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Private Practice Startup Podcast
Episode 360: Beyond the Trip: Integrating Psychedelic Experiences for Growth
00:34:16
Meredith Futernick-Gerak
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- [00:01]
A
Welcome to the Private Practice Startup Podcast where we help mental health professionals grow their dream practices and live a life they love. We chat with successful private practitioners, business coaches and marketing experts, bringing you tons of practice building tips. We invite you to take advantage of our private practice paperwork and our signature marketing E course. And we have a gift for you. This is the exact methodology we use to create our six figure private pay practices and have helped many other therapists do the same. Go to private practicestartup.com and on the homepage click the button to download a free copy of your dream private practice playbook. Now on to today's episode.
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B
Hey. Hey everybody. Welcome back to another episode of the Private Practice Startup Podcast. I just want to acknowledge our loyal listeners who've maybe been with us since the beginning. We are getting close to June. We're still in May here recording, but June 6th is our anniversary date and that will make I believe eight years for us podcasting, which is crazy. This podcast will be released after that. But yeah, eight years on the podcast we've learned a thing or two. Surreal.
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C
It's so mind boggling. Yes, we have learned a thing or two along the way.
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B
Yeah, to be here. I remember when we first started, it's like yesterday when that had happened. Anyway, so welcome back and I just want to acknowledge our loyal listeners and if you're new tuning into us, awesome. You're kind of catching us in a different series if you will. We're kind of really turning the focus on lot more clinical work and some kind of hot topics around the world of mental health today. So today we're talking about beyond the trip, integrating psychedelic experiences for growth. We had previously done a podcast with Cali England, really Talking about psychedelics 101, harm reduction, how to find a therapist and today we're going to be talking with Meredith Feud, Nick Garrick, certified psychedelic assisted therapist and certified brain spotting practitioner. All about this topic. So let me tell you a little bit more about Meredith. Meredith describes her journey as a therapist as parallel to her journey as a client. She completed an intensive year long training in psychedelic assisted therapy last year, adding ketamine assisted therapy and integration to her repertoire to assist clients with getting unstuck. She places heavy emphasis on integration therapy to process and apply insights from PSAL journeys into ones daily life. Hey Meredith, how are you? Hi.
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D
I'm happy to be here. Thanks for having me.
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B
We're happy to have you. And before we begin to dive in, let's just take a quick moment for our sponsor.
- [02:38]
C
If you're Looking for an awesome full service EHR? Definitely check out TherapyNotes. They're the number one electronic health record system on the market and they even have a telehealth platform. Working with TherapyNotes will help you streamline your onboarding systems for new clients, save time when it comes to documentation each day, stay organized with your scheduling and takes the headache out of compiling the data for your practice. As a group practice owner myself, being able to save time while tracking and measuring the data from my practice is a huge resource. I love being able to look at the numbers to know what's working so I can track the growth of our business without having to actually crunch the numbers myself. TherapyNotes makes it super easy to contact them with phone support seven days a week. For any questions you might have regarding notes, billing forms, telehealth, et cetera, visit therapynotes.com and use code PPS, as in Private Practice Startup for your first two months for free.
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B
So Meredith, I'm sure, I mean, we'll just dive right in. Dive right in. I'm sure people are wondering like, how did you get involved in psychedelic assisted psychotherapy and do you have your own story on how you got passionate about that?
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D
Yes, of course. There's always a story, right?
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B
We always love a good story, you.
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D
Know, so, you know, I'm pretty transparent with my own journey as a client, you know, a person struggling with mental health issues throughout my life. And so, you know, throughout the years, I think the first time I was in therapy I was 12 and definitely at that time in my teenage years did some like recreational substances and you know, then, then kind of got out of that phase. And then later, you know, as an adult deciding to go back to school and become a therapist now kind of realizing when I look back at that time, it's like, oh yeah, I was self medicating actually. That really helped me get through a hard time and that really helped kind of release a lot of the shame around that time in my life. So then kind of fast forward a little bit. You know, we're trained. Well, when I went to school to become a therapist, I was originally trained in, you know, very like cbt, dbt, heavy cognitive focus. And so that was kind of what I was doing at the time also as a client in therapy. And I just felt like I got to a place in my own progress as a client where it's like, okay, there's still just like something more, you know, that's like missing in my work with my therapist and like feeling that also with my clients that like, okay, when it comes to trauma, not really feeling fully equipped. That's actually what led me to become trained in brain spotting, which is like a more of a mind body connection modality. You don't have to talk, you don't have to like try to challenge or change thoughts. And that really resonated with me in my first training that I did for brain spotting. Worked through some stuff that I, you know, in 12 years in therapy, had never really touched before. So then being able to follow the path to become certified in that was then able to feel more equipped helping my clients with trauma. And then somewhere along the line just again feeling like, okay, but like sometimes with some clients, you know, this is not like for everybody. But I feel, I felt like I would get to a place where again, like there'd just be this stuck point pandemic happened, you know, 2020, I had a baby. And so. Right. Like a lot of like trauma around that. Personally helping clients also who are like deep in this trauma process through the pandemic. And I went for ketamine assisted therapy as a client for the stuff that I was going through and. Except actually what I did was not ketamine assisted therapy. It was a, it was like a ketamine infusion at a clinic. There was really no therapy, so it was helpful. But I did feel like, wow, it's really felt kind of harmful that there was no like therapy with this. Luckily I had a therapist and luckily, like I had done all this work on myself already, but it really like threw me into just what kind of work could be done around processing these kinds of experiences. So that was what led me to do this year long training in psychedelic assisted therapy.
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B
Wow.
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C
Yeah. Thank you so much for sharing your journey and how you just kind of the path that you went on both as a client and then how that informed your work professionally and the different areas that you've grown. Tell us a little bit about where you find a ketamine provider to work with and collaborate with in the work that you do with your clients and how you choose the right provider. Because you had mentioned earlier, you know, some that don't have the support in place can do more harm than good. So obviously it's going to be a very important decision about who you partner with. So tell us a little bit about that process.
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D
Yes. So as soon as I started my training, that was kind of my initial thing of like, okay, I need to. Well, first of all, I'm licensed in five states, so I knew that some of the work I'D be doing was probably going to be remote. So first thing I did was open up an office here in New Jersey to do in person work. And I was like, oh yeah, I need a prescriber, at least a prescriber in New Jersey to work with. And first like reaching out to some local clinics and there was, you know, it's, it's very like medical model and a lot of the clinics that are doing IV ketamine. So you know, it's been kind of a tough road to collaborate with the local clinics. Then I learned about a company and I'll give them a shout out Journey Clinical who they do, they're in quite a few states now and they do remote prescribing. They're, they've just been fantastic to work with. So I've been working with them for about a year and a half now. And so I will refer, I can refer a client to them. They get like a full psychiatric assessment and then they're prescribed ketamine for us to use during the ketamine assisted therapy sessions.
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B
And so they're doing that with you at the office.
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D
Is that. So they're, they're all remote and then. So. Okay, so. So this has been kind of interesting. My intention when I first started doing ketamine assisted therapy was I'm never going to do this remote. I'm going to only do this in person. That's why I opened an in person office after being remote since 2019. And what happened was the first session I suppose have in person, there were some barriers that came up and they couldn't get transportation. So we were like all ready to go. And I was like, you know what, let's just do it remote. Like we're ready. We did the preparation and everything and it was amazing. I mean, you know, doing this kind of therapy remote, the person's in their own house, they don't have to worry about like getting transportation to and from my office. It is a requirement that there's someone home with them, like just in case. And I have their phone number that I can text them, you know. But so now I've been doing this actually mostly remote. So it kind of worked out that way.
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C
Yeah. And tell us, tell us a little bit about your process of offering the ketamine assisted counseling and what that looks like. Just from start to finish, just kind of high level.
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D
Right. So most of the clients. So now, you know, at this point I'll have clients refer to me just for ketamine assisted therapy. But if I'm Working for, with a client for a while and we get to a place where they're just stuck. Like really stuck is kind of the key word. It's like there's just some kind of block. And when, you know, maybe we've been doing brain spotting for a while, like they've worked through a lot of trauma. That's when it kind of like things in my head of like, oh well, like why don't we try this? So it's kind of, it's kind of like my next call to action after brain spotting to take things a little bit deeper. Because what it really does is it, it gives you some distance from yourself for a short amount of time and it really helps clients gain a different perspective on whatever the thing is that they're stuck on. So if we're talking about it, I'm never like pushy or, you know, it's just kind of like, here's some information, like let me know what you think. And if we decide to take that path, then I will refer them to the prescriber, they meet with the prescriber, they get prescribed enough medicine for two sessions. The recommendation right now is usually like six to eight sessions in total. That's usually over the course of like two to four months. So it's either weekly or bi weekly for six sessions. And then for the amount of time that we're doing the ketamine assisted therapy, it's a two hour session where they self administer the medicine. You know, we set intentions beforehand and then usually people aren't talking during a session, but afterwards they might have some things like they want to remember. So I'll write everything down. And then within 72 hours we're having an integration session. And in the integration session, that's where I really feel like that's where the magic happens, so to speak. Because that's where like we go over the notes, we go over whatever insights came up during their journey and like really making sense of it and like figuring out how they can apply some of those insights into their daily life. So we do that, you know, for the six to eight sessions.
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B
And is there any reason it's 72 hours or that's just kind of.
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D
Yes. So one of the really amazing things that they found doing all this brain research is that with within the 72 hours following a ketamine treatment, neuroplasticity is enhanced and it stays enhanced for a couple weeks. But that's like, it's the most enhanced during the 72 hours. So it's like if we're going to put any new habits into place like that's the time you want to do it because it's like you can really cement in some new ways of thinking and habits.
- [13:52]
B
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D
It depends. I would say Typically we have one integration session in between dosing sessions. But really integration is everything that happens, you know, in between the dosing sessions. So for some clients, it's journaling. For some clients it's art. For some clients, clients, it's music being in nature, you know, so integration really refers to like the process that's happening in between the dosing sessions and then, and then after the series.
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C
And I'm sure there's a lot of like psycho education that you do with a client before they actually undergo this and a lot of questions that they have that you're answering and whatnot. So how do you describe the process of what it's like when a client is prescribed the ketamine and what they can expect from that experience?
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D
Yeah, so there's so many great resources out there now, which I'm really grateful for. I have like a whole document that I made of resources that I will send either like the whole document or kind of pick and choose resources from there to share with clients so that they can really understand. So like, you know, for, for my more analytical people, I'll send like a lot of the research. For, like, my more spiritual people, I might send some like, experiences that people have had that they describe. So there really is a lot of resources out there that I share. I also like to talk about, like, how ketamine has been used historically as an anesthetic. Like during wartime. Ketamine was like the anesthetic of choice because it does not suppress respiration. And so we're talking about like, in much, much higher doses. For decades, this has been used as an anesthetic, like, even in surgeries with children. So I'm like, okay, like, if they're using this in much higher doses with children, like, that makes me feel like in much, much lower doses. But we're using. It's pretty safe. So I talk a lot about that, about the safety. And, you know, it's also interesting, kind of parallel to my experience when I first became a therapist. I think like, the mindset was really like, I remember being told if a client asks you how you're doing, you kind of like direct that back to them and ask them, well, why is that important to you? Where now I feel like it's, you know, people want like a human therapist usually. So I feel really grateful and excited that things have kind of shifted into a place where I feel a little more comfortable with self disclosure. I'm not going to get into like, why I did ketamine therapy for myself as a client, but I do tell my clients that I have done this myself, and so that that helps. You know, they're like, okay, like, this is a therapist, like, recommending something that they've actually done and has been helpful for them and a lot of their clients. So those are, like, a few of the key points that I like to touch on.
- [19:50]
B
And can you share a little bit about, like, your own integration? Like you said you went to, like, a clinic, but they didn't have integration, and thank goodness you had your own therapist. So what. Maybe can you share that personal experience, what that was like for you?
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D
Yeah. So, you know, really, an integration therapy session is really just therapy for the most part. You know, the. It can be whatever kind of therapy you're already doing with your therapist. So, you know, if I was working with a brain spotting therapist at the time, so we would process the difficult experiences because part of that was traumatizing because I didn't have that preparation session before. I didn't have someone in the room with me. Like, they're holding space for me. So I was able to process some of that. And then also some things that came up, some, like, really big items that came up for me during the actual treatment. So really, it's. It looks a lot like regular therapy that, you know, probably you're already doing. The difference is, like, maybe you were able to process stuff that was a little bit deeper that had bubbled up, you know, during the ketamine session.
- [21:06]
C
And you mentioned earlier the importance when you're doing this virtually of having a person, another person in the house. What are some of the other safeguards that you put in place as you're approaching clients to work in this way?
- [21:22]
D
Yeah. So one of the most important pieces is the preparation session. So though that could be one session before a dosing session, or it could be months, you know, because it's really important that the client feels as safe as they possibly can going into that first dosing session. So we're talking about things like, what are your fears? You know, like, what if this does work? What if it doesn't work? You know, like, really managing expectations. So, right, there's, like, that side of things, and then there's the logistical stuff, like, make sure. We got to make sure, like, your laptop's charge, your phone's charged, you know, your headphones are working, like our mute. The music is working. So there's like, those logistical things. They do have to take their blood pressure before, and there's, like, a range. You know, if it's too high, then they won't be able to do the session. But that, that really hasn't happened because I do some grounding work in the beginning before they even do the blood pressure. So we're doing grounding, setting intentions, kind of addressing anything that may have come up that they need to process that could get in the way of their journey. And yeah, I think having that person there home with them, like knowing that if you need the support, whether that's like kind of like a helping hand to the bathroom or even just like someone to hold your hand, I can text your chaperone, you can always, you know, tell me that and I can text them. So it's, it can be pretty individual, like what's going to help a person feel the most safe and comfortable in their space.
- [23:07]
C
And you mentioned earlier that you know, there's typically not a lot of talking during the session, that two hour period. So are you there just kind of observing and watching and guiding and I don't know, tell us a little bit about your role because you said it's, you know, they're just kind of relaxing and going through their journey and you're, you're there. But I'm just curious about that role.
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D
Yeah, it's a, it's such, such a big shift because it's sometimes it's counterintuitive like to just be there and I'm like, oh my gosh, someone's paying me to just be here. But actually there's so much value in being able to hold space for someone and like really be there with them. So for me personally, I have to put my phone like really far away from me because otherwise I'm tempted, you know, to pick up my phone. It's just so automatic. But I'm watching their breathing. I'm taking down, I take down so many notes of things that like may or may not be important for them in their integration process, but just in case it is. And so yeah, really just holding that space and clients will tell me like, like I know we weren't talking but I really felt you, you being there for me. And for a lot of people, like they don't have that in their day to day life. Someone just like attending to them for that amount of time, like it's really powerful actually.
- [24:37]
C
So it's more of an internal journey that they're on and then as they're coming to and they're sharing things, you're writing that down and that way you can process it in that processing session. The integration session.
- [24:51]
D
Exactly.
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C
Gotcha.
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D
I do have some clients who talk through the whole session and. But that's kind of like the. That's not as common. The. The more common thing that I see is a very internal experience.
- [25:04]
C
Gotcha.
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B
Yeah, and I was wondering about that. Like, I'm. Like some clients might like, say something or a word or blurt something out, right? And you're kind of like writing that down to refer back to.
- [25:16]
D
Exactly, exactly. It really does keep you on your toes because people respond really differently just depending on the individual. So, you know, a person can be in their journey for 30 minutes, or a person can be in their journey for 75 minutes, and they can look very different from person to person. And so it really is kind of like a refreshing part of my practice because it's just. It's just so interesting that part of it, that people respond differently too.
- [25:44]
B
And what are some of the results? You know, are you kind of seeing clients before? Like you said, sometimes you're doing brain spotting and they've just got plateaued. And then you're suggesting this. So what are some of the results your clients are seeing after they do ketamine assisted therapy?
- [26:01]
D
Yeah, I mean, of course it varies, right? Like, this isn't like a be all end all for everybody, but the majority of people that I've worked with that have gone through like the full six to eight. I mean, I. I've worked with clients who have like, high suicidal acuity, who in two months or like working, you know, like, it's like that. It can be that powerful, like that much of a transformation for people just to get like a break from the brain for a little while and to have a shift in perspective. So that I would say that's at like, like the far end of like, wow, just transformation. And even in clients doing trauma work where, you know, they had been feeling stuck and like, there's this thing, usually I would say like 90% of the time they're able to get to the other side of that, whatever that is. Whether it's like they've gained a different perspective about it, or they just like, understand it better or accept it. It's the shift that happens for people. It's. I've had clients say it's like 10 years of therapy in, you know, six sessions.
- [27:16]
B
So it's pretty powerful, pretty amazing. And it's interesting when you talk about, like, the suicidality and the research that I've done on ketamine, that's kind of where it started, right? Like they were giving ketamine to suicidal patients on like, Emergency calls or something like that, and then they would follow up with them and they were doing so much better and it was something to explore. Yeah.
- [27:35]
D
Yes, yes.
- [27:36]
B
Very interesting.
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D
Yeah.
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B
Have you had clients that there's been no result or an adverse effect?
- [27:46]
D
No, I honestly had not had, luckily, knock on wood, adverse events, I would say, like, at the very least for someone to have that time where they just like I've had clients call, like forced relaxation, you know, is helpful because I think just like where so many of us are just go, go, go all the time to just have that time, like set aside. It's like self care on steroids kind of. Because you really, you can't do anything during that time. So like, even if you're a person who struggles to meditate and sit still, it's like you kind of have to. So there's really like not much else to do. And. And the other thing is that it, it really helps people detach from like the rabbit hole thoughts that or like the rumor rumination that we can go get into. So maybe like not everybody has this like profound transformation, but at the very least, just having that little bit of space, I like, I can't imagine that not being helpful, you know, but it's definitely not like a, like a magic bullet kind of thing where you like, you take this medicine and you're better. There's a lot of work that goes into it.
- [29:07]
B
Yeah. And I think that. And even the podcast we did last time, and even what you're talking about is, you know, I don't know. I don't know if that's the American way. Right. Take this diet pill, lose weight, what, you know, you got to do the work that's really important. Right. Like, this can help it along, but you have to do the work. I know someone described ketamine to me and I thought it was a very interesting analogy. Is like, you know, our neural pathways in the brain, it's kind of like, you know, for anyone who lives in cold weather states that has snow, it's like sledding down the same path. Sledding down the same path. And the ketamine just kind of sprinkles a new snow across the path. Right. And so you're able to have, you know, a different experience or like you said, neuroplasticity, which is fascinating to me. Right. Like that this, you know, this drug, this chemical like creates a neuroplasticity to help new neuropathways form. I just think that's fascinating. So very interesting. Is there anything that we didn't cover that. You wanted to make sure that we touch on.
- [30:01]
D
I know we did touch on it, and I know it's like the topic of this podcast, but I really do want to reinforce, like, the importance of the integration, because I know I think everyone's probably heard the term, like, bad trip, right? Like having a bad trip on psychedelics. That's okay. So my perspective on that is that there's not necessarily such thing as a bad trip. There's difficult experiences with psychedelics, but having preparation set and setting that's appropriate and safe, and then the integration afterwards, like, you know, it really is my belief that the medicine's not going to give you anything you can't handle or eventually integrate. So I think it's just such an important piece of what makes these very powerful medicines such an amazing tool for healing is really like, the whole process around it.
- [31:02]
B
Gotcha. Awesome. And what you said you're a license in five states. What five states are those?
- [31:09]
D
New Jersey, Florida, Colorado, Maryland, and Virginia.
- [31:13]
B
Perfect. Cool. All right, well, what do you really hope our audience takes away from your message today, Meredith?
- [31:20]
D
I really hope that, you know, the stigma around some of these medicines can be reduced and, you know, that they can be used therapeutically when in the right setting with proper preparation and integration. And then again, really reinforcing that importance of, like, the assisted therapy part, you know, that this is not like. This is not like, just like recreationally using substances. This is really using a powerful medicine to assist your therapy process.
- [32:00]
B
Nice. Thank you so much. And Meredith, where can people find you?
- [32:05]
D
Well, My website is integrativejourney.com. i guess that's probably the easiest way to find me. I. I'm not very active on social media. I. It's just. It's one of my things that I have a hard time really keeping on top with. But integrativejourney.com is my website. You can subscribe to my page there. I do like to write blogs occasionally, so. And you can get in touch with me there. Email, phone, you know, all those things.
- [32:36]
B
Awesome. Well, we'll definitely have that on the Show Notes page as well. And we just really appreciate your expertise and just kind of sharing authentically and helping folks understand this new emerging world. Although it's kind of been around for a long time. Right. We talked about, like, LSD and alcoholism back in the 60s, and I know it's reemerging in this era and our lives.
- [33:00]
C
Yeah. Meredith, thank you so much for being here. This was really informative and I'm sure Startup Nation really enjoyed this episode. So Startup Nation, we want to encourage you to subscribe, rate and review our show. We always love hearing feedback about how the podcast has been helpful for you. We want to encourage you to share it with your friends and fellow colleagues who could benefit also. And if there's a topic that you want to suggest, reach out to us. We always love to hear that feedback too, so we can really create create the content that's going to be most helpful for you along your journey. All right. So in the meantime, stay inspired. We'll see you next time.
- [33:34]
B
Take care everybody.
- [33:38]
C
Thanks for joining us on the Private practice startup. Visit theprivatepracticestartup.com for awesome resources, free trainings, attorney approved private practice paperwork, and so much more.