In this episode, Joel, Steve and Ange take a long look at psychedelic assisted therapy (PAT) and how MI may or may not fit. We are joined by Joshua Bringle, PhD, Joji Suzuki, MD, Candida Mauer, PhD and Michael Fluop, MD who are all engaged in funded clinical trails ketamine and psylocibin. The conversation was fun, illuminating and mind altering (or changing) for some. The audience chat is included in the Transcript section.
On a side note, MIB is heading into our third year, with 42,000 down loads and continues to build a lovely international community of friends. MI Around the World is a international project offer low cost to no cost MI training in three time zones over the next two months. For more information, please visit us: https://www.eventbrite.co.nz/o/dr-joel-porter-18627665246 or emai: miworkshops@mail.com
In this episode, Joel, Steve and Ange take a long look at psychedelic assisted therapy (PAT) and how MI may or may not fit. We are joined by Joshua Bringle, PhD, Joji Suzuki, MD, Candida Mauer, PhD and Michael Fluop, MD who are all engaged in funded clinical trails ketamine and psylocibin. The conversation was fun, illuminating and mind altering (or changing) for some. The audience chat is included in the Transcript section.
On a side note, MIB is heading into our third year, with 42,000 down loads and continues to build a lovely international community of friends. MI Around the World is a international project offer low cost to no cost MI training in three time zones over the next two months. For more information, please visit us: https://www.eventbrite.co.nz/o/dr-joel-porter-18627665246 or emai: miworkshops@mail.com
Below is the chat conversation of the episode
9:04:24 From Clive Tobutt to Everyone:
Hi Joel
19:04:28 From Margo Bristow to Everyone:
Hello All, Margo - Chicago, Il USA
19:04:32 From Paula Casaretto to Everyone:
Bay Area, California
19:04:36 From Michelle Drapkin-Clarke to Everyone:
Hi everyone! It’s Michelle Drapkin (MINTie and Clinical Psychologist) from NJ
19:04:37 From Michael Clark to Everyone:
Hello from Oregon
19:04:39 From Sandy Francis to Host and Panelists:
Hi all - Sandy UK Somerset
19:04:39 From Clive Tobutt to Everyone:
Clive from London, UK
19:04:39 From Jeremy Nikel to Host and Panelists:
Jeremy, Tulsa OK
19:04:40 From Karen Gall to Everyone:
Good afternoon - Karen Gall, LMSW from Michigan
19:04:40 From John Baer to Everyone:
John Baer, Seattle WA, USA
19:04:42 From Debbra Snyder to Everyone:
Debbie, Ann Arbor MI
19:04:42 From MICHAEL FLAUM to Host and Panelists:
Michael Flaum here in Iowa
19:04:43 From Olivia Finnegan to Everyone:
Olivia, Boston!
19:04:43 From Kathleen Moreira to Host and Panelists:
Kathie Garrett Colorado
19:04:44 From Michelle Lynn Stephen Seigel to Everyone:
Hello from Michelle in the Ozarks en route to Bozeman USA today
19:04:46 From Alexander Faris to Everyone:
Madison, WI. Hi!
19:04:46 From Paul Burke to Everyone:
Paul Burke here from Victoria, BC< Canada
19:04:48 From Denise Barnes to Everyone:
Hello, Denise from Boulder CO
19:04:48 From Valle to Host and Panelists:
Milwaukee Wisconsin
19:04:49 From Brad Brazeau to Host and Panelists:
Calgary, Canada
19:04:49 From MICHAEL FLAUM to Host and Panelists:
Candida Maurer from Iowa City, Iowa
19:04:49 From Rachel Verhagen to Host and Panelists:
Hello from Rachel in Miami FL!
19:04:50 From Amanda Meinhardt to Everyone:
Kia ora Amanda from Aotearoa
19:04:52 From Jody Hereford to Host and Panelists:
Howdy from Boulder Colorado USA!
19:04:52 From Kathleen Moreira to Everyone:
Kathleen Moreira, Denver, CO
19:04:53 From Susan to Everyone:
Susan Larrabee from Boston, MA! Happy to be here!
19:04:59 From Mike Howard to Everyone:
hi all fro. a sunny West Wales
19:04:59 From anthony giardina to Everyone:
Tony Giardina- psychologist-Hawaii
19:05:00 From Kyle Bonbrake to Everyone:
Hi everyone from Huntington Indiana
19:05:04 From Bethany Hinchcliffe to Host and Panelists:
Hi all, Beth North Yorkshire
19:05:10 From Laura Blue to Everyone:
Laura Blue, Portland Oregon, USA. It is late morning and the sun is shining bright
19:05:11 From Alexandra Heinz to Everyone:
Hi folks! Alex Heinz - Boston, MA, USA
19:05:22 From Carrie Bader to Everyone:
Carrie Bader from Salem, OR
19:05:25 From Wanda Gallegos to Everyone:
Hey if you don't want to be here you can use this app to send a bot to the meeting with your name, and it'll record everything for you https://zoom.beulr.com/
19:05:50 From Valle to Everyone:
Milwaukee, Wisconsin
19:06:25 From BRIAN BORSARI to Everyone:
Brian Borsari - San Francisco VAMC and UCSF
19:06:53 From MICHAEL FLAUM to Host and Panelists:
I’m here. Candida
19:07:02 From FLORENCE DA SILVA to Everyone:
HI !
19:07:24 From Joshua Bringle to Host and Panelists:
Hi from Asheville NC!
19:09:18 From Kathleen Moreira to Everyone:
Kathie Garrett Golden CO
19:10:00 From Clive Tobutt to Everyone:
In the UK a University in the South West of England is offering a post-graduate certificate for treatment in this topic.
19:10:18 From Gina Javier to Everyone:
Hello! Gina Javier from the Philippines
19:12:36 From Valle to Host and Panelists:
My son just had ibogiane treatment at Beond in Cancun. And is now at Inscape Recovery in Mexico for 6 weeks for aftercare. Just did an ayawasca ceremony
19:13:02 From Valle to Everyone:
Is anyone else having issues with the audio?
19:13:18 From Michelle Lynn Stephen Seigel to Everyone:
Audio coming through great over here
19:14:15 From Valle to Everyone:
Just reset my AirPods and seems to be working now
19:14:49 From Michelle Lynn Stephen Seigel to Everyone:
Iowa City Iowa! Close to my hometown. Go Hawks!
19:15:02 From Candida Mauer to Host and Panelists:
Hi Michelle!
19:23:39 From BRIAN BORSARI to Everyone:
Thanks for naming this issue Dr. Suzuki
19:27:57 From anthony giardina to Everyone:
re- traumatization
19:28:20 From Michael Clark to Everyone:
Amen. Caution needed here.
19:29:05 From Michael Clark to Everyone:
Yea....Joshua
19:30:03 From Olivia Finnegan to Everyone:
I think one of the arguments, from a different framework, is the problem of monopolizing on indigenous/first nations' longstanding ritual/ceremonial healing for financial gain and perpetuating inequities against these people... I mean look at how expensive PAP cert programs are and think about who can actually afford those
19:30:04 From Margo Bristow to Everyone:
I wonder if you can discuss micro-dosing and full dosing. I have quite a few clients who discuss the benefits of micro-dosing.
19:30:32 From Michael Clark to Everyone:
agree Margo
19:31:24 From Michelle Lynn Stephen Seigel to Everyone:
Agree Margo, hearing a lot of chatter about micro dosing
19:33:07 From Carrie Bader to Everyone:
seems potentially easier to have a control group in a micro-dosing study?
19:33:23 From Joshua Bringle to Host and Panelists:
great point, Carrie
19:34:29 From Michelle Lynn Stephen Seigel to Everyone:
Such an important point so the general public can make informed choices—research is needed to guide those choices.
19:35:19 From Olivia Finnegan to Everyone:
Much of what appears to be most helpful with PAP is the self-healing-self, non-directive approaches... curious to hear how you all think MI either fits in with this approach or may veer off from it?
19:35:32 From Michelle Drapkin-Clarke to Everyone:
The challenge here is that we don’t have a clear path forward for the intervention side of the experience so still thinking about how Motivational Interviewing would fit in - prep/readiness and consolidation of gains from the experience? My mind is still trying to figure it out. Would love to hear more from this crew.
19:35:34 From Michael Clark to Everyone:
MI's need to enter this field, from my perspective, is to ensure it stays (becomes?) client-centered. I sense a fight in research,...."Science or Spirituality?" Science AND spirittuality?" Where's the client in this?
19:36:58 From Olivia Finnegan to Everyone:
Michael, I was thinking that too... there's always a risk of exploitation in the MI framework, as much as I love MI, I worry about clients getting "steered" towards a therapist's agenda rather than staying client-centered
19:38:02 From anthony giardina to Everyone:
ACT seems to be really involved in PAP integration.. a cousin to MI
19:38:17 From BRIAN BORSARI to Everyone:
I am interested in what the target behavior is if MI is being used? In order to be able to define what change talk and sustain talk is in the first place? The role of self-disclosure will also be very interesting to discuss as generally the less self disclosure the better in MI
19:38:43 From Michael Clark to Everyone:
Exactly. The client's voice should have a big impact on the destination
19:38:55 From Molly Magill to Everyone:
Hi Brian!
19:39:07 From Olivia Finnegan to Everyone:
Agreed, Brian-- I see the utility most for helping a client decide whether or not they even want to engage in PAP as part of their treatment, and then perhaps around changes they may want to make in integration
19:39:07 From BRIAN BORSARI to Everyone:
The issue of equipoise is intriguing in this context
19:39:17 From Joel Porter to Host and Panelists:
Hi Molly
19:39:17 From Margo Bristow to Everyone:
Trauma - Ketamine is being used in conjunction with CBT here in Illinois.
19:39:47 From BRIAN BORSARI to Everyone:
Hi Molly! What a great group on the chat
19:40:18 From anthony giardina to Everyone:
yeah Rogerian, client centered makes sense and is a big part of MAPs approach based on my training with them.. not sure of a target behavior with PAP is evident
19:40:41 From Joel Porter to Angela Watkins(Direct Message):
brb need to bring my dog in
19:40:51 From BRIAN BORSARI to Everyone:
Great point Anthony
19:42:11 From Kathleen Moreira to Everyone:
Has there been any movement in the use of MDMA therapeutic-assisted couples therapy?
19:42:30 From Kathleen Moreira to Everyone:
Pollan
19:42:50 From Olivia Finnegan to Everyone:
Thank you, Candida! I went to a conference and one of the presenters from Europe had a much different framework with his PAP like you are describing and I thought about the potential utility of that framework with addictions specifically (I'm a substance use disorders social worker)
19:43:02 From Joshua Bringle to Host and Panelists:
Yes, Kathleen, new studies within the department of veterans affairs in America at least. Early stages
19:46:49 From Joel Porter to Host and Panelists:
Cover story podcast
19:46:51 From Valle to Host and Panelists:
Interesting perspective about hypnosis in therapy
19:47:14 From Seonaid Anderson to Host and Panelists:
I'm interested to hear more about using MI during preparation for therapy and the potential contrast DURING session, e.g. client's perception of importance/confidence
19:47:23 From anthony giardina to Everyone:
the non-verbal/somatic aspects of psychedelic experience seems to be the space that is accessed and is most therapeutic.. so wonder if verbal therapies are even on the right track
19:48:26 From Kathleen Moreira to Everyone:
Excellent point Anthony
19:48:33 From Alexander Faris to Everyone:
Hi All. I’m interested in this group’s thoughts on what MAPS describes as inner healing intelligence. MDMA-AT is an “inner-directed approach” that puts a premium on calling forth a person’s unique agency to heal and recover. The mdma-AT therapists operate with Beginner’s Mind… placing trust in the person to have the “trip” that they need to have. They often follow rather than guide or direct. That’s very much client centered and MI-spirit aligned. But how does change talk fit in? Change talk is directional. To what extent does a psychedelic therapist use MI to influence choices in one way or another?
19:48:52 From Michael Clark to Everyone:
Yet, Anthonly, for me the description of the somatic
19:49:11 From Michael Clark to Everyone:
is integral
19:49:42 From BRIAN BORSARI to Everyone:
Right Alexander - I think of coding a PAP session and I imagine lots of FN unless you've got many different target behaviors identified?
19:50:07 From Michelle Lynn Stephen Seigel to Everyone:
Micheal your comment is such a guiding force for working with those who may be using psychedelics therapeutically -their voice should have a big impact on the destination and approaching with curiosity about what benefits they are experiencing etc
19:50:09 From Laura Blue to Everyone:
Meditation research has included east-meets- west components with Buddhist monks and fMRI scans and such. Is there anything similar in PAP?
19:50:13 From anthony giardina to Everyone:
or moving your body/being still- yoga/meditation etc, ..a form of description beyond wrds
19:50:57 From BRIAN BORSARI to Everyone:
and lots of therapist structure
19:53:48 From Alexander Faris to Everyone:
I’m reminded of what C. Wagner said in the talk about MI and theory. He spoke about the role of MI practitioner being to get behind and boost the person’s change talk… whatever that target might be… to help them find a path out of the woods. That pathway out would be the person’s own, but he would think of MI as a way to empower them through that process.
19:54:39 From Michael Clark to Everyone:
Michelle, It's almost like MAT and Opioid treatment. A huge fight if you give MAT ("forever") or if you work to titrate down and wean off after a time. Often, the client is NOWHERE in this conversation / decision.
19:54:47 From Michael Clark to Everyone:
Don't want this happening here.
19:56:36 From MICHAEL FLAUM to Everyone:
Basic “set and setting”
19:57:30 From Laura Blue to Everyone:
Set and setting seems like a worthy research area.
19:57:54 From Kathleen Moreira to Everyone:
Like a birthing room
19:59:19 From Mike Connell to Everyone:
Is there data on what % of people find the experience of using hallucinogens to be pleasant/enjoyable versus frightening or a jive trip?
19:59:26 From Alexander Faris to Everyone:
Agreed Kathleen
19:59:55 From Michelle Drapkin-Clarke to Everyone:
This attention to the experience is very aligned with MI training - not all clinicians are trained to be so attentive (believe it or not)
20:01:15 From Carrie Bader to Everyone:
@Mike - here's one study https://pubmed.ncbi.nlm.nih.gov/27578767/
20:01:44 From Valle to Host and Panelists:
Do any of you have experience or knowledge of Ibogaine treatment for opiate addiction? I realize it’s not a legal therapy in US but in Mexico there are clinics. Some are better than others. I feel like my sons experience at Beōnd was really well done. So much preparation as well as during the flood dose and subsequent boosters and then post therapy, and experiences to help guide them to recovery. He went to a different clinic initially which was fine but the follow up/integrations etc. was no where near like at Beōnd. Im not sure if they specifically use MI but it sure seems like they do!
20:02:07 From Michael Clark to Everyone:
Thank you!
20:02:47 From BRIAN BORSARI to Everyone:
uncovering personal argument for change
20:03:34 From Amanda Meinhardt to Everyone:
guiding
20:03:35 From Alexander Faris to Everyone:
Here’s what I wrote from Wagner… There are many right ways to do it… So much is about momentum… getting out of my own head and thinking about what someone should do…should be tuning in to look for those moments and help someone get momentum in whatever way out of the woods they want to go
20:06:53 From anthony giardina to Everyone:
lots of room for bad actors
20:07:18 From BRIAN BORSARI to Everyone:
Thanks for naming this Stephen
20:07:20 From Olivia Finnegan to Everyone:
I went to a conference this year called "Psychedelic-Assisted Psychotherapy: Promises and Perils"... I thought it was the perfect name for the conference! A lot of potential for healing and a lot of potential for abuse
20:12:02 From anthony giardina to Everyone:
https://medium.com/@theiridescentmind/you-deserve-to-feel-safe-on-your-healing-journey-4104a9f488a5
20:12:16 From Carrie Bader to Everyone:
Joel must have micro-dosed before this session
20:12:47 From Joel Porter to Host and Panelists:
hahaha
20:13:21 From Michelle Lynn Stephen Seigel to Everyone:
LOL Carrie!
20:13:57 From BRIAN BORSARI to Everyone:
Macro-dosed on caffeine
20:14:54 From Michelle Drapkin-Clarke to Everyone:
There are vulnerable people who are so desperate for help and protecting them and disseminating this is the most careful way driven by more solid data is important.
20:16:19 From Margo Bristow to Everyone:
Is that out of Tim Fongs group Michael?
20:16:36 From Alexander Faris to Everyone:
The drugs will be ready for use before the infrastructure (clinics, trained therapists, etc.) is ready.
20:16:44 From Michael Clark to Everyone:
How about collating PAT patients stories? To compile the "Good / Bad" from their actual experiences.
20:18:07 From Paul Burke to Everyone:
What I'v elearned today … I once heard Steve be asked "can I use MI with people with psychosis?" He replied by asking "would someone with psychosis want to be treated in the context of partnership? With respect? Empathically? With compassion? (etc). Of course, the answer was yes to all. It's probably the same with this. More emphasis on the relational dynamic between helper and patient, and less emphasis on the technical (and directional) aspects is probably good advice, at least until the science of the therapy itself is better understood.
20:18:45 From Onna Brewer to Everyone:
Well said, Paul
20:19:06 From Michael Clark to Everyone:
Well said Paul
20:19:50 From Michelle Lynn Stephen Seigel to Everyone:
Thanks for bringing this back to client values and experiences Joshua
20:21:18 From MICHAEL FLAUM to Everyone:
Steve is helping us understand the potential of MI in integration
20:23:32 From Michelle Lynn Stephen Seigel to Everyone:
MI 5 thoughts!
20:23:51 From Michael Clark to Everyone:
Steve: What is the idea you think should have been in MI 4th?
20:26:02 From Stephen Rollnick to Host and Panelists:
Michael - I was simply responding to Joji’s suggestion that Bill’s work on quantum change was relevant here in out discussion of psychedelics. In MI4 we never discussed this. And Michelle, MI5? Forget it! Not me anyway!
20:26:43 From FLORENCE DA SILVA to Host and Panelists:
Any searchers in France as far as you know?
20:29:14 From Kathleen Moreira to Everyone:
Thank you all. This has been a fabulous discussion.
20:34:10 From Joji Suzuki, MD to Host and Panelists:
sorry I have to jump off, thank you all!
20:34:15 From Margo Bristow to Everyone:
Eye opening discussion. Thank you all.
20:34:21 From Joshua Bringle to Host and Panelists:
So many great comments in the chat. Thank you for your contributions.
20:34:32 From Molly Magill to Everyone:
Thank you!
20:34:32 From Karen Gall to Everyone:
Thank you all. This discussion was remarkably well rounded and considered.
20:34:49 From Stephen Rollnick to Host and Panelists:
Bye Karen
20:34:58 From Michelle Lynn Stephen Seigel to Everyone:
Agree Karen, thanks Joel and crew!
20:35:04 From Olivia Finnegan to Everyone:
Thank you for a rich dialogue today!
20:35:21 From anthony giardina to Everyone:
Thanks all!! Aloha!
20:35:35 From Stephen Rollnick to Everyone:
Michael Clark: Michael - I was simply responding to Joji’s suggestion that Bill’s work on quantum change was relevant here in out discussion of psychedelics. In MI4 we never discussed this. And Michelle, MI5? Forget it! Not me anyway!
20:35:36 From Jody Hereford to Everyone:
Thank you, thank you, thank you.
20:35:39 From Bethany Hinchcliffe to Host and Panelists:
Thanks everyone
20:35:39 From John Baer to Everyone:
Thanks! Great conversation.
20:35:41 From Mike Howard to Everyone:
thanks for a great conversation folks
20:35:42 From Laura Blue to Everyone:
Thanks much everyone!
20:35:57 From Stephen Rollnick to Everyone:
Cheers John Baer lovely to have you with us
20:36:00 From FLORENCE DA SILVA to Host and Panelists:
Thank you so much Indeed. See you everybody !
20:36:16 From Joshua Bringle to Host and Panelists:
Hope to see you all in Copenhagen!
20:36:31 From Carrie Bader to Everyone:
👏
20:36:39 From Denise Barnes to Everyone:
thanks
20:36:40 From Amanda Meinhardt to Everyone:
thanks Joel and great panel. Hei k