The Practice of Therapy

Dori Lewis: Hi. Well, thanks for having me on the Practice of Therapy podcast today. My name is Dory Lewis and I'm excited to join you to talk about psychedelics, ethics, and maybe a few myths and misconceptions that people have about this work.
Gordon Brewer: Perfect.
Hello everyone and welcome again to the podcast and I'm really happy for you to get to know today. Dory Lewis. So welcome, Dory.
Dori Lewis: Thank you. I'm so glad to be here.
Gordon Brewer: Yeah. So Dory is is kind of, her expertise is in the use of psychedelics and that sort of thing, but as I start with everyone, Dory, tell folks a little more about yourself and how you've landed where you've landed.
Dori Lewis: I'm a licensed professional counselor in the state of Colorado. I've been practicing as a therapist since I think 2013. I. Originally did not start in the psychedelic space. I started working in community mental health work in New York working in therapeutic foster care and outpatient mental health services in Brooklyn.
And really loved doing that work. Loved the community-based work that I was doing. I was doing that for about four years. Moved out to Colorado and started to work for other folks in private practice and got my feet wet in working in that space, and then eventually opened up my own private practice in 2018 called Reflective Healing.
The intention was not to do psychedelic work, it was really to do transpersonal, which is like kind of psychospiritual. Talk therapy with women and sex therapy work. And then it kind of slowly became its own being as I think our creations often do. And I started to get into ketamine, work through a few clients of mine who are utilizing it in the community.
And then I was trained officially. And then I started teaching at trainings, teaching about set and setting and ethics and cultural appropriation in psychedelic spaces. And it kind of just grew from there. It's been its own organic evolution.
Gordon Brewer: Yeah, that's really cool. I love hearing people's stories and just how they, kind of go along this path, you know? And in our therapeutic work, I think all of us, I think back when I first started in, into, into the therapy world and that sort of thing is totally different place now than I was then back in the day when I was working for an agency. So, I mean, it's just neat to hear how it evolves.
So, I know, I know one of the things that we were talking about before we started recording was just maybe some of the myths around. The use of psychedelics and mushrooms and that sort of thing. And one of the things that you said that just kind of stuck, stuck out for me was just that particularly mushrooms are not a good use, not necessarily.
A good indication for trauma and so, mm-hmm. Yeah. So tell us what you know about all of that and what you've learned.
Dori Lewis: Absolutely. So, like I said, not all psychedelics are created equal, right? They're all really different. And, and when we say psychedelics, that's such a large term. What is that? What are we talking about?
Right? Are we talking about ketamine? Are we talking about MDMA? Are we talking about LSD? Right? These are LSD is like your classic psychedelics or mushroom. Mm-hmm. So. When, when I think about psychedelics, my practice has involved three psychedelics in particular, I've worked with Ketamine. I worked with MDMA on the research study with maps.
The multi I. Disciplinary Institute for psychedelic studies during the crossover study. And then I I had been now working with mushrooms for the last seven plus years as a, as a facilitator. So I spent a lot of time in the underground, that's what we call it before it was legal, when some of us were kind of, we knew that mushrooms were helpful and.
We kind of said, well, we're gonna do it anyway, so we did it. Mm-hmm. So I've had experiences with these three medicines in particular. I can't really speak to LSD or DMT because I personally haven't facilitated those spaces, although I have done those medicines personally. So when I'm thinking about mushrooms in particular and your comments about trauma.
It's not that mushrooms are totally not useful for trauma, it's just, it wouldn't be my like first line of defense for somebody coming in and saying, I've done everything I can. I, there's no medications that work. I have PTSD, you know, please help me. I think mushrooms are gonna help. I would say, okay, let's pause.
And let's talk about a lot of factors. 'cause as we know, PTSD is a pretty broad term. Is it complex? PTSD? Was it a single incident? Was it, you know, early childhood attachment trauma that resulted in PTSD symptoms. What symptoms do you have right now? How do they look? How do they impact your life, your relationships, all those factors.
And so if somebody has never really delved into their trauma. If they really haven't had an opportunity to develop a trusting relationship with the therapist that they're gonna be working with, if they've really never understood the impact of the trauma on their somatic body, I. I wouldn't do mushrooms initially.
It might be something we would do down the road after a good therapeutic relationship was built after they've practiced some somatic work after some of their symptoms have been well managed by other skills. Maybe EMDR has been utilized. Maybe narrative exposure therapy. Maybe they've done some attachment work with a therapist.
And then it might be appropriate to introduce mushrooms at a later date. But if somebody reached out and said, I have PTSD and my symptoms are really intense and I have a lot of anxiety you know, I have a lot of flashbacks. I'm really activated in relationship and in life, and I'm having a hard time functioning, I certainly would not say, here, let's do a mushroom session next week.
Gordon Brewer: Mm-hmm. Sure, sure. You know, you know, one of the things, that, that I think about when we think about psychedelics and particularly mushrooms and things like that there's probably a lot of stigma for a lot of therapists that they have around that. Do you wanna say something that might, may maybe say some things about that and just how it's helpful and maybe kinda how it kind of, maybe some of the science behind how it works?
That's a broad question. I know.
Dori Lewis: That for therapists who are hesitant, that makes a lot of sense. This is kind of a, it's a, it's a kind of a popular time to be talking about psychedelics and they've become quite fashionable, I think. They're not, they're not for everybody. They're not for every therapist and they're not like to facilitate and they're not for every client.
And so it's not always like, yes, psychedelics are gonna cure everything. I really wanna add a little bit more nuance to this conversation. I'm not one of those psychedelic providers who's like psychedelics for all this is gonna help everybody. So I think that. It's good to have a tempered approach to listen.
This is for some clients at a certain stage of their work, just like any other tool that we would use as providers. If we can, as a, as therapists, broaden our understanding that psychedelics are simply a tool. They're a tool like EMDR is a tool like IFS Skills are a tool, like somatic practices are a tool like type, certain types of meditation are a tool.
You know, if we can apply psychedelics to that kind of menu of options of tools. Just as a therapist doesn't have to love or, or even believe that maybe certain modalities are super helpful. It's the same with psychedelics. It's not a, it's not a panacea. It's not gonna help everybody and anybody, and it's, it's not always appropriate.
But if we can understand the nuance of, there are certain times with certain folks where this would be really well applied. Wonderful. And can we be collaborative with other providers if we ourselves don't wanna offer it, but we have a sense that maybe our clients are curious. This is the other piece about psychedelic therapy.
It's client led. So if a client comes to you and says, I'm really curious about this, it's our job to be curious and to encourage them to explore. Okay. How can I support you in providing resources for this curiosity? Because this is something that you can't access, and even if you're in a state where mushrooms aren't legal, you're still probably in a state where ketamine is legal.
Because ketamine is, is, it's a, it's being federally, it's, it's federally accepted and used because it's being used off label. Mm-hmm. You know, even if you're in a state where, you know, it's not. Legal to use mushrooms. You probably can connect somebody to someone who has experience with ketamine. Mm-hmm.
And so it's our responsibility to support our clients in their curiosity and to have another professional and collaborate with them and say, you know, talk to this person. I really actually don't know about it. Mm-hmm. Or sometimes it's our job to educate ourselves about it. Right. I wish I could say more about the science in terms of what we know, especially with mushrooms, the psilocybin mushrooms, and how they work on the brain.
I'm not the person that knows, there's a lot of people that have a ton of knowledge about the, you know, the, the psychopharmacology and the neuro, the neurobiology of, of how psychedelics work on the brain. Specifically mushrooms. I'm not that person, so I'm not gonna speak to that piece, but I will say that I personally have seen it really help a lot of people, but I've also seen it.
Happen and people don't really know what to make of it, and it's not necessarily the most helpful for them. It's, like I said, it's not this like golden cure all, but mm-hmm. For the right people at the right time. I've seen it do incredible, incredible things in a way that psychotherapy just was not able to touch alone and ended up itself.
Gordon Brewer: Right. Right. Can, can you give, maybe give some examples of that? I mean, just the kind of, the successes you've seen and why, why you think it made a big difference.
Dori Lewis: In my experience, my clients have worked with me for sometimes many years or months before we introduce psychedelics. I've had clients who after maybe few years of talk therapy, they've said, you know, I think I'm ready for something.
Like, I know that you do this, so I'd like to, I'd like to try it. Especially like with ketamine, I've seen a lot of benefit to folks who have. Ruminating thoughts. You know, this type of depression that's just. Constant negative thinking over and over about the self. And it's hard to get up in the morning and I can't really get out of this.
Kind of a friend of mine, Dr. Craig Peacock calls it like black bear depression, you know, like I am almost like, looks like seasonal effective disorder. Mm-hmm. Ketamine is incredibly helpful for that. I've seen there are folks who are kind of in that malaise and. We give them, you know, a three or four Ketamine journeys and they are like markedly different.
They are motivated, they are waking up and greeting the day they have energy. They're no longer having that ruminating thoughts. They make healthy choices that end up leading to a better experience and better mood. Mm-hmm. That's been really great to see with ketamine. And then with mushrooms, I've seen folks who are going through, or have maybe lost a parent many years ago and come in and were doing other types of work.
And in the mushroom journey, they're able to connect with an access that grief in a really profound way. Where they're able to actually metabolize it. I think oftentimes our emotions, our mental concepts, and we have a hard time somatically processing them and, and, and really emoting from those feelings.
Mm-hmm. And I have found that mushrooms can help people access those emotions. Mm-hmm. In a somatic and felt sense. And actually. Metabolize and process the loss or the grief that has been more of just kind of a vague concept swirling around them, mm-hmm. And they can really feel it and move through it and get to a new stage of peace in, in whatever that loss or grief was.
That's just an example of how some people right.
Gordon Brewer: Right mushroom. I love, I love that. I love the way that you use the word metabolize. I've never thought about it in that way and that just having gone through ki kind of my, as people that are listeners to this podcast, know just kind of my grief journey with having lost my wife a couple of years ago or and just that.
That ma, that ma the word metabolize just really resonates. And so yeah, I I love that. I love that. Yeah. So, Dory, what, what are really kind of you know, you think about psilocybin and mushrooms and ketamine. What, what are the big differences between the two? I mean, you know, ketamine, I think of as a manufactured substance.
I might be wrong about that, versus, you know, the mushrooms that are not. No,
Dori Lewis: that's definitely true. Yeah, ketamine is often made at a compounding pharmacy and it is. So it's a dissociative, we call it kind of like the cousin of a psychedelic because it in and of itself is not technically a psychedelic, it's a dissociative.
So ketamine at high doses is used in the emergency room. You know, when somebody breaks an arm and they need to set it. They'll give you ketamine because you're a high, high dose of ketamine. It's gonna make you re like, knock you out. World Health Organization actually names Ketamine as one of its essential drugs because it's incredibly safe and it works really well.
So it it real at high doses cause you to. It can be an anesthetic, but at low doses. And what I use in my practice, which I use oral ketamine because my clients can go pick that up at the compound compounding pharmacy and bring their prescription in, and then they take it in my office as I am there supporting them through the experience.
One of the benefits of ketamine is it is brief, so, you know, and, and a mushroom experience can be five plus hours. A ketamine experience can be about 30 to 60 to 90 minutes when you're doing it oral. So there's a huge benefit and a cost benefit to being, to doing ketamine. Mm-hmm. I often explain, and I was on a podcast back from the abyss not too long ago, where I talked about why I often use ketamine first before I introduced someone to psilocybin mushrooms.
But ketamine, like I said, is a dissociate. If you take it at a lower dose, you're gonna have this. Dreamlike state where you're not anesthetized, you're slightly dissociated depending on how much you've taken or you know how sensitive you are, you're slightly or more dissociated. And in that dissociated state, the default mode brain network, click quiets down.
It's the part of our brain like is making lists and is thinking about what am I making for dinner tonight and how many times do I have to walk the dog this week? And those kinds of things. And it kind of quiets that down and it allows. A more. Insightful, a more calm, maybe wise part of the mind to kind of gently float to the surface and offer information, maybe even visions like, like, you know, visual hallucinations or a sense of physical peace and calm, where the nervous system gets to experience that.
Maybe images or thoughts kind of float in and out of the mind that provide information and insight into. How this person maybe wants to operate differently in their lives or insights that are helpful for them to understand. I've had clients come in and, you know, they're the, at the end of their, their experience, they're saying, okay, it's, it's okay for me to become.
Mm-hmm. It's okay for me to rest. That's what my inner heal, we, we use this word, the inner healing intelligence. Mm-hmm. And I think all people have this, you don't just have to do psychedelics to have an inner healing intelligence. Right. The inner healing intelligence is the part of our psyche or higher self, or maybe some people might say their spiritual guides.
Everyone has different language for it. IFS might say the self with a capital S. But when, when we access that part of ourselves. That part knows what we need to heal mm-hmm. And knows what we need to be a whole being. And when we get into contact with that part, we're able to listen to that guidance and follow it.
Mm-hmm. As much as possible when we come back to the to the light of day, so to speak. Or the sober mind. Right, right. And I think both ketamine and mushrooms give us access to this inner healing intelligence. Mm-hmm. It's just in different ways. You asked about the difference with mushrooms, and so mushrooms are going to be longer experiences.
You are less dissociated. So with ketamine, you need to help somebody go to the bathroom. Like their legs might not work. They might be not able to stand. Their body might feel really heavy. You know, they might not be able to sense your fingers or your feet or that even, you even have. Have a body with mushrooms, that's not probably likely.
Although unless you do an incredibly, like what we call a hero's dose, then you might actually have that physical dissociation. Mm-hmm. But for the most part, with, with the clients that we're working with in psychotherapy folks should be physically, totally online. They should be able to open their eyes to get up, to move, to walk without much hindrance.
So it's not dissociative. It is. More hallucinogenic at times, although not always. Mushrooms can also be really somatic. Mm-hmm. Could be very, very body centered. In fact, someone's whole journey might just be about experiencing different sensations in their body and moving. From that, that place. It could also be having a lot of visual hallucinations, you know, seeing sacred geometry or having visions as if you're kind of being shown parts of your life and you're getting kind of a review of what's been going on lately and how to relate to that.
Some people in mushroom journeys might experience connection with. Ancestors, past loved ones and feel like they're connecting with higher beings, or there's a big spiritual component to PS mushrooms. And I think that that, that also adds to the complexity and the beauty of, of working with mushrooms.
Gordon Brewer: Right, right. Well, I know there's, there's a lot of kind of ancient wisdom and I mean, just I think immediately of a Native American indigenous. Cultures and the use of psilocybin and that sort of thing, and how important that was for their whole spiritual life. And just that connection. But yeah, it's, this is just fascinating and I think, I think kind of the take home for me with all of this is that I think one of the things that's just indicative of therapy in general is getting people to think about themselves and their situation.
And their world and their experience in different ways. And so the use of psychedelics is just a, like you said before, Dory is just a tool to help with that. And that if we can experience something in a different way, that creates a huge change for people.
Dori Lewis: Absolutely. Yes, it can. Yeah. And good integration is a really big part of psychedelic therapy, you know?
Mm-hmm. Being able to help somebody in the meaning making process. I a, a journey in and of itself is, is can be profound, but it's usually not enough to really make the changes. People I think, are often coming to me in my practice and wanting like. They want this immediate change. I'm gonna do mushrooms and then all this stuff is gonna shift.
That's like pretty unlikely. Mm-hmm. What's most likely to happen is you're gonna have an experience with this medicine and then you're gonna go back to your life. And nothing's really gonna change. Mm-hmm. Unless you choose to take the information from your experience and try to weave the wisdom and the information, and the suggestions and the insights into your daily life.
So your daily life starts to look and feel different. But that's a, that's a two person, that's a, that's a team effort. Meaning that, that's you as the journeyer, the mushrooms, and maybe your, you know, facilitation guide, your integration coach, whoever it is you're working with or, you know. You could do it yourself without that third person, but this is collaborative.
I think we have to shift our perspective of what healing is in the Western world. It's not, you take this thing and then it. Changes get made and your symptoms are gone. That's not how mushrooms work. Mushrooms require participation from the person who does the medicine, and we as psychedelic providers have a responsibility to educate people on the responsibility that they have as the junior, and that this is not just going to change their minds and change their lives because they do mushrooms.
It will take. Work and commitment to change and to the process of integration in order to to really see their lives change.
Gordon Brewer: Right, right. Wow. This is just, this is great stuff, Dory. And I've gotta be mindful of your time and, and all of that, but maybe real quickly before we kinda wrap things up, what, what sort of ethical considerations would you want people to know about.
Dori Lewis: Yes. And I would like, I would like to add a little piece at the end of this if mm-hmm. If people are interested in becoming psychedelic therapists.
Gordon Brewer: Yes, definitely. Definitely. Yes. Yeah, we'll add a
Dori Lewis: piece at the end. So sorry, would you repeat your question?
Gordon Brewer: Yeah, yeah. Just some of the ethical considerations Yes.
That, that come to mind. Yeah.
Dori Lewis: I mean, there's a lot, right? People are in altered states. There's a huge power dynamic because we already have a power dynamic in therapy, right? You've got the therapist and this person is coming to you and saying, help me. I, you know, please, I think you have answers that I don't.
And, and with psychedelics, this is, this power dynamic is even more weighted. We've got. This person who's giving you this powerful, psychedelic, spiritual, at times medicine that gives you access to these powerful journeys and information and insight and connection to higher or a more expanded consciousness and.
It's very easy for a therapist or a facilitator to take advantage of that power dynamic without even knowing it. I have a whole course, I mean, I teach, I teach on psychedelic ethics. I. So there's that power dynamic creates a lot of opportunity for the vulnerable clients to be taken advantage of either intentionally or unintentionally by the provider.
Mm-hmm. So that's something to consider. The other ethics is that, the clients are more susceptible to wanting touch or connection with the provider and seeing the provider as like the guru or the spiritual teacher. And so that adds to this power dynamic and the ethics that need to be considered when we're holding space.
Mm-hmm. Not just around how we hold space, but like types of touch that are used in psychedelic spaces and even how. We communicate. It's never our jobs to interpret somebody's experience for them. And it's very easy as a therapist to try to get into therapist mode and to start helping someone make meaning and offering insights and solutions and ideas.
That's actually not our job in psychedelic work, and so therapists have a lot of unlearning to do if they do choose to be facilitators and psychedelic work. There is a lot that is markedly different than our role as. Therapists that needs to be unlearned or considered when shifting your role as a therapist to a psychedelic facilitator.
Right. And those are different roles.
Gordon Brewer: Right, right. Well, well, Dory, tell folks a little bit more about how, if they're interested in this, how they can connect with you and things that you're, you've got for people.
Dori Lewis: So I am the co-founder of Elemental Psychedelics and that is a Colorado approved training center for licensed facilitation for mushroom facilitation in the state of Colorado.
So if people are interested in applying, we do have a fall cohort that we're currently accepting applications for. We are one of the smaller programs in Colorado, so we keep our cohorts at about. 25 to 30 people. And we do have, it's a hybrid program. So many programs are mostly online with a few in persons.
I would say we are about 50 50. We have a fair amount of in-person hours and we also have virtual hours. So our program is small, it's, it is intimate. And we also do try to bridge the kind of western. Clinical framework with more indigenous and spiritual practices so that we are kind of creating this bridge between these two worlds because this medicine is also a bridge.
I will say if you are interested in applying to elemental psychedelics, you have to have experience with mushrooms. And I wanna say this, if you're interested in doing psychedelic therapy. Try psychedelics first. Try medicine. Try mushrooms. Try ketamine. Have your own experiences. Those are the first teachers that should be teaching you about this work.
Mm-hmm. Is your own experiences with these substances and these medicines and these plants and these fungi. It should be. Those are your first teachers, and then once you've had your own experiences exploring programs and finding out what is your orientation to this work based on your own experiences.
Gordon Brewer: Right, right. Yeah. So the, yeah. The conventional wisdom of, as therapists, you, we need to do our own work. Yes. Yeah, yeah, absolutely. Which I'm. People hear that from me all the time. Well, oh good. I'm glad we're on the same page. Do. Yeah. So, Dory, tell, tell folks a little bit about where they can go to, to find you websites, that kind of thing.
Dori Lewis: So I also am the founder of Reflective Healing, so you can find me@reflectivehealing.com. I offer consultation and supervision to other therapists. And license for licensing for LPCs in the state of Colorado as well. And you can reach out to me on that website and just hit the contact US button. And you can also, if you wanna train with me at Elemental Psychedelics with Dr.
Shannon Hughes, my co-founder, you can find us@elementalpsychedelics.com. We do not have any in social media. We have chosen not to engage in social media personally and professionally, but reflective healing.com or Elemental Psych. psychedelics.com and just hit the contact us button and I will re receive the email.
Gordon Brewer: Awesome. Awesome. And we'll have links in the show notes and the show summary for people to get to that easily. Well, Dory, I've really enjoyed our conversation and this was really very enlightening for me and hopefully for our listeners as well. And hopefully we can connect again soon.
Dori Lewis: Yeah, thanks Gordon.
Take care.
Gordon Brewer: Take care.