0:06
hi everyone I'm Kelly O'Horo and this is
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Adaptable Behavior Explained hi
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everybody thank you so much for tuning
0:14
in today to Adaptable i'm Kelly O'Horo
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your host and I'm so excited to have you
0:18
here for a topic that's got a lot of
0:21
buzz in the mental health field right
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now and that's the subject of ketamine
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assisted psychotherapy i have with me a
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friend and colleague Dr dr eddie Shaaz
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who I worked with for seven and a half
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years she worked at Infinite Healing and
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Wellness with me and continued on her
0:37
own to to go do her own thing now and
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I'm so excited to have you here today so
0:42
thank you for being here tell us a
0:43
little bit about yourself so I'm Dr
0:45
eddie i'm a psychiatric nurse
0:47
practitioner and I focus on integrative
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care and holistic care awesome and if
0:53
you want to learn more about that we
0:55
have another episode that was back in
0:57
the deck before this one dropped so
0:59
check that one out for more on Dr eddie
1:01
and integrative healthcare and a whole
1:03
slew of great uh nuggets of information
1:05
related to psychotropics and mental
1:07
healthcare so but today we're going to
1:08
zero in on ketamine assisted
1:10
psychotherapy and so tell me a little
1:12
bit about your history and what made you
1:15
decide you wanted to go get trained to
1:16
be a prescriber in this arena well I
1:19
think that the research is robust and I
1:22
was having clients come in to see me
1:24
that had already had an experience with
1:26
ketamine and they were showing such
1:30
improvement with their anxiety levels
1:32
improved sleep decreased emotional
1:36
reactivity and so that really got me
1:39
interested in what does it really look
1:41
like what does it do to your brain and
1:43
and how can I help more clients kind of
1:45
reach their best self right it's funny i
1:48
Infinite Healing and Wellness was late
1:50
to the game on this and I was really
1:52
phobic i didn't want to jump in and be
1:54
you know like too fast on this bandwagon
1:57
because I've always been kind of a
1:59
thinker of you know you can't put a
2:01
band-aid on a broken ankle you've got to
2:03
do the heavy lifting and do the hard
2:04
work to get to healing and wholeness and
2:06
I'm also not a fan of like popping on a
2:09
quick fix because I think that that's
2:10
one of the main problems in our culture
2:12
and country in general is like everybody
2:14
doesn't want to do the hard thing to get
2:16
to the good place right and and so I was
2:19
really reluctant to go and research and
2:22
I think about six years into its
2:24
popularity increasing I was like I've
2:27
got to figure this out because I'm
2:28
seeing the changes and the the research
2:30
cannot be denied right and so I I went
2:32
ahead and went and got trained and talk
2:34
about humbling experience in like I
2:37
thought I understood helping you know
2:39
trauma work and then I learned this and
2:41
is neurogenic the right word for it like
2:43
the pathways that develop so quickly
2:45
right and I think that's the wonderful
2:47
thing about ketamine is that you were
2:49
saying you know it's we have to do the
2:51
hard work and yet when clients are using
2:54
ketamine as a tool in their integration
2:57
process and their just processing their
3:00
trauma it actually really helps them
3:03
process this in a way where it's more
3:05
comfortable well I don't know how to
3:06
explain that but so it's an anxolytic
3:10
and so you know when you think about the
3:13
benefit of ketamine assisted
3:14
psychotherapy because it's an anxolytic
3:16
clients will at the onset of doing this
3:19
kind of treatment they tend to be
3:20
anxious but because of the anxolytic
3:23
properties they are not anxious while
3:24
doing the experience which I think is so
3:27
wonderful and I think that's one of the
3:29
benefits that you likely have seen so
3:31
much of too but the other piece that I
3:33
think has been so beautiful and I'm I'm
3:35
sure you could attest to that too is the
3:38
defenses that are part of the right you
3:41
know the makeup of our trauma work and
3:43
our walls and our protectors from like
3:46
IFS language our managers you know all
3:49
of these things that get in the way and
3:50
keep us maybe too intellectual in our
3:52
trauma work or whatever else it sets
3:54
that default mode down it's a good way
3:56
to put it i think we could say something
3:58
like it helps decrease the rigidity with
4:02
the patterns and processes that you know
4:05
are associated with those feelings and
4:07
emotions and that are associated with
4:10
that trauma right and so when you think
4:12
about all the work people want to do
4:14
I've experienced you know their head
4:17
gets it right their head is there
4:19
they're like I've done all this EMDR
4:21
with you Kelly you know we've been at
4:22
this for a long time i just want my body
4:25
to be freaking caught up with what my
4:27
head knows to be true and we're doing
4:28
all of this you know integrative work
4:30
with IFS and parts work related to and
4:33
sematic experiencing and things like
4:35
that in conjunction with my EMDR
4:37
approach and getting them in to do
4:40
ketamine assisted psychotherapy it just
4:42
softens all those walls and people fly
4:45
through their EMDR work right you know
4:47
if they've done a lot of the pre-work
4:48
for sure what's been your experience
4:50
with patients who maybe didn't do a lot
4:53
of you know I think it can happen both
4:55
ways people want to at the onset do
4:57
ketamine assisted psychotherapy and then
4:59
do more of the EMDR work or in my
5:02
experience my clients have mostly done a
5:04
lot of EMDR first and then have done
5:06
some ketamine assisted psycho
5:08
psychotherapy after that what would you
5:10
say would be pros and cons to either
5:12
approach so I think the approach that I
5:14
like best and the approach that I think
5:16
has the best outcomes it's for clients
5:19
that have already gone through a lot of
5:21
the processing and have a lot of
5:22
experience with EMDR uh sematic work or
5:27
just building the skills that they need
5:29
in general right um so when they're not
5:32
just jumping into ketamine and expecting
5:34
it all to just happen naturally you know
5:37
that's when we're seeing most of those
5:40
really robust responses where clients
5:42
are just feeling better in general you
5:44
know they're able to titrate down on
5:46
medication they're sleeping better
5:48
they're they're just in a better place
5:50
emotionally yeah I would I would say
5:53
that I I totally agree with that it's
5:55
almost like if they have an
5:56
understanding of their internal
5:58
landscape how they work why they work
6:00
the way they work a bit about their
6:02
history and why they respond the way
6:04
that they do in certain experiences with
6:07
you know with with environmental
6:08
triggers and their and how they show up
6:11
and they have such an acute awareness or
6:14
an astute awareness might be a better
6:16
way to say it of what's happening and
6:18
then they can drop in in their ketamine
6:20
experiences with you know a specific set
6:23
setting intention and be able to really
6:26
lean in in such a more vulnerable way i
6:29
I've seen such beautiful outcomes and as
6:32
a therapist you know I think what's been
6:34
really cool is dropping expectations and
6:37
really having to model that for a client
6:39
when they have all of these desires of
6:41
of what they want it to look like and
6:44
every time is different with every
6:45
patient is different like there's no I I
6:47
I really got nothing for you when they
6:49
go "What do you think's going to
6:50
happen?" I can go "I can tell you what
6:51
happened for me." Yeah you know I went
6:52
through the whole six series done a
6:54
couple of touch-ups and I I can tell you
6:56
what that was like but everybody in our
6:58
cohort and there were eight of us had a
7:00
different experience every single time
7:03
and so it's not predictable which is
7:04
maybe part of what we want to look at is
7:06
like it's okay to not need to know
7:08
exactly yeah i agree with that and I
7:10
think if clients have a background with
7:12
IFS work right that really helps them
7:15
understand the process and really helps
7:18
with the integration piece right you
7:19
know just for for those of you who
7:20
aren't familiar with IFS that stands for
7:23
internal family systems it's an approach
7:25
a theory of an approach it's not of of
7:28
pathology like of structural
7:29
dissociation or what have you but it's a
7:31
theory on how we can approach parts of
7:34
self where we have developed adaptations
7:36
that are not serving us and they're
7:38
defensive in nature and they're really
7:40
meant to be temporary at the time of the
7:42
events or the experiences or navigating
7:45
our familial experiences that are
7:47
perceived as dangerous and we adapt so
7:50
that we can navigate these situations
7:52
and then we bring those adaptations into
7:54
our current life experiences and often
7:56
times those things are in the way like
7:58
you know getting too angry or shutting
8:00
down and getting too small or being
8:02
frenetically anxious in the absence of
8:04
someone in a more preoccupied anxious
8:06
attach attachment way so with IFS we
8:08
address the internal workings and so I
8:10
think you're right the knowledge of
8:13
what's going on me in me as a client
8:15
gives me a lot more insight as to what I
8:17
would like to address
8:19
process of so talk to us about some
8:21
maybe even thinking of a case example
8:23
where you were like night and day from
8:25
the work you had done you knew they were
8:26
doing work with an EMDR therapist and
8:28
then you saw you know a pretty specific
8:31
or out you know outstanding change can
8:33
you talk about a client yeah so I'm
8:35
thinking of one particular client who
8:37
for years and years has just had the
8:40
worst sleep regardless of you know
8:42
medication that they've been on whether
8:44
that's benzo or hypnotics or
8:47
anti-depressants anti-anxiety meds um
8:50
has been through a plethora of therapy
8:53
EMDR processing um pretty significant
8:56
trauma history and sleep has always been
8:58
the biggest challenge so for a very long
9:01
time she kind of resisted you know
9:03
whether or not ketamine was the right
9:05
thing feeling very anxious about you
9:08
know the dissociation that could occur
9:10
and what that would look like for her
9:12
it's a dissociative so that's that's
9:13
happening yes um so once she went
9:16
through the full six sessions she has
9:19
actually um gotten off of most of her
9:22
medication the most important thing
9:24
she's gotten off of her sleep meds so
9:26
right now we're just doing supportive
9:27
care and she's doing wonderful and she's
9:30
able to shut her brain off at night
9:32
she's able to sleep through the night
9:34
and she doesn't have you know that fight
9:37
or flight right is just it's turned off
9:40
a little bit she's able to sit within
9:44
herself and you know when triggers come
9:46
up she's able to identify what it is
9:48
that's bothering her and not ruminate
9:51
about it right before she sleeps right
9:52
there's more space between that stimulus
9:54
and her response so that she can kind of
9:56
attest to the truth of her current
9:58
reality right right so awesome you know
10:00
I think that it got a lot of buzz
10:02
because my experience has been you know
10:04
the the big uh the big push for ketamine
10:07
assisted psychotherapy started with
10:09
ketamine clinics that are primarily run
10:11
by anesthesiologists and so they don't
10:13
have any mental health training
10:14
background integrative work with trauma
10:16
like yeah they know how to administer a
10:18
medication but they don't understand
10:20
that like um a lot of this trauma
10:22
happened in the absence of a caregiver
10:24
that was supportive or safe and so if
10:26
they're going into an associative state
10:28
in a dark room by themselves that's
10:30
terrifying and so I became interested in
10:33
becoming trained primarily because we
10:35
were kind of cleaning up the mess of
10:36
people who had gone that route desperate
10:39
for help desperate for support and at
10:41
the same time you know they got the
10:43
autonomic nervous system reset but they
10:46
were kind of additionally traumatized by
10:48
the experience because they felt alone
10:50
and sometimes you feel a little
10:52
untethered in that experience and I mean
10:54
it's so beautiful to be able to put your
10:55
hand out and have someone who's a
10:57
grounding element of safety and trust
10:59
and support with you in that experience
11:01
so maybe talk to us a little bit about
11:03
any clients you've had that have gone
11:05
either route and what their experiences
11:07
have been so similarly I've had clients
11:09
that have gone gone through like the
11:12
intravenous ketamine process right and
11:15
both that were you know um suicidal at
11:18
the time depressed or having really
11:21
significant trauma responses and their
11:24
experience has been completely different
11:27
you know doing the intravenous versus
11:29
doing like the oral or the intramuscular
11:32
route with a therapist actually going
11:35
through the reintegration process
11:37
whereas when they did the intravenous
11:40
route it was exactly what you said they
11:42
went in there they did the treatment and
11:45
that was it there was no no followup to
11:47
that and so they weren't able to process
11:50
what they experienced and those memories
11:52
and feelings and emotions they just kind
11:54
of sat with those and that's not really
11:56
beneficial yeah and we we're not
11:58
bringing like you know heart to mind and
12:00
connecting the body to the mind and I
12:02
and the other thing I love about it is I
12:04
I really believe in the triad of healing
12:06
you know it's mental it's physical it's
12:08
spiritual and I think the part of this
12:10
this that gives us access to this other
12:13
dimension of imagination and you know
12:16
elements of the experience that that as
12:18
a therapist I don't I would never even
12:21
consider saying and also how dare I
12:23
because who am I to say what your
12:25
spiritual you know travel should look
12:27
like and so for the fact that this gives
12:29
us access to like that inner self in a
12:31
way that just talk therapy or bottomup
12:34
therapies just don't give us access to
12:36
me has been so beautiful and and I know
12:39
that in my own experience um and I'll
12:41
share a little bit about it i um one of
12:44
my sessions I was I was trying to figure
12:46
out it was actually input from one of my
12:47
sons he says "Mom you come in too hot
12:50
you've got all these opinions about what
12:51
it is you think I need to be doing and
12:53
what I make up about it is you don't
12:55
trust me that I'll figure it out or if I
12:57
do mess up that I'll be able to be
12:58
resilient enough to figure it out and I
12:59
was like whoa that's a hard message as a
13:01
mom to hear and he's so right and so I I
13:04
you know he told me that in between our
13:06
first and our second experience and I
13:07
went in and I was like I need to explore
13:09
this because the last thing that I want
13:11
is for someone that I love to feel
13:14
reluctant to come to me about things
13:16
because the because of the way that I
13:18
you know in a way make it about me
13:19
because I'm anxious that he's going to
13:21
have a hard thing and I try to insert my
13:24
opinion and I don't stay in my lane and
13:26
all of those things and so I went in and
13:27
I was like what is the part of me that
13:29
does that and what is that about and you
13:31
know I had the most wild and beautiful
13:33
experience and that I turned into a lion
13:37
and he turned into a lion and all of the
13:40
lions of my family with their normal
13:42
faces and then like lion manes and I
13:44
mean it's so you know you can't make
13:45
this up and I have no affinity towards
13:47
you know wild cats but it just happened
13:49
and I think that's because my intuitive
13:51
self needed to see what a strong
13:53
powerful mother looked like that doesn't
13:56
need to go micromanage every moment and
13:59
to see that in the state of a of a
14:01
lioness I was like "Oh she's a badass
14:04
she is in charge but she lets them have
14:06
their moments." Like they fall down and
14:08
she's kind of like smack you know but
14:10
it's just it was beautiful because just
14:12
being able to internalize that that was
14:14
a total spiritual experience for me and
14:16
you know not that I'm a lioness but it
14:18
gave me a really physical real world
14:20
example of what it is I would like to
14:22
try to embody when interfacing and with
14:25
people that I love and
14:27
no no talk therapist or no EMDR therapy
14:30
session was going to turn me into a lion
14:32
you know so anyway I think that that
14:35
spiritual component has been so
14:37
important that definitely resonates with
14:38
me i mean my experience was motherhood
14:41
and grief and so my experience was
14:43
beautiful as well just kind of coming to
14:46
a point or just this moment in time when
14:50
I did my own treatment that you know I
14:52
was worthy of being a mother i can be a
14:54
good mother i can be in you know still
14:57
have this motherly presence and still do
15:01
all the other things that I want to do
15:03
and need to do so yeah there's such a
15:05
just even in the thing in motherhood
15:06
interestingly that both of our you know
15:08
intentions were around motherhood and I
15:10
think that just as business women who
15:13
have positions of power who are are
15:16
strong in our own right and then the
15:17
softening that is really best when it
15:19
comes to being a good mother and like
15:21
that nurturing side there's a lot to
15:23
balance in that absolutely and a lot to
15:25
question in ourselves so I'm so glad for
15:28
you that you were able to kind of maybe
15:29
pull from more that grounded self-
15:31
energy that confidence that exists in
15:34
you but that you were able to harness in
15:35
a better way that's awesome that's
15:37
wonderful that's so beautiful so
15:39
anything you'd caution about people
15:41
seeking this kind of treatment or rule
15:43
out so that people can kind of determine
15:45
if this might be a fit for them right so
15:48
clients who have a history like cardiac
15:51
illness can sometimes be a red flag and
15:53
that varies from person to person
15:55
actively high blood pressure is a big no
15:57
no so if you're seeking you know to do
16:00
that in the future having your blood
16:02
pressure under control is really really
16:04
important and that means with medication
16:06
it's okay if it's medication right it's
16:09
okay if it's medication managed and
16:11
there are some safeguards that you know
16:12
are taken like taking your blood
16:14
pressure before treatment and making
16:16
sure that you're not above a certain
16:17
number so that you can do that safely
16:20
and also any clients have a history of
16:22
psychosis so it doesn't mean that you
16:25
cannot do it it just means that during
16:28
your ketamine treatment you would have
16:30
to be on like a mood
16:32
stabilizer to help you stabilize your
16:35
mood while you're going through that
16:36
treatment oh that's good to know i
16:38
hadn't heard that part of things so
16:40
that's great well I you know is there
16:42
anything else we need to make sure our
16:44
audience knows is related to this topic
16:46
i've got two other episodes about this
16:48
so please if you're interested and
16:50
you're really doing your research check
16:51
those out but what are is there anything
16:53
else we need to make sure we share with
16:55
them i think um just you know most
16:59
clients when they go through it they say
17:01
it's it really is a mental reset you
17:04
know and I think that piggybacking off
17:06
of that it's really that glutamate surge
17:09
that occurs that basically promotes
17:12
and so when we're going through therapy
17:14
for those of us that have you know a
17:17
trauma trauma background or whatever the
17:20
case may be you can process it to a
17:22
certain degree and but our brain doesn't
17:25
I mean It does change i don't want to
17:26
say it doesn't because with EMDR it does
17:28
change it definitely changes but it it
17:32
occurs at a faster rate you know with
17:35
ketamine and so I think that's wonderful
17:38
knowing that you can go into something
17:40
and that there's actually the
17:41
neuroplasticity occurs as you're going
17:44
through it and and it can really just be
17:46
a reset for your life and everything
17:49
awesome i I I can't say enough about it
17:51
with clients and I know that there has
17:52
to be predicating factors to like you
17:55
know encourage a client to go through
17:56
this kind of treatment for it to be
17:58
prescribed and for a prescriber to
17:59
ethically be able to do so but I got to
18:02
say that if not for those red tape
18:04
moments I really think anyone who has
18:06
the resources and the time who can who's
18:08
had any sort of trauma like what a
18:10
beautiful avenue to go to be able to
18:12
kind of see that side of things from
18:14
that deeply spiritual internal
18:15
perspective that we just can't get
18:17
access to very easily easily and and
18:19
it's so robust and so powerful so agreed
18:22
yeah well thank you so much for being
18:24
here i love talking with you i feel like
18:26
we could do a whole other show on just
18:27
our our experiences and what that was
18:30
like to give people an opportunity i
18:32
appreciate you inviting me and I'm happy
18:34
to be here i'm so happy to have you
18:36
thank you so hopefully that gave you
18:38
guys some good nuggets to take back to
18:40
your research board related to your
18:42
potential getting uh psychotherapy via
18:45
ketamine assisted psychotherapy like I
18:47
said I had two other episodes that we
18:49
did related to this topic so please feel
18:51
free to check out my channel Adaptable
18:53
Behavior Explained and do your research
18:56
and and hopefully you'll find someone
18:57
that is doing the work with you as
18:59
opposed to um separate integration at a
19:02
later date i I find that a much more
19:04
powerful experience if you have the
19:05
ability to do that so thank you so much
19:08
for tuning in today until we meet again
19:11
don't forget to lead with love it'll
19:13
never steer you wrong