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Psychedelic Therapy and Non-Verbal Support: Marg Ryan
158 Plays3 months ago
In this episode I’m joined by Marg Ryan, a colleague and fellow psychedelic-assisted psychotherapist. We explore the important and, at times, complex topic of non-verbal support in psychedelic-assisted psychotherapy. We talk about our practice as somatic therapists, our respective journeys into this work, somatic psychotherapy and psychedelic therapy, non-verbal support in psychedelic therapy, the Importance of the attachment lens in psychedelic work and consent and boundaries.
Marg is a senior clinical psychotherapist with twenty years in mental health and private practice. She conducts therapy and supervises clinicians working with individuals, couples, and those developing psychedelic-assisted therapy skills. Marg has been involved in psychedelic-assisted psychotherapy research at Monash University’s Clinical Psychedelic Lab in Melbourne, Australia. She served as a core therapist in Australia’s largest psilocybin trial for Generalised Anxiety Disorder and in the MDMA-assisted therapy for PTSD trial. She completed intensive psilocybin training and MDMA therapist training with MAPS in 2021. Marg co-facilitated a training program for psychedelic trial therapists at Curtin University, delivered by Monash, and assisted in the first Australian MAPS MDMA training at Monash. She is also a tutor for the MIND (Berlin) two-year psychedelic therapist training program.
keep in touch with me at Insta: dresmedark
Linkedin: www.linkedin.com/in/dr-esme-dark-627156a0/
website: https://www.esmedarkpsychology.com.au/
find Marg at https://www.counsellormelbourne.com/
Find Monash Clinical Psychedelic Lab at www.monash.edu/psychedelics
Disclaimer: This podcast if for general information only and does not constitute an endorsement or recommendation for psychedelic- assisted psychotherapy.
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Transcript
Introduction to Beyond the Trip
00:00:04
Speaker
Hello and welcome to Beyond the Trip, a psychedelic therapy podcast with me, Dr. Esme Ta. During this podcast, I'll be bringing you conversations with thought leaders and other inspiring humans, exploring a wide variety of themes relating to the use of psychedelic-assisted psychotherapy in the healing of human distress.
00:00:26
Speaker
Whether you're an aspiring therapist, already a therapist, or just simply interested in the emerging field of psychedelic therapy, then this podcast is for you.
Invitation and Acknowledgment
00:00:36
Speaker
Join me for a journey into the psychedelic world. Before we get started, I want to take a moment to acknowledge the traditional custodians of the unceded land on which this podcast is recorded. The Wadda Wurrung people. I pay my respects to elders past, present and emerging.
00:00:54
Speaker
and I extend that respect to any Aboriginal or Torres Strait Islander peoples listening today.
00:01:03
Speaker
Hi everybody.
Meet Mark Ryan: Expertise in Psychedelic Therapy
00:01:05
Speaker
On this episode, I'm going to be talking with Mark Ryan. Mark is a senior clinical psychotherapist with 20 years experience in mental health and private practice. She conducts therapy and supervises clinicians working with individuals, couples, and those developing psychedelic assisted therapy skills. Mark has been involved in psychedelic assisted psychotherapy research.
00:01:31
Speaker
at Monash University's clinical psychedelic lab in Melbourne, Australia, which is where I work together with her. She served as a core therapist in Australia's largest psilocybin trial for generalised anxiety disorder and in the MGMA assisted therapy trial for PTSD. She has completed intensive psilocybin assisted psychotherapy training and MGMA assisted psychotherapy training with MAPS.
00:01:57
Speaker
Marg co-facilitated a training program for psychedelic trial therapists at Curtin University, delivered by Monash University, and she assisted in the first Australian Maps MDMA training at Monash University. She's also a tutor for the MIND two-year psychedelic therapy training program based out of Berlin.
Complementary Approaches: Somatic Therapy
00:02:20
Speaker
In this conversation we get into ah somatic therapy being as we're both trained in a type of somatic therapy. We share our respective journeys into that work and why we feel somatic therapy and psychedelic therapy are so good for working together. We talk about nonverbal support in psychedelic therapy, the importance of holding in the attachment lens,
00:02:44
Speaker
and we're getting to some depth around consent and boundaries in this work.
Dr. Esme Ta and Mark Ryan in Conversation
00:02:49
Speaker
So I really hope that you enjoy this conversation as much as I did. Now let's get into it. Hello, Mark. Hi, Spie. Welcome to Beyond the Trip. Thank you so much for being here today, for taking time out of your day to sit here with me. It's such a lovely way to spend some time.
00:03:11
Speaker
It feels great, actually, because we don't really get to do that very much to have that uninterrupted space. So going to be I'm looking forward to it. It's going to be nice. Yeah, me too, me too. You and I you know have known each other for quite a few years now. I was trying to remember. it's but yeah I think it's three years ago that we met. Yes, yeah. In training, when we were with Sean and we were doing the psychedelic training for Saiga,
00:03:39
Speaker
clinical trial, I think. Yeah, yeah, that's right. Because you and I both work together at the clinical psychedelic lab at Monash uni, like, and we joined at the same time, and we both kind of joined a little bit late, didn't we? And so I can remember feeling really nervous about the fact that everybody else kind of had got to know each other, and they'd had like some time training together. And then yeah you and I had this like, kind of personal training, just well, you know, with us, just the two of us, and then a couple of other trainers and And that was really lovely. And it meant that we didn't know each other pretty well actually, which is really nice. It was good that there was two of us starting at the same time, given that was the situation. And I think it allowed us to have a soft landing and already get to know each other a little bit more before we joined the bigger team. So, yeah, it was really good. Yeah, totally.
00:04:34
Speaker
So today we're going to be talking about something that you and I are both really passionate about, which is somatic psychotherapy.
The Body's Role: Somatic Therapy Explained
00:04:42
Speaker
And we're also going to be but like focusing in on ah so topics that people have a lot of feelings about, and we'll talk a bit about that later. But it feels really important in psychedelic assisted therapy, which is ways of providing nonverbal support.
00:04:59
Speaker
And we'll get into all of that in a minute. in But before we do that, I think it's quite useful. I've referenced somatic therapy a few times now on this podcast, but I'm not sure that I've really defined it and explained to people what we actually mean when we're talking about that. Sure. So I might make a start and just explain that. I mean, you know, I trained in obviously two different types of somatic psychotherapy. So I trained in sensory motor psychotherapy with a woman called Pat Ogden in her school. And somatic comes from the word soma, which means of the body. And so in somatic therapy, we take this sort of bottom up approach, don't we? And a lot of psychotherapy and a lot of psychology, especially when I was trained, it sort of starts in the top down. So thoughts,
00:05:49
Speaker
and thinking and then kind of goes and the processing goes from the thoughts and the thinking down into the body through the emotions. Whereas as a somatic therapist, I tend to start with from the bottom up. So the body is the entry point for healing.
00:06:03
Speaker
and that And that we really focus on tuning into the wisdom of someone's body. And teaching people and teaching ourselves as therapists as well how to listen deeply to a client's body and and how helping clients to kind of really get connected to their own body is a really important part of it.
00:06:23
Speaker
And in my, the school that I trained in, they talk about something called the Core Organizers. And so we're kind of paying attention to those, which is the the way that your body is told tension, the breath is super important, of course.
00:06:38
Speaker
posture and movement, five sense perception. And so we're kind of working with all of those. And just to say that we also do, just as a lot of traditional psychological therapy starts with thoughts, and of course, as people go towards the body at times, we also do ah pay attention to emotion and to cognition, but it's it's usually not the entry point for our work.
00:07:03
Speaker
And so maybe, I mean, there's a lot more I could say, but that's the kind of the short version of a a long story about what somatic therapy is. And I'm sure more will come out in our conversation. But do you want to just start by explaining a little bit about the type of somatic therapy that you trained in and what was, why you were drawn to this approach and why why you were drawn to this way of working as well? Yeah, sure.
00:07:30
Speaker
I think I was really fortunate, Esme, in that I trained about 20 years ago and it was, certainly in a college that no longer exists, but at the time was quite at the, was a forerunner in that it was the Australian College of Somatic Psychotherapy and It was looking very much in my training at Trauma and Pat Optin's work. So how lucky were you to be training directly with her? um Peter Levine and a number of people that were interested in how the body kept the score when people were suffering and how they held their pain in their body. And the training that I did was quite intensive.
00:08:19
Speaker
but I was sort of trained in such a way that it wasn't all, it was an embodied training. So it wasn't all theoretical, although there was a stringent theoretical intellectual component, but there was body-based learning and experiential learning around the sort of things that you've already mentioned, the breath,
00:08:42
Speaker
tracking the body non-verbally, grounding, understanding the felt sense, like what you were feeling in your five senses, so that you could learn how to use your body as sort of signals and ways of understanding what was happening for your client in the room. So yeah, so that's sort of how I got started in it. And I think the reason I was attracted to it was because I'd done psychology at university and postgraduate studies and things like that. But I hadn't felt like any of those approaches when it came to healing really seemed to include the whole person. And I felt like there was something missing. yeah And certainly what I found was one time when I actually was having a difficult stressful time. I went to see accidentally a somatic psychotherapist and I found the way that she worked with me made so much sense and shifted a lot of things quickly and just in a more kind of connected present embodied way that I just loved it and I thought I need to understand and know more about this because this is the way I think that will help people heal.
00:10:05
Speaker
yeah so it's so ah you know It's such an important part of the way we are in the world. you know our ah Our body keeps the score, not just of trauma, also of positive events, also of neutral events. and you know So much of our experience in the world is is not made up from verbal experience. It's implicit body-based memory, isn't it? so it's always It makes so much sense when you talk about it.
00:10:33
Speaker
that it would be such an important part of healing, but I agree. ah My training as a clinical psychologist was all was was great, and I was very, very lucky that I trained in the UK under someone who really was an excellent teacher. and But when I kind of started working, I was working largely with a refugee in the science-seeking mental health, and It was in that work where I was working with torture survivors and people who had experienced war-related trauma that I realised that there was so much that needed to be done in terms of working with the body with that population, but actually with all populations.
00:11:12
Speaker
and you know and and it was and then Luckily for me, my work supported me to go off and do the the sensory motor training, and they both with time off and some funding, which was amazing. Super grateful for that. and It was ah such a beautiful personal journey. Our training was very experiential as well. Probably not not too different to yours in many ways. and It really showed me the importance
Nonverbal Communication in Therapy
00:11:37
Speaker
of this work. and you know and it's It's extremely important, isn't it, in in psychedelic-assisted psychotherapy as well. and There's many ways that we could talk about that. But I think you know maybe the first maybe the first thing I'll say before we get into the rest of it is that
00:11:54
Speaker
you know, drawing on somatic approaches in psychedelic work generally is so important because the psychedelic work will take people out of the verbal a lot of the time. Some people are very chatty, aren't they? You know, yeah I could be chatty. I've been chatty before. But thought Yeah, but some people are very chatty. But other people are, you know, a lot of the processing can kind of take happen in an embodied way. And, you know, you get kind of all sorts of things happening in the body, shaking, involuntary body movements that that feel like the body is kind of doing its own healing, like it's almost doing its own somatic processing. yes i don't know if Yeah. And so it feels really important to draw on this work in that in that because of that.
00:12:42
Speaker
100%, because what you're talking about in terms of the psychedelic work, and we'll get into this more I'm sure, but is that if there's not a lot of verbal stuff coming and someone is very internal, particularly on a dose day, well not even on just a dose day to be honest, sometimes there's just not a lot of words, someone's got to describe their experience or what's happened to them, then if you can use the felt sense and your tracking and your non-verbal signals, then you can help support them and ground them and also
00:13:23
Speaker
help them provide you with what you need to know to help them a bit more without them feeling like they have to have this beautiful, flowy, cognitive kind of story, which as we know, if you've been traumatized, you don't have anyway. You know, it's often kind of snatches and pieces of memories and sometimes no words.
00:13:47
Speaker
Yeah, absolutely. That's right. And so you kind of I think the first part of ah when we're working outside of the dosing sessions, the first part of what I'm often doing with clients is is is working out how they're connected to their body if they are at all, because also trauma can make people who have feel quite disembodied, can't it? Maybe the experiences are fragmented and they don't have words, but also that there's a disconnect yeah between themselves and their body.
00:14:17
Speaker
And so, you know, yeah they can feel that they really don't have a sense of it. Sometimes not everybody, everyone is so different in this work. And, and I think kind of teaching people and and assessing that at the beginning of working with someone is really helpful because it allows you to know how to help them like you're saying. Yeah. And, and I love that you say everyone's really different because I guess that's where our training and our skills come in, in that, you know, I've had participants as we call them in the trial or clients as I call them in private practice, who have got beautiful senses of connection with their body and ways of describing them. And you can use that as a doorway in really quickly and easily. And others that have a complete disconnect, which is quite common in our culture.
00:15:10
Speaker
So when you can help them get some more language or tools to work out what they're sensing and feeling and you know what's happening, are they kind of tight in their tummy or in their shoulders or are they kind of doing that or are they wiggling in their chair? And when they can start to use that information, it really helps them have more access to what's going on inside for them. so Yeah, yeah, yeah. Yeah, absolutely. And I think, you know, as somatic therapists were trained in tracking, and I've spoken about this in other episodes of this podcast, that you kind of, when you're in a room with a client, you're tracking, you know, their body, their detentions, it holds the movements, it makes their breath, and also your own as well. but and And that's a very important thing in
00:16:04
Speaker
it It's like a deluxe, like a therapy, because yeah in in order to track to be the most grounded possible support for someone, you've got to be pretty good at ah tracking and grounding your own body. And the stuff that comes up in your body can be a really useful piece of information that you might want to use in the therapy. I could say so much about that, but I don't want to go on it. Yes. I was just thinking that that the transference and the counter-transference and how you use your body to, you know, if you're feeling like a lot of sadness and they're not expressing any sadness, perhaps sometimes sharing, oh, I'm wondering what's happening in your heart or your chest or
00:16:47
Speaker
yeah you know There's ways that you can use your body to inquire about what's happening for them. But you were trying to get us on a different track, so I don't want to go too far off track. I know. I know. I know. as There's so many tracks, right? We probably need to do a few episodes, Mark. But I guess what we... that I think there's a lot to say about transference and countertransference in this work. And perhaps it's going to come up a little bit more as we talk about the next topic, which you know is really that idea of supporting people non-verbally. That's something that we do in somatic in somatic psychotherapy and also in psychedelic-assisted psychotherapy. and I think it would be really great if we could share a little bit about this topic because
00:17:35
Speaker
It's quite a, it can feel quite a complex topic for people. And so how do you think that this use of non-verbal support or interpersonal grounding is really useful in somatic work and in psychedelic work? Yeah, I find it so useful at every stage of therapy and in all the work that I do. I think the first part is someone feeling safe and comfortable with you. And that can be, you know, your voice tone, how warm and welcoming you are, you know, with your face, you know, not necessarily even your words, with your body. And so I use it every single session. And it doesn't always mean that the non-verbal support or intervention
00:18:33
Speaker
is actually physically reaching out and touching someone. Though obviously with consent in our work, we may at times choose to do that. It's not always about that, you know? It can be about, as you say, someone's telling you something.
00:18:51
Speaker
really difficult for them and I'll find myself slowing down my breath and really grounding and so that I can be present with them but also to help them as they navigate something really tricky that they're finally telling someone.
00:19:11
Speaker
Yeah. that' so I really love where you've gone with this question, Mark, because I feel like it's so true, isn't it? That idea of non-verbal support is yeah actually extremely wide in in how we might use it. and if someone I definitely think it's it's important. you know is is There's ah that famous phrase in trauma therapy that you need to learn and how to put on the brakes first.
00:19:38
Speaker
and And so ways that you can help clients put on the brakes, which before you do any trauma processing is by slowing down your speaking, slowing down your speech, slowing down your breathing. And also it might be like, i you know, leaning a little bit closer to someone, maybe kind of moving and mirroring their body language, which a lot of us do without, I think, even thinking about it, actually. So if someone is talking, we'll kind of use our body to show them that we're listening to be really present.
00:20:07
Speaker
And to kind of, and I might even say, you know, at times I might say, Hey, could we just slow down for a moment and just breathe? It's not that I don't want to hear you. I do, but I just really want to invite you just to kind of slow down and feel your body for a moment as you're talking to see if they feel safe enough to continue. That's right. That's right. Yeah. And so.
00:20:29
Speaker
support to stay connected to all of them, really, all of themselves. Or when someone kind of gets sort of overwhelmed, then you can tell that they're not fully, they might be in their story, but they're not really connecting to their feelings and what's going on in their body. It's a good way, it's a good tool, slowing them down and breathing or asking them, how are you doing right now, telling me this? Like, is there anything, can you notice what's happening in your body right now? You know, in your sensations, you know, in your feelings, in your thoughts, like anything at all, you're getting any images, just slowing it down can help someone go, oh, actually, this feels like a
Connecting to the Felt Sense: A Therapeutic Goal
00:21:20
Speaker
lot.
00:21:20
Speaker
yeah that's happening. yeah And even being able to give someone that permission to sort of slow it down and take a break and zoom out a little bit. Oh, what's going on here helps a lot. Yeah, absolutely. I think what you're talking about there is getting is is actually connecting someone to the felt sense, which is the word that you used earlier and something that we talk about a lot.
00:21:43
Speaker
in somatic therapy, but just for anyone who isn't quite clear on what we actually mean by that. i mean you know it's it's the It's described in a number of ways, but one of the descriptions I really like is that it's the river of sensations that happen inside of your body. It's also it's that's kind of always shifting and changing in response to what that goes on outside.
00:22:08
Speaker
Oh, that's a beautiful way of describing it. I think that was Peter Levine. I think so. Yeah, I could be wrong, but I'm pretty sure. I can't take credit for that one. But yeah, I think I really like it because if I tune into that in myself, like if I sit here for a moment and just close my eyes and tune into that.
00:22:26
Speaker
I can feel the river moving. you know I can feel like I'm always tense in my shoulders, but if I move them a bit, it shifts a little bit. it's like you know There's tingling in my hands. there's you know and it's It's forever changing.
00:22:43
Speaker
So I think that's a really important thing to help people to get connected to. And when we're meeting people in psychedelic-assisted p psychotherapy and PrEP, we we're kind of, in preparation for psychotherapy sessions, we are getting to know them, aren't we? And we want to hear a bit about them, what's brought them here. And that can sometimes, when people have experienced trauma or perhaps when they've had a lot of therapy before, they or a lot of experience in the mental health system, they'll come and see someone like me or you and sort of say, okay, I'm just going to tell absolutely everything in this two sessions. And actually, that's when it can get really dysregulating for people. So that's why it can be really important to slow them down. Yeah. And I think in preparation, it's also that sense of we do want to really listen and get to know someone. But
00:23:33
Speaker
weirdly, well not weirdly really, in a way, having someone show all of themselves by being able to talk about a particular thing maybe that has brought them to psychedelic-assisted therapy. You know, it might be a specific incident or it might be a whole lot of things that have brought them.
00:23:55
Speaker
But if when they're telling you, they can tell you the thoughts, but then also if they can connect to other parts, the feelings, the body, the the felt sense.
00:24:08
Speaker
then they tell you're getting all the pictures of the, like the pieces of the puzzle, I guess is what I'm trying to say. And then the pieces that they can't tell you about help you understand where they might be really stuck, where emotion is not freely moving through or where it's not okay to be angry about that really awful thing that happened. And because things do get kind of,
00:24:37
Speaker
caught and stuck in the body, you know, that's the start of us understanding where are the blocks here for this person's healing. a Yeah, absolutely. That's so important, isn't it? And it can give us a sense of some of the things that might come up in in our dosing, but we never really know exactly what's going to come up. But maybe we should talk a little bit about non-verbal support in the dosing session, which can, in the way that we work, it can include physical touch. It's not always, but it can. And with the solid consent process that in the trial work that we did, that we
00:25:18
Speaker
worked with people very, very clearly beforehand and asked a lot of quite detailed questions, didn't we, about about what they would feel okay with a knot before we went into the dosing. So that's a really important thing to note. There's probably more to say on that.
00:25:34
Speaker
But shall we talk a little bit about that? Yeah. so Where would you like to take that topic? Because it's such a hot topic in this work, I think it gets spoken about a lot. And I think it would be really useful to talk about our perspectives, not to say we have all the answers, but not by any means to just share our thoughts. Yeah. Yeah. So I guess it's From my experience, it's as you say, it's me. Everybody is so different and nonverbal support. Some people need it with hands on, as in a hand on the shoulder.
00:26:12
Speaker
with consent you know that's all been talked about and you know even practiced before dose day in our situation, or someone might need you just sitting close by, or someone might need you sitting a long way away a and might want you to turn down the music before you approach and just use approaching them when they've got headphones on with your voice. so
00:26:45
Speaker
It's so different for everybody. There's personal sensitivities, I guess. And then there can be kind of cultural sensitivities. And with traumatized people, we also, it's not like everybody's traumatized, but we do want to be really mindful of any boundary violations. So we don't want to get into anyone's space that it's not going to be supportive for them or right for them. And so,
00:27:13
Speaker
that's why it requires That's why it can sometimes feel complex, I think, and it requires consent, but it also it means that less support might end up being more for that particular person. yeah What might be really supportive is not doing anything in terms of non-verbal support, you know, with your hands. Yeah. Yeah, absolutely. And I think, you know, it'd be great to talk a bit about attachment and attachment theory as well as in a moment. But I think, you know, there's so many different ways. The important thing for me in this, when I think about being with people in these spaces,
00:27:57
Speaker
We're asking people to kind of go into this dosing experience where they've got the the headphones on, the eye shades on, and so much because so much of the work happens when they're really meeting with themselves.
Consent and Touch in Therapy
00:28:12
Speaker
or and It's quite an internal focus.
00:28:15
Speaker
me and then you know and and For me, what's important is they have a sense that we're with them, that we're alongside them, that we're not leaving them alone with their pain because so much of our trauma is is is a result of being left alone with our pain so often. and It doesn't necessarily matter to me if it's a ah physical hand. For some people, they really value being able to say, come over here like we know we would do.
00:28:44
Speaker
We would work through some hand signals and nonverbal ways for people to communicate because sometimes people are outside of words aren't they into the universe somewhere or yeah you know in a different place outside of the verbal part of their brain. but So we might say you know the person might say ill I'd like you to come over and support me and for some people having a hand on the shoulder that's really, really grounding, really, really supportive, really, really helpful. And for other people, it might be just a hand on the forearm, or it could be. Also, you can use objects, you know, in in somatic psychotherapy.
00:29:20
Speaker
That's what we do a lot. i That's why I do a lot is kind of, you know, rather than actually touching people with my hands, if I'm going to support someone's body through a process, I may use a pillow, hold the pillow up, for example, for someone to push into my hands. Or it might be in our work on a dose date, just giving someone a pebble or a stone to hold that shows that we're there with them so that they can kind of feel us without needing to use.
00:29:46
Speaker
physical touch as well. And I think it's really I always really like to give people lots of options, because and everyone's different with the comfort levels of what feels important. For some people, it feels really important to you have a hand on the shoulder though. Yeah, and yeah, what do you think are the kind of Yeah, what do you think are the reasons why why it might be really important and also maybe the reasons why it might be sticky for people? I guess this is where I'd say attachment theory informs my work.
00:30:15
Speaker
in that If you have a little baby that has been cuddled and held and nurtured non-verbally and supported in that way throughout their childhood, then often their nervous system will be regulated and they'll find touch relaxing.
00:30:36
Speaker
but You know, what we learned when we started attachment theory was, of course, so many people haven't had that really attuned, really grounded parenting. that's allowed them to feel that sense of security and safety within their body, with someone else touching them, you know a parental figure holding them. And so with those kind of situations, then for some people it might be really supportive to have their hand held because they didn't get that when they were little.
00:31:13
Speaker
Or it might be, I'm so not comfortable with that because I didn't get that when I was little. Or I've had something awful happen to me, so I just don't let people get close to me physically or emotionally. so And then everything in between happens in the room, as you know. And so you're really letting the participant be your guide and providing and curating an environment where they get to call the shots and help you understand what is going to be supportive for them.
00:31:49
Speaker
Yeah. That's really important, isn't it? That they get to call the shots and that they, and because choice and control is such an important part of healing from trauma, having choice and having control. And so I think any way that we can do that helps the person to feel safer.
00:32:07
Speaker
I understand that this for some practitioners that the use of physical contact like this could feel quite scary and different to their training. And, you know, there's probably a lot to say around that. But in this work, because people are so often out of sight of the verbal and in with the eyeshades on the headphones on, it feels like something that is really important to have as an option.
00:32:33
Speaker
as something that can be on the table for the person to understand that they can do that, that they can reach out and have someone put a hand on their shoulder or something similar. I had a ah so many people who I've worked with say that, well, when you did that, I was able to connect to some other bigger emotion or bigger experience or you know to to know that you were you with me, allowed me to go further with something. And that feels something that's really important.
00:33:02
Speaker
Yeah, because it's kind of like a corrective experience or, you know, in terms of that attachment idea, it's like perhaps someone is feeling vulnerable or scared, and yet they're having this new experience of two, in our case, in the clinical trial, two people really being in their corner, supporting them.
00:33:28
Speaker
and providing them with whatever they feel they need in order to work through what's happening and going on for them. yeah So it can be really powerful at times.
00:33:42
Speaker
Yes, ah yeah it certainly can. Done well at times. Yes, absolutely. I agree. ah you know I think yeah attachment um might just take a moment to just explain attachment theory, but most people listening will probably know what that is. But maybe if they don't, it's just it's a a theory that talks about the importance of the caregiver-child relationship and that having a secure attachment where your parent or whoever the caregiver is is able to respond most of the time in an attuned fashion to your needs and to be present for your emotions as a child as a baby.
00:34:25
Speaker
It means that you will developer can develop a secure attachment and that that helps you to feel able to be safe with other people in your future relationships. And so the idea being that those early childhood experiences of relationships are then kind of patterned for how you are in your relationships in your adult life. Do you want to add a anything to that, Mark? I think that was a good explanation. I think there's probably more though.
00:34:52
Speaker
Yeah, there he is. But it's kind of like, I think the good part of non-verbal support is this is where it's not very complex, I think, in our work, in that if you're kind of connected to yourself and in your body and grounded, then you get the feeling as to whether or not if you reach out a hand or if you make your tone a bit louder or softer or if you smile or don't sort of focus right directly at the person, you get a feeling as to what's going to make them
00:35:30
Speaker
comfortable in that moment. and so In some ways, attachment theory is really about the idea that for all of us, we can be good enough parents or good enough therapists or good enough people in the world and we're not going to get it right all the time. But as long as there's this real attempt to try and understand and be respectful of someone's boundaries and what's right for them,
00:36:00
Speaker
but allow them the opportunity to try things new that they haven't done before or to let you kind of maybe hold their hand when that feels risky in a dose day, then they can learn a lot about, okay, this was not, that was good. That didn't feel as scary as I thought that might.
00:36:20
Speaker
Yeah, absolutely. And I really liked what you said before about it being such a corrective experience. And that, you know, so often, as I said earlier, you know, some of part of the trauma is being a left alone with our pain. And that's so often, you know, and that not everyone that we work with, but lots of people that we work with, maybe they grew up in an environment where full whatever reason they weren't able to get their emotional needs met by their parents or caregivers in the way that they needed. And so that it can feel like the idea of being the corrective experience is it is okay to reach out for support.
00:37:04
Speaker
it you know It is okay to say, hey, I'd really love it if you could come over here you in a nonverbal way, usually in a dose day with it. Usually it's like a hand signal of some sort and to lean into that and it's okay. And we're here for that. We can be that for you in this space. Whilst you're meeting with sometimes really younger parts of themselves can come up, can't they in dosing or difficult emotions or all the other things that can happen that can get intense.
00:37:31
Speaker
knowing that one of us will be alongside them with that. Yeah, absolutely. And it makes the whatever is happening less overwhelming. And so trauma-reducing kind of thing, and yes, corrective, and then creates confidence that whatever's happening in their body and their feelings and their mind is bearable and can be felt and understood and organized in a way that they kind of go, okay, it's not that bad. i can yes I can have a really big cry about something terrible that happened, but I'm okay after that. I actually feel relief. I actually feel better from being able to maybe sit up and get very sad
00:38:29
Speaker
but know that there's someone there right close to me who, if I choose, I can hold their hand or I can have some other way of being confident and then to realize, okay, I did that and it wasn't the end of the world and it did sort of work through. The experience changed and shifted because I wasn't alone with that pain.
00:38:52
Speaker
Yeah. Yeah. And and also that it they came out the other side of it, and but also that other people could bear it with them. Yeah. So
Cultural Norms and Emotional Expression
00:39:04
Speaker
true. Because that comes up so often for people. That we're all right. You know, we're there with them. That we can bear it with them. Because so often people get really They get messages from the world around them that certain emotions are not okay, especially not in public and especially not yeah in front of other people. but I was like that. I couldn't cry in front of people for years. I've got it down now after some therapy of my own, but it took me a long time to be able to cry outside of very, very close people. I used to cry on my own really easily. you know And then so much so many people like that in the world for really good reasons.
00:39:44
Speaker
And so just showing them that that humans can get messy. Being human emotions can get messy and that's all right. And we're all right with that. It's a really important corrective experience. And and because I think that's one of the reasons that you know being able to put a hand on someone's shoulder, for example, is important to me because it shows that they might be kind of quite internally focused and not be able to see or hear us really, but they can feel us there.
00:40:10
Speaker
hundred percent As you were talking, I was just thinking about navigating with someone on dose day just to go um hop up and go to the bathroom and then being in a very sort of deep state prior to that and being someone that wasn't very comfortable at all with the physical side. And so there hadn't been any actual sort of touch as such.
00:40:37
Speaker
But what was beautiful on the way never getting to the bathroom was she asking to sort of loop her arm through me, like her choice and also her holding me. So then she could choose to let go at any point, but didn't. And that sense of solidity of someone's there and they're going to catch me if I you know, tripped a little bit or not that that even remotely happened, but you know, but kind of that metaphorical thing of catch me if I stumble or fall, you know, but I choose and it's safe enough to ask and there's nothing wrong with asking and they're okay with it. They're okay with all this. They're okay with all of me. Yeah.
00:41:24
Speaker
Yeah. I love that. What you just said, they're okay with all of me. I feel like that's so much of our work as psychedelic assisted therapists is you know is kind of giving people that message and there's a lot to what we do, but that is one of the key things. They're okay with all of me. I can show people all of me and there they're going to be here and they're okay with it.
00:41:49
Speaker
That's where I think being able to be really authentic. I know that word's bandied around a lot now, but the more you can be yourself and sit in your own humanity and have a sense of just as as it could be me on that couch with those headphones and eyeshades on as it is you. And it's all human emotion and human experience and responses to that.
00:42:18
Speaker
I think our participants have a sense that if we can hold that humility, then any non-verbal support that we offer comes from that place of, you know we're in this together yeah and I'm just a human here trying to support you as a human, do what you need to do.
00:42:39
Speaker
yeah Yeah, absolutely. ah Yeah, maybe we should talk a little bit about the things that can feel a little tricky about this or that people listening therapists might have concerns about about it. I don't know where you if you would like to start or I can start but I think that's an important thing because I think you know, I've named that before but for some people this can feel tricky. Yeah, can feel really edgy, I think.
00:43:05
Speaker
What were you thinking of in particular? Because I'm not sure. Yeah, what but sort of stuff? Yeah, I think so, you know, if you're a therapist listening to this who's a somatically trained therapist, it probably does it like it. For me, it it never when I learned that in this work, we might be in on it working with people using putting a hand on the shoulder or holding their hand if they needed us. I actually didn't find it confronting because i you know in somatic therapy we might use touch or pillows or other kinds of ways to support people. yeah But I think in some trainings and some like psychiatry or psychology in the more mainstream, it's not something that
00:43:47
Speaker
is used as frequently or talked about as frequently. and So people can have all kinds of parts that come up. and i mean you know we can feel and ah There's some really good reasons why it can feel sticky. I think you know it's important to say that you know in in this work in psychedelic assisted therapy, there has been times where touch has been used in a way that's harmful both in the underground and in other settings as well. And so we do need to have a really clear consent process. We do need to be really sure about how we're doing it.
00:44:21
Speaker
And I'm sure that this is a thing that's going to evolve over time. I don't claim to have with this podcast, I don't claim to have all the answers at all for this work. But I feel like, you know, I think if you have a really clear and proper consent process and you're really ah really good supervision, you know yourself really well as a therapist and that you get support with that, then I think you can use this in a way that's really effective and can be really supportive for all the reasons that we just talked about.
00:44:50
Speaker
Yeah, but you're right. There are risks and it would feel, you know, maybe in some trainings that's actually really considered wrong to do any of this non-verbal support. And some of the key things I think is it's, there's so much vulnerability in our clients and this, no matter how hard we try, there's sort of a power differential because they're coming to us for help. So those power dynamics, when someone's vulnerable, could potentially be amplified with this non-verbal support, or there could be a misinterpretation of intentions. And at times, you know maybe that has happened, as we know, in where people have taken liberties.
00:45:45
Speaker
and so that sense of, so let's just not have any risk of any sort of boundary violations between client and therapist. So let's just not do anything that could be considered edgy or blur those boundaries.
00:46:04
Speaker
and because it could be misinterpreted or misunderstood. So it is understandable that depending on your training and background, that you'd want to be really cautious and clear and communicate very respectfully about what you are and aren't doing and why and how come and that the person you're doing it with has a lot of say and choice in what's happening.
00:46:31
Speaker
Yeah, absolutely. And I think, you know, understanding yourself and your own boundaries, if you're a therapist listening to this and thinking, you know, it because clients can tell if if you're doing something that doesn't feel quite right for you too. So yeah kind of working, ah only going using any kind of nonverbal grounding approaches in a way that feels okay for you is super important. yeah and And checking in with yourself around what parts of you come up around this and and does it feel okay or not. Yeah. Because there are other options, you know, like I said, around using pebbles or cushions or other ways that don't involve touch that you can let someone know you're there and you're with them. Yeah. Have you had a time where you felt like not not a big thing, but you know, where you kind of came out of a session and thought, we shouldn't have done that, you know? Yeah. Because I'm thinking of one I can share. I did it this week.
00:47:26
Speaker
Yeah. Well, why don't you start with that for a moment and then I'll, I've got a few. Yeah. Yeah. I've got lots. So, you know, being a flawed human therapist, these things happen and to me, it's actually about rupture and repair. But, you know, with one particular participant that was extraordinarily distressed, understandably, because of some deep traumatic experience that they'd had. And this person actually sat up and was grief-stricken. And we had agreed that it was okay for me to initiate touch, which is I went over to her and I i did that.
00:48:12
Speaker
but I felt so moved and upset for her in her grief, even though I was trying to encourage her to, let's let go. This is great. You're doing a great job. That I went from there and then I just put my hand gently on her back. And then I thought that doesn't feel right. And I took it off and we just agreed this and I stayed there for a little while and then I disengaged and and just I knew I could just feel that wasn't right and that it was more me going, I'm with you. I want you to know that I'm here. You're doing a great job. But she didn't need that in that moment. She was full on into her grief and she just needed me to be close by and this felt OK. I could feel she was like leaning into that and that was OK. But just a gentle touch on the back. That was too much.
00:49:09
Speaker
So when I walked out, it was more the question of how come you did that, Marg? And learning from it and going, it's because you were upset for her rather than yeah letting her do what she needed to do so beautifully that she was doing. Yes.
00:49:27
Speaker
And you know some people will be watching this, some people will be listening. And so for the people listening, you ah the first thing that you'd agreed, it sounds like, is to have a hand on the shoulder. And that was one of the things. yeah and And you did that, and that felt OK. And you I really liked how you described how you checked if it was OK, because it felt OK because she relaxed, yes because she she was open, and she wasn't tensing.
00:49:49
Speaker
No. And then something, you put the hand on her back just for a moment and that didn't feel so good and you took it away. And I think, you know, that is such an important thing. And and so of course, as therapists sometimes, actually in this work, I feel very often that I'm very moved by what's in front of me. Yeah. I cried and got tearful in sessions. Yep.
00:50:11
Speaker
you know, reasonably frequently, and that's okay. And I, you know, I think you'd have to be, I'd be kind of concerned if I wasn't getting tearful sometimes in the work that I do. In kind of any of my therapy, really, I think sometimes people share something and that really moves you know, been a, I've been a grief, a grief counselor a lot in my career and I guess that taught me that it is just really human if someone's in a big grief to feel like your client was, to feel that with them. And I think that's a normal and healthy experience to have. But I think there's been quite a few times I've had, maybe I'll share something slightly different.
00:50:53
Speaker
Where I was working with a client who, you know and this is a topic we haven't really dived into too much, but is a big topic is helping people to get clear with their requests around what they want in in the therapy in general. you know ah that question that happens so often at the end of the session, how was this for you can feel quite like that's often something that that I'll ask at the end of a session and clients but might find it really hard to to say if something hasn't felt right. And some people don't, some people ah really find it easy.
00:51:28
Speaker
And that's the same, I think, in terms of asking for support in a dosing. Some people, it's really easy and they're clear. For some people, for all sorts of reasons, it can feel difficult for them to even ask or not be unclear. And I had one client who, participant who, I was tracking his body and he was lying there and I thought that he'd requested that I came over because we'd agreed a beckoning hand signal and i was like Oh, I don't know. It might just have been a stretch. And and and the tension is often is is often that you don't want to pull someone out of a big experience that they're having, but you also don't want to leave them alone. yes So i I kind of sat with it and I checked in with my co-therapist and we were like, oh, I don't know. Maybe it wasn't.
00:52:16
Speaker
And so I didn't go over because I was erring on the side of caution to leave him as as he was, not wanting to interrupt. And then when we debriefed afterwards in the integration sessions, he had had actually that was him asking, but it was such a small movement that I hadn't realized. And I'd left him alone when he was asking for help. And that but was felt tricky.
00:52:42
Speaker
Yeah, the good thing about these examples though is the kind of rupture repair that you learn as a therapist in the sense of, as you say, in integration. I bet you there was some beautiful work that came about in him being able to be brave enough to say, well actually I really didn't want you to come over in that moment or you being able to kind of go, I'm so sorry, I misunderstood the signal. and you know, that that sense of creating deeper connection and intimacy and safety by, oh, we kind of missed each other. We had a clunky moment, but best intentions and we can get it better and right next time. And it was the same with my participant in the checking in in integration. Sometimes these medicines are very forgiving because I checked in about that particular
00:53:36
Speaker
time and she was absolutely fine and said, no, no, I, it was fine. I was so in my own place that I kind of vaguely registered that you were there and that was kind of nice, but that was the extent of it. So, you know, you can overthink these things and Yes, absolutely absolutely. And that's why kind of talking about it with a ah your co-therapist or your supervisor is so important as well. It's really important to reflect. but yeah And that rupture and repair piece happens, of course, in all therapy. and yeah We are human. I i was in a don't know if you were there, Mark, but I was in a seminar.
00:54:17
Speaker
when was it last weekend, talking about this exact thing as part of some training that we're doing for MDMA assisted psychotherapy with maps yeah that we're involved in. And we were talking about like getting it wrong, just generally, and how I should hope we all have lots of examples of that, because, you know, we're human, and I'm not a perfect person, and I'm certainly not a perfect therapist, and I don't try to be. And and it's not when we talk about being the good enough parent right you don't have to be the perfect parent you just have to the the research shows doesn't it that that if you make a mistake or you do something that is upsetting for your child like you lose your temper for example which i think most parents have done at some point
00:55:02
Speaker
that if you go back and make a repair with your child, that is the thing that's healing. And that can really allow the child to kind of feel safe. It's the same in the therapy experience. And I think there's so much good work can come from those moments, if you name them and talk about it. Yeah.
00:55:19
Speaker
And it's very empowering for your client to be able to say, hey, you got it wrong or no, I was fine. Or can you do more of this or I want you to hold my hand more or for longer next time or no, no, no, I'm all good now and I don't need next dosing. I feel like I'm going to be great. Now I know what I'm in for. I understand what goes on.
00:55:45
Speaker
Yeah, absolutely. I can remember a participant that kind of brought in objects and we also had pebbles, didn't we, that we were able to give people. And I can remember giving this this person, they they were kind of lying there, they had all these these pebbles and they were holding them and that was a really nice thing. And then partway through the dosing session, they just kind of left them and let them all go and they were wouldn't have even known they were there, you know? And it's like sometimes what you need at the beginning of a session is not what you need in the middle of it as well. Exactly. Yeah. And you know, one thing we haven't spoken about around this work in those days, yeah for me personally, in my self-experience when
Dr. Esme Ta's Personal Journey with Psychedelic Therapy
00:56:29
Speaker
we sat with
00:56:31
Speaker
the medicine ourselves as part of our training in psilocybin assisted therapy. I reached out for my co-therapist's hand because I felt like I just needed a tether. Part of me still needed to be in this moment. I wasn't distressed, but I could have got quite anxious, I think, because it was a very strong experience. And so just knowing that someone was there,
00:56:54
Speaker
just helped me to go further into what was going on. And so that's a kind of personal part of experience for me. I love that you've said that because it's so true. That experience that we had of learning how the medicine was and in the setting that we were going to be taking people through for the psilocybin, for the generalized anxiety trial was quite profound. And I can remember having similar experiences where um sitting up and feeling quite a lot of grief. And my therapist being able to who I luckily I, you know, really did have quite a
00:57:38
Speaker
solid relationship with and had known for quite a while, but was able to almost like support, sit behind me while I sat up and put a very solid hand, which had been agreed, you know, on my back. And that actually was so supportive to stay with the grief that was coming yeah and to go deeper into it, but also just to let it move through your body and your heart and your mind and very healing and relieving and supportive.
00:58:12
Speaker
Yeah. Yeah. Thank you for sharing that, Marg. And, you know, I think, you know, I very recently had someone say to me that you putting your hand on my shoulder allowed me to cry more deeply than I've ever cried before. Yeah. I've never managed to get to that. She's kind of similar to what you're saying. And I thought, yeah, it is important, you know, to find ways to do this in a way that feels safe and okay, yeah I think in this work. I think we would lose a lot otherwise. Yeah. Yeah, we sure would. We're so privileged, aren't we? We're so lucky to have these beautiful clients and participants that are willing to kind of be courageous and allow themselves to go to these places inside themselves and with us there
00:59:07
Speaker
and allow us to sort of get to know them and see them from the inside out and go through something really amazing and special with them. Yeah, absolutely. And it's so humbling. And so moving, you know, I think, you know, I have probably talked about this before, just how incredibly moving this work can be. And so as a witness, as a therapist, watching someone go there and and being willing to go there, you know, yeah, I feel like that all the time.
00:59:43
Speaker
Yeah. And the thing I learned in my training and which I see more and more now is it's very hard to take someone to a place where you haven't been yourself. And so as a therapist, the more you've done your own work in all these areas, therapeutically or you know with good supervision and got the right training and But also go on to these places in yourself that are scary to go to, perhaps the grief, you know, the feelings of being alone with overwhelming feelings. The more when someone else trusts you enough with going to those places themselves, you really can understand and be with them and hold them through that because
01:00:33
Speaker
you've been there yourself. Yeah, exactly. And you know, we're kind of probably coming to the end and you're kind of answered with one of my final questions that I always like to kind of ask or that we could both share and I suppose is What advice do you have for anyone who's interested in psychedelic-assisted psychotherapy? And it's funny because you've kind of started to answer it, I think. Yeah. Right? Do your own work. It's so important. Get to know yourself and theyre really in a deeper way than, you know, as as deep away as you can. I think it's really important. Yeah.
01:01:14
Speaker
and If you are in a situation where you want to learn about non-verbal support, then yeah, one of the best ways of learning is to be the client.
01:01:28
Speaker
a Yeah, absolutely. And we were really lucky that we were able to do that with really lucky the trial that we worked on. But there's also other ways, you know, in our other parts of our training, we did a music journey, didn't we, that kind of simulated a psychedelic journey so that we had the music on and the eyeshades and practiced in that way, which can be a really powerful way because not everybody at this time has access to it's like the excessive therapy is part of their training but maybe they will one day. That's true they don't but even they're doing their own work as you say that might be going to see someone who is a more embodied therapist that can help them learn more about how they find their own felt sense and track and grounding their own body and
01:02:17
Speaker
use that as part of their work. And so it doesn't even necessarily need to be with altered states of consciousness to develop those skills. i think which So I think that's accessible to everyone at the moment, which is yeah which is really good.
01:02:33
Speaker
Yeah, absolutely. And I'll include some links in the show notes to some of the somatic therapy sort of schools that we've mentioned. And it's really sad that yours is not available anymore. Yes. But I can put links to some of the other big ones out there, including sensory motor psychotherapy. Yes. Yeah. That'd be great. Is there anything else you want to add, Mark, before we wrap up?
01:02:58
Speaker
I think it's a really complex topic and I think for helping therapists and other people out there have an understanding of some of the reasons why or why not, we'd use non-verbal support. Hopefully we've given them a little bit of an insight into what's important there and also that it's okay not to do it at all and to be respectful and manage you know what you're comfortable doing in a room with a client or a participant. so
01:03:33
Speaker
It's not for everybody. And i guess this help I hope that this has helped everybody understand just a little bit more about what's involved in it. Yeah. Yeah. Brilliant. Thanks, Mark. Absolutely. And you know I think, as I said, for me, the key is finding a way to let the client know that you're there with them or the participant know that you're there with them. And and it's really important to do that within the boundaries of what feels comfortable to you as a practitioner.
01:04:03
Speaker
and There's so much more that we could say on this topic and and we're never going to get into the every single nuance in ah in a short in a podcast. yeah and you know It is a very complex area and I think one that we will continue to learn about and grow with as this work kind of moves more into the mainstream here in Australia. I look forward to that and I'm sure there'll be people, I'm sure you and I will talk about this more as well. so Thank you so much, Marg. Thanks. It's me. It's lovely to spend the time with you. Thanks for listening. If you're interested in following along on the journey with me, check out my Instagram or website details listed in the show notes. And if you enjoyed this episode, please leave a review and share this podcast to help get this important conversation out to more listeners.