The Current State of Psychedelic Treatment with Erin Wright

In this episode of the Relational Psych Podcast, host Dr. Carly Claney is joined by Erin Wright, a leading expert in the field of psychedelic therapy. They delve into the current state of legal psychedelic treatment, exploring the transformative power of substances like MDMA and psilocybin in mental health care. Wright offers invaluable insights into the latest research, ethical considerations, and the future of these groundbreaking treatments. Whether you're a mental health professional or someone interested in the evolving landscape of therapy, this episode offers a thoughtful and informative perspective on one of the most exciting developments in modern psychology.

Links:

Erin Wright Counseling: https://erinwrightcounseling.com/

Instagram: @erinwrightcoaching

MAPS (Multidisciplinary Association for Psychedelic Studies): https://maps.org/mdma/

Dance Safe: https://dancesafe.org/

DrugsData.org: https://www.drugsdata.org/

ClinicalTrials.gov: https://clinicaltrials.gov/

Psychedelic Support Network: https://psychedelic.support/network/

Spirit Pharmacist: https://www.spiritpharmacist.com/

Psychedelics Today Podcast: https://psychedelicstoday.com/podcast/

Chacruna: https://chacruna.net/

Polaris Insight Center: https://www.polarisinsight.com/

© Relational Psych 2023

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Transcript

The Current State of Legal Psychedelic Treatment with Erin Wright
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[00:00:00] 

Carly Claney: If you want to learn about psychological growth without getting lost in complicated language, you're in the right place. This is the relational psych podcast. I'm your host, Dr. Carly Claney. Licensed psychologist and the founder and CEO of relational psych. On this show, we learn about the processes and theories behind personal growth. Please keep in mind that this podcast isn't a substitute for therapeutic advice, but we're here to point you in the right direction.

Well, today we have Erin Wright. Erin Wright is a consultant, supervisor, educator, coach, and psychotherapist who specializes in psychedelic integration in Seattle, Washington. She has completed training in MDMA assisted therapy through the Multidisciplinary Association of Psychedelic Studies and has training and [00:01:00] experience in ketamine assisted psychotherapy.

Carly Claney: Erin is co president of the Northwest Alliance for Psychoanalytic Study and on the board of the International Forum for Psychoanalytic Education. Erin, thank you for joining me today. Yeah, I'm really 

Erin Wright: happy to be here. Thanks. Yeah, 

Carly Claney: so the question that we're going to be talking about is what is going on with psychedelics?

And I feel like there's so much to say about it. So where should we start? 

Erin Wright: Yeah, I think it's important, whenever we're talking about something, especially in the mental health field, is to give a little background on how we got into something. I had a really amazing supervisor at one time. I think she's actually been on the show, Rachel Newcomb.

Who, yeah, she I love the stance. She holds that all theory is autobiographical. And I think that is really important to, so we know where people are coming from as they present information and talk about things. So I'll just talk real briefly about what drew me to an interest in psychedelics.

Kind of [00:02:00] two things are happening at the same time. I was working with a client that I had been working with for quite a while. They started experimenting with psychedelics on their own. I used to work in an emergency room, so I kind of saw the dark side of drugs and came from this stance of all drugs are bad because of what I had seen in the ER.

And when I think about it now most of the things that came into the ER were not psychedelic related substance emergencies. A lot of What were they? What did you see? A lot of meth. A lot of meth use. Heroin, overdoses but the main one was meth that we would see a lot of coming into the ER.

So I kind of had that bias. Coming in to this work and then this client started bringing some of their experiences up and I was really amazed at some of the insights they were coming to around exploring these substances and. [00:03:00] They had been doing really good work for a long time, but it was like they were starting to finally get some things on a really felt level.

I think that work that we do in therapy trying to bring things down and really change people's affective responses and nervous systems, it seemed like that was really happening with this client around some things. And so I was like, wow, this is Actually, really incredible. So I started getting interested in it from that and then kind of alongside that I have been doing my own work for a very long time.

Then a lot of therapy. Yeah. So I've done a lot of good personal work that I am. But I kept bumping into things in my life that just didn't feel great to me and were really impacting my life in really significant ways. And someone who is really close to me has known me for a really long time and really knows my journey and story really well.

It was like, "Erin, I was you know, talking to somebody the other day about psychedelics and I just [00:04:00] couldn't help but think of you as I was talking to them about this". And so, that led me to exploring these things on my own for my own personal use. And they had a really tremendous impact on me and my life.

And I was like, man, This is really incredible. And so then I just kind of jumped in from there into learning more about things. So, yeah, 

Carly Claney: yeah, that's incredible. It seems so significant to both see it in a client's life, especially the work that I'm guessing you do the depth oriented work where you know people really well, you know what's the work that they're doing to really get to know themselves and sit with themselves.

But it sounds like it was a move from that insight, like just kind of in their head. And once they started the psychedelic work and the integration with you if that is what it was at the time, then they really were in their body, not just in their head. And then maybe a similar thing for you, you got to experience it and I think it's always really amazing when people who know [00:05:00] us really well can make that kind of recommendation. It can be so scary or overwhelming to start something brand new, especially like psychedelics. There's so much I don't know feeling about it. There's so much fear around it or questions or unknowns because it's so new and so to have someone to bring you into it in a way that might make it feel a lot more approachable and personal for this will be helpful to you.

So then it sounds like you got started on education and what did that look like? 

Erin Wright: Yeah. So, I kind of started just gobbling up things wherever I could find them. I used to run for about a year and a half or so. I used to run a health care professionals networking group for people who are interested in learning more about psychedelics.

So, brought a group of people together for a while to network and learn more. So I was doing that. And then The Multidisciplinary Association for Psychedelic Studies, MAPS is the acronym for that. They were doing an [00:06:00] MDMA assisted therapy training program. So I applied for that program and got accepted and went through that training to MDMA and what kind of the that will likely head towards legalization here in the next couple years.

So that was the main thing I was really interested in. I'm really interested in PTSD and there's so much trauma in our world in so many different ways. And I think MDMA is a really incredible medicine to help people work through trauma. So that's really what drew me towards that one specifically.

And then also pursued training in ketamine assisted therapy. And was doing that for a little bit until my clinic closed and what drew me to that was it's legal now, so people can go get ketamine now. And I wanted kind of some of that more legal sitting experience with people at the time.

Carly Claney: So I think we've listed a lot of different names so far, a lot of different psychedelics. [00:07:00] Can you give me an overview of what we're talking about there? 

Erin Wright: Yeah. So MDMA is what we call an empathogen. The long name for it is 3, 4 methylenedioxymethamphetamine.

So it is an amphetamine. It is a stimulant. been around for a long time. It was actually first developed through a pharmaceutical company called Merck in Germany in 1912. And then really wasn't paid much attention to at the time and then was re synthesized by a chemist here in the U. S. In the 70s his name is Alexander Sasha Shulgin, who's not alive anymore.

So that made an appearance then in the U S and really MDMA, a lot of people don't know was legal here in the U S for a long time until about the eighties. I think it was mid eighties where it got outlawed, but you could go into the bar and order a drink and a tablet of ecstasy. Yeah.

So that's MDMA and [00:08:00] then ketamine is what we call a dissociative anesthetic and has been around for a long time. It's actually considered an essential drug by the World Health Organization because it's. It's a very safe drug. It's cheap. It's been used by the military and battlefields for quick medical use.

But what they eventually found was that given in low doses ketamine can produce psychedelic effects. So And 

Carly Claney: can you even define that? What does that mean to have a psychedelic effect? What's happening? 

Erin Wright: Yeah. So, Whenever we talk about psychedelics and usually how they're working this includes ketamine what we often refer to as the default mode network.

And basically what that is is a network in your brain. I'm gonna put it in real simple terms here. We all have kind of these neural pathways and grooves that have developed in our brain over time, often due to life experiences that we've had. So, there are ways, their tracks in our brain that we see the world through and it can be hard to get out of those, [00:09:00] right?

And that's often what leads people to therapy and therapy works with that. But it takes a very long time and what psychedelics do is including ketamine is, it turns down the default mode network in the brain and helps parts of the brain talk to each other that haven't either communicated in a really long time or maybe haven't communicated before.

And so they turned down the tone on that default mode network and help us maybe get some access to some other ways of thinking and experiencing things. 

Carly Claney: So rather than maybe just one map, I'm thinking of like a road with grooves and all of that. Yeah. Okay. Is it possible to think that it becomes three dimensional?

There's like a different variations that rather than what you're seeing, there could be like a bridge between that's not actually there or a different path. Is that visual or how would you change that? 

Erin Wright: It can be visual. It can be insights. It can be a different affective way [00:10:00] of experiencing things.

It could be a different way of experiencing in the body that you haven't experienced before. It can look a lot of different ways, 

Carly Claney: but very, it's just a different thing that would, it wouldn't come from you originally. It wasn't a part of your original map road that you've experienced before. 

Erin Wright: Right.

So one of the things we are doing in therapy is trying to help people have different ways of experiencing things or thinking about things. Sometimes one of the things we're doing is maybe having that corrective relational experience as well. So we're trying to really help people, we're trying to help people rewire their brains in a way, right?

I mean, there's a lot of neuroscience behind that. You think about Dan Siegel on the developing mind. That's a lot of the work that's happening in therapy. The way I think about psychedelics in this default mode network is psychedelics are kind of a supercharged way to do that kind of work.

And it often goes a lot faster, which can [00:11:00] be really good, but can also be difficult for people as well. Yeah. Which is really why it's really important for people to have really good supports while they're exploring using these medicines. 

Carly Claney: Yeah, for sure. Okay. Thank you for that side tour because I think that's helpful to even know what we're talking about when we're thinking about psychedelics, and I interrupted you at Ketamine, 

Erin Wright: Yeah, it's okay.

MDMA, Ketamine, and then you have what's called your classic psychedelics. So that would be like psilocybin, which is the The psychoactive ingredient in magic mushrooms. That would be LSD. DMT, which is the psychoactive ingredient in ayahuasca. And then another compound called five M E O D M T as well.

Carly Claney: And so that all those that you just listed, those all are types of 

Erin Wright: psilocybin. No. So, psilocybin is just the active ingredients in magic mushrooms. So, psilocybin is just mushrooms by itself. Yeah. Okay. Okay. Yeah. And so, the way those differ for something like [00:12:00] MDMA or ketamine is the way that they work in the brain and the different receptors they work on.

So, your classical psychedelics are going to be a bit more visual in nature. And they work on what's called the 5 HT receptors in the brain. Whereas something like MDMA is working more on how they think it works is turning down the smoke screen on the amygdala. So it turns on the body's fear response and is more releasing chemicals like serotonin oxytocin and dopamine into the brain, which creates this really safe feeling.

And then ketamine works on the glutamate system in the brain. 

Carly Claney: Thank you. I think that's a really helpful outline of all the different substances we're talking about. And I think you did a little bit of this of bringing it back to therapy, bringing it back to what is it? Like, why are we even thinking about this in therapy?

Why has the field expanded in this way? And maybe to get a little bit of that history what is, [00:13:00] why are we talking about this 

Erin Wright: now? Yeah, so there is a ton of psychedelic research going on in the fifties and sixties. That was really what we would call kind of the first renaissance or the first golden age of psychedelic research.

There's lots of stuff going on with LSD, especially. A lot of people don't know this, but one of the primary ways Bill White, who's the founder of Alcoholics Anonymous got sober was through LSD. Oh yeah. And so, the book, the AA board wasn't exactly on, on par with all of that.

And so they wanted to like very complete sobriety model. So that part kind of got quieted a little bit in the history, but LSD was a huge catalyst and what helped Bill White get sober. Yeah. So there's a lot of great research happening. And I really think until psychedelics started becoming outlawed and maybe illegal in the seventies, which was a broader war on drugs that started happening,

I really think [00:14:00] we might be doing therapy differently now if those medicines hadn't been illegal and they were placed in schedule one which if you're familiar with the drug schedule in the U S so the drug enforcement agency basically schedules. Drugs in the U. S. into Schedule 1, 2 3 there may be a 4, I'm not sure.

But psychedelics were put into Schedule 1. Schedule 1 means highly addictive and no accepted medical use. So once they were put into that category, all research had to be shut down. What else would be 

Carly Claney: in that 

Erin Wright: category today? Marijuana is considered a schedule one substance. So methamphetamine which is wild if you think about it, opiates are not in schedule one. Ketamine to schedule three drugs so it can be used accepted medically Really, I think what it points to is how the war on drugs and drug scheduling in this country is more related to politics [00:15:00] more than any actual science. Something like mushrooms and mdma, they are not What we would call like physically addictive. So you're not necessarily going to experience withdrawal symptoms if you use mushrooms and MDMA now, can you abuse them? Yes, for sure. That can definitely happen. But if you think about something like alcohol, which is not in schedule one either If you think about how alcohol, if you drink too much you know, you can become physically dependent over time.

You can experience withdrawal to where you need medical detox. With these psychedelics I think the bigger risk is maybe more of a psychological addiction where you kind of become addicted to the experience of itself, because these can be some really amazing experiences and somebody just wants to stay in that space all the time.

But they're not going to necessarily get your body hooked on them. Now, if you do abuse them, something like MDMA, if you abuse that frequently [00:16:00] over time it can deplete the serotonin system in your brain to where you can develop like chronic depression over time because of your abuses.

And we're talking about like chronic use here, like every week or something like that. You know, I wouldn't ever recommend somebody to do that. 

Carly Claney: Yeah. So yeah, I think that's helpful. Even abusing, we're talking about every week. Is it also how much you're taking at once? 

Erin Wright: How much every week? So like any other substance, there's potential for abuse.

Yeah. Yeah. So we, so if we come back to therapy now You know, Matt started doing a lot of their own research and started up the MDMA trials for MDMA assisted therapy for PTSD kind of in the late 90s. And they've spearheaded a lot of that research, MDMA for PTSD. So, now we're in what people would call kind of the second psychedelic Renaissance where there's been a lot more research going on.

I think the important thing to note though, is the research that's happened has [00:17:00] primarily been funded by private money which really limits the size of the trials that can be done. And what a lot of people maybe don't know is that most of the medical research in this country is funded by NIH, which is the national institute of health.

And there was a period of time where the only clinical trials involving psychedelics NIH would give money to would be trials that were basically showing them as dangerous. So they did just issue I think in the past year or two, they did finally give some money to do a study for psilocybin for tobacco cessation as well as they did give some money for that.

So I'm hoping that they'll show some willingness to fund some more studies. Yeah. Yeah. 

Carly Claney: Yeah, it's interesting. Why is there that connection between psychedelic work and trauma? 

Erin Wright: So like, how do, how can psychedelics help somebody with trauma or why has maybe it been effective with trauma? Yeah. Yeah, 

Carly Claney: I think both like why it got started in the first place, making that linking and then, [00:18:00] yeah, how it helps.

Erin Wright: Yeah. So I think let's talk about MDMA with that because those are the studies that have been done specifically for PTSD. MDMA is a pretty incredible medicine and that and you'll hear me, sorry, you'll hear me use these terms interchangeably, medicine and drugs. I prefer to use the term medicine, but because I have grown up in a society that you know, uses the term drugs a lot it will come out from time to time, but I really think these are medicines because they can help people in really incredible ways.

So MDMA is really helpful with working with trauma, because if you think about trauma, One of the things that causes PTSD is that feeling of the trauma still happening in the present and it can be really difficult for people to maybe go back and look at traumatic memories and stay within kind of that window of tolerance where they don't maybe get re traumatized by revisiting those things because as we know That's kind of part of trauma [00:19:00] work is being able to go back and revisit and affectively experience some things to try to put that back in the present to help the nervous system know that we're safe now and life can go on.

It can be really difficult to do. It can take a really long time. And I don't want to say that we don't have great therapies now for trauma because people, there's many different ways to heal from trauma. And I definitely believe that therapy is one of the things that can help people.

But where I think MDMA is really incredible is because the way it works in the brain, right, so turning down that amygdala, turning down the smoke screen, it allows somebody to go back and revisit traumatic material without getting overwhelmed. So MDMA creates this really beautiful cocoon, that helps somebody feel safe.

And they can go back and look at those things in a way that they might not be able to in regular therapy. So 

Carly Claney: it sounds like they can stay within that window of tolerance. Their body [00:20:00] stays regulated while they're exploring the memories and thinking about it in different ways. 

Erin Wright: Yeah, I mean, it can stay regulated.

You know, that's not to say that people don't have a difficult time during the experience. That's where having a really good psychedelic therapist or guide can be really helpful in those moments because it can get a little overwhelming but it creates the , we call this inner healing intelligence.

So there's this idea Let's say you get a cut on your arm and you go to the emergency room, the doctor at the ER, he or she doesn't necessarily directly heal the cut. What the doctor does is they provide the optimal healing conditions for the body to engage in its own natural healing process.

So that would be giving medicine, giving antibiotics, giving stitches. And once those things are done, the body will then heal itself over time. So the idea is the same thing with the psyche. [00:21:00] So if we can create the optimal healing conditions we all have inside us, I think the ability to heal ourselves and that we really do know what's best for us and what we need.

So the idea with MDMA is that because of how it works in the brain and because of the kind of safe and feel good conditions it provides makes it safe enough for somebody to revisit the things that they need to that they haven't necessarily been able to before. 

Carly Claney: I love that approach or that emphasis that the body is doing the healing that the body always doing its own healing, whether it's physical or emotional or based on just the psyche.

And I think that's a really good image of clarifying. It's an environment that's created similar to in a therapeutic relationship, but in a different way in the body system in order to really facilitate that healing. Yeah. Yeah. What about the people who say I can't be healed?

I'm too broken. I'm too messed up. I the [00:22:00] system that could have healed itself is like broken. 

Erin Wright: Well, I think all of our own healing journeys take their unique paths. The way I would think about that is. There is something about That narrative that is doing something for that person, right?

That narrative is if you want to think about it I'm not trained in ifs or internal family systems, but it does make me think of either internal family systems or maybe psychoanalysis who thinks about us having multiple self states multiplicity of the self that part is showing up, I think, because it's protecting something inside of that person and so, for whatever reason, that narrative is helping that person stay safe, or help them feel safe enough in the moment and because something different feels too unpredictable or too Unsafe or might disrupt things too much so I think that person could be [00:23:00] helped by psychedelics, but there might be a lot of work to do beforehand as far as like letting go some of that narrative and being open to something different and you don't want to rush or disrupt that process.

I think if you throw people into psychedelic experiences without good enough preparation work beforehand or if they're in a place where maybe they're not 100 percent on board or I don't know if this is really going to work, but a part of them is like willing to try it.

That's a little different than the person who's this isn't going to work for me. So I think we cannot rush people into these experiences or recommend them if the psyche's just not ready.

They're not ready yet. And that is okay. That is okay. Yeah, I want to have a lot of grace for that narrative, too. 

Carly Claney: Yeah, I appreciate that because I think there's something that feels really like cool and edgy about psychedelics, and as a therapist, I've felt the pressure sometimes if I'm not immediately on board and understand it and on the [00:24:00] cutting edge of something that's so shared to be so amazing, then It really feels like I'm uncool.

Like I'm not like there's something I'm missing about like a cool factor because of I don't know, maybe because of that edginess. And so I hear from you, like it's for one, it's not about that. It's not about coolness, but I, can you talk a little bit about that thoughtfulness? Should everybody be doing it?

Should we all be excited? Is there concerns here? Is there like, how do we think about 

Erin Wright: it? Yeah, it's both a really exciting time for psychedelics I think there's a lot of excitement. There's a lot of hype. There's a lot of wow, these things are really amazing, which I think is true.

I think what is also true is we're losing a little bit. The fact that psychedelics are not a panacea. They do not heal everything, they do not fix everything, and they are certainly not, I'm going to take a pill or do one journey and my life is going to be completely different and I'm never going to feel this [00:25:00] depression that I've felt for 20 years of my life ever again.

So I feel 

Carly Claney: like a drop in myself about that of all the disappointment of that lesson, learning that lesson again. And again, it's 

Erin Wright: not just a quick fix, right? And I think that's so hard in our culture, right? Like we live in a culture that wants the quick fix that like, we're really, we don't like suffering.

We don't like pain, which granted makes sense. And those are maybe also. Parts of life to that. We got to learn how to integrate and deal with so Yeah, so I will say who maybe who? Shouldn't do psychedelics. So there are rule outs and contraindications to psychedelics. So if you've first one, maybe it would be if you've had a family history of psychotic disorders, so I would say probably more an immediate family member.

So mom, dad sister, brother, maybe even grandparent who has had like a diagnosis of schizophrenia or some other major psychotic disorder should [00:26:00] really Be careful when thinking about using psychedelics because they could trigger a latent psychosis in people. So that's one of the screening things in the clinical trials that you need to and that everybody should be aware of.

Dissociative Identity Disorder is another rule out for psychedelics. And then there's medical issues as well. Like people who have heart issues shouldn't use MDMA. You also have to be able to tolerate going off psychiatric medications for a lot of these meds. Yeah. So you don't want to use MDMA and be on something like an SSRI because of the risk of serotonin syndrome.

So you can risk death doing that. Now, the only one you don't have to is ketamine. Ketamine is actually safe to use in conjunction with most psychiatric medications. There's some that can affect how ketamine works. So it's always [00:27:00] important if you're pursuing ketamine to make sure you talk with whoever the medical screening is about what psychiatric medications are on so they can advise if if you're on a remote routine or something like that, if you need to skip some doses around your ketamine experience. So heart problems and then With psilocybin, you can be on an SSRI and use psilocybin, but the SSRI is going to blunt the effects of the psilocybin.

Okay. So you, it's just kind of unreliable and unpredictable as to Whether or not you'll respond to it. So that's why in the clinical trials, people have to be able to tolerate going off the psych meds for that. Yeah. 

Carly Claney: Okay. So those are reasons.

Contraindications, reasons why not to go at it. Is there anything that a person who might be listening right now is well, when would I pursue it? Or what should be going on inside of me to think that this could be helpful? 

Erin Wright: I think people who haven't found [00:28:00] improvement from all other treatment interventions.

So there's kind of that feeling of like they've been exhausting everything, like they've exhausted medications, therapy a lot of other treatments and just feel like they're not getting enough out of it. They could find psychedelics helpful. People with PTSD, chronic depression, anxiety. I think they can be really helpful for people seeking personal and spiritual growth.

Or for someone who chronically feels stuck in their life or end of life anxiety or depression can be helpful for that as well. I'm not a huge fan of some of the personality disorder diagnoses like borderline. I think really what we're talking about there is complex trauma and complex PTSD.

But somebody who has a really hard time in relationships and Thinks of the world extremely black and white and can't maybe tolerate a graying of boundaries. Really might think twice [00:29:00] before utilizing psychedelics just because it could be difficult for them to get into a space where they feel safe enough with a psychedelic therapist.

And not to say that it can't be helpful for people like that, but I think They really probably need to work with somebody who's really skilled really trained and really good at doing a lot of preparation work with that person beforehand. Yeah, 

Carly Claney: it sounds like this is always going to be a specialty, those guides that you're mentioning. And yet there's instances where even like a more specialty within it would be really important.

Erin Wright: Yeah. And there's a lot of people who are really desperate for help and have been suffering a really long time and are going to do what they're going to do to get a psychedelic experience and I can certainly understand that.

And everybody deserves to have access to healing and healing experiences. But there's some things that I think are just better and more of a controlled setting [00:30:00] where we have really good systems of support in place to help somebody. I don't want to encourage anybody who has that in their mental health history or has a family member like a direct family member to use psychedelics. I'm just saying like there could be a potential in the future. I think if they're if these things do get legalized for medical use to maybe run some clinical trials in some very controlled settings where that person has excellent support through psychiatry therapy and other things.

To be able to safely experiment. 

Carly Claney: Yeah. Yeah. But I think that just emphasizes, we just don't know. There's a lot of thoughts that of what could happen, but something like that, where there's such risk involved the research just hasn't 

Erin Wright: been done yet.

Yeah, and I think especially to have something like psychosis, you know, back in the fifties and sixties, part of what they were using psychedelics for was to see if it could mimic something like schizophrenia to see if they could find better ways to treat [00:31:00] schizophrenia, which I think is really fascinating, to me. Yeah. They were using it to try to understand better. But the reason why it's a rule out is because people with psychotic disorders often are really open already and really sensitive to the world around them to where psychedelics would open them up in a way that even further, that is, they can't collect the pieces and put it back together because it's way too open.

Yeah. 

Carly Claney: I'm thinking someone experiencing psychosis is maybe seeing things or hearing things that aren't there. And if that's part of what the experience of let's say a psilocybin is allowing the brain to imagine things or see things or hear things that aren't there.

There's like a, where is reality and coming back to that integration piece that you're saying, it seems like there'd be a lot of confusion about where the line of reality is. How would you change that? Is that the right way to think of it? 

Erin Wright: [00:32:00] I wouldn't say confusion, but just That the openness would be too overwhelming.

And there's not a way to collect things and be able to operate in the world as we need to. Yeah, 

Carly Claney: we've alluded to this a little bit. What is the process? What is, what does integration mean when we talk about psychedelic integration? 

Erin Wright: Integration can look a lot of different ways, but basically, it's somebody taking what has come of their psychedelic experiences and then Thinking about what is that experience potentially saying about their life?

And either changes they need to make or new insights and how do they incorporate those things? And make make movements in their life. So that can be taking things to therapy, like all of these things came up and now I'm trying to sort through what is this mean? How do I feel?

What do I do [00:33:00] with this? How does this impact me relationally? You can take that and discuss it with their therapist. Somebody else might be like, Oh my gosh, like I felt more connected to my body during this psychedelic experience than I've ever felt in my life. I'm not in that experience anymore. I might feel a little more disconnected from my body, but maybe now I'm going to go do some somatic work with a trauma informed massage therapist to help me become more connected to my body and everyday life because I had that experience during my psychedelic journey and I want more of that, right? Because we can't stay in the psychedelic journey all the time, so we've got to figure out a way to take bits and pieces of that and do the work. I think integration is the most important part of any psychedelic experiences because that's where really where the lasting change is going to happen for somebody.

I think psychedelics kind of Opens a window to the change that's possible. But it's up to us to put in the work afterwards of making those [00:34:00] changes in our life, which can be hard for some people. 

Carly Claney: Yeah, I imagine it'd be hard if you want to stay in that experience, or if it's just really complex and you don't know how to make sense of it.

So if someone was really interested in this, if someone wanted to access these experiences now, how do they go about 

Erin Wright: it? Yeah. Yeah, I think there's a lot of different ways to do that. So ketamine is legal right now. There's a couple different ways ketamine works or is able to be accessed.

There's a few different models. One is what we call the strictly medical model. So you'll see a lot of clinics in the area offering like ketamine infusions. And what kind of how this model works is you go and get the ketamine infusion and through the blood. Yeah, so it's through an IV.

Yeah, so an infusion is through an IV. And the idea is that the medical properties of ketamine can give somebody enough of a shift and enough of a lift to maybe give them some space from some really difficult feelings to start getting some [00:35:00] traction and, Maybe making some changes in their life.

So it kind of means really effective for something like what we call treatment resistant depression where somebody's tried everything and is still stuck in these really deep depressive episodes. So it can be really helpful like that for that. So that's one, one way to do it. The other would be Through pursuing ketamine assisted psychotherapy.

And that model is a little different. So, what you're doing is you're taking ketamine with a therapist and they are there to accompany you throughout the journey. And like discuss what their experience was like during the session. And start putting together the dots around, Oh, what is this thing about my life entering into integration? And I think whether somebody is doing ketamine assisted psychotherapy or they're pursuing that medical model, everyone who's going to a ketamine clinic needs to ask the question, is there somebody going to be providing support for me[00:36:00] in the room the entire time? Because some ketamine clinics will assign one nurse to three patients at a time and might be in and out of the room, which can leave people feeling alone, especially if they're having a really difficult time.

So that's a really important question to ask any ketamine clinic that you're thinking about going to do. There's also some psychiatrists will prescribe something called Spravato and that's called ESK.

The name of that is s ketamine. S ketamine has actually been approved by the FDA as a treatment for depression. So a psychiatrist can prescribe it's provided as like a nasal spray of ketamine and can be helpful for folks as well. But it's a different experience.

It's not, you're not using that. And then having this like deep psychedelic experience. It's when you're 

Carly Claney: at home, when you're struggling or just in daily life. 

Erin Wright: You can just as prescribed by the psychiatrist. Yeah. Okay. So yeah, so those are the different ways ketamine can be accessed.

And then so if you're [00:37:00] interested in something like MDMA or psilocybin You know, these are still illegal substances in the U. S. So, at the federal level. So people want to keep that in mind. So right now my recommendation would be if you go to clinical trials dot gov you can find clinical trials that are happening with psychedelics throughout the country and see if you.

might qualify or be eligible for one of those trials. That's another way. And then the other thing is, so Oregon has approved or made legal psilocybin settings. So, you know, for those of us who live here in Washington, that's another option as well. You have to go to what's called a licensed service center in Oregon.

And you can go to these centers and you don't even have to have a mental health diagnosis or any other kind of medical diagnosis. Which is I really love that about their model that people can access these things without that. And they do, the service centers do screening [00:38:00] and that sort of thing.

But you can go experience psilocybin at one of the service centers in Oregon. So that's an option. And then Colorado also approved A bill that they're going to set up a system that's somewhat similar to Oregon and making psilocybin accessible for the public as well. Yeah, 

Carly Claney: it does sound like there's some options and yeah that to be cautious about What is available and what risks you're taking by accessing them in different and different?

It's, but the clinical trials dot gov is interesting. The image that came to mind when you said that is like getting a I'm probably not going to put the edit point, but this is just for you, like getting a permission slip, like daddy government is like allowing you to skip the line.

Erin Wright: Yeah. Yeah. Yeah. So I do want to talk a little bit about what's happening with MDMA. I think it's important for people to know as far as access. So MDMA and psilocybin are the closest, I would say to becoming legal [00:39:00] forms of treatment by the federal government. And I just, I want to say this because I hear a lot of well, NDMA is going to be legal in 2024 and I'm going to wait and then I'm going to be able to access it.

And I kind of want to temper people's expectations a little bit around that because MAPS has completed all the clinical trials necessary for FDA approval, and they, last I heard by the time this comes out, maybe this will change, but last I heard they are going to be submitting the application to the FDA for approval by the FDA at the end of this year with hopeful FDA approval in 2024.

At some point, that could happen mid year, that could happen end of next year, who knows. And it'll be really interesting because the FDA doesn't regulate therapy. So this will be the first time that they, I think, have approved, will approve a drug in conjunction, to be used in conjunction with therapy.

So that's really interesting to me. So anyways, the [00:40:00] FDA will have to approve this. Let's say they do this end of 2024. Next year. Okay. So that has to happen. And then what happens after that is the DEA has to reschedule the drug because MDMA and psilocybin sit in schedule one right now. And so they have to be rescheduled to be in one of them where there is an accepted medical use to be able to use it clinically.

I don't know how long that takes. I don't know how fast or slow the DEA is with rescheduling things. And then what has to happen after that is we have to have the infrastructure in place to be able to offer these medicines safely for people. And I think, that's what you're kind of saying when these ketamine clinics, so some of these clinics are popping up and, they're offering ketamine, but they're also popping up in hopes of offering MDMA and psilocybin. So they might be a little more ready to offer those medicines, but then you also have to have therapists who are trained [00:41:00] in the model and certified enough therapists to meet the need enough prescribers who are knowledgeable to meet the needs as well.

So I still think we're a ways off from the public being able to access these in a legal setting. Yeah. Yeah, I think we'll get there. But I just, I think it's still going to be quite a bit longer than people realize. 

Carly Claney: Well, yeah, even in terms of what you just said about the therapist being trained and ready to offer it.

There's already some shortage in so many areas that regular therapy, talk therapy that you find the people to offer. It might be also tricky. 

Erin Wright: Yeah, and I think too, I keep wondering if we'll see changes in the model. It also the model that the FDA is going to likely approved for MDMA assisted therapy. It's a combination of 12 hour and a half psychotherapy sessions spaced in between three eight hour MDMA sessions. And right [00:42:00] now that has to be with a team of three people. One is a medical prescriber the other is a licensed therapist. And I think that they got the approval for the other one to be a bachelor's level provider who has gone through the MDMA assisted therapy training.

But the other thing we have to think about as these things start coming online is cost. Yeah. So if you think about that how much is that going to cost somebody? I'm honestly not sure how practical that is in the medical system that we have in America. So I'll be curious to see what transpires.

I also think we need insurance to cover it. And I'm curious how the insurance industry, we know how insurance and mental health is, so I'm like really curious to see how they're going to approach covering psychedelic I don't think it's impossible. And there's this one company, I can't remember the name off the top of my head right now.

But there's this one company, I know that's a startup that's trying to offer psychedelic assisted therapy, starting with ketamine as like an add on for somebody's insurance. So it's [00:43:00] something the employer could purchase. To be able to get ketamine coverage for their employees if the regular insurance doesn't offer it.

So that could be another way to go about that as well. Oh, 

Carly Claney: yeah. That's an interesting like side way of combining the two.

Wow, this is so much information. Anything, as we can start to wrap up, anything that we missed? Anything that would be missing for anyone listening to learn right now? 

Erin Wright: Yeah, I mean, I'm really big on what we call harm reduction. So I really giving people information to, for them to take and make informed decisions about how they want to pursue their own healing.

So there's a couple just things I like people to know about. So dance safe. org is a. Amazing organization. They do a lot of really good harm reduction work in the community and at festivals. They sell drug testing kits that are completely legal. So somebody can go online and buy those. And so if they are somebody who's using something like MDMA or LSD[00:44:00] they can go buy those kits and then test them at home to make sure that their sources don't have something like fentanyl.

And then the other thing I like a lot is a website called drugsdata. org. This is actually a legal drug testing lab where people can send in a small amount of their drugs with cash. It's completely legal, although the sender does not get their drug sample. And this lab will test it for you, so that's another way to know if your drugs are safe or not.

And then I always like to give people some questions. You know, if you're going to go access these medicines on your own, I know I have made a reference to guides before, I don't want to encourage people to access illegal. Drugs underground.

But if somebody is really desperate and finds themselves headed that way I think important questions for therapists, they can ask their clients or clients can ask others is, how did you find this person? Do you know anyone else who has worked with them? Have [00:45:00] they had any training? What is their experience?

What are they charging you? Did they talk to you about things like consent and touch? Do they work alone or do they work with someone else? Will you provide the substance or will the guide? If it's the guide, have they confirmed they've tested the drugs and are able to prove they're clean? Does the people you're working with, do they provide any sort of preparation or integration?

Where will the session be taking place? And did they do a medical screening? I think it's perfectly appropriate for therapists to ask their clients these questions and for clients to ask anybody they're thinking about working with those questions. 

Carly Claney: That's a such a good resource because I think when we are talking about something that is illegal and anything that even on the spectrum of shame inducing or privacy or just keeping anything that we, we want to hide, it can limit then this really important risk analysis that's happening [00:46:00] of making sure that we are talking about the things that we can talk about or set ourselves up for having a protective experience with when it comes to consent and risk and everything that you just enlisted.

So that's a really good resource. Yeah. Any final resources? We can link things in the show notes so we don't need to take a ton of time, but anything else we can pass on? 

Erin Wright: Yeah I know I sent you some links for the show notes, so I would encourage people to check things out there. I will highlight Psychedelic Support Network I think they're a really great resource.

They're kind of like the psychology today of therapists who have had training and experience in psychedelics and psychedelic integration. So if you're trying to find somebody who you know, has knowledge of those things, that's a great place to look. I also like it for clinicians too, because they offer trainings and some of those trainings are free as well.

So they're a really A really great resource. And then I really like the psychedelics today podcast as well. I like a lot of the information they give[00:47:00] and a lot of the resources they give there too. And I think it's helpful for both clinicians and therapists exploring these things. So yeah.

Carly Claney: Thank you. And then if anyone were to want to get in touch with you, or is there anything going on locally in Washington? 

Erin Wright: Yeah. So I, yeah, so I do provide consultation for both therapists and clients who have questions about psychedelics or have a client and they're not sure how things are going with it.

I'm very open to consulting with people about that as well. There is some stuff going on in Washington. The University of Washington is the, is opening a place called the Center for Novel Therapeutics. So they're going to be doing psychedelic research out of that part of the university.

So that's. That's really exciting. Psychedelics are also decriminalized in Seattle. So what that means doesn't mean it's legal, doesn't mean it's legal. What it means is it has made the lowest priority for law enforcement. [00:48:00] And so they're told to not go after it if they're found with somebody.

So yeah, but it doesn't make it legal that they are decriminalized, which is a good step in the right direction. So that's 

Carly Claney: great. And then I saw, too, that the. Organization that your co president for the Alliance, they're having a training upcoming this next year. 

Erin Wright: Yeah. So in the fall of 2024 we'll be bringing in a psychoanalyst. Her name is Megan Rundle. She's out of the, psychedelic Institute of Northern California, which is pink, and she will be coming to do a training next fall on ketamine and psychoanalysis. So that'd be a good resource for therapists who are interested in these things.

Yeah, 

Carly Claney: that's really exciting because that was something that we didn't have time today to really unpack that connection between psychoanalysis and psychedelics, even though a lot of the themes that we talked about are. I'm sure just expanded upon what the, what that will be, but that would be a great [00:49:00] resource.

I 

Erin Wright: have to do another interview. I know, part two. Yeah, part two. 

Carly Claney: Cool. Well, thank you so much, Erin. I really appreciate talking to you. And I think this was just really good information as a starting point for anyone who's just been curious about what's going on with 

Erin Wright: psychedelics. Yeah, thanks. Yeah. 

Carly Claney: ​Relational Psych is a mental health group practice providing depth oriented psychotherapy and psychological testing in person in Seattle and online in Washington State.

If you're interested in mental health care for yourself or a family member, please reach out. Our website is relationalpsych. group. Relational Psych is a mental health group practice providing depth oriented psychotherapy and psychological testing in person in Seattle and online in Washington State.

If you're interested in mental health care for yourself or a [00:50:00] family member, please reach out. Our website is relationalpsych. group. ,