Enamory – Psychedelics and Couples Therapy

Enamory – Psychedelics and Couples Therapy

Kyle Buller: Hello. Welcome everybody to Psychedelics today. Really excited to have both of the co-founders here of Enamory, Dr. Chandra Khalifian, and Dr. Kayla Knopp, welcome to the show. Really excited to have you guys here.

Chandra: Thanks for having us. We’re excited to be here.

Kyle Buller: Yeah, we’ll do some intros. We’ll let you introduce yourself.

Kyle Buller: So Chandra, you’re next to me. I’ll start off with you if you wanna give an intro on who you are.

Chandra: Awesome. Yeah. So I am a clinical psychologist and a co-founder along with Kayla of Ena. Marie and Kayla and I, um, have been academic researchers throughout our career. We met while we were at the University of California San Diego / Veteran Affairs Consortium.

Chandra: So our work has really focused on couple based clinical trials. And we started Ena Marie a few years ago, um, because we were. Both really interested in [00:01:00] continuing to do more work in with psychedelics and really had a dream of kind of creating an academic model where we could have more freedom. And so Enam E is now our private practice clinic, a training institute where we work with other therapists who are interested in learning psychedelic assisted couple therapy and a nonprofit where we do research focused on couples and psychedelics.

Kyle Buller: Cool. I love how integrated that is. Mm-hmm. And Kayla, I’ll pass it over to you.

Kayla: Normally I don’t need much of an introduction. After Chandra goes, we sort of introduce each other together. But yeah, I’m, I’m also a, a licensed clinical psychologist. Chandra and I are based in San Diego and so we work with people all throughout California and, um, yeah, and Anne Marie has been our passion project for the last few years and we’re so excited to be here talking with you about working with couples in psychedelics.

Kayla: It’s such an exciting area and one where I think it’s gotten a lot of underground attention, but not so [00:02:00] much academic research attention. And so we’re really excited to be bringing it to the mainstream.

Kyle Buller: Yeah, there hasn’t been much research. I know like, um, they were trying to do some of the, uh, I know Anne Wagner was like doing some stuff and I know the myth offers were trying to do some stuff with like MDMA for couples and, but yeah, it’s a really exciting thing.

Kyle Buller: So I would love to hear like your journey, like how did you guys get interested in, like focusing on, on couples work?

Chandra: So, um, I, we’ve both been interested in couples throughout our training. Um, I have been kind of on my own personal journey with psychedelics. I went to undergrad at uc, Berkeley and read PL and was very interested in how psychedelics can support openness and empathy and love and vulnerability.

Chandra: Um, but didn’t bring those worlds together until I got to San Diego, and Kayla and I both worked with, um, our mentor, Leslie Moreland, and we were working on a couple’s PTSD trial. It was the world’s [00:03:00] largest couple’s trial until, I mean. It is the world’s largest couple’s trial. Um, but it was specifically focused on PTSD.

Chandra: So when we finished that trial, maps reached out to Leslie and asked if she would do an MDME trial. And she said, I don’t know anything about psychedelics and Kayla. And I said, we are absolutely doing this. We’re gonna do it together. We’re a team. And so Kayla and I were actually trained by Annie and Michael, mid Hofer and have done a lot of work with Ann.

Chandra: Um, so that was kind of how we got there initially. And maybe Kayla, I’ll let you kind of take over what Anne Marie has built and what we’ve done so far there.

Kayla: Sure, yeah. Yeah. We’ve really enjoyed, I think, working with, um, couples and psychedelics in the context of mental health disorders, which is sort of primarily where the academic research has gone and full credit, a Ann is a good friend and has been an absolute pioneer of this work, particularly in the context of treating PTSD.

Kayla: Um. But Chandra and I are couples people first and foremost. And so [00:04:00] we really wanted to pursue what does it look like to just work on relationship healing, um, using psychedelics. We both, um, had our own kind of solo private practices, um, that we did on the side starting in postdoc. And, um, really started just developing this shared vision for what would it be like to be able to build a clinic where we can offer legal, psychedelic assisted therapy, which right now is ketamine assisted psychotherapy with couples, um, and where we can train other people who wanna learn this model.

Kayla: We, we developed the interest in training because, um, once we started doing this work, we looked around for training and guidance from other. Researchers and therapists and there just really wasn’t much published out there. I think there were a lot of people who were sort of doing this work under the table, um, and kind of, you know, doing it quietly.

Kayla: But, um, we couldn’t find, you know, published validated models of, of psychedelics working with couples outside the context of, uh. Mental health disorder. And so we made it, um, people were [00:05:00] asking us for, for, you know, sort of how we did our work and wanted to learn from us. And so we built this training program.

Kayla: Um, and you know, at heart, Chandra and I are also both researchers, we are PhD psychologists, we write papers and grants for a living. That’s what we do. And so we are also, we have a nonprofit foundation that we built so that we can run research studies also within the context of our clinical work, um, at ena.

Kayla: So we’re building a little academic medical center at ena. That’s

Kyle Buller: amazing.

Kayla: Um, so that we can really move this work forward in a way that’s aligned with our vision and, and that isn’t quite so constrained as you are in an academic setting.

Kyle Buller: Yeah. That’s amazing. Awesome work. I’m curious, you were talking about like being part of like that largest study on PTSD with couples and like, what was like the interventions, like how were you guys working in that study?

Chandra: Yeah, the protocol is cognitive behavioral conjoint therapy for PTSD, um, CBCT, and it really focuses on, um, kind of establishing safety in the relationship, learning communication skills, identifying [00:06:00] where the individual with PTSD, the, the study that we worked on was with veterans, but it’s also been done with community couples, um, where they’re avoiding, where PTSD is kind of constraining their life.

Chandra: And then they work on challenging some of those maladaptive stories together. Um, so things like, I can’t have my back against the door, or It’s dangerous, or All the doors need to be locked, or if I show vulnerability, then I’ll be taken advantage of. So things like that that are impacting the relationship, but also the person with PTSD, their life.

Chandra: And so that that treatment is also the treatment that has been used with MDMA so far. Um, so the study that we worked on and the study that Ann Wagner and Michael and Andy and Candace worked on in the community was CBCT with MDMA sessions, um, in the treatment protocol.

Kyle Buller: Amazing. [00:07:00] Yeah, I would love to kind of dig into Yeah.

Kyle Buller: Some of your work. Um, and how do you guys structure, like your ketamine sessions when it comes to couples work? Are you doing it together? Is one person going at one time and another time like Yeah. I would love to hear about like your protocol and, and how you approach this work.

Kayla: Kylie, you should sit in on our training at the end of the month.

Kayla: We can tell you all about it. I love it. Um, but, but yeah. I, yes. Um, so we are a very, we, we practice with a very psychotherapy centered model of ketamine assisted couple therapy, which means the way that we practice and the way that we train therapists, it’s to really think first and foremost about. What model of couple therapy are we using?

Kayla: What are the mechanisms of change that we think are active here? What are we trying to target to help this couple get unstuck from the patterns that they’re stuck in to make the shifts that they wanna make to have the relationship that they wanna have? And so we always start with a really detailed assessment con joint and individual assessment interviews, and we build this case formulation that we can [00:08:00] present to the couple in the form of this visual pattern, um, that we pulled from a couple of different models of evidence-based couple therapy that sort of traces this infinity loop of the interaction cycle that couples can get stuck in.

Kayla: Um, from there we can identify, you know, where they’re getting stuck and where we wanna shift to help them get out of that stuck place. And. Ketamine comes into the treatment plan to support some flexibility, some openness, some shifts in those kind of tricky stuck spots, right? Like we know that ketamine can help us make contact with emotions and stories and memories that are otherwise a little bit difficult for us to have capacity to hold.

Kayla: It helps us be more open and able to understand our partner’s perspectives. It helps us feel more empathy and, and closeness with our partners. And so we use Ketamine to support those couple therapy changes that we’re trying to make on the basis of our specific, like unique assessment for a particular couple.

Kayla: And um, Chandra, do you wanna talk a little [00:09:00] bit about the dosing models and how we think about that?

Chandra: Yeah, so there are several different dosing models. So Kayla just went through kinda assessment and then they’re gonna develop relational intentions during prep, and that’s really gonna help inform what dosing model we do.

Chandra: So we can either do. Dual psychedelic, which is gonna be a full dose. Both partners are there, um, and they’re gonna have a psychedelic experience. And we’re really looking for that big shift in perspective, a lot more flexibility and understanding around those stories. Um, or we can do dual psycholytic.

Speaker: Hmm.

Chandra: And that’s really gonna be kinda that softening and openness, but we’re still gonna be able to kind of communicate and do work during the session rather than a full psychedelic dose. And then we do most of the work during integration. Um, or sometimes we’ll choose to do an individual session, an individual [00:10:00] psychedelic session.

Chandra: And that’s really, if there is some pattern that is interfering, um, with the couple being able to kind of drop into the session together. So sometimes there is like a really strong caregiver pattern and so maybe that would. Stop one person from being able to fully drop into the experience. Um, or maybe we’re doing kinda some trauma work or exploration initially before doing a conjoint session.

Chandra: So anything that we’re choosing to do in the medicine session is going to be in informed by the assessment and case conceptualization. And then we move into integration and we are building this so that anyone with any evidence-based couple therapy training can do this model. So it’s not like the Chandra and Kayla model that like you have to learn this whole new thing starting from scratch.

Chandra: [00:11:00] The integration, all of the skills that therapists are. Like learning during integration are called what they actually are and exist across evidence-based couple therapies. So softening into vulnerability, cross reflecting approach instead of avoidance. So emotion focused couple. Therapy has their own names from it.

Chandra: Integrated behavioral Couple therapy has their names more kind of behavioral like Gottman may have different names. So we really, um, encourage therapists to come to our training knowing what their model of couple therapy is and understanding how the mechanisms influence change for couples based on their model.

Chandra: So then we can all talk about it together and then take our Ketamine assisted couple therapy training and then just fit it into their practice in a way that feels really streamlined.

Speaker: That makes sense. Uh, that’s really cool to like be able to have that flexibility on like, you know, what [00:12:00] type of dosing strategy to do and Yeah, it makes sense really based off of like the um, you know, assessment and um, whatnot.

Speaker: I’m curious, like when you do like the dual psycholytic dosing, like are they, like, are the couples usually chatting together at times? Or like, are you guys like really like having them focus internally and maybe not doing that? Um, yeah. Curious how you approach that psycholytic dosing when you do it together?

Kayla: I wouldn’t say chatting, but they are interacting a little bit more. That’s kind of the purpose of doing the lower dose Ketamine. If you’re not fully dissociated and on a fully inward journey, you can come out more and do more external processing. And we use that specifically when we want the couple to be interacting more and, and couples who might be engaging in a ketamine journey on their own might choose that when they wanna be able to, to share with one another, right.

Kayla: What they’re feeling and experiencing. So typically it looks like very soft, very slow, just kinda sharing and listening in that space. We’re specifically not trying to do a whole lot of like. Problem solving and, you know, adjudicating conflicts that came up [00:13:00] over the week. We’re not try, that’s not a space where we wanna be doing a whole lot of cognitive work.

Kayla: We want people to really be in their experience and sharing whatever sort of comes up for them in terms of their thoughts, their feelings, um, whatever it is that they’re experiencing. And, um, you know, even with the psycholytic dose, typically people do have some inward time. We’ll encourage folks to start with an inward focused meditation and just tune into whatever is coming up for them.

Kayla: And then often people will sort of come outta their eye, shaves and outta the headphones and wanna share something. And, and often the things that people are sharing in that space are really beautiful. Just really soft. Connected reflections. I had one couple not that long ago who was like, I just had this to his partner.

Kayla: He said, I just had this vision of you as this like beautiful moth that would just drop flowers behind you after you were flitting around in the world. And it was just like, so lovely. So I think that’s typically the kind of communication that people are having.

Kyle Buller: Oh, that’s beautiful. And, uh, can’t remember if you mentioned it, or maybe I listened to it in one of your other talks somewhere.

Kyle Buller: You guys do, uh, lozenges and sublingual, right? [00:14:00] Or do you do any Im at all. Or mostly just we,

Chandra: yeah, we do sublingual in our practice. Um, we do collaborate with other prescribers. So sometimes couples will go do IV or Im and do prep and integration with us. Yeah. But if we are doing the medicine sessions in our clinic, we do sublingual.

Chandra: Cool.

Kayla: And I’ll just mention too for, um, I, I think just one of the things that’s really important that we train therapists on is how to stay within your scope of practice. Yeah. Which is that we are psychotherapists, we are not medical doctors. Ketamine’s a prescription medication. So we really rely on our prescribing partners to co build a treatment plan with us.

Kayla: So they write the prescription, they do, they decide on the dosing, we’ll inform them about, you know, this is the kind of session we wanna have and, and they’ll work with us on that. So a really tight relationship with your prescribing partners is so valuable, but we don’t. Right. The medicine, we don’t provide the medicine.

Kayla: It’s self-administered, um, lozenges in our clinic.

Speaker: Yeah. Super

important.

Chandra: And there’s so many for anyone who’s listening, um, there are lots of paths [00:15:00] to link up with prescribers. So Journey Clinical, um, exists in most states in the US so that’s something that you can Google and be connected with. And then, um, we have really amazing prescribing partners here in San Diego, so if people have questions about how to, you know, reach out to MDs, usually people who care about this space wanna be collaborative and they wanna work with you.

Kyle Buller: Yeah. Beautiful. I’m curious, you brought up some of these stuck points, um, when you were chatting a little bit ago, and I’m curious, yeah. What are some common stuck points for, for couples that you see over and over again?

Chandra: I’m a burden, my partner would be better off without me.

Kayla: Mm-hmm. If my partner did something that hurts me, it was.

Kayla: Either on purpose, done maliciously on purpose to hurt me, or it’s because there’s some sort of fundamental flaw with me. Um, rather than, you know, sort of focusing on just the behavior. People tend to really personalize things like [00:16:00] that, um, stuck points around. Um, it’s not safe to be vulnerable, right?

Kayla: Mm-hmm. The only way that I’m ever gonna get my needs met is to either pull back, to protect myself or to get really angry and demanding. And, um, both of those things keep me safe. I think that’s a place where people get really stuck rather than sort of being fully present and, and open. Yeah,

Chandra: yeah.

Chandra: Unfortunately, um, in our culture, we don’t do a good job of teaching. I mean, in many cultures, um, teaching people how to share their emotions or how to hear someone’s emotional experience, not as criticism or a threat to the relationship. And we cannot have intimacy without vulnerability. And so if we’re never able to share what we’re experiencing, we’re never going to feel intimately close.

Chandra: And in the beginning of a relationship, that’s typically okay because there’s lots of [00:17:00] passion and fireworks and you’re having a lot of sex and like, that’ll keep you bonded. Um, but over time, that is going to stabilize and new relationship energy is gonna. Kind of balance out and fade. And then we have this opportunity to have this very deep, vulnerable connection where we truly see someone and are seen and understood, and, and we have no playbook on how to do that.

Speaker: Mm-hmm. Why do you think that is? Or where does that come from?

Kayla: Well, so many places, um, for a lot of human history, intimate partnerships have not been about. Close, intimate connection, right? It’s been a property deal, it’s been a financial arrangement. And I think now, you know, in sort of recent history, we have really high expectations for what our romantic relationships provide for us in terms of meeting our, like deepest, most intimate needs.

Kayla: We want our partners to be our [00:18:00] best friends, and we want them to be, um, you know, our, our sort of life partners. And also we want them to be, you know, uh, somebody that we can, um, you know, turn to when, when things get tough. And that we put a lot of pressure on our partnerships, right? And I think like we just haven’t fully caught up yet in terms of the skillset that it takes to support a partnership that feels like that, right?

Kayla: Um, and in the US we just don’t live in a society that really values vulnerability and authenticity. We live in a society that tends to value competitiveness and individualism and. Like harshness, right? People wanna win. People wanna, um, you know, get one over on other people. And so I think like we just don’t grow up in a society either that really values sort of the more communal, softer ways of, of staying connected with people.

Kayla: Even though all of the research is extraordinarily clear that that is the key to like life, success and happiness is the [00:19:00] strength of our connections with other human beings. It’s not how much you get paid at work. It’s not how often you win a competition. It’s how close you are to other humans.

Chandra: And the beautiful thing about psychedelics is that you like almost can’t not feel that when you do psychedelics.

Chandra: Like I right? Don’t know anyone who has done psychedelics and hasn’t felt this like deep connection with the earth and people and desire to love and support one another. Like that is a. Common, almost universal experience of psychedelics and so they’re so helpful for couples when couples have lost contact with that or dunno how to access it or haven’t learned it.

Kayla: Yeah.

Kyle Buller: What about those times where people might feel a little bit more disconnected after psychedelics, where maybe they realize I’m not connected with my friends as I [00:20:00] used to. I’m starting to see the world a little bit differently. Or like partners, right? Like mm-hmm. That’s a really challenging thing.

Kyle Buller: People come back and they’re like, Nope. Like I realized I need to cut the cord here.

Chandra: Mm-hmm. Yeah. We actually do a fair amount of work in our practice focused on conscious uncoupling, and so I think that that, that experience is. Like it happens, people have a psychedelic experience and realize like, I’m not living in line with my values.

Chandra: Either I’m disconnected from my friends and I want to be, or I’m not quite like this group that I’ve been a part of, or my partner and I are growing in different directions. And psychedelics can also be helpful in that process to navigate that process with love. So we are often taught that a relationship that lasts a lifetime is a relationship success.

Chandra: And it doesn’t matter if you [00:21:00] miserable, you stay in that and you continue in that relationship.

Speaker: Mm-hmm.

Chandra: And we very much don’t believe that. We think that relationships that are connected and kind and we put effort toward, like that’s a relationship success. And so doing the process of conscious uncoupling.

Chandra: With the help of psychedelics can, can facilitate gratitude and love and moving through this process and still potentially having shared community or family. Um, so you don’t have to kind of rip it apart and hate each other. You can go through the process and still be connected in a really healthy way.

Kayla: Yeah. And I, I think like that’s, that’s sort of one issue, right? Which is like, you do a psychedelic experience, you have a psychedelic experience, and then you sort of are confronted with a truth that’s been inside you, right? That like, maybe this place that I’m in isn’t right for me. Um, actually we hear that a lot with people who come out of [00:22:00] a psychedelic experience and I’m like, I gotta quit my job.

Kayla: Um, right. I gotta get out of something that I’m doing. We always caution people, you know, like, you don’t wanna be making huge decisions right away. You wanna sort of sit with something and integrate it and allow the meaning to sort of emerge over time, right? We, we don’t always know immediately after a psychedelic experience, like how that’s gonna translate into our life.

Kayla: So we always urge like, just give it some breathing room and see how that develops. Um, the other issue that I think you were alluding to, Kyle, which is what if I do a psychedelic experience on my own and my partner isn’t there and I come home and they’re like. I don’t know what you just did. I don’t know who this new person is, who’s in my living room.

Kayla: Like we have this like 20 year marriage that I still feel really heard about and I’m glad that you’re feeling better. But what, how do we, you know, how do we reconnect around this? And so we are really, really passionate about doing integration together with couples, even if only one person has done a psychedelic experience because, um, it is so difficult to [00:23:00] understand what your partner has gone through if that’s not an experience that you’ve had.

Kayla: And if you can have support. From a, a therapist or coach or other professional to do that integration together and really sort of be on the same team about what that experience means and, um, you know, how you can understand one another through this transition, through this change. I think that can also be really helpful because that, that can be really painful for people.

Kayla: That discussion.

Kyle Buller: Have you seen like times where that tension got really intense and the other person really couldn’t like, understand or, or see the person that went through the psychedelic experience?

Kayla: Honestly, I think we don’t really see that because the people who are working with us are working with us as a couple.

Kayla: Yeah. Yeah. And they’re like, we’re really able to help them with that. We, so I have certainly heard a lot of stories from folks when we give talks or do workshops, we, we give talks and workshops at festivals and around the community and things like that. And often people will come back up to us afterward to go, man, I wish I had heard this bef while I was in my last relationship because this was such a pain point for [00:24:00] us that I would have an experience or my partner would have an experience and we just couldn’t figure out how to reconnect afterward.

Kyle Buller: Yeah. I always come back to a lot of, uh, like, uh, Dell La France’s work, like really trying to like prep systems and it’s something that we don’t always think about, but like we are in systems. Like we’re social creatures, we come back to different systems, and it’s like, sometimes that change can be so jarring where it’s

Kayla: like,

Speaker: whoa, what, what did you just do?

Speaker: What are you into now? Like, and it can be like, yeah. Really confusing for the whole system.

Kayla: Yeah, that’s, we talk about that a lot in couples work of any type, which is that any time you change a component of a system, even if it’s a really, really good change, it’s gonna discombobulated the whole system.

Kayla: Right? Like, it’s like this precariously balanced baby’s mobile above the crib, right? Like, you change one piece of that and the whole thing’s gonna bounce around until it re stabilizes in a new position. So, yeah. And, and when you think about a really big change, like sometimes people experience on, on a psychedelic, um, uh, journey.

Kayla: Yeah, for sure. [00:25:00]

Kyle Buller: Yeah. That’s why I kind of love like what you guys are doing and trying to like Yeah. Help the system instead of it being so separate. Right. Yeah. Um, and I’m kind of curious too, you kind of use, you used this term like conscious unc uncoupling, and it just makes me wonder about like, the different generations and like how maybe each generation has different perspectives on relationships and how has that like, you know, shifted over the decades and, and whatnot.

Kyle Buller: Um, like, you know, you’re bringing up like before, you know, you were committed to a relationship and if you were in it, that was successful. If you were in it for a while now, you know, it’s like the newer generations are kind of thinking about relationships in a much different way. Um, and I’m wondering, yeah.

Kyle Buller: Are there any like challenges or whatnot that have been coming up in, in your work?

Chandra: Yeah, I think different generations definitely think about relationships differently. I think that by the time they get to us, they’re, they’re more [00:26:00] open-minded about it. So, I mean, we have couples in our practice that are in their sixties to late seventies and are thinking about what do they want the next 20 to 30 years of their life to look like, which is a long time.

Chandra: Um, and so there’s not, I think couples can or more can decide what they want their relationship to look like or not look like at any point in time. And I think that there is more education about different relationship structures and opportunities. So, yeah, I think when people come to us, they’re kind of more curious and have questions and are open-minded.

Chandra: I think that we of course, don’t see a lot of the relationships that are very structured and stagnant and are going to stay in that.

Kyle Buller: Right.

Chandra: Potentially unhappy for.

Kayla: Yeah, I do [00:27:00] think more and more people of all generations are giving themselves permission to not stay in unhappy relationships. Right. I think that is a cultural shift.

Kayla: It’s also an economic shift because I think, um, the ability to do that depends on whether each partner has the ability to financially support themselves. And I think as. Um, particularly for women, I think that’s becoming increasingly the case, which means that people don’t have to stay married in the same way that they used to, um, among younger folks.

Kayla: I think it, like Chandra is saying, there’s a lot more like open-mindedness and awareness of different kinds of relationship structures. Our clinic does specialize in working with folks who are non-monogamous and who have other non-traditional relationship structures. So we certainly see a lot of people coming to us to explore that specifically.

Kayla: But I think even in the general population, there’s more awareness of an, an interest in different kinds of relationship styles and structures. The challenge that I see for the younger folks who work with us is sort of a decision paralysis that I think is related to more awareness of choice. [00:28:00] I work with a lot of young adult couples who have been together for.

Kayla: Eight to 10 years, right? Since their early twenties. And just can’t decide, do we wanna commit to one another in a more permanent way? Do we wanna have kids? Do we wanna get married? Do we wanna buy a house together or like not? And how do we even make that decision given all of the possibilities in front of us?

Kayla: And I think that’s a, a real challenge for a lot of people in a unique one.

Kyle Buller: How do you approach that?

Chandra: Sorry. I was, uh, slightly different, but on this, I was just thinking about, um, one of my individuals that I’m working with who, um, another person in our practice has seen them as a couple. Um, she’s in her late fifties and she’s monogamous.

Chandra: Um, and one of her close friends who’s younger, uh, is also monogamous, but there’s a desired difference in that relationship. She wants a lot more sex. Her partner wants less. And my patient was like, I just told her that [00:29:00] she should have sex with other people. And I’m like, what? I’m like, you’re, you’re monogamous.

Chandra: And she’s like, I know, but you know, I had my ketamine session and I’m understanding that people can love people differently. And I told her that she should come to you guys or they should come to you guys and they can have any structure they want. I’m like. Wow. That was a big shift. You came in here pretty close-minded.

Chandra: She was like, yeah, I don’t have to be that way anymore. I’m like, all right.

Kayla: There’s, maybe that’s our new tagline. Do ketamine get non monogamous? Just kidding. Um,

Chandra: she’s staying monogamous.

Kayla: She, but she’s like, okay,

Chandra: my friend doesn’t have to be.

Kayla: Well, that’s true. That’s true.

Chandra: Yeah.

Kayla: I think, Kyle, to speak to your question, like how do we work with that when people are stuck in this decision paralysis, I think a lot of it is helping people get connected to their values.

Chandra: Mm-hmm.

Kayla: Um, if you’re not making a decision based on constraints. And instead you’re making based on your own free choice. Then the only guiding factor you have, the only guiding light is your values. This really comes from acceptance and commitment therapy, which is [00:30:00] a very excellent evidence-based third wave, CBT.

Kayla: Chandra and I both practice from Act quite a bit, and it really is centered around the idea of getting connected with your own values and then choosing how you wanna engage in your life in accordance with those values. Right? And that might not be maximizing short term happiness all the time. That might be building a life that feels meaningful and connected and purposeful, and something that gives you a bigger sense of meaning.

Kayla: It’s that, that’s why it’s such a nice pairing with psychedelic work. So we start there with partners, right? Like what are your values as an individual? What is your value as a couple? Right? Or in a relationship together. Mm-hmm. And how does your life relate to those values? Is that informative at all in coming to this decision?

Kayla: The other piece of it that I find myself working with folks a lot on is comfort with uncertainty and ambiguity. Because we can never fully know the outcome of our choices. And young folks, um, I think do tend to be quite anxious for a number of different reasons. People really wanna know for sure that things are gonna work out [00:31:00] okay.

Kayla: And of course, if you look at the world around us, of course people are anxious. Like that makes sense. Um, but the reality is that’s not how life works, right? Sometimes we just have to make a choice and trust that whatever happens, we’re gonna be okay. We’re gonna be able to handle it. So I think those are the, the two biggest tasks I take.

Kayla: I’m curious, Shandra, what you do actually,

Chandra: I think, yeah, also definitely everything that you are talking about and also reminding people that like choices are not permanent. Everything in life is always shifting. I was working with, um, a woman yesterday and she’s like having decision paralysis and she’s like, I just can’t make a choice.

Chandra: I’m like. Of course you can. And if it isn’t right with the life that you wanna build, we’ll make another choice. And that’s okay.

Speaker: Mm-hmm. It’s fascinating, you know, just like outside of like relationships, you know, I definitely see that in clients too, like career friends, where do I [00:32:00] wanna live? What do I wanna do?

Speaker: You know, and it’s like, I think in like, you know, our time in human history, like we are so bombarded with like optionality, right? It’s like,

Chandra: yes,

Kyle Buller: you can kind of do anything in a weird way. Um, and with like the technology, the opportunities versus like, yeah, you think about like. A hundred years ago or whatnot.

Kyle Buller: Right. It’s like maybe you grew up in a small town, you had this job, you had this family, and that’s what life was. Um, yeah. And you know, now we can get on planes, we can communicate through PE to all sorts of different parts of the world through this technology. And, um, yeah, it’s, it’s pretty interesting that like, I think in human history, like we’re at this point where I think, yeah, we have so many options in a way.

Kyle Buller: It does create a lot of paralysis of like, what the hell do I do? Right.

For

Kayla: sure.

Speaker: And then with all the uncertainty that’s unfolding around us too, then it’s like compounds. And you’re like, what the hell do I do now? It’s like, is AI gonna take our jobs? Like

Kayla: Yeah. Yeah. And people feel a lot of [00:33:00] pressure to, to make the perfect choice or to like make the best possible choice.

Kayla: I think that there’s been this sort of cultural zeitgeist for a, a long time around this idea of like maximizing your personal potential, right? This is like a very like Bay Area tech bro biohacking kind of a thing. Like eat the perfect food to maximize all of your biological systems at all times. And it’s like, or have a meal that you enjoy, you know, with people that you care about.

Kayla: And I think people take that a, we, we’ve really had this like cultural pressure to like at all times be maximizing right? And be doing the perfect thing. And, you know, and really like that is, I don’t know, I don’t know about y’all, but like that is not how I view the purpose of my life. I we’re here for. A short while.

Kayla: And I think that we can make other choices to just live the best possible life that we can in the time that we’re here, and really take a lot of pressure off of ourselves to always be making the exact perfect right choice. And as Chandra said, like everything’s gonna shift, everything’s gonna change anyway.

Kayla: The only certainty is that change will occur. So all we [00:34:00] can do is make the best of the moments that we have and just like, try our best to relax about the rest of it.

Speaker: Yeah. I think you bring up a good point about like our own values, right? Really helping people to figure out, like yeah, what do they value in life?

Speaker: What do you believe in? Um, yeah. Really help guide us, um, doing couples work without ketamine, um, versus in incorporating ketamine and, and psychedelics. Like, what is, what have you noticed? Has it made the work a little easier? Has it made it challenging in different ways? Like yeah. How, how’s that been?

Chandra: It. F broadly definitely makes the work easier.

Chandra: Um, just because if we do a medicine session early on after that assessment phase, we’re able to have kind of a big shift in perspective. And that’s often where we get most stuck in couple therapy is like people are so backed into their [00:35:00] corner and it’s so difficult for them to see their partner’s perspective and soften and have a deeper understanding.

Chandra: And that’s the point that we’re trying to get to in any evidence-based couple therapy really is having a deep understanding of our partner’s experience. Because once I have a deep understanding of your experience. What you’re doing makes sense and I don’t wanna hurt you. And it’s so much easier to make behavior change.

Chandra: And so with ketamine there is kind of more ease and we can kind of get to the outcome that we’re looking for. Whatever the couple has identified, is their goal, the life that’s meaningful to them. Typically in about half the time, a typical course of traditional couple therapy is about 20 sessions. Um, and so we could maybe get there and, you know, 10 to 12, um, or sometimes there’s like so much rigidity that [00:36:00] couples won’t soften, but that’s, mm-hmm.

Chandra: That’s not typical. Um, typically couples will benefit from couple therapy.

Kayla: Yeah. As a researcher, I like really wanna know the empirical answer to this question, Kyle. And I don’t think that we have a, we don’t have a data based answer yet. We’re trying to collect data. Um, if you, if anybody out there knows some philanthropists who feel like funding some research studies on this, like we are really trying to collect some data so that we can answer that question well.

Kayla: Like, what does ketamine do for us in our couples work? Is it worth it? Um, anecdotally my experience is the same as Chandra, is that we just see change happen so much more quickly, uh, which is a beautiful thing for couples who have been struggling and suffering for a long time. Additionally, I think that there are at least some cases that I’ve seen where I don’t think that couples would’ve been able to make the shifts in their relationship.

Kayla: Mm-hmm. Or in their perspective of their relationship without a psychedelic experience. I think they, couples therapy doesn’t work all the time for every couple. Right. Sometimes people are too stuck and and are unable to get out of their own [00:37:00] way in order to do the work that they wanna do. And I think there are certainly some cases where they can get there with ketamine or other psychedelics where they otherwise wouldn’t.

Chandra: I think another question is like, are there differences between couples who are seeking ketamine assisted couple therapy compared to couples that are seeking traditional couple therapy? So of course our clinical experience is with couples who are coming to us saying that that’s the treatment that they are interested in, or they start couple therapy and then.

Chandra: They say that they are interested in trying ketamine. Um, so there hasn’t, there hasn’t been like any randomized controlled trial.

Speaker: Right. So I mean, you’re getting probably a pretty open group of folks coming in. Right. It’s like they probably don’t research open, are desperate or desperate

Chandra: and open.

Speaker: Yeah. Um, what about challenges that you’ve kind of bumped up against in this work?

Kayla: I mean, um. It’s expensive. Yeah. That’s a challenge [00:38:00] for clients, right? Like I think, well couple therapy is so rarely covered by insurance. Anyway. That’s been a real source of frustration I think for a lot of folks and, and for us in our practice is that insurance companies don’t value relationships and they don’t value couples therapy.

Kayla: And the only way that some couples therapists are able to bill for it sometimes is by saying, oh, it’s a depression treatment, you know, or whatever, which is frustrating. So I think accessibility is a real challenge. Um, you know, ketamine sessions are not covered by most major insurance companies and can be quite expensive for people to access.

Kayla: So that is a challenge that we would like to, to really figure out a way to, to work around. Um, and, you know. Ketamine’s a prescription medication too. So sometimes people who are interested in doing ketamine therapy are not eligible for some sort of medical contraindication. Um, and that can be frustrating for folks, although ketamine is so much easier to work with than some of the other psychedelics that we have worked with in the context of research studies, like NDMA, um, ketamine has way fewer medical [00:39:00] contraindications than NDMA, which is lovely

Speaker: and kind of nice too, that it’s a lot shorter.

Kayla: Yes, shorter duration.

Chandra: Yeah. And Kayla and I really care about increasing access and so we will work with couples, um, to figure out like how can we potentially do self-guided sessions. The real cost is kind of the three hours in clinic. And because ketamine. Is such a inward focused journey. If you’re doing a psychedelic dose, the couple can be set up really well with preparation and they can do their medicine session at home, and then we can meet for integration either later that day or the following day.

Chandra: Journey Clinical covers the ME eval. Typically it’s in, it’s covered by insurance. And so if couples are interested in this, there’s probably lots of different, um, flexible options. You can talk with your providers [00:40:00] about to increase accessibility.

Speaker: How do you guys feel about at home use?

Chandra: I think if it’s set up like so we provide our couples with what they’re gonna listen to.

Chandra: We talk through how they’re setting up the environment. We meet with them before and we meet with them after. And so if they have the right. Environment and it’s safe and quiet and kind of contained. We know what they’re listening to. It is, it’s great. It’s been great.

Kayla: Yeah. And also, you know, working with responsible prescribers, right?

Kayla: Like I feel quite strongly that like I’m comfortable with prescribing a few doses of sublingual lozenges for at home use. It’s pretty difficult for that to become a drug of abuse for people just because of like the way that you have to consume it and, and all of that. There have been a lot of really high publicity news stories of folks who have been prescribed vials of injectable ketamine for at-home use, and that’s been quite dangerous.

Kayla: So I’m not a fan [00:41:00] of that. Um, so I think like responsible prescribing practices are so important and then having a. Some kind of structure and support is also really important to scaffold at home use. We created, um, a couple’s preparation and integration guide for couples to use for ketamine journeys that are not gonna be working with a therapist ’cause maybe therapy isn’t accessible or something like that.

Kayla: Because we still wanted to have folks who are gonna do these experiences on their own to have all of the information about how to set themselves up for success. So, um, I think ketamine absolutely can be used safely for at-home dosing, but it does require some attention to sort of the safety and best practices.

Chandra: And what Kayla is talking about, that’s on our website. Anyone can go there and get it. It’s a PDF and it walks through preparation, how to set up the space, what questions to ask your partner to identify relational intentions, um, goes through different dosing models, and then integration, also kinda what questions to ask after to make meaning and how to continue [00:42:00] integrating so anyone can get that.

Speaker: I kinda love that model of like, yeah, working with like couples or partners like that. ’cause it’s like, yeah, you could do like this sitter journey or pair with them and like they are in a safe environment. Like Yeah. To your point about like, you know, ethical prescribing and dosing, you know, it’s like,

Chandra: yeah.

Kyle Buller: I think for some folks like at home makes it way more accessible if they’re like trained and have experience and they can do it safely. Like it can sometimes be lifesaving in, in a way. Absolutely. Um, versus like, yeah, I mean I had a client, his. It was so much, you know, and getting prescribed like doses was really high.

Kyle Buller: And then like having like ample amount of it too, and I was like, what is going on here?

Kayla: Yeah. Yeah. Which is just not in the best interest of the patient, right? Like, first of all, I, yeah, ketamine is a little bit difficult to dose, uh, precisely because people’s absorption rates are different and the subjective experience of it can be really different.

Kayla: But we know from the research that if you take too [00:43:00] much ketamine, we, we stop having mental health benefit and it starts becoming an anesthetic, right? And like that is actually not helpful for people. So more is not more when it comes to ketamine.

Speaker: Right. And then also like, I guess like method too. Are they spitting it out?

Speaker: Are they swallowing it? Right? Are they getting like that more prolonged experience? Um,

Kayla: yeah.

Speaker: Yeah. Have you guys thought about like, you know, just thinking about like accessibility too, like group work with, uh, couples too. I don’t know if you guys do that already or,

Chandra: yeah, we love groups. Um, it’s been challenging to get like a group of people consistently who can make the same time, who comes.

Chandra: So there’s like more logistical challenges with groups. But we have, I mean, we’re both trained in the va and the VA has lots of groups and there’s so much benefit to learning from other people’s experiences and feeling connected. You’re not alone. Um, practicing skills [00:44:00] together like. We love groups and we would love to run groups.

Chandra: Mm-hmm. Um, we developed an acceptance and commitment therapy protocol for individuals that is kind of focused on relationship challenges. It’s been easier to get individuals in a group still kind of working on relationship skills. I think it’s easier to get couples to like a retreat, so mm-hmm.

Speaker: Yeah.

Chandra: Like a weekend rather than something that’s weekly ongoing. But

Speaker: that’s what I was kind of thinking, like retreats format. Yeah. Yeah.

Kayla: I attended a couples ketamine retreat actually in upstate New York with, um, it’s, uh, oh, I forget their branding. It’s Jane Gum’s group. Oh, yeah. In upstate New York. Yeah, yeah, yeah.

Speaker: Like with so

Kayla: ketamine. Exactly. Um, and it’s, it was a phenomenal experience. I attended with my, my partner at the time, and it was just like a beautiful. Um, group of couples altogether supporting one another. Our experience is that people often think they don’t want [00:45:00] groups ’cause they’re like, oh, it’s private.

Kayla: I, I don’t wanna share with other people. I don’t know that I want a group. And if anybody listening to this is thinking this, I promise you, like doing a group therapy experience will be one of the most profoundly beneficial and positive experiences of your life. People. Love groups once they get into them, they think they don’t want them, but they love them.

Kayla: And so I think we’re, we’re really trying to figure out a way where we can facilitate more group couples experience, not only to make it more accessible, but also because there’s magic that happens when you’re together with a group of other people who are all sharing the space and working on the same thing together.

Speaker: I was one of those people thought I would, I hated groups when I first started. Right. Any sort of group work and Yeah. Now I love it because, you know, it’s like, you know, just being able to connect with others and, um, yeah, we’re social beings, right? Like we can’t do this work in isolation all the time.

Speaker: Like, we need to have connection and, um, as one of my teachers say, we’re the descendants of successful tribes, you know? Mm-hmm. Like the ones that. Went off on their own, [00:46:00] usually didn’t make it. But it also, I think, hits some of our most primal fears. Like, what happens if RU projects me? Right? Or if I don’t fit into the group?

Speaker: Like, that’s terrifying. Um, and so I think maybe that’s what keeps people out at times.

Kayla: It absolutely does. And I, I will often tell people, like, I can summarize my job as basically helping people do the thing they don’t wanna do. Right. Like the thing that you’re scared of, you should probably be doing that thing.

Kayla: Um, in this case, like being vulnerable with other people. Of course. That’s scary. That is an evolutionarily reinforced fear, right? Of being rejected by your social group. And the more you can lean into that and realize, oh wow, I can let people see me and I will be okay and I will be loved, and actually some people might not wanna be with me, but other people will.

Kayla: And that’s okay too. Like those are incredibly powerful healing experiences. So the fear is pointing you at something that matters.

Speaker: Yeah. I know this is, might be kind of like individually based, but you know, you’re talking a lot about like vulnerability and like [00:47:00] communication and I wonder what type of, if somebody is like really struggling with that, like how do we foster vulnerability and like open communication.

Speaker: Mm-hmm.

Chandra: Really, really slow down.

Speaker: Mm-hmm.

Chandra: I think that a lot of therapists, um, also feel kind of discomfort with quiet or space and really slowing down. I’m, I’m working with a couple right now that came to me from another couple’s therapist. Um, and that was exactly, the woman had a lot of difficulty dropping into vulnerability just because, so first there has to be space for it.

Speaker: Yeah.

Chandra: And then we can kind of do small shares first. Right. Exposure. So we can share something if we’re thinking about, you know, vulnerability, we can share something that is kind of just below the surface and get deeper and deeper. And we get deeper when our vulnerability [00:48:00] is met with supportive responsiveness.

Chandra: And that’s often something that has to be taught to couples, right? So I am only going to make myself as vulnerable as the person who I’m talking with can create a safe space for me. And so we do that over time together in couple therapy, and then the couple learns it and they can do that on their own.

Kayla: Mm-hmm. I would also say, like, I think a lot of times people think that they’re being vulnerable and they’re not. We can be so guarded that even sometimes we, we don’t even realize how guarded we’re being. Right? So like, if, if I go to my partner and I say, you know, I just wanna tell you how I’m feeling. I wanna be vulnerable.

Kayla: And what I’m feeling is really annoyed that you didn’t pick your socks up off the floor. That’s not actually a vulnerable share. And I’ve had couples tell me to my face, mm-hmm. I was vulnerable. I told them how much, what they were doing pissed me off. That’s not vulnerability, right? And so often it starts from within of really getting in tune with [00:49:00] yourself, um, to sort of like, look under the hood, right?

Kayla: Okay, you’re angry, you’re frustrated, you’re annoyed. What’s, what’s that about? What’s under the surface there? Can you peel that away and look underneath and find the hurt? Find the pain, find the shame. Find the fear that’s underneath. Some of those harsher, defended emotions, right. Look underneath the armor.

Kayla: What are the stories that come up for you, right? That sort of reinforce, um, why this is so painful for you? You know, this really reminds me of the time that, um, you know, I used to come home from school and no one was there to take care of me, and I felt abandoned. And so now the minute that my partner’s not where I expect them to be, then I panic, right?

Kayla: Okay, now we’re getting somewhere. Right. So it really does involve a lot of self knowledge too, and a lot of introspection that I think can also be really difficult for people.

Chandra: And I think the socks, like, it’s kind of a silly example, but it’s so common, right? Socks, dishes. And so for people who are listening often, um, the [00:50:00] vulnerability that is connected to that is like, I am alone in the relationship or the work that I do isn’t appreciated.

Chandra: And so going into that place, exactly what Kayla’s saying of kind of lifting up the hood and like, what does the sock represent? It represents that. I have to take care of things on my own and I’m alone. Mm-hmm.

Speaker: And what I’m hearing is like in that example, it’s like one part, that first example you gave, it’s almost like placing blame in a way.

Speaker: It’s like, I’m annoyed and maybe not going deeper. And it’s like, well, why? Why am I annoyed, right? Mm-hmm. Like, why am I feeling this way? Oh, okay. There’s actually some deeper stuff there. That’s right. Yeah.

Kayla: Yeah.

Chandra: It’s teaching people how to access and communicate their emotions, but then also teaching the partner how to create a space where it’s safe to share.

Kayla: Yeah, totally.

Speaker: Yeah. Right. ’cause then there could be that like fear of like, what if this isn’t accepted? What if it creates more low back? And now we’re like in a, another fight with something. [00:51:00] Instead of

Chandra: trying to hold that space, I could say, this makes me feel lonely and like, you don’t care about the home.

Chandra: And my partner could say, that’s stupid. I do care.

Speaker: Yeah.

Kayla: Yeah. That’s really painful. Yeah. There is no vulnerability without some risk, right? Mm-hmm. And there is no intimacy without kind of taking that risk too. That is what makes relationships so special and so beautiful. And so, you know, a lot of this is.

Kayla: One discernment, right? Get vulnerable with people who are safe to be vulnerable with, right. Who you can trust with your vulnerability. And two, is sort of an inner fortitude, knowing that I am strong enough, I am valuable, and I am worthwhile. Even if I don’t get a sensitive response, even if I don’t get an empathic response from my partner, that actually doesn’t mean that I’m not worthwhile, right?

Kayla: So I think it’s, it’s both of those at the same time that we work with people on.

Kyle Buller: Yeah. Chandra, you were, uh, mentioning something about silence. And silence I think is really hard [00:52:00] for people. Like what makes silence special? Like how, like when can it be therapeutic versus like just being lost in the void and feeling really awkward?

Chandra: Yeah. Um, I mean, silence creates space, right? And that doesn’t have to be. With a couple or in a therapy session, it can be those things. It can also be alone, right? So constantly throughout our lives, we’re listening to music, we’re doing something we have the news on, like we don’t actually give ourselves much space for silence.

Chandra: And silence is the space where we can learn about ourselves or learn about the person that is in front of us, because when we’re silent, then we can experience our emotions, we can experience our thoughts. And all of those things are communication, right? So people are often very afraid [00:53:00] of their emotions.

Chandra: They think that if they feel angry, they’re gonna destroy everything. If they feel sad, they’re gonna fall into a bottomless pit and never find their way out. And sitting in silence allows you to feel those emotions and. Have that communication and then make a decision moving forward both with yourself or with the person that’s in front of you.

Chandra: And so with therapists, like it’s so important to allow that silence so that couples and individuals can step forward and share and have their own learning.

Kayla: Mm-hmm. Silence is ye yes to everything Chandra just said. And I think in and of itself, silence is also uncomfortable.

Speaker: Mm-hmm.

Kayla: And so helping people get used to holding themselves even in discomfort is really important, right?

Kayla: I think like we live a lot of our lives trying to avoid discomfort, but discomfort is actually your friend. Discomfort is, um, important. And so when we [00:54:00] stop trying to avoid every moment of discomfort, then we have a lot more freedom and a lot more capacity in our lives. So sitting in silence is good practice with that too, right?

Kayla: Like, if this is uncomfortable for me, what is it like to be uncomfortable and to just stay there and not try to resolve it?

Speaker: We will use some silence here. Yeah, no, I think it, it’s so good. Like I’ve been, uh, telling my clients I like to use silence more because there is that time where it’s like people share things and sometimes we expect a response right away.

Speaker: Um, versus like, sometimes people need that space and do a little bit deeper processing, and it’s like if we just respond right away, then it’s like, yeah, we’re, we’re maybe guiding things in a different way versus like. People kinda need to let that like dust settle after, especially after a big vulnerable share where they’re like, should

Kayla: Yes.

Speaker: Really shared that. Like how do I, you know, and then let, let people sit with it a bit.

Kayla: Yeah. In our, we were, we were trained by maps, um, for MDMA assisted therapy, and as [00:55:00] part of the consultation that we got in, in, um, so we were, you know, using that in the context of a research study that we were on. And so our tapes would be reviewed and we’d receive consultation and a big piece of feedback, you know, always with anybody learning to do psychedelic work is say less, do less, leave more silence, leave more room for the client.

Kayla: And I think by the, by the end of this trial, we were really leaning into that and I had so many experiences of leaving a session and being like, oh my gosh, I’m so glad I shut up because when I stopped talking. And left space for the client. They did something incredible. They did something profound in the room that I left for them when I got out of their way.

Kayla: And so, yeah, I think trusting the person that we’re with that, like in the silence, something incredible can emerge from you. I don’t need to, I don’t need to be directing that. I’m just gonna get in your way.

Kyle Buller: Has that challenged your traditional training [00:56:00] as a psychologist?

Chandra: I don’t. I, so I learned, I really liked teaching new therapists that acronym wait, which I forget where it comes from, but it’s not mine.

Speaker: I always think it’s Dick Shorts, but it could have come from so many different people.

Chandra: Yeah, so, so weight stands for why am I talking? And I think that applies to. All therapy, no matter what you’re doing.

Chandra: And it’s something that we teach in our training. It’s like the words that you use should have a purpose, right? You should know what you’re saying and why you’re saying it. And you know, that goes back to our assessment and the mechanisms of change. And if you’re saying something and you don’t know why the hell you’re saying it, like don’t say it.

Kayla: Mm-hmm. Yeah, I, I, I think that it has definitely complimented and strengthened my traditional [00:57:00] therapy, um, kind of training, um, and skills and has made me feel more confident and more comfortable in doing exactly what Shandra said. ’cause we do get trained to shut up and get out of the client’s way. And yet it can feel hard to do when you have a 60 minute session and you’re like, we gotta get stuff done and I’m on a protocol.

Kayla: You know? So I think that it has given a lot of permission and a lot of confidence in just being like, I’m just gonna like take some breaths and we’re gonna sit here and be here together and see what emerges.

Speaker: Yeah, that makes sense. Yeah, because I know sometimes people feel like they always need to be like talking or directing instead of like this more non-directive approach where you just like sit back and like maybe let things unfold in a way.

Speaker: Mm-hmm. Um, and yeah, I think sometimes that can be challenging for, for some people to like maybe unlearn that very directive approach and be like, okay, maybe I can take a non-directive approach in this situation versus always being very directive. And it’s a balance, right? They’re both important.

Chandra: And that’s, I mean, again, like harping [00:58:00] on conceptualization, like that’s why that is so important because if you have a good conceptualization and you have a map, a treatment plan, ultimately, like we want clients to.

Chandra: Get to that shared vision through their experience and their insights. And you can hold that and you can be directive, but you’re not talking all the time, right? They’re, they’re doing that work that you’ve mapped out together, that you’re working toward, and you can support that work without taking up the whole session.

Kayla: Yeah, we could monologue about this for a while, Kyle. We have strong opinions about this, but yes. I, something, another show. Yeah. Something very powerful happens when you as the therapist are very clear on what approach you’re using and what mechanisms of change you’re trying to support. Right? And you have [00:59:00] that very clearly and you’ve collaborated with your client on that, and then you back up and allow it to happen rather than trying to micromanage every moment.

Kayla: Um, I think that there’s a misconception about what non-directive means among a lot of folks. It doesn’t mean we’re not doing anything in the session. When we were first trained, we, we trained with, with Michael and Annie mid Hofer and got to watch a lot of their tape. And, um, I was watching them going, oh, they’re not doing nothing.

Kayla: They’re doing internal family systems. That’s what they’re doing. That’s what they’re trained in. They’re doing IFS, but they’re not showing up to session being like. Okay, client, I will now do IFS at you. Right. What they’re doing is they’re holding that frame of allowing different parts of people to emerge.

Kayla: Right? And that’s what they’re supporting and creating. And so that’s, that’s sort of the approach that we take to our work, right? Is that we build a space, right, for the, the kinds of healing experiences to emerge that we know need to emerge on the basis of our case formulation and, and the theory of change that’s in our psychotherapy, and [01:00:00] then we let that happen.

Chandra: And a really cool thing about psychedelics. Another really cool thing is that like psychedelics, kind of like the, like inner healer. I was like, I don’t know if I buy this, but like the inner healer actually like, kind of does evidence-based treatment. Like I remember when I started learning acceptance and commitment therapy as like a fresh PhD student, and I was like.

Chandra: I already know this, like psychedelics taught me acceptance and mindfulness and like cognitive diffusion. Like I’ve been in this place, I’ve felt all of these things before. And so like of course it’s a treatment because of course that’s what leads to openness and engagement and a meaningful life, and identifying your values.

Chandra: So as we’re watching these tapes in our training, like patients are naturally doing this, and if we [01:01:00] have the conceptualization in our mind and we know evidence-based treatment, then we can support it because we know the mechanisms of change and they’re happening in front of us naturally.

Speaker: When you said like that inner healing intelligence, maybe like a little skeptical, has that changed for you?

Speaker: How do you approach that? Because it is like kind of, I hate to use that term like woo woo, but like sometimes people feel that way and they’re really turned off by like that term. Yeah. So like how do you approach that as clinicians?

Chandra: I think that everyone’s inner healer is a little different, and I think sometimes your inner healer works really well and sometimes, like, I remember Kayla and I were sitting in the session in our training together and I’m like, what if sometimes the inner healer is a little broken?

Chandra: And like, I think sometimes people feel that way is like, I’m not having the outcome that I’m looking for. I’m not reaching the places that I’m supposed to get to. And that experience is [01:02:00] okay too. And that’s why you’re doing this work with a therapist. You’re not doing it on your own, and so you’re not alone in it.

Chandra: And your inner healer has a buddy.

Kayla: Mm-hmm. I, I. There’s a big part of me that tends to think that at the end of the day, all psychotherapy is the same thing, and we just call it different names. I think the Inner Healing Intelligence is a different name for something that, you know, we, um, different concepts that we are very familiar with.

Kayla: Right. Which is like a sense of intuition and a sense of your own values and a sense of your own sort of deep needs. And if we can get out of our own way, you know, we can know ourselves and support ourselves. And I’m, I’m down with that, right? I think at the end of the day, what we’re trying to do is to help people let go of the psychological defenses that are keeping them stuck and welcome experiences, good and bad, that are gonna let them live a meaningful life that’s.

Kayla: Name the psychotherapy where that’s not the [01:03:00] goal, right? Like that’s always what we’re trying to help people do. Um, and so we might label it different things. I don’t mind that I, you know, I think we can call it whatever. And I think it, especially in psychedelic work, it’s so important to leave room for whatever, meaning people wanna construct of it.

Kayla: Right. Is the psychedelic experience literally true? Is it a metaphor? Is it its own thing that you then get to make meaning of what? Like, it’s not important to me that we all agree on what that is. I think it’s okay that we all make our own meaning at the end of the day, we’re kind of all on the same path.

Kyle Buller: Yeah. Beautiful. John, when you were saying like, maybe the inner healer’s like broken, um, you know, something that I kind of think about is. Especially with trauma like that lack of like when we get our agency taken away, like something has happened against our will and then there’s like that lack of trust in our own self.

Kyle Buller: Um, and I feel like a lot of that work is like helping people to like reclaim their agency and trusting whatever that is, their inner voice. But it’s really hard to [01:04:00] do. When I remember I had a client say like, how do I trust things when like the universe is just constantly shit on me. Yeah. Yeah. It’s scary to trust, right?

Speaker: It’s scary to listen to yourself, um, if like bad things just keep happening over and over again.

Chandra: Yeah. Yeah. It is really scary. Um, and, you know, trust is so, I mean that’s something that we see with trauma is like, it becomes this blanket. I can’t trust anything. Nothing safe. Yeah. And trust is like so nuanced, right?

Chandra: I can trust my. Friend to take out the trash. When I ask her to take out the trash, I can trust someone with my finances. I can trust someone with my kids. I can, right. Like once we start breaking it down, people can see that, oh, I can trust myself to show up to work on time, or I can trust myself to listen to my friend when they need me.

Chandra: And so the work of building that is, um, [01:05:00] bit by bit over time and that feeling is so common and I like totally okay. Starting from that place of, it’s too scary to trust anything right now.

Kyle Buller: Yeah. Yeah. It takes time. It takes time to, to rebuild that. So,

Chandra: and anything that’s broken can be put back together. I think that visual, I don’t remember if they showed in the MDMA, um, training or like somewhere else, but.

Chandra: Or like what that process is, but the process of, um, like when bowls are broken, fusing them back together with gold and creates like this really beautiful, um, new piece. I think just reminding people that Right, everything’s a process and we’re gonna get to some outcome that we’re looking for together.

Chandra: And it doesn’t have to be today and it can take time.

Kayla: Yeah. Kintsugi is what that’s called. It’s called Kintsugi. I love that. Yeah. And, uh, that was [01:06:00] the Burning Man temple. This, this past year was, uh, supposed to be a Kintsugi. Yeah.

Kyle Buller: Oh, nice. Are you guys both burners.

Chandra: Yes.

Kayla: Chandra’s an old burner. I’m a new burner.

Kayla: Yes. But yes, we’re both burners. Nice.

Kyle Buller: Nice. I still haven’t been it.

Chandra: Kayla, Kayla’s a burner from the day she was born.

Kayla: I,

Chandra: she’s like, I dunno if I’m gonna be able to do this. And then we got out there and I’m like, you are the, it was my 13th burn. I’m like, you are the best burner.

Kayla: I’m a new burner in this life.

Kayla: I must have been a desert rat in a past life though.

Chandra: Yeah. I have not. And she has everything I could ever need. I’m like, I don’t know how I survived out here for over a decade without you. Like, everything I need is in that bag,

Kayla: Kyle. You gotta go. I, that’s, it’s an experience. It’s, I think it’s so much more than, I’m sure everybody says this, that’s so much more than you can possibly describe in words, but the experience of humanity at its very, very best I think is the experience you get at Burning Man.

Speaker: Yeah, yeah, yeah. One day I’ll make it out there. Have you guys, uh, come across Joe’s art car out there at any point?

Chandra: What is his art car?

Speaker: Big [01:07:00] crab. Um, it’s like a big red crab. The crab car.

Kayla: I dunno that I’ve seen the big red crab car.

Speaker: Yeah, you’ll have to chat with them about it then at some point. Yeah. All right.

Kyle Buller: Well, I see that we’re getting at time. So you guys have a training coming up at the end of the month and I would love to hear it and yeah. Let some of the listeners and audience know about what you guys are up to.

Kayla: Mm-hmm. We are offering our second training for Ketamine assisted couple therapy. We offered our first, last fall in person in San Diego, and it was so fun to be with people in person.

Kayla: This time we’re offering it online so that it’s more accessible to folks. It’s Saturday and Sunday, February 28th, March 1st, starting at, what did we decide about eight or eight 30 in the morning Pacific time. Um, so ought to be reasonably accessible in most time zones. Um, so yeah, folks can register from, from anywhere in the world if you wanna join on those two days.

Kayla: And we, it’s a really comprehensive didactic training. It’s 14 [01:08:00] continuing education credits for mental health professionals, and it covers the assessment that we’ve been talking about. It covers different models of dosing, ketamine with couples. It covers integration. Um, it covers, you know, everything that you need to know from start to finish, um, to start feeling really confident in working with couples, doing ketamine work.

Kayla: And it’s the first step on kind of a more comprehensive support structure that we’re building for

Chandra: therapist. And, um, doing that training also gives you access to weekly consultation, weekly group consultation, um, with us for three months. Kayla, is it three?

Kayla: Sure. I can’t remember.

Chandra: It’s on the website. Um, so that’s also an amazing deal.

Chandra: If you are starting to work with couples and you’re feeling a little bit like you don’t know exactly what to do, you do the training, you get all the information, you’re not alone. After that, you can come to weekly consultation and ask questions. [01:09:00] And we also will have upcoming experientials after that.

Chandra: So you’re very well kind of taken care of in that. And yeah, we’ll be supportive.

Kyle Buller: Sweet. And does anybody that’s joining need to have any sort of training in couples therapy or can they come not knowing too much about it?

Chandra: So we expect you to have some training in couple therapy just because of kind all of what we talked about with you today.

Chandra: People should at least be coming in with some model and kind of know why their treatment works. We did have some people join the in-person who, um, had like come with their partners to San Diego and then learned about what we were doing and asked if they could come and they actually like participated and had great questions.

Chandra: So if you are worried that your training maybe isn’t enough. Email us and [01:10:00] we can either connect you with something in the next month, a webinar, that would be enough, or we can talk about whatever training you do have and if that is enough to be able to participate in this.

Kayla: Yeah, you don’t need to be extensively experienced in working with couples.

Kayla: Didactic training is fine and in fact, like a one or two hour webinar is probably sufficient. Um, we just want it to not be all brand new because we’re not providing a solid foundation. Um, in, in couple therapy we’re expecting that, you know, a little bit. Same with Ketamine work. We’re expecting that folks know some of the main principles of working with ketamine.

Kayla: Um, and if not, then we can direct you towards some, some great webinars on that.

Kyle Buller: Wonderful. Well thank you for doing that work. Um, it’s really exciting that you guys are out here doing it. ’cause Yeah, it seems like it’s not a big focus in the psychedelic world. I think it’s so important, um, to, to be offering this and I hope more research happens.

Kyle Buller: Um, so yeah,

Kayla: me too.

Kyle Buller Anybody wants to help fund research, push you in your direction? Um,

Kayla: yes, please.

Speaker: I would love, I would love more research in, in

Kayla: this

Speaker: area.

Kayla: It’s a [01:11:00] tax write off. We have a nonprofit come write us a big check and, and really help move this, this research forward.

Chandra: And so many people, I think that I, I do think that a big issue is that people don’t know that there are people who can do this research because there are so many couples all around the world whose relationships have been changed dramatically by psychedelics.

Chandra: And so I think as pe more people know that we’re doing this and like we are trained as academic researchers. We can definitely kinda get this done. Then there will be more opportunity for people to donate.

Kyle Buller: Yes. Wonderful. Anything you guys wanna close with for today? Any closing thoughts?

Kayla: Thanks so

Chandra: much for, it’s really fun to talk with you.

Kayla: Yeah, thanks for having us on and for, for everybody listening and, and we hope that this inspires people to care about, um, psychedelics for relational work. This is like our life’s passion, so we’re really excited to get to [01:12:00] talk about it and share it with y’all.

Chandra: And we’re happy to talk with anyone who has questions.

Chandra: So you can email either of us. It’s chandra@enamarie.org or kayla@enamarie.org. We’re responsive. Um, reach out to us. We love to talk with people.

Speaker: Awesome. Well, thank you both for joining today. It was a really fun conversation and thank you everybody for tuning in and listening. So we’ll catch you next time.