Episode 50

full
Published on:

27th Jun 2026

From Surviving to Thriving: Integrative Psychiatry - Dr. Nora Nneka Ekeanya

Episode Summary

Dr. Michael Passmore sits down with Dr. Nora Nneka Ekeanya, a psychiatrist, writer, and integrative thinker based in Los Angeles. The conversation moves well beyond symptom management to explore what it truly means to flourish — touching on the intersection of psychiatry, creativity, spirituality, and self-actualization.

About Dr. Ekeanya

Dr. Nora Nneka Ekeanya is a psychiatrist with experience across inpatient, community, forensic, and private practice settings. She is also a poet, visual artist, and advocate for narrative medicine. Her work sits at the crossroads of psychopharmacology, creativity, and spirituality, with a particular focus on guiding high-achieving individuals from simply coping to genuinely thriving.

Key Topics Covered

Dr. Ekeanya's origin story — how a traumatic childhood, a mental health crisis in medical school, and the intervention of two deans set her on the path to psychiatry The wounded healer — why physicians' own lived experience with struggle, therapy, and vulnerability makes them better clinicians (referencing Victor Frankl's Man's Search for Meaning) Art and medicine — how poetry, visual art, photography, and film became inseparable from Dr. Ekeanya's psychiatric practice and personal healing The crisis in psychiatry — burnout, compassion fatigue, over-medicating, piecemealed care, and the systemic pressures that strip psychiatrists of what makes them effective Integrative psychiatry — moving beyond the medication-only model to incorporate supplementation, somatic therapy, spirituality, creative practice, and movement Psychedelic-assisted therapy — a candid discussion of psilocybin, ketamine, and cannabis: their real promise, the current limitations, the gray market in LA, and the critical importance of psychotherapeutic integration TMS and ECT — where neurostimulation fits in the expanding toolkit, and honest assessments of access, cost, and evidence The sacred therapeutic bond — what telemedicine eroded and why physical presence, micro-moments of human connection, and even dancing with a catatonic patient matter Self-actualization for high achievers — why the standard psychiatric model fails people whose lives look good on paper but feel hollow inside.

Resources & Links

Swallowed Words — Dr. Ekeanya's chapbook of poetry, released 2022 https://www.amazon.com/Audible-Swallowed-Words/dp/B0CC3TVRSQ

Dr. Ekeanya's private practice https://www.spiritandsoulpsych.com/

Victor Frankl, Man's Search for Meaning https://a.co/d/0byI1N5W

Oliver Sacks, Awakenings https://a.co/d/08Qusf3r

Connect with Dr. Ekeanya https://www.facebook.com/norawithnohhttps://www.youtube.com/@noranneka?app=desktophttps://www.instagram.com/nora_nneka/?hl=enhttps://www.linkedin.com/in/drekeanya/

The Neurostimulation Podcast is hosted by Dr. Michael Passmore, Clinical Associate Professor in the Department of Psychiatry at the University of British Columbia. The information shared is for educational purposes only and is not a substitute for medical advice. Always consult your healthcare provider.

Transcript
Mike:

Welcome to the Neurostimulation Podcast.

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I'm Dr.

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Michael Passmore, clinical associate

professor in the Department of

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Psychiatry at the University of

British Columbia in Vancouver, Canada.

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The Neurostimulation Podcast is all

about exploring the incredible world of

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neuroscience, clinical neurostimulation,

interventional mental health, and

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general mental health and wellness.

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We explore how the brain works, the

latest research breakthroughs, and most

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importantly, how that research is being

translated into real-world treatments

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that can improve health and wellbeing.

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So if you're a healthcare professional,

a student, a researcher, or someone

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who's curious about how our brains

work and what we can do to help them

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work better, this podcast is for you.

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My mission is to make the

science accessible, inspiring,

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and relevant to your life.

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This podcast is separate from my clinical

and academic roles and is part of my

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personal effort to bring neuroscience

education to the general public.

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Accordingly, I would like to

emphasize that the information

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shared here is for educational

purposes only and is not intended

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as a substitute for medical advice.

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Always consult with your healthcare

provider to discuss your specific

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health needs and treatment options

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Welcome back to the Neurostimulation

Podcast where we explore the

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frontiers of brain science, mental

health, and human potential.

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Today's episode is a particularly rich

and multidimensional conversation I'm

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hoping, and it's one that is gonna move

beyond simple symptom reduction and into

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the deeper question of really what it

means to feel whole and full of vitality.

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I'm joined today by Dr.

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Nora Nneka Ekeanya, a psychiatrist,

a writer, and a truly integrative

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thinker in mental health.

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Dr.

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Ekeanya brings a unique perspective shaped

not only by her clinical work across

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things like inpatient care, community

care, and even forensic settings, but also

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by her lived experience as a client and

her creative work in the arts, things like

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poetry, visual art, and super interesting

to me, this idea of narrative medicine.

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And so her work sits at the intersection

of psychopharmacology, creativity,

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spirituality, really exploring we can

try to encourage clients, especially

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high-achieving individuals, from simply

managing, to survive with p- perhaps

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simply from, from surviving and perhaps

coping with residual to thriving having

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a deeper sense of things identity

purpose, vitality, self-actualization.

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And so I'm really excited to explore

all those interesting topics and more.

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Dr.

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Ekeanya, thanks so much for being here.

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Welcome to podcast.

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Nora: Thank you for having me.

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I'm to be having this discussion.

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Mike: Yeah, so am I.

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It's just so interesting to get familiar

with your background and, and all

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your current work and your projects.

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So perhaps, you know, you could just

start by introducing yourself to us

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and talking a bit about your background

and what's brought you to where you're

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at today and the kinds of projects

that you're excited about currently.

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Nora: Yes, thank you so much.

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Um, so yes, I creatively go

by my first and middle name,

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Nora Nneka, um, but I'm Dr.

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Ekeanya.

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I'm originally from Florida.

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I was raised by immigrant,

Nigerian immigrant parents.

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And really, um, my early childhood was

very traumatic, but I was motivated

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by wanting to be a physician.

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I knew very early on that I wanted

to be a doctor, and like most people,

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sort of that at least gave me some

stability to get through the trauma.

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And, but what happened is I went to

medical school, um, and it was the

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first time that I was away from any

of even the chaotic people in my life.

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I was just around no one, and

the, that's when my mental health

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really suffered in medical school.

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And so for the first time, I

wasn't a straight A student,

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I wasn't eating, you know?

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And it took an intervention from two

deans at the medical school, um, on my

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behalf to really honestly save my life.

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And I was officially, like, I was

forced really, if I wanted to stay in

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medical school, I was, you know, forced

to seek, get help, to seek treatment.

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Um, and so my interest in being a

physician and my interest in being a

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doctor because I like talking to people

and I think as a survival mechanism, I

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learned very early how to read people's

cues and become interested in how people

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are thinking because I had to, you know?

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Um, so that interest already led me to

psychiatry, but what really gave me a

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sense of meaning and purpose was going

through, um, mental health treatment

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myself, going to a therapist, you know,

processing my own traumas, um, being

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on medication, knowing what that feels

like, you know, to not be like yourself

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and hoping that a pill is going to help

you feel more like yourself, you know?

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What a radical idea.

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Um, and so, and you know, I, I met

my husband in medical school and so

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I went to residency in Kansas City,

and I really, you know, now I look

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back on that and know that I, I

did not want to be in Kansas City.

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I kind of like acquiesced because it

was, you know, it was g- something

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good for the couple, right?

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But it didn't really feed my spirit.

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This, the place didn't feed my spirit.

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Um, but the r- it was a good

residency program and that's when

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I started to dabble more into a

previous, like, practice of writing.

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Um, as a child, I wrote poetry and

essay and I've always been very lyrical

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and musical, um, but I was always

taught that you need to separate that.

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If you wanted to be a doctor,

you need to be professional and

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professionals aren't being whimsical

and having notebooks of poetry.

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But I really had that urge to write

again because now I'm finding myself in

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a pl- in residency and in a place that

I really didn't physically align with.

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Um, but I s- did it as medical writing,

so I started writing these nonfiction

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essay from a, as a perspect- from the

perspective of a Black female physician.

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So that's how I started feeling

comfortable, you know, getting

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into writing again, um, and I was

getting paid for it, you know?

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So it's like this is, you know,

:

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$300 every essay and I can push

out an essay profusely, you know?

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And that was how I supplemented my income

initially, and then I, as I met more,

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'cause I'm creative, I would meet friends

who are creatives and, um, in Kansas

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City because there is sort of a vacuum

of things to do, it allowed me to play.

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And that's how I got, really got back

into being comfortable with art is

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that, you know, residency was residency.

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I knew I wasn't gonna find

my best friends there.

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I've never really, I've always been

sort of the strange one, you know,

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like among the strange people, right?

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Like as psychiatrists, we tend

to all be sort of like the

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weird ones of the cohort- Yeah

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but I'm always the

weirdest of the weird ones.

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So I've always sort of gravitated

to artists and sort of left

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medicine at the hospital.

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Um, you know, I pop in

as a fairy and pop out.

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And so I made these, as I made friends

in Kansas City who are artists, just out

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of pure boredom, we would collaborate.

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And so that, this is how I expanded

myself creatively from writing Because

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once you identify yourself as a

writer or s- or a creative and you

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pick a medium, people tend to wanna

pigeonhole you into that medium.

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But I, as a creative, believe that

we are all creative, it's just how

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much do you wanna push yourself?

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What are you interested in, and

how much do you want to grow?

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You know?

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And so that was, you know … And so

it started out with photography, and I

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would … My friends who are photographers

need to test equipment, and I would have

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ideas that I would want to bring to life.

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And so then we would collaborate visually

because I would … And I would write

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essays based on the visuals, you see.

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And then I started filming these things,

and then, then it built into poetry

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because I would work with friends

who were cinematographers, and they

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wanted to play in that way, you know?

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And so, and I joined collectives.

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And so, and in these colle- these

fem collectives, you know, you

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have makers, you have creators.

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So everything, it became … Creativity

was a f- became a full experience for

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me, being in this vacuum of Kansas

City while continuing to process my

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trauma, because k- I started therapy in

medical school, but it really continued.

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It's a thread that's always continued

because I had so much to unpack.

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And so initially it was, "Don't kill

yourself in medical school," you know?

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"What do we need to process to

keep you, you know, safe now?"

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And then you can go into more and more.

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And as life changes, right, we know

the benefits of kinda revisiting

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and saying, "Hi, I just got married.

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I need to process what that

means to be a wife, or a

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husband, or a partner," you know?

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Mm.

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Um, so that's how it kinda wove into

the art, sort of the medicine, you

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know, the, the medicine woven to my art.

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And as a psychiatrist, I see

all … You know, you have these

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interesting cases that you can't talk

to anybody about, and you want to

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express to people, like, the things

that you're noticing about humanity.

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And so then- Mm … I started

wanting to write about my

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experiences with people, you know?

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It, like, the thing that give me

meaning grew, and it has bloomed.

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You know?

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Mm.

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I don't know what's coming next, because

right now my big focus is integrating

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myself, continuing- Mm … this

journey, being the artistic psychiatrist

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and owning it, not being the weird

psychiatrist who is an artist, not

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being the artist who kinda whispers,

"Yeah, I'm a doctor," you know?

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Like, I don't … "You don't

need to pay me for this.

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Like, I, I just wanna have fun," you know?

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Mm-hmm.

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I'm, I want to be both.

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I can be both.

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I should be both, because I've

just found that that's- The thing

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that I see help other people

is the thing that I also need.

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Mm-hmm.

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So in launching my private practice

and really, you know, expounding on

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integrative psychiatry, that has been

a, a- that's been my growth journey.

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Creatively I want to paint,

but that will come at a time.

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You know, when it happens as it happens.

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Um, but this is a part of

my creative journey as well.

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Yeah.

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Mike: Well, yeah.

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That- it's amazing.

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Thanks so much for explaining that, and I

think it's just so inspiring because, you

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know, clearly y- you have a real passion

for it and it's just so heartwarming to

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see how you've been able to get to where

you're at and just be able to live in a

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way that is bringing together these two

really important aspects of your vocation,

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so the medicine, the psychiatry- Mm-hmm

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and the art.

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And I can…

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I really, there's a few things, a few

threads that I thought it would be

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interesting to pick up on on that.

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The first one has to do with this

idea that I think physicians, I

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mean, it goes way back to the, I

guess maybe was it Hippocrates?

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Mm-hmm.

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That, you know, it's know a physician,

know thyself or heal- sorry.

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Physician, heal thyself, right?

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I think- I'm getting the

Oracle of Delphi mixed up with

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Hippocrates- But yeah, yeah, yeah.

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Mm-hmm … so physician

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Nora: heal

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Mike: thyself, right?

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Yeah.

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And this whole concept of more, maybe

more contemporary writers like Henry

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Nouwen and, and Victor Frankl talking

about the wounded healer, right?

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Mm-hmm.

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And how having some sense of

that and some vulnerability and-

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Nora: Mm-hmm

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… Mike: and, and exploring one's own

trauma, um, one of my great mentors in

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residency- Mm-hmm … said something

that just struck me to the core during…

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It was kind of an offhanded thing really.

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It wasn't even something that I think he

intended to emphasize, but he just said,

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and, and it, it, it really quietened

down the room 'cause I think it had an

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impact with all the audience members.

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And he said, "You know, we're all

traumatized to a certain degree or

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another e- early on in life," right?

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So I think that knowing that and, and

to be comfortable with being vulnerable

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about that is, is really important,

I think, for caregivers especially.

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So-

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Nora: Mm-hmm

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… Mike: um, so yeah.

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So thanks for explaining that aspect of

your story, and it's really inspiring.

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And then the other thing that I thought

would be interesting to touch on as

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well is just how exciting it is for me

to see you talk about your passion for

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bringing together the arts and medicine.

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Mm-hmm.

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Because surely, you know, they talk

about the art of medicine, but I think

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in school, as, as you're alluding

to, it's very true that they kind of

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just give lip service to that, right?

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Yes.

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And if you wanna try and explore an

artistic kind of thing, it's, it's

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sort of like, you know, on your own

time, and it's- Yeah … it's, it's

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not really well accepted or encouraged.

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But I think truly the best clinicians

really are artists at work in, in- Yeah

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… undercover artists, shall we say, right?

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Nora: Yes.

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Yes.

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And you know, I, I got…

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I arrived to this knowledge, this

knowing that as a healer, we also

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needed to be healed people through the,

the mentors that I had in residency.

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You know, um, I was lucky enough that

in the same physical building, we had

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acute units, we had state chronic units,

forensic units, an emergency room, and a

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psychoanalytic institute of Kansas City

was actually based in the same building.

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And so we, it, we had a lot more daily

interactions with psychologists who

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really wanted us to put a mirror to

ourselves for the first time, you know?

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And, and in doing that, well, the thing

that cracked me open was actually Victor

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Frankl's, um, Man's Search for Meaning.

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Mm.

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That, that is a book that I read

every time that I have an ego death

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because how sweet of an irony that

he found meaning- In thinking about

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other people's thoughts, in being a

psychiatrist, in, you know what I mean?

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In just b- in the thing

that he enjoys, right?

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Gave him meaning, it kept him alive.

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How beautiful, right?

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How beautiful.

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Mm-hmm.

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And that's the, that's the

emotion that I sit, that I like,

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I wanna sit in because that's what

resonates with people, you know?

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The patients that click with us, they

click because w- we are also human.

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We are human guides, right?

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We are not gods.

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And I think as psychiatrists sp- like,

particularly, you know, that's why I

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don't get offended when people sort

of mix psychiatry and psychology.

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I just kind of, like, correct them

and say, "I c- I do medications," and

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there is a scientific component to

it that is more, you know, uh, rigid.

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But- Mm-hmm … but on the

spectrum of physicians, we sit

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in that liminal space more often.

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It really is.

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There's so much of mental health that

is this in between, and what bridges

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that gap is knowing that we are also

humans in this lived experience, living

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the experience with them, the third.

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You know what I mean?

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That third needs to be healthy, and for

the health, like, that third space to

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be healthy, we must also embody that.

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I think also that's why there's such a

crisis in mental health right now where

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there's a pushback against psychiatrist.

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You know, everybody-- you'd rather see

m- like, an untrained nurse practitioner

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than a psychiatrist because psychiatrists

is burnt out from the pandemic.

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We're burnt out from

just healthcare as it is.

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I mean, as a psychiatrist, like, I

don't know about you, but, like, you

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know, I remember when the shift happened

when everyone went from being like,

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"Oh, you must be weird or dumb, and

that's why you became a psychiatrist"

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Totally.

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To

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it being like, you know, the,

like, you are, you are the, a top

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echelon, and people are fighting

to get into psychiatry residencies.

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People are fighting to, to, you know,

to get into the doctor's office.

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And so a lot of psychiatrists who

weren't trained to think of their

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own selves really overgave during the

pandemic, and they burnt themself off.

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And so I w- see a lot of our

colleagues who are zombies.

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They just- They're working through life.

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15 minutes, are your meds working?

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You know.

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And because they are so, you know,

exhausted emotionally and not keeping

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track of that, they have nothing

to give, and so we piecemeal it.

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You know, we say, "I do your meds.

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You talk to your psychologist."

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And then your psychologist says,

"Okay, you need a social worker."

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And then the social work-

do you see what I'm saying?

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And that's how- Mm-hmm … piecemealing

mental health treatment, and it's like,

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how, how much, how vulnerable can you

be truly when you're in the crisis?

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How many times can you share with

someone, a different someone, and hope

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that they get it, and hope that they

can help you, and that they don't just

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give you a link or a number or a thing?

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And so this is sort of the,

the shift that I've seen.

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And I, I, I know from my own experience

that art and medicine, you know, there is,

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there is a role for it, um, as an artist.

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But really, I I came to the, like, the

knowledge of it just going through,

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like, research studies and stuff,

you know, kind of looking up, um,

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like how, like what happens neural,

neural, neuroplasticity wise, you know?

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What happens, um, you know, when

you integrate art and medicine.

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And every time it shows up that,

like, for high achieving people you

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need, like, a, there's a certain

thing, I'm gonna, like, find it.

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It's a certain phrase that, um,

I wrote down- Mm-hmm … like,

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to tell it to patients, you know?

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Um, that the synthesis is that, like,

medication stabilize the circuits, right?

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Psychotherapy- Mm-hmm … it,

like, you know, it reorganizes

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your rec- your cognition and,

you know, gives you recognition.

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But spiritual practice give you meaning.

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Mm-hmm.

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Spiritual practice gives you perspective.

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Creative practices, you know,

give you flexibility, you

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know what I mean, in a way.

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And so these, these are easy and intuitive

ways to lead people away from, "I need

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dopamine, let me go smoke a cigarette."

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It's

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that they do, "I need dopamine, I'm

gonna go dance with strangers," right?

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You know?

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Mm-hmm.

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"I'm gonna move my b- I'm

gonna go scream," right?

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Um, and also something that, you

know, because I work with a lot of

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people who have, you know, PTSD and

trauma, something that I realized is

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that in processing physical, like s-

som- somatic, uh, somatic therapy is

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very important for processing trauma.

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And so you would find, I would

find myself walking, taking walks.

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"Okay, l- this is a secluded

area where we can walk and talk.

333

:

Um, do you wanna go hiking?

334

:

Do you, you know, wanna go biking?"

335

:

You know?

336

:

And I found that, like, just being,

it allowed people to process,

337

:

you know, versus sitting and just

reporting, and then you have to worry

338

:

about all these barriers, you know?

339

:

Um, so yes, I kind of go back and forth

with that, but I really do think that

340

:

for us to survive in mental health as

psychiatrists, medical doctors working

341

:

in mental health, we are going to have to

go back to honestly what everyone thought

342

:

psychiatry was during that Freudian era.

343

:

It really is just 'cause, like,

you know, we, they haven't

344

:

sub-specialized and there's not a lot.

345

:

You know what I mean?

346

:

Like, it- Mm-hmm … but, but I,

the value of those, that time, that

347

:

era, was that your psychiatrist did

everything related to your mental health.

348

:

Everything.

349

:

They managed, they

managed all aspects of it.

350

:

They didn't piecemeal it out.

351

:

And so for us to survive, and, you

know, we need to bring it back to that.

352

:

We cannot keep like, you know,

sub-specializing and sub-specializing,

353

:

and I only see anxiety and I

only like Zoloft, you know?

354

:

I've met so many doctors who

have favorite medications, and it

355

:

makes me a heart- my heart so sad.

356

:

Mm-hmm.

357

:

Why do you have a favorite medication?

358

:

The medication's a tool, you know?

359

:

What's the patient need, right?

360

:

So anyway.

361

:

Mm-hmm.

362

:

Mike: I hope that makes sense.

363

:

No.

364

:

Mm-hmm.

365

:

Uh, yeah, for sure.

366

:

I, I agree with all of that.

367

:

And I mean, it, it is really

interesting because they're complicated

368

:

and challenging- issues for sure.

369

:

I mean, I think- Yeah … and it

comes back, like it reminded me when,

370

:

when, like, when you were, this, this

quote, I believe it's Maya Angelou.

371

:

Nora: Mm-hmm.

372

:

Mike: You know, "People, people

won't necessarily remember what

373

:

you say to them, but they'll

remember how you make them feel."

374

:

Exactly.

375

:

Right?

376

:

And it's, it's, an, an ideal, I

suppose, for psychiatrists and all

377

:

caregivers to try to- Yeah … remember.

378

:

Nora: Yes.

379

:

Mike: Um, myself included.

380

:

Mm-hmm.

381

:

For sure.

382

:

I'm at the top of that list.

383

:

Nora: Mm-hmm.

384

:

Mike: Um, but yeah, it's, it's, it's

because, yeah, you know what I mean?

385

:

And I think that that burnout issue

is a really important- Mm-hmm … one

386

:

to- Mm-hmm … to, to be-

387

:

Nora: Mm-hmm

388

:

… Mike: to be really highlighting because

burnout, again, and I'm at the top of

389

:

the list with this too- Mm-hmm … and

compassion fatigue and feeling like- Yes

390

:

you just need to get through

the day and- Yes … seeing,

391

:

seeing medicine as more of a job-

392

:

Nora: Yes

393

:

… Mike: that you just have to

get through to pay the bills.

394

:

Mm-hmm.

395

:

And, you know, one, one, one client to

the next, to the next, and then- Mm-hmm

396

:

… by the time you're halfway through

the afternoon, you're thinking about

397

:

getting home as fast as possible- Yeah

398

:

and what's gonna be in the fridge for

supper and all that kind of thing.

399

:

Nora: Mm-hmm.

400

:

Mike: Right?

401

:

Nora: It rolls.

402

:

Yeah.

403

:

Mike: And so, yeah, I guess it comes

down to balance to a certain extent.

404

:

Yeah.

405

:

Obviously, there are practical aspects of

work that you have to take into account,

406

:

but what- Of course … strikes me as

really inspiring and exciting though

407

:

is this idea of, of integrating art

with medicine and, and clinical work.

408

:

You know, it doesn't have to be medicine,

but caregiving- Mm-hmm … shall we

409

:

say, in a way- Yeah … that, that,

that fosters a sense of play maybe.

410

:

Is that part of it?

411

:

Yes.

412

:

Because that's, that's restorative.

413

:

Mm-hmm.

414

:

That's, that's inspiring, and that'll

hopefully help to counteract the,

415

:

the mundane grind of day in and

day out kind of work that probably

416

:

engenders caregiver strain, burnout,

and compassion fatigue, right?

417

:

Nora: I agree.

418

:

Like, and that's how I live my life, is,

you know, those tiny moments of whimsy,

419

:

of joy, of connection that I can make

are what feed me to feed other people.

420

:

And, and it, it does, it grows.

421

:

And so, and you can…

422

:

And it's in small ways.

423

:

It's in little ways.

424

:

And it helps humanize us.

425

:

I feel I'm one of those people that,

you know, when I would have a bad day,

426

:

I would tell my patients, like, "Hey,

sorry, I have been a little, like, grumpy.

427

:

Like, my toddler woke up.

428

:

Like, it sucks, so, like, I'm not myself.

429

:

I'm not myself."

430

:

And they say, "Oh, that's fine.

431

:

You're a person too," you know?

432

:

And so in humanizing myself and adding

fun, you know, like I used to hand

433

:

out candy, like, just secretly, you

know, or dance with the patients.

434

:

If they're doing, like, expressive therapy

and they're dancing, "I'm gonna go dance

435

:

with you," when I was doing inpatient.

436

:

Those mi- those tiny moments-

are the moments that really

437

:

do feed you, feed your spirit.

438

:

And those are the moments that I

remember, and I want to remember it all.

439

:

I want to- Mm … I want to be

able to savor, I mean, when I

440

:

cannot move anymore, my goal is

to savor the memories, you know?

441

:

Um, one of my favorite me- like,

moments, and it inspires my art too.

442

:

So I had a, a patient

with catatonia, and he…

443

:

It was pretty bad.

444

:

He was, you know, in the hospital

for a better part of a month, right?

445

:

But as he improved, the one thing

that, um He was really into music,

446

:

so I knew he was getting better

when, you know, the shimmy started.

447

:

And I was like, "Okay, we're moving.

448

:

We're moving our body.

449

:

You know, this is good."

450

:

Mm-hmm.

451

:

And, uh, you know, I, I, like,

I, I grew up like a hipster

452

:

kid in college, you know?

453

:

So Pho- the band Phoenix came on and

it was like a really- Mm … and I

454

:

started dan- like, we were outside.

455

:

They were on, doing their

Fresh Air break and I was like,

456

:

"Man," you know, like, "Dr.

457

:

E back in the day, a Parliament light and

a Red Stripe and this song," you know?

458

:

And he got up and danced with me.

459

:

Wow, that's- And we all…

460

:

You know what I mean?

461

:

It was one of those moments that everyone

was like, "Oh my God, he's better.

462

:

He's b- like, he's dancing.

463

:

He's moving all his limbs.

464

:

We are dancing."

465

:

And that's a moment I'll

never forget, you know?

466

:

Mm-hmm.

467

:

And it's clinical because I'm like,

"Okay, like, he's, he's getting better."

468

:

Like, how much Ativan

do you need, you know?

469

:

Mm-hmm.

470

:

Are we moving towards, like, ECT?

471

:

Do you see what I'm saying?

472

:

Like, there was, like, a real medical

imperative to- Mm-hmm … get him better.

473

:

But personally, I just wanted to see…

474

:

I loved seeing him just

a little bit happier.

475

:

Yeah.

476

:

That little shimmy, you know?

477

:

And if it takes me being a fool

and telling people that, yes,

478

:

like, I was a, a grungy, you know,

strange person back in the day, and

479

:

now I'm a doctor and here we are.

480

:

Mike: Totally.

481

:

Yeah.

482

:

Nora: Yes, yes.

483

:

Mm-hmm.

484

:

Mike: Amazing.

485

:

Yeah.

486

:

It's a, a real world example of

something kinda like that, that

487

:

book and the movie Awakenings.

488

:

You know Oliver Sacks- Yeah.

489

:

… and then Robin Williams and-

490

:

Nora: Yes

491

:

… Mike: with catatonia.

492

:

Yeah.

493

:

Amazing.

494

:

Yes.

495

:

Yeah.

496

:

Well, it, it's really so the, the, the

story that you told about in residency

497

:

when the psychology colleagues would,

so to speak, you know, encourage you

498

:

all to hold up a mirror to yourselves-

499

:

Nora: Mm-hmm

500

:

Mike: it really does, I think that

really is so profound because-

501

:

Nora: Mm-hmm

502

:

… Mike: you know, again, from personal

experience and seeing colleagues

503

:

and talking to people, it, it really

does, um, you know, at the expense of

504

:

maybe overanalyzing and- Yeah … and

getting too psychoanalytic, but- Right.

505

:

… you know, surely there's a reason

for some of us why we're drawn

506

:

into certain fields, you know?

507

:

Exactly.

508

:

In medicine, psychiatry in particular.

509

:

Mm-hmm.

510

:

Mm-hmm.

511

:

And perhaps part of that is kind

of a defense in some way, you know.

512

:

I can't remember what the, what

the mature defense mechanism is.

513

:

Right.

514

:

Yeah.

515

:

Sublimation or something like that, right?

516

:

Yeah.

517

:

Yes.

518

:

Um, and so maybe part of it and part

of why that struck me hard when-

519

:

Nora: Mm-hmm

520

:

Mike: when my mentor said, "Oh, we've

all been traumatized- Yes … to

521

:

some degree or another," it's like-

Mm-hmm … "Oh, okay, maybe I was,

522

:

you know, and I don't really realize

it or I'm defended against it.

523

:

Maybe that's why-

Yes … I'm in psychiatry."

524

:

Nora: Yeah.

525

:

Mike: Right?

526

:

And so having some vulnerability,

some, some insight into that and being-

527

:

Nora: Yes

528

:

Mike: willing to be vulnerable and, and,

and engage in some e- self-exploration

529

:

or with a therapist, right?

530

:

Nora: Mm-hmm.

531

:

Mike: Or in a group.

532

:

Um, can, can be super helpful.

533

:

And I wonder if perhaps, maybe

I'm going o- on a bit of a limb

534

:

here, but I'd- Mm-hmm … I'd

appreciate your thoughts about it.

535

:

Mm-hmm.

536

:

If that kind of dynamic in general

is extended from individuals to more

537

:

of like a collective or institutional

phenomenon that has contributed to

538

:

psychiatry kind of overcorrecting towards

objectivity and, and being detached

539

:

from patients and, and, and being overly

concerned about boundaries- Mm-hmm

540

:

um, and siloed with the siloed care,

as you say- Mm-hmm … at the expense

541

:

of more relational presence and-

542

:

Nora: Mm-hmm

543

:

… Mike: comfort sharing and disclosing

and- Mm-hmm … honestly, like the term

544

:

you're not allowed to say, you're not

allowed to even think about the term

545

:

love, but surely love has to come- Yes.

546

:

Yes … and be at the heart of a

therapeutic relationship, right?

547

:

Exactly.

548

:

Nora: Yes.

549

:

Yes.

550

:

I agree.

551

:

I d- I do, and it's something that,

you know, a lot of my psychoanalytic

552

:

mentors mentioned this hard, like,

overcorrection in psychiatry to try

553

:

to gain more credibility amongst

our, our other colleagues, right?

554

:

And it's like we must make it, you know…

555

:

And, and for me, it's very, it was very

sad to see because there was a point

556

:

where I had an argument with someone.

557

:

I'm like, "What is the difference now

between a psychiatrist and a neurologist?

558

:

And have you ever met a happy

neurologist who wasn't autistic?"

559

:

You know?

560

:

Like, I just…

561

:

You know, and they are our cousins.

562

:

And it, it did, it drained away, and I

think that's part of the problem and,

563

:

and it, we overcorrected, and because we

overcorrected to gain this, it also put

564

:

blinders up for us, where it used to be

okay to have that sort of discussion,

565

:

you know, that you would cross that

boundary of like, "You're strange.

566

:

You're a psychiatrist

'cause you're strange.

567

:

Why are you strange?

568

:

Because you probably have

mommy issues," or whatever.

569

:

You know, that discussion, no

one has that discussion anymore.

570

:

We don't even play like that

anymore, but we all intuitively

571

:

knew, like, you become a psychiatrist

because there, there's something.

572

:

There's a thing.

573

:

There, there's something about you.

574

:

There's something about your experience.

575

:

Like mine was I, I have to learn cues.

576

:

I had to learn people's behaviors

'cause it's a safety thing,

577

:

and so that's my comfort.

578

:

You know, on a, a great day

for me is people-watching.

579

:

I like to go to the beach and

just sit and watch everyone,

580

:

watch all their interactions.

581

:

Sometimes I interact, sometimes

I don't, you know, like if I want

582

:

to, but I love that, and that's

why I became a psychiatrist because

583

:

I'm like, "Ooh, I don't care if

you have high blood pressure.

584

:

Tell me about your marriage."

585

:

You know?

586

:

Um- Sure.

587

:

So I, I do agree, and I, and in my last

few jobs, so I've been moving up in

588

:

my career medically, as, as one does.

589

:

Um, the interview answer I always

give to why I've left employment is,

590

:

you know, upward mobility If you want

to, you know, get paid market rate as

591

:

a physician, you know, leave a job,

go get a, go get another job, right?

592

:

Get another hospital job.

593

:

But really the reason was ethics, morals.

594

:

I did not…

595

:

I found myself losing what made me

special, the thing that makes me a good

596

:

doctor, the reason why people wanna see

me, my bubble, my light, and my joy,

597

:

it was being drained away by unethical,

immoral, illegal behaviors that as a

598

:

psychiatrist, we, we are like, kinda

like the lawyers of the medical world.

599

:

You know, people look to us

to assume a lot of liability.

600

:

And, um, and so I would leave a, a job and

go somewhere else because I love mental

601

:

health, so I'm like, "Well, let's…

602

:

I don't care if it's inpatient or

outpatient or community," at that time.

603

:

My last few jobs were in medical

directorships and I, so I was

604

:

so close to making the change.

605

:

It's like the patients want it,

you know, the, the psychiatrists

606

:

are finally like waking up to the

fact that we can have fun at work.

607

:

Like work should be fun.

608

:

Like what do you like about medicine?

609

:

Do you want to talk about cytochromes?

610

:

Let's geek out about cytochromes,

but also it's okay if your patient,

611

:

you know, like wants to give you a

hug, give them a Christian side hug.

612

:

You know?

613

:

Mm-hmm.

614

:

We were finally getting to that point.

615

:

The problem is, is that

it has to be a top down.

616

:

It has to be from the CEO who's

not a doctor and who doesn't care.

617

:

Um, mental health psychiatry

does not make money.

618

:

It's not a big revenue gainer

for, you know, um, for hospitals

619

:

be- so they don't invest in that.

620

:

They don't invest in, you know, making an

environment cohesive to relax and healing.

621

:

You know what I mean?

622

:

We, they just don't value that.

623

:

A lot of our administrators are not

doctors, they're not physicians.

624

:

Um, so that's the battle

that I came against and my

625

:

solution was do it on my own.

626

:

I'm lucky enough to live in LA and

where yeah, like, you know, sure you

627

:

can, you can launch your own pra-

you can a- and you'll be success-

628

:

there will be people who will come.

629

:

But I do feel for empathy for the

physicians who live like me, you know,

630

:

lived in Kansas City, live in Iowa,

live in places where it is just you,

631

:

y- you're accepted as being your own

individual, but it's really hard to

632

:

impact community to also make the change.

633

:

They just want you to be the weird one.

634

:

You be Freud, you be whoever,

you know what I mean?

635

:

You be the special shrink.

636

:

But it's, you know, so I'm starting,

I wanna start the movement.

637

:

The movement starts with me, you

know, living the life that I-

638

:

I'm trying to get other people

to see that they can live too.

639

:

Like you're doing now, you know, like

you have your podcast and that is

640

:

something beautiful and it's something

interesting and it brings in your

641

:

medical side, you know what I mean?

642

:

It's, it's fulfilling in such a

unique way because you're pulling

643

:

from all these realms of yourself.

644

:

Um, yeah.

645

:

Anyway.

646

:

Yeah.

647

:

No,

648

:

Mike: thank, thank you for that.

649

:

I really appreciate it.

650

:

Those are very kind words and yeah,

I, I totally resonate for sure.

651

:

I think probably a lot of, a lot of

clinicians probably mid-career get to

652

:

a point where they kind of look around

and they feel, you know, they've lost

653

:

the imposter syndrome hopefully- Mm-hmm

654

:

you know, and they feel, they look

around and they kind of are, uh, uh,

655

:

um, um, this is sort of like me just

talking from personal experience.

656

:

Mm-hmm.

657

:

You sort of look around and feel a bit

more confident about making judgments

658

:

around institutional patterns that

you see, and checking in with yourself

659

:

and saying, "Okay, well, like, do

I wanna continue, you know- Mm-hmm

660

:

here in, in sort of like a cog in

this sort of dysfunctional system-

661

:

Nora: Mm-hmm

662

:

… Mike: for, for another,

like, for 15, 20 years?

663

:

Or- Yeah … or am I done with,

am I done with this crap, right?

664

:

Right.

665

:

Do I wanna- Right … do I wanna

just like, like, it's not worth like,

666

:

you know, s- take a pay cut, right?

667

:

If I'm gonna- Yeah … be miserable

for the rest of my career, like- Yeah

668

:

what's the point, right?

669

:

Nora: Yeah.

670

:

Mike: And so I think that, um, and I think

particularly, you know, with psychiatry

671

:

because so many colleagues have just

been so frustrated because, you know,

672

:

you end up in, say on, well, inpatient or

outpatient, as you know- Mm-hmm … some,

673

:

some, some clients who, who just have

these refractory problems and they can't

674

:

afford therapy, so they end up- Yes

675

:

on three, four, and five

different psychotropics, and then-

676

:

Uh-huh … two more to treat the

side effects from- Uh-huh … the

677

:

cocktail that they're already on.

678

:

Nora: Yep.

679

:

Mike: And so that's the other reason why

I'm super excited to talk to you a bit

680

:

about, like, other methods, like the-

681

:

Nora: Yeah

682

:

… Mike: neural stimulation and, and

ketamine-assisted psychotherapy- Mm

683

:

psychedelic-assisted psychotherapy.

684

:

Mm-hmm.

685

:

You know, because that in particular

to me seems like a real exciting

686

:

frontier that can try and- Yes … bring

together these aspects that we're

687

:

talking about in an integrative way.

688

:

You know, you mentioned the

term integrative psychiatry

689

:

in your current practice.

690

:

I'd be so, so interested to hear

more about that, 'cause I think it's

691

:

exactly what those of us who have

become burnt out and jaded and cynical

692

:

about the psychopharmacological

limitations and the, the, the

693

:

capture, the, the pharmaco-industrial

complex capture that's endemic- Mm

694

:

in terms of the research and-

Yeah … all the rest of the training

695

:

and everything and, and, and a lot

of us are just done with it, right?

696

:

Nora: Yes, exactly.

697

:

And you know, I hit that wall too

that many of us do where you're just

698

:

like, you know, there's just not

enough resources for these patients.

699

:

They need more than just the pill,

and the pills are not enough.

700

:

And that's really how I started sort of

to peek my head into what else can we do.

701

:

Um, but I always have to preface

and say, like, there are…

702

:

Most of psychiatry is

just keeping people alive.

703

:

Just, you know, being…

704

:

They're gonna be a cog in a wheel, and

they just need to numb themselves enough.

705

:

That's mo- what a lot of people want,

which is sad, but you know, they come to a

706

:

psychiatrist and they're like, "It's fine.

707

:

The med's fine.

708

:

I don't feel anything.

709

:

I'm kinda numb.

710

:

That's great.

711

:

I don't wanna kill myself anymore.

712

:

I'll see you next week."

713

:

So there is that, that entry-level

psychiatry where it's just like,

714

:

"I just need to stabilize."

715

:

But- What something that I really,

I stepped into is those people who

716

:

don't wanna do pharmaceuticals for

whatever reasons, okay, well the

717

:

pharma- then you have these intellectual

conversations where it's like, "Well,

718

:

where did the pharmaceuticals come from?

719

:

They come from these herbal supplement-

supplements or these plants.

720

:

Why can't I just take that?"

721

:

It was patients asking me that,

"Why can't I just take that?

722

:

I feel more comfortable,"

that made me start looking

723

:

to supplementation, you know?

724

:

Um, and also, I also function on

this idea as a doctor that I am

725

:

not … I can tell you all the options.

726

:

I can tell you what I would do.

727

:

I would tell you what other people

who are psychiatrists may do, like if

728

:

it, if it differs from the ver- why

it is, and I leave it to them, right?

729

:

Mm-hmm.

730

:

I leave it to them, and in doing

that, it made me have to open

731

:

up to, okay, well, not everyone

wants to take, you know, Lexapro.

732

:

Maybe they want to take St.

733

:

John's Wort, and I just have to tell

them like, "Hey, you're just gonna

734

:

have like a really restricted life

outside of that," but I'm open to it,

735

:

and then they live the experience, and

maybe they come back and say, "Mm, no."

736

:

Or, or as a creative, they don't want to

be numbed, and so I have to say, "Well,

737

:

we're gonna underdose your medication

so you're a little bit hypomanic

738

:

'cause you want to be hypomanic,"

and let's say, and they're art honest

739

:

and they say, "Oh, I smoke a whole

bunch of weed," and I'm like, "Okay.

740

:

Well, here's how we need to balance

everything out now that we're doing this."

741

:

So that opened me up to this.

742

:

I do think, I think it's a spectrum,

and it's something, it's a lot more

743

:

fluid than people, um, realize,

and we already kind of do it.

744

:

It, you know, it's just that

we create the blocks, right?

745

:

We as psychiatrists say,

"No, I'm not open to that.

746

:

You need to talk to your primary care

doctor or this," but, but people are

747

:

always kinda asking for the other.

748

:

They're asking for, "Hey, Doc, can

I walk 'cause I'm really nervous?"

749

:

And that's how I got

into soma- somatization.

750

:

The place for psychedelics, honestly, if

I'm being honest, as an artist, all my

751

:

friends, you know, because as the doctor

friend, I kind of sit in this like line

752

:

of like I can't do the drugs with you.

753

:

But I'm around you when you're doing

the drugs, and, um, because I worked

754

:

with all these psychoanalysts who are

very, you know, they're near retirement,

755

:

so they were very open about their

psychedelic use and how they used

756

:

it in processing trauma and things.

757

:

It really opened me up to the

fact that like a lot of people

758

:

could benefit from that that

integrative experience all at once.

759

:

'Cause that really is you having

a spiritual moment, you're having

760

:

this psychological integration

of the, you know what I mean?

761

:

You're kind of looking and getting

perspective in a different way, and it's

762

:

some- it's doing something physically to

your body the same way a medication could.

763

:

And so that's what opened me up

to like, oh, this could be useful.

764

:

But I, I'm, I lean more towards, you know,

being, working with people in trauma, a

765

:

lot of cannabis, a lot of cannabinoids

and all that stuff has been used, and

766

:

it's very helpful because, you know, I We

know as clinicians sort of the horrible

767

:

things that we can induce in people.

768

:

You wanna sleep, now I'm giving you

a medication that's a sledgehammer,

769

:

and so now you have no choice.

770

:

And as a traumatized person, you

don't wanna choose do I stay awake

771

:

all night or do I have no agency

in what my body is doing, right?

772

:

And if they come to me and say,

"Doc, I just took an edible and that

773

:

was just fine and I slept great and

I woke up feeling good," who am I?

774

:

Who, who am I, you know?

775

:

Um, so I, I've opened myself up to that.

776

:

And so that's what helped

me sort of in cannabis.

777

:

And then the psilocybin really that's

also sort of like a trauma work area

778

:

too because especially in Canada it

became like all my Canadian therapy

779

:

friends were trying to find doctors who

were willing to partner with them to do

780

:

psilocybin assisted sort of like therapy.

781

:

And so I was opened up to that.

782

:

And then, you know, on the West Coast

everyone's microdosing and things,

783

:

and so I was getting more information.

784

:

And it, it is useful.

785

:

Again, of, uh, having all the

experiences all at once, you know?

786

:

Um, TMS I think is, it's useful, but

it is in, it's still in its infancy and

787

:

ta- it's, it's very by nature classist

and racist and you know what I mean?

788

:

Like, who has 40 sessions?

789

:

Who can leave their job for an hour

and commute to go sit down for 15

790

:

minutes and be zapped, you know?

791

:

Mm-hmm.

792

:

Yes, it's helpful.

793

:

We're probably gonna need to be

on a medication if you really

794

:

want any lasting effects.

795

:

We don't really…

796

:

So it's still so early,

but it's very helpful.

797

:

It's…

798

:

And for the people, I've seen people

have benefits to it, but they also

799

:

are people who were set up to succeed.

800

:

They're, they're already, they're tryna,

they're set up for self-actualization

801

:

and they just need something to

really neuromodulate, you know?

802

:

Um, so I haven't seen it be used e-

and I, when I worked at the VA, um,

803

:

it was very, that was a very big push

to, like, get veterans to try TMS.

804

:

But by and large they would have,

like, two weeks of like, "Oh, clarity.

805

:

Like, I feel like I'm balanced.

806

:

Not great, not horrible, just balanced."

807

:

And then ultimately they would

have to be back on medications

808

:

and start the whole cycle again.

809

:

Ketamine is something that I feel

is, that has, is, I feel has the most

810

:

potential, but being in LA, um, I'm a

little bit jaded because it's still…

811

:

Same thing with TMS, you know?

812

:

I don't like anything where you have

to lie about a diagnosis in order to

813

:

qualify to get it paid for, right?

814

:

So people are saying, "We can treat

autism, but we're gonna write it

815

:

down as major depression, you know?"

816

:

Mm-hmm.

817

:

"So that we can get it paid by insurance."

818

:

So that kinda muddies the

water too for me for TMS.

819

:

Um, ketamine the same thing.

820

:

These are cash pay clinics and so

effectively there hasn't, because

821

:

there is no- forced psychotherapeutic

work to process these things as, you

822

:

know, the structural, the structural

changes are happening What ends

823

:

up happening is like this loop.

824

:

I feel like a lot of the ketamine

providers, especially here

825

:

in Cata- California, end up

being drug dealers, you know?

826

:

We're just giving them

ca- keyholes, you know?

827

:

Like I was a raver in, in college, and so

I'm like everyone's walk, walking around

828

:

just a little bit high, and when the

high wears off, they go back, you know?

829

:

And as long as they have

the 500 bucks to pay.

830

:

And so I really do think that

these pla- these, like especially

831

:

psychedelics have a really profound

place in medicine just because we

832

:

can do so much with, so quickly.

833

:

You know what I mean?

834

:

Things that take months and years of

integration, you can do it all in,

835

:

you know, a couple of sessions, right?

836

:

Mm-hmm.

837

:

But it's still very young, and we

need, and it needs to, somehow we

838

:

need to separate, or psychiatrists

need to really push for accuracy in,

839

:

you know, d- diagnosis and uses and

usefulnesses of things because like

840

:

we're messing up our own data, you know?

841

:

Mm.

842

:

We're just making sure that we can

get things paid for by insurance, we

843

:

can get people in the door because

we bought this $3,000 machine.

844

:

We are messing up our own data on what

we're actually treating, what's the use.

845

:

And so I, I fall back on ECT a lot.

846

:

I've talked a lot of people into ECT

because I'm like, "It's tried and true."

847

:

Mm-hmm.

848

:

It is tried and true, and it's not

One Flew Over the Cuckoo's Nest.

849

:

You go to a hospital, anesthesia, you

wake up, gr- you know what I mean?

850

:

So if you're at that point- Mm-hmm

… and you're thinking about investing

851

:

millions of dollars in ketamine,

then you should go ahead and zap your

852

:

brain, you know, in this way, so.

853

:

Yeah.

854

:

Yeah.

855

:

Long-winded, but yes, it is

useful in the early stages.

856

:

I just, it's weird that it's, y- you're

in this gray zone as a psychiatrist

857

:

'cause people do come to you and they

tell you about their drug use, and

858

:

I have to be honest with them, and

I have to like preface it and say

859

:

like, "This is, this is a, this is

off the record," you know what I mean?

860

:

Like, "This is not like a

psychiatric recommendation.

861

:

This is me as a human being, as

a do- human being who has medical

862

:

knowledge saying like, 'Okay, if

you're going to use these drugs,"

863

:

"stay away from these.

864

:

Stay away from these.

865

:

Use this in moderation.

866

:

Maybe use this, this type,

you know, if you're going to."

867

:

Um, so I'm looking forward to a time

where we can openly, you know, talk to

868

:

our patients about these things and not

f- have to worry about is someone gonna

869

:

report me to the board or is someone…

870

:

You know what I mean?

871

:

'Cause it is that gray area.

872

:

Or do it off the books completely and

it's just this cash pay drug dealing

873

:

situation that it feels like it is in LA.

874

:

Mm.

875

:

Mike: Yeah.

876

:

Yeah.

877

:

Yeah.

878

:

Thanks so much for explaining.

879

:

Those are complex dynamics for sure,

and it's- Yeah … in some ways it, it's

880

:

kind of like the proverbial elephant

in the room when it comes to, on the

881

:

one hand, you know, there's a lot of

hype and hyperbole, particularly the

882

:

psychedelic assisted psychotherapy idea.

883

:

Mm-hmm.

884

:

But I think at least Um, at least as you

say, you know, if there can be maybe some,

885

:

some more advocacy for the importance

of the psych- the psychotherapeutic

886

:

integrative piece of it- Yeah … right?

887

:

Because that's critical- Yes … even

though the, the molecules themselves

888

:

obviously have an effect, but it's…

889

:

But yeah, because the more that there

can be an emphasis on with clinical

890

:

treatment guidelines- Mm-hmm … really

underlining the importance of the psych-

891

:

the psychotherapeutic integrative c- Yes

… component, then hopefully that will…

892

:

Just because even though, as you

say, I'm, I also find that the

893

:

mills are distasteful for sure.

894

:

Mm-hmm.

895

:

Um, you can understand why they

come about just because- Yes … you

896

:

know, it's just business as usual.

897

:

Yes.

898

:

But on the other hand, it's like,

you know, because it is driven

899

:

by client demand- Mm-hmm … if

clients have more understanding

900

:

of the importance, like I had this

discussion with a client yesterday.

901

:

Nora: Mm-hmm.

902

:

Mike: Um, and, uh, if, if so, if, if the

consumer has more of an understanding

903

:

about it's buyer beware, if the consumer

has more of an understanding about,

904

:

"Okay, well, yeah, there's this, but I'm

not gonna get a, a, an opportunity to

905

:

explore and do- Mm-hmm … integrative

psychotherapeutic work- Mm-hmm … and

906

:

that's less likely to, you know, not

only help treat symptoms, but- Mm-hmm

907

:

get me to a point where I'm

self-actualized and I have vitality-

908

:

Yes … as opposed to just- Yeah

… not being anxious and depressed-

909

:

Nora: Right

910

:

… Mike: then I'm gonna choose to go to the

clinic where I'm gonna get the- Active

911

:

… integrative psychotherapy as well, right?

912

:

Yeah.

913

:

Nora: Yes.

914

:

Because ultimately they all e-

people get to that point, you know?

915

:

Um, fulfillment is something

that a pill cannot give you.

916

:

It's, it's, it's a place that you…

917

:

And so, uh, yes, I, I take the

same approach that you do, which

918

:

is I just kind of lay it out.

919

:

Like, we can do these things, but

this is the importance of really

920

:

thinking about why you're doing it and

what you're trying to get out of it.

921

:

What do you want different

after you do ketamine?

922

:

Do you wanna do ketamine

for the rest of your life?

923

:

Like, what does it mean, right?

924

:

And so, yeah, we really…

925

:

It's moving that way- forcibly.

926

:

I, I do think that the beauty of

being an integrative thinker, an

927

:

integrative psychiatrist, is that

the world is moving this way.

928

:

Sort of like the layer,

you know what I mean?

929

:

The layers are being shed-

930

:

Mike: Mm

931

:

… Nora: outside, and you

know, outside of our bubble.

932

:

And because of that, and because we

deal with emotion, it is happening here

933

:

too, where the layers are being shed.

934

:

It's no…

935

:

The things that once, once were

conspiracies are no longer conspiracies.

936

:

What is real?

937

:

Well, reality is-

Mm-hmm … what you can make.

938

:

So let's name the reality.

939

:

So that's what gives me sort of the hope

that like, okay, in naming the elephant

940

:

in the room, maybe we can start actually

doing something about it, you know?

941

:

Mike: Mm-hmm.

942

:

Mm-hmm.

943

:

Nora: Yeah, yeah.

944

:

Mike: For sure.

945

:

For sure.

946

:

And one thing I just wanted to actually

put a pin in is something you said earlier

947

:

on just now, which was this idea about

medications definitely have a role, right?

948

:

Mm-hmm.

949

:

Psych- psychiatric medications

definitely have, have a role.

950

:

So I think for people who are watching

and listening- Mm-hmm … if, if, you

951

:

know, f- just like we're, we're…

952

:

I don't, I think, you know, you and I

would agree that we don't wanna throw the

953

:

baby out with the bath water, so to speak-

No … in terms of, you know, encouraging

954

:

people to stop taking medication or- Yeah

955

:

or avoid medication, because

they definitely have a role.

956

:

But as you said earlier as well, like

these are part of what are, what…

957

:

Is, it's exciting because the

toolkit is expanding, right?

958

:

Mm-hmm.

959

:

So the toolkit is expanding.

960

:

Yeah.

961

:

And it doesn't necessarily need to

be like you were saying, a siloed

962

:

approach where, "Oh, I only prescribe

X, Y, Zed medication," or- Mm-hmm

963

:

"I only do X, Y, Zed psychotherapy."

964

:

Of course you're gonna have areas

where you feel more competent

965

:

and you're more interested-

Yeah … and that's totally fine.

966

:

But at least to have some awareness,

like, "Okay, well, if, if I'm not familiar

967

:

with, or I don't have the training in,

in like a neurostimulation technique,

968

:

then I know where to refer you on to."

969

:

Yeah.

970

:

But at least to have this

toolkit that is expanding.

971

:

And so there are

neurostimulation as you say.

972

:

Mm-hmm.

973

:

TMS for sure, it's out of reach

for the majority of folks.

974

:

Absolutely.

975

:

And that's a big problem.

976

:

Um, but maybe other, other…

977

:

You know, if, if the depression's

not as severe, maybe tDCS and- Yeah

978

:

something that's a bit more, um,

you know, accessible for people.

979

:

Accessible.

980

:

And then on the psychedelic assessment,

psychedelic, sorry, integrative

981

:

psychotherapy side, yeah, harm

reduction approach for sure, right?

982

:

So- Mm.

983

:

And then how do clinicians sort of

navigate those concerns around, oh,

984

:

you know, it's a gray market kind

of thing, and I actually give this

985

:

advice, how do I do it kind of like,

you know, on the DL sort of thing?

986

:

Yeah.

987

:

And so it's, it's really, it's

interesting for sure, right?

988

:

It's, uh, it's- Yeah … it makes, it

makes, makes the job challenging but

989

:

also exciting at the same time, right?

990

:

Nora: Yes.

991

:

And you know, uh, it's, it's really,

and that's what makes it fun.

992

:

You know, like, uh, you know, I

feel like as psychiatrists, it, we

993

:

live on the frontier of medicine.

994

:

You know what I mean?

995

:

There's not a lot of, the, of course like

hardware and things get, you know, um,

996

:

improve in other aspects of medicine.

997

:

There's new drugs and things,

but we always live on that, like,

998

:

that edge of the human frontier.

999

:

What is next?

:

00:49:21,947 --> 00:49:22,367

What does…

:

00:49:22,407 --> 00:49:26,337

You know, like, we feel and

we, we help people navigate

:

00:49:26,387 --> 00:49:28,567

the changes of society, right?

:

00:49:28,937 --> 00:49:31,587

And I agree, like, medicine is a tool.

:

00:49:31,777 --> 00:49:37,377

And I, and the thing is it's a tool that

makes life so much easier, you know?

:

00:49:37,597 --> 00:49:38,877

If used correctly.

:

00:49:38,877 --> 00:49:42,057

Like, I have to remind people,

it's like, yes, you will get there.

:

00:49:42,067 --> 00:49:46,067

We will get there just talking

about it and feeling the pain and

:

00:49:46,067 --> 00:49:47,327

journaling and all that stuff.

:

00:49:47,497 --> 00:49:53,227

It'll happen, but man, it can happen

a lot faster if you just slept or

:

00:49:53,267 --> 00:49:57,287

ate, or you weren't manic or cycling

or whatever, or hearing voices.

:

00:49:57,287 --> 00:49:57,657

You know?

:

00:49:57,657 --> 00:50:00,407

Like- Mm-hmm … life

can be so much easier.

:

00:50:00,407 --> 00:50:04,067

And we have that tool that

no one else has, you know?

:

00:50:04,077 --> 00:50:04,267

Mm-hmm.

:

00:50:04,267 --> 00:50:08,397

So it's, I try to, like, remind

myself of that, and that's

:

00:50:08,397 --> 00:50:09,757

what gives me the excitement.

:

00:50:09,757 --> 00:50:13,877

I may not like what's going on now, but

I can be part of the change by naming,

:

00:50:13,937 --> 00:50:15,947

naming it and steering the narrative.

:

00:50:15,957 --> 00:50:16,777

So yeah.

:

00:50:16,887 --> 00:50:17,167

Yeah.

:

00:50:17,277 --> 00:50:17,597

Mike: Mm-hmm.

:

00:50:18,017 --> 00:50:21,847

One of the things that struck me as well

is when, when, when you're talking about

:

00:50:21,907 --> 00:50:25,797

the, you know, some of your thoughts

on psychedelic-assisted psychotherapy,

:

00:50:26,177 --> 00:50:29,637

it made me really 'Cause I've become

really interested in that, and I've

:

00:50:29,637 --> 00:50:33,317

done workshops and retreats and, and-

Same … tried to train myself to, to

:

00:50:33,317 --> 00:50:35,487

get a, a better familiarity with it.

:

00:50:35,497 --> 00:50:35,827

Mm-hmm.

:

00:50:36,007 --> 00:50:39,477

Um, and one of the, one of the common

threads, and oh, I know, it was when you

:

00:50:39,477 --> 00:50:42,927

talked about how the plant medicines,

the traditional plant medicines, you

:

00:50:42,927 --> 00:50:45,787

know, and the interesting role that they

have and, and the appropriate role that

:

00:50:45,787 --> 00:50:50,067

they have and is, is the common thread

that I've noticed and I think is really

:

00:50:50,167 --> 00:50:56,837

crucial is this idea of, of the sacred

nature of, of the, of, of the whole

:

00:50:56,977 --> 00:50:58,727

practice, I suppose you would say, right?

:

00:50:58,737 --> 00:51:04,397

And so how, how the sacred, how the, how

there's a real importance to recognizing

:

00:51:04,417 --> 00:51:08,657

and fostering that, that sacred nature

of, of the, of, of, I guess, what

:

00:51:08,657 --> 00:51:11,027

would you say, the therapeutic process.

:

00:51:11,277 --> 00:51:11,717

Yes.

:

00:51:11,717 --> 00:51:18,107

And, um, and how that allows for this,

this inner, this sort of like innate

:

00:51:18,107 --> 00:51:22,667

inner healer to sort of be able to kind of

like work, work in the background, right?

:

00:51:22,667 --> 00:51:25,947

Or, or, or be allowed to

sort of flourish where the…

:

00:51:26,037 --> 00:51:30,697

That's, I think, really been missing

in, in sort of more contemporary legacy

:

00:51:30,727 --> 00:51:34,437

mental health- Yes … psychiatric

kind of training and practice, right?

:

00:51:34,847 --> 00:51:35,687

Nora: Mm, yes.

:

00:51:36,007 --> 00:51:41,177

And, and that was the role of the

psychologist is really fostering the,

:

00:51:41,247 --> 00:51:46,787

the importance of like the s- the

sacredness of the therapeutic bond.

:

00:51:46,857 --> 00:51:47,807

It's so sacred.

:

00:51:47,817 --> 00:51:47,827

Mm.

:

00:51:48,067 --> 00:51:52,557

And so in feeding that initially and

naming it and make- and keep- and

:

00:51:52,557 --> 00:51:55,587

feeding, tha- and that's where the

love comes in that you talk about.

:

00:51:55,907 --> 00:52:01,117

You know, you have to show

love to keep something pure

:

00:52:01,317 --> 00:52:04,147

and, you know, honest and open.

:

00:52:04,397 --> 00:52:07,117

Um, and that's where

the healing takes place.

:

00:52:07,117 --> 00:52:12,287

And you don't have to do anything but come

and, and name, name the specialness of it.

:

00:52:12,597 --> 00:52:14,337

And that's why a lot of people…

:

00:52:14,457 --> 00:52:19,777

So the shift during the pandemic to

telemedicine, it really also harmed

:

00:52:19,787 --> 00:52:24,977

psychiatrists too because even if

you had a psychiatrist who, you

:

00:52:24,977 --> 00:52:27,817

know, just gave you 10 minutes and

refilled your meds and never asked

:

00:52:27,817 --> 00:52:31,077

you questions or anything, there was

something about them giving you space.

:

00:52:31,847 --> 00:52:32,107

Mm.

:

00:52:32,427 --> 00:52:33,017

Physical space.

:

00:52:33,821 --> 00:52:36,861

You know, opening the door,

fixing the couch, making

:

00:52:36,861 --> 00:52:38,031

sure that you're comfortable.

:

00:52:38,281 --> 00:52:43,071

Those little micro, you know, movements,

moments, you know, those are the

:

00:52:43,071 --> 00:52:46,941

things that create that therapeutic

bond of like we care, you know?

:

00:52:47,241 --> 00:52:51,971

Um, so the pandemic kind of put

a hard stop to that where like

:

00:52:51,971 --> 00:52:56,061

we're doing this over a screen

with people and we're emotionally,

:

00:52:56,211 --> 00:52:58,691

you know, distant and not attuned.

:

00:52:58,711 --> 00:53:01,201

And so it's like, what, what is it?

:

00:53:01,391 --> 00:53:05,011

You know, then people are seeking answers

for some, from everyone, and that's

:

00:53:05,011 --> 00:53:08,131

when you get patients who are like,

"Well, you know, Joe Schmoe down the

:

00:53:08,131 --> 00:53:11,561

street, the life coach, said I should

do this," and that, you know, because

:

00:53:12,001 --> 00:53:15,131

Joe Schmoe gave them the sacred space-

:

00:53:15,711 --> 00:53:16,041

Hmm

:

00:53:16,361 --> 00:53:20,111

… process to think, to dream, to worry.

:

00:53:20,141 --> 00:53:21,691

You know, whatever it may be.

:

00:53:22,221 --> 00:53:24,751

So we do need to get back to that.

:

00:53:24,911 --> 00:53:28,701

But that's a healing that,

I don't know, I, I also…

:

00:53:28,911 --> 00:53:33,091

I think because I was forced to, to be

in therapy to initiate my therapeutic

:

00:53:33,091 --> 00:53:36,961

journey, like it was a crisis that

initiated my own therapeutic journey,

:

00:53:37,381 --> 00:53:41,811

I have a different perspective because

I understand why there is such a

:

00:53:41,811 --> 00:53:45,311

disconnect if you've never been

forced to be vulnerable in therapy.

:

00:53:45,311 --> 00:53:50,541

If you never had to be a patient

at a time where you weren't

:

00:53:50,551 --> 00:53:51,871

see- like you weren't Dr.

:

00:53:51,871 --> 00:53:53,331

So-and-So, you know?

:

00:53:53,341 --> 00:53:53,361

Mm-hmm.

:

00:53:53,371 --> 00:53:55,371

Because there is like a, a, a big shift.

:

00:53:55,371 --> 00:53:58,471

Once you become a physician, people

treat you differently no matter what.

:

00:53:58,711 --> 00:54:03,951

But before then, if you've never had

a therapeutic interaction, um, as the,

:

00:54:04,031 --> 00:54:08,791

as a patient, not a physician, you, you

don't really get the importance of it.

:

00:54:08,811 --> 00:54:11,721

We have micro moments of it,

but it's mostly image-based.

:

00:54:11,721 --> 00:54:14,321

You know, when I go to my doctor

I'm like, "You're my colleague, but

:

00:54:14,321 --> 00:54:19,481

also my doctor, and I don't know

how much to share because I'm gonna

:

00:54:19,481 --> 00:54:21,171

see you professionally," you know?

:

00:54:21,171 --> 00:54:21,921

Mm-hmm.

:

00:54:21,921 --> 00:54:24,641

Um, so I think that's also something.

:

00:54:24,641 --> 00:54:30,491

So like I, I really do push for, you

know, psych residencies to have, like

:

00:54:30,521 --> 00:54:33,001

to make people ha- like we have therapy.

:

00:54:33,021 --> 00:54:33,921

We need to have therapy.

:

00:54:33,931 --> 00:54:33,951

Mm-hmm.

:

00:54:33,961 --> 00:54:37,671

You can't be a good therapist if you

never actually sat in the seat and had

:

00:54:37,671 --> 00:54:41,561

to be vulnerable and know like, "Oh my

God, this is what it feels like to have

:

00:54:41,561 --> 00:54:45,081

this trigger, to have this response,

this automatic response," you know?

:

00:54:45,481 --> 00:54:47,001

Um, yeah.

:

00:54:47,111 --> 00:54:50,261

So I was lucky enough to have that in

residency, and that was the blessing

:

00:54:50,301 --> 00:54:55,281

of, you know, Kansas City's, my time

there, is that I did have a really

:

00:54:55,291 --> 00:55:01,391

phenomenal education as a basis

that expanded, you know, over time

:

00:55:01,471 --> 00:55:03,101

with just different environments.

:

00:55:03,131 --> 00:55:03,541

Yeah.

:

00:55:04,241 --> 00:55:05,201

Mike: Mm-hmm.

:

00:55:05,211 --> 00:55:08,361

Yeah, it's cool to hear about the

experience i- in- that you had in Kansas

:

00:55:08,361 --> 00:55:12,181

City 'cause it reminds me, I mean, I don't

know, maybe I'm projecting, but when,

:

00:55:12,231 --> 00:55:15,561

when I got matched it was to, I grew up

in Vancouver on the west coast and I got

:

00:55:15,581 --> 00:55:17,561

matched to Halifax on the east coast and-

:

00:55:17,561 --> 00:55:17,881

Nora: Mm-hmm

:

00:55:17,881 --> 00:55:20,801

… Mike: I was excited, but I was also

not too sure about what to expect.

:

00:55:20,841 --> 00:55:22,011

It's a smaller town-

Yeah … this and that.

:

00:55:22,321 --> 00:55:25,231

But it really was a blessing in

disguise 'cause you got exposed to

:

00:55:25,551 --> 00:55:27,821

a whole really awesome community of-

:

00:55:27,901 --> 00:55:28,251

Nora: Mm-hmm

:

00:55:28,251 --> 00:55:31,731

… Mike: clinicians, from psychologists

to psychiatrists to social workers

:

00:55:31,731 --> 00:55:34,881

to everyone, nurses and everyone was

just, it was just an awesome team.

:

00:55:34,891 --> 00:55:34,911

Yeah.

:

00:55:35,211 --> 00:55:38,121

So it sounds like maybe you had a

similar kind of experience there- Yeah

:

00:55:38,401 --> 00:55:38,961

in Kansas City.

:

00:55:39,281 --> 00:55:39,751

Nora: Yes.

:

00:55:40,021 --> 00:55:42,021

Same thing with like,

you know, medical school.

:

00:55:42,021 --> 00:55:45,471

I went to medical school in Blacksburg,

Virginia, so in the Appalachian Mountains,

:

00:55:45,471 --> 00:55:47,071

in the heart of the Appalachian Mountains.

:

00:55:47,231 --> 00:55:49,671

And honestly, I just chose my medical

school 'cause I like, it was pretty.

:

00:55:49,901 --> 00:55:57,181

Um, and, but those, because it was like

away from everything and e- everyone there

:

00:55:57,181 --> 00:56:00,951

was genuinely there as a healer, you know?

:

00:56:00,951 --> 00:56:00,991

Mm-hmm.

:

00:56:00,991 --> 00:56:04,271

And being, being a healer taught

by other healers is very different

:

00:56:04,271 --> 00:56:07,761

from someone who's just doing,

working, going through the motions.

:

00:56:07,771 --> 00:56:11,331

They will tell you how to be

productive, but my, I don't, I don't

:

00:56:11,331 --> 00:56:12,561

wanna learn how to be productive.

:

00:56:12,561 --> 00:56:13,391

I can be productive.

:

00:56:13,421 --> 00:56:18,121

That's, that's what pre-medical

school is, is just like h-

:

00:56:18,121 --> 00:56:19,361

can you deal with intensity?

:

00:56:19,361 --> 00:56:20,601

Yes, I can deal with intensity.

:

00:56:20,681 --> 00:56:26,361

I need to learn how to blend

that intensity and that knowledge

:

00:56:26,361 --> 00:56:29,921

and my nerdiness with like what

makes people human quickly.

:

00:56:30,131 --> 00:56:30,711

You know what I mean?

:

00:56:30,711 --> 00:56:36,045

Like- Mm-hmm That's the skill that

I'm, I'm trying, like I'm growing,

:

00:56:36,115 --> 00:56:42,435

is like how can I be the best

psychiatrist naturally and quickly?

:

00:56:42,445 --> 00:56:43,375

Like I just…

:

00:56:43,505 --> 00:56:45,225

And it, and it should

come in and come out.

:

00:56:45,225 --> 00:56:46,045

It's part of me.

:

00:56:46,055 --> 00:56:46,815

It is me.

:

00:56:46,815 --> 00:56:49,395

It's not something that I want

to hide anymore, you know?

:

00:56:49,725 --> 00:56:51,085

So, um, yeah.

:

00:56:51,785 --> 00:56:52,505

Mike: Yeah, for sure.

:

00:56:52,775 --> 00:56:54,455

I'm also respectful of your time.

:

00:56:54,465 --> 00:56:54,485

Yeah.

:

00:56:54,485 --> 00:56:56,505

Are you okay for another 10 minutes or so?

:

00:56:56,565 --> 00:56:57,195

Nora: Yes, yes, yes.

:

00:56:57,195 --> 00:56:58,455

We can do another five minutes.

:

00:56:58,555 --> 00:56:58,695

Okay.

:

00:56:58,695 --> 00:56:59,055

Then I'll go pick up

:

00:56:59,175 --> 00:56:59,325

Mike: my kid.

:

00:56:59,325 --> 00:56:59,645

Five, five minutes.

:

00:56:59,995 --> 00:57:00,295

Yeah.

:

00:57:00,305 --> 00:57:00,955

Okay, five minutes.

:

00:57:01,005 --> 00:57:01,905

Yeah, that, that's really…

:

00:57:01,955 --> 00:57:02,485

That's cool.

:

00:57:02,495 --> 00:57:03,925

We'll wrap up in, in a sec here.

:

00:57:03,925 --> 00:57:05,115

Such a great conversation.

:

00:57:05,585 --> 00:57:07,055

Um- Yeah … 100%.

:

00:57:07,145 --> 00:57:10,005

I mean, I've, I've been in therapy

myself, so it resonates for sure what

:

00:57:10,005 --> 00:57:13,545

you're saying about coming to terms

with various different experiences

:

00:57:13,555 --> 00:57:17,665

that a, a caregiver or clinician has

had, and just understanding that the

:

00:57:17,665 --> 00:57:21,795

more one understands about one's own

challenges, then we can translate that

:

00:57:21,795 --> 00:57:27,355

into, you know, perhaps- being in a

situation where we can really truly

:

00:57:27,355 --> 00:57:29,125

be empathetic towards someone, right?

:

00:57:29,125 --> 00:57:32,115

And, and share in that, in

that sacred space as you say.

:

00:57:32,455 --> 00:57:36,185

Maybe to wrap up, we can talk a little

bit about then, so this concept of

:

00:57:36,185 --> 00:57:39,155

self-actualization and seeking vitality.

:

00:57:39,445 --> 00:57:43,235

You know- Mm … w- w- maybe you can

just help us to explain, so where, where

:

00:57:43,235 --> 00:57:47,915

have you landed in terms of how you're

trying to bring your, you know, wisdom

:

00:57:47,915 --> 00:57:52,325

and your knowledge and your passion into

that, that combination of, of, of medical

:

00:57:52,325 --> 00:57:56,445

psychiatric practice with your artistic

work in order to help people flourish?

:

00:57:56,905 --> 00:57:57,435

Nora: Yes.

:

00:57:57,675 --> 00:58:04,005

Something that became very clear to me

moving through my career is that high

:

00:58:04,005 --> 00:58:08,595

achievers, you know, the medical model

as we have it right now does not, does

:

00:58:08,595 --> 00:58:13,535

not, you know, uh, for, for mental

health, does not serve high achievers.

:

00:58:13,585 --> 00:58:16,355

Because the medical model

just looks for stability.

:

00:58:16,385 --> 00:58:19,495

You know, are you, are you a danger

to yourself or others, right?

:

00:58:19,685 --> 00:58:21,705

And are you getting somewhat better?

:

00:58:21,995 --> 00:58:24,425

The, the goal is some sort of growth.

:

00:58:24,445 --> 00:58:28,105

It's not, you know, the growth

that you want in particular.

:

00:58:28,365 --> 00:58:33,605

And so I was finding these people

saying, "My life on paper looks good,

:

00:58:34,225 --> 00:58:36,495

but I don't have joy or meaning.

:

00:58:36,515 --> 00:58:40,275

I don't know why I'm doing the

things that I'm, I'm doing."

:

00:58:40,535 --> 00:58:46,555

These sor- sort of, like, existential,

you know, existential questions,

:

00:58:46,925 --> 00:58:51,945

and I had to, the, to put a name to

it was like, oh, okay, you need to

:

00:58:51,945 --> 00:58:53,865

integrate in order to self-actualize.

:

00:58:53,865 --> 00:58:57,995

You need to be able to, you know, we

need to separate your productivity and

:

00:58:57,995 --> 00:59:04,785

what you look like, you know, on 2D

with how you're feeling 3D, you know?

:

00:59:04,985 --> 00:59:10,465

Um, and so my, that has been, I saw there

was a need for it, and it's something

:

00:59:10,465 --> 00:59:15,545

that I've also sort of needed, a need,

I needed to have those discussions.

:

00:59:15,745 --> 00:59:18,145

These are discussions I wish

I had with my psychiatrist.

:

00:59:18,455 --> 00:59:20,575

These are discussions I wish

I had with my own therapist.

:

00:59:20,575 --> 00:59:22,025

Like, why are we here?

:

00:59:22,185 --> 00:59:24,795

What is the meaning, you know, of it all?

:

00:59:24,935 --> 00:59:28,185

Um, what gives me purpose,

uh, besides paying bills?

:

00:59:28,195 --> 00:59:29,015

I can pay my bills.

:

00:59:29,015 --> 00:59:31,425

Everything is good on paper, you know?

:

00:59:31,655 --> 00:59:38,363

And so- That's how I was inspired, and

what I try to do is meet people, and what

:

00:59:38,363 --> 00:59:45,013

we all should be doing is meeting people

where they are, like, ready to expand.

:

00:59:45,043 --> 00:59:48,773

My own art, I use it, like, it,

because it was my healing, I use it

:

00:59:48,773 --> 00:59:50,653

as an example, so I will show people.

:

00:59:50,653 --> 00:59:54,903

Like, like I, I wrote a book 'cause

my therapist actually told me to.

:

00:59:55,383 --> 00:59:57,053

You know, she was like, "You're writing."

:

00:59:57,333 --> 01:00:00,963

We needed to proc- I needed to

process a specific trauma, and

:

01:00:00,963 --> 01:00:02,883

so I wrote it as a chapbook.

:

01:00:02,963 --> 01:00:06,463

And for my own self-esteem, I

submitted it to see if it w- if it

:

01:00:06,473 --> 01:00:09,813

would garner any sort of, like, award.

:

01:00:10,053 --> 01:00:12,643

Is it good enough in other people's eyes?

:

01:00:12,943 --> 01:00:19,563

So I try to guide people through

their own sense of meaning outside

:

01:00:19,563 --> 01:00:25,753

of productivity, outside of, you

know, sort of like the social things.

:

01:00:25,793 --> 01:00:29,953

I mean, like, kind of think about how many

psychiatrists you know, how many physician

:

01:00:29,953 --> 01:00:36,313

friends you know who have perfect lives

but are unsatisfied and alcoholics.

:

01:00:36,313 --> 01:00:36,753

You know?

:

01:00:36,843 --> 01:00:40,323

Cheating with the nurse at the hospital

because they needed a rush, right?

:

01:00:40,323 --> 01:00:41,043

They're chasing dopamine.

:

01:00:41,043 --> 01:00:48,403

Um, and so yes, my, I try to get people

to the place where they can feel free

:

01:00:48,423 --> 01:00:55,073

to be vulnerable and not have to sort of

keep on the image, because they're slowly

:

01:00:55,113 --> 01:00:57,313

just decaying from the inside, you know?

:

01:00:57,533 --> 01:00:58,333

Um- Mm-hmm

:

01:00:58,713 --> 01:01:01,103

I don't know if that answered your

question particularly, but yes.

:

01:01:01,193 --> 01:01:01,643

Mm-hmm.

:

01:01:02,271 --> 01:01:03,251

Mike: 100%, yeah.

:

01:01:03,291 --> 01:01:04,001

It really did.

:

01:01:04,031 --> 01:01:07,421

And, um, really interested

to, to hear about your book.

:

01:01:07,481 --> 01:01:12,231

Is that something that, um, people can,

can, you know, go pick up a copy of?

:

01:01:12,401 --> 01:01:14,811

Or what, how- Yes, yes … what's

the … Oh, that's fantastic.

:

01:01:14,811 --> 01:01:17,161

So we'll, maybe can you just

show it to us in the screen here?

:

01:01:17,621 --> 01:01:17,671

Yes, yes, yes.

:

01:01:17,671 --> 01:01:18,831

So this- I'll put links in the show notes

:

01:01:19,121 --> 01:01:21,111

… Nora: yes, Swallowed Words.

:

01:01:21,501 --> 01:01:30,011

Um, so this is a chapbook, uh, that I

rote in, and I released it in:

:

01:01:30,021 --> 01:01:31,491

Yes,:

:

01:01:31,821 --> 01:01:35,071

Um, so like I said, I was pro-

at that time I was processing

:

01:01:35,101 --> 01:01:37,131

sort of my maternal trauma.

:

01:01:37,201 --> 01:01:41,851

Um, my mom being my primary caregiver

was also the most, like, emotionally

:

01:01:41,851 --> 01:01:47,621

and physically abusive to me, and so

this was my sort of processing that.

:

01:01:47,661 --> 01:01:51,941

And like I said, you know, um, I

thought, "Okay, let me just see if other

:

01:01:51,941 --> 01:01:54,581

people would want to read," you know?

:

01:01:54,621 --> 01:01:55,631

And it did resonate.

:

01:01:55,661 --> 01:01:57,721

And so, and the- Mm-hmm … and

it builds on that, too.

:

01:01:58,211 --> 01:02:01,401

Um, but yeah, so that, that

was part of my healing.

:

01:02:01,401 --> 01:02:01,651

Mm-hmm.

:

01:02:01,651 --> 01:02:02,881

Mike: Mm-hmm, mm.

:

01:02:02,891 --> 01:02:04,131

Thanks so much for sharing that.

:

01:02:04,181 --> 01:02:06,711

And so yeah, we'll put, we'll

put links in the show notes

:

01:02:06,711 --> 01:02:08,291

to where people can, uh- Yeah

:

01:02:08,291 --> 01:02:09,411

find Dr.

:

01:02:09,451 --> 01:02:13,641

Ekeanya's book, and any other aspects

of content in her clinic, anything else

:

01:02:13,641 --> 01:02:14,871

that- Mm-hmm … you know, is there.

:

01:02:14,871 --> 01:02:17,341

I'd really encourage you

all to just check that out.

:

01:02:17,381 --> 01:02:19,381

It's gonna be really

helpful and inspiring.

:

01:02:19,701 --> 01:02:20,851

Um, Dr.

:

01:02:20,871 --> 01:02:25,571

Nora Nneka Ekeanya- Yeah … thank

you so much for talking to me today.

:

01:02:25,591 --> 01:02:26,921

It was just lovely.

:

01:02:26,951 --> 01:02:31,051

Um- Thank you … just so glad to have

met you, and it was such a powerful

:

01:02:31,051 --> 01:02:32,831

and deeply thoughtful conversation.

:

01:02:33,251 --> 01:02:37,351

Um, you know, what really stood out to

me is that mental health care doesn't

:

01:02:37,411 --> 01:02:39,101

end with symptom reduction, right?

:

01:02:39,101 --> 01:02:41,091

It actually in some ways

begins there, right?

:

01:02:41,091 --> 01:02:41,184

Mm-hmm.

:

01:02:41,184 --> 01:02:44,621

And the, the real, the real

work that we explored today

:

01:02:44,621 --> 01:02:46,671

lies in this integration, right?

:

01:02:46,701 --> 01:02:52,391

Identity, meaning, creativity, the

sacred, love, you know, and, you know,

:

01:02:52,401 --> 01:02:56,041

bringing together the biological with the

psychological and the spiritual, right?

:

01:02:56,041 --> 01:02:58,961

So, um- Yes … so thanks

so much once again.

:

01:02:58,961 --> 01:03:03,221

Just really, really, like, yeah,

appreciated the conversation, and

:

01:03:03,231 --> 01:03:04,841

hopefully we can do this again sometime.

:

01:03:05,261 --> 01:03:05,731

Nora: Yes.

:

01:03:05,771 --> 01:03:07,071

I'm looking forward to doing it again.

:

01:03:07,071 --> 01:03:11,081

I, I really appreciated the time and

the space, and, and the platform.

:

01:03:11,081 --> 01:03:12,251

Thank you so much.

:

01:03:13,231 --> 01:03:13,671

Mike: That's great.

:

01:03:13,671 --> 01:03:14,481

Okay, thanks again.

:

01:03:14,481 --> 01:03:14,881

Take care.

:

01:03:14,881 --> 01:03:15,461

All the best.

:

01:03:15,861 --> 01:03:16,191

Nora: You too.

:

01:03:16,471 --> 01:03:16,581

Mike: Okay.

:

01:03:16,581 --> 01:03:17,131

Nora: Bye.

:

01:03:17,161 --> 01:03:17,411

Mike: Okay.

:

01:03:17,731 --> 01:03:18,011

Bye-bye.

:

01:03:18,071 --> 01:03:18,281

Bye.

:

01:03:18,501 --> 01:03:18,821

Bye.

:

01:03:18,901 --> 01:03:19,461

Thanks, Nora.

:

01:03:20,324 --> 01:03:23,424

Thank you so much for joining us

today on the Neurostimulation Podcast.

:

01:03:23,724 --> 01:03:26,884

I hope that you enjoyed this

exploration into the fascinating world

:

01:03:26,894 --> 01:03:31,184

of mental health and neuroscience and

neurostimulation as much as I did.

:

01:03:31,714 --> 01:03:34,724

If you found today's episode

interesting, don't forget to like

:

01:03:34,744 --> 01:03:36,384

and subscribe to the podcast.

:

01:03:36,654 --> 01:03:40,274

It's the best way to make sure that you

never miss an episode, and it also helps

:

01:03:40,274 --> 01:03:42,444

us to reach more curious minds like yours.

:

01:03:42,984 --> 01:03:45,604

Also, if you think that today's

episode might resonate with a

:

01:03:45,614 --> 01:03:49,084

friend, a family member, or a

colleague, please share it with them.

:

01:03:49,384 --> 01:03:52,424

Knowledge is better when it's shared,

and you never know who might find

:

01:03:52,434 --> 01:03:55,244

this information helpful or inspiring.

:

01:03:55,984 --> 01:03:57,714

For more details about Dr.

:

01:03:57,754 --> 01:04:03,044

Ekeanya's work and all the aspects of

the psychiatric care, mental health

:

01:04:03,044 --> 01:04:06,184

care, and the technology that we

discussed today, please check out

:

01:04:06,184 --> 01:04:07,744

the links in the show notes below.

:

01:04:08,004 --> 01:04:11,584

You'll find everything that you need

to dive deeper into the topic, and I'd

:

01:04:11,584 --> 01:04:14,994

love to hear your thoughts, so please

join the conversation in the comment

:

01:04:15,004 --> 01:04:17,104

section or reach out on social media.

:

01:04:17,504 --> 01:04:21,104

Your questions, ideas, and

feedback make this podcast better.

:

01:04:21,714 --> 01:04:23,934

Finally, don't forget to

tune into the next episode.

:

01:04:23,944 --> 01:04:27,494

It's going to be another exciting journey

into the cutting edge of neuroscience.

:

01:04:27,804 --> 01:04:28,904

Thanks again for listening.

:

01:04:29,154 --> 01:04:33,764

Take care, stay curious, and I'll see you

next time on the Neurostimulation Podcast

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About the Podcast

The Neurostimulation Podcast
Exploring the frontier of interventional mental health.
Welcome to The Neurostimulation Podcast — a deep dive into the expanding frontier of interventional mental health.

Hosted by Dr. Michael Passmore, a psychiatrist specializing in neurostimulation and geriatric mental health, this show explores how cutting-edge interventions — from non-invasive brain stimulation (TMS, tDCS, and beyond) to ketamine-assisted psychotherapy — are reshaping the landscape of modern psychiatry and neuroscience.

Each episode bridges science, clinical experience, and human insight, featuring thought leaders and innovators who are redefining how we understand and treat the mind.

Whether you’re a clinician, researcher, student, or simply fascinated by the brain, you’ll discover practical knowledge, fresh ideas, and inspiring conversations that illuminate the evolving art and science of mental health care.

Subscribe for episodes that stimulate your mind, deepen your understanding, and connect you to the future of brain-based healing.

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About your host

Profile picture for Michael Passmore

Michael Passmore

Dr. Michael Passmore is a psychiatrist based in Vancouver, BC, with expertise in non-invasive neurostimulation therapies, geriatric mental health and ketamine-assisted psychotherapy. Having completed specialized training in multiple neurostimulation modalities, including electroconvulsive therapy at Duke University and transcranial magnetic stimulation at Harvard University, Dr. Passmore brings a robust clinical and academic background to his practice. Formerly the head of the neurostimulation program in the department of Psychiatry at Providence Health Care, Dr. Passmore now serves as a clinical associate professor at the University of British Columbia’s Department of Psychiatry. At Sea to Sky NeuroClinic (seatoskyneuro.clinic), Dr. Passmore offers interventional mental health treatments tailored to clients across Canada.​