so I went to a conference, in the mountains, with an amazingly diverse group of people. the point of attending this conference was, I’m sure, as diverse and varied as the attendees, but for me it was essentially two-fold, maybe three-fold.

first of all, I have heard a lot over the past few years that psychedelics (think magic mushrooms or psilocybin, LSD, MDMA, DMT) as well as a few non-psychedelic chemicals (think ketamine) are not just effective in treating what is collectively known as Affective or Mood Disorders (depression, anxiety, and trauma originated disorders such as PTSD) but is holy shit super duper effective in the treatment of these issues. Like almost instantly curative in treating them. with a sales pitch like that let’s say my curiosity has been peaked for a while. I also really wanted to find out what these crazy claims were based on.

secondly I do need to maintain my license and to do so I need to acquire Continuing Education or CE’s and would you look at that this conference had a bunch of available CE’s from the very classes I was curious in attending. to add further shine to that particular apple my employer (I know ew, working for someone) will reimburse a not insignificant amount of the expense for attending this conference.

lastly and possibly most importantly the conference was in Denver, Colorado which is a mere hour and a half away from the Stanley Hotel, which for the uneducated is where Stephan King stayed for a night or two and came up with the materials for his late 70’s book The Shining. he also supposedly had more than a few ghostly encounters while he was there which has really added to the mystique of the place. Being a major Stephan King fan this hotel has been on my bucket list since forever and this conference though didn’t really facilitate the checking off of this particular item but it sure gave me the excuse I needed to make it happen.

one could say I started this trip on the plus side of things with the checking off of this item.

back to the drugs….eh…I mean science

anyone who has ever tried psychedelics will tell you there is something quite amazing that happens when you take them, but does this amazement come with the cure all for mood issues? the short answer is, it really depends on who you ask or in this case, what training session you sat in.

first a little professional bias confession.

as you all may already know, I am a Clinical Psychologist, that is to say a doctor and depending on who you ask I am also a Physician (medical doctors don’t think so but the companies who pay me do as do my patients so what the heck guys?). That actually brings me to my confession, I think only trained and licensed clinical psychologists should be conducting psychedelic psychotherapy. there I said it. why do I believe that? that is a bit complicated,

More background first.

I am also a Clinician or a Mental Health Services Provider, again depending on who you ask. These terms, unlike the others I mentioned above, also include a lot of other licensed professions. Nurses, Social Workers, Marriage and Family Therapists, as well as unlicensed professions such as life coaches, counselors, and even religious professionals (rabbis and priests for example) in certain conversations or from certain professions they could also be referred to as clinicians or mental health services providers. Now an unlicensed life coach is not going to get paid by an insurance company but they could charge a fee for their services directly from their clients, and there are many who do just that. the problem with counselors and life coaches for me begins and ends with they fact that they are unlicensed and therefor anyone could call themselves a life coach without having to prove any level of education at all.

the bias part comes in, not just from me, but from each of the different categories of profession, that each is the best or most necessary, or most capable at providing services. I happen to agree with that sentiment so long as everyone stays in their lane, which happens less and less these days.

for example Psychologists, Social Workers, and Marriage and Family Therapists (MFT’s) are all trained to some degree or another to provide psychotherapy (think of Freud and his couch), and depending on the practitioner I think they are all equally effective in helping people (naturally I am the best but the others can be okay too). The problem comes up when Social Workers (to pick on one group) attempt to do things that they are not trained or responsible for doing, such as assessments or diagnosing patients which are areas of doctoral not just expertise but responsibility. I can’t tell you the number of times I have had to listen to a social worker in a meeting talk about the “assessment” she or he just completed with a new patient and have to deal with their irritation when I correct them by saying “that was not an assessment, it was an intake,” only to be told that “in my field we call intakes assessments.” Well in my house I call myself the king but that does not make me royalty does it? for the record assessments refer to very specific types of psychological tests only doctors are trained to administer, score, and interpret.

my point here is that each profession tends to think of themselves as not just vitally important but as good if not better than the rest of the professions (notice I did not mention Psychiatrists above, they don’t do psychotherapy for the most part but only prescribe medications).

to be clear I think all of these professions are important parts of the healthcare system and without them the entire system would fall apart (don’t get me started on how important nurses are to healthcare) and anyone with a bit of training could read a diagnostics manual and come up with not only a reasonable diagnosis for a patient but a fair treatment plan as well. however each of these professions has their own sphere of effectiveness and needs to work together with every other profession. and stop trying to take their jobs, because the differences between professions are just as if not more important than the similarities. I’m talking to you social workers….

meanwhile back at the conference….

the first few classes I attended where actually panel discussions with multiple non doctorate level clinicians, mostly the same guy who is the head of a very prestigious school’s nursing program and a social worker who is also the head of a equally impressive sounding school’s social work program. to them add a couple of other social workers and even a person who claimed to be a Native American Shaman. these panels would discuss different aspects of being a “psychedelic practitioner” and though the names of these classes sounded like a how to go about becoming said psychedelic practitioner most of them boiled down to these people talking about how great their particular program or school was and why their particular class or professional is “perfectly suited and poised” to take over as psychedelic therapists.

so the head of the nursing program talked a lot about how “nurses are the perfect group to become psychedelic practitioners” and the head of the social worker program talked about how “social workers are the perfect group….” I’m sure you get it.

for those of you wondering the “shaman” stated quite adamantly that the most perfectly suited group of people to become psychedelic practitioners was, you guessed it, native shaman (shapeople?) and a group she referred to as “underground shaman” which I can only assume meant people providing these drugs for others and then sitting with them through their trip. back in the old days we would refer to these people as drug dealers and trip guides but I digress.

what I found missing from all of these talks was the patient. not one of these people in any of the six or so classes I sat through mentioned the need to take care of the patient. even the class titled something like Caring for Clients boiled down to a 45 minute lecture on nurses being the perfect group for doing this sort of work.

I found all these lecture not just disappointing but bordering on terrifying and really irresponsible.

now I am not saying these other professions are not clinicians nor am I saying they could not learn to conduct psychedelic psychotherapy but I am saying that these profession are not taught how to conduct psychotherapy as part of their usual training, so to be not only fair to them but effective in treatment these people would need to be taught how to conduct psychotherapy before they were taught how to conduct psychedelic psychotherapy.

that is just the first issue I had. the untrained personnel being held high as the saving grace of this practice and the fact that patient safety was not mentioned once. even when someone asked a question about it the subject was dodged.

secondly these drugs are extremely powerful, LSD doses are measured in micrograms, referred to as mics, which for the uninitiated is millionths of a gram, and the effective dose (the amount you need to take to get the effect) is 100 mics or 100 millionths of a gram which is a tiny, tiny amount. in comparison consider the over the counter effective dose for ibuprofen is 400 milligrams (mili = thousandths) and Benadryl is 50 milligrams and you may see my point here. magic mushrooms are dosed in grams and when the psilocybin is isolated we are back to milligrams, so to safely administer as well as monitor the average person on a psychedelic trip requires a bit more clinical skills than what I know to be the training program for social workers, nurses, and even psychologists. this is where the psychiatrists should come in but they were absent from these classes entirely. not once was the word “overdose” mentioned or discussed.

oh and they refused to refer to these substances as drugs instead opting for “sacred medicine”

also wouldn’t it be a good idea to discuss administration of these substances and what safety protocols are a good idea to have in place before the drugs are given out? I don’t know, maybe have a medical doctor there to prescribe if not administer the drugs?

another consideration is that to be effective drugs like ketamine (which is not a psychedelic but a hypnotic tranquilizer but was often mentioned with other psychedelics. oh and fun fact: there are now health care “clinics” which will provide a person prescribed ketamine in a home administration kit. I suppose eating the ketamine or taking it in a pill is good enough for the home user) and DMT need to be administered intravenously to be effective. that is they have to be injected. though DMT can be smoked it is really difficult to control the dosage of a drug administered in this way so it was “recommended” to be given by injection. so many problems with this statement, starting with the fact that a person without a license to prescribe medication was making drug administration recommendations which breaks a few laws and even more ethical issues. beyond that let’s just focus on the fact that I was never trained how to properly inject someone with something and I am pretty sure social workers and MFT’s weren’t either. I could be catastrophizing here but I am thinking a lot of things could go wrong if an injection is done oh let’s be nice and say improperly, but what about dosages? .002 milligrams per kilogram of weight sounds easy enough to figure out, just need a scale, a syringe and a calculator but to quote Lewis Black here, what if you forget to carry the two?…..

and before you say it yes nurses are highly trained and totally necessary medical personnel (also the only ones I want giving me an injection of anything), so yes having one in the room would be a wonderful idea, but ethically speaking if you are providing the psychedelic psychotherapy and a medical issue comes up, you need another person in the room to act as the medical professional otherwise you could find yourself in a dangerous duel relationship. duel relationships in this case I would think would be unethical but I also believe they might be illegal.

and while many an “underground shaman” may have needle using experience, again out of an abundance of caution here, there are sterilization requirements for healthcare programs I am going to go ahead a say these folks are not prepared to meet. and would you really want one of these people injecting you or your loved one?

everyone in their lanes, I think I mentioned that already. so I will be the psychotherapist and you will be the medical emergency person, the same person can’t be both because it is irresponsible at best, dangerous at worse, and ultimately even if everything goes off without a hitch in order for this session to be effective at all I need to focus on the psychological stuff while someone else is focusing on the biological stuff. that is why there is more than one person in a surgical suite during an operation–yes the brain surgeon knows how anesthesia works but she isn’t going to be doing much brain surgerying if she is also monitoring the IV drip line and heart monitor…..

last bit on this rant; all these people kept referring to the same study (I forget the name of) which was completed in the before time (research with these drugs was made illegal in the 60’s) as justification for basically every mental illness in the book being effectively treated with psychedelics. though I admit this study indicated astronomically high symptom reduction rate (like 85% improvement after one dose of psilocybin maintained for something along the lines of 10 years which is unheard of in any treatment for any medical or psychological condition) the study was done on cancer patients who were dying and was measuring their fear of dying not depression, though any reported improvement there as well, and only included like 6 or maybe 8 participants–so it was a very small study and not generalizable to the entire population of people.

I tell you after a day of this I was ready to hang up my attendee badge and find other things for Mrs. SoulDoc and I to do in Denver I decided to take a look at the other sessions available to see if there was anything else I could do with the rest of today before calling it quits.

I scrolled through the conference ap, yes they actually developed as ap just for the conference which listed, amongst other things, all the training sessions available by date, time, and learning track. I imagine this seems less strange to my younger readers but I can tell you for a guy my age (still quite young) who has attended many a conference over the years and spent many an hour pouring through a stapled copy of the days itinerary to have an program on my cell phone which allowed me to see at a moment’s desire everything going on was quite a treat. I know kids and their toys….

I found a session titled something along the lines of Psychedelics and Dreams, texted my wife that I was going to give this place one last chance, and off I went.

thank the maker I did, because not only did I find my tribe (as the kids say) but I found the information I had come to Denver looking for…..

more on that in part ii……