Plant Medicine Podcast

In this episode of the Plant Medicine Podcast, Adam Aronovich returns to discuss the phenomenon of psychedelic narcissism. Adam is a doctoral candidate at the Universitat Rovira i Virgili in Spain, focusing on Medical Anthropology and Cultural Psychiatry. He is an active member of the Medical Anthropology Research Center (MARC) and part of the Ayahuasca Community Committee at the Chacruna Institute for Psychedelic Plant Medicines. In the last four years he has conducted extensive fieldwork in the Peruvian Amazon, where he has been doing qualitative research in collaboration with ICEERS, the Beckley Foundation, and, more recently, the Centre for Psychedelic Studies at Imperial College. Beyond his work conducting and coordinating research, Adam regularly facilitates workshops at the Temple of the Way of Light, a prestigious healing center in the Iquitos area.

In this wide-ranging conversation, Adam unpacks some of the darker sides of the modern psychedelic movement, discussing the psychosocial dynamics around psychedelic use which can lead to things such as ego inflation, conspiratorial thinking, and narcissism. Adam recalls his own experiences slipping into messianic fantasies during a period of initial enthusiasm around psychedelic experiences. He views issues of alienation and lack of social support as being instrumental in leading to these types of delusions following profound spiritual experiences. While it is difficult to reach people who’ve slipped into psychedelic narcissism, Adam suggests that communal support is the best safeguard against these dangers and the most effective strategy for grounding people who’ve lost touch with reality.

Drawing on his academic expertise, Adam distinguishes traditional uses of plant medicines from the Western paradigm for approaching psychedelics. He stresses the relational and communal aspects of the spiritual traditions which use psychedelics ceremonially. The pro-social aspects of these wisdom traditions, he claims, help safeguard against the traps of psychedelic narcissism and ego inflation, as there are established mechanisms for keeping people grounded following intense spiritual experiences. 

Adam closes the discussion with an insightful analysis of modern gurus and self-proclaimed shamans. Adam encourages people to beware of deeply held spiritual fantasies, where a master can appear as more than human. Instead, he emphasizes that even skillful and well-intentioned healers are themselves nothing more than human beings, so there will always be imperfection and messiness. This does not, however, mean that impactful work cannot happen—in fact, this insight helps protect against the idolization of charismatic psychedelic personalities, which can lead to harmful experiences.

In this episode:

• Defining psychedelic narcissism

• Clinical vs coloquial understandings of narcissism

• The intersections of the psychedelic movement and conspiracy theories

• The importance of social and communal support for avoiding ego inflation following psychedelic or spiritual experiences

• How psychedelic experiences can actually deepen ego attachments and accentuate narcissistic tendencies

• The importance of humor in combating spiritual narcissism

Quotes:

“Many of the underlying ideologies upon which Western cultures were built, like hyper-individualism and so on, kind of predispose us and prime us for certain aspects of narcissism.” [5:36]

“Ego inflation, spiritual narcissism, messianic episodes—all of these are things that are fairly common within both people who are in some sort of spiritual or psychedelic path.” [12:17]

“In traditional societies for the most part really there isn’t such a thing as a self-proclaimed shaman. A person doesn’t wake up one morning and is like ‘oh, I’m the shaman’—that’s a title or a role or a recognition given to that person by the community.” [38:03]

“The best measure of whether somebody is genuine and helpful is not whatever credentials or titles he assigns to himself, but rather what other people feel. So, you know, you will know a tree by its fruits.” [45:08]

“Having these experiences by themselves does not necessarily mean spiritual growth or psychological development or any enhanced benefit if we’re not constantly, painfully, mindful of how we actually integrate and embody those things in daily life over very long periods of time.” [54:29]

Links:

Adam on Instagram

Temple of the Way of Light

Psychedelic Medicine Association

Porangui

This episode of the Plant Medicine Podcast is the final installment in a three-part series with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City. 

In this episode, Dr. Holland speculates on the future of psychedelic therapy and the emerging issues within the broader psychedelic movement. Lamenting the lack of governing organizations and accountability, Dr. Holland discusses the complexities of regulating an industry with a history of operating underground and in legal grey areas. This raises questions such as how to grandfather-in established psychedelic practitioners now that various coursework in psychedelic therapy and systems for credentials are beginning to emerge. 

Another issue related to legality which Dr. Holland discusses is the relation between the medical establishment and psychedelic therapies. The fact that individuals interested in pursuing plant medicines for therapeutic reasons are not able to easily consult with primary care doctors is a huge hurdle to harm reduction, and, as Dr. Holland points out, this leaves the responsibility for ensuring safety entirely on the psychedelic practitioners. Because these practitioners range from underground ayahuasca circles to clinically approved, legally operating therapists the amount of attention and care paid to harm reduction can vary greatly, which is why it will be essential to establish standards and best practices for psychedelic therapy as demand continues to increase.

Dr. Holland also discusses the issues of “psychedelic capitalism” which are coming to the fore as these treatments become more mainstream and more accessible. While there are no clear answers for how to navigate the intersection of psychedelic therapies and capitalist market dynamics, this is an issue that deserves care and attention so that there can be equitable access to these medicines. Dr. Holland closes with a discussion of the parasympathetic nervous system–the “rest and digest” mode–and its importance for not only personal health, but also social well-being. 

In this episode:

• Why it is essential to begin establishing best practices and safeguards around emerging psychedelic therapies and other practices involving plant medicines

• Issues that arise from the intersection of capitalist market dynamics and the emerging psychedelic industry

• The future of medical consultations prior to consuming plant medicines

• Activating the parasympathetic nervous system and its pro-social impacts

Quotes:

“I think part of it is just this fear that if we admit there are some bad actors, that the whole house of cards is gonna fall.” [9:26]

“Just because of the way capitalism is, there is IP, there is proprietary information, there is anti-competitive behavior. That to me also really needs to be addressed.” [11:31]

“In any interaction there is a choice of being hurtful or helpful, and it’s a choice, everyday.” [20:18]

“Anyone who can out themselves should, because it will move this whole thing along a lot more. If you are a soccer mom who also microdoses, put that bumper sticker on your car.” [24:58]

Links:

Dr. Holland’s website

Good Chemistry: The Science of Connection, from Soul to Psychedelics

Psychedelic Medicine Association

Porangui

This episode of the Plant Medicine Podcast is the second conversation in a three-part series with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City. 

In this episode, Dr. Holland talks specifically about the nuances of antidepressants and psychedelic medicine. As is commonly known, many prescription antidepressants have contraindications with various psychedelic compounds, meaning there are concerns regarding how people taking such medications will be able to also access psychedelic-assisted therapies. 

Dr. Holland discusses the specific contraindications for individual psychedelic medicines and suggests some strategies for safely and effectively tapering off antidepressants in consultation with a medical professional. She suggests various wellness practices, such as regular exercise, as particularly helpful during the course of tapering, and even mentions situations where an additional antidepressant is prescribed to support the tapering process, stressing the complexity and delicacy of this process.

To give context to this discussion of psychedelics and antidepressants, Dr. Holland provides an overview of the history of psychiatry over the past forty years, showing how antidepressants came to prominence as a therapeutic tool. She also explores additional considerations, such as how things like hormonal birth control interacts with SSRI antidepressants on a psychopharmacological level. The common thread Dr. Holland weaves through this conversation is the importance of connection, both as support for the tapering process and as the end goal of effective therapeutic practice.

In this episode:

• Health and wellness practices which can act as support while tapering off an antidepressant in consult with a medical professional

• Contraindications between various psychedelics and antidepressants

• The difference between microdosing and macrodosing psychedelics while taking antidepressants

• Why falling in love can present a good opportunity to taper off antidepressants under supervision

• Why Dr. Holland sees the divide between recreational and therapeutic use as a false dichotomy in some cases

Quotes:

“There was a lot of hand-holding and de-stigmatizing back in the 90s, educating people around antidepressants. But twenty years later most of my work was really around people [who] had been medicated for ten, fifteen, twenty years and wanted to be off meds.” [6:15]

“The people who really responded from MDMA-assisted psychotherapy who had PTSD were the people who’d never been on SSRIs. The people who had a muted response who didn’t get as much better as the other group were the ones who had been on SSRIs.” [9:47]

“Coming off of psych meds is no easy feat. You really have to do a gradual taper, there has to be somebody who is supervising you, and you’ve got to have other things in place.” [10:42]

“You have to have somebody helping you… It’s not the kind of thing you can really go alone. Getting off antidepressants requires somebody who knows what they are doing to help you.” [14:16]

“Your brain learns to be sad, your brain learns to be anxious, your brain can learn to be at ease and learn to have joy.” [21:31]

Links:

• Dr. Holland’s website

• Good Chemistry: The Science of Connection, from Soul to Psychedelics

• Psychedelic Medicine Association

• Porangui

This episode of the Plant Medicine Podcast is the first installment of a three-part conversation with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City. 

In this first installment with Dr. Holland, the conversation focuses on the idea of connection she explored in Good Chemistry. Dr. Holland begins by discussing the importance of feeling a connection with oneself and details how many things in modern life can get in the way of this connection. Self-connection is important, she stresses, because if we are not grounded in ourselves, it can be difficult to establish healthy connections with others. Dr. Holland explains how various neurotransmitters such as oxytocin and dopamine are involved in connecting with self and others and how pharmaceuticals such as opiates act on some of these same systems to simulate comfort.

In addition to discussing human connection from a pharmacological perspective, Dr. Holland also explores the topic through a psychological lens, looking at the role trauma can play in muddying opportunities for connection. This is an area where psychedelics can be particularly impactful, as these substances can disrupt the constant ruminations and patterns of behavior which keep people from pursuing or deepening connections. 

Dr. Holland then brings some insights from the science of connection to bear on the practice of psychedelic therapy, discussing how group facilitation of psilocybin therapy could be more impactful by allowing the experiences and integration work to happen in community. The conversation closes with a discussion of how psychedelics can impact the connections one feels, especially to the natural world, and some speculations regarding how the feelings of interconnection elicited by psychedelic experiences could impact political convictions. 

In this episode:

• How distractions and addictions get in the way of our ability to connect with ourselves

• How the epidemic of loneliness and the epidemic of overdoses intersect 

• The pharmacological pathways of oxytocin and the function of the dopaminergic system

• How psychedelic experiences “shake up” one’s sense of self and the therapeutic effect of this process

• The double-edged sword of the feelings of group cohesion produced by oxytocin

• The impact of psychedelics on one’s worldview 

Quotes:

“If you’re not in your body, and embodied, and feeling your feelings, you’re not gonna be much use to anybody else in a relationship.” [5:59]

“One of the reasons why opiates are so soothing is they really quell that unease, that anxiety, and they really mimic the chemistry and physiology of what we feel when we are taken care of, held, attended to.” [10:40]

“We are not healthy when we are disconnected. It is a proinflammatory state when we are disconnected, and it is anti-inflammatory when we feel cared for.” [13:35]

“There’s always trauma and everybody carries it around in their bodies to some extent and it really needs to be unearthed and investigated for us to be healthier and happier. So everyone can avail themselves of MDMA-assisted psychotherapy or psilocybin-assisted psychotherapy.” [24:30]

“Oxytocin facilitates neuroplasticity, it facilitates learning. And we learn better in group than we do individually. When we are isolated we do not learn as well.” [29:13]

“There is actual research to show that people who take psilocybin mushrooms and have psychedelic mystical experiences do feel more connected to the planet and do feel more of a sense of obligation to take care of the planet.” [37:23]

Links:

Dr. Holland’s website

Good Chemistry: The Science of Connection, from Soul to Psychedelics

Psychedelic Medicine Association

Porangui

In this episode of the Plant Medicine Podcast, Dr. Mark Braunstein returns to discuss potential concerns surrounding the use of ketamine, especially use which is not overseen by a knowledgeable medical professional. Dr. Braunstein is a whole-health psychiatrist with 22 years of clinical experience. He is the medical director for multiple mental health and psychedelic psychotherapy clinics in Colorado, New Mexico, and Utah and he also runs in-patient and out-patient programs for addiction. Additionally, Dr. Braunstein is involved in multiple projects focused on expanding access, awareness, research, and safety in the field of psychedelics.

To begin this conversation, Dr. Braunstein shares how his original exposure to ketamine wasn’t in a medicinal context, but rather as a recreational drug of abuse. However, since then he has seen the transformative effects this substance can have on patients when used in a physician-directed context and for therapeutic purposes. Nonetheless, Dr. Braunstein stresses that this does not mean ketamine use does not come with certain risks.

Ketamine can be addictive and even carries a risk of overdose, particularly when used recreationally in a context where the purity of the substance is unknown. Dr. Braunstein distinguishes recreational and therapeutic uses of ketamine, explaining that recreational doses are often lower and dosing is more frequent, whereas ketamine is used in high doses in a therapeutic context, with extended periods between sessions.

Dr. Braunstein stresses both the responsibility of physicians and of patients to ensure ketamine is prescribed responsibly and used as directed. Despite the dangers posed by recreational ketamine use Dr. Braunstein describes in this conversation, it is still a medicine he believes can have significant positive impacts for patients. This requires, however, that it not be treated merely as yet another quick fix pill. Instead, Dr. Braunstein emphasizes that ketamine treatment ought to coincide with psychotherapeutic work. This combination, he says, will maximize the therapeutic potential of ketamine while also helping to ensure that the medicine is used responsibly, under the close direction of a medical professional.

In this episode:

• The addiction and overdose potential with recreational ketamine use

• How dosage can dramatically change the effects of ketamine

• Responsible prescribing practices for physicians working with ketamine

• The psychological and physiological harms of ketamine abuse

• How Dr. Braunstein talks to his patients about responsible use before prescribing ketamine

• The importance of combining psychedelic medicines with psychotherapeutic work

Quotes:

“Part of why ketamine works is because it lights up your brain in all these different ways and when done occasionally, intentionally, it moves you. But if you’re always doing that, it ends up having the reverse effect, causing damage.” [12:56]

“This is a heavy-duty medication that, if you cross the line, can cause you to stop breathing and then die. So there is an actual, real danger to ketamine.” [16:25]

“I think the organ that is most prone to damage from overuse of ketamine is the same organ we are touting it fixing: the mind.” [18:39]

“When we think about these medications, we should think about combining them with therapy and not just taking these medications as medications… So that’s why with ketamine I’m really recommending it with therapy.” [25:04]

Links:

• Reconscious Medical

• Psychedelic Medicine Association

• Porangui

This episode of the Plant Medicine Podcast features a conversation with Shannon Carlin, MA, LMFT, to discuss how to become an MDMA-assisted therapist, including a discussion of the MAPS training program. Shannon is the Director and Head of Training and Supervision at the MAPS Public Benefit Corporation (MAPS PBC), a wholly owned subsidiary of the Multidisciplinary Association for Psychedelic Studies (MAPS), a 501(c)(3) non-profit where she oversees the development and implementation of clinical training programs that prepare mental health and medical professionals to deliver MDMA-assisted psychotherapy in approved clinical settings. Shannon started working with MAPS in 2011 before joining MAPS PBC in 2016.

In this conversation, Shannon discusses her personal background and some of the nuances of psychedelic-assisted therapy. Shannon shares her experiences being trained as an MDMA facilitator in 2014 when this therapy was much less mainstream and mentions how much the program has grown and evolved since then. In discussing her own background with various forms of therapeutic work, Shannon emphasizes the unique client relationship obtained in the longer sessions of MDMA therapy, saying that this therapy is very well-suited to meeting people in their time of need.

Shannon also discusses the details of the 100-hour MDMA-assisted therapy training program she leads and supervises at MAPS. The program consists of an online course, a training retreat with senior MDMA-assisted psychotherapy researchers, and opportunities for experiential and didactic learning. 

Shannon additionally touches on the topic of MDMA therapists-in-training undergoing this treatment themselves as a learning experience, stating that this is an opportunity MAPS tries to make available and that many of those who have had this opportunity found it beneficial to their future work with MDMA in a therapeutic context. In closing, Shannon discusses MAPS’ commitment to equity and mentions that some scholarships will be available for the training program.

The MAPS MDMA Therapy Training Program is now accepting applications from trained mental health and medical practitioners. To learn more, visit https://mapspublicbenefit.com/training

In this episode:

• How MDMA therapy differs from traditional talk therapy

• The importance of nurses and other paraprofessionals in MDMA-assisted psychotherapy 

• The history of the use of MDMA in therapeutic contexts prior to prohibition 

• Current training programs in psychedelic-assisted psychotherapy 

• The future of legal MDMA use in therapy

• What skills translate from MDMA psychotherapy to other forms of psychedelic psychotherapy 

• How to enroll in the next round of MAPS MDMA training

Quotes:

“Our training program really focuses a lot on the therapeutic relationship in MDMA therapy and the ways that that relationship changes, deepens, becomes more complex.” [13:20]

“As we do our training program we have a really multidisciplinary group. We have physicians and psychiatrists and we have nurses, we have psychiatric nurses, social workers, therapists, psychologists, clergy people.” [15:56]

“We work in a cotherapy model so every session has two providers in the room, so we always have one person who is licensed to practice psychotherapy and then we have flexibility about exactly what the role of the second person is.” [26:09]

“We’re looking at possibly MDMA-assisted therapy becoming a legal treatment medicine, not only in the US, but in multiple countries, even as soon as in the next two years.” [28:21]

“It’s really difficult to do healthy volunteer therapist studies because the FDA thinks about clinical trials in terms of treating a disease.” [35:21]

Links:

• MAPS MDMA Therapy Training

• MAPS Public Benefit Corporation

• Psychedelic Medicine Association

• Porangui