Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

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

In this episode of the Psychedelic Medicine Podcast, Alexander Lebedev, MD, PhD joins to discuss psychedelic medicine and psychosis. Dr. Lebedev is a physician-scientist, medical AI engineer, and entrepreneur working at the frontier of health and technology. His work spans collective societal dynamics, psychedelics, and medical AI; he leads Lebedev Labs and is co-founder of Dreamseer and Once Wellbeing Center. In this conversation, Dr. Lebedev explores the complex relationship between psychedelics and psychosis, examining what decades of research—and more recent clinical evidence—actually tell us about the risks. He explains why individuals with personal or family histories of psychotic disorders are typically excluded from clinical trials, clarifies the distinction between transient psychotic experiences and chronic psychotic disorders, and discusses why current evidence has not established a causal link between psychedelic use and persistent psychosis in screened populations. Throughout the discussion, Dr. Lebedev emphasizes the importance of careful screening, preparation, integration, and context, arguing that psychedelics should be understood through both scientific and phenomenological lenses rather than simplistic assumptions about safety or danger.   In this episode, you'll hear: What inspired Dr. Lebedev to study psychedelics and psychosis Why psychedelics became associated with psychosis and how that perception developed historically Why case reports of psychotic episodes following psychedelic use are not definitive to establish a causal link between the two How the lenses and frameworks we employ can significantly color how we understand psychosis and altered states of consciousness The role of set, setting, sleep, substance use, and integration in reducing psychological risks How psychedelic experiences overlap with—and differ from—psychotic states from a phenomenological perspective The intersection of psychosis and bipolar disorder and the relevance of this overlap to psychedelic medicine Why researchers are beginning to reconsider whether certain psychosis-spectrum populations should eventually be studied under carefully controlled conditions   Quotes: "The first framework within which psychedelics were studied and considered was the psychotomimetic framework, meaning that they were considered as tools that are supposed to mimic psychotic states." [9:22] "In the pre-prohibition era, psychedelics were tested on very large populations of different patients—including people with psychosis spectrum disorders, including people with schizophrenia spectrum disorders—with some mixed results. But there was already some data indicating that from a populational perspective, from a statistical link, we didn't have clear indication, even back then, that that link [between psychedelics and psychosis] exists." [12:48]  "Interestingly, unlike for cannabis, for tobacco, for some other substances, this link [with psychosis] was not verified in these large studies for psychedelics." [15:54] "If the only lens that you have is pathology, you can pathologize transformation as well. On the other hand, if the only lens that you have is spirituality, you can spiritualize the compensation that can come with the psychotic experience." [20:21] "From a phenomenological perspective, there are, of course, clear similarities [between psychedelic experiences and psychosis] . But of course, the background, the emotional content is very different. … If you read sometimes descriptions of people's mystical experiences or bad trips, sometimes they can actually on the surface look remarkably similar. What is different is the affective balance of it. And that's true for psychedelic experiences and also for psychotic experiences." [40:37]   Links: Dr. Lebedev on LinkedIn  Dr. Lebedev on Instagram  Dr. Lebedev on Threads Once Wellbeing Center website Once Wellbeing Center on Instagram Once Wellbeing Center on LinkedIn Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Arsalan Azam, MD joins to unpack the intersection between psychedelics and GLP-1s. Dr. Azam, founder of Daydream MD, completed his residency in Emergency Medicine at the Metropolitan/Harlem Emergency Medicine Residency program in New York before practicing emergency medicine nationwide. Drawing on that experience, he developed a comprehensive ketamine-assisted therapy practice and now blends functional medicine with personalized GLP-1 services to help patients achieve sustainable, biologically tailored health outcomes. In this conversation, Dr. Azam explores the emerging intersection of GLP-1 medications and psychedelic therapies, arguing that both create temporary windows for behavioral change that can be leveraged to improve long-term mental and metabolic health. He explains how GLP-1 medications act primarily on the brain's reward and craving circuits, reducing "food noise" while creating opportunities to reshape habits and addictive behaviors. The discussion also covers how GLP-1s may complement psychedelic-assisted therapies for conditions such as addiction and PTSD, potential interactions with ketamine and classic psychedelics, and important clinical considerations, including nausea, delayed gastric emptying, medication dosing, and the importance of individualized treatment strategies.   In this episode, you'll hear: How GLP-1 medications influence the brain's reward, craving, and motivation circuits Why Dr. Azam views GLP-1s and psychedelics as complementary therapies that each create windows for lasting behavioral change The potential role of GLP-1 medications in treating addiction alongside psychedelic-assisted psychotherapy What patients and clinicians should know about combining GLP-1 medications with ketamine and classic psychedelics How delayed gastric emptying may alter the timing, intensity, and safety of orally administered psychedelic experiences Why careful dosing of GLP-1 medications is important to avoid emotional blunting while preserving their therapeutic benefits The importance of using both psychedelic and metabolic therapies as opportunities to build healthier long-term habits rather than relying on medication alone   Quotes: "Not all behavioral health symptoms are driven purely by things going on in the brain and the nervous system and mood and whatnot. Sometimes it's well outside that. And so that's where, naturally, GLP-1s caught our gaze. Here's a medicine that treats probably one of the biggest of the two health crises I think right now facing America: one is—I do think—mental health, but the other is metabolic health." [4:52] "Just like psychedelics create a window [of transformation], GLP-1s create a window. It's this pharmacologic scaffolding that you can use to start to really reexamine your relationship with food, with craving, how you've been eating, why you've been eating. And you can essentially use GLP-1s to hit the pause button on that noise, and that makes it easier to eat less. But it also makes it easier to start to ask the questions of why? Why was I eating the way I was eating?" [9:59] "In general, GLP-1s seem to play pretty nicely [with ketamine]. I'd say the bigger thing that I've observed that doesn't get named all that much is that craving and reward are important. They're part of how we see salience in the world and also derive pleasure from it, and if you go too high on a GLP-1, people experience a flattening. They feel kind of blah, and it's not in their head. It's because you've over-damped the salience and reward circuitry. And so it's about finding the sweet spot where there's enough to motivate you in life without being noisy." [20:13]   Links: Daydream MD website Daydream MD on Instagram Daydream MD on Facebook Dr. Azam on LinkedIn Psychedelic Medicine Association webinar: GLP-1s and Psychedelics: Clinical Considerations, Interactions, and Emerging Questions Psychedelic Medicine Association Porangui