Episode #59

Laura Dawn: It’s always this funny moment when I hit record and we’ve already been talking and I’m like, hi, 

Dr. Erica Zelfand: hi Erica. it’s like, it just feels like unnatural in 

Laura Dawn: that way. I just had this moment of like, how do we wanna start? Hi. So nice to see you. Thanks for coming onto the 

Dr. Erica Zelfand: show. oh, hello. I didn’t hear you walk in.

Dr. Erica Zelfand: um, thanks for having me, Laura. 

Laura Dawn: Yeah, I really appreciate your time. I’ve been really looking forward to this conversation and been tracking some of the work that you’ve been doing in the space. And I think for listeners who aren’t familiar with you and your background, and I’m also curious to hear too, a little bit of your professional background, especially coming from the medical side of things.

Laura Dawn: And when you started blending that and veering off as well into the path of, of incorporating psychedelics and microdosing into the work that you’re doing with people. 

Dr. Erica Zelfand: Sure. Well, I’ll say that my, my path, even to becoming a physician was somewhat of an unusual one in the sense that I, I realized as I was thinking about doing a career in medicine, that conventional medicine was really good at treating acute things at handling crises at really pulling heroics, but where it was maybe falling short was in the management of chronic illness, like autoimmune diseases, um, and mental health as well.

Dr. Erica Zelfand: And so I actually chose to go to apathic medical school. There were only five in the country. Um, and in my medical training, I was really, really taught to look at the whole person. And I was really taught to understand. There really isn’t much of a separation between what’s happening in the body and what’s happening in the emotional body what’s happening in the mind.

Dr. Erica Zelfand: Um, and that when you bring all of that together, you have a synergism and you have a person. So I was no stranger to understanding that how a person thinks and how they feel is gonna affect their physical health. And when I opened my medical practice, I opened as just a general family primary care clinic.

Dr. Erica Zelfand: I had an interdisciplinary clinic with acupuncturists and massage therapists, chiropractors, and a medical doctors as well. I quickly realized that a lot of my patients had depression and anxiety. And, you know, there’s this thing that we, we have all these memes about, about like the moms who are like barely holding it together.

Dr. Erica Zelfand: And then after their kids go to sleep, they drink half a bottle of wine. And then they joke about how much wine they drink. And I realized, I think we can be doing better. And I had a wonderful arsenal of tools in my toolkit cause I had conventional pharmaceutical medications plus herbal medications, nutritional supplements, homeopathic remedies, et cetera, et cetera.

Dr. Erica Zelfand: But I also realized that I wasn’t able to access an even deeper level, which was the level of the spirit and that I needed a better tool to help people do that. And I wasn’t about to go close my practice and go live in the jungle and prove for three years to become a shaman. You know, it just, that just wasn’t in the cards for me.

Dr. Erica Zelfand: Um, and so I was like, how, how can I help people heal on this level? And as it turns out, there’s a wonderful toolkit for that. And it’s in the psychedelic realm. It’s not the only way to do that. Of course. Um, but it sure is like a. Super highway for it. So, um, what started out as an academic interest then became really a big focus of what I counsel people on now and what I educate other healthcare providers and medical systems on, which is how we can integrate these medicines into the medical model, into our culture, um, and that they do have a place in healing.

Dr. Erica Zelfand: Hmm. 

Laura Dawn: And on your path towards becoming a physician, were you already having personal experiences with psychedelics or was it more that you were doing research and seeing things start popping up about depression and psychedelics that caught your attention and did that lead you towards starting to explore these substances on a personal level?

Dr. Erica Zelfand: It was a little bit of both. I felt like there were these two parallel processes happening where one, I. A relatively new business owner in, in private practice. And I, and I wanna emphasize private practice. I was not part of a big hospital. You know, I was not part of an HMO or a group practice. So there weren’t rules on how I had to do things, which was one of the reasons I chose to practice on my own, but I had all these patients coming in and I just felt like I, I, first of all, I was shocked at how many of them had mental, emotional imbalances.

Dr. Erica Zelfand: How many of them I felt like were walking around with their souls, kicking and screaming inside of their bodies. And I think homeopathy can help those people. I’m just gonna admit I’m not, I’m not a super strong homeopath. So there was that happening where I just felt like I needed something to help these people.

Dr. Erica Zelfand: And then the flip side of that was I was on the back end of medical school, followed by a medical residency, followed by opening a brand new. I was working 60 to 80 hours a week. I had bought my first home. I no pressure, you know, could barely afford the mortgage on my home. So I was doing Airbnb renting out rooms in my home.

Dr. Erica Zelfand: So I was coming home at like 10, 11:00 PM at night. And I really just kind of wanted to like sit in my underpants on the couch, eat vegan ice cream and watch cartoons to decompress. But I couldn’t do that cuz I had to be on in my home cause I was renting out rooms and I actually burnt out. And so my, my, my personal journey of healing paralleled me wanting something more professionally to help my patients and yada yada, yada, find myself deep in the throes of an IO Waka trip.

Dr. Erica Zelfand: one day. Um, and I just realized it was, it was sort of like something ignited within me before I even made the connection that it could help my patients. I realized, oh my gosh, this is fascinating. Why am I seeing fractals? Why are they rainbow colored? I have to understand how this is working on my brain.

Dr. Erica Zelfand: And then that led me down more of like an academic rabbit hole, where I just loved reading about psychedelic research, proposed mechanisms of action. Um, I was really more interested in the sciencey bit of it. Um, and that going down that road, that road kind of turned and brought me back to my patients and realized, oh, okay, now I understand how this works.

Dr. Erica Zelfand: I can see what the best applications of it might be. Hmm. 

Laura Dawn: Super interesting. What year was that? Generally? Cause even now the psychedelic space is so different than it was even three years ago. Let alone, yeah. You know, six or seven years ago. 

Dr. Erica Zelfand: for legal reasons. I’m not gonna say what year it was, but I’ll say it was early.

Dr. Erica Zelfand: It was, it was early on in my, in my medical practice days. Mm-hmm mm-hmm so it was, you know, they say tho those first few years of practice are really where you, you find your style as a provider mm-hmm . Um, and that I felt like I was kind of finding my stride what my style was. Um, but this, this work really at first, I wasn’t sure where, where it fit in.

Dr. Erica Zelfand: I didn’t think it did. And, and as after a while I realized like, oh, this is a big part of my style. Mm-hmm as a provider. Mm-hmm . Yeah. Even, even for the patients that I, I don’t ever say peep to them about psychedelics, maybe I, I don’t disclose that that’s something that I’ve done or I don’t even recommend it for them just having done psychedelics.

Dr. Erica Zelfand: I feel like I have, um, I just have a different approach now. Mm-hmm in how I. Receive a person in my practice on how I listen on how I hear their story. I pay attention to what I hear. I pay attention to what I don’t hear, and I can support them in with different modalities mm-hmm . But my work with psychedelic medicines has informed how I approach medicine now, and I think I’m a better doctor for it.

Laura Dawn: And do you recommend, do you put psychedelics on the table as an option for clients and is there legal risk in that? I mean, I’m so curious to, to hear that process, like, are you like, yeah, well maybe you wanna 

Dr. Erica Zelfand: do a, a deep dive with psychedelics. It’s usually not where I start with folks. Um, and in terms of, you know, the legal risk, I mean, I’m not an attorney mm-hmm , but I’ve consulted some and we do have a precedent for psychedelic work and the, the precedent is cannabis.

Dr. Erica Zelfand: So looking at cannabis as was explained to me by. A couple of other attorneys is that when doctors who were recommending cannabis were getting called to explain themselves or were getting their licenses challenged or were having to end up in court, they were ultimately winning those cases because of freedom of speech.

Dr. Erica Zelfand: I went into medicine to help people, sometimes helping people means me doing the tap dance of tapping around, you know, dancing around the laws. Um, I’m really careful not to just, I I’m, I’m, I’m really not interested in being a martyr, you know, mm-hmm so, you know, there’s a line between telling a patient. I think something like this would help you and aiding and abetting illegal activity.

Dr. Erica Zelfand: Mm-hmm and typically by the time people come to see me, I’m not the first doctor they’ve seen by the time they come to see me, they’ve already seen 3, 4, 5 other people they’ve already been on the meds. For 10 years or more, they’ve already tried this, that or the other thing sometimes, actually a lot of people who come to see me have already used psychedelics and had hard experiences and they still have problems.

Dr. Erica Zelfand: And they’re like, now what mm-hmm or they’ve done psychedelics with the proper set and setting and intention and they still have the issues. And now they have despair. They’re like, well, psychedelics didn’t help me. Nothing else will. And that’s not true either. So I’m, you know, I, I know that as anything gets specialized in medicine, whether it’s psychedelics or intermittent fasting or testosterone replacement therapy, people become zeal about it.

Dr. Erica Zelfand: And doctors do too. And so, you know, sometimes I go to conferences and I meet these doctors and they’re like, oh, I’m a water fast doctor. I put all my patients on a water. Okay. Or, you know, oh, I’m a low dose naltrexone doctor. I prescribe a lot of low dose naltrexone. I prescribe a lot of TT. And when you’ve got there’s that saying, when you’ve got the hammer, everything looks like a nail.

Dr. Erica Zelfand: And I think that my most important job is to stay versatile is to actually look at the person in front of me and see what does this unique vessel carrying an intelligent mind and a radiant soul? What does it need right now in this chapter of its life, if it’s time on this planet. Um, and sometimes that does, I think the, the, the most healing supportive thing for them would be a psychedelic medicine.

Dr. Erica Zelfand: Mm-hmm . And I will also say, because you know, now if you Google my name psychedelics will come up on the first page. A lot of people consult with me because they wanna do psychedelics. And I tell a lot of them, I don’t think this is the right time for you to do this also. And why would that be, um, other things going on in their life support system might not be there?

Dr. Erica Zelfand: Um, I don’t, or maybe I don’t feel like they’re resourced enough to be able to roll with the punches. If things get Rocky mm-hmm before, during or after their psychedelic experience, mm-hmm, , you know, a psychedelic experience because of how powerful it is. It can really catapult somebody to the next level in a good way, or it can really unravel somebody in a, in a painful way.

Dr. Erica Zelfand: Mm-hmm and I wanna make sure that if that unraveling happens, there’s a container for it. Mm-hmm mm-hmm um, also, you know, some, some people chemically, I just think it would rock them a little too hard. There are of course different medicines, right. So it’s not like it’s not a yes or no, it’s a, okay. Which one?

Dr. Erica Zelfand: Um, sometimes. I think that the psych them seeking out a psychedelic is their bypass.

Dr. Erica Zelfand: also, it’s like, no, there’s this isn’t a, you know, eat mushrooms and all your problems are fixed. Mm-hmm , that’s, that’s applying the reductionistic Western model to psychedelics mm-hmm mm-hmm and that works about as well as that model being applied to synthetic pills, I think mm-hmm so also a lot of people come and they say things like, you know, I’ve had depression for 10 years.

Dr. Erica Zelfand: I’m tired all the time. Nothing brings me joy. Um, I wanna do psychedelics, like, okay. Has anyone ever checked your thyroid right. Has anyone ever looked at your iron levels? Um, you live in an old home ever been tested for like heavy metal toxicity. Those are the kinds of things that can cause physical and mental illness.

Dr. Erica Zelfand: that psychedelics aren’t gonna fix mm-hmm right. If you, if you have lead poisoning, psychedelic, medicine’s not gonna Keate metals outta your body. Mm-hmm , it’s just not, it can’t do that, which 

Laura Dawn: is that we know you bring such a, a unique perspective and this holistic framework and really looking at the whole person is so essential.

Laura Dawn: So it’s, it’s just amazing that you’re doing this work. I do really wanna dive into all things, psychedelics and depression. Specifically, you have an article on the psychedelic.support website that I’ll link in the show notes about microdosing for depression. What do we know about the research in terms of psychedelics and we’ll get into macro dosing versus microdosing mm-hmm, but just general research around psychedelics being efficacious for the treatment of depression.

Dr. Erica Zelfand: Mm-hmm we know quite a bit. For starters, we have better quality research on macro dosing than microdosing mm-hmm . Main reason for that is the FDA has said that these substances, you know, we’re talking about psilocybin, LSD, that these are schedule one substances. The schedule one substance is a substance with no medical use and high chances of becoming addictive or significantly hurting somebody.

Dr. Erica Zelfand: So other schedule one substances, just to give you a reference heroin as a schedule, one substance Oxycontin is not curiously, so we gotta change the laws we’re on it. Um, but so when you have a substance that the government has essentially deemed to be radioactive, right, or very risky, it’s gonna be really hard to get a study approved in which the person gets to go home with this substance, take it every day and be trusted not to divert it.

Dr. Erica Zelfand: It’s a lot easier to get a study approved where people come to a hospital or approved center, take the substance or observed for a period of time and then get sent home. So. For that reason. That’s the main reason we have a lot of data on macro doses. And what that data shows is that doing a macro dose or a, you know, normal dose and medicinal dose therapeutic dose of psilocybin.

Dr. Erica Zelfand: Uh, we have more data on L SD now, um, significantly can help with depression and anxiety. Hmm. In a significant way. And a lot of this data comes from populations that were previously considered treatment resistant. So people that have already tried psych meds who have already tried therapy and who are still struggling, those folks can be helped with psilocybin and other classic psychedelics.

Dr. Erica Zelfand: And I think the reason for that there, I think there are a few reasons for that. One is. Depression and other mood disorders is a habit. Your brain gets in the habit and it runs its loop. And it plays that loop over and over and over again. And every time you play that loop, you reinforce it and it gets stronger.

Dr. Erica Zelfand: It’s kind of like carving out a Riverbed and then the water flows that way. So it keeps carving that bed that Riverbed deeper and deeper and deeper. And then the water is gonna move, move down that way. And what psychedelics do is they temporarily fill in that Riverbed and they let the water flow in different directions.

Dr. Erica Zelfand: They let the brain try things on from different look at things from different angles, fire in different ways. Different parts of the brain can communicate with other parts of the brain. It normally doesn’t talk to. And it really helps push that person out of the rut out of that neurological rigidity that they have been stuck in, in playing and replaying and helps their brain go, oh, what if we sent the water this way?

Dr. Erica Zelfand: What if we carved a river bed that way and sent the water in this direction, in that space, people also have an opportunity to do a deeper reconciliation of whatever may be at the root of their ailment. So whether it’s a traumatic event or a story in the, uh, course of miracles, they call it the tiny mad idea.

Dr. Erica Zelfand: So sometimes people come and they’re like, I don’t understand, like what’s going on. You know, I had a, a pretty good childhood and. My parents were there for me and they didn’t get divorced and I was never assaulted or molested and like what what’s going on. So I’m gonna share another case with you. So this is the case of a young man with a very severe neurological condition that is causing paralysis in his body.

Dr. Erica Zelfand: And he actually, his prognosis is not good. Um, so by the time he had his first psychedelic experience, he was, he could still walk, but he needed assistance. And he realized through the psychedelic experience that because he was a middle child and people talk about middle child syndrome and they joke about it that somewhere along the line, he had picked up this little crazy idea that because he was a middle child, his parents didn’t love him.

Dr. Erica Zelfand: There’s no. Data or evidence in his life story to support this statement. And yet he picked it up and carried it in his nervous system. Hmm. And his psychedelic experience was all about confronting that little crazy idea and being like, Hey man, get outta here. Thanks for trying to help me. But that’s not the truth.

Dr. Erica Zelfand: I’m so loved. My family loves me a lot and I’m claiming some, I’m claiming a different story for myself now. Right. And this was someone who came from like super loving, awesome family parents, still married, affluent suburb, good schools, you know, summer cancel that jazz, but it’s hard being a human. It’s hard being a human and our brains are like Velcro and they pick up and stick to weird things and we have negativity bias.

Dr. Erica Zelfand: We know that, um, and psychedelics can really help challenge all of that. 

Laura Dawn: And did it improve his neurological condition? 

Dr. Erica Zelfand: It improved his attitude about it because having such a severe diagnosis, it can really affect one’s quality of life. So what has changed is that the diagnosis doesn’t stop him from enjoying his life.

Dr. Erica Zelfand: So he’s a happier person. Now he’s having more meaningful connections with his family, more meaningful connections with his friends. He’s having a hell of a lot more fun. He’s feeling grateful. It’s horrible. He has this diagnosis, but how wonderful that he has a wonderful family and parents that let him move back in and who are paying for his medical expenses.

Dr. Erica Zelfand: Mm-hmm so it’s shifted his outlook. Mm-hmm it’s too soon to say what it’s gonna do for his physical health. If anything mm-hmm it’s possible. It will help his physical health. It’s possible. It won’t. I don’t know. But did the psychedelic experience help this person, undoubtedly? Yes. Without a doubt. 

Laura Dawn: It’s so funny to hear you say this story too, because, uh, the first thought that came to my mind, it’s like, everything’s fine.

Laura Dawn: I had a loving childhood, no trauma, but why am I depressed? And it’s like, when you look at like the state of the planet right now, it’s like moving through a multi-year pandemic. People are being squeezed by inflation. I mean, it’s just like everyone is feeling it, you know? So it’s like, yeah, there’s just also the context of like, These are times of change.

Laura Dawn: We haven’t really learned how to actually make peace with change, how to make peace with impermanence, how to grieve what no longer is, you know? So there’s all these other factors that I feel like also play such a big role in what we’re experiencing. Stress is correlated to depression. Burnout is correlated to depression, which isolation, 

Dr. Erica Zelfand: isolation mm-hmm , uh, inflammation.

Dr. Erica Zelfand: Mm-hmm it’s like what this pandemic did was it took a problem we already had, which is that people are isolated and disconnected and it cranked that amp to 11 to quote one of my favorite movies. Mm-hmm it turned up the dial. And what did we do to people when they sought out connection during the pandemic in person connection, we shamed them.

Dr. Erica Zelfand: Hmm. And we know that rejection by the tribe is one of the most painful traumas. That a living organism can experience rejection by the tribe. Biologically is death. It’s a death sentence because when it, when a pack animal is rejected by its tribe, it means you need to go into the woods alone and, and you’re gonna die alone out there.

Dr. Erica Zelfand: Mm-hmm and that’s exactly what happened to individuals who didn’t want to be isolated during this pand