Psychedelic-Assisted Psychotherapy with Emma Bragdon PhD & Benjamin Asher MD

The field of mental health is on the brink of evolving in a promising direction with the introduction of psychedelics as a viable treatment option for a wide range of psychological challenges. In this episode my guests Emma Bragdon and Benjamin Asher discuss their work providing Ketamine-Assisted Psychotherapy (KAP) and an overview of the outcomes they’ve witnessed.

WENDY (INTRO): This is Wendy Halley and you're listening to Lucid Cafe.

Hello and thanks for tuning in to Lucid Cafe, a podcast exploring healing, consciousness and the complexities of being human. If you're a regular listener, you already know how encouraged I am about the emerging new frontier in mental health: the introduction of psychedelic assisted psychotherapies as a legit, safe, and effective treatment option. In today's episode, I speak with two seasoned practitioners, Emma Bragdon and Benjamin Asher, who work as a team providing Ketamine assisted psychotherapy in Vermont. Currently, Ketamine is the only legal option for doing this type of therapy. It looks like other psychedelics like MDMA and Psilocybin, will be approved for use in the not too distant future. Pretty exciting.

Emma Bragdon has been a pioneer in body mind spirit wellness for 50 years. She's written seven books and co produced two documentary films on topics related to health and healing. She's been a teacher in experiential learning for adults since 1985. Emma is a mental health clinician with a PhD in transpersonal psychology specializing in issues of spiritual emergency. She is the founder and Executive Director of the Foundation for Energy Therapies, a not-for-profit 501 C 3 company dedicated to education and research. Integrative Mental Health for You, or IMHU, is an educational website and is a project of the foundation.

Benjamin Asher is a New York City based board certified head and neck surgeon who is renowned for his innovative, nonsurgical approaches. Prior to attending medical school, Benjamin worked as a fulltime meditation teacher. His four decades of meditation practice and spiritual inquiry have informed his perspectives on health and wholeness. He serves patients from throughout the United States and Canada, as well as those who seek his care from as far as Europe, South America, Asia and the Middle East. Please enjoy my conversation with Doctors Emma Bragdon and Benjamin Asher.

Thank you both so much for joining me.

EMMA: You're very welcome. It's a pleasure to be here. Thank you.

BENJAMIN: It’s a pleasure to be here.

WENDY: I'd like to start out getting an idea of who you both are and then how you work together. So, Emma, why don't you start and tell me a little bit about what you do and then Benjamin, I'd love to hear what you do and then how you both work together.

EMMA: Okay, so I live in central Vermont in a small town called Windsor, just below Hanover. And my major job really is being the executive director of an organization called Integrative Mental Health for you, acronym Imhu. And we give courses. We now have over 40 courses. Most of them are presented online. And it's all about really educating people about the effective alternatives to over relying on psycheds. So we're not anti psychiatry, we aren't anti anything. We're pro information. So one of the niche courses, I guess you could call it, is how to effectively support someone in Spiritual emergency. And we actually certify spiritual emergence coaches after they've taken that course and taken another workshop. And this brings them into the opportunity to assist people who are having spontaneous spiritual experiences, either as a result of psychedelic assisted psychotherapy or their own exploration with psychedelics or their own spontaneous experiences. So this is something I've been deeply involved with since the early 1980s, which is helping people in spiritual emergency. And I've written two books about it. And the other courses are all from that point of view, that spirituality has extremely positive potential in terms of assisting us into optimal human mental health. So people can go online and take a look at the courses we offer. And I also do private consultation. I have a private practice, and I lead a support group with Kyle Buller, who is one of the founding members of Psychedelics Today. We do a support group online for small groups. And Benjamin called me last spring, I think it was and said, Emma are you open to doing Ketamine assisted psychotherapy with me? We could be a team. So we got together and started to do that for individuals. And it's been a great pleasure. I actually had some training in this back when MDMA was legal in the early 1980s and saw the extraordinary potential, positive potential of MDMA assisted psychotherapy. So I'm very pleased to be aligned with Dr. Asher, and we are continuing to do that individual work in the area of the Upper Valley.

WENDY: Awesome. All right. Thank you. There's so much there. I want to ask a million questions, and hopefully we'll get to at least a half a million of them later. So, Benjamin, how about you?

BENJAMIN: So I'm an integrative physician. I have been a meditator for the last 52, 53 years.

WENDY: Is that all?!

BENJAMIN: And I'm a meditation teacher. Way back after I graduated College, I became a teacher at Transcendental Meditation, of which I practiced. But I'm not actively involved in teaching at this point. And I've always been interested in the psychospiritual aspects of medicine and health, and that's been a big part of my work as a physician. I'm an ear, nose, and throat specialist by training, and I was a surgeon for many years. But I gave up surgery about 18 years ago and had a practice. I still do have a practice just sort of doing integrative medicine. And my interest really is looking at illness as a Port away into personal growth. And so I try to work with people on understanding what's going on with them and what making some meaning of whatever is happening. And that kind of got me into the world of psychedelic medicine. So I finished a training from the California Institute of Integral Studies on Psychedelic Therapy and Research, and I've been doing Ketamine therapy for the last…time really flies. But for the last probably two years. I do it both here with Emma in Vermont, and I also do it in New York City. And it's a really interesting medicine. It provides a lot of insight to people. So that's kind of where I'm at in terms of the ketamine side of things and the psychedelics. Basically, my medical practice for the last 25 years has been working mostly with people with chronic illnesses in that particular piece of people that are looking at their entire life through the lens of illness and how to change that lens so that you're not seeing everything with that particular perspective. So I've got a large practice of people with chronic Lyme disease, for instance. And when that happens, people feel like that every aspect of their life is lime related, and there's a deeper layer to all of this. And if you look at the studies that are going on right now in the world of psychedelic medicine and the people with cancer and end of life anxiety, basically, once people have this mystical experience with the psilocybin, it completely changes their perspective on their cancer. And that is true for any particular illness. If you are able to experience something from a more elevated perspective, has that been the focus of your ketamine assisted therapy? Well, that's one of the reasons why I do it. So I offer to people that are feeling that are stuck in their world view and are interested in having a broader worldview about it. And I've had some pretty interesting experiences with people.

WENDY: Okay. Well, why don't we start with the basics, like what is ketamine? My understanding is that it's traditionally used as an anesthetic, but in lower doses it has a different effect. Can you talk a little bit about this, Benjamin?

BENJAMIN: Sure. So Ketamine actually was developed as a battlefield anesthetic because in high doses it doesn't suppress your respiratory system. So you can give somebody ketamine and not have to worry about their airway, and you can do something. They use it a lot in emergency rooms, but it was discovered that in lower doses, ketamine has a psychedelic effect. But the other thing that they discovered about it is that in lower doses, it had an effect on depression. So people they started using ketamine for treatment resistant depression, and that's if you look up ketamine and see what it's mostly being used for, that's the big reason it's being used. There are protocols that are designed specifically for that, and ketamine is also very effective for eliminating suicidal ideation. It actually will eliminate suicidal ideation in people for a period of a few weeks, certainly. So that's another thing that's being used for now. There's a lot of different ways that people are finding uses for this ketamine assisted psychotherapy. So in the depression treatment, it's basically getting ketamine as a way of another medicine to reset your brain. But it's also useful that if you give somebody ketamine, they get a different perspective on their life or what's going on, and you can actually do processing with them while they're under the influence. Okay. Just so I understand, are you talking about using ketamine as you would an antidepressant like you take a regular dose of it. It's complicated because Ketamine is given intravenously. So the treatment resistant depression protocol is you do it twice a week for three weeks, and then once a month. Okay. So you get a dose of Ketamine, they give it to you, like over an hour, and you leave. There's no psychotherapy associated with it? There can be. But these centers are often run by anesthesiologists; they're not run by psychiatrists or people that are necessarily interested in mental health as their medical practice. So that's one Avenue that people are receiving it. Then this other aspect of doing psychotherapy with Ketamine, you give it to people and you can work with it. Ketamine is available. You can take it orally. You can take it as a nasal spray. You can get it as an intramuscular injection. You can get it as an intravenous infusion. So there is a pharmaceutical company that developed a nasal spray that people do use. And I'm not that familiar with how it's being used, but that would be more in the line of using it as kind of for its antidepressant effect and using the ketamine nasal spray every day or a few days.

WENDY: Okay, I see. Because I'd heard that there is a lozenge you can take and it dissolves.

BENJAMIN: Yeah. So the lozenge, most people that I believe are doing the lozenge is a psychedelic, too. So there are Ketamine companies like Mind Bloom, where you work with a therapist. They ship you your Ketamine laws and you take the Ketamine lozenge, and then they do Ketamine assisted therapy on the Zoom with you while you've taken your lozenge.

WENDY: I don't know how I'd feel about that. Anyway, we won't get into that! But what I'd like to get into is how a session might look when using Ketamine as a psychedelic assisted therapy and how the two of you work together. Emma, do you want to speak a little bit, just to give an overview of how a session might look?

EMMA: Yeah, I'd be happy to. And I hope that Benjamin will feel free to add or delete or however edit. But one thing that's very important is that if someone really wants to do this with us, it's not just arranging a session, and then they come in off the street for the session. So we follow a very responsible protocol, I think, which is that Benjamin really had someone fill out a medical record. So we understand a little bit more what the medical background of a person is. And it includes also the psychiatric issues that might be there in brief, for instance, has a person been hospitalized? Are they taking psychiatric medication, et cetera? And so that allows us together to review is this person really a good candidate to be helped by the therapy? And then after that is complete and it looks like a go for that person, then we do actually an interview with them. So it's Benjamin and I online preparing and basically walking through what's going to happen and what they can expect. But also asking the most important question, which is, what would you like to work on? What are your intentions for the session? So the person on inner intelligence may be buried because they're likely looking for something and they don't know where it is, but the intention is extremely important, and their own inner intelligence will be guiding the session to a great degree. So we provide about an hour for that preparation session. And then once a person comes in where we do the individual sessions in a very homelike setting, it's not clinical, it's not a hospital. All of this is completely legal. We haven't mentioned that yet, but because Benjamin is a physician and he can prescribe and also give the intramuscular ketamine, all of it is above board, but it's a home-like setting. So generally people feel very comfortable. And we started out not in a full blown shamanic ritual, which can be pretty dramatic, but we basically start out with offering respect to the energies that are present and doing some purification, staging, for instance, with the environment as well as for ourselves. Both Benjamin and I, as well as the participant, and really dedicating the whole session to something that we could consider a higher intelligence than ourselves, which may also be something that, of course, we have inside of us. It's not all out there, so that particular part can be extremely important in terms of just calming the whole environment and preparing us to receive what is to come. And then Benjamin and I basically are there present in order to hold the space for anything that may need to occur. And we aren't generally asking any kinds of questions like one might find in a therapy session, but really looking for direction from the person who's going through the experience. So that doesn't mean that from time to time one of us might reiterate one of the intentions that a person has already stated around why they're there. So if someone seems to be a little bit lost in space, as it were, we might just bring it back. But the interventions are generally very modest, and it's much more about holding space for the person to be experiencing what they need to experience in reference to what their intention is. Just as an example, one person who came to us, an elderly person, I don't want to call them elderly at this point in my life, probably in her 70s, had chronic pain, and she also had a very strong desire to grow on an emotional, spiritual level into a place of fearlessness that she had noticed in one of her spiritual teachers in her session. I would say 90% of it really was her moving around, dancing while she was laying flat on the bed. In other words, she wasn't standing ever or sitting, she was on the bed. But there's a tremendous amount of movement if you're on a Queen size bed, you can move in a lot of different directions. So we watched her basically in this kind of dancing, and she said she had no pain at all, which she had not experienced for a long time. And of course, the connection is there that some of the pain that she'd been holding in her body was related to something going on mentally for her. So it was a profound session in that regard. We wanted to say that the chronic issues that Benjamin brought up are really valuable in terms of people bringing something that's either been a physical problem or an emotional spiritual problem. Those are extremely important. But some people do the Ketamine assisted psychotherapy because they want to grow on a spiritual level. They want to go to the next step. So what can happen is someone goes into a lot of quietness and almost like a meditative state and moves into a place of perceiving what they thought were issues from a place of there's no issue left, it's gone and a profound sense of peace. So to go back to what happens in a session, Benjamin and I are holding space for whatever happens, and it can vary quite a bit. And we offer the session for 3 hours. The intensity of the session is usually about 45 minutes, which doesn't feel like 45 minutes for the participant, but we're keeping time with that. And towards the end, a person really comes back into themselves in a way where they're balanced on their feet and they can speak very fluently. They may not want to speak a lot, but they can. But we suggest that they don't drive immediately for several hours, even into the next day, just as a safety precaution. So it's best if people are dropped off by a friend and then picked up later after the three hour session.

WENDY: Okay. And during the session, are they listening to music? Do you have a soundtrack for them?

BENJAMIN: I have a few different playlists that I've put together. Ketamine has a funny effect on the senses. So certain kinds of things that you may like in regular consciousness, in the non ordinary state of Ketamine consciousness, you may not like that music. So I have music that sort of is different, that may elicit feelings that things may come up that would be supportive to the person. So we play music. Some people don't want music, so I turn it off. It's not a requirement. Some people like to wear eye masks, some people don't. Some people like to talk during a session and some people don't. At least in the initial piece for the first 30, 40 minutes, most people don't talk, but then after that, people will report about what's going on and what they're experiencing. But if somebody is in some experience and they're talking, as Emma said, what I do and what Emma does is just kind of have the person go back to whatever it is that they're talking about as it relates to what their intention was about doing the session in the first place.

WENDY: Like a redirection.

BENJAMIN: Yeah. It's always important to go back into that place because that's where really the material’s coming out from the sort of the inner healing intelligence of the person. So whatever's up for the person. And it may just be I've had people just ask me a million questions about what's going to happen next, what's going to happen next. And their intention was learning sort of more about trusting their own air self. So I'm like, okay, so you're having a lot of questions here. What's happening with your ability to turn in and trust in that? And I've had some people get all hung up on how big of a dose they got. So sort of processing what that is and how having fear of missing out issues what it is that they think that they're missing. So it's kind of like directing that rather than continuing the conversation of the narrative.

WENDY: Okay. So you're really not engaging a lot on an intellectual level. You're trying not to get their brains active and in that thinking mode.

BENJAMIN: Right. It's about sort of going into the deeper layer of yourself. The experiences can be very profound for you. I had one patient who had come to see me because of his having these episodes of his throat closing off. And he was getting going to the emergency room all the time and afraid of not breathing and panic attacks. And under the Ketamine session he actually went back into this experience when he was nine years old of seeing he was out in the street playing, and a neighbor friend of his came running out of the street and got hit by a car and killed right in front of him.

WENDY: Oh, man.

BENJAMIN: And he'd never processed that, ever. And in the experience of ketamine, he saw that experience. He saw some other things that were related to that experience. He had so much anxiety. I actually didn't give him that big of a dose. But in the 30 minutes that he was really in the ketamine, he kept on swallowing and swallowing and checking out his throat. And ever since then, it's all gone. He's not had another episode.

WENDY: Wow! That's what I wanted to ask is how lasting are the impacts of their experiences when doing these treatments?

BENJAMIN: That's a great question. And I'm sure Emma's got an answer, too. So I want to give her a chance to answer it. But I don't want to promise people that it's a one experience fix, because it's certainly not that in most people, it's all just part of the process of learning more about yourself. And it is a very powerful tool for that. Some people have profound experiences that change them for long periods of time. Some people will want to do it more than once because they want to go back into the experience and work with it, but it's variable.

WENDY: Okay, how about you, Emma? What are your thoughts on that?

EMMA: Well, I totally agree with what Benjamin said, that it's variable. So it's a difficult question to answer, but I'm thinking about one person who came to us who is very identified as a spiritual practitioner, deep meditator teacher, healer, and she loved the experience because it moved her along in her spiritual growth and said she was anxious to do it again and with her spiritual community because she felt that it could help all of them, herself included, continue to move along and also grow more connected. So that was her intention right after her session. I haven't worked with Benjamin around people who wanted to come back frequently, but I was just working with someone yesterday in my private practice who is having a lot of suicidal ideation, has been deeply depressed for a number of years. And I was thinking about his candidacy for doing the Ketamine. And I would definitely never give him the idea that, oh, it's going to be one time and that's it, because having listened to some of the traumas that he not only had in the past, but is going through presently, I imagine that there are several layers that he would want to go through. A lovely book that just came out in July is called A Dose of Hope by psychiatrist Dan Engel. And he provides a really wonderful kind of schedule and format for people who are doing psychedelic assisted therapy. In his case, it was MDMA that he was providing, imagining that it was legal in the next few years, and it's not legal yet except in special clinics, which is doing research. But he was suggesting that this person come for three different sessions. And this person was basically garden variety person who was not really happy and not really unhappy and just and felt like his childhood been okay like everybody else. And there was no significant trauma. But he definitely benefited from doing three sessions and also being in psychotherapy at the same time. So he was continuing to process and integrate. And he also had peers that he could speak to. In his case in the book, it was his grandfather and grandmother, not his parents, but also a friend at work. So there were several different layers of support that he had as he was making really transformative change in his life. So I think that's an important aspect to bring in, because it's not just in this case we're talking about Ketamine assisted psychotherapy. It's not just come in and expect a kind of magic bullet, but come in and yes, you can get profound insight. There's a possibility that you might break through in one session, some chronic physical issues you've had, but the integration can be even more important. So Benjamin and I actually provide about a week after a person has had a session, we provide integration and an hour long integration session. And we would be listening very intently for whether a person feels that they need to go on and do another session or not. And we might be in a situation where we might advise, hey, it might be good to contemplate doing another session. What do you think? So it's very individual is what you're saying. It's not like on average, people will have three sessions, and then they feel like they have typically gotten through what it is they need to get through. Doesn't work like that. No. So the Maps MDMA protocol for PTSD does do three sessions of MDMA therapy, but interspersed and all of that is lots of integration. There's the pre sessions, and then there's like three integration sessions between each MDMA session. So there's a huge amount of therapy that's going into the work that you're doing when you're on the MDMA.

WENDY: Can you talk a little bit about the importance of the talk therapy integration piece, as opposed to just getting a dose of MDMA illegally and doing it on your own or Psilocybin on your own or whatever?

BENJAMIN: I believe it was Stanislav Groff who coined the term set and setting. But don't quote me on that, but set and setting is what it's all about in terms of what can unfold in a particular experience. So how you set it up, what you're doing during it, the kind of support you have, how you're going to handle the material that comes up. It's all about the process. So if you're doing something recreationally and you have, quote, unquote, a bad trip, you've hit something that you can't deal with, and that can really be upsetting, it can be really scary. Some people get really freaked out. Some people have a long term trajectory of trying to deal with that stuff that comes up, that's come up. But if you're doing it in a situation where there's a skilled therapist who understands how these medicines work, understands what's going on. You can work with a person when they're in their shadow material, because really on one layer to discover that we're all just an aspect of divine consciousness. That's a very powerful, mystical experience that many people may have on a psychedelic that has to be integrated into a person's experience in there of all of the dark stuff that everybody carries around with them. So how we work with that, and when that material comes up, how you can handle that in a compassionate, loving way so that you can actually let that material sort of transmute in you. So it's no longer grabbing you. So a skilled therapist in a psychedelic session is a really important thing. And there are tools and ways you prep people about how to work with the material that comes up. So they say that if the monster comes up, you jump in its eye and look out through its eyes and see what it's seeing.

WENDY: So it's really inviting in everything that is scary and see what happens. That's very shamanic, that idea of making friends with your shadow creatures.

BENJAMIN: Right. It's also Jungian.

WENDY: So, Emma, do you have anything you'd like to add to the importance of the integrative period?

EMMA: Yes. I think an awful lot of pain that people carry around that they'd like to work through comes because they weren't sufficiently or adequately supported in their early life or in their later life. They experience betrayal or disillusionment or some kind of real difficulty in relationship to other people. So the integration, which can happen, of course, in a session as well as after the session, the integration can sometimes be connecting with someone who is a totally different model of what they had experienced before. In other words, there's a man, and in the case of Benjamin and I, there's a man and a woman there to relate with and connect with, who's not going to disappear, who's not going to betray them, and who is going to give support, just unconditional support. Obviously, there are some conditions around we wouldn't condone violence in any way. And we are agreed to be very ethical in terms of the therapy that we give, so that there's no kind of going over the boundaries of ethical sexuality. And I mentioned that just because it's in the news now that there have been more abuses with guides who are doing the psychedelic assisted psychotherapy. So Benjamin and I work together and do have certain boundaries, but within those boundaries that really create a lot of safety and respect for the participant, there is a tremendous amount of support and unconditional high regard and high regard also for the intelligence of the person. In other words, their inner knowing of what they need to go through for their own healing. So creating that kind of a safe place and maintaining it while someone is in a very deep state and vulnerable state can be extraordinarily healing for someone.

WENDY: Absolutely.

EMMA: And they would miss out on that if they were doing it by themselves.

WENDY: That's an excellent point.

EMMA: And possibly get restimulated. In other words, if, let's say the shadow or the monster arrives and they go, oh, okay, this is my opportunity to deal with it. But they aren't really skilled or they don't quite have the support that they need to move through it, then it can just re-trigger the problem and it dives deeper into the unconscious or get shoved aside again.

WENDY: No, I could see them getting kind of lost or start drowning in the emotions of the experience and not be able to pull themselves out.

EMMA: Right.

WENDY: Which I have a feeling is a lot of the work that you probably end up doing. Right. Emma, around spiritual emergencies?

EMMA: Yes. So I just wanted to say I think it's a missed opportunity for some people when they do it by themselves, because things may emerge that are very rich territory for them to explore. But if they don't have the skill and they don't have the support that they need to really face into it, then it's a missed opportunity.

WENDY: Would you say that's true for both a really positive experience and a more challenging experience where they are facing some of their trauma history?

EMMA: Well, certainly in the situation where they're facing trauma history, it can be extremely useful. And if a person has more facility and knowledge of what they're doing, they may just be able to sail into a very wonderful expansive experience, not be so much in need of support. But I think all of us actually are support deprived. In other words, most of us did not have it when we were younger. And to be in a situation where there is that kind of support, even if you're having a wonderful positive experience and don't necessarily need to talk about it or need someone to Echo back to you what's going on. Just being in that environment of total support can be extraordinary and propel even deeper experiences

BENJAMIN: On that point, so even the, we'll call them positive experiences. I don't really like the word whatever you're going to call that expansive experience. So a person has to there's a context of that experience. Right? So let's say you really don't have any spiritual experiences, and it's just not even been on your radar screen, and you are given this medicine and you take it, and then you have this expanded experience of nondual. And that could be frightening and of itself. But let's say you go with that. Then when you're out of whatever the experience is, then what is the meaning of that experience to you? One way some people will look at it is go, I just had a drug experience, right. Oh, well, wow. That drug was really amazing. So they relate it to the drug, but actually it's not the drug. The drug is revealing a deeper part of oneself which is very real, which exists whether you take the drug or not. And many people have those experiences without a psychedelic. So part of somebody who's holding space is to be able to really let a person recognize what it is they are when they're having the experience of who they really are. And that's an incredibly powerful thing when that happens.

WENDY: Yeah. I can't even imagine. I'm also wondering about just how incredible it must be on the trust realm to learn how to trust not just the people who are being of service to you and supporting you, but trusting yourself. Right. And trusting your body's wisdom and your body's ability to heal itself. What a profound experience that would be for anyone. It's not like I read about it in a book or it's not the drug itself. The drug is creating an experience. Right. For you to have. I can't imagine just on very deep, subtle levels how much trust must be built as a result of having one of these experiences or am I wrong?

BENJAMIN Right. No, look, it really depends on what layer you're asking that question and who's doing the trusting and what's trusting what and all of that.

WENDY: Well, that's heavy!

BENJAMIN: It’s a big question. Right. Well, ultimately, when you move into these expanded non ordinary States as the boundaries of time and space and what we think we are are sort of peeled away, then you're in this other place. Right. So what is it that's happening and who is doing the trusting and who are we and of ourselves?

WENDY: I love that question.

BENJAMIN: Right. And it's an interesting question when you're in that state to ask it, if you were on a medicine and you were having the question of trust, so the question that I would come back to you with would be that, okay, who's doing the trusting?

WENDY: I think it's probably complicated.

BENJAMIN: It is. It depends on what layer you're living and what the reality is you're seeing. But these medicines allow us to understand that there are just so many layers to the reality that we live.

WENDY: There certainly does seem to be that. It's complicated. So are they presenting issues that are not suited for psychedelic assisted therapy? From your experience?

BENJAMIN: There are certain things that if you're on certain medications. So Ketamine is actually a pretty user-friendly medicine because it doesn't interact with a lot of other drugs. People can be on SSRIs, SNRIs, and you can do Ketamine. It doesn't interfere with anything. There are no interactions or complications. There are some potential complications of Ketamine. You can get elevated blood pressure. People can get nauseated. People can't have anxiety. And I keep medicine in my bag for that, but I've never had to use it. So if a person has uncontrolled high blood pressure, I wouldn't give them Ketamine. I just wouldn't. Other medicines like you cannot mix. So if you're on an SSRI, you can't do MDMA, for instance. That's a problem. Psilocybin, you can do that with some of the medications. You just have to have an experience. You need a much higher dose. There was just a paper, actually, that came out saying that SSRIs and psilocybin are totally fine to mix. So those are the things that in terms of the medical contraindications, I think that the other issues about a person's mental health and using these medicines is really how comfortable a practitioner is in working with people with certain issues. Right.

WENDY: Makes sense.

BENJAMIN: There will be people that say, oh, you should never give this with people with this particular psychological disorder. And other people would say, I don't have a problem with that. So it's a matter of how you're comfortable holding space and if the pieces fall apart, how you're comfortable helping reassemble them, and you have to be comfortable with that if you're taking on that responsibility. I have my limits about what I think that I can handle, and I'm very careful. But I know in some of the protocols that they've done some really challenging people with, quote, unquote challenging disorders, and they found that actually they all resolved with the psychedelic, mystical experience the person had.

WENDY: Amazing. Okay.

BENJAMIN: So I think that the world of mental health is going to be turned on its head with all of these medicines that are coming out because we attach labels to people. That's what we're really great at. You have blah, and that's great. So you got a label now we know your labels. Then what to do with label, and labels don't do anything since they pigeonhole you into this place. And I think that this more holistic way of looking at what our mind is and what a rich place of all these people that have different experiences of living, and they're all.

WENDY: Okay, can I ask you a really practical question that I have a feeling that people might want to know the answer to?


WENDY: Can you get addicted to doing Ketamine assisted therapy?

BENJAMIN: That's a really good question. And the answer is no. Ketamine is not a particularly not a physically addicting drug. There are some people that get psychologically addicted to Ketamine as a party drug. That's a whole different scenario.

WENDY: Okay. Well, that's good to know. So, Emma, do you have anything you'd like to add to the question I'd ask around contraindications, in your experience, have you seen where if somebody's in a particular state that you wouldn't advise doing Ketamine assisted psychotherapy?

EMMA: Well, I don't like to use the labels, for instance, schizophrenia or psychosis, etc. And I try to avoid that kind of language because I don't like to pigeonhole people. But if someone is in a really disturbed state, they're extremely uncomfortable. Maybe they've been through a series of trauma or somehow the trauma they've had earlier in life has become uncorked, and they're really unable to carry on life. Go to work, et cetera. As Benjamin said, I would really think carefully on what is it that I would be willing to take on, because as far as I'm concerned, a person might have extremely positive experience. They may even be able to work through what it is in one session. But on the other hand, if they don't, for instance, they start uncovering other layers, and there's just a tremendous amount that they need to process in order to come back together again. Then I would be taking on a lot of responsibility for their integration. I don't want people to be either leaving a session really feeling disturbed or being in a situation where they can't come back for more support, or being in a situation where I'm the only support person and they don't have anyone else to turn to. So there are a lot of things to think about in terms of what is it that is going on with that person at that particular time. And as Benjamin was referring to, like, how much am I willing to take on and they're unknowns. You don't know exactly what is going to come up for someone in a session. And something about their history may give you an indicator about what might happen. Were they hospitalized recently? Were they given a lot of drugs? Were they traumatized in the hospital? All kinds of things.

WENDY: Lots of factors.

EMMA: Yeah, lots of factors.

WENDY: So as we wind down our conversation, if someone's interested in looking into working with you, how would they go about doing that?

EMMA: Well, I gave the URL Webpage for a series of interviews between Benjamin and I that people can just watch for free. And it has all of our contact information on it, as well as giving more preparation and education for people and giving them the opportunity to share with someone else, maybe who didn't see this podcast, what it's all about. So that would be one way that people can reach out to us is through that particular free course at Imhu. But we also can provide phone numbers. Mine is 802-674-2919. That's in Vermont. And the email address is E B, my two initials And Benjamin has his own contact information.

BENJAMIN: Yeah. People can call my office phone number, which is 212-23-4225. They can also go on my website And if they want to email me, it's

WENDY: Okay. And I will include all of these links in the show notes as well for folks. And just to clarify, you're offering Ketamine assisted psychotherapy sessions in Vermont and in New York City?

BENJAMIN: I offer them in New York City and Emma is not coming to New York doing them with me. My medical practice is mostly there. The only medical thing I do in Vermont is Ketamine.

WENDY: Okay.

BENJAMIN: So I draw from my medical practice in New York for Ketamine sessions, and I have other therapists that I work with, but I always work in this Dyadic model with a male and a female therapist. And I think it's really important to do that.

WENDY: Do you want to just speak to that for a second? Why you feel it's important to have a male and a female practitioner?

BENJAMIN: Well, I just think for safety purposes, I want people to feel absolutely comfortable. You're giving them a mind altering medication. And I don't want anybody to feel like that they're at risk for anything. I also think that their representation, as Emma said, of a male and a female being both there can be really helpful because a person can whatever is coming up for them will project whatever is going on on one of the two of us. Right. So that is helpful, having that energy like that. And I personally think that giving Ketamine in the least medically invasive environment as possible is really the way to do it. The only thing that's medical about the way we do it is I take your blood pressure and I give you an injection. There's nothing else medical about it.

WENDY: It sounds like a very healing experience.


WENDY: Well, thank you both. So much for coming on and chatting with me. You covered a lot of ground in a really short period of time, so I really appreciate it.

EMMA: Thank you for your questions.

BENJAMIN: Thank you for your questions and thank you for having us. Really appreciate it.

WENDY (OUTRO): Crazy, exciting possibilities. Benjamin and Emma clearly take the responsibility of this kind of work very seriously, which is so good to hear. Unfortunately, this is not always the case. At the risk of getting on my soapbox and I'm about to do it anyway, I really want to urge you, if you're seeking this kind of treatment out to please be cautious about who you work with as this modality settles into the mainstream, we're going to be seeing a lot more people offering this kind of treatment legally and illegally, and some of those people may not really be trained or equipped to handle your experience in the most therapeutic way, which at the very least is a wasted opportunity and at the other end of the spectrum, could be counterproductive and possibly even harmful to you. Okay, that's my public service announcement. I'm now stepping off my soapbox. As I mentioned earlier, I've included links in the show notes. If you'd like to connect with Benjamin and Emma on the Integrative Mental Health for you or website, you'll find a catalog of online course offerings as well as free educational content. Definitely worth checking out.

Well, thank you for listening. If you're enjoying Lucid Cafe, I hope you'll consider supporting the podcast in whatever way you can by giving it a positive review or letting others know about the show by making a donation of any amount using the link in the show notes or by checking out the new offerings at the Lucid Path Etsy shop.

That does it for this episode…until next time.

Psychedelic-Assisted Psychotherapy with Emma Bragdon PhD & Benjamin Asher MD
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