Ayahuasca, psychedelics, and Dr Joe Tafur's journey from trained doctor to the Peruvian Amazon

20:08Dr Sophie Shotter:So as we understand that and then we realize, okay, wow, there might be some underlying issues. Like, for example, a big area of research that's been in the last decade or so is adverse childhood experiences. Let's say that you had some serious trauma or whatever, some degree of trauma when you were younger and that was never resolved or processed or addressed even. And then that kind of perhaps can linger on within the body, within the brain, and even psychologically. And that's just sitting there and it's an added stress within the system. So you have this kind of like stress wear and tear of things that are not addressed that accumulate within the body.

20:57and that eventually they start kind of demonstrating themselves through symptoms.

21:03Dr Sophie Shotter:And so you have, let's say, in the book and Fellowship of the River, I talk about like migraine headaches and psoriasis having some relationship to this or these other problems, you know, the psychological, you know, depression and anxiety and PTSD and addiction being kind of symptoms of the same kind of thing that could also manifest physically into some of these other problems I was just bringing up with the skin problems or breathing problems or gut problems. So then if you could go into the body, into the brain, into the system in a deeper way, let's say with psychedelics or plant medicine and kind of reopen some of these issues and find a way to process them and heal and kind of give yourself another opportunity to, as they would say, rewire around some of those experiences, then maybe you could bring that threshold down when you wouldn't be so prone to those symptoms.

22:02Dr Sophie Shotter:And so definitely seen evidence of that. Well, there's no question around the mental health issues that we brought up, that you brought up around the research, but do those people have overall improvement in their physical health when they get, you know, when they have a massive turnaround with their PTSD? Yeah, I would say that's pretty common, not that they would all fully improve, but many of them, you know, some of them are suffering with body pain and these different kinds of chronic fatigue, etc., that that would improve. Yes, you do observe that. And so in Fellowship of the River, working with people in Peru, with ayahuasca and traditional Amazonian plant medicine, I described a few cases of some big turnarounds with a migraine headache case or a psoriasis case or ulcerative colitis.

22:50Dr Sophie Shotter:And so there are people beginning to explore that area more and more, but it's just back to this mind-body issue, that how much of the toll on the body is related to these unprocessed, unresolved traumas.

23:07Dr Joe Tafur:And can we move into the trauma discussion and epigenetics and how your work chimes with the work of people like Bruce Lipton and the biology of belief. What do we now know about psychedelics and trauma? What's the latest data telling us? You've also previously said that we know trauma is linked to epigenetics and there's some evidence that indicates that we could undo or reverse some of this damage, so to speak. We know that meditation also has an epigenetic effect, for example. Shall we also talk about the epigenetics research project that you're a part of? Because it's really interesting to talk

23:44Dr Sophie Shotter:about how we can actually measure change yeah well that concept like from bruce lipton this idea of like okay just it's a shift in biology and the understanding of biology where people would be very focused on your hardwired genes and your genetic code that's just determining everything there's no way out it's fatalistic this is just because of your genes that you're like this and that when there are problems that let's say appear physical like these health problems we just talked about where there's this inflammatory gut problems or these other things that the folks would be, well, that's just your genetics because look, it's your biology.

24:24Dr Sophie Shotter:The physical body is responding. So that's something that's hardwired. And so then Bruce Lipton and a lot of researchers were sharing about how there's a growing body of evidence that actually there is a genetic code, but that genetic code is shared by all the different cells in your body and is expressed very differently in different cells that there would be a skin cell with the same DNA and a sperm cell with the same DNA and a red blood cell with the same DNA so each one is kind of programmed differently and it's expressing the genetic code in a much different way and so that reads the blueprint and then can alter the way the blueprint is actually put into construction.

25:19Dr Sophie Shotter:Actually, how are we going to build out this plan and use it in a different way to, like I said, make a red blood cell or make a neuron? So that being said, then it's like, okay, there's something, it's called the epigenetics. So the epigenetic refers to that which is on top of the gene. So there is the DNA code, but then there's all this biochemical machinery that's involved in actually expressing the DNA code. These proteins and different things, all these different elements within the cells that actually are responsible for bringing the DNA code to life. And that epigenetics, that machinery that exists on top of the jeans is where the contractor is changing the plan and reading the plan a little bit differently over here and a little bit differently over there.

26:13Dr Sophie Shotter:And so that that is something that's kind of programmed. And that's something that is kind of has a certain software capacity that it can be changed. There's the hardware of the computer, the laptop, the cables, and then there's a software, right that can be updated and can crash and can all the different things we can do with the software with the apps and etc etc so then the idea is that there's this software that is has some malleability within it and that they're within the system that this malleability that yeah that it kind of closes down around certain areas so there's like windows of development there's time is when you're more plastic than others around certain issues so when you're growing up, for example, that a lot of your emotional kind of development and your relationship kind of development is more open at that time when you're attaching to your caregiver, whoever you're being raised with.

27:13Dr Sophie Shotter:And that's shaping how you kind of relate to other people, to yourself, to your own emotions. And so that's all being shaped in that period. And then there's a period when that kind of like becomes less plastic. It becomes less malleable. People become more set in their ways. Personalities start taking shape. Ego structure starts taking shape as a result of the conditioning that the person went through. So there's some kind of like response. It takes shape. So then how do we reopen that again? Can we reopen what they call, I guess, a critical window of development? Can you teach an old dog new tricks?

27:53Dr Sophie Shotter:What does that involve? Because it could look like it's biological. It looks genetic hardware. There's somebody who's got this really heavy PTSD from trauma that's been sitting on them for decades. It just seems like that's part of who they are. And people will just consider that, oh, maybe there's something genetic. Actually, well, maybe it's just something that's really locked in to the system and we need to somehow reopen this plasticity, reopen the malleability, where then we can try to decondition the system and then recondition the system. So that's some of the ideas around epigenetics.

28:29Dr Joe Tafur:Is the research showing that you can do that?

28:32Dr Sophie Shotter:Yes. So when we talk about trauma, so you're asking about the research study. This was a big like theme or idea presented in the book Fellowship of the River, in large part because I was having experiences, visionary experiences with the ayahuasca that was guiding me saying, Joe, this is an area to focus on. You should focus on this, get support for this, look into this. So we asked the MAPS study because there was, there's people like Rachel Yehuda in New York, big researcher, trauma researcher, who is one of the people among others who have been focused on this idea that trauma would lead to epigenetic imprints within the body that would kind of linger and stay and affect people's physiology.

29:15Dr Sophie Shotter:And then could this be reversed? And they show evidence that, yeah, that there was psychotherapy, can reverse it to some degree. They were seeing some reversal or at least shifts within the epigenetics in response to some antidepressants in some individuals. You could see this kind of loosen up and allow them to reprogram, perhaps, within a therapy setting. And that meditation was also doing the same kind of thing, again, opening up the possibility for these things to change again and reprogram, I guess I would say. So there was evidence up to that point, and there continues to be research in this area.

29:53Dr Sophie Shotter:It's a new area. It's an expensive area to do that kind of fine laboratory research. So there's definitely people pursuing it. We pursued it with the MAPS trial. So that study is pretty much over. We were considering some further follow-up, but I think it's kind of over. I don't think we're going to really collect anything else from the people that went through the trial, unless they go after the new extended trial here in the United States. So these people were having these big transformations, many of them, like almost 70 % of them were no longer meeting criteria for PTSD after this 12-week intervention involving MDMA.

30:29Dr Sophie Shotter:So that would indicate some kind of transformation. Like you asked at the beginning of the interview, does it stick? In this case, yes. One-year follow-up, two-year follow-up still. So something did shift. So again, this is like, huh, could it be biological? Because it's shifting and it's stabilizing. So is it possible that it's happening at the epigenetic level? Or is that a component of this? So we had people with saliva samples. You swab them and get some saliva that you can get some blood cells that you can just then get some DNA analysis and epigenetic analysis from to get kind of a snapshot of where they are.

31:13Dr Sophie Shotter:And you could look and compare that to these data banks that are with PTSD and say, we know that these gene regions are known to be impacted by trauma. And so we look at those areas and then we're looking for change. in the people that got better, also in the placebo arm, without even the MDMA, but the people that actually got better, that showed improvements, could you correlate that to epigenetic changes? Or this is like, it's pretty technical, this methylation of the DNA strand. Can you show that there is significant change happening, that you can correlate to their clinical improvement, the improvement of their PTSD symptoms?

31:55Dr Sophie Shotter:And so we had a pilot study. We're trying to piggyback on the MAPS trial. It wasn't easy. A lot of things, moving parts. And then COVID hit. And so we weren't allowed to collect saliva anymore. And we had to go through this whole thing with the university. But we managed to get 20-something samples. We thought, we're never going to be able to find something with 20-something samples. It's too small. It's too fine-tuned. There's too much noise. But we did. We did find something that we could publish. So that opened the door for other people to explore further. And so there are people collecting data.

32:28Dr Sophie Shotter:I know there's Rachel Yehuda's team is doing MDMA research in New York. They're collecting this data. Unfortunately, it takes years because it's people running through these trials and they're collecting the samples. And it takes a long time. So we're still waiting to hear from other people. There are Imperial College of London has investigated a little bit in a Peruvian study. I think that one was more, there was a lot of variables. maybe too many variables.

32:53Dr Joe Tafur:I mean, this sort of, thank you for all of this. It's fascinating. And it sort of tacks on to our next question, which is when it comes to trauma, we've mentioned MDMA, we've mentioned ketamine, we're talking about ayahuasca. If somebody wants to deal with trauma and they've done the work and it is for the right reasons, and they do have access to the right people, how do they navigate the choice? What is, I think you might hate this question, what's best for trauma but like generally speaking like if somebody has deep-rooted trauma i think that they

33:24Dr Sophie Shotter:i personally and we'll see the researcher somebody's going to prove me wrong one day i really think that and this is in my experience as well each one of them can be very helpful and so i think that's what i that's my message right and here's another like perspective like in the Amazon if you're working in the Amazon plant medicine from the culture and you don't even have a pharmaceutical laboratory in the region you're not like waiting to find the oh this subs this breakthrough substance oh that's the one like you always hear about them the drug scene the psychedelic scene the most common thing I run into is some new people have you tried this oh my god but this is the one oh wait till you do this like this is now the oh this is going to do it.

34:10Dr Sophie Shotter:But in the Amazon, none of that's going to happen where your only access is to be able to cut down these plants. At least, I mean, it's changing, but traditionally and cook it in a pot from some water and make it, you're going to try to make the most out of that. You're going to use that for everything that you can use it for. And you're not going to limit it in any way, shape or form because you're not waiting for some other magic substance to come along and replace what you might be able to do with that. So that's a different perspective. And I find personally, like just to throw it out there, here in Arizona, I get a friend who has a ketamine clinic in Tucson.

34:51Dr Sophie Shotter:And so ketamine has its own set of issues. And now are there people that abuse ketamine? Are there people that seem to be addicted or something? At least problematic relationship with ketamine? Yes, we know that's a real thing. It's very widely available. It's easy access. so it's full of problems that way. That being said, she was a nurse practitioner that's going to get her PhD in trauma research. And she wanted to challenge because here, then everybody was saying, well, the research is showing that because of the studies that exist, well, MDMA, that's the best thing for PTSD. Like that's the gold standard because the double-blind placebo, what did they did it?

35:27Dr Sophie Shotter:They did the research. So we know that's the case and there's nothing that can touch that. And so then she said, well, you know, no, I'm working with ketamine. That's what's legal here in Arizona. And while everyone's waiting for MDMA or to get underground MDMA or find it somehow, could ketamine be useful like this? And so she collected her data. It's a small study that she did as part of her doctoral thesis, but she had wonderful results in working with PTSD with ketamine. And so to me, it's more, I know you said, I mean, I always bring it up and it's just like if whatever tool you have available, that's the most important thing.

36:07Dr Sophie Shotter:So it is possible to expand like our awareness and our consciousness and even our spirituality and that those things are very deeply intertwined to our health and well-being. That's kind of the subject of the new book, Medicine Song, is talking about that. And so just to kind of touch on that, the end of the book is my friend and colleague Sochi Bukuru, who's an indigenous healer from Colombia, who's getting exposed to the psychedelic movement and to psychedelic therapists that I bring down to Colombia to go through ceremony. and she as a traditional person she has the same perspective that she likes to bring to people's attention it's like there's so much focus in the west around the substance and around the altered state and the psychedelic and like being somewhere else besides here and she's like we don't use it for that like this is to help you develop your natural consciousness like that's what we're trying to do.

37:04Dr Sophie Shotter:So there is such a thing. Like there is a natural consciousness and this is what's being revealed in the psychedelic research, this kind of expanded interconnectedness. Like an awareness of the interconnectedness is becoming a growing kind of goal of helping people find deeper healing. So then it becomes about these other measures, not just the substance, not just what somebody said, not the propaganda around the substance, but actual measures of like, is the person's mental health improving? Are their relationships actually improving? Is their physical health responding to what they're doing?

37:42Dr Sophie Shotter:Do they have more emotional ease in dealing with their day-to-day life? What can they say about their spiritual well-being as it's kind of being measured by modern academic assessment that is being correlated to physical function. What can we say about that? So to me, those become the stronger measures. I don't want to necessarily, it's interesting to learn about the new substance and the different options. More interesting is like, how is that going? This particular practice that we're discussing from these particular individuals, not in general, but this actual reality of this practice. You know, if I'm going to refer my grandma to these people, how are they doing over there?

38:30Dr Sophie Shotter:What's going on? I know they can tell me they did this. They told me that they did this. They told me about that. But what's actually happening to the people that go through that? Where are they at in their mental health, in their emotional well-being, in their spiritual well-being, in their physical health? And how is it going with their relationships with themselves, with each other, with the earth, and with the universe? I don't know. I think that's my goal is to move the discussion a little bit towards that direction, because I think those are the significant points.

39:00Dr Joe Tafur:We've heard you say that people working with ketamine have become very curious about the sacred. Is this essentially saying that ketamine works on more of a biological molecular level, but doesn't offer the spiritual journey that, say, ayahuasca does?

39:15Dr Sophie Shotter:I think what I said in the book was people were... I gave the example of an older man that had a spiritual experience, a near-death experience after he had a heart problem and had a major intervention in his heart. And he almost died. And he traveled to some sacred realm, you know, in his experience. And he showed up to the clinic in Phoenix, Arizona, saying, you know what I heard. And another person was saying, here in the American culture, showing up saying, you know, I think something's missing for me. I think that something is spiritual. And I heard you guys might be able to help me find that.

39:53Dr Sophie Shotter:And the older man said, I heard you might be able to help me get back to that place. So back to the same thing that we were getting at is that this spiritual experience, wherever it was that this guy went to, that mystical, mysterious place, the idea is that exists in some form, in some dimension that exists. This keeps cropping up throughout human society all over the world, that there's some kind of mystical phenomenon. phenomenon. There's a higher dimensions. There's the quantum physics indicates that the mathematics is indicating that. So then the idea is that the ketamine can open you to that.

40:34Dr Sophie Shotter:Is it a pharmacological biology? Yes, it is. It has a biochemical effect on your body. But as I talked about in the book, that its effect on the brain neuroscientifically is related to the effect of psilocybin on the brain. It's related to the effect of via wasp on the brain. And one of the things you see when you see these neuroscientific shifts that you could talk to David Nett about and people like that is that people become more open to the mystical.

41:04Dr Joe Tafur:And how has your relationship with plant medicines evolved over time? I mean, are there any plants, medicines, psychedelics that you feel particularly drawn to? Have you had any particularly profound experiences that you'd be happy to share beyond your early days when you were in med school you know how has your relationship changed yeah i mean i think it's

41:25Dr Sophie Shotter:evolving i maintain my relationship with ayahuasca and sacred plant medicine and the traditions from south america and also now in addition to working with my teacher ship people in peru ricardo maringo I work in Colombia as well with the Yahweh tradition and have learned about that and have had some very profound experiences happening. And the healings that we participate in there and our kind of ceremonial work goes on and on. Yeah, it's not like it's always happening. It's not always so profound and amazing, but it often can be. And it definitely depends heavily on the set and setting and the approach and all the degrees that you put into it.

42:09Dr Sophie Shotter:And so then that's an added component that I talk about in the medicine song is bringing some of those ceremonial elements into working with ketamine. So going to a place that is considered like a sacred space in nature here in Arizona and a place that is being cared for by people that maintain a spiritual relationship with the land, according to their ancestral tradition, ancient tradition coming from Mexico, indigenous traditions. and the way that that is creating a context where then when we go in and do kind of an opening blessing according to some spiritual tradition and then go into the ketamine that way and now bring live singing into that ketamine experience not just recorded music but live singing from ceremonially trained people that that are responding to the moment and how doing that that way that we have really powerful, profound experiences often with the people with ketamine, where people are having what they would call spiritual experiences, having experiences of contacting diseased loved ones, going deep into their past, all these different things.

43:21Dr Sophie Shotter:So for my, myself, working with a psychologist, and I described that in the medicine song, going into a ketamine session for my own healing with a Western trained psychologist who's very kind of spiritually oriented and kind of union and very open-minded that I had like some deep healing into areas of my own life and trauma with a car accident that I had when I was a teenager. That the ayahuasca ceremonies had helped me definitely to a large degree, but there was another wrinkle to get into that that particular, it wasn't just ketamine, it was ketamine with her and her advanced skill set that helped me get to a new layer that I hadn't gotten to before that made a really big difference for me.

44:08Dr Sophie Shotter:And so I described that in the medicine song and tried to demonstrate that it's like this was a profound spiritual healing for me personally that built upon my own work with the plant medicines, my experience and working in those kind of states. but still it was this western approach that really took me one more step.

44:30Dr Joe Tafur:Finally in all of this it would be remiss of us not to talk about any risks and contraindications. What can you tell us here?

44:37Dr Sophie Shotter:Yeah I think there's a lot of risks and contraindications and I think people should be careful and they should be very careful. It's maybe not as there's definitely some misinformation However, you should be very careful with these things. And so in the case of in general, like there's major risk factors related to people's mental health. And so when people have had prior history of bipolar with manic episodes and psychosis and schizophrenia, it can be very destabilizing, very seriously destabilizing. And so for that reason, I think with ayahuasca, it's definitely something that in general people avoid.

45:19Dr Sophie Shotter:There are a few people that are exploring with bipolar, but, you know, that's very high risk. It's definitely been published and I've witnessed it, that it is uniquely potent to push people into manic episodes and mania. So there's the mental health concerns. There's cardiovascular concerns. You know, you're going to get stressed out to a point that you'd have a heart attack or a stroke or something. Are you really like able to withstand the stress? And are you, have you addressed that? There's medications that people might be on that could be contraindicated with any number of these substances.

45:54Dr Sophie Shotter:It's different for the different ones. It's different what would contra, would have some kind of reaction with ayahuasca versus MDMA versus psilocybin versus ketamine. So those are some of the big things to worry about. Then there's, like you said, with ketamine, there are people that are abusing it and getting into kind of an escapism with that. We see that more than we see with the other substances. So it's definitely a concern. And then there's just like how are you really ready to integrate these experiences? Where are you at with yourself? could people get spun out into some kind of narcissism or some confusion and lost an illusion yes that's true so that's like you need a lot of guidance we feel you need a lot of support is that really there for that person do they have support in their life and they're going to go through one of these experiences who are they going to be able to talk to about it with afterwards and who's going to be able to help them.

47:00Dr Sophie Shotter:And if they do get into kind of like something that goes beyond the scope of practice of whoever they're working with, who are they going to go to next? Are they going to go to this guide or this counselor or to a therapist or psychologist or psychiatrist or beyond that? So I think there's just a lot of considerations and people should be careful and respectful and in the set and setting, make a big difference in how people are going to react and respond. So those are some of the basic concerns.

47:27Dr Joe Tafur:thank you so much joe for sharing so much wonderful information and you can find joe on socials at dr.joetafur spelt t-a-f-u-r and find out more about joe and his work and his books at all the w's drjoetafur.com again thank you so much joe yeah thank you very much wonderful to

47:53Dr Sophie Shotter:beyond. Thanks for including me.

47:56Dr Joe Tafur:And that ends this week's podcast. If you want to find out more about me and my work, or maybe book a consultation, head to drsophyshotter.com. And you can find me on socials at drsophyshotter. And again, thank you so much for listening.