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Episode 720: Psychedelic-Assisted Psychotherapy with Jonathan Sabbagh · The Trauma Therapist

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Or welcome back to the Trauma Therapist Podcast. My name is Gaming Person.
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My mission is to help trauma therapist be their incredible cells, to be human,
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to be real, not just a clinician. I'm a big believer in
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who we are is more important than what we know, and this requires cultivating
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authenticity, genuineness, and vulnerability, and that requires intention. Can learn more
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about my courses and workshops by going to the Trauma Therapist project dot com.
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That's the Trauma Therapist Project dot com. Let's get started, all right,
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So five four, three, two and one, our folks, welcome back
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to the podcast. I am very excited to have as my guest study Jonathan
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Saba. Jonathan welcome, Thank you for having me. Nice to be here,
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awesome. So. Jonathan is the co founder and CEO of Journey Clinical,
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the leading telehealth platform expanding access to psychedelic assists psychotherapy. A serial entrepreneur,
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Jonathan built his career in finance, spending over two decades working for hedge
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funds and building his businesses in Switzerland and New York City. After receiving a
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difficult diagnosis of PTSD and extreme burnout, Jonathan left the world of finance to
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focus on his mental health, during which he personally experienced transformative benefits of plant
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medicine and ketamine assists psychotherapy or KAP. Jonathan's personal healing journey inspired him to
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begin formal clinical psychology training at the New School with the vision of expanding access
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to transformative psychedelic assisted therapies to the billions of Americans living with depression and anxiety.
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Jonathan, welcome, Thank you. So just before we get going here,
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you know, reading your bio, I can't help but remark on the
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people get involved in that field in business and finance, and you know a
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lot of things seem to happen that lead them to turn around. But we
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will get to that. I just had this sad to say that before we
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get going, Jonathan, show the listeners where you're from originally and where you
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are currently. Sure, So, I grew up in Switzerlands. My family
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are Egyptian Jews actually stare all immigrants over there, and my father was actually
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raised in Brooklyn. So I used to come to New York quite often,
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and I now live in New York, which was a early childhood dream of
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mine, and so I'm pretty happy. I've been here for almost ten years.
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Well, awesome, awesome, all right, So let's start out here.
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I'm really curious about how this started for you. Sure, so you
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know, as you read it in my bio, I spent most of my
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career working in finance. And yes, a lot of people in that field
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burnout. It's very intense, it's very difficult to work in sustain a career
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in that field. But really to burnout, I think was more a result
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of years and years of neglect of a condition I wasn't aware of, and
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so I struggled really with depression, with anxiety, with substance a use for
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a very very long time, not understanding what was going on with me.
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And as you can imagine, that's quite daunting to have a condition that you
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don't really understand. Until maybe eight years ago now, a friend of mine,
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where I was really on a downward spiral, recommended trying ayahuasca and brought
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me to a traditional ayahuasca ceremony here in New York, and it was very
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helpful, very transformative. I actually did seven of them in two weeks,
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and so it was a lot. And after continuing to work with that medicine
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for almost two years, I started to find myself in a loop, you
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know, and it was very helpful. I really was able to stay realized
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a lot of my condition, but I didn't quite understand what was going on
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I was. I became unable to process essentially those ceremonies, and I seeked
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help, and I seeked help from a psychedelically informed therapist here in New York
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who I've been working with for years now, and for the first time in
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my life, I was given a diagnose of post traumatic stress disorder, which
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was obviously difficult but also relieving in when I got that diagnosis, we did
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a lot of work with ketamine assisted psychotherapy, and I really had the chance
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to experience the power of the therapeutic alliance, working with a professional who understood
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what I was going through and who was able to use this treatment as an
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adjunct to therapy, and that really informed a lot of what we've built a
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journey clinical And you know, after a while, I didn't feel connection with
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the work and finance anymore. I didn't feel a sense of purpose really,
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and so I quit finance and I went back to school here in New York
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at the New School to study clinical psychology, and as much as many do
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I believe when you do this kind of work, you know, you want
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to reconcile who you were with who you want to be. And I believe
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that we all have a change in perspective essentially, and we just see ourselves
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as we were, but in a different lights. And so, you know,
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I decided that it was a good idea for me to bring back all
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of that experience I had as an entrepreneur to support my goal of expanding access
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to these treatments. And that's when I decided to find Journey Clinical. To
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found the Journey Clinical A few thinks. You mentioned that earlier on you going
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through a lot of challenges, suffering, maybe even discomfort. You use the
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word you said you had a condition that went on reckoned. What do you
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mean by condition PTSD? Early on? I've had from my whole life,
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your whole life, yeah, okay, and if I may do to what
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childhood trauma? Okay, okay, So there was a lot going on there.
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Had you ever prior to the ayahuasca treatment, had you ever sought out
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any other therapy? I had? Actually, when I had that burnout,
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I found a very good psychiatrist in Switzerland's who really saved me. And it
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really helped me out. And he treated me with traditional psychiatric medication. And
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it's important to note that I really believe in traditional psychiatric medication. I think
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they have their place. I don't think that's psychedelics are a panacea. And
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so, you know, he treated me with antidepressence and mood stabilizers and that
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really saved my life at that moment time. But after a while, you
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know, working here, at some point in New York, I had a
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psychiatrist who prescribed me to antidepressence, antipsychotics, mood stables, benzodiazepines, and
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it was just really just medication without anything. And so that's when I think,
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you know, there's a there's a crossroads of holistic medicine to incorporate that
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with therapy, with frontier treatments. And so I think that's also a lot
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of my personal ethos and our company's ethos. With that first ayahuasca experience,
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What was it about that specifically that you learned, that you saw, that
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you experience that shifted things for you. Well, you know, when I
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went to that experience, I really think I was at the end of the
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road. I didn't have any expectation. I was just open to whatever,
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and you know, I said, why not, let's try this. And
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I never worked with any kind of drugs, at least psychedelics in a way
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that was you know, sort of like intentional and ceremonial. It was mostly
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recreational, which can also be fined. But when I did that, I
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think that experience I didn't t anybody who's tried IOSCA. It's definitely not a
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recreational experience. And I think what I saw it was essentially the inner conflict
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that I was, you know, dealing with. I think an IFS for
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example, parallel here could be. I look, I saw you know,
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the exile and the firefighters that were and the defenses really that were polarized in
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my own system. And it was very difficult. Honestly, it was a
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very difficult experience that had remained a difficult experience for a long time. And
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so when I when I was able to essentially view what was going on,
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you know, I at least had some kind of understanding of the condition that
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I had been in for all these years. Um, okay, so talk
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about the the the the evolution of journey clinical Go ahead, Yeah, sorry,
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can we pause one second? Of course, yea, thank you.
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Yeah. Sorry, no, no, no, I can we do that.
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I can redo that last question if you want. I got distracted because
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someone keep deciding our thing. No no, no, that's still where is
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at all? Um? No? My question was can you talk about uh,
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you know, how and why you started journey clinical. Of course,
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when we started to consider how to support mainstream adoption of these treatments, what
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we landed on is that empowering license mental health professionals to incorporate these treatments as
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an adjunct to therapy in their practice is actually the most scalable and the most
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sustainable and safe way to do it, very much like MDR and the reason
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for that is because they're embedded in local communities, they have a relationship with
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a patient population. Even more importantly, the therapeutic alliance that they have with
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their patients is, in our perspective, the safest container to deliver these treatments.
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And so we started to consider what was the main barrier to entry or
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a therapist to include these treatments in their practice, and what we landed on
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after interviewing six hundred of them, was that forming and maintaining relationships with prescribing
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physicians is actually the main issue. I don't know if you know this,
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but actually there's only twenty five thousand psychiatrists in America. They're mostly located in
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large cities. There's an equal shortage of psychiatric nurse practitioners. And you have
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forty million people in paratherapy supported by about one point three million therapists. So
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you know, that's a real problem. And what tends to happen is that
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when they do have these relationships, they're quite fickle. Actually, they also
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put a lot of pressure on costs for the patients and the therapists, which
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limits the ability to expand their practice and increase their revenue. And so for
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the most part, what they're doing is referring out either to clinics or direct
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to consumer platforms. And if you are a patient, you know, I
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mean you know this. You know, finding a therapist that you like is
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really hard. It takes time to find someone, and building that therapeutical alliance
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takes a lot of time, and you're all of a sudden being asked to
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have potentially the most cathartic experience of your life with someone you've never met or
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maybe an app. And so that as a patient experience, really is it
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reasonable? Right? Right? And on top of that, you know they're
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also having a disjointed experience with a prescriber who is not necessarily informed, so
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their medication is managed separately, there's no communication with a therapist. So you
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know, that whole dynamic really led us to believe that supporting and empowering these
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therapists in their practice is really what's most important. And so what you know,
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what we decided to do is and it's important to make that distinction about
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us. We're not a Kenemine clinic. That's not what we do. We're
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not a Kenemine provider. We're essentially building the back end infrastructure for psychedelic assisted
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psychotherapy to exist. Right, Like if you look at organizations like Maps or
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Compass Pathways, their whole ethos is including the therapist in this process and so
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they cannot do that without essentially delivery mechanism, which is what we're building to
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enable that distribution network to have it. Right. So we're a network,
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we're an infrastructure solution. So, okay, we got listeners here who are
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therapists, survivors, combination of the boat of the two. They come to
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you and what happens. Yeah. So what we do essentially Journey Clinical is
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we set them up with everything they need to incorporate kenemine assisted psychotherapy in their
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practice. And that starts with a tell ahealth platform where we support a collaborative
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care model, and practically, what that means is that therapists become members of
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Journey Clinical. They refer their patients to our in house medical teams, so
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we are the doctor. We employ thirty medical professionals in our company and we'll
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see those patients for a full hour intake, will take full medical and psychiatric
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history. If they're eligible for the treatment, we'll send them enough for two
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CAP sessions, will send sublingual kenemine to their home. They'll and they'll have
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two CAP sessions, which they can do in a variety of modalities. We
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support at home. We support in person, remote group, promote retreat format.
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That's even a couple of therapy and we're always adding to it. And
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the reason why we do that is because we believe that therapists need to have
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the flexibility to adapt the treatment modality to their practice and to their needs.
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And that also patients, you might want to try one modality with our therapist
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and evolve to another. So we're here offering flexibility in that way the patient
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will come back to us. Sorry, okay, So yeah, I just
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want to make sure I get what you're saying here. So first of all,
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when you said you support, does that mean a therapist comes to you
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and says I have a client, client gets in contact with you, you
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provide them with and support for a CAP session. Does that mean that you're
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supporting? And if so, how online? Is there a therapist with them
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online or when they're taking So the way it works is that you're a therapist.
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So you're a therapist, You become a member of Journey Clinical. You
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refer your patients to our team through our portal, and I'll walk you through
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all the other services that we give for therapists, and that patient will book
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a telehealth consultation with our medical team okay, and then we'll send your patients
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the ketamine and they will have the ketamine session with you the therapists in a
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variety of modalities, modalities that we describe. So you are essentially delivering the
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CAP session, right. We believe that that's the container that that should be
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done in. So generally we observe. For example, the therapists will do
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a preparation session, the dosing session, and integration work. Right, so
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that that that structure and that protocol is taught to and delivered by the member
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therapists. We are essentially acting as your in house doctor, okay, right,
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and so the therapist, if I'm that therapist, I'm getting educated by
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you, okay, yeah, okay, yeah, So we have of course
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no no, no, for sure, So maybe just to finish on the
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on the essentially treatment modality and then I'll walk you through all the education that
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we have. So so essentially that patient would come back to us for dose
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adjustments and then we'll see them regularly. The other part of what we do
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is that we're here essentially supporting a collaborative care model. You know, so
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if there is a difficult experience or a difficult event, you know, the
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patient will triangulate with a therapist and our medical team, and you know,
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we'll assess and support the therapist and the patient that process. And so that's
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really important because that's the power of what we deliver a journey is the collaborative
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care model that mitigates negative outscome substantially because of that relationship. But on top
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of that, what we also do is that we you know, collaborate with
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the therapist to build a bespoke treatment plan at scale for the patients. So
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you know, we don't believe that there is one size fits all for these
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treatments. We don't think that patients do six cdemine sessions a month and that
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keep coming. You know, everybody's different and everybody needs to have a a
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tailored treatment plan. So what we're delivering essentially is concierge mental health at scale
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by supporting the therapist, who is our primary customer. Then you know,
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we have a whole tech platform and it's all technitable. So there's a prescriber
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portal for our in house medical team, but there is a therapist portal,
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and on that portal there is a twenty two module training that Fluence developed for
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us, which is included in their membership, which they have access to.
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We have pure consultation groups, the experiential learning, so they can have a
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CAP session that's facilitated with other buy other Journey members if they're eligible. Of
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course, we help them with legal resources and marketing resources and library of resources
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for just CAB in general and patients. We have webinars with specialists who delivered
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you know, our long talks or for our webinars on consent to touch and
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ifs. So there's a whole slew of services and it's all a hip ho
17:38
compliant and very easy to use. So they refer their patients for the platform
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and then they can track their outcomes and communicate with a therapist, and then
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there's a patient portal. So it's a very holistic model. And we have,
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you know, today almost eight hundred therapists in our platform that work with
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us, and we've seen you know, close to two thousand patients in the
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last ten months. And I was really amazed actually to see the other day
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that through our network in the last ten months, we our therapists have delivered
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more than thirty five hundred cap sessions. So that was really an awesome number,
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very impressive. I like what you're saying. I m you know,
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because I was thinking to myself there are probably therapists out there thinking, well,
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I, you know, how am I going to do this? I
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don't where do I start? But it sounds like you're providing a lot of
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education. Yeah, it's more than that. It's education it's resources. It's
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also community, right, that's really important. I think people tend to forget
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that being a therapist is a pretty lonely job, and so having access to
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a network of peers work with you. You know, we're doing peer consultation,
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there's a lot of there's a lot of meetups. This mentorship of our
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port today is if there's a whole community dynamic that's really quite amazing between our
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therapist that we support and enable and facilitate, and that makes it very unique
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as our offerent. So something that we've doubled down very much as the community
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aspect as well. Yeah, and I think you hit the nail on the
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head too. That is crucial for a lot of therapists out there. So
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what do you say to the therapists who are listening to this, who are
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saying, well, okay, how do I know of my client that might
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be right for this? That's suually an important question and a question we get
19:26
all the time. So you know, we have, for example, on
19:30
our portald, like you know the weekly meetings with our medical team, we
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have protocol meetings that we also have a meeting with our medical team that explains
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what a good referral is and people would be surprised that. You know,
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today about twenty percent of Americans suffer from anxiety and depression, so a large
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part unfortunately. Who would say that's a low estimate. If you it might
19:53
be a low estimate. It might be low, Yeah, it might be
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higher. And you know, so what we find, and the surprise of
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our therapist is that, you know, actually a large part of their patients
20:03
are probably eligible for these treatments. Again, we don't believe it's a panacea.
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We don't believe it's for everybody. We don't approve everybody, but a
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lot of people who are unfortunately suffering from these conditions and others like PTSD or
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CD. That's something like, you know, if they have bipolar depression.
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There's a whole spectrum of conditions that really can be supported by that. And
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what we found was that especially for patients who have been stuck or have not
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been progressing, you know, the feedback from our therapist was, you know,
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wow, after a few sessions, I had a patient who has not
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been progressing for years and finally had a breakthrough. And and that doesn't only
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help the patients, it also helps the therapist, right people forget the therapists
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burn out as a real thing, and working with patients who don't progress for
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years can be very, very difficult. No, this might seem like a
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basic question, but and I know every case is different. What is the
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goal of a CAP session? What's a very good question. Actually, what
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is the goal? I think, you know, there's a structure to it,
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and maybe we can start with that, you know, in terms of
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what is psychedelic assistant psychotherapy and so you know, we believe that it's not
21:22
simply giving someone drugs and having them have a reaction. There are some positive
21:26
outcomes to people just taking ketamine to reduce anxiety, suicidality, depression. There's
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a lot of studies that show that. But our perspective is that working with
21:37
the patients in the context of preparation, dosing, an integration is what's going
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to lead to long term behavioral change. Right, So, if you have
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a patient who is first of all, it's good to understand what preparation is.
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It's not just intention setting, it's actually you know, managing expectations,
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because there is such a thing as transference to the medicine itself, and so
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having them bring a mindful approach to that session, no matter how it unfolds
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or how strong the experience is, is really important. Then having the cap
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session, you know, for example, it's always in the context of a
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therapeutic alliance. That's how we work. So even if we do at home
22:12
treatment, they have to do preparation before, they have to vet the chaperone,
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they have to check in before, they have to check in after,
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and then they have to do integration works. We're not just giving ketamine to
22:22
people at home to take a loan. And you know, when they do
22:26
those sessions, then you know they're holding space, they're creating a container for
22:30
their patient to essentially be able to have this potentially extremely cathartic experience. And
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then the other part is and that's very important, is the integration. And
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a lot of studies have shown that it's through integration that long term behavioral change
22:48
happens. Right, And so ketamine has a lot of properties. It helps
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with you know, a regulation of glutamate. It also increases neural plasticity,
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and so there's a window of neural plasticity that how then after that session where
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the therapist can work with the patient to really integrate that experience and and progress,
23:06
and so that's that's the goal essentially of that tool. But it's the
23:10
goal of what we're doing is to have as an adjunct to therapy and so
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work it into a therapeutic process and have it on as a needed basis when
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it's appropriated. So some people might need a lot of kademy sessions in the
23:22
beginning, not needed for a while, have an event and come back and
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need it again. So that's why we find that working with the therapists and
23:30
being there back end basically is how it we'll support this the best. What's
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the usual time that a CAP session take would take. Yeah, it's roughly
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ninety minutes. Okay, are we talking about microdocing or not? It's we
23:48
don't do microdocing. You can talk about psycholytic versus psychedelic. That might be
23:53
different. So, like, depending on the format, if you want to
23:56
have a more conversational interaction, a lower psycholythic session may be more appropriate for
24:03
a couple OF's therapy. For example, if someone wants to go deeper than
24:07
they hired those uh, you know, more inward experience might be more.
24:12
Yeah, yeah, I mean obviously there's a lot of attention now being given
24:18
to psychedelic assisted therapy. I've had several people on the podcast. I think
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what makes you stand out? Jonathan and Journey Clinical stand out? If I
24:32
may say this, you seem to have done a lot of research into what's
24:40
what therapists are looking for and what's needed. It's very interesting. I'm wondering
24:48
if you feel and I'm thinking imagine a lot of therapists are thinking to themselves
24:52
or listening to this. Do you feel it's necessary for the therapists themselves to
25:00
go through this? You know, it's a very good question. So some
25:07
people feel that way, and they feel that it's necessary for a therapist to
25:11
have a psychedelic experience to do so. Some feel that it's not. There
25:15
is evidence of both. I think what we've done you there are people in
25:19
clinical trials or doctors who administer medication are an ongoing basis and don't necessarily take
25:25
it themselves. There are doctors, there are others who believe that having a
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psychedelic experience is essential to be able to understand the space in which the patient
25:34
evolves. And we don't have a perspective. But what we did do is
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we did manage to offer the opportunity for therapists to experience it by you know,
25:44
having you know, group cap sessions with other Journey therapists and so we
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but they have to be eligible, so we don't you know, if someone's
25:52
not doesn't have a condition, we will not prescribe to them. So that's
25:55
important because we want to protect the licenses of our prescribers as well. Just
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remind everyone. I'm speaking with Jonathan Seba of Journey Clinical and your website.
26:07
Jonathan, is what journeyclinical dot com okay? Really interesting? I love the
26:15
idea that therapists can come to you not only get an education, but get
26:18
support. There's a community there. It sounds like you've developed this in a
26:23
very three hundred and sixty degree way and from a perspective like that. So
26:30
for those who are interested, what do they do? Well? They can
26:33
go to Journeyclinical dot com and they can sign up for a demo with our
26:40
team on our website and we'll book a call with them and we will be
26:44
happy to walk them through what we're doing through our platform and onboardom okay,
26:49
and in terms of getting up to speeds such that they're ready to refer and
26:56
have a client go through this process. How long would that take? You
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know, we've seen it about on averages, about a month I think for
27:03
people to go through all the you know, these twenty two modules of training.
27:07
They also can get see credits for our training. We have got another
27:11
training on preparation integration, which is not required. We do make exceptions,
27:17
of course, for people who are who have gone through other CAP trainings that
27:21
don't need to redo it. They have access to their training, but they
27:22
don't have it as a requirement if they've already done another training. So you
27:26
know, it depends, but usually it's about a month, i'd say.
27:29
Okay, and just before you go, can you talk a little bit about
27:33
the difference between say academy and assisted session and other psychedelic sessions, other psychedelics
27:40
meaning like other composes. Yeah, yeah, I mean, and by the
27:45
way, we'll definitely be integrating those other compounds as we develop, as they
27:48
become FDA approved, right, so we're open to we're drug agnostic in that
27:52
way. I mean, you know, it's it's just the difference I think
27:55
is the impact on the brain of what how could I mean functions and so
28:02
you know, keremine is an antagonist and MDA receptors, which essentially causes reabsorption
28:07
of glutamates. It also causes increased neural plasticity. Other psychedelics also cause increased
28:15
neural plasticity, but they work on different neural receptors, and so you know,
28:21
there is an argument people call them traditional psychedelics, but you know they
28:25
do have different interactions of the brain. M okay um our, Jonathan,
28:30
really appreciate you coming on here once again. Journey clinical dot com super interesting
28:37
and I really appreciate you coming on here and sharing your passion and your story
28:41
too. Thank here, Thank you, there's a lot there appreciate that.
28:45
Thank you, Thank you for having me at a great time art, so
28:48
take care. Thank you, right