Ketamine Therapy: What Is MDMA Assisted Therapy? A Clinical Psychologist Explains

And we're gonna start with a quick round of myth or fact, but I wanna talk what I just mentioned, the difference between using these substances-

Mm-hmm

... recreationally versus in a therapeutic setting.

So I think one of the, the best ways to segue into that conversation is actually to talk about the concept of set and setting.

Mm-hmm.

I don't know if you've heard that term before.

Yes.

I imagine you have, yeah.

So this is something, um, that also segues nicely into this idea that I think is a really useful one in terms of thinking about psychedelic compounds in general, is rather than thinking about them as having very specific predictable effects depending on the compound on each individual the same way that we would think of, like, ibuprofen or Tylenol-

Mm-hmm

... for example, um, is the idea that these compounds are nonspecific amplifiers, and I think the first person that maybe spoke about that was, um, Grof, Stan Grof, uh, who was a psychiatrist who'd done early research with psychedelics.

Nonspecific is important because we don't always get to predict exactly what gets amplified, and there's-

Hmm

... a couple ways to think about amplification.

So there's amplification of the external environment, so what's happening around you, who you're with, what is the setting, and then there's also amplification of the internal environment of the individual.

Right.

And so while there are definitely specific subjective effects associated with each different compound, there is an interaction effect with the interior, the internal state of an individual, the environment in which they're taking it.

So set actually refers to mindset, and then setting is the environmental factors that lead up to it.

So I think those things pretty much explain exactly the difference between recreational versus therapeutic clinical use or research use or, say, more traditional spiritual use depending on the indigenous cultures-

Mm-hmm

... um, that have worked with these compounds in their own lineage and history.

And so, um, this then very quickly explains, I think for a lot of people, how a drug that typically might be used commonly in a rave setting, right?

Right.

Where eyes are open, maybe there's alcohol involved, other substances, dance music, socialization, completely different vibe, versus the same compound, although maybe a little purified because it's going through a research lens-

Mm-hmm