Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

In this episode of the Psychedelic Medicine Podcast, Stacey Armstrong, PhD joins to discuss the latest research on psilocybin treatments for PTSD. Dr. Armstrong is Associate Director and Senior Researcher at The Ohio State University's Center for Psychedelic Drug Research and Education, and a clinical psychologist with advanced training in treating PTSD in veterans. She is the first author on a recent pilot study of psilocybin-assisted therapy for veterans with severe, treatment-resistant PTSD.
In this conversation, Dr. Armstrong discusses her team's pilot study of psilocybin-assisted therapy for veterans with severe, treatment-resistant PTSD, explaining why this population urgently needs new treatment options and how trauma, repeated exposure, military culture, and difficulties with reintegration may contribute to the severity and persistence of PTSD among veterans. Dr. Armstrong emphasizes that the potential benefits of psilocybin cannot be separated from the therapeutic context, including extensive preparation, trust-building, supportive care during dosing, and integration focused on psychological flexibility and personal values. The conversation explores how psilocybin may create a window for new ways of thinking and behaving, why preparation itself appeared to contribute to symptom improvement, and what larger, controlled and more diverse studies will need to investigate before psilocybin-assisted therapy can become a more established treatment for PTSD.
 
In this episode, you'll hear:
Why veterans with PTSD may experience particularly severe, chronic, and treatment-resistant symptoms
How trauma, military culture, and difficulties transitioning back to civilian life can complicate PTSD treatment
The preliminary findings from Dr. Armstrong's pilot study of psilocybin-assisted therapy in 12 veterans
How the study used four extended preparation sessions and two ascending-dose psilocybin sessions to build trust and gradually introduce participants to the psychedelic experience
How acceptance and commitment therapy themes, psychological flexibility, and values informed the preparation and integration process
What future research should investigate, including larger controlled trials, longer-term outcomes, more diverse participants, and the potential therapeutic effects of preparation alone
 
Quotes:
"[Dr. Morski] What do you think the mechanism of action of why psilocybin might be effective in treating PTSD?

[Dr. Armstrong] That's a great question. You know we don't know for sure. That's the straightforward short answer. But there are some hypotheses right. So there seems to be some impacts at the mechanistic biological level, some some changes in brain functioning from what we can tell that perhaps it opens up an opportunity, psilocybin itself, to be able to think in new ways or or perhaps not foreclose on a coping strategy that maybe before I would have been like, no way. I'm absolutely not going to go into that triggering, you know, grocery store at the busiest time on Saturday. So it might create a window of opportunity to basically try out and create new pathways in the brain of ways to think. And, and maybe we feel a little bit different when we're doing things because of these new ways our brain is functioning. But at the same time, you know, there seems to be something important—or at least I feel pretty compelled—that there's something happening psychologically as well. So a lot of the hype and the excitement—of course, and understandably—goes towards the psychedelic itself: like what's happening with the psychedelic and why is it creating better outcomes for some people. But I think there's a really important piece of the story too, which is: it's a therapy and it's a therapy around what we're doing to prepare somebody for a psychedelic experience and how we're showing up for them during a psychedelic dosing session. So, you know, we don't just put them in a room and walk away and we're there. We're with them for the whole day, making sure they don't need anything. If they're feeling anxious, they're having a hard time. You know, we're there to help support them throughout that process, but then also to kind of put the pieces together on the other side, which is this integration piece. And there seems to be something perhaps quite compelling about this complete picture." [12:14 - 14:47]
"Psilocybin when taken at high enough doses can create an experience that can change drastically one's perception of themselves, other people in the world. And so there often are experiences that people are having during a dosing session that can be leveraged in integration, for instance, to help somebody take advantage of that biological window of opportunity. So they're saying like, 'man, I had this really, really significant insight about my trauma,' right? 'I essentially felt a profound sense of forgiveness that I've never felt before. And now I know what that feels like.' And so then we go into the integration session, having had that experience and say, 'what does that sense of forgiveness now allow you to do to get you back into your life in a way that is really important to who you are and your values and who you want to be?' And so it seems, at least for me, that if we're not looking at the whole picture, then we're going to be missing some answers to that question that you've asked, which is why is [psilocybin for PTSD] working?" [14:50 - 16:10]
"If we think about somebody having this profound experience—they're feeling better, they're doing things different, they're living their life in a different way, and now they're engaging in their world different—it's going to take a bit of time for all of those different layers and systems around them to really get used to and understand and start to react to the new way that this person is engaging in their life. And it can take some time to practice those new skills and figure out what works and what doesn't and hone them. And so this idea that it would take a little bit of time before we see full improvement [after psilocybin treatments] does make quite a bit of sense. [25:37 - 26:21]
 
Links:
Dr. Armstrong on LinkedIn
Center for Psychedelic Drug Research & Education website
Center for Psychedelic Drug Research & Education on LinkedIn
Dr. Armstrong's article: "Safety, feasibility, and preliminary clinical outcomes of psilocybin-assisted therapy for veterans with severe, treatment-resistant PTSD: an open-label pilot clinical trial"
Psychedelic Medicine Association
Porangui

In this episode of the Psychedelic Medicine Podcast, Christian Jurlando, PhD, joins to unpack the topic of extended difficulties following psychedelic experiences. Dr. Jurlando is a humanities professor at Stevens Institute of Technology in Hoboken, NJ, and a researcher and advocate focused on psychedelic safety and extended post-psychedelic difficulties (EPPD). Drawing in part on his own lived experience of prolonged difficulties following psilocybin use, his work focuses on improving recognition, care, and support for people experiencing adverse psychedelic outcomes.
In this conversation, Dr. Jurlando discusses extended post-psychedelic difficulties, drawing on both research and his own experience of EPPD following a low dose of psilocybin. He explains that these difficulties can take many forms, may occur even after relatively small doses, and can persist long after the acute psychedelic experience has ended. The conversation explores how to distinguish acute crises and shorter-term difficulties from extended post-psychedelic difficulties, as well as the importance of recognizing when someone needs professional support. Dr. Jurlando also discusses the emerging infrastructure for supporting people who experience adverse psychedelic outcomes, including peer support, harm-reduction services, specialized clinics, and the development of clearer pathways for escalation and referral. Throughout, he emphasizes the importance of acknowledging these experiences within the psychedelic field, developing more nuanced approaches to risk and informed consent, and recognizing that recovery can take time and may involve different approaches for different people.
 
In this episode, you'll hear:
What extended post-psychedelic difficulties can look like and how they may differ from psychosis or other acute psychedelic complications
Four questions for assessing whether someone experiencing post-psychedelic difficulties may need additional support
How peer-support and harm-reduction services can identify when someone may need to be referred for more specialized care
What is currently known about risk factors, set and setting, and the prevalence of extended post-psychedelic difficulties
Why psychedelic risk needs to be considered in relation to the potential benefits and the individual circumstances of each patient
 
Quotes:
"In my research, I found that back in the late 50s, that was kind of the rule of thumb: that smaller doses were more dangerous because people didn't process what was coming up and could get stuck in a negative state." [5:16]
"The best estimate [of extended post-psychedelic difficulties] that we have right now is from the Global Psychedelic Survey… over 6400 people were surveyed and 8% reported difficulties lasting a month or longer that meaningfully disrupted their daily functioning." [10:43]
"It's very difficult when something presents so fast to realize that the remedy or getting better takes time. It takes, in fact, sometimes a lot of time. And there can be a lot of resistance to that because you think 'hey, if I just took some mushrooms and then suddenly felt this way, surely I can just take something else and suddenly feel better, right?' It doesn't work that way. And so I think that that's sort of an added level of distress, and it's maybe unique." [13:59]
"What we're finding is that what people really need is just acknowledgment that these sorts of things happen. That's the first thing that would have been really helpful for me—because when you're in that state and you think that you've broken your brain or something, then it can just start snowballing." [17:37]
"It does seem like there's a wide variety of treatments [for extended post-psychedelic difficulties] and some work for some [people] and some work for others." [32:05]
 
Links:
Dr. Jurlando on LinkedIn
Dr. Jurlando's article: "The invention of challenging psychedelic experiences: Meaning, measurement, and foreclosure of extended harm"
Dr. Jurlando's article (pre-print): "Strengthening the Psychedelic Safety Net: A Call for a Coordinated Ecosystem of Post-Psychedelic Care"
Challenging Psychedelic Experiences Project website
Fireside Project website
Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans
Previous episode: Who Is a Good Candidate for Ibogaine? with Fernando Rivas, MD
Psychedelic Medicine Association
Porangui

In this episode of the Psychedelic Medicine Podcast, Nigel Denning, MA, MPsych, joins to discuss the reasons profound psychedelic experiences don't always lead to lasting change. Nigel is a Counselling Psychologist and Director of Integrative Psychology & Medicine, with nearly 40 years of experience working with psychedelic and non-ordinary states. He has trained with MAPS, and served as co-lead therapist on three psychedelic clinical trials.
In this conversation, Nigel emphasizes the importance of preparation, integration, and creating the conditions for new experiences to become part of everyday life for effective psychedelic therapy. He explains that psychedelic sessions can open a period of neuroplasticity, but that without adequate reinforcement, people may naturally return to familiar patterns and ways of understanding themselves. Nigel discusses his three-phase approach to integration, which begins with simply becoming familiar with the experience, moves into narrating and embodying it, and ultimately arrives at meaning-making. He also highlights the importance of somatic awareness, curiosity, breathwork, and stabilization in helping people integrate experiences without prematurely imposing intellectual interpretations. Throughout the conversation, Nigel cautions against rushing back into ordinary routines or repeatedly pursuing psychedelic states in search of a lasting transformation, instead encouraging people to give new experiences time and space to become woven into their everyday life.
 
In this episode, you'll hear:
The importance of preparation and setting realistic expectations before a psychedelic experience
Why curiosity is more useful than trying to control or rush to interpret what happens during a session
How somatic awareness and breathwork can help integrate psychedelic experiences
Why integration requires stabilization and creating space after an experience
Why it's never too late to begin integrating a psychedelic experience from the past
The risks of "state change chasing" and repeatedly pursuing psychedelic experiences instead of integrating them
 
Quotes:
"[Psychedelic therapy] is a very different way of intervening psychologically. You're really preparing someone to be curious about anything that arises so that they're not going in with expectations that this is going to be this incredibly wonderful experience that's just going to change their life—it might be a really awful experience—but that as long as you can make meaning of it as you're coming out of it, that's where the transformation comes." [5:28]
"We can't predict, we can't shape and control what happens in the session. Therefore, let's just get really curious. Let's learn how to breathe and slow down and relax ourselves into meeting anything that emerges." [6:11]
"The real meaning, the real return to subjectivity, is part of the integration process" [7:21]
"[Integration] is all about familiarizing the unfamiliar without racing into a top-down reduction of it into a thing that meant this." [21:45]
"It's amazing how stabilizing the breath can be. If you're in the depths of a psychedelic hell-world and you've got no perspective on anything, what you can still do is breathe. … that quality of centering in the breath creates then that capacity to at least remember you have a body." [27:21]
 
Links:
Nigel on LinkedIn
Integrative Psychology & Medicine website
Integrative Psychology & Medicine on Instagram
Psychedelic Medicine Association
Porangui

In this episode of the Psychedelic Medicine Podcast, Fernando Rivas, MD, joins to unpack the safety and screening considerations for ibogaine therapy. Dr. Rivas is an emergency physician with over 15 years of clinical experience. As Chief Medical Officer of Transcend Clinic, he has led the development of innovative treatment protocols in addiction medicine and the clinical application of ibogaine.
In this conversation, Dr. Rivas discusses who may be a good candidate for ibogaine therapy and the clinical considerations involved in determining its safety. He explains that ibogaine has the strongest current support for interrupting substance use disorders and addressing TBI and PTSD, while potential applications in other areas remain emerging and require further research. Throughout the conversation, Dr. Rivas emphasizes the importance of distinguishing absolute from relative contraindications and of carefully screening patients for psychiatric risks, cardiac conditions, and medication interactions. He also discusses medically supported detox protocols, the importance of evaluating treatment through an individualized risk-benefit framework, and how lower-dose or non-psychedelic approaches may eventually broaden access to ibogaine's potential neuroplastic effects.
 
In this episode, you'll hear:
What conditions ibogaine has been most studied for and where its potential applications may be expanding
The psychiatric and physical conditions that may make someone an unsuitable candidate for ibogaine treatment
How patients with active opioid or alcohol use may be medically supported and stabilized before treatment
Why relative contraindications should be evaluated through an individualized risk-benefit analysis
How ibogaine's typical psychedelic experience may be shorter than its reputation suggests
Why the immediate improvements some patients experience should be understood within the broader context of neuroplasticity and long-term integration
 
Quotes:
"Ibogaine is the most robust of the [psycho]plastogens in terms of the window of time that it is able to open [for increased neuroplasticity]—at least as per preclinical research. So the potential is tremendous." [3:22]
"Cardiovascular health is the most important [safety consideration for ibogaine therapy]. If you have a big hypertrophic heart and a large dilated heart, the risks are greater. If you have rhythm disturbances, the risks are greater and sometimes unacceptable." [11:08]
"The chances [of an adverse cardiac event] are mitigated by properly screening and vetting patients, as well as by the addition of magnesium to ibogaine treatment. Magnesium is an essential component, as it is cardioprotective. … It simply raises the threshold for an irregular heartbeat or to occur."  [17:38]
"A first degree relative with schizophrenia, for example, would be a relative contraindication. However, we must think of this in terms of risk and benefit. If this person is injecting fentanyl every day, they are at risk of overdose and death every single day. … so that relative contraindication should always be ascertained in terms of risk-benefit, particularly risk to life when it is present." [29:31]
"The science currently supports that sufficient exposure over a short enough period of time can yield pretty much the same results in terms of [neuro]plasticity without incurring a psychedelic experience. And we have tailored some specific treatments for patients that did not wish to incur a psychedelic experience, yet wanted to obtain the benefits of the plastic component of ibogaine treatment." [32:15]
 
Links:
Dr. Rivas on Instagram
Transcend Clinic website
Previous episode: Psychedelics and Psychosis with Alexander Lebedev, MD, PhD
Psychedelic Medicine Association
Porangui

This encore episode of the Psychdelic Medicine Podcast features a conversation with Kyle Buller on psychedelics and breathwork. Kyle is co-founder and host of the Psychedelics Today podcast and he has studied breathwork since October 2010 with Lenny and Elizabeth Gibson of Dreamshadow Transpersonal Breathwork. Kyle earned his BA in transpersonal psychology from Burlington College where he focused on the healing potential of non-ordinary states of consciousness, exploring topics such as shamanism, reiki, plant medicine, and holotropic breathwork. He has also earned an MS in clinical mental health counseling with emphasis in somatic psychology and has since worked with at-risk teens in crisis and individuals experiencing an early episode of psychosis.
Kyle opens this discussion by providing a basic definition of breathwork and sharing his own journey with this modality. He discusses how breathwork can refer to a wide variety of practices, but what unites these disparate techniques is utilizing the breath to induce specific physiological states and experiences. The holotropic style of breathwork has roots in transpersonal psychology and the work of Stanislav Grof and it is this modality which is often compared to psychedelic experiences.
Kyle discusses how holotropic breathwork can be an incredibly powerful practice for trauma-healing and inducing visceral experiences—similar to the classical psychedelics. He recounts his own experiences with this practice, describing how he was able to relive the experience of being born in the state conditioned by the method of breathing. Due to the synergy with the psychedelic experience, Kyle mentions that there is a lot of potential for breathwork to help individuals integrate or prepare for psychedelic experiences, as well as being a powerful tool for clinicians involved in psychedelic-psychotherapy to better understand the non-ordinary states of consciousness their patients will be experiencing. 
Because of the wide variety of breathwork techniques, Kyle discusses the possibilities of tailoring practices to the specific experiences of a client. Everyone has a unique "window of tolerance" depending on their background and constitution, and some people will benefit more from techniques which downregulate the nervous system and allow for peace and relaxation, while others may find more value in techniques which are highly stimulating and provide deeper, emotionally complex experiences that allow for self-exploration.
 
In this episode:
What breathwork is and how it relates to psychedelics
The origins of holotropic breathwork and Stanislav Grof's transpersonal framework
Breathwork vs meditation
How to use breathwork to integrate and prepare for psychedelic experiences
The effects of different types of breathing on the nervous system
 
Quotes:
"[Breathwork] offered a really great tool for training, for understanding how to sit with people in non-ordinary states of consciousness."  [8:49]
"Some breathing techniques, like these more deeply cathartic techniques, they're bringing up a lot of emotional memory and people are starting to work through a lot of somatic sensations, they are working through trauma." [13:38]
"We really need to look at somebody's whole picture, where they're at, how they could potentially benefit, look at their nervous system, attune to that, and really think about what they could tolerate, what's going on in somebody's psyche." [30:29]
"The breath is this flexible tool, it's a vehicle—we can help to regulate our nervous system with it and explore it." [39:38]
 
Links:
Psychedelics Today
Psychedelics Today Education Center
SettingSun Wellness
Dreamshadow Transpersonal Breathwork
Psychedelic Medicine Association
Porangui