Latest / Finding New Waters / Trauma, Recovery, and the Responsible Use of Ketamine-Assisted Psychotherapy with Chantelle Thomas

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Trauma, Recovery, and the Responsible Use of Ketamine-Assisted Psychotherapy with Chantelle Thomas · Finding New Waters

0:00
So I've seen people go do ayahuasca or an underground
0:03
thing with someone who used five different psychedelics on them
0:06
in one day, and it is appalling to me.
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It's dangerous. And I think a lot of people who
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are experienced with psychedelics to treats do have
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no complex understanding of the intersection of addiction and
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trauma. And so because they might be
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expert in a particular type of modality delivery around
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psychedelics, it does not make them expert.
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It certainly does not make them safe clinicians for you in your
0:31
recovery process. And that edge of escaping,
0:36
losing yourself, like finding the ultimate solution or answer
0:41
the way that kind of lives in people in long term recovery, it
0:44
needs to be cared for and cultivated and nurtured and
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watched. All right.
0:50
Welcome back everybody to another edition of Finding New
0:53
Waters. My name is Bea Reeves.
0:54
I'm the Director of Business Development here at New Waters
0:57
Recovery in Raleigh, here with our CEO, Justin McClendon, and
1:01
our very special guest today, Doctor Chantal Thomas from
1:05
Windrose Recovery in the Manor. And she's in Wisconsin
1:09
somewhere. Where are you?
1:12
I'm in Madison, WI. How cold is it in Madison, WI
1:16
right now? Well, my kids have been talking
1:20
about the fact that they're going to close the school
1:21
tomorrow because it's going to be so cold.
1:23
But today is a little warmer. Nice.
1:27
It's I mean, for us it's warmer. So it's like low teens.
1:30
Oh man, wow, that's cold. I can't live.
1:33
Like and I did not have to shovel the driveway this
1:35
morning, so I'm pretty excited about that.
1:38
I hear you. Well, you know, we're supposed
1:39
to be getting 5 inches this weekend, so everybody's in full
1:42
panic. Full panic mode.
1:44
Yeah, I tried to go to the grocery store last night and
1:46
that was should not have done that.
1:49
When you say too cold, do they not because of more snow or
1:53
sleet? Is this it can be too cold?
1:55
No. OK.
1:56
Yeah, my youngest daughter was telling me that if you go
1:59
outside for 10 minutes in the predicted temperatures tomorrow,
2:03
you'll get frostbite. Oh wow.
2:05
If you're, if you're not, if your face is not fully covered.
2:08
So that's why they're thinking about having the kids stay home.
2:11
Wow, y'all get some interesting weather 'cause when I was there
2:15
this summer in Madison where we hung out, we.
2:19
Were wearing shorts. Wearing shorts, but not only
2:21
that, that was the hottest I've been in probably 10 years
2:24
anywhere on Earth. And people were blaming it.
2:28
They were. And tell me, is this true?
2:29
People said. And it was so humid that they
2:32
said that there's some weather phenomenon that is the corn
2:39
starch from the cornfields gets in the air and makes it even
2:42
more humid and sticky. Is that was somebody?
2:43
Was that like snipe hunting or somebody messing with me?
2:49
I believed it. They made sense.
2:50
It made sense. They got you.
2:52
They. Were they from Iowa?
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Maybe, I don't know, the corn was the yeah, the the the air
2:58
pattern was from Iowa. I don't know about the person.
3:01
That's so interesting. Well, it's good to see you.
3:04
I haven't heard that one. Yeah, it's good to see you too.
3:08
So I've know, I know you, we've met, I've been to the Manor.
3:12
Will you just start though? Because what's how does what's
3:16
the like the the structure, Windrose Manor and all that.
3:19
Will you just start with there? Yeah.
3:20
So Windrose recovery is kind of the was the umbrella of the
3:25
organization and that's because of our work with a program
3:29
called Positive Sobriety Institute, which is in Chicago,
3:33
which is for professionals. But our primary focus now is the
3:38
Manor, which is our residential substance abuse treatment
3:41
facility. It's a pretty small and intimate
3:43
program, up to 11 beds. And really what I think about
3:49
the manner is a trauma reprocessing program that the
3:53
gateway through people come to us is through through their
3:56
substance use issues. But that's really our Forte, an
3:59
area where I think our therapists are incredibly
4:03
experienced and they have developed this really tremendous
4:07
capacity to help a lot of our clients bypass the hyper
4:12
intellectualization or kind of the minimization of maybe early
4:16
environmental circumstances or the ways in which they feel
4:20
really disconnected from themselves.
4:22
And we see that as kind of intrinsically connected to why
4:25
substance use is such a compelling way to survive life.
4:29
And so that's really our primary focus is helping people not just
4:34
in their recovery journey, but become more emotionally
4:38
integrated, kind of more authentically who, what their
4:41
full potential is. And a lot of that is through
4:44
reconnecting emotionally and also through their body.
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So a lot of somatic work as well.
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So that's our main residential substance use program.
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And then we have a program called Inagrata, which is our
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ketamine assisted psychotherapy program where we do trauma work
4:59
with the addition of ketamine. And is that, are you guys doing
5:02
that on an outpatient basis or is that also part of the
5:05
residential structure? So we do both.
5:09
Some folks will receive ketamine assisted psychotherapy at the
5:14
Manor and but not everyone. So it really depends whether or
5:20
not they are considered appropriate for that particular
5:25
intervention depends on how their trauma reprocessing work
5:29
is going. So we don't believe in using
5:32
ketamine to kind of bypass people being stuck or blocked
5:36
necessarily, but it's rather it's an amazing tool to add when
5:41
someone has started to get some internal capacity and ability to
5:46
kind of know what's happening inside and is becoming connected
5:50
back to themselves and starting to feel more.
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Because it's an issue for a lot of our clients.
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They can't feel much of anything.
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And when you ask them about their feelings, they're like, I
5:58
don't know what you're talking about.
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And so that kind of thawing out is what I call it.
6:04
Like, you know, persistent substance use really does create
6:07
almost like a Free State emotionally for a lot of people.
6:10
And then you compound that with a lot of intellectual capacity
6:14
and maybe even a lot of success professionally.
6:17
And it takes people a while to be able to feel the full range.
6:20
And so when that starts to happen, what we find is adding
6:23
the ketamine assisted psychotherapy can really deepen
6:26
that work and almost kind of supercharge their ability to
6:30
kind of work with really difficult content in a way that
6:33
doesn't kind of shoot them outside of their window of what
6:35
feels tolerable. That's amazing.
6:37
Yeah, Yeah, that's so as you're explaining that you can't, I
6:42
think you did answer. So the people are starting to
6:44
feel again. And so is the idea that the
6:49
emotions and the feelings are possibly too strong to handle or
6:53
is it that they're kind of sort of trying to they're coming out
6:56
and they want don't want them to be?
6:58
I guess I'm asking the same thing twice too strong is that
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is it not? Does it tamp it down or or?
7:04
Heighten it does. The ketamine help in that.
7:06
How does it help in that way? You know, that's a really great
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question. In some ways it deepens capacity
7:13
to feel and in other ways I think it turns the dial down on
7:19
some of the more fear based like panic, anxiety that can come
7:24
with encountering really difficult content or memories.
7:27
Right. So what, what I've noticed about
7:30
using ketamine really skillfully when you're using it in the
7:33
context of trauma work is that it can amplify certain types of
7:39
emotional experiences and then other more difficult or
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challenging experiences can get dialed down enough.
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That what's also really cool about this is when we use this
7:51
modality, people have done enough work that we're not
7:54
directing where they go in that session.
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That's also a little unique. A lot of the time when you're
7:58
doing trauma work, depending on the modality you're using your,
8:01
you have a little bit more of an agenda about where someone goes
8:04
and what they process. We've done enough work to the
8:07
point where we introduce ketamine that we're really
8:09
trusting their system and their process to go where it needs to
8:13
go. And that is also pretty
8:15
unconventional insofar as it's probably similar to things like
8:20
somatic experiencing where you're helping someone kind of
8:23
find their way, even maybe with EMDR and floating back.
8:27
But it is a very much client LED intervention and they're
8:32
deciding where they go. And what's amazing to me is
8:34
people will spontaneously move towards some really difficult
8:37
content because I think what happens is there's a chemical
8:42
signature associated with ketamine that creates like a, a
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more of a anxiolytic, like a relaxation effect in the body.
8:49
So they feel a little safer internally.
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There's less of that tension and tightness.
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And then the other quality of ketamine, which I think allows
8:58
that is it creates a lot more spaciousness.
9:00
So where there would normally be a lot of chatter or noise
9:03
internally, people people will feel a lot quieter inside.
9:07
So there's more room to kind of explore and in in another way.
9:12
What's really cool is I don't think people realize how much
9:15
their experience of emotion is blended with judgement or
9:19
criticism. So it's pretty rare that people
9:22
feel sadness without them feeling shitty immediately
9:25
because they feel sad or telling themselves I shouldn't feel this
9:28
way. And what ketamine allows people
9:30
to do is create just enough distance from those other kind
9:34
of attached stories about what they're feeling.
9:38
So they can feel pure sadness or potentially pure grief or even
9:44
pure joy, which is the other fascinating thing that I've seen
9:47
in working with addiction. People are just as afraid to
9:49
feel good as they are to feel bad because is it associated
9:53
with some sort of an addictive process or I shouldn't feel this
9:57
way because something bad is going to happen next?
9:59
So it's really about creating a certain kind of safety with
10:02
different emotional States and allowing people to linger with
10:06
them longer than their intellect would typically allow them to
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do. You know, that's just amazing
10:12
what I what I thought about. We said that.
10:13
Yeah, it is. But, you know, it sounds to me
10:15
and tell me if I'm wrong here. Yeah, I just remember I get
10:18
sober and people started telling me the worst thing about getting
10:21
sober is you feel your feelings. The best thing about getting
10:23
sober is you feel your feelings. And it sounds like this is what
10:27
we're talking about. But here on a much more
10:30
medically supervised trauma. I don't want to say informed
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because I don't think that's the right verbiage here, but but am
10:39
I on the right track with that? Totally.
10:42
Yeah, I think, look, there's plenty of reasons to be
10:47
concerned about using a compound like ketamine, right?
10:50
It's a drug of abuse. Lots of people have come into
10:53
our center been like, Oh yeah, I partied with ketamine.
10:57
Some of the most severely traumatized people I've worked
11:00
with have liked using ketamine because it allowed.
11:02
If they use it at high enough doses, they disappear.
11:06
They completely escape themselves or they fall into AK
11:09
Hole, Right? Which would for most people who
11:10
don't want to disappear for themselves, it's like their
11:13
worst nightmare to be in AK Hole.
11:15
It's a terrifying, disorienting place to be.
11:18
Like, that would be my worst nightmare, right?
11:20
But the key there is talking about the dosage and the
11:25
container in which it's happening.
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So we're using sub dissociative doses, whereas like in a
11:31
ketamine infusion clinic, they're kind of going for this
11:33
thing they call the therapeutic dissociation window, which kind
11:36
of float outside of yourself. You feel a lot less it.
11:39
The feeling that people describe an acadamine infusion clinic is
11:42
like weird, Spacey, dissociated, strange.
11:47
You know, it's you're kind of just floating outside of
11:49
yourself. It's not necessarily an
11:51
emotionally evocative process. And then you have people who do
11:55
ketamine psychedelic assisted therapy, which is like blasting
11:58
way past that. That's kind of more classic
12:01
psychedelic ego dissolving, like you're in another reality,
12:05
another world. You make completely lose sense
12:06
of who you are. We're dosing below the
12:09
dissociative window, so you're very much aware of who you are.
12:12
You don't lose your identity, but you have a softening of ego
12:17
defense structures. And in that dosage range, what
12:20
we found with ketamine is it actually amplifies your sense of
12:24
your body as opposed to leaving your body, which happens in the
12:27
dissociative range. So you, so I've had some clients
12:30
who can't feel their body most of the time because they're
12:33
stuck here, right? Or because of trauma.
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They just like don't want to be in tune with somatic sensations.
12:38
I worked with a woman who had tremendous trauma, couldn't
12:41
meditate at all. And like on our 4th ketamine
12:44
session, she was like, Oh my God, I have a body.
12:47
It was like all of a sudden she could feel her body because I
12:50
think again, the safety there, right?
12:52
So in that lower range, when you prep people, you help them to
12:58
recognize their dissociation, you increase their capacity to
13:01
feel things safely, Then what? You're what you're getting.
13:07
I think the reason why feeling feelings is so hard for people
13:10
in early recovery is because so many of the messages they've
13:14
received around their feelings are really critical, harsh.
13:18
Like our society doesn't create a very safe place for men in
13:22
particular to feel the range of feelings.
13:25
You know, you're allowed to be angry or pissed, but you're not
13:27
allowed to cry or become emotional without all this other
13:30
chatter about, you know, who you are as a person or a man or
13:33
masculinity. Then on the other end of that
13:35
spectrum, you have women who, who, when they're really
13:37
frustrated, might cry and everybody's like, oh, are you
13:40
sad? And they're like, no, I'm
13:41
fucking pissed, right? So there's not a lot of
13:44
permission to feel openly, even though, you know, we all
13:49
recognize it's a really important, healthy part of our
13:52
existence. And so again, I think what
13:55
happens is when you turn down the chatter or the judgement
13:59
about the feeling, people develop a relationship with
14:02
feeling that is very different than what they're accustomed to.
14:05
If early stories of the first time you cried, your parents
14:09
like you don't have a reason to cry.
14:10
I mean, you very quickly, you get shame loaded in alongside of
14:14
sadness. And that is a bond that sticks
14:18
around in perpetuity through adulthood, right?
14:22
And then when people get sober, we're like, oh, you should feel
14:25
your feelings. But every time they feel them,
14:26
it's a horrible experience because they have all this
14:28
crushing self judgement. So it's like people need a lot
14:32
of help reassociating positively to their emotional landscape in
14:36
a way that doesn't feel like tremendous shame.
14:40
And so that's really what I see the opportunity there to be for
14:44
people in a therapeutic setting where it's being really closely
14:47
monitored. It's amazing.
14:49
I mean, that is definitely, you know, I think there's, there's a
14:52
a lot of attention and focus on that.
14:54
It's becoming much more popular to use in clinical practice.
14:57
But I think this is probably the first time I've heard anybody
15:00
talk about this kind of like pre, you know, dissociative kind
15:03
of dose. I don't, I don't think I've
15:05
heard anybody talk about it that way before.
15:07
So that's very interesting. Yeah, it's a less common way to
15:11
work with ketamine. I think there's a lot of people
15:17
who end up using ketamine and they really lean on the medicine
15:20
itself. So they're it's like a, it's a
15:24
psychopharmacological alternative model.
15:27
It's almost like an extension of something like ECT, right?
15:31
For really severe depression, they're really just relying on
15:34
the ketamine to work at a brain level to induce an
15:38
antidepressant effect. We believe there's neurogenic
15:42
effects where we see new neuronal growth after ketamine
15:46
neuroplasticity. But by the way, neuroplasticity
15:49
is not always good. Like addiction has
15:50
neuroplasticity too. So brain changes can happen as a
15:53
result of negative things as well.
15:55
But this working in this what I call the relational dosing range
16:00
is very different because it's you're not just relying on the
16:02
ketamine. We have two therapists working
16:05
therapeutically with someone while they're experiencing that
16:07
expanded state of awareness with ketamine.
16:11
And it's really a therapeutic facilitated session with the
16:16
catalytic or amplification that's provided with the
16:20
ketamine to do trauma work differently.
16:22
And again, that big distinction is it's being client LED, not
16:26
therapist LED, but it is being therapist supported.
16:30
No big surprise. This version takes a lot more
16:33
work, takes a lot more preparation, it's more labor
16:37
intensive, it's more costly. And, you know, sometimes you run
16:42
the risk of working with a client whose system isn't really
16:47
ready to be open to that kind of exploration.
16:50
And so a lot of the times you might have a client say, like,
16:53
nothing's happening. And instead of going, oh, give
16:56
them more ketamine, we go, OK, let's be curious about why
17:00
nothing's happening. Or you think nothing's
17:02
happening, but maybe this is the first time in your life you've
17:06
actually experienced being still inside, and you think that
17:10
nothing's happening. And then you're like, well,
17:12
when's the last time you felt this?
17:14
I've never felt this in my life. So we, we actually are using
17:21
ketamine in that dosage range to really get a better
17:24
understanding of someone's internal map, their psychic kind
17:28
of internal map. And what are those first and 2nd
17:32
layers of not defense, but protection that might keep them
17:36
from going to places that are really challenging.
17:39
And we're not going to overpower those windows by giving more
17:43
ketamine. We're going to work with that
17:45
state to see if we can understand more about it.
17:49
Because I think you get into some risky territory where you
17:53
bypass people's internal protective structures with
17:57
medicine when they're not fully consenting.
18:01
So yeah. It's different kind of hearing
18:03
you go ahead. Well, I was just going to ask,
18:06
you mentioned before we kind of started focus on the ketamine
18:10
specifically that you don't do it with everybody in the
18:12
residential program. So I'm, I'm curious like you
18:15
know, what are those kind of contraindications or as you
18:17
mentioned, maybe you know, emotionally speaking, they're
18:20
just not in a place where they're ready for that.
18:22
But I'm curious like what? What's the deciding factor in
18:24
between doing and not doing it? Yeah.
18:27
So it was a big move integrating it into our treatment center.
18:31
I remember this was back in 2020 when we first started doing
18:35
getting mini and psychotherapy. I should also mention I've been
18:39
doing clinical trial research with psychedelics since 2013.
18:42
So I've been working at the University of Wisconsin Madison,
18:45
working with psilocybin MDMA assisted therapy for PTSD.
18:50
And then I've also worked with five MEODMT.
18:55
So I've been doing clinical trial research and had been
18:58
doing clinical trial research for seven years before I ever
19:01
considered us integrating anything like this at the Manor.
19:05
Thanks to the open mindedness of our CEO and his trust in me.
19:10
I think it wasn't until I started working on the MDMA
19:12
assisted therapy trials for PTSD that I started to see like, wow,
19:18
like this could be a game changer for some people who have
19:23
spent. I mean, I think the average
19:24
amount of time that people spent in therapy in the PTSD trials is
19:27
17 years without the needle moving, right?
19:30
PTSD is so hard to treat. And So what I found myself doing
19:36
as I was working on the trials while I was also running the
19:38
manners, I'd go up and run a group and I'd sit in a group and
19:40
I'd not everyone I saw was I like, oh, I would love to use
19:44
this. But some clients, clients that
19:47
are like motivated, they understand the extent of the
19:51
work. They have enough relational
19:52
trust in you, but there are parts of their system they just
19:55
cannot crack. Like a pervasive desire to die,
20:00
right? For example, like suicidality
20:02
that's so entrenched, they just can't unhook it for, for
20:06
whatever reason or an orientation to themselves that
20:10
feels so shameful. So other things are moving, but
20:13
their default setting is so ingrained.
20:16
That it they just can't get enough relief, even with, you
20:21
know, the modalities that we can use because the relationship
20:24
inside is pretty caustic. Those folks are people who I
20:28
love using this modality with, not people who are still in
20:32
denial of their seriousness of their use.
20:36
People who stay so cerebral they their system is just not ready
20:41
to feel. And I do think you absolutely
20:44
need, for me, the mechanisms of using this effectively with our
20:47
team, kind of the engine that powers cap for us is feeling and
20:54
somatics and relationality. So if you don't have a really
20:58
strong relational bond with the client, if they can't start to
21:01
feel again, if they're totally disconnected from their body and
21:05
they want to stay disconnected. So you add ketamine to someone
21:09
who wants to escape and they'll use it to escape.
21:11
So that's where they have to be more invested in the idea of
21:16
going in and deeper than they are in the idea of getting
21:20
relief through escape. And so that is kind of a good
21:25
distinction. For me.
21:26
I would imagine that a red flag would be somebody who was really
21:28
eager to do it right. Like, yeah.
21:32
Well, in my other question, another, you know, Justin asked
21:35
what I, I was going to ask also. And then the other thing is,
21:38
sounds like that what I'm hearing is that there this is a
21:40
big cumulative effect thing and not a quick fix, which which,
21:44
you know, like all good things, it takes work.
21:47
So they come to the Manor and they say they're appropriate for
21:50
this. You feel they're appropriate for
21:52
this treatment. How long, how often are they
21:56
getting it? And then how long does one need
21:59
to stay on it? And is it a you know they
22:01
titrate is how's this work? Yeah, no, it's, it's just like a
22:05
one, one to two session protocol for most people.
22:09
So this is not a maintenance at all.
22:12
They essentially get preparation work specifically to the cap
22:16
session which lasts about two to three hours.
22:20
No, this is a that we're using ketamine catalytically.
22:23
We're trying to catalyze a therapeutic process that then in
22:28
many ways unlocks a pathway of understanding that just that
22:32
wasn't accessible. So I don't believe it creates it
22:36
necessarily, although you could kind of argue with the
22:39
neurogenesis effect. Like we do see dendritic
22:42
regrowth in people in some studies where after a ketamine
22:45
administration. So are they literally developing
22:48
a new neural pathway or connection that didn't exist
22:50
before potentially that sometimes they see that where
22:53
they're like they've been looking at the same trauma
22:56
memory forever and all the sudden they developed this new
22:59
way to Orient towards it. And, and we don't really know,
23:03
is that literally a new pathway that just got built or is it a
23:07
part of the brain? You know, when we look at
23:09
psychedelics effects on the brain and this again in very
23:12
controlled settings, there is something there are parts of the
23:17
brain that normally talk to each other that we find other parts
23:22
of the brain kind of cross connecting systems in a way
23:25
that's almost unpredictable. So that people don't stay in the
23:29
same neural networks kind of looping in the same way.
23:33
They all the sudden are intersecting a new brain
23:35
network. So we see less predictable
23:39
patterns of communication and we see patterns of communication
23:43
that are outside of the norm of what we would normally see.
23:47
And this is what's so exciting is like how many people can't
23:50
relate to the idea that isn't an addictive cycle just being stuck
23:53
in the same loop over and over again.
23:55
Isn't that also true with depression?
23:57
Isn't it also true with PTSD? Isn't it also true with an
24:00
eating disorder? I think that's why psychedelics
24:03
are being held with so much trans diagnostic potential,
24:07
because it's not simply about a diagnosis and symptoms, it's
24:10
about changing the orientation someone has to themselves and
24:14
the problem. And it's allowing new
24:17
psychological flexibility to consider that the way they've
24:21
always been thinking or feeling about something might actually
24:24
be skewed by a survival response and not actually by what's
24:30
possible. Did I answer?
24:32
Your question, yeah, you did and I think I got it.
24:36
You know, I I was totally expecting you to say that this
24:39
was, you know, we started there and then it's like another six
24:42
months, you know, I mean, that's really amazing, you know,
24:45
because not there's anything, you know, there's a place for
24:48
most of stuff that we're you know, whether it's been around a
24:51
long time or newer. But you know, I think that that
24:53
being able to not be on, you know, MAT basically, you know,
24:58
that's amazing. So those clients that do this,
25:02
you kind of make that call, you know, you got a little what,
25:05
what's that? How long are people typically at
25:06
the Manor? Six weeks is our sweet spot
25:09
that's we say it's a six week program.
25:11
Some clients will stay as long as eight weeks will never do
25:14
ketamine with anyone who can't stay at least six weeks.
25:18
And that's just because you know, it's a pure function of
25:21
time like there's too much to do first two weeks are
25:24
stabilization orientation. People are just starting to feel
25:27
around week 3, right? And the exercise of being in a
25:32
nice treatment facility gets old.
25:35
And they're like, OK, I'm done with this.
25:38
And then we get to the other parts of the person, right?
25:41
When they're tired of the newness, you know, we have
25:45
amazing chefs. The beds are great, right?
25:47
Yoga's wonderful. We've got massage.
25:49
You know, the therapists are really skilled.
25:50
They're developing all these insights and they're like, oh,
25:52
this place is great. We aren't really getting into
25:56
the parts of the system that need the most attention for most
26:01
clients until week 4. And if they think they're
26:05
discharging at the end of week 4, their system will not let
26:08
them go there because they shore themselves up because they know
26:12
they're leaving. And if they stay this great
26:15
grateful client the whole time. I don't want to say that that
26:18
doesn't happen for some people, but trust me, like the grateful,
26:24
kind, integrated, pleasant human being that we're seeing is not
26:29
the person that's experiencing the most suffering.
26:31
So we really want to keep people in the process long enough to be
26:37
able to work with some of the parts of them that are really
26:39
hard for them to love and embrace and allow us to
26:42
understand how to work more deeply in that system.
26:44
So six weeks is really, if you're going to do trauma
26:46
reprocessing, you can't do it in four.
26:48
For almost all of our clients, I would say that's the case.
26:51
And and that's, you know, some clients will be like, but if I
26:54
work really hard and I'm like, this is not about how hard
26:57
you're willing to work. Our clients work hard.
26:59
They're ready to work hard. They want us to give them double
27:01
the amount of sessions everyone gets like five, 5 1/2 hours of
27:04
individual therapy, sometimes 6. They're like, can you just
27:07
double them me on the therapy that you give me?
27:09
And I'm like, look, it's not about that.
27:12
It's about your system's level of safety and readiness.
27:16
And that takes time. Like we can't speed that up.
27:20
If anything, it's about slowing that down because parts of you
27:24
could be really motivated for this, but those aren't the parts
27:27
that get you stuck. You know, your capacity to power
27:31
through, that's great. And that's why you've been
27:34
successful in some other areas of your life.
27:36
That's not going to help us get to your wounded child.
27:39
Like that's not that's not happening.
27:41
And you know, on a timeline where you've got this plan and
27:44
you want everybody to work harder to get there, that's not
27:47
how that works. So yeah, I would say six weeks
27:50
to 8 weeks is a a real sweet spot for someone to potentially
27:54
do this and get a couple sessions in.
27:57
The other complexity is we really will not look at cap
28:01
unless someone has a really robust continuing care plan.
28:04
So we don't want to collude with the idea that this is like, as
28:07
it is already trauma work is confusing for people because if
28:11
you do it under the right side of circumstances, right
28:13
therapist, people feel a lot of relief and they might confuse
28:19
that relief with recovery. And so we are like, look, you
28:24
feel this good because you're getting this much work with this
28:27
much help in this environment. You have to have a robust
28:32
continuing care plan. And of course, and with the cap,
28:36
they'll get even more relief. So people could delude
28:38
themselves into thinking like I'm fixed, like I'm good to go.
28:42
You know, unfortunately, psychic and emotional relief does not
28:45
equal long term sobriety. It doesn't, not unless it's
28:48
built foundationally on modifying your environment,
28:53
getting people in your system that understand how this works.
28:56
And then if you're in recovery and you've done something like
28:58
CAP, we need to make sure that your recovery coach, your
29:01
sponsor, you're sober living, don't all think you relapsed in
29:04
treatment. So we have to reach out to all
29:06
those people and say like, OK, this is not, you know what you
29:09
think it is, right? Like it's about addressing the
29:11
whole family system, a long term sustained recovery program.
29:15
And we do not want to collude with the idea that this is a
29:17
solution or an answer to a long term problem that actually needs
29:22
really a lot of care around it. Yeah.
29:25
I mean, we talk about this all the time, you know, the
29:27
especially helping the families understand that.
29:30
And they talk to the loved one after they've been with us for a
29:33
little while. They hey, they're going to sound
29:34
a lot better. They're going to look a lot
29:36
better and they're going to be speaking a new language and
29:39
they're a whole lot better than they were when they got here.
29:41
But this is just the beginning. And we and the last thing we
29:44
want is somebody to feel like they admits it can be a false
29:48
sense of security, you know, and then they think that they are,
29:52
you know, struck, struck sober, struck trauma free, whatever it
29:55
is, and then go back out to the world and it's like not ready.
29:58
Yeah. Yeah.
30:01
And it's not to take away how good that feels, but it's to
30:05
it's to help people understand this is a state, this is not
30:09
where you live. Like you're in a state of
30:11
feeling this way and you've touched into your capacity.
30:18
This is what's possible, but you are totally underestimating
30:23
that. You're being surrounded by 20247
30:25
care and we are neutralizing a lot of variables here to help
30:30
you. We're creating optimal
30:31
conditions for you to connect to the most authentic version of
30:34
yourself to be able to get as much relief as possible, for you
30:37
to recognize that you don't actually need to use to get
30:40
relief. And the version of relief you
30:42
get this way is not undercut with a ton of shame.
30:47
So, but that's going to require work and that's going to require
30:51
maintenance. And even though it feels like a
30:52
big investment and it's wonderful that you're in a
30:57
position to be able to afford this treatment, this is going to
31:01
require, it's an investment that you've got to keep investing in,
31:04
which is, I wish it was the other way for people, I really
31:07
do, but it's just not. We know this over time.
31:09
What did you just say a second ago?
31:11
You said this, you know, we're talking about the false sense of
31:13
security. And you said this is not a
31:15
state, this is a state, but you said this is possible.
31:18
Is that what you just said? Yeah, yeah.
31:20
This is what's that that I'm going to steal and because that,
31:24
but that's so good because that. But that's right.
31:26
It's, you know, that's that's it.
31:28
Yeah. What you're feeling now is
31:29
possible if you continue to capitalize and keep this
31:32
momentum going and keep maintaining.
31:34
Yeah. And I love that because so I'm a
31:37
clinician and I think, you know, just, you know, the experience
31:40
you you experience these moments, whether it's you to do
31:42
an individual work with someone or, you know, these light bulb
31:45
moments or these emotional moments that happened in a group
31:49
setting. I wish you could kind of just
31:51
capture that in a bottle for that person, right?
31:53
Because like the light bulb goes off or they experience this
31:56
moment of clarity. And it's like, yeah, I love what
31:58
you just said there. I think I might do that as well
32:00
and steal that. It's like.
32:02
Because. You do, you wish you're like,
32:03
Oh, yes, this is this is like a thing, you know, you can
32:05
experience this clarity, like these feelings can be real for
32:08
them. But sometimes it's just kind of
32:11
a fleeting moment and you're just hoping they can continue to
32:13
work where they can start, continue the work where they can
32:17
have those moments more consistently, I guess, right?
32:20
Totally. And I and I think it's, it's
32:22
kind of shitty when people try to take that away from clients
32:25
and go, oh, it's not real. You're on a pink clock, right?
32:28
Like no. One wants to hear that.
32:30
Right. Like it's like, oh, you feel
32:31
great, Just wait. It's like you're a new parent
32:34
and they're like, oh, you're happy.
32:35
Just wait, wait till your kid is born.
32:37
I'm like, screw you. Like I don't need you telling me
32:40
that. Like the moment I'm having right
32:41
now isn't a great moment because it's going to suck later, right?
32:45
Like, so yes, notice what this feels like.
32:49
Let's not forget the conditions around you that optimized your
32:54
opportunity to feel this way. This is you.
32:58
And how are you going to recreate those conditions when
33:01
you leave here? Because it that's this is an
33:05
interaction effect. And the, you know, I, I used to
33:11
joke like I think some clients would feels so good.
33:16
And I would say, you know, you can exist on manner fumes for a
33:21
little while, right? Like we all put, I am the person
33:25
who drives my car until it's I've discovered how long you can
33:28
go on zero. I'm not proud of it, but you can
33:30
go on fumes, right? Like you can go on fumes for a
33:33
while. And some people will make it
33:35
weeks on fumes. Some people will even make it
33:37
months on fumes. I mean, some people make it a
33:39
year on fumes. It's a total gamble, right?
33:42
And so then why not just put gas back in the tank?
33:46
You know you got to put gas back in the tank, right?
33:49
We know what it looks like when the tank is full.
33:51
So like, let's not chance it. Like me an idiot who's waiting
33:54
to see if I can make it to the gas station, right?
33:56
Like let's really invest in in refueling you because this is
34:01
what's possible. Yeah, it makes me think of this
34:04
too. Is the kind of the difference
34:07
between a spiritual experience and a spiritual awakening of the
34:13
educational variety. So it's kind of, I mean, for
34:15
when I was in treatment, I had what I would call a spiritual
34:17
experience where I felt like I was sort of struck sober a
34:21
little bit and struck with some serenity for the first time in
34:25
peace that I hadn't felt since I was like probably 15, you know?
34:29
And but I wouldn't ever be able to maintain any of that if I
34:35
didn't continue to do what's required and suggested for me to
34:38
continue to have a spiritual awakening of the educational
34:42
variety, which, you know, that it's going to have little peaks
34:45
and valleys, but we try to shoot for those smaller valleys and
34:49
smaller peaks instead of these 10's and ones.
34:52
But the it's it, I think on some level, I don't know if somebody
34:57
had to have told me, but what happened to me in treatment, you
35:00
know, somebody in so many words said, you know that that's
35:02
what's possible, but it's going to take doing this going
35:05
forward. And that's, you know what I've
35:07
largely tried to do. What do y'all do about?
35:12
So you mentioned talking to sponsors.
35:17
What I mean, is there ever any kind of push?
35:19
Like what, what's the response? If they're like, Hey, whether
35:21
you're, you know, your response, he's in here doing great, but
35:24
done, done 2 sessions of, you know, non dissociative level.
35:32
Like what? Yeah, You know, I've been
35:36
delighted and surprised about the response in recovery
35:39
communities about talking about this.
35:43
Now, there's a certain percentage of people in recovery
35:46
communities that will never, no matter how much research is
35:50
done, support something like that.
35:53
Not in a million fucking years. And that's fine because they
35:57
will help a lot of people in a very specific way of operating,
36:04
and maybe they won't help some people in a very specific way of
36:07
operating. But when I first spoke, I don't
36:11
know, Bea, were you at the first time that I spoke at leadership
36:15
about psychedelics? Was that in, I don't know,
36:18
Tahoe? That was in Aspen.
36:22
No, you weren't there. OK.
36:25
No, that was the second time I spoke because the first time I
36:27
spoke at a recovery invitation only Recovery Summit was I think
36:35
three to four years ago. And I said we had already been
36:38
doing CAP for a couple years. And I said to Nancy, who's her
36:43
VP of outrage? She's she's since moved to
36:46
another program. Where is she?
36:47
Yeah, she's. Yeah, yeah, she's taken a new
36:50
position with the mental collective.
36:53
No, no, no. It's.
36:53
Great. I actually I did know that.
36:55
I did know that. I did know that.
36:56
Nancy's the best. She's been such a strong ally
36:59
for me and we're so happy for her.
37:00
Of course we miss her, but I said, Nancy, I think I need to
37:05
talk about this and this is going to be the time to do it.
37:08
Like we need to come out of the proverbial closet because we
37:11
didn't have it on our website. What we had done is we had
37:14
reached out to our reference and people we really trusted and
37:18
programs we consistently referred to and we explained the
37:22
model just to kind of because you can't do this work in
37:25
isolation because people refer to you and you refer them out to
37:28
sober livings. And we weren't going to set our
37:30
clients up like that. It doesn't matter how much we
37:31
believe in something is systemically, it's not
37:33
supported. They're totally at A at a loss.
37:36
So we talked to people that we really trusted and said, look,
37:39
this is how we're doing it. This is what it is.
37:42
It was a lot of work. It took us like 2 to three years
37:44
then kind of converting staff or not converting them, but like
37:50
listening to people's concerns and you know, it was pretty
37:53
cutting edge stuff. Like I don't think there was any
37:55
other treatment center at the time that I, there was one other
37:58
program that was doing cap was really more ketamine therapy,
38:03
but they were a mental health and a substance use program and
38:05
they were doing it very differently.
38:07
And I was so nervous it would just like implode our program
38:10
because like we had built what I thought was a really strong
38:13
program. I think we were developing a
38:16
really good reputation. It was solid work.
38:19
It was hard work. It was actual trauma
38:22
reprocessing, which, you know, lots of people don't have the
38:24
circumstances aligned to actually do trauma reprocessing.
38:27
They do trauma informed. And so I was like, OK, I'm going
38:33
to talk about this. It's like a room full of people
38:37
in recovery and people who interventionist.
38:40
And I have never been so nervous in my life.
38:46
Like I was like sweating and Oh my God, I still remember it.
38:52
But when I spoke, you know, I used research to support the
38:56
position and I was in a good spot.
38:59
Like I'm a very fortunate spot to be having one foot in
39:03
clinical research and 1 foot in treatment and 1 foot in the
39:06
recovery world at the same time that I have, that would mean I
39:09
have 3 feet. And so I don't have that, but I
39:12
was really lucky to be in a position where I could
39:15
potentially build a bridge from academic, clinical research,
39:19
trauma work and recovery. And so that was my bridge was
39:24
trauma work, 'cause this, this happened in recovery
39:26
communities, right? Like I remember, so I very first
39:30
started working in Malibu in treatment centers, right?
39:33
And there were not many treatment centers that were
39:35
talking about trauma at the time.
39:36
It's like over 20 years ago, people were saying like, you got
39:39
to be sober for like a year before you can do trauma work
39:42
because you know, you're going to relapse if you do trauma
39:44
work. And the model that I was
39:46
operating under at the time based on the people that were
39:49
leading that program was that if you don't do trauma work, people
39:52
are going to relapse. So that's evolved in the field,
39:55
right? It was, it was more like, oh,
39:57
you got to stabilize for a long time before you can do it.
40:00
And then, you know, there's, there's other kind of.
40:04
Questionable modalities people have a lot of opinions about
40:07
same thing with Suboxone, right? Like how many sponsors support
40:09
Suboxone versus not, right? So we have these inflection
40:13
points in the field where we have to consider new modalities
40:16
because people are still dying. And pure 12 step recovery works
40:20
for a lot of people but doesn't keep a lot of people sober.
40:23
Sometimes if they're psychic mental anguish, they're not
40:26
getting relief or if the trauma work gets unaddressed, right?
40:29
So when I gave that talk, I was shocked at how many people came
40:35
up to me positively and said, I want to know more about this.
40:39
And the way that you talked about it really makes sense to
40:41
me. And then what that was great,
40:44
was a huge relief. I was like, OK, great.
40:46
We're not delegitimized because I really believe in this work
40:49
and I'm doing this work. So like, I wasn't too worried
40:52
about that. I just didn't know if the field
40:53
was ready when people were open to it.
40:56
Then the problem was is that some people came back to me like
40:59
a year later and they're like, Oh yeah, I'm doing online
41:02
ketamine now and I'm using it daily.
41:05
And I was like, that is not what I fucking said.
41:07
I did not say to do an online daily ketamine program.
41:13
So then I asked the organizer of that program.
41:15
I said, can I come back and talk about the potential risks, which
41:19
I think B is what you saw that talk where I was like, look this
41:23
has tremendous potential, but it can go really badly in the same
41:27
way that Suboxone can go really badly, life saving measures or
41:30
greater EMDR can go really badly if you do it while someone is
41:35
actively using, right. So these, these therapeutic
41:39
opportunities are not just like stand alone net positive or
41:44
negative, they're contextually determined.
41:47
So we have to look at the context, what's being how
41:51
they're being used Is their therapy attached?
41:54
Is their responsibility there. It adds more complexity to
41:59
treatment. It doesn't simplify treatment,
42:01
but what's possible is amazing. So, and then the other thing
42:06
that I just want to name 'cause I think it's really important is
42:09
what's really bad in my opinion and needs to be talked about
42:14
with more transparency is people in long term recovery that go
42:16
get underground work or go to these retreats where they're
42:20
like, oh, I have a buddy who did ayahuasca.
42:23
Those people I am so worried about because not because people
42:28
can't get healing at those retreats.
42:30
There's something about people in long term sobriety that if
42:36
all the sudden their brain opens to something new, they, I have
42:40
seen people they don't have a framework of discernment to be
42:45
able to say like, hey, is this a good program or does this make
42:48
sense to me? They kind of like just offer
42:52
full allegiance to whoever's running this program because a
42:56
friend's cousin's brother recommended it, and they don't
42:59
apply any of the same principles that have allowed them to stay
43:02
sober to evaluate whether or not this makes sense for them.
43:08
So I've seen people go do ayahuasca or an underground
43:12
thing with someone who used five different psychedelics on them
43:15
in one day, and it is appalling to me.
43:19
It's dangerous. And I think a lot of people who
43:22
are experienced with psychedelics to treats do have
43:24
no complex understanding of the intersection of addiction and
43:29
trauma. And so because they might be
43:32
expert in a particular type of modality delivery around
43:35
psychedelics, it does not make them expert.
43:37
It certainly does not make them safe clinicians for you in your
43:40
recovery process. And that edge of escaping,
43:45
losing yourself, like finding the ultimate solution or answer,
43:50
the way that kind of lives in people in long term recovery, it
43:53
needs to be cared for and cultivated and nurtured and
43:57
watched so that we don't kind of reinforce the wrong things.
44:02
And I have so many concerns about the amount of underground
44:07
work that I've heard happening in recovery communities in a way
44:11
that I feel is really dangerous. I love that we ended up here
44:16
because that needed to be said. Yeah, I.
44:18
Completely agree with that. That's because I think that some
44:20
people, you know, it's, it's like, well, you know, you can't,
44:24
you, you're, it's not something you can, you can't abuse
44:26
Ayahuasca. So it's fine, you know, and and
44:29
that's, I think that's how a lot of people kind of justify it
44:31
like that they're going to do this one thing and they can't
44:34
abuse it. And so it's and it's all for,
44:36
you know, my motives are pure that I want to get better.
44:39
And so it's, you know, Alka, illogical thinking sounds like.
44:45
Yeah. And and what's even more
44:47
heartbreaking is people really suffer with those compounds,
44:52
with those medicines when they're not delivered ethically,
44:54
responsibly, and integration doesn't follow.
44:58
These compounds have tremendous power for transformation and
45:04
they have tremendous power for disruption and destruction.
45:07
Like you can't have something that has that much potential in
45:11
One Direction and not have potential in another direction.
45:14
So I just think, you know, reality gets slippery the way
45:20
people become more susceptible, vulnerable to, to having their
45:26
thoughts modified in real time while losing grasp of reality.
45:32
Under the right set of circumstances, it can bring
45:34
tremendous clarity. Under the wrong set of
45:36
circumstances, it can go really sideways.
45:40
So I just, I can't say it enough, find a trusted
45:44
professional, talk about it out loud.
45:48
Don't just go off of a friend's fourth hand recommendation.
45:52
Protect your psyche, protect your internal content.
45:56
It is precious and it deserves to be treated with a lot of
46:00
care. So I just and you can't unring
46:04
certain bells and. I.
46:07
Really strongly feel people need to take care of themselves and
46:11
be we need better guidance, support for the risks that
46:15
people can incur through these things and there's not enough
46:19
about that in the media in my opinion.
46:21
I hear him. Well, thank you.
46:22
Let's end there 'cause this is a great place to wind up.
46:25
But but this has been absolutely awesome.
46:28
Amazing. Really.
46:29
Really. Schedule more time to just keep
46:30
talking about this stuff. Yeah, it's a lot of fun.
46:34
So we'll, this is tell us how to find you.
46:36
We're going to put all your stuff on the on the.
46:38
Oh, sure. Yeah, OK, cool.
46:40
So, yeah, So we have Win Rose Recovery, which you can find
46:43
onlineanddiscoverthemanor.com, which is our program website,
46:48
theresintegratahealing.com, which is where our ketamine
46:51
assisted psychotherapy program, We do intensives there.
46:53
So we do outpatient work. We've had clinicians come for
46:56
somatic and emotionally focused relational cap intensives.
47:03
And then I also have our podcast, which is blind Spots,
47:06
exploring what we cannot see, and that's got a lot more
47:09
content on it. So I'm so happy to talk about.
47:12
Maybe I could talk to you for hours.
47:13
Yeah, awesome. And I'll just say I've been to
47:16
the Manor and visited. It's amazing and that they're
47:18
awesome. And obviously from this
47:19
conversation, you can tell how awesome they are.
47:21
But I'll see you in real life soon.
47:24
And just thank you so much for being here today.
47:26
Yes. Thank you so much.
47:27
So fun talking to both you and to meet you.
47:29
Yes, very nice to meet. You likewise great to meet you.
47:32
Awesome. All right, Chantal, thank you so
47:33
much. If you liked what you heard
47:34
today or just want to know more, give us a call on 9196708119 or
47:41
visit us at newwatersrecovery.com.
47:43
Thank you.