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Psychedelic-Assisted Therapy with Jessica Punzo, PsyD. · The Trauma Therapist

0:00
Speaker 1: Welcome to the Trauma Theripists podcast. My name is gaming
0:03
Speaker 1: Person and I interview incredible people who share the story
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Speaker 1: of how trauma has shaped their lives. And a big
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Speaker 1: thank you for sponsoring today's episode goes to my guest
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Speaker 1: and our sponsors. So five four three two one our folks,
0:24
Speaker 1: welcome back to the podcast. Very excited to have as
0:27
Speaker 1: my guest today, Doctor Jessica Punzo.
0:30
Speaker 2: Jessica, welcome, Hi, Thanks for having me awesome.
0:34
Speaker 1: Doctor Punzo is a licensed clinical psychologist and president of
0:37
Speaker 1: the APA's Division on Trauma Psychology. She specializes in trauma
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Speaker 1: and PTSD and owns two practices, Middle Path Psychotherapy focused
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Speaker 1: on complex trauma and Rooted Journey Wellness where she provides
0:51
Speaker 1: Kenmine assistant psychotherapy. Certified in psychedelic assisted therapy through the
0:56
Speaker 1: Intricatives Psychiatry Institute, Doctor Punzo is passionate about educating both
1:01
Speaker 1: clinicians and the public on the promise of psychedelic therapies,
1:05
Speaker 1: and we're doing this interview in conjunction with one of
1:10
Speaker 1: our sponsors, Journey Clinical, so I'm really excited to learn
1:15
Speaker 1: more about that. But first off, I just got to say,
1:17
Speaker 1: after reading a bio busy enough, damn.
1:22
Speaker 2: Yes. Yes. I have a hard time saying no to things.
1:28
Speaker 3: I get super excited about things. I love what I do,
1:31
Speaker 3: so when opportunities present them to me, I almost always
1:35
Speaker 3: say yes, and then I have a very full schedule.
1:38
Speaker 1: Awesome. So let's start if we can learn a little
1:42
Speaker 1: bit about you, what got you into this field, and
1:44
Speaker 1: then we'll segue into KAP kind of an assisted psychotherapy
1:50
Speaker 1: and journey. So how did this start for you? How
1:53
Speaker 1: did all this is passion begin?
1:57
Speaker 3: Let me ask a clarifying question question about it? How
2:00
Speaker 3: did I get into psychology in general? Or how did
2:02
Speaker 3: I get in the eketymene world?
2:05
Speaker 1: First psychology trauma?
2:07
Speaker 3: And then we'll do Yes, that's a long journey.
2:12
Speaker 2: So yeah, you know, I actually.
2:13
Speaker 3: Started undergrad as a pre law major and really thought
2:19
Speaker 3: I wanted to do be a lawyer.
2:21
Speaker 2: And so a little bit of a backstory.
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Speaker 3: Both of my parents are immigrants and so I'm first generation,
2:28
Speaker 3: and I think there was a sort of unspoken uh rule,
2:34
Speaker 3: might you say of that you know you're going to
2:37
Speaker 3: do something. Yeah, so it was like doctor lawyer, that
2:42
Speaker 3: was kind of I mean, they never said that to me,
2:44
Speaker 3: and they never pressured me in any way, but it
2:46
Speaker 3: was sort of just an unspoken expectation.
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Speaker 1: Yeah, you know.
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Speaker 3: They they left everything to come here, you know, and
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Speaker 3: made a life for themselves, so you know, and I'm
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Speaker 3: an only child, so I feel ahead of additional pressure
3:00
Speaker 3: to make them proud. And so, like I said, I
3:03
Speaker 3: was like, all right, I'll be a lawyer. So I
3:05
Speaker 3: went pre law and quickly learned that that was not
3:09
Speaker 3: for me. It was very boring and no offense to
3:12
Speaker 3: the lawyers out there, but wasn't for me. Simultaneously, I
3:17
Speaker 3: was taking an abnormal psychology class and it's just part
3:20
Speaker 3: of like general education requirements, and I was like, wow,
3:23
Speaker 3: this is like really interesting, really fascinating. And then I
3:26
Speaker 3: learned you could be a doctor of psychology, and sort
3:30
Speaker 3: of the rest was history. Finished, I changed my major
3:33
Speaker 3: to psychology and a minor in biology and finished undergrad
3:39
Speaker 3: and then went straight to graduate school at Adler and
3:41
Speaker 3: got my side. And then initially when I was when
3:45
Speaker 3: I first went to Adler, I thought I was going
3:46
Speaker 3: to do neuroscience because I had the science.
3:49
Speaker 2: As my minor. I was really interested in biology and
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Speaker 2: the brain.
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Speaker 3: It was another field where I'm like I love this
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Speaker 3: and it's super interesting but not for me, right, I
4:01
Speaker 3: really wanted to do therapy. I realized, like I love
4:04
Speaker 3: talking to people, I loved helping people in that way,
4:06
Speaker 3: and neuroscience was a little less personal for me, and
4:11
Speaker 3: so I started taking more classes. And then I found
4:14
Speaker 3: out that we had a trauma concentration in our school
4:17
Speaker 3: and my mentor was the head of that program. And
4:21
Speaker 3: so again sort of rest is history. I was on
4:24
Speaker 3: my first internship and saw a very complex trauma case
4:29
Speaker 3: and like fell in love with the work and fell
4:31
Speaker 3: in love with the clients, and that was it. So
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Speaker 3: I went through the concentration, graduated, and here we are.
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Speaker 1: That's I mean, just trauma's intense. Yeah, what you know,
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Speaker 1: you said you encountered a complex case. How what was
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Speaker 1: that like for you?
4:54
Speaker 2: Yeah?
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Speaker 3: You know, I think and I still remember this client
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Speaker 3: like it was ya yesterday, right, And this was probably
5:02
Speaker 3: twenty years ago at this point, And I think what
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Speaker 3: struck me is the depth of the work that was there, right,
5:10
Speaker 3: that there was something that so terribly happened to this person,
5:14
Speaker 3: and that they had had and this person in particular
5:17
Speaker 3: had years worth like they were coming to me in
5:20
Speaker 3: their sixties and had not and still had been dealing
5:22
Speaker 3: with trauma symptoms since a child, and I just found
5:26
Speaker 3: it so sad that they didn't have any help up
5:29
Speaker 3: until that point, because they didn't have someone who knew
5:32
Speaker 3: a lot about trauma.
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Speaker 2: And just the relationship.
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Speaker 3: It's hard to kind of explain in words when you
5:38
Speaker 3: work with trauma survivors, it's sort of an unspoken thing.
5:43
Speaker 3: There's just a depth in the relationship and a specialness
5:46
Speaker 3: about being able to be a safe place for people
5:49
Speaker 3: that have historically been harmed by other people. So I
5:53
Speaker 3: think that was sort of what drew me in, and
5:56
Speaker 3: just being able to see them get to a place
5:58
Speaker 3: where they could get better was so rewarding.
6:02
Speaker 1: Did you feel scared at all? Was there hesitancy at all?
6:09
Speaker 1: Was there a feeling like holy crap, but still you
6:16
Speaker 1: wanted to walk into that.
6:17
Speaker 2: Yes, yeah, totally.
6:19
Speaker 3: I mean I remember this client was probably highly, highly dissociative,
6:25
Speaker 3: and at that point in time, I hadn't been experienced
6:29
Speaker 3: like now, looking back, you know, I've heard so many things,
6:32
Speaker 3: but at that point, the level of trauma that I
6:34
Speaker 3: heard it was a lot. It was a lot for
6:38
Speaker 3: a young therapist, and but you know, a lot of
6:43
Speaker 3: people ask me, how do you do this? How do
6:45
Speaker 3: you hold all that? And my answer is I don't
6:47
Speaker 3: really know.
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Speaker 2: I just I just love the answer. It's it's I know,
6:53
Speaker 2: it's so weird.
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Speaker 3: I just I feel called to that work, and I don't,
6:57
Speaker 3: you know, like some people work with sex offenders and
6:59
Speaker 3: I'm like, how do you do that? And They're like,
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Speaker 3: I don't know, I just do it. I think there's
7:03
Speaker 3: a specialty for everyone. And this was what called me,
7:08
Speaker 3: and so yes it was and it has been over
7:10
Speaker 3: the years, like it has affected me personally, you know,
7:14
Speaker 3: listening like you can't not Yeah, I mean, you're a
7:17
Speaker 3: robot if it doesn't, right.
7:21
Speaker 1: Okay, So you find your one, one of your multiple callings,
7:28
Speaker 1: one of your passions. What happens after that? Do you
7:34
Speaker 1: start you graduate and you start opening up your clinic
7:38
Speaker 1: or what.
7:38
Speaker 2: Yeah.
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Speaker 3: So I did a two year fellowship at the VA
7:42
Speaker 3: in San Diego, so when I had did my internship
7:45
Speaker 3: out there in California as well, and so I was
7:48
Speaker 3: mostly working with military sexual trauma in the VA, so
7:52
Speaker 3: veterans who had been sexually abused while on active duty,
7:56
Speaker 3: another population.
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Speaker 2: Very near to my heart.
8:00
Speaker 3: And you know, I in that space, you know, I
8:05
Speaker 3: was living in California, but I'm from Chicago, and so
8:07
Speaker 3: I knew I wanted to come back home and be
8:09
Speaker 3: with my family. So I transitioned here. And at the time,
8:14
Speaker 3: I don't think the VA here had any openings, so
8:17
Speaker 3: just that wasn't an option, and so I started looking
8:20
Speaker 3: at other jobs, and another one of my areas of
8:23
Speaker 3: expertise is queer LGBTQ folks, And there was an opening
8:29
Speaker 3: at the Center on Halstead, which is a large, major
8:32
Speaker 3: health community health organization in the city, and the position
8:37
Speaker 3: was for an anti violence director and so basically I
8:39
Speaker 3: was able to do all of this free trauma therapy
8:44
Speaker 3: for victims of violence who also identified as a queer
8:48
Speaker 3: in some capacity. So I went and I got that position,
8:51
Speaker 3: took that position, did that for a few years, and
8:54
Speaker 3: then got pregnant and then decided, Okay, I don't know
8:57
Speaker 3: if I can do full time anymore. I want to
8:59
Speaker 3: spend time with my child, and then opened my practice
9:03
Speaker 3: when he was like three months old, and I've been
9:08
Speaker 3: there ever since.
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Speaker 1: It's just interesting and fascinating to hear the specialties. I mean,
9:14
Speaker 1: you've really kind of dived into these particular specialties, which
9:19
Speaker 1: is very interesting to me, and all of which are
9:23
Speaker 1: so demanding, not that being a general practitioner isn't. But
9:29
Speaker 1: so let's talk about your interest in psychedelics. How did
9:33
Speaker 1: that come about?
9:35
Speaker 3: So no surprise here my clients, I say, my clients
9:38
Speaker 3: teach me so much, and over the years have taught
9:42
Speaker 3: me so many things. I'm indebted to them. But I
9:45
Speaker 3: actually had a client who was doing ketamine infusions. This
9:48
Speaker 3: was probably prior to the pandemic, so maybe around twenty
9:52
Speaker 3: eighteen twenty nineteen, and she was getting these infusions and
9:57
Speaker 3: I was academy, and I was like, isn't that.
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Speaker 2: Like a horse tranquiliz Like, what what is happening?
10:01
Speaker 1: Like?
10:02
Speaker 3: At this point, I had heard nothing about psychedelicasist that therapy,
10:05
Speaker 3: nothing about katamine. It was all very new to me
10:08
Speaker 3: at that time. And she would come in and report
10:12
Speaker 3: her experiences and I'm like, what, Wow, that sounds really interesting.
10:16
Speaker 3: And so I said, you know, as as as I
10:19
Speaker 3: as I I say, as a good therapist would do
10:22
Speaker 3: uh sort of understand real life understanding of what that meant.
10:26
Speaker 3: So I asked the provider that was working with her
10:29
Speaker 3: if he would give me an infusion of kadamine.
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Speaker 2: WHOA yeah, whoa in.
10:34
Speaker 3: Terms of for an educational purpose, to understand what my
10:38
Speaker 3: clients were experiencing in those moments. And he agreed, and
10:43
Speaker 3: he felt that it was important that therapists working with
10:46
Speaker 3: clients undergoing catamine infusions did understand that process to really
10:50
Speaker 3: help them. So went in had an infusion and was like, whoa,
10:55
Speaker 3: this is uh now I get it.
10:58
Speaker 2: And then I kind of did a little bit.
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Speaker 1: You cannot just gloss over that. What the hell? What
11:07
Speaker 1: did you experience? Yeah?
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Speaker 3: I mean I had a beautiful experience, you know, and
11:14
Speaker 3: at that point I was extremely psychedelic naive, had never
11:19
Speaker 3: you know, had never had a traditional psychedelic drug at
11:22
Speaker 3: that point in time, and so I was so scared.
11:25
Speaker 3: I was so nervous. But it also then gave me
11:27
Speaker 3: that understanding of what clients feel going into that experience,
11:31
Speaker 3: you know, and and knowing.
11:34
Speaker 1: Let me just interrupt you here for s because you're
11:36
Speaker 1: saying a lot of interesting things here. So you said
11:39
Speaker 1: you were so scared, Yeah, and you were so nervous,
11:41
Speaker 1: but you did it.
11:43
Speaker 2: Yeah.
11:44
Speaker 1: Wow, I have so much respect for you and admiration
11:47
Speaker 1: for you. Wow.
11:49
Speaker 2: Yeah, So you do this?
11:52
Speaker 1: Was it in an office? Was it in Costa Rica? Somewhere.
11:58
Speaker 3: Yeah, no, no, this was it was more metal base.
12:00
Speaker 3: So typically ketamine infusion clinics will be more of a
12:04
Speaker 3: medical model of ketamine tend to be a little more
12:07
Speaker 3: sterile because right they're doing an IV and so at
12:11
Speaker 3: that time, yeah, it was just a little little chair,
12:14
Speaker 3: comfy chair he had. He hooked me up to the IV,
12:16
Speaker 3: he gave me some music, put the headphones on, and
12:20
Speaker 3: sort of off.
12:21
Speaker 1: I went, what did you experience?
12:26
Speaker 3: And this is this is why I did it, because
12:28
Speaker 3: it's almost hard to describe, right, and this is where
12:31
Speaker 3: it becomes challenging. You know, A lot of it was
12:34
Speaker 3: feeling sort of very warm and like enveloped in like
12:37
Speaker 3: a marshmallow. I had that sort of feeling almost like
12:41
Speaker 3: probably like being back in the womb of some sort
12:44
Speaker 3: of h space. And then there was just a lot
12:48
Speaker 3: of nature, a lot of abstract like figures, shapes. I
12:53
Speaker 3: had a lot of themes of like as tech Mayan
12:57
Speaker 3: visions that came. It was a lot of randomness, but
13:04
Speaker 3: all in all was like very cool.
13:06
Speaker 1: And how long did it last?
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Speaker 3: That was probably about forty five minutes, like the the
13:13
Speaker 3: extent of the journey, but usually you know, you get
13:15
Speaker 3: about thirty minutes till it like comes on and then
13:18
Speaker 3: you have this peak experience and then you're sort of
13:20
Speaker 3: coming out. So from start to finish maybe two to
13:23
Speaker 3: three hours.
13:24
Speaker 1: And do you go in with an intention?
13:28
Speaker 2: So at that time again no, at that time I know,
13:31
Speaker 2: I didn't.
13:32
Speaker 3: It was just to learn and to see, so it
13:35
Speaker 3: was kind of more educational. But if I, you know,
13:40
Speaker 3: after that having other experiences, would try to be more.
13:44
Speaker 2: Intentional about that. But I didn't know what I was
13:48
Speaker 2: walking into.
13:50
Speaker 1: So you have that experience, what happens next? How do
13:52
Speaker 1: things unfold?
13:53
Speaker 3: Yeah, So after that I was like, oh, wow, this
13:56
Speaker 3: is this is interesting. And I was seeing my clients
13:58
Speaker 3: have a lot of like positive benefits from a depression
14:02
Speaker 3: sort of antidepressional sort of effect from the ketamine. I
14:06
Speaker 3: was like, Wow, this is this is cool. And then
14:09
Speaker 3: I started doing a little research and found that you
14:12
Speaker 3: could pair this with psychotherapy, and I said, oh, how
14:16
Speaker 3: cool is that? And then I dug a little deeper
14:17
Speaker 3: and was like, oh, yeah, they also do this with
14:19
Speaker 3: psilocybin and other compounds like MDMA. And then I, again
14:23
Speaker 3: digging a little deeper, saw that at that time MAPS
14:26
Speaker 3: was in the process of clinical trials for MDMA for PTSD.
14:30
Speaker 2: And I was like, oh my god, like I do
14:33
Speaker 2: PTSD work, You're something really cool.
14:35
Speaker 3: Like I have to do this, And so I researched
14:38
Speaker 3: a couple of programs that were offering certifications and ended
14:42
Speaker 3: up choosing IPI And yeah, I finished that program last
14:46
Speaker 3: year and it was wonderful. And now I'm doing CAP
14:51
Speaker 3: in my office with my clients. It's so cool with
14:54
Speaker 3: Journey Clinical.
14:55
Speaker 1: So yeah, Now, for those who maybe who are listening
15:01
Speaker 1: who aren't very familiar, how does ketamine differ from the
15:05
Speaker 1: other psychedelic therapies out there.
15:09
Speaker 3: Yeah, so there's a lot of different compounds, but ketamine
15:13
Speaker 3: right now is a legal drug that is available medicine.
15:17
Speaker 2: Is legal all in all states.
15:20
Speaker 3: It is not a classic psychedelic like we would look
15:23
Speaker 3: at psilocybin LSD. Those are your true psychedelic drugs, right versus,
15:29
Speaker 3: Ketamine is technically classified as a dissociative anesthetic drug. So
15:33
Speaker 3: it's routinely used in surgeries and in the er. A
15:37
Speaker 3: lot of times they'll give people ketamine, even children, to maybe.
15:41
Speaker 2: Stitch up a wound. If a small child has a.
15:43
Speaker 3: Wound, it kind of helps them to dissociate a little
15:45
Speaker 3: bit so that they can work on the area that's affected.
15:50
Speaker 3: And high high doses of ketamine, that's where we see
15:53
Speaker 3: it being an anesthetic and people going to sleep. Sub
15:57
Speaker 3: anesthetic doses is where we use it in the psychotherapy component.
16:02
Speaker 1: Now, does that mean that the patient is not going
16:08
Speaker 1: to experience the degree of psychedelic images that one might
16:14
Speaker 1: experience on with psilocybin.
16:17
Speaker 3: It's different, right, because I think it depends on the person,
16:20
Speaker 3: and some of my clients their journeys will be very
16:24
Speaker 3: similar to what I've heard and experienced in psychedelics myself,
16:29
Speaker 3: and then others will be just more of a dreamlike state,
16:32
Speaker 3: more like my personal experience in psychedelics where it's more abstract.
16:37
Speaker 3: But every client is so different. That's what I love
16:40
Speaker 3: about ketamine. You kind of never know what you're going
16:43
Speaker 3: to get when you get when you get into it.
16:46
Speaker 3: So and the dose it's dose dependent too, right, So
16:50
Speaker 3: higher doses we're going to see more dissociative qualities, potentially
16:54
Speaker 3: more visuals, but some clients just don't report visuals.
16:57
Speaker 2: But they will feel like a more.
16:59
Speaker 3: Somatic dissociation from the body, kind of what I mentioned
17:02
Speaker 3: earlier with that hugging sort of feeling or yeah, all.
17:07
Speaker 1: Right, let me just remind me what I'm speaking with,
17:09
Speaker 1: doctor Jessica Punzo. We're talking about ketamine therapy, and now
17:14
Speaker 1: let's get into your relationship with with Journey Clinical. How
17:17
Speaker 1: did that come about?
17:19
Speaker 3: So after I was done with my training and IPI,
17:22
Speaker 3: I was thinking, all right, now I've been trained in psilocybin,
17:26
Speaker 3: MDMA and ketamine. I live in Illinois. The only thing
17:29
Speaker 3: that's legal is ketamine. So that was the option I
17:33
Speaker 3: knew I had to go. And actually in our IPI program,
17:38
Speaker 3: they did mention Journey as a potential way to start
17:41
Speaker 3: doing this work. And so, you know, after I was done,
17:45
Speaker 3: I was trying to figure out, all right, how am.
17:46
Speaker 2: I going to do this? How does this work? Right?
17:48
Speaker 3: Because it's very similar to opening up like a therapy practice.
17:52
Speaker 3: Now I'm opening a ketemine practice. I wasn't trained on
17:55
Speaker 3: that per se, you know, so I was trying to
17:58
Speaker 3: figure out all the logistics of that, how I was
18:00
Speaker 3: going to charge, was I going to take insurance?
18:02
Speaker 2: What would that look like? All of this stuff?
18:05
Speaker 3: And so technically you need a prescriber to prescribe the kedemine, right,
18:09
Speaker 3: whether you're going to do.
18:10
Speaker 1: That, ivy.
18:13
Speaker 3: That can be a nurse practitioner too, anyone who can prescribe.
18:16
Speaker 3: I mean, so typically it's either an MD or a
18:20
Speaker 3: nurse practitioner, Okay. And so you know, I could have
18:25
Speaker 3: partnered with, you know, someone in the community, even the
18:28
Speaker 3: person that I who did the first infusion for me,
18:31
Speaker 3: but it felt very isolating. It felt like I would
18:34
Speaker 3: just I was there, like the only therapist doing this,
18:38
Speaker 3: and I had no one to kind of talk to.
18:40
Speaker 2: So I stumbled upon.
18:42
Speaker 3: Journey because you know that MD's and they just administer
18:45
Speaker 3: the medicine that they're not trained in keteminicisted psychotherapy, right,
18:50
Speaker 3: So they have a very medical model way of doing that.
18:53
Speaker 3: And I think people should know there is a difference
18:55
Speaker 3: between ketamine infusions medical model versus kedeminicists and psychotherapy and
18:59
Speaker 3: what we do in Journey clinical.
19:02
Speaker 2: Because they're different, very different.
19:07
Speaker 3: And so stumbled upon Journey, And you know, I think
19:10
Speaker 3: I ended up getting like a free free month from
19:12
Speaker 3: a referral from another Some of the other people in
19:15
Speaker 3: my cohort had signed up and were enjoying it, and
19:18
Speaker 3: I signed up and taught. It's a whole community of
19:21
Speaker 3: therapists doing this, right.
19:22
Speaker 1: So also in person online this is all virtual, all virtual.
19:27
Speaker 3: Yeah, So Journey's platform is like a sort of online
19:30
Speaker 3: platform that the whole point of it is they're connecting
19:33
Speaker 3: therapists with prescribers. So the prescribers will do the medical
19:37
Speaker 3: intake and prescribe the ketamine, but they will only do
19:41
Speaker 3: that if.
19:42
Speaker 2: The client has a therapist.
19:44
Speaker 3: So this is also different than sort of our mail
19:47
Speaker 3: home sort of ketamine subscriptions that are bordering on probably problematic,
19:53
Speaker 3: where you just get ketamine shipped to your door and
19:56
Speaker 3: you don't have to be doing any therapy.
19:58
Speaker 2: Journey's motto is very strict.
20:00
Speaker 3: They will only prescribe in a therapeutic container, which is
20:04
Speaker 3: something that I really appreciated.
20:06
Speaker 1: So, for example, give us how an idea is how
20:10
Speaker 1: this would work?
20:11
Speaker 2: Yeah, so how it worked for me.
20:13
Speaker 3: The first client I ran through was one of my
20:15
Speaker 3: long term clients, right, so someone I had been seeing
20:19
Speaker 3: for at this point probably three or four years, right,
20:23
Speaker 3: trauma survivor childhood sexual abuse. We had done a ton
20:27
Speaker 3: of great work, but we're kind of getting to a
20:29
Speaker 3: plateau which happens in therapy, right, and sometimes sure, you know,
20:33
Speaker 3: you just you do a lot of work and you
20:35
Speaker 3: kind of get stuck. And it wasn't that the client
20:38
Speaker 3: again hadn't made progress or wasn't feeling good, but we were.
20:41
Speaker 2: Kind of like, there's something else, we need to get
20:43
Speaker 2: something else.
20:44
Speaker 3: So the client knew that I was doing this training
20:46
Speaker 3: and was interested, and so I make the referral and
20:49
Speaker 3: say the client said, I do want to do this,
20:51
Speaker 3: I want to try this, and I make a referral.
20:54
Speaker 3: She sees the Journey Clinical prescriber. They do a medical
20:58
Speaker 3: intake to ensure, say for ketamine, make sure you know
21:02
Speaker 3: everything's good from a medical perspective, and then they prescribe
21:05
Speaker 3: her her prescription. Now, Journey Clinical use rapid dissolving tablets
21:10
Speaker 3: of ketamine, so ketamine can be done intravenously, intramuscularly, intrnasally,
21:17
Speaker 3: or sublingually.
21:19
Speaker 2: So we at.
21:20
Speaker 3: Journey use sublingual tablets. This way, the client can do
21:23
Speaker 3: the journeying in the therapist's office, so we don't need a
21:26
Speaker 3: medical person in the room for monitoring. The clients come,
21:31
Speaker 3: they take their blood pressure before we make sure that's
21:33
Speaker 3: in range. It has to be within a certain range
21:35
Speaker 3: to proceed. Then the client will take the pills themselves
21:39
Speaker 3: or the tablets. They let them dissolve in their mouth,
21:42
Speaker 3: They swish it around, and then they spit it out,
21:44
Speaker 3: and then they lay back on the couch and have
21:47
Speaker 3: their experience, all while I'm sitting there sort of supporting them.
21:53
Speaker 1: How long are you setting aside for that experience?
21:55
Speaker 2: It's about a three hour session, okay.
21:59
Speaker 1: And obviously well not obviously, but with a client with
22:05
Speaker 1: the understanding that all everyone's different, is there more of
22:10
Speaker 1: a intention set in this kind of setting?
22:13
Speaker 3: Mm hm yes, So I should back up before we
22:18
Speaker 3: even do. That's that's called the dosing session, that three
22:20
Speaker 3: hour block. Before that, we have what are called two
22:24
Speaker 3: preparation sessions. So in those preparation sessions, we're talking about
22:27
Speaker 3: what is what can they expect when they take ketamine?
22:31
Speaker 3: What is kind of meine, how does it affect the body?
22:33
Speaker 3: So a little psycho education about ketamine. And then we
22:36
Speaker 3: spend the second session all about expectation management and intention setting,
22:41
Speaker 3: So we're very We spend a whole session just talking
22:44
Speaker 3: about what are their intentions, what do they want to
22:46
Speaker 3: get out of it, but also realizing what they want
22:49
Speaker 3: to get out of it might not exactly be what
22:51
Speaker 3: they get and how do we manage that?
22:54
Speaker 1: Well, that was I was thinking, does it even matter
22:58
Speaker 1: if you set an intention?
23:00
Speaker 2: I think it does matter, I do, I think.
23:02
Speaker 3: But what clients will realize was, and this has been
23:06
Speaker 3: my experience personally, often what they want to come in
23:10
Speaker 3: and work on is.
23:11
Speaker 2: Not what comes up in the ketemine session.
23:14
Speaker 3: So I still think it's important to say, like, why
23:16
Speaker 3: are we doing this right? And be grounded in that,
23:21
Speaker 3: but be okay and be flexible with whatever presents itself
23:24
Speaker 3: in the medicine session. And really the medicine session is
23:28
Speaker 3: just one part of the work. The real work is
23:30
Speaker 3: in the integration session. So the integration sessions happen within
23:34
Speaker 3: usually twenty four to forty eight hours after.
23:37
Speaker 2: That dosing session.
23:38
Speaker 3: The reason that we do it in close proximity is
23:41
Speaker 3: because ketamine is a neuroplastic agent, right, so it really
23:46
Speaker 3: helps the brain be open to new sort of experiences
23:50
Speaker 3: or thoughts, right, And so when we have a therapy
23:54
Speaker 3: session after that, the client's brain is sort of open
23:57
Speaker 3: in a.
23:57
Speaker 2: Way that it hasn't been before.
23:59
Speaker 3: And that is the sort of gold soss of ketamine.
24:03
Speaker 2: Not the dosing session.
24:05
Speaker 3: Like, because clients can have no experience sometimes in those sessions, right,
24:09
Speaker 3: and that can be disappointing for them, and then we
24:12
Speaker 3: process that. But it's everything that follows that. It is
24:18
Speaker 3: really has been really amazing to watch.
24:22
Speaker 1: Wow, So who would you recommend? Who's this four?
24:29
Speaker 2: It's a great question, you know.
24:31
Speaker 3: I think when ketamine first came out, or when you
24:34
Speaker 3: see IV ketamine specifically, most often it's targeted and spravado
24:38
Speaker 3: is the nasal form, the FDA nasal spray form of ketamine.
24:43
Speaker 3: It's actually different model. It's esketamine versus racemic ketamine. Probably
24:46
Speaker 3: could talk your ear off about all this cool scientific steff,
24:50
Speaker 3: but that is specifically for treatment resistant depression. Typically, that's
24:56
Speaker 3: what ketamine has been associated people who've tried multiple medication
25:00
Speaker 3: for their depression without any avail, without symptom reduction. I
25:05
Speaker 3: think it's like only two, but most of my clients
25:07
Speaker 3: have probably tried five upward of five different medications. Oh yeah,
25:13
Speaker 3: and you know when we look at complex PTSD, we're
25:16
Speaker 3: looking at a ton of symptoms, right, and there is
25:19
Speaker 3: no there is no medication for PTSD.
25:23
Speaker 2: So that's how it's been marketed.
25:27
Speaker 3: But what I say, I really think kindamine can be
25:31
Speaker 3: for lots of different things. I think it is good
25:33
Speaker 3: for depression. I've seen it great for anxiety for PTSD,
25:38
Speaker 3: but I also think it can be for people who
25:40
Speaker 3: are just feeling stock and or want to do some.
25:43
Speaker 2: More self growth. Like I don't think people have to be.
25:46
Speaker 3: So struggling to access this type of treatment. Right, Maybe
25:51
Speaker 3: you're doing well, but you're just feeling like you don't
25:54
Speaker 3: know where to go with your life, or you've plateaued
25:56
Speaker 3: in your therapy, right and you want to try something different.
26:00
Speaker 3: So I think it could cut across a lots of like,
26:02
Speaker 3: who could this be for? I think it can be
26:04
Speaker 3: for a lot of people.
26:05
Speaker 1: And what about who who is maybe is contraindicated for?
26:09
Speaker 3: Yeah, so right now, contraindications typically are any sort of
26:14
Speaker 3: active psychosis, right, or thought disorder. But it's interesting they're
26:18
Speaker 3: still doing research, right, And it is hard because I
26:22
Speaker 3: feel like a lot of people who have psychosists or
26:24
Speaker 3: thought disorders are ruled out from every sort of treatment thereas.
26:28
Speaker 3: And it's really sad because those people deserve the same
26:33
Speaker 3: help as everyone else. But right now, that is tends
26:36
Speaker 3: to be a big contraindication. There was some talk about
26:39
Speaker 3: bipolar bipolar one because sometimes ketamine can trigger a manic episode,
26:46
Speaker 3: but it seems like some of that has loosened up
26:49
Speaker 3: a little bit. But I would say those would be
26:51
Speaker 3: the two major things. And I would also say the
26:56
Speaker 3: way that I'm doing ketamine so kindamine assisted psychotherapy with
27:00
Speaker 3: subling well in my office, I would say, if someone's
27:03
Speaker 3: like acutely suicidal, this is not going to be the
27:05
Speaker 3: treatment we're going to go to first. We definitely want
27:08
Speaker 3: to get someone stabilized first. While catamine and specifically kind
27:12
Speaker 3: of meane infusions show about an eighty percent reduction in
27:15
Speaker 3: suicidal ideations, I think doing it in the therapeutics like
27:22
Speaker 3: container that I'm doing it in that would be too hard,
27:25
Speaker 3: right because we want them to get the symptom reduction
27:28
Speaker 3: first and then be able to do the therapy. So
27:32
Speaker 3: I guess what I'm saying is, people who come to
27:34
Speaker 3: kedemenis is a psychotherapy, we want them to have some
27:36
Speaker 3: sort of baseline coping in place, because a lot of
27:41
Speaker 3: things can come up in the session, and so we
27:44
Speaker 3: don't want someone who's not resourced at all or has
27:47
Speaker 3: any sort of support outside.
27:49
Speaker 1: That makes sense. So as we kind of wind down here, Jessica,
27:53
Speaker 1: what do you think. One last question here, I mean,
27:56
Speaker 1: what do you think you bring to this particular passion?
28:04
Speaker 2: Hmm, say more about that? What I don't know?
28:07
Speaker 1: Well, I mean it's obvious obvious. Look, it's clear you
28:11
Speaker 1: have a passion for this work, for getting in there
28:13
Speaker 1: and working with people who I've experienced some severe you know,
28:22
Speaker 1: abuse people LGBTQ community. But what is it let me
28:31
Speaker 1: rephrase the question, what does it take as a therapist
28:33
Speaker 1: to work in this field of.
28:35
Speaker 3: KAP Yeah, I think it takes, Like I say, it's
28:41
Speaker 3: not for the faint of heart.
28:43
Speaker 2: I'll put it that way.
28:45
Speaker 3: I got into this I had been already a therapist
28:48
Speaker 3: for you know, over ten years before I started doing
28:51
Speaker 3: this work. And I think that that's important. I think
28:54
Speaker 3: you have to be able to hold a lot of
28:58
Speaker 3: discomfort as a therapist and hold a lot of pain.
29:06
Speaker 3: And I don't think a lot of times when we
29:07
Speaker 3: first get out of graduate school, like I wasn't prepared
29:09
Speaker 3: for that either, right, And so I think having so
29:15
Speaker 3: much experience working with trauma and having that ability to
29:18
Speaker 3: like sit in really hard, hard spaces with people and
29:23
Speaker 3: hold them in that way had really prepared me to
29:26
Speaker 3: do this work in ketamine, right, because a lot of
29:30
Speaker 3: what comes up in ketamine can be super painful, but
29:33
Speaker 3: also it can be super beautiful. And I want to
29:36
Speaker 3: also let people know that it's not all like terrible
29:39
Speaker 3: and hard. And you know, some of my clients it's
29:42
Speaker 3: like a different experience for them to feel joy, right,
29:46
Speaker 3: and like they're not used to that and what that
29:48
Speaker 3: blissful feeling as well.
29:51
Speaker 2: So to me, I think in order to do this.
29:53
Speaker 3: Work, you have to be a skilled therapist. You have
29:56
Speaker 3: to be able to sort of roll and like be
29:59
Speaker 3: able to to move on your feet, because the reality
30:02
Speaker 3: with ketamine is sometimes you don't know what you're walking into.
30:05
Speaker 3: I've had clients, like I said, hanging out there enjoying
30:08
Speaker 3: themselves and it's all beautiful and then some I mean wailing, screaming,
30:14
Speaker 3: crying with so much pain, right and because a lot
30:18
Speaker 3: of times this is the first time they're able to
30:19
Speaker 3: feel some of that because they've been so detached from themselves.
30:25
Speaker 1: All right, Tessica, how do people learn more about you
30:28
Speaker 1: and journey so forth?
30:30
Speaker 2: Yeah, can visit.
30:32
Speaker 3: You can just google me my name, you know, and
30:36
Speaker 3: you should be able to find me pretty easily.
30:38
Speaker 2: Routed.
30:38
Speaker 3: Journey Wellness is my Kedemine practice. My other practice is
30:42
Speaker 3: Middle Path Psychotherapy, which is more of my talk therapy practice.
30:47
Speaker 3: But yeah, reach out to me there LinkedIn. I'm also
30:49
Speaker 3: on social media, doctor Jessica Bunzo and yeah, and if
30:56
Speaker 3: they want to learn about Journey Journey clinical a, get
30:58
Speaker 3: another easy Google search and we'd love we'd love to
31:01
Speaker 3: have you.
31:02
Speaker 1: Awesome. We'll have that all that linked up here at
31:05
Speaker 1: the STENTS page at the Trauma Therapist podcast dot com
31:09
Speaker 1: or Jessica awesome, so inspiring. Love to have you back
31:13
Speaker 1: at a later date and we'll be in touch.
31:16
Speaker 2: Awesome.
31:16
Speaker 1: Thank you, so all right, take care him