Dr. Sara Lewis Psychedelic Assisted Therapy TRT 53:35 [MUSIC] Hello, and welcome to Mindful U at Naropa. A podcast presented by Naropa University in Boulder, Colorado. IÕm your host, David Devine. And itÕs a pleasure to welcome you. Joining the best of Eastern and Western educational traditions Ñ Naropa is the birthplace of the modern mindfulness movement. [MUSIC] DAVID: Hello, and welcome to another Mindful U podcast. Today I have the pleasure of speaking with Dr. Sara Lewis. Sara is the Associated Professor and Chair of the Contemplative Psychotherapy and Buddhist Psychology at Naropa University. She has a PhD from Columbia University and two masterÕs degrees from the University of Chicago, specializing in psychological anthropology, global mental health, and clinical social work. When I read this, you are such an accomplished person, and itÕs an honor to have you on the podcast. So welcome. Dr. Sara Lewis: Thank you so much, David. IÕm excited for our conversation. [00:01:21.17] Erica: Me too. So, I would also just like to add that IÕm very excited to discuss psychedelics and therapy in an academic setting. This is a topic that IÕve been very passionate about and have done my own research and my own practice within. IÕm forever a Terence McKenna fan. The fact that psychedelics and education are coming together shows me that we as a collective people are willing and able to explore the gifts and potential of our hearts and minds. So with that, before we speak about the program and the body of content, can you just tell me a little bit about who you are, and how you found your way into all these academic achievements, and then also into teaching at Naropa University? Dr. Sara Lewis: Sure, IÕd love to. As you noted, you know, my work has always been very interdisciplinary. Although for me, really, my academic interests have always kind of coalesced around mental health, culture and spirituality. You know, when I started out as a college student, I kind of thought that that meant psychology because I was interested in the mind and mental health. But you know, I soon discovered like a lot of people that the questions that were being asked in psychology, were really not quite encapsulating everything that I was really interested in terms of the mind and spirituality, and then how that changes from culture to culture. So from my kind of early days, as a student, IÕve always been crafting kind of an interdisciplinary trajectory to answer those kinds of questions. And when I was a college student at St. Lawrence University, which is a liberal arts college in upstate New York, there were some faculty members, who had been working with a Shipibo community in Peru on ayahuasca. And so as a student, I got to join in some of that research. And then later, when I was a graduate student at the University of Chicago, in anthropology, I did a project that was looking at people from the global north, who would go to Peru to use ayahuasca, or using ayahuasca in ceremonial context, you know, in the US, or Canada, or Europe, and those who actually came to have spiritual emergencies, or spiritual crises with psychological distress as a part of those ceremonies. So that was back in 2004. And then I trained as a clinical social worker and began working in community mental health alongside the academic work that I was doing. You know, so IÕve always loved academia. I loved doing research, but then also really had this interest in working clinically. As a doctoral student at Columbia, I got interested in Ñ I mean, I was already interested in meditation and mindfulness, and specifically Tibetan Buddhism, you know, from my own kind of personal practice. But then, as a doctoral student at Columbia, I embarked on this project, which took me to Dharamsala, India, where I did some field work in the Tibetan refugee community where I was interested in trauma and resilience. You know, so then post graduate school, you know, I was really looking for a place where, you know, somehow all of my interests could kind of coalesce and come together. I mean I had long heard of, you know, Naropa and really liked that it had sort of a radical edge to it. And thatÕs probably how I ended up here. DAVID: All right. Yeah, I love the idea of having an interdisciplinary approach to what youÕre doing. And it seems as though you necessarily didnÕt know exactly the direction you wanted to go in, you were kind of just following some interest. And then that led to another interest. And it almost sounded like the Ñ the psychedelic part of it. Because it sounds like youÕre in anthropology and mental health world already. And then somehow psychedelics sort of slipped in there. Is that like a true statement? Or is that something you were interested in and weÕre looking to integrate into your interdisciplinary approach? Dr. Sara Lewis: Yeah, itÕs a good question. I mean, it was definitely the focus of my masterÕs degree. And then, you know, I think psychedelics were just sort of a personal interest Ñ a personal practice for me, you know, my Buddhist meditation practice and my psychedelic work, you know, always just seemed like, they fit together, you know, so perfectly. Even though thereÕs a lot of Buddhist practitioners who are very skeptical about psychedelics, and we could, you know, perhaps get into that. But it was really more a part of my personal path. I donÕt think it was until, you know, it started becoming apparent that oh, wow, this actually is going to become legal, you know, that I really started to think and when I came to Naropa, you know, there were already a number of faculty and students really, you know, who were like Naropa needs to offer this training. A lot of it came directly from grad students, many of whom were choosing to come train as therapists or chaplains, specifically, because they wanted to do psychedelic assisted therapy work. So itÕs very, you know, one of those synergistic moments that just seems to be kind of like arising, you know, right place, right time. DAVID: Yeah. And you sort of spoke upon the, like, radicalism of Naropa. And the teachings that they have there, and I kind of wonder if the psychedelic approach to therapy would have Ñ program would have happened, if we werenÕt so radical? Dr. Sara Lewis: I donÕt think so. Yeah. [00:06:58.01] BEN: You know, if we were just like, traditional school, like, oh maybe we should work with this thing thatÕs so illegal. Dr. Sara Lewis: I donÕt think so. I mean, a lot of the more, you know, obviously, research based universities, you know, thereÕs a lot happening, you know, in terms of research and clinical trials, and Ñ which is amazing, you know, I think itÕs like each institution can kind of play its important role. Naropa is less focused on research, although many of the faculty here, you know, are trained researchers. But really Ñ we are really deeply interested in the training of psycho therapists and chaplains, you know, itÕs not so much looking at the safety and efficacy of psychedelic medicines, but how for those who are training, what are the important things that people need to actually train in to provide, you know, high quality, ethical, and helpful therapy. And I think Naropa also can play a role in understanding more about safety, about assessment, you know, because psychedelics are, itÕs so exciting whatÕs happening. And of course, theyÕre Ñ theyÕre not right for everyone, and they can actually even be harmful sometimes. So I think we have a unique role to play. DAVID: True, yeah, they can be very risky. And itÕs very important that you know, what youÕre doing and or are with somebody who knows what theyÕre doing. So being trained is kind of essential in such a setting. So weÕre kind of like talking about the generalization of everything. But there is a program at Naropa University. This program is labeled as a psychedelic assisted therapy certificate. What does that actually mean? And with this type of certificate, what are the parameters in which someone can practice the work that Ñ what theyÕre learning? Dr. Sara Lewis: Yeah, so this is a training program that we are launching in March 2022. And weÕll begin soliciting and accepting applications around November 1. So this is a 200 hour, 10 month certificate program that really is aimed for clinicians and therapists who are already licensed or who are on the path to licensure. So in terms of the parameters of who can apply, weÕre really in a way bound by the collaboration that weÕre doing with MAPS, the multidisciplinary Association for psychedelic studies, because weÕre offering the MDMA assisted therapy is protocol embedded in the training. And so this is, you know, a protocol and training thatÕs really an approved method in terms of the collaboration with Ñ with the FDA to actually work with MDMA. And so there are folks out there who I think probably are interested in getting psychedelic assisted therapy training, but our program might not be, you know, the one for them if theyÕre not already, kind of an established licensed therapist or clinician. Because to be able to work with MDMA, you need to meet that certain set of criteria. DAVID: Yeah, and one of the questions was, are there any prerequisites that are needed to engage into the program and it does sound like there is a level of Ñ it is kind of like a masterÕs program certificate, you could say itÕs like, you got to have some sort of therapist training to even approach it. Dr. Sara Lewis: Mm hmm. Yeah. I mean, within that, you know, we Ñ we are really interested in taking kind of a, again, an interdisciplinary approach. So if folks want to visit our landing page, you know, we have a list of the different certifications that we accept. But usually, you know, this will be someone who has at least a masterÕs degree or higher in the clinical field and either licensed or on the pathway to licensure, someone with on some kind of background already in working with trauma, and then 1000 direct clinical hours. DAVID: Okay. So itÕs not no, like undergrad like, oh, that sounds fun. You gotta be on a path to healing and towards clinical therapy work. Dr. Sara Lewis: Yeah. And, you know, I think itÕs good to, you know, kind of acknowledge that this is more advanced work, you know, so itÕs not really that weÕre wanting to kind of be gatekeepers in the sense of keeping folks out who are interested, but just recognizing. I mean, I talk to, you know, undergrads and grad students all the time about this and sort of help them find out like, okay, if this is what you want to do Ñ you want to be a psychedelic assisted therapist, what might be next for you, you know, in terms of your training. So training in somatic therapy would be an awesome way to go, coming to Naropa to train in contemplative psychotherapy or the chaplaincy program. So it might just be a matter of kind of helping people, you know, find out like whatÕs next for them in their training path. DAVID: Yeah, and I think thatÕs important to recognize is the fact that Naropa has got some awesome clinical therapy programs that you can take to get ready for the program in which we are talking about. Dr. Sara Lewis: Definitely and we also now have a psychedelic assisted therapies course for graduate students. DAVID: Okay. Dr. Sara Lewis: So if Ñ yeah, people are you know, still at the Ñ the grad level, thereÕs already things that they can get involved in, NAPS, the Naropa Alliance for Psychedelic Studies is an awesome student group. They get amazing speakers from all over the world to come and talk about psychedelics. So thereÕs, you know, if youÕre someone whoÕs interested in psychedelics of any kind, I think itÕs an awesome time to be at Naropa. DAVID: Yeah, very cool. Okay, hereÕs an interesting question. What type of classes could a student expect while taking this course? Like, do you have any class titles or Ñ Dr. Sara Lewis: Yeah Ñ DAVID: Like, today, kids, weÕre gonna take a heroic dose of, you know, and like, touch our soul. What can they expect? Dr. Sara Lewis: Yes, hopefully, we will be touching our souls, but probably not taking heroic doses of anything during the training. Although we do and this is, you know, this is really a part of the MDMA protocol, we do require all trainees to have an experience of non Ñ a non ordinary state of reality. So thereÕs different options. DAVID: Pretty vague. You know, itÕs like, oh, I astro travel this one time, you know, like, right, how does one define such things? Dr. Sara Lewis: Yeah, well, we have a few options for that. And this is recognizing, you know, Rick Doblin the head of MAPS. I mean, everyone is pretty much in agreement with this, has really said that in order to really effectively be a good psychedelic assisted therapist, you need to have had the experience of the medicine that youÕre actually giving to people. So MAPS has been allowed now by the FDA to give MDMA to trainees, but itÕs a small number. So thatÕs where weÕd like to get where Ñ where we actually will be able to kind of have trainees have their own experiences of the medicine. Before thatÕs really legal, we have some other options. So either doing holotropic breathwork, participating and ketamine assisted therapy, which is already legal. ThereÕs a practice at Naropa called my tree retreats, which is a very psychedelic practice. And then there may be some opportunities for trainees to actually travel abroad to either Amsterdam or to Peru to participate in some psychedelic ceremonies there. DAVID: Amsterdam. Dr. Sara Lewis: Amsterdam. Yes! DAVID: What kind of like psychedelic experiences do they have? Because I know they sell mushrooms, but thereÕs like a waiting limit. And itÕs like, totally weed friendly. IÕve been to Amsterdam a couple times for such endeavors. But IÕm curious, like, is there anything else? Dr. Sara Lewis: Yeah, so weÕre working on establishing a partnership with a group from the Netherlands who provide psilocybin assisted therapy. Yeah, so then the kind of certificate itself you know, as I said, is 200 hours spread out over 10 months, and we have two retreats. A week long retreat in March and a week long retreat in August, and then the rest of the time trainees are participating remotely, you know, because we really want people from all over the world potentially, to be able to access this program. You know, so people will be kind of tuning in for didactic lectures and training. And then also cohort based learning in smaller groups. You know, if youÕve been on trainings that have, like 150 people, which is the amount of trainees weÕre looking at, you know, itÕs great, but then itÕs really important for people to be able to kind of discuss whatÕs going on and do some of the deeper training in small groups. So some of the topics to your question like, well, what might we be doing on a given day? DAVID: What we getting into? Dr. Sara Lewis: What weÕre getting into? I am more and more really getting interested in somatic therapy and somatic work. So thatÕll be a really important topic. Ethics, we spend a lot of time on ethics, a lot of time on right use of power, you know, and again, this is really a Naropa kind of value thatÕs shaping this program. So thereÕs so much to talk about in terms of equity and access, right relationship with indigenous communities and BIPOC communities. So I think for folks who are not that interested in those topics, we probably would not be the right program for you. If youÕre someone whoÕs really interested and ready, you know, to really understand your own positionality, your own social locations, and why thatÕs actually important, you know, to become an ethical, psychedelic assisted therapist, then we might be the right program for you. DAVID: Yeah, and you know, who you are. If this sparks an interest in you, and you look at Ñ look it up, youÕre gonna know. YouÕre gonna know if this is calling your name or not for sure. Dr. Sara Lewis: Yeah. DAVID: So in your opinion, what kind of relationship does therapy and psychedelics have with each other because I donÕt know, this seems fairly new. And when did these two things begin collaborating for mental health and physical health? Because, you know, weÕve had therapy for a very long time, but now weÕre starting to shift towards this, like assisted psychedelic therapy. So when Ñ when did those come together? Dr. Sara Lewis: Well, I think it depends, like what you really consider to be therapy. I mean, if you look at indigenous use for healing, we can say, oh, this has already been happening for thousands of years that people are using psychedelics, in, you know, context with trained practitioners, this is already been happening for centuries. If the question is more about, you know, kind of modern psychotherapy, you know, the Ñ there was a lot of research that was very robust, you know, starting in the 1960s, and 70s. But then, you know, of course, because of the war on drugs, that sort of came to a screeching halt, and organizations, like MAPS, you know, and -- and others have kind of slowly, slowly since the 1980s been working to begin, you know, bringing MDMA and -- and other psychedelics kind of through the legal FDA process. ItÕs an interesting question to consider. You know, why now? One of my colleagues, Travis Cox, who is the chair of Eco-Psychology at Naropa, I remember we were in a conversation, and he said something like, well, itÕs no accident to me that this is arising at the same moment as the climate change crisis. So maybe youÕll have the opportunity, David, to talk to Travis about some of his ideas of like, why now, you know, and itÕs like, a lot of people are like, oh, I read Michael PollanÕs book. And now IÕm curious, but you know, thereÕs still this deeper question of like, why, what are the causes and conditions that are coming together, you know, to kind of bring psychedelic therapy more into the mainstream? DAVID: Yes, yes. And personally, I think itÕs some therapies work, some therapies donÕt. And the thing is, is a dissolving of ego is really important to see whatÕs really happening. And sometimes itÕs very painful to do that. But if youÕre in a therapy setting, itÕs very healing at the same time, and you can do a lot of work in a short amount of time. You might be kicking and screaming, but youÕll Ñ youÕll come out of it, a completely different person. I think itÕs scary to some people, but other people were like, okay, itÕs time. Dr. Sara Lewis: Yeah, and a lot of folks, you know, particularly if you look at the data for the clinical trials for MDMA, and psilocybin, you know, these are folks, many of whom have tried everything else. So I think when we think about the kind of person who would be using psychedelics in therapy, we might think of like, the Burning Man crowd, you know, or like, people who are already interested in this and yeah, I mean, thatÕs great and awesome that, you know, those folks are, you know, kind of coming along. DAVID: Shout out to my people. Dr. Sara Lewis: Yeah, exactly. But itÕs also a lot of sort of ordinary people who have tried everything else, you know, veterans, first responders, sexual assault survivors, people who have already been through years and years of therapy and different kinds of medications, people with substance abuse, you know, people who have had suicide attempts. So the fact that, you know, the FDA has given MDMA and psilocybin, itÕs now been demarcated with a status called breakthrough Ñ breakthrough status, you know, which basically just means that the results have been so efficacious, that drugs are sort of given the status and expedited when it seems like you know, the results are so promising. And thatÕs actually done for ethical reasons. You know, sometimes this happens with like, chemotherapy drugs, right. So the idea is like, this has been shown to be so effective in clinical trials, that itÕs actually really important that we kind of expedite this process so that more and more people can be helped. So you know, I think itÕs always good to sort of keep that Ñ keep that in mind, like moment to moment, like, what is our motivation for doing this, and it is exciting to work in psychedelics, itÕs creative, itÕs innovating. But you know, ultimately, our motivation should really be to, you know, to help and to be of benefit. DAVID: Yeah. And the healing doesnÕt lie. Dr. Sara Lewis: Yeah. DAVID: I think thatÕs whatÕs the most important is how youÕre saying is some people have tried it all. And then they try the thing that is mostly taboo. And there it is, thereÕs potential there. So itÕs one thing to take a psychedelic journey, and discover the potential self and others, but it is another to approach it with an intentionally healing perspective. How does the assisted therapy approach differ than engaging in these practices without a therapy setting? And how important is the space in which we create for the explanation of our health? Dr. Sara Lewis: Mm hmm. Yeah, I love this question. And I feel like, you know, IÕm a trained psychotherapist, but IÕm also an anthropologist, as we talked about. So itÕs like, on the one hand, IÕm participating myself in the practice of psychotherapy, and at the same time, I see it as just one pathway. I mean, thereÕs actually something a little bit strange and unusual among like most euro American cultures, we have this idea that like sitting in a kind of sterile clinical room with a perfect stranger, telling them all of our deepest thoughts and feelings and emotions, that thatÕs what we consider to be like, most helpful. Right, in many other cultures across the globe, thatÕs considered pretty strange. You know, and most healing happens, like in families, in communities, in ceremony, through ritual, you know, like, really kind of being in the collective. So my view of whatÕs therapeutic, you know, I think of as a little bit broader. At the same time, I think, we can look at Ñ and I look at psychotherapy as a skillful means, but I donÕt see it as the kind of end all be all for psychedelics. So I really appreciate some of the critiques that are out there about psychedelics becoming overly medicalized and kind of the dangers, you know, of having these medicines be kind of controlled and regulated by the FDA. Right, there is something that might be lost, if theyÕre being regulated in that way, and kind of moving away from a ritual and ceremonial or kind of family and community based context. You know, so to answer your question, I think it all has therapeutic potential. At the same time, I think the kind of models that have been developed for psychedelic assisted therapy, really create a container of safety, right? And so at a festival or concert or just being with friends, the container is sort of open in a way. Right? So in a therapeutic context, a really, really close, safe container is created. And I think thereÕs something about that, that really allows people to let go, and that probably, you know, I might venture to say is the number one most important thing in psychedelic therapy is being able to actually let go. Now, if weÕre in a container and a context where actually itÕs not safe to let go, thatÕs intelligent. Right? So if weÕre at a festival or a concert, and you know, we donÕt know whoÕs coming into our space, we donÕt know are we using something thatÕs illegal? You know, where we could get in trouble for that. Are you someone with a with a social identity for whom you know, the Ñ the police might be scrutinizing you more than others. ThatÕs not a safe context where itÕs actually smart or intelligent to let go. So I think the therapeutic context really creates, you know, kind of a special opportunity, where actually, it is safe people to begin to let go. DAVID: Yeah. And thereÕs been many experiences that IÕve had where IÕm at a festival in which things are going on and you kind of look around, youÕre like, this might be a little unsafe here, you know? Yeah, I totally feel that. So, you know, weÕre talking about psychedelics and drugs, and essentially psychedelics are drugs. And when people hear that they think of various drugs out there in the world Ñ they think of like something that is harmful, you know, and weÕre talking about drugs, psychedelics, in a healing modality. Some psychedelics are harmful and some arenÕt and how do we define the difference between drugs and psychedelics? Dr. Sara Lewis: Well, psychedelics are drugs as youÕre saying caffeine is a drug, right? DAVID: Sugar, red meat. Dr. Sara Lewis: Tobacco. DAVID: All the stuff. Dr. Sara Lewis: Yeah. So they are drugs, you know, and I think drugs are contextual. Awesome book that everyone needs to check out, Drug Use For Grownups by Carl Hart. Michael PollanÕs new book, This Is Your mind on Plants. Right? Those are two books that really go into looking at the social, cultural and political context of drugs. You know, thatÕs what makes all of this really interesting, right? I mean, like, why is LSD a schedule one, and caffeine is not a schedule one drug, right? Or alcohol. Right? I mean, if we look at the kind of dangers of alcohol, the risks of alcohol use and abuse, versus something like cannabis, we can see pretty easily, you know, how, you know, the Ñ what we kind of impute Ñ the meaning that we impute onto drugs is completely political. And at the same time, you know, like you mentioned, there are clear risks. Psychedelics are not for everyone at every time in their life. So that presents a good question of how might someone know, you know, if itÕs the right time for them to begin using psychedelics. So thatÕs Ñ really will be a big part of the our clinical training, you know, to really train the therapists and chaplains coming out of our program, actually, not to just be, you know, opening the doors and taking anyone to begin this therapy, but really kind of working through a screening process. DAVID: Yeah, this is very adult stuff. This is not playing around. This is some healing, legit research, and dissolving the social psychological fabric of somebodies makeup. This isnÕt a joke. This is some real stuff. And whatÕs interesting from you is IÕm hearing this community narrative, community definition of what drugs Ñ drugs are bad, drugs are bad. And just like we take drugs all the time. We cannot function unless we got drugs mixtures in our brain, you know, we have endogenous drugs within Ñ within our brains at all times. And I donÕt know, IÕm feeling like thereÕs this a social change of the definition of how we define drugs, because there Ñ there is many different classes in which you sort of stated, and also stated that some are not even like engaged upon. Dr. Sara Lewis: Yeah, and thereÕs a lot of interesting studies right now talking about ketamine assisted therapy, which is already legal. And unlike with MDMA, and probably psilocybin, where you need to taper off SSRIÕs, you donÕt actually need to do that for ketamine therapy. It is recommended that people are off benzodiazepines for a period, you know, 24 or 48 hours Ñ there are some different thoughts about that in advance. But a lot of studies are beginning to show that actually folks who really have become dependent on their psychiatric medication, that ketamine is a way for people to begin to kind of transition away from actually needing those medications. So it might say like, well, arenÕt you just substituting ketamine for Prozac? But actually, you know, what Ñ what seems to be happening is that folks might need, you know, six to eight sessions of ketamine to kind of work through, you know, some of the root causes of their depression. And then over time, you know, in therapy, people are able to, you know, much more quickly get to a place of not actually needing those drugs anymore. So, yeah, like, I see drugs as sort of neutral in a way, you know, I donÕt see them as necessarily positive or evil. But itÕs like, whatÕs the context? WhatÕs the interpersonal context, the political context, the social context. You know, as a Buddhist, I might say that drugs are sort of empty of inherent nature, you know, itÕs what weÕre kind of imputing that the meaning that weÕre imputing onto them that matters. DAVID: Yes. So our good friend, Timothy Leary, the godfather of LSD, who was quoted for saying LSD is a psychedelic drug, which occasionally causes psychotic behavior in people who have not taken it. And IÕve always found that to be very interesting, because the people who have an uproar are the people who have yet to experience such a pleasure and or exotic place, you know? This speaks to the notion that people who are most afraid of psychedelics are the ones who have never experienced them and potentially regulating them. How do we, as people of the mental health community educate and convince policymakers and others of the healing power of these medicines? Dr. Sara Lewis: Well, I think thereÕs different ways to do it. I mean, so one way is absolutely through scientific data thatÕs being generated. You know, so the facts, as I was mentioning before, that FDA did kind of give breakthrough therapy status to both MDMA and psilocybin is Ñ is huge. I think thatÕs been very convincing to lawmakers. And the other is through narrative and personal story. So I think as more and more people are helped by these medicines, again, you know, regular folks out there who have had extraordinary events happening in their lives, more and more people who are helped by these medicines, you know, I think talking to people and kind of hearing firsthand about these stories of how people are actually helped, that that will probably go a long way. And the third thing IÕll say is, I think that for Naropa, and other institutions who are interested in Ñ in training therapists, I think we have an enormous responsibility to not screw this up. Right? So there are risks. And so because there are risks, there will be negative outcomes, there have already been some negative outcomes. Right? But you know, I think that we have a huge responsibility to kind of roll this out in a way thatÕs safe, in a way that maybe is a little bit slower pace than some of us might like, but I think that thatÕs better to really kind of set the groundwork and create a good and safe container. DAVID: Yeah. And of course, thereÕs going to be risks, thereÕs pretty much risk in any therapy setting, whether itÕs talk therapy, movement Ñ Dr. Sara Lewis: Oh, SSRI, I mean, thereÕs a huge body of data, which shows that thereÕs an increased risk of suicide when you put adolescents and young adults particularly on an SSRI. Why, because they start feeling a little bit better, and then they actually have sort of the energy to carry out a suicide attempt. So thereÕs already, right, like plenty of risks, as youÕre saying out there with conventional therapies. DAVID: Can you say what an SSRI is for our audience? Dr. Sara Lewis: Yes, itÕs a class of drugs thatÕs used for psychiatric conditions, mostly for depression and anxiety that impacts your serotonin levels. DAVID: Okay, so IÕm actually excited to ask this question. Is there anything you could say about the difference between a natural psychedelic compared to a synthetic psychedelic, for instance, ayahuasca compared to MDMA, or psilocybin compared to LSD? So we keep talking about psychedelics, but in my mind, I have this, like, hold on, wait a minute, because thereÕs plant medicine, thereÕs psychedelics in plants, and then thereÕs psychedelics in scientifically based person made synthetic drugs. And what like Ñ what is it about it that makes it a psychedelic? Dr. Sara Lewis: Yeah. Well, in terms of what is it that makes it a psychedelic, I donÕt know. I mean, IÕm sure that there is a technical definition out there, right. I mean, there are some folks in Boulder and elsewhere who are using cannabis, right as a psychedelic medicine, right. So kind of used in the ceremonial context or therapeutic setting. You know, so would we call cannabis, a psychedelic? I donÕt know, thereÕs probably lots of different, you know, definitions out there. But I love your question, and IÕll speak to it actually with a kind of personal insight. So I went through a ketamine assisted psychotherapy training program with PRATI, which is the Psychedelic Research and Training Institute. And this is Dr. Scott ShannonÕs group out of Fort Collins. And as a part of the ketamine assisted therapy training program, they actually have the therapists and clinicians going through the program actually go through their own ketamine sessions. Which again, I think is so critical, you know, the idea that we might be kind of using these medicines with clients and not actually understanding like, what it feels like, you know, is a far fetched idea. So when I went through the training, and did a couple of ketamine sessions, which were, you know, personally, IÕd say among surprisingly, some of the, you know, greatest psychedelic experiences IÕve actually ever had. So that was quite surprising to me. And one of the things that ketamine sort of said to me, you know, I was sort of like, what are you about ketamine? DAVID: Who are you? Dr. Sara Lewis: Who are you and what are you about? DAVID: What are you doing? Dr. Sara Lewis: Yeah, one of the things that ketamine said to me was, okay, listen, you have a bit of a bias about sort of natural plant medicines as like a little bit morally superior, or a little bit superior in some way to synthetic medicines. And what ketamine said was, you know, ketamine and MDMA and LSD actually come out of human brilliance, like, you know, these were actually developed and invented from the human mind. DAVID: I mean, LSD was accidental. Dr. Sara Lewis: Right! Yeah. DAVID: Oops. Dr. Sara Lewis: And yet, right, itÕs like, there was some kind of human, you know, brilliance, which was maybe interfacing in some way. I mean, depends how out there we want to get, you know, like, these sort of accidents. Was there some kind of like divine intervention happening, right. And so ketamine was kind of like, these drugs are actually coming from the human realm, which is also sacred, you know, so plant medicines might have this different kind of connection to the spiritual, you know, sort of plant and animal realms, right. And thereÕs some special qualities about those plant medicines and what they access. I think thereÕs something about ketamine and MDMA and LSD, which are very, you know, they somehow have this deep connection to our human nature, right, because they come out of human brilliance. And so that really changed my perspective, you know, and also got me kind of thinking about, you know, Western medicine, and I mean, right now, in 2021, weÕre in the middle of the COVID pandemic, but sort of even thinking about things like vaccines, you know, it sort of has opened my receptivity in a way to not seeing like, oh, natural plant based medicines, good, you know, Western synthetic medicine, kind of bad, evil Ñ DAVID: Poopoo. Dr. Sara Lewis: You know, poopoo. DAVID: No, I hear that. So, I just randomly thought of this. So I did Ñ I did watch a documentary about the basis of synthetic versus, you know, plant based medicine and the guy was talking about Ñ was it 5 MEO DMT, or Bufo Ñ Bufo, which is the -- the slime you get off of a exotic toad from the Amazon and you smoke it, you smoke this like, you dry, you chip it off, you smoke, the dried slime, and it gets you really going. But he was talking about he was like, we can recreate the exact same thing, molecule by molecule in a lab, and youÕre not endangering the toads. YouÕre not hurting the ecosystem. And a lot of people were against it. But ultimately, chemically, itÕs the same thing. But in a sense, do you think the psychedelic that is a plant base has a spirit in itself? That is, you know, synthetic? I donÕt know, like, does it Ñ does the synthetic have a spirit to it? Dr. Sara Lewis: I really think so. DAVID: Okay. Dr. Sara Lewis: Yes. I really think that there is a spirit of MDMA, a spirit of ketamine. And I donÕt think IÕm the only one out there who thinks that but, you know, itÕs a good question youÕre asking because even you know, looking at psilocybin right now, the trials that are happening are with a synthetic compound, you know, so people arenÕt chewing and swallowing mushrooms, theyÕre taking a pill, and thatÕs done in part so that everyone is taking exactly the same compound and exactly the same dosages. So if people are chewing up, you know, pieces of mushrooms, like we donÕt know you know exactly how much psilocybin is in each of those kind of doses. So this is a question a lot of people are asking, does that mean that then the spirit of psilocybin is washed away? Somehow I donÕt think so. Somehow, I think that the spirit of these medicines are like able to withstand that and are probably fine. ItÕs probably us who are like, less fine. But I think you know these are all really good questions. IÕm sort of, you know, a pragmatic person in a way, IÕve worked mostly in more kind of conventional paradigms, tried to bring, you know, some of this work in. You know, so I did my PhD at the School of Public Health at Columbia University, like, you know, very not Ñ not a place like Naropa at all! So itÕs a little more unusual for me to be now at a place like Naropa, which is already very radical, where thereÕs like skepticism, you know, about science Ñ skepticism about kind of traditional, conventional hegemonic practices, which I like. But I also think that we can get a little bit too skeptical, a little bit too uncertain, maybe, you know, so I really always admire people who were able to kind of work in both worlds. And I think that thereÕs a lot of benefit that can be brought in, when people are willing to kind of straddle the conventional with the unconventional. DAVID: Yeah, and I agree without that. The ability to be neutral and to funnel in information from both sides of the spiritual, and also the scientifical. And then create a hypothesis or an analysis from there, it is very important, because, you know, like stuff, just like the universe has its own workings. But then science is very, like, here we go. This is why that happened. Dr. Sara Lewis: Yeah. And couldnÕt they be one in the same like, this was part of, you know, what, ketamine kind of schooled me on a little bit. ItÕs like, science is magic too. DAVID: Yeah. And I love your story about ketamine because medicines, they talk to you, they want to talk, they say whatÕs up, and they Ñ they say what needs to be said sometimes, and sometimes itÕs not easy to hear. But itÕs super important. And I always feel like their message is so simple, but so impactful at the same time. You know, itÕs Ñ itÕs something that you could literally do, once you come back to the real life, you know, like, stop being a jerk, stop carrying the trauma from your childhood, because you are a completely different person now, but yes, you did go through that, and donÕt allow it to hold you down. Dr. Sara Lewis: Yeah, and sometimes the message is big, you know, like in integration work, we tell people to actually avoid making huge life decisions in that period. So itÕs, you know, sometimes people will have, you know, one psychedelic experience, and then be like, Oh, my God, I now realize I have to get divorced, or I now realize I have to, you know, change Ñ quit my job and start doing this. And so sometimes the messages are really big. And so we really encourage people to kind of take time to like, work through and sometimes it can take years to integrate one psychedelic experience. And it doesnÕt mean that that was wrong, or bad or something, you know, negative happened, but itÕs like the scale might be a little different. That is absolutely fine. If you have a big experience and you need years to integrate that Ñ itÕs still working, and itÕs probably working really well, if something had that big of an impact. DAVID: Yeah, and weÕre humans, you know, like, weÕre gonna take the time that we need, but as long as youÕre honest with yourself, take as much time as you need, just be honest. You know, be Ñ be loyal, be honest, be truthful. And then like, move in love. Dr. Sara Lewis: Yeah. DAVID: Like, donÕt fuck around, just Ñ just make good decisions. Dr. Sara Lewis: And when you say, loyal, like, IÕm curious about that, like, what might we be loyal to do you think? DAVID: To the potential of healing ourselves. Dr. Sara Lewis: Yeah. DAVID: Loyal to the messages that serve us. Loyal to opening up to what is needed in the moment. Loyal to not knowing, also, like, itÕs okay to not know whatÕs going on. But loyalty doesnÕt just have to decide that you can be loyal and not knowing and then wait for something to pop up that feels in alignment with the direction in which you want to go, you know, very ambiguous stuff. But, you know, like, thereÕs, I feel like itÕs pretty clear at the same time. Dr. Sara Lewis: ThatÕs it! DAVID: So I donÕt know. Dr. Sara Lewis: Yeah. I mean, I was just curious and got me thinking about the founder of Naropa Trungpa Rinpoche wrote a lot about loyalty, actually. And he talked about loyalty to sanity. You know, and I wonder if that Timothy Leary quote that you read was actually referencing that? A loyalty to sanity is not always the easiest path to traverse. DAVID: Yeah. Like when I discover difficult moments in my life, I like to ask Ñ I call it consulting the council. So I like to ask all the voices in my head, like, what Ñ yÕall what do yÕall think? Okay, youÕre not allowed to sit here anymore. Go away. Okay, oh, thatÕs a good one. And then I asked my heart, and then I say like, what do you say? And then they all say different things. And then I just Ñ I like to meet in the middle. My actions showcase the meeting in the middle, or whatÕs more in alignment than the like Ñ the thought I had thatÕs kind of crazy and angry. I donÕt want to act that, you know, because we are not our feelings. We are how we deal with our feelings. You know, thatÕs something I like to say, too. So I got two more questions. This is super fun, but I just want to respect your time and I just got two more. So psychedelics have a taboo notion, when it comes to public awareness? How is it that you are able to do therapy work with a substance or plant that is essentially illegal or is not known to the public? And is there any special regulations, laws or anything specific to the type of therapy that you have to honor while doing it? And does the FDA actually make the MDMA for you? Like, do you have to get it from governmental places? Or is it kind of just like sanctioned areas? Or how does that work? Dr. Sara Lewis: Yeah, so itÕs a little complicated. So right now, itÕs not legal to do MDMA assisted therapy, or psilocybin assisted therapy. Ketamine is federally legal, and then cannabis is, you know, legal state by state. If you consider cannabis assisted therapy, a thing that is psychedelic, and many people do. So but itÕs not legal, to be using psychedelics, there are therapists who do underground work, many of us, myself included, you know, donÕt want to put our license at risk, you know, so I donÕt work with clients in that way. And at the same time, it is so important to recognize all of the good and deep, important work that these underground therapists have been doing for decades, really helping people who, again, have tried everything else, and also really helping to kind of, you know, develop many of the protocols, you know, that weÕre using today to train. So itÕs sort of an interesting situation, in that MDMA and psilocybin are not legal yet. And at the same time, itÕs close enough that folks are beginning to train. So in order to use MDMA, post legalization, which the FDA has suggested, perhaps 2023, but we donÕt know. So if MDMA goes all the way through the FDA process, and that is approved at 2023, for therapists to use MDMA, in their clinical work, they need to have actually gone through the MAPS protocol, and from what I understand that will be about five to seven years post approval, that, you know, clinicians need this specific protocol. After that period of time, itÕs unknown, itÕs open, you know, like, what kind of training will be allowed. So definitely, if people want to work with MDMA, they should come to the Naropa training program, or contact MAPS, or CIS is also Ñ has been doing a certificate program for a number of years now. Psilocybin is a little bit more unknown. So the FDA has indicated that perhaps 2024, they would approve psilocybin, it hasnÕt really been announced yet exactly what kind of training clinicians will need in order to get that authorization. But a super interesting thing happened in November, at the time of the presidential election, where Oregon voters actually passed a ballot to make psilocybin available in therapeutic contexts in 2023. We could do a whole podcast on that, because itÕs super interesting because it Ñ DAVID: LetÕs do it. Dr. Sara Lewis: Yeah. ItÕs not like itÕs circumnavigates around FDA exactly. But itÕs like a different channel. ItÕs a different channel of kind of bringing psilocybin into the Ñ into legal use. So itÕs going to be super fascinating to see what sort of happens there, you know, in terms of who is allowed to get the therapy, who is allowed to practice it, what are the parameters. So definitely, weÕre paying really close attention to that for the Naropa certificate. ItÕs already the case that anyone who goes through our training at the end will be, you know, fully MAP trained up until the evaluation stage. And weÕre paying close attention to how to make it possible in our training for folks to be able to then also use psilocybin when theyÕre finished with the training. DAVID: So what IÕm hearing itÕs a very new space, and itÕs still being worked out. ItÕs sort of is sort of not legal, and you know, itÕs very special. ItÕs very new. IÕm very excited for this whole thing. It feels as though thereÕs so much healing potential for so many people out there who as you said, tried it all. You know, and might need a little something else Ñ itÕs just to get you there. Dr. Sara Lewis: Yeah, and I mean, the clinical trials for MDMA and psilocybin are recruiting participants. So if youÕre someone out there who has been dealing with PTSD, go on the MAPS website, and you can actually apply to be a study participant. If youÕve been dealing with depression, thereÕs actually a number of different studies for psilocybin, you can actually just look them up on clinical trials.gov. See, if you qualify to be a part of the study, if you donÕt fall into those categories, ketamine assisted therapy is legal. And thatÕs something that you could consider trying right now. DAVID: Awesome. So what would you say to someone who is opposed to this type of therapy and is against psychedelics in general? And any insight to help change the minds of others who are afraid or think that this is a bad idea? Dr. Sara Lewis: Actually, no, I feel more concerned about the people who are like, you know, who are like overly enthusiastic and think itÕs the answer to everything, I think that could be more harmful. I think for people who really have concerns about psychedelics, you know, I actually think itÕs important to continue to have those critical voices in the mix. I think that that will help to actually serve as a check and balance to perhaps the enthusiastic people like me and my colleagues, you know, who want to start this program. So I actually think that that is fine. And thereÕs also like, many paths to healing like music, art, dance, somatic work, you know, thereÕs so many avenues. I think psychedelics are just one way or just one path. You know, itÕs like, if I think about something like meditation, you know, going on a Upasana retreat is not for everyone, nor is a, you know, Tibetan Buddhist Tantra practice. So itÕs like, you know, the Buddha talked about, thereÕs 84,000 different teachings, because thereÕs just that many different kinds of minds out there. So I wouldnÕt do anything to change the mind of the skeptic, IÕd say probably, thereÕs actually some wisdom, you know, in whatever their hesitancy is. DAVID: Thank you. I would love to talk to you more about this, but I feel like that is our time. And if anyoneÕs interested, please go check out the Naropa psychedelic assisted therapy certificate program, and itÕs gonna go in effect when? The Ñ2022? Dr. Sara Lewis: March 2022, we will enroll our first cohort of 150 trainees, we will have scholarships Ñ equity scholarships available to recognize the unfair access of BIPOC and other historically excluded groups. So people, please feel free to check out our scholarship opportunities, and the program will be announced more fully, later this fall and applications open November 1. DAVID: Amazing. And thank you so much for sharing your knowledge, your experience and just your like your enthusiasm behind such a topic that I feel very enthusiastic about as well. And Sara, it was just such an honor to speak with you today. Thank you so much. Dr. Sara Lewis: Thanks, David. This was great. [MUSIC] On behalf of the Naropa community, thank you for listening to Mindful U. The official podcast of Naropa University. Check us out at www.naropa.edu or follow us on social media for more updates.