This Past Weekend with Theo Von - E341 Ketamine Doctor Jason Pooler

00:00:00.000 Today's episode is brought to you by Liquid Death. You know, it's good.

00:00:06.740 What's up, guys? I want to let you know that I will be touring in St. Louis. We've added a show.

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00:00:41.520 So go to the links through Theovan.com slash tour. And thank you for supporting me in my dream.

00:00:47.520 Recently, I've undergone ketamine therapy. And I wanted to speak with someone who is an expert

00:00:55.120 in that field and to learn more about my experience and learn more about the therapy

00:01:00.960 overall. Today's guest is the founder and the medical director at the Chattanooga Ketamine Center.

00:01:07.720 It is Dr. Jason Pooler.

00:01:10.640 Shine that light on me

00:01:14.880 I'll sit and tell you my stories

00:01:20.600 Shine on me

00:01:25.560 And I will find a song

00:01:29.800 I'll be singing just for me

00:01:33.160 Dr. Jason Pooler. Thanks for being in here today, man.

00:01:41.500 Thank you.

00:01:42.360 I appreciate it. And so you're a doctor of...

00:01:47.920 Well, I'm an MD. So I'm a physician.

00:01:53.680 And I'm...

00:01:54.280 And a physician is what? Just a doctor?

00:01:56.240 A medical doctor. Like you go to four years of medical school after college.

00:01:59.500 Okay. It's not like Dr. Dre. That's not a...

00:02:02.520 No, no. It's like the...

00:02:04.920 In the United States, you know, the MD is sort of the...

00:02:08.840 What people think of when they think of physician.

00:02:11.080 Those are, you know, that's the standard process.

00:02:13.920 You go to medical school.

00:02:15.180 Okay.

00:02:15.540 Then you usually do a residency to sort of subspecialize into a different area of training.

00:02:20.840 Okay.

00:02:21.600 And then you go to work.

00:02:24.320 And so these days you're working in a ketamine.

00:02:27.960 How did you get working in a ketamine therapy?

00:02:29.940 And like, where are you at with it right now?

00:02:31.900 Like, are you actually practicing it?

00:02:34.580 Are you running a practice that provides the therapy to people?

00:02:40.040 So both.

00:02:41.520 Okay.

00:02:42.580 I was...

00:02:44.040 It's kind of one of those long routes to get back to where you started.

00:02:49.500 And I originally trained as a general surgeon a long time ago.

00:02:57.600 And then I went into anesthesia and I did that for about a decade.

00:03:01.160 And ketamine therapy sort of became more studied as a result of its use in anesthesia.

00:03:13.000 And because it's an anesthesia medication.

00:03:16.520 But it had some interesting side effects that they looked at over time that they couldn't explain.

00:03:22.120 And that research is what has brought us to ketamine therapy today in the use of treatment resistant depression and other, you know, mental health problems.

00:03:37.260 What exactly is it used to treat the therapy?

00:03:40.540 So you can use it to treat a lot of different things.

00:03:43.400 It depends on what you're doing with it.

00:03:46.180 The way it is used most often is to help people who have had a lot of problems with depression, who have failed a lot of other therapeutic approaches.

00:03:57.940 And so what ketamine offers is a new tool to help people who are still suffering tremendously kind of springboard back onto the road of life.

00:04:14.820 And it's really interesting the way it works.

00:04:21.940 It doesn't work like normal antidepressant medicines.

00:04:24.580 It has nothing in common with them.

00:04:26.040 It's almost a new technology then, I guess, in approaching treating depression.

00:04:33.720 So the easiest way to describe it is why they started studying it to begin with.

00:04:39.640 And that was back almost 20 years ago.

00:04:42.920 Oh, dang.

00:04:43.360 They realized that when they gave ketamine to patients getting operations, they required less narcotic pain medicine during the operation in the hospital and after the hospital stay than other patients.

00:04:59.440 And they said, why is this?

00:05:00.320 This just doesn't, you know, why are they having less pain?

00:05:03.040 They had no explanation.

00:05:04.100 So they looked at it and what they discovered was that what it does is it changes your perception of pain.

00:05:12.200 So you can see something that you've experienced as less painful.

00:05:20.280 Hence, you don't need as much medication to cover your pain.

00:05:25.340 I see.

00:05:25.940 So you're not feeling as much pain because you're not seeing it.

00:05:29.400 You're not seeing the seed of whatever it was as painful.

00:05:32.340 So therefore, like the growth of the pain isn't as severe at that time, the way the best way I like describe it to people is.

00:05:40.380 Yeah, I have two daughters and say we go get flu shots and one daughter gets a flu shot.

00:05:46.480 She's like, oh, and my other daughter, she gets a flu shot and she's like, oh, and her response is much more.

00:05:52.460 OK, we know that the the shot is the same, but the response is different.

00:05:58.880 So one is perceiving something with more distress than the other.

00:06:03.820 And the way ketamine works is it helps your pain sort of shift from that that more visceral response to a more that hurt.

00:06:16.120 But I'm OK response.

00:06:18.180 OK, it's a like it's like changing the lens on how you see pain so that you can see things and you can kind of look at them from a distance and sort of.

00:06:29.760 Go around things that have happened to you and you can kind of connect to yourself from those places.

00:06:36.640 And it's a it's it's it's not spiritual, but it's not far from it.

00:06:42.160 Right. Do you think it gives you like a look at yourself like you kind of see yourself?

00:06:47.580 Whereas a lot of us have a tough time seeing ourselves because we're in ourselves, you know?

00:06:51.580 Exactly. Yes, 100 percent, because it's like if you're on the playing field, you can't really see what's going on.

00:06:59.880 And it sort of puts you up in the stands of your life.

00:07:03.280 That's interesting.

00:07:04.100 And you have a lot of places in your past or a lot of patients that have come to me is, you know, you're living your life and life's hard and people get hurt.

00:07:15.480 And depending on where they are in their life, they sort of package that up and they put it away because they don't want to feel that anymore.

00:07:22.760 But it doesn't really go away.

00:07:25.620 And so those those let's call them firewalls.

00:07:30.920 There are no go places in your brain, but they're still sort of resonating through your existence.

00:07:36.500 So they're shaping typically your relationships and your career.

00:07:43.100 Right.

00:07:43.680 And that's like that that what is that movie Kung Fu Panda?

00:07:50.160 You know, I was thinking of Master Oogway and his we often find our destiny by trying to avoid it.

00:07:58.520 Oh, yeah.

00:07:59.540 Interesting.

00:08:00.320 Yeah, I was thinking of that movie where that boat gets stuck in Boston.

00:08:02.940 I'm talking about where they go fishing.

00:08:04.200 You know, I'm talking about.

00:08:04.880 And there's all the storm.

00:08:07.080 Perfect storm.

00:08:07.680 Oh, yeah.

00:08:08.140 Oh, yeah.

00:08:08.820 Yeah.

00:08:10.500 That didn't have a good ending, though.

00:08:12.780 Yeah, it didn't.

00:08:14.340 But so I see what you're saying.

00:08:16.240 So, yeah, it kind of gives you an experience to step outside of yourself.

00:08:18.740 So were you able to see that whenever you was working in anesthesia?

00:08:21.440 Were you able to see people having that experience?

00:08:24.000 Were you able to visually see that or were you not able to grasp kind of the concept of it of exactly that until I'm guessing later,

00:08:33.100 which we haven't discussed yet until you got into actually experiencing using ketamine?

00:08:39.420 When I was practicing anesthesia, I used it.

00:08:43.680 Because you're that hit man.

00:08:44.420 Anesthesia guy is that hit man that rolls in there.

00:08:46.320 Yeah.

00:08:46.420 That's the guy.

00:08:47.080 A lot of people, some people don't even need.

00:08:49.160 They'll be like, they just want the anesthesia.

00:08:50.980 Some people.

00:08:51.400 I have a buddy who's addicted to inoculations.

00:08:57.900 And he's breaking into Walgreens and doing all the damn whatever it is.

00:09:02.880 The COVID?

00:09:03.960 I don't know if it was COVID.

00:09:05.000 It was before this.

00:09:05.600 So he was just doing flu shots, you know.

00:09:08.500 But that's, you know, people get into certain things, you know.

00:09:13.300 But anyway, I don't even know why I told you that exactly.

00:09:15.340 But what I'm trying to tell you right now is just that, okay, so yeah, so were you able to see stuff whenever you were working as an anesthesiologist?

00:09:23.340 Were you able to see some of that?

00:09:24.560 Or was it more like that you got a stronger idea to work with ketamine, like, and understand it later on?

00:09:31.880 What I noticed was that when we used it, and we didn't use it a lot.

00:09:36.220 I mean, you just give them it as part of anesthesia.

00:09:38.560 They did better.

00:09:40.000 So everything seemed to work better.

00:09:42.360 They just sort of seem more functional.

00:09:44.040 They had what we saw was they just, they felt better.

00:09:49.640 They came out of it better.

00:09:51.520 They got up.

00:09:52.420 They got around.

00:09:53.860 And that was sort of how the ball got rolling on why is this happening?

00:09:57.640 And then, you know, then they started figuring out that, hey, this is actually doing something in the brain for real, not just some accident.

00:10:06.120 And then they started experimenting, not experimenting, but they started, you know, using it in a more of a clinical sense for people who are really struggling.

00:10:14.740 Because before ketamine, really the only thing that they had was ECT, you know, putting electricity through your head.

00:10:22.340 Right.

00:10:22.460 And I have taken care of a lot of patients with that, and they did not like that.

00:10:27.280 And I can see why.

00:10:28.460 So what, did you ever have to do that to people?

00:10:31.120 I did actually.

00:10:32.460 I'm not, not as.

00:10:33.920 I'm not even familiar with that.

00:10:35.220 Yeah.

00:10:35.520 I did it when I was an anesthesia resident about a decade ago.

00:10:40.260 They'd bring us a bunch of patients from the psychiatric hospital and they'd line them up and we put them to sleep and the psychiatrist would shock their heads.

00:10:49.920 And we were like wide eyed and like, is this real?

00:10:53.520 And I guess it helped.

00:10:57.200 So you would put them to sleep first?

00:10:59.200 Yeah.

00:10:59.500 Just very briefly.

00:11:01.080 So you just.

00:11:01.420 With a.

00:11:02.020 Like propofol or something.

00:11:03.140 Okay.

00:11:03.360 So you just, you would just make them unconscious just for a few minutes.

00:11:06.520 And I remember this, this, this psychiatrist, she had like this, had a hair that was like huge and it was like gray and kind of like back to the future style.

00:11:16.860 Yeah.

00:11:17.060 And, and she would, she would put these probes on this guy, on these guys' heads and like, and, and, you know, we're kids and we're just like, okay.

00:11:29.420 Wow.

00:11:29.880 And zap them decently.

00:11:31.080 Oh yeah.

00:11:31.540 Oh yeah.

00:11:31.780 Yeah.

00:11:32.100 Yeah.

00:11:32.300 Cause we had to paralyze them because when you, when you shocked them, they'd be like.

00:11:36.140 And what was supposed to be happening?

00:11:38.100 So my understanding is.

00:11:39.480 Because that seems kind of bootleg, you know.

00:11:40.620 My understanding is it actually helps a lot of people, but it is not readily accessible.

00:11:48.120 So we were doing this in a hospital, in a recovery room with an anesthesia team in sort of the critical care area of the hospital.

00:11:58.120 So that's not something that is accessible to 99% of the population.

00:12:03.300 Right.

00:12:03.720 Any given day.

00:12:04.480 And, and so that's sort of the problem.

00:12:07.340 So, so, so this electroconvulsive therapy, this, uh, in which small electric currents are passed through the brain, triggering a brief seizure, changes in the brain chemistry, quickly reverse symptoms of certain mental health conditions.

00:12:19.940 So this was, this was almost, this was kind of like a ketamine.

00:12:25.000 This is ketamine is kind of like that.

00:12:27.760 No.

00:12:28.320 Okay.

00:12:28.900 No, that, um, this is what they were doing early on.

00:12:31.240 This was the only alternative.

00:12:33.020 Okay.

00:12:33.400 So you go to provide what?

00:12:35.260 Uh, relief from depression.

00:12:36.840 Okay.

00:12:37.420 I see what you're saying.

00:12:38.380 Cause they still have a therapy.

00:12:39.800 I have friends that go and get electrocuted a little bit every day.

00:12:42.400 Yeah.

00:12:43.060 Yeah.

00:12:43.420 So, so that is sort of like the, um, oh yeah, there's a good one.

00:12:48.640 See that guy right there?

00:12:49.560 On the left.

00:12:50.440 Oh yeah.

00:12:50.980 Oh yeah.

00:12:51.420 He's going deep.

00:12:52.340 Yeah.

00:12:52.480 That's what they did.

00:12:53.240 I was got a candle in his mouth.

00:12:54.420 That dude.

00:12:54.820 That's, that's so when he bites down from the electricity, he doesn't break his teeth.

00:12:58.400 Oh my God.

00:12:59.980 Yeah.

00:13:00.220 Right.

00:13:01.640 You know, so it was hard.

00:13:03.240 That's Frankenstein.

00:13:04.100 It's hard to get a lot of people to sign up for that.

00:13:05.880 Cause I mean, you Google it and you see that and you're like, no, I'll pass.

00:13:10.440 Yeah.

00:13:10.780 They're grilling that brother up, man.

00:13:12.340 Unfortunately, that's pretty heavy.

00:13:13.520 It seems like to me.

00:13:15.240 Um, so, so, so how, so how did they evolve?

00:13:19.560 Out of this.

00:13:20.020 So this isn't really practiced readily anymore.

00:13:21.660 It wasn't easy.

00:13:22.320 You said there was, you had to have a lot of people on site to do it.

00:13:24.880 So ECT, um, is still used in limited form today.

00:13:30.720 The, the problem with it is it's a pretty big deal to do.

00:13:34.840 And so you don't have doctor's offices doing ECT.

00:13:39.980 These are special circumstances, usually with patients who have profound problems, usually

00:13:45.620 patients who are in, uh, inpatient psychiatric hospitals.

00:13:49.640 These are not people who are out walking, trying to hold jobs.

00:13:54.040 So this is a different level, different level.

00:13:58.600 You know, people who come and seek care for depression, they, they, you know, get talked

00:14:04.660 to by their doctor or their provider and they get, you know, put on a medication or something

00:14:08.680 and they, they go to a therapist and they try and work through that.

00:14:11.480 And usually at some point, um, some people sort of hit the wall with that.

00:14:18.280 Um, not everybody, but a lot of people are hitting the wall with it.

00:14:21.240 And what they do is.

00:14:22.420 With ECT?

00:14:23.460 Uh, no, with just, just going to, um, some, almost no one gets referred for ECT.

00:14:28.840 Yeah.

00:14:29.140 That's, I mean, cause that seems like, yeah.

00:14:30.640 So you're saying that's more like in psych wards and stuff like that, like bottom of the

00:14:33.560 barrel.

00:14:33.880 Really?

00:14:34.640 They're trying to jumpstart.

00:14:35.600 I mean, it looks like the damn Lord's jumper cables.

00:14:37.840 It is.

00:14:38.080 You know what I'm saying?

00:14:38.780 It's, it's, it literally is.

00:14:40.000 It's like, you're, you're trying to jump off the brain.

00:14:41.860 Wow.

00:14:42.240 Trying to get it hit to fire again.

00:14:44.160 Yeah.

00:14:44.620 And so that's like people who are like, you know, in, in hospitals, mostly people who

00:14:50.140 are not holding down jobs.

00:14:51.500 People are not having relationships because they can't.

00:14:55.280 Okay.

00:14:55.920 Right.

00:14:56.480 So, so, so the rest of people who are struggling, you know, they go to their doctor, they get put

00:15:02.020 on antidepressants.

00:15:03.020 They go to a lot of therapy.

00:15:04.300 Right.

00:15:04.740 That's me.

00:15:05.140 That's been me.

00:15:05.660 I'm, I'm an example of that.

00:15:06.920 Yeah.

00:15:07.200 Yeah.

00:15:07.480 And so, so you're, you're sort of chugging along and, and you're existing, but you're

00:15:13.960 not really, you know, if you look at like the road of life, you want to be on the middle

00:15:18.100 of it and you want to be comfortably cruising down it, you know?

00:15:23.040 And these are the people who they're like on the shoulder or they fall off into this,

00:15:27.520 they go off and on the side of their shoulder and they, they have a hard time pulling themselves

00:15:31.180 back up and it's because they're, the, the medicines, they help, but they don't necessarily

00:15:38.860 get people to a place of wellbeing that they're seeking.

00:15:42.640 You know, there's, there's existing and then there's like really living.

00:15:48.380 Right.

00:15:48.940 Yeah.

00:15:49.180 I think I can definitely test testament to that.

00:15:51.900 Yeah.

00:15:52.260 I kind of feel like, like, I don't understand.

00:15:55.460 And one of the reasons I went to get the ketamine therapy is because I didn't know why I'm still

00:16:00.240 on antidepressants.

00:16:01.400 It's like one of the weirdest medicines that, you know, I was having a tough time when I

00:16:05.280 was like 20 and I went in, they put it on, they put me on it or I agreed to be on it.

00:16:10.680 You know, I mean, I took part in it and, and then now 20 years later, I'm still on it.

00:16:15.960 So it's kind of like, like if you broke your leg, you wouldn't have a cast on forever probably.

00:16:20.720 So some of that to me is like, how, what's going on here?

00:16:23.160 Like, is this something I need to be on forever?

00:16:25.280 So that's one of the reasons that I went in probably to check it out, you know?

00:16:29.120 And, you know, it's the, the work that is being done in this is, is amazing.

00:16:37.660 I mean, the, there are some very smart people who sort of helped shape this sort of treatment

00:16:44.700 path and the way I, I look at it, um, is I, I look at people who come to me and they have

00:16:53.600 all these symptoms.

00:16:54.460 They either, they're depressed, they're anxious, they can't sleep.

00:16:58.400 Um, they're, they have like attention problems.

00:17:01.560 They, they, they zone out because they can't zone in.

00:17:04.860 Um, then you have people who are like trying to kill themselves, um, or they're addicted

00:17:09.800 to things.

00:17:10.460 And what it really is, is somewhere within them, they have a lot of pain.

00:17:15.360 Okay.

00:17:15.840 They have a lot of distress.

00:17:17.800 Something is, is primarily wrong and that is not going away with the antidepressants.

00:17:25.220 They're just more like a bandaid to it.

00:17:27.760 They're covering the symptom as opposed to addressing the symptom.

00:17:30.960 Right.

00:17:31.080 So the driver is usually pain that is from somewhere in that person's past that they

00:17:38.680 have not been able to truly grieve over and feel like sort of reconnected to themself.

00:17:45.080 And, and as you probably experienced to some degree, when you went into the ketamine room,

00:17:52.180 you could see your pain.

00:17:55.380 You could see around in yourself and you could kind of go places, those, those firewalls.

00:18:01.680 You could kind of look in places that you couldn't look in before because you had the capacity

00:18:05.800 to, you were sort of protected by the ketamine.

00:18:08.640 So you could look around corners in your mind and see, oh yeah, that's there.

00:18:15.580 You know, I wish I'd had a better, I was in there with a therapist and I, I think they

00:18:20.340 were just more of like there, if I had an issue, um, I sometimes wish that somebody would

00:18:26.940 have been like prodding me more or telling me how to, it's almost like when you go snorkeling,

00:18:33.040 that's what it kind of felt like a little bit.

00:18:35.300 It was like, I'm looking at a lot was going on.

00:18:39.780 You know, if I felt like I'm a roller, I'm on a roller coaster.

00:18:42.540 I felt like the world is kind of, I felt like I was on space mountain sometimes with my eyes

00:18:46.660 closed, you know, just kind of like moving through.

00:18:48.560 Like, did you have the round shapes or the square shapes?

00:18:51.860 I mean, I, I mean, I think there was a turf war going on because there was a lot of, there

00:18:57.700 was some real, I think it was a lot of shapes out there.

00:19:00.620 You know, it was definitely like somebody was, um, I mean, I remember one time literally yelling

00:19:06.600 out that I was a cryptocurrency.

00:19:07.680 I thought I was like, I went, it got pretty gnarly, you know, like it got pretty gnarly.

00:19:13.800 Like I remember one time thinking there's no way I'm going to end up back in my chair in

00:19:18.360 this therapist's office.

00:19:19.260 I don't know how I'm going to get there from where I am.

00:19:22.500 Yeah.

00:19:22.840 I had, I've had some fun, you know.

00:19:25.320 So that kind of stuff was kind of exciting.

00:19:26.900 And I think sometimes I got too caught looking at the, the, the, the experience and not using

00:19:33.640 the experience.

00:19:34.660 Right.

00:19:35.000 So that's why I wish that there had been more before I went in to get it, that I had

00:19:40.520 had more of an understanding of how to navigate the universe a little bit and how to use the

00:19:46.540 experience.

00:19:47.420 Yeah.

00:19:48.220 Um, because that I, that I didn't have.

00:19:50.940 That, that's sort of a, um, so we're learning as we go.

00:19:54.480 Right.

00:19:55.300 And so what, and this, this is relatively recent, um, ketamine assisted psychotherapy.

00:20:01.460 So what is it?

00:20:02.380 And, and that's exactly what we're talking about is we know ketamine helps.

00:20:06.160 We know it works.

00:20:07.340 Do we know exactly how it works?

00:20:08.800 People are debating it because you have competing interests, you have competing ideologies, but

00:20:14.120 we know that people feel better.

00:20:17.040 Now, what we want to try and do is make that a more durable state, not you come in and get

00:20:24.920 your ketamine, you feel good for a couple of days, and then you, you come back a month

00:20:28.580 later and you get more ketamine because that's going to present a societal problem in time.

00:20:33.820 If you're, if you're always on ketamine, you know, we've kind of done the opiate thing.

00:20:38.100 So that, that's one thing that is, we don't want to do because you have some places that

00:20:43.840 are like given you to go home with, and that is sort of like, um, you can do a lot more

00:20:53.200 with ketamine assisted psychotherapy.

00:20:54.820 You can use that place you're in to visit the pain that has brought you to this distressed

00:21:02.420 state.

00:21:03.700 Yeah.

00:21:04.120 There was a moment.

00:21:04.860 I remember there was a moment where I got to see my dad, be around my dad.

00:21:09.040 Right.

00:21:09.320 And I'd never, my dad died when I was like 16 and he was really older, man.

00:21:12.700 He was 86 when he passed away and I was 16.

00:21:15.480 So he was older when I was born.

00:21:16.660 He was an adult, you know, he was senior citizen, but, um, I got to have like this experience

00:21:23.060 around him and it was like a real, like, it felt like I was around him and I got to let

00:21:29.040 him, I got to, you know, I felt like my dad never knew how much I loved him.

00:21:34.000 I felt like I had just never gotten to an age where I could tell him that I loved him, you

00:21:38.680 know?

00:21:38.900 And I didn't realize how much that was kind of haunting me, I think somewhere inside of

00:21:42.620 me, you know, like, um, yeah, exactly.

00:21:45.100 I just never knew like that.

00:21:46.840 That was such a big thing going on underneath me somewhere.

00:21:50.900 And, uh, and I literally got to have a moment or a little bit, a couple moments with him in

00:21:57.840 a emotional state.

00:22:00.080 It kind of, it felt like anyway, to me, it felt very real to me that I was letting him

00:22:03.780 know, uh, how much I loved him, you know?

00:22:07.800 And that, and that's priceless.

00:22:10.020 Cause there's no, there was no other way to do that.

00:22:11.840 I mean, there may, there may have been, but I hadn't found that yet.

00:22:15.300 Yeah, that, that is like core to what, um, ketamine is psychotherapy gives people access

00:22:24.740 to.

00:22:25.160 It's like those little gaps, those little holes in our heart that, that happened to

00:22:29.980 us when we're young shape a lot of our life.

00:22:33.240 And so to be able to reach back in time and, and find yourself then and there, and that,

00:22:40.200 that sort of that grief, pain of separation that you, you didn't get to have with him,

00:22:46.780 you could connect to yourself and, and sort of complete almost in a way like the grieving

00:22:52.560 process.

00:22:53.060 So you could release that tension from yourself, that, that, that distress that's, that's like,

00:22:58.580 that's in there and it's always in there and it's, it, you don't know how to get it out

00:23:04.140 and you're pushing through life and a couple of decades go by and you're like, I'm still

00:23:10.100 haunted by things.

00:23:11.160 And some people are not able to even see some of those things because I, I've taken care

00:23:16.800 of people.

00:23:17.880 I mean, I've taken care of some pretty funny people, you know, like I have trees on my,

00:23:24.320 in my room where I do it and they're like sitting there and they're, you know, they're

00:23:27.960 giggling and, and then, you know, they're like, oh, that tree just got up and ran out

00:23:31.040 of here.

00:23:31.280 And I'm like, okay.

00:23:32.860 And, but then some of them start singing for me and then some people start like trying

00:23:37.740 to do yoga poses in their chair.

00:23:39.380 Really?

00:23:39.700 And I'm like, I'm like, hey, you can't quite do that right now.

00:23:42.780 Right.

00:23:43.320 And they, you know, no, I mean, it's, it gets a little wild.

00:23:48.280 Well, I remember even being a child, I remember getting something was wrong with my penis when

00:23:52.120 I was young and they had to like, like I had like a small urine hole or whatever.

00:23:56.600 I mean, I could pee probably 11 feet.

00:23:59.480 You know what I'm saying?

00:24:00.020 Like I could really pee.

00:24:01.960 And it was, people were like, oh, he's magic and stuff.

00:24:04.080 People, you know, small town people think you're, you know, with a rival church or something,

00:24:08.340 you know, all kinds of shit.

00:24:09.480 But, so anyway, yeah, they said they had to cut the hole larger on my urethra, I think

00:24:15.080 it's called.

00:24:15.820 Urethra.

00:24:16.440 So I remember we went in and they put me on anesthesia.

00:24:19.580 And when I came out, I asked where all the big black women are at.

00:24:24.960 And I remember the doctor telling my mom that like, we thought it was just the craziest

00:24:30.040 thing.

00:24:31.000 And my mom had said that before when I was even younger, I'd had a surgery and I had a

00:24:35.960 law, a big black nurse was my nurse, was the nurse.

00:24:38.820 So I wonder if maybe there was just some moment that was like stuck in my head, like through

00:24:42.900 those little kind of deals.

00:24:44.260 But, but anyway, I, I, I don't know why I went off on this tangent, but I guess I just

00:24:51.200 wanted to know, like, yeah, I guess, is there, what's happening during the experience when

00:24:55.800 somebody gets the ketamine, what's happening?

00:24:58.840 So the way, the way I do it is I, I put a IV in them so I can like turn it up and turn

00:25:05.600 it down.

00:25:05.980 So you can slow down if they start getting overwhelmed.

00:25:08.200 Okay.

00:25:08.560 Because sometimes people, and you can just see it, you know, they're like, cause it's

00:25:12.880 like, there are lots coming at them and, and I'm sitting there and, and you, they tend

00:25:19.480 to start having like their blood pressure and their heart rate go up cause they're getting

00:25:22.340 like, they're seeing stuff.

00:25:23.620 And so you want to kind of try to minimize that.

00:25:26.620 You want to make it constructive yet sufficient to like have the experience.

00:25:34.260 It can't be so low that you're like, I didn't feel anything.

00:25:36.800 Right.

00:25:36.940 But you don't want to like, you know, ruin them.

00:25:40.300 I mean, not ruin them, but you don't want to make it so overwhelming.

00:25:42.840 It's no longer useful.

00:25:44.700 Right.

00:25:44.860 I see what you're saying.

00:25:45.560 Yeah.

00:25:45.740 So you want to kind of have a, find a balance.

00:25:48.080 And yeah, that's what the, the one I did, the place that I went, they, they, they did

00:25:51.820 it and then they kind of just, it was a low dose until they kind of got to you to a level

00:25:55.880 where they could, where it seemed like it was manageable and effective, I guess, to communicate

00:26:00.400 with the therapist.

00:26:01.260 Yeah.

00:26:01.800 Cause what, what I do is, you know, the way the research was done is you do six, six

00:26:06.760 infusions and I like to have them come in and I don't usually have somebody start ketamine

00:26:12.520 right away.

00:26:12.940 I usually want to talk to them cause I want to know like their life narrative to some degree.

00:26:18.120 And then you kind of get an idea where, where the boundaries are.

00:26:21.460 Like you can tell, like, I go through this thing where I'm like, okay, how was, you know,

00:26:27.540 where'd you live?

00:26:28.100 Where'd you move?

00:26:29.160 How was that place?

00:26:30.020 How was this place?

00:26:31.360 How was first grade?

00:26:32.800 How was second grade?

00:26:33.700 And you keep going through it and things start popping up pretty fast and people don't realize

00:26:38.220 what's in their head.

00:26:39.060 And then they're like, oh yeah, I forgot about that.

00:26:41.780 And, but you can kind of tell, and this is not in ketamine.

00:26:45.180 This is just sort of getting to know them because you got to know what are you going to do with

00:26:48.520 the ketamine experience?

00:26:49.440 So I want to have like a roadmap.

00:26:51.300 Right.

00:26:51.940 And, and then as we do this, the first couple of sessions, you want to get their,

00:26:57.380 their sort of like get everything chugging.

00:26:59.660 You just want to get them into a better state of wellbeing so that their capacity to examine

00:27:04.680 some of these longstanding things is available to them.

00:27:10.140 You don't want them to not be able to, to sort of explore this.

00:27:14.460 You want them to be in fighting, good enough fighting shape that they're like, I can do this.

00:27:19.660 Um, and we go through it and I've had people who couldn't remember entire years of their lives.

00:27:26.180 These are smart, very successful people who, who have been, it's like something's been wrong their whole life.

00:27:34.560 And, and you start going through it with them and it keeps going back further and further and further.

00:27:42.060 And it's sort of like the, the beginning of the flick of the wrist on that little thread of pain.

00:27:47.520 And, and, and a lot of times these little firewalls conceal it and then they have their ahas and they remember more and more and more.

00:27:55.660 And I'm not telling them what to remember.

00:27:57.560 I'm just listening.

00:27:58.480 And so what are examples of some things, right.

00:28:00.500 And what are some examples of, so, so, well, what are some examples of things that people could remember kind of, if you can share that and that you don't have to be specific to that person, obviously.

00:28:10.500 Right.

00:28:10.520 Um, so I had a patient who, um, had a series of moves that were sort of stressful on, on him as a child.

00:28:20.260 And, um, it's, uh, at one of the, after one of the moves, um, he was, um, very seriously disciplined by his, uh, by his dad, um, to such a degree that, that, um, he didn't remember it until we sort of toggle the switches around it.

00:28:42.160 And we started sort of gently, like, how is this location?

00:28:45.140 He was like, that was warm.

00:28:47.020 That was nice.

00:28:48.020 How was this location where you moved to?

00:28:50.260 I didn't like it.

00:28:51.600 How was this house you lived in, in this place?

00:28:55.060 I don't remember.

00:28:56.360 How was this house?

00:28:57.340 I remember not being happy.

00:28:58.620 So already we're pointing to narrowing it, narrowing it.

00:29:02.280 Yeah.

00:29:02.620 And he didn't remember in the ketamine session.

00:29:05.400 And then later that night he did.

00:29:08.540 And so then we came back around the next time and we talked about it and we sort of work into the, and, you know, I, I, I approach this with, I guess the right word is.

00:29:20.260 Like a great deal of reverence.

00:29:21.600 You know, these people are, are sharing with me their emotional pain and I'm helping or trying to help them connect to themselves so they can feel whole.

00:29:33.340 Because all this, all this distress that people have in a way, it's like incomplete grieving.

00:29:40.960 Yeah.

00:29:41.160 And people can't cry that much.

00:29:44.040 And so they, they sock it away.

00:29:45.900 And, and what the ketamine does is it allows you an opportunity to kind of go back in places that you can't do awake.

00:29:54.220 You just can't.

00:29:55.140 Yeah.

00:29:55.580 And I've seen that.

00:29:56.160 I've seen patients.

00:29:56.940 I start talking and I'm, you can tell they're like, they don't want to talk about it.

00:30:00.200 You know, I had a lady who I took care of, who I was the first person she told in 40 years that she was raped in high school and she's, you know, she's in her sixties and her life has been tough.

00:30:15.540 And, you know, so her life has been shaped by fear.

00:30:21.660 Right.

00:30:22.620 Yeah.

00:30:23.500 I'm sure fear, probably feeling like she couldn't tell people things, shame.

00:30:29.480 And it shaped her relationship.

00:30:31.220 So she was in, you know, not the best relationships because she was put in this state by this experience that had shaped her ability to interact with life.

00:30:42.540 Right.

00:30:43.360 And here we are 40 years later.

00:30:44.960 And she's a wonderful lady.

00:30:47.720 And, and I'm, it's, that's why, I mean, it's like, I feel, I, I, I approach it with a great deal of, I think the right word is reverence because it's, it's not sad, but it is, it is like a, a very important, meaningful and tender thing to do.

00:31:04.740 Yeah.

00:31:05.160 A hundred percent, man.

00:31:06.040 Yeah.

00:31:06.480 Yeah.

00:31:06.500 I feel sometimes like I'm trying to make rope out of like the tattered, the very frayed pieces of like, of my youth kind of.

00:31:19.600 Right.

00:31:19.840 As I get older, you know, and not very frayed.

00:31:23.980 I don't want to, I'm not trying to have any self pity or something, but I feel like that, that's what you try to, as you, as you get old, you're just still trying to make this rope or make a knot out of this, make different knots out of rope.

00:31:35.180 That was kind of like ramshackly kind of tied to the beginning of the foundation at certain points.

00:31:41.280 Yeah.

00:31:41.440 The underpinnings of, of wellness start early.

00:31:44.740 Yeah.

00:31:45.200 And, and usually attachment feeling, you know, attachment injuries is no joke.

00:31:53.280 So most children, when I mean most say 99.999% of kids are loved by their parents.

00:32:00.280 Okay.

00:32:01.200 But what happens is parents can show this much love and the child actually needs more love than, than they get.

00:32:13.540 And it's not that there's a malicious thing.

00:32:15.420 It's just, there's a mismatch.

00:32:16.800 Right.

00:32:17.200 And that, that mismatch creates this, like this emptiness, the start of loss or grief or, or, or not being cared for.

00:32:25.460 Or, and depending on how it gets nudged in life, it starts showing up as, you know, how they choose, you know, relationships, how they try to navigate life.

00:32:35.820 And, and if it's really bad, then they start having other things pop up and, and they get on medicine and it works or it doesn't, you know, medicines do work.

00:32:45.060 So let's, let's not say they don't work, but, but they don't work great.

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00:35:19.740 Yeah, I notice, I start to notice that the behaviors that I feel like affected me when I was young are behaviors that I now exhibit, you know, and ones that I like imitate, you know, towards others that kind of keep me in a place that is comfortable, even though it's not the best place that I want to be in a lot of times, you know.

00:35:41.160 Yeah, the devil you know.

00:35:42.160 Yeah, it's interesting, man.

00:35:43.740 So with the, when people go under the, under the, the solution, under the ketamine therapy, right?

00:35:52.420 Right.

00:35:52.540 So I remember like, I mean, I remember like I would, yeah, I wish I'd had, I think when I went and met with the therapist, we started the same day that I went.

00:36:06.820 So I do wish that I'd had a little bit more of a breadth of communication with them.

00:36:10.560 So I'd have probably had just so that there was a better, so that we're like, okay, these are five points that we want to try and attack, you know, or, or meander around or things, you know.

00:36:21.320 Yeah.

00:36:21.480 Um, because sometimes I felt like, not that I was wasting my time, but that I was wasting the experience.

00:36:28.020 And I may not have been, it could just be me being judgmental, but, um, because I think it was helpful.

00:36:32.900 But there were times where I felt like, like I was just kind of swimming through some of the same waters without really knowing what we were looking for or trying to do.

00:36:41.380 That, that's sort of the, um.

00:36:43.060 But that may be okay.

00:36:44.140 Maybe that's just what you do sometimes with it.

00:36:46.180 Well, and that's why, you know, this is a on ongoing, um, evolution and care because ketamine assisted psychotherapy really hasn't existed very long because you're right.

00:36:58.080 People were like, okay, what are we doing with it?

00:37:00.640 And then as we started to, you know, explore what we could do with it, we realized that, hey, we can do a lot more than we thought.

00:37:08.540 When did it start?

00:37:09.940 Ketamine assisted psychotherapy.

00:37:11.540 Yeah.

00:37:11.720 Or even just ketamine assist.

00:37:12.860 Like when did ketamine start?

00:37:13.920 I mean, everybody's always calls it a horse tranq all the time, you know?

00:37:16.720 Well, ketamine was originally, I think it was invented in what, the fifties or sixties.

00:37:22.920 And it is, it's an anesthesia medicine.

00:37:24.900 So horse tranquilizer anesthesia, it's, it is an, it's a dissociative anesthetic by definition.

00:37:30.860 Okay.

00:37:31.180 Okay.

00:37:31.400 So you use it to put, help put people to sleep for operations or procedures.

00:37:36.320 And is it found in nature or no, it's not?

00:37:38.060 No, it's made, um, no.

00:37:40.200 Not that we know of.

00:37:41.000 It could be out there.

00:37:41.600 Do you think it could be or no?

00:37:42.680 Probably not.

00:37:43.920 Um, but yeah, there, there are other things that are sort of like.

00:37:49.780 Synthesizing 62 of our professor.

00:37:52.460 It was tested on animals, which provided promising results.

00:37:55.520 It was used for testing on human prisoners in 64.

00:37:58.180 There you go.

00:37:59.220 I didn't know that.

00:38:01.680 Proof to act faster and reduce toxic behavior, which made it the preferable anesthetic choice

00:38:06.300 over PCP.

00:38:07.400 Damn.

00:38:07.640 It's interesting.

00:38:08.980 It's amazing how many drugs used to be just available.

00:38:11.980 Like, I remember I was working on, um, I was working in Mississippi on a farm for a while.

00:38:16.800 And the man said that they used to buy ecstasy at the bar.

00:38:21.360 They had it like in a jar on the bar and you could go buy it.

00:38:24.700 You could buy a tab of ecstasy.

00:38:25.880 Like before it was, I guess, illegalized, you know, like there was a brief time where it

00:38:30.520 was a legal drug you could buy.

00:38:31.800 They, you know, prior to like, I think it was 1970, the LSD and all that psychedelic

00:38:39.180 research was, was actually going really strong.

00:38:42.520 And what happened was, I think the government finally said enough because it started to begin,

00:38:48.520 it was recreating too much.

00:38:50.280 That was when you had sort of like the hippies and LSD and all that stuff.

00:38:53.840 And, oh yeah.

00:38:54.340 And so when they shut it down, they, they, they shut down all the research too.

00:38:59.060 So it clobbered the, the ability to investigate all these kinds of interesting substances for

00:39:07.940 real clinical aid, you know, use, roll the ball forward, you know, 20, 30 years.

00:39:14.240 And now, now you actually have like, um, the government is, is, um, very interested in,

00:39:20.220 in some of these therapies.

00:39:21.760 And, and the real reason is the state of veteran health.

00:39:27.480 Um, you know, there, you have so many veterans that are struggling and, you know, they have

00:39:34.200 these, these organizations that are trying to reach out to veterans, but the suicide rate

00:39:38.900 among veterans is, is just really horrible.

00:39:44.020 Wow.

00:39:44.100 I didn't even know that.

00:39:44.980 Yeah.

00:39:45.220 I, I saw a metric a while ago.

00:39:48.160 It was like more combat veterans, uh, from Afghanistan have killed themselves and have died

00:39:53.780 in, uh, the line of fire.

00:39:56.500 Wow.

00:39:56.960 So, so you think about the, they're that distressed and then they come back here and they just,

00:40:02.780 you know, go back to work and it doesn't work that way.

00:40:06.460 Yeah.

00:40:06.980 And so the, you know, the government's funding research on this stuff because they got to

00:40:13.340 figure out how to help people.

00:40:14.380 So it's, yeah, it'll help save them money too, if they can, uh, it is not to put it

00:40:18.500 right there, but also, yes, it is, but it's actually providing the, the, the gas for helping

00:40:22.920 actual therapies that work as opposed to just, um, throwing dollar bills at things.

00:40:29.060 Yeah.

00:40:29.500 So that's, you know, I'll take it, you know, if we can help get serious about it.

00:40:33.440 Yeah, for sure.

00:40:34.700 Um, and so, so those are types of people.

00:40:37.740 So can people really use this therapy to get off of antidepressants and how does that

00:40:43.100 work?

00:40:43.420 Short answer is don't know.

00:40:46.500 Um, what, what I have seen in, in, like I said, this is sort of on the fly.

00:40:53.440 Like this is, this whole body of knowledge has grown a lot is, is people who have, um,

00:41:02.980 profound distressors in their life that are under addressed are going to have probably

00:41:08.640 pressure to have symptoms.

00:41:10.220 So they're going to be in depressed states.

00:41:12.540 And if you can help people through something like ketamine is assisted psychotherapy, resolve

00:41:17.540 those longstanding pains of emotion in them, then it stands to reason that the odds of them

00:41:25.380 finding a way forward are better.

00:41:29.500 Does that make sense?

00:41:32.180 Yeah.

00:41:32.400 It's sort of a wishy-washy statement, but it's, it's the same thing.

00:41:35.900 It's like, like, uh, you know, at my place, we sort of break down why people are depressed

00:41:40.280 and it's, and it's, and you sort of break them into these categories, um, where you have

00:41:45.180 your, your, your groups that's more like, um, serotonin, um, and then you have your dopamine

00:41:49.700 people.

00:41:50.100 So I actually asked my patients, I'm like, what gets you high?

00:41:53.420 I'm like, uh, what's booze do for you?

00:41:55.680 Or, uh, what's, uh, cocaine do for you?

00:41:58.460 And, uh, and, or shopping or gambling or, cause you're trying to stratify them.

00:42:03.440 Like what, what, what's goosing them?

00:42:06.300 Right, right, right.

00:42:07.000 And so that helps you pick like your therapy, because if you got a guy who can't stand cocaine

00:42:12.240 or stimulants like that, then it's probably, he's probably needs more serotonin.

00:42:17.660 So you can sort of shape what you do for them to help them with that.

00:42:20.820 And you can mix it.

00:42:22.300 So it's all becoming like this basket of ketamine sits alongside, um, a lot of other tools.

00:42:30.000 And if you're using all of them together and you're helping this person who comes to you

00:42:36.660 unpack what you're carrying and you give them better tools in their pack to go on.

00:42:42.240 Then the odds of them staying on the road are better.

00:42:46.240 Right.

00:42:46.800 And that's sort of like how, like integrative psychiatry works now.

00:42:50.620 It's like, you don't just say, Hey, here's your prescription.

00:42:55.360 Get out of my face.

00:42:56.200 You actually sit down and you talk to me and find out why they're suffering.

00:42:59.820 Yeah.

00:43:00.060 Not, Oh, you have depression.

00:43:01.520 It's like, okay, where, what, what's your, you know, what's wrong?

00:43:07.480 What hurts?

00:43:08.820 When did it get started?

00:43:10.180 Right.

00:43:11.160 How's it shaped you?

00:43:12.840 Can you talk about it?

00:43:14.320 And what level of detail can you talk about it?

00:43:16.840 And that's why, I mean, it's, it's a very, like almost a, it's a very

00:43:21.840 intimate conversation.

00:43:27.740 Yeah.

00:43:27.880 You know, that's a great, that's a great word.

00:43:29.280 Intimate.

00:43:29.600 I feel it felt really intimate.

00:43:31.460 You know, I remember, I mean, right when I started going to, I just started tears just

00:43:35.220 like rolled out of my eyes, you know, like, I don't even know what was going on really,

00:43:39.280 you know, I think it could have just been like, I mean, me, I'm always probably 30% sad.

00:43:44.640 So who knows what it was, you know, but, but I remember it just being pretty emotional out

00:43:49.700 of the gate.

00:43:50.120 And the first day I was dehydrated, literally just from like crying, I think half of the

00:43:54.280 whole session, like, and some of it, I didn't even realize I was crying.

00:43:56.900 Like, I didn't even really feel it.

00:43:58.280 Cause I was kind of also, you get kind of, you're kind of anesthetized in a way.

00:44:03.580 So the main part of me that's still awake is kind of this, kind of that all knowing place

00:44:09.220 inside of your head where you have ideas and stuff, you know, like whenever you're thinking

00:44:12.780 about something, you envision something like that place, you know.

00:44:15.900 I have had quite a few patients that, and I tell them this, I'm like, Hey, you know, they,

00:44:23.240 a lot of them tend to feel pretty quiet.

00:44:24.640 Like they have like, um, all the, the, the mental movie is sort of taking a break when

00:44:29.380 they're, when they're done for their session for the day.

00:44:31.020 And they kind of like, I'm like, yeah, just roll with that.

00:44:33.560 Don't do any homework.

00:44:34.540 Just sort of like try to, you know, I, I try to keep them on zero.

00:44:39.040 Um, and I, and I say it is, you know, very possible that if you just start burst out into

00:44:44.280 tears later tonight, that's normal.

00:44:46.380 Yeah.

00:44:46.640 That means like you're, you've connected to something and that's like an overdue release.

00:44:51.640 And so, uh, I remember I was talking to this, this young lady and, and she was, um, she

00:44:59.740 was upset.

00:45:00.240 She was like, what am I crying?

00:45:01.060 I can't stop crying.

00:45:01.840 I was like, I was like, you're going to hate me for saying this, but this is very good.

00:45:06.060 Yeah.

00:45:06.720 Because she was just releasing all this thing that she had packed up in her.

00:45:12.320 And, and the next day she kind of like, you know, it's like after a good cry, you like,

00:45:17.800 but she cried, you know, a big chunk of her life out in a night.

00:45:22.460 And, uh, yeah, yeah, that's, that's a great way to say it.

00:45:24.920 I think it felt like that, like just a lot of stuff that was going on.

00:45:28.680 You kind of got to like take the pressure valve off a little bit in some ways.

00:45:34.300 Um, but yeah, I would like to have another experience with it in the future and be able

00:45:39.180 to know going in, have more of a game plan going in so that I can, but then one of my

00:45:46.320 issues sometimes is controlling things.

00:45:48.560 So it's interesting.

00:45:49.600 So I don't want to go in sometimes to that and try to manipulate, you know, control the

00:45:54.500 situation, you know?

00:45:56.440 So, which might not even be possible under that.

00:45:59.620 Um, it's, it kind of depends on your mindset on it.

00:46:03.300 You know, I think what I try to do is I try to give people a lot of sort of neutralizing

00:46:11.180 information so that they understand exactly what's, you know, the more you understand

00:46:15.120 what's going on and why we're doing this, they sort of, their, their, their, um, guard

00:46:19.980 starts to come down because really if you don't want it to work, it's not going to work.

00:46:25.180 And, and so you want them to be like, okay, I understand why this is going to happen.

00:46:30.700 And so one of the best things I like to do actually is, is find out what they can do

00:46:35.760 with it.

00:46:36.420 So I do this thing where I give my patients a, it's a, it's like a butcher paper.

00:46:42.720 It's, you know, it comes off a ream, but it's actually graph paper and I haven't put it

00:46:45.800 up on the wall.

00:46:46.440 And we do these five columns and it's your age down the middle and then where you lived,

00:46:51.440 what your relationships were, what your activities were and what your substances were.

00:46:55.940 And you just sort of write it down from zero to today.

00:47:00.560 And if they can do that, then you can kind of get a, they can sort of look at their life.

00:47:05.260 And if they can't do that, that sort of shows me where we need to sort of use ketamine to

00:47:10.360 examine some things that are like, sort of like they're no go zones.

00:47:14.440 And I got a number of guys who they can't finish it because it's sort of like you can't

00:47:20.220 finish it.

00:47:20.700 And if you can't finish it, then, you know, I, I, you know, I don't know how we're going

00:47:25.880 to finish it in this context without it being emotionally brutal on you.

00:47:30.960 Right.

00:47:31.360 And that's what the ketamine allows is it takes the edge off looking at things that you can't

00:47:36.500 look at.

00:47:37.140 Oh, wow.

00:47:38.200 Yeah.

00:47:38.580 It was interesting.

00:47:39.060 Like, I wonder if there were things where maybe my, my being or whatever was just afraid

00:47:43.360 to, uh, to unwind them or just couldn't, you know, or couldn't find like the key, the way

00:47:51.300 into them.

00:47:52.100 Sometimes it's so, it's such a small opening into getting into like an old feeling or an

00:47:57.660 old way.

00:47:58.360 I see that pop up all the time.

00:47:59.840 Yeah.

00:48:00.080 It's pretty fascinating.

00:48:00.760 We got a question that came in right here from a young gentleman right here.

00:48:03.060 This seemed like a decent guy right here.

00:48:04.520 What up?

00:48:07.240 I got a question for Dr. Pooler and for Theo.

00:48:09.860 So I wanted to start off, uh, Dr. Pooler, what is the negative connotations with the ketamine

00:48:15.520 therapy?

00:48:15.980 And then what would be your argument against that?

00:48:19.060 Um, Theo, what was your favorite thing about ketamine therapy versus regular therapy?

00:48:23.620 Gang, gang.

00:48:24.200 Gang, man.

00:48:25.140 Um, that's a good question.

00:48:26.180 What you got, doctor?

00:48:27.420 Um, so the, the negative connotations, I, I think the, the societal thing is.

00:48:33.600 There's sort of a societal sort of frown against like psychedelics in general.

00:48:41.200 And, you know, it got started back probably with like the hippies and LSD.

00:48:45.800 And so you kind of get this blanket, oh, this is that psychedelic hippie trippy stuff.

00:48:51.820 And, and so it can marginalize its actual utility as a, a real medical therapy.

00:48:57.600 And there's an organization, um, called maps that, that is dedicated to doing high quality

00:49:03.600 research to counterbalance that notion that this is like, you know, step into my van type

00:49:09.820 stuff.

00:49:10.200 And, and, uh, and to make it legitimate and the proper studies and the proper funding

00:49:15.840 from, you know, like the DOD and things like that, because they want it to be as legitimate

00:49:21.380 as possible.

00:49:23.200 Um, yeah, it's interesting.

00:49:24.540 You almost, you really have to, like, there has to be a group kind of monitoring that branding

00:49:28.920 and how that really, how it hits the public and stuff like that.

00:49:32.100 It's a little wild westy right now.

00:49:33.800 They've even said it in some of the publications because the, you know, all the ketamine right

00:49:39.220 now, it's, it's technically off label the way they're, the way everybody's using it.

00:49:44.080 Not a lot of medicines get used off label all the time.

00:49:46.620 So, um, is that a problem?

00:49:49.460 No, but, but it, it needs to be looked at down the road because, you know, it's like

00:49:57.460 those Saturday Night Live skits in the eighties where, you know, you go to your doctor and

00:50:00.580 you get a, Hey doc, I got a, I got a, I got a, you know, my pinky hurts.

00:50:05.940 Oh, here's a prescription for some weed.

00:50:07.780 Oh yeah.

00:50:08.040 You know, remember those skits that, that were like that.

00:50:10.300 And it's like, you gotta, you gotta be careful.

00:50:11.940 Hopefully you don't have the slippery slope because I get, I get, um, mailings from places

00:50:16.840 they want to ship me, um, like ketamine lozenges and stuff.

00:50:20.060 And that's, that's not gonna, it's not going to go well.

00:50:25.340 Yeah.

00:50:25.740 I don't, I, I, I had six infusions like you're talking about, like you, like you mentioned

00:50:31.500 it's probably the product, probably protocol, not protocol, but it's the best.

00:50:35.980 No, it's the best.

00:50:36.660 That's the research.

00:50:37.800 That's the research.

00:50:38.780 Um, that is what they ferreted out in the research was the most legitimate and best

00:50:44.800 way to proceed is, is what you did.

00:50:47.980 And after four, I felt good after four, the last two, I felt a little, it got a little

00:50:54.360 griswoldy, you know, I felt like I was on a, you know, it felt like I was just on a kind

00:50:59.160 of a gnarly vacation, you know, it was like, I don't really know if I needed the last two

00:51:03.400 or, or maybe I did.

00:51:05.000 I don't know.

00:51:05.460 I just, I think at that point, I started to think, wow, I wish I had a better game

00:51:10.940 plan going into this so I could use it to the best of my ability.

00:51:14.020 I didn't know if I was using it to the best of my ability.

00:51:16.340 The therapist was saying, um, and it was a great, it was a great place and everything,

00:51:20.040 but he was saying that it worked, it'll work kind of no matter what.

00:51:24.420 There is.

00:51:25.560 Is there some truth to that, that it'll work no matter what?

00:51:27.880 Yes.

00:51:28.780 Um, so we know it works.

00:51:30.120 Okay.

00:51:30.560 The question is, is how long does it work?

00:51:32.720 Right.

00:51:33.040 And, and what the, um, sort of like the industry, the professional side of this industry is trying

00:51:39.720 to do is make this a, a very serious one-time attempt to get as much utility out of it so

00:51:51.920 that, that the effect is very durable and that's why you got to do all the side work with it.

00:51:57.160 And that's why you want really, really good, uh, assisted psychotherapy because you can

00:52:03.060 sort of unwind things that are still sort of in the background if you're, if you're sort

00:52:07.940 of poking around and, and the more things you can resolve, the more your heart can be

00:52:12.540 at rest, um, the odds of you needing more of it are less and that's very desirable.

00:52:19.940 So, you know, like at my place, um, I've only had one patient ever need a booster and he

00:52:30.800 was a, he's a veteran and his, it, there's some, you know, there's some confounders with

00:52:35.860 that, but, but most people are, are, and I, I don't let them go either.

00:52:40.120 I don't like, when they come to me, I, I take them on and, and we get to know them

00:52:45.340 on the front end and we're following them on the back end and I'm taking care of all

00:52:48.260 their other sort of issues.

00:52:50.800 I don't, I don't like send them to places to, you know, you, you come to me and I work

00:52:55.560 with you and the idea is that we're here to get you into a better place of durable wellbeing.

00:53:01.160 We're not here to give you ketamine.

00:53:03.520 Right.

00:53:03.580 It's not, you're not like a sawmill.

00:53:04.860 You're doing actual boarding kind of, you're actually bringing them on.

00:53:07.980 Um, what is the number one thing that a lot of, uh, veterans struggle with, or what is,

00:53:16.160 what is the, so some of that trauma you always hear about the PTSD.

00:53:19.800 There's two things actually, and it's actually interesting the way this is starting to pop

00:53:22.920 up.

00:53:23.820 Um, so PTSD and actually, uh, concussions.

00:53:28.240 So traumatic brain injuries.

00:53:30.040 If you take a, somebody who has been, uh, in combat and has had ordinance exploding around

00:53:36.660 them and they've been taking those shockwaves to their head, even though they look fine,

00:53:39.960 it's hasn't a pretty serious depressive effect.

00:53:44.440 Right.

00:53:44.720 And it's, it, I talked to a guy out in Colorado last week about this.

00:53:49.920 They're, they're trying to find ways to heal these guys because they tend to be like very

00:53:54.720 sensitive to emotional dysregulation.

00:53:58.140 Cause you think about it, you take a fishbowl and you put, you cook up like 30, 30 bags

00:54:03.780 of ramen.

00:54:04.320 Okay.

00:54:04.840 And you, and you put it in a fishbowl.

00:54:06.720 How big of a bowl?

00:54:07.660 Like, like a goldfish bowl.

00:54:09.180 So it's like completely full of noodles, right?

00:54:11.400 Okay.

00:54:11.600 Say that's your brain.

00:54:12.640 And then you hit it with a bat.

00:54:14.280 The noodles are going to move.

00:54:15.900 So if you're taking concussions repeatedly, it's going to scramble your noodle.

00:54:20.540 Yeah.

00:54:20.820 And so those are nerve connections that, that are responsible for your daily function.

00:54:25.120 And as those get ripped apart and try to heal, they don't necessarily get it right all the

00:54:29.160 time.

00:54:29.420 And so like people are, they're, they're, they're hurt in a way that's hard to address.

00:54:38.940 Yeah.

00:54:39.340 Because it doesn't seem like we're meant to be batted around that much, you know?

00:54:42.460 No, not at all.

00:54:43.820 Um, so those are some of the most common things you see as far as veterans is like, uh, stuff

00:54:50.120 from concussion stuff.

00:54:51.420 That's, that's one.

00:54:52.440 Okay.

00:54:52.620 The other one is, is frankly, the, the grossness of war.

00:54:57.280 I mean, you see two of your buddies incinerated in front of you and that gets on a record that

00:55:02.540 won't come out of your head and, and that's all they can see.

00:55:06.400 So then they get like super, um, super sensitized.

00:55:10.620 So, so they're stuck in this place in their mind where they're still driving down that road

00:55:16.500 when that car bomb went off.

00:55:17.740 And so when they hear a door slam or something that that's a neural circuit that got burned

00:55:23.380 in, in the strongest of ways.

00:55:24.940 So they have this, they have this nerve pathway that that's just seared into you.

00:55:29.860 And so it's on alert because it's still there.

00:55:33.500 And so your neighbor, boom, closes the door and you're like, and, or you hit the deck or

00:55:38.840 you do those kinds of things.

00:55:40.060 And so that's one of the things that, you know, they're proposing, um, that they use

00:55:45.780 ketamine, uh, to work with, you know, patients on.

00:55:49.140 Why does trauma create such strong, like neuropathways or like connection?

00:55:52.980 Does that make sense?

00:55:55.000 The, and does it, it sounds like it must, right?

00:55:57.280 It does because, um, so it's, it's post-traumatic stress.

00:56:05.040 What, what happens is when something happens to you, you form a temporary memory.

00:56:11.820 Okay.

00:56:12.260 Like what'd you eat for dinner last night?

00:56:14.340 You could probably tell me what it is.

00:56:16.640 Um, salad, but, but two years from now, two years ago, what'd you eat for dinner?

00:56:21.060 I have no idea.

00:56:21.920 Yeah.

00:56:22.260 I don't know.

00:56:23.120 So intense experiences make different signals like, right.

00:56:28.940 But I could tell you if I was in like a boat accident.

00:56:30.760 Correct.

00:56:31.560 Now ramp that up to about 11 and, and we're Andrea Galen.

00:56:38.480 Yeah.

00:56:38.580 Then it gets pretty deep.

00:56:39.440 And then, then you can't forget about it because it's, it's, it's, it's sort of your, your,

00:56:43.660 your neurochemistry has decided that this needs to be a permanent reminder, probably from

00:56:49.280 a more for safety.

00:56:50.420 Probably.

00:56:50.780 Yeah.

00:56:51.180 More of a, like fight, flight, or flee type thing.

00:56:54.440 And so given where we are in the world today.

00:56:57.500 So it's inflammation kind of then.

00:56:59.840 Yeah.

00:57:00.340 So those are, yeah, because that's the craziest thing about it is, is the way the immune system

00:57:08.000 works with your mind is, is phenomenal.

00:57:12.720 Like you can even measure it now.

00:57:16.060 Like, you know how, when you get the flu, you, um, you feel crummy, you don't want to

00:57:19.900 get off the couch, food doesn't taste good.

00:57:22.660 Sex isn't interesting.

00:57:23.860 All that stuff goes away.

00:57:24.860 Right.

00:57:27.340 Imagine being like that, walking around, living life like that.

00:57:30.500 That happens because your immune system knocks out your dopamine system.

00:57:34.840 So you don't have access to your dopamine system because you're sick, because of your immune

00:57:40.120 system, because you're supposed to be healing under a tree.

00:57:43.080 But if you're walking around and you have your immune system activated, you begin to look

00:57:50.100 like somebody who doesn't have access to the feel good.

00:57:54.460 Wait, explain that to me again.

00:57:55.380 Sorry, I got lost.

00:57:56.540 So, so your immune system, when you're sick, takes your, your dopamine system offline.

00:58:04.760 Oh, that's just what it does?

00:58:05.880 That's what it does that on purpose.

00:58:07.020 So you can heal.

00:58:07.960 Oh, because they don't want you trying to feel good because you're not going to heal.

00:58:10.880 Correct.

00:58:11.220 Right.

00:58:11.820 Got it.

00:58:12.220 But if you're walking around, if you're walking around day in and day out, year in, year out,

00:58:17.320 and your, your immune system is slightly activated and your dopamine system is always offline,

00:58:23.620 then life is flat and feeling good is inaccessible to you.

00:58:29.360 And are you depressed or you just not have access to your dopamine system?

00:58:33.860 Wow.

00:58:34.140 That's interesting.

00:58:35.180 Yeah.

00:58:35.440 That's a great question.

00:58:36.480 And you can check that with, um, it's actually pretty straightforward to check now.

00:58:40.120 Now you got to get a simple lab drawn to see if your immune system is activated and that

00:58:45.380 helps point therapy.

00:58:47.140 So like what I do is when people come to me is I, I check some labs on them.

00:58:51.620 I get to know them a little bit in, in ways that I do my thing.

00:58:55.220 And so I kind of want to know where they're at so we can start shaping what comes next.

00:59:01.240 And that's before we take them in the room, because I look at it as I want, I want this

00:59:05.500 to be as useful as possible.

00:59:06.980 Right.

00:59:07.340 And then so that when we get to the other side of it, we still are learning things, but

00:59:12.160 like, uh, I had a patient who he was done.

00:59:15.740 Okay.

00:59:16.660 But something else popped up in his mind because he was having this problem where on a regular

00:59:21.260 basis, he would have panic attacks at a certain time of day.

00:59:24.360 Okay.

00:59:25.400 Like clockwork.

00:59:26.140 And I, I talked to him.

00:59:27.160 I was like, what time of day did your dad get home when you were a kid?

00:59:32.260 And he just stopped same time of day, all his life.

00:59:39.540 That's crazy.

00:59:40.360 But he was able to see it then because before he couldn't even see it, but now we could talk

00:59:44.780 about it and resolve it.

00:59:46.080 And so he was able to see it when he was under the therapy after afterwards.

00:59:49.800 So we were done.

00:59:50.680 This popped up even later because he was saying, you know, I'm doing pretty good, but I still

00:59:54.260 have this one thing that's popping up on me.

00:59:55.720 And I said, well, what is it?

00:59:57.200 We talked about it and I asked him and he's like, yeah, yeah.

01:00:02.260 What, um, what could, do you have a question that came up, Sean?

01:00:06.180 Sorry.

01:00:06.400 Let's get to that.

01:00:07.740 Oh, actually, this is a comedian friend of mine, Shane Moss, um, who he is a psychonaut.

01:00:15.060 So he's like a man who he's very funny man.

01:00:18.620 And he also is a man who has experimented with different psychedelics and stuff over the years

01:00:24.700 to have experiences just like an astronaut would with like outer space.

01:00:28.680 He's kind of done them with like inner space.

01:00:30.460 So awesome to, uh, have this from him.

01:00:33.820 Theo, Shane Moss here in case you can't recognize me.

01:00:37.580 I hear you're getting ketamine treatment.

01:00:40.040 I think that's fantastic.

01:00:42.340 Very, very worth exploring.

01:00:44.840 See if it suits you.

01:00:46.940 Psychedelics are not always the most linear, uh, thing in the world compared to other medications

01:00:54.180 or drugs or what have you, but mental health isn't a linear thing either.

01:00:58.540 And so I wish you the best of luck.

01:01:00.380 I hope it, uh, it shows some improvements.

01:01:03.620 Thanks, man.

01:01:04.120 Um, and my question for your guest is I'm wondering if you could talk a little bit about experiential

01:01:11.000 versus chemical change rather than, uh, taking, say, antidepressant every day and, and altering

01:01:17.820 your chemical imbalance or whatever.

01:01:20.280 A psychedelic journey is, uh, a lot more about using that temporary, uh, chemical, uh, chemically

01:01:28.000 induced change to have more kind of personal breakthroughs and insights.

01:01:33.500 And those insights are kind of what leads to the personal growth, uh, more than some

01:01:41.000 permanent chemical change that you're doing or, or a long-term change that you're doing

01:01:46.600 to your mind.

01:01:47.460 Oh yeah.

01:01:48.320 Hmm.

01:01:49.060 Yeah.

01:01:49.860 Um, so this is like a two headed animal here.

01:01:56.140 Cause you have like the, the neurochemistry of what happens.

01:02:00.680 Okay.

01:02:01.420 And then from there you have what you experienced as a result of the neurochemistry and, and

01:02:07.100 he's, he's, he hit the nail on the head with that is, is therapy like this allows you

01:02:14.440 to have, so you're, you're getting therapy or you're getting mood elevation from either

01:02:18.600 therapists or from like a medication you're on regularly.

01:02:22.100 Yeah.

01:02:22.540 Well, you have this thing where it's a, a, called a, uh, um, a rapid gain.

01:02:28.340 So you're, you're cruising along and all of a sudden you have something that goes way

01:02:31.000 up.

01:02:31.220 You're like, Oh man, I figured that out.

01:02:32.820 And, and it goes like that, but it doesn't work like that.

01:02:35.200 You actually have to go for a long time and you don't have those very often with therapy.

01:02:38.840 Okay.

01:02:39.500 Right.

01:02:39.860 So what, what ketamine does and psychedelics is it's like a lot of access to rapid insight

01:02:47.320 for prolonged period of time relative to say, go into therapy for five years.

01:02:53.500 Right.

01:02:54.660 And it could be a couple hour, a couple minute actual portal.

01:02:58.420 Is that what you mean?

01:02:58.860 Kind of like that.

01:02:59.440 Well, and that's where you talk about what happens is we know that ketamine helps nerves

01:03:05.760 grow.

01:03:07.540 So if you have nerves that are firing in a way that is causing you to have a depressed mood

01:03:14.200 state or anxiety, and you basically soak those in ketamine for a, say a period of a couple

01:03:24.020 of weeks with six infusions, you can get some plasticity in how those nerves work.

01:03:32.540 So you can change how those nerves are connected.

01:03:35.360 They grow a little bit.

01:03:36.620 They actually like, they've seen it on the, under microscopes.

01:03:39.260 These nerves actually grow little sprouts and they, they can change.

01:03:42.360 And so you're enhancing your ability to change at a, at like a microscopic level.

01:03:48.480 And that translates into like a change in perspective on things.

01:03:54.400 Yeah.

01:03:54.820 Sort of metaphysically.

01:03:56.000 I mean, this is kind of like we're, we're going into the, into the, the realm between

01:04:01.200 electron microscopy and spirituality.

01:04:05.440 You know what I mean?

01:04:06.200 But, but it, it is.

01:04:08.060 So, so if you look at it, how a person experiences it is that they can see what they've experienced.

01:04:15.380 They can find things that they've experienced and connect to themselves more fully.

01:04:20.180 And if they can be a more full person and have less pain carried in them because they were

01:04:28.060 able to have an emotional release by connecting to a loss from the past, then they're probably

01:04:34.480 going to walk away from it feeling better about life globally.

01:04:40.400 Yeah.

01:04:40.920 You know, I think that's a good summation, a little bit of just what I felt.

01:04:43.800 I felt, I felt like there were new ways to connect.

01:04:50.000 Yeah.

01:04:51.300 Kind of.

01:04:51.880 And I couldn't describe it exactly.

01:04:54.440 And I couldn't manage it.

01:04:58.900 But I felt like it was helpful.

01:05:04.300 I felt like when, when I knew more tricks and how to almost use the controller better,

01:05:08.360 I would go back and play the game again.

01:05:11.460 If that makes any sense.

01:05:12.620 It does.

01:05:13.800 Um, so what's, so what's, uh, Shane is saying is that, so you're saying that, so ketamine is

01:05:20.140 more of like an experiential type of thing.

01:05:22.360 It's both.

01:05:23.360 So, so, so to, to the person who's experiencing it, they're, they're gaining, um, sort of a,

01:05:31.140 they're gaining like this alternate or this, this additional view of things.

01:05:40.160 They're, they're gaining insight.

01:05:41.560 They're like, they're up here and they can look around themselves more like, like, not

01:05:46.520 like they're not in the game.

01:05:47.900 Sort of like they're looking at the game.

01:05:51.700 And from that, they can be like, you know, that really, that doesn't hurt as much as I

01:05:55.200 thought.

01:05:56.080 And they can see like, oh, I can see that.

01:05:58.080 Yeah.

01:05:58.200 I never really got over that.

01:05:59.780 That's been sort of haunting me.

01:06:01.280 And I'm like, okay, I'm okay.

01:06:03.920 And, and so that's what it can provide.

01:06:08.800 Now, the nice nudge is when you can have somebody like say, well, you remember you'd mentioned

01:06:12.900 this and let's, let's explore this a little bit and see how those decisions sort of were

01:06:20.160 pushed by emotional distress or pain and rolled the ball through this event.

01:06:25.360 And then you kind of, so you try and sequence it through, through life.

01:06:30.180 So you don't want to miss things.

01:06:31.940 Right.

01:06:32.500 It's the gaps.

01:06:33.580 The gaps are the key.

01:06:35.320 Yeah.

01:06:35.660 I could see that.

01:06:36.940 Yeah.

01:06:37.200 I wish I, yeah.

01:06:37.860 In hindsight, I would go with like a timeline, kind of a little bit of like a plan.

01:06:41.320 I like, I like doing the school thing.

01:06:43.100 Like, yeah.

01:06:43.840 The grades, you know, the one question I like to ask people is, is when was the last time

01:06:49.040 you felt whole Jesus and then what was it that began to separate you from that feeling?

01:06:58.600 Yeah.

01:06:58.960 I don't even know, man.

01:07:00.460 I probably was a damn zygote.

01:07:03.600 Yeah.

01:07:04.040 And then, and then you go back to, if they can't, if they can't dial it back that far,

01:07:07.580 you go back to like when they were like five, four, three, when did they feel love to one

01:07:12.920 blast off is when I probably felt it.

01:07:14.600 Maybe I don't even know.

01:07:15.720 Yeah.

01:07:16.080 I don't know.

01:07:16.740 I don't know.

01:07:17.400 I mean, I know you're not asking me, but it's just, yeah, it's interesting for people

01:07:20.360 to think that the place I was at, the therapist hadn't done the experience.

01:07:24.520 Does that matter if they've done it or not?

01:07:30.600 I, I don't know.

01:07:32.920 Yeah.

01:07:33.240 Maybe it doesn't.

01:07:34.380 It's kind of one of the things that depends on, on where the therapist is.

01:07:38.460 What, what made you care about this?

01:07:41.700 How'd you get into this whole universe?

01:07:44.180 You know, I did anesthesia for quite some time.

01:07:46.440 And I, and you were a real doctor then.

01:07:49.880 Yeah.

01:07:50.760 Yeah.

01:07:51.120 I have an MD.

01:07:51.760 Um, and, um, I saw ketamine work pretty well and cause I was, I did anesthesia, right?

01:08:02.020 Was it fun doing anesthesia?

01:08:03.600 It was interesting.

01:08:04.800 It was fun and it was crazy and it was, but it was, uh, you know, I mean.

01:08:09.620 Were you listening to music and stuff where you'd go in there?

01:08:11.380 Nothing like that.

01:08:11.980 We had a, actually, we had a surgeon who, who would get noise complaints from the other

01:08:16.720 ORs because he would listen to death metal all day and he would turn it up all the way.

01:08:21.020 And so he sort of had like a, his own little crew because you kind of have to be like the

01:08:26.080 right, be in the right mindscape to go in there and listen to mega death for 12 hours at, you

01:08:32.960 know, 80 dB all day long.

01:08:36.000 Yeah.

01:08:36.360 That's crazy.

01:08:36.880 You're cracking up in a rib cage and you're all hopped up.

01:08:39.280 Well, the surgeons next door in the rooms next door would complain, you know, it's like being

01:08:42.940 in a hotel.

01:08:43.560 They'd be like, dude, tell them to knock it off.

01:08:45.600 But it was, I mean, it was, it was, it was crazy.

01:08:49.200 I mean, it was, it was good, but it was, it was like super busy, super high intensity.

01:08:54.620 Yeah.

01:08:55.140 Um, and you have to stay the whole time or you just hit them with that dose and you roll

01:08:59.020 out.

01:08:59.780 It depends.

01:09:00.840 Okay.

01:09:01.160 But the way our model was we had, uh, uh, nurse anesthetists and, and so we would, we

01:09:07.720 worked together with them and they would stay the whole time.

01:09:09.620 And I would, I would come in and troubleshoot things and get the, get the ball rolling.

01:09:13.500 And, and, you know, we were at a place where we, we took care of really sick people.

01:09:17.500 So it was, um, you know, it was, but you sort of acclimate to it and then you look around

01:09:23.340 and you look at what you acclimated to.

01:09:25.080 And, uh, but, but for me, what, what got me turned into the corner of this is, is, um,

01:09:33.340 sort of my understanding of suffering has evolved a lot.

01:09:37.720 Um, and, um, I had a brother and he died last year.

01:09:45.560 He was injured as a child, um, terribly.

01:09:50.560 Um, and he never could get the help he needed.

01:09:55.740 And so he, he did a lot of drugs.

01:10:01.700 He tried to take his own life several times.

01:10:04.300 Oh man.

01:10:04.620 Sorry to hear that.

01:10:05.360 He did all these things and, and I was sitting there and, and he knew he was dying.

01:10:12.100 He was in hospice, but I was, you know, looking at what was coming down the pipeline.

01:10:16.340 I was like, you know, if, if we can help people who've been traumatized, like it's sort of like

01:10:22.700 for me, it's like, if this would have been around 20 years ago, maybe I'd still have a

01:10:26.060 brother because he, he was sexually abused as a kid and didn't ever tell anybody, nobody.

01:10:34.120 The only reason we found out about it is because our, our pastor was imprisoned after the fact

01:10:41.420 by somebody else.

01:10:42.520 Dang.

01:10:42.920 And so I couldn't figure out what was wrong with him his whole life.

01:10:46.360 And I, I asked him one night and he goes, yep.

01:10:48.400 And I was like, and, but the damage was just like.

01:10:55.020 Yeah.

01:10:55.380 How much that shapes somebody that's young.

01:10:57.440 That's man, that's heartbreaking.

01:10:59.020 I'm sorry.

01:10:59.900 Yeah.

01:11:00.200 So, so.

01:11:00.900 And I'm sorry for him.

01:11:01.780 I'm sorry that, you know, it's heartbreaking to see, you know, I've been, you know,

01:11:05.240 a lot of my family and being in recovery and struggling through those, you know, struggling

01:11:09.200 through trauma and stuff like that, childhood trauma, not like that, but different types

01:11:13.960 of trauma and stuff has been pretty prevalent in my family.

01:11:16.040 And it's heartbreaking to see the effect that it has on people, you know, it, it was, you

01:11:21.320 know, the last six months of his life, I finally got him to say, cause he was like a, he was

01:11:26.240 a, he was a crusty guy.

01:11:28.140 Was he?

01:11:28.600 Yeah.

01:11:28.860 Yeah.

01:11:29.260 And the last.

01:11:30.480 Were you guys pretty close?

01:11:31.540 Yeah.

01:11:32.120 Oh, that's cool.

01:11:32.700 And he knew he was, he knew he was dying.

01:11:34.600 Was he drinking himself to death?

01:11:35.920 Yeah, he did.

01:11:36.420 And he had the operations and, and he kind of stopped actually, but the problem was,

01:11:42.900 is the damage was done.

01:11:43.980 And, and, but like, you know, one of the last times we, we spoke, um, I was sitting with

01:11:51.260 him in the hospital.

01:11:51.860 He was on hospice and, and for the last six months of his life, I got him to tell me that

01:11:57.040 I told him I loved him every day.

01:11:58.620 And he was like, I love you too.

01:12:00.320 And like, just for him to, to be able to express emotion was priceless.

01:12:04.020 Yeah.

01:12:04.320 And then, you know, one of the last moments we spoke, I said, I love you.

01:12:07.480 And he said, I love you.

01:12:08.740 I love you too.

01:12:09.440 And then he goes, he flips me the bird.

01:12:11.460 And I was like, that's, that's Mike.

01:12:13.100 And, uh, and so it was like, you know, I, he knew at least he was loved.

01:12:17.640 Yeah.

01:12:18.460 And, and, um, that was in, um.

01:12:21.660 It's important.

01:12:22.760 Yeah.

01:12:23.120 I think a lot of people's life, if they struggle with trauma, I think some of it is just,

01:12:26.700 yeah, thinking that people don't care.

01:12:28.500 People that think it unable to feel love.

01:12:30.740 It's weird how a traumatic event can block off other things, you know?

01:12:34.200 Yeah.

01:12:35.080 He couldn't, he, he didn't have the capacity and he never, so he, he was stuck and he could

01:12:43.300 never get out of it.

01:12:44.160 And you kind of wonder or hope that if somebody else comes to me and who's a little younger

01:12:50.220 and hasn't burned themselves physically, like, like damaged themselves enough that you can

01:12:56.220 help them turn the corner and get healing going in a way that they, they can get back

01:13:01.700 on the road of life.

01:13:02.520 And, and that's sort of, that's to me is a very rewarding way to interacting with life.

01:13:10.040 You know, I can look over my shoulder and be like, I am okay with what I'm doing.

01:13:15.220 I'm helping people find peace.

01:13:21.220 Yeah.

01:13:21.780 It's it, man.

01:13:22.220 It's so fascinating how, like, if you can, if you don't feel loved or if something makes

01:13:25.940 you feel so unloved or so damaged that then you, it's very hard to feel love after that.

01:13:31.540 Cause I think there's just receptors in you that just do not trust it or just do not trust

01:13:36.740 the world almost in a weird way.

01:13:39.260 And I don't even think you can access it sometimes like that's the, that's the such

01:13:44.800 hard thing is to be able to access why or what or how to change it, to get the clay in

01:13:52.040 your hands.

01:13:52.680 You know, it feels like you just can't find it, you know?

01:13:59.880 Um, so it's fascinating to hear that there's opportunities that this could be a way where

01:14:03.400 people can, I'm, I'm, you believe it.

01:14:06.640 I believe it.

01:14:07.420 I do.

01:14:07.920 I really do.

01:14:08.480 Cause, um, I've seen it work.

01:14:10.120 I've seen it work on a lot of people.

01:14:12.600 And it, it's one of those things where it's, it's like you get to see these people come to

01:14:18.560 you and they're, they're just broken.

01:14:19.640 And, and, and the first time you hear them laugh and, or smile and you're just like, it, it's,

01:14:29.160 it, it's, I'm in the right place.

01:14:32.540 Yeah.

01:14:35.320 That's fascinating, man.

01:14:36.600 Yeah.

01:14:36.800 I noticed after a couple of treatments, I'd had an idea.

01:14:39.640 I was running one day and I just had like a good idea and I used to have good ideas all

01:14:44.000 the time.

01:14:44.400 Um, I mean, I'm just, I'm judging my own ideas, but I thought they were pretty good.

01:14:47.300 But, but I used to have ideas a lot and I just, for like a year, I just hadn't even gotten

01:14:51.540 an idea.

01:14:52.360 Like I've just been kind of living with the pieces of every day, you know?

01:14:56.020 And it's been fine.

01:14:56.900 Life has been fine.

01:14:57.680 I'm not, I'm not complaining.

01:14:59.400 I'm not asking for any pity.

01:15:00.460 I'm just explaining where I'm at.

01:15:01.880 But, but I hadn't found it, gotten anything new to come out of my brain, you know?

01:15:06.920 And so I noticed that I was running by some turkeys somewhere at this park.

01:15:10.900 And then I don't know, I just got like an idea that was like fun and it made me laugh.

01:15:15.540 It made me smile.

01:15:16.320 And I was like, oh man, what a gift.

01:15:17.800 Like when something's able to just kind of travel through us and make us feel good, which

01:15:22.320 is how we probably should be a lot of times, you know, is to be a conduit for joy to at

01:15:27.000 least pass through instead of being kind of a, a place where something has put up a

01:15:33.340 fence or something has put up like a firewall or, you know, different elements like you're

01:15:37.380 saying.

01:15:40.300 What are the, what are, what are some of the side effects that we honestly do not know

01:15:43.540 about?

01:15:43.880 Because just to be very honest and transparent with people who are considering this treatment.

01:15:48.700 So there, there's, there's, there are limitations, like there are actual limitations.

01:15:53.320 Like you, you can't really have problems with like psychotic type problems or schizophrenic

01:16:01.860 type problems.

01:16:02.640 It doesn't, it, it, it's like, it doesn't work.

01:16:06.620 That wouldn't be cool.

01:16:07.180 Yeah.

01:16:07.360 No.

01:16:07.640 And if you have a, if you have problems with seizures, you really got to look into that

01:16:12.400 because it used to be that ketamine was an automatic.

01:16:15.540 No, if you have a seizure disorder.

01:16:17.520 Um, and, and depending on what's going on with that, they're looking into it.

01:16:21.300 Um, but, um, the other things is like, sometimes what you get is, is, um, patients actually,

01:16:28.920 um, vomit and, and it happens and I can almost see it coming now.

01:16:35.300 It's almost like a, the physical need to expel bad.

01:16:41.580 Ah, interesting.

01:16:42.800 So, so like I've taken a couple of patients very recently and they were super overwhelmed,

01:16:48.580 like way overwhelmed crushingly.

01:16:51.500 And, and, um, and they, they just started vomiting and I knew it was going to happen

01:16:57.360 and it wasn't a problem, but they didn't understand it.

01:17:00.080 I was like, yep.

01:17:01.080 It's like, you needed to get it out.

01:17:02.620 Wow.

01:17:03.080 It was like a, it was like a metaphysical expulsion of badness from them.

01:17:08.460 Oh yeah.

01:17:09.260 And, um, and so that it doesn't happen very often though.

01:17:12.860 I can see that.

01:17:14.580 I could really see that.

01:17:15.760 Sometimes I think all types of things like that are a mole or something.

01:17:18.480 You see somebody with a mole and you say that's a bad, somebody, you know, that's a bad idea

01:17:22.360 or something you had, or that's a something, you know, that's something bad that happened

01:17:25.280 to you, you know, or sometimes you see like someone like I'll feel sometimes like when

01:17:30.100 I'm really going through therapy and it's going pretty good, I'll get pretty close to

01:17:33.020 this feeling like there's something in my throat that I never was able to say or like

01:17:36.700 to talk about when I was young or I was afraid to talk.

01:17:40.320 And so I can almost feel the mass, whatever.

01:17:43.080 It's not, you know, it's all probably in my head, but it feels very real.

01:17:47.720 It's all those connections from your, you know, your, your core emotional centers are,

01:17:52.900 are there.

01:17:54.380 They're reaching out into everything.

01:17:55.960 And, and, you know, if you think about a nerve connection, think of like a thread of

01:17:59.700 hair from an experience to somewhere else in your brain, it's still there.

01:18:03.960 It's just how, how often it lights up and, and it starts pushing on things.

01:18:08.400 And, and that's, you know, like post-traumatic stress is the hair is the size of my, you

01:18:13.240 know, pinky.

01:18:13.980 Yeah.

01:18:14.360 And so it's, it's got domain over your operating system, so to speak.

01:18:18.800 Yeah.

01:18:19.460 And, um, what's the question that came in for, uh, do you have another question that

01:18:23.580 came in, Sean?

01:18:24.720 I know we have one from a young, uh, yeah, let's play this fellow right here.

01:18:28.200 Theo, what is going on, my brother?

01:18:29.720 I just got a question for Dr. Ketamine as he's in the house.

01:18:34.280 Um, this is Sam from Sydney here and, you know, down in Sydney, we, we're team ketamine

01:18:40.980 down here, you know, we got that special K on deck, I would say.

01:18:45.260 Um, my question for the doc is, is this an addictive substance and are there, will there

01:18:51.100 be lasting effects from this kind of therapy?

01:18:53.680 Um, because I can tell you from secondhand right now, I got some friends that could argue

01:19:00.180 there are some more long-term effects from this substance and it could be quite addictive.

01:19:05.980 Um, some fellas getting banged out out there in Australia.

01:19:08.320 Sign up, gang, gang.

01:19:09.580 Gang, brother, cheers, man.

01:19:10.940 Yeah.

01:19:11.300 What are some of those, what are some of the effects?

01:19:13.480 So it is addictive.

01:19:15.300 Um, it is not that addictive, but I have talked to somebody who was completely addicted to

01:19:22.120 ketamine.

01:19:22.380 Wow.

01:19:23.120 Now the problem with ketamine, um, is, is it's unclear, but this is what the best sort

01:19:32.160 of notion on what's going to happen to people is if you're always taking a substance that

01:19:36.320 causes neural growth and neural change, well, keep that ball rolling and see what happens

01:19:41.180 to your mind.

01:19:42.300 So, so if you're always changing it and you're always growing it, your ability to be you is

01:19:47.580 going to be called into question.

01:19:51.520 If you're always abusing it, it's not like, you know, opiates, you can take opiates for

01:19:55.100 20 years and come out of it, um, and still be your person.

01:20:01.520 Ketamine is putting like putting your brain in a grow box and you're trying to grow all

01:20:06.900 these new sprouts and all these new connections so that you can connect in a healthier way to,

01:20:12.280 to traverse injuries from the past.

01:20:15.500 Okay.

01:20:16.120 Now we know this is happening at the microscopic level physically.

01:20:20.220 So if you keep doing that all day long for years, where's, what's going to end up?

01:20:25.680 Remember that, that bowl of ramen?

01:20:27.240 You keep putting more ramen in there.

01:20:29.720 I don't know what's going to happen, but I can probably reasonably predict that these

01:20:34.760 people are not going to be the same and not in a good way.

01:20:38.540 That's why, again, you know, the, the research was a set of infusions in order to traverse

01:20:46.080 something that is essentially beleaguering you in a way that's preventing you from having

01:20:50.720 access to wellness.

01:20:51.820 Um, long-term dosing of it, I, at a, at a lower level, I'm not sure if that is gonna,

01:21:02.860 I, I don't do it.

01:21:05.040 You don't prescribe it?

01:21:05.880 No, I don't.

01:21:06.660 Because I, I have seen a lot of things and I want it to be done in front of me.

01:21:12.360 I want the, like, like the, the chap from earlier, you want the events to be very meaningful.

01:21:17.920 You want the sequence of events to be very, um, enlightening and very, um, meaningful and

01:21:27.080 connecting to yourself emotionally.

01:21:28.560 You want, you want those six sessions to be sort of like a time of, of introspection and

01:21:34.320 healing that's been brought to an immensely higher level because you're seeing ketamine

01:21:38.920 a lot.

01:21:39.920 You, I don't want that to be wasted.

01:21:42.740 So I want to do it right from beginning, from before beginning to afterwards.

01:21:47.920 But I don't want to be picking up that tool very regularly because, because I don't want

01:21:52.980 to use that as the crutch because we, we've done that crutch with other substances in the

01:21:57.960 past and it hasn't worked out so well.

01:22:00.540 Yeah, it gets bad.

01:22:01.160 It gets, and then people also have to make their own choices, but if there's some addictive

01:22:04.540 nature to it, then yeah, it can be tricky.

01:22:06.720 Um, and that's what I want to say.

01:22:08.160 Like, I'm not telling anybody to go get this therapy or saying that this is, you know, I wanted

01:22:13.200 to have an experience with it.

01:22:14.660 Um, cause I'm going to try to get off of antidepressants.

01:22:17.880 Yeah.

01:22:18.020 So, um, I'm working with my doctor now and try and like slowly wean myself off.

01:22:22.840 Um, which is some, which is cool.

01:22:24.300 The, the, the place that I went there, they have like some follow through there with like

01:22:27.800 trying to help me like do that and, and manage that.

01:22:30.400 So I'm excited about that.

01:22:31.520 And I'm still working with my regular therapist.

01:22:34.320 Um, but yeah, I definitely wanted to have the experiences.

01:22:36.820 So I knew kind of what it was like, um, and what's possible.

01:22:40.980 Um, you know, I love to kind of figure out how I'm thinking and feeling and why and stuff

01:22:44.520 like that, you know?

01:22:46.120 Um, so it's, it's nice to kind of see if what things I can get, get through and get away

01:22:52.320 from.

01:22:52.840 And I find that like anchors, I can pull up kind of find that, you know, in, in my practice,

01:22:57.680 about half of my patients don't get ketamine.

01:23:01.760 Like we, we, you know, it's sort of like, why are you here?

01:23:05.240 And they're, they're more like, they don't know why they're there.

01:23:07.620 They're like, they, they want access to wellbeing.

01:23:10.980 They want relief from distress.

01:23:14.280 That's what they really want.

01:23:15.600 Right.

01:23:16.080 But they come in with like diagnoses and I'm like, well, let's talk about what you, what's

01:23:20.000 really going on.

01:23:21.260 And then, you know, we, we talk and we, we gotta, you know, it's like, we gotta get to

01:23:25.300 know each other.

01:23:25.800 It's not like, I'm like, Hey, yeah, here, get out.

01:23:28.520 Um, and they may turn into ketamine patients.

01:23:32.660 Once we find like hard stops, places that are, are, you know, like I shared earlier,

01:23:39.100 I had that lady, she wasn't a ketamine patient.

01:23:43.580 Okay.

01:23:44.920 And as we got to know each other and I was sort of helping shape her therapy using other

01:23:49.040 things, we, she felt comfortable sharing me with some pretty disturbing stuff.

01:23:55.120 And then she shared some even more to start and then she, she couldn't, she stopped.

01:23:59.100 I was like, um, yeah, it's sort of like, let's, let's change gears because we're running

01:24:06.640 into some very emotionally distressing things that she couldn't articulate at that point.

01:24:11.520 And in order to get through those, we, I wanted to protect her.

01:24:15.720 So that's when we slid over into the ketamine room and now she's, she's about, she's in

01:24:21.780 process and she's autumn.

01:24:23.780 You could just see the light in her eyes.

01:24:25.320 Now she's, you know, it's like, she, it's like, it's not just like go get ketamine.

01:24:30.120 It's like, why are you here?

01:24:31.100 Right.

01:24:31.820 And, and that's why we, we talk about what's going on.

01:24:37.480 And.

01:24:38.600 Well, there was an experience.

01:24:39.760 One moment I had an experience at one point where I felt like I ended up like in a corner

01:24:43.320 of the world kind of, it was kind of like, I felt like you ever been in like a video game

01:24:47.740 and you get stuck somewhere on it and you can't even move like your guy gets stuck and you're

01:24:51.440 just, I felt like I got stuck at like the edge of the universe.

01:24:55.040 Like where the universe, like we, like I finally found like the two walls of the universe,

01:24:59.520 like the ends of it.

01:25:00.580 And I got stuck like in the corner and I don't know what was going on.

01:25:05.540 Were you leaving the chair or coming back to the chair?

01:25:08.240 I was on my way back to the chair.

01:25:09.420 Okay.

01:25:10.400 Yeah.

01:25:10.940 It's interesting.

01:25:11.780 Like, you know, cause like, did you feel like you were like getting light in the chair

01:25:16.020 and then like your fingers started to get all.

01:25:18.880 Yeah.

01:25:19.080 You know, I didn't even notice that.

01:25:20.140 I just remember kind of talking in a conversation.

01:25:23.040 And then next thing you know, I go on this ride and I'm not even talking that much anymore.

01:25:27.760 I'm just kind of on this journey.

01:25:30.680 People are, so I talk to my patients a lot and they, some of them remember, some of them

01:25:36.180 don't, but they come in different, they come in different like personalities.

01:25:42.100 Like you can kind of, there's, I'm starting to get a, there's different types that come

01:25:46.760 in there.

01:25:46.940 Like I got my musicians and they start singing for me and you know, they're belting it out

01:25:52.060 or they're composing right there in front of me.

01:25:54.420 And I'm like, this is cool.

01:25:55.700 And then, you know, you got the guys who are, my, my trees are running off the screen and

01:25:59.620 my one kid who tried to hop up and run out, but he forgot he was on ketamine and you can't

01:26:04.160 move.

01:26:05.300 And he didn't even get out of the chair.

01:26:07.620 You could just see it.

01:26:08.200 He was like, no, no, no, no.

01:26:09.120 And I was like, it's okay, man.

01:26:12.060 And, uh.

01:26:13.020 That's crisped out, man.

01:26:14.300 He was probably all crisped out.

01:26:16.220 Yeah.

01:26:16.460 He, he had some issues.

01:26:18.200 It gets, I mean, it's definitely gnarly.

01:26:20.820 I was, I, it didn't feel like, I guess in some ways it felt like a drug.

01:26:25.040 It felt like an experience to me.

01:26:26.900 Right.

01:26:27.460 You know, um, I felt like I was kind of grateful for the experience.

01:26:31.300 I was grateful to be back from the experience whenever I got back from the like trip or whatever

01:26:35.260 you kind of go on during it or whatever, like the visual, the experience, the out of

01:26:39.320 body kind of experience.

01:26:40.360 I felt grateful whenever I got back to my chair.

01:26:42.500 Cause there was moments where I was like, I am never, you know, I don't care.

01:26:49.120 Yeah.

01:26:49.580 I'll never, they'll never find me.

01:26:51.460 Yeah.

01:26:52.060 It's like, I'm lost.

01:26:53.060 Like, where am I in the world, in the universe that will never find me?

01:26:56.220 I was at like, I was in Atlanta.

01:26:57.740 I was in Castlevania, that video game for when I was a kid, I was in some, I was on the back

01:27:03.000 of someone's neck.

01:27:05.040 I was, there was a lot.

01:27:06.080 I was sliding down stuff, a lot of like moving along huge.

01:27:12.500 I don't know if it was like electronic land, sides of walls.

01:27:18.860 I had a lady recently, she could hear, I got like these pictures of a forest or in my,

01:27:25.600 one of my rooms and she could hear the forest.

01:27:28.740 Wow.

01:27:29.220 And then she was like, then she could hear a lawnmower.

01:27:31.560 Like, and I was like, that's pretty cool.

01:27:33.860 You know, cause it was, she was not disturbed.

01:27:35.980 She was just like, oh yeah, I can hear the forest.

01:27:37.800 And I was like, that was a first.

01:27:39.520 Like the auditories were, were, are not as common.

01:27:43.020 That's strong.

01:27:44.240 Is there a reason why do we all need therapy now?

01:27:46.620 What's going on?

01:27:47.420 Have we got, are we weak people?

01:27:49.100 Do you think?

01:27:49.920 Are we, you know, it's funny cause I'll talk about therapy and stuff with my mother and

01:27:56.000 she doesn't, she doesn't not believe in it, but she's just like, you just keep moving

01:28:00.020 on.

01:28:00.420 You know, you keep going.

01:28:01.700 She's more of like you tough it out type of vibe.

01:28:04.560 And I come from more of like a, well, why, well, what's going on?

01:28:09.000 Like that kind of type of vibe, you know, I think, you think it's an American pro like

01:28:14.760 not problem, but do you think it's like a, I think it's a, there's like a, there's a couple

01:28:23.500 of things.

01:28:24.580 Resiliency.

01:28:24.980 Okay.

01:28:25.600 People, people don't bounce back very, as well as they think they do.

01:28:33.520 And the other thing is, is like how, how old you are and how like, I'm sorry, young

01:28:45.020 and having problems happen to you when you're young is very problematic.

01:28:51.320 And because if you look at like, say you're writing a program, okay.

01:28:57.060 I got a coder here in Nashville, actually, you're writing a program.

01:29:01.280 Okay.

01:29:01.420 The earliest code you're writing, okay.

01:29:03.320 Is sort of goes through everything.

01:29:06.160 Okay.

01:29:06.440 So when you're, when you're a child, that's your earliest programming.

01:29:09.620 And so that tends to resonate through your life.

01:29:12.940 And if you're not being shaped with sort of like a good societal structure, good parenting

01:29:20.000 structure, you know, they, they talk about keeping people out of the system or once they're

01:29:23.900 in the system, the system doesn't work.

01:29:25.560 Okay.

01:29:25.680 Well, how did they get in the system?

01:29:27.260 Right.

01:29:27.940 So where do we, where do we set the boundaries from the get go?

01:29:33.080 You know, they used to have TV shows like, um, leave it to beaver and things like that.

01:29:37.760 It was like, sort of like showing you how people are supposed to behave and, and Andy Griffith's

01:29:42.920 show that were, they were very like structured on this sort of false reality of how people

01:29:49.280 are supposed to conduct themselves, but it was very civilized.

01:29:51.900 It wasn't dysfunctional.

01:29:53.160 It was based on like love, authority, respect, um, and things like that.

01:29:58.600 And then as you sort of, everybody does their own thing now, well, they sort of do their

01:30:02.520 own thing and everything.

01:30:03.320 And so the, the, the underpinnings of youth have sort of gotten more flexible, but that

01:30:12.080 also means that their emotions are also more flexible in all directions.

01:30:16.660 Does that make sense?

01:30:17.940 At the end part, doesn't, I don't know.

01:30:21.440 Like, I mean, I mean, I know it, it probably should.

01:30:24.160 I just don't know.

01:30:25.060 If I was different person, I would understand it.

01:30:27.780 I bet.

01:30:28.140 Like I, the way I grew up is like you, you do X, Y, Z, right.

01:30:32.160 And you chug through and, and you, everything was supposed to be fine.

01:30:39.520 But as, as we've moved forward as a society, like my parents and, and a lot of people's

01:30:45.500 parents, they had jobs where they had pensions and they had, they had more stability.

01:30:49.620 Right.

01:30:50.120 And it's less stable now.

01:30:51.220 Now you have, you have more flexibility, but with more flexibility comes more uncertainty.

01:30:56.340 Ah, yeah.

01:30:57.080 So, so people are like.

01:30:58.440 More questions.

01:30:59.080 People are feeling less secure in the world.

01:31:02.740 In reality, they're probably more secure.

01:31:05.280 Right.

01:31:05.520 But they don't feel that way.

01:31:07.200 And like after 2020, you know, 2020 is like a rubber band, you know, the, the suicide rate

01:31:14.220 actually came down.

01:31:15.180 Okay.

01:31:16.180 Well, what's going to happen?

01:31:18.720 Right.

01:31:18.960 I don't know.

01:31:19.580 Cause I have people showing up in my office now that are like, they're beginning to cope

01:31:25.440 with what happened to them in 2020.

01:31:28.040 And, you know, yeah, that's why we're here.

01:31:32.800 Yeah.

01:31:33.220 It's interesting, man.

01:31:34.080 I mean, uh, you know, I had like during the pandemic, I had like five friends that overdosed

01:31:39.360 and died like that just cause they couldn't get to recovery meetings.

01:31:42.040 I think, I think it's, they didn't ever say that they're dead, but they, uh, you know,

01:31:46.700 I believe if they still had opportunity to get to meetings, which were closed, um, it

01:31:51.960 would have just been helpful to some of them, you know, um, just to still have the ability

01:31:56.600 to go.

01:31:57.060 Like once you lose that connection, you start to isolate more than so much stuff happens.

01:32:01.200 You get stuck in your own world.

01:32:02.740 Um, and yeah, I think some of that too, I think we also are at a time where there's

01:32:06.960 just so much technology now and we get such a quick reflections of us that are like just

01:32:12.700 out in the world that aren't, that aren't like rooted in ourselves.

01:32:17.160 Um, I think that that can be very unnerving to people.

01:32:20.460 The, um, the, you know, I, I share with patients, I'm like, you know, being connect,

01:32:27.120 being connected, the feeling of being connected, it's not the icing on the cake.

01:32:30.840 It is the cake.

01:32:32.120 And you see that, um, we're, we're an incredibly disconnected society.

01:32:37.240 You go into any city and nobody knows anybody.

01:32:40.920 Yeah.

01:32:41.440 Even though they're living next to a million people.

01:32:43.560 And if, and, and you can look at the history of like earth, you know, you go to these blue

01:32:48.760 zones where people live unusually long, right?

01:32:51.180 Okay.

01:32:51.400 You go to like Okinawa, Costa Rica, um, like I think Sardinia, Croatia, these, these places

01:32:57.460 are not terribly affluent, but people are like really happy and they live a really long

01:33:01.360 time.

01:33:01.740 And they're like, why, you know, a big chunk of it is they, they have this thing with

01:33:07.880 community, like they're all connected.

01:33:10.320 They're all part of, they're together.

01:33:12.740 And so when you, what's the opposite end of that is everybody's alone.

01:33:16.020 And when you're isolated, bad things happen.

01:33:19.940 Yeah.

01:33:20.280 And I think that's one of the things that happens to our brain.

01:33:22.300 Our brain is a, is literally a piece of machinery that's has the ability to connect with other

01:33:28.700 people.

01:33:29.300 You have to.

01:33:31.020 And it's like, so when we take our brain away from that and we're not doing it, of

01:33:34.060 course our brain's going to get sick.

01:33:35.700 Yeah.

01:33:35.960 You know, it just makes sense.

01:33:37.180 It's like a plant, you know?

01:33:39.160 Um, yeah.

01:33:40.220 I mean, it's not like a plant, but it's like something.

01:33:41.780 Being connected is, is, is crucial and, you know, my, our, our family, um, my wife's

01:33:51.300 grandparents are still with us.

01:33:52.500 So, so they're, you know, in their, um, nineties and, um, and some of their brothers

01:34:00.840 and sisters are still with us.

01:34:02.080 And so last year it was like awful because these are people we would see every week and

01:34:08.040 we, I mean, all the time we would see and they'd show up to like events.

01:34:11.780 And, and then for like a year they disappeared.

01:34:14.980 Yeah.

01:34:15.540 And like they'd stop and you'd wave at them because you were so afraid to, you know, cause

01:34:20.040 I worked, I'm doing my thing and, and I hadn't been vaccinated yet.

01:34:24.240 And so everybody's living in fear and everybody's isolating and you're just like, this is awful.

01:34:29.320 And then you see that, you see that, uh, you know, that you see that match.com commercial

01:34:34.180 with the Satan dates, 2020, you know, a match made in hell.

01:34:37.760 It's the funniest thing.

01:34:39.060 I haven't seen it yet.

01:34:39.960 It's, it's a, it's a, a great sort of representation of how bad last year was.

01:34:45.680 Damn.

01:34:46.680 Yeah.

01:34:46.960 I believe in Satan though, but I would like to see the commercial, but I'll probably see

01:34:50.080 it.

01:34:50.460 Uh, we can watch it later on.

01:34:53.140 Um, any other questions that came up?

01:34:54.600 Sean, there was one from a young lady that came up.

01:34:56.280 Do you want to play that real quick?

01:34:57.260 And then we'll get you, uh, and then we can close it out.

01:35:00.540 We've gone almost two hours, huh?

01:35:01.560 Sean?

01:35:02.060 Uh, hour and a half.

01:35:03.500 Hour and a half.

01:35:04.040 Okay, cool.

01:35:04.600 Cool.

01:35:04.780 Hi there.

01:35:06.760 My name is Courtney.

01:35:07.740 Um, I actually have my first, uh, ketamine therapy appointment scheduled for next month.

01:35:14.060 And, um, I've had some, um, prep appointments, but I just wanted to get your point of view

01:35:20.700 as to, um, the potentials for how ketamine therapy can, um, benefit people with, um, complex

01:35:30.920 post-traumatic stress syndrome.

01:35:32.560 Um, I know there's a lot of information, um, going around right now, and I am just really

01:35:38.600 interested to hear, uh, your thoughts on it.

01:35:41.160 Thank you so much.

01:35:42.220 Gang gang.

01:35:42.560 Thanks, Courtney.

01:35:43.280 And we may have answered that really, didn't we?

01:35:45.480 Or did we not?

01:35:46.260 Um, I can, uh, I can answer it in a way.

01:35:49.720 Um, so ketamine therapy is, I think, a more genuine or credible way to look at what ketamine

01:36:04.040 therapy does is it allows you access to healing, to, to reconnecting with yourself from seeing

01:36:11.200 pain that you have in a different way, like at a, at a more like ethereal way.

01:36:16.820 Right.

01:36:17.860 So, so a diagnosis, um, is not really a description.

01:36:23.900 That is, is what we're trying to do, why the diagnosis is, is a better way to look at what

01:36:30.820 we're trying to approach.

01:36:32.160 And like, I have people who come to me who've had very bad things happen to them.

01:36:35.800 And so, so I want them to be able to reconnect to that part of them that's stuck in there.

01:36:42.320 And if, and if that, if that part of their emotional baggage that's sort of pinned to that moment,

01:36:49.760 if, if they can connect to it and grieve and get that, that release, that emotional release

01:36:54.740 of connection, then they can begin to feel better.

01:36:59.440 And it's not like we're checking off, like, oh, anxiety, check, PTSD, check.

01:37:04.560 It's more like, what's, what's, you know, what, why are you hurting so much?

01:37:11.400 And, and how does that show up in your life?

01:37:13.940 Because you can take somebody who's struggling with something and somebody will have insomnia

01:37:18.620 and you can take somebody who's struggling with something and they'll have depression.

01:37:22.080 And so it's like, what, what really is the distress?

01:37:24.920 That's what really is the root of their pain, as opposed to like a diagnosis.

01:37:30.620 And it's more fundamental.

01:37:32.940 It gets back to what's wrong.

01:37:35.520 Yeah.

01:37:35.940 You know, as I'm hearing you say that, I, I, I felt like sometimes when I'm in therapy, it's hard.

01:37:41.140 Sometimes it's like, if my mood is, isn't that great that day, I won't even want to talk to my therapist.

01:37:45.360 I won't want to share with them.

01:37:46.900 Sometimes I want to be like, you know, I want to be kind of, I don't know.

01:37:53.240 Sometimes I won't really be in the mood.

01:37:56.020 Sometimes I'll keep information from them because I'm scared to share it or because I don't feel comfortable.

01:38:01.040 Right.

01:38:01.580 You know, but this kind of, I felt like this kind of takes away some of that.

01:38:06.720 For me anyway, it took away some of that, my own thoughts, my own bullshit, whatever I'm attaching to, whatever's bothering me in my life.

01:38:14.680 And let me kind of just see what was bothering me.

01:38:18.420 Yeah.

01:38:18.680 A little protection.

01:38:19.860 Yeah.

01:38:20.240 It just kind of like, it didn't even, it just, it felt like I was just there to get some help.

01:38:26.860 It was like, it was almost like going in for like a deep, deep, deeper deal.

01:38:31.240 Yeah.

01:38:31.480 You're, you're all your normal defense mechanisms are sort of taking a break.

01:38:35.680 Yeah.

01:38:36.040 And you can be more genuine with your emotional state and, and in that state, you can be like, what really hurts versus what have I convinced myself is my problem versus what is really bouncing around in the back that I don't want to look at.

01:38:49.080 And, and, and it's just, it's, it's, it's a, yeah, it's a much more like rich sort of conversation with yourself.

01:38:58.420 Yeah.

01:38:59.760 Yeah, man.

01:39:00.440 It was, it was definitely, it was, it was really interesting.

01:39:04.420 You know, I would like to get some more tools.

01:39:06.300 So then I go, when I go back, what are some tools you think that I could use when I go back to, or what are tools that someone can use when they go into their ketamine therapy?

01:39:17.560 After they've done, you know, met with their therapist and stuff like that, what are things that they, you feel like they can do to best get the most effectiveness out of their experience?

01:39:26.680 Well, so a couple of things are, is kind of getting some information on where you are.

01:39:32.120 So what I, what I like is I, I want patients to get a couple of labs because I want some, I want some pointers.

01:39:38.040 I want, I want some data to, to show me where they are.

01:39:42.080 So I get them, have them get a vitamin D.

01:39:44.240 I have them get a high sensitivity CRP test.

01:39:46.580 CRP is like a test for inflammation.

01:39:49.280 I, I do some brief questionnaires.

01:39:53.340 So we have this little online thing.

01:39:56.140 They're little, and, and they get these health questionnaires, but it's like, it generates a number.

01:40:01.060 It's like, how distressed are you?

01:40:03.240 And then we start sending that to them every week or so.

01:40:06.420 So we want to see what we're doing.

01:40:07.580 We want to see the baselines.

01:40:08.820 Where are we starting?

01:40:09.920 Because what are we doing?

01:40:10.820 And so we get some data on the front end and I get to know them on the front end.

01:40:15.320 And then as you go into the ketamine, you sort of organize your, I think I mentioned that I got this big thing of paper and, and I want them to like, look at their life because that's how you sort of want to like, where, what are we doing?

01:40:28.620 Where are we going with it?

01:40:30.280 Where do we propose that your distress is sort of seated?

01:40:35.820 You know, what happened?

01:40:38.200 And so then you kind of know where to toggle it.

01:40:42.200 And what can they do?

01:40:43.860 If they are, if, if the patient is sort of.

01:40:47.620 Like, how can they best help you and the medicine or the therapist and the medicine?

01:40:54.580 Usually it's, it's just, I got to get to know them a little bit.

01:40:59.100 So, so it's like, I gotta, I gotta know what brought them to me.

01:41:02.940 Right.

01:41:03.260 Like what really brought them to me as opposed to a diagnosis.

01:41:06.040 I see.

01:41:06.820 Is there a state that they can be in?

01:41:08.680 Is there an attitude that they can have?

01:41:10.560 Or is there.

01:41:11.280 Yeah, absolutely.

01:41:11.700 So, so we know now that a, a predictor of failure is resistance or the inability to accept it.

01:41:23.080 So if you're, basically it's, if, if you're not willing to let go into it, it's not going to work that well.

01:41:29.440 So we know this.

01:41:30.100 It's actually a, a study popped up.

01:41:32.940 I saw it a month ago.

01:41:34.100 I can't remember what it was, but they actually have some predictors now.

01:41:37.380 And the resistance to the process is, is going to keep it from working for you.

01:41:44.940 So if you're like, I don't want to do this.

01:41:47.000 I'm not ready to let go.

01:41:48.860 I would get yourself into a better headspace first.

01:41:51.740 And that's why we like, we want to get them into a better headspace going into it.

01:41:55.180 Like I got to get them sleeping first.

01:41:56.960 If you're not sleeping, you can't do anything.

01:41:58.580 So first thing I do is get people sleeping because then you can, you got to be able to sleep to do anything.

01:42:04.140 And so I try to get my patients sleeping first.

01:42:06.720 Oh, you do?

01:42:07.880 I mean, like when they come in.

01:42:09.320 So like, I, I usually see my patients for a couple of weeks at least before they come in.

01:42:12.800 So I want to get them sleeping on a regular schedule.

01:42:14.860 Oh, sleeping on a regular schedule.

01:42:16.240 I thought you meant put them to sleep when they get there.

01:42:18.000 No, no, no, no, no, no.

01:42:19.160 I'm sorry.

01:42:19.600 Like, like, so prep work is, I want to get their sort of, their life sort of moderated to some degree so that the process is far more useful.

01:42:26.960 Right.

01:42:27.280 Unless they're in like really bad shape and then you just do it because it's, it's harm reduction.

01:42:31.860 That's a different category.

01:42:33.600 Yeah.

01:42:33.740 My comp, dude, I had to go to a comedy show one night after it.

01:42:36.440 And that was pretty, Jesus Christ.

01:42:38.820 How'd it go?

01:42:39.500 It was okay, man.

01:42:40.840 I mean, it was pretty good, honestly, but it wasn't top notch.

01:42:45.860 You know, I just felt a little glitchy.

01:42:47.440 I had a, I was, you know, I felt like I was about two centimeters off of my regular skin and, and, and I'm in this, I'm in this fellowship of people out of the Integrative Psychiatry Institute out of Boulder.

01:43:03.020 And we had a little get together, like a Zoom session.

01:43:07.140 And there was, uh, one of the psychiatrists, she had just gotten back from surgery on ketamine and she was like talking to all of us.

01:43:16.560 And we were like, and it was, it was fascinating.

01:43:20.160 I mean, she was like fresh and she had gotten like something done to her.

01:43:23.760 And, and we're just sitting there watching this.

01:43:25.520 And I was like, wow.

01:43:26.800 And she was having like insights about her relationship with her mother.

01:43:29.560 Wow.

01:43:30.140 And that went back like decades.

01:43:32.020 And, and, and, you know, it's, it's, it's fascinating.

01:43:36.640 I mean, you stick around, you just hang out in the, in the, in the areas where people are doing this and you can really, you kind of get an idea of what this is doing to people.

01:43:46.260 It's just the insights and the perceptions and the healing that, that are sort of swimming around in this whole thing.

01:43:55.020 It's not covered by a lot of insurances, right?

01:43:57.800 Not yet.

01:43:58.660 Not yet.

01:43:59.500 So, so it depends on where you are, you know.

01:44:02.920 Where I am, not so much.

01:44:05.200 But my understanding is if you, kind of like the further west you go, the insurers are, are, you know, more friendly to it.

01:44:13.180 However, interestingly, because of 2020, mental health is actually getting much more, it's being considered much more important historically in, in sort of all the industries.

01:44:28.160 And so that is good because A, it's long overdue.

01:44:32.200 And B, it means that people can really get access to kind of healing as opposed to limping.

01:44:41.520 And, and it's sort of like, it's the hope of everybody who's in this is that when you have somebody who's been harmed in a way that they are not able to interact with the world in a way that is peaceful.

01:44:55.800 You want to do everything you can in a way that is safe and sort of research based to get them on the road again.

01:45:05.860 Yeah.

01:45:06.060 Why not?

01:45:06.520 Well, I'm sure that 30 years ago or whenever there was a conversation between two people about like, uh, antidepressants that was just like this possibly, you know, it's like, you never know, like something new is always coming along.

01:45:19.540 New things are always coming along and we're always evolving and stuff in different spaces.

01:45:23.480 And yeah, I'm certainly curious.

01:45:25.220 I love the idea of actually trying to find some healing as opposed to, uh, getting a crutch every day, you know?

01:45:33.380 Um, cause that starts to be ridiculous.

01:45:35.380 When I think of that every day, I have to take a pill when I, right.

01:45:37.800 When I get up, just that my mind has to even think about that instead of being able to be in this free space where it can just wake up.

01:45:43.660 Um, like it's kind of crazy to me, you know, it almost wonders how much of a hitch in my vibe is that overall, just that my brain knows right when it gets up that I, it has to remind me to go take a pill.

01:45:55.960 It's like, it's kind of weird, you know, it's kind of feels very unhuman.

01:46:01.040 Um, what, what actually happens to your brain, to the parts in your brain during the ketamine therapy?

01:46:08.320 Um, so what, what happens, there's a bunch of, there's actually two things that happen.

01:46:15.380 Um, the receptors get tagged that are responsible for your like anxiousness and depressive symptoms.

01:46:24.700 But the other cool little thing is, is there's a triggering cascade, uh, from a, it's called BDNF.

01:46:31.340 And what it is, is it helps your neurons like sort of change, like grow little sprouts and, and, and the synapses, the little ends can sort of become plastic and make, make changes to your, your nerves.

01:46:45.840 And they grow a little bit and you can actually see it.

01:46:48.440 They've, they've, they've imaged this.

01:46:49.800 You can, you can Google it and find pictures of dendritic sprouting, um, or dendritic spines that have been exposed to ketamine.

01:46:57.300 And so that's like actual, like growth.

01:47:02.460 So if you think like, if you're growing things in your head, you know, you can do something with it.

01:47:08.660 And that's, that's like that, that cyborg stuff.

01:47:11.320 Like you could have a new garden.

01:47:12.680 Well, you, and you slide an electrode in there and, and all of a sudden you can like grow connections into different things.

01:47:18.740 And, you know, you're going to have high def out the rear, no time on the back of your head.

01:47:23.920 You don't have a backup camera.

01:47:24.780 Uh, I mean, you think about it.

01:47:28.560 I mean, we didn't have cell phones 20, you know, we didn't have an iPhone 20 years ago.

01:47:33.640 So what we're going to go to the moon, um, every day in 10, I would bet we're going to be pretty augmented.

01:47:42.080 Kids don't have any problem wearing electronic gear on their heads now.

01:47:44.980 Yeah.

01:47:45.520 So I don't know.

01:47:47.640 I'll have, I'll have neurons growing onto a chip out my ears pretty soon.

01:47:51.300 It'll be, Hey, be pretty freaky.

01:47:53.800 But look, let me know how it goes.

01:47:56.040 Yeah.

01:47:56.260 Okay.

01:47:56.740 I'll call you.

01:47:57.540 I'll call you.

01:47:58.180 As long as you're the guinea pig first, man.

01:48:00.540 No, uh, I think that'll work out.

01:48:03.540 Uh, Dr. Jason Pooler, thank you so much for being here with us today, man.

01:48:06.420 You bet.

01:48:06.720 Thank you.

01:48:07.060 We really appreciate it, man.

01:48:08.020 Now I'm just floating on the breeze.

01:48:11.760 And I feel I'm falling like these leaves.

01:48:14.720 I must be cornerstone.

01:48:19.900 Oh, but when I reach that ground, I'll share this peace of mind.

01:48:24.680 I found I can feel it in my bones, but it's going to take a little time for me to set that parking brake and let myself unwind.

01:48:41.140 Shine that light on me.

01:48:47.380 I'll sit and tell you my stories.

01:48:52.800 Shine on me.

01:48:55.800 And I will find a song.

01:49:00.300 I will sing it just for you.

01:49:07.800 And now I've been moving way too fast on a runaway train with a heavy load of my past.

01:49:15.840 And these rails that I've been riding on, they're worn so thin that they're damn near gone.

01:49:24.320 I guess now they just work.

01:49:28.000 Ladies and gentlemen, I'm Jonathan Kite, and welcome to Kite Club, a podcast where I'll be sharing thoughts on things like current events, stand-up stories, and seven ways to pleasure your partner.

01:49:39.360 The answer may shock you.

01:49:41.100 Sometimes I'll interview my friends.

01:49:43.160 Sometimes I won't.

01:49:44.020 And as always, I'll be joined by the voices in my head.

01:49:47.760 You have three new voice messages.

01:49:50.820 A lot of people are talking about Kite Club.

01:49:53.680 I've been talking about Kite Club for so long.

01:49:56.360 Longer than anybody else.

01:49:57.980 So great.

01:49:59.340 Hi, sweetheart.

01:50:01.020 Here's a deal.

01:50:02.340 Anyone who doesn't listen to Kite Club is a dodgy bloody wanker.

01:50:06.280 Do you know what I mean?

01:50:07.540 Hi, I'll take a quarter pounder with cheese and a McFlurry.

01:50:11.160 Sorry, sir, but our ice cream machine is broken.

01:50:14.020 I think Tom Hanks just butt-dialed me.

01:50:18.180 Anyway, first rule of Kite Club is, tell everyone about Kite Club.

01:50:22.300 Second rule of Kite Club is, tell everyone about Kite Club.

01:50:26.540 Third rule, like and subscribe wherever you listen to podcasts.

01:50:30.220 Or watch us on YouTube, yeah?

01:50:32.320 And yes, don't worry.

01:50:33.560 My Brad Pitt impression will get better.

01:50:35.400 Thanks.

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01:50:41.900 Thanks a lot.

01:50:43.620 Thanks.

01:50:44.160 Bye-bye.

This Past Weekend with Theo Von - May 21, 2021

E341 Ketamine Doctor Jason Pooler

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