drugs so their job is to make sure that drugs are safe and that they're more effective than placebo that's their two mandates they don't know much about therapy and so um so the idea of having a drug which goes along with therapy is not something they've had to deal with before and so they for example aren't always clear about who does therapy so one of their early ideas was that psychiatrists did therapy well most of us know that a lot of psychiatrists primarily manage medications i mean certainly some do therapy and some do medication management in a therapeutic way but the bulk of psychotherapy is done by biologists clinical social workers marriage family therapists lpcs you know and and advanced practice nurses um and so it really depends on how that regulation comes to bear um there are some organizations which are starting to talk about certification for future certification for psychedelic therapists um i'm a strong advocate for nurses being included in the list of professionals that could be involved in this and i would encourage as this develops for other nurses to lend their voice to of support to that um because you know what we don't want to run into a situation where we're playing catch-up as a profession as nurses and saying hey don't forget about us you know because i think you know for example a lot of a lot of people don't know that psychiatric nurse practitioners are trained in psychotherapy as part of our that is part of our competencies we are tested on that and so that's definitely within our wheelhouse and so um i think it's important that as a profession as nurses that we advocate for ourselves um and i think it's really important that we have a voice in the development of this these protocols whatever they look like that we are are definitely included in that because as i hope to have pointed out today our profession brings a lot to that conversation absolutely absolutely um we have some audience members here um that are concerned a little bit about safety they're asking how frequently do you encounter anger rage during a session uh how might this be prevented and or treated during the session yeah so you know there's this kind of archetype around psychedelics of the bad trip right and everyone's heard that term um you know in the harm reduction work that i've done with uh organization called zendo project out of maps um we don't use the word bad trip you know we say difficult does not equal bad and so difficult experiences will emerge people will have strong emotions dan groff talked about that psychedelics are non-specific amplifiers so whatever you tend to have in your mindset going into the session may very well get louder may get bigger and we prepare people for that so we don't say oh you know you can't get angry in here you can't get upset in here we do make agreements we say let's make an agreement that you won't harm yourself let's make an agreement that you won't leave this room until the until seven hours is up let's make an agreement that you're not gonna break anything in here and all of our subjects say you know of course i'm not gonna do any of that and it has never really been a problem you know we have rescue medications if we needed them if somebody became acutely hypertensive we not we've not had to give that we have benzodiazepines and antipsychotics if we needed them we've never needed them so we have those that are available to us but really um what does tend to happen with these sessions is that emotions are intense can be intense they may not always be visibly intense they can be internally very intense so people can be having very intense internal emotional experiences that are not necessarily visible to the outside observer um but the other thing that happens too is that it's kind of like they say about the uh the weather in england you know if you don't like the weather wait 10 minutes because it'll be different you know and it's kind of like the same thing with strong emotions and psychedelic sessions because you know i have seen people go from like giggling to crying you know to really crying in about 45 seconds you know so there is a kind of emotional lability that happens in in these sessions but that's not necessarily a bad thing so we want to make room for all of it um and and that's part of our own work as therapists to make ourselves spacious enough that we don't get those scared that we shut that down right so this isn't about being reckless this is about being a big enough container that somebody can be angry in that room somebody can be really sad in that room and that we can hold that space and and not communicate to them that those feelings aren't welcome there because we want to make sure that whatever comes up is welcomed into the into that space well an excellent it's really neat and actually leads into the next question um someone was asking about the specific environment in which the therapy is conducted in um you know if there's any music being used if there's any you know sensory simulations being used like essential oils or anything like that is key to the environment yeah so the environment is typically kind of like that space that i showed you in in one of the slides so you know we say a living room like environment so usually there's a couch that we will turn into kind of a day bed so that people can lie back and and um we always offer eye shades um we have some really nice comfortable eye shades so that and that allows you sometimes people see that picture and they say why is the person blindfolded it's not blindfolded it's like the eye shades you would wear on an overnight flight um and what they allow you to do is really just to relax um you don't even have to keep your eyes closed if you don't want to um but it allows for that inward attention of dire inward direction of attention music is also essential to this too so we'll typically have uh good quality headphones and sometimes we'll have the music playing in the room in the background and it's music that is intentionally selected this is sort of one of my hobbies i like to make playlists spotify which i think has sort of fallen into some challenging moments this week but um but you know really finding music that that takes people from a very sort of gentle gentle experience to maybe a more intensive experience and then brings back down to sort of a gentle experience again and and a lot of it is music that does not have words um or at least words that are not going to be understandable to the to the the subject um a lot of is what you might call ambient music um so it's it's music that really kind of holds that space beautifully and it and you know if it's sort of like if you've ever watched a movie with the sound off a movie that would make you cry and you're suddenly you'll notice like i'm not feeling the same emotions right it's amazing the effects that music has us and interestingly i just learned today that florence nightingale talked about music as a healing modality and you know she talked about how certain music was really helpful for patients so you know florence nightingale would have been an amazing psychedelic therapist had she that she lived long enough yeah um i think she i think she was dialed in to these sensibilities that that really um nursing brings to this work so that's how so that's what it looks like we have um you know ideally you would have a study room that has a bathroom attached you know ensuite um we have to go down the hall to ours which is not ideal but you know that's what happens when you work in a building was built in 1950 um you know so so there's those kind of things are nice to have i personally in the future would love to do this work outside um i would love to have a little cabin in the woods somewhere where people could be outside and have fresh air sunlight trees you know really beautiful peaceful setting that allows people to really feel this kind of connection with a larger sense than just themselves is that something i didn't really talk about in here but you know people talk about these unity experiences in in psychedelic states with the natural world with other people and a lot of that i think comes from the dropping that temporary dropping of that ego because one of the things that ego does and it's a useful function in some ways is to tell us like it's like our skin you know our skin is important i mean we all know what people what happens to people in burn units right like if you don't have a skin an intact skin you're in trouble because now the inside of your world is is communicating with the outside world and there's a lot of perils out there in the outside world in in in that ego in that decreased ego state you know we can feel a sense of connection with the larger world but we can also sometimes realize like how much we've been participating in our own separation and you know that perhaps that sense of separation is really at the core of many of our maladies regardless of what section of the dsm they're in you know that these are really these are really diseases of disconnection and that maybe we have that transient moment where we feel a connection to something larger than ourselves larger than our own story larger than our own suffering and that maybe getting a glimpse of that allows us to believe that it is actually truly possible uh these speculations but there you have them well that's that's really really neat and i almost kind of goes into a little bit like it's like analytical with all the ego and the development of that in the childhood and how it kind of translates into adulthood that's that's really really interesting um and then i think we just have enough time for one last question uh the question is at what point in the psychedelic experience do people begin to experience the healing nature of it so i guess at what point is the ego starting to dissolve maybe i mean i would say that people probably start healing the minute they decide to do this treatment you know i think a lot of our i think a lot of healing happens before we ever enter the therapist's room you know because well because it's you know i used to have teachers that said action follows intention you know and so it's when you begin to intend to make a change then it's it's kind of like what the german poet rocca said about you have to live into the questions and so i think that the you know this is why we have such challenges with people starting to get better at the beginning of a session before they even get treatment which is something we have to we have to guard against in research because then you don't know if the treatment actually was what made the difference or if it was you don't know if it was the drug that made the difference or was it just the larger treatment protocol but when we get into clinical work and this is outside of research that's not going to matter so much because people aren't going to care if you know what why they felt better they're just going to be happy they felt better and so i think a lot of the the benefit starts to happen as we intend to do the work but then i think the other big place where healing really begins to happen is in the integration part because without integration it's just kind of like a strange it can be just like a strange experience you know that you're not sure what to make sense out of it but it's really in that integration that we see how the things that we experience in the dosing session relate to our world and perhaps the changes that we're wanting to make and and that is the opportunity that we're trying to leverage in that window of time after after treatment and you know one of the other big questions that we don't have an answer to yet is we have a little bit of data is how long does this last and there has been some data that indicates that this may last for months even years um you know there's there's so much enthusiasm that people sort of started talking about cures which you know i'm all for it if we can do it let's do it i would love to move out of the palliative model and into a curative model but even if we only have to do this like once a year or twice a year or something like that still i think there's a lot of benefit to that and you're also avoiding the downsides to say having to take a medication every day that gives you side effects you know so this kind of procedural episodic treatment instead of this chronic treatment that we do now um so these are all potential changes in the delivery of healthcare uh as we know it that's i guess really really exciting to see what the long-term results are for sure going down the road and see exactly how long um its effects actually last for and hopefully it is curative that'd be really really incredible and amazing and i can only imagine how expensive it can get uh if it does kind of get to that point uh with the research um so it's now 7 56 um so this wraps up our q a session uh thanks so much for joining us tonight and a big thank you to you andrew for sharing your knowledge and your passion with us tonight uh we hope everyone found it was that it was interesting and informative um and at the end of this you'll be receiving an email with the within the next few days including a link to the recording of tonight's session some resources that our speaker recommends information about nursing continuing education credits and a feedback survey uh we encourage you to respond to the survey and share your feedback as we strive to improve the series and we hope to create future psychedelic learning opportunities based on the interests and feedback of our audience uh so the next session in the series will be on tuesday february 15th once again at the same time from 6 30 p.m until 8 30 by 8 00 sorry 8 00 pm uh please note that the next session is the only one that is on a tuesday all other sessions are on wednesdays and just a reminder that you will need to register for each session individually going forward as well um if you aren't able to watch it live by registering you will receive a follow-up email with a link to the recording so thank you all for joining us tonight hope to see you at the next session thank you so much

Channel: Penn Nursing

Views: 20,021

Keywords: Penn Nursing, Penn Nursing Science, Care to Change the World, Penn Nurse, Nursing Research, Nursing Science

Id: TfraYldVv8c

Length: 84min 29sec (5069 seconds)

Published: Thu Feb 03 2022