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Dr David Spektor: Dyad work and the importance of vulnerability
293 Plays5 months ago
In this episode, I talk with Dr David Spektor , who worked alongside me as my dyad partner on a two year clinical trial looking at Psilocybin assisted Psychotherapy to treat generalised anxiety disorder.
We discuss the challenges with the medical model of human distress, psychedelic research, the importance of the dyad model in psychedelic assisted therapy, the self experience study we were lucky enough to be a part of and the importance of vulnerability in therapy.
David is a Senior Clinical Psychologist having worked in the UK, New Zealand and Australia. He has 20 years of experience working in mental health as a clinical psychologist and much of that was spent in the public sector working with severe and enduring mental health issues. He currently runs a private practice based in Melbourne(www.psychologycare.com.au). He worked as a senior lecturer at the University of Melbourne as a part of the Clinical Psychology Program. He is trained in a type of emotion-focused and psychodynamic psychotherapy known as Intensive Short Term Dynamic Psychotherapy (ISTDP). Nowadays David works in psychedelic psychotherapy research through the Monash University Clinical Psychedelic Research Lab in Melbourne, Australia. He worked as a core therapist on the psilocybin-assisted psychotherapy for generalized anxiety disorder trial and currently works as a supervisor for the MDMA-assisted Psychotherapy for PTSD trial.
keep in touch with me at Insta: dresmedark
Linkedin: www.linkedin.com/in/dr-esme-dark-627156a0/
website: https://www.esmedarkpsychology.com.au/
Find David’s practice at: https://psychologycare.com.au/
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
Podcast Introduction: '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.
Acknowledgement of Traditional Custodians
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.
Introduction of Dr. David Spector and Psilocybin Trial
00:01:03
Speaker
I am very excited to introduce you to our next guest, Dr. David Spector. David is a dear friend of mine and a close colleague. As you'll find out from listening to this episode, we worked as dyad partners on the trial at Monash University, looking at psilocybin-assisted psychotherapy.
00:01:24
Speaker
to treat generalized anxiety disorder, which meant that we worked together two days a week with participants for about two years, taking them all the way through the psychotherapy journey as part of the trial, working as co-therapists in a pair, both in the psychotherapy sessions and in the dosing. And we really both feel really strongly that the DIAD model of working in psychedelic-assisted psychotherapy is a real key part of the process.
00:01:51
Speaker
And so we'll share a little bit about that today and about our relationship and working what it was like working together so closely for that length of time. David is a senior clinical psychologist and has worked in the UK, New Zealand and Australia. He has 20 years of experience working in mental health as a clinical psychologist and much of that was spent in the public sector working with severe and enduring mental health issues.
00:02:15
Speaker
He currently runs a private practice based in Melbourne, Australia. He we've worked for many years as a senior lecturer at the University of Melbourne on their clinical psychology program. As well as being a clinical psychologist, he has spent more than 10 years training in a type of emotion focused psychodynamic psychotherapy known as intensive short term dynamic psychotherapy or ISTDP. He'll talk a little bit about that in this episode and and in a future episode as well.
00:02:45
Speaker
Nowadays, David works with me in psychedelic psychotherapy research at the Clinical Psychodelic Research Lab at Monash University. He worked on the trial with me so with psilocybin-assisted psychotherapy for anxiety disorder and is currently a lead supervisor for their other trial, looking at MGMA-assisted psychotherapy to treat PTSD. I hope you find this conversation as fascinating and as I did.
Dyad Partners in Psychedelic Therapy
00:03:15
Speaker
So let's get into it. Hi, David. Hello. It's really great to have you here on the podcast today. Thank you so much for taking the time out of your day to be here with me. I'm used to spending all of Tuesdays with you. I know. This is our day. So this is a pleasure because I haven't got to spend Tuesdays with you for some weeks since we finished the trial.
00:03:42
Speaker
Yeah, that's right. And so, you know, when I was thinking about starting this podcast and really wanting to create a space where we could kind of talk about the psychotherapy part of psychedelic assisted therapy, in you know, obviously moving towards clinical use here in Australia, and it feels really important to be having more conversations about the therapy side.
00:04:06
Speaker
of success. And when I was thinking about that, of course, the person who I most wanted to have some of those conversations with was you because you and I have been so incredibly, incredibly involved in each other's journeys in work as diad partners, which we'll explain a bit more about in a minute. And so it feels like a really great place to start this conversation. Well, I'm very touched by that. But yes, I suppose you're the person that I've worked with the most um in the psychedelic space, but also psychotherapeutically. and i used I'm used to working individually. I'm not used to, until I started doing psychedelic assisted psychotherapy, I wasn't used to working with another. So actually, not only are you the person I've done the most psychedelic work with, but you're also the person I've done the most psychotherapy alongside as well.
Personal Connection and Shared Values
00:05:00
Speaker
so Yeah, so maybe we'll just outline a little bit about how we know each other. And like, for people listening kind of, so obviously, you and I met at the start of our work together, particularly my work together, on the the trial at Monash looking at psilocybin-assisted psychotherapy to treat anxiety and less anxiety disorder and And on that trial, people work as a dyad and in a lot of psychedelic-assisted psychotherapy, that's a standard practice where you work in a pair and there's really good reasons for that, which we will probably get into some of today, I guess. um And so we worked together as a pair, didn't we, for the whole three months or more treatment arc. Sometimes it was six months with
00:05:51
Speaker
particular pattern, doing kind of psychotherapy sessions together. i'm and so we and then And then also the dosing sessions, integration sessions. and um And so we've worked together a lot in that space. I kind of counted it up as me. I think we've done over 200 integrations and preps and we've done well over 50 plus doses together.
00:06:21
Speaker
So it's actually a lot of time spent together and with our participants. Yeah, absolutely. Well, that is a lot. Thank you for counting those up. And I'd to take it back a step, actually, and kind of talk a bit about how we first met. When we were first kind of, you know, we obviously started work, I started work on the trial, I joined a little bit later than others. And in our one of our like colleagues who was organizing who would work with who who kind of put us together, we'd never met. up but we had not And so you were, I remember actually you being very keen and forthcoming with wanting to meet up and get to know me. And that was a really lovely experience for me to ah kind of really
00:07:13
Speaker
feel that desire for connection from you from the beginning, so as to get to know each other. o And then we met up. And I just, I don't know, like, maybe you can start with your memories of that process, because I have memories like, what was your take on like our initial meeting? Well, I mean, to set it up as well, I had been involved in getting ready to become a psychedelic assisted psychotherapist for a couple, almost a year before We started, I was originally trained to do MDMA for PTSD via maps. And then that trial was supposed to start first, but actually, ah relatively with short notice, we were thrown into training to psilocybin-assisted psychotherapy for generalized anxiety disorder. And unfortunately, you weren't part of that training, and I was originally paired with somebody else. And so you do quite a lot of work to get to know that are the other person you're paired with. And unfortunately, my original pairing had to exit.
00:08:11
Speaker
and um I was paired with you who who wasn't on the urgent training. You had your own training and then we met up and I really wanted to establish that relationship. The the trial was starting pretty quickly. So we had a lot of ground to come. And I remember um meeting you at a cafe in North good. I think it was yeah having no idea. I didn't even know what you looked like. So I had no idea what I was, who I was going to be out, how it was going to go down. I was also super anxious. You know, I have this thing.
00:08:42
Speaker
where I you know i think like most professionals do want to give a good impression. And so i wanted and also I wanted to ah prove to you that I'm a worthy diet partner to you. And so I remember like realizing that as we were talking when we met for the first time, one, how much we had in common in the sense that we were both trained.
00:09:07
Speaker
in the UK were both clinical psychologists, were both disillusioned and also were taught by people who were generally disillusioned by clinical psychology and psychiatry in the UK. And that we both had trained in other models post-qualifying that were much more within the traditions of psychodynamical, psychoanalytic or um psychotherapeutic trainings or models.
00:09:36
Speaker
So I remember for me, and I don't think this was the case for you, but for me, I found myself like trying to prove that I was good enough to be your partner, you know, who's talked about my own insecurity and really trying to lay out this is what I've done. This is where I've come from. This is how a accomplished I am. And, um you know, so look back at that quite embarrassed, but also just that's very human.
00:09:59
Speaker
You know, like, I'm just trying to give a good impression and um and tell you who I am and what I've done and try and get you to be impressed with me so that you um feel that I'm your worthy, dire partner. How was it for you? so So it was funny because actually I was more, and this speaks to me as well, I was more interested in how I was coming across than how you were coming across in that moment, which was the wrong way for it to be. But I just talked about that anxious first meeting with your diad partner yeah um and all the kind of human things that happen in that moment. Totally, I think. You know, you didn't seem nervous to me at all. You seemed very confident and I was like, oh, this is a very experienced professional. And i I went along to that meeting kind of just really excited to kind of step into this space that I would have been
00:10:54
Speaker
you know really looking forward to working in and but also I was a little bit nervous I thought I'm a little bit of an unusual in inverted commas clinical psychologist in my work and think and you know both of us as you spoke to much were trained by two people who so you were trained with Mary Boyle as one of your teachers one of my teachers woman called Lucy Johnson. And actually they collaborated and wrote something called the power threat meaning framework together. yeah So they went on the same course in the UK. We were very similarly trained. And as soon as I found that out, I felt so much more relaxed.
00:11:36
Speaker
Because I've had other situations where, you know, I've kind of felt like I come from a little bit of a different frame than other people in person. So as soon as I, I just felt like, you know, I were quite kindred spirits in the way that we think and our values set. Particularly in that we kind of center this kind of idea of it's not about
Therapeutic Benefits and Philosophical Underpinnings
00:11:58
Speaker
these labels and diagnostic frameworks, it's much more about the trauma informed approach to understanding someone's distress. And you talk about like, you know, you have great ways of talking about that. Do you want to say about how you Yeah, I mean, yeah, so that you know, I think we both agree that we don't believe in the medicalization of misery.
00:12:21
Speaker
yeah And unfortunately, we see in our society how often what's seen as disordered is the person rather than what happened to them.
00:12:33
Speaker
And I think we can all agree that from the majority of people that we see in our clinical practice or most of the people that have mental health issues, um if you look into their history, it's very clear that many disordered things happen to them. yeah And the fact that they then are given a disorder and they are told they are disordered is actually a failure of our humanity and a failure of the way in which we understand each other and can therefore have empathy for each other.
00:13:02
Speaker
Yeah, you know, I think, and that, and you know, that brings us right to the foundations of why psychedelic sister psychotherapy is important. Because perhaps it will give us a different way of looking at mental health. Yeah. So yeah, so I think we're both brought up in that tradition, whereas we see people, I think you said this before, and maybe you should say what Lucy Johnston often talks about, people Yeah, I think, you know, I really like how she talks about it's not about what's wrong with you. It's about what has happened to you. And that her and Mary Boyle, you know, created the power threat meaning framework, which is really a trauma-informed approach to collaborative um creation of an understanding of someone's distress that you create with them. So it's not about putting something a label on a person.
00:13:55
Speaker
as opposed to working together with them to co-create an understanding of where that distress comes from, a holistic approach that's based on them and their experiences of trauma in their language, like power and how power operates in in this person's life. And then the threat part is, is how they've responded to that power balance.
00:14:17
Speaker
um And then what meaning they make of it. And I think that's really useful. And the reason why I think it's important for us to talk about this at the beginning of this podcast is because when we're thinking about how psychodelic-assisted psychotherapy works, I think one of the things that drew me to it and that I think can be really helpful is that it really does get to the core of that distress for a lot of people. And yeah, I don't know if you want to add anything to that.
00:14:45
Speaker
Yeah, look, I mean, my foundational belief in psychotherapy and psychology and mental health is understanding that what was damaged in relationship must be healed in relationship.
World-First Study: Therapists' Psilocybin Experience
00:15:00
Speaker
And often when we're working with people who suffer, and I use often the term suffer instead of mental health issues, just so we can clearly say what it is, yeah that when people are in suffering, they're often in suffering because They suffered from some kind of trauma, neglect or abuse or loss in their early years. And so then they had to cover up aspects of themselves which could be hurt. And as a consequence of that, they were damaged in relationship. And you know one of my greatest teachers said about psychotherapy that our job is to make what went wrong go right.
00:15:39
Speaker
yeah And there's nothing more powerful than that, than the relationship you have with your participant client. And there's nothing more powerful than the psychedelic-assisted psychotherapy model to to accomplish that, if done right. Exactly. Within the diet context, yeah. Yeah, that's that's part of why we're here today, talking about our diet experience and all and the the importance of the diet and the psychotherapy aspect of this work, I think.
00:16:09
Speaker
And you know, so our first meeting for me, you know, take it back to that for a moment, I just felt quite relieved. yeah I felt relieved that I was going to be working with someone that would understand me. And what are the chances for that too? that That's a pretty unusual thing to have. We both live in Australia now. So my course has long gone shut down. um So there's not many other, I think we were the last cohort through. So yeah, it feels,
00:16:37
Speaker
it felt really good. And I i felt really connected to you straight away, which was important because the next thing that happened is we were really fortunate im on as part of the Monash trial that they have. So, you know, we took 72 participants in total as a therapy team. We took through the process of the psilocybin-assisted psychotherapy for anxiety disorder and that was the whole trial but as well as that and kind of before that and a little bit overlapping with that we also were able to take part in a self-experience study weren't we? Yes we were. yeah
00:17:20
Speaker
And for people listening that involved um us having kind of a shortened version of the psychedelic and psychotherapy process. um And it was another research kind of trial, another trial as part of the research process. And we were able to have a one preparation session, which we'll explain more about in a moment. A dosing with psilocybin accompanied by two therapists in a diet.
00:17:46
Speaker
yeah And then an integration session afterwards. a And so you and I sat for each other and were each other's therapists. And I think today would be really helpful to so talk a bit about that and the importance of that and how that was helpful and how that was maybe challenging in different ways yeah and and why it was an in important part of this process. Yeah. I mean, it was a world first study, right? um We were the first people in the world.
00:18:22
Speaker
to give an opportunity to therapists who are going to engage in psychedelic-assisted psychotherapy to have the treatment themselves first, which is rather remarkable. and you know The idea of giving therapy to the person you are doing therapy with as a diet partner is incredibly unique, challenging and kind of um cutting edge and risky. you know I can't imagine being in clinical psychology training and even talking about the possibility that this would be happening one day. you know The ethics around this would be very have to have to be and were very carefully thought of. But there is something right about, well, we're offering a treatment to someone
00:19:10
Speaker
that is so, and they call it ineffable, and so hard to describe, how can we honestly sit with people with confidence and tell them about the experience if we haven't had the experience ourselves? And not only have the experience, but know what it's like to be vulnerable in front of each other. yeah And so there was this amazing moment in each of other people that we took through where we could say, and I sat fair as me,
00:19:40
Speaker
Yeah. And Esme sat for me and we sat in your chair and we lied where you're going to lie and we took the medicine you're going to take and Esme held my hand and watched me cry for eight hours. Yeah. And I was there for Esme through her process too. Yeah. And they instantly, there's a connection between you and the participant, us as a diet towards a participant. And there's also, and more importantly, this just as importantly, there's a connection between me and you. Yeah. yeah You know, it's a once in a lifetime experience. And I took you through it with the help of somebody else. And you took me through it with the help of somebody else. And that, you know, what a gift. Absolutely. What a gift. And I think, you know, I think that every single participant that we've had has led to us. It's been so, so helpful.
00:20:31
Speaker
to know that you have been where we are going to be. Because one way, you know, one of my teachers who in the world of psychotherapy ah said to me, we should never ask our clients to do anything that we wouldn't do ourselves that we haven't tried ourselves in terms of therapeutic interventions. We our own therapy during our training. And we also, in the somatic psychotherapy training that I did, we We kind of did take each other through some processes, um but you're still kind of asked to work with just the thing that feels okay enough, you know, in those sessions. But there's something really powerful and important about that. If we're asking people to step into the unknown of the psychedelic experience, what a powerful thing to be able to say that we've done that in the same way that they're doing it with two people supporting us.
00:21:27
Speaker
which had its own edges and challenges, I think, as well, right? Yeah, I mean, you know, we had to be vulnerable. Yeah. And how was it for you, I think, be nice to us each to share a little bit about that. because it was For both of us. yeah We had the ah the honor to go first. So you were the first person to take this I've been on the trial, I was the first therapist with another person.
00:21:56
Speaker
to hold space for you. That's right. And we had just met. i Really, I think yeah yeah it was only a couple of weeks later, there wasn't much chance for us to have many meetings. And but you know, our first meeting went well. And then I think we followed it up with a few phone calls. And and then suddenly there was there I was in a therapy room.
00:22:20
Speaker
with you and ah and another one of the ancillary therapists. so Just to make it clear, there are six core therapists, so three diode teams, that did most of the therapy within the psilocybin-assisted psychotherapy for GAD trial, and then when it just wasn't possible within our schedules for one of the six,
00:22:40
Speaker
To do it, there would be other extra therapists who would come in. They also did the training, et cetera. And so what we had was you as one of the core therapists with an ancillary male therapist who then I was meeting on a afternoon the day before I think I was due to dose and we had a ah prep session. And I have the distinct honor and I do feel very honored to be the first person who legally was able to take psilocybin in Australia.
00:23:09
Speaker
yeah Because I don't think, as a therapist, I should say, because I don't think um ah that that had been done before. And you had the honour of being the first therapist to sit alongside a therapist who was legally able to say psedocybin So met with you and our wonderful therapeutic colleague Campbell and um Townsend, um who created the space for me and my decision, whilst these are colleagues, so these are so you know, the thing the weird thing here is these are colleagues, and they know you in a professional level, but they don't know you potentially as a human. And you just imagine in your workspace,
00:23:52
Speaker
that you are around all these people and they know you in a work capacity, but often you keep your vulnerability or your truth hidden under a mask. And you might even do that with your friends or family, ah but it will work, colleagues.
00:24:08
Speaker
who I'm about to spend the next two years with doing this study and one who I'm, which was you, who I'm going to sit next to every day on a Tuesday and Wednesday and either do a dosing or many preps and integrations. And I had to decide how was I going to approach this? Was I going to hold something back? Or can you when you're going to take psilocybin or am I just going to lay it all on the line? And my decision was I'm going to lay it all on the line. And I'm going to be as vulnerable as I possibly can be in order to also open the way for you to be vulnerable with me. no ah Because I knew in a couple of weeks after I did it, would it would be reversed and I'll be sitting with you. And so I remember going in there and just putting it all down yeah and telling you all of the things that had happened to me and led me to be where I am.
00:25:00
Speaker
And my intention was, if I remember correctly, was mainly how do I put down my walls against emotional closeness? So whilst I'm a therapist and I am very good at that, I still recognize there was something about me which was fearful to love deeply. And I mean really deeply because to love really deeply is to love without fear.
00:25:30
Speaker
And that means placing the people I love, ah the people's needs, who I love the most ahead of my anxiety. And um that's not an easy thing to do, right? no And so, like you know, and we went into it, and we did a prep, and you guys were fantastic. And I also was aware no one knew what the hell they were doing.
00:25:58
Speaker
yeah because I was basically the pack practice run. yeah yeah I remember coming in and everybody being excited because it was the first one. There was also, I think, a TV crew around because they were filming a documentary that weren't sure. They were going to show these bits. And um yeah and I remember setting up and getting in my pajamas and lying down on the couch and having the headphones on and eyeshades on and popping 25 milligrams of psilocybin, having never, by the way, done it.
00:26:28
Speaker
before in my life. I i never experienced drugs. i I wasn't somebody who was involved in that scene or had that desire before. um So it was really a step into the unknown. Yeah. And you know I remember, I feel so grateful to you for that the vulnerability of that sharing, because it absolutely allowed me to do the same in a few weeks time.
Vulnerability in Therapy for Therapists and Clients
00:26:58
Speaker
i And it is a tricky place. Working with your colleagues in this way, and people that you're going to be sitting with, and I think you know we were very careful with like thinking about kind of confidentiality and keeping things
00:27:18
Speaker
in the diet relationship and kind of kind trying to keep some separation between what we're doing and our work and our lives. But also the reason that it's so important that we do this or that that in in ah when we're working in a diet is because in psychedelic cystic psychotherapy, all of your stuff comes up.
00:27:39
Speaker
And when someone told me that transference and countertransference were on steroids in this work, I didn't really quite remember how much until I started doing it. i yeah And so, but we'll say more about that later, but it felt like such an honor for me to to hold space for you. And as you went through that process, and you know, I can just remember that kind of acts of just being with you while you has all the experiences come up and supporting you with the occasional hand holes. And it was a bit more like how long I held your hand for. Certainly for a while. Right. And, and kind of just witnessing you be really emotional and connect deep feelings. And yeah, I think it was it's been
00:28:29
Speaker
Being able to be vulnerable with each other is something that's always been important in our diode relationship and I think is important in general in the diode relationship because things are gonna come up during your time working together when you work with someone two days a week. But in the way that a lot of clients, your own stuff is gonna get triggered. And so for us to know a little or probably quite a lot about each other's piece has been really helpful.
00:28:57
Speaker
I think. Yeah, I got couldn't agree more. And what a but ah andly like I got to experience what it was like to be cared for by you yeah you know and be in the room as somebody who was a patient in that moment yeah to be cared for by you. And you're right in the sense that you know here is a man who is often in the role of giving care to others And often psychologists are, and that's their job. Or mental health professionals are, that's their job. And suddenly it's flipped. yeah And it's flipped with your colleagues who you know. And that's quite a jarring thing to just let yourself be cared for when you're used to caring for yeah so much of your day, so much of your week.
00:29:52
Speaker
And also, I'm a man who wants to but doesn't often cry. and i just wasn't its just something that it' I find it very difficult. I'm a man of a certain age. From a very, very young age, I was taught that that's something we don't do. And it's almost like I want to. There's nothing I have against crime. but is something that seems to be so hard for me to let go of. And this speaks to both of our understanding of mental health issues. you know We learned from a young age what is safe to do and what is not safe to do. yeah And what is accepted and what is not accepted, what is loved and what is not loved. And um and obviously, many men of a certain age learned that showing emotion is not accepted and you will not be loved as a consequence. In fact, you will
00:30:44
Speaker
and be rejected ah in some form for that. So here I am with this, wanting desperately to be able to do that. and And what does the psilocybin do? It breaks me open and I cry for eight hours. I still think I hold the record on that couch for crying the longest. And it was the most joyous, lovely, wonderful opening and yeah needed. And it wasn't too often a pain.
00:31:11
Speaker
It was often tears of joy and gratitude. and um that lot There was a lot of kind of comments around being grateful and connecting to love on a deeper level. yeah connected just ah just feelve I've never felt more grateful for being alive in my life and I've never felt more love in that day ever and and that carried on past that day too. But what was amazing was that, you know, if you were going to tell me six months ago, six months before that, I was going to cry for eight hours in front of my colleague. I i would have probably felt very ah uncomfortable or find it very
00:31:54
Speaker
um ah revealing. you know very yeah You'd feel rather rather naked, but you both handled it in such a beautiful, loving, compassionate way, and there's no doubt that it put our intimacy, i would relate our work intimacy ah into a place where we could break down our walls and become a very effective diet very quickly.
00:32:21
Speaker
Definitely. So there's so many ways I could take the next question. But I think I'd love to ask like, what you mentioned before around kind of that, your your intention, and then what has stayed with you from that experience in terms of that? Because, you know, it's been quite a long time now, right? Two years. Yeah, it's been about two years. Yeah. Yeah. It's really hard to to discern that because it really does become part of your life. What I learned very clearly was that the more grateful you are, the less desire you have, which is a you it sounds so obvious, but until you feel it,
00:33:04
Speaker
and experience it and see it and really it shows you what you have to be grateful for and you feel it. Every single little tiny bit of that you don't realize how important gratefulness is and it really made me realize that the more I'm aware of what I have the less I want or need. And and and no no doubt did it enhance my capacity to love, to show my love and to love openly and honestly the people who are ah closest to me. Yeah and I think you know for me also when I think about supporting you I learned a lot from that day in just how to be alongside and with something on those days you know you don't do a lot of psychotherapy interventions
00:33:59
Speaker
But you're doing a lot. You know, like you're doing a lot like I was kind of checking in and tracking your body, your emotions, watching if you're asking for support, if you seem that you needed anything, like water or some object to hold, or our hands to hold. And obviously we had pre agreed how we would support you is with touch. And perhaps we'll say a lot more about that in a different episode, because it's quite a big topic. But I think You know, you, I really reflect on kind of just the power of just being alongside with another person. so um and ah co-therapist And kind of that wire model and holding you as you go through big feelings and big emotions and big piece of processing felt really incredibly powerful. Yeah. Yeah.
00:34:52
Speaker
well, we need to talk about your experience as well, you know, like what it was like. Yeah, exactly. So, so I was just thinking about my experience and what happened a couple of weeks later. And, you know, I, so when we when I of joined the team, I do remember like, just speak to the humanness of it, of the kind of vulnerability that you spoke to, kind of having a bit of imposter syndrome, for sure. And like, oh my goodness, this is something that I've wanted to do for a long time. And, you know, obviously, I'm, you know, I know that I've got some years of being a psychologist behind me and being like a therapist, but
00:35:31
Speaker
I still had a lot of like, oh, you know, and good enough should I be here? Is everyone going to find out that I don't know what I'm doing? That's my usual dialogue. And can I just say for the audience how that if you see as me in the room with the client, patient, participant, whatever, the fact that such a wise and learned therapist can think that should give all other therapists who think that pause because um we all have it, no matter what how how how learned we are, how how much experience we have and how um um much skill we have as a therapist. So it still happens. Exactly. And especially for me in new scenarios, because people I don't know that well yet, I tend to lie and down as I settle into the sort of social aspects of being a new team and kind of get my head around it.
00:36:28
Speaker
But I hadn't done much of that when we we did our first dosing when you sat for me. I also remember thinking, uh-oh, David was really vulnerable, so now I'm going to have to be really vulnerable. And I feel like I knew that was really important because I knew yeah enough. I know enough about this work to know that when you're working in a dyad, it's really helpful for us to know each other in that way. And so I went in there and I was pretty anxious to share colleagues my own personal experiences in the world, how I've come to be who I am, you know, we all have our own suffering in different ways. And I think it's very human to feel a bit nervous to be vulnerable, especially in workspace. Also, though, you're both you and Sabrina, who was my co therapist, was so good at like minor
00:37:22
Speaker
quite high. And then I remember like pretty quickly, you both put me at ease, which was obviously because you're both skilled therapists. And then off off I went into my dosing the week after, I think. Yeah. well yeah Yeah. um And I think, you know, my memories of that, and having two people, there was something as ah as a therapist, it was quite challenging, actually, for having having two people to look after you for the day. And I think ah when we reflected on the self experience, we're usually the ones doing that. And so for us to spread those in that way was kind of weird, and really important and really helpful for
00:38:03
Speaker
um for us to learn what it's like to be like that. And also the kind of way of kind of lying down when you do the dosing session, you have course your eyeshades, your headphones. And so the kind of way that you might reach out for support and stuff is a little different. And and I think that was a really important part of what I learned from doing that because I certainly did ask for your support. no and And I remember reaching out for your hand and I am as we agreed. But not because I was struggling at that point of this, because I wanted a little bit of nonverbal grounding. Yeah, I wanted a slight mind of where I was a little bit. And it was someone with me, someone alongside me. And that happened to you alongside me or Sabrina, I'm not even sure who was that was holding like, allowed me to explore and go kind of into my experience, the psychiatric experience more deeply, I think, and if in which was interesting.
00:39:00
Speaker
And there's a lot that happened, which I could go into, but something that really sticks in my mind was that, oh, quite a long way through the session, I kind of sat up with a stomach pain. And ah just as a bit of context, one of my intentions was around kind of family and creation of family, but also kind of ah feeling the different emotions that I feel about being distant from my family, which are all in the UK.
00:39:28
Speaker
and Most of them. And I kind of, I've been kind of traveling pretty well for the whole day. And I remember having this pain and sitting up and feeling really blank.
00:39:40
Speaker
like I kind of just couldn't think properly. um There wasn't much going on. And I just wanted to go away from the feeling and I kind of came out and I was like, you know, I think I want to get up and I can't remember exactly. but I didn't want to be in there. And we're very nice and you and Sabrina and you just said, do you think that stomach pain is something that you might want to go back into?
00:40:05
Speaker
And so I laid down, closed my eyes, and kind of that piece that we talked to our clients about around experiential avoidance was definitely at play there. I was trying to avoid this feeling, hurting, I didn't want to be there.
00:40:20
Speaker
And then as soon as I went towards it, I remember having this feeling of joy and expansion. And then being in the garden, my aunties garden with my auntie, my grandmother, my mother, and all the women from that side of my family around, very connected to them. And, you know, in an insight, you know, and I was also birthing nature, that there was nature coming out of me like flowers and And that was what I know. And that's a hard thing to explain right in terms of correct how do you tag people. yeah But for me, it connected very much to my intentions, which were about kind of, you know, not feeling ah grief and loss around not being close to my family in in England. And then
00:41:09
Speaker
Even from that day till now, I still feel that image helps me to feel very connected and close and reminds me that even though I'm here, I'm still connected to them. Then I feel like i strongly whenever I connect to that image, which is an integration piece that I have done and that you helped me with Sabrina. That's a beautiful experience. Yeah. and now What a beautiful experience. Yeah.
00:41:37
Speaker
Does that still hold to today, two years later? Definitely. And I've worked with it, you know, like I've meditated on it. I've drawn it badly because I'm terrible at drawing, but I'd love to find someone out there to draw it for me, actually. um a But I've very much like, I've placed a photograph of my auntie's garden that I kind of have in my mind when I sort of envision it well.
00:42:03
Speaker
i And that just, it helps me to feel, it's become a somatic resource, which is like an embodied ah ah ah resource that I feel in my body that I can connect to, to help with feelings of loneliness, or if I'm missing my family or feeling far away. Do you, on a sort of separate topic, a sort of a topic of afterwords, did you have any, once you recovered from your dosing experience,
00:42:32
Speaker
Was there a moment afterwards where you're like, oof, I really let go there? And was there any regret or any tension around having exposed yourself or being vulnerable in front of two work colleagues? I don't think there was because I feel like, I think it happened more before for me. I definitely felt that before. I was really worried about it. Yeah. But once I had done it,
00:43:00
Speaker
I don't, I was and I think because you and I had such, you know, that enabled us to work together as a diet in a really deep way from the beginning. And I think, kind of,
00:43:16
Speaker
the structure of our relationship and the way that we work as a dialogue and an in-depth debriefing that we always do after sessions and that allows space for that to be but spoken about if it needed to be. I just, I'd actually be feeling close with you.
00:43:33
Speaker
Yeah, right, totally. I mean, if we come out of that experience and we didn't feel closer to each other, that's something went drastically wrong, right? But yeah it kind of gave us the permission, I think, if I can speak for us, the permission to no longer pretend yeah that we were infallible. ah You know, that most people, you know, when they're entering into a relationship, there's some sort of mask of trying to be perfect, flawless and not guilty. But what the self-experience really does is it just shows the beauty of your shared humanity and that we are all imperfect, flawed and guilty in the most beautiful ways. And that gave us permission to just be human. And most importantly, when you're working alongside someone else, to be a mistake maker.
00:44:17
Speaker
yeah to just be somebody who's not always going to get it right. yeah um And that's okay. And we don't need to pretend that we're going to get it right. And it just creates, it enables the juices of creativity to flow in the therapeutic relationship as a diet. yeah And so if I reflect on it, I was like, I cannot imagine having done the work we did, having not had the self-experience.
00:44:43
Speaker
Yeah. And I know that's most people's experience. Yeah. Yeah, that's right. And I think, you know, maybe now's the time to move into like how our participants responded and two to us having done that as well. There's kind of a few tracks I'd like also to talk about.
00:45:02
Speaker
you know, you how the the container that we set and the importance of setting that container um for people who are thinking of doing this. And I really hope it is something that happens in other trials. That also happens in trainings in Australia now that we're from where that might become possible in the future. Yes.
00:45:21
Speaker
But maybe we'll do that at the end. But, you know, I think I said this earlier, that every single one of our participants that we spoke to said, it was so helpful, so, so helpful to know that you have laid on that couch, yeah and that you've been vulnerable in front of each other. And also that you've taken the medicine that they're taking, because the vast majority of the people who came on to this trial have had very limited experience with psychedelics themselves. yeah And certainly,
00:45:50
Speaker
I don't think anyone would have had the kind of synthetic psilocybin that we were yeah giving people on the dose that we have. I don't think that was because only really it's used only in trials. Well, it was at that time. Yeah. And so know that's a really brave thing to do, especially if you're someone who's naturally bit and has some anxieties in the world as well for anyone. And so I think absolutely people reflect on it as being something that they found quite reassuring. um And the
00:46:25
Speaker
it allowed them to feel connected to us. And also, I think it allowed us to explain it more detail in a way that we wouldn't have been able to otherwise. so But it's so tricky. Yeah, I mean, yeah, I think it is tricky to explain something that is traditionally unexplainable, or inexplicable.
00:46:45
Speaker
And um you know one ah yeah one of the things we did often, um not only did we set it up, you know the very beginning when we introduced who we were, we were one of us would often say, you know and we sat in that chair, as I said before, and we've laid on that couch and we've done this and we've done that. And actually the person who was doing it to me was Esme or was David.
00:47:05
Speaker
and um And straight away, they're like, oh, this is this is really serious. like They've done what I'm doing. They know where I've been. They've had to be in a position I'm in. And as you said, straight away, there's this connection.
Explaining Psychedelic Experiences and Therapist Insights
00:47:18
Speaker
The other thing it enabled us to do was there were moments when we're trying to explain something.
00:47:24
Speaker
And we can't do it justice unless we use our personal experience. yeah And one of the things that we often talk to people about was paranoia. and how you know What are the kind of things that might happen in a psychedelic which causes you to be paranoid and how the paranoia can then become a loop and they can stop you from gaining or get getting stuck. It can get you stuck in the psychedelic and not really going towards the healing that's on offer. Did you have any paranoia? Yeah. They came up for you.
00:47:56
Speaker
and you know And I would share that for me, towards the end of my experience, actually, I started to wonder if I was kind of not being interesting enough for you, if I wasn't doing enough, because I'd been lying down. that's right And like, you got to be bored. And I think also underneath that was like, am I doing it wrong?
00:48:16
Speaker
Right? Yeah. Which, which actually, if you think about that whole, like what I was sharing before around the imposter syndrome or like that kind of not good enough thing that sometimes creeps up in new situations for me, even after so many years of, you know, pretty sure I do actually know what I'm doing as a psychotherapist these days.
00:48:36
Speaker
I think so. i think so see yeah But you know it still pops up and how I think I was able to say usually what comes up is somehow connected to something in your psyche and so it's all important and that just saying it can really help it to move through. Right, right exactly. really Yeah, and move on watching the loop. And the other thing I was gonna say is that's important what you just said, I think that like, you don't have to go into depth. And I'm always thinking about like, if I'm going to share something with a participant that's about my or client, my own experience, it's like knowing that whatever it is, I feel okay with
00:49:17
Speaker
So it's not something that, yeah, there are some things about my self experience that I wouldn't share with a client and probably you're not on the podcast either, right? What bits of it feel okay enough to share? And, you know, I think self-disclosure is actually quite powerful and very useful in this work, but you need to do it in a way that feels safe for you. That's different for everyone. is Absolutely. And, you know, there's a,
00:49:47
Speaker
It's a really tricky tightrope you're walking now. Yeah. And it has to be very much a considered decision based on that based on clinical skill as to who's the person in the room with you and and how safe is it for that disclosure to be made. Yeah. And of course, there are some people where you're going to censor or limit what you say. And there are some people where you know it's going to be beneficial.
00:50:13
Speaker
And it's also okay to get that wrong sometimes because again, we're mistake makers and you can get it wrong and this rupture comes with repair if you're a good therapist. so um totally yeah but Well, also, you know, we talk about experiential avoidance. You know, what did we face in our own experience that we found difficult to go towards? You know, the idea of psychedelic therapy. For me, that was my stomach ache. Right. so i just but out I just wanted to go where I didn't want to be near it. Right.
00:50:50
Speaker
you know, in psychotherapy, they talk about the in and the through going towards what's difficult. That would be quite hard to explain if you don't have a personal example, of or a client example that you can use, I guess. Yeah, exactly. And so we can use our experience, there's some things that I had to face in there which I really knew was going to take me to a really painful place. But I knew my job as well on that day was to surrender that you know my fear to love, which we all have to some degree,
00:51:31
Speaker
Was being presented in a way towards me in my psyche that made me want to hide and and not have to face it and my job on that day cuz you and Campbell did such a good prep was to surrender go towards go in it and through it so I can get to the other side and through the other side was gratitude and and love to a point that I'd never experienced before. So there's, and there's an example of, and again, I wouldn't go into that much detail with a participant because you also don't want to set up an expectation that they're going to have a similar experience, but I can use the ideas from that to explain what we mean by going towards and in and through and trust that go via. Yeah, that's right.
00:52:17
Speaker
and i think i think um you know I think now would be good to sort talk a bit about if I can change slight tactic a little bit. Like what other, if if other trials or other people who are writing trainings, because that's also possible, are wanting to use this kind of self-experience part as part of it. and What do you think are the things to really bear in mind? And there's probably quite a few, right? But and in terms of ah of things to be mindful of, of perhaps to be cautious of, or, you know, what do you think? Yeah. So I think as with any trial, the most important part of a trial is the screening. Yeah.
00:52:58
Speaker
It doesn't matter who you're screening, whether it's the therapist on the trial or it's the participants that will take part. If you have a good screening, then you will lower the complexities that may come up. There will still be complexities that come up, but you really need to have trust in the skill and the maturity of your clinicians or therapists or whatever term you want to use, um that they can, one, be with patients within a psychedelic assist psychotherapy protocol, but also sure if they're going to do the self-experience, that they are safe, one, to go through that experience themselves and two, to be with others, other professionals and and colleagues who are going through that experience as well. yeah So there is a ah large screening process, I think, that needs to occur.
00:53:49
Speaker
Yeah, I think it's important actually to say that, you know, it was ah absolutely a choice. So, you know, everybody on our team chose to go through the self experience and had, you know, and I think it should always be a choice.
00:54:05
Speaker
um Yes, people might be the wrong time in their lives. Or it might be that there is there just for whatever reason, don't feel comfortable doing it in that kind of environment. And I think that's okay, too. Yeah, there's other ways that you can kind of learn this work. I think it is one of the most powerful ways. But there are other options as well, like holotropic breath work or other kinds of breath based office space. Yeah.
00:54:31
Speaker
And I would say we definitely should make it an exclusionary for people who want to do this work. It should never become a hurdle requirement for them to become a psychedelic assistant psychotherapist because there may be that people have certain health conditions or certain beliefs whether they're cultural religious that would exclude them from partaking in a dosing session. So it's something that we should keep open to everybody, um but it definitely should never be a hurdle requirement. Yeah. And I think, you know, if you are thinking about using a self-experience as part of training or in a research trial, it's also really important to have a supervisor available to report by ads in general as they're working together because, you know, we
00:55:22
Speaker
you know, we've always got along really, really well and have a really good relationship on the beginning, which I'm so grateful for. And we've also spent time being vulnerable and getting to know each other and debriefing a lot. So it's not an accident that that happened. I don't think I've worked on it. But you know, sometimes things come up that maybe you require that extra third person And I think that can be really helpful as well and having different spaces where you can talk about um any kind of transference or counter-transference that comes up. And I'm mindful I'm using jargon. Do you feel like defining it or shall I do it? We can both have a go if you want. Yeah, go on. People get very confused with transference, but I often
00:56:12
Speaker
think it's relatively simple and simplistic. You just take their ends out of transparency and you can understand what it's saying. It's transparent, right? So what we do is when we're young, we have we are born to parents of primary caregivers who you know they become the model of everything we see in the world. you know We place that model and that template onto all our other relationships. So if I have a mother that's a certain way or a father that's a certain way, I will go into the world and I will see other human beings with that template and maybe not always see those other human beings, but rather see them and treat them as if they were my mother.
00:56:53
Speaker
or as if they were my father. So I transfer my template of how human beings were to me onto them. And there's this like, you can just say like, I expect to be treated as I was treated. Yeah.
00:57:08
Speaker
is that and that's kind of transference. So I go into a relationship with this expectation of how I'm going to be treated and I transfer that onto the person in front of me, often the therapist, and I expect them to treat me as they were treated. it And even when they don't, I still expect them and respond to them as if they do. So this is how I explain trans growth. How about you?
00:57:32
Speaker
Yeah, I always really like listening to you explain to clients. And I think I explain it as kind of like you're wearing the glasses, seeing the world through the glasses of how you were treated when you were growing up. Yeah, yeah. Yeah, yeah exactly. Which is much more simplistic way than I just said. Well done. And then if people want a bit more, then we can get more into it. Yeah, yeah, yeah.
00:58:01
Speaker
But you know, it can happen in a dyad, where you've got you and me and then the participant or the client in the room. And I i remember that, you know, for a certain clients, we might have become very kind of people have a lot of parental transference onto us. Yeah. So my parents, like I've been close mom and dad and you at different times. And so i i one of the reasons that this that working and knowing your dyads so well is so important is that when that happens, which it will, that you both can pick it, understand it, talk about it, because you know each other deeply and you know yourself deeply. is that Exactly. yeah Yeah, totally. And also, you know, why you react into the client in a specific way is that that's the counter transference. Yes. You know, why and being able to talk about what are we bringing in?
00:58:57
Speaker
Yeah. To this relationship and that stops us from seeing the client or the client is bringing stuff up in us that reminds us of our early attachment relationships. And so we, you know, whenever we talk about transference, account transference, there's something getting in the way from seeing and relating to the person that's in front of us as they are. And instead we relate to them as we perceive them to be yeah based on what we're transferring onto them. Yeah.
00:59:24
Speaker
And so that is an incredibly important thing to be able to talk about with your diet partner. And if you can't do that, if you're not vulnerable enough to do that and get into the weeds about it, your therapy is not going to be as effective yeah as it needs to be. Exactly. I think it's really important that what you just said. and i think um you know, for anyone, it's one of the things that I guess I've been wanting to kind of end all of these podcasts with is people listening who are wanting to get into this space and wanting to be like a daily persistent psychotherapist or who are interested.
Vulnerability and Self-Experience Importance
01:00:02
Speaker
But what are the important takeaway messages and I think
01:00:06
Speaker
what you just said, it's really key, like being able, if you're working in a diet, to find a way to be able to be vulnerable about what comes up for you with a client, listen to what comes up for them. And then to be able to reflect on that and to set up processes. two and like Yeah, I agree. I mean, exactly. And if that was a formal question, like what do people need to know? Yeah.
01:00:32
Speaker
what I would say as well as, you know, there's a few principles that I'm just pulling out in my own head right now, but one is to allow yourself to be a mistake maker. Allow your diet partner to be a mistake maker. One, accept that you're imperfect, flawed and guilty as a human being and allow your vulnerability and your humanity to come into the room. Two, the most three the three most powerful words as a therapist is I don't know. yeah It's okay to not know.
01:00:59
Speaker
don't pretend to know something you don't know, people will see through it. And the final one, I would say that invest in your diet relationship, get to know them. And I would also say that debriefing is is a must. is ah You have to have that space after the sessions. two And we did this thing, our colleague Campbell again, Townsend, suggested that we all of us, all of the dyads, um always do a zing-clang. And so we'd say zing, which is a good thing that we think each other did, and we think we did ourselves. And a clang, which is ah
01:01:39
Speaker
You know, what is something that happened that jolted us that we didn't think was good. And obviously the zings can be quite easy, but the clangs are quite difficult. But if you've got an honest relationship where you're allowed to be flawed and guilty and imperfect and a mistake maker, then the clangs become the best bit. The clangs become where you learn, where you're vulnerable, where you get to feel what it's like to be somebody who's not great all the time.
01:02:08
Speaker
in front of somebody else and how they accept you and love you regardless and I would argue that a lot of professionals find that very difficult and they find it difficult for a reason and Esme and I work really hard to create a relationship where we could just be flawed in front of each other and make mistakes. Yeah and I think you know, that I remember when we started and yeah, massive thanks to Campbell for suggesting that just structure is good, yep being so ah to bring up a client with you. yeah um And because that's hard for me, like, ah you know, going on a bit of a journey around like letting to speak up that this work has definitely
01:02:57
Speaker
been super powerful with and for for for many professionals that can be difficult. But once I did it once or twice, it just actually became really, really easy and the most interesting part of our conversation often. And what was, that you know, fascinating was when you thought, I thought something was a client, you're like, I didn't even notice. yeah it Was it was a client you did notice? And then we go, Okay, what was that? We've been been going for about an hour now. So is there any kind of final comments that you have on the importance of the self experience or on any of the other topics? Anything that you want to finish by saying I think before we wrap up for today? um and Just that you know, we talk about continued professional development being important. And I would say in my experience, having done many years of continued professional development, nothing has made me develop more
01:03:55
Speaker
yeah than this experience. I agree. a And so, you know, it might not be for everyone, but it makes utter sense. It just makes complete and utter sense that you, if you're going to engage in psychedelic assisted psychotherapy, that part of the training is to sit and be and open yourself up and face what you need to face, just like you're asking your participants or clients or patients to do.
01:04:21
Speaker
yeah And um so from my own experience, having been there, having done it, i've been having done it with others, because Esme and I didn't just do it with each other, we did it with a large number of other therapists we also sat with. It's too big thumbs up for me. Yeah.
01:04:39
Speaker
Me too. With caution. Yeah, thumbs up with caution, right? And safety. With caution. Screening. Important questions about containers and what will be shared and what won't be shared outside of those spaces. um That might be a bit different to normal therapy because I don't think it would have been helpful if you said we'll never talk about what happens in this room again. But really mindful about keeping it within your relationship. That's right.
01:05:07
Speaker
and working with people around what feels okay for them too. I'm getting quite detailed about that. But yeah, thank you so much, David. I think we can wrap up. Thank you, mate. Yeah, let's do it. It's been really lovely to revisit some of this work together and to talk about what we have done so far on this journey. Thank you, Esme, as always.
01:05:33
Speaker
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.