Is Psilocybin Safe for Me? with Seth Mehr, MD

In this episode, Seth Mehr, MD joins to share his expertise on safety planning prior to a patient undergoing psilocybin therapy. After a 20 year career as an Emergency Medicine physician, Seth founded Cascade Psychedelic Medicine in 2021, treating clients with depression, anxiety and PTSD with psychedelic ketamine therapy. He also serves as the Health & Safety Director and a state licensed psilocybin facilitator at the Innertrek service center in Portland, Oregon. In this conversation, Dr. Mehr outlines key risk categories for psilocybin therapy: medical conditions, medication interactions, and mental health history. He emphasizes the importance of individualized safety planning over binary yes/no decisions. Dr. Mehr discusses specific considerations such as cardiovascular issues, diabetes, serotonergic medications, substance use disorders, suicidal ideation, and family history of psychosis. The conversation also covers strategies for mitigating risk, including delaying treatment, contingency plans, improving support systems, and ensuring informed consent. Throughout, Dr. Mehr stresses a collaborative, nuanced approach that balances potential benefits with careful preparation and personalized care.   In this episode, you'll hear: Stories from Dr. Mehr’s practice of helping patients with different conditions and histories ensure safe psilocybin experiences Interactions between GLP-1 agonists and psilocybin How Dr. Mehr works with patients who have family histories of psychosis Harm reduction practices which leverage other psychedelics or non-psychedelic interventions to help prepare a client for a psilocybin session Why insulin dependent diabetes can be a contraindication for psychedelic therapy What medication combinations can increase the risk of serotonin toxicity with psilocybin  Supporting clients experiencing spiritual emergency following psilocybin therapy Safety considerations when working with clients who have a history of seizures The importance of having contingency plans if medical emergencies arise during psilocybin therapy The intricacies of providing fully informed consent for psychedelic therapy   Quotes: “There is some evidence now that taking a single serotonergic agent—say, taking Lexapro—and no other medications that increase the risk of serotonin toxicity seems safe where I am not at this point recommending that people stop, skip, or taper a single SSRI in preparation for a psilocybin session due to safety.” [12:20] “One of the difficulties with making these decisions or speaking with some confidence or authority on the matter is that the clinical trials that have been done largely exclude people with lots of conditions—family history and specifically first degree relatives with history of psychosis and bipolar disorder… So we have anecdotal evidence, we have population based surveys to go by. And so when I talk to clients about this, I speak from a place of humility.” [27:30] “I always emphasize to clients that while we're talking about a specific safety issue like serotonin toxicity, we don't want to trade that for psychological instability and crisis and declare success because we've helped somebody taper off of a medication that seems less safe and now they aren't sleeping, they're agitated, they're depression is worse, their suicidality is worse. So we have to take a holistic approach to this and consider the totality of what's happening with that client.”  [36:45] “There are so many different components to trying to set somebody up for success rather than a yes/no, black and white approach [to psilocybin therapy].” [48:44]   Links: Cascade Psychedelic Medicine website InnerTrek website Managing Medical Risk In Patients Seeking Psilocybin Therapy CME/CE Course Psychedelic Medicine Association Porangui  

In this episode, Monnica T. Williams, PhD, ABPP joins to discuss how psychedelics may help alleviate mental health impacts of racial trauma. Dr. Williams is a licensed clinical psychologist and professor at the University of Ottawa in the School of Psychology, where she is the Canada Research Chair in Mental Health Disparities. In this conversation, Dr. Williams begins by highlighting the daily stress and trauma experienced by people of color, likening it to PTSD. She discusses a survey her team conducted which revealed that many people of color use psychedelics to manage racial trauma, showing significant reductions in stress, depression, and anxiety. Additionally, Dr. Williams emphasizes the importance of a safe environment and culturally competent therapists. In closing, she discusses ongoing research at this intersection and the need for more funding and awareness in this field.   In this episode, you'll hear: How racial trauma manifests as conditions like PTSD, depression, and anxiety The importance of an intersectional perspective Current treatments for mental health struggles stemming from racial trauma Results from Dr. Williams’ research into psychedelic use amongst people of color The importance of safe and supportive settings for psychedelic experiences How shared life experiences between a therapist and client can strength the therapeutic alliance and improve outcomes Why bias training is particularly important in the context of psychedelic therapy   Quotes: “People of color who live in these white dominated Western contexts are continually bombarded by subtle —and not so subtle—messages about their worth, about their standing in society, about their intelligence, their character, on and on and on and on. And so really the daily onslaught just wears and wears away at people, and the stress of that can actually become traumatizing.” [1:49] “People heal from trauma when someone witnesses their pain, right? When people can compassionately witness your pain and join in it with you—this is the basis behind all therapeutic approaches for trauma treatment.” [10:13] “We saw [from our survey study] that many, many people of color are using psychedelics to manage racism, often very quietly. But it seems for many people to be quite effective and quite helpful.” [11:53] “We looked at some separate psychedelics where we had enough people who described a specific one like psilocybin or LSD or peyote in some cases. And so we were able to look at those psychedelics separately and we didn't actually find a difference. It didn't seem to matter which psychedelic it was. It seemed that they were all, more or less equally effective.” [15:20]   Links: Dr. Williams’ website Dr. Williams on X Dr. Williams on Instagram Dr. Williams on LinkedIn Dr. Williams’ study “Investigating the associations of acute psychedelic experiences and changes in racial trauma symptoms, psychological flexibility, and substance use among People with Racial and Ethnic Minoritized Identities in the United States and Canada” Behavioral Wellness Clinic - Connecticut Behavioural Wellness Clinic - Ottawa  Masters Program in Psychedelics and Consciousness Studies at University of Ottawa Psychedelic Medicine Association Porangui

In this episode, Robin Carhart-Harris, PhD joins to elucidate the intersection of psychedelics and neuroplasticity. Dr. Carhart-Harris is the Ralph Metzner Distinguished Professor in Neurology and Psychiatry at the University of California, San Francisco. Robin founded the Centre for Psychedelic Research at Imperial College London in April 2019, was ranked among the top 31 medical scientists in 2020, and in 2021, was named in TIME magazine’s ‘100 Next’ – a list of 100 rising stars shaping the future. Dr. Carhart-Harris begins by discussing the impact of psychedelics on neuroplasticity and mental health. He explains neuroplasticity as the brain's ability to change, emphasizing its role in mood disorders and substance use and describes how stress atrophies the brain, leading to mental illness. Dr. Carhart-Harris differentiates between neuroplasticity and neurogenesis, noting that while neurogenesis is limited in adults, neuroplasticity can be influenced by psychedelics like ketamine, psilocybin, and MDMA. In closing, he also discusses the entropic brain hypothesis, suggesting that increased brain entropy leads to richer subjective experiences.    In this episode, you'll hear: The relationship between neuroplasticity and “canalization”  Why homeostatic neuroplasticity may promote mental wellbeing Differences between ketamine, MDMA, and serotonergic psychedelics in terms of neuroplasticity The details of the entropic brain hypothesis Psychedelics’ effect on the default mode network The frontiers of research into psychedelics and neuroplasticity  Quotes: “So changeability is what plasticity is. And neuroplasticity—that's the ability of the brain to change. Okay, and how is neuroplasticity related to mood disorders like depression and anxiety or substance use disorder or something like that? Well, that's a great question cause we don't have it entirely nailed down. But one of the most reliable findings in biological psychiatry is that stress atrophies the brain.” [2:47] “The main thing with ketamine is that the window of increased plasticity is brief… That makes sense because that reflects how ketamine seems to work therapeutically—that it provides relief somewhat short-term, unless it is twinned with, say, psychotherapy or you do repeat administration and get someone out of the rut they were in.” [22:15] “We’ve seen in people with depression, brain networks can become quite segregated from each other—they are ordinarily, they’re quite functionally separate and distinct—but that modularity might be a bit elevated in depression. But what we’ve seen with psilocybin therapy is that separateness between systems, that segregated quality of organization of brain networks, brain systems actually decreases after psilocybin therapy for depression. I’ll put it another way: the brain looks more globally interconnected after psilocybin therapy for depression and the magnitude of that… correlates with improvements.” [39:19]   Links: Carhart-Harris Lab website Dr. Carhart-Harris on X Dr. Carhart-Harris’ 2025 article: “Neuroplasticity and psychedelics: A comprehensive examination of classic and non-classic compounds in pre and clinical models” Dr. Carhart-Harris’ 2012 article: “Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin” Dr. Carhart-Harris’ 2010 article with Karl Friston: “The default-mode, ego-functions and free-energy: a neurobiological account of Freudian ideas” Psychedelic Medicine Association Porangui

In this episode, Dori Lewis, MA, MEd, LPC-S discusses the common myths and misconceptions surrounding psilocybin for healing. Dori is a psychotherapist, co-founder of Elemental Psychedelics, and owner of Reflective Healing in Fort Collins, CO, who specializes in psychedelic-assisted therapy, blending transpersonal psychology with spiritual practices. With experience facilitating ketamine sessions and training clinicians, she advocates for ethical standards in psychedelic medicine while championing a feminine-centered approach to facilitator training. The first myth that Dori addresses in this conversation is the idea that it is the psilocybin mushroom itself that does all the healing work. Contrary to this common misconception, Dori suggests that it is the client’s own initiative working in tandem with the mushroom that really spurs healing. She also emphasizes that there are not any set protocols for how often psilocybin should be taken for healing, instead suggesting that clients should be guided to attune to their own internal intuition to determine when a psilocybin journey may be particularly helpful.  Another misconception Dori addresses is that healing with psilocybin can occur without causing deep transformations in one’s identity or shifts in one’s worldview. She suggests facilitators must be very transparent about these possible impacts to best prepare clients for these kinds of major changes that psilocybin can catalyze. In closing, Dori reiterates that clients should be supported and prepared to encounter intense emotional experiences with psilocybin, as some of the most difficult psychedelic journeys can actually be the most healing.   In this episode, you'll hear: The biggest myths and misconceptions Dori encounters working with clients in her practice The importance of a relational understanding of psychedelic healing The specific types of trauma where psilocybin may be a particularly effective healing modality  The training for psilocybin facilitators in Colorado under the Natural Medicines Program and the importance of scope of practice Why some people’s mental health gets worse before it gets better following a psilocybin experience What can cause lack of response to psilocybin therapy and how better preparation can often mitigate this   Quotes: “Mushrooms are amazing and they can help us in our healing journey. But they are one tool in a mosaic of other tools that we can use to help ourselves heal and grow and change.” [6:54] “I don’t really know where this message came from—that mushrooms cure PTSD—but that is a huge myth. They can help—with certain types of trauma within the context of a healthy therapeutic relationship with a skilled provider, yes, at times when it is right. But ultimately the best medicine for trauma is going to be MDMA—and ketamine.” [18:18] “It is the responsibility of providers and facilitators to inform clients of the realistic expectations they should have for their [psychedelic] journeys—and that is also an ethical need and something that facilitators need to consider through an ethical lens.” [25:20] “There’s a lot to be said about the unique ways that mushrooms express through our bodies and through our minds and through our hearts that give us information about where we are at and where we need to work or continue to work in order to access the healing we so desire.” [37:34]   Links: Dori on LinkedIn Elemental Psychedelics on LinkedIn Elemental Psychedelics website   Previous episode: Integrating Challenging Psychedelic Experiences with Keith Kurlander, MA Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans Previous episode: The Dangers of "Ayahuasca Told Me…" with Jerónimo Mazarrasa Psychedelic Medicine Association Porangui  

In this episode, Jodie NewDelman, PsyD joins to discuss the benefits and risks of leveraging psychedelics for professional growth. For over three decades, Dr. NewDelman has been an executive consultant, health system advisor, licensed psychologist, and clinical supervisor. She is also trained and certificated in psychedelic medicine and has been working with growth-oriented professionals developing greater alignment between their leadership roles at work and their personal lives. In this conversation, Dr. NewDelman discusses the typical struggles people experience in their professional lives and where psychedelic experiences may provide insight and empowerment to become more aligned with one’s work. She unpacks the psychological experience of being “stuck,” something that psychedelics may specifically help overcome.  Beyond individualistic approaches to professional growth, Dr. NewDelman also discusses the importance of humanizing the workforce and how conscious leadership is crucial to achieve this goal. In closing, Dr. NewDelman warns against the danger of trying to implement radical changes after a psychedelic experience without sufficient integration, emphasizing the importance of a holistic approach to this work.    In this episode, you'll hear: Navigating feelings of imposter syndrome and experiences of marginalization The importance of work life balance and how to psychedelic experiences can empower reflection on this topic Why clear intention is crucial for leveraging psychedelic experiences for professional growth The danger of spiritual bypassing after profound psychedelic experiences   Quotes: “No matter who you are, you're going to have your own set of intentions. The intentions will be bespoke. And maybe you don't know the first or second time what you want to work on when you go into it—an experiential medicine session. But eventually we can narrow those themes down to what it is that we really need insight on.” [22:01] “if you need to focus on some nitty gritty, annoying detail [at work], no matter how transcendent your perspective is in your psychedelic medicine session, you still have to do the thing at work. You still have to make the practical changes. So we need to kind of stay tethered to reality in that way.” [38:58] “Our tendency is to avoid pain, right? We want to go away from the obstacles. And if psychedelics teach us nothing else, it's that we need to go through the storm. We need to turn toward the issue.” [40:25]   Links: Essensuate website Essensuate on Instagram Essensuate on LinkedIn   Essensuate on Facebook  What Are The Habits of Mind? - The Institute for the Habits of Mind Previous episode: Psilocybin for Addressing Burnout with Tracy Kim Townsend, MD Psychedelic Medicine Association Porangui Email: [email protected]

In this episode, Tracy Kim Townsend, MD, joins to discuss the potential efficacy of psilocybin therapy for addressing burnout, particularly in healthcare professionals. Dr. Townsend is a Harvard-trained medical doctor, licensed psilocybin facilitator, and the Co-Founder & CEO of Meadow Medicine, one of the only legal psilocybin service centers based in the U.S., founded and led by an MD. In this conversation, Dr. Townsend gives an overview of burnout and discusses its prevalence amongst healthcare professionals due to the intense nature of these professions. She mentions the relevance of the wounded healer archetype for many physicians and how this identity can intersect with experiences of burnout. Turning to psilocybin therapy, Dr. Townsend discusses how these psychedelic treatments can help address burnout through promoting neuroplasticity and facilitating effective emotional processing. Following these experiences, patients are often much better poised to make well-considered life changes to help stave off burnout. Dr. Townsend concludes by emphasizing the importance of integration following psychedelic journeys to ensure maximal benefit and effectiveness of these treatments.    In this episode, you'll hear: How burnout develops How technology and culture have contributed to the rise of burnout The symptoms of burnout Supporting career longevity for physicians How psilocybin may support patients looking to address burnout Clinical research into psilocybin for burnout in healthcare professionals Why loosening the grip on one’s identity and ego dissolution may be tied to the therapeutic benefits of psychedelics   Quotes: “One core area that I see psilocybin playing a role [for addressing burnout] is just creating these spaces where we can process emotions and integrate them.” [21:41] “SSRIs, which are the gold standard intervention right now for depression, usually result in about a nine-point drop [in depression scores on the Montgomery-Åsberg Depression Rating Scale], which is really no better than placebo… Whereas psilocybin showed a three-fold drop—there’s really no intervention for depression we see with that dramatic of results.” [25:17] “Another thing that I think is remarkable, too is… you continue to see the benefits—if you check scores immediately after the [psilocybin] journey and then at six months out, there continues to be improvement in mental health scores.” [29:06]   Links: Dr. Townsend on Instagram Dr. Townsend on X Meadow Medicine website  “Psilocybin Therapy for Clinicians With Symptoms of Depression From Frontline Care During the COVID-19 Pandemic: A Randomized Clinical Trial” by Anthony L. Back, MD et al. Psychedelic Medicine Association Porangui  

In this episode, Christina P. Kantzavelos, LCSW, MSW, MLIS joins to discuss the use of psychedelics to address chronic illness. Christina is an international psychotherapist, coach, writer and artist, who specializes in treating clients with chronic illness, and complex trauma utilizing various modalities, including psychedelic assisted therapy. In this conversation, Christina overviews the complex mental and physical health impacts of chronic pain conditions and shares her expertise on psychedelic and non-psychedelic treatments for these conditions. Christina mentions that chronic pain can put one’s body in a state that encourages fight, flight, freeze, and fawn responses which can disempower the patient’s efforts to address their condition. She also explores the intersection of identity and chronic pain conditions, discussing how that while receiving a particular diagnosis can be helpful and affirming, taking this as a core part of one’s identity can also be a major roadblock to healing. In closing, Christina emphasizes that pain starts in the brain, so leveraging neuroplasticity through psychedelics and other means can be a particularly powerful way to address both physical and mental health aspects of chronic pain conditions.    In this episode you'll hear: How Christina got involved in working with patients with chronic pain The common mental health presentations in those with chronic pain The importance of addressing physical health and mental health concurrently  Why psychedelics may be helpful for addressing chronic pain conditions The immunomodulating effects of psychedelics The power of neuroplasticity for addressing chronic pain  Utilizing neural retraining and microdosing in conjunction to prepare for more successful higher dose psychedelic experiences   Quotes: “I use all kinds of modalities and I don’t just treat someone’s depression or anxiety or complex trauma—I see it as everything is interwoven and related to each other. And it’s important that we look at the entirely mosaic piece rather than just focusing on one area.” [5:20] “There is a state of empowerment versus disempowerment in identifying with our chronic illness. I’m not saying that it is not real and it's not happening to you but it definitely is not you. It’s something you are experiencing. Even if it’s chronic and lifelong, it’s still something you are experiencing—it’s not you as a whole.” [17:48] “I’ve noticed that any of my clients who have gone through neural retraining have had little to no bad [psychedelic] trips which is amazing and I feel like that’s partly because they worked so hard to resource themselves in advance.” [25:19]   Links: Christina on Instagram Christina on LinkedIn Begin with Today website When the Body Says No: The Cost of Hidden Stress by Gabor Maté PMA CME/CE accredited course: Managing Medical Risk in Patients Seeking Psilocybin Therapy Search for providers on the Psychology Today website Psychedelic Medicine Association Porangui  

In this episode, Jerónimo Mazarrasa joins to discuss how to interpret visions and insights disclosed during ayahuasca journeys more effectively. Jerónimo is Program Director at ICEERS, founder of ICEERS Academy, and creator of AyaSafety, an online course for people interested in increasing the safety of ayahuasca ceremonies. To start, Jerónimo emphasizes that answering the question of whether ayahuasca visions originate in the plant medicine itself or if these are just disclosures of one’s own subconscious is actually not what's most important. Instead, he suggests that in either case, what is crucial is spending time carefully considering how one should respond to these disclosures. Jerónimo shares insights from expert facilitators on how one can best go about interpreting and responding to such experiences, suggesting that an important aspect of this process is that participants feel comfortable taking personal responsibility for whatever decisions they eventually decide to make rather than thinking of these major life changes as necessary consequences of the psychedelic experience itself. In closing, Jerónimo discusses the tension between externalization and psychologization of psychedelic experiences and why both of these can lead to issues.    In this episode, you'll hear: The common experience of feeling as though the ayahuasca has communicated something to you Examples of where taking an ayahuasca vision literally can lead to problematic outcomes  The “three confirmations” one should look for before making a major decision based on a psychedelic experience The metaphor of ayahuasca as a microscope How skilled ayahuasca facilitators ensure proper psychological hygiene with participants Judging the validity of potential repressed memories that seem to surface during psychedelic experiences   Quotes: “The way that ayahuasca becomes useful for people, I think, is that it shows you—it amplifies and shows you—what is already inside of yourself. Now, this is very useful for certain things but one has to understand the nature of the language.”  [9:23] “Facilitators should instruct their participants that one rule is that you shouldn’t make any decisions during an ayahuasca ceremony—unless they are decisions related to taking yourself out of danger.” [14:42] “Ayahuasca is not a shortcut for personal development—it’s just a flashlight that can help you shed some light on some darker parts of [your] issues and problems, but it is not a shortcut.” [35:47] “The main contraindication of psychedelics is not wanting to take psychedelics. You should absolutely never ever ever ever ever take psychedelics if you don’t want to because it is going to be horrible. It’s like a kiss—when you want it, its beautiful, intimate, gorgeous; when you don’t want it, it's the most intrusive, disgusting, blech thing ever.” [50:27]   Links: Jerónimo on Instagram Jerónimo on Facebook ICEERS Academy website ICEERS Academy on Instagram AyaSafety course  Previous episode: Guruism and Cult Dynamics in Psychedelic Practices with Joseph Holcomb Adams Previous episode: Can Psychedelics Lead to False Beliefs? with Hugh McGovern, PhD Psychedelic Medicine Association Porangui

In this episode, Hugh McGovern, PhD joins to discuss his research on the impact of psychedelics on beliefs. Dr. McGovern is a Research Fellow at the School of Medicine, Deakin University, Melbourne, Australia. To start, Dr. McGovern introduces the inference or predictive processing framework utilized in his paper “An Integrated theory of false insights and beliefs under psychedelics”. He explains the role of prediction in cognition, showing how insights occur when our existing perspectives are unable to make sense of our experience. In this vein, Dr. McGovern discusses how the psychedelic experience disrupts our normal modes of prediction and perception, leaving room for greater influence of environmental factors on insight production. In closing, Dr. McGovern shares ideas on further clinical directions for this research that could give guidance for helping patients more effectively integrate insight experiences.   In this episode you'll hear: The research into how psychedelics can influence and change beliefs The role beliefs and insights can play in psychedelic journeys  How false insights can be experimentally induced The connection between prediction errors in our cognition and insight experiences The hippocampus, memory, and psychedelics The association between insight moments and increased mental health following psychedelic experiences   Quotes: “[In psychedelic experiences] your expectations are no longer helping you make sense of your current sensory experience. And so you’re uniquely susceptible to environmental input under psychedelics—which would account for things like visual hallucinations [and] these novel insight moments.” [18:30] “When you have really really strong prediction errors or really really strong insight moments, they can have a disproportionately important influence on your worldview going forward.” [20:03] “Psychedelics, from a few different studies, show they can impair the formation of hippocampally dependent memories but they can perhaps even enhance the formation of cortically dependent memories. So what that means is you come out of the experience with this sense of knowing but it's in some sense lacking in details.” [29:04]   Links: “An Integrated theory of false insights and beliefs under psychedelics” by Hugh McGovern et al. Dr. McGovern on Bluesky Previous episode: Guruism & Cult Dynamics in Psychedelic Practices with Joseph Holcomb Adams Psychedelic Medicine Association Porangui  

In this episode, Heather A. Lee, LCSW joins to discuss the topic of psychedelic healing for grief and loss. Heather is a licensed psychotherapist, educator, speaker, and consultant. With over 30 years of practice in mental health, her focus is on supporting midlife and beyond women as they navigate life transitions. In this conversation, Heather explores the ways psychedelic healing may have transformative contributions to peoples’ journeys navigating grief and loss. She explains that we live in a culture that doesn’t have a good understanding of grief, how to navigate it, or how to support others who are grieving, so it can be a difficult issue to address. Heather discusses the neuroplasticity-promoting effects of psychedelics and elucidates the ways this can be helpful for processing grief, especially by allowing the person grieving the opportunity to hold their grief in new, productive ways alongside other healthy emotions. In closing, Heather emphasizes how psychedelics can also provide healing for existential distress brought on by the many planetary crises humanity is now facing through providing a broader, life-affirming viewpoint on these issues.   In this episode you'll hear: Heather’s journey from working in hospice settings to working with psychedelic therapy Navigating the grief of losing others and the grief of realizing the imminent end of one’s own life Why Heather thinks psychedelics are particularly useful for grief and loss How grief can manifest both mentally and physically Client stories from Heather’s practice where patients are able to process grief to achieve a better quality of life Neuroplasticity, psychological flexibility, and processing grief Psychedelics for end-of-life grief and anxiety Physiological impacts of spending quality time in nature   Quotes: “Psychedelics are a really important and powerful option that are coming into the conversation about how people can take some control of how they navigate that psycho-spiritual-emotional component of coming to end of life.” [3:19] “There is no right or wrong way to grieve and there is no normal and abnormal. I think it’s just about having markers so that we can know when and how to provide support to people.” [9:27] “On the [psychedelic] medicine, you experience that grief, that loss—whatever that is—you’re experiencing it while you’re in that [neuroplastic] state so that you have the opportunity to get a fresh perspective. And it’s in that fresh perspective that you create the new patterns of thought around [your grief].” [20:12]   Links: Heather's website Medicine Woman Retreats website  Heather on Instagram  Heather on LinkedIn Psychedelic Medicine Association Porangui