Roots To Thrive: Ketamine-Assisted Therapy Program
How Psychedelic-Assisted Therapy & Transpersonal Psychology Are Supporting Frontline COVID-19 Healthcare Workers
The COVID-19 pandemic has taken the lives of over 2 million people world-wide, with 18,426 of those deaths in Canada as of January 20 2021. Clearly these are devastating numbers but the physical effects of the virus only tell one part of the story. The combination of a deadly global virus leading to wide-spread lock-downs, massive disruptions to work, routines and lifestyles, significantly reduced contact with friends or family and confusion around inconsistent messaging from both politicians and the medical field have also led to what some are calling a mental-health crisis. According to Dr Adrian James, the president of the Royal College of Psychiatrists in the UK, the COVID-19 pandemic “is going to have a profound effect on mental health” and is “probably the biggest hit to mental health since the second world war”. And one group in particular — front line health care workers — are experiencing a crushing mental health toll as a result of the COVID-19 pandemic.
Under normal, non-pandemic conditions, healthcare workers are often overworked, stressed and suffer from burnout due to the high personal and emotional demands of their jobs. During the COVID-19 pandemic, healthcare workers have been pushed beyond capacity and are suffering increasing levels of psychological distress and burnout. Last July healthcare workers in Canada accounted for nearly 20% of all COVID-19 infections, and in Norway 28% of healthcare workers have met the diagnostic criteria for PTSD. With unmanageable workloads along with increased risk of infection due to inadequate supplies of Personal Protective Equipment (PPE) in some areas, along with the vicarious trauma of direct patient care, healthcare workers are struggling with increasing levels of anxiety, depression and even PTSD. And if things could not get any worse, the combined effects of stress, anxiety, PTSD and the emotional toll of direct patient care has led to a growing sense of demoralization among healthcare workers. The COVID-19 pandemic is having a crippling effect on the mental-health of our healthcare workers at a time when we need and depend on them the most.
This critical need to rapidly address the growing mental-health crisis among COVID-19 healthcare workers has led to increased interest in alternative and lead-edge treatments. One of those leading-edge treatment approaches for anxiety, depression and PTSD is psychedelic-assisted therapy. One Canadian program which has set itself apart is the holistic, transpersonal psychology based and ketamine-assisted Roots To Thrive (RTT) program out of Vancouver BC. In the following sections I will provide a summary of ketamine-assisted therapy, transpersonal psychology and how the RTT program has combined these approaches to deliver not only a specific treatment program for addressing the mental health crisis among healthcare workers and others struggling with anxiety, depression and PTSD, but a general treatment program for delivering optimal psychological health, well-being and thriving.
Ketamine-Assisted Therapy
Psychedelic medicines are all the rage these days and we are witnessing a psychedelic renaissance across the world. Although psychedelic medicines like psilocybin and MDMA have shown incredible promise in the treatment of anxiety, depression and PTSD, these substances remain illegal in both Canada and the USA. Although legalization is expected by 2022, or even as early as late 2021, we need solutions NOW to help address the growing mental-health crisis among our critical healthcare workers during the pandemic. This is where ketamine-assisted therapy may be one of the most promising, rapid-acting and legal treatment approaches for the growing levels of anxiety, depression, PTSD and burnout faced by our healthcare workers.
Although illegal psychedelics like MDMA and psilocybin have received much of the press (and research) around their use in treating anxiety, depression, PTSD and end-of-life distress, a legal psychedelic known as ketamine has also shown remarkable success in treating many of the same conditions shown to be successfully treated with psilocybin and MDMA. Ketamine — which can be legally prescribed by doctors in Canada — is mostly known for its use as a general anesthetic particularly in veterinary medicine, as well as a recreational drug (Special K). But in 2000 the first double-blind study showed significant reductions in depressive symptoms among patients within 72 hours of a single treatment which has led to increased attention and research into ketamine.
Along with the rapid effects (24–72 hours) in treating depression and PTSD, what also sets ketamine apart from the traditional drugs used to treat these conditions, is that unlike many traditional pharmaceuticals which work through the brain’s serotonergic and noradrenaline systems, ketamine works through the glutamate system by blocking NDMA receptors. What this means in practical terms is that along with being a fast-acting antidepressant and PTSD treatment after only a single dose, ketamine is also shown to be an effective approach for treatment-resistant depression when traditional SSRI’s (selective serotonin reuptake inhibitors) have been ineffective. In fact studies have shown that 60%-70% of those suffering from treatment-resistant depression have responded positively to ketamine-assisted therapy. Ketamine has also been found to be a fast-acting and effective treatment for suicidal ideation.
When it comes to supporting our front-line COVID-19 healthcare workers in dealing with the mental-health crisis they are facing, time is of the essence. And given the 6–12 weeks often needed for traditional therapies and pharmaceuticals to demonstrate effectiveness, ketamine treatments can begin showing anti-depressive and PTSD symptom reduction within 24 hours and in some cases with lasting effects for up to 14 weeks!
Transpersonal Psychology
In order to describe transpersonal psychology, a bit of a history lesson may be helpful. During the 60’s and into the 70’s — a period when the humanistic theories of Maslow and Rogers were popular — there was also an explosion of interest into Eastern philosophies, psychedelics, shamanism, meditation, mystical states and other ancient wisdom practices. This renaissance of interest into spiritual, psychedelic and self-transcendent states of consciousness drew attention to the fact that even the new holistic and humanistic psychologies of the time were incomplete. What humanistic psychology lacked were a number of critical human characteristics and states of non-ordinary consciousness which often had deeply meaningful and even transformational “awakening” effects which could lead to personal thriving and well-being. Dissatisfied with humanistic psychology, Maslow (along with Anthony Sutich, Stanislav Grof and others) felt that a “comprehensive and cross-culturally valid psychology had to include observations from such areas as mystical states; cosmic consciousness; psychedelic experiences; trance phenomena; creativity; and religious, artistic, and scientific inspiration.” (Grof, 2008). What humanistic psychology needed was to adopt a transpersonal (beyond self) orientation.
So in 1967, a working-group consisting of Abraham Maslow, Anthony Sutich, Stanislav Grof, James Fadiman, Miles Vich and Sonya Margulies met in California with the goal of defining and creating a new Fourth Force of psychology (transpersonal) which would embrace the full spectrum of human experience. Including the non-ordinary, self-transcendent states of consciousness which had been shown to play such a significant role in exceptional states, psychedelic experiences, contemplative practices and were described in ancient wisdom traditions dating back thousands of years. The psychological significance of these exceptional, non-ordinary and transpersonal states of consciousness which spurred the creation of transpersonal psychology, is further apparent when we consider that Maslow (in his later years) revised his iconic model of human motivation — Hierarchy of Needs — and replaced self-actualization with self-transcendence as the pinnacle of optimal human functioning and thriving. In his own words Maslow described self transcendence as follows:
“Transcendence refers to the very highest and most inclusive or holistic levels of human consciousness, behaving and relating, as ends rather than means, to oneself, to significant others, to human beings in general, to other species, to nature, and to the cosmos.” (The Farther Reaches of Human Nature, New York, 1971, p. 269
A few years after that fateful meeting in 1967 with Maslow, Suttich, Grof and others, in 1969 the Journal of Transpersonal Psychology began publication and in 1971 the Association for Transpersonal Psychology was established, which recently celebrated its 50 Year Anniversary. Today, interest in transpersonal psychology is on the rise, and transpersonal theories or models continue to expand into many areas of traditional psychology, psychiatry, psychotherapy, business leadership, general approaches to wellness and even life coaching.
In summary, transpersonal psychology represents not only the natural and increasingly holistic (whole person) evolution of psychology in general, but also provides one of the most culturally, spiritually and scientifically comprehensive models for mental-health, personal transformation and human thriving. And when these holistic, transpersonal theories of psychology and human thriving are combined with the revolutionary treatment approaches of psychedelic medicine, we have the Roots To Thrive ketamine-assisted therapy program.
Roots To Thrive: Ketamine-Assisted Therapy Program
Early in 2020 when the pandemic hit and healthcare workers began struggling under the increased workloads leading to growing stress, trauma and burnout, Dr. Shannon Dames — who’s doctoral studies explored some of the core factors that “promote human flourishing in healthcare providers” — knew that something had to be done. It was the combination of the growing trend of stress and burnout among professional caregivers during COVID-19, along with the evidence for psychedelic medicines being effective in rapidly treating anxiety, depression and PTSD, which led to the creation of the Roots To Thrive (RTT) program by Dr. Shannon Dames.
Although healing from trauma and addressing healthcare worker stress and burnout were the initial goals of the program, the founders of RTT decided to set their sights even higher — human thriving — and adapted the program “to serve all people”. With funding secured through a Michael Smith Foundation grant, the format and curriculum of the RTT program was then developed through a multi-disciplinary and collaborative team of doctors, scientists, therapists, caregivers, indigenous elders and other experts.
Along with providing leading-edge psychedelic treatment approaches to address the growing rate of anxiety, stress, PTSD and burnout among healthcare workers and others, the RTT program is unique in another way. The 3-month RTT program and therapy process is also grounded in humanistic and transpersonal theories around building resilience and a sense of wholeness by nurturing those factors known to contribute to a sense of meaning, authenticity and ultimately human thriving. The larger goals of RTT are clear; a program which “promotes the development of personal resources that buffer us from stress and promote a greater ability to thrive”.
The RTT program is 12 weeks long and consists of weekly 2-hour “Communities of Practice” meetings with a cohort of approximately 6 patients who remain a group through the entirety of the program. The cohorts are moderated by patient-partners who are mental-health and healthcare workers that have also been through the RTT program. There are three ketamine-assisted therapy sessions, each followed by an integration process within the safe container of the Communities of Practice sessions. This integration process delves into the experience with the medicine, how they relate to the intentions and needs of the patient and how those experiences and lessons from the medicine can be integrated into daily life. Once again, the goals of the RTT program are not limited to merely addressing issues such as anxiety, stress or PTSD, but to provide the psychological tools, resources and experiences which can lead beyond mental-health towards human thriving.
During a recent webinar moderated by one of the founding members of the Canadian Psychedelic Association, Dr. Pamela Kryskow joined the directors of RTT along with 3 patient-partners, to discuss the structure of the program and the impact it has had on them. Which, in the words of one of the patient-partners, was “astounding” (Griffin — patient-partner). Below are some selected quotes from the patient-partners who attended this webinar, describing their challenges and personal experiences with the RTT program.
“I came to the program very burnt out. I came from a very trauma-laden environment as a bedside nurse. It was in those types of environments where there was a deep incongruence with the way in which I wanted to provide care, and the way in which I was actually able to provide care…So I came to the program seeing even though it was something that would really challenge me. I knew there would be times that it feels very messy and there would be times where I would be hesitant because really, this is a group of strangers that I am leaning into. But the community that I knew would be created, I knew I had trust in the community that would be created and would help to support my healing — which it did”. (Karen — patient partner)
“For me personally it has made me a much better physician. I feel like the elevation is continual. Witnessing with all of you and training with our team. We embody this in our training and our meetings. It is truly a lovely and humble team and it is actually THE best team I have ever worked on in my whole career as a medical doctor and to not cry while I say that is hard. So the ripple effects are amazing”. (Pamela — patient-partner)
“One of my healing intentions for coming into the program was coming home, coming back to me. I can certainly say that I am at that place. I am more me than I have ever been. I feel more safe and loved and cared for and loved to be me in my best way. And in a more practical aspect I am definitely a better coworker, a better teacher, a better nurse… I am the best version of myself I have ever been, that’s who I am”. (Margaret — patient-partner)
“I am so thankful and often I am describing this as a gift of a lifetime. Now that I have been reflecting on it and everything I have gotten out of it and continue to get out of it, I can definitely say that I am a changed man and I still have changes to make, but I feel empowered. I feel I am able to make those changes and I know that so much of that is rooted in the community that has been afford to me through the RTT program and then certainly aided and fast forwarded in major ways through the experiences of ketamine”. (Griffin — patient-partner)
“I worked on Reserve, Front Line for five years in family medicine. It was really challenging work and honestly I didn’t have any support while I was working. So I was just burnt out and I heard about this amazing course from a friend and it felt like a life line that possibly my life could change….mainline treatments were not getting at where I wanted to go. I really felt like there was something there that I was meant to do and I just had no concept of how to get there…I think the k portion gets a lot of hype and I agree that’s really an important part of the program. But the RTT 12 weeks meeting, building and setting intentions and really like growing together and learning to trust other people and all these other things are so important and really hold these other ketamine experiences together…I have also experienced times of just contentment and happiness and presence in my own life that I have not experienced in like 15 years. So it’s been a true gift to feel like my life has moved on to a different trajectory. ” (Zhiish — patient-partner)
“There is a lot of practising around connecting to yourself while also being connected to other people. To me I am seeing that translate into my relationships at home, with my children, with my partner, with my colleagues. And again most importantly with myself. Continuing to come back to that connection with my body, with myself…. It’s astounding” (Griffin — patient-partner)
Summary
The COVID-19 pandemic has created unsustainable levels of psychological distress for front-line healthcare workers (and others) which include anxiety, depression, PTSD, burnout and even demoralization at a time when we depend on their support more than ever. Although many treatments exist for dealing with these mental-health conditions, few if any of the traditional methods work as effectively or as rapidly as psychedelic-assisted therapies. Legal psychedelic-assisted therapy with substances like psilocybin and MDMA are at least 1–2 years away. However, ketamine is currently legal in Canada and has shown itself to be an equally effective and fast-acting treatment for the many mental-health conditions faced by front-line healthcare workers (and others) dealing with the COVID-19 pandemic.
The Roots To Thrive program in Vancouver BC is very much on the leading edge when it comes to its comprehensive, evidence-based ketamine-assisted therapy programming combing neuroscience, transpersonal theories and unconditional positive regard within a safe-container of Communities of Practice. The comments from patient-partners in the previous section speak loudly as to the profound impact of the RTT program in each of their lives and professional practices. But what truly sets the RTT program apart from most other psychedelic-assisted programs, is the focus not only on immediate healing from anxiety, stress or trauma, but also an approach which “promotes the development of personal resources that buffer us from stress and promote a greater ability to thrive”. Something we could all use a lot more of today. Developing the skills and connecting with resources not merely just to heal or get to get by, but to thrive and excel in our lives in meaningful ways. With the expansion of the RTT program beyond front-line healthcare workers, anyone can now take advantage of these promising and evidence-based psychedelic-assisted treatment programs for both healing and thriving.
Roots To Thrive
https://rootstothrive.com
Revolutionizing Mental Health: Ketamine-Assisted Therapy
https://youtu.be/8fZ8DgOAV6w
Canadian Psychedelic Association
https://www.psychedelicassociation.net/
MAPS Canada
https://mapscanada.org/
