Dr. Sara Lewis – Psychedelic Assisted Therapy

The newest episode of our university podcast, ‘Mindful U at Naropa University,’ is out on iTunesStitcher, Fireside, and Spotify now! We are excited to announce this week’s episode features special guest Sara Lewis, join Dr. Sara Lewis, Associate Professor and Chair of the Contemplative Psychotherapy and Buddhist Psychology  to discuss psychedelics and therapy in an academic setting with an interdisciplinary approach. ’

play-icon Dr. Sara Lewis – Psychedelic Assisted Therapy

“But it’s 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, people who have had suicide attempts.

So the fact that the FDA has given MDMA and psilocybin, it’s now been demarcated with a status called breakthrough — 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 the results are so promising.”

About Sara Lewis, PhD, LSW

Faculty Co-Director

Dr. Sara Lewis is the Associate Professor and Chair of Contemplative Psychotherapy and Buddhist Psychology at Naropa University. She earned her PhD from Columbia University and two master’s degrees from the University of Chicago, specializing in psychological anthropology, global mental health, and clinical social work. She is the author of “Spacious Minds: Trauma and Resilience in Tibetan Buddhism,” (Cornell University Press, 2019) which explores how Buddhist concepts of mind, memory, and emotion shape responses to trauma in the Tibetan diaspora. She is a former Fulbright fellow, and her work has been supported by the Mind and Life Institute, and the Mellon Foundation. She is also a psychotherapist in private practice and has conducted research on how psychedelics can be a catalyst for change in therapeutic settings.

Full transcript

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. I’m your host, David Devine. And it’s a pleasure to welcome you. Joining the best of Eastern and Western educational traditions — 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 master’s 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 it’s an honor to have you on the podcast. So welcome.

Dr. Sara Lewis:
Thank you so much, David. I’m excited for our conversation.

[00:01:21.17] Erica:
Me too. So, I would also just like to add that I’m very excited to discuss psychedelics and therapy in an academic setting. This is a topic that I’ve been very passionate about and have done my own research and my own practice within. I’m 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, I’d 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, I’ve 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 I’ve 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 — 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 that’s probably how I ended up here.

DAVID:
All right. Yeah, I love the idea of having an interdisciplinary approach to what you’re doing. And it seems as though you necessarily didn’t 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 — the psychedelic part of it. Because it sounds like you’re 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 we’re looking to integrate into your interdisciplinary approach?

Dr. Sara Lewis:
Yeah, it’s a good question. I mean, it was definitely the focus of my master’s degree. And then, you know, I think psychedelics were just sort of a personal interest — 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 there’s 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 don’t 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 it’s 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 — program would have happened, if we weren’t so radical?

Dr. Sara Lewis:
I don’t 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 that’s so illegal.

Dr. Sara Lewis:
I don’t think so. I mean, a lot of the more, you know, obviously, research based universities, you know, there’s a lot happening, you know, in terms of research and clinical trials, and — which is amazing, you know, I think it’s 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 — we are really deeply interested in the training of psycho therapists and chaplains, you know, it’s 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, it’s so exciting what’s happening. And of course, they’re — they’re 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 it’s very important that you know, what you’re doing and or are with somebody who knows what they’re doing. So being trained is kind of essential in such a setting. So we’re 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 — what they’re learning?

Dr. Sara Lewis:
Yeah, so this is a training program that we are launching in March 2022. And we’ll 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, we’re really in a way bound by the collaboration that we’re doing with MAPS, the multidisciplinary Association for psychedelic studies, because we’re offering the MDMA assisted therapy is protocol embedded in the training. And so this is, you know, a protocol and training that’s really an approved method in terms of the collaboration with — 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 they’re 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 — it is kind of like a master’s program certificate, you could say it’s 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 — 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 master’s 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 it’s 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 it’s good to, you know, kind of acknowledge that this is more advanced work, you know, so it’s not really that we’re 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 — 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 what’s next for them in their training path.

DAVID:
Yeah, and I think that’s 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 — yeah, people are you know, still at the — the grad level, there’s 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 there’s, you know, if you’re someone who’s interested in psychedelics of any kind, I think it’s an awesome time to be at Naropa.

DAVID:
Yeah, very cool. Okay, here’s an interesting question. What type of classes could a student expect while taking this course? Like, do you have any class titles or —

Dr. Sara Lewis:
Yeah —

DAVID:
Like, today, kids, we’re 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 — a non ordinary state of reality. So there’s different options.

DAVID:
Pretty vague. You know, it’s 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 you’re actually giving to people. So MAPS has been allowed now by the FDA to give MDMA to trainees, but it’s a small number. So that’s where we’d like to get where — where we actually will be able to kind of have trainees have their own experiences of the medicine. Before that’s really legal, we have some other options. So either doing holotropic breathwork, participating and ketamine assisted therapy, which is already legal. There’s 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 there’s like a waiting limit. And it’s like, totally weed friendly. I’ve been to Amsterdam a couple times for such endeavors. But I’m curious, like, is there anything else?

Dr. Sara Lewis:
Yeah, so we’re 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 you’ve been on trainings that have, like 150 people, which is the amount of trainees we’re looking at, you know, it’s great, but then it’s really important for people to be able to kind of discuss what’s 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 we’re getting into? I am more and more really getting interested in somatic therapy and somatic work. So that’ll 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 that’s shaping this program. So there’s 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 you’re someone who’s really interested and ready, you know, to really understand your own positionality, your own social locations, and why that’s 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 — look it up, you’re gonna know. You’re 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 don’t know, this seems fairly new. And when did these two things begin collaborating for mental health and physical health? Because, you know, we’ve had therapy for a very long time, but now we’re starting to shift towards this, like assisted psychedelic therapy. So when — 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 — 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. It’s 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, it’s no accident to me that this is arising at the same moment as the climate change crisis. So maybe you’ll have the opportunity, David, to talk to Travis about some of his ideas of like, why now, you know, and it’s like, a lot of people are like, oh, I read Michael Pollan’s book. And now I’m curious, but you know, there’s 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 it’s some therapies work, some therapies don’t. And the thing is, is a dissolving of ego is really important to see what’s really happening. And sometimes it’s very painful to do that. But if you’re in a therapy setting, it’s 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 you’ll — you’ll come out of it, a completely different person. I think it’s scary to some people, but other people were like, okay, it’s 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, that’s 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 it’s 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, it’s now been demarcated with a status called breakthrough — 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 that’s 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 it’s actually really important that we kind of expedite this process so that more and more people can be helped. So you know, I think it’s always good to sort of keep that — keep that in mind, like moment to moment, like, what is our motivation for doing this, and it is exciting to work in psychedelics, it’s creative, it’s 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 doesn’t lie.

Dr. Sara Lewis:
Yeah.

DAVID:
I think that’s what’s the most important is how you’re saying is some people have tried it all. And then they try the thing that is mostly taboo. And there it is, there’s potential there. So it’s 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, I’m a trained psychotherapist, but I’m also an anthropologist, as we talked about. So it’s like, on the one hand, I’m participating myself in the practice of psychotherapy, and at the same time, I see it as just one pathway. I mean, there’s 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 that’s what we consider to be like, most helpful. Right, in many other cultures across the globe, that’s 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 what’s therapeutic, you know, I think of as a little bit broader. At the same time, I think, we can look at — and I look at psychotherapy as a skillful means, but I don’t 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 they’re 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 there’s 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 we’re in a container and a context where actually it’s not safe to let go, that’s intelligent. Right? So if we’re at a festival or a concert, and you know, we don’t know who’s coming into our space, we don’t know are we using something that’s 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 — the police might be scrutinizing you more than others. That’s not a safe context where it’s 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 there’s been many experiences that I’ve had where I’m at a festival in which things are going on and you kind of look around, you’re like, this might be a little unsafe here, you know? Yeah, I totally feel that. So, you know, we’re 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 — they think of like something that is harmful, you know, and we’re talking about drugs, psychedelics, in a healing modality. Some psychedelics are harmful and some aren’t and how do we define the difference between drugs and psychedelics?

Dr. Sara Lewis:
Well, psychedelics are drugs as you’re 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 Pollan’s 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, that’s 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 — what we kind of impute — 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 it’s the right time for them to begin using psychedelics. So that’s — 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 isn’t a joke. This is some real stuff. And what’s interesting from you is I’m hearing this community narrative, community definition of what drugs — 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 — within our brains at all times. And I don’t know, I’m feeling like there’s this a social change of the definition of how we define drugs, because there — 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 there’s 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 SSRI’s, you don’t 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 — 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, aren’t you just substituting ketamine for Prozac? But actually, you know, what — 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 don’t see them as necessarily positive or evil. But it’s like, what’s the context? What’s 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, it’s what we’re kind of imputing that the meaning that we’re 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 I’ve 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 there’s different ways to do it. I mean, so one way is absolutely through scientific data that’s 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 — is huge. I think that’s 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 I’ll say is, I think that for Naropa, and other institutions who are interested in — 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 that’s safe, in a way that maybe is a little bit slower pace than some of us might like, but I think that that’s better to really kind of set the groundwork and create a good and safe container.

DAVID:
Yeah. And of course, there’s going to be risks, there’s pretty much risk in any therapy setting, whether it’s talk therapy, movement —

Dr. Sara Lewis:
Oh, SSRI, I mean, there’s a huge body of data, which shows that there’s 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 there’s already, right, like plenty of risks, as you’re saying out there with conventional therapies.

DAVID:
Can you say what an SSRI is for our audience?

Dr. Sara Lewis:
Yes, it’s a class of drugs that’s used for psychiatric conditions, mostly for depression and anxiety that impacts your serotonin levels.

DAVID:
Okay, so I’m 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 there’s plant medicine, there’s psychedelics in plants, and then there’s psychedelics in scientifically based person made synthetic drugs. And what like — 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 don’t know. I mean, I’m 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 don’t know, there’s probably lots of different, you know, definitions out there. But I love your question, and I’ll 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 Shannon’s 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, I’d say among surprisingly, some of the, you know, greatest psychedelic experiences I’ve 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, it’s 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 there’s some special qualities about those plant medicines and what they access. I think there’s 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, we’re 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 —

DAVID:
Poopoo.

Dr. Sara Lewis:
You know, poopoo.

DAVID:
No, I hear that. So, I just randomly thought of this. So I did — I did watch a documentary about the basis of synthetic versus, you know, plant based medicine and the guy was talking about — was it 5 MEO DMT, or Bufo — 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 you’re not endangering the toads. You’re not hurting the ecosystem. And a lot of people were against it. But ultimately, chemically, it’s 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 don’t know, like, does it — 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 don’t think I’m the only one out there who thinks that but, you know, it’s a good question you’re asking because even you know, looking at psilocybin right now, the trials that are happening are with a synthetic compound, you know, so people aren’t chewing and swallowing mushrooms, they’re taking a pill, and that’s 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 don’t 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 don’t think so. Somehow, I think that the spirit of these medicines are like able to withstand that and are probably fine. It’s probably us who are like, less fine. But I think you know these are all really good questions. I’m sort of, you know, a pragmatic person in a way, I’ve 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 — not a place like Naropa at all! So it’s a little more unusual for me to be now at a place like Naropa, which is already very radical, where there’s like skepticism, you know, about science — 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 there’s 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 couldn’t they be one in the same like, this was part of, you know, what, ketamine kind of schooled me on a little bit. It’s 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 what’s up, and they — they say what needs to be said sometimes, and sometimes it’s not easy to hear. But it’s super important. And I always feel like their message is so simple, but so impactful at the same time. You know, it’s — it’s 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 don’t 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 it’s, 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 — 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 doesn’t mean that that was wrong, or bad or something, you know, negative happened, but it’s 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 — it’s still working, and it’s probably working really well, if something had that big of an impact.

DAVID:
Yeah, and we’re humans, you know, like, we’re gonna take the time that we need, but as long as you’re honest with yourself, take as much time as you need, just be honest. You know, be — be loyal, be honest, be truthful. And then like, move in love.

Dr. Sara Lewis:
Yeah.

DAVID:
Like, don’t fuck around, just — just make good decisions.

Dr. Sara Lewis:
And when you say, loyal, like, I’m 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, it’s okay to not know what’s going on. But loyalty doesn’t 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, there’s, I feel like it’s pretty clear at the same time.

Dr. Sara Lewis:
That’s it!

DAVID:
So I don’t 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 — I call it consulting the council. So I like to ask all the voices in my head, like, what — y’all what do y’all think? Okay, you’re not allowed to sit here anymore. Go away. Okay, oh, that’s 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 — I like to meet in the middle. My actions showcase the meeting in the middle, or what’s more in alignment than the like — the thought I had that’s kind of crazy and angry. I don’t want to act that, you know, because we are not our feelings. We are how we deal with our feelings. You know, that’s 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 it’s a little complicated. So right now, it’s 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 it’s not legal, to be using psychedelics, there are therapists who do underground work, many of us, myself included, you know, don’t want to put our license at risk, you know, so I don’t 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 we’re using today to train. So it’s sort of an interesting situation, in that MDMA and psilocybin are not legal yet. And at the same time, it’s 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 don’t 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, it’s unknown, it’s 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 — 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 hasn’t 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 it’s super interesting because it —

DAVID:
Let’s do it.

Dr. Sara Lewis:
Yeah. It’s not like it’s circumnavigates around FDA exactly. But it’s like a different channel. It’s a different channel of kind of bringing psilocybin into the — into legal use. So it’s 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, we’re paying really close attention to that for the Naropa certificate. It’s 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 we’re paying close attention to how to make it possible in our training for folks to be able to then also use psilocybin when they’re finished with the training.

DAVID:
So what I’m hearing it’s a very new space, and it’s still being worked out. It’s sort of is sort of not legal, and you know, it’s very special. It’s very new. I’m very excited for this whole thing. It feels as though there’s 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 — it’s just to get you there.

Dr. Sara Lewis:
Yeah, and I mean, the clinical trials for MDMA and psilocybin are recruiting participants. So if you’re 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 you’ve been dealing with depression, there’s 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 don’t fall into those categories, ketamine assisted therapy is legal. And that’s 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 it’s 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 it’s 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 there’s also like, many paths to healing like music, art, dance, somatic work, you know, there’s so many avenues. I think psychedelics are just one way or just one path. You know, it’s 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 it’s like, you know, the Buddha talked about, there’s 84,000 different teachings, because there’s just that many different kinds of minds out there. So I wouldn’t do anything to change the mind of the skeptic, I’d say probably, there’s 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 anyone’s interested, please go check out the Naropa psychedelic assisted therapy certificate program, and it’s gonna go in effect when? The —2022?

Dr. Sara Lewis:
March 2022, we will enroll our first cohort of 150 trainees, we will have scholarships — 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 http://www.naropa.edu or follow us on social media for more updates.

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