Combining Ketamine Therapy with Other Modalities with Genesee Herzberg, PsyD

In this episode of the Psychedelic Medicine Podcast, Jon Dean, PhD joins to discuss the potential of psilocybin therapies for phantom limb pain. Dr. Dean is an assistant professor at UC San Diego, where he co-founded the Center for Psychedelic Research and his laboratory conducts fMRI-based studies on psychedelics such as psilocybin and DMT for relief of chronic pain and neurological conditions. In this conversation, Dr. Dean discusses emerging research on psilocybin as a potential treatment for phantom limb pain, a condition that affects many people following an amputation. Preliminary findings from his small pilot study suggest that a single dose of psilocybin may produce clinically meaningful reductions in both phantom limb pain and residual limb pain lasting at least four weeks. Dr. Dean also explores potential neurological mechanisms underlying these effects, including changes in communication between the brain's default mode network and thalamus, and discusses the importance of further research to establish the treatment's safety and efficacy. Looking ahead, he considers how combining psychedelics with targeted interventions such as mirror therapy could improve outcomes for people living with chronic pain.

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 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 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 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.