Ketamine Doctor Jason Pooler | This Past Weekend w/ Theo Von #341

today's episode is brought to you by. liquid death. you know it's good. what's up guys i want to let you know uh. that i will be touring in. st louis we've added a show cincinnati. charlotte durham we've added a show. chattanooga knoxville wilmington wilkes. bar. minneapolis charleston richmond. baltimore albany we've added a show. buffalo new york. and columbus ohio columbus we will be.

adding a show if we haven't. already theovan.com tour the only place. to get tickets. all other sites uh they're going to jack. up the prices so. go to the links through theovan.com tour. and thank you. uh for supporting me and my dream. recently i've undergone a ketamine. therapy. and i wanted to speak with someone. who is an expert in that field and uh to. learn more about. my experience and learn more about the.

therapy. overall uh today's guest is the founder. and the medical director at the. chattanooga ketamine center. it is dr jason pooler. [Music]. [Music].

[Applause]. dr jason pooler thanks for being in here. today man. thank you i appreciate it and so you're. you're a doctor of well. i'm a i'm an md so okay i'm a physician. um and i'm and a physician is what just. a doctor. uh a medical doctor like you go to four. years of medical school after college. and uh okay that's sort of.

like dr dre that's not enough it's. like the um in the united states you. know the md is sort of the. what people think of when they think of. physician those are you know that's. the standard process you go to medical. school okay then you usually do a. residency. to sort of sub specialize into a. different area of training. okay and then you go to work. and so these days you're working in the. ketamine how did you get working in the. ketamine therapy and like where are you.

at with it right now like. are you actually practicing it are you. running a practice that provides um. the therapy to people so both. okay i was it's kind of one of those um. long routes to get back to where you. started. and i i originally trained. as a general surgeon a long time ago. and then i went into anesthesia and i. did that for about a decade.

and ketamine therapy. sort of became um. more studied as a result of its use in. anesthesia and because it's an. anesthesia medication. but it had some interesting side effects. that they they looked at over time that. they couldn't explain. and that research is what has brought us. to. ketamine therapy today in the use of.

treatment resistant um depression and. other you know mental health problems. what exactly is it used to treat the. therapy. so you can use it to treat a lot of. different things it depends on. what you're doing with it the way it is. used. most often is to help people who have. had. a lot of problems with depression who. have failed. a lot of other therapeutic approaches. and so. so what ketamine offers is a new tool.

to help people who are. still suffering tremendously kind of. springboard. back onto the road of life and and. um it is it's really interesting. that the way it works it doesn't work. like normal antidepressant medicines it. has nothing in common with them. um the way it's almost a new technology.

then i guess in approaching. treating depression so the the easiest. way to describe it is. why they started studying it to begin. with okay and that was back. almost 20 years ago oh dang they. they realized that when they gave. ketamine to patients getting operations. they required less narcotic pain. medicine. during the operation in the hospital and. after the hospital stay. then than other patients they said why. is this just doesn't you know.

why are they having less pain they had. no explanation. so they they looked at it and what they. discovered was that what it does. is it changes your perception of pain. so you can see something that you've. experienced. as less painful hence. you don't need as much medication to. cover your pain i see so you're not. feeling as much pain because you're. not seeing it you're not seeing the seed.

of whatever it was as as. painful so therefore like the growth of. the pain isn't as severe. at that time uh the way the best way i. like describe it to people is yeah i. have two daughters and. and say we go get flu shots and one. daughter gets a flu shot and she's like. ow. and my other daughter she gets a flu. shot and she's like and her response is. much more. okay we know that the the shot. is the same but the response is. different. so one is perceiving something with more.

distress than the other. and the way ketamine works is it helps. your pain sort of shift from that. that more visceral response to a more. that hurt but i'm okay response okay. it's a persp like it's like changing the. lens on how you see pain. so that you can see things and you can. kind of look at them from a distance and. sort of. go around things that have happened to.

you and you can kind of connect to. yourself. from those places and it's a it's. it's it's not spiritual but it's not far. from it. right do you feel like it gives you like. a look at yourself like you kind of. see yourself whereas a lot of us have a. tough time. seeing ourselves because we're in. ourselves you know exactly. yes 100 because it's like if you're on. the. playing field you can't really see. what's going on and it sort of puts you.

up in the stands. of your life that's interesting and you. have a lot of places in your past. or a lot of patients that have come to. me is you know you're living your life. and life's hard and people get hurt. and depending on where they are in their. life they sort of package that up. and they put it away because they don't. want to feel that anymore. but it doesn't really go away and so. those those let's call them firewalls.

um they're no-go places in your brain. but they're still sort of resonating. through your existence. so they're shaping typically your. relationships. and your career right and that's like. that. that uh what is that movie um. kung fu panda you know oh i was thinking. of uh. master oogway in his uh um. we often find our destiny by trying to. avoid it. oh yeah interesting yeah i was thinking.

of that movie where that boat gets stuck. in boston i'm talking about where they. go fishing you know what i'm talking. about. and there's all the storms perfect snow. oh yeah oh yeah yeah. that didn't have a good ending though um. yeah it didn't. but um so i see what you're saying so. yeah it kind of gives you an experience. to step outside yourself. so were you able to see that whenever. you was working in anesthesia were you. able to see. people having that experience like were. you able to visually. see that or were you not able to grasp. kind of the concept of it. of of exactly that until i'm guessing.

later which we haven't discussed yet. until you got into actually. experiencing uh using ketamine. when i was when i was practicing. anesthesia um. i used to do that hitman anesthesia guys. that hit man that rolls in there. that's the guy a lot of people some. people don't even need they'll be like. they just want the anesthesia some. people. i have a buddy who's addicted to um. he was addicted to uh inoculations and. he's breaking into walgreens and doing. all the damn uh.

whatever it is the covenant in the. [ __ ] i don't know his cove is before. this so he was just doing flu shots you. know. but that's you know people get people. get. people get into certain things you know. but um anyway i don't know how i told. you that exactly but um. what i'm trying to tell you right now is. just that okay so yeah so. were you able to see stuff whenever you. were working in as an anesthesiologist. were you able to see some of that or was. it more like. that you got a a stronger idea to work. with ketamine. like and understand it later on what i.

noticed was. that when we used it and we didn't use. it a lot. i mean you just give them it as part of. anesthesia they did better. so everything seemed to work better they. just sort of. seemed more functional they had. what we saw was they just they they felt. better they they. came out of it better they they got up. they got around. and um and that was sort of how the ball. got rolling on why is this happening. and then you know then they started. figuring out that hey this is.

actually doing something in the brain. for real not. just some accident and. then they started experimenting not. experimenting but they started you know. using it in a more of a clinical sense. for people who are really struggling. because before ketamine really the only. thing that they had. was um ect you know putting electricity. through your head. right and i have taken care of a lot of. patients with that and they did not like. that. and i can see why so what did you ever. have to do that to people.

i did actually um not not even familiar. with that. yeah i i did it when i was an anesthesia. uh. resident um about a decade ago they'd. they'd bring us a bunch of patients from. the. uh psychiatric hospital and they'd line. them up and. we put them to sleep and this. psychiatrist would. shock their heads and we were like. wide-eyed and like is this real. and i guess it helped. so you would put them to sleep first. yeah just very.

briefly so you just with uh like. propofol or something okay so you just. you would just make them unconscious. just for a few minutes and i remember. this. this the psychiatrist she had like this. head of hair that was like. huge and it was like gray and kind of. like uh back to the future style yeah. and uh. and she would she would put these probes. on this guy. on these guys heads and like this is in. and you know we're. kids and we're just like okay. wow and zap them decently oh yeah oh.

yeah yeah yeah because we had to. paralyze them because when you. when you shocked them they'd be like and. what was supposed to be happening. so my understanding is kind of bootleg. you know my understanding is it actually. helps a lot of people but it is not. readily accessible so we were doing this. in a hospital in a recovery room with an. anesthesia team. in sort of the critical care area of the. hospital so that's not something that is. accessible to 99 of the population right.

any given day and and so that's sort of. the problem. so so this electro convulsive therapy. this uh in which small electric currents. are passed through the brain. triggering a brief seizure changes in. the brain chemistry quickly reverse. symptoms of certain mental health. conditions. so this was this was almost. this was kind of like a ketamine this is. ketamine's kind of like that. no okay no that um this is what they.

were doing early on this was the only. alternative okay so you go to provide. what. uh relief from depression okay i see. what you're saying. because they still have a therapy i have. friends that go and get electrocuted a. little bit every day. yeah yeah so so that is sort of like the. um oh yeah there's a good one see that. guy right there. on the left oh yeah oh yeah he's going. deep yeah that's what they did. he's got a candle in his mouth that. dudes that's that's so when he bites. down from the electricity he doesn't. break his teeth. oh my god yeah right.

you know wow so it's hard that's. frankenstein it's hard to get a lot of. people to sign up for that because. i mean you google it and you see that. and you're like no i'll pass. yeah they're grilling that brother up. man unfortunately that's pretty heavy it. seems like to me. um so so how so how did they evolve out. of this so this isn't really practiced. readily anymore it wasn't easy you said. there was you had to have a lot of. people on site to do it. so ect um is still used. in limited form today the the problem.

with it is it's a pretty big deal to do. and so you don't have doctors offices. doing ect. these are special circumstances usually. with patients who have profound problems. usually patients who are in uh inpatient. psychiatric hospitals. these are not people who are out walking. trying to hold jobs. so this is a different level. different level you know people who come. and seek care for depression.

they they you know get talked to by. their doctor or their provider and they. get. you know put on a medication or. something and they they go to a. therapist and they try and work through. that. and usually at some point um. some people sort of hit the wall with. that um not everybody but. a lot of people are hitting the wall. with it and what they do is with ect. uh no with just just going to um some. almost no one gets referred for ect yeah. that's i mean because that seems like.

yeah so you're saying that's more like. in psych wards and stuff like that like. bottom of the barrel really. they're trying to jump start i mean that. looks like the damn lord's jumper cable. there it is it's it's it literally is. it's like you're trying to jump off the. brain. wow trying to get it hit to fire again. yeah and so that's like people who are. like. you know in in hospitals mostly. people who are not holding down jobs. people are not having. relationships because they can't okay. right. so so so the rest of people who are. struggling.

you know they go to their doctor they. get put on antidepressants they go to a. lot of therapy. right that's me that's been me i'm an. example of that yeah yeah and so. so you're you're sort of chugging along. and and. you're existing but you're not really. you know if you look at like the road of. life. you want to be on the middle of it and. you want to be. comfortably cruising down it you know. and these are the people who. they're like on the shoulder or they. fall off into this they go often on the. side of their shoulder and they. they have a hard time pulling themselves.

back up and it's because they're. the the medicines they help. but they don't necessarily get people to. a place of. well-being that they're seeking you know. there's there's. existing and then there's like really. living. right yeah i think i can definitely test. testament to that. yeah i kind of feel like like i don't. understand. one of the reasons i went to get the. ketamine therapy is because i didn't. know why i'm still on antidepressants.

it's like one of the weirdest medicines. that. you know i was having a tough time when. i was like 20 and i went in. they put it on they put me on it or i. agreed to be on it you know i mean i. took part in it and. and then now 20 years later i'm still on. it so it's kind of like. like if you broke your leg you wouldn't. have a cast on forever probably so some. of that to me is like how what's going. on here like is this something i need to. be on forever. so that's one of the reasons that i went. in probably to check it out you know. and you know it's the the work.

that is being done in this is is. amazing i mean there are. some very smart people who sort of. helped shape this. sort of treatment path and. the way i i look at it um. is i i look at people who come to me and. they have all these symptoms they're. either. depressed they're anxious they can't. sleep. um they're they have like attention.

problems they. they zone out because they can't zone in. um. then you have people who are like trying. to kill themselves. or they're addicted to things and what. it really is is. somewhere within them they have a lot of. pain okay they have a lot of distress. something is is primarily wrong. and that is not going away with the. antidepressants they're just more like a. band-aid. to it they're covering the symptom as. opposed to addressing the symptom.

right so the driver is usually. pain that is from somewhere in that. person's past. that they have not been able to truly. grieve over. and feel like sort of reconnected to. themselves. and and as you probably. experienced to some degree when you went. into the ketamine room. you could see your pain you could see. around in yourself and you could kind of. go places those.

those firewalls you could kind of look. in places that you couldn't look in. before. because you had the capacity to you were. sort of protected by the ketamine so you. could. look around corners in your mind and see. oh yeah. that's there you know i wish i'd had a. better i was in there with a therapist. and i i think they were just more of. like there if. i had an issue um i sometimes wish that. somebody would have been like prodding. me more. or telling me how to it's almost like.

when you go snorkeling that's what it. kind of felt like a little bit. it was like i'm looking at. a lot was going on you know if i felt. like i'm a roller coaster i'm on a. roller coaster i felt like. the world is kind i felt like i was on. space mountain sometimes with my eyes. closed you know just kind of like moving. through like. did you have the round shapes or the. square shapes. i mean i i mean i think there was a turf. war going on because there was a lot of. there was some real i think it was a lot. of shapes out there you know it was.

definitely like somebody was. um i mean i remember one time literally. yelling out that i was a cryptocurrency. i thought i was. like i went it got pretty gnarly you. know like it got pretty gnarly like i. remember one time thinking. there's no way i'm gonna end up back in. my chair in this therapist office i. don't know how. i'm going to get there from where i am. yeah i. i had some fun you know so that kind of. stuff was kind of exciting and i think. sometimes i got too. caught looking at the the the experience.

and not using the experience right so. that's why i wish that. there had been more before i went in to. get it that i had had more of an. understanding of. how to navigate the universe a little. bit and how to use the experience. yeah um because that i that i didn't. have. that that's sort of a um so we're. learning as we go. right and so what and this this is. relatively recent um ketamine assisted.

psychotherapy so what is it. and and that's exactly what we're. talking about is we know ketamine helps. we know it works. do we know exactly how it works people. are debating it because. you have competing interests you have. competing ideologies. but we know that people feel better. now what we want to try and do is make. that a more durable. state not you come in and get your. ketamine you feel good for a couple days. and then you. you come back a month later and you get. more ketamine because.

that's going to present a societal. problem in time if you're if you're. always on ketamine. you know we've kind of done the opiate. thing so that that's one thing that. that is we don't want to do because you. have some places that are like giving. you to go home with. and that is sort of like. um you can do a lot more with. ketamine assisted psychotherapy you can. use that place you're in. to visit the pain.

that has brought you to this distressed. state. yeah there was a moment i remember there. was a moment where i got to see my dad. be around my dad right. and i'd never my dad died when i was. like 16 and he was really older man. he was 86 when he passed away and i was. 16. so he was older when i was born he. was an adult you know. he was senior citizen but um. i got to have like this experience. around him and it was like a real. like it felt like i was around him and i. got to let him. i i got to you know i felt like my dad.

never knew how much i loved him i felt. like i had just never gotten to an. age where i could tell him that i loved. him you know. and i didn't realize how much that was. kind of haunting me i think somewhere. inside of me. you know like um exactly i just never. knew like that that was such a big thing. going on underneath me somewhere. and uh and i literally got to have. a moment or a little bit a couple. moments with him in a. emotional state kind of it felt like.

anyway to me it felt very real to me. that i was letting him know. uh how much i loved him yeah. and that and that's priceless because. there's no there was no other way to do. that i mean. there may there may have been but i i. hadn't found that yet. yeah that that is like. core to what um. ketamine is psychotherapy gives people. access to it's like those little gaps. those little holes in our heart. that that happen to us when we're young.

shape. a lot of our life and so to be able to. reach back in time. and and find yourself then and there and. that. that sort of that grief pain. of separation that you you didn't get to. have with him. you could connect to yourself and and. sort of complete. almost in a way like the grieving. process so you could release. that tension from yourself yeah that. that distress that's. that's like that's in there and it's.

always in there and it's. you don't know how to get it out and. you're pushing through life and a couple. decades go by. and you're like i'm still haunted by. things and some people. are not able to even see some of those. things. because i've taken care of people i'm. not taking care of some pretty funny. people. you know like i have. trees on my in my room where i do it and. they're like sitting there and they're. you know they're giggling and then you. know they're like oh that tree just got.

up and ran out of here and i'm like. okay and but then some of them. start singing for me and then some. people start like trying to do yoga. poses in their chair. and i'm like i'm like you can't quite do. that right now. right and they you know. no i mean it gets a little wild well i. remember even being a child i remember. getting something was wrong with my. penis when i was young and they had to. like. like i had like a small urine hole or. whatever i mean i could pee probably. 11 feet you know what i'm saying like i.

could really pee. and it was people were like oh he's. magic and stuff people you know small. town people think you're. you know with a rival church or. something you know all kind of [ __ ] but. um so anyway yeah they said they had to. cut the whole larger on my. uretha i think it's good urethra so. i remember we went in and they put my. anesthesia and when i came out. i asked where all the big black women. are at. and i remember the doctor telling my mom. that like. we thought it was just the craziest.

thing and my mom had said that. before when i was even younger i'd had a. surgery and i had a laura a big black. nurse was my nerve was the nurse. so i wonder if maybe there was just some. moment that was like stuck in my head. like through those little. kind of deals but um but anyway i i. i don't know why i went off on this. tangent but um. i guess i just wanted to know like yeah. i guess is there. what's happening during the experience. when somebody gets the ketamine what's. happening. so the way the way i do it is.

i i put a iv in them so i can like turn. it up and turn it down so you can slow. down if they start getting overwhelmed. okay because sometimes people you can. and you can just see it you know. uh they're like because it's like. there's lots coming at them. and and i'm sitting there and you. they tend to start having like their. blood pressure their heart rate go up. because they're getting like they're. seeing stuff and. okay so you want to kind of try to. minimize that you want to make it. constructive yet um.

sufficient to like have the experience. it can't be so low that you're like i. didn't feel anything. right but you don't want to like you. know. ruin them i mean not ruin them but you. don't want to make it so overwhelming. it's no longer. useful right i see what you're saying. yes so you want to kind of have a find a. balance. and um yeah that's what the one i did. the place that i went they they. they did it and then they kind of just. was a low dose until they kind of. got to you to a level where they could. where it seemed like it was manageable. and effective i guess to communicate.

with the therapist yeah because. what what i do is you know the way the. research was done is you do six. six infusions and i like to have them. come in and i. don't usually have somebody start. ketamine right away i usually want to. talk to them because i want to know like. their life narrative to some degree and. then you kind of get an idea where. where the boundaries are like you can. tell like. i go through this thing where i'm like. okay how was um. you know where'd you live where'd you. move how was that place how was this.

place. uh how was first grade how was second. grade and you keep going through it. and things start popping up pretty fast. and people don't realize what's in their. head and then they're like. oh yeah i forgot about that and. but you can kind of tell this is not in. ketamine this is just sort of getting to. know them. because you got to know what are you. going to do with the ketamine experience. so i want to have like a road map. right and and then as we do this. the first couple of sessions you want to. get there they're sort of like get. everything. chugging you just want to get them into.

a better state of well-being so that. their capacity. to examine some of these long-standing. things. is um available to them okay you don't. want them to. not be able to to sort of explore this. um you want them to be in fight good. enough fighting shape. that they're like i can do this um and. we go through it and i've had people who. couldn't remember entire years of their. lives. these are smart very successful people.

who who have been it's like something's. been wrong their whole life. and and you start going through it with. them. and it keeps going back further and. further and further and sort of like the. the beginning of the flick of the wrist. on that little. thread of pain and and a lot of times. these little firewalls conceal it. and then they have their ahas and they. remember more and more and more and i'm. not telling them what to remember. i'm just listening and so what are. examples of some things right and what.

are some examples of. so so well what are some examples of. things that people could remember kind. of. if you can share and that you have to be. specific to that person obviously right. um so i had a patient who um. had a series of moves that were sort of. stressful on on him as a child. and um it's. one of them after one of the moves um he. was. um very seriously disciplined by his.

uh by his dad um to such a degree that. that it um he didn't remember it until. we sort of toggled the switches around. it. and we started sort of gently like how. is this location he was like. that was warm that was nice how was this. location where you moved to. i didn't like it how was this house you. lived in. in this place i don't remember how was. this house i remember not being happy so. already we're pointing to.

narrowing it narrowing it yeah and he. didn't remember in the ketamine session. and then later that night he did. and so then we came back around the next. time and we talked about. it and we sort of work into the and. you know i i approach this with i guess. the right word is. like a great deal of reverence you know. these people are sharing with me. their emotional pain and i'm helping or. trying to help them.

connect to themselves so they can feel. whole because all this. all this distress that people have in a. way. it's like incomplete grieving yeah. and people can't cry that much and so. they. they suck it away and and what the. ketamine does is. it allows you an opportunity to kind of. go back in places. that you can't do awake you just can't. yeah and i've seen that i've seen. patients i start talking and i'm you can. tell they're like. they don't want to talk about it you.

know i had a lady. who who i took care of who um. i was the first person she told in 40. years that she was raped in high school. and she's you know she's in her 60s. and her life has been tough. and you know so her life has been shaped. by fear. right yeah i'm sure fear. um probably feeling like she couldn't. tell people things shame. and it shaped her relationship so she.

was in you know. not the best relationships because she. was. put in the state by this experience that. had shaped her ability to interact with. life. right and here we are 40 years later and. she's a wonderful lady. and and i'm it's that's why i mean it's. like i feel. i i i approach it with a great deal i. think the right word is reverence. because it's it's not sad but it is. it is like a a very important meaningful.

and and tender thing to do um yeah 100. man yeah i feel sometimes like i'm. trying to make. rope out of like the tattered. the very frayed pieces of like. of my youth kind of right as i get older. you know um and not very afraid. i don't wanna i'm not trying to have any. self-pity or something but i feel like. that that's what you try to as you. as you get older you're just still. trying to make this rope or make a knot.

out of this. uh make different knots out of rope that. was kind of like. ram shackly kind of tied to the. beginning of the foundation. at certain points yeah the underpinnings. of of wellness start early. yeah and and usually um. attachment feeling you know attachment. injury is. is no joke so most children. and what i mean most say 99.999 percent. of kids. are loved by their parents okay but what.

happens is. parents can show. this much love and. the child actually needs more love than. than they get and it's not that there's. a malicious thing it's just there's a. mismatch. right and that that mismatch creates. this like this. emptiness the start of loss or grief or. or not being cared for. and depending on how it gets nudged in. life it starts showing up as.

you know how they choose you know. relationships how they. try to navigate life and and if it's. really bad and they start. having other things pop up and and they. get on medicine and it. works or it doesn't you know medicines. do work so let's. let's not say they don't work but right. but they don't work. great debt can often feel like an uphill. battle. if you're carrying a credit card balance. and you keep chipping at that little. daddy. and you keep chip chopping at it but you. can't really get a big chunk.

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and to support the podcast. visit macweldon.com. theo and enter promo code theo that's. m-a-c-k-w-e-l-d-o-n. dot com slash theo that's right twenty. percent of your first order. macweldon.com theo inner promo code theo. yeah i notice i i start to notice that. the behaviors that i feel like affected. me when i was young. are behaviors that i now exhibit you. know and ones that i like.

imitate you know towards others that. kind of keep me in a in a place. that is comfortable even though it's not. the best place that i want to be in a. lot of times. you know the devil you know yeah it's. interesting man. um so with the. when people go under the under the the. solution under the. ketamine therapy right right so i. remember like. i mean i remember. like i would.

yeah i wish i'd had i think when i went. met with the therapist we started the. same day that i went. so i do wish that i'd had a little bit. more of a breath of communication with. them. so i'd have probably had just so that. there was a better so that we're like. okay these are five points that we want. to try and. attack you know or or meander around or. things you know. yeah um because sometimes i felt like. not that i was wasting my time but that. i was wasting the experience. and i may not have been it could just be. me being judgmental but.

um because i think it was helpful but. there were times where i felt like. like i was just kind of swimming through. some of the same waters without really. knowing what we were looking for trying. to do that that's sort of. the um but that may be okay maybe that's. just what you do sometimes with it well. and that's why you know this is on. ongoing. um evolution and care because ketamine. assisted psychotherapy. really hasn't existed very long because. you're right people were like okay what. are we doing with it.

and then as we started to you know. explore what we could do with it we. realized that hey. we can do a lot more than we thought. when did it start. ketamine assisted psychotherapy yeah or. even just ketamine assist like when did. ketamine start i mean everybody always. calls it a horse track all the time you. know well ketamine was originally i. think it was. invented in what 50s or 60s. and it is it's an anesthesia medicine so. horse tranquilizer anesthesia. it's it is an it's a dissociative. anesthetic by definition.

okay okay so you use it to put help put. people to sleep for operations or. procedures and is it found in nature no. it's not no it's me. um no not that we know of it could be. out there do you think it could be or no. probably not um but yeah there are other. things that are sort of like. um in 62 by professor. it was tested on animals which provided. promising results it was used for. testing on human prisoners in 64. there you go i didn't know that.

proof tax faster and reduce toxic. behavior which made it the preferable. anesthetic choice over pcp damn. it's interesting it's amazing how many. drugs used to be just avail. like i remember i was working on um i. was working in mississippi on a farm for. a while and the man. said that they used to buy ecstasy at. the bar. they had it like in a jar on the bar and. you could go buy it you could buy a tab. of ecstasy like before it was. i guess illegalized you know like there. was a brief time where it was a legal.

drug you could buy they. you know prior to like i think it was. 1970. the lsd and all that psychedelic. research was. was actually going really strong and. what happened was i think. the government finally said enough. because it started to begin. it was recreating too much that was when. you had sort of like the hippies and lsd. and all that. stuff and oh yeah and so when they shut. it down they. they they shut down all the research too. so it clobbered the.

the ability to investigate all these. kind of interesting substances. for real clinical aid you know use. roll the ball forward you know 20 30. years and now. now you actually have like um the. government is. is um very interested in in some of. these therapies and and the. real reason is the state of. veteran health um you know they're. you have so many veterans that are.

struggling. yeah and you know they have these these. organizations that are trying to. reach out to veterans but the suicide. rate among veterans is. really horrible wow i don't even know. that yeah. i i saw a metric a while ago it was like. more combat veterans from afghanistan. have killed themselves than have died in. uh the line of fire. wow so so you think about the they're. that distressed.

and then they come back here and they. just you know go back to. work and it doesn't work that way yeah. and so. the you know the government's funding. research on this stuff because. they got to figure out how to help. people it's yeah it'll help save them. money too if they cannot. it is not to put it right there but also. yes it is but it's actually providing. the. the the gas for helping actual therapies. that work as opposed to just. um throwing dollar bills at things yeah. so that's.

you know i'll take it you know if we can. help get serious about it. yeah for sure um and so. so those are types of people so can. people really use this therapy to get. off of. antidepressants and how does that work. short answer is don't know um. what what i have seen in. and like i said this is sort of on the. fly like this is. this whole body of knowledge has grown a. lot is. is people who have.

um profound distressors in their life. that are. under addressed are going to have. probably pressure to have. symptoms so they're going to be in. depressed states and if you can help. people. through something like ketamine assisted. psychotherapy resolve. those long-standing pains of emotion in. them. then it stands to reason that the odds. of them finding a way. forward are better.

that makes sense yeah it's sort of a. wishy-washy statement but. it's it's the same thing it's like like. you know at my place. we sort of break down why people are. depressed and it's and you sort of break. them into these categories. um where you have your your your groups. it's more like um. serotonin and then you have your. dopamine people so i actually asked my. patients i'm like what gets you high. i'm like uh what's booze do for you or. uh what's. cocaine do for you and uh and or.

shopping or gambling or because you're. trying to. stratify them like what what what's. goosing them. right right right so that helps you pick. like your therapy. because if you got a guy who can't stand. cocaine or stimulants like that. then it's probably he's probably needs. more serotonin. so you can sort of shape what you do for. them to help them with that. and you you can mix it so it's all. becoming like this basket. of ketamine sits alongside. um a lot of other tools and if you're.

using all of them. together and you're helping this person. who comes to you unpack. what they're carrying and you give them. better tools in their pack to go on. then the odds of them staying in on the. road are. better right and that's sort of like how. like. integrative psychiatry works now it's. like. you don't just say hey here's your. prescription get out of my face you. actually sit down you talk to him and. find out. why they're suffering yeah not oh you.

have depression. it's like okay where what. what's your you know what's wrong what. hurts. when did it get started right how has it. shaped you. can you talk about it and what level of. detail can you talk about it. and that's why i mean it's it's a very. like. almost it's a very. intimate conversation yeah you know. that's a great that's a great word. intimate i feel.

it felt really intimate you know i. remember. i mean right when i started to go under. i just started tears just like rolled. out of my eyes you know. like i don't even know what was going on. really you know i think it could have. just been. like i mean me i'm always probably 30. sad so who knows what it was you know. but. um but i remember just being pretty. emotional out of the gate. and the first day i was dehydrated. literally just from like crying i think. half of the whole session like. and some of it i didn't realize i was. crying like i didn't even really feel it. because i was kind of also.

you get kind of you're kind of. anesthetized in a way. so the main part of me that's still. awake is kind of this kind of that. all-knowing place inside of your head. where you have ideas and stuff you know. yeah like whenever you're thinking about. something you envision something like. that place you know. i i have had quite a few patients that. and i tell them this i'm like hey you. know. they a lot of them tend to feel pretty. quiet like they have like um. all the the the mental movie is sort of. taking a break when they're when they're. done for their session for the day and.

they kind of like. like yeah just roll with that don't do. any homework just sort of like. try to you know i try to keep them on. zero um. and i and i say it is you know very. possible that if you just start burst. out into tears later tonight. that's normal yeah that means like. you're you've connected to something. and that's like an overdue release and. so. i remember i was talking to this this. young lady. and she was um she was upset she was.

like what am i crying i can't stop. crying it's like. i was like you're going to hate me for. saying this but this is very good. yeah because she was just releasing all. this things that. she had packed up in her and. and the next day she kind of like you. know it's like after a good cry you like. but she cried you know a big chunk of. her life. out in the night and yeah yeah that's. that's a great way to say it i think it. felt like that like just a lot of stuff. that was going on. you kind of got to like take the.

pressure valve off a little bit yeah. in some ways um but yeah i would like to. have another experience with it in the. future and be able to. know going in have more of a game plan. going in so that i can. but then one of my issues sometimes is. controlling things. so it's interesting so i don't want to. go in sometimes to that and try to. manipulation you know. so which might not even be possible. under that um.

it kind of depends on your mindset on it. you know i think. what i try to do is i try to give people. a lot of. sort of neutralizing information so that. they understand. exactly what's you know the more you. understand what's going on and why we're. doing this they sort of their their. their guard starts to come down because. really. if you don't want it to work it's not. going to work and. and so you want them to be like okay i. understand why this is going to happen.

and so one of the best things i like to. do. actually is find out what they can do. with it so i do this thing where i give. my patients a it's a it's like a. butcher paper it's you know it comes off. a ream but it's actually graph paper and. i haven't put it up on the wall and. we do these five columns and it's your. age down the middle and then. where you lived what your relationships. were what your activities were and what. your substances were. and you just sort of write it down from. zero to. today and if they can do that.

then you can kind of get a they can sort. of look at their life. and if they can't do that it sort of. shows me where we need to. sort of use ketamine to examine some. things that are. like sort of like their no-go zones and. i got a number of guys who they can't. finish it because it's sort of like. you can't finish it and if you can't. finish it then you know i. you know i don't know how we're gonna. finish it in. this context without it being. emotionally brutal on you.

right and that's what the ketamine. allows is it takes the edge off. looking at things that you can't look at. oh wow. yeah it was interesting like i wonder if. there were things where maybe my. my being or whatever was just afraid to. uh. to unwind them right or just couldn't. you know or couldn't find like. the key the way into them sometimes it's. so it's such a. small opening into getting into like an. old feeling. in an old way i see that pop up all the. time yeah it's pretty fascinating we got.

a question that came in right here from. a young gentleman right here that seemed. like a decent guy right here. what up i got a question for dr pooler. and for theo. so i wanted to start off uh dr pooler. what is. the negative connotations with the. ketamine therapy and then what would be. your argument against that. um theo what was your favorite thing. about ketamine therapy versus regular. therapy. gang gang hang about um that's a good. question what you got doctor. um so the the negative connotations i.

i think the the societal thing is. there's sort of a societal sort of. frown against like psychedelics in. general and. you know it got started back probably. with like the hippies and lsd and so. you kind of get this blanket oh this is. that. psychedelic hippie trippy stuff and and. so. it can marginalize its actual utility. right as a a real medical therapy and. there's an organization. um called maps that that is dedicated to.

doing. high quality research to counter balance. that notion that this is like you know. step into my van. type stuff and yeah and uh and to make. it legitimate. in the proper studies and the proper. funding from. you know like the dod and things like. that because they want it to be as. legitimate as possible um. yeah it's interesting almost you really. have to mod like there has to be a group. kind of monitoring that branding and how. that really.

how it hits the public and stuff like. it's a little wild westy right now. yeah they've even said it in some of the. publications because. the you know all the ketamine right now. it's it's. technically off label the way the way. everybody's using it not a lot of. medicines get used off label all the. time. so um is that a problem no but. but it it needs to be. looked at down the road because you know. it's like the saturn life skits in the. 80s where you know you go to your doctor.

and you get a. hey doc i got a i got a i got a you know. my pinky hurts oh here's a prescription. for some weed. you know remember those skits that that. were like that and it's like you gotta. you gotta be careful you don't have the. slippery slope because i get. i get um mailings from places they wanna. ship me um like ketamine lozenges and. stuff and. damn that's that's not gonna. that's not gonna go well yeah i don't i. i i had six. infusions like you're talking about like.

you like you mentioned is probably the. pro. product probably protocol not protocol. but that's the best. no it's the best that's the research. that's the research. um that is what they fared it out in the. research was. the most legitimate and best way to. proceed is. is what you did and after four i felt. good after four. the last two i felt a little it got a. little griswaldy you know i felt like i. was on a. you know it felt like i was just on a. kind of a gnarly vacation.

you know it's like i don't really know. if i needed the last two or. maybe i did i don't know i just i think. at that point i started to think. i wish i had a better game plan going. into this so i could use it to the best. of my ability. i didn't know if i was using it to the. best of my ability the therapist was. saying um. and it was a great it was a great place. and everything but he was saying that it. work it'll work kind of no matter what. there is is there some truth to that. that it'll work no matter what. yes um so we know it works okay the.

question is is how long does it work. right and and what the um sort of like. the. industry the professional side of this. industry is trying to do. is make this a a. very serious one-time attempt. to get as much utility out of it. so that that the effect is very durable. and that's why you got to do all the. side work with it and that's why you. want. really really good assisted.

psychotherapy because you can sort of. unwind. things that are still sort of in the. background if you're. if you're sort of poking around and the. more things you can resolve. the more your heart can be at rest. um the odds of you needing more of it. are less. and that's very desirable so you know. like. at my place um. i've only had one patient ever. need a booster and he was a he's a.

veteran. and his there's some you know there's. some confounders with that but. but most people are are and i i don't. let them go either i don't like. when they come to me i i take them on. and and. we get to know them on the front end and. we're following them on the back end and. i'm taking care of all their other. sort of issues i don't i don't like send. them to places to. you know you you come to me and i work. with you and the idea is that. we're here to get you into a better. place of durable well-being we're not.

here to. give you ketamine right it's not you're. not like a sawmill you're doing. actual boarding kind of you're actually. bringing them on. um what is the number one thing that a. lot of uh. veterans struggle with or what is what. is the. so some of that trauma you always hear. about the ptsd there's two things. actually. and it's actually interesting the way. this is starting to pop up. um so ptsd and actually uh. concussions so traumatic brain injuries.

if you take a. somebody who has been uh in combat and. has had. ordinance exploding around them and. they've been taking those shock waves to. their head even though they look. fine it's has a pretty serious. depressive effect right and it's it i i. talked to a guy out in. colorado last week about this they're. they're trying to find ways to heal. these guys. because they tend to be like very. sensitive to. emotional dysregulation because you. think about you take a fish bowl.

and you put you cook up like 30 30 bags. of ramen okay. okay and you put it in a fish bowl like. like a goldfish bowl. so it's like completely full of noodles. right okay say that's your brain. and then you hit it with a bat the. noodles are going to move. so if you're taking concussions. repeatedly it's going to. scramble your noodle yeah and so those. are nerve connections that. that are responsible for your daily. function and as those get ripped apart. and. try to heal they don't necessarily get. it right all the time and so.

like people are they're they're. they're hurt in a way that's hard to. address. interesting yeah because it doesn't seem. like we're meant to be batted around. that much you know. no not at all um so those are some of. the most common things you see. as far as veterans is like uh stuff from. concussion stuff. that's that's one okay the other one is. is frankly. the the grossness of war i mean yeah. you see two of your buddies incinerated.

in front of you and that gets on a. record that won't come out of your head. and and that's all they can see so then. they get like super um. super sensitized so so. they're stuck in this place in their. mind where they're still driving down. that road when that car bomb went off. and so when they hear a door slam or. something that that's a neural circuit. that got. burned in in the strongest of ways so. they have this they have this nerve. pathway that that's just. seared into you and so it's on alert.

because it's still there and so. your neighbor boom closes the door. you're like and. or you hit the deck or you do those kind. of things and so. that's one of the things that you know. they're proposing. um that they use ketamine to work with. you know patients on why does trauma. create such strong like neuropathways or. like connection does that make sense. the and does it it sounds like it must. right it does because. um so it's it's post.

traumatic stress what what happens is. when something happens to you you form. a temporary memory okay like what'd you. eat for dinner last night you could. probably tell me what it is. um salad but but two years from now two. years ago what'd you eat for dinner. i have no idea yeah i don't know so. intense experiences. make different signals like right but i. could tell you if i was in like a boat.

accident. correct now ramp that up. to about 11. and. and where andrea galen yeah then it gets. pretty deep and then then you can't. forget about it because it's. it's it's it's sort of your your. neurochemistry. has decided that this needs to be a. permanent reminder. probably from a more for safety probably. yeah more of a. like fight flight or flea type thing and. so. given where we are in the world today so. it's inflammation kind of then.

yeah so those are yeah because. that's the craziest thing about it is is. the way the immune system works with. your mind. is is phenomenal like. you can even measure it now like you. know how when you get the flu. you um you feel crummy you don't want to. get off the couch. food doesn't taste good sex isn't. interesting all that stuff goes away. right. imagine being like that walking around. living life like that.

that happens because your immune system. knocks out your dopamine system. so you don't have access to your. dopamine system because you're sick. because of your immune system because. you're supposed to be healing under a. tree. but if you're walking around and you. have your immune system activated. you begin to look like somebody who. doesn't have access to the feel good. wait explain that to me again sorry i. got lost so so. your immune system when you're sick.

takes your your dopamine system offline. oh that's is what it does that's what it. does that on purpose so you can heal. oh because they don't want you trying to. feel good because you're not going to. heal correct. right got it but if you're walking. around interesting if you're walking. around. day in and day out year in year out and. your your immune system is. slightly activated and your dopamine. system is. always offline then life is flat. and feeling good is inaccessible to you. ah. and are you depressed or you just not.

have access to your dopamine system. wow that's interesting yeah that's a. great question and you can check that. with um. it's actually pretty straightforward to. check now you got to get. a simple lab drawn to see if your immune. system is activated. and that helps point therapy so like. what i do is. when people come to me like i check some. labs on them i get to know them a little. bit. in in ways that i do my thing and so i. kind of want to know where they're at. amen so we can start shaping what comes.

next. and that's before we take them in the. room because i look at it as i want. i want this to be as useful as possible. right and then. so that when we get to the other side of. it we still are learning things but. like i had a patient who he was done. okay but something else popped up in his. mind because he was having this problem. where. on a regular basis he would have panic. attacks at a certain time of day. okay like clockwork and i i talked to. him i was like.

what time of day did your dad get home. when you were a kid and he just stopped. same time of day all his life wow. that's crazy but he was able to see it. then because before he couldn't even see. it. yeah but now we could talk about it and. resolve it and so he was able to see it. when he was under this. the therapy after afterwards so we were. done this popped up even later. because he was saying you know i'm doing. pretty good but i still have this one. thing that's popping up on me and i said. well what is it we talked about it and i. i asked him and he's like.

yeah yeah. what um what could you give a question. that came up sean sorry let's get to. that. oh actually this is a comedian friend of. mine shane moss. who he is a psychonaut. so he's like a man who he's very funny. man. and he also is a man who has. experimented with different. psychedelics and stuff over the years to. have experiences just like an astronaut. would with like outer space right. he's kind of done it with like inner.

space so awesome to uh have this from. him. theo shane moss here in case you can't. recognize me. i hear you're getting ketamine treatment. i think that's. fantastic very very worth exploring. see if it suits you psychedelics are. not always the most linear thing in the. world compared to other. medications or drugs or what have you. but mental health isn't a linear. thing either and so i wish you the best. of luck i hope it uh.

it shows some improvements thanks man um. and my question for your guest is i'm. wondering if you could talk a little bit. about experiential versus chemical. change. rather than taking say antidepressant. every day and. and altering your chemical imbalance or. whatever a psychedelic journey is. a lot more about using that temporary. uh chemical chemically induced. change to have more kind of personal.

breakthroughs and. insights and those insights are kind of. what. leads to the personal growth uh. more than some permanent chemical. change that you're doing or a long-term. change that you're doing to your mind. oh yeah yeah thanks brother. so this is like a two-headed. animal here because you have like the. the neurochemistry of what happens okay.

and then from there you have what you. experience. as a result of the neurochemistry and. and he's he's. he hit the nail on the head with that is. is. therapy like this allows you to have so. you're getting therapy you're getting. mood elevation from either therapist or. from like a medication you're on. regularly. yeah well you have this thing where it's. a called a. uh a rapid gain so. you're cruising along and also you have.

something that goes way up you're like. oh man i figured that out. and and it goes like that but it doesn't. work like that you actually have to go. for a long time and you don't have those. very often. with therapy okay right so what what. ketamine does in psychedelics is. it's like a lot of access to rapid. insight for a prolonged period of time. relative to say going to therapy for. five years. right and it could be a couple hour a. couple minute. actual portal is that what you mean kind. of like that well that's where you talk.

about. what happens is we know that ketamine. helps nerves grow so. if you have nerves that are firing in a. way that is. causing you to have a depressed mood. state or. anxiety and you. basically soak those in ketamine for a. say a period of a couple weeks with six. infusions. you can. get some plasticity in how those nerves.

work so you can change how those nerves. are connected. they grow a little bit they actually. like they've seen it on the under. microscopes these nerves actually grow. little sprouts and they. they can change and so you're enhancing. your ability to change. at a at like a microscopic level amen. and that. translates into like a change in. perspective on things. yeah sort of metaphysically i mean this. is kind of like we're getting. going into the into the the realm.

between. electron microscopy and spirituality you. know what i mean. but but it it is so so if you look at it. how a person experiences it is that they. can see. what they've experienced they can find. things. that they've experienced and connect to. themselves more fully. and if they can be a more full person. and have less. pain carried in them because they were. able to have an emotional release.

by connecting to a loss from the past. and they're probably going to walk away. from it feeling better about. life globally yeah you know i think. that's a good summation a little bit of. just what i felt. i felt like there were. new ways to connect yeah. kind of and i couldn't describe it. exactly. and i couldn't manage it. but i felt like.

it was helpful i felt like when that. when i. knew more tricks and how to almost use. the controller better i would go back. and play the game again if that makes. any sense it does. um so what's so what's uh. shane is saying is that so you're saying. that so ketamine is more of like an. experiential type of thing. it's both so so to to the person. who's experiencing it they're they're. gaining. um sort of a.

they're gaining like this. alternate or this this additional view. of things. they're they're gaining insight they're. like they're up here. and they can look around themselves more. like like not. like they're not in the game sort of. like they're looking at. the game and from that they can be like. you know that really that doesn't hurt. as much as i thought. and they can see like oh i can see that. yeah i never really got over that. that's been sort of haunting me and like.

okay. i'm okay and and so. that's what it can provide now the nice. nudge is when you can have somebody like. say. well you remember you mentioned this and. let's let's explore this a little bit. and see how. those decisions sort of were pushed by. emotional distress or pain and rolled. the ball through this event. and then you kind of so you try and. sequence it through. through life so you don't want to miss.

things right. it's the gaps the gaps are the key yeah. i could see that yeah i wish i yeah in. hindsight i would go with like a. timeline kind of a little bit of like. a plan i like i like doing the school. thing like yeah. the great you know the one question i. like to ask people is. when was the last time you felt whole. jesus and then what was it that. began to separate you from that feeling. yeah i don't even know man i i probably.

was a damn. and a zygote yeah and then and then you. go back to if they can't. if they can't dial it back that far you. go back to like when they were like five. four three when did they feel love two. one blast blast-off is when i probably. felt it maybe i don't even know. yeah i don't know i don't i mean i know. you're not asking me but it's just yeah. it's interesting for people to think. that. the place i was at the therapist hadn't. done the experience does that matter if. they've done it or not um.

i i don't know um maybe it doesn't. it's kind of one of those things it. depends on on where the therapist is. what um what made you care about this. how did you get into this whole. universe you know i did anesthesia for. quite some time and. i and you're a real doctor then yeah. yeah i have an md um and um. i saw a ketamine work pretty well and. because i was.

i did anesthesia right was it fond being. anesthesia. it was interesting it was fun and it was. crazy. and it was but it was a you know i mean. you listen to music and stuff where you. go in there nothing like that. you know we had a actually we had a. surgeon who who would get noise. complaints from the other ors. because he would listen to death metal. all day and he would turn it up all the. way. and so he sort of had like a his own. little crew because. you kind of have to be like the right be. in the right mindscape to go in there. and listen to. mega death for 12 hours yeah at you know.

80 db all day long yeah that's crazy. you're cracking up in a rib cage. and you're hot all hopped up the. surgeon's next door in the room's next. door would complain. you know it's like been in a hotel. they'd be like dude tell them to knock. it off. but it was i mean it was it was it was. crazy. i mean it was good but it was it was. like. super busy super high intensity yeah um. and you have to stay the whole time you. just hit them with that dose and you. roll out. it depends okay but the way our model.

was we had. uh nurse anesthetists and. and so we would we worked together with. them and they would stay the whole time. and i would i would come in and. troubleshoot things and get the. get the ball rolling and and you know we. were at a place where we. we took care of really sick people so it. was um. you know it was but you sort of. acclimate to it and then you look around. and you look at what you acclimated to. and uh but but for me what what got me. turned into the corner of this is is um.

sort of my understanding of suffering. has evolved a lot. and um. i had a brother and he died last year. he was injured as a child. terribly and. he never could get the help he needed. and so he he.

did a lot of drugs he tried to take his. own life several times oh man. it's hard to hear that he did all these. things and and i was sitting there. and and he knew he was dying he was in. hospice. but i was you know looking at what was. coming down the pipeline i was like you. know if. if we can help people who've been. traumatized. like it's sort of like for me it's like. if this would have been around 20 years. ago maybe i'd still have a brother ah. because he he was sexually abused as a.

kid. and did never tell anybody nobody. the only reason we found out about it is. because our. our pastor was imprisoned after the fact. by somebody else. dang and so i couldn't figure out what. was wrong with him his whole life. and i i asked him one night and he goes. yep and i was like [ __ ]. and but the damage was just. like yeah how much that shaped somebody. that's young that's. man that's heartbreaking i'm sorry yeah.

so. and i'm sorry for him i'm sorry that you. know it's heartbreaking to see you know. i've been. you know a lot of my family and being in. recovery and struggling through those. you know struggling through trauma and. stuff like that childhood trauma not. like that. uh but different types of trauma and. stuff has been pretty prevalent in my. family and. it's heartbreaking to see the effect. that it has on people you know. it it was you know the last six months. of his life i i finally got him to say. because he was like he was a he was a. crusty guy. was he yeah yeah and uh the last were.

you guys pretty close. yeah oh that's cool and he knew he was. he knew he was dying. was he drinking himself to death yeah he. did he had the operations and and. he kind of stopped actually but the. problem was is the damage was done and. and but like you know one of the last. times we. we spoke um i was sitting with him in. the hospital he was on hospice and. and for the last six months of his life. i got him to tell me that. i told him i loved him every day and he. was like i love you too.

and like just for him to be able to. express emotion was priceless. yeah and then you know one of the last. moments we spoke i said i love you and. he said i love you i love you too and. then he goes and he flips me the bird. and i was like that's. that's mike and uh and so it was like. you know i. he knew at least he was loved yeah and. and um that was in um it's important. yeah i think a lot of people's life if. they struggle with trauma i think some. of it is just yeah. thinking that people don't care people. that think it's unable to feel love it's.

weird how a traumatic event can block. off other things you know. yeah he couldn't he he didn't have the. capacity. and he never so he he was. stuck and he could never get out of it. and you kind of wonder. or hope that if somebody else comes to. me. and a little younger and hasn't burned. themselves. physically like like damaged themselves. enough that you can help them turn the. corner. yeah and get healing going in a way that.

they they can get back on the road of. life and. and that's sort of that's. to me is a very rewarding way to. interacting with life you know i can. look over my shoulder and be like. i am okay with what i'm doing i'm. helping people. find peace right. yeah it's it man it's so fascinating how. like if you ca if you don't feel loved. or if something makes you feel so. unloved or so damaged that then you it's. very hard to feel love after that.

because i think there's just receptors. in you that just do not trust it. or just do not trust the world almost in. a weird way. and i don't even think you can access it. sometimes. like that's the that's the such hard. thing is to be able to. access why or what or how to change it. to get the clay in your hands. you know it feels like you just. can't find it you know um so it's.

fascinating to hear that there's. opportunities that this could be a way. where people can. i'm i'm you believe it i believe it i do. i really do because um. i've seen it work i've seen it work on a. lot of people. and it it's one of those things where. it's it's like you get to see these. people come to you and they're just. broken. and and the first time you hear them. laugh. and or smile and you're just like it. it's. it it's i'm in the right place yeah.

that's fascinating man yeah i noticed. after a couple of treatments i'd had an. idea i was running. one day and i just had like a good idea. and these have good ideas all the time. i mean i'm just i'm judging my own ideas. but i thought they were pretty good but. but i used to have ideas a lot. and i just for like a year i just hadn't. even gotten an idea. like i've just been kind of living with. the pieces of every day you know. and it's been fine life has been fine. i'm not i'm not complaining i'm not. asking for any pity i'm just explaining.

where i'm at but. but i hadn't found it got anything new. to come out of my brain. you know and so i noticed that i was. running by some turkeys somewhere at. this park and then. i don't know i just got like an idea. that was like fun and it made me laugh. it made me smile i was like oh man what. a gift like. when something's able to just kind of. travel through us and make us feel good. which is how we probably should be a lot. of times you know yeah is to be a. conduit for. joy to at least pass through right. instead of being kind of a um.

a place where something has put up a. fence or something is put up like a. firewall or. you know different elements like you're. saying yeah um. [Music]. what are the what are what are some of. the side effects that we honestly do not. know about because just to be very. honest and transparent with. um people who are considering this. treatment so there's. there's there are limitations like their. actual limitations like. you can't really have problems with like. psychotic type problems or schizophrenic.

type problems it doesn't see that. it it's like it doesn't work that. wouldn't be cool yeah no and if you have. a if you have problems with seizures. you really gotta look into that because. it used to be that ketamine was an. automatic no if you have a seizure. disorder. um and and depending on what's going on. with that they're looking into it. um but um the other things is like. sometimes what you get is is uh patients. actually um vomit and.

and it happens and i can almost see it. coming now. it's almost like a the physical need to. expel. bad ah interesting so so like i've taken. a couple patients very recently and. they were super overwhelmed like way. overwhelmed. crushingly and and. and they they just started vomiting and. i knew it was going to happen and. it wasn't a problem but they didn't. understand it i was like yep.

it's like you needed to get it out wow. it was like it was like a metaphysical. expulsion of badness from them oh yeah. and um and so that it doesn't happen. very often though. i can see that i could really see that. sometimes. i think all types of things like that. are a mole or something somebody with a. mole and say that's a bad somebody you. know. that's a bad idea or something you had. or that's a something you know that's. something bad that happened to you. you know or sometimes you see like. someone like i'll feel sometimes like. when i'm really going through therapy.

and it's going pretty good i'll get. pretty close to this feeling like. there's something in my throat that i. never was able to say or like to talk. about when i was young. yeah or i was afraid to talk and so i. can almost. feel the mass whatever it's not you know. it's all. probably in my head but it feels very. real so those connections from your. you know your your core yeah emotional. centers are. they're they're reaching out into. everything and. you know if you think about a nerve. connection think of like a thread of. hair.

from an experience to somewhere else in. your brain it's still there. it's just how how often it lights up and. and it starts pushing on things and. and that's you know like post-traumatic. stress is the hair is the size of my. you know pinky yeah and so it's it's got. domain over your. operating system so to speak yeah and um. what's the question that came in for uh. you have another question that came in. sean. i know we have one from a young uh yeah. let's play this fella right here. the uh what is going on my brother i. just got a question for.

dr ketamine as he's in the house um this. is sam from. sydney here and you know down in sydney. we we're team ketamine down here you. know we got that special k. on deck i would say um but my question. for the doc. is is this an addictive substance and. are there will there be lasting effects. from this kind of therapy. um because i can tell you from second. hand. right now i got some friends that could. argue there are some.

a little more long-term effects from. this substance and it could be quite. addictive um. some fellas getting banged out out there. in australia. gang brother cheers man yeah what are. some of those what are some of the. effects so. it is addictive um it is not. that addictive but i have talked to. somebody who was. completely addicted to ketamine wow now. the. problem with ketamine is. is it's unclear but this is what the.

best. sort of notion on what's going to happen. to people is if you're always. taking a substance that causes neural. growth and neural change. well keep that ball rolling and see what. happens to your mind. so so if you're always changing it and. you're always growing it your. ability to be you is going to. be called into question if you're always. abusing it it's not like you know. opiates you can take opiates for 20. years. and come out of it and still be. your person ketamine is.

putting like putting your brain in a. grow box. and you're trying to grow all these new. sprouts and all these new connections so. that you can. connect in a healthier way to to. traverse injuries from the past okay. now we know this is happening at the. microscopic level physically. so if you keep doing that all day long. for years. where's what's going to end up remember. that that bowl of ramen. you keep putting more ramen in there i. don't know what's going to happen but.

i can probably reasonably predict that. these people are not going to be the. same. wow and not in a good way that's why. again. you know the the research was a set of. infusions. in order to traverse something that is. essentially beleaguering you in a way. that's preventing you from having access. to wellness. um long-term dosing of it. i at a at a lower level i'm not.

sure if that is gonna. [Music]. i i don't do it you don't prescribe it. no i don't because i. i have seen a lot of things and. i want it to be done in front of me i. want the like like. the chap from earlier you want the event. to be very meaningful. you want the sequence of events to be. very. um enlightening and very. meaningful and connecting to yourself. emotionally you want you want those six. sessions to be sort of like a time.

of of introspection and healing that's. been. brought to an immensely higher level. because you're seeing ketamine a lot. you i don't want that to be wasted so i. want to do it right. from beginning from before beginning to. afterwards. but i don't want to be picking up that. tool very regularly because. because i don't want to use that as the. crutch. because we we've done that crutch with. other substances in the past and. it hasn't worked out so well yeah it.

gets bad it gets. and then people also have to make their. own choices but if there's some. addictive nature to it then yeah it can. be tricky. um and that's what i want to say like. i'm not telling anybody to go get this. therapy or. saying that this is you know i wanted to. have an experience with it. um because i'm going to try to get off. of antidepressants. so i'm working with my doctor now and. try and like. slowly wean myself off which is some. which is cool the the place that i went. the. there they have like some follow through. there with like trying to help me like. do that and. and manage that so i'm excited about.

that and i'm still working with my. regular therapist. um but yeah i definitely wanted to have. the experience just so i knew. kind of what it was like and what's. possible. um you know i love to kind of figure out. how i'm thinking and feeling and why and. stuff like that. you know so. it's it's nice to kind of see if what. things i can get get through and get. away from and. i i find that like anchors i can pull up. kind of i find that you know. in in my practice about half of my.

patients don't get ketamine. like we we you know it's sort of like. why are you here and they're more. like they don't know why they're there. they're like they want access to. well-being they want relief from. distress. that's what they really want right but. they come in with like diagnoses and i'm. like. well let's talk about what you what's. really going on. and then you know we we talk and we we. gotta you know it's like we gotta get to. know each other it's not like i'm like. hey yeah here get out. um and they may turn into ketamine.

patients once we find like hard stops. places that are you know. like i shared earlier i had that lady. she wasn't a ketamine patient okay. and as we got to know each other and i. was sort of helping shaper therapy. using other things we she felt. comfortable sharing me. with some pretty disturbing stuff and. then she shared. some even more to start and then she she. couldn't she stopped. i was like um.

yeah it's sort of like let's let's. change gears. because we're running into some very. emotionally distressing things that she. couldn't articulate at that point. and in order to get through those we i. wanted to protect her so that's when we. slid over into the. the ketamine room and now she's. she's about she's in process and she's i. don't you could just see the light in. her eyes. now she's you know it's like she it's. like. it's not just like go get ketamine it's.

like why are you here right. and and that's why we we talk about. what's going on and. well there was an experience one i had. an experience at one point where i felt. like i ended up like in a corner of the. world kind of. it was kind of like i felt like you ever. been in like a video game and you get. stuck somewhere on it you can't even. move like your. guy gets stuck i felt like i got stuck. at like the edge of the universe like. where the universe. like we like i finally found like the. two walls of the universe like the ends.

of it. and i got stuck like in the corner. and i don't know what was going on were. you leaving the chair or coming back to. the chair i was on my way back to the. chair. okay yeah it's interesting like. you know because like did you feel like. you were like getting light in the chair. and then like your fingers started to. get all yeah you know i don't even. notice that i just remember. kind of talking in a conversation and. then next you know i go on this ride. and i'm not even talking that much. anymore i'm just kind of on this journey.

people are so i talk to my patients a. lot and they. some of them remember some of them don't. but. um they come in different they come in. different like. personalities like you can kind of. there's i'm starting to get a. there's different types that come in. there like i got my musicians. and they start singing for me and uh you. know they're belting it out or they're. composing. right there in front of me and i'm like. this is cool and then you know you got. the guys who might my trees are running. off the screen. and my one kid who tried to hop up and.

run out but he forgot he was on ketamine. and you can't move. he didn't even get out of the chair you. could just see it he was like and i was. like. it's okay man and uh that's crisped out. man he's probably all crisped out. yeah he he had some issues it gets i. mean it's definitely gnarly i was. i i didn't feel like i guess in some. ways it felt like a drug it felt like an. experience to me right you know um. i felt like i was kind of grateful for.

the experience i was grateful to be back. from the experience whenever i got back. from the like trip or whatever you kind. of go on during it or whatever like. the visual the experience the. out-of-body kind of experience i felt. grateful whenever i got back to my chair. because there was moments where i was. like i am never. you know i don't care yeah they'll. i'll never they'll never find me yeah. it's like i'm lost like where am i. in the world in the universe that will. never find me i was at like i was in. atlanta i was in castlevania that video. game for when i was a kid.

i was in some i was on the back of. someone's. neck i was a there was a lot it was i. was sliding down stuff a lot of like. moving along huge. i don't know if it was like electronic. land sides of. walls i had a lady recently. she could hear um i got like these. pictures of. a forest or in my one of my rooms and. she could hear the forest. wow and then she was like then she'd.

hear a lot more like and i was like. that's pretty cool. you know because she it was she was not. disturbed she was just like oh yeah i. can hear the forest. and i was like that was a first like the. auditoriums were. are not as common that's strong is there. a reason why do we all need therapy now. what's going on have we got are we weak. people. do you think are we. you know it's funny because i'll talk. about therapy and stuff with my mother. and she doesn't. she doesn't not believe in it but she's. just like you just keep moving on you.

know you keep going she's. more of like you tough it out type of. vibe and i come from more of like a. well why well what's going on like that. kind of type of vibe you know. i think you think it's an american pro. like not problem do you think it's like. a i think it's a. there's like a. there's a couple things resiliency okay. people. people don't bounce back um. um very as well as they think they do.

um and the other thing is is like. how how old you are. and how like i'm sorry. young and having problems happen to you. when you're young. is very problematic. and because if you look at like say. you're writing a program. okay i got a coder here in nashville. actually. um you're writing a program okay the.

earliest code you're writing. okay is sort of goes through everything. okay so when you're when you're a child. that's your earliest programming so that. tends to resonate. through your life and if you're not. being shaped with sort of like a good. societal. structure good parenting structure you. know they talk about keeping people out. of the system. or once they're in the system the system. doesn't work okay well how did they get. in the system. right so where do we where do we.

set the boundaries from the get-go you. know. they used to have tv shows like leave it. to beaver and. things like that it was like sort of. like showing you how people are supposed. to behave. and and andy griffith show they were. very. like structured on this sort of. false reality of how people are supposed. to conduct themselves but it was very. civilized it wasn't dysfunctional. it was based on like love authority. respect. um and things like that and then as you. sort of everybody does their own thing.

now. well they sort of do their own thing and. everything and so. the the the underpinnings of youth have. sort of. gotten more flexible but that also means. that their emotions are also more. flexible in all directions. does that make sense at the end part. doesn't. i don't know like i mean it i mean i. know it it probably should i just don't. know. if i was different person i would. understand it i bet like i. the way i grew up is like you you do x y.

z. right and you chug through right and and. you everything was supposed to be fine. but as as we've moved forward as a. society like. my parents and and a lot of people's. parents they had jobs where they had. pensions and they had. they had more stability right and it's. less stable. now you have you have more flexibility. but with more flexibility comes more. uncertainty ah yeah so so people are. like more questions. people are feeling less secure in the.

world. in reality they're probably more secure. right but they don't. feel that way and like after 2020. you know 2020 is like a rubber band. you know the suicide rate actually came. down okay. well what's gonna happen right i don't. know because i have people showing up in. my office now that are like. they're beginning to cope with what. happened to them in 2020. and you know yeah that's why we're here.

yeah it's interesting man i mean uh you. know. i had like during the pandemic i had. like five friends that overdosed and. died like that just because they. couldn't get to recovery meetings i. think i think. it's they've never said that they're. dead but they. i you know i believe if they still had. opportunity to get to meetings which. were closed. um it would have just been helpful to. some of them you know. um just to still have the ability to go. like once you lose that connection you. start to isolate more than so much stuff.

happens. you get stuck in your own world um and. yeah i think some of that too i think we. also were at a time where there's just. so much technology now we get such a. quick. reflections of us that are like just out. in the world that aren't. that aren't like rooted in ourselves um. i think that that can be very unnerving. to people the um. the you know i share. with patients i'm like you know being. connect being connected the feeling of. being connected it's not the icing on.

the cake. it is the cake and you see that um. we're we're an incredibly disconnected. society. you go into any city and nobody knows. anybody. yeah even though they're living next to. a million people and if. and and you can look at the history of. like earth. you know you go to these blue zones. where people live unusually long. right okay you go to like okinawa costa. rica um. like i think it's sardinia croatia these. these places are not terribly affluent. but people are like really happy and.

they live a really long time and they're. like why. and you know a big chunk of it is they. they have this thing with community like. they're all connected they're all. part of they're together and so when you. what's the. the opposite end of that is everybody's. alone and when you're isolated. bad things happen yeah and i think. that's one of the things that happens to. our brain our brain is a. he is literally a piece of machinery. that's. has the ability to connect with other. you have to people.

yeah and it's like so when we take our. brain away from that and we're not doing. it of course our brain is going to get. sick. yeah you know it just makes sense it's. like a plant you know. um yeah it's not like a plant but it's. like something being connected is. is is crucial and you know. my our our family um. my wife's grandparents are still with us. so so they're. you know in their um 90s and. um and some of their brothers and.

sisters are still with us and so. last year it was like awful because. these are people we would see every week. yeah and we i mean all the time we would. see and they'd show up to like. events and and then for like a year they. disappeared. yeah and like they'd stop and you'd wave. at them because you were so afraid to. you know because i worked i'm doing my. thing and and. i hadn't been vaccinated yet and so. everybody's living in fear. and everybody's isolating and you're. just like this is awful and then you see. that.

you see that uh you know that do you see. that match.com commercial with the. satan dates 2020 you know a match made. in hell uh-uh that's the funniest thing. i honestly but it's it's a it's a a. great. sort of representation of how bad last. year was damn. yeah i believe in satan though but i. would like to see the commercial but. i'll probably see it. uh we can watch it later on um. any other questions that came up shown. there was one from a young lady that. came up you want to play that real quick. and then we'll get you. uh and then we can close it out we've.

gone almost two hours hi sean. uh hour and a half hour and a half okay. cool cool. hi there my name is courtney um i. actually have. my first uh ketamine therapy appointment. scheduled for. next month and i've had some. prep appointments but i just wanted to. get your point of view as to. the potentials for how ketamine therapy. can. benefit people with complex.

post-traumatic stress syndrome i know. there's a lot of information. um going around right now and i am just. really. interested to hear your thoughts on it. thank you so much. ganging thanks courtney and we may have. answered that really didn't we. maybe not um i cannot i can answer it. okay in a way um so. ketamine therapy is. i think the a a more. genuine or credible way to to.

look at what ketamine therapy does is it. allows you access. to healing to to reconnecting with. yourself from seeing pain that you have. in a different way like at a more like. ethereal way right so so a diagnosis. um is not really a description. that is is what we're trying to do why. the diagnosis. is is a better way to look at what we're.

trying to. approach and like i have people who kind. of had very bad things happen to them. and so so i want them to be able to. reconnect to that part of them that's. stuck in there. and if and if that if that part of their. emotional. baggage that's sort of pinned to that. moment. if they can connect to it and grieve and. get that that release. that emotional release of connection. then. they can begin to feel better and it's.

not like we're checking off like. anxiety check ptsd check it's more like. what's what's you know what why are you. hurting so much. and and how does that show up in your. life because you can take somebody who's. struggling with something and. somebody will have insomnia and you. could take somebody who's struggling. with something. and they'll have depression and so it's. like what what really is the distress. what really is the root of their pain as. opposed to like a diagnosis.

and it's more fundamental it gets back. to what's wrong. yeah you know as i'm hearing you say. that i i i i felt like. sometimes when i'm in therapy it's hard. sometimes it's like if my mood is. isn't that great that day i won't even. want to talk to my therapist i don't. want to share with them. sometimes i want to be like you know i. want to be. kind of i don't know sometimes i won't. really be in the mood. um sometimes i'll keep information from. them because i'm scared to share it or. because i don't feel comfortable.

right you know but this kind of i felt. like this kind of takes away. some of that for me anyway took away. some of that. my own thoughts my own [ __ ] whatever. i'm attaching to whatever is. bothering me in my life and let me kind. of just. see what was bothering me yeah a little. protection. yeah it just kind of like it didn't even. it just. it felt like i was just there to get. some help it was like. it was almost like going in for like a. deep deep deeper deal.

yeah your all your normal defense. mechanisms are sort of taking a break. yeah and you can be more genuine with. your emotional state. and and in that state you can be like. what really hurts versus what if i. convince myself. as my problem versus what is really. bouncing around in the back that i don't. want to look at. and and it's just it's it's a. yeah it's a much more like rich. sort of conversation with yourself yeah. yeah man it was it was definitely it was.

it was really interesting. you know i would like to get some more. tools so then i go when i go back. what are some tools you think that i. could use when i go back uh. to or what are tools that someone can. use when they go into. their ketamine therapy after they've you. know met with their therapist and stuff. like that. what are things that they you feel like. they can do to best get uh. the most effectiveness out of their. experience well. so a couple of things are is kind of.

getting some information on where you. are. so what i what i like is uh i i want. patients to get a couple of labs because. i want some i want some pointers. i want i want some data to uh to show me. where they are. so i get them have them get a vitamin d. i have them get a high sensitivity crp. test crp is like a test for inflammation. i um i do some brief. questionnaires so we have this little. online thing. uh their little and and they get these. health questionnaires but it's like. it generates a number it's like how.

distressed are you okay and then. we start sending that to them every week. or so so we want to see what we're doing. we want to see. the baselines where are we starting. because what are we doing. and so we get some data on the front end. and i get to know them on the front end. and then as you go into the ketamine. you sort of organize your. i think i mentioned that i got this big. thing of paper and and i want them to. like look at their life. because that's how you sort of want to. like where what are we doing. where are we going with it where do we.

propose. that your distress is sort of seated. you know what happened right and so then. you kind of know where to. toggle it and what can they do. if they are if the patient is sort of. like how can they best help you and the. medicine. or the therapist and the medicine uh. usually it's it's um. just i gotta get to know them a little. bit so. so it's like i gotta i gotta know what.

brought them to me. right like what really brought them to. me as opposed to a diagnosis. i see is there a state that they can be. in is there an attitude that they can. have or is there. absolutely so so we know now that um. a a predictor of failure. is resistance or the inability to accept. it. so if you're basically it's if if you're. not willing to let go into it. it's not going to work that well okay so. we know this it's actually.

a study popped up i saw it a month ago i. can't remember. what it was but they actually have some. predictors now and. the resistance to the process is. is gonna keep it from working for you. okay. so if you're like i don't want to do. this i'm not ready to let go. i would get yourself into a better head. space first and that's why we like we. want to get them into a better head. space going into it like. i got to get them sleeping first if. you're not sleeping you can't do. anything so first thing i do is get. people sleeping.

because then you can you got to be able. to sleep to do anything. and so i try to get my patients sleeping. first oh you do. i mean like when they come in so like i. i usually see my patients for a couple. of weeks. at least before they come in so i want. to get them sleeping on a regular. schedule oh sleeping on a regular. schedule i thought you might put them to. sleep when they get there no no no no. no i'm sorry like like so prep work is i. want to get their sort of their life. sort of. moderated to some degree so that the. process is far more useful. right unless they're in like really bad. shape and then you just do it because. it's.

it's harm reduction that's a different. category. yeah my account dude i had to go to a. comedy show one night after and that was. pretty. good it was okay man i mean it was. pretty good honestly. but it wasn't top-notch. you know i just felt a little glitchy i. had a. i was i don't know i felt like i was. about two centimeters off of my. regular skin and and i'm in this uh i'm. in this uh. fellowship of people out of um the.

integrative psychiatry. institute out of boulder and we had a. little. get-together like a zoom uh session and. there was uh one of the psychiatrists. she had just gotten back from surgery. on ketamine and she was like talking to. all of us and. we were like and it was it was. fascinating she was like fresh. and she had gotten like something done. to her and and were just sitting there. watching this i was like. wow and she was having like insights. about her relationship with her mother. wow and that went back like decades.

and and you know it's it's. it's fascinating i mean you stick around. you just hang out in the. in the in the areas where people are. doing this and you can really you kind. of get an idea of. what this is doing to people it's just. the insights. and the perceptions and the healing that. that are. sort of swimming around in this whole. thing. um it's not covered by a lot of. insurances right. not yet not yet so so it depends on.

where you are you know. where i am not so much um but. my understanding is if you kind of like. the further west you go. the insurers are you know more friendly. to it. however interestingly because of 2020. mental health is actually getting. um much more. um it's been considered much more. important historically. in in sort of all the industries and. and so that is good because a it's long.

overdue. b it means that people can. really get access to. kind of healing as opposed to limping. and and it's sort of like it's the hope. of. yeah everybody who's in this is that. when you have somebody who's been. harmed in a way that they. are not able to interact with the world. in a way that is peaceful. you want to do everything you can in a. way that is.

safe and sort of research based. to get them on the road again yeah why. not well i'm sure that 30 years ago or. whenever there was a conversation. between two people about like uh. antidepressants that was just like this. possibly you know it's like you never. know like something new is always coming. along new things are always coming along. and. we're always evolving and stuff in. different spaces and yeah i'm certainly. curious i love the idea of. actually trying to find some healing as. opposed to.

uh getting a crutch every day you know. um because that starts to be ridiculous. when i think of that every day i have to. take a pill when right when i get up. just that my mind has to even think. about that. instead of being able to be in this free. space where it can just wake up. yeah like it's kind of crazy to me you. know it almost wonders. how much of a hitch in my vibe. is that overall just that my brain knows. right when it gets up that i it has to. remind me to go take a pill it's like. it's kind of weird you know it's kind of. feels very unhuman.

um what what actually happens to your. brain to the parts in your brain during. the. ketamine therapy um so what what happens. there's a bunch of there's actually two. things that happen. um the. receptors get tagged that are. responsible for your like. anxiousness and depressive symptoms but. the other cool. little thing is is there's a triggering. cascade. uh from a it's called bdnf and what it.

is. it helps your neurons like sort of. change like grow. little sprouts and and and the. synapses the little ends can sort of. become plastic. and make make changes to your your. nerves and they grow a little bit. and you can actually see it they've. they've imaged this you can you can. google it and find pictures of. dendritic sprouting or dendritic spines. that have been exposed to ketamine. and so that's like actual like.

growth so if you think like. if you're growing things in your head. you know you can. do something with it that's that's like. that that cyborg stuff like you could. have a new garden. well you and you slide an electrode in. there and. and all of a sudden you can like grow. connections into different things and. you know you're going to have high def. out the rear in no time. on the back of your head you have a. backup camera yeah. i mean you think about it i mean.

we didn't have cell phones 20 you know. we didn't have an iphone 20 years ago so. we're going to go to the moon um every. day in. 10. i i would bet we're going to be. pretty augmented kids don't have any. problem wearing electronic gear on their. heads now. yeah so i don't know i have i have. neurons growing onto a chip out of my. ears. pretty soon it'll be hey it'd be pretty. freaky. look let me know how it goes yeah okay. i'll call you. i'll call you as long as you're the. guinea pig first man.

uh i think that'll work out uh dr jason. pooler thank you so much for being here. with us today man you bet thank you. really appreciate it man. now i'm just floating on the breeze and. i feel i'm falling like these leaves i. must be. cornerstone. [Music]. [Music].

but it's gonna take a little. time for me to set that parking brake. and let myself go. i'll sit and tell you my stories.

[Music]. and now i've been moving way too fast on. the runaway train with a heavy. [Music]. [Music]. b.