The Journey to Conscious Health: Getting the Most Out of Ketamine Therapy

Podcast Highlights

• How early psychedelic experiences gave Remi the calling to shift from his career as an ER doctor to other forms of healing.
• A deeper look at ketamine and its history of use from anesthetic to a treatment for depression and suicidality.
• How the hands-on approach at Remi’s clinic differentiates itself from that at an infusion center.
• The importance of coaching alongside psychedelic experiences.
• Comparing potential outcomes of telemedicine to the “thick-wall container” of the in-person clinic experience.
• Why the “skill of surrender” is so important—and so difficult.
• Balancing the capacity to let go with the commitment to living consciously engaged in the world.
• Insights from Remi’s psychedelic training journey.
• The demographics that visit Remi’s clinic, and how individuals are screened.
• The need for willing participation when it comes to transformation.

Show Links

1. Lucid Therapeutics
2. Dr. Drozd’s presentation, “Ketamine 101”
3. Paul F. Austin’s Mindbloom Experience
4. Episode 152: Lauren Taus: Pain Opens Pleasure: Psychedelic Healing, Therapy, and Somatic Practices
5. Episode 128: Jeffrey Becker: The Science of Ketamine: What’s Really Going on in Your Brain?
6. Episode 173: Rick Doblin, Ph.D.: Healing the Heart of Humanity: Legalizing Psychedelic Medicine
7. Third Wave’s Coaching Certification Program
8. Book, The Ketamine Papers by Phil Wolfson M.D
9. California senator Scott Weiner’s introduction of legislation to decriminalize certain psychedelics
10. Remi’s clinic featured in the Santa Barbara Independent
11. Dr. Drozd on YouTube
12. Dr. Drozd on LinkedIn
13. Lucid Therapeutics on Instagram
14. Lucid Therapeutics on Facebook
15. Lucid Therapeutics on Medium.com

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Podcast Transcript

0:00:00.0 Paul Austin: Welcome back to the Psychedelic Podcast by Third Wave. Today I am speaking with Remi Drozd, the founder of Lucid Therapeutics.

0:00:09.6 Remi Drozd: In our clinic with ketamine, it shows you the truth. It shows you the absolute truth and the truth will liberate you. It liberates you from those old beliefs and the narratives that had you stuck. You don't get the trip that you want, you get the one that you need. And then what? And then what is so important, because that's where the work starts.

[music]

0:00:35.1 PA: Welcome to the Psychedelic Podcast by Third Wave, audio mycelium, connecting you to the luminaries and thought leaders of the psychedelic renaissance. We bring you illuminating conversations with scientists, therapists, entrepreneurs, coaches, doctors, and shamanic practitioners, exploring how we can best use psychedelic medicine to accelerate personal healing, peak performance and collective transformation.

0:01:11.7 PA: Hey, listeners, I'm so excited to have Dr. Remi Drozd on the podcast today. Remi is a physician trained for the emergency room who discovered the potential benefits of ketamine just a few years ago, and has now opened a ketamine clinic in Santa Barbara where he works with people who are interested in not only healing, but transformation through this powerful modality. We've had a lot of medical professionals on the podcast to talk about telemedicine ketamine and what that entails. But Remi is the first person that we've had on who actually owns and runs a ketamine clinic. And so in the podcast today, we go deep into why a brick and mortar clinic versus the telemedicine ketamine approach. We discuss Remi's assessment process for different clientele that he works with. We go into Remi's personal story about what really inspired him to start to get into this work.

0:02:04.4 PA: And it's a phenomenal look as well into someone who had worked in the ER who had used ketamine in the ER to then actually make a fundamental shift in using it, not necessarily for emergencies, at least physical emergencies, but instead to really help with that spiritual emergences. Anyway, it's a beautiful podcast today. I really do hope you enjoy the conversation that we had. But before we dive into today's episode, a word from our sponsors.

0:02:33.8 PA: Hey, listeners. Today's podcast is brought to you by the Apollo wearable. I first started wearing the Apollo in the midst of the COVID quarantine over two years ago. It helped my body to regulate itself, to calm down, to stay more focused, and to meditate in the morning. And I use it to really regulate my nervous system in a time of incredible stress, and I've continued to use it on a day-to-day basis. It is indispensable in my daily routine. Here's the thing. The Apollo is a wearable that improves your body's resilience to stress by helping you to sleep better, stay calm, and stay more focused. Developed by neuroscientists and physicians, the Apollo wearable delivers gentle soothing vibrations that condition your nervous system to recover and rebalance after stress. I tell folks that it's like a microdose on your wrist that helps you to feel more present and connected, especially when in the midst of a psychedelic experience. It's a phenomenal compliment to any psychedelic experience.

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That's it for now. Let's dive into my conversation with Dr. Remi Drozd.

0:04:25.8 PA: Hey folks, welcome back to the psychedelic podcast. Today we have Remi Drozd who is joining us, Dr. Remi Drozd. Remi is a physician, a board certified physician who lives in Santa Barbara and has been running a ketamine clinic there over the last few years. And we wanted to bring him on the podcast today to talk about that process of not only setting up a ketamine, a physical ketamine clinic but also the assessment process that he brings clients through the transformation that he notices, the holistic habits that surround ketamine treatment. And this will be... We were talking about this before we went live Remi that we've had a few other MDs on that have talked about telemedicine ketamine. But you're our first guest that's really running an actual physical clinic, which I think will be really exciting to go into. So I just wanna welcome you to the show and thank you for showing up. Thank you for joining us.

0:05:16.2 RD: Of course, Paul. Yeah, thanks a lot for having me here.

0:05:19.0 PA: So to help the audience orient a little bit let's start with your story. Where you were born where you went to school, how you ended up working with ketamine in particular. And then I'd love to hear you talk a little bit about just the process of setting up a clinic itself, a physical clinic, and sort of what that entails and some of the challenges that maybe came up along the way.

0:05:47.3 RD: Great. So we're going all the way back, right? So I actually was born in Poland, but grew up in New England, Maine, and New Hampshire. I went to school upstate New York at Union College. I took a year off in... Actually spent a year in San Diego. I think that's where you are and... But I did medical school back in New England and ultimately just became an ER physician. That was my calling. I felt like right, everyone... Usually most doctors just find their right pace. And I'll fast forward to the pandemic actually. During the pandemic there was... I think a lot of people started having this interaction between their external and internal environment. They kind of knew who they were with, who they were and their... And all of a sudden the world around them changed. And so it was hard for them to navigate this to their internal climate and in the contents of their external climate being so different.

0:06:44.8 RD: And I was no different. And I'm an ER board certified, ER physician. I was seeing a lot of suffering, and something called to me... When I was a teenager, I'd done psychedelics. It was actually the reason I became a doctor. I did... I had one experience when I was 17 and and maybe just to want to dive into physiology and consciousness. And I drifted away from that and be... I was a good student. But then something called to me and I went camping with some friends and I had this incredible experience where I had a full ego death unity with everything around me. And it was the first time that I realized that there was a difference between subjective and objective. And I could change the sky to white and the sky to yellow.

0:07:33.9 RD: And I realized that all the things that were happening to us, the pandemic kind of wasn't real. It was incredibly real. I saw it every day, but it was as real as I let it. It was... I realized that we're largely responsible creating our own reality. And I was... I embodied that entire experience. So I went back to work and I love the ER. Actually, I still love ER, but it kind of changed it for me. I realized that I could, the world's abundant and I could do anything. And if I could do anything, would I go to work in this way? And I don't wanna sound obtuse, it's not that I didn't want to show up at a job. We all have to work.

0:08:13.9 RD: But part of the doctor, the trained doctor in me died that day and the healer woke back up and I said, "You know what? ER's incredible." But only 40% of what we do is real acute care trauma. Maybe 30% is subacute stuff that should have been taken care of by someone else. But I'm still happy to show up for those patients, and it's good work. 30% of it isn't, 30% of it is, it's mental health. It's people that dial 911 or show up 'cause they're in distress and they don't even know why. They're having a somatic experience from some cognitive issue. They have unresolved trauma, grief, they can't even identify it. The caregivers that are supposed to care for them didn't, there's... And there's... I mean, the list is... This entire conversation can go into that topic. But ultimately they make... They are fighting and struggling. And actually a lot of those... A lot of the 40% that do have real issues, they're actually in the same boat, but they end up abusing alcohol, running out of money and going... Having and needing to indulgent crime to get the substance that need to help self-medicate.

0:09:33.1 RD: And it took me a long time, maybe 10 or 15 years to see it. But as I... After I saw it and then I woke up and I went back to work, I go, you know what? I think I could do more for this population based on the things I knew. And now suddenly I had this calling this it... Suddenly I realized that it was my duty to take the information I knew and actualize it. And so I knew about plant medicine and psilocybin, but I knew it was gonna be years before it's legal. It wasn't my intention... Actually at that point, I did what everyone should do when they have a shake up in their life. I took a sabbatical. I decided to take a step back retreat into myself and say, "What's going on here?"

0:10:18.8 RD: We got an RV, my family and I were in Yellowstone one shiny summer month. I was listening to, I think this podcast, I didn't tell you that Paul, but a psychedelic podcast. And someone there said something about The Ketamine Papers and they're like, "Oh, you have to read this book if you wanna know ketamine and Phil Wolfson." And I didn't... I've never heard of it. And to be honest, I was drinking the demonized ketamine's bad Kool-Aid. I'm a doctor. And then, you know, we get a lot of information. Ketamine is... Actually, I'm an expert in ketamine. I mean, ER doctors use ketamine. It's only us and anesthesiologists that ever use this agent. So I'd use it hundreds of times in children. But there's a common side effect, it's something called emergence phenomena where you have this mimic psychosis is what they say.

0:11:07.3 RD: You have this side effect where you can have an out of body experience. And it actually was... It's so interesting, I think about it all the time at my current work where I go how medicine labels that as a side effect but it's actually incredible. And it would be a side effect. If you're sitting in a fluorescent lighted place surrounded by non-sympathetic people, you're the worst container ever. And you're given ketamine, then you do have a bad experience. But ultimately I went to the visitor center, downloaded The Ketamine Papers, ripped through the whole thing. And I couldn't believe that this incredibly well written doctor was describing the experience I had a few months earlier that seemed so, so obvious. He was describing these transpersonal experiences and in a layered way as a scientist talking about psychedelics different than the guys from the '60s. He was really speaking to me.

0:12:05.1 RD: Fast forward, we end up in Santa Barbara a month later. It turns out one of his, Lauren Taus is teaching a class with Phil as a guest. Lauren's a guest here on your podcast a few years... A year ago, a few months ago. And I ended up having... Going to this experiential training and having this incredible, this tremendously profound experience transcend time and space, this interpersonal intelligence. And it was another affirmation, I just realized that I was exactly where I was supposed to be. And yeah, I moved back to Santa Barbara and honestly a few days later started my practice.

0:12:53.1 PA: So there are a couple interesting tidbits in this. One, as a former ER doctor, you mentioned that only really ER doctors and anesthesiologists use ketamine, right? And that it's often used, as you mentioned with children because it's incredibly safe. And I'd love to... Do you have any sort of... What anecdotes or stories or observations of ketamine in that context, what did you notice about it? What was it great at doing? Why was it efficacious? Why has ketamine been used in the ER now for I think 40, 50, 60 years? Just tell us a little bit about that sort of medical rooting. 'Cause in many ways that's why and how ketamine was invented. It was only, I think in the... Well, John Lilly did it in the '80s, but in the early 2000s that KAP came on board and we went, "Oh, maybe this is effective for suicidality and depression and these other things as well." So I'd love to hear you talk a little bit about the sort of rigorous medical use in emergency rooms and with anesthesiologists. Why ketamine?

0:14:00.7 RD: Yeah. Why ketamine? It's exclusively... It's only really FDA approved as anesthetic, and it's really interesting because it has... It's the only anesthetic that preserves cardiovascular systems in the sense that it doesn't suppress your breathing and it doesn't lower your blood pressure. So it's commonly used in trauma and in places where you haven't secured an IV and you need quickly to change someone's level of alertness. So once you have an IV, you can reverse various medicines and you can support their blood pressure. But it's principally used in the ER, because we can treat a child. If a child had a dog bite to their face and they are gonna have a pretty significant scar and you want to immobilize them long enough to close that wound. You can give them ketamine. And they won't have that emergence phenomena and you can close up their wound and then clean it, and they'll have a good wound closure and you won't worry about their blood pressure changing. You won't worry about them changing their breathing. You just gonna sit by them, without ever starting an IV.

0:15:14.2 RD: So it's been incredibly helpful. I did one of them... My last sabbatical before that one, I spent six months in Nepal and I would... And I was running an high altitude aid post in Manang and we had ketamine there...

0:15:30.4 PA: I have been to Manang. Manang is beautiful.

0:15:32.4 RD: Cool. Yeah, I was there and then the earthquake hit. So that changed my...

0:15:37.3 PA: Oh wow. Wow.

0:15:37.3 RD: But through the first three months I would do dental work on kids and I'd pull out teeth by giving them ketamine. So it's... And there was... And I remember thinking, I'm like, "This might be a bad idea. I have no support here, should I be doing this? And it's the only agent that I've I trust in that way 'cause... So. And I'll tell you actually a theory at the risk of someone telling me that it may not be accurate. I always say that psychedelics are wasted on the young, psychedelics are almost designed to help you reevaluate your ego and if you don't have an intact ego then you can't have a dissociative experience.

0:16:15.8 RD: So I think on young children, it's almost like they can't tell the difference between reality and not reality. So it won't be anxiety provoking or challenging to have the psychedelic experience for a little kid. They'll just kind of go to sleep and come back and they're like, "Yeah, whatever, it's Flintstones. I saw God [chuckle] the same thing."

0:16:37.2 PA: Now why only children? So you mentioned a few times that you use ketamine in the emergency room often with children, same in Nepal. Why is it not necessarily used as an anesthetic for adults or is it at times it's just not... It wasn't necessarily your expertise or background?

0:16:50.6 RD: Oh yeah, great question. So it is used in adults a lot in adults and it's... But only really safely at higher doses. If you do it at the lower doses, they'll have this psychedelic experience and they'll have that emergent phenomenon, and they'll have a consciousness experience that now you have to manage. So you take a client that you try to stabilize and they come out and they're having... And now they're having a crisis episode 'cause you just, you scared them. [chuckle] They just saw something that was profoundly psychedelic and now they're more unstable than when you started. That being said is excellent to mix it. So if you give ketamine and a Benzo or ketamine and Propofol or ketamine and Etomidate then it mutes that response. And so therefore... So it is used in adults. But in the ER you kind of have your Swiss army knife of tricks. And so in... As an ER trained provider we use that for kids.

0:17:50.1 PA: Okay. So trivia question, and you may or may not know the response to this, but I thought I would offer it to you since this is kind of part of the conversation. When was it that ketamine made the leap from just being used as an anesthetic in emergency rooms and hospitals to, "Oh my gosh, this could actually be extremely helpful for suicidality depression." Do you have any sort of context on why that leap happened? When it happened? Just any sort of background on that in particular.

0:18:18.5 RD: Yeah. I wish I was more prepared. I did a lot of this reading when I first got into this. I know I could think back to Eli Kolp, was this Russian researcher that did really great work on addiction and specifically alcoholism. I don't know what year that was, it was more than 10 years ago and... But let's say 15 years ago. And I remember reading some really good data, just looking at the difference between putting people into alcohol rehab with no programming versus really intentional program versus really intentional program and ketamine. And it was unbelievable how much more effective the combination of all three were. And I think this is one of the first things that really caught my attention. But I don't know when kind of the Western KAP model started. By all means it was not popular even it's five or six years ago, but I don't know its origins.

0:19:18.3 PA: Yeah. We had Dr. Jeffrey Becker, who's a friend and a psychiatrist on the podcast. He's also... He's in LA and I think he mentioned that he had started working with it in the early 2000s, maybe 2002 or 2003, and that he was one of the first to utilize ketamine within sort of a psychedelic way. I don't remember when The Ketamine Papers were published by Phil Wolfson, I want to say 10 to 15 years ago, maybe like a good enough time, it wasn't necessarily recent. And of course, this even gets into sort of KAP versus the injection. Sort of just come in, gets six injections, see you later. I'd love... Sort of the next evolution of this conversation. I'd love for you to talk a little bit about your methodology at the ketamine clinic that you're running in Santa Barbara, and how it defers from a more traditional medical model. And just so the listeners have context on that, there's a lot of ketamine clinics that just simply do ketamine infusions. You get an infusion, you sit in a chair for an hour, and then you go, there's really no prep or integration. And so anyway, yeah. I'd love for you to just talk a little bit about kind of your model and how it differentiates from that.

0:20:34.5 RD: Yeah, yeah. You are right. And when I enter this space, I evaluated that, and I was shocked by how many infusion centers just do infusions, but it was so clear, and I had really great teachers. I was taught by... The therapy model right away, that we're responsible for creating our reality. So what's, what do we do with that information? And I learned by running this practice and getting the phone calls and hearing what people need. The truth is they call because they're desiring to make a change. And I think I've heard it here. I've heard a lot of places, when the... Change happens, when the desire for change is greater than the desire to stay in that pain. So everyone wants a change in, typically it's depression, anxiety, trauma, and they've tried multiple modalities, and some of them haven't, desire to change also comes from people that are well, and their doctor says, "We should put you on Lexapro."

0:21:31.5 RD: And they go, "I'm not that guy, I've been meditating. I've been doing all the right things. Why can't I get better?" So, our practice focuses on creating that awareness to... Allows people to deepen the relationship with themselves, so that they know who and how they can change in the first place. So everyone sees one of our integration coaches no one just gets ketamine. We start by sitting down, having a deep conversation and chatting about, "What are the things that you're looking to gain from this? What do you wanna let go? If this were to be very successful, how would you be different?" And we create this exercise, this daily somatic practice, journaling. I have everyone write a haiku every day day, write a gratitude practice. We create a mantra together using the word, show me, teach me, help me. And I want... And we customize it to them, show me how to... Not like, change my life but it becomes very specific to them.

0:22:31.1 RD: And they have to show up as an active coping mechanism, because if they're not doing some of the work then... We're not willing to work harder than they are. But if they're not doing some of the work and they're not writing the invitation to change. Really, you have to create or write the invitation to be spoken to by this psychedelic experience. And then... And that's the mindset, the set and setting, it's almost cliche, but so I won't even jump into that. But I'll say that that invitation is the mindset and then the setting's, our job. Our job is to cultivate the right environment for them to listen. So you've been spoken to, and here we'll listen. Someone's always gonna be sitting with you, witnessing your experience and reflecting it back to you. We're both writing it down. But our therapists are incredible actually. They're all experienced in non-ordinary consciousness.

0:23:28.7 RD: Some of them tell me they like see one another's experiences. It's pretty high touch. I'll even use the word intimate and that shift happens differently for everyone. So it's not like a protocol. But once people have that little program, they spend a week or two doing it, and they start to self-actualize. And I tell them, "This isn't gonna make you better. This is gonna deepen your relationship with yourself." Some people say that does make them better. Others say, I don't know. I'm... I just feel more of the shadows. I go, "That's okay. Knowing your shadows is important because when we disintegrate your shadow into a million pieces, I want to know how we wanna rebuild it. There's not enough space on this planet to bring back all the things you just saw. So let's be selective about it."

0:24:17.9 RD: And so, once they kind of know who they are, once you have some self-realization, you can have this... Your own transpersonal experiences. Just with seeing a sunset, making eye contact, and having a really beautiful experience with someone at a party or an event. That's the goal. But the way the medicine works is, will take a round trip ticket from the desire to change, right to that transpersonal experience. And once you get there and you skip all the steps in our clinic with ketamine, it shows you the truth. It shows you the absolute truth. And that's like the truth will liberate you. It'll liberates you from those old beliefs and the narratives that had you stuck. And it'll show you. And if you already cultivated those words and you've said, this is what I wanted to let go, this is what I wanted to see more of, this is what was serving me. This was... This is what I hate. Then it'll show you that all the work needs to be done here or somewhere else, or it'll show you something brand new.

0:25:21.2 RD: You don't get the trip that you want. You get the one that you need. And then what? And then what, is so important, because that's where the work starts. A lot of people come to me and say, "Okay, I read online this is gonna be three or six journeys, might have to pay for boosters. This is a life of work. The truth is, once you see, once you hear the message your work has just begun. Doing three to six is onboarding to conscious health. And that's, we tell everyone, "We're here, we're gonna learn as much as we can from you, and we're gonna help you learn as much as you can about yourself."

0:26:00.2 RD: "And this might take three and we might never see you again, but if this takes six, and then you pause, and then we keep working together, we'll do whatever it takes." We kind of put everyone... We give everyone an opportunity to understand that there's three ways of rolling out of their onboarding. You can take the experiences that you've learned just like learning a good diet or going to CrossFit and onboarding at the gym, and you can go home and practice this daily. If that works, you're gonna feel great. You're gonna feel a lot better. You've opened doors and you've made changes in your life. Other people, you take those techniques, but you can't quite get everything out of it. So we endorse holotropic breathing. Go find friends, indulge in plant medicines. There's a lot. There's things that are legal out there. The things that are... Things that you can access that are safe.

0:26:52.9 RD: And then yes, you can stay in our programs. Not even even us, myself, the therapists that I work so closely with, all of us are healing and we're continuing to heal. So I sit with the medicine about quarterly. So I said the same thing, if you can do this work and you want to come and sit with us quarterly, that'd be great. Also we're opening a much larger practice in a few months, and we're gonna have group integrations probably weekly, maybe biweekly sound baths with the medicines. Once you're a client of ours, you can get medicine at that sound bath just like it's a treatment. And they'll be the traditional sound bath. And we have some of our therapists and musicians will create these programs, community events. And so this isn't for you to do alone. It's not like, "Take this pill, go home and tell me if you're better or worse." This is, "Open yourself up and then let's heal together."

0:27:52.6 PA: So a word that's coming up as you're talking through this is discernment, right? So if the shadow has opened up, if there's an awareness that's come to, if there's a memory that's recalled, if there's a step that wants to be taken, right? Then there's a process of, okay, well what aspects of myself do I wanna let go of because they're no longer serving? And what new ways of being do I wanna step into? And I think this gets to your point about the necessity and importance of an integration coach. And so to... And to work with coaches and professionals as well. Like I really commend you for, like you said, you're doing this quarterly, you're doing your own inner work. You mentioned something before we went live, which was, for healers, for people who are holding space, they can only take clients as deep as they've gone themselves. And I think that's especially relevant for psychedelic medicine for ketamine. Because the experience is not necessarily... It can't be fully described by words and the felt experience, and what comes up in that is quite important in terms of what we embody.

0:29:04.8 RD: Paul, let me finish your thought there or contribute to what you said there. The entire value of this experience can be experienced in a single moment. And when you're in this experience, it might feel like months, but it could be in a second, and if you're... And people sit up and they'll just say, "Everything is different now." And if that coach there will witness that, and she can reflect that to you today in the moment. But then really more importantly, the next day, and I get... I hear so much feedback on they... Someone will walk out a little bit dazed, shocked, really awestruck, it'll be incredible.

0:29:43.6 RD: But if they don't remember, they might lose that opportunity. So the next day when they do the integration and there's a one-to-one ratio, no one skirts by. If you're not showing up, we created strict boundaries. You have to integrate or else you are not healing. The next day they'll say "Everything... After it all precipitated back in my body, then my coach reflected it back to me, and the meaning totally revealed itself." So without coaching, and coaching isn't to complicate things, doctors complicate things. Coaching is to simplify things into a feeling, into a subjective experience. So I agree.

0:30:22.2 PA: That's met and personalized for the individual who's going through it. And so what you're talking about is a mirroring process. And that's so necessary and important in a coaching. Because when we mirror back that power to the clients that we're working with they can come to a fuller recognition of it, which leads to, there's an incredible sovereignty that comes from that. And it also speaks to the power of community in that we're not doing this alone, we're not doing this as individuals. And I want to get into this in the... I think towards the end of the podcast. 'Cause I want to hear more about kind of the vision of what you're building in Santa Barbara as you start to look more into group work as well. 'Cause I think group work with ketamine or any psychedelic for that matter has a potential to be even more healing because of the bonding and the sort of social fabric that comes from that.

0:31:11.2 PA: So one question that I had that's coming up is we've had quite a few folks on the podcast who are... They're running telemedicine ketamine businesses, or they're doctors who are co-founders and medically supporting telemedicine ketamine businesses. And there's a lot of upside to telemedicine ketamine. Some people would say it's less expensive, people can do it from the comfort of their own home. It often happens with lozenges, which can sometimes be a little bit softer than let's say an IM treatment or even IV. And what's great about telemedicine ketamine, that's what's great. But what's interesting is there was a research paper that was published maybe three to six months ago, Mindbloom helped to lead it, where they found incredible efficacy for telemedicine ketamine. I forget the precise numbers, we'll link to it in the show notes, but it was substantial. It was something between 60 and 70% of people saw a reduction in depression and anxiety and other symptoms.

0:32:11.9 PA: So I'm curious with someone who runs a physical ketamine clinic, I would love for you to make the case as to why in-person ketamine in a clinic may be more beneficial for certain types of people. Why a clinic? Why in-person? Why do you think it's, again, not to say that these are mutually exclusive. But why do you think it's a great way to do things with ketamine specifically?

0:32:37.8 RD: It comes down to my personal experience. And the first thing I said on this podcast is I showed up to work and I had an incredible job. And I said, I don't wanna show up for 40%. I think I can show up for 95% or a hundred, whatever. So I've tried IV treatments, I've used troches, I've done a little bit of nasal spray work just in the beginning. And it was very obvious that it's all about the container, the container and the modality. So how can we max build the thickest walled container so we could do the biggest work? So I got really lucky and met some incredibly people. And we kind of trained together and we built a program that was very effective. So if I've got a thick walled container that I can use, that I want to use the most powerful agent. So IV and IM have the pharmacokinetics that'll get... That will put you into a psychedelic place very rapidly and will dissociate you from those narratives.

0:33:50.3 RD: We're here to eradicate old beliefs and narratives so that you could stand next to it and say, "I don't want that. I can't believe that's been governing my life." That being said some people have in credible troche sessions. It's harder, a little harder to... It's slower onset and there's fewer, there's more side effects. But God, I want everyone to feel better. My purpose is to just to get my community to smile. There's no better thing than standing in a coffee line, you know, we have some great coffee shop at Santa Barbara, and just being surrounded by good, happy peoples. I just want people to vibrate higher. So... And ketamine is expensive right now. So doing that is... So ketamine lozenges at home is a good modality. I just think this one's a little better. So I'm gonna spend my energy and doing this, and if I can figure it out, I can make it cheaper, and more cost effective. I feel like I've just started, so we're gonna, I've got a lot of ideas and and I think we can offer to more people. And there's some people doing that, and I'm gonna let them run with it. And I think it's... But I'm not against it. I think giving people the medicine and making sure that you support them as best you can is exactly what we're all doing together in just different ways.

0:35:15.8 PA: And to speak to that, I love how you described it like the... It's a thick walled container when you're in... And both literally, but also metaphorically, when you're in a physical clinic. And that allows you to take the patient deeper, which one thing we've learned from the clinical research on psychedelic medicine is that oftentimes the deeper the experience, the more profound the healing. And like you said with lozenges, it's difficult for the majority of people to go very deep, largely because they're just very new at working with these types of medicines. So they don't know necessarily how to perfectly dial it in.

0:35:57.9 PA: Again, I think this is the role of coaching and assessment, which I want to hear a little bit more about from your end. This is part of our training even for coaches. We'll coach our coaches on, if you're gonna have ac ketamine experience, you're coaching someone through a telemedicine ketamine experience with lozenges or troches, how can you still help them set up a container that could be incredibly profound and deep? And I talk a little bit about my own example in that I did the Mindbloom protocol a couple years ago. And I set up a session, I was living in Miami at the time. I set up a session in my little studio where I had an acupressure mat, the Shakti Mat, I wore the Apollo Neuro device. I used a playlist that Mindbloom had provided, and I did 300 milligrams of ketamine in lozenge form and swallowed it. And I was on the verge of full disassociation. And if you take too much as you know, you can black out, just don't remember.

0:36:51.6 PA: But I'd previously done 100, 150, 200. So I kind of knew the general landscape of that. And I assumed by having a grounding device with the Shakti Mat and a physical like... I don't know if you know Shakti, acupressure mat, but the... It keeps you really physically open and grounded. And then the Apollo would just help with regulating my nervous system. So it didn't tip too much. I had, and again, this is just, I'm literally laying on the floor of my studio in Miami. I had one of the most meaningful experiences that I've ever had with psychedelics. I had this full-blown mystical experience where all of this anger and resentment that I had been holding in my root chakra, which I tend to hold more than I would prefer, just sort of came through and I ended up having this loud yelling sound that just came out of me. I didn't force it, I didn't try to do it even, it just came out of me for about three minutes where I just was releasing release...

0:37:50.8 PA: And after that it felt like I had lost... I let go of a million things, a million pounds. And I came out of that session with a ton of downloads and insights about X, Y, and Z. I wrote... We'll link to it. I wrote about my experience, I did a couple of blog posts on it, 'cause it was that meaningful. And again, what I'll say is the same thing I mentioned before, IV and IM it's a bit more, I don't wanna say guaranteed, but more likely to happen. And a lot of the way that these telemedicine ketamine companies teach people is they teach them to just simply swish it in their mouth and spit it out. And again and again, what I hear from folks is it's helpful, but it's not necessarily deeply, profoundly meaningful. Because of course, the telemedicine companies are essentially trying to hedge their potential liability. 'Cause they don't wanna send people into a deep, deep, deep, deep state if a trained professional isn't physically present necessarily. So just some interesting sort of contacts and trade-offs of in-person versus telemedicine.

0:38:50.8 RD: And actually, I could speak directly to that. I've treated... I've done at least 1000 treatments since I've got to Santa Barbara. This is all about the act of surrender. And it's all about the active intentionality. You are running an incredible psychedelic podcast, you're not only hearing and interviewing and getting educated about consciousness every week, you were obviously a student of consciousness. You're gonna be able to surrender. You may be able to get that level of surrender with a different modality. You might need less. What I have to deal with is everyone, and some people they want to heal and surrender is very challenging. I mean this isn't Ayahuasca. And ketamine it's not a guaranteed surrender either, but it is an easier surrender than most typical psychedelics.

0:39:51.4 RD: So for someone that can surrender, troches will get you there, perhaps the same or... So what I can control for is a general population. And as psychedelics are becoming more mainstream, we're getting more people that wouldn't normally relate to the counterculture or to people that would do drugs or the psychedelics at all. So we have a lot of education. So the prep work becomes intentional, but there's... In... When you enter their subconscious, they're still pumping the brakes pretty hard. And that won't come out. They'll be very aware and very alert and very deliberate about what they want to do.

0:40:24.7 RD: But they're a little nervous. They're too nervous to surrender to it. That's the last thing I tell everyone. I go... We do some breath work, we do a lot of intentions to help. Right in the bed, right before I do the injection, I go, "Now surrender." And I say, "Surrender is not the act of going to a zen bliss blackness. Surrender is letting, allowing anything to come up. Lean back, float downstream. Don't anticipate the turns. Don't worry about brushing against the bottom of the riverbank. Let anything happen." How many people do you know that can surrender and let go of the steering wheel ever? So I am really, really push and push, move the needle on the surrender part. You probably just stood at surrendering.

0:41:10.9 PA: One, it dovetails with what we were talking about earlier, which is this isn't just do the drug and see you later. This is building and cultivating a relationship with it. That this is not simply one and done or do I need to get more boosters. But this is the beginning of, for what many, many people, is an entirely new path because of the ego dissolving sort of nature of psychedelics and especially ketamine in many regards. And so I think what you're speaking to is just like we can learn the skill of psychedelics, we can also learn the skill of surrender or letting go. And the sort of cultural framework and community and even family framework that so many of us have been raised in does not necessarily encourage that skill or that capacity.

0:41:55.4 PA: And so what I'm even learning in this conversation is there's a beautiful overlap then between the skill of psychedelics and the skill of letting go. And that what is central to the efficacy of these medicines is the capacity to let go. And I think one more note on this, the medicine... The type of medicine will dictate the sort of amount, if you will, of letting go. Or not even the amount, but the nuance of it. Because as you know, ketamine has a different sort of come up than 5-MeO-DMT, which has a different sort of come up than Ayahuasca, which has a different sort of processes compared to LSD. And there's a lot of nuance there. But the final example I'll give is for me, it's no problem to let go with the use of ketamine. It's very easy to surrender, and I think it's a great medicine, just for a lot of people to start with for that reason. Because it teaches them how to let go and it doesn't...

0:42:57.6 PA: It can be difficult for some, but I've heard way more horror stories about 5-MeO-DMT. And I think 5-MeO-DMT is a bit more of a punch in the face. And so even... I've worked with it twice, once at a high dose, more than a year ago, now. And what I came away from it, thinking and sort of reflecting on is I really don't know how to let go and surrender. Because with 5-MeO, it's just like everything. And I ended up, I wouldn't say I fought it, but I definitely was very active in it. I didn't simply surrender into unity consciousness and divine white light. And when I came away with after that, I was like, I would really love to work with 5-MeO more often, because it really does feel like a master teacher in that regard. And that as I would imagine, as I work with 5 more, there's just more and more of an ability to totally let go and surrender.

0:43:50.6 PA: But, or, and there's still something important to be said about creation, about being active, about being out in the world. And I think what I've seen with some people who work too much with psychedelics or too much with 5 or even Ayahuasca, is there can start to be a detachment that feels somewhat nihilistic and somewhat, I would say shirking responsibility. And so, yes, letting go is an important skill to teach. And like you said, that that sort of commitment to conscious health, when we come out of that is so necessary than to go, "Okay, I can totally let go and allow what needs to emerge emerge." And so much of integration then is, how am I, like you said, putting back the pieces to create a new existence or a new reality?

0:44:37.6 RD: Yeah, absolutely. Every spirit has a different way of teaching us, 5 and psilocybin. And I think maybe someone that's really good and can really communicate well with one, doesn't necessarily just have a free ticket to the next one. But luckily that's all in the pipeline. I think proposition 519 is gonna get some more of these agents legalized hopefully in a couple years.

0:45:08.9 PA: Is this the one in California, right? That's Scott Wiener has been working on.

0:45:11.0 RD: That's right. Yeah, I think came out in August. So he's looking at a few agents, but psilocybin and DMT will likely be, will piggyback on that. And we have... And I did my MAPS training. So.

0:45:24.9 PA: You did your MAPS training with MDMA?

0:45:26.2 RD: Yeah, I did my MAPS training and so...

0:45:27.0 PA: Yeah. What, tell us a little bit about your training in terms of... I mean we heard about the ER and you went to school. What's what... You went to Union?

0:45:34.0 RD: Yeah.

0:45:35.3 PA: Okay. In New York, right?

0:45:36.7 RD: Mm-hmm. Upstate New York.

0:45:38.0 PA: Okay. And then what other trainings have you done? I remember you mentioned the Lauren Taus with Phil Wolfson. Have you done ketamine trainings? Have you done MDMA trainings? Tell us a little bit about kind of as you've now become interested in this space, who have you learned from? What programs have you done? Why did you choose those programs?

0:45:55.5 RD: Yeah. It's so interesting. I'll say... I wanna begin the... I'll slightly answer that differently. I couldn't believe that after doing one training that all the trainings are the same. It was... Actually I could almost pitch myself to realize that all this work is identical and all you do is you change the dose, you change the intention, and you change the side effects. But all of it is the same. And a couple times during the MAPS training, that was the best written one. I was like this is what I've been doing for seven months. And I'm like, I don't think I've made it up, but like, where did I... I think like I got a little bit from Lauren and I read a lot. Like I did a really intensive cell study on the existing materials.

0:46:41.4 RD: I'm like, this is... And then so every iteration of it has a similar flavor. The things I'm describing is now my nuanced version of it. But the trainings, it's I think really encouraging. Working in non-ordinary consciousness is kind of like one experience. And so it becomes how are you pulling out the material? How are you getting to liberate someone from these narratives that are causing them trauma and internal strife? And to teach them that we're living in a constructed world and that you have an option to change your mind. To realize that the trauma happened but suffering is optional. What are you gonna do with that information if it's real. And so the... I think the next legal agent is gonna be MDMA. Probably... I met with Rick Doblin in September, and we chatted about some of the ideas I had and his team.

0:47:46.0 RD: And I think in my training, they thought it would be legal this year in '23 and the end of '23, but his team was pretty convinced it was gonna be second quarter of '24 at best. So I think that's the next one I'll add. That's quite different though. With MDMA, your, it's, MDMA is 2,3-Methylenedioxymethamphetamine. It's a stimulant. Your frontal lobe is firing. You are very awake. It is a strong empathogens, it's... It up regulates the same receptors like mescaline would. So it has a mystical type flavor, but ultimately its signature is empathy and connection. So you can connect to your trauma and with your amygdala muted so you're not really aggravated and work through it. With the other agents, DMT, when that comes online, that's another... It's not a dissociative, it's a strong psychedelic, but that takes your mind off. So you are entering it from a completely different corridor than the one that you normally use. But I feel like MDMA is kind of the same corridor with a lot of different experiences peppered throughout.

0:48:51.0 PA: It's interesting that you mentioned there's a ton of overlap or a lot of these programs are one and the same from, especially from the perspective of someone who has built and developed a training program. I think this is what I've always been mindful to or aware of, that I do think a lot of the clinical and therapeutic models, let's say CIIS, MAPS, IPI, I believe Phil Wolfson has one. A lot of them do have significant overlap because they're more or less created from the same philosophy, let's say. And I think what's really unique about our program with Third Wave is the philosophy is a totally different lens, and that the focus isn't on the clinical, therapeutic and medical, but it's on the sort of betterment of well, people performance, leadership, growth, creativity, awareness, etcetera, etcetera.

0:49:37.4 PA: And I think that is often what's required, especially for a lot of these medical professionals in the space. As you said, the more complexity they can hold, the better healers they'll become. Because the type of clients that they're working with are very unique and they're getting to the core and the essence of who they are by working with this medicine. And so my lens or my North Star in developing our training program has always been a sort of phrase, which is inner transformation leads to external mastery. In other words, if we as coaches or facilitators or space holders can transform our inner worlds, if we can enrichen our landscapes. So if we can explore more of what's between the antipodes of our existence, then by doing that, we in fact, we come out into the external world, way more capable. Way more powerful, way more sovereign, way more more able to handle all of the sort of curve balls that working with psychedelic medicine might throw you. Because I think if there's one thing that I've learned being in the psychedelic space for this so long, the most important skill to train, even more so than letting go and surrender, and even more so than the skill of psychedelics, it's the capacity to be with the unknown, and to be with uncertainty and to be with that. The liminal space because...

0:51:04.1 PA: And surrender is part of that, and the skill of psychedelics is part of that. But I see the sort of that capacity to be with a non-linear or mythical intuitive world. Then if you're a coach and you have that, then whatever needs to flow through you will flow through you and so... Anyway, so I just thought I'd share a few things on that. Okay, we have about 10 minutes left or so... I wanna get a final couple of questions in that are practical questions for you. One of which is, tell us a little bit about who comes to the clinic, kind of demographic-wise, what type of folks who are seeing. Are they only from Santa Barbara, do they come from all over Southern California, other places? What are they often struggling with, why are they coming in, why are they choosing your clinic, and then what's your assessment process? What process do you bring them through if they say, Hey, I wanna come to Remi's ketamine clinic, what do they have to do before they actually land in your space and have that ketamine?

0:52:17.0 RD: Sure. And so democratic first. So it's a little bit more female. Let's say 60% of women to men, I think 'cause that's... People are willing to work on themselves, and I think that's probably similar to just therapy in general. I'd say it's 80% are driving and are close by. And 20% heard, somehow picked up on my videos presentations or podcasts and realized that it resonates with them and they'll come out here and travel and stay here. And who are they? It's interesting, they have to be told to show up. So the media, the world has told them that treatment resistant depression, anxiety and trauma is... Responds to psychedelic therapy. And How to Change Your Mind, the Netflix series, a lot of people have pinged us and said, "Do you have psilocybin?" "No." And then they do a little research and come back two weeks later, "Oh I think ketamine does it too." And then they actually sign up. And so it's people that, as the first thing I said, desire change.

0:53:23.3 RD: And they're told that this can work for them. And I'm gonna explain my answer and say, what I'm doing now is trying to tell the world that it's for everyone. It's for you and me, and it's for people that are looking to go from good to great. It's people that realized they all have a little bit of shadow work. They all had adverse childhood events, or they had these little minor traumas. I think I saw someone just a few days ago, and they're just talking about like, "God, my life is kind of perfect, but I'm losing these qualities in my life. I want to open some doors. I wanna liberate myself from all these limitations."

0:54:05.0 RD: In order to live well in this, I'll just say, mildly toxic western world, you've gotta be really well adapted. And you've gotta have, put up some thick walls. You've... A doctor, an ER or doctor woman in the in the hospital has to deal with all the male egos. I just watched... That must have been difficult. It's only barely getting easy. And then there's a million other archetypes like we talk about. But we have to build up all these walls and we do decades of work to create these walls so that we can function and get paid and survive. And then we go home and supposed to just take them down, just relax and love our significant other and be a great parent or I don't know, and have fun. So those three populations are showing up, but my team... And we're beginning to try to find a platform to say, this is for people that have a personal coach. And then they go to the gym every day. They don't have a cook per se, but they understand nutrition and they're making good food for themselves, consciousness health is next.

0:55:17.1 RD: And it doesn't have to be in the clinical set like mind, but that soon plant medicines are gonna be legal and there's ways of approaching this, and if you have some coaching... And I know you guys are even offering that. If you've got a little someone to help you, guide you through it, it could be incredibly meaningful. So those are the... Those are the people that are coming in here. And I apologize. What was the second question?

0:55:40.5 PA: Oh, your assessment process. So once...

0:55:44.4 RD: Oh the assessment process.

0:55:45.6 PA: Yeah. Like what process do you bring people through? Do you have to... I imagine there's an interview because it has to be prescribed. I imagine there's an assessment form, an intake form in which you ask them questions. But I'm just curious, like yeah, what is that process like? What do you think is important for you to understand and discover about that client as they're going through that process?

0:56:02.1 RD: Sure. We have a very detailed protocol and I don't wanna bore you with it, but it's... I had a 67 question questionnaire and you call our office and it's... And they have a very mild screening process. And the reasons that the hard stops are organic mental health disease like schizophrenia, Schizoaffective disorder and mania bipolar with mania... Addiction. We work with, but people that have strong... That have addiction and they can't show up sober, you can't work with. You have to have some element of control. As long as they make it through a minor screening process, then we ask them 67 questions. And I'm asking some really personal questions. I wanna know how they... What they do for fun. What's their... Do they have traumas? What were their childhood like? And I'm beginning to pull apart these details about what their life looks like and what they want. And so that's really how we're cultivating the relationship. But then the screening process then goes into just seeing if they have enough insight to work with the material. Some people show up and says, "I'm here to be... " I saw someone just a few weeks ago, it's kind of funny. And I told him like, "This is an active coping mechanism."

0:57:31.5 RD: I'm doing my talk. We need you to show up. And then, and I'm like, "You canceled on your prep with your therapist. What's going on?" And he is like, "What you... I have to do all this stuff." And his just face drops like, "Oh, oh man, can I still have the medicine?" I'm like, "No, no, you, this is work. If you're not doing it now, these are the boundaries I'm setting, then you're not gonna do it later." So we can only, you know, meet you halfway and you've... And I've already gotten 70%. So... And we'll give them a little bit of wiggle room, but insight's actually really important, but most people have that. There's way more to it, but I'll leave it at that.

0:58:15.5 PA: Maybe we could link to it. I'll just... For whoever edits this, if you have a... If, not the private form, but if you have any other context or detail that you want to share and it's... I think it's potentially helpful. And specifically speaking to the facilitators, 'cause there are a lot of coaches and therapists and doctors who listen to this. And so knowing that assessment process and I think even being open sourced about it, and I'm not saying you should be now on the podcast podcast 'cause I agree that a level of detail is not necessary. But the more we can open source these, without really worrying about, oh are they gonna steal mine or whatnot, then I think the... Everything is personal often to the coach or to the clinic or to the... Like we all have our own little unique distinct way and we come up with these... We come up with any new creative process by collecting others and reviewing and assessing through and all that.

0:59:04.7 PA: So I appreciate you sharing some of those context. I think the holding a boundary of ensuring that that client makes a commitment is important because I think what people have been conditioned to do is to just expect miracles without doing much. And what we know time and time again is transformation comes through willful participation. That you really have to be wanting it for it to actually shift and change. And so that's a great thing to prime and coach people on.

0:59:33.9 RD: You know, one thing I learned early on and I started this practice as just a sole proprietor. 'Cause I wasn't sure it'd work. I believed it 'cause I had an incredible experience, but I wasn't sure if I could really make a business out of this. And within my first a hundred clients, I realized that half of my work is teaching people that after they have the first journey that blows their mind that they're gonna come back down. That this isn't... We're not going from peak experience to peak experiences and doing a bunch of spiritual bypass here. I'm like... And so then they'd email me the next day. It was almost like clockwork. "I can't believe that I can't go back to those old ways you've changed my life. I'll never have this experience." And I... Sometimes I'll be like, "It's... Just in a couple days you're gonna start to feel your own self come back to this. I'm so happy for you, but this is where you need to really look inward."

1:00:27.5 RD: And then they do it and it's successful. But I really learned how to... I had to reorient people to not wanting to chase the dragon to connect peaks that you... That... When you have that peak, that's when you have to really focus and say, "I love this as much as I love the shadow." And that's where the real work is done. Having people, it's like, it's all this rain we got in Southern California, fill your... Fill buckets with the rain because it's the red... The droughts coming. And so you... We really need to prepare people for the drought. And even though we've come in with a fire hose.

1:01:07.8 PA: Remi, it's been a pleasure. I wanna honor your time. I know we had until half past three. If people want to find out more information about your work, where, where can they go?

1:01:17.6 RD: Let's find us online. Where... My companies are... My practice is Lucid Therapeutics, so thelucid.life, and we're gonna... And we're doing more community outreach. It's all about community. So I do wanna share, actually we're gonna do monthly masterminds where I meet with the providers, the therapists, the doctors where we do go over cases once a month and I'll share that. You can get on our list, we'll share that there. We might... And we're looking to roll out integrations for free, for people that wanna tag into integrations, that would like livestream from our practice. A sound bath where you can kind of tap in and say, "I'm... I don't wanna drive across town or I'm in Illinois." And so connect and share and give. So we're gonna... So thelucid.life is our website and that's where you could learn about us and, and see things that we're doing.

1:02:08.1 PA: Beautiful. Well, thank you for sharing so much wisdom today and knowledge. It was a pleasure to have you on and I look forward to visiting at some point and experiencing what you're up to.

1:02:19.6 RD: That'd be terrific, Paul. Yeah, thanks for your time. Thanks for the real intentional interview.

1:02:25.6 PA: You're welcome.

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