Evolution of Transformative Psychiatry

Ceremony, ritual and rites of passage have been part of human evolution, they help us maintain a connection to the sacred. Indigenous people around the globe have been using plant medicines such as peyote and ibogaine in the healing arts for thousands of years. In fact, archeological discoveries in Peru have revealed traces of San Pedro cactus (a hallucinogenic) in caves inhabited by humans 8,000-10,000 years ago. Shamanic lore passed down through centuries explains the connection between spiritual healing and psychedelics.

In 1938, Switzerland chemist Dr. Albert Hoffman was working to synthesize a compound to affect cardiovascular and respiratory processes and thus discovered LSD. It was not ideal for his purposes so he shelved the compound. Years later, in 1943, he was re-examining the compound and accidentally absorbed some through his fingertips and had his first psychedelic trip. This early discovery of a synthetic psychedelic opened up the door to a new thought-provoking paradigm of consciousness.

The 1950’s were a fertile time in the development of consciousness expansion and psychedelia. Psychiatrist Dr Humphrey Osmond utilized psychedelics to offer insights in an effort to understand and treat psychosis. Dr. Osmand shared the LSD experience with a few notable scholars. Aldous Huxley best known for penning The Doors of Perception, describes one of the benefits of psychedelics to reawaken us to the sacred. Huxley writes about the dangers of a progress driven society and the value of psychedelic substances to help remind us of the potential to create a human society driven by equanimity.

Dr. Osmond also shared these experiences with Bill Wilson the founder of Alcohol Anonymous. Wilson found psychedelic treatment to be profoundly transformative and therapeutic for addiction. However the politics of the time did not allow for the continued collaboration.

In 1960, Timothy Leary, Ralph Metzner and Richard Alpert worked together as part of the Harvard Psilocybin Project. Collectively, they developed several experiments to explore the benefits of psychedelics. The Concorde prison experiment offered psychedelics along with supportive psychotherapy to the inmates of the Concorde prison system to assess for reduced recidivism rate.

The Marshall Chapelle experiment, aka The Good Friday experiment was an opportunity to offer psilocybin to divinity students to explore if it would increase capacity for spiritual growth. Huston Smith was one of the Divinity students at the time who went on to author several textbooks on comparative religion and contemplative studies. During a follow up to the experiment 25 years later Rick Doblin reports all but one of the participants felt the experiment to be one of the high points of their spiritual life.

Psychiatrist Dr Stanlisov Grof is responsible for over 4000 LSD assisted therapeutic interventions. When psychedelics were reclassified and no longer available for research or treatment Dr. Grof leaned into accessing non-ordinary states of consciousness through other means developing holotropic breath work.

The decades from 1950 to 1970 were rich with clinical therapeutic use of psychedelics in the healing arts.

In the 1970s psychedelic substances were deemed drugs of abuse with no medicinal benefits. This was a politically driven movement in response to social/cultural changes. As a result psychedelic research was halted.

MDMA, first synthesized in 1912, was used for supportive psychotherapy during the 70s and 80s until it too was restricted by the federal government in 1985.
Frustrated by lack of access to these medications, in 1986, Rick Dublin formed MAPS (The Multidisciplinary Association of Psychedelic Science), an organization committed to furthering the research of MDMA and psilocybin for the treatment of addiction and mental well-being.

Research was silenced for 20 years until in 1990 when psychiatrist Rick Strassmann gave DMT to healthy volunteers, later referring to it as ‘The Spirit Molecule’.
Once the door was cracked open by Dr. Strassman, a series of clinical research began ushering in the second renaissance of the psychedelic revolution:

• 1993 Dr. Dave Nichols created the Hefner Institute to advance the study of psilocybin in the treatment of mental health.
• 1999 John Hopkins University opened a psychedelic research program under Dr Roland Griffith
• 2011 Dr. Charles Grob published research demonstrating psilocybin efficacy in reducing anxiety in patients with advanced cancer.
• 2014 saw the opening of Usona Institute a nonprofit organization researching psilocybin for the treatment of depression
• 2016 California Institute of Integral Studies creates the first graduate program offering certification in psychedelic research and therapy.
• 2017 FDA grants ‘breakthrough therapy’ designation and approves phase 3 clinical trial with MDMA assisted psychotherapy for PTSD
• 2019 FDA approves ketamine as a medication to treat depression.
• 2021 NYU department of psychiatry established Center for Psychadelic Medicine.
• 2021 National Institute of Health supports an investigative study researching the impacts of psilocybin on tobacco addiction, this is the first time in 50 years the NIH has supported research into psychedelic medicine.

This is a sample from academia which does not touch on centuries of experiential treatment and research that has been ongoing across the globe in a variety of cultures, tribes and communities.

Internationally, there are over 600 clinical trials producing promising results that showcase the benefits of using psychedelic medicines for treatment of addiction and mental health disorders. MDMA is on a path to approval for rescheduling by the DEA in 2023. Psilocybin is now decriminalized in certain areas within the US and the path to approval is impending. With rescheduling psychedelic medicines, the future of mental health treatment is shifting and we are changing the way we think about addiction and mental well-being.

As clinicians and caregivers, we have been examining life and consciousness through the scientific lens. Psychedelics affect the lens – allowing us to see from new and different perspectives. This broader vision and increased empathy allow for a holistic view of trauma and how it affects us in mind, body and spirit. I am optimistic that science, humanity and love can braid a healthier path towards wholeness.

History of Ketamine

Why are we talking about Ketamine? Ketamine and psychotherapy, together offer a deep dive into transformational healing.

A few of the potential benefits of this type of therapy:

▸ allows for deeper access to our core essence

▸ invites the inner witness to come online

▸ exploration of our survival (defense) mechanisms that inform our perception and responses

▸ exploration of transgenerational and transpersonal trauma

▸ integration of body, mind and spirit

What is ketamine? Ketamine is a molecule that has been used as a dissociative anesthetic since the 1960s. Effectively and safely, it induces a trance like state providing relief from pain. Ketamine alters global neuronal connectivity allowing for improved mood and eases rigidity. Studies conclude that ketamine treatment provides beneficial relief for people suffering with PTSD, depression and addiction.

Since the early 2000’s ketamine had been recognized to have significant anti-depressant effects. In 2019 the FDA approved ketamine for use in treating individuals for depression. Ketamine is versatile. It can be administered intravenously, intranasally, orally or intramuscular. Different modes of administration highlight different benefits. For individuals suffering with treatment resistant depression and suicidality, ketamine has been shown to be most effective when administered in a series of sessions. KAP as an adjunct to the therapeutic process requires less frequent dosing. Oral and intramuscular are both effective for KAP.

The oral administration comes on slower and is a more gentle experience. Utilizing this route of administration clients are more available for talk therapy this is the form we refer to as psycholytic therapy. The intramuscular injection offers the same benefit as the oral with the addition of a short-lived dissociative experience. This more intense experience offers the potential for mystical transformative psychedelic experiences. A series of ketamine assisted psychotherapy sessions can offer profound transformative experiences. KAP facilitates this process by accelerating one’s access to insights and augments the psychotherapeutic process. A leading benefit of KAP is that it can help dissolve conscious and unconscious defenses allowing for greater insight and change. KAP can allow us to re-experience and remember parts of our life without the associated emotional charge of the memory, it allows for an emotional disconnection of sorts creating the opportunity for us to re-integrate the story without the pain.

* Disclaimer: Ketamine is the only transformative psychedelic we prescribe. Ketamine therapy is not appropriate for everyone. We do not promote or provide any illegal substances. We do support harm reduction but not the abuse or misuse of any illegal substances.