Gita Vaid, MD; Exploring MDMA & Ketamine Therapy

In this fascinating conversation, Dr. Gita Vaid, a board-certified psychiatrist and psychoanalyst based in Manhattan, discusses the emerging field of psychedelic-assisted therapy. Dr. Vaid shares her expertise on MDMA and ketamine, explaining their potential for treating depression, anxiety, PTSD, and relationship issues.

The discussion covers:

• The unique benefits of MDMA and ketamine in psychotherapy
• How these medicines can help process trauma and increase self-awareness
• The potential for psychedelics in couples therapy
• Making psychedelic therapy more accessible and affordable
• Using psychedelics for personal growth and "peak performance"
• The importance of tailoring mental health treatments to individuals
• The nature of subjective experience in psychedelic journeys

Dr. Vaid offers profound insights into how psychedelic medicines can expand our understanding of consciousness, memory, and healing. This episode is a must-listen for anyone interested in the future of mental health treatment and personal transformation.

This conversation between JD Kalmenson and Dr. Gita Vaid took place at the Emerging Themes in Behavioral Health 2024. For more information: https://emergingthemesinbehavioralhealth.com/

Follow JD at JDKalmenson.com

Transcript

00:00:01:06 - 00:00:28:23
JD Kalmenson
Thank you so much for joining us today. We're sitting with Dr. Gita Vaid, who is a board certified psychiatrist, an extraordinary psychiatrist as well as a psychoanalyst based out of Manhattan and deeply immersed and involved in maps and the emerging psychedelic form of medicine. And I'm so excited to be speaking with Dr. Gita. I've been a big fan for a while now, and having this conversation was on my bucket list, so we'll get right to it.

00:00:29:00 - 00:00:30:05
JD Kalmenson
Thank you for being with us today.

00:00:30:06 - 00:00:31:06
Gita Vaid
Thank you for having me.

00:00:31:07 - 00:00:52:09
JD Kalmenson
Of course. Of course. I'm going to ask you an interesting question. There was a show in Britain called I think Desert Island. One of the questions that they would ask a lot of the guests was celebrities and different important people. If you were on an island, what song? If you could only choose, what song would you bring with you?

00:00:52:12 - 00:01:11:01
JD Kalmenson
And that's not what I'm going to ask you. But if you were to go to an island and there was a population there that had no medicine, no methods of treating depression, anxiety, trauma, or any other form of behavioral health, one modality, that's all you could bring. What would it be?

00:01:11:03 - 00:01:15:12
Gita Vaid
You're talking about a treatment, medicine or an approach or.

00:01:15:14 - 00:01:16:21
JD Kalmenson
Either.

00:01:16:23 - 00:01:23:21
Gita Vaid
I think the idea of self inquiry, meditation and self inquiry. Maybe that's too. But I think they're kind of captured in one.

00:01:24:00 - 00:01:24:18
JD Kalmenson


00:01:24:20 - 00:01:29:15
Gita Vaid
Because it's all so easy. It's available. It's affordable, scalable.

00:01:29:18 - 00:01:33:09
JD Kalmenson
Wow. So can you elaborate on self inquiry a little bit?

00:01:33:11 - 00:02:02:10
Gita Vaid
Well, I think that to know more about who I am, what informs what my actions and behaviors lead me to every day, we take it for granted, but we are so used to habits. We are creatures of habits. Even our thinking, our actions, our responses. Oftentimes we don't stop to question them or to delve in a little bit deeper or to open up that exploration and self-discovery.

00:02:02:13 - 00:02:29:16
JD Kalmenson
Yeah, I love that for the longest time. And you're and you're using very, you know, eloquent clinical language for what I always just refer to as what not. Why So often we begin our questions with why? Why is brimming and laden with judgment. It puts whoever you're asking the question to on the defense and precludes authentic, safe self-exploration.

00:02:29:18 - 00:02:52:21
JD Kalmenson
What is a different story? For example, and I just used this the other day, you know, you have a deer who goes to the riverbed every single day, and it takes the same trodden path, and the path becomes very comfortable and convenient. And then one day, a tree falls over the path, obstructing the path, and also leaving splinters of wood strewn across the path.

00:02:52:22 - 00:03:20:02
JD Kalmenson
And so now there comes to the path and sees the splinters and the potential danger that it can wreak. And it could it can inflict on its hooves. But this is the path that it knows. Yes. And so it can technically explore and and and and chart a new terrain. But it can it defaults to its normative path.

00:03:20:04 - 00:03:44:12
JD Kalmenson
And the why could be. What do you why are you doing that, Mr. Deer? Mrs. Deer, why you engaging in a practice that could be inflicting self harm? Or we can ask what what happened here? And if we unpack the what, it's that it defaulted to what it was comfortable with, as opposed to having the courage to break the trend, even though it acknowledged that it was better.

00:03:44:12 - 00:04:03:10
JD Kalmenson
So the what versus why I feel like it's so constructive even in a non-clinical setting. You know, you're talking to a child, you're talking to a spouse, you're talking to a colleague, you know, trying to have some constructive dialog. What is always more pragmatic and effective than the why.

00:04:03:12 - 00:04:12:04
Gita Vaid
I agree with you just opening up with a curiosity. Yeah. And an ability to not assume, you know, even by yourself.

00:04:12:06 - 00:04:12:10
JD Kalmenson
Right.

00:04:12:11 - 00:04:23:10
Gita Vaid
So you can actually discover what's a little bit behind that behavior. Where does it come from? Or what if you stopped making that turn to the left instead of the habit of doing so?

00:04:23:14 - 00:04:53:01
JD Kalmenson
That's right. I think another very important contribution of self inquiry is the ability to break the external influence that is so embedded in and wrapped in our decision making in our consciousness that we actually take it for granted and we think it's coming from ourselves. So I always see, for example, feelings as, you know, having really three separate categories, three categories of emotions.

00:04:53:03 - 00:05:22:19
JD Kalmenson
You have natural instincts and then you have environmental feelings, environmental emotions, which is the result of the culture, the community, the family, the ethnicity, the religion. And then you have the hardest, the hardest to stimulate, which is the intelligent emotions, the emotions that come from the byproduct of meditation, of thoughtful exploration, and coming to certain conclusion and then allowing it to resonate emotionally.

00:05:22:19 - 00:05:47:23
JD Kalmenson
But the middle category, environmental, we don't recognize or pay enough attention to how much of what we feel is not really us, but is society and culture sneaking into our thoughts and and our and our feelings and us not taking the moment, taking the time to distinguish what is it and asking, what do I really want?

00:05:48:01 - 00:05:49:00
Gita Vaid
Yes.

00:05:49:02 - 00:05:54:17
JD Kalmenson
Yeah, we know. And just asking what do I really want? Sometimes yields very interesting answers.

00:05:54:19 - 00:06:13:06
Gita Vaid
Absolutely. What you're really talking about, all these different layers that one can become skillful at identifying and perhaps opening up an inquiry to get beyond and a little bit beyond or even open up different streams. Yeah, you're describing to have awareness about all of these contributing factors. Yes, I love it.

00:06:13:08 - 00:06:16:20
JD Kalmenson
Just to go back to the island. Question, if you could take one medication, what would it be?

00:06:16:20 - 00:06:17:19
Gita Vaid
One medication.

00:06:17:19 - 00:06:22:07
JD Kalmenson
And I'm including psychedelics and traditional medication, but only one.

00:06:22:11 - 00:06:36:02
Gita Vaid
Only one. Okay. Probably just because I think it's the easiest to navigate for people. So you don't need so much lead time more probably MDMA.

00:06:36:04 - 00:06:51:02
JD Kalmenson
wow. And for everybody who's listening, you're actually a map certified therapist. That's MAPS is the the leading movement to bring MDMA to a state of FDA approval. And we're hoping from for some exciting news.

00:06:51:05 - 00:07:22:12
Gita Vaid
And let me say two reasons why not because I think it's an effective way to treat trauma only, which, of course, it has been shown to have breakthrough status, which is unprecedented in the treatment of PTSD, because I'm assuming on this island there's not necessarily a high incidence of PTSD, but largely because all psychedelics, I think, really allow people to learn and discover what it's like to feel safe and to be in a state of safety and maybe the way you employ them can be different.

00:07:22:12 - 00:07:32:08
Gita Vaid
And there's a different kind of atmosphere with each. MDMA, I think, is one of the easiest ones to know how to navigate because it opens you into a heart open, safe space and I think.

00:07:32:08 - 00:07:33:12
JD Kalmenson
Reduces the amygdala.

00:07:33:16 - 00:07:53:21
Gita Vaid
It does. It works just kind of reduces our fear centers our fears. So we drop into a state of just safety in the body and in the mind and in the emotions. And so people have a chance to either process unprocessed trauma or even open up into what it's like to be them in a state of safety. And it's not as psychedelic or mind altering.

00:07:54:00 - 00:07:55:14
Gita Vaid
So it's easier perhaps to.

00:07:55:17 - 00:07:57:01
JD Kalmenson
As what as, let's say.

00:07:57:03 - 00:08:15:21
Gita Vaid
LSD or psilocybin or these other ayahuasca. So it doesn't necessarily open up those channels for people where you have these heavy visuals or information. So it's less trippy, but it's easier to navigate because it's pretty, you know, it's pretty much like being in a very safe, cozy embrace.

00:08:15:22 - 00:08:16:03
JD Kalmenson
That's.

00:08:16:03 - 00:08:41:18
Gita Vaid
Beautiful. And the reason why I think it's important is, as I said, not only for processing trauma, but once where it's safe, not at the energy that we didn't even realize it was tied into keeping ourselves safe gets to be in some ways dismantled. And all that energy which was tapped into that system or those systems gets liberated for creation and imagination as a way of reclaiming your self.

00:08:41:18 - 00:08:43:01
Gita Vaid
Really? Wow.

00:08:43:03 - 00:09:04:23
JD Kalmenson
So I've just a couple of fascinating answer. I it's intriguing. I would love to get and I know it's a complicated thing to do a one minute sort of breakdown of the difference between MDMA and ketamine, both are chemical compounds. Both are composites produced at a lab. They're not natural plants, and both are going to change the world of behavioral health.

00:09:05:01 - 00:09:14:18
JD Kalmenson
So maybe just a one or two minute understanding of what makes them different and what is more effective for what these are.

00:09:14:20 - 00:09:48:02
Gita Vaid
These are not naturally occurring chemicals as you mentioned, but our brains do have receptors to receive these molecules. And one works on a serotonin and dopamine system and that's MDMA. It causes a huge release of all these neurotransmitters that we might be familiar with from psychiatry and MDMA is a novel antidepressant. It's been around forever for anesthesia and pain, but more recently, it's come into vogue in psychiatry for its rapid action of antidepressant effects.

00:09:48:07 - 00:10:34:07
Gita Vaid
And it works on the glutamate system. So it works in a pathway that hasn't really been very present in our minds in psychiatry. But for the purposes of today's conversation, aside from having a pharmacological treatments, I think the most radical aspect of both is that they can, in a way get us out of our thought loops, because normally people who are depressed or people who come into treatment for behavioral problems are dealing with negative thinking patterns, rumination, the way they feel about themselves, identity loops that they're stuck in, those can actually be in some ways broken and people can have a time out from those patterns to really go a little bit deeper in their

00:10:34:07 - 00:11:09:15
Gita Vaid
inquiry of who they are and even a re inquiry or renegotiation of who they might be, because sometimes we join the dots on our early life in a very particular way and we stick with them. And this is a way of almost upgrading our operating system. And in addition to that, to actually learn how to feel safe. And in that field of safety, as I said, in a very automatic way, not therapist driven, but the subject driven themselves, they get to really process whatever is in their psyche or in their bodies that they may may or may not know of that.

00:11:09:17 - 00:11:21:03
Gita Vaid
But it comes out in a way where they can really get free of what stuck in them or find novel solutions to work it out. It's a very beautiful process.

00:11:21:08 - 00:11:44:04
JD Kalmenson
That's amazing because unlike SSRI said, unlike traditional or pharmacological intervention, which requires a maintenance regimen here, the way I always see it, it's like you're in a dark room all your life, and every time you get up, you bump into a piece of furniture. So you begin to think that the entire room is not you know, is not you can't navigate it and you can't you can't have mobility.

00:11:44:06 - 00:11:59:03
JD Kalmenson
And freedom of passage. And then the lights go on. And even if it's for 2 minutes and you see the layout of where the desk is and where the shelves are and what you've been tripping over, and you also see the space that you can navigate around it, even as the lights go back off. You know how to get your way around.

00:11:59:08 - 00:12:23:19
JD Kalmenson
Yes. And that's so important because you know that that is one of the most breathtaking contributions of the psychedelic intervention is that it doesn't make you feel less of yourself, which is a common symptom of SS arise. People feel weak, lethargic, or they they don't feel alive. And it's sort of a life sentence. Whereas here it's not, you know, hopefully not the case.

00:12:23:19 - 00:12:39:09
JD Kalmenson
It's something that occurs over a few sessions and you're able to have that insight into how not to fall back into those loops, into those patterns of fear, of insecurity, of depression. Is that accurate?

00:12:39:15 - 00:13:11:08
Gita Vaid
It's completely accurate. I would say it actually allows you to get to the underpin things of your problems. So rather than just treating the symptoms of why are you sad, it gets into how do you process what's bothering you to have more of yourself back to get to the underpinnings to solve those issues. And sometimes it's not even so much about having to work out a problem, but sometimes it's more about growing ourselves to hold more of ourselves, hold difficult feelings, let go of certain feelings or experiences we've had in our past.

00:13:11:10 - 00:13:44:03
Gita Vaid
And the process is so different. Sometimes it's also providing what wasn't provided. So there's a way we can actually, on a pharmacological level, these drugs create a hyperplastic and hyper hyperplastic mind and brain state. So brain and mind are primed for transformation. And also some of the critical windows of our early development get opened up so we can have new, in a way, new information come in to correct corrective experiences and being able to take in what wasn't provided for us.

00:13:44:03 - 00:14:07:15
Gita Vaid
Even something as simple as care and attention being seen, being listened to, being validated, some of these things, which might be a little bit fraught from early life, which build one's self self-esteem, self-identity, feelings of worthiness, some of these things can actually get to be re experienced and correct it for it's quite stunning.

00:14:07:18 - 00:14:36:17
JD Kalmenson
Very interesting. So I'm going to ask a little bit of a nuanced question, please. So there's hardware and software. TMS, for example, targets the hardware of the brain. Yes. The therapy. You know, talk therapy is all about the software right now. We're all talking about the golden standard of psychedelic treatment, which is with maps, protocol, with therapy. But my question is a little bit of the following When you have an intervention of MDMA or ketamine.

00:14:36:19 - 00:15:06:13
JD Kalmenson
So number one, let's just take MDMA, for example. You're entering into a state where you feel safer because of what the MDMA is doing to the brain, you know, lowering the amygdala, lowering the fear center. And so now you're primed and positioned to be able to obtain levels of self awareness and insight that normally your defense mechanisms wouldn't allow you to probe and ask those really challenging, potentially existentially debilitating questions.

00:15:06:17 - 00:15:49:08
JD Kalmenson
But you can ask those questions now because you're in a safe space, an emotional, cozy invest. So now that insight is something you can walk away. That's the goodie bag that you can take home, right? So that's a little bit on the softer side. But what about the hardware? Does it actually also create a physiological change to the brain, which allows for that insight to be implemented and to upend and change decades of toxic and negative thought patterns and behavioral patterns because something physiologically shifted through the MDMA intervention?

00:15:49:10 - 00:16:11:19
Gita Vaid
Yes, absolutely. There are personality changes that are enduring. Post the session, you see, an enhanced of connectedness is more like the more we can connect with ourselves. The more we can then mirror that and connect with other people. And you see that personality traits are really sustained and you see much more openness, much more connect fitness.

00:16:11:21 - 00:16:15:08
JD Kalmenson
Even without therapy, ongoing therapy sessions.

00:16:15:10 - 00:16:48:04
Gita Vaid
You know, I would say the studies usually have a lot of therapy within within them. And actually some subsequent sessions. So it's not just the pharmacological effect. It's really in the context of pretty intensive psychotherapy and support, but those behavior traits are sustained. And what's also interesting, there's an enhanced tool, so nature relatedness and community relatedness. So it's affecting not only personal health, but also, you know, ecological health and community health, which is so necessary in the world we live in.

00:16:48:07 - 00:16:50:21
JD Kalmenson
That's right. So it's a little bit of both.

00:16:50:23 - 00:17:07:08
Gita Vaid
Absolutely. I think it's really interesting because psychiatry has swung between the psychological approaches and now more recently, the biological approaches, both of which have been somewhat disappointing. Right. And this is really an opportunity to bring both of those together.

00:17:07:10 - 00:17:49:09
JD Kalmenson
Yes. And I think that the fact is that even though we're so complicated as human being and we're composites of so many myriads of different parts and and angles and and moving pieces, we are a unified organism and, you know, not appreciating that, appreciating that in a treatment model and a treatment plan and only isolating one area, one symptom and focusing on that, it's just not going to be sustainable and effective and bringing the biological and everybody's talking about that right now, the biological and the psychological and the spiritual all together is really the key is really the only way who would be a candidate for ketamine as opposed to MDMA?

00:17:49:11 - 00:18:00:02
JD Kalmenson
Because just for those who don't know, ketamine is such a softer experience timewise, it's 2 hours, you know, MDMA, what is it, 8 hours?

00:18:00:04 - 00:18:02:02
Gita Vaid
MDMA is 3 to 6 hours, really.

00:18:02:02 - 00:18:02:17
JD Kalmenson
So it's maybe.

00:18:02:18 - 00:18:28:18
Gita Vaid
Within sometimes we give a boost to which can boost extend the session. Yeah. Yeah. I work a lot with ketamine in my office and I teach at the ketamine training center. And ketamine is a very versatile medicine for all the reasons you mentioned, It's really well-tolerated on the mind and body. At short acting. Oftentimes you don't have to come off anti-depressants if you've already taking them for symptoms because sometimes it's hard to come off them when they've been partially helpful.

00:18:28:19 - 00:18:50:14
Gita Vaid
So it has a lot of advantages. I would say it really depends on how it's employed. You know, I think that ketamine can be a wonderful tool for ketamine, assisted psychotherapy, where you're using ketamine as a psychedelic to open up a healing process. It just takes a little bit of learning how to navigate and dose effectively. But it's a beautiful medicine in some ways.

00:18:50:16 - 00:19:11:00
Gita Vaid
I like to use the example of, you know, each one of us, the person that we're the same. The person does not change and you can learn about yourself through traveling the world and going to Italy or going to Europe or going to India. And you can look at a person and know something about their makeup to make an assessment of you would be better off going to Europe than going to India.

00:19:11:00 - 00:19:38:08
Gita Vaid
In India might be too stressful for you. And so you can really tailor the medicine for the individual. I would say people who have a lot of, you know, who I think oftentimes people who have a lot of issues with control and letting go and a fear of being in a long experience, sometimes ketamine has the advantage to know it's going to be short lived and even at low doses might even last only about 20 minutes, 20 to 40 minutes.

00:19:38:10 - 00:19:59:10
Gita Vaid
And just learning how to navigate the experience can be really nice. I would say, you know, in so much of this depends on the dose because ketamine is very different at high doses than lower doses. But at low doses, it almost allows for a meditation, which can be a very, very gentle experience. So it can be a very nice way to start someone into a process.

00:19:59:12 - 00:20:19:18
Gita Vaid
It is a little bit of an internal experience. So you do oftentimes have your eyes closed and you're going inwards. And for people who can't tolerate that, who maybe have had so much anxiety about abandonment and lost sometimes that requires a lot of early preparation or perhaps something like MDMA, which can be more outward related, might be a better choice.

00:20:19:20 - 00:20:25:17
Gita Vaid
So you have to look at the individual and the type of trauma they have and what they're holding.

00:20:25:19 - 00:20:38:11
JD Kalmenson
Right. But broad strokes, would you say one is more effective as far as diagnoses are concerned, whether it's depression, anxiety, trauma, which is, say, just on a very generalized basis, that one is more suited. Yes. For certain diagnosis.

00:20:38:11 - 00:20:58:19
Gita Vaid
I think there's obviously a cross diagnosis and a trans diagnostic is what we call. So I think they all get to the underpinnings. But generally speaking, I would say there is a lot of data, and I think this is definitely true that ketamine is really good for depression and suicidality. It can really break those thought loops right away and give you a little bit of a lift the day after.

00:20:58:21 - 00:21:23:08
Gita Vaid
And so it's a really good treatment that I think of first line really compared to other psychedelics for major depression and treatment resistant depression, or with a lot of depressive underpinnings. And MDMA, I think is can be good for depression, but really it's very good for processing trauma. And you can have a depression a little bit afterwards because it causes serotonin depletion.

00:21:23:10 - 00:21:39:08
Gita Vaid
So you can actually have a little bit of blues or a little bit of a letdown after an MDMA session, which is not terrible if you not expected, but if you already are struggling with depression, that could be a little bit of a disappointment or an exacerbation. So you have to be a little bit careful about that. Yeah.

00:21:39:08 - 00:21:45:06
Gita Vaid
So I would say by and large, those are the two big camps, but the devil is in the details and they're also unique.

00:21:45:08 - 00:21:54:12
JD Kalmenson
Which one gets rid of ego in a more aggressive way? Well, I'll tell you and I'll tell you afterwards after your answer why I'm asking that question.

00:21:54:14 - 00:21:56:06
Gita Vaid
When you say get rid of it.

00:21:56:06 - 00:22:03:23
JD Kalmenson
If so, I'll jump straight to it. Tell me like you know, because I come across couples who are struggling.

00:22:04:01 - 00:22:05:01
Gita Vaid
Yes.

00:22:05:02 - 00:22:33:18
JD Kalmenson
And a lot of them really are cut out for each other. They really are the perfect match. Yes. There's just so much ego and small things become big things all because of narratives and a rigidity too big for confirmation bias to see all subsequent cross interactions within the prism of that narrative that they created. And the inability to leave that narrative is very often ego driven.

00:22:33:19 - 00:22:40:00
JD Kalmenson
Yes. And so I feel so strongly that one of these psychedelics is going to change the game of marriage counseling.

00:22:40:02 - 00:23:01:10
Gita Vaid
I think they all could in their own way. But the one that has a lot more, I think immediacy might be MDMA. They've done some studies looking at it for spouses of PTSD because of course, PTSD wreaks havoc. Yeah, in relationship to. But I think it makes sense because you can have your eyes open, you can be in conversation with each other, you in a very heart open space.

00:23:01:11 - 00:23:29:23
Gita Vaid
So in that space, it's very easy to remember why you chose the other person and get beyond some of the drivers that we all tend to get locked up in in everyday life. That being said, you know, I think ketamine can be another pathway. And I have done very, very beautiful ketamine sessions where people can actually have sessions lying side by side and dropping into themselves and in a way a different way of experiencing themselves and being close by to their partner.

00:23:29:23 - 00:23:35:21
Gita Vaid
And when you come out of the session, a really open field for frank discussion and intimacy.

00:23:35:21 - 00:23:36:05
JD Kalmenson
After the.

00:23:36:09 - 00:23:37:17
Gita Vaid
After, yes.

00:23:37:19 - 00:23:41:00
JD Kalmenson
You've paved the path for very healing.

00:23:41:00 - 00:24:07:11
Gita Vaid
And absolutely. I mean, I think sometimes you can do low doses while you're talking during it. But really I think what's nice is to drop out and connect deeply with your self. And I don't mean necessarily flying off to another realm, even to drop in to remembering who you when you're safe, because we tend to get triggered in couples situations and we don't feel safe and we're trying to stand our ground to have our to defend really ourselves and our wounds.

00:24:07:13 - 00:24:23:20
Gita Vaid
And if you can drop out of that and connect with yourself and feel safe and recover from that, it's a very different climate from which to see the other person and connect with the other person and perhaps see what they're saying from their point of view and come together.

00:24:23:21 - 00:24:33:23
JD Kalmenson
Beautiful and very profound that I hope it actually begins to take off because it's it's one of those things that people can spend so much time in marriage counseling and make things worse.

00:24:34:03 - 00:24:34:21
Gita Vaid
I see that in.

00:24:34:21 - 00:24:59:10
JD Kalmenson
More tales and get more frustrated. Dr. Willow Hall, I don't know if you know she is. I do. You do. So I actually interviewed her a couple of years ago about her work at Maps. Yes. And it became clear to me how expensive this would be if it hits the market, if maps protocol, I'm not not referring to the compound.

00:24:59:12 - 00:25:19:11
JD Kalmenson
And I don't mean expensive in a bad way. It's because there's two license therapists with you for 3 to 6 hours. Now, that is that is very prohibitive at a cost level. Absolutely. And ketamine is is a lot cheaper. I don't mean the compound. I mean even the monitoring, the supervision. And they're just very different, as you're describing.

00:25:19:12 - 00:25:29:12
JD Kalmenson
Yeah. What is do you have any ideas of how we can make this amazing MDMA maps protocol somewhat more affordable and accessible?

00:25:29:13 - 00:25:59:08
Gita Vaid
Well, I think you get into different pros and cons. So we do need to make these medicines more available and accessible. And it's really a lot of time and energy to have 3 to 6 hours with one patient, even if there's one therapist versus two therapists. So I do think even when these medicines come available, I'm not sure that they're better off doing a series of ketamine sessions with me rather than just to have the process keeping on unfolding and growing rather than one shot at MDMA.

00:25:59:08 - 00:26:31:15
Gita Vaid
So I think that, you know, it's true. That's why I'm a big fan of ketamine. It's a beautiful medicine, and I think it's available right now. Right. And so people can access it right away. It's still not completely affordable and available. Ketamine itself is, but therapist's time is expensive, although a lot of people because I do three hour sessions, you know, initially felt like it was very costly, but it shifted my way of working with someone instead of weekly psychotherapy to maybe once a month where actually they see me for 3 hours a month rather than 4 hours.

00:26:31:16 - 00:26:51:08
Gita Vaid
And I do build by the hour. So it's overall less expensive, not more expensive. So there's different ways of navigating and working with these medicines. But I think we have to become you need to have different systems available and we do need to have insurance coverage. At some point of interest, though, is there's a lot of interest in group psychotherapy.

00:26:51:08 - 00:27:04:02
Gita Vaid
So I think if you have one or two therapists in a small group that might make it more affordable, and then you also get the, you know, the benefit of the group itself, which can be very, very valuable in healing.

00:27:04:04 - 00:27:27:11
JD Kalmenson
Yes, I think that group therapy is, you know, it's very powerful for optimization, for deeper insight and for becoming a better person. I think it's hard to get to the bottom and the underpinning of your specific story, of your specific narrative in a group setting. Because if you do begin to share too much, it's not fair to the group either, even if you're comfortable sharing all that.

00:27:27:13 - 00:27:29:19
JD Kalmenson
And so there's a room for both, you know, the risk.

00:27:29:19 - 00:27:59:06
Gita Vaid
But I think with MDMA, because the sessions are long, there might be room for introspection going inwards as well as being out and in conversations. So there might be a way to blend that together. I know there's a really nice study that is going to be done, the sort of approval for, I think, 400 subjects, not all in one go in one large group, but in smaller groups with therapists in Israel, which I think will give us a lot of data, me, MDMA, and I think that allow us to have a lot of information, which of course has a lot of.

00:27:59:08 - 00:28:08:12
JD Kalmenson
Aspects because because generally they're seen their behavioral health seen as is is more primitive than here in America. So I'm surprised that they're doing something cutting edge.

00:28:08:12 - 00:28:10:10
Gita Vaid
Well, I think there's a lot of big need.

00:28:10:11 - 00:28:11:23
JD Kalmenson
For it for.

00:28:12:01 - 00:28:20:03
Gita Vaid
Treatment. Treatment. Right. So right now. So fortunately, there are a lot of initiatives to help address the trauma and suffering that is happening over there.

00:28:20:03 - 00:28:48:09
JD Kalmenson
Absolutely. Absolutely. And then two more quick things that come to mind. Peak performance, I not going to say recreational, but peak performance. There are a lot of folks out there who don't have a diagnosis. They've never been to a psychiatrist. They might not have even been to a therapist. They're intrigued. They see friends who come back and everybody has gone through a psychedelic experience and had a positive one.

00:28:48:11 - 00:28:51:21
JD Kalmenson
Becomes a self-appointed missionary and wants to share this with the world.

00:28:52:02 - 00:28:53:11
Gita Vaid
Does seem to be a trend.

00:28:53:13 - 00:28:57:16
JD Kalmenson
And wants to share their experience with the world and how this is going to change your life.

00:28:57:22 - 00:28:58:14
Gita Vaid
Right?

00:28:58:16 - 00:29:19:00
JD Kalmenson
And so they hear about this a lot and they do feel a little bit of stagnation in their life, whether it's corporate burnout or a non aggressive, midlife crisis. What's your take about psychedelic use for somebody who just wants more out of life and doesn't have what we might call medical necessity?

00:29:19:01 - 00:29:47:23
Gita Vaid
I think what you are really tapping into is we all have different levels of trauma that we're dealing with. I think it doesn't mean to say that you have to be, you know, rendered incapacitated to qualify for trauma. There are different this trauma with a lowercase t, but we all have different levels of trauma. And I think there is a real yearning that a lot of us hold to to really break out of that and to to actually meet ourselves and to, you know, start a healing journey.

00:29:48:01 - 00:30:18:06
Gita Vaid
And where you start the healing journey might be from severe symptoms and pain and suffering or might be less, more ambiguous, but still yearning for something more. And I think the healing journey is really a pathway towards meeting oneself and blossoming into one's authenticity. And I think we were talking earlier on how the human condition is such that we do get stuck in these patterns and we do not really have access to our full creative potential.

00:30:18:08 - 00:30:43:14
Gita Vaid
And I like to use the example of dreams because I am a psychoanalyst and I do recognize their value, but I think all cultures in history have recognized there's something magical and very important about our dream life, because you have access to this real, deeper knowledge. But that's us. Sometimes we don't recognize that's a part of our capacity that we are not utilizing in everyday life.

00:30:43:16 - 00:31:22:04
Gita Vaid
And I think these medicines really open up these pathways to tap into our higher intelligence, our truth wisdom from know that we're carrying within us, and to really open up those pathways to recover ourselves and perhaps find who we really are on a deeper level and what what is our purpose? Why are we here, which I think is sometimes lost and disconnects us from ourselves and really from gets to these underpinnings of why are we struggling, What could we be doing here that could really be rewarding to give us purpose and meaning?

00:31:22:06 - 00:31:31:00
JD Kalmenson
Very interesting. So in a certain sense, we can all benefit from a psychedelic experience in a safe set and setting.

00:31:31:02 - 00:31:56:19
Gita Vaid
I would say we can all benefit from this inquiry, from this. Whether or not you need to take psychedelics is a separate issue. I think the idea of trying to go deeper to meet ourselves, I don't think psychedelics is the only way to do it. I think there are many people who can do this without psychedelics through introspection, through different practices of self inquiry, meditation is one, but I think people have their own ways of what is meditation, spiritual parts.

00:31:56:21 - 00:32:14:04
Gita Vaid
And I do think that that's a really important inquiry, which I would endorse people should undertake. Psychedelics is just one tool. It's a little bit of a lazy man's tool, but I think it's a very helpful one. Yeah, and I think some people don't have, you know, have too much trauma to actually really be able to break out of it.

00:32:14:04 - 00:32:38:10
Gita Vaid
So this gets into the, you know, who's a good subject. And psychedelics also have some risks with them too. So they might be people who have medical conditions or psychiatric conditions which would which would make them ineligible or would be a little bit more dangerous for them to use. So you have to be careful. But that doesn't mean to say that they couldn't find other paths towards accessing non ordinary state, even pranayama breathwork.

00:32:38:14 - 00:32:46:14
Gita Vaid
There's all sorts of approaches to hack on nervous systems to access more of ourselves. Psychedelics is just one way very interesting.

00:32:46:16 - 00:33:10:00
JD Kalmenson
And you know, the idea of this being a lazy person's approach, I mean that's, that's obviously, you know, in the in the in that context, you know, you certainly see with certain folks who they don't become addicted to psychedelics, but they do have an unhealthy sort of relationship and dependency on using this lazy path to access.

00:33:10:00 - 00:33:28:07
Gita Vaid
And there are no shortcuts as well. So when I say lazy, I mean that with respect. Guess meditators can get there from sitting for hours a day and in this day and age, some of us don't have the luxury of being able to dedicate several hours a day to our daily self-care practice. We have a lot of demands on our time and energy.

00:33:28:08 - 00:33:29:12
Gita Vaid
Yeah.

00:33:29:13 - 00:33:47:22
JD Kalmenson
And then two final questions, please. What bothers you the most about the current health care scene today? Behavioral health, The method of treat, methods of treatment protocols, legislative. What what really disturbs you the most?

00:33:48:00 - 00:34:11:15
Gita Vaid
I think what disturbs me the most is that it's really very generic looking at the generic solutions to pretty much say how one should treat depression. It's not tailored to the individual. And we're all so unique on our stories are so individual to look at each case, to just have a prescription for the individual before I've even laid eyes on them is very, very annoying to me.

00:34:11:17 - 00:34:31:09
Gita Vaid
Because, you know, when you get the whole picture. I used to work in an anxiety and depression clinic very early in my career, and it was just really a good lesson because I could see how everyone wound up with depression and anxiety. But each story was so unique, so individual, and the way you want to treat them has to be unique.

00:34:31:09 - 00:34:46:18
Gita Vaid
Otherwise I think you're really shortchanging them. It just winds up being it's a little bit like, I think, taking care of children. You know, I think that each child, that individual attention, if you try and just give every child the same treatment, it's a little bit dehumanizing. Yeah, to say the least.

00:34:46:19 - 00:34:52:13
JD Kalmenson
That's right. That's right. And that is disturbing. I mean, I come across that all the time.

00:34:52:15 - 00:34:53:22
Gita Vaid
Yes.

00:34:54:00 - 00:35:12:08
JD Kalmenson
Whether it's in substance use disorder, whether it's in depression, anxiety, we just look at symptoms. Absolutely. And we treat symptoms Very seldom is there like an investigative like Sherlock Holmes level of scrutiny as to how did you come to these symptoms?

00:35:12:10 - 00:35:30:18
Gita Vaid
And I think it's really important not only to get the right treatment path, but then also to really empower the individual you're with, to realize, Wow, someone is interested in me, they're asking these questions. And I think implicitly, why am I not asking those questions myself and opening up this road of discovery?

00:35:30:19 - 00:36:06:03
JD Kalmenson
That's right. Last but not least, currently for ketamine, it's it's typically described as the preferred method to treat treatment resistant depression. Yes. So those who have failed with traditional treatment, antidepressants. SS Arise in your view? Yes. Is that the right way? Should we stop seeing ketamine? And then, you know, pretty soon MDMA as last resorts for those who are treatment resistant and start looking them as, you know, potentially a first resort as well?

00:36:06:03 - 00:36:07:08
JD Kalmenson
Not for everybody.

00:36:07:10 - 00:36:31:05
Gita Vaid
But I think that they're very different way of treating depression. And so I would like it not just to be last resort end of the road, largely because I practice ketamine, assisted psychotherapy, which is different just using ketamine, which is a wonderful tool, which oftentimes I will refer people to go to a clinic to just get rapid acting antidepressant coverage when they have failed other treatments, which is a beautiful indication.

00:36:31:06 - 00:36:54:09
Gita Vaid
But I think the difference is it allows an individual, when you're doing the therapy, not just to treat the symptoms, but to actually delve behind the scenes, to figure out what is bothering them, where does it come from? And I can give you an example just to illustrate the beauty of it. When I was working with a young woman who had tremendous PTSD, had done a lot of work to really address the problem.

00:36:54:09 - 00:37:21:23
Gita Vaid
I wouldn't say cure the problem, but deal with it better. And this was a young woman who had two rape episode in her life, unfortunately, and was in an environment which was getting triggered constantly because it was the scene of where this event had occurred. When she went into her session, she actually saw during the ketamine session a whole beautiful, intricate tapestry with all sorts of elegant stitching and threads and yarns.

00:37:22:01 - 00:37:45:19
Gita Vaid
And she saw that as a representation of her life and who she was. And she also saw stain on this tapestry, which she recognized was these terrible, you know, abusive events that had happened to her. But during the session actually was very joyful. She saw the fallacy in how she had recognized the stain to be her center of gravity and how it dominated her life.

00:37:45:19 - 00:38:05:08
Gita Vaid
And it helped her when in fact it was just a stain on one section of her fabric. And then there was all this richness, which was her. And in that moment, she herself managed to reorient herself to a fuller sense of who she is, which was not so hijacked by these terrible events, which is really what trauma does.

00:38:05:10 - 00:38:23:22
Gita Vaid
But it was the most beautiful piece of work in rapid speed for her to use her creativity, her intelligence, her imagination to really find herself through this trauma and towards recovery in the most elegant way. Wow.

00:38:24:00 - 00:38:53:23
JD Kalmenson
I love that. You know, the imagery of the tapestry and then also talking about dreams and their significance. It just begs the question, and I get this a lot with people who have come from an ayahuasca trip or another psychedelic trip, and they see a vision and then they with its significance and even when they are able to unpack and extrapolate a message that has relevance and personalized significance for them, a lot of times they'll ask like, But is this really true of meaning?

00:38:53:23 - 00:39:04:02
JD Kalmenson
Yes, I may have seen it, but what's the objective sort of value proposition here? And how do you answer that?

00:39:04:03 - 00:39:26:08
Gita Vaid
Well, I'm going to do answer in an indirect way. I'm going to say something about memory. In general, memory is incredibly unreliable. I was talking to my colleague and friend, Dr. Bessel Van der Cole, who's a trauma expert and we were talking about really how memory itself, by its nature, is very unreliable. You see this at like maybe family events and the stories get more and more elaborate about the past.

00:39:26:08 - 00:39:49:18
Gita Vaid
And we start exaggerating bits and pieces and by their nature they're unreliable. And how we weaving together keeps changing. That's just nature of memory and trauma actually prevent that from happening. We keep on re-experiencing the painful truth. Unfortunately, it doesn't become unreliable. We keep on having the bad event be wreaks periods re triggered and re-experience it over and over again.

00:39:49:20 - 00:40:11:04
Gita Vaid
In a way, we want to process the memory during the treatment so it can just be like ordinary memory and go back to being unreliable and woven back into the tapestry of everyday experience. So in terms of did it happen or did it not happen, I think we're talking about subjective experience and how we can shape our world.

00:40:11:10 - 00:40:38:01
Gita Vaid
And there's something really beautiful about what happened and the experience definitely happened for sure. For that individual, whether or not happened really, or it's their imagination or it's different realms, I think we can leave that aside. I think it gets into This is your subjective experience. And to me it's that whole landscape between dream life and waking life and all the space in between that we're constantly weaving in and out of daydream, imagination, play.

00:40:38:01 - 00:41:02:15
Gita Vaid
And actually to have that expansion I think is growth in and of itself because we are constantly shaping our reality. No two people have the same reality, even if they're having the same experienced such people to live in. That richness allows for actually an expansion of our daily experience, but also allows for us to really use these experiences usefully because our inner world is being reoriented, reshaped.

00:41:02:16 - 00:41:34:09
Gita Vaid
We look at what what really the underpinnings of what organizes the lenses, that organizes our experience, usually that form from early life and from what Freud caused primary process thinking, which is symbolic thinking, which is which is really creative, and the poetry of and of everyday life. That's right. This gets us into these layers in these experiences. And so it's a it's a way of almost swimming, swimming in the river of our inner worlds and the inner tapestry of our inner wolves to really make changes at that level.

00:41:34:09 - 00:41:42:02
Gita Vaid
And I trust we make the changes at whatever level we need to our beings. Now, our intelligence guides us.

00:41:42:04 - 00:42:13:23
JD Kalmenson
That's so profound. In other words. What you're saying is it makes no difference because there is objective value in my subjective perception. Absolutely and that shapes and forms my subjective experience and that is objectively trackable. You could see how that changes me regardless of whether the the mystical vision or the tapestry of what I was seeing occurred in someone else's world or in the outside world.

00:42:13:23 - 00:42:15:10
JD Kalmenson
It happened for me.

00:42:15:12 - 00:42:16:18
Gita Vaid
If you think about it, it's all we have.

00:42:16:23 - 00:42:17:11
JD Kalmenson
That's right.

00:42:17:11 - 00:42:22:15
Gita Vaid
It's actually the only thing we can measure is our subjective experience, right? The rest of it is a speculation.

00:42:22:16 - 00:42:27:13
JD Kalmenson
That's right. That's right. I'm reminded I conclude with this a beautiful quote from Bernard Shaw.

00:42:27:15 - 00:42:28:18
Gita Vaid
Please.

00:42:28:19 - 00:42:43:13
JD Kalmenson
Above a Bobby Kennedy later plagiarize that it was some people see things that are and ask why I dream of things that never were and ask why not Beautiful. Yeah.

00:42:43:15 - 00:42:44:10
Gita Vaid
Thank you.

00:42:44:12 - 00:42:49:07
JD Kalmenson
Thank you. This session. It's been a real pleasure. All right.

00:42:49:09 - 00:42:50:16
Gita Vaid
That was fun.

00:42:50:18 - 00:42:51:21
JD Kalmenson
And that up a lot more.