404: The Truth About Ketamine with Dr. Chantelle Thomas

Hello, friends!

In today’s episode, we delve into the transformative potential of ketamine therapy for mental health with Dr. Chantalle Thomas, a leading expert in ketamine-assisted psychotherapy.

Dr. Thomas discusses the complexities of ketamine as a treatment, its various administration routes, and the profound changes it can facilitate when integrated with therapy. We also explore the importance of therapeutic integration in maximizing the benefits of ketamine, the ethical considerations in psychedelic medicine, and navigating the current regulatory landscape.

Additionally, Dr. Thomas shares her personal journey into mental health and psychedelics, and the importance of authenticity and attachment theory in therapy.

As always, you can send me questions to duffthepsych@gmail.com and find the full show notes for this episode at http://duffthepsych.com/episode404

Links:

https://windroserecovery.com/podcast/therapy-unblinded-inside-mdma-research/

https://www.fluencetraining.com/

https://maps.org/

Did you know that a once popular club drug is now a groundbreaking treatment for depression and other mental health issues?

Chantelle Thomas: ketamine is a dissociative by its label, right?

An anesthetic dissociative, it seems to be, I like to also call it like, um, meditation medicine on steroids because it allows, um, an amplification of senses that I think are Hardcore meditators are able to accomplish really easily.

Stay tuned because in this episode, we’re going to dive into the complexities of ketamine therapy.

Chantelle Thomas: ketamine is a really interesting landscape because it’s like you can be talking about four different medicines depending on what’s the route of administration, people have fundamentally different experiences with it in an infusion setting than they might in a therapy setting because they’re just being taught to work together.

differently with what’s happening.

I’m excited to introduce Dr. Chantal Thomas, a leading expert in ketamine assisted psychotherapy.

Ketamine isn’t just effective for reducing suicidal thoughts. It’s a game [00:01:00] changer when it comes to mental health treatment.

But here’s the catch. Many treatment programs miss a crucial element, the integration of therapy. The actual helping part. Dr. Thomas will guide you on how to combine ketamine treatment with essential therapeutic support.

Chantelle Thomas: And so it is a very, again, it’s an entry point from a place of being really gentle and calming as opposed to some of the psychedelic medicines have a really intense ramp, um, that leads people into experience.

And that can be, um, a big ask for systems that nervous systems that are just like living in fight, flight, or freeze.

Whether you’re a potential patient seeking the right clinic or a clinician wanting to enhance your practice, Dr.

Thomas has invaluable insights for you. Plus, we dive into the latest on psychedelics and FDA regulations about MDMA in treatment and research.

Chantelle Thomas: It’s so important for more and more practitioners to become a little bit more literate about what this means and what it doesn’t mean as the interest grows, as the enthusiasm grows for this work. patients are gonna be [00:02:00] seeking it out. They’re gonna want to know.

Dr. Thomas is not only an expert, but a fantastic person to talk to. We had an amazing conversation about our shared passion for mental health and why she’s in this field in the first place.

Chantelle Thomas: And then when I worked in community health care for like eight years, it was the same thing. And it’s like people who, um, are just trying to survive life and have very limited resources have to rely on their instincts and their guts. level impressions about people. So being really authentic was incredibly important

So stick around. You’re about to learn something that could change your life. Enjoy the interview.

Robert Duff: so we have a guest on the show today, everybody. We have Chantelle Thomas and I’m very excited to welcome Dr. Thomas to the show. Uh, Dr. Thomas is a clinical psychologist and also the executive clinical director of Windrose recovery, which is a multi level residential addiction program offering detox intensive outpatient, as well as ketamine assisted psychotherapy.

She also specializes in chronic pain, trauma disorders, substance abuse disorders, and psychedelic [00:03:00] integration. And she supervises the sponsored clinical trials for MDMA assisted psychotherapy for PTSD. And last but not least, Dr. Thomas teaches advanced certification for ketamine assisted psychotherapy with Fluence organization, who is, who paired us up in the first place.

So how was that for an intro?

Chantelle Thomas: always feel like, I feel like I have to brace myself for impact when people read my intro. I don’t know why.

Robert Duff: it could have been longer. I pared it down a little bit. You’ve done more than those things.

Chantelle Thomas: I always want to say to people, don’t worry about it.

It’s fine.

Robert Duff: like, just like Chantelle’s here. Hey, I feel, I know you kind of the stand there, like, like when you’re getting

happy birthday sung to you and you kind of just stand there awkwardly,

Chantelle Thomas: Yes, exactly. Mm

Robert Duff: important context, important context, Um, Chantelle, how are you? How are you feeling today? Just generally,

Chantelle Thomas: I, you know, I’m good, but it’s, there’s been a lot of things happening lately and a lot of excitement in the news about psychedelic work. And so,

Robert Duff: this is [00:04:00] true.

Chantelle Thomas: yeah, so I’ve been kind of in it having those discussions and trying to figure out how to translate those for folks that I come into contact with and also giving myself time emotionally to digest what we know and what we don’t know.

Robert Duff: Okay. Yeah. We’ll, we’ll get into that for sure. So you’ve been busy. you’ve been

in the thick of it is what you’re saying.

Chantelle Thomas: Yeah. Yes.

Robert Duff: Okay. Before we get so far into the

specifics of that, um, I’m, I’m just curious, you know, about

you individually as a person, like what’s a little bit of your background. How did you get into like mental health in this field in the first place?

Chantelle Thomas: Mm hmm. Yeah. So, um, I grew up in Southern California, actually, and, um, my dad was an addiction medicine doctor. He was one of the first, um, group of physicians to be licensed in addiction medicine, actually, which he’s very proud of. Lets everyone know. Um, so I think I, [00:05:00] Um, started to be very interested in that, uh, field of kind of questioning human behavior and being really curious about it, probably around the dinner table, um, as a kid.

And then, um, also had a, a love for working with substance use disorders and, and, and I don’t know, depth work in general appealed to me and I run pretty melancholy and I love, you know, artists who are a little tortured and create beautiful music and films and works of art. And so I’ve always been drawn to that.

And then, um, I was an English lit major in undergrad and kind of trying to find my way, uh, before going to grad school and, and thought, you know, people and understanding people’s interesting to me. So I think I will go get my master’s in psychology, which then led to my doctorate in psychology. And, um, yeah, kind of, that’s what set me on the original trajectory.[00:06:00]

Robert Duff: One thing leads to another, leads to another

and suddenly you’re a doctor.

Chantelle Thomas: Yeah, kind of. Or, but the perpetual student, as everyone in my family joked around, because I’m the only one who’s not a quote unquote real doctor in my family. The rest of them are physicians.

Robert Duff: so funny. That’s

Chantelle Thomas: yeah.

Robert Duff: It’s like it, for me, it’s the exact opposite experience where most of my family, like, you know, maybe graduated high school later in

life, no higher education for you, you’re like the runt of the litter in that

regard.

Chantelle Thomas: Totally.

The, the butt of a lot of jokes when we were talking about whether or not I’d ever really get a real job because I’ve been in school for so long.

Robert Duff: Yeah, yeah, absolutely. Okay. So, so you came to it, there’s a variety of ways that people kind of come into mental health. It’s like your own

issues that you’re working out, your

parents issues that you’re working out, or

you’re like just really in tune for whatever reason. It sounds like for you, you just really had that appreciation for the human condition.

You were trained to it a

little bit, a little bit of nature and nurture.

Chantelle Thomas: Yeah. And definitely, like, working through my own stuff, you know, trying to be helpful to others, which was un, undoubtedly [00:07:00] influenced by my role in my family and, um, lots of mental health issues on, primarily on my maternal side. Um. Yeah. So I, I was a very young therapist for my mother, so I totally get that. Uh, and that made a lot of sense to me and probably for my dad in a different kind of way.

Robert Duff: Sure, absolutely.

So, you know, in your, like, personal approach, uh, clinically and stuff, do you

have any underlying kind of style? like, do you

like, how do you see human nature? How do you see people

changing? Like, what is your style?

Chantelle Thomas: Mm hmm. Well, I think I’ve always been very, um, I think showing up in a really authentic way has felt really important to me. for lots of different reasons. I worked in the um, substance use treatment field for a long time while I was um, going to grad school and, and with that population,

you ascent, you just can’t get past like the [00:08:00] first line without being tuned out if you can’t just like roll in a pretty authentic, using humor. I I have a proclivity towards, curse words that are

helpful. So I think I know how to punctuate a good explicative. Um, I think I, um, I, I can, I think I, I do have some skill for engaging and I, I, and I actually have a tremendous amount of compassion for people who suffer in Kind of unique ways. So I think that really helped me, um, on that path.

And then when I worked in community health care for like eight years, it was the same thing. And it’s like people who, um, are just trying to survive life and have very limited resources have to rely on their instincts and their guts. level impressions about people. So being really authentic was incredibly important.

And I think I’ve always been interested in what I would call like relational work. So it’s like our relationship together is one of the primary, um, [00:09:00] nexus points for how things improve. Um, but then I would say I got much deeper into understanding attachment theory and how people You know, early relationships with primary caregivers kind of set a template for, um, what comes next in terms of relationships.

And then through my work in working with trauma, substance use, and through psychedelic work, I would say that I came into a real deep appreciation for how important it is to help people safely feel what they need to feel and use those feelings as a way to tune in to what’s needed. Um, within themselves, um, to kind of tap in, um, to their own kind of source of wisdom. Um, and like I said before, I like big feelings, so holding space for people to feel things safely and respectfully felt like a really deep honor for me.

Robert Duff: Hmm. Yeah. You mentioned both trauma and substance abuse, which,

you [00:10:00] know, the, I think a core thing beneath both those is avoidance, right? Trying to

avoid those big feelings that you’re talking about making space for.

Right.

Chantelle Thomas: hmm. Mm

hmm. Yeah.

that’s a really good point, and I think, and this idea of like exquisite sensitivity. So I was an incredibly sensitive kid. I was told I was too sensitive of a kid all the time, and because I had really big feelings, I, I actually conceptualize trauma, and particularly substance use is.

As humans who just feel a little too deeply at times and don’t have the right spaces to contain that. And so then they go to substances to numb it, to contain it, to kind of transmute it in some way. And so I, I’ve, I’m a real champion for the, um, the proper cultivation of sensitivity in human beings to be a superpower, not a liability.

Robert Duff: That’s great. I really love that. I have, uh, one kid who is very, very, uh,

Similar in that regard, um, and the world’s [00:11:00] not made for, you know, capitalism isn’t made for

people like that. You know, the school system isn’t made for people like that. So

yeah, I really appreciate that.

Chantelle Thomas: Mm

Robert Duff: So it makes a lot of sense how and why you got into this field.

Where in your journey did psychedelics start to come into play?

Chantelle Thomas: hmm. Mm hmm. Yeah. Well, I was working at a community health care center here in town. Um, I worked across three different clinics, which are really incredible. And I was working alongside of a physician by the name of Dr. Randy Brown, who’s an addiction medicine doc, um, who I worked alongside of treating, um, substance use disorders in that setting. Because it’s not, you know, treating substance use is not for everyone. A lot of. clinicians kind of avoid it. They sidestep it because it feel the work feels, um, a little befuddling. There’s a fear that you’re going to be manipulated by clients or by patients or that you can’t tell when they’re telling the truth.

And, um, but I, I really, [00:12:00] had a ton of respect and appreciation for that population. So, uh, I was working alongside of Randy and he had mentioned to me that there was a, um, there was an opportunity to be involved in a psilocybin study that they were looking for psychologists. Cause that’s my training. I’m trained as a clinical psychologist.

They were looking for psychologists who could assist with the screening and assessment of appropriateness of participants for the high dose psilocybin study. Pharmacokinetic study that they were running at University of Wisconsin Madison, and this was in 2013.

Robert Duff: Okay. Can you, uh, translate that to

normal people language for, for the audience? Pharmacokinetics and, you know, I think most people know psilocybin is

Chantelle Thomas: Okay. So psilocybin is magic mushrooms, uh, and it was a safety study, which is what basically what pharmacokinetics means is really looking at how the body is processing with the hope of determining that it’s safe. It is safe to process these compounds [00:13:00] even when there is a dose escalation.

So at higher doses, dosage ranges than had been studied from a safety perspective. And so I was looking at doing this with a smaller population of folks that had prior experience with psychedelics. And we would, in the context of this safety study, would be obtaining vitals very regularly and blood draws throughout.

the experience. So it’s potentially a more invasive study than people might normally have because in the beginning when they’re trying to establish safety of a compound, they want to get lots of measurements over time of how it’s impacting the body.

Robert Duff: just out of curiosity. So you said larger or higher dose, um, for those people, like how did the dosages in the study compared recreationally?

Chantelle Thomas: Oh, that’s, that’s a little bit of a tricky question, but I can say that most, um, studies that, um, looked at psilocybin at the [00:14:00] time, they were going for 25, um, the 25 milligram marker for the studies. And we were escalating, we were starting. Around that dose and then escalating up from there. So there were three doses that got, um, determined based on the weight of the participants.

So someone who was particularly large might even get up to 70

milligrams of psilocybin, which would be, I remember at the time, Many, um, of the researchers from other institutions thought, wow, that is a lot of psilocybin

to be giving people and kind of had questions about whether or not that could be safely navigated in a clinical trial setting. Um, and again, it was really just to be able to give some precedent for why we might be able to use different doses safely with different populations moving forward when it, when we’re studying psilocybin.

Robert Duff: Okay. Yeah. So that was your entry point. That was, it would

sort of kind of incidentally you stumbled into it.

Chantelle Thomas: Yeah. I mean, I just happened to know Um, the right [00:15:00] person at the right time. I, I was curious, so I didn’t say, oh, no way. I, I, very naive to psychedelics. I was, grew up in a very conservative, um, religious family. I’m also a control freak. So the idea of just like surrendering to something that may or may not take

you back to reality.

Robert Duff: your mind, right? Like your

work is here. So like screwing that up is a very

scary prospect,

Chantelle Thomas: Yes. Very scary prospects. So, um, yeah, so that, but I, I’ve always been curious because, um, and I do tend to lean into things that are a little novel and disruptive. I like the idea of disruptive compounds and like the idea of pairing, the idea of doing psilocybin research in a university setting

seemed really, that, that juxtaposition seemed really

satisfying to me.

Robert Duff: it kind

Chantelle Thomas: exactly,

exactly, yeah.

Robert Duff: And okay. So, so take me from [00:16:00] there. So there’s,

you know, you started there, um, you’re still in the world of this and, and very

active. So what kind of, did the spark just go from there? Yeah.

Chantelle Thomas: Yeah. I mean, I think back to what I had mentioned before about my interest in depth work. I think one of the reasons that working in residential treatment environments for substance use disorders was so appealing to me early on in my career was that I love the idea of having deeper access to how people operated across situations.

So like an outpatient setting, you were with someone from 45 minutes to an hour. And then you, I always have a thought like, I want to follow you home, not in a creepy way, but I want to see how you interact with your kids. And I want to see what happens and how do you present differently when you’re not with me. So there’s always this striving to want to understand more, to contextualize someone, knowing that I was getting of certain version of a person, um, valid, legitimate, important, but [00:17:00] often felt like there were parts of the equation I was missing. And so, yeah, and, and residential really gave us more of a 360 view of what was happening, you across peers and in different environments with different therapists.

And then when I started to do the work with psilocybin in the clinical trial context, you got to see more. You got to see more of someone’s psyche, more of their emotional range. Um, they, you know, they, they, they, experientially felt different in the room, their relationship with you changed through that experience.

It got deep, it got vulnerable. Um, a lot of those typical, um, like the cloaks we wear as like patient and therapist and kind of the rigidity of that hierarchy, um, start to dissolve a little bit in ways that we have to be careful about as well. But it felt like a much more human exploration than it did, um, this [00:18:00] hierarchical, um, kind of intrusion on someone’s life trying to figure out what was wrong with them, if that makes sense.

Robert Duff: right. You know, let me, let me diagnose and treat you as, as

Chantelle Thomas: Mm hmm.

Robert Duff: versus, you know,

connecting as humans with a certain skillset that you have.

Chantelle Thomas: Mm hmm.

Yeah.

so that, so that was super compelling. I, I remember at the time I’d been trained primarily in trauma based modalities that were exposure based. And my first thought about psilocybin is it, Oh, this is just like a new way to do exposure work. It’s just kind of cool because it’s happening from the unique internal landscape of this individual instead of what I’m deciding is needs to be on that exposure hierarchy.

And so, um, Um, that was compelling working through that trial. It got me really excited about the possibility of doing that kind of work. And then through that and a connection through, um, a nurse who worked on that trial, she connected me [00:19:00] with, um, myself and my husband with Rick Doblin, who, um, provided us the opportunity to, to enroll in the, the maps at the time, maps, MDMA assisted therapist training.

Um, and so we became a site at university of. University of Wisconsin Madison, my husband and I did. And then we got trained in MDMA assisted therapy. And then we worked on the phase three trial all the way to its completion, um, in October of last year. And then alongside of that, I started, uh, working with ketamine in 2019 after attending the Ketamine Training Center, um, therapist training through Phil Wolfson.

And then I got kind of excited about the possibilities of using ketamine in different ways and alongside of the clinical work that I’m doing in residential treatment settings. Mm

Robert Duff: The ketamine is probably the one you use most in sort of the non research

settings, right? I mean, it’s, that’s the legal one and it’s

not exactly a psychedelic, um, but it has similar functions. Um, I, the ketamine is probably the one that my audience has heard the most [00:20:00] about,

um, because, you know, I’ve had, um, you know, various doctors, you know, on the show for ketamine clinics to talk about it.

My wife has gone through ketamine infusions,

Chantelle Thomas: Oh, wow.

Robert Duff: her experience on the show and stuff. Thank you.

I, I’m very curious though about how ketamine assisted therapy, you know, and integrating it, how that actually looks versus some of these, you know, park you in a chair, give you the infusion,

send you off on your way, sort of treatments

Chantelle Thomas: Mm hmm. Well, I love talking about this.

Robert Duff: that, cool, go as deep as you want. I mean, this, this is really interesting to me because

yeah,

I, I have, you know, I think Park and get infusion is great. If

you’re suicidal, if you’re acutely depressed, it will flip that around,

but then what sort of is the way

Chantelle Thomas: Mm hmm. Yeah. Yeah. So I think maybe because, um, I fell in love with a way of working with people through the MDMA assisted therapy trials because the model that I felt I was [00:21:00] trained in, um, through that modality was, really hinged on the idea that people had inside what they needed to heal, and that the real barrier to that healing often came, um, from environmental variables, um, and really a culture back to your point from the beginning, that doesn’t know how to tolerate feelings, that often wants to pathologize people who have big feelings, and that there’s so much discomfort with emotionality, um, and there is such a reflex that I’ve seen over and over again in our society to pathologize people that can’t get better in the existing healthcare system in the same way that people who have medical conditions that aren’t easy to treat get labeled as difficult patients and the whole chronic pain debacle, and That’s another area of specialization for me.

So what, um, what was really exciting to me about being able to do this work, [00:22:00] um, within the context of that trial is I felt like I witnessed for the first time people healing themselves through optimal conditions. And it really was a massive nod to how little we actually know about the trajectory of what’s needed for someone’s healing because, um, basically, again, I don’t want to make any claims that aren’t substantiated.

And this is a big one right now about whether or not we can even speak to the data, um, with the MDMA

trials and what’s happening with the FDA. But I will tell you from my personal perspective, working on the trial and witnessing what was happening in real time for the participants that, um, it has been said that these psychedelic compounds can work as amplifiers, nonspecific amplifiers.

And the way that I think about it is they’re turning up the volume on important feelings, [00:23:00] thoughts, memories, sensations that need attention, but get diverted out of awareness because of the ways we have to shore up ourselves to survive being human in the world as it’s currently laid out. And so, um, I didn’t appreciated about it was not the Like, really leaning to the drug is the answer, but rather how the drug allows you to put a megaphone on the internal message that’s needed to be heard, expressed, connected with, in a way that was hard to not recognize, um, and so, the process of helping people Rediscover their internal experience and really be with themselves in a way that didn’t feel scary or alienating or pathological or shameful. Um, in many ways, it felt like what we were doing is restoring people [00:24:00] to themselves. And this therapy associated with this compound was a massive catalyst for that. And so when I went to get trained in ketamine and there was a lot of people there that were very, um, you know, ketamine is a really interesting landscape because it’s like you can be talking about four different medicines depending on what’s the route of administration, what’s the dosage, are you doing any therapy alongside of it, what’s the container, what’s being told to the patient about that’s taking it, like people have fundamentally different experiences with it in an infusion setting than they might in a therapy setting because they’re just being taught to work together.

differently with what’s happening.

Robert Duff: Or nasal spray or whatever,

Chantelle Thomas: Spravato versus, you know, kind of the IM, um, application, right, or the bolus, the IV

bolus, where

Robert Duff: now

Chantelle Thomas: or, home home based lozenges through some of the mail order companies. So yeah, so I just, the big message that I [00:25:00] often start with with ketamine is ask about the dose, ask about the route of administration, ask about the set and setting, because it is profoundly emphatic.

impactful in shaping the experience. And when I, um, because I don’t have a practice relationship with psychedelics that predated my work therapeutically with them, I think I was more cautious to just believe they were always going to be helpful for people. I really, I think the work on the MDMA trial actually taught me to trust people even more than medicine.

And so then I thought, well, if we can use these as amplifiers that can kind of catalyze the therapy and the other piece that came through for me is, so I just kind of removed this idea that people are resistant to getting better. Like I think I at one point in time really might have held that deeper than I wanted to admit because when I didn’t have ways to help them, it was easier [00:26:00] to say that they just didn’t want it.

Robert Duff: Sure. Otherwise it’s your fault, right?

Chantelle Thomas: Yes. And so coming into deep awareness with that and responsibility with recognizing, um, you know, how I put that into the experience for people allowed me to really respectfully consider that. I believe almost everyone wants to get better and they just need more help inside to do so. And that combined with the trauma movement that was really looking at ways to help people feel safer inside, as opposed to just purely going the exposure route, which is a different effective strategy, but can be really hard on people, that I started to have, um, a deeper appreciation for the way that. a compound such as ketamine can physiologically induce a felt sense of being safer in one’s body, safer with one’s emotions, [00:27:00] not always, but under the right set of circumstances. And so Um, I started to essentially just pretend in some ways that ketamine was MDMA and did the same therapy model that I felt like I was being taught in, um, and did it with ketamine while we maintained a real strong therapeutic alliance, ideally, and a lot of relational support in real time, teaching people how to work with, quite frankly, the weirdness, the abstractness of ketamine, and allowing kind of that Um, because ketamine is a dissociative by its label, right?

An anesthetic dissociative, it seems to be, I like to also call it like, um, meditation medicine on steroids because it allows, um, an amplification of senses that I think are Hardcore meditators are able to accomplish really easily. I think it allows [00:28:00] for that quieting of the analytical quieting of the, um, intellectual or the predictive processes that are run by certain parts of the brain and allowing for more of a sensory experience that, um, in many ways is what people are trying to accomplish with meditation.

Um, not to say it’s a substitution for, but I have noticed

that it, It’s it seems to be like a great crash course on like, this is what it feels like to be in deep presence with your body, for example. Or this is what many times when I work with people with ketamine and I work in lower dose ranges, they’ll say, um, Yeah, well, nothing’s happening.

And then when you look a little closer, you ask them a few questions, they’ve never experienced deep presence with themselves that hasn’t been overrun by analytical questions or analysis or kind of that constant chatter in the [00:29:00] background. And so they don’t even know what it feels like to be in presence with

themselves. So depending on your agenda, co created agenda with the person that you’re working with, It, it can be this incredible tool that gives people more, um, experiential distance inside of themselves from some of those voices or, um, messaging that just feels so oppressive that it’s hard to get a sense of who you are outside of it or with a little bit of distance from it. Does that make sense?

Robert Duff: Yeah. Yeah, absolutely. I mean, there’s so many layers. You have to work through with somebody to kind of get to the meat, right? It’s

Chantelle Thomas: hmm.

Robert Duff: first like calm your body down. So your frontal lobe even works in the first place, right? And then let’s get through some of this, like, you know, like the background chatter, things like that.

So we can actually access the deeper stuff. And then we start to work with the deeper stuff

versus like, here’s a tool to help you, you know, um, So you can remember there is deeper [00:30:00] stuff there and experience that in the moment.

Chantelle Thomas: Yeah. Yeah, totally. And, and, and I, I just came, you know, I think there’s a lot of things that we will tell ourselves about. Um, you know, I was raised with a very, um, strong undercurrent of if, if it’s going to work for you, you probably should be suffering. And so, you know, whenever I talk to my dad on the phone about how he’s doing, I was always sure to tell him like, it’s really hard.

I’m working so hard. And he was like, I’m so proud of you. Right. It was like this idea of like, being able to work in a state of ease, being more productive potentially and working on difficult content when you’re coming from a place of pleasure, whatever. Like that, that feels a little, to me felt pretty revolutionary in terms of like my conceptualization around like, let’s go for the darkest, hardest thing.

And then this was a real revamp of that. Like if, if in fact we allow you [00:31:00] to feel really good in your body spontaneously, you will kind of use that as a resource to go for the thing that’s harder. With, with, when given that frame, it’s actually this idea that people are not, inherently avoidant all the time, which was another thing I think I told myself is that, oh, people are just avoidant or I have probably had the same judgment for myself. Sometimes people just need more resourcing. And once they have more internal resourcing, they can actually, um, they feel prepared and invested in understanding what they need to feel differently and going for it without you having to push them there.

Robert Duff: So as you got into this, you know,

type of work, did, did you have to struggle with any like shame you felt about being a psychologist, you know, uh, kind of brought up through that traditional system of like, there’s

psychic pain. We’re going to diagnose that psychic pain. We’re going to treat that psychic pain, et cetera.[00:32:00]

Chantelle Thomas: Uh, yeah. So when you said in the beginning, like, Oh, you, you were drawn to this work because it just was synergistic. And I was like, Oh, no, it’s

all of the above.

Robert Duff: is also my own shit in

Chantelle Thomas: Oh, my God. Yes. I mean, I try to talk about it probably ad nauseum for those who ever end up listening to my podcast. Like, I am not it. afraid to talk about the fact that I am a major work in progress. And yes, I carried a lot of shame. Um, I mean, even throughout my work on the trials, I became much more aware of, you know, the responsibility of being interpersonally fairly effective is that you can really steer people without knowing you’re steering them, or you can steer them, um, um, you can really steer people without them knowing and without you yourself consciously being aware.

But the consequences for that can be pretty great. And so, um, these subversive and very subtle ways in which, um, I could, you know, manipulate [00:33:00] a patient. without really being explicit about how that was happening. Um, you know, in some ways therapy, uh, is often thought of as a form of manipulation for some people, but it’s, for me, the key piece was I was, it was out of my awareness how that was really showing up.

So there was no transparency around my agenda in that regard. It was much more subtle. Um, And a lot of it came down to like my deep seated issues around worthiness or wanting to feel important or wanting to have an answer that came from my family of origin that I wasn’t willing to sit with not knowing, or I certainly wasn’t willing to give it back to the person I was supporting and saying, like, I actually think it’s in you. Um, because I think that created a bit of identity crisis vacuum

Robert Duff: What are you there for them? Like, why, why are you there if it’s just on [00:34:00] them?

Chantelle Thomas: Yes. Yes. And I, you know, I think some of the stories I told myself is, I mean, I remember being so such a naysayer of like Rogerian therapy in the beginning because I thought, oh, it’s so unsophisticated. And I completely revamped my understanding of what that’s really like when you’re in genuine relational attunement with people. Um, yeah. The deep power of really profound relational work, being in real relationship, being in true authenticity and really taking responsibility for when you mess things up or you get things wrong and the hurt, the hurts or the harms that result from that.

Robert Duff: Yeah. Yeah. Great stuff. Great stuff. Um, so to return to the ketamine thing,

I’m curious about what it, so I don’t know exactly from, you know, in

your practice, what it looks like. If somebody doing ketamine while

you’re talking to them, do they have a

session and then you integrate another day? Like, what is

that?

Like, and also, is it the same for everybody or is it different depending on where you go?[00:35:00]

Chantelle Thomas: Yes. I think it is different depending on where you go, but I think there’s some unifying principles for people who practice what they would call ketamine assisted psychotherapy, which was, um, I think probably one of the first papers that spoke about it on a larger scale was, um, a paper by Phil Wolfson, um, Dore and turnip seed.

And it was, I think it was published in 2019 if I’m not mistaken. Oh, no, I, that’s when I went to the training. So I actually think it was actually published the same year that the FDA approved spurt Spravato,

which is interesting. Yeah. And it was a large, larger scale across three clinical outpatient practices where they, what Wolfson and the colleagues in that paper were trying to make an argument for was that the subjective effects occasioned by ketamine.

So the way it feels and kind of what’s going on in those changes to the state of consciousness are not just like vexing byproducts of the compound, but actually the way in which your [00:36:00] consciousness shifts is where the healing potential lies. So there is no question that ketamine is doing something on a pharmacological level, on a biological level.

It has rapid and robust antidepressant properties. There’s compelling animal data that looks at the way it promotes neurogenesis and creates new spine density and neuronal regrowth. There’s interesting studies that look at how it, um, Um, shifts the default mode network, um, activity in depressed patients to look like normal patients for 10 days after one infusion.

So we know all of that stuff, but for people who are kind of operating under the ketamine assisted psychotherapy model, they are really wanting to teach people how to harness, work with, and, um, and tune into the way in which their psyche shifts in the presence of ketamine because there is some um, really important opportunity for either emotional release, touching into existential questions that quite frankly, are not [00:37:00] often satisfyingly addressed when you stay in the non transpersonal realms of therapy, which is where, um, people can transcend themselves.

They can reconnect with their grandmother who passed away. They can feel themselves in, you know, the galaxy of stars. They can find themselves underneath the earth, you know, like all these range of experiences and how

Robert Duff: of their minds,

Chantelle Thomas: That’s right. Yeah, exactly. So these ways of helping us question the stories that we have about the limitations of who we are and what we’re capable of, or, um, the, they get overshadowed by certain voices of critique or criticism or self judgment.

Um, if we could get pause from those things, or they, they transform themselves in different ways. And we can you know, kind of connect with the, our inherent sense of worthiness or goodness or capacity to connect beyond ourselves. That alone serves as a striking contrast to the other [00:38:00] voices that we hear in our head about, you know, whether it be depression or, uh, I’m unworthiness or feelings of shame.

So what you’re really doing is creating some dissonance between someone’s experience of themselves in the world and what’s possible while they’re still in their current psyche. So that that can be used as a powerful contrasting tool to then say, if, if I can experience this, then. Maybe a lot of what I’m telling myself is actually not about truth, but it’s rather a recapitulation of what’s been handed to me. It’s an inability to break myself out of this narrative that I have about myself. And now I can actually not just intellectually get it, but I have a felt sense of what it means to be worthy. I have a felt sense of my own value. I have a felt sense of the truth. Of my existence in a way that actually can counter some of those narratives that actually feel pretty superficial.

Robert Duff: That’s yeah. I mean, when in [00:39:00] working with people that are depressed, right. One of the things that, you know, if you go. conventional therapy and kind of common pop psychology route, you might think, okay, well, you know, think of a time when you felt this, or you kind

of asked them to go back, you

know, say you’re doing behavioral activation,

trying to get somebody back to feeling pleasure.

It’s like, I don’t know what that is. So in this case, they can be confronted with, this is what that is. You can feel that.

Chantelle Thomas: and it’s, and what’s really cool about it is you’re not planting it. They’re exp, they’re experiencing it spontaneously being pulled from their internal experience.

So, um, It’s like

as they’re feeling it, In real time, you’re helping them really be with those sensations and, and in some instances check the validity of them so someone’s feeling really good in their body and having an appreciation for their body when they’ve spent most of their life loathing their body as a. torture chamber [00:40:00] or this suit that they can’t wait to get out of. Um, and for the first time they say like, my body is actually really capable. In that moment as a therapist, in that session, I would say, can you really just be with that sensation of capable? Where are you noticing it in your body? And can we linger with this as long as possible so you can remember what this feels like?

Robert Duff: a proof of concept sort

Chantelle Thomas: Yes. Yes. And it, I mean, it’s truly like one of the most, every time I come out of it, I have a little bit of chills just talking about it. Like I

get emotional every time I talk about it. Cause every time I come out of a session, even the hard ones, I think. I can’t believe that I get to share this gift with people because we’re, again, you’re just like, I’m not saying it’s not hard.

I’m not saying it’s appropriate for everyone. I’m not saying it doesn’t require a lot of skill on the part of condition, you know, the clinician to not exploit the vulnerability that is occasioned by these states of consciousness, but the [00:41:00] ability to give someone back a restored sense of their worthiness or their value that came from them.

It’s like,

I mean, it’s, it’s really hard to not be in awe of it in many instances.

Robert Duff: So are you sitting side by side with somebody as they’re getting an infusion or what do you do in your practice?

Chantelle Thomas: do lozenge based work.

yeah, I mean, I,

Robert Duff: you said lower dose

Chantelle Thomas: lower dose. So, um, the bioavailability. So like how much gets into passes, passes the blood brain barrier and gets into someone’s system is lower with lozenges. And so it can be anywhere from a quarter to 30 percent of what people get access to through an infusion.

And so

it’s

Robert Duff: intentional?

Chantelle Thomas: Um, no, I think it’s just the route of administration, the uptake of the body. Um,

Robert Duff: I I mean is that intentional for you use that modality

Chantelle Thomas: Oh, do I use lozenge? Yeah. So, yes, yes. Um, what I like about lozenge is there’s a couple [00:42:00] reasons. Well, one, infusions are invasive, and then you have to, the way that medical providers need to be involved is different, and that could be hard for some people. Um, I do think there’s tremendous sweet spot to infusions.

So if I had the whole setup, I, I would, you know, I would be gladly open to the idea of integrating it into our practice, but because you’re getting the absorption of ketamine through the mucous membranes in the mouth as you’re swishing and swishing the fluid as it’s accumulating, it’s a slower onset and so that the, it’s much more gradual.

I talk about it with patients or clients as though like you’re wading around in the shallow end of the pool as opposed to like being dropped into the deep end. Um, and, um, I kind of, not to say that you can’t do it that way with infusions. It depends how they dial up the intensity. IM is, is usually pretty different.

Like IM is a pretty quick dropping off point, um, just based on that route of administration. But, and then, uh, Spravato, I know a little bit less about in terms of how it sets [00:43:00] in or sets on, but. Um, I do like the really gradual entry point because I think for people, most of the people that I work with have trauma related conditions, whether it be because they’ve had some big PTSD event or they’ve just experienced relational betrayal from primary attachment figures

and, you know, For example, um, and letting go of control is a really big ask.

Robert Duff: they wouldn’t be out there doing kind of flooding exposure therapy in the first

Chantelle Thomas: Yeah, yeah, exactly. So I love that you get to have this very gentle introduction to something that typically the first signatures of ketamine when you’re doing it in that way is relaxation, body gets heavy, you know, you start to feel calm. calmer than you anticipated. And so it is a very, again, it’s an entry point from a place of being really gentle and calming as opposed to some of the psychedelic medicines have a really intense ramp, um, that leads people into experience.

And that can be, [00:44:00] um, a big ask for systems that nervous systems that are just like living in fight, flight, or freeze. So that’s one of the things I really love about working with lozenges.

Robert Duff: Cool. Thanks for clarifying that.

So, um, that gives me a mental picture of kind of what it actually, you

know, looks like. And it makes a lot of sense. It makes a lot

Chantelle Thomas: Mm hmm.

Robert Duff: um, yes, I’ve seen the infusions and that can,

you know, I, I’m trying to think about how to do therapy with somebody who is, you know, off the deep end as, as you

said, that could be pretty challenging, right?

Until they start to either the ramp up or come down. Right.

so.

Chantelle Thomas: or the ascent. Yes.

Robert Duff: yeah.

Hey, we’re gonna, we’re gonna pause the conversation. We’re

still recording, but I want to check in with you. How’s your time looking? Cause I could

talk to you for like 25 hours.

Chantelle Thomas: This has been awesome. I’ve got some time I can go a little bit over

if that’s, if, if

Robert Duff: Yeah. and and the audience should know that we both have kids. So if there’s a scream

in the background, it could be either one of us.

Chantelle Thomas: My children are unsupervised downstairs right now, but I, I have confidence they will come [00:45:00] to me if they need something.

Robert Duff: Awesome. So, The landscape of this in terms

of what, what people actually have access to right now,

Chantelle Thomas: Mm hmm. Yeah.

Robert Duff: legality wise here in the United States, ketamine is kind of it that outside of a clinical trial, right?

Chantelle Thomas: Wait, say that again.

Robert Duff: In terms of what, what people have access to,

like what, what, what, what people can actually go and get treatment for outside of a clinical trial right now, is it just primarily ketamine?

Chantelle Thomas: it is. Although, um, in certain states in the country, um, for example, Oregon, they, I do believe they are actually operating now to provide a psilocybin for people, um, in designated centers. where people have gone through the requisite training to sit for people through psilocybin experiences.

I do also know in some, um, I guess it’s counties and states that have approved cannabis for therapeutic uses or for medical uses. There is, um, such a thing as cannabis assisted therapy [00:46:00] that I think happens in Colorado. I’ve, I’ve heard of people using cannabis in that way, but yes, primarily right now it’s ketamine that is, um, kind of across all the states available as a modality to use that isn’t classified as a classic psychedelic, but has psychedelic properties, particularly when it’s dosed high enough.

Robert Duff: Right. Okay. What’s the hallmark of, um, what you would consider like good or appropriate treatment. You know, if somebody is on the client side of it and they’re wanting to, you know, really go deep and work on some stuff that they haven’t been able to work out in traditional therapy or with traditional

medications, what should they be looking out for in your opinion?

Chantelle Thomas: Mm.

Robert Duff: Like how do they find somebody or a good place to go to?

Chantelle Thomas: Well, if you’re interested in the therapy accompanying the medicine, so for example, if we just talk about ketamine, I think one way to screen through providers is to actually Google for ketamine assisted psychotherapy. to look for a therapeutic [00:47:00] component. Another way to do it is to look at, when you look for ketamine clinics, look at who their staff are.

And if none of them are licensed mental health clinicians, then that’ll tell you a lot about kind of what the agenda of the organization is. Again, we need these clinics that can, can operate from a place where therapy, it’s not hinged on therapy for people who are really looking for immediate relief, um, for those who need it.

happen to be good candidates, but I do think, um, people talking about their experience, where they’ve been trained, their approach, like anyone who leans really heavily on talking just about ketamine, I think that’s important, but I, I would like to see an equal, um, compelling dialogue about how they see themselves fitting into the equation and their approach and how operate. Alongside of, um, the quite miraculous, uh, properties that ketamine does provide, you

know. So that, that’s one thing I would like to say. Another question if you were talking to providers is, um, is a [00:48:00] great question is to ask them, how would you assess my progress? Like, how are you determining whether or not I’m making progress with this treatment? And they may assess it based on a number of sessions that have been supported in some of the clinical trial res it’s actually not. Not as much as, um, it’s just there’s been a lot of publication about infusion therapy for the treatment of depression.

And so they may quote the NIMH study, um, which actually there’s not as many studies looking at the perfect algorithm because we just, it’s different for different people, but they may say, We’re going to go ahead and give you six sessions within two to three weeks, and that’s how we operate because that’s what we know is needed.

And, and so questions I would have is, you know, what are the exceptions to that? How do you navigate that? Will you pause at three sessions if you feel like someone is non responsive? How do you make sense of the fact that some people are non responders? What do you think is needed in those circumstances?

So these are all questions that I

would really love to clinicians to be able to answer with, with thoughtful nuance in a [00:49:00] way that makes sense to you and not just in doctor speak or in clinician speak in a way that disempowers you from being able to feel like you’re making choices.

Robert Duff: Or evasive, right? Like I, I

can imagine a lot of them would be, Oh, well, you know, we just do that. We have great success. We have people

we have our normal course.

Chantelle Thomas: Or they’ll go to the literature. Yeah. Or they’ll say, well, the, the research says that’s always really good because you know, you want to say like, okay, well tell me specifically, because if you look at some of that research, it may not be. Yeah. participants or the patients that were treated in some of that research, um, first of all, they don’t say a lot about what was accompanying it.

They don’t talk a lot about patient selection sometimes. And so, um, I think it’s really important for you to be able to say like, Oh yeah, I’ve seen these studies and they, these patients sound just like me. Then maybe you can generalize from those, but if they don’t sound just like you, then there there’s limitations and how much we can extrapolate at times.

Robert Duff: We, we have a, you know, in our field efficacy versus effectiveness.

And that’s a, that’s a, whole thing that often isn’t really [00:50:00] picked up on in when the news grabs research and stuff like

that. So it’s not always representative for who you actually are as an individual.

Chantelle Thomas: Mm hmm. Exactly. So yeah,

so those are really good questions to ask, including, um, you know, how much experience someone has, um, and what’s their philosophy about how they feel ketamine works together with, you know, its properties and then, you know, What do they feel you as a patient need to do to optimize your success with this treatment?

I mean, I think, again, any treatment that’s being put out as a passive treatment where you just show up and it happens to you and then success, I tend to be really cautious with because, um, not what we see a lot of the time with ketamine. Ketamine can be really potent and very effective, but it can also be very time limited.

And for me, that’s piece of using those, um, experiences to kind of shift some of the deeper narratives about [00:51:00] yourself and then working therapeutically on that shift is a way to sustain changes maybe in a way that are not simply reliant on the pharmacological changes that are time limited at ti with, with ketamine.

Robert Duff: It’s almost, I mean, it’s a shame, you know, there, I see a lot of clinics that are like that out there that are just

sort of park you infusion places. And

you know, the way that I kind of conceptualize ketamine is it brings the walls down and it brings, it brings the processing up. So you’re in prime condition to, to

do that work. But like if there’s no way that you’re doing that work, then no work still gets done,

right? You’ll have that, that effect you were talking about and then it fades and then what are you left with? but you know,

Chantelle Thomas: I love you saying it though. It’s like, to me it just feels like, ah, it’s such a missed opportunity.

Robert Duff: yeah,

Chantelle Thomas: Such a missed

Robert Duff: almost there. Like the, yeah,

it’s one more thing and you’d be in a much

better spot. .So for people that, you know, say they’re in sort of a desert, so to speak of there aren’t, you

know, KAP, ketamine, assisted

psychotherapy [00:52:00] providers in the area.

They only have access to

just at the doctor’s office or anesthesiologist or what have

Chantelle Thomas: Mm-Hmm.

Robert Duff: Any perspective on how they might be able to integrate some of the philosophy of this

for themselves?

Chantelle Thomas: yeah, well, um, one thing that is kind of neat is that sometimes, I mean, with COVID virtual, um, options for accessibility did open up. It created some different challenges in terms of, um, The, the non regulation of mail order ketamine and people having large supplies of it without being therapeutically supported or medically monitored. That being said, because the field is growing, there are more and more therapists now. When I’m looking to find a provider for someone, for example, I got a referral from someone in Southern California and they had talked about coming out to Wisconsin to do some work and I, and I said, well, let me see if I can find someone in your area. It was a town that. I had no idea. I searched for providers on, um, actually on psychology

today. I usually search by trauma. That’s usually a good [00:53:00] way to do a first filter because tends to be people who are interested in trauma work or depth work are also tend to be drawn to psychedelic work or people who are interested in somatic work also tend to be friendly to psychedelic work in some, in some capacity.

So I do some filters by region and then you might find someone who does integration work. does preparation work or does ketamine assisted psychotherapy virtually? Um, so it may be that you go the pathway of Spravato, for example, because it can be covered by insurance, which

is wonderful. Just doing a little bit of research, if you Google ketamine assisted psychotherapy preparation strategies, you can do some of that work in your own right.

Like educating yourself about what preparation means or finding a psychedelic integration coach or a psych, you know, someone who’s been trained through, I think a lot of the time, that’s what we’re seeing at Fluence is providers are kind of coming from all over the country and they’re creating these little niches of people who have areas of specialization.

And I [00:54:00] think they’re looking to service their existing community, but they’re also looking to service desert communities, for example, where they don’t have, where there’s an impoverishment of resources or there’s providers who may not have that kind of exposure or interest in doing that work. And so, you know, um, I think there are creative ways to find that.

And I’ve, I’ve had a lot of success just searching by regions and then finding out if people will work virtually with people, if that

makes sense.

Robert Duff: Yeah, it definitely in, in, in my own experience. So I don’t have, you know, um, the ketamine assisted training through, through a program like, like you have, um, my, my personal experience, my personal research, and then

just clinical work. But, um, you know, there’s one instance that comes to mind as somebody that I’ve, I’ve, uh, worked with in the past that had, um, borderline personality disorder

and, you know, the greatest, uh, change that we saw is when they were going through, uh, one of the mail, you know, home ketamine treatments.

And it just makes so much [00:55:00] sense to me in terms of like, Hey, where are you talking about when you say personality disorder, somebody’s

Chantelle Thomas: Mm. Mm.

Robert Duff: from rip that down to the

studs and sort of work on rebuilding that back up? What can do that? You know, potentially. Ketamine psychedelics, things of that sort.

Chantelle Thomas: Yeah, I mean, there’s, I say with great power comes great responsibility, right? So when you’re working with potentially transformative compounds, um, one of the trickier things and I think we’re education and training and awareness can be an amazing resource is to recognize sometimes if people are not.

kind of thoughtfully tracking what that trajectory looks like, people can be disrupted into shifts and changes that quite frankly feel so overwhelming or so disorienting that they kind of lose figure ground. And so, um, yeah, it’s, it’s so, we just don’t know enough yet. I mean, we’re, we’re learning, we’re learning, we’re learning, but trying to identify the right person, the [00:56:00] right patient.

And so I say like, there’s, there’s really, there’s great wisdom into going slowly and watching for the biases that we load in around anything that’s treated like a silver bullet or like the next solution. Not just taking the word of the individual who’s having these experiences, but sometimes it’s.

including family members and saying, you know, this individual feels like massive changes are happening. They feel really positive about it. And then maybe their partner is like, I’m actually so worried because they’ve been yelling at the kids more

lately or that, you know, so it it is, um, that’s not intended to be infantilizing, but I think when we are working in novel territory, I think it’s important to do a 360 eval as much as we can to see like, well, how is everybody else noticing it?

And, and here’s what I’m noticing. And here’s what you’re noticing, and let’s really weigh the risks and the benefits of what we’re seeing happen in real time as opposed to this over idealization that this is going to be the thing.

Robert Duff: Yeah. I mean, I appreciate that you’re [00:57:00] obviously, this is an area of specific interest for you. You’ve had so many awesome experiences

and the ethics of this are very important to you for that reason.

Chantelle Thomas: Because you, you have deeper reach, and people do not always consent to what gets unearthed, um, in this work. And so, um, That is a great responsibility. And within that, there’s a ton of idealization of the provider who’s alongside of them, who’s helping them through these experiences. And you, you can really influence people in very subtle and profound ways to, when they look to you to help ground themselves in reality and you say to them, they, they look at you and say, did this really happen? When they’re accessing something that they couldn’t access before and you look back and say, yes, it did. That’s a problem because you don’t, you know, we’re working in an abstract, [00:58:00] nonlinear, metaphorical space that may or may not mean what we think it means in the moment. And so

Robert Duff: You’re certainly experiencing it, whether that happened or not.

Chantelle Thomas: in this moment, what, you know, I want to be really careful in helping you be with what’s happening right now.

So what, how can I support you? What is, what is needed in this moment for you to be with what’s happening

Robert Duff: That’s so humbling for you as a clinician, right? Like you have to really

take your desire to know the answers out of it.

Chantelle Thomas: Yeah, I mean, it’s, it is definitely humbling and it’s also liberating because it also helped me realize how often, um, I would prematurely arrive at a conclusion and then rob someone of the opportunity to really find their own answer.

Robert Duff: Good point. Good point. Um, it sounds like you’ve done a lot of, um, talking about this recently when it comes to the recent sort of, uh, FDA, uh, situation with MDMA. Is that something that you [00:59:00] want to talk about here? Would you want to point people towards something to look into to learn more about that?

Chantelle Thomas: Yeah. I mean, there are a number of, um, you know, there’ve been a number of different, uh, postings about, you know, the ICER report that came through that was evaluating kind of risks versus benefits of MDMA assisted therapy. And then this, um, advisory panel that recently, um, uh, happened with the FDA and what that means.

Actually, I just recorded a podcast today with Ingmar Gorman on my podcast,

um, where we kind of unpack that and we’re going to be

Robert Duff: Then why don’t we, why don’t we, uh, point toward that?

Right. I think, I think, you know, that’s a that’s a huge thing that we

Chantelle Thomas: Mm hmm.

Robert Duff: all the way into,

Chantelle Thomas: Yeah.

Robert Duff: everybody listening, like when you post that, I will share that. Cause I think it’s a

really important thing to, to learn more about.

Chantelle Thomas: Yeah. We’re trying to demystify a little bit of the, um, the ways in which, um, aspects of clinical trial research are just, of course, wrong.[01:00:00]

understandably hard to interpret

for the population who are not involved in it and the way in which that gets, um, melded with other conversations about ethics and what is in the best interest of participants and what are the risks of being involved in clinical trial research. Um, and. And this topic is highly emotional and people have very strong feelings about it and it’s polarizing and it’s a revolutionary, um, thing for a therapy to be evaluated by a drug

advisory board.

Robert Duff: Well, yes, that’s a

super deep. It’s a super deep topic. So I’m

happy to punt that back to you.

Um, and that also gives a good opportunity to ask you about your podcast. Can you tell people a little bit about what you do on your

show?

Chantelle Thomas: Yeah, absolutely. I started it during COVID actually. And, um, it actually was birthed for me from my growing awareness of my own blind spots. So, [01:01:00] uh, the name of the podcast is called blind spots and it’s exploring what we cannot see. And it really, what my effort was. I think to try and have more vulnerable, authentic conversations about what I was becoming more aware of in real time through the work that I was doing, and also, um, encouraging a dialogue to make it safer, hopefully for people to talk about the thing that’s being felt, but not named in the way in which that shifts or, um, shapes conversations, um, Unfortunately, it’s it’s having a big impact, but it’s not being explicitly named or it’s not being talked about in real time in terms of a process.

Um, and so that was kind of the inception point of it and the curiosity of that. And then as it grew over time, my first conversations were really Um, about the substance abuse treatment industry because of a lot of, uh, thoughts about [01:02:00] blind spots that exist in that industry and kind of our conceptualizations about substance abuse treatment or substance abuse, um, substance users or people with substance use disorders.

So, um, and then because I was doing clinical trial research alongside of it, um, I started to talk more explicitly about our work with ketamine assisted psychotherapy. And then it became this, um, Maybe gratuitous opportunity to talk to a lot of the clinicians I had met in the field through the work on the trials and these kind of amazing humans that I felt really inspired by their perspective and what brought them to this work and also to give maybe the larger public a felt sense for who are the people that are drawn to this and what are the questions they’re asking themselves and what does it feel You know, you, I think you can get an idea that people who are doing psychedelic research or psychedelic work are pretty fringe in many regards.

And so I think it’s really important for people to have an understanding of how many different pathways will lead [01:03:00] people into this work.

Robert Duff: Cool. And so it’s called blind spots, plural,

Chantelle Thomas: Blind spots. plural. Yeah. And then it’s a colon exploring what we cannot see.

Robert Duff: I’m assuming available of them kind of

everywhere.

Chantelle Thomas: All the platforms. Yeah,

exactly. Yeah. Yeah. And so. Ingmar and I had a great conversation this morning that I’m hoping that we’ll be able to post there. Um, and just to also name that this advisory panel, uh, for the FDA is not a binding recommendation.

So the FDA will still make a determination in August of this year. Um, and so, know, I’m sure many people have been feeling that just in the last week. It’s so important for more and more practitioners to become a little bit more literate about what this means and what it doesn’t mean as the interest grows, as the enthusiasm grows for this work. patients are gonna be seeking it out. They’re gonna want to know. Let’s say it doesn’t get approved. That might push [01:04:00] more people into the underground to do work in a non sanctioned way. And so helping people navigate conversations around harm reduction and psychedelic harm reduction is, has been a primary platform Fluence and their training model is how do you help clinicians thoughtfully, ethically, professionally navigate, um, the, the potential of this work and also at the same time maintain their licenses and recognize what’s in scope of practice and also provide a really important resource to them. For, uh, individuals in terms of harm reduction, instead of getting really scared about the conversation, shutting it down or telling people, I wouldn’t look into that because we all know that that is not going to be

effective or helpful for people. Yes, exactly. Let’s just please stop talking about that.

Robert Duff: Yeah, that’s, yeah. So, so Fluence is the organization that kind of paired us up. They

Chantelle Thomas: Mm hmm.

Robert Duff: if I want to talk about

psychedelics. You know, I asked if they had anybody that did that, but also, you know, the assisted [01:05:00] therapy and stuff. So I’m

really happy they put us in touch.

Um, so that’s, it’s, it’s an organization that

provides training for clinicians and the stuff that you’re talking about.

Right.

Chantelle Thomas: Exactly. Yeah. And they have a number of different pathways for individuals. I, I know that they, um, they have like advanced certificate in psychedelic harm reduction and integration as one of their certifications. And then they have a ketamine therapy certificate that they offer.

And it’s kind of neat because it It’s geared towards folks who would like to work alongside of psychedelics potentially, but it’s also geared towards folks who maybe want to add on to clients who are pursuing these experiences and they want to help with better preparation or the integration of these experiences and

help them more thoughtfully kind of weigh the pros and cons of going different pathways.

Robert Duff: That seems super valuable. Yeah, especially as you know, we’re in this state where people, I say state, not geographically,

but currently, you know, people can’t [01:06:00] exactly pursue these in very many cases through a through a legal route. You can’t directly be

super involved with the care for the same reasons.

But when it comes to planning, harm reduction,

reduction, integrating something they’re doing anyway,

um, that can still be done in a, in a clinically sound way. Okay.

Chantelle Thomas: Yeah. And we, we have really great research from the substance use world, right, that being able to have a dialogue about risk mitigation and harm reduction, to stay in conversation with people when they’re not quite ready to make drastic decisions around stopping use or discontinuing, Um, it’s really important that we get curious about how these things are functioning for people and help them ask questions to better elucidate their thought process and how they’re kind of weighing the pros and cons of something. Um, and what would help guide them in that decision making process while still maintaining your integrity as a clinician and being able [01:07:00] to, to know enough about the research to say, you know, I don’t know a lot about that research. Here’s what I know. Maybe you should look at these sources as another way to educate yourself about whether or not that actually bears out and what, what were, what has been researched or what’s being spoken about now.

Robert Duff: Yeah. Well, that’s, that’s awesome. It’s a good resource to know that’s out there from my perspective as a clinician. I know there are clinicians in the audience, so I think we’ve covered like a really good overview of, you know, what these things are we’re talking about, you know, how you feel like they help what actually looks like and how people can.

You know, start to pursue this from either side. So I think that’s a good place to kind of wrap for today.

Like I said, I could talk to you for a bajillion hours, but that’s not going to be very, I don’t think productive for the, uh, audience.

Chantelle Thomas: Or our children, probably.

Robert Duff: That too, that too. Um, before I do let you go, is there anything else that you want to shout out or direct people toward?

Um, obviously I’ll post your show when it comes out with that episode you’re talking about, but is there anything else you want to point people toward?

Chantelle Thomas: [01:08:00] Yeah, no, I think, I think it’s good to look in your local area for, um, you know, education trainings. I think going through podcasts is a really great way to self educate, um, to be hearing about something that resonates. I, I just would also really encourage people, anytime a dialogue feels polarizingly positive to just, take some caution.

And if you’re asking yourself questions or raising some criticisms, I think that’s a really important part of what the field needs is to be questioning and to be asking questions. So I, I really, um, I think one of the things I’ve really appreciated about working with Fluence is that they are really trying to have a balanced dialogue around this.

And there are also a lot of wonderful clinicians in the space that, um, have a lot to contribute, but there’s also a lot of people. Um, Who are maybe looking to really double down on the capitalistic endeavor and not necessarily taking into consideration the ethics and

Robert Duff: You’re saying cash in is what you’re trying to say.

Chantelle Thomas: [01:09:00] Pretty much, yeah, yeah, cash in or just represent this as a quick fix or, um, you know, Um, you know, it’s, it’s really a devastating reality when people, um, have had unsuccessful treatment elsewhere and then something that’s propped up as a silver bullet does not work for someone.

There are serious consequences for that. So just to also name, there are a lot of reasons why something may not be effective for someone and it’s none of them have to do with someone failing a treatment.

Robert Duff: Very good. Thank you so much for your time.

Thank you for talking with me. Um, I’ll link, you know, some of the stuff we talked about in, in my notes and hopefully people will come over and listen to your show as well.

Chantelle Thomas: Cool. It’s lovely talking with you. Thanks for the time.

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