Relational Healing, Neuroplasticity, and the Power of Psychedelic-Assisted Therapy: An Interview with Dr. Alexa Altman and Shira Myrow

Curt and Katie chat with Dr. Alexa Altman, Ph.D., and Shira Myrow, MFT, co-founders of iPsychedelic Therapy, about psychedelic-assisted therapy and how it supports trauma healing, neuroplasticity, and relational transformation. We explore how psychedelics are being used in clinical settings, what integration really means, and the ethical and practical guardrails clinicians must consider as these treatments become more available. Alexa and Shira explain how clinicians can prepare and how therapists can support clients who are exploring these experiences.

Transcript

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(Show notes provided in collaboration with Otter.ai and ChatGPT.)

About Our Guests: Dr. Alexa Altman & Shira Myrow, MFT

Co-founders Shira Myrow, MFT and Alexa Altman, Ph.D. bring together decades of expertise in mental health, trauma recovery, relationship counseling, and spiritual growth. With a focus on complex trauma and attachment disorders, Shira is deeply committed to helping couples and individuals transform traumatic experiences and patterns into resilient narratives and healthier relationships.
Dr. Altman brings a background in trauma-informed psychology and spiritual counseling, supporting clients through transformational journeys with safety, respect, and heart-centered guidance. Together, they offer a holistic approach that honors the profound inner wisdom of each person they work with, guiding them toward sustainable healing, self-love, and purposeful living.

In this podcast episode: The Promise and Precautions of Psychedelic-Assisted Therapy for Trauma and Transformation

As the field of psychedelic-assisted therapy grows rapidly, therapists are facing increasing questions—from clients and themselves—about what these treatments are, how they work, and who they’re for. In this episode, Alexa and Shira share grounded, research-informed insights and practical considerations to help modern therapists prepare. They highlight the promise of healing, the risks of commercialization, and the responsibility we all share to slow down and go deeper.

Key Takeaways for Therapists Exploring Psychedelic-Assisted Therapy and Trauma Work

“This idea that [Psychedelic-Assisted Therapy] is a bypass, that we’ve heard a lot of people probably in the flesh of a psychedelic experience thinking, Oh my God, I’ll never need therapy again. I’m healed. I’ve completed my work in this lifetime. I’ve made my peace with all the things. And it’s not really true, it’s an amplifier, it’s an accelerant, it’s a catalyst.” – Shira Myrow, MFT (Timestamp: 04:24)

• Psychedelics can act as amplifiers and accelerants in trauma therapy, but they’re not shortcuts or magic pills.
• Safety, intention, preparation, and especially integration are essential to effective psychedelic-assisted treatment.
• Integration allows clients to meaningfully translate mystical, emotional, or somatic experiences into long-term change.
• Some clients are not ideal candidates due to fragility, lack of ego strength, or minimal therapy background.
• Therapists must do their own work, examine personal biases, and receive specialized training in this evolving modality.
• Ketamine is currently the only legal psychedelic treatment option in the U.S.; MDMA and psilocybin are expected soon.
• There’s a strong need for regulatory bodies to create ethical and practical guidelines as the field expands.

“I think of integration as like seeds that were planted through the [psychadelic-assisted] journey, and it’s our work to water it and provide sunlight and fertilizer. And without that, it’s just potential. It really needs that ongoing work and attention.”  – Dr. Alexa Altman (Timestamp: 37:35)

 

Resources on Psychedelic-Assisted Therapy and Trauma Healing

• iPsychedelic Therapy Website
  
• iPsychedelic Instagram
  
• Free Integration eBook via their website (there is a popup when you go to the site)
• MAPS (Multidisciplinary Association for Psychedelic Studies)
  
• Third Wave
  
• How to Change Your Mind by Michael Pollan
• Research from Johns Hopkins, Roland Griffiths, and Robin Carhart-Harris
  
• Andrew Huberman podcast

Relevant Episodes of MTSG Podcast:

• Psychedelic-Assisted Therapy, An Interview with Dr. Craig Heacock, MD
• We Answer the Question: Is EMDR a Pyramid Scheme?
• What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings – Part 1
• What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings – Part 2
• The Power and the Peril of Pop Psychology
• Topic: Skeptics and Outliers

Meet the Hosts: Curt Widhalm & Katie Vernoy

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

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Music by Crystal Grooms Mangano https://groomsymusic.com/

 

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:12
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our practices, the things that happen in our evolving field, and we are once again, moving into a topic around psychedelic assisted therapy. This is something that we talked about some time ago, and we had some questions around things at the time, it was just kind of starting to emerge. And since then, there has been a lot of progress in the field. There has been a lot of research and support of how this whole new thing ends up working. And since Katie and I are not experts or practitioners of this, we do as we normally do, and we bring on our friends who are practicing this. So we are joined today by Dr. Alexa Altman and Shira Myrow. And thank you so much for coming and sharing your expertise on all of this.

Shira Myrow 1:16
Thank you so much for having us. We’re really delighted to be here. We’re big fans of this show.

Dr. Alexa Altman 1:22
Yes.

Katie Vernoy 1:23
So we’ll start with the question we always start with when we have guests, is, who are you and what are you putting out to the world?

Dr. Alexa Altman 1:30
Yes, Katie, thank you. I’m Alexa Altman. I’m a clinical psychologist and trauma informed psychedelic practitioner. You know what I’m most passionate about is opening up a conversation around psychedelics, my favorite conversation, one that’s grounded, respectful and thoughtful. And I think the main thing I want people to understand them better. I want to demystify them, offer sourced information and education, and make this work accessible to those who might benefit from it. At the heart, I mean, as clinicians, we know that healing happens in relationship and relationship to ourselves to others, but in the case of psychedelics, opening to something bigger. And I do see psychedelics as one path of many, right, that can support this kind of deep reconnection.

Shira Myrow 2:20
I’m also a psychotherapist. I’ve been in the field for almost two decades now. My focus tends to be on couples and relational healing, and my work centers around the intersection of trauma, attachment and emotional intimacy. And what drew Alexa and I to psychedelics was a profound revelation of its transformational potential, and we founded ipsychedelic therapy last year to invite, I think, a very ethical and thoughtful approach to this emergent breakthrough therapy. It isn’t for everyone, but we, we want to be on the cutting edge of the of that conversation. And we, we really want to open up the possibility for its healing potential as an adjunctive form of therapy to conventional therapy.

Curt Widhalm 3:18
So over the few years that I’ve been tracking what psychedelic assisted therapy is, I was part of the California Association of Marriage and Family Therapists their ethics committee, when they came out with some ethical recommendations around practitioners who want to do this. So I’ve been aware of some of the myths and mythologies that go on about psychedelic assisted therapy, but maybe here’s the chance correct, what are people getting wrong about this?

Dr. Alexa Altman 3:50
I think what people get wrong first and foremost is around feelings of safety, right, that they hear psychedelics and there’s this bias war on drugs counter culture. Are these medicines safe and safe in a clinical setting? And do we have enough, well, we it’s not in the public yet, but are we going to have enough guardrails in place to support clinicians to safely practice this form of therapy and protect the public? So I think safeties are always number one point to talk about, Shira, do you want to take other point?

Shira Myrow 4:24
Sure, I would say this idea that it’s a bypass, that we’ve heard a lot of people probably in the flesh of a psychedelic experience thinking, Oh my God, I’ll never need therapy again. I’m healed. You know, I’ve completed my work in this lifetime. I’ve made my peace with all the things. And it’s not really true, it’s it’s an amplifier, it’s an accelerant, it’s a catalyst. But we, we want to clarify that we don’t think it’s going to put conventional therapy out of business. We really think that there’s a reciprocal relationship with this type of therapy, and there’s been so much excitement around it, and I think a rush towards mainstreaming and a rush towards commercializing it and monetizing it, which we have strong feelings about. But we think that it’s really important to go slow and careful, as Alexa said, to protect the sacredness, the power, but also just keep those ethical guardrails front and center for patients.

Dr. Alexa Altman 5:34
And I think finally, for clinicians to examine their own biases. We come into our clinical room with our client and come in with all these sets of belief systems and fears, and for clinicians to educate themselves, because more and more clients are seeking this in the underground and bringing this to their therapist. Should I do this? Can you support me? And for clinicians to find those really well sourced information, those places to be able to hold what might need to be held clinically with a really safe container. And it takes a lot of education and consultation to get there, and so just really being able to support clinicians in that way.

Katie Vernoy 6:18
What is psychedelic therapy at this point? Because I know we talked about it. I’ll link to the other episode that we had that was kind of the 101 in our show notes over at mtsgpodcast.com. But just for to frame briefly, frame this conversation, what are we talking about when we’re talking about psychedelic assisted therapy?

Dr. Alexa Altman 6:38
Yeah, so if we’re looking at what currently is FDA approved, we’re talking about ketamine assisted therapy, and that’s approved intranasal, IV and lozenge form, and for the treatment of treatment resistant depression and a variety of other mental health conditions, anxiety, we’re seeing trauma. And clinicians can go get that training and support, not distribute those medicines, but support clients who have been prescribed those medicines in their office. So that’s what’s currently, FDA approved. And then the other medicines, Shira, do you want to take, take it?

Shira Myrow 7:14
Sure. So they’re, they’re in the pipeline. There, there are trainings, MAPS, for example. Or there’s, I mean, there’s actually a bunch of trainings available, both for psilocybin and for MDMA. And most of the protocols sort of revolve around, let’s say the MAPS protocol, where there is an intake a preparation, there’s the journey day itself, and then there’s the critical integration component, which we think often is is not very, I want to say robust and where, where things kind of fall down. And we also want to invite clinicians to to learn more about the integration piece. Because without the integration piece, so much focus is on the journey day, all the expansion and the insight and the revelations that come forward on the medicine, but without integration, sometimes these experiences can dissipate in their potency and they can be fragmenting they you know, psychedelics are quite variable to that extent. But back to the protocol itself, that’s what it includes, a thorough intake where certain medications or conditions might rule out people for this kind of, you know, therapy, a deep preparation about what to expect, the journey day itself and then, and then maybe several integrations afterwards. But integration is a process that can, that can go on for weeks, months, even years, if, if you’re really seeding deep change in in someone’s consciousness.

Dr. Alexa Altman 8:51
But to further name the psychedelics, it’s hard, because psychedelics is such an umbrella term for so many different medicines, right? So we’re speaking to which you’re speaking to MDMA, currently in phase three clinical trials with MAPS, Multidisciplinary Association for Psychedelics, phase three clinical trials for the treatment of trauma, which, by the way, their outcomes, 88% of participants had clinically significant results, or decrease in their trauma symptoms, and encompass pathways for the treatment of major depressive disorder, again, clinically significant results, and they’re also in phase three clinical trials. So I think that when we speak to what are we talking about, right? Which medicines? Those are looking to be approved, those two medicines probably within the next year or two. So what we’re looking at is clinicians to be ready, to want to be those interested, to be available to go seek training. Because I think that’s going to be one of we’ll probably talk about barriers. But one of the barriers is clinicians to be trained and ready for when these therapies become available, to be able to roll them out to the public.

Shira Myrow 10:01
And they all already are being rolled out in certain states, Oregon, Colorado, I believe, Utah, Utah and there, there are places everyone knows; Costa Rica is where you can go for a transformative Ayahuasca retreat. Also in Australia. Australia is has led the charge. They’ve they’ve already approved both MDMA assisted therapy and psilocybin assisted therapy and and I think there’s places you could go in Mexico where there’s more access to these types of medicines. But back to your question, Curt, I wanted to be sure to name this; there isn’t one of the the hurdles, and I think a linchpin in this whole process, is some kind of regulatory body that includes both the compound itself and and the therapeutic component. And it doesn’t exist yet. So the FDA is not quite equipped in terms of how they how they process medications, because this is novel in that respect. And so the question is, who would create that body? Is it a is it state, like the state boards, like the BBS, or do, do we have, like, a national body that says, Okay, these are the rules and these are the parameters. But we absolutely believe that some kind of regulation needs to exist for everyone.

Curt Widhalm 11:27
Does it seem like there’s anybody who’s stepping forward and leading the charge on that? As listeners of our show have heard us talking about things such as the social worker compact or the counseling compact that we’ve had people talking about MFTs not getting that, because there’s no one really stepping into that regulatory space in a meaningful way. Are you finding the same kinds of things with psychedelic assisted therapy?

Dr. Alexa Altman 11:56
I think there’s a delay, because there was no FDA approval in August. Everybody was thinking in August of 2024, MDMA assisted therapy would be approved. I do believe there will there, there, there will be more front runners, as you’re saying, who are moving in that direction. I think without that approval, you know, it’s hard to mobilize in the ways in which you’re describing.

Shira Myrow 12:21
I mean, another component of that is that, you know, there are commercial interests that that want to monetize this, and certainly, well, the wellness industry has has embraced this. So I think there’s, there’s probably different parties and lobbies who who have their own agendas around this. There is something that we discovered, there’s a psychedelic, psychedelic Bar Association, so now there’s a community of attorneys who specialize, particularly with cannabis, but also now psychedelics. So that’s something that’s interesting to watch. And we think the rollout might look like a state type of rollout, similar to cannabis, if it’s not going to happen, you know, in a national FDA type way.

… 13:07
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Katie Vernoy 13:09
So what are the other hurdles to becoming approved for the general public do you think?

Dr. Alexa Altman 13:14
I think one hurdle is access to care. These treatments are a lot of hours, clinical hours. We’re talking 10 to 20 minimum clinical hours. How do we make this affordable? Will insurance cover it? And currently, people can do the Costa Rica retreat, but that’s for a very small percentage of the population. So how do we make this equitable? I think another hurdle is safety, the protocols that we talked about really ensuring that the public is safe and that clinicians are trained thoroughly. Shira?

Shira Myrow 13:51
I think the well, personally, I do not believe it should be mainstreamed, and I feel strongly about that for all the reasons that we’ve been talking about, because psychedelics are so powerful and there are kind of like coming back, let’s say, from rehab, this was something that was cited in the FDA assessment of the clinical phase three trials. You have a huge, maybe mystical, expansive healing experience, and you come back into your world, into your marriage, into your life, into whatever framework you came out of and you’re not prepared. You can’t create a kind of cohesive, you can’t integrate the experience into your daily life, and the world around you isn’t supportive. So there’s this component, okay, yes, the clinicians need to be trained and and and containing. But what if your world doesn’t support the changes? And we say that, you know, after a big journey, don’t make any radical decisions, right? Don’t force your wife, don’t quit your job, don’t move to Bali, although you might eventually. But. Yeah, you can, right, it can be shattering. It can be it can be spiritually awakening. There’s, there’s, there’s so much opening that happens. And so there has to be, I think, even on the part of someone who’s curious and interested, that it’s, it’s not, it’s just a lot more variable. It’s not like taking an SSRI for depression. So that we can have all kinds of new expansion that we don’t know how to language, and we really don’t know how to sort of pull back in. And going back to that piece about integration, it’s like this is a big process of sifting through and, in a sense, like putting everything back together again in a way that helps you move forward in life. So on the one hand, you know, we kind of see this fascinating and very exciting, almost, medicalization, right? We’re using psychedelics, very specifically for therapeutics. Back in the second wave, you know, with Tim Leary and Ram Das. They were like, Let’s disrupt culture and society and check out. Go to India, find your guru, which was exciting and interesting for all kinds of reasons, and maybe fostered a lot of musical, amazing albums. But here we are in the third wave, where now these are applied psychedelics. And so there’s a whole continuum of applications. And I think that’s something that we’re so interested, right? They’re calling it the psychedelic Renaissance. But that’s why it’s so interesting, because there’s so many applications. And so I think for someone who’s curious, including therapists, where do we plug in?

Dr. Alexa Altman 16:41
I think a final hurdle is really cultural, as Shira is pointing to the just decades of misinformation, the legacy of the war on drugs and it really shaped the public perception, which is part of why I think we’re on this parade of trying to get really sourced information out there, because perception is hard to change one person at a time, and I think that’s going to be a really big space in which there’ll be more advocacy when people can come along for this ride.

Curt Widhalm 17:14
How does this work? How do psychedelics work in trauma work, and being able to help people have some of these experiences that are so therapeutic.

Dr. Alexa Altman 17:26
This is our favorite conversation, the like, how does it actually work? And I feel like Shira, we could spend the whole time actually talking about this part, but I’ll do my part, Shira, and we’ll go back and forth. It’s in it’s such a profound way, if we’re speaking specifically first of MDMA, we know as clinicians, the activation of a nervous system as a result of trauma, and that activation is what we’re working with in the room all the time, right, helping to regulate so we can actually get to the source of the trauma. Well, MDMA quiets the amygdala. It allows for that spaciousness to examine the traumatic memory, somatic expression of the trauma for lengths of time that the nervous system, ordinarily in a normal state of consciousness would never permit. You would be working really hard to stay regulated with that human in front of you as a clinician, where they have access to regulation for a long time, so you can get to traumatic pieces that honestly, it would take a really long time to get to with the EMDR, somatic. It it just it does expedite the processing. Furthermore, another fun fact is, psychedelics work on the default mode network. The Default Mode Network is the part of our brain when we’re not focused on the outside world, when we’re kind of daydreaming that communicates implicitly who we are, our story of ourselves based on our environment and our context, like we are our context in many ways, well, that falls away. And so the story of our small sense of self, there’s a plasticity in which we see ourselves through a lens that’s not conditioned conditional on our context, which allows us to see ourselves much bigger than we are and redefine the story of how we’ve seen ourselves to be, and that in and of itself, in that plasticity, or that deep seeing of self in a new way, can be one of the many and sure it can speak to other powerful reflection that feels very sacred can feel very sacred.

Shira Myrow 19:37
I’ll just chime in on, on the on a note around, right, the neuroplasticity, right? What’s the mechanism of action? And on, on some levels, and this is fascinating, we do know that it affects the the serotonin receptors, but the precise mechanism, mechanism of action we don’t actually know, which is pretty fascinating, as it relates to this idea of neuroplasticity. It floods, let’s say we’re using MDMA, tt floods the brain with these positive neurotransmitters, norepinephrine, serotonin, dopamine, oxytocin. So it is suppressing the amygdala function, which, as Alexa said, would get activated in a normal circumstance and this, these other positive neurotransmitters create this kind of feeling, this, this cushion where you’re able to take those very, very painful narratives of of self, or maybe reprocess very traumatic memories, sometimes memories that have been buried for years will will surface in a psychedelic assisted journey, and you’re able to file them away, maybe re narrate them. In a couple setting, which is quite interesting, right, your defenses are down, and those negative narratives that you’ve had about your partner soften, so you’re able to sort of see either self or the other with a set of of new eyes, tender eyes, and in that moment, you can kind of reconstruct certain types of things. And the the trauma narrative loosens its vice grip. What is so powerful, I would say, is that it’s a it’s a sustained experience. So even, let’s say the often, you know the setting is with a mask and with music, but but sometimes in that interaction with with the therapist themselves, just knowing there it can be a sustained, reparative attachment experience with with a therapist or even with a partner, because you you have this prolonged period of time, even though your sense of time is totally out the window, suspended. You know, oftentimes in therapy, it might be a cumulative where you start to feel secure and you start to feel, ah, yes, you know, I my, my attachment now is, I’ve had these repeated experiences where, in a psychedelic experience, it’s, it’s one prolonged, sustained experience of connection, and it can be profoundly healing, so that there’s something about that in itself, that that provides a different type of experience. It’s not to say that you can’t get there in other ways, but, but this is the amplifier and the accelerant component of psychedelics.

Dr. Alexa Altman 22:20
And I think we’d be remiss in talking about trauma if we’re not also talking about shame. I feel like they’re one in the same. And one of the both, all the medicines we’re talking about have a profound way of bringing self compassion to the material and that self compassion that of A not seeing myself as broken because we talked about the loosening of the narrative, which most trauma survivors either feel broken or bad, and so the loosening of that narrative with that element of self compassion that for many have never felt. They’ve they’re trying self compassion practices. They’re doing the steps, and they feel the compassion from their clinician or their pastor or their friend, but it doesn’t fully enter their own heart and to be able to feel, have a felt sense, not a mental kind of conception of it, that self compassion can be transformative.

Katie Vernoy 23:18
Shira, when you were talking about the connection the openness. I started thinking about the safety concerns again, and both the need for clinicians to be very well trained because of the vulnerability of the client in this situation, but also to be vetted, because it feels like that would be a very, very vulnerable position for a client to be in. What does the training look like to make sure that clinicians are being effective and also actively not causing harm or crossing boundaries?

Shira Myrow 23:55
That’s a great question, Katie, and we’ve done a bunch of different trainings. There has, first of all, consent and a full preparation about what to expect on the journey; touch that has to be outlined at the beginning and before, before administering any kind of substance. Usually, sometimes no touch at all, maybe sometimes a handhold, or that’s usually it. There was some concern about that, because you’re absolutely right that there is room for potential abuse or exploitation when people are so vulnerable on these drugs. So the trainings we took, including the MAPS training, was, was quite rigorous about the importance of of holding very gentle, protected safe space. And I mean, nothing could be more paramount than then, that commitment to making sure that your client is is protected. What one of the components of psychedelic assisted therapy is also the sentence setting. So it’s usually done in an office or like a safe, enclosed space, not in some you know, not in a park, not in a place running, you know, kids running around, or anything like that. That that set is the mindset and the setting is the environment that it’s as as protected as possible, so that you can maximize the experience. And coming back to the importance of regulation, and having a regulatory body, you know, I think that it’s important to work with somebody who, let’s say he’s a trauma specialist. Like, if I was going to do it and I was working through trauma, I wouldn’t just go with someone who, you know, got their training in, I don’t know, Peru for 48 hours, you know, Shamans R’Us thing. Like, I’d not to say that there aren’t people who are deeply rooted in those practices, but I do my homework to make sure that I was with both a clinician and a facilitator who had a lot of experience.

Dr. Alexa Altman 26:07
I think to your point with that training and the thorough intake, there are so many people where this is not appropriate for them. Anyone with a thought disorder, psychotic disorder, certain medical conditions, personality disorder, although there’s some research right now with psychedelics and personality disorders; anyone that has a kind of fragile sense of self, there isn’t a ton of ego strength. I are not ideal candidates for any of the psychedelics. People might say otherwise, but that stand firm in that position, that to your point, Katie, there’s this opening, this vulnerability, and if there’s a fragileness in the system, that could be very disorganizing. If you’re with a clinician that’s not holding that safe space where there’s not that positive rapport tethering you in that attachment relationship also could be a big red flag for a potentially negative experience.

Shira Myrow 27:06
Agreed. Yeah, absolutely. And I think even the this question of: who’s this right for? There are people who come to it without a lot of self awareness, who haven’t been in therapy, who haven’t done inner work. And for us, those those types of people, they might have an initiatory kind of experience, but people who have more infrastructure of right, have more capacity to process, more conscious awareness of themselves, their their patterns, their their past traumas, are likely, not always but likely to get a lot more out of the experience than someone who’s kind of coming in cold, and it’s more out of curiosity, as opposed to, okay, we’ve tried other things that they haven’t worked, or I’m feeling really stuck and and we need something to move the needle on the dial. And that’s, I would say, maybe that’s a little bit more appropriate in as opposed to someone just looking to, you know, have have a wild ride. That’s, that’s, that’s psych assisted therapy. That’s something else.

Curt Widhalm 28:16
One thing that I haven’t really heard anybody talk about yet, is, what is it that the clinician is doing while the patient is under the influence of the psychedelic? It is, it’s more than just babysitting somebody who’s tripping, right? That you’re doing something active there.

Dr. Alexa Altman 28:36
There’s not one answer, the same way we’d say in sitting with a client in an ordinary state of consciousness in a clinical setting, but the clinician, for the most part, is less actively involved in analysis, in deep questioning. There isn’t a lot of mentalization happening. So the clinicians following the client’s lead, that we do in our clinical work, some at times, where we kind of meet the client where they are. So what it can look like is a lot of sitting back and being a witness to a process unfolding, and most of a lot of the material that surfaces is often material, we could say has been relegated to the shadow or underground of that person’s psyche has never been witnessed before by them or having a witness with them, so it can look like, Curt, a lot of quiet time where you’re watching and listening. And the clinical skills, I think, come in when there’s more active there’s moments of IFS that could show up and where you might be processing that in a way that feels similar to a somatic experiencing session, right, where those clinical skills come in, but there’s a lot more holding, as we say, holding space, holding safe space.

Shira Myrow 30:09
Also, I want to add the facilitator might be taking some notes, important notes, to process an integration. But the way we’ve been trained in that this is the MAPS protocol. Is this the premise, the basic premise is that the medicine activates the inner healing potential, or the inner healing wisdom of a client’s psyche. So in a sense, the therapist is is taking a supportive role during the journey as as the medicine and the inner healing, and this is where the parts working come forward, which is that you’re trusting that every client has the capacity to heal and to be in conversation with themselves about the material that’s surfacing. So it’s not six hours, just to clarify, six hours of intensive therapy, which probably doesn’t sound fun, it’s but I mean, that’s there’s enormous beauty, I would say, in witnessing that coming forward in a client that can often feel distressed after years and years of carrying complex trauma or relational distress or depression or anxiety that feels unyielding, to see the cracks and to see them be able to distance themselves from this mental kind of suffering that’s so defined them, and to see it potentially dissipate and have other, you know, no longer monolithic, where the other things are coming forward, other parts are coming forward, the realizations are coming forward and that that’s there’s real beauty and compassion in that work. The other piece I did want to circle back to about the self compassion, I don’t know how you feel as clinicians, but I’ve known that it’s one of the hardest nuts to crack in regular therapy. People have an intellectual understanding of self compassion. But it’s like they have to white knuckle it. It’s so hard, and oftentimes on psilocybin and MDMA it, it just arises, and they have direct access to that. And that, in and of itself, can be profoundly healing.

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Katie Vernoy 32:19
What is integration? How does that actually work? Because it sounds like you’ve been banging that drum, Shira around: we must have better integration. What is a what is an ideal integration look like?

Dr. Alexa Altman 32:36
Shira, do you want to beat that drum?

Shira Myrow 32:42
I actually, it’s, it’s quite a sacred process, which is to sift through, right after you’ve had this, this experience is, is to sift through some, sometimes people want to record it. Oftentimes, the facilitator will take a lot of notes. You’re, you’re trying to, we use the word integrate. We’ve translate this all the things. And sometimes there’s words for it. Sometimes, as Alexa mentioned, it could be a very somatic experience or a mystical experience. Sometimes you’ve worked through an enormous trauma and you feel exhausted, but relief, and because I think of the mystical nature of some of these psychedelics, it might be coming to you as different types of knowing. So sometimes there is a narrative. Sometimes there is a linear through line. There might be mantras that come forward. You know, I’m sure you’ve heard people say, Oh, I’ve got the download. Sometimes it is a kind of a download experience, where you’re getting information, clarifying information that is helpful, sometimes past memories, sometimes people imagine a future. Sometimes people see archetypes. So it’s almost like there’s a whole array of potential things that come forward that now we’re just trying to translate. And so I would say the integration process is first, like coming down. It’s like you’re landing from a big experience, you’re coming back into the body, and you’re resting, and it’s like you’re you’re coming back down. And then the the next piece of it is you’ll have several sessions with your facilitator where you’ll start to outline, you really sort of outline the map of what happened. And that can, like I said, it’s, it can feel opaque. And this is where we actually created a integration ebook that that we’ll have on our website, available for for clients and clinicians, to give a little bit of a roadmap to say, okay, where to now? And one thing I think we didn’t mention, which is hugely important, which is the intention setting. When you go into a psychedelic assisted therapy, you’re you’re setting up intentions, directions about things that you want to heal or open up, or transform. And there is a misperception that you’re going to manifest all the I want to meet Mr. Right. I want that promotion. You know? I want to never feel depression again. And it doesn’t exactly work that way. But the intentions are directions, and they could see change, because post journey, you’re in this maximal window of neuroplasticity that can last for several days, up to two weeks. And that’s really where you want to take advantage of this neurological openness to say, all right, these are the things that I want to start implementing in my life. And this is also a wonderful time for for people to go back into their therapy and to say, okay, these things that I’ve been working on, that I’ve I felt stuck in, what can I bring with this sense of either somatic expansion, emotional expansion, a psychological expansion? Because sometimes that, that is the thing that we need, instead of beating down our intentions by just trying to sort of cognitively white knuckle change.

Dr. Alexa Altman 36:07
It’s interesting because Shira and I do reflect on this often, that in all the training we’ve done, the thing that gets the least amount of attention in our training is the integration, and we believe, as Shira’s been, I mean, it’s the most powerful part, and that’s where clinicians in private practice or in practices can have such a large impact with clients who are deciding to do this kind of therapy. I a case example just came to me, it’s sometimes hard when talking about integration, like, what does it look like? This gentleman who came in whose intention was to be able to show up more vulnerably with his children, to be less activated and angry and move into these more vulnerable parts of himself and through his journey, what, what really showed up a lot was the very young, very vulnerable parts that were never really, there was never safety to allow. And then the direct experience in that integration is the experience of safety he felt being vulnerable in the journey, and how he was able to express those parts and realize the safety that exists within himself now, to let those parts be known, right? We can’t show up for others in ways that we can’t show up for ourselves first. And so the work, the real work of integration, is continuing like a like a lap like we’re making laps all the time, therapy, continuing to go back to that intention and that deep experience. I think of integration as like seeds that were planted through the journey, and it’s our work to water it and provide sunlight and fertilizer. And without that, it’s just potential. It really needs that ongoing work and attention. It’s sad to see the good work lost. So yeah, we’re really continuing to refine how to support clinicians and clients and coach them in creating the right conditions for the optimal amount of growth.

Curt Widhalm 38:20
For people who are curious about psychedelics but hesitant to maybe jump into this kind of a treatment, what do you recommend for people to find out more?

Shira Myrow 38:31
Let’s say education MAPS is a great site. The Multi-disciplinary Association for Psychedelic Studies, they have a ton of research available. Andrew Huberman, biohackers and optimizers. He actually has interviewed a lot of the big guns in the field of the researchers. Johns Hopkins is doing incredible research. I mean, there’s, there’s so much research coming out. Roland, Griffiths, Robin Cartwright, we’ll add some we’ll add some resources. But I would say education, that that’s the first place. And there’s, there’s so many books. Michael Pollan, if you haven’t read, How to Change Your Mind. There’s also, say, a less compelling Netflix series, but it’s also very good. All of these places are entry points and the hesitation, I mean, it isn’t right for everyone, as as we said, and I would say education is probably the first place to explore. I don’t necessarily think you’re missing out. As I mentioned before, there’s there’s, there’s other ways. I think there’s so much excitement around psychedelics and and some people are sort of pushing it as a panacea or a magic pill. It really isn’t. And the psychedelic assisted therapy process it it’s even though, back to this idea of it being a shortcut, the integration piece is robust and substantial, and it takes time and commitment. So more exploration, listening to podcasts like this one, I think will be a good starting place.

Katie Vernoy 40:13
It’s great to have this conversation. I know that a lot of our colleagues are concerned about the, you know, the state of the profession, AI therapists coming in, all of these things. And I feel like this is an interesting avenue. It’s innovative, and it’s something that I think has some staying power. And so for clinicians who want to get trained or who want to move forward, what do you recommend for for clinicians who are all in and ready to go?

Dr. Alexa Altman 40:45
There are a number of places to get training as Shira said MAPS the Multidisciplinary Association for psychedelics, CIIS actually just created a program for clinicians, as well as non clinicians, to get training in facilitation. The Third Wave offers training.

Shira Myrow 41:04
And a lot of education. The Third Wave is a great site for education. They have a huge website. It’s extraordinary. That’s Paul Austin’s work.

Dr. Alexa Altman 41:14
I appreciate the add. I think when I’m sitting with a bunch of psychologists and therapists, it’s like my favorite group of people, because I’ll go around the room, and basically what everyone says is, look at the new training I’m doing it. We are forever learners, and I love the curiosity and the interest. I feel right at home. I’d say, follow that curiosity to a sound program where you feel like it’s it’s robust in its integrity, and it’s research, but also provides this level of training that we’re talking about. I wanted to add that the thing that the training piece we didn’t get to was honoring the spiritual and the sacred. And I’m so appreciative of the Western psychology models, and they are have been just so necessary and informative in being able to name things and see things, but the added training and working with the ineffable and those states of consciousness that we don’t have language for yet, I think, is another really important component of training, how to hold those spiritual places.

Curt Widhalm 42:21
Where can people find out more about each of your work and your work together I guess?

Shira Myrow 42:28
We have a website: i-psychedelic.com. is that correct?

Dr. Alexa Altman 42:34
Yes, that’s correct. Okay, and hold on, we have our we also have our Instagram.

Shira Myrow 42:39
Our Instagram, which is i dot, psychedelic dot, IPT, that’s integrative psychedelic therapy. But I would say the website is probably the best place where we’ll also offer that free eBook integration Guide, which I think will will very much add a lot of detail and clarification for what the integration process is, and we offer integration, integration preparation and education at this point. And Alexa offers ketamine therapy, and we’re waiting for approval, proper approval, of these, these other, other substances. And when that happens, we’ll be ready to pull the trigger, but we don’t condone doing any of this, you know, on the DL, we really support the the safety process and believe in it.

Curt Widhalm 43:31
And we will include links to all of those in our show notes over at mtsgpodcast.com. Follow us on our social media. Join our Facebook group, the Modern Therapist Group, to continue on with these conversations, and until next time, I’m Curt Widhalm with Katie Vernoy, Dr. Alexa Altman and Shira Myrow.

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