Psychedelic Therapy and Mental Health: A Psychoanalyst’s Perspective (#07)
Episode Summary: Psychedelics and Mental Health Breakthroughs
Stephan is a Zurich-based psychotherapist and a pioneer in the emerging field of psychedelic therapy. In this episode, we delve into how psychedelics like psilocybin, MDMA, and LSD are being used to treat conditions such as PTSD and depression. Stephan shares his firsthand experiences with MDMA treatment during therapy, including the transformative effects he has witnessed. We also discuss the potential benefits of MDMA in couples therapy, the societal implications of legalizing psychedelics, and the current legal landscape in Switzerland regarding these treatments.
Expect to learn about the therapeutic potential of psychedelics, the challenges and opportunities in integrating these substances into mainstream therapy, Stephan’s perspective on the cultural stigma surrounding psychedelics, and what the future might hold for these groundbreaking treatments, plus much more…
About Stephan: A psychoanalyst with keen interest in psychedelic therapy
Stephan is a psychoanalyst based in Zurich with a keen interest in the transformative potential of psychedelics for mental health. He specializes in Gestalt Therapy and has a strong interest in integrating substances like psilocybin and MDMA into therapeutic practices, offering new hope for patients with challenging mental health conditions. With extensive experience in this emerging field, Stephan sheds light on both the science and the human stories behind these innovative treatments.
Full Transcript
Read the full transcript of my conversation with Stephan, where we discuss the practical applications of psychedelics in therapy, Switzerland’s legal stance on their use, and the broader implications for mental health treatment. Learn how these substances are breaking down barriers in traditional therapy.
Mike: [00:00:00] Stefan, thank you very much for joining me today. How are you?
Stephan: Thank you for having me.
Mike: I’m great. I’m really excited about this. I wanted to, before going into some of the specifics, I wanted, I was hoping you could first tell me a bit about your background and how you became interested in psychoanalysis.
Stephan: So, uh, I’m a psychologist and a psychotherapist and, uh, my background is in, uh, integrative gestalt therapy. Uh, so it’s a psychotherapy school that, um, has its roots in psychoanalysis. But, um, it went its own way and, uh, how I get there, that it’s a, a long story, but I keep it a bit short. So, uh, when I was younger, maybe 16, 17 years, um, uh, I always [00:01:00] was Interested in consciousness and what we can do with our mind.
And, uh, me and my friends, uh, uh, experimented with, uh, different substances at that time. And, uh, when I was 16, uh, I took my first, uh, LSD tap and, um, this was. A huge revelation for me and it opened up a whole new world. Uh, it’s kind of changed my perspective on life and, uh, on this, uh, usual perception we have, uh, in our normal waking state.
And it was so, uh, breathtaking that I, um, thought I really wanted to study the mind. And, uh, uh, that’s probably, um, my first, it was the first incentive [00:02:00] to study psychology. And, uh, with, uh, 20 years, I started studying psychology and. Yeah, psychedelics never let me go. And, uh, from then on, when I was maybe 21, I saw Stanislav Grof, uh, in Basel.
Uh, he’s a pioneer in psychedelic therapy. He did thousands of sessions in the fifties and, uh, he’s a psychiatrist. He’s still alive. He’s, I think maybe 95 years old. And, uh, he was also, uh, a figure I really looked up to and I started reading, uh, books, um, for example, LSD psychotherapy. And that’s when I knew, okay, I also want to work with these substances and I want to help people with these substances.
Mike: You said your first [00:03:00] experience with LSD was 16 years old. Now. You are still legally a child at 16 years old. So I can imagine that is quite an experience. I mean, if you’re an adult, you can, you sort of can anticipate what you’re getting yourself into, but at 16 years old, what was that like for you? What was the before and after feelings that was going through your head?
Stephan: So I would say I was in this state of, um, Many adolescent, uh, boys have of, uh, I’m feeling invulnerable and I can do anything. And, uh, so I just took the tab and, uh, it showed me just, uh, a world, um, which cannot be comprehend by language. Yeah. Just opened. Up everything. My whole mind was just open and I [00:04:00] was connect to everything.
And I really wouldn’t recommend doing psychedelics. Before 20, maybe even 25 years old. So, uh, but I can’t change my past. Yeah. But if you would ask me, so, Oh, when should you start with psychedelics? I would say 20 years, 25 years old. Um, I think the mind should be, uh, Quite mature to do psychedelics. But I was just curious and, um, yeah, I don’t regret doing it, even if it was a bit early.
Yeah.
Mike: You then said that you, uh, especially you specialize in Gestalt therapy. Can you explain to me a little bit what that is and how it differs from what people consider typical therapy?
Stephan: So, uh, Gestalt therapy, uh, [00:05:00] belongs to the humanistic approach of psychotherapy. There is the, the cognitive behavioral schools, the psychoanalysis and the humanistic approaches and Gestalt therapy belongs to the humanistic approaches.
That means, um, uh, we have, uh, we meet the client on an eye to eye level. Okay. We are not the experts who tells the client what to do. Um, we try to have a. an approach that works with the here and now as well. So gestalt therapy is a, an emotion focused and experimental, uh, kind of therapy. And we try to evoke the emotions in the here and now, because we think that Going through these emotions is just, [00:06:00] yeah, important.
You have to go through some certain and difficult, uh, emotions. Otherwise you can’t really heal from, let’s say trauma or, uh, uh, or similar things. And it’s, it is also a lot of, um, kind of, um, meditation like techniques, uh, where we just look at what does the patient or the client feel in the here and now.
What are the impulses at the moment and to kind of explore your psyche and your body in the therapy session. And the therapy sessions should also be kind of like, um, the playground, uh, before you go to the outside world where you can practice. Um, let’s say talking to your brother, like a famous technique in Gestalt Therapy is the chair work where you put maybe your mother, your [00:07:00] father, or part of yourself on the chair.
And then you talk to this chair, you go into a dialogue. And that can be really, really powerful.
Mike: So if I came to you and wanted to, um, yeah, just discuss my past, say I came to you and within 15 minutes, you thought, okay, there is some serious, um, signs of depression or mental illness or something like that.
What are some of, what is a, I guess it’s different for everybody, but what is an example of the steps that you would take me through this, this here and now part is a part that I’m struggling to wrap my head around what that actually looks like.
Stephan: So, um, If you come to my practice and talk about your problems, I would really focus on where your emotions lie, where I can see something maybe in your face or in your eyes that gives me a sign of, oh, ah, that’s something I [00:08:00] maybe have to dig in deeper.
So I kind of have my senses on and I, Don’t really focus that much on the content you tell me, um, and more on the how you tell me something. That’s my focus. So, uh, there’s not a real structure where you say, okay, first step you do this, second step you do that. It’s not really that structured. Um, it’s more, I tried to find where my patient is at the moment.
And even if he says something, okay, um, that’s, um, maybe, okay, I feel depressed because that and that, I don’t always focus on that. I try to focus on maybe the hidden things as well. Or, uh, typical for humanistic approaches is, I also focus on your resources. Okay, what are the things that work [00:09:00] well at the moment?
Where do you still have some kind of a sense of love or energy or, uh, similar things? So it’s, it’s really hard to, uh, explain Gestalt therapy because every Gestalt therapist is kind of, uh, different. Yeah. And it’s kind of has his own style. It’s also something that we are really confrontative as a Gestalt therapist.
It’s a huge difference to psychoanalysis where the therapist is kind of like a blank paper, right? And we show ourselves as human beings as well, yeah? We bring ourselves into the therapy. And we also try to evoke these emotions, even if you are struggling, we, we don’t let go [00:10:00] of these problems and we just try to dive in deeply.
Mike: Is part of your education then learning to read body language? Because it sounds like that’s a huge part of your job.
Stephan: Yes, body language reading is really, really important and also kind of reading your own body language. It’s really important to see yourself as a therapist, as a, like, let’s say a musical instrument that kind of is reacting to the patient.
And if I’m getting angry in the therapy session, I ask myself, okay, Why am I getting angry? And oftentimes maybe it’s even not my anger. Even maybe it’s the patient’s anger. Yeah. And when we look at it, when you look at the patient, he seems so depressed and there’s no energy in him, but I feel anger. Why, why is that?
And oftentimes it’s a hidden anger of the patient. Yeah. [00:11:00] So I think we as Gestalt therapists, we use our body and our whole psyche as a therapy tool. And I think that’s also a really powerful way to do therapy.
Mike: How connected is the body’s physical state with the mental state of your patient?
Stephan: So in my opinion, it’s, uh, really, I mean, it’s, it’s connected.
But I can’t, uh, cite any, um, Uh, papers, but, uh, I often have the feeling that the body keeps the score. It’s, uh, that’s something that, um, uh, famous, uh, trauma therapist set. And, uh, I had the experience with one, one of my patients, um, where, uh, we did an exercise and, uh, where we kind of stand [00:12:00] like this and then we kind of put our Heads down to the ground and, uh, we are going into a similar state, uh, as, um, um, how do you say it when, uh, uh, before birth, um, when you’re in this embryo state in a way where you lie down like this fatal position.
The fetal position, exactly. And at this moment, he just started to cry because he somehow, um, through this, uh, position found some kind of connection to, um, his own upbringing when he was younger and, uh, there was some kind of memory saved up in this position, so that was really, really powerful and he just could access, uh, Uh, memories that he otherwise wouldn’t have access.
Mike: I mean, I can only [00:13:00] imagine when, I mean, I think, I feel like most people can relate when you’re particularly stressed just because of work or life or lack of sleep. You feel your body ache and that is due to short term stress. I can only imagine that if you have a lifetime of trauma. Built up into your body that the impact that has on your physical well being must be huge.
What sort of patients do you typically work with? This is in Zurich, uh, is there a Do you speak to people with a certain kind, who are looking for a certain kind of help? Is there a pattern with the kind of people that see you?
Stephan: I wouldn’t say I’m really specialized in a topic. Uh, I have a lot of patients with, uh, depression, anxiety, uh, ADHD as well.
And I have a lot of younger patients from, uh, ranging from 20 to [00:14:00] 30 years old, who are really struggling with, uh, Yeah, with life and, uh, especially, uh, for example, even with, uh, their studies or, um, um, or with relationships right now, um, I would say I, um, have patients, uh, who can still have a functional life in a way.
but are still struggling. I used to have, uh, let’s say a patients who are more sick. Yeah. Especially when I worked, um, uh, in a bigger clinics there, I also, uh, treated people with, uh, substance use disorders and, uh, schizophrenia. I don’t have that anymore. Yeah.
Mike: How much, it sounds like gestalt therapy with the whole philosophy of being eye to eye with your patient.
Then it must [00:15:00] be a very emotional session for patient, but also for you. How do you feel after a day’s work when you have a number of these sessions?
Stephan: It is really emotional because, um, you can’t hide between a job description. Yeah. You are there as a human being. You are there as a Stefan Fundinger. Yeah. I work with my personality as well. So, uh, it’s not always easy to just. Let go and, uh, come home and don’t think about the patients, especially if they’re in a crisis, um, it also happens that I come home and still think about them.
And, uh, yeah. Uh, but, uh, fortunately there are. to, um, help with this, [00:16:00] with these things. Uh, therapists usually have a intervention and supervision. So they have, uh, a group of friends, let’s say of other therapists and they meet regularly to talk about their patients. Or they have a kind of like a supervision, um, where they go to a more experienced therapist and talk about their patient and how they feel with, uh, uh, the therapy work.
And that is something that really, really helps.
Mike: Do you have a preference in the sort of, I mean, it sounds odd when it’s people’s Mental health we’re talking about, but do you have a preference in the kind of patients that you see?
Stephan: Yeah, that’s a good question. And, um, I have to be a bit cautious of how I, uh, to answer it.
Um, to be really honest, of course, um, everybody has preferences. Yeah. And, uh, [00:17:00] I also like to, um, do therapy with, uh, motivated people, uh, and who can also reflect a little bit. So, uh, um, sometimes it’s harder to, uh, work with. who, yeah, aren’t that motivated. And, uh, so I used to work, uh, quite some time with, uh, people who have a substance use disorder and motivation was always, uh, some, uh, problem.
Uh, and I really liked work there, but there are certain limits, I think. Yeah. And the success rate. It’s definitely lower than, uh, working with people who have maybe a, uh, just a singular depression or anxiety.
Mike: One of the reasons I wanted to talk to you today was because of your fascination and interest in psychedelics when it comes to psychotherapy.[00:18:00]
Can you share your experience witnessing or hands on experience with treating patients using psychedelic drugs?
Stephan: Yes, um, so yes, I’m, I’ve been interested in psychedelic therapy, yeah, since I was 16, as I told you, and, uh, it was maybe one and a half year ago, I, uh, uh, had the, uh, possibility to work with a patient, uh, with MDMA.
A good friend of mine, uh, she’s, uh, a medical doctor, and she invited me to, uh, help her out with this patient. And the patient, she’s, uh, uh, a younger patient with, uh, ADHD, uh, trauma with a lot of, um, psychosomatic pain. [00:19:00] And she tried any possible therapy you can imagine.
Mike: What’s like, what’s psychosomatic pain?
Stephan: Um, it’s, uh, the thing we talked about before, um, where, uh, you have some kind of pain in your body, but when you go to the doctor, everybody says, Oh no, we can’t see anything. Yeah. Um, some doctors even say, Oh, you might imagine this. Yeah. But it’s a psychosomatic pain. Yeah. It’s still there. Yeah. It’s still there.
Really real. Yeah, but you can’t find anything on some on these scans. Yeah, but yeah, so she had a pain in her face and also in her neck and like mostly all the time, but especially when she was in contact with other people. So, she really needed a lot of space and time [00:20:00] just on her own. Otherwise, she would get really, really bad pain.
And, uh, because she’s also had some traumatic experiences, and the ADHD is also, um, a good indicator, um, we, uh, started with MDMA, because it’s the easiest one to, um, do, I think. And with LSD and psilocybin, uh, it takes longer and you can go into, um, other worlds, even with MDMA, it’s a bit easier that the patient has a good experience.
And we did three sessions with her. The first session was, uh, the most impressive one. Um, she really had the pain in her neck during the session. And. When she closed her eyes, [00:21:00] she saw her father putting his foot down on her neck and she really saw that everything is coming from her father. And her father was this choleric, really impulsive person who was so hard on her when she was a child.
And it, but she never realized that This pain has something to do with her father. That was so, so amazing to see. Yeah. And I could, I could tell a lot more, but I mean, uh, we don’t have, uh, enough time, I think, yeah, for this whole process.
Mike: Well, what does the actual session look like? So it’s still a therapy session that she comes in and it’s still a one on one interaction with a psychologist.
Stephan: Yes, so, um, we met, uh, at my friend’s praxis, and it’s, the setting is different than usual therapy, uh, so, uh, there should be some kind of, [00:22:00] uh, bed where, uh, a patient can lie down. And it should be a living room atmosphere. It shouldn’t be too sterile. That’s not good for psychedelic therapy. And then she lies down, takes the medicine.
And there are usually two therapists. So I was there and my friend was there. And in the beginning we just wait. Yeah, we started with them, uh, uh, uh, meditation, a body scan where she can just relax a bit. And then we wait till the, um, drug effects start. We usually also play music and, uh, you usually have a playlist and usually we play Half of the time we play music because music is also, can help you to go into this [00:23:00] process easier and for MDMA, it usually takes maybe four to six hours.
Uh, session, but with her, we stayed at least 10 hours because she, she still had some effects that was unbelievable. But it’s also an exhausting process because you have to be there all the time. You have to be, um, concentrated, um, what music to play, what intervention to do. Just, uh, need, um, yeah, a long breath to do this work.
Mike: What’s the dosage like in a situation like this?
Stephan: So with MDMA, um, you, with MDMA, it’s kind of difficult. Excess, maybe if she’s a, she was a female, so she gets a little bit less than a male usually. [00:24:00] Um, for females, normal would be 1.3. Uh, her body weight with male, it’s 1.5. Uh, his body weight and she was really, really, uh, skinny and small.
And we thought about, okay, maybe we should give her about 75 milligrams. And then we talked with another supervisor and he recommended to go up a bit. So we did 100 milligrams of MDMA to have a good booster dose.
Mike: What is the, what criteria does a patient have to get to be allowed to go through psychedelic treatment in Switzerland?
Stephan: So the criteria would be Um, at least having [00:25:00] tried two antidepressants and at least a couple of years of therapy that didn’t really work. In the end, it’s about also the medical doctor, um, who writes this report. to the BRG. And, uh, at the moment, it’s still, uh, in this limited or compassionate use mode. We hope that, uh, more people can get access to it, but right now it’s still very limited and only the treatment resistant, uh, people.
can get access to this treatment.
Mike: And why do you think it’s so difficult? Is it mainly just because of the reputation of these drugs? Because historically they’re mainly used recreationally and recreationally the stories can be negative. Is that, is there anything medically [00:26:00] that you think, Oh, this is more risky than other treatment for patients like this?
Stephan: Yeah. I mean, it still has a, this. Baggage of okay. LSD is a bad drug. Um, you can, uh, you may jump out of the window if you take LSD and this cultural baggage is still there, even in Switzerland. But I think Switzerland, uh, has a. A special role in this psychedelic therapy renaissance we are in. And I think, yeah, I think we are, uh, in a special position because Switzerland isn’t that big.
And, uh, we can just talk to the government and, uh, Even on an eye to eye level and talk to them and they can change these things or have this, uh, uh, special rule with the BRG where we can, uh, access the [00:27:00] substances. And also, uh, Switzerland. Um, I mean, you know, uh, Albert Hoffman, uh, is the founder. Is he, he discovered LSD.
So there is already a connection there, and I think that makes it easier for, uh, a country like Switzerland to, um, do psychedelic therapy. Do,
Mike: do you And about the, yeah, sorry, go on. No, no. I interrupted you.
Stephan: Uh, you asked also about the risks, right? Mm. Of, uh, psychedelic therapy and, uh, I mean there, of course there are risks.
Uh, because these are really powerful, uh, drugs and, uh, tools, um, that can bring healing. But also, I think there’s also a risk for, uh, trauma even, yeah, through psychedelic therapy. If it’s not, uh, used in a really ethic and, uh, best practice way, [00:28:00] it can re traumatize patients. So, uh, we should be really, really cautious with these substances.
And, uh, I think it’s good that we take it step by step.
Mike: The different psychedelic drugs, and I guess maybe we should clarify when you say psychedelic drugs, it’s psilocybin, LSD and MDMA are the three. Are there any other ones?
Stephan: Um, in Switzerland, there are these three. Yes. Okay.
Mike: Would you say that each of these would be used to treat different medical conditions or each of them can be used to affect the same one, but be done in a different way?
Stephan: That’s a really good question. Um, each can be used for, uh, every, um, or nearly every mental disease or mental illnesses. Um, but usually if you’re, uh, have a patient with depression, [00:29:00] you don’t give him MDMA. There are a couple of reasons. Uh, for example, right now, when you take, when you take MDMA in the psychedelic therapy sessions, we have to taper off the antidepressant medication.
And for some people it’s really, really hard to do, and you can have a relapse. And also after an MDMA session, there’s a possibility or a risk that you feel a little, little bit more depressed a couple of days after, or even a week after the session. So, uh, with a patient, uh, who has depression, you usually, uh, go with, uh, psilocybin or LSD.
And the other way around, uh, with a patient with a PTSD, with trauma, I wouldn’t start with psilocybin or LSD because these are such, um, let’s say these are, [00:30:00] Experiences that can go into this transpersonal realm and can be also really difficult. Um, I would suggest to start with something that’s a bit, uh, gentler like MDMA and, uh, with, because MDMA gives you kind of this.
This armor of safety, uh, and with this armor of safety, you can go into a trauma, trauma again and re experience it in a, like in a better way where you feel safe.
Mike: What about ketamine? You haven’t mentioned that. And that seems to be based on what I have heard and listened to do my own research. That seems to be coming, becoming more and more, more and more popular as a treatment option.
Thank you.
Stephan: That’s true. Yeah. Ketamine, uh, I mean, it’s not a real psychedelic, it’s a dissociative, uh, and an anesthetic. And I mean, it has been used, uh, for, um, a couple of decades, uh, in the, um, in the treatment to, [00:31:00] uh, in the, um, with anesthetics as an anesthetic to, um, do, uh, certain operations where, um, uh, you had to watch out for the.
capabilities to breathe. Yeah, because other anesthetics, they can kind of attack your breathing pattern and it can be really, really dangerous. With ketamine, it doesn’t kind of attack this, your breathing. And then I think maybe 10, 20 years ago, it’s been rediscovered as a, uh, a drug for treating depression.
And nowadays, every clinic does ketamine therapy. And it’s, uh, yeah, I think since maybe 2000 and, uh, 20, every clinic, uh, it’s been doing a ketamine therapy and it’s mainly used for, uh, treatment [00:32:00] resistant depression, but I think it’s different than, uh, the classical psychedelic. Because with classical psychedelics, you do therapy, um, during the psychedelic session,
Speaker 3: ketamine.
Stephan: Nowadays, especially in the bigger clinics, they don’t really do a therapy when the patient is taking ketamine. They just, uh, kind of observe him and don’t do anything. And then the patient can go home. It’s kind of like an antidepressant. It’s kind of like a drug where you just give it to a patient and, uh, it kind of, uh, The patient doesn’t have to do anything.
Mike: So going back to then psilocybin and or LSD, have you experienced treatment with either of those two?
Stephan: No, not yet. No, not yet. But there are some sessions planned with a good friend of mine who is a [00:33:00] psychiatrist. And, uh, I think for me the potential with LSD and psilocybin is even bigger than with MDMA. I think, The effect that you can feel this oceanic boundlessness, it’s called, to be one with everything.
I think that’s the best antidote for depression, in my opinion. Because depressed people, they feel isolated from everyone and from the world. And psychedelics, they just go into this other direction that you feel connected with everything again.
Mike: What is the difference between LSD and psilocybin in terms of what goes on in your brain?
Because to me, they’re pretty similar. Do you actually know what the difference is in terms of what the chemical release, the brain activity?
Stephan: So the brain activity is really, really similar. Yeah. It’s also [00:34:00] works. Um, On the serotonin receptors on the serotonin receptor hg2a To be specific and um with lsd, I think there’s also more Um, they work also more on the dopamine and, uh, noradrenaline receptors.
So LSD is a bit more stimulating than, uh, psilocybin and it has some kind of an anchoring effect that it kind of this receptors, they, uh, it can’t leave the receptor. And that’s why LSD, um, has such a long duration. If you take LSD, you can have a trip for 12 hours, right? With psilocybin it’s half of it, six hours.
So I think the duration is, uh, the biggest difference. And, uh, [00:35:00] I also think that. Psilocybin it’s more earthy and you are more in your body
Speaker 4: in a way.
Stephan: Yeah. And LSD is more analytical and cognitive, so you can really decipher a thing and analyze, uh, your own patterns and, Yeah, so it’s more thinky, LSD, and I think psilocybin is more, has to do with your body and your emotions.
So I think there’s also a qualitative difference between those substances.
Mike: One of the criticisms or the defenses against, or the arguments against this would be. What about all of the people and the stories of people who have bad trips and I can imagine Someone who is not in a good place of mind is really vulnerable to a [00:36:00] bad trip.
Even if there is a the right setting and the right dosage and the right Monitoring of this person. Can it still go? I can imagine someone who is So depressed that they qualify for this treatment a bad trip for them could be horrific
Speaker 4: Mm hmm
Stephan: Yeah, I mean, uh, so, uh, there are patients, uh, who I wouldn’t give, uh, these psychedelics to.
Um, I mean, I think it’s obvious you shouldn’t give people who have schizophrenia, uh, psychedelics, uh, because I think you can just reactivate, uh, a psychosis. And also if, uh, a patient has a really close relative who, uh, suffer from schizophrenia, I wouldn’t risk giving them psychedelics [00:37:00] because, uh, it can kind of activate a psychosis if you have a disposition for schizophrenia.
So I would be really cautious with these, uh, patients and the other, I think that’s Interesting question you just asked. I also saw, um, I heard from a patient who was really depressed and she was in a really, really bad state of mind. And this depression was just so overwhelming. And she did. And a psilocybin session and she went into a really, in a worse state even.
And it was kind of traumatizing for her. Yeah. It wasn’t in a re it wasn’t in a legal setting. Yeah. Where this happened. So, uh, that was even more of a problem if it was in a legal setting, maybe [00:38:00] the therapist, uh, could have handled it better, but for her, it was just a traumatic. And, um, after the session, she, her depression got worse even.
Yeah. So if. The setting is not right. Yeah. And the set is also not right, then you shouldn’t give someone a psychedelic, but let’s say someone is depressed for the last 10 years and is has been in this state for such a long time. And, uh, it’s kind of a normal state for this person. I think that could be a good indicator to try psychedelics.
Yeah. So there are bad trips, even in a psychedelic in this therapy session or setting, but a therapist can kind of help the patient [00:39:00] to This experience from another perspective that is not only bad. Maybe there was some kind of message that the medicine, uh, wanted to tell the patient and. Also, you can, in the therapy setting, there’s also this integration, integrative sessions, the integration sessions after the psychedelic session.
So usually the day after you talk about the session again, and after that you usually have weekly session where you can integrate what you have experienced. I think if you have all these settings, the setting with preparation. Uh, substance, uh, session and integration, then the risks of bad trips are really, really small.
Mike: If someone is going through a bad trip, is there [00:40:00] anything the therapist can do to bring them out of it? Besides Talking them out of it, especially if it’s LSD and it’s a 12 hour period and two and a half hours in, they’re having a bad time. Is there something medically you can do to bring them out as an emergency?
Stephan: So, yeah, we have to probably differentiate between, uh, what is a bad trip and, uh, what is a challenging experience. And it’s not always bad to go through something that’s maybe hurtful or that scares you. Sometimes, and I think even I would say often, you kind of have to go through these emotions during a psychedelic experience.
And I wouldn’t call it a bad trip then, just because you are really, really sad during the therapy session or just when you are, uh, fearful. I think you should, you have to go in there and you have to be [00:41:00] courageous, uh, to go through this. But of course there are times where even the therapist thinks, okay, We have to change something.
Um, the patient seems to really in a really bad state, then there are different options to do that. Um, sometimes it helps to change the music or, um, kind of change the setting as well, go into a different room with the patient. Uh, talking down, holding hands, or do some, uh, bodily exercise where you, uh, maybe stomp on the ground to feel the ground, to be connected again with reality.
All these things can help you, um, get out of this experience. And if nothing really helps, then there’s still, uh, medication you can give the patient. Like [00:42:00] benzodiazepines, they can really help you to calm you down and you’ll feel less fearful.
Mike: Where do you hope that the, I guess we can use Switzerland as an example, but really everywhere it goes with this kind of therapy, if it seems like at the moment At least I’ve noticed that the research and the discussion around the benefits of it are becoming bigger and bigger.
If in the next sort of 5 to 10 years things go your way, what sort of, what level, what do you hope therapy looks like? Um, with these different drugs.
Stephan: So unfortunately things didn’t go our way. Um, maybe you heard about, uh, the FDA, uh, who didn’t give MDMA and, uh, lycos this, uh, company, the okay for, uh, uh, MDMA, uh, [00:43:00] treatment.
So that was a shock for the psychedelic scene. And it’s so a lot of people hope that MDMA will be available in the U S uh, yeah, from maybe this year or next year on. But now, uh, with this FDA, um, result, it probably takes another, I don’t know, five years or so. Fortunately, uh, in Switzerland, uh, it’s different, right?
Um, right now there are maybe 70 psychiatrists in Switzerland who do psychedelic therapy and the number is growing. Yeah. I think it will still grow. Um, but at some point there has to be some kind of change in the system right now. Uh, It [00:44:00] takes always, it takes a couple of weeks or even months to get approval for psychedelic therapy because the BRG, yeah, the ministry, the health ministry, they get so many, uh, applications reports from psychiatrists that Yeah, they are not enough people working there.
And at the moment, the substance is really, really expensive. And the patient has to pay the substance himself for a dose of MDMA. It costs around 300 francs and on the street you can buy MDMA for maybe 15 francs or so
Mike: for
Stephan: those.
Mike: I was about to ask that. Where does it come from? So I guess if it’s legal then it’s tested and produced in a lab in Switzerland versus coming from someone who’s got it from somewhere and you have no idea.
Stephan: Yes, yeah, yeah. Yeah, that’s the difference, of [00:45:00] course. Yeah, but it’s still really expensive. And, uh, the insurance companies, uh, don’t cover that usually. And also the therapy is also expensive because, uh, a doctor and another therapist, they have to sit with you maybe for eight hours or so. And right now the medical doctors.
They can’t charge you eight hours of therapy. Because in their medical system, they don’t have a therapy form where they can charge a patient for eight hours. They can charge you a maximum for 90 minutes per day. So, that’s also a problem in the system and that has to change in the future.
Mike: What do you think the impact would be on society if it was, if these drugs were legalized and, um, everybody?
Because it sounds like It transformed your life, even though you [00:46:00] had it earlier than you would recommend others. Do you imagine that it would be a net positive if everybody could try these things at least once recreationally?
Stephan: So, um, after my first trip, when I was 16, I thought every world leader has to take psychedelics, then the world would be a better place.
I don’t believe that anymore, uh, but maybe some small part still believes it a bit, but, uh, Stan Grof, uh, the psychiatrist who has, uh, has really a lot of experience said, uh, psychedelics are, uh, unspecific amplifier. So it shows you things about yourself, but you can’t control what it shows you. And let’s say there was a.
Uh, video going around, uh, on Instagram, uh, the last few days of, uh, what would happen if, uh, Donald [00:47:00] Trump would take ayahuasca
Speaker 3: and,
Stephan: uh, it was such a, it was such a fun video, uh, he drank ayahuasca and then he faced his demons and he find found enlightenment. Then he went to the Buddhist monks in the Himalaya.
He, uh, meditated there for a couple of years. And then, uh, He, uh, founded his own meditation group, and then he started facilitating ayahuasca sessions to these groups. And in the end he, he said, okay, I’m the greatest shaman now. And in a way he healed, but he still had this, um, narcissistic, narcissistic, uh, way of looking at things.
And, uh, I think psychedelics don’t. People better in general, they can [00:48:00] even kind of amplify, uh, the, the being that you are that I think for narcissistic people, there’s this risk of becoming even more narcissistic to have this ego inflation. Okay. I experienced that I was Jesus or I was God. Maybe I am Jesus.
So there’s this risk, but. To come back to your question, I think it would be really beneficial if psychedelics are legal because, uh, in my opinion, it’s, it’s just, uh, people or like these altered states of consciousness shouldn’t be illegal. Yeah. And I mean, it’s unethical, uh, in my opinion to, uh, illegalize these substances.
I think everybody has the right to experience, um, oneness and these altered [00:49:00] states and a legalization would help that, but. I wouldn’t just legalize it. I would still, um, have some kind of system behind it where you can maybe buy psychedelics in a pharmacy and you have to maybe even do some kind of a pilot training to, uh, uh, kind of travel with these, uh, or fly with the substances.
And. There’s need, there need to be some kind of age limit as well. So we have to be really careful with this legalization. I think it should be legalized, but in a, let’s say, regulated way.
Mike: Besides self exploration and for treatment of very mentally ill people, what other use cases can you imagine these drugs to be [00:50:00] really good for?
Stephan: I mean, we talked shortly about, uh, couples therapy. Maybe we can, uh, talk about this, uh, for a bit. So Alexander Shulgin, he was kind of like the rediscoverer of MDMA and kind of like the father of MDMA. And he had a good friend, Leo Zeff, who was a psychotherapist. And he told this Leo Zeff, so, okay, I found this.
Uh, the substance MDMA, and I think it’s great for therapy. And Leo Zeff just gave it to other therapists and, uh, they discovered that it’s really, really useful for, uh, couples therapy because, um, I, Talked, um, about it, this, this armor you get [00:51:00] through the MDMA, this soft armor. It helps you to talk to your partner.
Sometimes in a relationship, uh, you can say just a word and the partner is get so angry because you don’t talk. Um, this content, um, level anymore, you talk on this relationship level, right? Um, even if this word doesn’t mean, doesn’t say a lot to outsiders for the partner, maybe, maybe the partner says, uh, I don’t know.
Oh, there’s a plate, uh, in the kitchen. And the other partners, um, meets. I have to clean again. Why do I have to clean again? And, uh, the communication is kind of stuck, right? And you get attacked so easily, but on MDMA, [00:52:00] you can say anything. You are kind of brave enough. To talk about things because you have this direct connection to these topics to these emotions and when you hear these things on MDMA, you don’t feel attacked.
You kind of feel empathetic towards the partner. And, uh, I think that’s so beautiful, uh, because it takes you out of this, Normal state of the relationship and you feel way more empathetic towards the other.
Mike: There is a, um, there’s a metaphor that I heard once. I can’t even remember where I heard it from. I think it was Duncan Trussell, who’s a comedian, American comedian, but he’s real hippie, but he’s actually quite wise, but he basically, Everybody has this certain amount of love inside them, which they can give it any one time.
And basically it is, it’s glass, which can be full. And when you take [00:53:00] MDMA, it allows the glass to overfill and overflow. And when that happens, you just want to give it to the people around you. And I thought that was quite a nice, uh, a nice visual.
Stephan: That’s beautiful, yeah.
Mike: Yeah. Okay, so, we’re running out of time, and I had a couple of other things I wanted to ask.
The first one was, do you have any recommendations for people to educate themselves better on this? Any, any book recommendations that you, that you have out there that you’re thinking this is a good place to start? Or people who they can follow up with? Yes,
Stephan: if you don’t have a lot of experience, I think you should start with how to change your mind.
You may have heard about this book. It’s from Michael Pollan. Yes. And I think it, yeah, it has a great overview about this whole renaissance and the psychedelic therapy in general. Uh, if you want to dig [00:54:00] a bit deeper into, uh, the treatment part, um, I would suggest, uh, Stan Grof’s books, uh, for example, LSD psychotherapy.
Uh, there’s these new books, the way of the psychonaut. That’s quite dense, but, uh, really, really good. Um, also books from the book from Albert Hoffman, LSD, my problem child is also a great book. Um, sacred knowledge from Bill Richards, uh, he’s a theologist and psychologists, uh, who worked also with hundreds of patients, uh, can really recommend.
I think for me, these were one of the most inspirational books to read. Yeah.
Mike: If someone listening to this thought, you know what? I want to try [00:55:00] this for the first time. What would you recommend? Let’s maybe narrow it down to either LSD or psilocybin because it’s quite a profound experience. What would you, what would you recommend their first time be like?
Stephan: The important question is, uh, why do you want to take it? If you have any,
Mike: let’s say it’s true. That’s if caveats are important, perfectly happy people with their life, just really curious about, you know, exploring something like this, but there’s no signs of mental illness. There’s no, they’re not looking to answer any questions or solve any problems.
Stephan: Okay. Yeah. They’re just curious about, uh, yeah, about life and about, uh, transpersonal state. Um, So I can still recommend starting with, uh, some kind of breathwork [00:56:00] technique, for example, holotropic breathwork as a starter, because it’s completely legal and it’s kind of a safe way to explore these states through these breathing techniques.
You also, Get it to this transpersonal state, but you can stop any time with the breathing, then the effects also stop. So you have more control over it. So I would really suggest starting with something like this. And then there are also, uh, retreats that are completely legal in the Netherlands, where there are a lot of good trained therapists who, um, facilitate, uh, this, uh, psilocybin truffles that are legal in the Netherlands.
There are, I mean, there are so many providers. Uh, I would recommend the Synthesis [00:57:00] Institute there. They have a really good team. Um, but I think these two are the ways to go.
Mike: Well, Stefan, we’re out of time, but I just wanted to ask you as a final question, is there anything else you wanted to share or bring up that we haven’t touched on today?
Stephan: I mean, you reminded me of a different, Techniques to get into this altered state. And also there’s this, uh, sensory deprivation tanks, uh, where you lie down in some kind of salt water and you just float. And I think these can also, uh, help you to get into this altered states without taking any substance.
So maybe as a last comment, I think ethics and safety are It’s really, really [00:58:00] important with psychedelic therapy and the timeline we are in, there are some risks and dangers with this kind of treatment. You can get re traumatized or there are even cases of, um, sexual abuse during therapy. Um, there was a case, uh, in Canada, uh, with a therapist from MAPS and they’re also Um, also in the Amazon, in these ayahuasca retreats, there are oftentimes, uh, there are some kind of, uh, sexual abuse and uh, uh, cases.
So we have to really, really be cautious about these things. Um, let’s say, uh, the topic of, uh, touch, usually most therapists, they don’t touch the client. Yeah, especially psychoanalysts. But in psych, psychedelic therapy, it can be really, really helpful. to [00:59:00] hold the hand, yeah, of the patient, or maybe help stabilize your head.
Uh, it just, uh, brings out some kind of new, um, effects during the psychedelic therapy. But all these things, you have to be really careful. Cautious. Yeah. How much touch is okay. Yeah. Uh, what is too much touch? I think all these questions about ethics and guidelines, uh, will be important in the next couple of years in developing this kind of treatment.
Mike: Very interesting. Well, Stefan, thank you very much for your time. This has been a very enlightening conversation.
Stephan: Thank you, Mike, for having me. Yeah, I was, uh, yeah, really happy to talk about all these things, . Great. Okay. See you later. See you. [01:00:00] Bye.
