1 00:00:00,019 --> 00:00:02,236 And I realized I wasn't really healing people. I 2 00:00:02,236 --> 00:00:05,419 I was just kind of like giving them band- aids to cover up the pain that 3 00:00:05,419 --> 00:00:06,739 they were experiencing. 4 00:00:06,901 --> 00:00:10,181 So I – and then I started to realize that pain is an experience and 5 00:00:10,181 --> 00:00:11,645 everyone experiences it differently. And 6 00:00:11,762 --> 00:00:14,062 And then the whole world started talking about these six sessions of 7 00:00:14,062 --> 00:00:17,150 ketamine to cure depression. And that's not how it works. That 8 00:00:17,185 --> 00:00:20,665 Actually, one of the coolest things is you have this amazing bed. Uh-huh. 9 00:00:20,785 --> 00:00:23,445 That vibrates. Yes. And plays the music. Yes. 10 00:00:23,531 --> 00:00:27,691 Right, they say music is the hidden therapist because music is supposed to 11 00:00:27,691 --> 00:00:28,911 bring up different emotions, 12 00:00:29,091 --> 00:00:33,151 And so what you do is you create a playlist and the bed vibrates 13 00:00:33,151 --> 00:00:34,268 to the music. So 14 00:00:34,324 --> 00:00:37,444 The point is it has to be comfortable. It has to feel safe. They have to 15 00:00:37,444 --> 00:00:40,040 feel like they could just kind of let go into that experience. And 16 00:00:40,086 --> 00:00:43,926 And that's really what we're doing now is less focus on the medicine and 17 00:00:43,926 --> 00:00:46,726 more on the everyday habits, right? 18 00:00:48,841 --> 00:00:52,601 Welcome to Augmented Wellness. Where we meet the people in pursuit of 19 00:00:52,701 --> 00:00:56,642 Better. Today, we speak with Doctor Michelle Weiner — 20 00:00:56,701 --> 00:00:59,921 pain physician and practitioner of whole- person care. 21 00:01:02,275 --> 00:01:05,165 Hi, welcome to another episode of Augmented Wellness. 22 00:01:05,197 --> 00:01:09,077 I'm very excited today to have Dr. Michelle 23 00:01:09,077 --> 00:01:11,937 Weiner here with me, longtime friend, 24 00:01:12,177 --> 00:01:16,237 a pioneer in some of the areas that we're going to be talking 25 00:01:16,237 --> 00:01:20,357 about. And obviously one of the most respected 26 00:01:20,357 --> 00:01:24,297 doctors down here doing amazing work in the 27 00:01:24,297 --> 00:01:28,357 areas of pain management, mental health 28 00:01:28,357 --> 00:01:32,557 and many other related areas. So welcome. Thank you for having me. 29 00:01:32,817 --> 00:01:36,017 It's nice to be in your presence. Ah, likewise. So, 30 00:01:36,297 --> 00:01:40,317 yeah, so obviously we're going to talk a lot about 31 00:01:40,317 --> 00:01:42,697 things that probably a lot of people have not 32 00:01:42,697 --> 00:01:45,817 have gone as deep as we have, 33 00:01:46,897 --> 00:01:48,977 literally, you know. 34 00:01:50,677 --> 00:01:54,597 But the idea, you know, of this podcast is to 35 00:01:54,597 --> 00:01:58,037 really get to know people that make the world better. Obviously, 36 00:01:58,937 --> 00:02:02,097 you know, in Betterness, that's what we do and we want to empower those 37 00:02:02,097 --> 00:02:05,917 that help others. In this particular area, obviously, 38 00:02:05,917 --> 00:02:09,197 you literally are everyday healing someone. 39 00:02:10,217 --> 00:02:14,177 So. But we'd like to start in the beginning. Tell 40 00:02:14,177 --> 00:02:18,097 us, you know, where did you grow up? And 41 00:02:18,097 --> 00:02:21,957 obviously, you know, what was the foundation for you to to follow, 42 00:02:22,177 --> 00:02:26,297 you know, your your calling? Sure. Yeah. So I grew up in New York. I 43 00:02:26,297 --> 00:02:30,457 actually have always been very athletic. So sports was a big part of 44 00:02:30,457 --> 00:02:34,297 my life and movement and nutrition from a very young age. 45 00:02:34,417 --> 00:02:38,257 And I thought I wanted to be either a physical therapist or a 46 00:02:38,257 --> 00:02:42,097 nutritionist. And then when I went to University of Florida from 47 00:02:42,097 --> 00:02:46,237 being from New York, I loved like being outside the warm weather, all that 48 00:02:46,237 --> 00:02:50,337 kind of stuff. And I I was at UF and I realized that 49 00:02:50,337 --> 00:02:54,517 I could potentially just go to med school and do a lot more and heal a lot 50 00:02:54,517 --> 00:02:58,617 more people. And I started to become premed and I 51 00:02:58,617 --> 00:03:02,357 went into something called physical medicine and rehabilitation, which is a 52 00:03:02,357 --> 00:03:06,277 specialty that really focuses on function and helping people who 53 00:03:06,277 --> 00:03:09,937 have debilitating neurological conditions like spinal cord injury, 54 00:03:10,057 --> 00:03:13,937 traumatic brain injury. And I saw a lot of suffering 55 00:03:13,937 --> 00:03:17,417 in my residency and a big part of it was pain. 56 00:03:17,817 --> 00:03:21,177 And so I decided to do a fellowship in pain management. I did 57 00:03:21,177 --> 00:03:25,057 interventional pain at University of Miami. And I was really trying to 58 00:03:25,057 --> 00:03:28,977 help people feel more love and have less pain, really. 59 00:03:29,277 --> 00:03:32,957 And I got into interventional pain, was doing 60 00:03:32,957 --> 00:03:36,677 epidural injections, joint injections, a lot of 61 00:03:36,677 --> 00:03:40,237 medication management. And I realized I wasn't really healing people. I was 62 00:03:40,237 --> 00:03:43,537 just kind of like giving them band-aids to cover up the pain that they were 63 00:03:43,537 --> 00:03:47,597 experiencing. And so I started to learn a lot more 64 00:03:47,597 --> 00:03:51,517 about pain. And I think that medical school does a horrible job 65 00:03:51,517 --> 00:03:55,577 teaching us about nutrition, movement and even pain management. And they're 66 00:03:55,577 --> 00:03:59,417 so focused on medication management, really. So 67 00:03:59,417 --> 00:04:03,257 I started to explore chronic pain. And I realized that 68 00:04:03,257 --> 00:04:07,397 we were using the same treatments for chronic pain 69 00:04:07,397 --> 00:04:10,337 as we do for acute pain, which is very different. You know, if, like, you 70 00:04:10,337 --> 00:04:13,437 injure your back or your knee, the way I would treat you is very different 71 00:04:13,437 --> 00:04:17,217 than if you've had this injury for five years, right? Exactly. So I – and 72 00:04:17,217 --> 00:04:19,777 then I started to realize that pain is an experience and everyone 73 00:04:19,777 --> 00:04:23,117 experiences it differently. And if their mood is depressed, they're not 74 00:04:23,117 --> 00:04:26,057 sleeping well, they're chronically stressed, the way that they perceive 75 00:04:26,057 --> 00:04:29,757 these pain signals are going to be amplified. So I really started to look 76 00:04:29,757 --> 00:04:33,957 at the whole person, not just pain. And with that comes 77 00:04:33,957 --> 00:04:37,917 a lot of mental health conditions as well. Yeah, so we're going to dig into 78 00:04:37,917 --> 00:04:41,957 all that. And obviously, as you know, my dad has 79 00:04:41,957 --> 00:04:44,957 been suffering for a while. And, I mean, 80 00:04:45,057 --> 00:04:48,917 it's hard to see him, you know, right now, how he's doing. 81 00:04:48,917 --> 00:04:52,077 He had back issues and then has led into this chronic. 82 00:04:53,377 --> 00:04:56,297 And, yeah, even people like us that have resources, 83 00:04:56,297 --> 00:05:00,337 it's still hard because there's no magic 84 00:05:00,337 --> 00:05:04,377 cure, right? But that's what a lot of times it is. It's actually your 85 00:05:04,377 --> 00:05:08,337 lifestyle habits. And it makes the foundation of your health. 86 00:05:08,337 --> 00:05:12,117 So how he's sleeping, if he's moving his body, if he believes that 87 00:05:12,117 --> 00:05:15,537 the surgery will cure him or if he believes that movement will make it 88 00:05:15,537 --> 00:05:19,477 worse, right? All of these things are his beliefs that affect his actual 89 00:05:19,477 --> 00:05:22,837 pain. So it's really, you know, integrated. 90 00:05:23,337 --> 00:05:27,497 Yeah, his ability to believe that he could 91 00:05:27,497 --> 00:05:28,717 do something about it. Right. 92 00:05:28,862 --> 00:05:32,511 Yeah. Yeah. we're going to go a little bit back on, on, you know, some of, 93 00:05:32,651 --> 00:05:36,711 some of the, you know, these areas that you discussed. But I 94 00:05:36,711 --> 00:05:40,911 want to, you know, go back into, you know, that, what you said 95 00:05:40,911 --> 00:05:44,591 functional, right? Like functional. know, I think many years ago, 96 00:05:44,791 --> 00:05:48,931 the concept functional medicine was not, you know, that 97 00:05:48,931 --> 00:05:51,931 common. Now a lot of people are talking about that. Can we talk a little 98 00:05:51,931 --> 00:05:56,071 bit about, about it? Because obviously your approach is, is, is holistic. 99 00:05:56,651 --> 00:06:00,651 You know, as you said, your interest was always nutrition and, 100 00:06:00,831 --> 00:06:04,851 and, and, you know, exercise. One common theme of a lot of 101 00:06:04,851 --> 00:06:09,051 the guests that I have is almost all of them were athletes, you know, 102 00:06:09,111 --> 00:06:13,011 and they have that, you know, in their DNA and, and, and, you know, and, 103 00:06:13,911 --> 00:06:18,111 and, has helped them sort of, you know, excel what they 104 00:06:18,111 --> 00:06:20,951 did. Talk a little bit about that, you personally 105 00:06:20,951 --> 00:06:25,071 and, and also how you incorporate that 106 00:06:25,071 --> 00:06:28,991 into your practice. Sure. Yeah. I think the body and the brain 107 00:06:28,991 --> 00:06:32,891 are very interconnected. And so because of that, that's really how I look 108 00:06:32,891 --> 00:06:36,751 at functional medicine is that we're not just our tissues. We're not just 109 00:06:36,751 --> 00:06:40,831 our organs. We're not just our beliefs, but it's all of it wrapped up 110 00:06:40,831 --> 00:06:44,131 together. So when I treat someone, you have to use a holistic approach, 111 00:06:44,131 --> 00:06:47,791 which means we're looking at the whole person. So it's like, how did, why 112 00:06:47,791 --> 00:06:51,931 does this person have this disease as opposed to this disease 113 00:06:51,931 --> 00:06:55,431 has this person? So we really want to understand a little bit more of who 114 00:06:55,431 --> 00:06:59,531 they are and what their belief systems are and then where their 115 00:06:59,531 --> 00:07:03,211 limitations may lie. Maybe they believe that they are not lovable or not 116 00:07:03,211 --> 00:07:07,171 good enough. And this plays into their actual biology. Like imagine if your 117 00:07:07,171 --> 00:07:11,071 belief systems changes your biology and people don't understand how 118 00:07:11,071 --> 00:07:14,571 interconnected the brain and the body are. So the fact that we're in this 119 00:07:14,571 --> 00:07:18,611 chronically stressed state and our amygdala is on high alert 120 00:07:18,611 --> 00:07:22,111 all the time. And how does that change the way that we 121 00:07:22,111 --> 00:07:26,091 perform in our everyday life? For example, prefrontal cortex 122 00:07:26,091 --> 00:07:29,071 is a part of the brain that's supposed to tell us to get up and go and do 123 00:07:29,071 --> 00:07:32,611 different things. And if our brain is kind of telling us, you know, stay 124 00:07:32,611 --> 00:07:36,431 down, it's not safe out there, we're not going to be as productive. So 125 00:07:36,431 --> 00:07:40,111 understanding how our brain is working is very important, but then also how 126 00:07:40,111 --> 00:07:43,591 it affects the body. And that really has to do with how we regulate our 127 00:07:43,591 --> 00:07:47,691 emotions, our nervous system and our beliefs. So when I think when we start 128 00:07:47,691 --> 00:07:51,351 to really look at the brain and the body as one and not separate, 129 00:07:51,511 --> 00:07:55,251 and I think neuroscience has helped bridge this gap, then there's a lot 130 00:07:55,251 --> 00:07:58,671 more than just taking blood and looking at labs. You know, we have 131 00:07:58,671 --> 00:08:02,131 functional MRIs. We have a lot of more 132 00:08:02,131 --> 00:08:05,791 advanced technology to help us. And at the same time, 133 00:08:05,791 --> 00:08:09,231 what's most important is just our foundation of health. You know, how we 134 00:08:09,231 --> 00:08:13,111 sleep, move, eat, socialize with other people, what we think about 135 00:08:13,111 --> 00:08:17,211 ourselves. So I think, you know, functional integrative medicine is new 136 00:08:17,211 --> 00:08:21,051 in the sense that it's not taught in medical schools. And that's really 137 00:08:21,051 --> 00:08:25,111 very sad because then we're still not right because then we're 138 00:08:25,111 --> 00:08:28,951 just looking at very basic biomarkers to help understand how people are 139 00:08:28,951 --> 00:08:32,331 feeling. The same way where, you know, we can't really measure 140 00:08:32,331 --> 00:08:36,071 neurotransmitters. Yet people believe that depression is a serotonin 141 00:08:36,071 --> 00:08:39,651 deficiency. And that's really not true. And a lot of research has shown 142 00:08:39,651 --> 00:08:43,351 that it's much more complex. It could be metabolic. It could be 143 00:08:43,351 --> 00:08:47,051 hormonal. It could be due to poor habits or 144 00:08:47,051 --> 00:08:50,991 what's going on in the brain. So, you know, I think my life has 145 00:08:50,991 --> 00:08:54,411 changed a lot as I've learned a lot more about neuroscience. And 146 00:08:54,411 --> 00:08:58,491 really, we were looking at pain as if it was in the physical body. And now 147 00:08:58,491 --> 00:09:02,391 we understand that anything that's chronic is actually mediated by our 148 00:09:02,391 --> 00:09:06,371 central nervous system, which is our brain and our spine. And most of it is 149 00:09:06,371 --> 00:09:10,551 people feeling stuck over time. And why did they get stuck? And how 150 00:09:10,551 --> 00:09:14,551 can we shift them out? And what is a good catalyst to create change? I 151 00:09:14,551 --> 00:09:17,711 think that's what we're all looking for. Like, how can someone connect 152 00:09:17,711 --> 00:09:21,831 deeper with who they truly are and understand what's important to them when 153 00:09:21,831 --> 00:09:25,731 they're stuck in a state of fear or they don't even have meaning in their 154 00:09:25,731 --> 00:09:25,991 life? 155 00:09:26,962 --> 00:09:30,002 how do you, you know, when you see a patient, 156 00:09:30,022 --> 00:09:34,222 you know, and obviously you said there's a very big 157 00:09:34,222 --> 00:09:37,742 difference between chronic, you know, and acute pain. 158 00:09:38,042 --> 00:09:42,202 How do you approach it? I mean, you said, you you understand their 159 00:09:42,202 --> 00:09:46,322 belief system, right? Yeah. I mean, we all know right now, I mean, 160 00:09:46,382 --> 00:09:50,462 the criticism of the medical, you know, relationship 161 00:09:50,462 --> 00:09:54,522 is you go in and 15 minutes, you're in and out. You know, how do you 162 00:09:54,522 --> 00:09:58,342 have time to actually, you know, you know, dig deeper 163 00:09:58,342 --> 00:10:01,922 into the patient? I mean, what is your approach? That's a great question 164 00:10:01,922 --> 00:10:06,062 because you have to create a model that works for you and your 165 00:10:06,062 --> 00:10:10,082 practice, right? So initially when I was a pain doctor, was just evaluating 166 00:10:10,082 --> 00:10:13,922 patients, seeing their MRIs, doing injections. And that to me is not 167 00:10:13,922 --> 00:10:17,982 treating the whole person, right? Why did a person who has 168 00:10:17,982 --> 00:10:22,142 an acute issue turn into chronic pain? Or why did someone who had some 169 00:10:22,142 --> 00:10:25,962 type of trauma develop PTSD or generalized anxiety? So 170 00:10:25,962 --> 00:10:30,002 we call it a biopsychosocial approach. What you're doing is you're looking 171 00:10:30,002 --> 00:10:33,982 at their physical body, at their genetics, their medications that 172 00:10:33,982 --> 00:10:38,062 they're on, different pathways in the body, which break down enzymes 173 00:10:38,062 --> 00:10:41,662 so that we understand a little bit more of who they are and how things are 174 00:10:41,662 --> 00:10:45,482 running in the body. And then we look at psychologically their coping 175 00:10:45,482 --> 00:10:49,202 mechanisms, their belief systems, socially who's in their 176 00:10:49,202 --> 00:10:53,082 environment, what type of work they have, if they have financial 177 00:10:53,082 --> 00:10:56,422 constraints. So if we can evaluate someone from a 178 00:10:56,422 --> 00:11:00,042 biopsychosocial approach, really understand all of these aspects, 179 00:11:00,242 --> 00:11:04,282 then it also helps us understand what they believe is going on and where 180 00:11:04,282 --> 00:11:08,202 they became stuck. You know, sometimes people are moving on 181 00:11:08,202 --> 00:11:12,142 in their life and they're actually operating with old belief systems 182 00:11:12,142 --> 00:11:16,002 or they're not able to move forward because the trauma that they experience 183 00:11:16,002 --> 00:11:19,602 is still plaguing them in their current present moment. So 184 00:11:19,602 --> 00:11:23,742 I actually evaluate people by what we call the experience of 185 00:11:23,742 --> 00:11:27,102 the patient, meaning if I'm sitting with someone, how do they make me feel? 186 00:11:27,282 --> 00:11:30,942 Do they have more of like a depressed, flat affect? Do they feel a little 187 00:11:30,942 --> 00:11:34,622 bit more anxious and kind of hypervigilant? Are they moving around and 188 00:11:34,622 --> 00:11:38,182 uncomfortable because they're in physical pain? So one is the experience of 189 00:11:38,182 --> 00:11:42,002 the patient after we do a biopsychosocial approach. And then 190 00:11:42,002 --> 00:11:45,902 it's can they tune in? You know, can they tune into their body accurately? 191 00:11:46,122 --> 00:11:49,562 Are they sensing these signals from an amplified perspective? 192 00:11:50,262 --> 00:11:54,402 You know, are they seeing the world like everything is a threat or are 193 00:11:54,402 --> 00:11:58,522 they able to actually feel safe in their body and be present? And I think 194 00:11:58,522 --> 00:12:02,362 that's important is that people have had past experiences that 195 00:12:02,362 --> 00:12:06,502 really create how they're moving forward in their life. And 196 00:12:06,502 --> 00:12:09,762 we have to understand what has happened in their past and then how they're 197 00:12:09,762 --> 00:12:13,882 able to sense their their physical body. So it's getting them back in 198 00:12:13,882 --> 00:12:17,922 touch with their body, but also understanding that their past is still part 199 00:12:17,922 --> 00:12:21,742 of who they are today. Yeah, which which obviously is 200 00:12:21,742 --> 00:12:25,782 is is what, you in a way connected us when when, 201 00:12:25,782 --> 00:12:29,762 you we were a Nue Life, you know, which was a company that that 202 00:12:29,762 --> 00:12:33,862 that we started with the Juan Pablo, which, you know, well, our whole goal 203 00:12:33,862 --> 00:12:37,722 was to, you know, can we actually create, you a company 204 00:12:37,722 --> 00:12:41,622 that, you know, could could democratize the access to to the 205 00:12:41,622 --> 00:12:45,302 medicine, but then, you know, really understand the user 206 00:12:45,302 --> 00:12:48,802 or the patient, you know, in a more holistic way. 207 00:12:48,802 --> 00:12:52,942 And I don't know if you remember back then, but, you we did one 208 00:12:52,942 --> 00:12:56,282 of the largest peer reviewed papers that 209 00:12:56,282 --> 00:13:00,362 that demonstrate the efficacy of the at 210 00:13:00,362 --> 00:13:04,002 home ketamine. But the second paper that we never got to publish 211 00:13:04,002 --> 00:13:07,142 and that one had a 50 percent reduction of symptoms, 212 00:13:07,702 --> 00:13:11,842 I think, within four weeks, which was obviously, you know, 213 00:13:12,122 --> 00:13:16,022 you know, the statistics of people that were treatment resistant 214 00:13:16,022 --> 00:13:20,182 to have that type of effect. Right. But the one that 215 00:13:20,182 --> 00:13:23,922 we didn't get to publish was the one that measure when they 216 00:13:23,922 --> 00:13:27,542 actually engage in lifestyle changes. And 217 00:13:27,542 --> 00:13:31,662 they did the other part of the program that we had. As you remember, we 218 00:13:31,662 --> 00:13:35,862 had like, you know, we had health coaches and we give them nutrition 219 00:13:35,862 --> 00:13:38,402 advice and we give them breath work and all that. 220 00:13:40,582 --> 00:13:44,142 You know, the the impact, I think, was when all the way up to like 70 or 80 221 00:13:44,142 --> 00:13:47,162 percent reduction in symptoms. So. 222 00:13:48,282 --> 00:13:52,202 So with that, I want to sort of get into a little bit of 223 00:13:52,202 --> 00:13:55,262 that time where we connected. Right. So we connected. 224 00:13:56,042 --> 00:13:59,202 But yeah, I was right around COVID after COVID. 225 00:13:59,982 --> 00:14:03,502 There was, you know, there was always interesting the 226 00:14:03,502 --> 00:14:07,582 psychedelic space. Obviously, maybe we'll go 227 00:14:07,582 --> 00:14:11,142 back a little bit of history on that. And obviously, I let you 228 00:14:11,142 --> 00:14:15,242 tell us a little bit. I remember in my in my 229 00:14:15,242 --> 00:14:19,182 particular. Perspective 230 00:14:19,182 --> 00:14:23,122 was Michael Pollan. Right. 2018, I think he wrote the book and that sort 231 00:14:23,122 --> 00:14:27,262 of reinvigorated the space. So tell us a little bit how you saw it 232 00:14:27,262 --> 00:14:31,122 from because you were already looking at pain and 233 00:14:31,122 --> 00:14:34,982 and mental health and all that. How did you? So 234 00:14:34,982 --> 00:14:39,082 I was trained in 2012 to do ketamine infusions for 235 00:14:39,082 --> 00:14:43,162 chronic pain in my pain fellowship. So I've been doing it for, you know, 236 00:14:43,382 --> 00:14:47,502 14 years now. Right. However, back then it was 237 00:14:47,502 --> 00:14:50,782 done in a very different way where they looked at ketamine as a 238 00:14:50,782 --> 00:14:53,822 dissociative anesthetic that was just supposed to give people a temporary 239 00:14:53,822 --> 00:14:57,242 relief from their pain. They didn't realize the amount of 240 00:14:57,242 --> 00:15:01,302 neuroplasticity that could be created and why you should have a 241 00:15:01,302 --> 00:15:04,942 coach or therapist there to steer or guide you in the right direction once 242 00:15:04,942 --> 00:15:08,282 the changes are happening within the nervous system. So I was using 243 00:15:08,282 --> 00:15:12,402 ketamine for chronic pain. And then I saw these therapists 244 00:15:12,402 --> 00:15:15,622 and psychiatrists start to use it for mental health. Which really made me 245 00:15:15,622 --> 00:15:18,982 curious. How are people using it for pain versus depression? Why is that 246 00:15:18,982 --> 00:15:22,862 different? Right. And then you have to understand why the same medicine 247 00:15:22,862 --> 00:15:26,822 could be used for multiple different conditions. And so if the goal is to 248 00:15:26,822 --> 00:15:30,722 create this neuroplasticity, then you can kind of get there 249 00:15:30,722 --> 00:15:33,842 with two different medicines. You can also do it without a medicine. Right. 250 00:15:34,202 --> 00:15:38,342 But ketamine is completely legal. It's a schedule three medication. It's 251 00:15:38,342 --> 00:15:42,482 been available since 1970. So over 50 years. Let's go into that because 252 00:15:42,482 --> 00:15:45,762 obviously, you know, we've been in this space. For a while. Yeah. You've 253 00:15:45,762 --> 00:15:49,702 been a lot longer than I have. There's all these misconceptions about 254 00:15:49,702 --> 00:15:51,882 ketamine. There's horse tranquilizer thing. 255 00:15:53,482 --> 00:15:57,582 As far as I've learned it and I remember it, I 256 00:15:57,582 --> 00:16:01,542 mean, one of the first instances where people understood 257 00:16:01,542 --> 00:16:05,422 that there was something that worked with ketamine was 258 00:16:05,422 --> 00:16:09,422 in Vietnam. Right. They called it the buddy drug. Yeah. Okay. So instead of 259 00:16:09,422 --> 00:16:13,522 giving someone morphine who was injured, you know, to relieve their pain, 260 00:16:14,062 --> 00:16:18,022 morphine also suppresses their respiration. So ketamine is very 261 00:16:18,022 --> 00:16:22,182 safe. It doesn't actually change any suppressions in terms of their 262 00:16:22,182 --> 00:16:26,262 respiration. So they're able to continue to breathe. And at the same time, 263 00:16:26,382 --> 00:16:29,522 they have pain relief because it's an anesthetic. But the bigger thing was 264 00:16:29,522 --> 00:16:33,202 that there was less of an emotional charge from the trauma that they were 265 00:16:33,202 --> 00:16:36,482 experiencing. So if you gave someone morphine, they're out of pain, but 266 00:16:36,482 --> 00:16:39,422 maybe you're going to give them too much and that's going to affect their 267 00:16:39,422 --> 00:16:43,242 vitals. Okay. So as opposed to giving them something like 268 00:16:43,242 --> 00:16:47,342 ketamine, they're able to not have pain, their vitals are stable, and 269 00:16:47,342 --> 00:16:51,022 they're also not experiencing the trauma at So realizing that people maybe 270 00:16:51,022 --> 00:16:55,162 had less PTSD or they had... Exactly. They were waking up with less PTSD 271 00:16:55,162 --> 00:16:58,502 because they were dissociating during the trauma. So they weren't 272 00:16:58,502 --> 00:17:02,402 experiencing all of these emotions and fear. And because of that, they were 273 00:17:02,402 --> 00:17:06,422 waking up in less pain, but also developed less PTSD. So Vietnam 274 00:17:06,422 --> 00:17:09,862 was the first time they started really using ketamine. Then people would 275 00:17:09,862 --> 00:17:12,862 use it in surgery and people would wake up and they would report feeling 276 00:17:12,862 --> 00:17:16,202 less depressed because it's such a rapid antidepressant. So then they 277 00:17:16,202 --> 00:17:20,382 started researching it. John Krystal researched it over 20 278 00:17:20,382 --> 00:17:24,542 years ago looking at ketamine for treatment-resistant depression. So 279 00:17:24,542 --> 00:17:28,722 people who've tried and failed all these different SSRIs and SNRIs, why 280 00:17:28,722 --> 00:17:31,902 would this work? It stimulates glutamate, which is an excitatory 281 00:17:31,902 --> 00:17:35,582 neurotransmitter, has a completely different mechanism. People who have 282 00:17:35,582 --> 00:17:39,582 already been on all these drugs and kind of frustrated and hopeless started 283 00:17:39,582 --> 00:17:43,482 to get ketamine and feel better. The problem was that he did a study, which 284 00:17:43,482 --> 00:17:46,822 was twice a week for three weeks, a total of six sessions. And then the 285 00:17:46,822 --> 00:17:49,742 whole world started talking about these six sessions of ketamine to cure 286 00:17:49,742 --> 00:17:53,662 depression. And that's not how it works. That study was done, and it's a 287 00:17:53,662 --> 00:17:57,282 great study, but it was really looking at short-term effects of ketamine. 288 00:17:57,442 --> 00:18:01,402 It's great for suicidal ideations. It helps someone very quickly. But with 289 00:18:01,402 --> 00:18:05,282 ketamine, sometimes you actually require maintenance. The other thing is 290 00:18:05,282 --> 00:18:08,202 that they made it into an FDA-approved drug called Spravato, 291 00:18:08,382 --> 00:18:12,502 which is S-ketamine because ketamine has two parts to 292 00:18:12,502 --> 00:18:15,882 it. And that's great because it's covered by insurance for people who need 293 00:18:15,882 --> 00:18:19,982 help and can't afford ketamine. But the problem is they didn't 294 00:18:19,982 --> 00:18:24,162 put therapy alongside of Spravato. So then people were just getting 295 00:18:24,162 --> 00:18:28,022 Spravato for a long time, you know, and they were feeling better. 296 00:18:28,222 --> 00:18:31,642 Let's go back because I remember obviously Spravato came around that time, 297 00:18:31,722 --> 00:18:35,882 right? It was 2020, I think it was. 2019. What has happened since? I 298 00:18:35,882 --> 00:18:39,082 mean, what have we learned, not learned? Right, so what we have learned is 299 00:18:39,082 --> 00:18:42,602 to pair ketamine or any psychedelic with coaching, 300 00:18:42,602 --> 00:18:46,722 preparation, and integration, which means that you have to prepare 301 00:18:46,722 --> 00:18:50,602 the person's mindset, have the right intention going into these sessions, 302 00:18:50,622 --> 00:18:54,202 and then also pay attention to the environment that they're in, and then 303 00:18:54,202 --> 00:18:57,902 have integration, which is make meaning out of whatever insight comes up 304 00:18:57,902 --> 00:19:01,262 during these sessions. So, for example, in the pain management world, I've 305 00:19:01,262 --> 00:19:04,362 learned we should keep people in a state where they're able to remember 306 00:19:04,362 --> 00:19:08,282 their sessions because they want to make meaning out of these sessions. The 307 00:19:08,282 --> 00:19:11,942 whole point is that you're missing an opportunity that if you're just 308 00:19:11,942 --> 00:19:14,982 anesthetizing someone, putting them to sleep during their ketamine session, 309 00:19:15,042 --> 00:19:18,282 then they wake up. Okay, maybe there's neuroplasticity, but there's 310 00:19:18,282 --> 00:19:22,042 actually no meaning that could be made. Which actually goes to what we're 311 00:19:22,042 --> 00:19:25,662 going to probably show later that we're talking about. Right, right, right, 312 00:19:25,662 --> 00:19:29,742 right. Music and how all that fits into that experience. Right, they 313 00:19:29,742 --> 00:19:33,842 say music is the hidden therapist because music is supposed to bring 314 00:19:33,842 --> 00:19:38,022 up different emotions, to allow people to go deeper and not to be stuck 315 00:19:38,022 --> 00:19:41,442 in their conscious thoughts because really their regular thoughts, their 316 00:19:41,442 --> 00:19:45,062 ordinary mind is kind of keeping them stuck. So we want to go a little bit 317 00:19:45,062 --> 00:19:48,822 deeper and see kind of can we blur that line where the subconscious kind of 318 00:19:48,822 --> 00:19:52,942 blends into their conscious thoughts. And so I think we've 319 00:19:52,942 --> 00:19:56,162 gone to more studies looking at how therapy can 320 00:19:56,162 --> 00:20:00,062 be used alongside of ketamine and not 321 00:20:00,062 --> 00:20:03,942 just one versus the other. And there's actual pain research showing how 322 00:20:03,942 --> 00:20:07,822 there's an 80% improvement when you do ketamine with therapy versus just 323 00:20:07,822 --> 00:20:11,542 ketamine or therapy alone in the pain management world, which is great. And 324 00:20:11,542 --> 00:20:15,542 then in terms of depression, we've been using ketamine for 325 00:20:15,542 --> 00:20:19,262 PTSD, OCD, all these things off-label for mental health, 326 00:20:19,262 --> 00:20:23,422 really because it's helping people shift out of these narratives 327 00:20:23,422 --> 00:20:27,082 or their maladaptive patterns that they've really 328 00:20:27,082 --> 00:20:30,902 become ingrained in. And so it's a great 329 00:20:30,902 --> 00:20:34,822 form of plasticity, I would say. It's just very different than 330 00:20:34,822 --> 00:20:35,662 psychedelics. 331 00:20:35,968 --> 00:20:39,588 And that's actually where I wanted to go now, do a leap into psychedelics 332 00:20:39,588 --> 00:20:43,268 because ketamine is not considered a classical 333 00:20:43,268 --> 00:20:46,708 psychedelic medicine, right? Right. So we talked 334 00:20:46,708 --> 00:20:50,888 a little bit. Ketamine works with different receptors, 335 00:20:51,188 --> 00:20:55,148 GABA, glutamate, Yeah, very good, yeah. Well, so it blocks the 336 00:20:55,148 --> 00:20:58,988 NMDA receptor, which upregulates glutamate, which is 337 00:20:58,988 --> 00:21:02,928 excitatory, but it actually blocks it on the GABA neurons, which are 338 00:21:02,928 --> 00:21:06,688 inhibitory. That's why you get this surge. So the surge of glutamate is 339 00:21:06,688 --> 00:21:10,788 supposed to help people transform their lives, just become motivated 340 00:21:10,788 --> 00:21:14,388 to stop having a narrow framework of how you're 341 00:21:14,388 --> 00:21:17,828 going through your life every day. And hopefully that motivation 342 00:21:17,828 --> 00:21:21,808 creates something that spirals into long term. But that's 343 00:21:21,808 --> 00:21:25,808 also why you have to do multiple sessions. Yeah, so it has that excitatory. 344 00:21:26,308 --> 00:21:29,608 So yeah, so let's go a little deep because obviously we love to geek out on 345 00:21:29,608 --> 00:21:33,428 this. So we do then the leap into 346 00:21:33,428 --> 00:21:37,568 traditional or classical psychedelic molecules. 347 00:21:39,088 --> 00:21:43,268 So you have the glutamate and that concept, but you 348 00:21:43,268 --> 00:21:47,408 also have obviously this association, right? So it 349 00:21:47,408 --> 00:21:50,668 makes you sort of feel lighter because 350 00:21:50,668 --> 00:21:54,208 there's a connection with the body, as you said, right? Yeah, it's like 351 00:21:54,208 --> 00:21:58,108 this disembodied type of feeling where you're present, but 352 00:21:58,108 --> 00:22:01,928 you're kind of observing what's happening. It does feel like floating. 353 00:22:02,128 --> 00:22:05,688 feels like the whole goal is to get people to let go and just surrender 354 00:22:05,688 --> 00:22:09,848 into that experience and not have them constricted in their fear. Or you're 355 00:22:09,848 --> 00:22:12,328 going into a session and there's uncertainty of what you're going to 356 00:22:12,328 --> 00:22:16,388 experience. So the goal is really to create safety so that they can let go. 357 00:22:16,508 --> 00:22:19,868 And then if your nervous system was to kind of let go for a little while, 358 00:22:20,108 --> 00:22:23,288 it would allow your brain to create a different perspective on what's going 359 00:22:23,288 --> 00:22:26,588 on. And what about the default mode network? I know that's the other big 360 00:22:26,588 --> 00:22:29,688 one. Yeah, the default mode network. So we have all these different 361 00:22:29,688 --> 00:22:32,588 networks within the brain. Like we have brain regions, but then we also 362 00:22:32,588 --> 00:22:36,068 have networks. And then like there's a default mode, the salience, the 363 00:22:36,068 --> 00:22:39,868 central executive, all these different networks. The goal of psychedelics 364 00:22:39,868 --> 00:22:43,548 is actually to increase functional connectivity amongst the network. So 365 00:22:43,548 --> 00:22:47,428 the default mode network is basically the self-representation of who you 366 00:22:47,428 --> 00:22:51,008 are. It's like what holds your story. So when you're daydreaming, 367 00:22:51,508 --> 00:22:55,468 mind wandering, it's very active. During psychedelics, it's very quiet. 368 00:22:55,468 --> 00:22:58,828 We deactivate the default mode. So you're not your story for a little 369 00:22:58,828 --> 00:23:02,708 while. So, you know, if you had a trauma or if you had pain, you're stuck 370 00:23:02,708 --> 00:23:06,788 in your story all the time. It's kind of guiding you or limiting you. So if 371 00:23:06,788 --> 00:23:10,688 you're not, if your default mode is not active during psychedelics, then 372 00:23:10,688 --> 00:23:14,728 other parts of the brain start to become active and start to connect. And 373 00:23:14,728 --> 00:23:17,648 that, you know, that's why you have all these different experiences and you 374 00:23:17,648 --> 00:23:21,528 have all of a sudden something that was so traumatic, seems so simple and 375 00:23:21,528 --> 00:23:25,448 easy to let go of or a belief that you had about yourself. You you 376 00:23:25,448 --> 00:23:28,588 question. It like the chatter, right? Like what people call like that 377 00:23:28,588 --> 00:23:31,828 little thing. the little voice in your head. So if the little voice in your 378 00:23:31,828 --> 00:23:35,908 head is quiet for an hour or two, it allows you to kind of wake up and 379 00:23:35,908 --> 00:23:39,228 think of things in a different way. Also, you feel different in your body 380 00:23:39,228 --> 00:23:43,188 because you're not really stuck in that belief system. So the default 381 00:23:43,188 --> 00:23:47,228 mode being deactivated during psychedelics helps people move past 382 00:23:47,228 --> 00:23:51,348 something, which is why preparation is so important to help, you know, get 383 00:23:51,348 --> 00:23:55,268 that intention there. Like I want to believe that I am lovable 384 00:23:55,268 --> 00:23:58,448 or that I'm good enough. You know, if you set someone's mindset up with 385 00:23:58,448 --> 00:24:01,448 that and then they go into the journey and their default mode is less 386 00:24:01,448 --> 00:24:04,668 active, then they're able to not be stuck in their story. 387 00:24:05,142 --> 00:24:08,562 when people obviously ask me about all this, I, you I try to 388 00:24:08,562 --> 00:24:12,762 get as specific as possible. So people understand how all these molecules 389 00:24:12,762 --> 00:24:16,862 work. Right. And and how, you know, how they 390 00:24:16,862 --> 00:24:20,542 affect you. Right. So default, it seems that all of them 391 00:24:20,542 --> 00:24:24,482 in a way. But let's go now into, 392 00:24:24,782 --> 00:24:28,622 you know, sort of serotonin. Yeah. You know, you know, 393 00:24:28,762 --> 00:24:32,762 with with obviously mushrooms and and 394 00:24:32,762 --> 00:24:35,882 and and and psilocybin and things like that. And then and then obviously 395 00:24:35,882 --> 00:24:39,962 MDMA. So walk us a little bit into sort of how they all differ 396 00:24:39,962 --> 00:24:44,062 from each other. So there's actually 16 serotonin receptors. 397 00:24:44,562 --> 00:24:48,582 And the 5-HT2A is one of the 398 00:24:48,582 --> 00:24:52,302 serotonin receptors that's known as a psychedelic receptor. So 399 00:24:52,302 --> 00:24:56,242 psilocybin, DMT, LSD activates the 5 400 00:24:56,242 --> 00:25:00,402 -HT2A receptors. And that's really important to understand that we have 401 00:25:00,402 --> 00:25:03,622 this one receptor that gives us these psychedelic experiences. 402 00:25:04,142 --> 00:25:07,482 And those are the classic psychedelics. What people say is, like, why is 403 00:25:07,482 --> 00:25:11,462 that receptor even there? Right. Right. Right. Well, I mean, that's it's 404 00:25:11,462 --> 00:25:15,362 kind of like there's like the body is so amazing in that 405 00:25:15,362 --> 00:25:18,902 sense, you know, like same way, like we have endocannabinoids, which are 406 00:25:18,902 --> 00:25:22,962 like these naturally produced cannabinoids in our body. we 407 00:25:22,962 --> 00:25:26,382 have cannabinoid receptors not just to smoke the cannabis plant. Right. 408 00:25:26,382 --> 00:25:29,562 Like it's because it actually balances us. Same thing like our opioid 409 00:25:29,562 --> 00:25:33,502 system. We make endorphins. That's our natural opioids helps us with 410 00:25:33,502 --> 00:25:37,522 pain. So we have these 5-HT2A receptors and they give us these 411 00:25:37,522 --> 00:25:41,322 psychedelic journeys. And it's like, how did the brain, you know, 412 00:25:42,222 --> 00:25:45,762 evolve to have all these different types of receptors and how much more is 413 00:25:45,762 --> 00:25:49,942 there for us to understand? So in, you know, the classic psychedelics, it's 414 00:25:49,942 --> 00:25:53,482 a it's a different journey. It's not it's going to stimulate serotonin. 415 00:25:53,622 --> 00:25:57,662 It's not as much of glutamate. But there's all this. It's actually more 416 00:25:57,662 --> 00:26:00,842 so about the functional connectivity going on amongst the networks where 417 00:26:00,842 --> 00:26:04,962 now they start to become integrated as opposed to like a hyperactive 418 00:26:04,962 --> 00:26:08,102 default mode. Now the default mode is paying attention to the other 419 00:26:08,102 --> 00:26:12,022 networks more so. So it's this integrated connectivity 420 00:26:12,022 --> 00:26:16,062 of the brain. That's why, like, you see the, you know, the picture 421 00:26:16,062 --> 00:26:19,202 of all the different connections. Once you give someone psilocybin and a 422 00:26:19,202 --> 00:26:23,082 functional MRI, there's a lot more going on. But there's still a lot more 423 00:26:23,082 --> 00:26:26,902 that we don't understand. Right. And so that's why the importance of, you 424 00:26:26,902 --> 00:26:30,602 know, set and setting, obviously, for for safety. But also these have 425 00:26:30,602 --> 00:26:34,162 longer half life. So ketamine works quick, doesn't last as long 426 00:26:34,162 --> 00:26:37,382 versus the other classic psychedelics are going to have a longer half life 427 00:26:37,382 --> 00:26:41,322 where maybe you do one session every four weeks or every six 428 00:26:41,322 --> 00:26:45,202 weeks and you'll have a longer integration and more neuroplastic changes. 429 00:26:46,462 --> 00:26:50,302 They also stimulate BDNF, brain derived neurotropic factor, 430 00:26:50,602 --> 00:26:54,742 which is also involved in neuroplasticity. so so the 431 00:26:54,742 --> 00:26:58,782 length of that half life changes as opposed to MDMA, which is an 432 00:26:58,782 --> 00:27:02,982 pathogen. It does stimulate the 5-H2A receptor, but 433 00:27:02,982 --> 00:27:06,792 also increases oxytocin. It has that amphetamine type of response. 434 00:27:06,842 --> 00:27:10,902 The way I usually explain it is, you know, psilocybin 435 00:27:10,902 --> 00:27:15,002 is serotonin is more about you looking out, you know, 436 00:27:15,102 --> 00:27:19,102 sort of, you know, your your way you interpret, you know, senses 437 00:27:19,102 --> 00:27:23,102 and signals. MDMA, which has also 438 00:27:23,102 --> 00:27:26,742 the dopamine and the endorphin or the pathogen 439 00:27:26,742 --> 00:27:30,542 aspect, you sort of have is a combination of 440 00:27:30,542 --> 00:27:34,062 serotonin and dopamine. Right. you sort of are 441 00:27:34,062 --> 00:27:37,742 looking in and out at the same time. Right. In a way. Yeah. 442 00:27:38,102 --> 00:27:42,022 And and and, you know, obviously, you have that sort of it's not 443 00:27:42,022 --> 00:27:45,302 you know, doesn't play some part in the senses, like obviously with 444 00:27:45,302 --> 00:27:49,442 psilocybin or LSD that you're sort of obviously you could go and see a lot 445 00:27:49,442 --> 00:27:52,842 of different things. You're feeling a lot more, but you could also 446 00:27:52,842 --> 00:27:56,522 sometimes see. Right. Yeah. I think 447 00:27:56,522 --> 00:28:00,542 psychedelics has just the classic like hallucinations. Right. Like you're 448 00:28:00,542 --> 00:28:04,042 seeing things that are not really there as opposed to with MDMA. It's a 449 00:28:04,042 --> 00:28:07,742 little more of that hard opening type of experience where you feel more 450 00:28:07,742 --> 00:28:11,582 love. You judge yourself less. You're in a different state. Like, 451 00:28:11,762 --> 00:28:15,222 you know, I think MDMA is great. I think it's a wonderful medicine for 452 00:28:15,222 --> 00:28:18,862 PTSD, for chronic pain. I think it has a lot of positives 453 00:28:18,862 --> 00:28:22,722 relationships. Yeah. I think it could be used in couples 454 00:28:22,722 --> 00:28:26,802 therapy. And that's the one that was is most likely to be 455 00:28:26,802 --> 00:28:30,862 approved for PTSD as opposed to psilocybin for treatment resistant 456 00:28:30,862 --> 00:28:31,282 depression. 457 00:28:31,474 --> 00:28:35,514 Where are we today? And, you know, because I again, 458 00:28:35,614 --> 00:28:37,974 I left that industry a couple couple of years ago. 459 00:28:39,594 --> 00:28:41,454 So unfortunately, there was all this, 460 00:28:41,694 --> 00:28:45,714 you know, we had all these expectations 461 00:28:45,714 --> 00:28:49,774 that MDMA was going to be approved and then it sort of fell 462 00:28:49,774 --> 00:28:53,854 through the cracks. Where are we today? And I know there's 463 00:28:53,854 --> 00:28:57,774 a lot of excitement, you know, because of the regulatory 464 00:28:57,774 --> 00:29:01,894 situation right now. And how do you see it? Yeah, 465 00:29:02,034 --> 00:29:06,074 I believe that some psychedelics may be available 466 00:29:06,074 --> 00:29:10,074 in 2027. So there's there's there's basically this 467 00:29:10,074 --> 00:29:13,834 movement forward to get these medications approved because there's so many 468 00:29:13,834 --> 00:29:17,714 people who are depressed, who are in chronic pain, who are suicidal. So 469 00:29:17,714 --> 00:29:20,934 they need other options. And actually, the research shows that we can't 470 00:29:20,934 --> 00:29:24,114 just keep using a medication to keep numbing people and think that they're 471 00:29:24,114 --> 00:29:28,134 going to have, you know, long term benefits. Right. So we see all these 472 00:29:28,134 --> 00:29:32,094 people on meds and still not feeling well. So I think that in 473 00:29:32,094 --> 00:29:36,154 2027, we potentially could have MDMA available for PTSD 474 00:29:36,154 --> 00:29:39,594 and psilocybin available for treatment resistant depression. 475 00:29:39,954 --> 00:29:44,134 The problem is how that actually looks in the doctor's office. If you think 476 00:29:44,134 --> 00:29:48,214 about it, you can't have one patient being seen per day for a 477 00:29:48,214 --> 00:29:51,854 six to eight hour journey, you know. So there's some states that are 478 00:29:51,854 --> 00:29:55,714 actually looking at doing group psilocybin and trying to get people 479 00:29:55,714 --> 00:29:59,554 together to do that in a group, which I think is a great experience. Which 480 00:29:59,554 --> 00:30:03,114 in ketamine happens, right? When you do group ketamine. I think that the 481 00:30:03,114 --> 00:30:06,414 group is nice because people are vulnerable. They get to witness each 482 00:30:06,414 --> 00:30:09,674 other. They get to see people have similar experiences and similar 483 00:30:09,674 --> 00:30:13,674 challenges in their lives. They get to connect with others. And I think 484 00:30:13,674 --> 00:30:17,534 that's a big issue is that people doing medicines alone are feeling 485 00:30:17,534 --> 00:30:20,774 disconnected and then they are in this environment where they're by 486 00:30:20,774 --> 00:30:24,054 themselves. So it doesn't really help them heal as well, I would say. 487 00:30:24,614 --> 00:30:28,754 Which, by the way, this is nothing new. Right. I mean, we 488 00:30:28,754 --> 00:30:32,714 know we, you know, we have our ancestors that have been doing group therapy 489 00:30:32,714 --> 00:30:36,594 with ayahuasca and, you know, San 490 00:30:36,594 --> 00:30:40,594 Pedro and other medicines. So, you know, 491 00:30:40,654 --> 00:30:44,574 obviously we're rediscovering things that we, 492 00:30:44,674 --> 00:30:48,394 you know, we knew from a long time ago. How do you, 493 00:30:48,594 --> 00:30:51,454 yeah, and that's sort of the challenge. How do you bring, you know, that 494 00:30:51,454 --> 00:30:55,234 sort of social aspect into the healing? 495 00:30:55,474 --> 00:30:59,014 I think that's really important, honestly. I think a lot of people, 496 00:30:59,014 --> 00:31:02,654 they really are very much 497 00:31:02,654 --> 00:31:06,534 disconnected and don't have meaning. And when they are with other people, 498 00:31:06,754 --> 00:31:10,914 it forces them to understand who they are and then also to really 499 00:31:10,914 --> 00:31:14,874 let go and try to be in that environment with other people. There's also 500 00:31:14,874 --> 00:31:17,734 the spirit of the medicine, I think, that is what you're talking about. So 501 00:31:17,734 --> 00:31:21,194 it's not just like socially who else is there and who they can connect 502 00:31:21,194 --> 00:31:24,974 with, but also each medicine has its own spirit. You know, each medicine 503 00:31:24,974 --> 00:31:28,614 has its own feel to it and how that person experiences it. So sometimes, 504 00:31:28,814 --> 00:31:32,554 yes, this may be available for this condition, but maybe another medicine 505 00:31:32,554 --> 00:31:35,834 may work better for someone else. I think that would be the goal in the 506 00:31:35,834 --> 00:31:39,754 future is to have multiple tools in our toolbox that we can understand who 507 00:31:39,754 --> 00:31:43,514 is best. And I also think that's where precision medicine comes in and 508 00:31:43,514 --> 00:31:47,014 understanding the brain better and different biomarkers to help us 509 00:31:47,014 --> 00:31:50,314 understand which medicines may be best. But the hard thing is, you know, 510 00:31:50,434 --> 00:31:54,534 having a doctor talk about the spirit of medicine. Right. 511 00:31:54,914 --> 00:31:58,494 I mean, you know, we're having a hard time now with nurse practitioner, you 512 00:31:58,494 --> 00:32:02,414 know, telling us, you know, how to, you know, I don't know, 513 00:32:03,294 --> 00:32:07,334 interpret your GLP-1. You know, now we're talking about. But I 514 00:32:07,334 --> 00:32:10,834 truly believe in it. You know, so I think that that's the difference is 515 00:32:10,834 --> 00:32:14,434 like when you actually have experiences that shift you in such a big way, 516 00:32:14,614 --> 00:32:18,654 you can't, you know, you can't deny it. Right. So so I do 517 00:32:18,654 --> 00:32:21,934 I think that there is there's a different there's basically it's a 518 00:32:21,934 --> 00:32:25,894 biopsychosocial spiritual approach now, because even culturally, we have to 519 00:32:25,894 --> 00:32:29,534 understand what people's beliefs are. Some people I I meet and they're like 520 00:32:29,534 --> 00:32:33,054 anti cannabis. No way, you know, and then God forbid someone in their 521 00:32:33,054 --> 00:32:37,074 family gets sick and they start to use it for chemo induced neuropathy 522 00:32:37,074 --> 00:32:41,234 or, you know, sleep or pain or whatever. it kind of changes them. So I 523 00:32:41,234 --> 00:32:45,354 think I think the point is to continue to stay flexible. And I think when 524 00:32:45,354 --> 00:32:48,794 we get in these rigid narratives, that's actually how we get sick. And so 525 00:32:48,794 --> 00:32:52,474 by even increasing cognitive flexibility allows us to see the world 526 00:32:52,474 --> 00:32:56,634 differently, opens us up to different ways of being and realizing 527 00:32:56,634 --> 00:32:59,894 that our nervous system is stuck in these different states and we have to 528 00:32:59,894 --> 00:33:03,181 shift it out into a more whole approach. Yeah. 529 00:33:03,245 --> 00:33:05,625 I don't know if you remember, but in Nue Life. 530 00:33:06,985 --> 00:33:10,285 You know, immediately when when we started the company. 531 00:33:12,565 --> 00:33:16,405 We, Juan Pablo, myself, were the two founders. You know, we had a long 532 00:33:16,405 --> 00:33:19,905 history with psychedelics. He actually 533 00:33:19,905 --> 00:33:23,885 in the traditional sense, I mean, his his his grandma 534 00:33:23,885 --> 00:33:27,765 was was a native American. And I don't know if you know this one. But he 535 00:33:27,765 --> 00:33:31,245 did his first San Pedro at eight years old. Wow. Yeah. Yeah. 536 00:33:32,205 --> 00:33:36,365 So that was a long time ago. Oh, Juan Pablo, I'm not saying how old 537 00:33:36,365 --> 00:33:40,145 you are. I mean, it was a while back. That's a young age for anyone. Yeah. 538 00:33:40,145 --> 00:33:44,305 Yeah. Yeah. So it's an amazing. I discovered actually I was in 539 00:33:44,305 --> 00:33:48,265 a in a panel with Rick Doblin where 540 00:33:48,265 --> 00:33:52,225 I shared that I tried LSD at 13 and and he 541 00:33:52,225 --> 00:33:56,345 like interviewed me on stage. He wanted to know exactly what 542 00:33:56,345 --> 00:34:00,045 happened. And I even shared that his kids, he tells them, you know, 543 00:34:00,125 --> 00:34:03,745 whatever age, you know, they're ready. You know, he you know, he's OK with 544 00:34:03,745 --> 00:34:07,625 it. Obviously, Rick Doblin is is is is one of the 545 00:34:07,625 --> 00:34:11,005 fathers of modern psychedelic therapies. 546 00:34:14,005 --> 00:34:17,505 And where was I? Oh, I was was going to get back. So so so when when Juan 547 00:34:17,505 --> 00:34:20,705 Pablo said, hey, we want to start this company. And I actually looked at 548 00:34:20,705 --> 00:34:24,185 the first time I ever heard about ketamine, even though I grew up in Miami 549 00:34:24,185 --> 00:34:27,685 in the 90s. You know, I had never heard of ketamine. 550 00:34:28,885 --> 00:34:32,985 And and I the first pictures I saw was of, 551 00:34:33,405 --> 00:34:36,665 you know, like someone like in the medical 552 00:34:36,665 --> 00:34:40,785 room, like recliner. Yeah. recliner. I'm like, oh, that 553 00:34:40,785 --> 00:34:44,685 doesn't look like great. Right. So I started digging 554 00:34:44,685 --> 00:34:48,445 into it and I found Mindbloom, which was, 555 00:34:48,505 --> 00:34:52,045 you know, was the first one I saw at home. And I say, oh, it's very 556 00:34:52,045 --> 00:34:55,785 interesting. started researching how they did it. And immediately I said, 557 00:34:55,865 --> 00:34:59,445 no, but we have to do something with music. Right. So I don't know if you 558 00:34:59,445 --> 00:35:02,885 remember this, but we actually had we we had a 559 00:35:02,885 --> 00:35:06,965 broadcasting license to broadcast music. We 560 00:35:06,965 --> 00:35:11,045 actually were probably the only psychedelic company with a full 561 00:35:11,045 --> 00:35:15,225 broadcast license. And we built our own music service. Wow. And 562 00:35:15,225 --> 00:35:19,385 I actually hired the one of the first music curators for 563 00:35:19,385 --> 00:35:23,085 Pandora. And we developed our own music algorithms to to 564 00:35:23,085 --> 00:35:27,125 to to to program music. So music was always like a big 565 00:35:27,125 --> 00:35:31,165 part of what we did. And you called it the hidden therapist. And I remember 566 00:35:31,165 --> 00:35:34,345 Johns Hopkins had this whole like 567 00:35:34,345 --> 00:35:38,045 playlist analysis that they did and and 568 00:35:38,045 --> 00:35:42,045 research that they did. There's so much research on the music on on how 569 00:35:42,045 --> 00:35:45,305 long your journey is going to be and when the peaks are going to happen and 570 00:35:45,305 --> 00:35:49,025 different types of songs that bring up different emotions. So there's so 571 00:35:49,025 --> 00:35:53,005 much research actually going on now because people can have a therapist. 572 00:35:53,005 --> 00:35:57,085 So the music allows them to feel different ways. And then hopefully 573 00:35:57,085 --> 00:36:01,145 they're able to integrate that just, you know, with with 574 00:36:01,145 --> 00:36:03,265 other people that may be familiar with the medicines. 575 00:36:03,590 --> 00:36:07,570 One of the things is, you know, again, go a little bit deeper into the 576 00:36:07,570 --> 00:36:10,650 music part, because I think it's fun and people could find it interesting. 577 00:36:11,310 --> 00:36:14,410 And obviously, with what I'm going to show, people can actually experience 578 00:36:14,410 --> 00:36:18,510 this. And the so one of the 579 00:36:18,510 --> 00:36:22,270 aspects of I remember the music part was the music had to be new 580 00:36:22,270 --> 00:36:26,470 to you in order not to carry like any meaning. So that way, 581 00:36:26,690 --> 00:36:30,710 you know, you sort of will, you know, will interpret it in a way that was 582 00:36:30,710 --> 00:36:34,870 new. And back then we had, you know, again, we had 583 00:36:34,870 --> 00:36:36,095 our music service. 584 00:36:36,205 --> 00:36:40,165 So, yes, I wanted to talk a little bit about a little functionality 585 00:36:40,165 --> 00:36:44,285 that we're going to be releasing here with Betterness and hopefully this 586 00:36:44,285 --> 00:36:48,425 week or next. First an iPhone or Apple 587 00:36:48,425 --> 00:36:51,745 Watch 588 00:36:51,745 --> 00:36:55,905 functionality that actually allows you to track ketamine-assisted therapy. 589 00:36:56,165 --> 00:36:59,465 So the same way that you would track any activity on the Apple Watch, like 590 00:36:59,465 --> 00:37:02,125 tennis or whatever, you could actually now track a session. 591 00:37:03,145 --> 00:37:06,665 What is interesting and why this fits 592 00:37:06,665 --> 00:37:10,825 with some of my previous work is a 593 00:37:10,825 --> 00:37:14,285 couple of things. First of all is to show people your heart rate during the 594 00:37:14,285 --> 00:37:17,425 session. Right? So see how the heart rate evolution is. 595 00:37:18,225 --> 00:37:21,705 So you'll see, you you're not spiking. You're not going to be, you know, 596 00:37:21,805 --> 00:37:25,085 most people are not going to probably see a lot of, 597 00:37:25,104 --> 00:37:29,104 you know, a lot of changes in their heart rate during the 598 00:37:29,104 --> 00:37:32,565 session. But I think the most important part, and, you know, when I showed 599 00:37:32,565 --> 00:37:36,645 it to you earlier, you said, oh, I love that song. I always, you know, it's 600 00:37:36,645 --> 00:37:39,085 the Poranguí song, 601 00:37:39,405 --> 00:37:43,165 which is almost like a classic in a playlist. 602 00:37:44,265 --> 00:37:48,125 But here what I try to do is this actually uses 603 00:37:48,125 --> 00:37:51,425 Shazam to recognize songs. So if you're with a therapist 604 00:37:51,425 --> 00:37:55,585 or, you know, with a sitter at home and 605 00:37:55,585 --> 00:37:59,225 you're putting the music as you're doing the therapy, this will recognize 606 00:37:59,225 --> 00:38:02,805 the songs playing. Which, as you said, it 607 00:38:02,805 --> 00:38:06,925 creates a connection, right? So ideally, you're not going to be in 608 00:38:06,925 --> 00:38:11,024 a state where you're completely out of it. So you could actually 609 00:38:11,024 --> 00:38:15,104 come back. And then the last thing I added was, which 610 00:38:15,104 --> 00:38:19,085 actually I did have in Nue Life too, is this ability to do a voice 611 00:38:19,085 --> 00:38:22,285 note. This is just me like. I like 612 00:38:22,285 --> 00:38:25,024 this feeling. I like. 613 00:38:26,785 --> 00:38:30,805 So, but, you know, just to be funny, 614 00:38:31,865 --> 00:38:34,665 the voice note said I like this feeling. But it's actually interesting 615 00:38:34,665 --> 00:38:38,705 because if you think about it, when a person is getting ketamine and we 616 00:38:38,705 --> 00:38:42,585 go in the room to observe how they're doing, we have no idea what's 617 00:38:42,585 --> 00:38:45,965 happening. They have eye shades on. They're listening to music. So by 618 00:38:45,965 --> 00:38:49,685 tracking this with the song and even their notes, 619 00:38:49,685 --> 00:38:53,585 it allows us to understand what happened during the journey at different 620 00:38:53,585 --> 00:38:57,524 times and also helps us unpack it later on. Because they're 621 00:38:57,524 --> 00:39:01,165 leaving these little notes for us to maybe they forgot what happened during 622 00:39:01,165 --> 00:39:04,385 a time because a lot of things happen during a journey. And the song is 623 00:39:04,385 --> 00:39:07,905 very important. Like, you know, once a song ends, it goes to a whole 624 00:39:07,905 --> 00:39:11,845 different song and then they go to a different place. Exactly. So, like, by 625 00:39:11,845 --> 00:39:15,865 able to by, you being able to review what they were saying or how they were 626 00:39:15,865 --> 00:39:19,005 feeling or even for us to understand what was going on with their heart 627 00:39:19,005 --> 00:39:22,925 rate or respirations or blood pressure during that time of the song could 628 00:39:22,925 --> 00:39:26,145 help because then you can also create other playlists for them going 629 00:39:26,145 --> 00:39:28,465 forward. You know, that's actually 630 00:39:28,465 --> 00:39:32,645 that's actually towards their intention. You 631 00:39:32,645 --> 00:39:36,425 know, like if you want to be like very like dialed in on something, you can 632 00:39:36,425 --> 00:39:40,445 kind of create a playlist for that based on what they've already previously 633 00:39:40,445 --> 00:39:44,425 told us from their information. Yeah. That's pretty cool. Yeah. Yeah. Yeah. 634 00:39:44,425 --> 00:39:48,104 So obviously love to to figure out how we extend this. 635 00:39:49,325 --> 00:39:53,145 We could figure out how we add constant heart rate monitoring to. Right. I 636 00:39:53,145 --> 00:39:56,745 mean, I'm sure there's devices that, you know, we could connect. Well, it's 637 00:39:56,745 --> 00:40:00,545 also just interesting to think about how we don't know what they're seeing 638 00:40:00,545 --> 00:40:02,765 or feeling, but this can help us track it. 639 00:40:03,068 --> 00:40:06,928 what type of music, you know, leads to a better clinical 640 00:40:06,928 --> 00:40:09,988 outcome for the person. Right. It's so important. People are like, oh, I 641 00:40:09,988 --> 00:40:13,968 don't like all these, you know, songs that sound like I'm in India or 642 00:40:13,968 --> 00:40:18,108 Japan. They want classical or they want birds or, you know, 643 00:40:18,148 --> 00:40:21,328 there's so many different types of music that they choose. And sometimes 644 00:40:21,328 --> 00:40:24,568 they don't like it, but sometimes it actually is good for them. Exactly. 645 00:40:24,828 --> 00:40:28,248 Yeah. Yeah. Yeah. They want to just feel happy and go into like all these 646 00:40:28,248 --> 00:40:31,968 like landscapes. But like really when it comes down to it, these the songs 647 00:40:31,968 --> 00:40:35,808 are supposed to make you have emotions. And if it makes you sad or if it 648 00:40:35,808 --> 00:40:39,068 makes you in fear, that could bring up another memory from the past that 649 00:40:39,068 --> 00:40:42,388 then helps you heal. Exactly. So the music is really important. And then 650 00:40:42,388 --> 00:40:43,188 tracking is great. 651 00:40:43,511 --> 00:40:47,531 So so let's go into now your 652 00:40:47,531 --> 00:40:51,511 particular way of of delivering this. Actually, one of the 653 00:40:51,511 --> 00:40:55,611 coolest things is you have this amazing bed. Uh-huh. That vibrates. Yes. 654 00:40:55,611 --> 00:40:59,271 And plays the music. Yes. So so tell us a little bit about your 655 00:40:59,271 --> 00:41:02,831 best practices. I mean, what do you recommend for people? I actually this 656 00:41:02,831 --> 00:41:06,471 weekend, one of my best friends, she just started doing 657 00:41:06,471 --> 00:41:10,631 ketamine therapy. And I was saying that, you she needs to go 658 00:41:10,631 --> 00:41:14,451 and see you and check out the bed. And she's like, I think it's too much. 659 00:41:14,671 --> 00:41:18,591 You know, she's you know, she's taking baby steps into 660 00:41:18,591 --> 00:41:22,111 this because for some some people, this is a lot. Right. 661 00:41:22,411 --> 00:41:25,531 How do you see it? How do you approach it? Yeah. Well, I think it's 662 00:41:25,531 --> 00:41:29,531 important how you approach it, because if if they are a little bit 663 00:41:29,531 --> 00:41:33,271 intimidated by even just the word ketamine, we have to understand that 664 00:41:33,271 --> 00:41:37,131 every medicine is based on the dose. You know, so you can give someone 665 00:41:37,131 --> 00:41:40,411 a medicine like ketamine, but you can give them a very low dose and they 666 00:41:40,411 --> 00:41:43,351 can have an experience where they're just able to experience themselves 667 00:41:43,351 --> 00:41:46,971 differently, create a little safety. It doesn't have to be like a huge 668 00:41:46,971 --> 00:41:50,471 session where we're sending someone to the moon, you know. So the bed 669 00:41:50,471 --> 00:41:54,271 actually is pretty cool. It's made by a guy in Colorado and 670 00:41:54,271 --> 00:41:58,371 he is very big into vibro acoustics. And so what you do is you 671 00:41:58,371 --> 00:42:02,331 create a playlist and the bed vibrates to the music. 672 00:42:02,331 --> 00:42:06,331 So it's like this all immersed, inclusive type of experience 673 00:42:06,331 --> 00:42:10,511 where your your whole body is feeling it. And 674 00:42:10,511 --> 00:42:14,711 so some people who've had a lot of trauma or they feel unsafe or they 675 00:42:14,711 --> 00:42:18,091 have a lot of pain, it may make their nervous system a little bit more 676 00:42:18,091 --> 00:42:20,931 sensitive and they're not a great candidate for it. You can always put on a 677 00:42:20,931 --> 00:42:24,431 lower amount. But it's a really cool experience because you feel like 678 00:42:24,431 --> 00:42:28,591 you're moving and you're listening and it's like the whole body is 679 00:42:28,591 --> 00:42:32,711 kind of shaking to all of like what's going on. So the bed is one 680 00:42:32,711 --> 00:42:36,651 option. Obviously, people sometimes like a bed. They like a recliner. The 681 00:42:36,651 --> 00:42:40,031 point is it has to be comfortable. It has to feel safe. They have to feel 682 00:42:40,031 --> 00:42:43,511 like they could just kind of let go into that experience. And then it all 683 00:42:43,511 --> 00:42:47,511 is based on the dose. So obviously we can do a low dose where they're able 684 00:42:47,511 --> 00:42:50,771 to remember the session. That's kind of like the sweet spot, that concept 685 00:42:50,771 --> 00:42:54,771 of dose discovery where we start low. We increase it over time, trying to 686 00:42:54,771 --> 00:42:58,351 get them to a place where they feel they could surrender, but they also can 687 00:42:58,351 --> 00:43:00,811 remember what's going on. We don't want to get them to a state where they 688 00:43:00,811 --> 00:43:04,611 couldn't remember it. And then it could be an oral 689 00:43:04,611 --> 00:43:08,391 lozenge, intramuscular injections, IV. What is the 690 00:43:08,391 --> 00:43:12,391 breakdown, would you say, that most people? mean, what 691 00:43:12,391 --> 00:43:16,411 is it? Yeah, so I'd say gold standard from research is IV. 692 00:43:16,411 --> 00:43:19,671 So when people want the best and they want to know this is definitely going 693 00:43:19,671 --> 00:43:22,991 to work and they don't want the route of administration to be a factor in 694 00:43:22,991 --> 00:43:26,931 why maybe ketamine is not working for depression or pain, they always use 695 00:43:26,931 --> 00:43:31,031 IV. And we would choose IV because it's a linear amount of medicine 696 00:43:31,031 --> 00:43:34,491 over a certain amount of time that's getting into their brain and body 697 00:43:34,491 --> 00:43:38,231 consistently. As opposed to intramuscular, we usually divide that dose into 698 00:43:38,231 --> 00:43:42,291 two, do a shot in the arm, divide it by 12 or 15 minutes. So the ride 699 00:43:42,291 --> 00:43:45,051 is very different because you get the medicine quickly, you get there, 700 00:43:45,251 --> 00:43:48,231 you're kind of there for a little bit, and then you get another dose. And 701 00:43:48,231 --> 00:43:51,851 so sometimes people like that ride where it's more of like the push out the 702 00:43:51,851 --> 00:43:55,071 window as opposed to just kind of like the lazy river type of feeling. 703 00:43:57,271 --> 00:44:01,051 Intranasal is a lower bioavailability similar 704 00:44:01,051 --> 00:44:05,111 to an oral lozenge. And we use the lozenges more in 705 00:44:05,111 --> 00:44:08,671 groups or if we're working with a therapist. And, you know, so it's all 706 00:44:08,671 --> 00:44:11,611 different ways of using it. But I think that's kind of the beauty and like 707 00:44:11,611 --> 00:44:15,111 the art of medicine is like figuring out the dose, route of administration, 708 00:44:15,111 --> 00:44:19,171 the setting that's best for that person. Sometimes even 709 00:44:19,171 --> 00:44:22,631 just like making the room smell nice and making the person feel very 710 00:44:22,631 --> 00:44:26,591 welcome will play a role into their mindset, which then affects 711 00:44:26,591 --> 00:44:30,371 their journey. And it's so interesting how their mindset affects their 712 00:44:30,371 --> 00:44:33,871 journey and then, you know, trying to leave everything at the door and not 713 00:44:33,871 --> 00:44:37,451 rushing to something stressful. And what you said before, which is 714 00:44:37,451 --> 00:44:41,171 important, which is doing something new or different afterwards. So how to 715 00:44:41,171 --> 00:44:44,911 get the person to not go back to their same patterns or how once the 716 00:44:44,911 --> 00:44:48,431 ketamine is in to use it like fertilizer. We got to push it in the right 717 00:44:48,431 --> 00:44:51,571 direction. We got to create a different habit. We got to do something 718 00:44:51,571 --> 00:44:54,991 different. Think about ourselves differently. I think that's also 719 00:44:54,991 --> 00:44:58,991 important. Let me let me explore something that just occurred to me. 720 00:44:59,171 --> 00:45:01,871 I mean, because obviously you're doing cannabis and you're doing ketamine 721 00:45:01,871 --> 00:45:05,271 and eventually there might be other. 722 00:45:06,131 --> 00:45:10,311 One of the most incredible experiences that I had, thanks to Juan Pablo 723 00:45:10,311 --> 00:45:13,751 and Cristina, went to Boston with this amazing 724 00:45:13,751 --> 00:45:17,191 couple that have amazing books 725 00:45:17,191 --> 00:45:21,211 all the way back to the 70s. And we did 726 00:45:21,211 --> 00:45:24,571 a whole weekend retreat. 727 00:45:25,491 --> 00:45:29,191 And we, you know, their concept was called layering, you know, 728 00:45:29,331 --> 00:45:33,251 and there was, you know, a number of layers into the 729 00:45:33,251 --> 00:45:37,371 experience. So as I think about it, you know, do you 730 00:45:37,371 --> 00:45:41,551 see a future where you could do ketamine 731 00:45:41,551 --> 00:45:45,611 and there will be cannabis and, you know, and, you know, you know, 732 00:45:46,051 --> 00:45:50,071 and all that happening in a clinical setting? Yeah, well, I 733 00:45:50,071 --> 00:45:54,071 think people who are familiar with cannabis like to use cannabis after 734 00:45:54,071 --> 00:45:58,151 a ketamine experience to get in their body. Because sometimes 735 00:45:58,151 --> 00:46:01,751 when they have a dissociative experience and they're kind of observing 736 00:46:01,751 --> 00:46:05,611 and they're not in their body for a little while and they're used to 737 00:46:05,611 --> 00:46:08,831 cannabis, it helps ground them to put them back in their body. And it could 738 00:46:08,831 --> 00:46:12,851 almost prolong the neuroplastic effects of ketamine. So I wouldn't use 739 00:46:12,851 --> 00:46:16,251 cannabis before a ketamine session. I think that could actually disturb 740 00:46:16,251 --> 00:46:20,391 what's about to happen, but sometimes cannabis afterwards. But the layering 741 00:46:20,391 --> 00:46:23,891 is interesting, you know, and I think the layering is interesting also 742 00:46:23,891 --> 00:46:27,911 based on the onset and total duration 743 00:46:27,911 --> 00:46:31,771 of the medicine. You know, you can inhale DMT and have a very quick 744 00:46:31,771 --> 00:46:35,871 experience and then you can layer that with cannabis 745 00:46:35,871 --> 00:46:40,011 or you can have a second inhalation. As opposed to a 746 00:46:40,011 --> 00:46:44,011 psilocybin journey, it's going to be six hours or so. Imagine nurses 747 00:46:44,011 --> 00:46:48,051 doing rapé. You know? Yeah. You know? Yeah. 748 00:46:48,251 --> 00:46:52,011 I mean, it's really about knowing the person, you know? So if you already 749 00:46:52,011 --> 00:46:55,031 have an experience with a medicine, you feel comfortable with that, maybe 750 00:46:55,031 --> 00:46:58,911 you can layer that in. If you are new to all are not rapé. rapé is, you 751 00:46:58,911 --> 00:47:03,031 know, it's basically a tobacco that people blow into your 752 00:47:03,031 --> 00:47:07,011 nose when you do ayahuasca or some of these 753 00:47:07,011 --> 00:47:10,811 medicines. But it's tobacco, right? So it's even like illegal. Stimulant 754 00:47:10,811 --> 00:47:14,411 almost. It's a stimulant. Yeah. But it's also just using the right medicine 755 00:47:14,411 --> 00:47:18,491 to get you where you want to be quick or if you want to stay there longer. 756 00:47:18,711 --> 00:47:22,811 So it's like it's nice to have these tools once they're available. 757 00:47:22,811 --> 00:47:26,931 But I think what's important now is safety and training providers so that 758 00:47:26,931 --> 00:47:29,891 they know what they're doing so that we're not just giving these medicines 759 00:47:29,891 --> 00:47:32,871 to people who shouldn't get them. Because there are people who shouldn't, 760 00:47:33,011 --> 00:47:36,411 people who are psychotic, schizophrenic, manic, you know. Yeah. Or the 761 00:47:36,411 --> 00:47:40,111 Matthew Perry, unfortunately, situation that, you know, then creates, 762 00:47:40,331 --> 00:47:44,491 I mean, the saddest part of all that is it creates all 763 00:47:44,491 --> 00:47:48,371 this negativity that then, you know, affects the people that really need 764 00:47:48,371 --> 00:47:52,131 it. Right. But it also, like, slows the movement down because sometimes 765 00:47:52,131 --> 00:47:54,931 people think, oh, these medicines are great. People are healing from them. 766 00:47:55,011 --> 00:47:58,291 Then they do it in the wrong environment or they don't really prepare 767 00:47:58,291 --> 00:48:02,351 themselves and they have a bad outcome. Yeah. So I think it's having 768 00:48:02,351 --> 00:48:05,991 the information to then properly train providers so that we are 769 00:48:05,991 --> 00:48:10,031 providing safe and long-lasting medicines. This isn't just like, you know, 770 00:48:10,091 --> 00:48:13,251 for the weekend you do something and you feel better and then your old 771 00:48:13,251 --> 00:48:17,011 beliefs come back, right? It's really a No, if you don't put the work up, 772 00:48:17,551 --> 00:48:20,551 probably, you know, you're not going to get much out of it. Right. And 773 00:48:20,551 --> 00:48:24,491 that's really what we're doing now is less focus on the medicine and more 774 00:48:24,491 --> 00:48:28,651 on the everyday habits, right? Like your daily habits, 775 00:48:28,791 --> 00:48:32,211 right? So it's how can we pair those things together? How can the medicine 776 00:48:32,211 --> 00:48:36,351 just kind of be that catalyst to create the desire to take 777 00:48:36,351 --> 00:48:39,831 care of yourself better or to create better health? Yeah. So 778 00:48:39,831 --> 00:48:43,871 just to wrap up here on boring, 779 00:48:43,871 --> 00:48:48,011 you know, business stuff, this whole 780 00:48:48,011 --> 00:48:52,111 Atai, Atai was, you know, one of the companies that was 781 00:48:52,111 --> 00:48:56,171 doing, you know, all this research on new type of 782 00:48:56,171 --> 00:48:59,531 psychedelic therapies. It got acquired by Lilly, 783 00:48:59,791 --> 00:49:03,751 which obviously is a big deal. But their whole 784 00:49:03,751 --> 00:49:07,891 point is that they're trying to do medicine that doesn't, I 785 00:49:07,891 --> 00:49:11,811 think, right? They don't have the sort of psychedelic side or the 786 00:49:11,811 --> 00:49:15,971 experience side. Do you know sort of what the science 787 00:49:15,971 --> 00:49:19,491 behind that is? Yeah. And what do you think about it? Well, there's certain 788 00:49:19,491 --> 00:49:23,291 companies that are trying to take the psychedelic out of the 789 00:49:23,291 --> 00:49:27,111 psychedelic, right? The psychedelic journey out of it. So and they're 790 00:49:27,111 --> 00:49:30,991 probably doing that by stimulating the 5-HT2A receptor less because 791 00:49:30,991 --> 00:49:34,731 other psychedelics also affect other serotonin receptors. So they're 792 00:49:34,731 --> 00:49:38,871 basically trying to take out one component. Imagine if you have the same 793 00:49:38,871 --> 00:49:42,451 neuroplastic effects but without the meaning. Are you still going to get 794 00:49:42,451 --> 00:49:45,751 better? So we don't really know that information yet. don't really have 795 00:49:45,751 --> 00:49:48,851 that. From your experience, what do you think? You know, that's kind of 796 00:49:48,851 --> 00:49:51,371 like sleeping through your journey. You know, are you going to get better? 797 00:49:51,751 --> 00:49:55,491 Sometimes, maybe, but maybe not long enough because I really believe like 798 00:49:55,491 --> 00:49:59,591 pain is this epidemic of fear or lack of meaning. And 799 00:49:59,591 --> 00:50:03,371 so if you're not really having purpose in your everyday life, then I don't 800 00:50:03,371 --> 00:50:07,071 really think that's going to create, you know, long-term happiness or get 801 00:50:07,071 --> 00:50:11,151 rid of your pain or depression. So I think the psychedelic experience 802 00:50:11,151 --> 00:50:15,211 can be very valuable, but I think some people are too in 803 00:50:15,211 --> 00:50:18,811 fear or uncomfortable to go there. And therefore, there's other ways of 804 00:50:18,811 --> 00:50:22,611 kind of using these medicines. You could just do a low dose, first of all, 805 00:50:22,831 --> 00:50:26,511 you know, or you can add other things to it like the vibrations 806 00:50:26,511 --> 00:50:30,691 or like the music or breath work, you know, 807 00:50:30,791 --> 00:50:34,371 like trying to just use the lowest dose you can of a medicine. That doesn't 808 00:50:34,371 --> 00:50:37,811 have to be such a psychedelic, like, you know, mind-blowing type of 809 00:50:37,811 --> 00:50:41,191 experience, but it creates that neuroplastic effects. And then you have 810 00:50:41,191 --> 00:50:44,891 accountability to follow it up. Yeah. Well, it was 811 00:50:44,891 --> 00:50:49,031 fun, you know, so I, it was love to, you know, 812 00:50:49,091 --> 00:50:53,071 it was amazing to recognize. And on all these, all these things that 813 00:50:53,071 --> 00:50:55,851 obviously connected us in the first place. 814 00:50:57,511 --> 00:51:01,331 And, and yeah, anything else just to add for listeners? Any? 815 00:51:02,291 --> 00:51:05,731 Well, I think the, I think the future is bright because there's a lot of 816 00:51:05,731 --> 00:51:09,711 research going on. And I think that we are starting to look at the 817 00:51:09,711 --> 00:51:13,351 body brain connection in more details. And people are starting to really 818 00:51:13,351 --> 00:51:17,511 understand that, that has, that you need to treat the body and the brain. 819 00:51:17,511 --> 00:51:21,191 You can't just, you know, use a medicine to treat the brain or change your 820 00:51:21,191 --> 00:51:24,331 movement and think that that's going to affect long-term change. So I 821 00:51:24,331 --> 00:51:27,531 think, I think it's not like this mind- body connection is woo-woo type of 822 00:51:27,531 --> 00:51:31,051 thing. It's, it's real, you know, and everything has to be interconnected 823 00:51:31,051 --> 00:51:35,011 in order for someone to have a whole life. Perfect. Well, Michelle, 824 00:51:35,151 --> 00:51:39,231 thank you so much. And hope, you know, hopefully we 825 00:51:39,231 --> 00:51:43,191 see each other, you know, in your, in your therapy because I'm a, I'm 826 00:51:43,191 --> 00:51:47,251 a very, I could have 827 00:51:47,251 --> 00:51:50,811 test for, for, for the therapy. Thank you so much. Thank you. Okay. 828 00:51:52,511 --> 00:51:56,411 So this does it for another episode. This was fun. And 829 00:51:56,411 --> 00:51:59,471 see you next week on the next one. Thank you.