Latest / The Trauma Therapist / The Benefits of Ketamine Therapy with Dr. Kristin Arden and Shari Botwin of Mindbloom

Transcript

The Benefits of Ketamine Therapy with Dr. Kristin Arden and Shari Botwin of Mindbloom · The Trauma Therapist

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  Speaker 1: Trauma Thepist podcast Plus listeners can listen to episodes early
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  Speaker 1: going to Apple Podcasts, searching for the Trauma Theverist podcast
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  Speaker 1: and signing up today. Welcome to the Trauma Nevers podcast,
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  Speaker 1: a show about the incredible people dedicated to helping those
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  Speaker 1: who experienced trauma. My name is Got macpherson, and my
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  Speaker 1: mission is to raise awareness of trauma and to inspire
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  Speaker 1: each of us to help those around us. You ready,
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  Speaker 1: all right, here we go, so five or three to one,
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  Speaker 1: our folks, welcome back to the podcast. Very excited to
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  Speaker 1: have two guests on today, Kristin Arden and Sherry Botwin.
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  Speaker 1: H welcome both of you. Hi there, hiy, Kristin, Hey welcome. Yeah.
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  Speaker 1: I'll read your bios and then we'll jump in here. So.
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  Speaker 1: Kristen as a lead clinician at mind Bloom and a
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  Speaker 1: Board certified psychiatric nurse practitioner with over fifteen years experience
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  Speaker 1: working in mental health. Her work has been instrumental in
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  Speaker 1: the development of mind Blooms treatment methodologies. In addition to
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  Speaker 1: work at mind Blooms, she was guest lectured at YU
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  Speaker 1: on topics such as psychedelic therapy and substance use disorders
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  Speaker 1: and practices, addiction medicine from a harm reduction mindset, individuals
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  Speaker 1: in the justice system. Sherry, of course, a repeat a
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  Speaker 1: guest here on the podcast, has been counseling survivors and
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  Speaker 1: recovery from all types of trauma and her Cherry Hill,
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  Speaker 1: New Jersey private practice for over twenty eight years. Her
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  Speaker 1: most recent book is titled Stolen Childhoods, released worldwide in
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  Speaker 1: May twenty twenty four in hardcover. Any book. She's been
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  Speaker 1: chosen by Tantramedia to narrate the audiobook which comes out?
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  Speaker 1: Which did that come out? Ready?
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  Speaker 2: It came out?
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  Speaker 3: Yep, last Us is out.
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  Speaker 1: Awesome. We'll have that length to pair of the show
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  Speaker 1: notes page. So welcome both of you. Before we get
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  Speaker 1: going here, I want to ask both of you where
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  Speaker 1: you're from originally. Kristin, why do you start where you're
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  Speaker 1: originally from and where you are currently?
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  Speaker 4: Yes, I'm originally from Los Angeles and that's where I
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  Speaker 4: started my mental health career in the state hospital system
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  Speaker 4: here in California, and.
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  Speaker 2: That's actually where I circle of life took me back
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  Speaker 2: to Los Angeles. So that's where I'm at currently.
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  Speaker 1: All right, awesome, how about you, Sherry.
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  Speaker 3: I am in the very hot and muggy and disgusting
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  Speaker 3: outside of Philadelphia, so I'm on the opposite side of
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  Speaker 3: the country.
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  Speaker 2: Is Kristin?
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  Speaker 1: All right? Awesome? So really fascinating here. We've got mind Bloom,
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  Speaker 1: We've got both of you and how you come together.
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  Speaker 1: Let's start with mind Bloom what it is, Kristin. I'll
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  Speaker 1: ask you to talk a little bit about that, and
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  Speaker 1: then we're going to talk about why you and how
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  Speaker 1: both of you are together here today.
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  Speaker 2: Sure.
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  Speaker 1: So.
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  Speaker 4: Mind Bloom is a mental health company that is on
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  Speaker 4: a mission to transform lives and transform the world by
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  Speaker 4: implementing different alternative therapies into the treatment of mental health.
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  Speaker 4: And specifically, what we've been utilizing is treatment with ketamine
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  Speaker 4: and it's at home ketemine therapy. So we've been in
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  Speaker 4: practice treating individuals for about five years now and have
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  Speaker 4: facilitated about four hundred and fifty thousand at home ketamine
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  Speaker 4: treatment sessions.
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  Speaker 2: And I thought you're going to.
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  Speaker 1: Say four and fifty but you kept going, yeah.
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  Speaker 4: Wow, arout thirty six states. So we have like about
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  Speaker 4: eighty clinicians, the psychiatric clinicians either psych in ps or
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  Speaker 4: psychas and about eighty psychedelic integration guides or coaches.
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  Speaker 2: That work for us.
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  Speaker 1: And it's at home at home. Yes, wow, okay, so
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  Speaker 1: many questions, but before we do, give us the thumbnail
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  Speaker 1: Kristen of your background. How did all this come about
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  Speaker 1: for you?
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  Speaker 4: Yeah, so all of this came about for me from
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  Speaker 4: like I already mentioned, I started my career in the
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  Speaker 4: government sector, so in California and the inpatient state hospital system,
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  Speaker 4: and then I transitioned to outpatient.
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  Speaker 2: Behavioral health of the VA in New York.
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  Speaker 4: And my whole goal when I started my career was
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  Speaker 4: I thought, like, go to where people have I thought
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  Speaker 4: like the most serious needs, and that's where you're going
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  Speaker 4: to be able to impact the largest change on the
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  Speaker 4: mental health care system, both in trying to improve outcomes
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  Speaker 4: and access to care. And after thirteen years, I didn't
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  Speaker 4: really see things change too much. So I kind of
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  Speaker 4: stood back and was like, how do I need to
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  Speaker 4: reevaluate my strategy for my career? And that's where I
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  Speaker 4: found that healthcare technology companies existed. And I've always associated
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  Speaker 4: startups and technology with innovation, and so I know that
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  Speaker 4: with innovation, if I'm working for a company that's innovative,
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  Speaker 4: maybe I can have be more involved of actually seeing
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  Speaker 4: things change in my lifetime of my career. And so
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  Speaker 4: that's how I ended up at at my Boom, which
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  Speaker 4: is actually my third healthcare technology company or startup. So
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  Speaker 4: a big passion of mine and what my doctorate was
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  Speaker 4: focused around was how do we cut down the timeline
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  Speaker 4: from evidence being published and available on paper to actually
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  Speaker 4: applied in practice and having a benefit on people who
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  Speaker 4: need need those outcomes in a practical and a practice setting.
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  Speaker 2: So that's what we're really focused at.
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  Speaker 4: I think of our focus at mind Bloom is like,
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  Speaker 4: we have a lot of great evidence out there for
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  Speaker 4: ketemine therapy that was sitting on paper, and there was
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  Speaker 4: a lot of opportunities to further innovate how we provide
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  Speaker 4: ketemine therapy to make it more affordable and accessible to people.
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  Speaker 1: Okay, and for we get to you, Sharry, for our
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  Speaker 1: listeners is what is ketemine? What is ketemine therapy? Christ
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  Speaker 1: And I'll ask you that.
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  Speaker 2: Sure.
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  Speaker 4: Yeah, So therapyst treatment the medication called ketamine and ketymine
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  Speaker 4: as a medication that was improved in the seventies by
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  Speaker 4: the FDA as an anesthetic, so it's used outside of
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  Speaker 4: a mental health treatment in an on label setting for surgeries,
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  Speaker 4: for anesthesia and for pain so in pain management.
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  Speaker 2: Over the course of.
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  Speaker 4: Time, people started realizing our clinicians researchers started realizing that
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  Speaker 4: people when they received ketamine for anesthesia or for pain,
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  Speaker 4: but they also noticed improvement in their mood. So clinicians
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  Speaker 4: since the first papers were published in the early two
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  Speaker 4: thousands have been growingly prescribing ketamine off label for mental
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  Speaker 4: health indications such as depression and anxiety.
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  Speaker 1: Okay, now ketamine is often correct me if I'm wrong here,
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  Speaker 1: but it's often talked about when people are talking about psychedelics.
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  Speaker 1: Is ketemine considered a psychedelic I would.
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  Speaker 2: I think there's a debate around that.
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  Speaker 4: I consider I mean a psychedelic because it produces psychedelic properties.
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  Speaker 4: It people experience like a mystical state of consciousness. They visuals,
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  Speaker 4: will hear things different. I always describe it as like
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  Speaker 4: your five senses are affected by the ketamine. So it's
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  Speaker 4: just like however you interpret things, three or five senses
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  Speaker 4: will be altered or can be altered. But some people
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  Speaker 4: would classify ketamine as a dissociative sub a substance and
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  Speaker 4: not a psychedelic.
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  Speaker 1: Okay, sure, now where do you fit in here? Where
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  Speaker 1: do I? So?
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  Speaker 3: I'm brand new to mind Bloom. I jumped on board
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  Speaker 3: a few months ago. One of the one of the
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  Speaker 3: people that works at mind Bloom saw and read some
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  Speaker 3: of my other books Thriving after Trauma, and saw that
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  Speaker 3: I did a lot of work and have been doing
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  Speaker 3: a lot of work with people who are in recovery
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  Speaker 3: from all types of traumas and been diagnosed with PTSD.
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  Speaker 3: So I was brought on board to offer content, to
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  Speaker 3: offer videos and recordings that address different aspects things that
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  Speaker 3: you and I have talked about on your show, whether
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  Speaker 3: it's overcoming shame, battling and learning how to deal with guilt,
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  Speaker 3: figuring out how to move into a place of grieving
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  Speaker 3: and self compassion and self care.
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  Speaker 2: So what I.
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  Speaker 3: Did was I developed this part of the program with
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  Speaker 3: some of the mind Bloom employees, professionals, people who run
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  Speaker 3: the company, and then I had a chance to talk
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  Speaker 3: which clients will be able to listen to me talk
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  Speaker 3: about here's what you need to do now that you're
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  Speaker 3: in a different state of mind, now that your mind
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  Speaker 3: is opening up and you may be seeing the world
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  Speaker 3: a little bit differently. Now's an opportunity to really look
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  Speaker 3: at the parts of your recovery where you feel the
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  Speaker 3: most stuck and implement some of the strategies that I
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  Speaker 3: talk about while undergoing the ketymine treatment.
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  Speaker 1: Oh wow. Interesting. So when you're Christian, when you're talking
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  Speaker 1: about or introducing the topic of ketymine treatment for people,
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  Speaker 1: where do you start? Let's say, I mean who is
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  Speaker 1: this for?
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  Speaker 4: Yeah, so I think when we start how we start
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  Speaker 4: at mind blooms through an evaluation with our clinician. So
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  Speaker 4: that's like people go through a screening process like a
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  Speaker 4: candidate survey, kind of like initial screen out process first,
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  Speaker 4: and then they schedule the psychiatric a full psychiatric evaluation
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  Speaker 4: with the clinician that's anywhere from forty five minutes to
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  Speaker 4: an hour long. That's typically where our clients start in
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  Speaker 4: this process. But kind of understanding like even before we
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  Speaker 4: get there, like what kind of person or if I'm
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  Speaker 4: a person considering this, like when would I even consider
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  Speaker 4: filling out the survey to see if I might be
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  Speaker 4: a good candidate? And I think that works a little
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  Speaker 4: bit differently for depending on the individual. So I would
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  Speaker 4: say that this if you're like, first off of your
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  Speaker 4: experiencing symptoms of depression anxiety PTSDU, it would be maybe
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  Speaker 4: I think that's the first step worth considering. Like so basically, everybody,
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  Speaker 4: what are the treatment options that are out there for you?
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  Speaker 2: Right exactly? And then I think it's like individual needs.
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  Speaker 4: There's definitely like some people who are see this, like
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  Speaker 4: are not into traditional treatments medications like SSRIs for whatever reason,
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  Speaker 4: the kedemy might be a good option for them because
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  Speaker 4: it's a whole different approach to treatment. It's not something
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  Speaker 4: you have to take every day. There's definitely a psychotherapeutic
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  Speaker 4: process that goes along with this too, So it's not
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  Speaker 4: just relying kind of giving our power to the medicine
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  Speaker 4: to fix us, Like we're an active participate in our healing,
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  Speaker 4: participant in our healing process, which some people are drawn to.
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  Speaker 4: But it also is a good option for some people
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  Speaker 4: to consider that are on SSRIs or other traditional medicines
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  Speaker 4: and maybe not receiving the full benefit. Maybe you've had
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  Speaker 4: like a fifty percent reduction in your in your symptoms,
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  Speaker 4: but like not really living your life still to its
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  Speaker 4: potential fullest, and you're looking for something to augment that.
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  Speaker 4: I think Kenna means a great option in the fact
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  Speaker 4: that it doesn't work through it primarily through the serotonin
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  Speaker 4: receptor system, which means that it can be taken in
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  Speaker 4: congruence with a lot of the medications that we use
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  Speaker 4: for mental health that are serotonergic without the risk of
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  Speaker 4: drug to drug interactions.
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  Speaker 1: Okay, so you mentioned depression, you mentioned anxiety. Obviously those
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  Speaker 1: are often can be symptoms of trauma too. So is
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  Speaker 1: this appropriate for people who've experienced trauma whether that you know,
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  Speaker 1: obviously there's a whole continuum of what trauma is.
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  Speaker 4: Yeah, it really that's something that's determined on the evaluation
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  Speaker 4: with the clinicians. So what our clinicians are doing in
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  Speaker 4: the evaluation is one identifying, like, is ketamine a potential
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  Speaker 4: treatment option for someone, like do they have an indication
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  Speaker 4: that evidence tells us that could ketamine could possibly be
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  Speaker 4: beneficial for? And then two is ketamine at home following
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  Speaker 4: mind Boob's protocol safe and appropriate? And I bring that
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  Speaker 4: up and specifically, I think most important context when we're
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  Speaker 4: thinking about individuals with past trauma or with PTSD, because
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  Speaker 4: we understanding how ketymine works and something I always share
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  Speaker 4: with with individuals is that a part of the process
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  Speaker 4: that leads to healing could mean that things get worse
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  Speaker 4: before they get better. So if you're doing this treatment
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  Speaker 4: at home and meeting with your therapist, you know, five
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  Speaker 4: days later, or maybe you don't have a therapist, maybe
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  Speaker 4: your therapist isn't aware of how to support you or
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  Speaker 4: help you process this like, it might then not be
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  Speaker 4: a good idea for that individual to go through ketymine
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  Speaker 4: treatment at that time, because we would want to make
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  Speaker 4: sure that they have all the supports in place. But
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  Speaker 4: if they feel like they they do have, like a
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  Speaker 4: therapist that can support them with processing and working through
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  Speaker 4: whatever came up them with the treatment, then ketamine therapy
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  Speaker 4: might be an option for that person. So it's really
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  Speaker 4: a matter of going to like what is their current
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  Speaker 4: level of resilience and an ability to like process or
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  Speaker 4: come you know, work through some challenging content if it
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  Speaker 4: did come up, and then what other support do they
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  Speaker 4: have around them to help keep them safe and feeling supported?
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  Speaker 1: Surey, what would you add to that in terms of
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  Speaker 1: the trauma piece and questions people might have to see
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  Speaker 1: if this is appropriate for them and so forth, or
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  Speaker 1: even if they're going through it, what they might want
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  Speaker 1: to keep in mind.
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  Speaker 3: I think one of the most important things when you're
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  Speaker 3: going to add different parts to your recovery is really
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  Speaker 3: making sure that you have a team of supporters, and
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  Speaker 3: like Kristen is saying, to be able to talk with
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  Speaker 3: a therapist who understands the use of psychedelics, or if
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  Speaker 3: you're a therapist that doesn't really have that type of
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  Speaker 3: training or background, to consult with somebody, whether it's at
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  Speaker 3: mind Bloom or in their own therapy network, to understand
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  Speaker 3: more about what would the role of psychedelics be and
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  Speaker 3: how would you implement that, especially if when you start
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  Speaker 3: using the ketamine you do notice that things are starting
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  Speaker 3: to feel even more raw and vulnerable. One of the
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  Speaker 3: things that I think is very important and that I
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  Speaker 3: value about mind Bloom is that there is attention and
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  Speaker 3: focus on one's safety. And as we all know, people
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  Speaker 3: who are battling with PTSD often struggle with different types
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  Speaker 3: of self harm, or eating disorders or substance misuse disorders.
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  Speaker 3: So to really be clear that when someone is considering
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  Speaker 3: using this type of treatment that it does happen when
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  Speaker 3: that person has a lot of support and also is
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  Speaker 3: in a place in one's life where if things do
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  Speaker 3: start to feel like they're unraveling, to know that they
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  Speaker 3: will not be by themselves in that process.
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  Speaker 1: All right, so let's if we can Christian here get specific.
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  Speaker 1: Obviously everyone's different, every case is different, but walk us
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  Speaker 1: through a scenario what this would look like. Say someone's
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  Speaker 1: listening to this, they have some anxiety, maybe they've experienced
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  Speaker 1: some trauma. They they want to go through with this,
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  Speaker 1: they're on board, what do they do? Walk us through
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  Speaker 1: what happens?
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  Speaker 2: Yeah, so step by step.
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  Speaker 4: So first thing you do is go to the mind
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  Speaker 4: Bloom website and you fill out the initial candidate survey.
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  Speaker 4: If you get past those initial screenings, that initial screening criteria,
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  Speaker 4: then you're going to fill out a health history like
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  Speaker 4: you're kind of like a history or in take form.
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  Speaker 4: Then you're going to book an initial consultation with a
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  Speaker 4: psychiatric clinician or they're going to do review how you're
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  Speaker 4: feeling today, your psychiatric history, your medical history, your family history,
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  Speaker 4: and they're going to make a determination with you based
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  Speaker 4: on that information on is.
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  Speaker 2: Mind bloom a good fit or not.
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  Speaker 4: If so, they're going to provide you with a lot
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  Speaker 4: of education about the program so that you can be
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  Speaker 4: informed of what to expect next and all the safety information,
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  Speaker 4: and then they will order your medication. So you yourself
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  Speaker 4: would then book your first treatment. So you're doing your
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  Speaker 4: first treatment on Zoom with the guide. So the first
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  Speaker 4: appointment is two and a half hours where you're on
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  Speaker 4: zoom for the first thirty minutes and on zoom for
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  Speaker 4: the last thirty minutes with the guide doing a preparation
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  Speaker 4: session where you're talking about your intentions. You're going through
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  Speaker 4: all the steps on how to take the medication. The
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  Speaker 4: guide's helping you take your blood pressure and your heart
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  Speaker 4: rate and or making sure nothing's changed physically, so we're
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  Speaker 4: doing it's a safety check and like making sure helping
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  Speaker 4: you get in the right mindset to do the session.
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  Speaker 2: You're signing off. You take the medicine. The medicine is
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  Speaker 2: a tablet.
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  Speaker 4: Form and it's sublingual, so you hold it like under
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  Speaker 4: your tongue or kind of in the space between your cheek,
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  Speaker 4: your gum and your cheek. You hold it for seven minutes,
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  Speaker 4: you spit it out, and then you then you lay down.
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  Speaker 4: You have headphones on and I'm ask on and you're
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  Speaker 4: generally listening to like the first seven minutes is like
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  Speaker 4: a spoken word or like content to help you kind
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  Speaker 4: of ease into the experience and prepare your mindset. And
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  Speaker 4: then it goes into a music soundtrack you lay down
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  Speaker 4: in kind of this like the best way I can
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  Speaker 4: describe how it feels as like a deep meditation.
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  Speaker 2: You still know who you are, where you are, what
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  Speaker 2: you're doing, but you're.
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  Speaker 4: Slightly removed here from yourself and genuinely like feeling like
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  Speaker 4: you're connected with yourself at a at a deeper level
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  Speaker 4: than maybe you.
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  Speaker 2: Would be on a on a typical typical day.
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  Speaker 1: Let me pause if I'm here, So this is something
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  Speaker 1: that you set aside. Ideally, what set aside a big
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  Speaker 1: chunk of the day to do the entire day?
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  Speaker 2: About two hours or so? Mm hmm.
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  Speaker 1: Okay, Now does does someone want If I was going
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  Speaker 1: to do this, would I want my partner there? Would
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  Speaker 1: I want someone else there?
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  Speaker 2: Yeah? Great question. That was something I was gonna going
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  Speaker 2: to highlight.
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  Speaker 4: And it's really key for safety and a criteria for
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  Speaker 4: treatment for mind boom is you have to have somebody
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  Speaker 4: there with you. So you can't do that take come
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  Speaker 4: alone and you need to have like an environment that
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  Speaker 4: you feel safe in and someone that you feel safe
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  Speaker 4: and supported by. So that's the other component too, Like
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  Speaker 4: if you're in a tumultuous relationship with someone and like
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  Speaker 4: that that home environment doesn't feel safe, then like doing
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  Speaker 4: this treatment might not be a good option for you,
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  Speaker 4: because like we pay a lot of attention to your mindset,
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  Speaker 4: set and setting, So your mindset going in making sure
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  Speaker 4: that that's healthy, and then also the setting in your
• 18:39
  Speaker 4: environment that makes sure that's healthy and conducive to a
• 18:42
  Speaker 4: therapeutic treatment.
• 18:44
  Speaker 1: Okay, so two hours' alarm goes off.
• 18:49
  Speaker 2: Mm hmm, there's some music plays of chime. Then you
• 18:51
  Speaker 2: get up.
• 18:53
  Speaker 4: We you know, you have the person that's there with
• 18:55
  Speaker 4: you next to you to make sure we call them
• 18:57
  Speaker 4: your peer treatment monitor there make sure that you're safe
• 19:01
  Speaker 4: and help you get to the bathroom if needed. And
• 19:03
  Speaker 4: then you're journaling for thirty minutes. So we encourage all
• 19:06
  Speaker 4: of our and we send all of our clients a journal.
• 19:08
  Speaker 4: It's either like you're collecting a chain of events of
• 19:12
  Speaker 4: thoughts that came up for you in the session or
• 19:14
  Speaker 4: using that time it's like a stream of consciousness to
• 19:16
  Speaker 4: just get out whatever you can on paper, and then
• 19:19
  Speaker 4: for the first session, you meet with the guide after
• 19:22
  Speaker 4: you've done the treatment in journal for thirty minutes to
• 19:25
  Speaker 4: talk about the experience and they help you kind of
• 19:28
  Speaker 4: frame what came up for you around your intentions, and
• 19:32
  Speaker 4: they give you some pointers on what you can do
• 19:33
  Speaker 4: in the next following days for a process that we
• 19:36
  Speaker 4: call integration, which in summarize what integration means high level,
• 19:40
  Speaker 4: it's like, how do we take an experience like the
• 19:43
  Speaker 4: one we have on ketemy and integrate it into our
• 19:45
  Speaker 4: daily life in some ways so that we can do
• 19:48
  Speaker 4: our best to affect lasting change, versus this being just
• 19:53
  Speaker 4: an experience that we have ends up in our journal
• 19:55
  Speaker 4: in a drawer some way, and we never think about
• 19:57
  Speaker 4: somewhere and we never think about it again. So the
• 20:01
  Speaker 4: treatments are six treatments once a week, like spaced out
• 20:06
  Speaker 4: generally about once a week. There are a couple more
• 20:09
  Speaker 4: check ins that you would do with your clinician as
• 20:11
  Speaker 4: well to adjust dosing. The last couple of things I'll
• 20:15
  Speaker 4: share is that the program does come with the one
• 20:17
  Speaker 4: other one to one integration session with your guide that
• 20:20
  Speaker 4: people usually do around the third or fourth treatment, and
• 20:23
  Speaker 4: then you have unlimited text support, the guide, direct access
• 20:27
  Speaker 4: to your clinician whenever you need them throughout that you
• 20:29
  Speaker 4: can check in with them, schedule those check ins throughout
• 20:32
  Speaker 4: the program. Digital content like what share you put together
• 20:37
  Speaker 4: that you can pick a pathway that you go through
• 20:39
  Speaker 4: if you want to go through a pathway that's focused
• 20:42
  Speaker 4: on trauma or focused on burnout, Like we have a
• 20:45
  Speaker 4: digital content or learning content that is guides people through
• 20:49
  Speaker 4: the experience as well. And lastly, integration circles which are
• 20:54
  Speaker 4: moderated by our guides and you have unlimited access to
• 20:57
  Speaker 4: and it's like a peer support group with the guide
• 21:00
  Speaker 4: that's moderating it.
• 21:02
  Speaker 1: One thing, kind of going back a little bit, you
• 21:04
  Speaker 1: mentioned intention, So if this person, this hypothetical person we're
• 21:10
  Speaker 1: talking about here who maybe has anxiety, they're interested in
• 21:14
  Speaker 1: doing this, talk about the importance of intentions and what
• 21:19
  Speaker 1: role does that play in this here.
• 21:22
  Speaker 4: Yeah, so setting the intention really helps you align on
• 21:26
  Speaker 4: what your purpose is for doing the treatment. And typically
• 21:30
  Speaker 4: all have people do before a session is one like
• 21:33
  Speaker 4: the best advice I give about like intentions is keep
• 21:35
  Speaker 4: it simple, you know, keep it more broad, because really,
• 21:39
  Speaker 4: what's something I say if we knew what we needed
• 21:41
  Speaker 4: going into these treatments, we would probably have it already
• 21:43
  Speaker 4: figured out.
• 21:44
  Speaker 2: So our ideas set this intention and let it go.
• 21:47
  Speaker 1: So what might an intention be, Like.
• 21:50
  Speaker 2: An example one like a very simple one that works
• 21:53
  Speaker 2: for some people.
• 21:54
  Speaker 4: It is like, my intention is to let go. My
• 21:57
  Speaker 4: intention is to trust this process. My intention is to
• 22:00
  Speaker 4: quiet my mind, reconnect with love for myself. So those
• 22:06
  Speaker 4: are all really common intentions for people.
• 22:09
  Speaker 1: Okay, and the clinician the guide to what degree are
• 22:19
  Speaker 1: they providing therapy? What are they doing? What's their role
• 22:24
  Speaker 1: more specifically here, Yeah.
• 22:26
  Speaker 4: So the clinician, they're psychiatric clinicians, and a good portion
• 22:31
  Speaker 4: of them have training to do to do therapy and
• 22:35
  Speaker 4: maybe do therapy in their private practice setting or something
• 22:38
  Speaker 4: outside of mind Bloom. But at mind Boom they're not
• 22:41
  Speaker 4: taking on the role of a therapist. So the psychiatric
• 22:43
  Speaker 4: clinician is primarily prescribing their medication, monitoring progress to make
• 22:50
  Speaker 4: sure that the like this is something that's working for
• 22:52
  Speaker 4: someone and they're able to do it do so safely.
• 22:54
  Speaker 4: They usually and do provide some brief interventional type of
• 22:59
  Speaker 4: support for someone.
• 23:00
  Speaker 2: It's not like here's your kind of even more out
• 23:02
  Speaker 2: the door.
• 23:02
  Speaker 4: It's a lot of like how are things going for
• 23:05
  Speaker 4: for you, Like tell me a little bit about your
• 23:07
  Speaker 4: session or your experiences, and they'll try to help clients
• 23:10
  Speaker 4: kind of understand their experiences. But the guide that I
• 23:14
  Speaker 4: mentioned too, is like the kind of like we think
• 23:16
  Speaker 4: of their treatment teament mind bloom as the psychiatric clinician
• 23:19
  Speaker 4: and then the integration culture guide, and that person's really
• 23:23
  Speaker 4: there to around to support them around their experiences, help
• 23:26
  Speaker 4: them understand like if this was my intention and this
• 23:29
  Speaker 4: is what came up for me, how might I make
• 23:32
  Speaker 4: sense of that? And then what are some things that
• 23:34
  Speaker 4: I can do to like help that those insights stay
• 23:37
  Speaker 4: with me. Uh, They're not a therapist and they're not
• 23:41
  Speaker 4: filling that role of a therapist. Another way I sum
• 23:43
  Speaker 4: it up because I can seem a little bit murky
• 23:45
  Speaker 4: in a way, like without specifics is I think about
• 23:49
  Speaker 4: Like the guides are very pragmatic, like this is your experience,
• 23:52
  Speaker 4: here's some steps you can do to get the most
• 23:54
  Speaker 4: out of this. And they're not going to the history.
• 23:56
  Speaker 4: They're not going to digging the deep into the deeper
• 23:59
  Speaker 4: parts of it, trying to understand the why and the
• 24:01
  Speaker 4: context and framing the bigger picture kind of root of
• 24:06
  Speaker 4: what someone's experiencing, but more so like pragmatic, this is
• 24:10
  Speaker 4: your experience.
• 24:10
  Speaker 2: Here's some things that you can do.
• 24:11
  Speaker 4: To integrate and create lasting change based on that share.
• 24:16
  Speaker 1: In terms of the trauma piece and the trauma pathway,
• 24:22
  Speaker 1: I think it was called fill in some gaps here
• 24:28
  Speaker 1: for us. If someone was kind of wanted to pursue
• 24:33
  Speaker 1: an intention around healing quote unquote healing from trauma, what
• 24:38
  Speaker 1: would you add here?
• 24:40
  Speaker 3: What I would say to people is, as you're undergoing
• 24:43
  Speaker 3: the ketamine and you're journaling and you're really processing, this
• 24:48
  Speaker 3: is the opportunity when you want to go to your therapist,
• 24:51
  Speaker 3: the person that you're doing the work with, the person
• 24:54
  Speaker 3: that you're telling your story to that knows your history,
• 24:58
  Speaker 3: and take that ability to process, maybe more openly or
• 25:03
  Speaker 3: with a little bit less emotional pain, to be able
• 25:06
  Speaker 3: to then go into your therapist's office and again not
• 25:09
  Speaker 3: just one time, but each time, and begin to explore
• 25:14
  Speaker 3: the parts of your trauma that you've been stuck in
• 25:18
  Speaker 3: or that you feel like you suffer the most from.
• 25:21
  Speaker 3: Like for example, when we did the content, we focused
• 25:25
  Speaker 3: a lot on shame, feeling worthless, feeling inadequate, feeling like
• 25:30
  Speaker 3: this world would be better off without me. So what
• 25:32
  Speaker 3: I would say to somebody undergoing the ketamine is, if
• 25:35
  Speaker 3: you want your intention to focus on letting go of shame,
• 25:40
  Speaker 3: what you would want to do is utilize the ketamine
• 25:42
  Speaker 3: and then come and journal about what are you wanting
• 25:45
  Speaker 3: to let go of and what do you imagine would
• 25:47
  Speaker 3: be on the other side if you let go of shame,
• 25:50
  Speaker 3: what other feelings would you be having? Journaling about that,
• 25:53
  Speaker 3: and then going into your therapy session the next day
• 25:57
  Speaker 3: whenever you're going to therapy, and actually really have a
• 25:59
  Speaker 3: conversation with your therapist so that you can begin to
• 26:03
  Speaker 3: develop different strategies to really not just say I want
• 26:07
  Speaker 3: to let go of the shame, but what are we
• 26:08
  Speaker 3: going to do to help you to actually do that.
• 26:11
  Speaker 3: So that's sort of the piece where I come in.
• 26:14
  Speaker 3: I'm not doing therapy with the clients at mind Bloom,
• 26:17
  Speaker 3: but I'm offering different examples and talking more in depth
• 26:22
  Speaker 3: about the different aspects of trauma so that if they
• 26:24
  Speaker 3: watch that content, they can then bring that with them
• 26:27
  Speaker 3: into and again it could be their therapist to whoever
• 26:30
  Speaker 3: their main supporters are in the process of trauma recovery.
• 26:36
  Speaker 1: So I'll put this out there as a question to
• 26:41
  Speaker 1: both of you in talking about kind of in therapy.
• 26:45
  Speaker 1: If we had this big whiteboard in front of us
• 26:48
  Speaker 1: and we put down if we wrote down psychotherapy and
• 26:54
  Speaker 1: that might include somatic therapy and talk therapy and all
• 26:59
  Speaker 1: the different types of therapy, and then you had ketamine therapy.
• 27:03
  Speaker 1: Is I'm wondering because ketyman therapy almost feels to me
• 27:11
  Speaker 1: it's not talk therapy, right, So where where does the circles?
• 27:19
  Speaker 1: Where do they overlap in a sense? Mm hmm.
• 27:24
  Speaker 2: Yeah.
• 27:24
  Speaker 4: So I say, like the way the way I understand
• 27:27
  Speaker 4: ketamine work and I've seen personally through my experience with
• 27:30
  Speaker 4: my clients, is that ketty meine can be a very
• 27:32
  Speaker 4: very supportive in tandem with another psychotherapeutic process that's going on.
• 27:38
  Speaker 2: And the way that I see.
• 27:39
  Speaker 4: That that that that happens and why is twofold. So one,
• 27:43
  Speaker 4: if we think about what ketymine does neurobiologically, ketamine enhances neuroplasticity,
• 27:48
  Speaker 4: and what that means is essentially repairs damage in our
• 27:53
  Speaker 4: brain that's happened maybe over time from our stress response
• 27:56
  Speaker 4: like cortisol. You know, it's damaging on the tissue in
• 28:01
  Speaker 4: our brain, especially the parts we need for forming new
• 28:03
  Speaker 4: memories or higher level cognitive thought processing, emotional regulation, so
• 28:08
  Speaker 4: kind of means restorative in our brain. So it kind
• 28:11
  Speaker 4: of makes from a biological standpoint, creates an ideal space
• 28:16
  Speaker 4: for therapy processing new thoughts and emotions and ways of
• 28:21
  Speaker 4: viewing ourselves and the world around us, and then kennamine
• 28:24
  Speaker 4: as a treatment during an experience. I think about it,
• 28:28
  Speaker 4: it's kind of like puts us in a third person
• 28:30
  Speaker 4: point of view where we can kind of step out
• 28:32
  Speaker 4: of ourselves, look at ourselves and get a different context
• 28:36
  Speaker 4: or awareness of our like maybe narratives that we've had
• 28:39
  Speaker 4: or viewpoints of ourselves. So we're like able to kind
• 28:42
  Speaker 4: of just get out of our stuckness in a way
• 28:45
  Speaker 4: access new content information that can then be valuable for
• 28:48
  Speaker 4: us and treatment. The other piece of it is that
• 28:51
  Speaker 4: this neuroplasticity and this openness doesn't necessarily like go away
• 28:55
  Speaker 4: right there after your treatment.
• 28:57
  Speaker 2: Like we do. See like people have periods.
• 28:59
  Speaker 4: Of days for treatments where they're like maybe like a
• 29:03
  Speaker 4: little bit more open, less resistive, like less feeling more
• 29:07
  Speaker 4: calm and peace, which then creates more openness. There's space
• 29:12
  Speaker 4: to then go further in therapy. I've worked with clients
• 29:15
  Speaker 4: who have been really stuck in their process with EMDR
• 29:18
  Speaker 4: is like one that comes up for me in front
• 29:20
  Speaker 4: of my mind, and it just has been a game
• 29:22
  Speaker 4: changer with them being able to move forward and steps
• 29:25
  Speaker 4: in that process by feeling more safe and like less
• 29:30
  Speaker 4: like defenses up and tight. So I've just really see
• 29:33
  Speaker 4: it help people get unstuck, which then is very supportive
• 29:36
  Speaker 4: and the other modalities for treatment that might they might
• 29:39
  Speaker 4: be going through.
• 29:41
  Speaker 1: Shoot that shure you're shaking your head.
• 29:43
  Speaker 3: Shaking my head saying, don't forget what you need to
• 29:45
  Speaker 3: say because this is so important. But there's a few
• 29:48
  Speaker 3: words that I would write on that whiteboard Integration, reframe,
• 29:53
  Speaker 3: and finding words when I think about all the work
• 29:56
  Speaker 3: that I've done with survivors through the years and their
• 29:58
  Speaker 3: struggle to even be able to talk about or describe
• 30:02
  Speaker 3: what happened to them, and then integrate these horrific memories
• 30:06
  Speaker 3: and figure out how when our memories are getting triggered,
• 30:09
  Speaker 3: how do we bring ourselves back to the present, Because
• 30:11
  Speaker 3: that's what integration is. And reframe is sort of like
• 30:15
  Speaker 3: what I was saying before, letting go of shame. Once
• 30:18
  Speaker 3: I can reframe my experience and look back on that
• 30:22
  Speaker 3: flashback or memory and go, wait a minute, that wasn't
• 30:24
  Speaker 3: my fault. I was just a kid then, and that
• 30:27
  Speaker 3: person was an adult. To be able to reframe what
• 30:30
  Speaker 3: happened to us, that is partly what helps us move
• 30:33
  Speaker 3: into a place of peace and contentment and keeping our
• 30:39
  Speaker 3: feet on the ground and being right here in the moment.
• 30:42
  Speaker 3: So those are the things that I think about when
• 30:44
  Speaker 3: I think about the advantages of adding ketamine to treatment
• 30:50
  Speaker 3: for PTSD, And that's one of the reasons why I
• 30:52
  Speaker 3: wanted to be involved in this program because I see
• 30:56
  Speaker 3: so many people struggling for years. You know, you get
• 31:00
  Speaker 3: to a certain point in the work where you've talked
• 31:03
  Speaker 3: about it, you've remembered it, you have flashbacks, but there's
• 31:06
  Speaker 3: a whole other level of processing in terms of our
• 31:10
  Speaker 3: feelings and the impact of our trauma that I feel
• 31:14
  Speaker 3: like mind bloom and ketamine is really going to help
• 31:16
  Speaker 3: people to be able to push past some of those issues.
• 31:21
  Speaker 1: So as we kind of wind down here, I think
• 31:23
  Speaker 1: I would be remiss if I didn't bring up the
• 31:26
  Speaker 1: topic of worries that people might have around this, right,
• 31:32
  Speaker 1: I mean, this is for all intents and purposes, new
• 31:38
  Speaker 1: in the therapeutic space. Obviously it's not, but it's getting
• 31:41
  Speaker 1: more and more traction and so forth. What are people
• 31:46
  Speaker 1: How would you delay people's concerns about this, Kristen? Maybe
• 31:51
  Speaker 1: people are really interested, but I mean, there's so many
• 31:55
  Speaker 1: things that could go wrong. I don't know, what do
• 31:58
  Speaker 1: you say?
• 31:59
  Speaker 4: Yeah, it's it like generally from my experiences and I
• 32:04
  Speaker 4: think the data that's out there published around side effect
• 32:07
  Speaker 4: rates for ketamine therapy versus SSRIs, people seem to tolerate
• 32:11
  Speaker 4: the ketamine treatment very well. I'd say, like we have
• 32:16
  Speaker 4: side effect rates are about a five percent or so
• 32:19
  Speaker 4: in the study that we've published, people experience side effects,
• 32:22
  Speaker 4: which we compare that to about you know, much higher
• 32:25
  Speaker 4: than that for SSRIs. I think the big difference too,
• 32:29
  Speaker 4: is like thinking about safety and why. I like ketamine
• 32:32
  Speaker 4: is an option for people. Since you're not taking it
• 32:35
  Speaker 4: every day, it's not like your body is growing a
• 32:39
  Speaker 4: tolerance or becoming used to this medication or leading to
• 32:43
  Speaker 4: the point point of where you could develop long term
• 32:46
  Speaker 4: side effect or issue from the medication. It's in and
• 32:49
  Speaker 4: out of your system pretty quick, like two and a
• 32:51
  Speaker 4: The half life is two and a half hours or so,
• 32:54
  Speaker 4: so you take the medicine in within two and a
• 32:56
  Speaker 4: half hours, it's about fifty percent out of your bloodstream,
• 32:59
  Speaker 4: So be thinking about the burden on your body physiologically
• 33:04
  Speaker 4: compared to an SSRI or something that you're taking every day.
• 33:06
  Speaker 2: You just can't compare. The other thing I would say, too, is.
• 33:09
  Speaker 4: That our clients going through our program like work very
• 33:13
  Speaker 4: closely with the clinician to find the right dose for you. So,
• 33:18
  Speaker 4: like I said, we're not aiming for I think people
• 33:20
  Speaker 4: might get scared of like having a bad trip or
• 33:22
  Speaker 4: you know, feeling out of their mind or not in
• 33:24
  Speaker 4: control of things, which can be scary. Like, that's not
• 33:26
  Speaker 4: what we're aiming for with dosing. We want our doses
• 33:30
  Speaker 4: are I wouldn't say mild, but the goal isn't for
• 33:33
  Speaker 4: it to be mild, but for you you just still
• 33:35
  Speaker 4: be conscious and aware so you can remember the experience
• 33:37
  Speaker 4: and have things to journal about and feel safe. So
• 33:41
  Speaker 4: I think that's another big component of it, is that,
• 33:43
  Speaker 4: like you have a lot of guidance and support to
• 33:45
  Speaker 4: make sure that you're started at the right dose and
• 33:50
  Speaker 4: your dose is adjusted appropriately to create safety, especially with
• 33:56
  Speaker 4: you being at home doing the treatments.
• 33:58
  Speaker 1: Awesome, all right again, and speaking with doctor Kristin Arden
• 34:01
  Speaker 1: and Sherry Botwin mind Bloom Kristen was the best way
• 34:07
  Speaker 1: for people to learn more about this and get in
• 34:11
  Speaker 1: touch with you.
• 34:12
  Speaker 4: Yes, so the best place is through our website. We
• 34:14
  Speaker 4: have a ton of great information around on our website,
• 34:17
  Speaker 4: both in safety, our safety page and our science page.
• 34:21
  Speaker 4: We have lots of blog posts and people can reach
• 34:23
  Speaker 4: me if they have questions for me, specifically just by
• 34:26
  Speaker 4: emailing support at mine boom dot com and asking for
• 34:29
  Speaker 4: me and they'll direct the message to me.
• 34:31
  Speaker 1: Okay, and Sherry, how about you, I.
• 34:34
  Speaker 3: Would say the best way to find me if you
• 34:36
  Speaker 3: want to ask me more questions about my role and
• 34:38
  Speaker 3: all this is to just go to my website, which
• 34:40
  Speaker 3: is just my name, cherrybotwe dot com and my email
• 34:44
  Speaker 3: address is in there and I welcome people to reach
• 34:46
  Speaker 3: out if they have any questions.
• 34:48
  Speaker 1: Awesome, appreciate it. Obviously this topic is huge and were
• 34:55
  Speaker 1: to another couple episodes on this, but I want to
• 34:58
  Speaker 1: I really appreciate you both coming not here. It's fascinating.
• 35:01
  Speaker 1: Thank you.