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Welcome to Adaptable | Behavior Explained! Ketamine-Assisted Psychotherapy (KAP) is an emerging approach to mental health treatment that offers valuable solutions for those struggling with various challenging issues. By combining the administration of ketamine, a medication with unique properties, and psychotherapy techniques, KAP enables therapists and clients to address deeply-rooted mental health concerns more effectively. KAP has demonstrated promising results for individuals grappling with treatment-resistant depression, anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), paving the way for its integration into modern clinical practice.
I'm Kelly O'Horo, Attachment based EMDR Therapist, EMDRIA Consultant, and Advanced Trainer. I'm a mom of 5, Nonna of 5, wife, and a healer. I have the honor of spending my workdays walking along side people while they brave their healing journeys. I try to live with the generous assumption that we're all doing the best we can with what we know. Therapists are teachers for the "life stuff" and "emotional vocabulary" that may not have been learned due to gaps in our care givers capabilities. In the last 15 years I've learned that people are freaking amazing, resilient, and inspiring. Most importantly, we are hardwired for connection and for healing!
I hope to bring an authentic, compassionate, and unpolished approach while we explore a variety of topics such as parenting, marriage, relationships, dating, trauma, attachment, adoption, depression, addiction, anxiety, and love! There's a why for all behaviors and an explanation that makes perfect sense as emotion is at the root of it all.
-- Links --
https://linktr.ee/kellyohorolpc
https://youtu.be/rLnARKekvgo
https://www.emdria.org/find-an-emdr-therapist/
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0:06
hi everyone I'm Kell ooro and this is adaptable Behavior explained hi
0:12
everybody thank you so much for showing up today uh on adaptable Behavior explained I'm really excited to have our
0:19
guest who is a board certified nurse practitioner her name is Jennifer montjoy she is just a Marvel at the
0:25
topic we're discussing today and others have referred her as uh referred to is a badass Medicine Woman and I think she's
0:32
very much earned that title uh she brings to us a wealth of knowledge and
0:37
warmth and education and I'm so excited to talk about psychedelic assisted
0:43
Psychotherapy today with Jennifer so Jen thanks so much for being here uh go ahead and introduce yourself thank you
0:50
Kelly thank you for having me I'm excited to be a part of the podcast today to be a guest and I think the
0:58
world of you as well so thank you for the lovely warm introduction
1:03
absolutely just a little bit about my background um I am a board certified
1:09
psychiatric nurse practitioner um I have a PhD also in
1:15
nursing and studied biobehavioral Neuroscience here at the University of
1:20
Arizona in Tucson where my practice is based and the focus of of my dissertation my research around that was
1:27
psychedelic assistant Psychotherapy for treating post-traumatic stress and the
1:36
focus also was utilizing ketamine uh as the Psychedelic so this
1:41
is my passion I I love the work that I'm doing and it's a privilege to be able to
1:48
work with folks on this uh this level of intimacy and it's been very
1:54
meaningful that's awesome thank you so much so my experience with treating
2:00
trauma for for many years now is that standard PTSD whether it's a single
2:06
event or multiple events that are traumatic in nature can be more easily addressed with things like EMDR therapy
2:13
or other sematic bottom-up therapeutic approaches but what I've really experienced is that the developmental
2:21
trauma that so many of our complex patients experience is just harder to
2:26
get at and we are so um we have to be so Artful at getting access to people
2:33
beneath their defense systems and beneath the mechanisms that they have so uh necessarily adapted to and uh have
2:41
have developed over time to survive their environments but sometimes their defenses are just too much of a good
2:47
thing so I am really excited for you to give uh us so much more information
2:53
about this topic and I'm really glad to have you here and we can hopefully shed
2:58
some light on uh this topic for those who are interested in seeking out psychedelic assisted therapy namely
3:05
ketamine assisted Psychotherapy and this uh day and age there's a lot of different things that are going on so we're going to dig into that so if you
3:12
find this topic helpful or interesting uh please make sure that you like or share it with someone who may find it
3:18
useful and of course subscribe so that you don't miss further episodes so let's Jen let's just go ahead and dig in um
3:25
can you give us a bit of the lay of the land as it sits now related to psychedelic assist Ed therapy in
3:32
society sure the the current state of
3:37
psychedelic assisted Psychotherapy is really fluid it's an emerging field uh which is
3:43
exciting and it started back in the really the 1940s and
3:48
50s and in 1970 the pause button was was
3:54
hit so to speak by the the government in a couple of different ways so that that
4:00
put the kibosh on on research and this exciting emerging field that was
4:06
happening then so fast forward to mid 90s late 90s and John's Hopkins
4:14
University was able to get approval from the FDA because most psychedelics
4:20
outside of ketamine are schedule one so they're still considered illicit uh substances which is why we were also not
4:28
able to do academic research utilizing these medicines so the field is uh
4:33
emerging since again late 90s early 2000s and here we are in 2024 so that
4:40
seems like a long time ago however with with Health Care Mental Health Care New modalities there is there's a a big lag
4:48
from bench science and clinical research to translating into clinical practice so
4:55
again the other piece with this is that uh there's a lot of different medicine being
5:00
researched however regardless of the medicines the um the approach
5:06
psychedelic assis Psychotherapy the the principles and tenants are are the same
5:11
whether it's with ketamine psilocybin uh LSD again in clinical research and bench
5:18
science research the only difference is the the length of the sessions because
5:24
the different molecules these different medicines have um different durations so
5:29
the experiences with ketamine for example typically that psychoactive experience
5:35
is about 30 minutes up to up to 45 50 minutes and some of those principles
5:44
that overlap with psychedelic assisted Psychotherapy some of those tenants that
5:49
are um really important with this work are preparation so preparing our clients
5:56
around the experience around the logistics uh around their support system and Community because there's still
6:03
stigma right with these with these medicines you know if I can chime in there it's so interesting that you bring
6:11
that up because I even personally had a lot of apprehension around this field
6:17
and this like you said this emerging approach uh I think that as Western
6:23
culture we tend to be a want to slap a quick fix on we want to cut Corners we want uh you know we want to do what's
6:30
fast and easy but not necessarily what's effective or what's honoring to the healing experience and I so I came to
6:38
this topic with with some apprehension and that I was also part of the dare you know generation where it was always you
6:45
know drugs are bad and and you know stay away from bad things and don't put bad things in your body and and yet we are
6:53
overmedicating with psychopharmacology with in my opinion medications that are far more damaging
7:00
far more addictive far yes far less useful because they kind of put a
7:06
Band-Aid on a broken ankle as opposed to help a person fully heal and come to their Hest their the fullest most whole
7:13
self and so can you describe for us a little bit about how you see ketamine
7:19
working when it comes to this opportunity for full healing certainly
7:25
and I think across the board with with ketamine and other psychedelics that in an optimal container so with you
7:34
know trust so that psychotherapeutic Alliance that um that you have with
7:40
clients um I think that these medicines including ketamine are overtime
7:47
softening those defenses right we call right internal family systems speak managers these protective mechanisms so
7:55
that we actually have access to this inner innate wisdom that we are all born
8:00
with um but throughout life and our our hurts relational wounds these defenses
8:08
get really rigid so I think you know I postulate with this that ketamine and
8:14
other psychedelics when people are in a a safe again container those managers
8:20
those defenses feel safe and okay that the medicines are allowing access to
8:26
that that self that higher self again that that inner wisdom that's innate in
8:32
each of us right you know I can say that how I met Jen as I went through her
8:37
training and and as did nine of us from infinite healing and wellness so that we could you know uh show up in this space
8:45
and this field responsibly and personally I felt a little bit late to the game because I was uh cautious
8:53
conscientious and I had heard so many things going on in you know neighboring
8:58
companies and other places that we doing uh ketamine assisted Psychotherapy or
9:03
just ketamine infusion and people are so desperate they will they will do
9:09
whatever they have to and you know I was kind of holding a stance that with EMDR therapy we can get access but I think
9:16
that the reason that EMDR intensives have become so much more popular is because it takes us so much more time to
9:24
get the the defenses fatigued for lack of a better word or whatever is happening that we can't fully understand
9:31
because we're on the outside you know watching but what I've experienced with the MDR therapy is that I can get in
9:37
there but sometimes it takes so long before things settle down or they fatigue or so that I can kind of get
9:42
behind those defenses to the vulnerability and the grief and the and the feelings that really need our full
9:48
attention having this experience with you and this training was just life-changing and that I love that the
9:54
experiential aspect is part of it and that us as practitioners are asked of
10:00
course not required but we all opted to participate in that experiential side of things and I just don't think I could I
10:07
could explain it as well had I not been through that series and um been able to
10:12
see the difference and so it almost felt to me and what I've seen with clients since I've been using this since going
10:19
through your training is that they're willing they're ready like you said there's the safe container we have the
10:25
therapeutic agreement the alignments the attachment relationship is built fortified and strong in our clinical
10:32
therapeutic relationship and they want to let me in they want to be defenseless
10:37
they want to find their way to healing and this seems to just bring that default mode of protection down so
10:44
rapidly and so I personally have had such amazing uh experience with my own growth
10:51
going through this but also I've gotten to see with clients just such a huge difference so quickly so can you tell us
10:59
a little bit about some of the different approaches that are out there because people really just don't know what they
11:04
know and I want to give them a good guide for how to make this decision with in with information so they can consent
11:11
to treatment knowingly yes ideally be fully informed and it's true
11:17
particularly with ketamine there are so many iterations and ways in which this medicine is being offered and by
11:25
different providers with different backgrounds and because because of that
11:31
there's Confusion And even semantically like the verbage around it is confusing
11:36
to folks and so with psychedelic assisted Psychotherapy utilizing ketamine it can be administered in a
11:43
number of different ways uh including IV which is the prevailing model for um
11:50
administering ketamine not for ketamine assisted Psychotherapy most of us that
11:55
are practicing um psychedelic assisted Psychotherapy again utilizing ketamine so we call it cap
12:02
Kap um are administering sublingually so compounded ketamine um sublingually or
12:10
intramuscularly and I think it's important for folks that are are seeking
12:16
services with this medicine that are looking for help to consider what what
12:22
they're being treated for and the backgrounds of the uh clinicians that
12:27
are offering the so for example most the IV infusion clinics have been owned and
12:35
operated by um Physicians Andor you know other
12:40
clinicians nurse practitioners as well who have backgrounds in
12:46
anesthesiology um emergency medicine Etc and they're treating patients or clients
12:52
for mental health conditions interestingly there's typically not any type of mental health
13:00
care clinician involved uh collaboratively in these clinics and so for me that's you know
13:08
that's something to consider as a consumer if you're being treated for let's say treatment resistant
13:13
depression um you know you want to work with a specialist whose background is
13:18
mental health care I think that's pragmatic um unfortunately that's not
13:23
been the prevailing again way in which ketamine has been offered so I think in vetting you know considering as a
13:30
consumer and being informed what are their backgrounds do they have specialized training perhaps they are an
13:36
anesthesiologist or a CRNA um so like a nurse who was trained graduate level uh to deliver
13:44
anesthetic medicines do they have do they have specialized training around ketamine and you know they may they may
13:51
have certifications or training this the specialized training is important do they leave folks alone are you in a room
13:58
with other patients other clients you know I with this work as you mentioned the
14:05
relational piece with our with the therapist with the person that's
14:10
facilitating these experiences is so important and a lot of these clinics
14:16
folks because the backgrounds of the clinicians offering the services are not
14:21
mental health care providers they they don't know what they don't know right exactly and so with with attachment
14:29
right these early life uh traumas the relational piece and having somebody
14:34
present that you can trust and that you do trust is it's critical yeah I I have to say that
14:41
personally speaking there are several of those ketam and IV clinics in operation nearby and we have actually had them
14:49
come to infinite for uh basically that the experience was traumatic because
14:55
they were left alone they weren't prepped with the setting and proper support from a family member and what to
15:02
expect for that day and and um really further compromised their levels of
15:09
trust in you know medical people or trust that people could have their back
15:14
because they weren't warned about things and I and like you said they don't know what they don't know and so we've had to
15:19
do reprocessing with clients that have had those experiences because it was so scary or painful or they were alone and
15:27
we have just not had that same experience here when administering it this way that we learned with your
15:33
training because you know there is such a tight Therapeutic Alliance there's safety in the moment everything's with
15:39
permission we're sitting right next to them in whatever proximity they ask for
15:44
they are you know it's so client centered they get to be in charge and we're just there journeying with them uh
15:50
and and and really uh able to transcribe everything that comes up that we can further integrate that they came up with
15:57
in the continued therapeutic relationship and I think that's the piece that's missing in a lot of these approaches is you know let me go get my
16:04
ketamine done and I sit in my room and there's nobody taking taking down the a
16:10
the data that comes up and then they don't necessarily know how to bring that information forward in a an appropriate
16:16
therapeutic way so I do think that's an incredibly critical part of becoming
16:21
informed about how is being administered and and I think that there is a misnomer that because someone may be a doctor
16:29
they might be more equipped to do this kind of work so I really appreciate you talking about if you're not trained in
16:35
mental health and more importantly if you don't know the client well there's a
16:40
lot of opportunity to miss if you're not sitting there in that Cadence and that space with them so I I I really think
16:46
it's important that people are looking for an approach where there is a mental health provider perhaps even including
16:52
your own mental health provider in the in the collaboration and the therapeutic experience for that so so I really
16:59
appreciate that so let's talk about some Logistics um we talk about the resources
17:04
how it's administered uh the scheduling what's best practice for how many times
17:10
someone must do this or to have the best outcomes can you talk a little bit about that yes so yeah some of the logistics
17:19
with cat again camine assisted Psychotherapy um it's important that folks have transportation lined up no
17:26
driving after receiving Pine the day of
17:32
and in terms of um you know other other logistics the
17:40
ideal again is that they're working with their therapist that knows their story
17:45
you know that really does that that knows their history and it's it's
17:50
challenging again when folks don't they don't realize um what they don't know
17:56
and the importance of that um and that it could be doing harm um and so typically the sessions
18:06
are two and a half hours depending two two and a half hours so um it it's a
18:13
Time intensive but it's also shortlived and based on based on the data we have
18:18
big data meta analyses of utilizing re mamine for treating Mental Health Care
18:25
conditions treatment resistant primarily depression um five to six sessions
18:31
within 3 weeks are what the data state
18:36
is is needed in terms of the best outcomes the most robust
18:41
Improvement and also for duration so the length of improvement after that initial
18:48
series of five to six sessions yeah so it's pretty time intensive for someone to commit to two to three times a week
18:55
for two to three weeks to make sure you can get all six of your sessions in um but I I have to say that that has been
19:02
the model here that we're encouraging like when you're ready to fully commit we want to make sure you get the full
19:08
experience the outcomes are so much better in in the research with that and each experience Builds on on the one
19:15
before and so and and every experience is different and I think that's the thing that you can't fully understand
19:21
until you go through it is don't have any expectations because that that's usually part of our desire to control
19:28
things any anyway but just let the process unfold in the most organic natural way that it can and and what
19:34
needs to be addressed will be revealed and it may not be what you hoped it was but I think that it's it's data
19:40
nonetheless and it's important that we have that information clinically as the therapist I want to know what's next
19:46
what's next on our list of things we need to we need to tackle to get you to your most optimal whole you know um
19:54
integrated self and so I I I really appreciate the the six experiences five
20:00
to six experiences in that short amount of time so how if I'm listening to this
20:05
how would I know if I'm a good candidate for KET immune assisted Psychotherapy because it's it's definitely gotten a
20:12
lot of Buzz how would I know if I'm a good candidate and and what things should I look for that's a great
20:19
question in terms of candidacy most of the folks that seek keman assistant
20:25
Psychotherapy have exhausted Trad addal and available treatment options most of the folks that
20:33
I've I've worked with over the years um some of some of whom have even gone through
20:38
ECT so um Electro compulsive therapy which is pretty extreme intense um
20:46
sometimes you know TMS as well transcranial magnetic stimulation of course multiple
20:52
medications and um typically are motivated so also therapy theyve many
20:59
many of whom and are often referred by uh colleagues in you know in mental
21:04
health care here in my community in Tucson and so I think folks who are
21:11
really feeling stuck um who are also motivated as you said it's a it's a time it's a high
21:17
resource um treatment even though it it's you know within two to three weeks
21:22
um but it is requires you know it's a time consuming and resource you know
21:29
consuming approach so I think for folks who again have exhausted uh are feeling
21:35
like they've tried everything and are stuck um also folks so clients who are
21:41
maybe um participating in EMDR or internal family systems other modalities
21:47
and are becoming activated too activated and again that that stuckness piece
21:54
right they're not able to um progress or maybe they've plateaued with those modalities tend to be good
22:02
candidates right that's that's great to know you know I am excited because there
22:07
are some long-term clients that I've had who have chronic PTSD who have put in so
22:14
much effort some people I even see you know once or twice a week you know for 90 minutes or two hours they are
22:20
invested and we are working we are not messing around in here and so I'm so excited that they now have an
22:26
opportunity that can help them to accelerate this process because they are working so
22:31
hard and I love that we have an opportunity to help them a little bit more expeditiously and help people come
22:37
to us a more uh whole sense of self and um you know I've seen it be really
22:44
effective now with people that are really hyperaroused or hypervigilant or
22:49
really um anxious and and and uh whatnot and I've also seen it be so effective
22:54
with people in a really hypo aroused state where they're blunted and it's hard to get access to affective arousal
23:01
and they're they're just flat and they feel you know sort of Les a fair about everything they can't access super sad
23:08
but they also can't access joy and Elation and so they're just living in that gray area with the emotional Human
23:15
Experience being so blunted and so I love the opportunity for people to open up that full array of you know the
23:22
rainbow of emotions that are part of the human experience it's so exciting for me to help people in this way now like I
23:29
said expedite their their work so I you know and I would also say that people
23:35
who have had other mental health conditions but uh and maybe they have the resources to do this and maybe they
23:42
haven't been at it for quite so long but they just don't want to be at it for five years you know six years seven
23:47
years working on it would you recommend that some of these more complex people could start it a little bit earlier that
23:54
they don't have to wait till they feel stuck or plateaued
23:59
yes I you know I think it's absolutely I think that this can be helpful for for
24:05
many many folks um you know at different points on their healing
24:11
Journey at different places so I I certainly you know wouldn't uh negate
24:17
working with folks or discouraging folks who are maybe um you know earlier just
24:24
starting in their their healing Journey um ideally they've you know they've at least Tri a couple
24:31
of um of options and part of that is is operating just within our our system
24:36
because it is off label use right utilizing ketamine So when you say a
24:41
couple of other options like they've tried other medications and they're not finding reprieve from their symptoms with other medications so now a a
24:47
medical prescriber can justify this for our use is what you're saying that's right that's the ideal yes
24:55
okay great so I want to go do this how do I find a a Academy and assisted
25:01
psychotherapist that meets some of the criteria we talked about in today's show yes so certainly certainly a Google
25:09
search is an option I also I have a directory of clinicians both uh
25:17
psychotherapists and prescribers on uh my website which is uh trip t rip ppaz
25:24
z.org and there's a directory Tab and so there's a list of of uh clinicians who
25:31
have gone through my 4-day training um predominantly in Arizona but also across
25:38
across the US so for folks tuning in from other places or perhaps with extended family or friends that might
25:45
benefit from care there are clinicians on on the directory as well that uh reside and are licensed in other states
25:51
in the US awesome I really appreciate that and and you know if they weren't
25:57
trained by you are there other trainings that you know are doing a decent job making sure that people understand the
26:03
full uh the full package the the relationship the set and setting the
26:09
Attunement that's needed the space the logistics the sound you know I mean
26:15
there are places that are doing this and maybe they have four of the five components but there's freeway traffic
26:20
right outside the window you know that's pretty it's pretty frustrating do you have a list of questions or some things
26:27
you might want to share with with someone calling and and trying to interview to find out if they're um if
26:34
they're qualified in a way so just in case they don't have someone that has been trained by you in their area we we
26:40
touched on it earlier in terms of psychedelic assisted Psychotherapy so ideally folks that have gone through
26:46
special trainings or you know certification programs that are applying these principles around set and setting
26:53
the music you know being having a witness of the spaceold fer and there
26:59
are there are some very reputable other you know organizations that train certainly you know I trained
27:06
with the camine training center which is based in the Bay Area in California and um you know they're a
27:15
phenomenal group of of uh Mental Health Care clinicians um you know in the Berkeley
27:22
area um there is the Korea institute and
27:27
um again very seasoned Mental Health Care clinicians and uh they've they've
27:33
trained a lot of folks a lot of a lot of license providers as well prati is based
27:39
in Colorado and so clinicians that have trained through through uh pry P
27:47
ATI I I would also um certainly trust their their skill set based on uh the
27:54
folks that are running that program and then um Polaris as well which is also in
28:00
the Bay Area um is another train and we'll go ahead and put a list of those in the description below for you guys to
28:07
to refer to later I I appreciate that and you know just like all modality is I think another important question to ask
28:14
is you know do you do your own work I think that's a fair question if you if you have a therapist that says uh that's
28:21
too personal or I don't know that that's an appropriate you know question to ask I think that's a good sign it's a good
28:28
sign that says you know what if we're not practicing what we preach and we don't have some of our own personal experience in these
28:34
areas I think that it's a little bit of a disservice to a client and of course that's not a requirement but I do think
28:40
that it's just a good thing to keep in mind you know we really ought to be doing trainings that offer experiential
28:48
uh sides of things and a lot of trainings do offer that because then we really know what we're asking of our
28:54
clients and we are so much better able to be attuned and comp passionate and loving and I think that's such a huge
29:03
part that is acts as a catalyst in this experience because feeling felt feeling
29:10
seen feeling held in ways that NE weren't necessarily true at the times of our traumas are are really a major
29:19
factor I think in the healing process yes I couldn't agree more Kelly
29:24
I really couldn't and you're you know to your point about people you know stuck in like the
29:31
sympathetic nervous system responses I I I think what's happening is we are we're
29:36
calling you know this freeze or shutdown response you know treatment resistant
29:42
depression because there is overlap and certainly they can co-occur right however I think it's being I think it's
29:49
being mislabeled and so um I you know I think it's important that people do know
29:56
firsthand what but you know what they're what they're doing and also that they're
30:02
on their own healing Journey because many of us as you know called to this work we're wounded healers for sure
30:08
right you know what's important is that we are we are healing wounded healers
30:14
right and I say healing intentionally right because it's ongoing and I agree I
30:19
I tell my clients we're not done because we're not dead there is always work to
30:24
be found and in healing and growth to to to pursue and we can do that in so many
30:31
different ways but this is really exciting to become part of our potential treatment re regimen for the people that
30:38
are ready to do the work that have suffered from depression anxiety PTSD chronic PTSD and I love that that's the
30:45
body of research you've added to your to the mix because it's such a beautiful um
30:51
it's such a beautiful additional option for people it really is and isn't it a
30:56
privilege Kelly to be able to bear witness to this yes it it really truly
31:03
is and that that quiet space of resonance that is afforded to us as
31:09
providers is um so powerful I mean I can even remember a few times that I've been
31:15
doing this and I'll have just this overwhelming whelming sense to just like send love in a moment because I don't
31:22
know exactly what's happening if they're not currently reporting and just having this overwhelming sense like love is
31:28
what's needed right here and right now and just allowing myself to just share that you know not with touch not with
31:34
words but just this resonance in holding this space and I think um I think it matters it really
31:42
matters I couldn't agree more yeah you it really it's it's beautiful and again
31:47
it's such a it's such a humbling experience as a as a provider well Jen
31:53
is there anything else you'd like to add before we we call it a day with this topic um in terms of if there are
32:00
clinicians listening that are interested in training I've just added some more dates again to the website they can find
32:06
those on uh the the trip a TPP a.org website so I've added some training
32:12
dates uh for the second half of 2024 this year and um yeah so thank you so
32:20
much for having about the training experience with you uh truly a badass
32:26
Medicine Woman and such a gifted teacher and practitioner and I'm so grateful to
32:32
have had you here today I think that people deserve healing and you are really a messenger of that healing so
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that we can all become better treatment providers and and and do do so conscientiously so thank you again for
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your gifts and your willingness to be here with us today I I can't thank you enough and um and I look forward to
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further conversations with you on this this topic this emerging topic as other medic medin become available uh and and
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FDA approved so thank you again Jennifer monjoy for being here uh we'll leave the
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links below and the resources that we've provided today but until then I hope
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that you all lead with love it'll never steer you wrong
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[Music]
#Mental Health
#Depression
#Drug & Alcohol Treatment
#Counseling Services
#Recreational Drugs