I’ve had questions about the emerging research on Psychedelics for healing in the world of mental health. So for this Ask the Therapist article, I interviewed Dr. Michael Burke. He shared about his practice and the world of psychedelic healing.
Can you tell me a little bit more about you, your background, and what exactly is Inner Path Psychiatry?
I was born and raised in Sioux City but lived out of the area for about 20 years before moving back last summer. Most recently, I’d been living in Los Angeles, where I did my residency and fellowship training in the UCLA system. This was also where I started working with psychedelics. I was fortunate to connect with people involved with psychedelic research and worked with ketamine-assisted psychotherapy (KAP) in private practice at California Center for Psychedelic Therapy (CCPT). These connections led to me beginning training in 2019 for MDMA-assisted therapy for PTSD as well as KAP. After this, I joined the MDMA team for clinical trials, including the Phase 3 study that recently finished. During this time, I also worked at CCPT offering KAP and did outreach or “street” psychiatry part-time before moving back here in August.
I want to get into psychedelics, but before we go there, can you talk about Inner Path Psychiatry? What are you doing there? How did you decide on the name?
Inner Path Psychiatry is the name of the practice I opened here in town. At the moment, it is a solo practice, and I’m offering ketamine-assisted therapy for depression, PTSD, and anxiety. The plan is to operate as a specialty psychedelic therapy clinic that will offer new treatments as they become available.
With regard to the name, based on my experience, the best answers come from within, and each person has the inner wisdom needed to be resilient and lead a life that is fulfilling to them. People may become disconnected from these parts of themselves for various reasons, and therapy can catalyze a process of self-discovery that helps patients uncover and develop their inner resources and a greater understanding of themselves. I decided on “Inner Path” for the way it represents the inward journey people undertake when they begin this work.
For anyone unfamiliar with psychedelics, how would you describe psychedelic therapy?
As the name indicates, it is a course of therapy in which a psychedelic is given. Psychedelic therapy is based on the principles that we all have an inner wisdom that knows how to heal and that, when taken in the context of therapy, psychedelics interact with this inner wisdom in a way that guides people toward wholeness. In this model, the therapist is not the expert and does not dictate what happens in the sessions. Instead, we allow the therapy to unfold by following the patient’s inner process because this will lead to the best outcome for the patient.
The metaphor we learned in training is that of wound healing. Surgeons may clean debris from a wound to create optimal conditions for the wound to heal, but the person’s body actually heals the wound. Similarly, a psychedelic taken in conjunction with therapy creates optimal conditions for benefit, but the patient’s inner wisdom leads the way.
Why do you think psychedelics are helpful with therapy?
Each psychedelic is different and has its own characteristics, and most are still experimental, so there is still a lot to be learned. But some similarities they share is they offer a perspective shift that allows people to see themselves in a new way. As we go through life, we may develop a somewhat fixed narrative about ourselves and view ourselves in a limited way where maybe certain negative aspects are highlighted. Our thought patterns and reactions can get even more limited in conditions like depression. With this perspective shift, we see ourselves and our lives from a point of view that is often more compassionate and can lead to a greater understanding of how we end up in certain patterns and situations. Or maybe people see some difficult things about themselves, but over time they realize they need to see this to become more balanced and live more aligned with what they actually value.
Psychedelics can create emotional openings that allow patients to work with unprocessed grief, sadness, or anger from which they had been disconnected. Although it may be challenging, simply coming into contact with these feelings can be freeing because they no longer need to be pushed away. People become more resilient because now they’re more capable of dealing with difficult emotions as they arise. People may also have experiences that they describe as “spiritual,” which research shows have positive effects.
Neuroplasticity is another common mechanism that psychedelics share. During the session, default neuropathways get interrupted, and new connections are made. New synaptic connections continue to be made following the session, which creates a period of time when changes in the brain can happen more quickly.
What is ketamine? Why did you decide to offer ketamine in your new clinic?
The FDA approved ketamine as a dissociative anesthetic in 1970, but since the early 2000’s, research has accumulated, demonstrating its effectiveness for treatment-resistant depression. It’s not a classic psychedelic, but it has some psychedelic properties, and a small subgroup of providers began to pair it with therapy to increase its benefits. As opposed to other medications and therapy, the improvements start to happen relatively quickly, typically within 1 to 4 sessions. Ketamine studies also demonstrate rapid effectiveness for suicidal ideation, and it seems to reverse brain changes that occur under conditions of chronic stress as well.
I wanted to offer ketamine-assisted therapy at Inner Path Psychiatry because it’s something that can help people with treatment-resistant conditions who have limited options otherwise. It’s also been an enjoyable way to work with patients as you witness people becoming more themselves, more resilient, and more empowered.
How can people contact you if they want to find out more about ketamine-assisted psychotherapy at your clinic?
By Jackie Paulson