The Practice of Therapy

Gordon: Good to have you here. And so I know as I start with everyone, Cameron, why don't you tell folks a little bit more about yourself and how you've landed where you've landed?
Cameron: Sure. So I'm Cameron Chobra. I'm a LPCS LMFTS in the state of Texas. So I think most of your listeners know, licensed professional counselor, supervisor, licensed marriage and family therapist supervisor, but I usually give the whole long word soup explanation. But anyway I've been off and on in private practice for, oh, I don't know, five years.
Cause we took a brief stint in foster care. Shortest version I can give is I've been through the mental health care, at least in North Texas, from inpatient, intensive outpatient, private practice, obviously, a little stint in juvenile justice and helping those kids out, transition and then foster care for three years, which I was a, you know, a foster parent, so I wasn't a clinician, but when we came back, what I realized is I had a very well rounded Trauma informed background.
And I didn't even know it all that time kind of saying, well, what's, what's a better way of doing business? Because I saw a lot of people just frankly not get the help that they were looking for very desperately. And I did ART training. That's another thing I do a lot, which is accelerated resolution therapy.
It's an eye movement based thing. It's very close to EMDR, but it's a little bit easier for clients because I tell them what to do. And they seem to just tolerate it better, but, you know, so we did really good with, you know, hitting triggers of trauma when I came back to private practice, but I, I still struggle with.
people and helping them change their story. I had my own ketamine story to tell. And the short version is crippling anxiety for a decade. Thought it was well managed. It clearly wasn't. Foster care kind of, because those kids rely on you and they push on you. And when you don't have a lot to give, that's, that's tough.
Right. So I came into my own ketamine therapy and had a Truly wonderful result. And then of course, like most evangelists, you're like this helped me a lot. I hope it can help a lot of other people. So it started with ketamine and now I just research all things psychedelic. Basically if it's a brain science thing, I'm into it, but psychedelics are the biggest next thing on the horizon.
So,
Gordon: right, right. So, so in your practice Yeah, so how have you begun to integrate that? And I know and having other people on the podcast talk about psychedelics and, and that sort of thing usually require for most therapists, it requires a partnership with either a psychologist or psychiatrist to help.
Prescribe that kind of thing. So what's your experience been like?
Cameron: To be honest with you a little difficult, but it's, it's changing and it's changing really fast. Faster than anything I've done in the past decade. I think it's fair to say, and I hope I don't ruffle any feathers, but I'm like, I think we're a slow business.
I think we're very, very slow business to pick up a new idea. The other deep kind of secret that I would tell kind of exists is we also have not had really good tools for a long, long time. And I know that any practitioner out there that hears it, it's probably nodding their head. Like, yeah, I've definitely had this client that we couldn't get unstuck.
They wanted to still do the work. I wanted to help everything I'm using just seemed to fall short. I will not be as so far as to say this is the magic bullet, but I will go as far as to say that the clinical data. I mean, we just. It's blowing everything out of the water. So to get back to how that goes it's been kind of difficult because I had early days, a few conversations with some psychiatrists and the biggest responses I generally got were, I don't do that kind of work.
Or I don't know anything about it. And I also have to say a thing that, you know, us counselors have to consider is like, this is kind of antithetical to the model that has existed, you know, they kind of insurance based, you know, 15 minutes. I got to see you every, you know, four to six to three, six months, you know, and just keep on going as a part of their survival strategy, I get it.
I also think that there's more work than we could do in a lifetime. So I think kind of trying to get people on board with the idea that like, yeah, you six and done, but also don't go tell other people. And, you know, everybody's one car rack away, one loved one dying away from, you know, frankly being in a really bad spot.
So that's another reason I don't buy that. We can just heal everybody. And then it'll, that'll be permanent. You know, things are always. Shifting. It's that my poor kids are so young, but I'm like, the world's moving towards entropy kids, like we, like, we always have to reorganize and pick back up. So, yeah, it's been, it's been challenging.
Gordon: Yeah, sure. So as you've integrated it with your practice, tell us a little bit about your process and all of that sort of thing. And maybe a little bit about kind of your clinical approach with all of it.
Cameron: So I'm at the hope place. It's I still work for myself, but I tell everybody I can't run things, but I'm a good right hand.
So I try to be very helpful in that regard. But you know, for most parts, you know, especially on the getting clients for maintaining clients, I still have to go keep what you kill, right? Like you gotta go out and find the people, make, shake the hands and keep relationships. We're building a new building.
They're Giving some play therapy space to that we've been kind of like outgrowing. And then I'll have dedicated space for in house psychedelic use, which the real hope is MDMA in 2024. It's looking like knock on wood. But right now we do a model where it's at home. They have to, you know, check in with me.
They do their own self administered vitals. They have a medical consult. Those meds come to their house. Some. Some practitioners have people do it in office. I like the version from a lot of different perspectives where you have a high structure proposition at home, and then we debrief the next day.
That would be the integration. So like, what were your insights? How are you feeling today? Cause I tell people the most important thing to me is the time in between. I care way more about that than the two to four hours or whatever in your experience. So that that's generally how it goes. We also, we also work in other stuff.
So like ART is still really good for traumatic triggers. I have not always seen psychedelics take care of that necessarily, but you know, they're, they process scenes a lot faster and they seem to get through those really high detail moments that keep them kind of stuck much faster when we do ketamine based integration.
Gordon: Right, right. So what was it you said you mentioned if you don't mind sharing, you had experienced ketamine treatment for yourself. And what was it that really made it click to think, okay, this is something I really want to integrate into my practice.
Cameron: The short version is I have, you know, benzodiazepines were the only things that work for me personally.
And I think anybody that looks for not too long, we'll figure out that it's a pretty high risk proposition, right? Like it's, it's not the best tool. It's just very effective at what it does. It also doesn't take care of it. I could never find a good counselor. I was one of those counselors that seemed to fire all his counselors.
So which wasn't their fault. That was a me thing, but we just couldn't click. So I just felt perpetually stuck COVID right. That super drove everything. And plus we had the foster kids home and anybody that's done any of that work or is keen on attachment or working with kids, like. The distress will show up where they feel safe.
And we were the safest and, but that was still a tough relationship. So I finally hit a breaking point. I remember scrolling Instagram and seeing an ad for ketamine based therapy. And my first thing was, I think it's a horses. Like I just, that was my first association. Right. Right. did my own homework because I'm a big researcher guy.
I like to be very grounded in what, what we have scientifically, what, what's, what is pointing to. And I was shocked to find there's like 20 years of research behind the thing. So that's what got me to sign up in the, when you fast forward, a lot of details I'm skipping over, but when I got to the end of it I just remember telling the practitioner, you know, when I'd wake up before I didn't know if it was going to be a 2000 RPM day or 7, 000 RPM day in my, you know, anxiety engine post ketamine, it's, it's like, it's not there, you know, it doesn't mean you don't get anxious, but it's not a baseline.
Which nothing had ever come close to that. So that was what really pushed me over.
Gordon: Right. Yeah. That's a, that's a fascinating thing because I think it's at least in my experience, it, it does seem to be very effective with the whole anxiety cycle and that sort of thing for people. Yeah.
Cameron: Yeah. It's been tough to kind of teach people like that's another psychedelic kind of thing that I always like to talk about is It's hard to say that it only treats that like they're used to, right?
Like, Oh, what's that medicine for? Oh, it's for depression. That's for anxiety. That's for whatever. Psychedelics are kind of, I mean, there's a little bit of, there's a better one for that than this, you know, kind of conversation, but it's not so much like it only treats this narrow range. That's, that's been kind of like eyeopening to me personally, but also right, like the field is kind of, I think going like, huh, there's tons of overlap, right?
Yeah.
Gordon: Yeah. So when somebody maybe walk us through, I know we're jumping around a little bit, but maybe walk us through when you have somebody that comes to you that is interested in doing. Maybe the ketamine treatment or psychedelics, what's, what's the process you use to kind of get them there and get them prepared and that sort of thing.
Cameron: Good question. I think the most important thing is, you know, which, what are your best hopes? I'm a postmodern therapist by trade. So bleeds through in a lot of the work. And that's, you know, it's what's your best hopes for therapy is usually how it starts off. But when we get into psychedelic use, I go, look, it's not business as usual.
So to me, this question question is doubly important. Because, you know, as you can imagine, there are some people that have been suffering for a long time, hey, I heard I can take ecstasy or mushrooms or, you know, Ketamine and, and be better. And I'm like, well, it's a lot of work, but it's the greatest propulsion I've seen in a decade.
I don't, you know, so that's, I always try to get down to it. Cause the weird part is, is like many treatments, if you're not actually motivated good luck, you know, it's, it's a fun two, I say fun air quotes could be very difficult, but you know, two to four hours you'll feel great for a week. Physically, but, you know, I've had those people that are like, I tried infusions.
I did not go to therapy and I did not see lasting change. Well, that makes sense. So I usually ask them that question. I am curious on like, what have you researched? Because frankly, I also get people that are coming out the street, like, well, can I take my own? And like, well, I can't, the board is not going to let me Condone that, but I've, I've grappled with it because frankly, there are people that are suffering at a level that they're just not going to wait.
They'll take the legal risk. So I try to adopt a harm reduction lens with them to talk about, okay, here's your best practices if you decide that. And that's not an endorsement. Cause usually when we get into those conversations, it gets really thick, really quick for the non experts. Like where'd you get it?
Who did, you know, how do you know it's pure? How do you know your dosage? Right. How do you know, what are you going to do if a medical thing pops up? You know at least right now, since ketamine is, you know, officially prescribed from a doctor. I'm like, we don't have those concerns. I can, I know where your substance is coming from.
I know who I can talk to if there's a problem or you could talk to you don't have to be cagey if you had to call 9 1 1. So, which is very rare, but right,
Gordon: right, right. Well, tell us maybe a little bit about some success stories you've had with people you've worked with.
Cameron: Oh man. Let's see. The, well, the one that always comes to mind.
So the interesting part I tell people is I've had more people over 55 and under 55 interesting to do this. Yeah. And I re I will never forget having somebody that was on the upper end of that age bracket. And alcohol had kind of plagued their life for a long, long time. And that was what they wanted to come in.
And like, I just need to drop it. Like I'm going to lose my, my marriage. I'm alienating a lot of people and in six sessions you know, we've a lot of work, right? A lot of I think covered up trauma that she didn't really know existed. At least the way that we experienced it. And but the big thing was, you know, okay, so how much time did drinking take up?
You know, this is a. Like a lot of addiction stories, no, like, Hey, you got to fill your time with something else, right? You used to spend a lot of time doing those substance. Well, this individual got to competitive dancing. I think it was an old love that they rediscovered, but I got contacted after new year's maybe like six months after we did all our intense work and just said, Hey, I'm still sober.
And you know, I'm, I'm winning competitions. with that. So, you know, most people are like, Oh, I'm too old for that. And I'm like, but wasn't stopping this person. So that's probably my favorite one to tell. Cause I'm like, you know, when it makes the case that like, here's somebody that's All of us would say, Oh, they're twilight years.
They need to be reflecting and all this, you know, good stuff. And I'm like, that's not her, that wasn't the story. And, but we were able to, you know, six very intense, you know, every week, you know, dosing and, and integrating. but able to get over that hump. So yeah, it was pretty awesome.
Gordon: Yeah. So with, with again, just to kind of jump in a little deeper with, I know that and I'm drawing a blank on the term it's used in EMDR about really read a rewriting or retelling the story about what happened, reassigning, I guess, reassigning meaning.
I think it's kind of, yeah. So, but anyway From the time that you start with someone, I'm assuming that you do kind of a bit of them talking about the trauma, talking about what has happened, that sort of thing, and then introduce the ketamine and then have them retell it after that. Is that kind of the process?
Cameron: Yeah. And you know, like many things, I think it's hard to lose structure. We'll go with loose structure because everybody's different. I do, Hey, tell me. Let me get to know some things about you. I mean, right. This is the always the biggest things like, you know, Connection to counselors, the number one predictor of success.
That's never going to go away in my book. People love a human presence, period, the end. So with that in mind, you know, it really depends, you know, if it's one acute issue, I got in a car wreck and it changed my life sort of thing. That to me is a little easier to work through than say like I had years and years of child abuse and neglect.
Cause I, I've told people that like when the rubber hits the road and you're far off in some other space in your head or in another galaxy, whatever, you know, like, You will have like, yeah, attachment is going to come right front and center. And you, you need somebody and that's, you know, I'm like you in this role currently, I'm not doing that, but there is a definitely a well practiced in house version.
I'm like that, that therapeutic alliance is like quadrupled in terms of its importance to me, because they got to be willing to like, You know, hold a hand you know, basically seek comfort and, you know, it's not to the people that aren't psychedelic savvy. We're not throwing away all our grad school stuff.
If you can't hug your client and kiss on them or any of that weird stuff, it's, it's literally a handhold or maybe escorting them to the bathroom because ketamine especially will mess with your balance. So it's a safety issue, but you know, they do talk about like on paper, on purpose, what is our plan?
What do you consent to before? So, you know, but I'm like, even that to me as a part of this whole relationship of like, how would you like to seek comfort touch? How would you like to seek safety touch? You know, where does that stop and end? And then so that, you know, client and counselor have a really clear definition, if that's the version they're doing in my version, I just tell people like, we, you're going to hit hard emotions and you've got to come back the next day and really kind of.
You know, open to talking about it. But funny part is that's all terrifying. Pre dose post dose. They're like, usually, you know, kind of like, I want to get this out. Like I want to, you know, basically I had some insight or something, some strange experience that now I have to share it. And to me, that automatically does a little bit of that re scripting, because I'm already getting a different perspective on it.
Right. And frankly, having a human being hear it, because some people, as you know, they don't ever tell the story, or they tell a very brief, short version of it. When you get the whole thing, and you don't see a person recoil and say, my gosh, that must have been so hard for you, boom.
Gordon: Mm
hmm.
Cameron: Their brain is already wired for change and now they got the first piece of evidence that like, oh, They're not going to instantly throw me away.
They're not going to instantly reject me. Right? Right. Yeah. So that's Yeah, it's still it's still very client led. But you know, I do tell people like hey You're gonna spend a lot of time and money like how? Close. Do you think you are to being able to really wrestle with this? Cause that's a part of the assessment process,
Gordon: right?
Right. Yeah. I'm I'm reminded I don't know what made me think of this, but I've, there was had pleasure meeting year, several years ago a guy that was really kind of his specialty is Dr. Alan Woolfelt, who was, did a lot of work in grief and kind of the early days after Kubler Ross of doing grief work and bereavement work and that kind of thing, and, and.
You know, of course, a lot of times with grief work, there's a lot of trauma that's involved with that as well. But I just remember him saying the the quote that sticks with me is grief shared equals grief diminished. And so, and, and I think about in this sense, there's something about the psychedelics that kind of unlock the ability of somebody to share something.
Kind of yeah, there's that inhibition and then when they share it, that's what unlocks it all.
Cameron: And there's two different approaches. One is very active, right? Like they are in an experience at some dosage level and we're literally having a very slow therapeutic processing type. The other one is the one that I'm currently doing, which is you're having a, a large dose experience at home with high structure before, after, and you have chaperone during, so they don't, they're not trained professional, but you know, Hey, that's your friend.
That's your mom. That's whoever you find to support, you know, literally being able to hold your hand. Get you a cup of water. I mean, that's, it sounds so basic, but I'm like, look, when you're a blob on the edge of the universe and all of a sudden somebody holds your hand, like, okay, okay, I'm, I'm not dead.
That's an important thing. It sounds strange if you've never been there, but I'm like, it's, you know, but most people hear that and they go, oh my gosh, I couldn't,
Gordon: who
Cameron: wants to watch the sausage being made? I don't. But I, you know, if you're of that type, Most people love it. I said, come for what comes after don't come for the big show.
I said, frankly, there's a lot of things that can give you just as much entertainment you know, so I try to really drive down, you know, like it's, yeah, it sounds like, Oh, we're getting high and then, but no, you might get a piece of that, especially at the beginning, but pretty quickly it gets. It gets difficult.
So yeah, I stole from a researcher trust, let go be open. Those are the most important qualities. If you think we can hit all three of those, then we'd probably have a good chance of success.
That's great. Well Cameron, I have to be respectful of your time. Any parting thoughts that you have about this whole course of treatment?
I think we're going to hear more and more about it. And I think probably there's going to be more people that are wanting to integrate that with their practice.
Yeah, honestly so if I had to drill at home, I'd probably say I'm a steal from what my business coach told me to do, you know, past an age, our brains need lube.
I, that's the one we kind of settled on, you know, anybody that knows brain science past 30, it's, it's getting drier. I have good clinical data that, you know, they're looking at. brain cells, you know, and neurons, but, you know, we have shown that 21 days of chronic stress, they're not only having less communication with the rest of their brain the bad thoughts are reinforced.
So the bad habits, the things that are not helpful. I'm like, that's on a neurological level. And that's frankly, I think what people in our Western type orientation really want is like, what's the science have to say about this? How am I going to help me outside of chance? So I usually show them that picture I have.
And I said, but the part they don't show you is the hard work that said rat would have to go through to actually change the behavior. I think it's going to be standard of care. I think right now, a lot of people are Trepidatious because frankly, the old associations, but I, anybody that's curious, I've said, look, I'm open to any conversation I can have, because at the end of the day, there's a lot of suffering and our tools have not.
Measured up and MDMA is. Looking likely for Q1, Q2 of next year. They haven't said that definitively, but you know, they published phase three results their final confirmatory phase. And 69 percent of the people leaving those studies are not meeting criteria for PTSD on 12 month followup.
That's a big deal. We're not even getting into the people that had gains, but still technically qualify. So, but it's not taking the drug and going to a club. That's not going to help you heal your trauma and the term was memory reconsolidation. That was, yes,
Gordon: that's it. That's it. Yep.
Cameron: That's what all this does is help me reconsolidate that memory, which I tell people like you feel triggered.
You got a five hour window. So I hit heavy on the science. I hope I'm not making anybody drown with it, but you know, like, It's just such a big tool. I would say to any clinician, Hey, look at the data. And if you have problems with the price tag, like part of the whole FDA approval process was to work with insurance.
So, you know, like basically I think it's a conversation that we need to be having with other practitioners. Cause most people go, Oh, I don't do that. You know, they get, they get scared and nervous. And I go, That's fine. But also, you know, people are really going to need this and you're going to get questions, maybe not right now, five years time, I guarantee you people will be asking questions because there's no putting the genie back in the bottle.
Yeah. Data is too strong. So yeah, sure. There's a certain amount of suffering. I think everybody gets to myself included. You go, I'll do anything. Yeah. What's that about? Right, right. Yeah. That'd be my parting words.
Gordon: Okay. Well, if folks want to get in touch with you, Cameron, what's the best way for them to do that?
Sure. So easiest ways, email Cameron C A M E R O N dot Schober, S C H O B E R at hope place, tx. com. That one doesn't get filtered. So hopefully I'm not inundated, but okay. That's literally the easiest way to get me.
Okay. And we'll have links in the show notes and the show summary for folks to access it easily.
Well, Cameron, I enjoyed our conversation. I hope that we can talk again soon.
Cameron: Absolutely. Thank you for your time.