This transcript was automatically generated and may contain minor errors or inaccuracies.

Joe Moore: [00:00:00] Here. Hi everybody. Welcome back to psychedelics Today, we’ve got Megan Portnoy on today. How are you today, Megan?

Megan Portnoy: I’m doing well. Thanks for having me on.

Joe Moore: Absolutely. Um, we had a lovely conversation a while ago, um, and I’m just, uh, excited to finally get you on the show. Um, so you are a doctoral candidate working towards PS D at Antioch, um, in New England.

Joe Moore: Uh, can you tell us a little bit about what you’re up to there?

Megan Portnoy: Yeah, so I am, um, in my fourth year of academics, so four out of a five year trajectory here. Um, I’m getting my mys D in clinical psychology and, uh, you know, there’s no formal specialty area for psychedelic assisted psychotherapy, but if the regulations shake out, that’s the direction I’d like to go.

Megan Portnoy: Um, in the meantime, my clinical work is with adult. Focusing on, um, relational issues, personality disorder, um, and then, you [00:01:00] know, depression, anxiety, those sorts of things.

Joe Moore: Hmm.

Joe Moore: Love

Joe Moore: that. And we got connected, I think, through the psychedelics organization. You won a presentation over there, you kind of got a, did you get first prize?

Joe Moore: Like how, how does it work over there?

Megan Portnoy: I did, you know, I signed up for it, um, because I had this idea for a talk that didn’t really fit in my academic space and they’re very open to kind of creative merging of different disciplines. And so, um, I submitted it and then found out that I got it and that it was a talk competition.

Megan Portnoy: I didn’t know when I submitted that. And, um, so yeah, they do, um, some kind of talk coaching and mentoring and you produce your talk and mm-hmm. Some, um, folks judge it and I won.

Joe Moore: Outstanding. That’s great. Um, can you give us a little understanding of what you were working on there? What is that presentation?[00:02:00]

Megan Portnoy: Yes. So it’s, um, set and setting through the lens of ontological design. So it’s taking this, um, kind of design theory, um, grounded in ontology and if you want me to get into the definitions of things I can. Um, but applying that to developing psychedelic assisted psychotherapy settings, um, moving away from what I see now as very solution oriented design, kind of this pyramid structure where we’re trying to control for outcomes.

Megan Portnoy: And the peak of the pyramid is to get someone to an internal experience. Um, and my argument is that, uh, you know. Based on what we know is happening in the brain on a psychedelic, based on what we know about how environment impacts psychology, that we should be designing through a lens of the environment being a feedback loop and interactive, um, relational process with the experience rather than a lay on the couch eye shades, go inside yourself.[00:03:00]

Joe Moore: Hmm. I just, um, saw a bunch of photos from a clinic that used to be operational in New York that looked like, um, looked like an art project, the whole thing, but they were actually using it as a clinical ketamine space. And I thought it was really great to like have, um, something that just felt really playful and engaging as opposed to like, you know, hyper sterile walls.

Joe Moore: Um. Mm-hmm. But this is a spec, it’s like kind of a spectrum. And it might not even be a spectrum. It might be multidimensional too, right? Like there’s, there’s a lot to it. Um, so yeah. Can you, can you kind of like back us into this like, uh, concept of ontological design a little bit further?

Megan Portnoy: So, um, if you think of ontology as kind of like a conceptual framework, um, or system of defining entities and relationships, uh, within a particular domain.

Megan Portnoy: So how things relate to each other. Um, so ontological design is that, um, is [00:04:00] kind of this idea that what we design, the spaces we design, design us back. So you go into a cathedral, it is designed to elicit awe. You feel awe when you walk in. And so can we design the psychedelic space to be able to resonate with what is coming up in the psychedelic experience?

Megan Portnoy: Is it adaptive? Um, you know, when somebody. Gets to the place where they are feeling very, um, boundaryless and open. Can the space accommodate that? Can the space accommodate movement, um, tactile stimulation, auditory, um, all of the, you know, kind of sensory input. And then when it’s time to ground the person is their responsiveness in the environment to allow them to do that.

Megan Portnoy: Yeah. So this creating this feedback loop where the environment is actually an active participant in the experience, not just kind of this backdrop. [00:05:00]

Joe Moore: Mm-hmm. Yeah. That’s great. And I think, um, it’s really important to talk about space design and, and like what are we actually bringing to the table here and, um.

Joe Moore: A thought I had recently, and I wanna hear your kind of thoughts on this before we kinda rewind the tape on you and your history is, um, I’ve been chatting a lot about how even IV ketamine is often performing better than standard of care for a lot of psychiatric situations, even if it looks really subpar and executed poorly by our standards.

Joe Moore: And I think like just there’s a lot of upward trajectory here and, and it sounds like you’re saying this kind of new framework could really help improve things, right?

Megan Portnoy: Right. Yeah. I’m not necessarily pointing out something that’s wrong. Um, and it’s not about aesthetics as much. You know, there are a lot of beautiful spaces being created, um, a lot of clinical spaces too, uh, that can appear very sterile, [00:06:00] but people have meaningful experiences in there.

Megan Portnoy: Um, I just think that we can enhance it and it can be done, um, better.

Joe Moore: Hmm. Yeah, absolutely. So, um. How was the talk and presentation received at psychedelics?

Megan Portnoy: Uh, I think, well, surprisingly, um, if I looked, I haven’t checked in a bit, but I didn’t, you know, I had a pretty average number of views from the YouTube, but, um, you know, I got some good questions, uh, from the audience, but it was a kind of a prerecorded virtual conference.

Megan Portnoy: Mm-hmm. So it wasn’t so much a direct interaction, um, with folks, but, uh, if folks go to watch it, I highly recommend doing it on 1.25. Uh, speed. ’cause I was, I was very tired that day and talking quite slowly. So, little tip.

Joe Moore: Well, great work. Um, excited to, you know, [00:07:00] dig deeper, learn more about that and, and, um, see where we can expand.

Joe Moore: Uh. That topic into our education and media to, you know, help people become more aware of that kind of thing. So let’s kind of rewind the tape for you. How did, how did you kind of end up in psychedelia and working on a Id, like, what, what’s your path been to get here?

Megan Portnoy: Um, non-linear for sure. Uh, so I’m an older student.

Megan Portnoy: Um, I went to undergrad 15 years ago, which is kind of, uh, anomalous in my program. It’s a lot of folks coming right outta undergrad. Um, and had I had careers in politics and, uh, yoga teaching. I owned a yoga studio in Chicago for a few years. Um, and then I worked with, um, a podcaster, an author in Austin, Texas for a brief period.

Megan Portnoy: Um, but it was really after the pandemic lockdown moving to [00:08:00] New Hampshire, uh, which was a big change for a city girl. Um.

Joe Moore: Where were you initially from trying

Megan Portnoy: to, so grew up in the bay area of San Francisco. Briefly lived in Indiana, then moved to, uh, Chicago, and then to Austin. Great. So most of my adult life and childhood cities.

Megan Portnoy: Uh, so now I live in a teeny tiny town where the demographic is pretty much 65 and up, uh, in New Hampshire and uh, on 50 acres. So it was a change, but it was kind of, um, you know, this question of what next? Um, what makes sense? And, um, you know, I had come to psychedelics in my early twenties through my own personal experiences, my own personal heal healing journeys.

Megan Portnoy: Um, and then kind of going into the wellness world and in Austin and seeing [00:09:00] some red flags about how these were being. Utilized for healing, um, made me really think about applying rigor to, um, applying rigor to the use of these. So I decided to apply to a doctoral program, um, and then got in and a week later found out that I was pregnant and then found out my due date was the first week of classes.

Megan Portnoy: So, uh, my, my little guy is three now, but I did it all at once.

Joe Moore: Um, yeah, so I wanna kind of like expand on this kind of misuse, um, and rigor kind of concept a little bit. Like, I think it’s really easy to become a sloppy thinker around psychedelics. It’s a little bit more challenging to actually say, oh.

Joe Moore: Yeah, like maybe those assumptions weren’t accurate. Maybe set and setting or what I’m bringing to the table were more ingredient than like, you know, the fundamental ground of being or something like [00:10:00] that. Um, mm-hmm. Yeah. So can you expand on kind of like, what were some kind of tricky things you were seeing that kind of made you wanna apply more rigor?

Megan Portnoy: Um, definitely, uh, stories of, of harm and abuse when facilitators are also using at the same time. Um, uh, none of my own personally, but stories of others in that environment. And then kind of, I had this question of my, my assumptions about psychedelics, uh, making people better, more open, more compassionate, uh, kinder, those sorts of things.

Megan Portnoy: And. That wasn’t universal. And so I began to start to see psychedelics as, uh, an amplifier of one’s internal experience and internal [00:11:00] world, and saw the importance of integration. And I think folks getting into chasing the insights without integration can get to some pretty, um, self inflated, self absorbed places.

Megan Portnoy: So, uh, grounding in, in real world, real life, real problems, um, and some form of integrating and putting it into practice, uh, whatever it is that happens to us when we get to see the world in a radically different perspective.

Joe Moore: Yeah. Um. And there’s all sorts of harms possible, right? From physical to emotional, spiritual, and financial, and probably other things too that I don’t even know about yet.

Joe Moore: Um, but, um, you, you saw a decent spectrum of those kind of harms

Megan Portnoy: Yeah. And, um, harms, but also [00:12:00] just

Megan Portnoy: folks who had become untethered.

Joe Moore: Mm-hmm.

Megan Portnoy: From reality. And, um, you know, as I learned more about the mind and psychology and psyche and school, um, understanding that these seem to create more flexibility in the brain. So they work really well with rigidity, but you get into too much flexibility and now there’s a problem.

Megan Portnoy: Um. Practically speaking on, on the importance of day-to-day living, um, and just kind of daily living activities. And then moving into, you know, things like psychosis, that’s a highly flexible brain. So when you push too much into one direction with, without any kind of grounding, I just saw folks that, like I said, [00:13:00] felt very, um, untethered and malleable in ways that could, that could lead to harm for them.

Joe Moore: Yeah, I think, um.

Joe Moore: There’s the line I like, you know, have an open mind, but don’t have your mind be so open that your brain falls out. And I think that kind of like mm-hmm. You know, is, is key here. You know, because we can’t say, oh, there’s so many interesting possibilities. Like, uh, what I was taught about reality isn’t really real anymore.

Joe Moore: So is everything that, you know, this new stranger is telling me true? Or can I have a little bit of rigor? Like, how do you, how do you see bringing rigor into this kind of thinking, um, in these spaces? Like, I, I find Western philosophy helps a little bit, but that can also be a weird trap, I guess people a little screwed up to.

Megan Portnoy: Mm-hmm. I’m very much, uh, [00:14:00] everything in moderation and, uh, everything to me is a both. And, uh, I’m, I’m very much not, um, one who lives in extremes, but, um. From my, you know, clinical mind. I say that therapy, um, skilled therapy is really helpful in grounding the experience and applying the insights. Uh, but you know, I didn’t have myself therapy in conjunction with my psychedelics, but, um, for me it was, um, a lot of my background in studying philosophy.

Megan Portnoy: I know, like you said, the kinda the western traditions of that. Um, but who was it? It might have been Alan Watts that said something about peoples think that enlightenment is, you know, when you, when you see, see God or whatever it is, but it’s really in. Peeling the potatoes and taking out the trash. It’s [00:15:00] in that sort of stuff.

Megan Portnoy: And I’ve been lucky enough to have people in my life that provide that contrast. And I did, um, you know, get to places, especially in places like Austin that are real echo chambers. Um, I met my, my now husband who is not from that world and could hold up a mirror to how bizarre, uh, some of the things and some of the ideas could be.

Megan Portnoy: Um, where, you know, if you’re outside of that world saying the things you say or behaving the way you behave, you forget that the vast majority of the world and society would look at you like, are you okay? Um, so I, there was a poignant moment where, excuse me, I was going to to work and I had moved in with him and he just very casually from his computer as I’m walking out the door, said, uh.

Megan Portnoy: Sometimes it doesn’t feel like you’re gonna work. It feels like you’re going into, uh, indoctrination. Just, just [00:16:00] drop that little MindWar casually as I bounced out the door. And, uh, that really opened up some, some deep inquiry for me.

Joe Moore: Hmm. Mm-hmm. Yeah.

Joe Moore: I, you know, I’ve been around the psychedelic space long enough where I’ve seen a number of cults go rise and fall.

Joe Moore: Some, some have been able to last a long time and, you know, I wanna be a little bit careful here. I wanna call them high demand groups. ’cause like, you know, cult, it’s not that useful of a term, it’s a kind of sensationalist term. Mm-hmm. Um, you know, capturing kind of a lot of the weird, I don’t know, moonies, um, the, the assorted alien religions from the eighties and nineties and um Right.

Joe Moore: Yeah. Just a lot of really interesting things there. But, you know. So what if somebody has a religion? Like, I’m not necessarily gonna wanna confront your religion, but if it’s like ruining [00:17:00] your life and your relationships in ways that aren’t, you know, beneficial for you, then maybe something’s up. Like you gotta pay another 80 grand to go to the next level up to clear out the, um, the infestations that, you know, whatever Didi gave you when you were incarnated.

Joe Moore: You know? And so like there’s a lot of interesting and funny organizations. There’s also helpful ones and you know, um, there’s a thing that happened recently around a kind of American politics where people are getting like really entrenched in like really weird views. And by being ashamed of the view and having that kind of alienation amplified, then they don’t want to actually backtrack.

Joe Moore: It’s kind of an interesting cult dynamic that happens where they have to like stay with it to save face or feel good about themselves. And it’s like a relatively well-documented kind of playbook. How to manipulate people like that. Have you, you know, I, any thoughts on any of that?

Megan Portnoy: Yeah, there’s [00:18:00] definitely that double down.

Megan Portnoy: Um, but, um, you know, I’ll, I can, I can tie that a bit to my clinical work, which has opened my eyes to how minds change. Um, and it’s, it’s such an emotional process and we think that it’s logical and we think that it’s facts and we think that it’s, um, shaming or making one feel dumb or ostracized. But the flip side of that is if somebody’s in a high demand group, what folks who, um, run those or who lead those types of groups do is they, they, they toggle between.

Megan Portnoy: This button of love and terror. So you’re in grouped and you’re out grouped. You’re in grouped, and you’re out grouped and you never know where you belong. [00:19:00] So if you have some extreme ideas and then someone is challenging those by out grouping you, it’s gonna try to re, it’s gonna kind of reinforce you back into, well, this ingroup believes these things and when I believe these things I’m accepted.

Megan Portnoy: Um, and so they retreat further.

Joe Moore: Mm. Mm-hmm.

Joe Moore: Yeah. And it makes it difficult, more and more difficult as you’re kind of sh providing more shame or like mm-hmm. Guilt or bad feelings. You’re making it more difficult for them to come back. So this is like a really interesting dynamic that we’re seeing play out at scale right now domestically, and it’s, um, it’s, mm-hmm.

Joe Moore: It’s fascinating and, uh. You said you were friends with Matthew Reky earlier, who’s a really great thinker. Um, and I, I really appreciate his work. And, um, do you think he’s been [00:20:00] helpful here in kind of illuminating some of these problems?

Megan Portnoy: Yes, and I, I use friend loosely in that we’ve, we’ve had a number of really great discussions, but we’ve never met in person ’cause he lives in, in Toronto.

Megan Portnoy: Um, but I was connected with him. Um, I worked very briefly for Jamie Wheel and was working to get him on the Cons Spirituality podcast, um, and connected with, with Matthew then. Um, but yeah, I absolutely love his work. Um, and he, yeah, I’m, I’m a big fan of the things that he is calling to light and, um, and highlighting about the zeitgeist in both.

Megan Portnoy: This merger of political and wellness spaces, which is a really odd and unique thing to me because my background in politics and then moving into wellness, those used to be so distinctly different. [00:21:00] Um, totally different communities. Mm-hmm. Totally different interests, totally different concerns. And now there’s this merging of what I see as like two, two past lives for me.

Joe Moore: An interesting ants. So. Mm-hmm. Yeah. I think there’s just so, so much to get into like it, have you been exposed to any kind of clinical data looking into kind of high demand groups and like, um, kinda like how people, I don’t know, like what, what have you seen in, in the psychology world around this kind of topic?

Megan Portnoy: Yeah. It’s not a primary focus of, um. Of what I do. I don’t have anyone, uh, that’s a client that’s in a high demand group, but there’s oddly a lot of overlap with, uh, clinically with, um, reactions to things like intimate partner violence and [00:22:00] domestic violence and the kind of really disorganized attachment that can happen in relationship.

Megan Portnoy: Um, and then seeing when, when clients of mine come into therapy and have kind of similar disorganized attachment and, uh, kind of a parasocial relationship with famous people, influencers, podcasters, that sort of thing. Um, I haven’t studied, I actually made a conscious decision not to, to choose not to use my academic work to go far down into the, the cult stuff.

Megan Portnoy: I kind of wanted to. Put those experiences behind me and not let them define my career. So, um, but I, there, there are corollaries there with, um, the attachment that you see in abusive relationships. Um, and then, you know, I’m, I’m loosely familiar with some, some research around, um, [00:23:00] what, what types of basically, um, organizations of mind calls someone to be attracted to those types of groups.

Megan Portnoy: Um, and how when you’re facing things that feel like existential risk, which I think that a lot of us are feeling in many different ways, um, that you’re more. Inclined to find belonging in a rigid, in group, in a high demand group, in a strong man, um, and a leader that’s gonna give a sense of safety and direction.

Megan Portnoy: Uh, and that’s what folks who lead high demand group try to do.

Joe Moore: Mm-hmm. Yeah. Yeah, the terror concept is really interesting. I’ve, I’ve been seeing it in kind of like a, some relationships where one person is, uh, kind of deeply narcissistic from, you know, probably from real [00:24:00] reasons, but then like similar manipulations are happening, right?

Joe Moore: Like the, the love and wonder and then the terror. Um, and it’s like, mm-hmm. It’s really interesting, you know, destabilization, I liked how you called it like disor disorganized attachment earlier. I think that was a really good turn of phrase. Um, yeah. Um. Cool. Kind of wanna talk about like, um, flipping back, unless there’s anything on this topic we wanna cover before going back into like environments and spaces.

Megan Portnoy: Um, no. Yeah.

Joe Moore: Cool. Um, so I wonder, like, so say, say you’re talking to an anesthesiologist who’s about to build a new ketamine clinic, um, for psychiatric conditions. Again, anesthesiologist spent most of his time doing kind of surgeries, um, prepping folks for surgeries, not really familiar with psychiatry, um, to any like, you know, substantial degree.

Joe Moore: Um, what kind of things might you say to a psychiatrist to say, Hey, maybe you [00:25:00] really want to invest in a space. Um, and like really thinking about how this thing looks and how it interacts with people and, and to your point earlier, feedback loops and, and things along those lines.

Megan Portnoy: Mm-hmm. Um, well, to appeal to.

Megan Portnoy: Kind of a probably more medical model, scientific mind, I would talk about what is happening, um, on a psychedelic very broadly. Each one is kind of different, but you have in general, um, somatic amplification, so mm-hmm. Heightened body awareness, um, emotional resonance, everything starts to kind of feel, um, very intense and sometimes profound.

Megan Portnoy: Um, that there’s alterations to default mode network. Uh, so ego dissolution and a blurring of boundaries between self and environment. So more susceptibility to environmental cues, um, that increased [00:26:00] neural entropy and hyper plasticity. So, uh, the ability to make new connections. And then this, uh, kind of going on Dr.

Megan Portnoy: Gold Dolan’s research about the potential for these to reopen. Critical learning periods. So social learning, emotional learning, those sorts of things. Um, and all of that to say that it’s this kind of, um, very unique mapping of the brain where, uh, it’s highly akin to what we see in a child or a baby. And you would never, um, I think I used this example in my, in my talk, but you would never, um, take a baby with a highly sensitive neuroplastic brain.

Megan Portnoy: Everything is very stimulating ’cause it’s all novel. Um, and put eye [00:27:00] shades on them and put them in a crib and say, okay, now learn about yourself. But that’s what we do with Brains on a psychedelic. They’re in a very similar state and there is definitely, um. Benefit to going into one’s in internal world, um, but to create a space that engages play and exploration, novelty seeking creativity, um, divergent thinking and spaces that can elicit awe and mystical experience, which we know from studies is one of the biggest indicators of, um, of positive therapeutic outcomes in a psychedelic, is that, that they had a sense of awe or mystical experience.

Megan Portnoy: Um, and so I would, I would kinda give the science to that doctor about why it’s important. Um, and I, it’s, it was a tricky presentation to make because what I’m trying to, what I’m not trying to do is create another checklist. I [00:28:00] think that spaces are currently designed by checklist, you know? Okay, so we have a room.

Megan Portnoy: Is there a door? Is it safe? Is there medical equipment? Is there a place for them to lay down? Is the lighting low? Um, and then maybe let’s, you know, I heard plants are good. Let’s put, uh, some plants over here, make sure we have a Buddhist statue and, and you know, eye shades. Um, but it’s this kind of checklist, solution oriented, um, mitigating risk type of mm-hmm.

Megan Portnoy: Design. Um, and, and driving toward a therapeutic outcome of relaxed and internal relaxed and internally oriented. Um, and I would say that there’s so much more that’s possible in the psychedelic experience. Um, if we can engage in play and. Sensory stimulation and movement and, [00:29:00] um, and awe. So I’m trying not to make another checklist of here’s how you ontologically design things.

Megan Portnoy: I think that there is certainly a bespoke nature to it that’s important, allowing people to bring in sacred objects, reflective symbols. Um, even the potential for inviting relationships into the room with, um, important people in their lives or animals. Um, but also, um, I’m thinking about having the space kind of resonate with, uh, the psychedelic experience.

Megan Portnoy: So looking at how ritual contains something. So the entering in the, there’s a, a threshold, there’s a process of entering, there’s a plot process of containing and closing that. Seals the, the space in a way that, um, that allows the person [00:30:00] to conceptualize it as this, this kind of special transformative container.

Megan Portnoy: Um, rather than it be kinda like a doctor’s office. You know, you walk in, you do the thing, you walk out. Um, I just think there’s so much more room to have more impact on the experience. Mm-hmm.

Joe Moore: I was at a talk last night, um, by some people who’ve been in, uh, the iboga space for a long time and they, they also brought up play and playfulness and like, um, the sense of improvisation.

Joe Moore: Like, you know, not coming to this sterile. Room because you have something wrong with you and you need to go to a mental healthcare facility. It’s, versus like, let’s make it a little bit more playful, a little bit more like playing improv with your situation, whatever your kind of psychiatric situation is that you’re trying to look at.

Joe Moore: And then they also had this really good, um, in my mind, good concept of, you know, extending the [00:31:00] stay. So in increasing liminality, um, in a way by saying, oh, your appointment’s 2.25 hours and you gotta get the hell out ’cause we got the next person coming in. But like, figuring out how to allow folks to linger and mm-hmm.

Joe Moore: You know, nice spaces that are actually really designed for this.

Megan Portnoy: Yeah, absolutely. And um, you know, I think that how we got to a solution oriented way of designing these places, um, is largely, you know, medical model. Thinking, uh, Western medical model thinking, but these studies are trying to measure outcomes on symptoms.

Megan Portnoy: We’re measuring symptom reduction. But I think, and this goes into more of like my actual dissertation, um, topic and that I’m working on is that I don’t think that’s the measurement we’re running into this, [00:32:00] um, this issue where folks who aren’t familiar with psychedelics in the academic and medical world are saying, well, how is it that these work on, they work on everything.

Megan Portnoy: Right. Okay. So it’s working on depression, on anxiety, on, um, personality, on all of these different things and how well, it’s not treating the depression, it’s reorganizing the self such that depression is no longer needed. And so I think more interesting questions are, um, not, you know, how is your anxiety now, right?

Megan Portnoy: This one to 10, but how is your relationship to yourself in the world different? And I think that orienting towards an ontological approach to designing these spaces are going to, um, elicit more interesting answers to those types of questions rather than, you know, rating Likert scale, how, how your mood is doing.[00:33:00]

Joe Moore: Right. I, I think that’s a really important way of reframing the whole conversation. And I, I think we’re getting there. I think people are understanding that more and more. Um, but. We have this kind of, you know, alleged, uh, hyperplastic window. Neuroplastic window, two weeks with psilocybin, four plus with hypo gain.

Joe Moore: So we’re like, you know, really interesting, you know, what is it? 72 with ketamine, which is a little subpar, but it’s still helpful. Um, and, you know, how do we actually leverage those things in a way that we can reorganize the self and, and our relationship to the world? Um, and I think that’s really, really a clever way of putting it.

Joe Moore: Um, are you finding any kind of analogies in other parts of psychology for this kind of framing?

Megan Portnoy: Um, I think, I don’t know if it’s analogies. I think that there’s, you know, in psychology, clinicians kind of [00:34:00] come from a certain theoretical framework. Right now, the dominant framework is CBT, you know, behaviorist, cognitive behavioral therapy, dialectic behavioral therapy.

Megan Portnoy: Um. Acceptance and commitment therapy. But these are all under this kind of umbrella of behaviors. Like if we can just change beha people’s behaviors, they can alleviate their symptoms of whatever’s bothering them. Um, and I think there’s a place for that. There’s a place for learning how to regulate your emotions and have coping skills and that sort of thing.

Megan Portnoy: But, um, the way I practice is from a psychodynamic lens, and that is more interested in transformational change, characterological change, um, insight. It’s an insight oriented approach. So I guess that would be the closest kind of analogy. In terms of, um, mechanism of change, I think that it’s very similar [00:35:00] to, uh, the mechanisms of change in, in psychedelics.

Megan Portnoy: I think that psychedelics could be an accelerant. In psychoanalytic or psychodynamically oriented therapy because I think the biggest critique and why it’s not, um, used as much anymore is that it, it’s a long, drawn out process. It’s that Freudian hours long on the couch at least once a week, hopefully sometimes more, um, exploration of self and uh, reorganization of self.

Megan Portnoy: And that’s a long, slow process when it’s in relationship between therapist and person. And I think that, um, psychedelics can kind of throw gasoline on that fire and, um, I think we could look at changing the person more holistically [00:36:00] rather than, um, symptomatically rather than just disorder oriented.

Joe Moore: Um, so psychodynamic worldview, can you, can you kind of explain that a little bit more? I like, I like the, we, we talk about depth a lot. We do once in a while talk about psychodynamic approaches. Um, but yeah. What do, how do you like to frame that when you kind of explain it to folks beyond what you’ve already said?

Megan Portnoy: Yeah. Um, so I guess I can say the way I frame it when clients come in and I talk about the type of work, um, is that a lot of our, um, relational problems, um, um, almost all of our stuff, it’s either relationship to work, relationship to self, relationship to others. So we’ll just say relation relational problems that folks come into therapy to, to get help for, um, are from a psychodynamic lens, [00:37:00] largely unconscious conflicts and patterns.

Megan Portnoy: Ways of being that are ingrained over time. So this is why the classic, you know, Freudian approach. Are you gonna talk, are we gonna talk about my mom? Yes. Um, because, uh, you know, these things get ingrained and patterned in our brains, in our neurochemistry, into our personalities, into our behaviors, and thus then into our character over a long period of time.

Megan Portnoy: And it’s the exploration and excavation of that where I as a clinician can get to know the person and start to analyze and see where there might be unconscious conflicts, where they might not be able to see themselves. And then I can hopefully hold up a nice mirror, um, to help them gently explore what, what that might be and bring it into consciousness.

Megan Portnoy: And when something is in your consciousness, [00:38:00] you have agency. To choose what to do with it. If it’s just operating on unconscious patterns, you don’t know what you don’t know. You don’t have the agency to change anything, you’re just running on autopilot. So that to me is, um, psychodynamic work versus more CBT manual treatment where someone comes in and they’re like, I’m anxious.

Megan Portnoy: It’s like, okay, let’s pull out the manual. You’re anxious, so we need to work on increasing your window of tolerance. Let’s talk about, you know, taking deep breaths. And I know I kind of trivialize it in a way. Um, but I do, I do utilize those kinds of approaches and, and help someone develop coping skills.

Megan Portnoy: ’cause a lot of times, um, not a lot of times, I’d say sometimes, um, folks just are not ready for insight oriented work. They don’t have the distress tolerance, they don’t have the, um, awareness of self yet. And you can kind of build up to that. And, [00:39:00] um, so that’s, that’s how I see the work I do.

Joe Moore: Hmm, that’s great.

Joe Moore: Um, yeah. So how would, let’s see, um, if you had kind of like a, a bit of a magic wand, what, what kind of, um, immediate changes would you kind of like to see in spaces and psychedelic se settings? Like more Buddha statues or, um, more incense?

Megan Portnoy: I, I love, do you know you’re using like a classic therapeutic technique, the magic wand question.

Megan Portnoy: I love that you’re giving that to a therapist. Um, if I could use a magic wand and change anything about

Joe Moore: like, the setting.

Megan Portnoy: The setting. Okay. Um,

Megan Portnoy: well, understanding that. We’re also constrained by the systems of, um, [00:40:00] incentives and resources and things like that. So, but in my, my world where we just had unlimited resources to create anything, I think that, um,

Megan Portnoy: I would like to see the field really engage in disciplinary, um, communication and effort and work creativity, reimagining what this could be, rather than trying to cram psychedelic assisted therapy and, and settings into, um, clinical medical models. I think that we have the potential to create something radically new and different.

Megan Portnoy: Um, if we can break outside of the box of if it can’t be measured, it’s not. Effective if it’s, if it can’t be measured, it’s not real. [00:41:00] So that’s what my hope would be.

Joe Moore: Um, so I’m kind of like, the subtext I’m hearing is kind of like, how can we create, um, s effective but not necessarily, well, I guess we’d have to even reframe effective whatever, effective two and four.

Joe Moore: But like these new containers that aren’t in a clinical facility that aren’t necessarily even led by clinicians, um, could be religious professionals of some kind or, you know, some sort of professional, fun person or what it, like, can you, can you give an example of what that might look like?

Megan Portnoy: I have seen too many professional fun people in, in Austin.

Megan Portnoy: I don’t recommend that. Um, but so I think for me. I’m obviously gonna have my, my bias towards clinicians doing this kind of work, [00:42:00] but it’s because there’s accountability built into being a psychologist or, um, any kinda mental health clinician in that we have, um, regulations, we have ethics to adhere to, or you can lose your licensure.

Megan Portnoy: And we have a system of what’s called supervision, um, where we are constantly not like supervisor in that I have somebody that dictates my schedule and things like that, but, um, supervisory experiences built into therapeutic work and you have somebody with much more experience, um, to go over your cases with, um, to help you find your blind spots to make sure that you don’t have any unconscious processes coming into the room here.

Megan Portnoy: Um, and you know, with. Life coaches, shamans, uh, that don’t actually [00:43:00] come from a, a, a trained lineage, like an extensively trained lineage. They don’t have accountability structures, religious leaders, possibly. We’ve seen how accountability works in a lot of large religions, so maybe not. Um, but that would be my, my argument and bias for, you know, clinicians and also recognizing that that does come from a kind of medical model mind.

Megan Portnoy: Mm-hmm. But like I said, I’m, I find the middle path. I think it’s a both and I think that there are areas where that kind of structure, um, is, is important to protect from harm. And then there are areas where we could be much more flexible.

Joe Moore: Totally. I find, um. I find a lot of clinicians are actually getting frustrated with the clinical model because they’re not able to actually do the work they want to do and find would be actually most ethical, which is [00:44:00] really interesting, including physicians and prescribers in a lot of cases, which is bonkers to me that they would just give up.

Joe Moore: They’re licensed, but they’re doing it. And, um, I find it’s wild to me. Um, I’ve also seen cases where people aren’t, um,

Joe Moore: they’re getting in trouble with their boards, but they’re not necessarily seeing penalties, you know, getting reported to their board and Hmm. Well, you know, in my mind, I don’t know that you should be a therapist anymore and, or for a few more years, but you know mm-hmm. You just like got told don’t do it again or something.

Joe Moore: Or if that. So, you know, I’m, I’m with you that we want to see some sort of, like, I’m, I’m seeing a world in which we get out of prohibition, hopefully, where we can then have accountability in these underground spaces where it’s not like, you know, you’re, you’re calling the cops on your drug dealer that also like, gave you your session and you know, that’s not gonna go great for anybody if anybody even gets any attention.

Joe Moore: Um, [00:45:00] and mm-hmm. Yeah, I think I’d like to see clinical inclusion in almost all of it. Um, if possible, like for safety screenings at the least. But then how do we Yeah. Do better accountability for the cases when it might not need to be a therapist, you know? ’cause it’s not necessarily the case that the therapist is the best person for that job.

Joe Moore: I, I think, but I think there’s a lot we have to explore here and. I think we do need an open mind to some degree or another for like, what is, what are, what are some optimal ways that this can get rolled out and do you agree that there’s not gonna be like a one size fits all solution?

Megan Portnoy: Yes, and I think that, um, I think that, you know, getting rid of prohibition and, you know, recreational use can coexist with clinical, therapeutic use.

Megan Portnoy: I think that, you know, I know lots and lots of [00:46:00] people that are interested in trying psychedelics, but they don’t want to go to a psychedelics dispensary and get it and do it. They want guidance, they want, um, and, and I know folks who would feel safer with a clinically trained person there. Um, and then there are folks who don’t want that.

Megan Portnoy: And I’m a big, um, believer in. Freedom of consciousness and our ability to tinker with and toy with our own consciousness. Um, and there’s definitely a public awareness and education role in how to do that, um, and harm reduction role and how to do that safely, um, that, that the mental health professionals can play a role in, in the recreational space.

Megan Portnoy: But I think that they can exist side by side and that, um, you know, what’s good for one person is not necessarily great for everyone.

Joe Moore: Absolutely. Yeah. Yeah. Um, it’s, uh, it’s tricky. One, one thing that I always like [00:47:00] ran into, um, and it’s kind of like informed how I’ve chose to play, play in the space is, uh, working away from a psychia psychiatric dominant.

Joe Moore: Kind of position with psychedelics because we’re seeing, you know, I’m a found founding board member at the Psychedelics and Pain Association. I really saw that as a hedge saying, oh, we need other clinical specialties here. Psychiatrists shouldn’t be the only ones holding the prescription pad here. Um, mm-hmm.

Joe Moore: Maybe they need to, you know, be part of the formula for pain patients or for, um, even non nonclinical applications of these things like betterment of the well and creative problem solving and whatever else. But, you know, it’s not that they should hold the keys. Um, but yeah, the pain stuff is gonna look, you know, I guess in a design sense, very different from what a psychiatric situation might look like, or a psychospiritual situation or maybe not.

Joe Moore: Like all, all of my chronic pain went away dancing at jam band shows. So like [00:48:00] very different, um, very, uh, zero clinical supervision. Maybe I should have had some, but, um, could, couldn’t find anybody that was helpful at the time.

Megan Portnoy: Yeah, and I mean, that opens up the question of is there, I mean, some of my own most profound body work, um, and releasing of pain and things like that, uh, with the aid of psychedelics has been my own yoga practice and foam rolling and working things out.

Megan Portnoy: Um, and if that’s what someone needs, is there a place for, you know, physical therapists to be in the room and help folks get through things? Um, yoga teachers that can do, you know, safe adjustments and all that kind of stuff. So, yeah, I don’t think that the answer is that, well, this is, I I also don’t think it’s the answer that [00:49:00] psychiatrists should be the only prescribers of any kind of psychiatric meds.

Megan Portnoy: I think. Psychologists. Um, and again, I’m biased, but we have also have five years of training and we are closer to, um, closer to the clinical presentations in that we are with folks on a weekly basis seeing how things are going for them. A lot of times psychiatrists are med management. They prescribe and then they’ll send you to someone like me to talk about your stuff.

Megan Portnoy: And then you check in with them, you know, every three, six months, how are your meds doing? All right, great, here’s your prescription. Um, but you know, I have had cases where, um, you know, full disagreement with psychiatrists on, um, what was being prescribed. ’cause I would see the day-to-day impacts on folks.

Megan Portnoy: And, um, and so I think that, [00:50:00] that it’s not just psychiatrists that should have prescribing ability.

Joe Moore: Yeah. Um, for sure. And, and we’ve seen this play out in a few states, right? Like there are states where psychologists are prescribing in the US

Megan Portnoy: Yes. Um, I am hoping after I get done with school to kind of lean on my political background to start rolling the ball up the hill for New Hampshire on that.

Megan Portnoy: It was tried in 2014 here, um, and it was shot down by a lot of lobby money. But, um, I think that there’s, you know, the, the mental health crisis, whatever that means, but there’s a greater need and, um, not enough access, especially in places like New Hampshire and more rural communities. Uh, but it is, um, [00:51:00] it is.

Megan Portnoy: In some states, just not widely, and it does require more training. It requires, um, I think it’s two more years of a psychopharmacology master’s, which I think is perfectly valid and, and worth it. Um, but it would increase access greatly and put prescribing rights in the hands of people who are closest to the patients.

Joe Moore: Mm. Yeah. I love that. Um, do you see any kind of, um, interest in the state of New Hampshire around psychedelics? Right now,

Megan Portnoy: New Hampshire is such a funny place to me ’cause, you know, it’s like it’s live free or die. Uh, but,

Joe Moore: and everybody should know that I’m from there.

Megan Portnoy: Um, yeah. I hope, I hope we can meet when you come back and visit. Um, but yeah, it’s this kind of. On its face, surface [00:52:00] level, freedom, loving, live free or diet. And yet we can’t even get marijuana legalization.

Megan Portnoy: Um, you, you know, you can, you can drive without a seatbelt. No one’s gonna bug you, but you can’t go, go, you know, have a, you know, smoke a joint in your house or whatever it is. Um, so it’s a, it’s a tricky kind of quirky place with a lot of inconsistency from what I can see. But I don’t, given how I’ve seen, um, the state legislature react to marijuana legalization, probably not, um, probably not, but Vermont, Massachusetts, maybe.

Joe Moore: Yeah. Yeah, I think those places need to go first. Um, there’s been, um, a lot of activity in the Massachusetts legislature [00:53:00] recently around psychedelics. Mm-hmm. I’ve seen a little bit less in Vermont, but it’s so much smaller of a state. Um, so we’ll, we’ll see. Do, do you know if there’s a huge veteran population in New Hampshire proportional to like other states?

Megan Portnoy: I don’t know how it is relative to other states, but I know, I mean, just kinda anecdotally and, and I’m looking at, uh, VAs for my, my internship, which is kinda our version of the fifth year residency where you get, kinda get matched and placed. So I’ll be applying to that, um, match process this fall. Uh, but I’m looking at, at VAs, so I’m a bit familiar with the kind of things they’re seeing there, but they don’t have, um.

Megan Portnoy: Like, they’re not doing ketamine and stuff even, but I know a lot of VAs, you know, in New York and stuff like that are, um, but

Joe Moore: there’s a strong interest group at the va. Um, generally not any [00:54:00] specific location where people are actually having really robust psychedelic conversations with a lot of folks who are also employees at the va.

Joe Moore: So. Mm-hmm. You know, even Rachel, kudos making moves in, in the, um, the New York scene and, and you’re right, there are some places that do cap, um, was it White River Junctions? Kinda like the only kind of one nearby in New Hampshire, I think. In terms of VA facilities or is there in New Hampshire based facility?

Megan Portnoy: There is, there’s one in Manchester. Okay. White River Junction is technically Vermont, but it’s, it’s right on the border. Mm-hmm. Um, but neither of them are doing, um, ketamine. Assisted therapy, unfortunately. Uh, and I do think that, I think I was told that there’s a VA in New York, maybe Brooklyn, that is doing MDMA research, I think, but I

Joe Moore: can’t reach, they got a bunch of cash recently to do it.

Joe Moore: I, I forget which facility, but it is New [00:55:00] York based. Um, I think Rachel Yehuda had had some involvement in that. So thank you Rachel, for pulling that off. Um, yeah, it was, it was like a slightly disappointing amount of funding for the MDMA pilot, but also it was happening. I chatted with, um, oh, who was it?

Joe Moore: He’s like the head of psychiatry at, uh, Walter Reed, and he was very interested in figuring out how to bring it into, um, active duty populations, which I think is interesting. And a lot of people are like, that’s bad. That makes we’re cheaper. It’s like, well, these are humans and they’re suffering really bad.

Joe Moore: And like, we’ve gotta do our best to help humans not suffer so bad. Like, you know, it’s not, it’s not really our place to say, you don’t get access to these treatments. Mm-hmm. Because of the, the job you signed up for. Um, and I’m like, I just, yeah. It’s, and I think they’ll make better decisions. Have you got a chance to bump into Sarco yet?

Joe Moore: The Boston Cop, who’s an MDMA therapist? [00:56:00]

Joe Moore: No.

Joe Moore: Oh. So I’m happy to introduce you. Um, he’s got a number of podcasts. I just was with him in Santa Fe at a conference the other day. Um, he speaks really skillfully about how first responders are just like not getting the care they need to make the decisions they need to make with the kind of care they need to make.

Joe Moore: Mm-hmm. Um, and how, um, MDMA and or ketamine could really help people, um, become better operators, more authentic operators when they’re in the field and, and make better lifesaving um, life and death decisions. Mm-hmm. And I think that’s a really cool conversation that’s unfolding. Um, and he’s, he’s usually pretty available.

Joe Moore: He was recently on Rogan, which is fun. Um, and they landed at a really cool place at the end of the show apparently. Um, okay. Yeah. Which is like, you know, harm reduction, safe supply, that kind of thing. But also, obviously we need to fund this research really, really well. So we actually know what we’re doing here.[00:57:00]

Megan Portnoy: Um, can I ask you a question?

Joe Moore: Go for it.

Megan Portnoy: Pedal out. No, no. Oh no. What

Joe Moore: do we got? What do we got?

Megan Portnoy: I’m curious what you think of. Um, I view it as attention, maybe it’s not attention, but the tension between um, what our current, excuse me, HHHS secretary has said about promoting psychedelics and legalizing psychedelics.

Megan Portnoy: Um, and is support of that. And then an administration that I am doubtful would be supportive of that. How do you think this is gonna do? You see, Rick

Joe Moore: Perry recently came out as an ibogaine user, um, which is like astonishing to me, um, in the last couple weeks. And I hear you totally. Um, well, so. Like part of the sales pitch to us on, on this, um, RFK [00:58:00] character is like that.

Joe Moore: Yes. Oh, we’re gonna get psychedelics. Cool. Like, we’re gonna really put attention on that. And, you know, I, I’ve yet to see the movement in the energy there, you know, we’re certainly doing a really good job pulling back attention and resources from vaccines and other lifesaving things. But we’re, you know, woke mob here talking about vaccine.

Joe Moore: I just got one earlier today. Um, no, I just, you know, yeah, I know. You can see it in my eyes. Right? Um, so the, the whole, um. Whole thing about like, where is the attention going and like why. And it’s, it’s not clear to me even inside HHS what’s going on. And I think it’s kind of, I don’t know. I, I get the sense things like House of Cards and Game of Thrones is like, kind of like the reality of the situation there.

Joe Moore: It’s like, did your thing get enough attention? Is it supportable? And like, [00:59:00] in what ways is it supportable? Like, am I gonna lose my job if I support this? Like there’s a lot of really interesting energy that, and, and, and stuff that the general public doesn’t get about politics. I’ve only kind of vaguely learned things just by being part of the psychedelic Medicine coalition group in DC over the past few years.

Joe Moore: And it’s, um, it’s astonishing. Is the administration doubtful to support it? Um. I think the administration will do a number of interesting things to, to, to try to work towards reelection. Like what are those things, you know, there’s been a reasonable amount of losses, um, but I I, I haven’t seen super many wins yet.

Joe Moore: Right? So like, what are those things that could go down in the next year or two that could look like a win? It could be things like cannabis, it could be things like, let’s actually hyper fund psychedelic research or just let’s just straight up make it prescribable, which I think could be a little [01:00:00] awkward right away.

Joe Moore: But I, I don’t like, I don’t think we’re linked to historical precedent anymore in a lot of ways. So like, what, what could happen could just be totally untethered from the past. Um mm-hmm. So yeah, like all of a sudden there could be a $50 billion. Um, Walter Reed. Psychedelic clinic, you know, there could, there, there’s so many things that could be possible.

Joe Moore: Um, but it’s really hard to say where it’ll go. Is there tension? A little bit, but I, you know, like, where do I want to go so I don’t get canceled by a, B, C, uh, like, I don’t know. I saw, I saw this thing the other day where, where like the, the leadership, um, was asked about grieving and then like, oh, but we’re gonna have the best ballroom in the world.

Joe Moore: I’m so pumped. And like, you know, that [01:01:00] it, there’s like, um, there’s some sort of detachment from the actual issues that I don’t, I don’t really know how this thing works anymore. And I’m, I’m, I don’t, I don’t know where to put faith or hope as an individual and let everybody make that up for themselves. But like, I just, you know.

Joe Moore: Is that where we’re gonna see the action? Perhaps what I think we might see is states actually pushing things forward in a way like Texas, Arizona, I heard Mississippi might jump in, um, to this like funding state level iboga research, which is obnoxious that the states have to do it, but it’s also a possible thing and it’s a possible thing that could say, um, in a way hopefully embarrassed federal lawmakers to say, yeah, we actually need to be leading here.

Joe Moore: Like it’s inappropriate for the states to be spending on this when we should be the leadership that actually should be saving lives. But, you know, there’s so many things like we haven’t even solved the Sackler problem [01:02:00] yet, which is in like totally tied to the IBOGA funding thing. Um, and the, um, the opiate.

Joe Moore: You know, uh, settlement money and all that kind of stuff that Hubbard talks about a lot. So there’s a lot here. Thanks for teeing me up for, for Grant that hopefully will get me in too much trouble. Um,

Megan Portnoy: that was, that was pretty pc.

Joe Moore: Um, yeah, I don’t know. Like,

Joe Moore: I think the tension’s more gonna come from states. I don’t know that like HHS is gonna get shot down if they start making suggestions. Like Matt Zorn is there. I kind of trust his judgment and hopefully leadership. But like, you know, there has to be, there has to be some excitement and momentum and I think that excitement and momentum’s building.

Joe Moore: But, um, I think we’re just seeing a lot of skepticism too, of like, are you guys actually here for us? Like, show us?

Joe Moore: Mm-hmm.

Megan Portnoy: You mean momentum and [01:03:00] excitement for psychedelic research?

Joe Moore: Right? Mm-hmm. Okay. Yeah, like it’s, it’s growing. It’s like, you know, I think the two biggest bipartisan issues right now are psychedelics and, and drum roll, please, Epstein.

Joe Moore: And like, I think, you know, it’s fucking horrible. Those are the two biggest bipartisan issues right now. Like, we should be working on a few other things, but I, you know, bipartisanship is not really important at the federal level right now, given the dominance of GOP. So like, what do we do and how do we, how do we get this on GOP radar?

Joe Moore: I think people just gotta call their lawmakers and say, Hey, I’m really interested in this. You know, write the letters, do the phone calls. There’s a certain kind of math, and you would, you would know this maybe better than me, but like, every phone call is kind of like, it’s not just a phone call. There’s a certain math to say, like, this many phone calls on these topics indicate voter sentiment.

Joe Moore: Mm-hmm. And there’s a certain kind of math around like, how, how sh what should I include in my, um, votes for my constituency, or my work for my constituency? [01:04:00]

Megan Portnoy: Right? Mm-hmm.

Megan Portnoy: Yes. And I think that we have, um, that sort of system works with rational actors. We are dealing with a lot of new, um, irrational actors, so we’ll see.

Joe Moore: So yeah, I think in time, hopefully we’ll see some movement here. Um, I’m, I’m not really waiting for any big changes from HHSI would hope it actually comes from the NIH corner. We’re actually start funding this stuff. Um. In terms of research and HHS could say, yeah, like let’s do that. Or a bunch of senators could say yes, like we believe in this.

Joe Moore: H-H-S-N-I-H go for it. Like, we need to fund this stuff and move forward. Um, I don’t necessarily think we’re gonna hear those words outta the [01:05:00] president, like we could hear it out of RFK. We’ve heard some, you know, nods in that direction from RFK. Um, I know he is aware enough of the topic. I think, you know what, what would get me excited Megan, is actual attention on psychedelics and chronic pain and funding that research because there’s an intimate link between opioid addiction, chronic pain conditions.

Joe Moore: Mm-hmm. And if we can actually treat the chronic pain condition as opposed to like use these opioids as like, um, some sort of palliative, we can then radically address opioid addiction through the normal medical pipeline, which is a substantial portion of addiction. Mm-hmm. Um, so I’m, I’m trying to see it as like a, a cyclical thing and how do we actually then, you know, address the thing that is, you know, feeding a lot of, um, uh, negative cultural stuff around [01:06:00] people not being able to get housing and addiction and, and people dying from fentanyl.

Joe Moore: Like if we, if we bring it all the way back to the Sacklers, like there’s a lot of really good stuff there that we need to address, and nobody’s really kind of talking about it. And I did. They, they might have got some sort of part in. Mm-hmm. Um, but

Megan Portnoy: yeah, I mean, but we did, we did randomly take a boat out off the coast of Venezuela, so really winning the war on drugs here, did it God,

Joe Moore: good God.

Joe Moore: Mission accomplished.

Joe Moore: Yeah. So I think, you know how. If we want to make meaningful change, we have to look at data. We have to like look at what is, what are the things that we actually value? I don’t know. Truth maybe could be one of ’em. And then, you know, rational moves towards making people better rational moves towards spending tax dollars better.

Joe Moore: Um, ’cause you know, like that missile is probably really [01:07:00] expensive and could have housed people for 20, 30, 50 years and like fed people. Mm-hmm. Gave them medicine and instead killed 11 people or whatever. I’m like, you know, how do we, how do we kind of like. Do this more appropriate math on like weapon spending versus like betterment of the country and, and kind of like, um, some sort of more egalitarian approach here.

Joe Moore: Like when everybody’s doing better, we’re all doing better. And, um, yeah, I, I see interesting movement in places like Utah where we’re actually like seeing them as a conservative government spending to house people, um mm-hmm. As opposed to jail people, you know? ’cause it’s like, if you look at the whole economic situation, Mormon culture’s quite, you know, fiscally smart and like, oh, mm-hmm this is actually better for the culture we wanna build here in Utah.

Joe Moore: If we could have learn lessons from like, what they’re doing there in other states, we could, you know, make some serious moves on mental health. ’cause mental health is very linked to [01:08:00] economic stuff.

Megan Portnoy: Mm-hmm. Yeah, absolutely. I find, um, there, there real therapeutic limits. Um. To what I can do to help someone with their mental health.

Megan Portnoy: When, you know, their housing is insecure, their ability to eat is insecure. Um, you know, I did, um, part of my clinical work was in neuropsychological testing and who got kids coming in, being tested and assessed for, you know, A DHD, oppositional defiant disorder, autism. Um, and, you know, I’ve had kiddos in front of me that I’m spending four hours of testing with, and it’s like, well, are you, are you oppositional?

Megan Portnoy: And, or have you not eaten in 24 hours because you can’t? And yeah, I’m diagnosing based on what I’m seeing on these numbers, but, you know, [01:09:00] the person had a, a proper diet and, um, you know, routine and consistency and safety. Would we be seeing these? Would there be mental health issues? Probably not.

Joe Moore: I was listening to, um, uh, to Harvard trained kind of nutritional psychiatrist, um, the other day.

Joe Moore: Um mm-hmm. Talking about kind of even, um, sugar and like adolescents and like what mm-hmm. What kind of behavior looks like four hours after 32 grams of HCFC and like, it’s wild, you know, cortisol spikes really bananas behavior and it’s. Nutritional. And I think like there’s so much left for us to look at and, you know, huge win that we put real sugar in something.

Joe Moore: It’s like, you know, so what, like that’s, you know, um, or, you know, got trans fats out of [01:10:00] Smashburger or whatever the fuck they’re doing. It’s like, you know, like what I, I was watching all these kinda like Maha wi wins and at the same time watching all these things like, like orders of magnitude more losses in like, in terms of like Maha agenda items that they, you know, don’t talk about.

Joe Moore: Mm-hmm. I’m just like, oh, okay, cool. Like now we can’t sue pesticide companies like for willfully killing us. Like what on earth is that? And you know, like, why are we, why, why are we not able to think holistically here? And you know, sure. We want our winds. But we also need to critique these losses and, and is this part of that kind of like high demand group dynamic we were chatting app or where we don’t, our heels are dug in and we can’t admit losses or can’t admit we’re wrong.

Joe Moore: Um, I admit I’m wrong all time. I’m a lunatic. I’m like, you know, I make a lot of mistakes. I say the wrong thing, but I’m always ready to fall on the sword. You know, like [01:11:00] it’s part of finding what the higher truth is of like, what is our mission here? Is it truth? Is it mm-hmm. What is it? I don’t know. Being right, I guess is, that’s, is a, um,

Megan Portnoy: that’s, uh, I think in indicative of proper psychedelic integration, right?

Megan Portnoy: The ability to, um, to take an afront to what might be your identity in stride and hold the openness and flexibility enough to. To see that, um, a position that you disagree with, but that is pro-social and beneficial at scale is not a threat to who you are or the group you identify with, or, um, you know, it’s, it’s just interesting, you know, the Maha movement, Maha moms, yeah, we got this die or whatever out of food, and yet we’re defunding school lunches.

Megan Portnoy: So you’d [01:12:00] rather like it, children can go hungry as long as they’re not eating the specific die.

Joe Moore: Right. And the down term, like developmental consequences of that are dire for the country. Like, we want everybody to be as smart as possible. My opinion, you know, I’m, I think that’s a really cool aspirational goal, but yeah.

Joe Moore: Um, you know, it’s not for everybody, I guess.

Megan Portnoy: Yeah, I’d say smart is harder to control.

Joe Moore: I didn’t say it. Um, yeah. Um, yeah, so study philosophy, everybody, um, you know, uh, David Hume isn’t, um, all that bad. Uh, be skeptical, you know, I kind of like love to bring leery back at the end of this kind of stuff where it’s like, think for yourself and question authority being kind of like a fundamental thing.

Joe Moore: Mm-hmm. And, um, it’s always [01:13:00] important to. To do that. Like, um, Socrates identified as what, being a gadfly of the state, like a, a bug that would just keep biting the horse’s ass to keep it moving. And you know, Bertrand Russell, who’s not exactly my speed, but I loved his politics. He’s like, you know, kind of identified as a gadfly for the state constantly.

Joe Moore: Mm-hmm. Kind of working towards peace and, you know mm-hmm. The anti-nuclear stuff and all of it. So, you know, there’s a lot there, everybody. Um, and, you know, what are you here for? Why are you here in the psychedelic movement? Um, we had an article a while ago Megan called, um, harming While Healing, and it was kind of very similar about being very pro psychedelic policy, but against, um, any kind of other meaningful drug policy changes.

Joe Moore: So you’re like, no, those people should still continue to get harmed, um, because they’re doing bad things and we’re doing good things over here. And it’s kind of like this kind of [01:14:00] weird ideology that helps create a, a subspecies of human, um mm-hmm. For you to look, feel better than, and it’s not. Mm-hmm.

Joe Moore: It’s, feel some alignment there.

Megan Portnoy: Yep. Yeah. Yeah. It sounds to me like very poorly integrated, um, or the wrong things being amplified in in psychedelic use.

Joe Moore: Yeah. Cool. Well, I’ve kept you for over an hour and thank you for your patience with me. Um, and thank you for asking me a question that kind of set me off on a tirade.

Joe Moore: Sorry. It’s all good. It’s all good. I, um, I obviously like talking too much, but it’s, um, it’s fun. So, um, where can people maybe find your presentation that you did at psychedelics? Where can people find, um, other parts of your work?

Megan Portnoy: Uh, so presentation is on YouTube, on the psychedelics, um, [01:15:00] YouTube site. Uh, you know, I knew this question was coming.

Megan Portnoy: No, I don’t have a good answer for it ’cause I’m not, uh, I’m still a student. I’m not doing a whole lot of public work yet, and I’m really hesitant on whether or not I’m going to do a whole, uh, professional, um, social media presence. I have my personal one, but it’s private. But I, I, I think that there’s enough noise in that space.

Megan Portnoy: Um, and I prefer my real world work. So we’ll see if I end up on social media in a, in a professional way. But my, my talk is on YouTube. Um, and on that talk there’s an email if anyone wants to contact me for some reason when you keep it old school. So.

Joe Moore: Outstanding. Um, and are we, like, I assume when you’re kind of done school will, some folks will be able to kind of catch up on your dissertation [01:16:00] work or catch some of your presentations from elsewhere?

Megan Portnoy: Yeah, at that point there will probably be a website, um, and stuff I intend to go into private practice. Um, so there will be some, some things pointing my direction in that way and the ability to work with me.

Joe Moore: Fantastic. Um, and anything you didn’t get an opportunity to mention that you, you’d love to share or you kind of covered it all?

Megan Portnoy: We covered a lot. A lot more than I, I knew we would cover. I don’t, I, we were over an hour, but I did wanna ask how was Burning Man?

Megan Portnoy: I know it

Megan Portnoy: was your first, is this your first podcast since you rega integrated back into Uh,

Joe Moore: no. I’ve done a, I’ve done a handful. Do you fall? Okay. You know, I haven’t chatted about it too extensively.

Joe Moore: It was really hard. Um, it was, uh, my first time kind of running a camp, I made a mm-hmm. Tremendous amount of mistakes. I worked really hard. Um, I [01:17:00] broke my circadian rhythms where I couldn’t sleep. Yeah. Um, it was my most sober of Burning Mans too. Um, yeah. Like to the point where my, my Ambien wouldn’t put me down, and I’m like, oh no, this is gonna get really uncomfortable.

Joe Moore: Uh mm-hmm. Um, yeah. But I, I eventually figured out how to regulate and I, I just like, um, tried to get a lot of sleep by the end of the week once I kind of, you know, was able to normalize and reintegration was not that bad. Um,

Megan Portnoy: okay, so this wasn’t your first, my worst. I wasn’t under the impressionist. With your first, your first time?

Megan Portnoy: No. Running a camp. Got it.

Joe Moore: Yeah. Okay.

Joe Moore: Um, but it’s, it’s definitely quite the thing. I, I don’t really know that I suggest anybody does it. Um, I, you know, if you feel called amazing, but it’s not something I, I think, you know, people should be like, this is the, this is the next big thing I need to do kind of moment.

Joe Moore: Like a lot of people are like, oh, it’s that and Ayahuasca and Costa Rica or [01:18:00] whatever. I’m like, yes. You know, it’s cool if you like, if, if it appeals to you, amazing, but I’m not gonna be selling it to you. Um,

Megan Portnoy: that makes sense. That’s fair.

Joe Moore: Yeah. I wanna, I wanna show you my, um, art project. Uh, I’ll throw it up on screen here for everybody.

Joe Moore: Um. This is what we brought the big crab car. That’s cute. Crab with a cakes. It’s not a real crab. Um, minivan. We turned into a art car, mutant vehicle out there. And um,

Megan Portnoy: I’m so glad you told me that was not a real crab. I was very concerned.

Joe Moore: I’m glad, uh, I could appease that. Um, yeah, so the spelling’s important.

Joe Moore: K crabb everybody. Um, k crabb and campus probable clause. Oh my God. But we’re relatively discreet in the camping area. I love that. Um, e except we’re not very discreet ’cause we have that thing out front. We, so, um, if you see that, that’s where we’re probably, um, but yeah, it’s been, it’s been fun. It’s a, it’s a good time.

Joe Moore: [01:19:00] I, uh, it was my hardest of years. Um, can’t wait for next year because I’m gonna, I learned from a lot of mistakes and it’s gonna be a lot better for me regardless of weather. Mm-hmm. I do really good in like 120 degree heat. I don’t do great when it’s rainy and you can’t walk around. Um, I’ll figure that out next time.

Joe Moore: Just plan for it in some way. Mm-hmm. But yeah, I was joking at the Santa Fe conference that it’s like, it’s like iga but longer. You never wake up, you never can get out and you’re just like stuck there for, for like 12 days. You’re like, oh my God, I’m gonna go for longer next year too, hopefully, if I’m lucky.

Joe Moore: Oh, wow. Yeah. Just as soon as they let me in, I hope to be there. And then, uh, like 14, 15 days would be nice. It’s just when you can calm your pace down, when you don’t feel rushed, it’s a lot better of a situation. Um mm-hmm. That was a big lesson for me. Um.

Joe Moore: Mm-hmm.

Joe Moore: Yeah. By being rushed, I feel like I lost a number of days.[01:20:00]

Joe Moore: Not ideal. Yeah, I already don’t even take speaking arrangement engagements out there because I don’t wanna like, have to hang out with colleagues too much out there. Come hang out, come hang out in the crab car, everybody, but I don’t necessarily wanna like go to the talks.

Megan Portnoy: Yeah, that makes sense.

Joe Moore: Yeah. Well, thanks for asking.

Joe Moore: Have you been out there? Mm-hmm.

Megan Portnoy: I’ve been twice, yeah.

Joe Moore: Mm-hmm.

Megan Portnoy: So still a rookie at it, but

Joe Moore: it’s, it’s, it’s like a, it’s like a mirror of the world. It’s so bananas. There’s so many like haves and have nots. There’s so much like ridiculous behavior both like in terms of weird psychedelic stuff and then just weird kind of like power dynamic stuff.

Joe Moore: It’s so crazy. And you see the people who are like totally clean and then you see the people who are just sleeping in a tent who are just like haggard as hell. I slept in a van. It was mostly sweaty, sweaty and dirty most of the week. And I’m like, Hmm, I wonder how the other side lives. Um, yeah, I have, [01:21:00] uh,

Megan Portnoy: it, the, the second time I went, I took my husband for the first time and, um, we were biking way out and then we stopped to rest at a, um, at, I don’t know, some art installation.

Megan Portnoy: We were kinda sitting down, leaning on it, kinda getting outta the sun. Um, and a group on some e-bikes, pristine, no dust, of course, sparkly, um, literally drove by us and like, kind of turned the wheels to kick their dust at us sitting there. And I looked up, I won’t, I won’t say his name, but I looked up and it was, um, a friend of somebody that I worked for who’s rather famous.

Megan Portnoy: And it was just this funny juxtaposition of like. You know, here you are. Oh, they, they kind of kicked us on [01:22:00] us and went Hi. And drove by, and they’re very sparkly, clean fanciness. Um, and it was just interesting that they had no idea that we were connected in the same community.

Joe Moore: Mm-hmm.

Megan Portnoy: But, right. Yeah.

Joe Moore: I know exactly what you mean.

Joe Moore: You think you’re anonymous and you’re not anonymous out there. Everybody, like, you can’t, there’s a little bit like, I’m certainly not anonymous out there. I would love to be, but like, yeah, there is accountability and like, you think you’re just shitting on some of the pos and it’s, yeah. What are you doing?

Joe Moore: Like, why would you do that? Mm-hmm. And like, you know, um,

Megan Portnoy: I think, and this is a deeply spiritual person. Of course, of

Joe Moore: course. Yeah.

Megan Portnoy: Love and light.

Joe Moore: Oh God. Uh oh, man. Amazing. Yeah, I just, I don’t, it’s, it’s, uh, like, it’s everything. It’s like the world with the volume turned [01:23:00] really high up. Mm-hmm. And it’s, you know, sometimes it’s easy to hide out there, sometimes it’s not.

Joe Moore: Um, and I don’t really know, um, the solution other than, you know, keep trying to show up with the right values and the right ethics and, you know, try trying, you know, to help help others do it the way they want to do it. And you keep doing it the way you want to do it. Um, and if you see people kind of being assholes, call it out.

Joe Moore: Make it loud. Mm-hmm. Um, and you know, if you know, like there’s a whole, I don’t know if you saw this, there’s a whole email that they set up. Um, doing it wrong@burningman.org. So if you see camps of these wealthy folks that just like paid a bunch of money, like they just can roll in and like mm-hmm. They got, you know, luxury RVs and whatever, like you can actually report them and like,

Joe Moore: what

Joe Moore: really make it so that organization can’t come back the next year.

Joe Moore: Like, they’ll do it again. They’ll find another way. Nature finds a way [01:24:00] in Jurassic Park, but like it’s um, you know, make it a little more inconvenient. And there’s the, these gigantic arc cars out there. Like, you know, we get a little crab, we can, we can get some people on sometimes from, you know, strangers and like new friends and whatever.

Joe Moore: And I love giving people rides. It’s so fun. But also mm-hmm. There’s these huge cars that are, it took many millions of dollars to build, like you’re not allowed on unless you’re part of their camp or something. Like you need a special bracelet to get on radically against the rules. Like you can get those folks in trouble too by reporting them to the Department of Mutant vehicles and like, you know, but it’s a also like, do you wanna spend your time ratting on people, you know, depends on how mad they made you, I guess.

Joe Moore: Um, but also there’s no legal consequence, right? It’s just you screwed up at the party and somebody’s going to hopefully talk to you about it. Mm-hmm. Or maybe you, are you familiar with to take a year off?

Megan Portnoy: Are you familiar with, uh, swing City? Have you [01:25:00] visited them?

Joe Moore: Oh God. Um, they

Megan Portnoy: have the big, they go every year, the big rig set up with, um, a lot of Cirque de Soleil and acrobats and, uh, they have, so they’re doing the huge Likek Yeah.

Megan Portnoy: The swing.

Joe Moore: Yeah. Yeah. A camp next to them last year it was awesome.

Megan Portnoy: Okay. That’s my camp.

Joe Moore: Oh man, my shoulders not, not in mine, but That’s right. Are not into that. I, I want my shoulders to do that, but I, they don’t want to do that. Um, but it looks so fun. A couple of my friends we were with, who were like really, really strong acro types and they were killing it on it.

Megan Portnoy: Mm-hmm.

Megan Portnoy: Yeah. It’s a, it’s a really good camp. It’s a fun place. But that, it was just this funny, um, that experience I shared is just this funny juxtaposition of like, I could through connections, resources, whatever, go to the plugin plays, but I choose to stick with my, my camp that I feel like does it right.

Megan Portnoy: Um, but there’s, there’s definitely a, a [01:26:00] spectrum of, of how people burn

Joe Moore: bananas. It’s, uh, it’s such a weird cultural phenomenon. Like I, I don’t know that I can quit, but it’s such like a.

Joe Moore: Endlessly. Interesting thing to think about. I don’t, I, I’m trying to be like quiet about it, so I’m not one of the obnoxious Burning man people. It’s like only he talks about, it’s all I think about, but I try not to talk about it, you know, I, you know, spend all year thinking about it and planning for the next one and, um, you know, trying to do better and bring more heat and all that.

Megan Portnoy: I had a, a funny experience where I was in kind of a peer consultation with other mental health clinicians and they just kind of brought up this icebreaker topic and they’re like, talk about, you know, something that really transformed you. And then Burning Man came to mind, and then I like kind of said that and then realized the company I was in and everybody was looking at me like, oh God, it’s one of those.

Megan Portnoy: And I was like, oh, [01:27:00] okay. Yeah, I would need more time for more context, but we’ll just, I’ll be burning man, girl now.

Joe Moore: Right. I, you know, this is my work. Yeah. Like there’s reasons to criticize it. Everybody, like, feel free. Mm-hmm. But I realize that it’s like, it’s not a, it’s not one thing, it’s, it’s like 80,000 things every year.

Megan Portnoy: It’s literally anything you want it to be. And that I also don’t enjoy doing that talks, there’s something that seems so wrong to me about the positioning of a person on a stage, talking at a, an admiring group of people and calling that community. Like to me, community is. When I’m with the crew helping raise the rig, and I’m doing my shift at the kitchen and, you know, I’m helping out a friend who’s struggling with an experience.

Megan Portnoy: Um, not the, you know, looking at your high demand [01:28:00] group leaders in their pristine costumes teaching you about life and relationship. And, um,

Joe Moore: I’m doing a great job biting my tongue. Um,

Megan Portnoy: I’m not, well kind of am, but Yeah.

Joe Moore: Yeah. Um, yeah. Well, how about we wrap it up here? Um, yes. And thank you so much and, um, thank you all for tuning in out there.

Joe Moore: We’re up to 138 people watching right now, so thanks everybody.

Megan Portnoy: Oh, wow. Don’t tell me that. I’m glad you told me that at the end.

Joe Moore: Oh, it’ll be thousands once we actually air it. But thanks everybody for tuning in. Thank you, Megan for making it. Um, and I hope we get to do more.

Megan Portnoy: All right. Thank you so much, Jeff.