Rapid Depression Remission and the “Therapeutic Bends” with Ketamine-Assisted Psychotherapy

Dr. Jessica Katzman at Healing Realms

For the first time in nearly three decades, novel classes of medication are being offered to those suffering from chronic refractory mental health conditions. Studies have shown that 60% to 70% of people with treatment-resistant depression respond positively to ketamine, and some encouraging results are being found with OCD, PTSD, and alcohol dependence

Though this discovery has been hailed as a massive boon to those living with persistent mental health concerns, their loved ones, and clinicians alike, it may also behoove us to explore the potential unintended consequence of these effective, fast-acting antidepressants.

Many welcome rapid recovery with relief and gratitude in being able to return to their lives; however, in our work with Ketamine-Assisted Psychotherapy, we have noticed that a small percentage of clients also experience a period of disequilibrium and difficulty in adjusting to these changes.

These reactions can range from over-reliance on older coping styles that no longer match one’s current state, to the distress that comes from the loss of a habituated identity (“I don’t even know who I am anymore, without my old buddy, Depression”).

I have come to refer to this response metaphorically as “the therapeutic bends,” as a way to suggest the effects that can occur when we ascend rapidly from great depths.

In two decades of clinical work, I have seen a variety of ambivalent-to-negative reactions to the prospect of “getting better.” Psychotherapy generally offers recovery as a gradual process, with adequate time to adjust and be supported; the “instant cure” has been seen as both unattainable and potentially illusory. The advent of these new treatments requires a shift in how we guide people through this work.

I would like to discuss here some possible layers where distress can occur, and interventions for both clients and providers to consider at each level.

Confronting Reality: Cognitive-Behavioral Layer

Ketamine infusion pioneer and psychiatrist Dr. Steven Levine has been noting this reaction for some time; in a recent blog post, he encourages providers to set expectations with clients that “even good change is stressful (marriages, moving homes, new jobs, and the birth of children are some of life’s most stressful events).”

More dramatically, he describes a process in which one emerges from a depressive episode, then becomes overwhelmed by the herculean tasks ahead:

[W]hen one looks around, one sees with new eyes the surrounding devastation and the casualties from an incapacity to do anything about the growing problems…[this] is akin to a poorly prepared survivor of a nuclear apocalypse stepping out of his bunker into a lonely world of destruction.

Dr. Raquel Bennett, a psychologist and founder of the KRIYA Institute, has also been observing the effects of therapeutic ketamine on one’s sense of self for many years. She echos Dr. Levine’s observations that:

Resistance can come up for some people; they get a little better, and then can get scared, sometimes retreating back into a remission, which is actually more psychological than chemical… People wake up and realize how much time was lost to their illness, how much money was spent, how many relationships ruined, how many opportunities missed… We need to think about how painful it is to just be with that, what this condition has done to one’s life (personal communication, August 12th, 2018).

Additionally, those accustomed to very brief respites from symptoms may have a habitual tendency to throw themselves headlong into intense task completion mode the moment remission begins, in an effort to “get everything that piled up done before the storm hits again.”

FOR PROVIDERS: Dr. Levine writes that “even a ‘magic bullet’ leaves a wound that requires a period of recovery,” and that key components to this recovery are social support and ongoing therapy. Therapy should, in part, focus on “teaching new skills to challenge and combat depressive thoughts, and working towards achieving successes that help rebuild self-esteem.“

Similarly, Dr. Wesley Ryan states that he frames ketamine treatment as something that can provide a catalyst for change, transiently lifting depression, and allowing people to more easily engage in other activities that will protect against relapse. He encourages “regular exercise, healthy eating, socialization, behavioral activation, structure/volunteering/work, work/life balance, addressing activities or relationships that clash with personal values (such as work, for some people), potentially setting better boundaries” (personal communication, August 13, 2018).

Providers may want to focus here on slowing the work down so as to not trigger overwhelm, cognitively reframing approaches to task completion, and teaching new ways to manage the demands of life. Psychotherapists may also invite expressions of regret and grief around the sense of lost opportunities as a way to work through these feelings effectively.

FOR CLIENTS: As stated above, it is important to not overwhelm yourself at this stage. Trust that you will have the opportunity to make repairs and address life tasks over time, and please access as much support as possible to assist you in this undertaking. This is an excellent time to begin practicing new self-care habits that will ensure longer-term change.

Additionally, you may benefit from making space in your life to acknowledge and feel any difficult emotions you may have around what has happened and talking to someone you trust who can listen without judgment. You may want assistance from a therapist, support group, or a good self-help guide in shifting how you think about yourself and your life.

Readjusting Roles: Interpersonal Layer

Dr. Bennett notes that often people’s intimate relationships become organized around the care-giving other people provide, and that “as soon as they start to improve, expectations and the relationship dynamics start to change.”  

In family therapy perspectives, the “identified patient” (also “symptom bearer” or “scapegoat”) is a member of a dysfunctional system that has been unconsciously selected to express the distress of that system. Other members may profess concern for the identified patient, but may also react instinctively (and unintentionally) to any improvement by working to reinstate the status quo.

What once seemed like an entirely biochemical illness can often be revealed as multiply determined when we notice loved ones’ discomfort with their ward slipping out of “sick role.” I have often felt concern in watching someone achieve remission, and then return to the same stressful environment in which the initial problems flourished.

In less pathologizing terms, let us remember that there is a social expectation in the continuity of the self over time. People around us have adapted to how we typically act and express ourselves, and react with surprise when that shifts. Those reactions may subtly encourage us to return to our previous baseline. This is rarely intentional, but is extremely important to recognize.

FOR PROVIDERS: Potential interventions to navigate through this period might include family therapy, couples therapy, or psychoeducation on the nature of family systems or group dynamics. We can assist clients in setting appropriate boundaries, and support them in having difficult conversations.

FOR CLIENTS: If this is something you would like to address in your life, please talk to your providers about your specific situation and best practice interventions. It may be helpful to talk through how your relationships might change if your mood improves, or any fears of what might be expected of you if your condition shifts. In general, reading about and practicing Nonviolent Communication is a good way to improve relationships with the people around you.

Exploring Identity: Personal Layer

Much like our intimate others, we also have an expectation in the continuity of the self. When one has lived with a longer-term condition, there are ways in which it can get woven into one’s own identity.  We become habituated to our capacities for activity and relating, and depend on our ability to predict how we might think and feel in any given situation.

It can be incredibly disorienting when a cluster of your regular experiences disappears overnight, and can foster a sense of not knowing yourself at all anymore. (This may be partly responsible for the “rubber band effect”–the tendency to return to our usual modes of being–that Dr. Phil Wolfson discusses in The Ketamine Papers.)

Participation in online forums and support groups can provide invaluable insight and camaraderie; as helpful as this can be, it may also reify one’s social role as a fellow sufferer. We come to define ourselves as a depressed person, as someone struggling with fibromyalgia, as a recipient of Social Security or disability benefits.

(Perhaps this is not such a novel occurrence, after all, as a similar phenomenon emerged with the advent of SSRIs. Peter Kramer noted in his 1997 book Listening to Prozac how his perspective on the nature of temperament was altered by witnessing responses to medication: “I was used to seeing patients’ personalities change slowly, through painfully acquired insight and hard practice in the world. But recently I had seen personalities altered almost instantly, by medication.” He reported similar disorientation and adjustment periods.)

FOR PROVIDERS: Just as we would allow space for someone to discover new aspects of the self during a coming-out process, recognize that the remission period is also a fruitful period for exploration. Identity-making is an ongoing conversation throughout the lifespan. Acknowledge that with every new gain made, there are losses, and parts of our selves and lives that we are saying goodbye to. Inquire about the feelings that might arise during this phase.

In our practice, we draw upon Internal Family Systems (IFS) techniques to help people have productive dialogues with different parts of their psyche, and discover (without judgment) what attachment to a depressed identity might mean for them.

FOR CLIENTS: This is a time to look deeper at the beliefs you hold about yourself, and question their accuracy. You may consider getting reflections from someone who can listen neutrally and without agendas for your direction. A great self-help resource for IFS-style work is Jay Earley’s Self-Therapy.

If you are concerned about returning to the workforce, many communities offer peer and professional support for those returning to work after a period of unemployment. This type of support should encourage autonomy, allow exploration of ability and identity, and avoid perpetuating disempowering ideas about what those with mental health struggles are able to contribute.

Sign up today for our free introductory course!

Letting it Out: Emotional Layer

Classic psychoanalytic conceptualizations regarding depression as “anger turned inward” can help frame the irritability or distress that may surface unexpectedly when symptoms remit.

We have supported clients who, once they were relieved of depressive burdens, were then able to confront and feel appropriate anger stemming from past trauma, abandonment, or loss.

This can be an incredibly healing process if one is supported by providers who understand the emerging emotional responses in context, but can be difficult to navigate on one’s own.

Dr. Bennett has also observed anger and/or grief reactions, with people suddenly feeling “angry at God for making them sick, or at the situation, or all the doctors that didn’t help them previously…[W]hen this is buried or held down in the depression, and then starts to come up and out following treatment, people need therapeutic support to address that.”

Though we think about depression as “sadness” and recovery as “happiness,” the reality is often not as simple. Depression can present with a numbing or flattening of emotions, and recovery may mean regaining access to a wide range of different feeling-states. Learning to navigate these states is essential.

FOR PROVIDERS: Set expectations for all involved that recovery may involve unearthing unanticipated feelings and memories. Trauma-informed treatment is essential when working with some of these frozen states. Encourage safe expression of affect in session, and offer psychoeducation around appropriate assertiveness, boundary-setting, and anger management techniques. Teaching and practicing grounding exercises, such as the ones in the Seeking Safety protocol, can help people learn to re-regulate themselves when distressed.

Additionally, Dr. Bennett notes that some continue to have suicidal ideation, but a critical shift occurs in its source, moving from a ruminative, painful “voice in your head that tells you that you’re better off dead,” to a response of grief, loss, or anger. She emphasizes the critical importance of attuned listening by clinicians to differentiate these sources, rather than assuming that the treatment was unsuccessful.

FOR CLIENTS: If strong feelings are emerging during your treatment, please talk to your providers and request specific support for these states. If you are feeling suicidal, please reach out for help from your support network, call a hotline, or access urgent/emergency care. We recommend you do not navigate this process on your own.

If you would like to learn techniques to manage anger, you may find an Anger Management Workbook useful. Interpersonal process groups and assertiveness trainings may also be appropriate. We highly recommend the grounding techniques from the Seeking Safety protocol for those looking to manage the overwhelm that results from a history of trauma.

Digging Deeper: Unconscious Layer

Above all, we must make space for the deeply personal and idiosyncratic responses people have to both their symptoms and the remission of those symptoms.

We can not assume that this process has identical meaning for everyone we see. Honoring the uniqueness of the self and its adaptations to life’s challenges is part of what gives this work its beauty and depth.

Furthermore, meaning is held both consciously and unconsciously. Deep structures of the self are laid down early in life, in the interactions between temperament and environment, and are rarely available for immediate reflection. It is the work of ongoing inquiry in the therapeutic relationship to bring these templates into awareness.

For example, I have had the experience of working with people who were eventually able to articulate their depression as the only link remaining with a lost loved one; there is a way in which these symptoms served as tributes to the depth of their connection. Rapid removal of these mood states may then trigger responses of loss and abandonment.

Other clients have also formulated depressions as a coping tool itself: as a protective layer that prevents one from having to engage fully in life, an escape from having to make difficult choices, or an avoidance of confronting painful realities.

Another example is indicated by psychoanalyst Patrick Casement in On Learning from the Patient:

I have noticed, with a number of patients, that the experience of feeling better is sometimes treated by the patient as a signal for further anxiety. Some analysts might treat this as a fear of losing the “secondary gains from illness.” Others might regard it as “negative therapeutic reaction.” However, I believe there are some occasions when a patient is indicating that an unconscious link has been formed between an earlier experience of trauma and the prior sense of safety, as if that “safety” had been a warning signal for the pending disaster. Perhaps an unconscious set is formed in which feeling safe and the subsequent catastrophe are seen as forever linked (1992, p. 364).

FOR PROVIDERS: Although psychoanalytic and psychodynamic frameworks are fundamental to understanding the operation of these deep templates, dogmatic adherence to any one theoretical system forecloses the open exploration of individualized responses. Curious inquiry and a desire to hear about any potential meanings that may arise go much farther than the most brilliant textbook formulation. In essence: “what does this mean for YOU?”

It can be helpful to explore the relationship someone has with their depression, and how that relationship has changed over time. Narrative therapy ideas and practices can assist people in re-writing the stories of their lives into a more integrated personal mythology.

FOR CLIENTS: Part of recovery inherently involves an investigation into the myriad internal, interlocking factors that keep us stuck in old ways of being. Though your situation will be completely unique, you are in fine company with the rest of humanity, as we all struggle to move out of safety and towards growth.

If you sense that there have been ways in which depression has protected you from confronting difficult aspects of life, please make sure you begin to discuss this with your providers. Together, you may begin to re-author the tale of your history in a way that conveys respect for your resilience, as well as hope for the future.

Spiritual Crisis: Transpersonal Layer

We know that higher-dose journeys with ketamine can produce psychedelic, dissociative states, facilitating a profound transpersonal or mystical peak experience and expanding one’s sense of self and understanding of existence.

Dr. Bennett shares that for some, this “contact with the Divine” can be intense and overwhelming, especially if there has not been much preparation for this self-expansion, and if one has been “out of touch with God for 30 or 40 years.” She also notes that the changes one can be called to make in one’s life following a peak experience can be disorienting.

Psychic and spiritual content–especially following the use of psychedelics–can be mistaken for symptoms of psychosis in our highly secular culture. It is extremely important to differentiate between an illness process, and an enhanced sensitivity to transpersonal material. When held in a supportive context, these experiences can be extraordinarily meaningful to people.

FOR PROVIDERS: Have conversations during the preparation phase about your client’s existential concerns, spiritual encounters, and beliefs about the nature of reality or the universe. Familiarize yourself with the techniques and mindset necessary for supporting someone during a spiritual emergence or crisis process. Contemplate the differences between a dark night of the soul vs. depression. Work to bracket your own belief systems in order to allow for free expression.

FOR CLIENTS: Again, adequate preparation for working with ketamine, especially at higher doses, is essential. Please choose your guides wisely, and work closely with them to help you navigate these experiences.

If you are troubled by existential or spiritual concerns following a journey and could use a framework for integration, contact the Spiritual Emergence Network for more resources, including spiritual coaches and helpful reading material. You could work with a provider that specializes in psychedelic integration, or attend a community integration circle. You may also want to seek spiritual guidance within an organized or non-organized tradition (whether Western, Eastern, indigenous, or other). The above linked material on grounding can be helpful if you are experiencing a great deal of energetic activation following treatment.

In practice, these layers are obviously intertwined, and interventions at one level may affect all others, as we present as whole beings, bringing surface-to-depth concerns to every interaction.

As a final note: please know that none of this is intended to frighten you away from obtaining ketamine treatment, but rather to assure you that should you have these experiences, you are not alone, and that there are many ways to move through this phase without necessitating a relapse or causing untoward effects in your life.

Being prepared for the possibility of the therapeutic bends often helps people feel less surprised or destabilized, and collaborating with your support team on how to handle this, should it arise, is of paramount importance.

Thank you so much for reading this post, and we welcome your questions and comments!

Dr. Jessica Katzman, Clinical Psychologist at Healing Realms, A Center for Ketamine Assisted Psychotherapy

About Dr. Jessica Katzman

Dr. Jessica Katzman is a licensed Clinical Psychologist with 19 years of experience as a therapist, and was trained at California Institute of Integral Studies (CIIS) in both traditional and transpersonal perspectives on healing. She is also certified as a Spiritual Emergence Coach, and approaches altered states of consciousness from a nonjudgmental, exploratory stance. 

In her private practice, she specializes in integrating psychedelic experiences, supporting LGBTQQIAAP communities and gender-creative folks, addressing alcohol and substance use from a harm reduction perspective, body image issues, mood/anxiety disorders, social justice conversations, and navigating non-traditional relationships and sexuality.

After assisting a local ketamine infusion clinic with psychotherapy program development, she and our medical doctor joined forces to provide integrated Ketamine Assisted Psychotherapy for Healing Realms. She is supported by information received at the KRIYA Conference, an advanced training in therapeutic ketamine, and ongoing consultation with her colleagues in the field.

So, You Want To Find a Psychedelic Guide?

find a guide

Psychedelic science and research has been getting a lot of mainstream media attention over the years and for good reason. The preliminary research suggests that psychedelics may be extremely beneficial in helping to treat mental health disorders and as tools for studying consciousness. As this research begins to hit mainstream channels, some people are left wondering, “How can I find a psychedelic guide or sitter?” If you are feeling overwhelmed by the search, feel free to set up a free 15 minute coaching session with us. We may be able to make your decision process safer and easier.

Michael Pollan, a well-respected journalist and author, released a new book called, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence where he surveys the history of and current state of psychedelic research and therapy. In his book, Pollan describes his experiences with trained underground psychedelic guides. He also explores these experiences in this New York Times article called, My Adventures With The Trip Doctors: The Researchers and Renegades Bringing Psychedelic Drugs Into The Mental Health Mainstream. Pollan’s work has been entering the mainstream and it seems that more people are becoming interested in or curious about psychedelic therapy – so much that many people are seeking ways to find underground therapists and guides to work with.

We, at Psychedelics Today, have been receiving a lot of requests from people asking for instructions on how to obtain drugs or for us to connect them with people offering underground services. While we understand that many people are suffering and seeking psychedelic treatments, sometimes out of desperation for healing, it is not easy to provide advice. Unfortunately, because of the legal system and the current laws in The United States, we are unable to help you on either of these fronts.

With that stated, we can provide some general advice for those looking for alternatives or legal options. Please take the time to conduct your own research as well.

First Thing First

It is important to question what your intentions are and ask yourself why you may be seeking psychedelics either as therapy or as an experience.

  • Are you seeking a therapeutic experience because of a mental health issue?
  • Are you seeking a psychedelic experience for spiritual or religious reasons?
  • Are you just curious to know what the experience may feel like or what it is all about?
  • Are you looking for a recreational experience or to have fun?

Whatever your reasons or intentions are, it is important to continue to be self-reflective and question whether or not this is the right path to pursue. Also, be sure to spend time reflecting on the risk/benefit ratio.

Get Educated

Before making any quick decisions, please take your time to get educated on this topic and also reach out to others who may have previous experiences. Psychedelics Today has a lot of great podcast episodes and resources for education, so take some time exploring our site and content. If you want to get a great basic overview of psychedelics, harm reduction, safety, check out our free webinar course, 8 Common Psychedelic  Mistakes: Exploring Harm Reduction and Safety or our more in-depth course Navigating Psychedelics: Lessons on Self-Care and Integration . Here is a link to a free – 101 version of our Navigating Psychedelics class so you can get a taste.

Mental and Physical Health Considerations

While psychedelics are generally considered safe both psychologically and physiologically, there are some important considerations to take into account. These medicines and substances affect everyone differently based on the set and setting as well as a person’s own biology.

If you are seeking a psychedelic experience because you are suffering from a mental health issue or looking for psychological healing, it is important to evaluate whether or not it is the best option. The research is promising, but it also requires a lot of work, support, and follow-up treatment. Psychedelics are not always cure-alls or silver bullets.

If you are seeking this treatment out of desperation because you have read how positive or healing the experience can be, it is important to note that this change does not always happen right away. It may be important to find a psychedelic integration therapist to work with after or before. Also, ask yourself, “Have I tried other options?”

There are some powerful and effective somatic-based therapies that can be extremely cathartic and healing, such as breathwork, Somatic Experiencing, and others. A list of alternatives and somatic-based therapies can be found below in the “Experiential Therapies/Approaches” section. These therapies may be worth checking out if you have not looked into these therapies before and may also be a great first step to working with non-ordinary states of consciousness.

Exploring Legal Psychedelic Therapies and Other Alternatives

Experiential Therapies/Approaches 

One thing that comes to mind is why are you looking for a guide? Is it to heal trauma or some sort of mental health issue? Are you looking for a spiritual experience or a way to reconnect with yourself? Depending on your intention, there may be other techniques and tools. It may not be as “sexy” as partaking in psychedelic work, but it is important to ask yourself, “What is my intention?”

There are some really powerful therapies and techniques that could potentially be helpful depending on the intention. In regard to therapy or addressing mental health issues, starting with a form of experiential therapy could be beneficial. You could look into some of these somatic approaches that could be helpful for dealing with trauma and other mental health issues before trying to seek underground work or travel outside of the country to work with psychedelic medicines.

Legal Therapy Options

Ketamine-Assisted Therapy

Ketamine is an interesting substance and has recently been used to help treat depression. There are ketamine clinics throughout the United States that provide treatment for depression and other mental health issues. If you are interested in learning more about ketamine-assisted therapy, check out a few of our episodes covering the topic.

Dr. Scott Shannon – Ketamine Therapies

Alyssa Gursky – Transpersonal Art and Ketamine Therapies

Shane LeMaster – Ketamine

Cannabis-Assisted Psychotherapy 

While many people do not think of cannabis as a psychedelic, some are exploring the therapeutic potential of cannabis in a legal and therapeutic setting. There are not many clinics operating with this protocol, so it may be hard to find, but as cannabis becomes legalized in more states for medicinal use and recreational use, this may become more accessible. Here are three resources that we know of so far for cannabis-assisted psychotherapy.

Medicinal Mindfulness

Did you know that when cannabis is used intentionally and skillfully, it is psychedelic and mimics other psychedelic medicines? Our participants commonly report experiences quite similar to MDMA, Psilocybin, Ayahuasca and even DMT. Cannabis is also safe, and legal to use in Colorado in this way. As the first organization to facilitate legal psychedelic cannabis experiences in Colorado, beginning in 2014, Medicinal Mindfulness has an incredible track record of keeping our clients safe and creating profound, life changing psychedelic experiences.

Conscious Cannabis Experiences are perfect for people who are curious about psychedelics but don’t know where to start. They’re also great for experienced practitioners seeking to deepen their psychedelic practice. As trauma informed practitioners, we also work with individuals who seek deep, transformational healing. As guides, we work with creative explorers of consciousness and complex problem-solvers, pushing the edges of what is possible.

Innate Path: Ketamine and Cannabis-Assisted Psychotherapy 

Innate Path, located in Colorado, is exploring the potential of cannabis-assisted psychotherapy and ketamine-assisted psychotherapy. As mentioned on their site, “Cannabis can be a powerful catalyzer of therapeutic process.”

Innate Path combines somatic processing with ketamine or cannabis assisted work, which is a unique bottom-up approach to psychedelic-assisted therapy.

Sara Ouimette Psychotherapy

Sara Ouimette Psychotherapy, located in Oakland, CA, offers psychotherapy, psychedelic integration services, and cannabis-assisted psychotherapy. As stated on Sara’s page:

When used in a particular way, cannabis can actually amplify or exacerbate your internal experience. You can become more aware of tightness or soreness in your body. Emotions are heightened; senses are more acute. You may have access to thoughts, fears, and feelings that are normally out of reach. You may even enter a trance-like state and “journey.” In these ways, cannabis can help deepen your therapy process.

To learn more about Sara’s work and cannabis-assisted psychotherapy, check out Sara’s article called, Checking In, Not Checking Out: Cannabis-Assisted Psychotherapy

Participate in Clinical Research

One way to find a psychedelic sitter/guide is to participate in the clinical research. Check out the following for more information.

  • Clinicaltrials.gov: This is a database of clinical studies from around the country and around the world. You can use this database to search active clinical studies on psychedelics and to search for recruitment opportunities. Just perform a simple search for “psychedelic” or anything else that you may be looking for in the search box. You can filter your search option and only search studies that are currently open for “recruitment.”
  • The Multidisciplinary Association for Psychedelic Studies: If you are already not aware, MAPS is streamlining research for MDMA-assisted psychotherapy. Check out their Participate in Research page for more information about how to get involved in one of their studies.

Psychedelic Retreats and Centers

This option is not always available to everyone because of the cost of travel, accommodations and other expenses. While we understand attending a retreat or center in another country is not accessible for most, it is one of the few legal options for participating in this work. We advise doing extensive research including interviewing the retreat staff/owner and past guests before committing to international travel.

One site that we recommend for finding retreats or reviews is the Psychedelic Experience. While this site is still growing, this may be a great starting point for research. Another popular site is AyaAdvisors.

Psilocybin Retreats

Traveling to another country to participate in this work is obviously not ideal, but the option exists. Mushrooms are legal in The Netherlands, Jamaica, and Brazil. Mexico has protection for traditional medicines, and mushrooms do fall in this category.

Ayahuasca Retreats

Ayahuasca has an interesting legal status in the USA, where many groups are offering sessions in various contexts and settings from religious ceremonies (Christian or shamanic), YMCA gyms, rural retreat centers, churches, etc. Ayahuasca is legal in some countries like Peru and Ecuador. Ecuador provides licenses for shamans/facilitators which no other countries currently do.

Ibogaine Retreats

These retreats exist in Canada, Mexico and other countries around the world including where the plant is from and traditionally used – Gabon. Some facilities are very clinical and others are very traditional. Please know that Iboga and Ibogaine have some serious dangers that need to be carefully considered. There are also environmental concerns around iboga. Please don’t over-use this plant and if you go forward with it, please try to give back to the local environmental movements in Gabon.

5-MeO-DMT Retreats

We currently don’t advise people go on these retreats. The pressure on toad populations is severe and our culture’s desire for the toad venom may push this toad towards an endangered status. After interviewing toad scientists (herpetologists) we have concluded that it is not ethical to be participating in this “market”. If you feel very compelled, the more ethical path (at this point in history) is to work with synthetic molecules.

Other Alternatives

Holotropic Breathwork and Transpersonal Breathwork

Breathwork is a term used to describe breathing techniques and systems that foster self-discovery, healing, and sometimes deeply emotional and physical cathartic releases. If you have been following Psychedelics Today, you have most likely heard us talk about this technique on the show. Breathwork is actually a legal and safe way to access a non-ordinary state of consciousness. There are various schools of breathwork, but the Breathwork technique that we are most familiar with is in the lineage of Holotropic Breathwork and Transpersonal Breathwork. Holotropic Breathwork was created by Stanislav Grof, who was a pioneer in psychedelic research in the early years, and his wife Christina Grof. Breathwork can sometimes be on par with some psychedelic-like experiences.

It may not sound as sexy as psychedelic work, but do not be fooled, it can foster powerful shifts in consciousness. We have both had tremendously powerful healing experiences using Holotropic Breathwork, which plays a huge part in why we talk about it so regularly.

What is Breathwork?

Elizabeth Gibson – Dreamshadow Holotropic Breathwork

Conscious Breathwork and Conscious Cannabis | Medicinal Mindfulness

Medicinal Mindfulness is a Colorado-based organization that provides services in psychedelic integration, breathwork, and conscious cannabis work.

Medicinal Mindfulness is a consciousness community/membership organization and education program that supports individuals and groups who choose to use cannabis and psychedelics with intention and skill. Through our Community Breathwork and Conscious Cannabis Events, we facilitate legal, accessible, safe and sacred psychedelic journey experiences that integrate the four primary paradigms of intentional medicine use: Creative, Scientific, Psychological & Spiritual. Our approach is Transpersonally aligned and somatically oriented.

You can learn more about the work at Medicinal Mindfulness on this episode of Psychedelics Today with the founder, Daniel McQueen.

Daniel McQueen – Medicinal Mindfulness & Conscious Cannabis Circles

Can we help?

If we at Psychedelics Today can help you in any way, we would love to. You can contact us here or you can sign up for a One-Hour Consulting Call to help you navigate through this very complex landscape. You can learn more about us here.

Conclusion and Legal Notice

Finding an underground therapist to work with is extremely difficult because unfortunately,many of these substances are still illegal. This is why we often refer people to check out techniques like Holotropic Breathwork or to find a legal way to pursue this type of work. Remember, many underground guides are putting their professional careers and lives on the line providing psychedelic work.

We advise you to learn as much as you can before breaking any law as the consequences can be severe. If there are any questions that you think are serious enough to cause harm to yourself or others, please contact a legal professional before acting.

Psychedelics Today, LLC and its affiliates can not be held liable for any action you take. We are not doctors and therefore, cannot provide any medical advice. Please be responsible and seek professional attention when necessary.

Best of luck out there, and expect us to share as much as possible when the laws change.

Navigating Your Way Through the Psychedelic Field: How to Get Involved

Psychedelics: A Re-Emerging Field

As psychedelic research re-emerges from its dark ages, the world is beginning to learn about their healing potential for various psychological disorders such as post-traumatic stress disorder, depression, and near-death anxiety due to terminal illness. The research is fascinating, exciting, and seems to be catching a lot more mainstream attention.  The preliminary research shows that psychedelics may be promising tools for mental health and could be the future of medicine. So the question is, how does one get involved in this work?

Joe and Kyle had the opportunity to talk with Ingmar Gorman, Ph.D.about how people can get involved in psychedelic research or in the field of psychedelics in general. Ingmar shared with us some really great information and we would like to recap some highlights. Some of the information provided is a mix between our own thoughts and what Ingmar mentioned.

Important Disclaimer: This is a fairly new field, so it is important to remember that the future of this work is not set-in-stone. Psychedelics are still illegal within the United States and many other countries around the world. While we remain optimistic for the future of psychedelic research, the landscape can shift at any moment. There is still a lot of work to be done!

First Thing First:

  1. Ask yourself, “Why am I interested in entering into the field of psychedelic research?”
  2. Do you want to get your foot in the door because you had an experience that changed your life or inspired you in some way? Did you have a healing experience that you want to share with others?
  3. Do you want to give back to the community in some way by furthering scientific research or inquiry? If so, what is your expertise and area of interest?
  4. What role can you play later on? Are there areas or specialties that need attention or growth?
  5. Understanding and asking yourself, “Why do I want to do this? What is my motive?”

Personal or transformational experiences may not always be the best option for pursuing an active career in researching psychedelics. Psychedelic experiences can be healing, transformative, and magical, but this does not mean you have to enter into the field of science or research. There may be other options that might suit your interests better. Obtaining a professional degree can be a well-worth investment with your time and money if that is surely a path that you wish to pursue. It is important to think outside of the box.

Also, an important thing to note here is that psychedelics are still illegal. While the research and science is happening, obtaining a research position is often difficult considering the limited amount of research. This is not to discourage any of you, but just saying it will require a lot of work! While MAPS is projecting that MDMA will be legal for psychotherapy by 2021, it is still uncertain what the laws and regulations will be. We are hopeful that the future looks bright for psychedelic careers, but it is also important to err on the side of caution as well.

General Information:

Along with asking the questions above, here is some general information or advice for individuals who not wish to pursue a traditional degree. We are all hardwired differently and earning a professional degree may not be in everyone’s best interest.

  • The Non-Traditional Approach: There are other ways to get involved that do not require the investment your time and money for a professional degree. Are you a visual artist? Do you produce music? An interviewer? Are you a product inventor? For example, Joe mentioned during the podcast that he did not feel the need to go on to pursue a mental health degree because he does not feel like being a therapist is the thing that he wants to do right now. Instead, Joe and I are creating this podcast as a resource for the community. The bottom line, is there anything that you can contribute or create for the field? Many researchers and scientists are not artists or graphic designers and the field needs art to help convey the visual experience. Look at Alex and Allison Grey or Android Jones for example.
  • Develop an Expertise: Whether you are taking a traditional or non-traditional approach, I think it is safe to say that developing an expertise is a smart approach. Develop an expertise that can translate well to psychedelic research. Ask yourself, “how can I help or what can I contribute?”
  • Apply Your Skills: Again, think about how you can develop an expertise and think about how your skills can be applied to the field. Are you an accountant or into finances? Maybe if Rick Doblin’s dream of psychedelic treatment centers become real in the future, we are going to need lots of people to manage everything.
  • Volunteer: It does not hurt to reach out and develop a relationship with the Multidisciplinary Association for Psychedelic Studies (MAPS), Erowid, Zendo Project, DanceSafe, Drug Policy Alliance, or any other psychedelic organization. These organizations might be looking for a helping hand in a project or event. Volunteering can help you become connected with an organization, develop a relationship, and maybe help you land a job somewhere! Worst case scenario, you meet some awesome people.
  • Festival Harm Reduction Services: There are various organizations that provide harm reduction services at festivals. This may be a great way to get experience in the field. Check out the Zendo Project, DanceSafe, or Kosmicare for potential future opportunities.
  • Create a Psychedelic Club or Society: Local psychedelic clubs and societies are popping up all over the place. You can create your own too! You can check out our guide Tips on Creating Your Own Psychedelic Group

Get Involved in Research

There are numerous ways to get involved in research projects. From self-report studies to actual participation, there are ways to get involved and possibly become a study participant. Here is a list of a few different options.


For Students:

If you are thinking about trying to get your foot in the door with psychedelic research, it is important to analyze which route you wish to take. There are many paths to choose from and you do not need always need to pursue a degree in science.

Are you currently or thinking about pursuing your Bachelor’s degree?

  • What are your interests? Are you interested in psychology or psychiatry? Neuroscience or neuropsychology? Chemistry? Biology? History or anthropology? Do you want to do therapy at some point? Figure out what interests you.
    It is recommended if you want to do therapy or conduct scientific research to earn a degree in science and psychology.
  • Find a niche or a specialty: If you’re off to an early start, figure out what you may want to focus on. If you’re a psychology student, maybe focus on trauma or addiction. Current psychedelic research is mostly focused on if these substances can be beneficial for certain psychiatric or mental disorders. The research funds are not really there for “how” these substances work, but that might not be the case down the line in a few years. The field is shifting rapidly.
  • Go to conferences: Just in case you missed this in the last section, remember to try and attend a conference or event!
  • Find A School: It is suggested that if you would like to do rigorous academic/scientific research it might be important to seek out applying to a traditional school. There are schools out there doing research and it might not hurt to look into their programs. MAPS has made a list of schools that might make psychedelic research easier.
  • Create a Club: You can always try to create a drug advocacy/policy club at your university. If you are unsure how to go about doing so, you could always check out the Students for Sensible Drug Policy and create a local chapter at your university or school.
  • Training and Education: There are plenty of training opportunities that may be helpful when thinking about adding new skills to your toolbox. Here are some examples of trainings that could be beneficial or helpful.

Harm Reduction

Techniques and Therapies

Some of these trainings/techniques may require advanced credentials and education.

Beyond The Bachelor’s Degree:

If you just had just completed your undergraduate degree, are currently a graduate student, or trying to figure out what is next, here is some advice.

  • Master’s Degree or Ph.D.: Many people get caught up on this decision/topic. Some people believe that pursuing a clinical psychology PhD or PsyD is the best option if they want to get their foot in the door with psychedelic psychotherapy. Earning a Ph.D. or PsyD or even a medical degree such as a Psychiatry is a large investment in both your time and money. This route may not be the best option for everyone and it is important to know what you are interested in or what skills you are strong in. Maybe science and math is not your strong point, so pursuing a clinical psychology degree to become a clinical psychologist may not suit you. Some people just want to be able to conduct psychotherapy and there are plenty of ways to do so, such as getting a master’s degree in clinical mental health or social work. Weigh your options and think about what fits you the best.
  • Specialty and Niche: Like the bachelor’s advice, what is your specialty or expertise? What role can you play later on? The field of psychedelic research is looking for individuals with specialties. Look into the ways how to develop an expertise in the field. If your interest is in trauma, research how to develop a focus in body psychotherapy for trauma disorders. Focus on alternative treatments for addiction.
  • Passion and Drive: Since earning a professional degree or a doctorate degree is both an investment of time and money, you are going to need to be passionate about what you are studying. There are many people who start programs and realize that it is not for them. Know that if you want to pursue a professional career in psychedelics, you’re in it for the long haul!
  • Is There Therapeutic Benefit: If you are interested in research Ingmar mentioned that the funding may not be there for questions like, “how do these substances work?” or “how do they heal?” Even though the Imperial College of London has been doing amazing “how” research (how LSD, psilocybin, and MDMA affect the brain) there is not much of that type of research going on within the United States. The MDMA-assisted psychotherapy study wanted to know not how MDMA cures or helps PTSD, but rather, does MDMA-assisted psychotherapy help with PTSD?
  • Find a Mentor or Professor: It does not hurt to research mentors or professors in the field to see where they are teaching. Katherine Maclean mentioned in our latest interview that she was interested in psychedelic research and knew that Johns Hopkins was researching psilocybin. Look for post-doctorate fellowships, internships, etc. Attend a school that is doing the research
  • Find Grants for Research: If you are enrolled in a program and can find a faculty member that supports your psychedelic mission, try to find grants or scholarship money to support your research program. The Source Research Foundation is a new organization that is helping to provide grant money to students who want to conduct psychedelic research.
  • Training and Education: As mentioned in the “For Students” section above, there are various training/education opportunities that will help you grow and develop new skills. Please view the list above for ideas.

Additional Resources


Articles about getting involved

Best of Luck! We wish you the best of luck on your psychedelic journey and hope that you find this information useful. MAPS has a lot of great information and be sure to check out their “resource” section.

Be sure to leave a comment, subscribe to our podcast, and connect with us. We would love to hear from you – info@psychedelicstoday.com

Author: Kyle Buller

Last Updated: 5/31/2018