Opening the Gift of Life: A Psychoanalyst’s perspective on healing

Podcast Introduction and Guest Welcome 0:00

that the psychedelic experience includes, there always seems to be sentience. There always seems to be a sense of me or I, or the being of me is being, even as I am losing my being, I still am noticing that I'm losing the being, that I am dying or I am dead, but I'm not dead because I know that I am dying or I am dead or dispersed over the landscape. So as he said, there still was an I, But it didn't matter that it wasn't together, that it wasn't under his control. And that could be just simply understood as like, whatever it is, it was before default, network mode, going offline, or some part of the brain going offline, but the self is still there.

Welcome to the To Curious MD podcast. I'm Dr. Ali Ahmed. And I'm Dr. Surya Ravan. With the wisdom from holistic, alternative, and these conventional medicines, we are here to challenge the status quo. We're curious about the connectivity and complexity between diverse fields of knowledge as it relates to consciousness, chronic illness, mental health, resilience, and beyond. learning more about the art and science of healing, or listening to stories of extraordinary healing. You're in the right place.

Let's dive in. Welcome back to our podcast, The Two Curious MDs, where we ask those unasked questions. Today we have Tom Broad, and Surya Raman is going to introduce him. He'll be speaking today on a topic that I think will be stretching the limits of this conversation on the ketamine experience, what's healing and what transforms in that ketamine experience. So I'll hand it over now. As we take that deep dive in, Soraya, would you be able to introduce Tom Broad for this podcast? Yeah, thank you so much.

I'm really excited for this conversation. Tom Broad, MD, is a psychiatrist and practicing psychoanalyst who works in the intensive emotion-based attachment model known as ISTDP.

Open the Gift of Life and Ketamine Preparation 2:06

Formerly, he was an associate clinical professor of psychiatry at UCLA Geffen School of Medicine. He has worked extensively in the ketamine-assisted psychotherapy or CAP sphere. He's active and teaches at the Los Angeles New Center for Psychoanalysis, coordinating the Film and Mind series and the Psychedelic Oriented Manifest Mind series. Inspired by Walt Whitman and the creative inspirations of Ketamine input, he shapes invocative poetry for Ketamine exploration. He's a compulsive assembler of eclectic playlists for CAP.

He has managed to hang on to his wife Lily for nearly 60 years. Welcome Tom to the Two Curious MDs podcast. Well, well, I am so excited to talk to you today because we're doing this work as non psychiatrists. You know, I'm not a mental health care provider from my training. And, you know, psychedelics, though, bring us into our process. When I talk to my patients and I hear about what they're going through and where we're going to. And you mentioned something about unwrapping this gift of life. And I wanted to kind of bring those two ideas in is that What are psychedelics here?

And then, you know, what are they here to do? What are they doing? How do we interact with them? Like all those ways in which we've learned. But also, what does it really mean? Like down to that question of how do we unwrap that gift of life? That really struck me because today I just did a couple of I want to check in, do my check in. I just did a group session and we had two observers, a therapist and a medical student. And it was really interesting to try to bridge those perspectives together.

And we did a lot of kind of building a container, everybody kind of getting to arrive, sharing their intentions and their perspectives. And everybody's coming to it from a different perspective. And then the two participants in the middle kind of have their journey and we're all silent and meditative and we're kind of here witnessing And then afterwards, everybody, every one of us is like, we're in it. We're feeling like, We've all arrived somewhere together and we're connecting so deeply with what the participants are relating.

And we're finding pieces in there for ourselves. And they're describing some architecture in there where one person is saying, every journey I've ever had, I felt like I was kind of getting to a place. And then this time, because of the way I prepped everything, they were describing kind of like this archer, kind of like drawing back their bow and piercing through. And that was like the psychological phenomenon that was happening of like them piercing through their fear and feeling at the same time and embodied kind of like opening in their chest.

And, you know, the medical students sitting there going, what is happening here? We don't watch this in training. And so I just got a little window into how weird it must be for people who are not doing this work, who are not in the psychological sciences or psychoanalysis or just this landscape that we all have the ability to inhabit and yet may not have any familiarity with. So those maps you know, that you and your professional life have really explored are just important and helpful. And, you know, I think Alia and I also kind of bring a cross-cultural element to this, which is just what are all the maps?

Let's see all the maps, you know. The global map. The global map. And, you know, I mean, I feel like, yeah, this this gentleman who was talking is of Latino descent, but his spiritual alignment is with Hanuman. And so what's happening there when you can pull from different traditions and your own tradition and really bring it together and it's operative, you make it operational. So I felt like today I saw one of my you know, really journeys that really like brings to light this idea of transformation and enlightenment and illumination and, and then some of those larger questions.

And I just felt like I wanted to share that with you guys as like maybe a starting point or an anchor for our discussion today. When I saw your statement, open the gift of life, I immediately thought of, you know, how do you open a gift of life? Like I've just never heard at way of looking at life that way, that you have to open to it, and you have to see it as a gift, and it is life. So tell us more about this phrase, and what does it really mean to you personally, professionally, and in the work that you're doing?

I've been working on some introductory remarks that I make with my patients, but ideally I am scheduling and there's sort of an informal tradition to call them flight instructions. So basically it's an invocatory column as flight instructions and what I'm doing, the intramuscular ketamine, I inject the patient and then I fiddle with various things that need to be done, whether it's the aroma therapy or the getting a second injection ready or I offer the patient's light and sound through a goggles instead of a mindful goggles.

So I'm maybe doing any of those things for a few minutes. Once the patient after three or five minutes says I'm beginning to feel it, I'm assuming this is about the first session for the patient. If it's first or early sessions, it's a little different. But then I read this poem, which keeps evolving and keeps changing. And At one point, I realized through my own Ketamine experiences that I like the poetic expression, open the gift of life, because it's all about our vitality, our beingness. There's a word that has to be in quotes, the miracle.

of being alive which extends far down into the so-called animal kingdom, everything that's alive, and in some way the botanical kingdoms and the fungi kingdoms too, I'm sure. But anyway, that's a diversion. So it's to be open to the awe, the freshness in the ordinary that is normally quite appropriately taken for granted or not noticed. It's built into the invisible ordinary that we live with. And that's one of our unspoken tests with the ketamine psychedelics is to make the ordinary visible again and awesome.

So that's what that phrase, open the gift of life is about blah, blah, blah. And I'm feeling like there's an element of maybe we've lost some of that, or it's always been this way where we kind of have to open to it. It's a participatory miracle in some way. And if we don't search, it doesn't arrive.

Psychedelics, Dreaming, and Unitive Experience 9:13

There's kind of like this coming together. And where do you think we All right now with this work, the relevance of this, the interest in this, almost kind of compared to the 50s and 60s when the first kind of psychedelic awareness increased in the West, how is this time different? Because this has happened before. We've opened as a culture to the all of life. Well, as you asked the question, I might've answered it differently a few hours ago or whatever, but as you asked the question, I think of it in evolutionary terms that life is continually making experiments and some of them work and some of them don't work.

And the ones that work over a long term tend to survive and become incorporated in the biological history. of the beings, and it's also true culturally. And right now we're in a gruesomely awful cultural time. But at the same time, with this psychedelic revolution, thanks to Roland Griffith's work, really, and then Michael Pollan following through. We're in an era where psychedelics, particularly through ketamine, but not only through ketamine, obviously, is opening people up to unitive experiences.

And I guess this will get to the core idea that I'm trying to work with right now. which is that psychedelic experience is a different form of dreaming. It seems to be very close neurologically to dreaming. and maybe also opening up more than just what was already previously stored in the tissues. That's a big question, isn't it? It sure is. You brought it in. That's the perennialist Aldous Huxley question, whether the funnel of consciousness is opened out and can bring in more than we previously have had.

So the purposes of our conversation at the moment, we don't have to decide whether these are literally transpersonal experiences that are downloaded to us in psychedelic states, or whether in a psychedelic state we are put into a kind of dreaming, sometimes called the oneric state, a kind of dreaming that allows us to take what we already know and freshly put it together. And we all know, as Jimi Hendrix called it, we are all experienced. So we know that there's something about the, do you want to call it the affect of love?

Let's leave that out. Let's just say there's something about love that's part of the experience. And that's part of the unitive experience that these various medicines provide us with. What does unitive mean? Unitive means the sense of all being connected in some way with different functions and different capabilities and different outcomes. So, I don't know. Did I get lost along the way? No, no, you're bringing it together. And what I'm hearing is a couple of things. One is that your meditative access, the dreaming access, that state of mind that we're able to utilize with ketamine to bring in that awareness into the open space of awe, right?

Into whatever awe looks like and whether that's the unitive one of the type of experiences is a unitive type of experiences where one feels that connection. And then the neuroscience for me, I know you're also a neuroscientist and have studied this in neurofeedback in the EEGs and seen that possibility of what changes in the brain in that sort of experience. And then comes the aspect of Well, why questioning like what is a unit of experience versus the access that you would get to so many different levels of consciousness, not just the subconsciousness, but the external consciousness that of things and how does that happen?

So, you know, I'm hearing these three categorically unique perspectives on this idea of opening oneself to the gift of life. So it kind of brings me to the question of healing. What would you say your view is on this aspect of what these treatments do biologically and existentially as well as humanistically to the human mind that brings them to a place of healing? And the guests, though, I am required to give an answer. I don't want to. I'd rather hear what you guys have to say and respond to that.

But, you know, I'll mumble a few things. So what is healing? It's a reorientation in a way that makes for better functionalism. So in classic psychotherapy, psychoanalytic psychotherapy, people are held back by their need to hold themselves in check because of the multitude of dangerous situations and dangerous thoughts about situations. that they learned in childhood and learned as they moved into adultness, adulthood and politeness and what politeness requires and all the big part of our brain is dedicated to inhibition and that inhibition protects us from being totally disorganized.

But healing helps us go to the places that have been overly scarred or tacked down, adapted through, I guess what we call defenses and sclerotization. So people get a free chance to loosen up and make connections that they hadn't allowed themselves to make connections. And at a deeper level, get a sense that what they've been frightened of is still possible to think about. whether or not it's acted on. That's very tight shorthand for the whole Freudian psychology. So you had mentioned earlier too that we're in this moment of kind of like great stress and breakdown.

And what I got from your description of it is that there are periods that happen like this and this exists in nature and we are nature and we're embedded in this greater thing of life, right? And I got this real great sense- And civilization. And civilization, and we're a civilization that is dependent on life, and we have a relationship to life, and we've kind of lost a relationship to this great idea that we're all part of our life. There's all of these layers of dissociation that we've had from it, But if we can flow with the great turning of life, which is the contraction and the relaxation, the destruction and the creation, I'm feeling like there's something psychological here that we as human beings are starting to recognize is useful to do.

Like you said, the alignment. back to functionality, where you mentioned sclerotization and getting hardened patterns. And what we're doing with these psychedelics is we're kind of shaking it up and loosening it and the taffy's getting a little bit warm because we kind of as a species need to do this.

Healing, Inhibition, and Cultural Breakdown 16:58

And we need to do it quickly because our technology has outstripped our ability to keep up with it. And I'm feeling like we are being asked, or maybe this is just us responding to the forces that are happening right now. And so even as you were describing, we're in this great moment of breakdown, but having that relationship to the great cycles of life brings me a place of peace, even in the midst of this crazy tornado, this just awesome destruction, as you mentioned, that is ongoing right now. And so you know, as you're kind of talking about like a spiritual jiu-jitsu almost.

Is that a spiritual what? Jiu-jitsu, you know, where you kind of have to, is that, is that the right one? Jiu-jitsu or the other one, you know, where you kind of have to gently yet forcefully redirect your energies because if we stay sclerotized and that's what we're seeing is people are just so entrenched in their stories of who is us and who is them and what is right and what is wrong and that's being used against us now right we are now in these encampments of warring factions where we've convinced that the other is so beyond the pale.

It's not about love. This is what the psychedelic type of medicines can teach us and are really permeating our culture. So we have a chance, maybe. Maybe we have a chance. But on the other hand, we do have some biology working against us, and that is that we're a predatory species. That's why we're on top. And the primitive force of winning and protecting our own It starts with protecting our family, and then it's protecting our own, and that gets defined. It's really a psychologically immature position.

It's a position of arrested narcissistic development, is what it really is. We've got to protect our own, so we're going to get rid of anyone who's not us. That's the kind of psychology, and it can poison a civilization. maybe worse than poison. So the more that we are able to enhance and support the love aspects that come from the use of the psychedelic methods, the more we have a chance to adjust our predatory nature. A few minutes ago, I mentioned simple stuff like as we get more mature, we become more polite.

so we don't front other people. That's really a simple bit of inhibition and integration. These are also the lessons of having a unit of experience. There's no doubt. Is there any doubt? I mean, I've just been reading about the arguments about mysticism and psychedelic mysticism the whole afternoon. But there isn't any doubt that these medicine experiences create the unitive sense, the sense of all being one and all being connected, however it's done. And if people are having these unitive experiences and getting a chance to contemplate them, it can provide a balance to these primitive forces that happen to be in power right now so i'm going to then now summarize a little bit just to simplify this for our audience you're saying that there's a certain level of wisdom i can show you my passport i've got a passport all right go ahead tell me tell us what do you mean your passport Well, you said it's been recorded.

It's an audience. They're all going to see it. But I have a passport. Oh, yeah. My house burned down six months ago and I'm not leaving where I am now. Yeah. So I have like three questions in my head. So I'm going to try and stick to the one, hopefully. The wisdom that you speak of that one gains or one has with maturity, with that unit of experience, that brings us together, that aligns us in our spirituality and aligns us with our society or with our culture. Yeah, social is society means social, right?

Yeah. Yeah, go on, please. Is there a lack of that type of experience without psychedelics? Are we living life the way we are away from that when that's the natural code or should be the natural code of, you know, pre industrial, pre technological times when we had daily almost, you know, practices of that unit of experience in all things we did, what we ate, how we slept, the rituals, you know, of sometimes the uncertainty of what we didn't know. and the magical thinking about how philosophies come together, the ideas that were shared around in storytelling and around the fireplace, around when we had community and connection.

You got three points. That was the first. So my response to it, it's not a direct response, is knowing that in Native American tradition, if you kill an animal to eat it, you honor its spirit and in some way you're honoring all that goes into the creation of that particular animal and its sacrifice for the good of the individual that's predating on it. That's a bit of an emotional problem. That's I guess why I try not to eat meat. At least there's respect, as you were saying, I'm echoing what you said, at that level there's respect for all the connections that are there.

There's not disregard. Well, I'll go down to the butcher shop and see how much it is about. And I want to bring in a little bit as you talk, both of you were talking, it sounds like what we're reaching for is that that this capacity does exist within us, because we must at some point have had it. Because as you said, Tom, in some cultures and a lot of cultures, they are ingrained. They are as part of the way of life that we've seen at some point we have lost track of it or because now our food comes packaged and different values are attached to it.

It's so far removed, right? So part of it is just what we're embedded in. As you were talking, Alia, I always thought as you watch a child developing, and their relationship to this world developing, right? So you've got infant, you've got toddler. We do have this moment when children say, and when they see an animal that's hurt, they feel for the animal. They really do. I mean, they are completely crushed by it and devastated by it, and they feel the emotion really strongly. And it's the acculturation around it.

that we've wrapped into it and said, oh, no, that's okay. Don't worry about it. And now we kind of, you know, and I think what we're recognizing is that that is an element that flowers in the human development. This is a capacity that opens up. And just like we know in certain times of development, certain capacities open up. And if we somehow shut those capacities down or negate them or tell them they don't matter, somebody who might be a very sensitive child is told no don't don't think you know what are you doing crying over that video of a suffering dog or something like that and they're just ashamed of that yeah and and and then they get shamed for it and there's this real armoring happening in, I think, the way we shut down that element of love and concern and connectedness for life that I think is embedded within us and I think everybody is born with.

Yeah, so I just want to- That's very profound, actually. Yeah. And it's simple as well. I mean, it's an idea that we've moved away from, I think, because it was ever-present. And we have to revisit it, as you said earlier. And we have to re-experience it. Well, our value system is completely turned around. It's like, study something so you can earn money instead of study something so you can enjoy it and learn about it and love it. And really discovered, and I think our musicians, our artists are the only ones that still hold on to that idea that your inspiration is the key to unlocking something and not how much it's worth.

That's ridiculous. Really? You mean our artists are the only ones? What about every hour that I spend with a patient, I feel that. There you go, you're an artist and because you're an artist claim your artistic self because you're right. What we do is also art. Absolutely. I don't think you know, I think what I mean is, yeah, like when you're not doing it for the money. you're not in that room with the patient because of the money, you're not, you know, and I think that's what matters. And then that's, that's the part that makes us, you know, think about it in that way.

But yeah, this brings me to my second question. Okay, which has to do with that. Experience of story of connection that you have with your patient as you're describing the setting of. You know getting the patient settled getting the injection ready and reading this beautiful poem that I still want to hear and setting that space.

Invocation and Flight Instructions Poem 26:48

that allows one to go into that discovery zone, call it. Are there any patient stories or anything that you felt was one of those experiences in your experience or in your patient's experience that really opened them up to the gift of life or they went and discovered the gift of life through that? Invocation. It's not that important what I'm sure the content is important, but it's not as important as the idea of an invocation. long ago. In college, I was an English major. I knew I was going to become a psychoanalyst when I went to college, but I thought I should do something in addition to my pre-med.

And from the Greek classics to the English classics, Milton and so on, always begin with invocation. And it's a way of the writer setting aside the ordinary and allowing, let's call it inspiration, to flow through and to be connected to the feeling that something greater is flowing through them. So flight instructions, if they're literally flight instructions, if you see a door open it, if you come to stairs, climb the stairs, that doesn't work so well anyway with Ketamine, because Ketamine is not particularly visual, but it works more with psilocybin.

But even literal flight instructions like that that say that, they're already creating a set that something is going to happen. And there can be expectation and a payoff when you expect something new to happen. And of course, also with those same flight instructions, the idea, don't turn away just because you're scared. That's the old Bill Richards thing, go toward what you're scared of. Did I address your question with the issue of invocation? You did. And now you have me curious to your invocation before your flight instructions.

What are your flight instructions? I have read them and I know they've evolved. But before you do, before you do, I want to ask you, you know, I believe this, I absolutely have found that to be true as well. And thank you for bringing in that. Yes, books and that inviting the muse, there's some sort of an invitation happening And I think psychologically, there's a mechanism that we're inviting. Either it's this sense of openness or either it's a sense of letting go of things here in this ordinary world to go kind of inward into a more familiar space, but also that ability that we have of when we repeatedly ritualize and go in, you know.

And I think that's what's also happening is our patients are hearing this over and over again. And that's allowing them each time to be in this perfectly primed astronaut, locked and loaded, you know, all the checklists are being done and the sense of preparation psychologically that we're doing. And I think you're right, that absolutely helps to center someone into the quality of the space because we've lost the ability to Yeah, drop into that on our every day. Like, when do we ever do that? When do we ever sit in that kind of relationship to reality anymore?

So would you like me to read my book called Flight Instructions, renamed Open the Gift of Light? Would you like me to share the screen or just read it? Yeah, I think that's a beautiful idea. If you can do both. put it on screen and read it? Or do you want to read it first? I think just read it and maybe we kind of do a meditative because this is... Closing your eyes. Yeah. I think we can kind of just invite our listeners to also do that and just take this moment to listen and settle in with your instructions.

Thank you. Okay. It's about four minutes long. And as I said, usually wait until there's some sense that the medicine is beginning to take hold, which is kind of a cheat because it makes it more beautiful than it might be otherwise, but you're going to hear it straight. We're going to just settle in our bodies and allow our breath to just kind of connect with our breath. Bring in that long deep inhale and just use that breath to fully engage with yourself and just with your thoughts and just allow anything that it is and any sensation, any awareness to just be noticed, just be acknowledged.

And then releasing with your breath as you exhale, any tension, any doubt, any question that takes you away from this very moment, just staying present with that, with yourself. Thank you, Ayla. Thank you. Open the gift of life. Turn into the wind. You're safe. Turn into the wind and be carried. Turn with the dust rolling, roiling, seen, unseen, teeming, tuning, turning into the air. You're welcome. Be welcoming. Welcoming the vast more as you turn into the wind. Turn with the sun, the source of life, to the east, south, west, to the north, turning above and below, orienting to the yet unknown more.

Unbound, you are in beauty and safe. From the east, dawn opens being, sun-seeking seeds stretching in light, turning towards next and next and next. Reach south, arching back ahead to radiate, lifting generations of aches, baked in being, illuminate the living of life, open west further toward ever, unbinding dimensions connected in more, Of north, ember's edge dissolved, light into dark, dark into light, it's now. Turn into the revealed realm of the ancient infused now, time without line, past seeking, past mine.

Now's timetable is ever now times all. Turn into the vast wind, you're more than the dust of rusting matter. turn through vast windows you're less than you ever dreamed before before you turned into mist winding the vast hole turn as a nut anchored to the wind secure to roll and plant in the edges of life a unit a cell of self the unfolded self me pressed into more than me now pressed into vast ever Safe you were as you turned, safe will be your return. And here's a mantra that you can repeat. I am safe in my being more than me.

I am safe. I welcome the more than me. I am safe. My being remembers the more than me. I am of the whole. My being in the more than me breathes me. I am of the whole. I am of the whole. The gift of life is vast. Now go, let go. Let God so-called the eternal find you. Go, let go. Safely find yourself within the vast more than me. Open the gift of life. That's it. That's incredible. Thank you. Oh, wow. The images, the structures you've captured in that cadence and the rhythm and the words that just poetry of the pace at which the opening happens and that right in that beginning.

And it's so lovely to have the accompaniment. of a human voice to just walk with you and say, this is okay. This is no, this is safe. This is safe. I know this place. We're all, we're all together in this place. Oh, thank you so much for. Yeah. Right. Not, not just writing, but reciting, you know, just how long have you worked on that? Oh, it's been more than two years. Like every time I have a Ketamine experience, it gives me a little bit more. So beautiful. It's inviting. It's curious. It's kind of activating.

There is a sense of lightness and when you invite the senses and the sun and the direction, the wind, part of the things that I feel sometimes with patients, especially is you don't want to direct their experience. Their experience is their own. And yet, here you're really giving them a platform from which they can launch, giving them the tools from which they can explore and just letting that happen and knowing that it's contained and it's still safe for them to do that. It's such a challenge for so many, that sense of safety in this mind exploration or this experience exploration.

So I'm really honing in on that part that really begins the next phase of their discovery. Also for many people, it certainly has in the past been my experience that going into the psychedelic state is terrifying to the flesh, giving up the control of the flesh through the experience.

Patient Transformation and Safety in Ketamine Sessions 36:38

So this poetry and my voice and the familiarity and the unfamiliarity that's all built into the poem happens at the time that they would be going through that yielding and giving up experience. So that's, that's what it's intended to do. Beautiful. And I do believe this is something that we can find on, like, I think you've shared it with the community. Is that correct? Yeah. I put it on the list of providers. Yeah. I don't know what everybody who students in is one of the providers. Yeah. Yeah, but thank you for doing that.

That's such a lovely gift to share. And I have to say, you know, just getting to know other people and yourself in this community, just how rich it is. And it's all about this inner experience and discovery. And each time we have this conversation, it's different with different people. So I've really enjoyed just how spiritual You know, this journey is for you, how meaningful, you know, and how grounded in our current reality. So thank you for sharing your wisdom, your deep, deep wisdom, and your beautiful poem.

You know, you said you've had 31 guests or something like that, and each one is different. And of course, that's exactly true. The fingerprints are unique. And that's one of the really interesting things to me about the ketamine experiences now I've done. I don't, I don't count anymore, but I've done well over a thousand hours. And, uh, because I, I work with some people once a week, you know, for years, like a psychoanalyst does, I don't think there are too many people who do that as a, as a therapeutic model, but I'm a psychoanalyst.

So it's for me, it's natural. And it's really, which I say it's reaffirming. to notice that every ketamine adventure is different from the other one, but each person has their own type of experience. They have their own clustered type of experience that's unique to them. That's part of why I know that it's like dreaming. It's the same way with dreams. There are certain themes, there are certain elements that may be in common. Ways of dreaming, yeah. I had a dream the other night that was extraordinary.

I'm not going to bother to go into all of it, but just this much. In this particular dream, it was a big meeting. And there must've been, you know, let's say more than a hundred people at the meeting. And it happened that one by one people got up and they said what they wanted to talk about. And the goddamn dreamer, that's me, made up all of these different people that I've never seen before. I don't know anything about them. I don't know what they look like or how they think. And they all showed up in the dream.

How did that happen? That's not the way I typically dream. But it happened to be what came through me and some of the conflicts and issues that were underlying it are very much mine. Thank you, Ian. Thank you for relating, I think, bringing also to question here or to the center here that we always talk about psychedelics in the perspective of healing, PTSD, depression, anxiety. And here we're talking, well, what's coming through for each individual is so different. And I find that they are kind of excavating and looking for their soul's purpose.

And each person's purpose is so absolutely different from another's that when people say, well, this worked for them, is ketamine going to work for me too? In that is this big question of like, I don't know, for some people, you know, they've done the pre-work, they've primed it, they've, you know, taken that bow and arrow and they've, you know, pulled it back and all the ketamine is helping them do is release it. Right. And then for some people, they're like, what's a bow? What's an arrow? I don't even know.

So I think just even recognizing that there is some sort of element of this, which is a clarification of each person's particular. Yes. Like what's coming through in your dreams, what's coming through you and paying attention to that and learning how to read it and learning how to be with it. You know, it's very interesting working with people over the long, long bowl and how they, how they slowly change. Oh yeah. You, you had a third point. I don't know if you remember what it was. I do. And one, one has to do with the difference between transformation and just that transformation and just, okay, I'm better now.

but relief, right? What is the difference that you've seen, I guess, patient to patient? Is it experience related? Like, does one have to have kind of a psychedelic experience to really transform, or are they going to just be okay if they just have the medicine and feel better as an antidepressant? Gosh, I don't know how to answer that. I mean, I have so many patients who look for quotes around to get better from my interest in them and what we work on together that have nothing to do with any kind of psychedelic medicine.

It's having learned how to listen in the context of a lot of interest in what the person is talking about that is helpful, as I understand it. And then the medicine provides a looseness and an availability and an intensity. The question that I'm seeking or the answer I'm seeking is, what is the difference between what really heals in the experience? Is it in the experience when one has this opening to the gift of life, whether it be with a substance or not, that they really heal? versus them getting a medicine and saying, I've had an experience, I'm better because of the medicine's chemical effects.

So there's that spectrum of effect. For me, what I see is it all depends on the patient. It all depends on the opening that the patient allows themselves to be. And are they ready for such an experience? Is this the right thing for them? And so that assessment that I think is often I feel more and more now after doing thousands of sessions, I feel like that's the question from safety point of view of because when these kinds of these sort of transformations occur, they change lives, they change people, they change identities, they change behaviors, they may alter their own the situation to the point that they can't deal with that.

You know, they can't live in the same environment because of the constraints around them, which is what led them to be in that constrained position. So there's that assessment. And I know I've asked, I keep going with a different kind of wandering from this topic to the other, but because to me that there is these certain points where I like to question what is better, what is better for this patient and how do they get there based on whatever place their in for themselves. You anticipate my response in your continuing the question, because you do have experience with thousands of people with some terrible, terrible, nightmarish experiences that keep happening to them.

And so maybe what you get is the question, well, how come people do get better? Why? How can they? It's so deeply stuck in them and then they get better. How? So can I turn it around for a moment and ask you? What do you think? Yeah. How do your vets get better? Well, I believe, and I think what's just the narrative medicine based ideology is you have to know where the patient is in their story. And it's following that patient in the arc of that story to really assess first is, you know, the critical nature of their presentation when they come in and their cream of the crop complex patient who have everything's failed them.

And when they've come in, this is their last resort. So it's, there's that impetus that I have to do something here. And when I've, you know, make that do that intake off and say, well, what are your barriers? You know, what would prevent you from you know this ideal imagined outcome that you're seeking for yourself whatever that is and understanding and their resources where they're at and often that spiritual nature getting the history of their spiritual experiences and spiritual access or spiritual beliefs Because for me, that helps predict kind of their belief system and their understanding of this kind of mystical, this type of experience and that letting go and that trust in something bigger and beyonder than themselves.

That gives them that trust and distrust. Yeah, trust and distrust. And after so many thousands of sessions, the answer still remains. in my head about, well, this patient is better from feeling better because now they're not depressed and they're motivated, they're moving their bodies, they're eating better, they have more. trust in themselves, they feel unburdened. And they've been able to communicate that, whether that in therapy or whether that in that trusted relationship, that alliance. And then there's their patients who have had psychedelic experiences and speak to the nature of that experience as something beyond themselves.

And we have this one patient who in their second session had an ego dissolution session. And since then, everything else has been mundane. But that one session just changed the nature of the game for them because they were able to completely dissolve. And now they go back. They had a dissolution of their life. They died in some way. We thought they were dead or about to die. Probably thought they were dead. And they came back through a loving membrane that stayed with them. Yeah. They reached out.

They were scared in that process. They held on. and knowing that somebody was with them in the room, knowing that they had that physical contact, that emotional contact, they've been okay since. It's almost like, do you need any more sessions? Because I mean, everything is less important than it was. The situation that they were surrounded by, it's not as important because they've seen something, they've released themselves in that. I imagine that if they were tripping on their own and had a very, not quite right shorthand, they had ego dissolutions.

Ego Dissolution, Dream Interpretation, and Meaning 47:48

They had an experience of dying and they were on their own and it turned gray and dark and cold. That's traumatic. and re-traumatizing, but being with you and your lovely smile and your voice and knowing that you're there and the whole security of the two person arrangement makes it a completely different thing. I've come back through, I'll use the phrase from before, I've come back through a membrane of love and it stayed with me. I love that, the membrane of love, because it's like the baby being reborn.

It's like if you die, you get to be reborn. And what that means is it's as if a little, you know, I took a little cotton wool and a little bit of cooling witch hazel and I just like kind of put it on top of a hurt, that cooling effect of that membrane that you're talking about and what it does for all of our pains and our hurts. any kind of jaggedy edges, as you said earlier, how it can help us to bounce back a little bit and be a little bit more less jagged, more kind of constituted in the way we're supposed to be, which is to feel whole and to feel love.

And yeah, I mean, I think sometimes that just that one experience and I've had patients who've you know, gone through and come back and never needed another experience again. You know, they're in that classic Alan Watts, like, if you hear the message, hang up the phone. They're like, I heard the message. I'm hanging up the phone now because I got this. And you're right, too. I think both of you recognize this is people who come to this medicine are coming when they've exhausted every other situation.

And I do think there is a level of desperation that is needed before any of us will jump into the unknown because it's scary. It's like if everything was OK in your life, Would you choose to do this? And yes, there are people who do it in the name of exploration. But for most people, this is not cool, because coming back to their everyday may be just too jarring. I have a completely different agenda item before we say goodbye, if I could introduce it. While I was reading and studying today for a paper that I'm attempting to pull together, I came across a Michael Pollan quote And it raises the interesting question about psychedelic experience, the mystical as personal experience.

And I'm going to get that quotation. It was used in a different way in the paper that I was reading it from, but I wrote it down. This is Michael Pollan's, I think, page 236 of the book. He says, and he puts that in quotes, Now, I turned into a sheaf of little papers, no bigger than post-its, as if they were being scattered to the wind. But the I, taking in this seeming catastrophe, had no desire to chase after those slips and pile my old self back together, no desires of any kind. In fact, Whoever I now was, was fine with whatever happened.

No more ego. Well, that was okay. In fact, it was the most natural thing in the world. And then I looked and I saw myself out there, but this time spread over the landscape like paint or butter, thinly coating a whole wide expanse of the world with a substance I recognized as me. What had always been a thinking, feeling, perceiving subject based in here was now an object out there. I was paint. He's a wonderful writer. So I was thinking about how you would interpret that as a dream. And at one level of the dream, if you just interpret it as just simply a dream, then he is taking the experience of, well, okay, I have to say it beforehand, but the psychedelic experience includes, there always seems to be sentience.

There always seems to be a sense of me or I or the being of me is being, even as I am losing my being, I still am noticing that I'm losing the being, that I am dying or I am dead, but I'm not dead because I know that I am dying or I am dead or dispersed over the landscape. So as he said, there still was an I, But it didn't matter that it wasn't together, that it wasn't under his control. And that could be just simply understood as like, whatever it is, it was before default network mode, going offline, or some part of the brain going offline, but the self is still there.

So it could just simply be, let's use the shorthand again, ego dissolution. But now let's look at this as a revelation. Revolutionary revelation in fact. It's a way of the beyond talking back to Michael Pollan saying, look at you son of a bitch, look at you. You're not gonna dissolve into nothing. Most people just turn into dust, dust that circulates as long as there's air around earth, but you're able to do something which is transmitted and translated and covers the whole globe. Little, little bits of you that don't have you in them and yet are you.

And it's what you've done. What's it called a prediction? Yeah. The landscape of blending of that connection to the, to the colors. So that's the future talking to him, talking to and talking through him. That's an interpretation. May or may not be right, but it seems right, doesn't it? Yeah, I love to think about that. I'm going to put that in my paper. Yeah, thank you. Good. The definition or the actual... That story, that little story in the dream interpretation. Yeah. And there's so many different ways of interpreting that, but that central piece, which is when I dissolve, there's still something there.

is something that when our patients encounter for the first time, they're kind of shocked by it because those two things have always been so interrelated. But I think that's the first step is like, what does it mean now that you can have this experience and that this person here now, all the things that are in your default mode network, personality, history, dah, dah, dah, dah, dah, is when it goes away, this you doesn't really care. and is actually looking at and yes there's this wonderful like perspective taking aspect which that gives us which i think is what gives us a lot of relief over the pains of our small self sufferings because it's just like well those actually don't matter in the grand scheme of things and And then what I'm kind of- They matter a lot to us.

To us, yes. As human beings, as embodied human beings, they matter a great deal. This person really cares about it. In a big picture, they don't. And we're all connected to the big picture. Yeah. And there's this kind of understanding of like, you talked about the funnel. I talk about it like the aperture of a camera, I think we're talking about a really complicated structure here that does have kind of like that qualities of being able to hone in and be small and then be able to expand out and somehow have more information coming through it, right?

And that going between couple of states in that constriction changes how we think about this self. that's as far as i'm gonna go with that interpretation but i think recognizing that we even have control over that funnel is probably like another step right that i try to teach my my patients is like you can get into this state from listening to music and exercise and being with somebody you love and you know being in nature and all of that you source more from this place access access and and then recognize also when it's getting constricted and constrained and is getting very tight and that nothing is getting through and that's that like no inspiration no love no nothing you know and whatever the reasons for that are and then then the next kind of framework that i think of is the concept of indras web.

Which is that everything in the cosmos is kind of yet you know contained in the microcosm as well as the macrocosm and. We are a web of meaning and we're each reflected in each other. So I contain within me both Alia and Tom in this place of non-dual being where it's like, I'm not me and I'm not you guys. You know, I'm kind of both and that's kind of cool too, cause we're all having an interaction, but it's hard to live in that place. But we kind of see that when we go into psychedelics, we really recognize and be with and experience the fact that We are all one.

We are all one. We are one and we are of one. Yeah. Right. Right. We are of one. And, and so, yeah, there's no separate talking about that. There's nothing that, there's nothing, there's no separateness. So going back to Michael Pollan, he's, he is all those pieces, but he's also the person, the being or the presence that can look at that experience and make meaning of it in some way. So that transpersonal nature of it. And the meaning changes. That single metaphor may be interpreted when it's revisited in so many different ways that the fragmentation of the posted notes and then the coming together is something else and that it evolves.

And I could read this again and say, wow, this is, this was what it means. No, no, no, no, no, no. Because of this experience, this is what it means. So it becomes something to anchor them, the patients to their sense of reality, like, just because of that experience, they're able to really engage with it. So I guess I answered my own question. Or you answered it for me. You answered it with that paragraph, really, that the experience is important. You know, that experience becomes meaningful. because we bring meaning to it and we see it in so many different ways and we're able to lift from that experience.

We can access it again. Yeah, if we've accessed it once, we can access it again. And I think that's where that trust piece comes in, to be able to trust that this is actually who we are. And that's a whole other conversation. And it is time to end this conversation. Like the psychoanalyst that I am. Thank you so, so much. This was absolutely beautiful. Thank you. Yeah, it was great fun. I feel like we're going to have another chapter in your book or in your next paper. And we need to revisit this again because there's other topics here that we still have not addressed.

For sure. Okay. Thanks so much. Thanks for joining us on the Two Curious MD podcast. We hope today's episode inspired you to ask new questions and explore fresh perspectives. We challenge you to ask us those unasked questions that you're curious about in your medical practice, condition, health, and wellness. If you enjoyed the podcast, don't forget to subscribe, share it with somebody just as curious, and leave us a review. It helps us keep the curiosity alive. Post your comment with a question or curious inquiry that you have and seek to explore or learn with us.

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