Search
  • Innate Path

A Discussion with MDMA Researchers

Updated: Mar 14

MDMA Phase 3 psychiatrist and podcast host Dr. Craig Heacock interviews Innate Path's own Director of Education and Phase 2 MDMA researcher Saj Razvi on trauma, working with psychedelic medicines, and Saj's own personal story of working with psilocybin in Amsterdam. This is an in-depth hour long discussion with practical information, warmth, and optimism for those with mental health conditions looking to work with psychedelic medicines.






Listen to this interview on your computer or

through the Back From the Abyss podcast on

your phone.






Podcast Transcript


Dr. Heacock:

Welcome to Back From the Abyss, I'm Dr. Craig Heacock. I am so excited to share today's episode with all of you. Usually we present a story of psychiatric healing, but today's episode is that and much, much more. My guest today is my dear friend and trauma therapist Saj Razvi, who weaves together his three fascinating perspectives that of a nationally recognized trauma expert, his own personal story of early childhood neglect and how that shaped everything else to come. Finally, his long journey of healing the deepest wound a person can have, eventually coming to MDMA, and then psilocybin at the latter part of his therapy journey.


Dr. Heacock:

Part one today ends with sadness, profound and life changing MDMA treatment. Then in part two, Saj shares some surprising and a hard one lessons about using psilocybin for psychological healing. A note to listeners, MDMA and psilocybin are both schedule one illegal substances. Saj's MDMA therapy session took place in the context of his training to be a therapist in the MAPS-MDMA Assisted Psychotherapy for PTSD Study. And his psilocybin session occurred in the Netherlands.


Dr. Heacock:

Saj, I'm so excited to have you here today because, well, one, you have an amazing story, your own story of healing. And two, you're my go to trauma expert. When I think trauma questions and trauma musings, you're the man to talk. And three, I think you more than almost anyone I know have some of the most interesting, and potentially useful ideas, and guidance and wisdom on the use of psychedelics in healing.


Saj Razvi:

Thank you, Craig. Happy to be here.


Dr. Heacock:

Just as an introduction, Saj, you are the director of the Innate Path in Denver.


Saj Razvi:

Yeah, I'm the Director of Education at Innate Path.


Dr. Heacock:

Yeah, tell us more about Innate Path.


Saj Razvi:

Sure. Well, we are a, we do three things. We provide a psychedelic psychotherapy, clinical services, we run trainings for clinicians around the country. Then finally, we are a research organization, where because we're trying to validate these medicines, particularly cannabis and ketamine for use in mental health around the country.


Dr. Heacock:

Is Innate Path specifically focused on trauma?


Saj Razvi:

We're not specifically focused on trauma, that is our background. And I think if you asked anybody there, we would say that, most of the people that we treat have had, either highly stressful or overwhelming experiences at some point in their life, particularly in childhood. That's most of who we end up seeing. Even without specifically being a trauma focused center, that's who walks in the door.


Dr. Heacock:

Yeah.


Saj Razvi:

That's the person that has treatment resistance. And right now, we're seeing people that have gone through years of psychotherapy. And a lot of times, they've gone through the psychiatric paths too. And so, they're using psychedelic work as a last line response. As the culture shifts around this, we're starting to see people engaging with psychedelic work as a first line response.


Dr. Heacock:

Before we get...


Saj Razvi:

Yeah.


Dr. Heacock:

Before we get more into some of the specifics of psychedelics and of your personal story, maybe we could bring everyone up to speed on trauma. Because I think some of the people listening to this are experienced trauma therapists and some people who know very little about trauma. I wonder if we might start with just talking a little bit about what trauma does to the body and mind. One of the most famous books in trauma is The Body Keeps the Score.


Saj Razvi:

Yeah.


Dr. Heacock:

Keeps the Score. I wonder if we might just start you talking a little bit about how the body holds trauma, and how that manifests over time.


Saj Razvi:

Yeah. Okay. So I would say, maybe a big definition, big level definition of trauma is that it's a series of responses that we enter into when under conditions of threat. And that could be threat that happens in the present moment or could have been threat that happened decades ago, and it affects all of us. It affects our biology, it affects our emotional state, it affects our thinking and the types of thoughts that we have. And I think most, the standard way that trauma is approached in mental health really is as working with it in terms of belief systems, and distorted thinking that can come with it. And we find that, I think there's a movement in mental health to say no, we have to go deeper when it comes to trauma. Because we can see the same reactions, symptoms, responses in other mammals that we see in us. We see...


Saj Razvi:

Let me just back up a little bit. So we know that the mammalian nervous system goes through a series of responses when it comes to threat. Initially, we'll have what we call mild stress responses, so anxiety, hyper vigilance insomnia, things like that, where there's some level of threat but nothing imminent is happening. And so, we just have to be on edge and paying attention to the situation. Think about walking down a dark alleyway in the city at night, you're just going to be on edge to do that, and that's an appropriate response.


Saj Razvi:

The next level of threat is when there's an active, life threatening thing happening to us. And so we go into a very high stress or a panic level response. If you think about being assaulted, or raped or being in a battlefield situation where you're being shot at, you having a ton of adrenaline released into your system, a major fight or flight response. And this is, that kind of situation is where we find panic attacks come from. Then we find that once the threat has gotten to a certain point of overwhelm where our capacity to deal with the threat is exceeded by the intensity of the threat, we move into passive solutions. Basically, there's a, what we call a parasympathetic response that emerges, which is a numbing or a shutting down.


Saj Razvi:

What we know happens physiologically in the body is that, we have these naturally occurring opioids, endogenous opioids that get released at that point. And so, we move from panic states to a very depressed, collapsed, hopeless, falling apart and kind of condition.


Dr. Heacock:

Mm-hmm (affirmative). I wonder, and my sense is that a lot of people, myself included until I did your training. A lot of people imagine trauma as they're activating the nervous system and making people hyper aroused, or anxious, or unable to sleep, or edgy or explosive, almost imagine like a beaten dog that you would adopt from rescue. And one of the interesting, and one of the most helpful takeaways I took from your training years ago was how powerful this final stages, the parasympathetic shut down dissociative opioid dump, if you will, that sends people into the numb. Dissociative freeze and how that actually is the end result of a lot of people's trauma, and why they can't get better.


Saj Razvi:

Yeah, I think the ball game is all in the dissociated realms. If you were lucky to come out of a difficult childhood or inexperienced, and you only had anxiety or panic symptoms, you're doing pretty well. Those are the people that we see. The prognosis is very good with those people because there's no splitting of the psyche, there's no dissociation turning on with that kind of response. But, yeah. So I think the true art and science of working with trauma resides in working with dissociation. So, which I would say a lot...


Saj Razvi:

There's... I've heard you say this before, Craig, that there's 1000 different roads that will lead to depression. I think one of the major pathways to people being depressed is this, being overwhelmed and having an opioid dump that which leads to... One option is that it leads to depression and hopelessness like we are talking about, where you're still feeling yourself, you're still feeling life but it's in a very depressed state. One step further beyond that is where the thread is so overwhelming that there's no point in feeling anything at all. This is when a line is taken down a zebra, and the zebra is going to be bitten into and eaten. And at that point, the zebras nervous system, which is also our nervous system, where we all have the same basic setup here. We'll move into a much more profound opioid release state, where you're not feeling much of anything at all.


Saj Razvi:

The interesting thing for us is that our cognitive capacity is online, and actually more unencumbered when people are in this final state of trauma, where they can talk fine, they're looking at the world fine, they can do math fine. They just can't feel fine. They can't relate to anybody. There's sort of a...


Dr. Heacock:

They're kind of a walking dead.


Saj Razvi:

Yeah. Yeah.


Dr. Heacock:

One of the big takeaways I had from your training and reading your work is that there are millions and millions of people out there who don't necessarily look traumatized, because they're spending so much time in this sort of parasympathetic dissociative numbed, empty feeling less state, and they sort, they look okay. But really, they're like that dying zebra that's just living but not feeling much, because they're so overwhelmed by the opioid response.


Saj Razvi:

Yeah. And I think that's what makes it really tricky, because they look... Behaviorally speaking, they look very calm. And just like, if you didn't have any threat, or if you weren't and didn't have any trauma in your system, you could be calm and responsive to the world. But if you had sort of the extreme of trauma, you would also be calm in the world. You're just not very responsive, because you're always in that numbed out calm. I would call it the eye of the hurricane kind of state.


Dr. Heacock:

Yeah. And if you think about the classic thing that a therapist might say in session, how are you feeling? How are you feeling, today? For people that are on and off in this dissociative state, that's kind of a meaningless question.


Saj Razvi:

Completely. Yeah, it's, I think any trauma, any kind of therapy that relies completely on self report is not effective here. Because the last person to know that they're deeply traumatized is the traumatized person, because the effects of the opioid is affecting their consciousness and their ability to notice anything.


Dr. Heacock:

Mm-hmm (affirmative). Yeah. In my sense in psychiatry is that, perhaps the two things that are most difficult to treat that we just do not have much to offer are; a, the negative symptoms of schizophrenia, b, complex trauma with the primarily dissociative presentation.


Saj Razvi:

Yeah, and that makes all the sense in the world to me. Because, again, that's an intelligent, adaptive response that causes people to go to that state. So, their body is doing what it's supposed to be doing under those conditions. And I think we tend to think that people who have trauma have to had to gone through something very big, like, a massive car accident or they have to be at war and lose a limb or something like that. And we find that's just not the case.


Saj Razvi:

I had a private practice for years where I was working with complex PTSD, and none of my people were veterans. These are people with these... These are really deep trauma states are created when people go through experiences, particularly in what I would call a developmentally sensitive window of childhood.


Dr. Heacock:

Is that a time? Is that zero to five, or is that... What would you say is developmentally sensitive?


Saj Razvi:

Yeah. I would say the earlier, the more developmentally sensitive it is. The further older you are, the better. Five is still pretty young for this. But, I mean, something that we know about, human physiology is that we are born incomplete. We are born because... And we are formed by our circumstances, by our environment, by the parenting that we have, by the situation we're growing up in.


Dr. Heacock:

You've talked about in your training and in your writings, and this idea that trauma that's manifesting more with sympathetic symptoms, and activation, and panic and insomnia, that, that has a lot of potential treatment points of EMDR. And even some anti genetic meds, or possibly even some behavioral therapies. But people who spend a lot of time in dissociative state, there's just not much for them. I'm wondering, prior to some of the psychedelic therapies that we're going to get into, what have been the effective ways to reach people when their trauma is manifesting mostly as that, the numbed dissociation?


Saj Razvi:

Yeah, I think this has been a major failure of our field. Not only have has the world of psychotherapy not been able to fully acknowledge and recognize dissociation, there wasn't... There really weren't any modalities that were geared towards working with it directly. Even the trauma modalities that we have had the most common ones, something like EMDR is designed to work with what I would call stress or high stress states. Meaning, that sympathetic activation states where you can see it, you can feel it, you can feel the anxiety and the stress. With dissociation, it's marked by what should be there but isn't there.

Saj Razvi:

And so, I think like I said, I think there's been very limited things that would address that, or even recognizing that we should go for that. I think things... The places that give me hope are sort of Peter Levine's work, the somatic experiencing work, which is, they really did articulate. I think that's one of Peters great gifts to the world of mental health and trauma technology is really articulating, there's this entire area here that is really essential for us to focus on if we're going to really resolve these symptoms. And I think what we've been doing at Innate Path, really focusing on working with what we call cold states, dissociated states and how to sort of, how the autonomic nervous system can pull people out of that. So it's been pretty limited, I would say. Even SE is, it's, and there's not a wide adoption.


Dr. Heacock:

So at Innate Path, my understanding is you're using both cannabis and, or ketamine to help people to reach people in this numb state and you try to bring them out?


Saj Razvi:

Yeah, I think that's one of the glories of psychedelic therapy is that they don't work through your conscious rational minds. They go far below that. And they're working with your subconscious, and causing all these things that have been hidden from you to really be seen, and felt and come to the surface. We think that... So I was one of the clinical researchers in the MDMA, in the MAPS-MDMA trials for treatment resistant PTSD. What we saw in those trials is very similar to, I think what we see at our clinic on a daily basis with these other medicines.


Saj Razvi:

I mean, there are differences to say. But I think generally, once these psychedelic medicines put people in a non ordinary state of consciousness like a dream state, if you will, that the subconscious tends to come to the surface, especially if you have a modality that's looking and inviting the subconscious surface.


Dr. Heacock:

Yeah. Could you say a little bit about your experience with cannabis, versus ketamine, versus MDMA, specifically in reaching people who have a primarily dissociative, parasympathetic numbing kind of trauma?


Saj Razvi:

Great. Great. Well, I'll start with MDMA. Let me start with regular therapy or the somatic work that we would do without any medicines on board. People will have some very core thing that they're, they have a dissociative protective mechanism around. Let's say it's sort of the core childhood wound, somehow of abandonment or some kind of abuse there. And their system is either split or is protecting it in some way. And if you were working in therapy with this person diligently with really good therapy, I think with that structure, it could still take six months to a year to really crack something really core and essential for people, which is, I think, still an improvement over what we've had. I think talk therapy won't touch dissociative realms. But still take quite a bit of time to do that.


Saj Razvi:

I think with something like MDMA, we see that accelerated greatly. We see that something that would have taken six months to a year can be cracked open, and in something like two hours. Or in a day long MDMA session can, yet the entire focus can be gone towards cracking this one piece.


Saj Razvi:

Now, the way that it manifests in a psychedelic MDMA session is really interesting, because it will manifest to sobriety. So people at the height of an MDMA session two hours into it, which should be a very powerful activating experience, you'll have people that are just flat out sober and not feeling anything. They'll think that they got a placebo dose.


Saj Razvi:

Yeah.


Dr. Heacock:

Okay, that's what's going on.


Saj Razvi:

That's what's going on. Basically, what's happening is that an opioid response, that their protective endogenous opioid response is meeting a psychedelic response. And the opioid response is crushing the psychedelic response. But that, I guess it's not just that because if you... So our trick with that is then to really stay with it, stay with the nothingness, stay with the sobriety. I mean, literally, people will think that they could, nothing is happening. So they'll take off their blindfolds or their eye shades and feel like, okay, I can just walk out of here and live my... Have my day. The suggestion here, the recommendation is that there is gold underneath the boredom. There is a...


Dr. Heacock:

That's a great statement, there's gold underneath the boredom.


Saj Razvi:

Yeah. So we as clinicians and the client's mind will think like, this isn't it. I want more than this, I think there should be more here. And we will be tempted to offer something, to attempt it to sort of say like, okay, let's focus on this and so you can struggle with this. But again, I think, they're switching the session to work with something that the client can actively engage with, versus what is naturally coming up, which is the dissociation, the nothingness, the numbing.


Dr. Heacock:

So what the MDMA therapist should be doing in that case with this person two hours in who seems "fine" or unaffected by the medication is actually encouraging them to go into the nothingness?


Saj Razvi:

Yeah.


Dr. Heacock:

Going into the numbness and the blackness?


Saj Razvi:

Yeah. It will crack. Like I said, it'll take 30 minutes or two hours, or maybe it'll take the whole session but it will crack. And when that dissociation cracks, there's an entire universe inside of it.


Dr. Heacock:

Does it sometimes take multiple sessions to crack?


Saj Razvi:

It can.


Dr. Heacock:

Yeah.


Saj Razvi:

Yeah. Which, again, is still very efficient, but that's not the idea that most clinicians or participants have of what an MDMA session is, or what a psychedelic psychotherapy session should look like.

Dr. Heacock:

Yeah.


Saj Razvi:

Now, I think the really intriguing thing here, though, is that what we've seen with cannabis is that it's even more effective at cracking dissociation than I think MDMA is. I'm saying that with, there's a fantastic therapeutic opportunity there but there's also massive pitfalls they have to look out for.


Dr. Heacock:

I'm so interested in this topic because two things well, one is that it's well seen and documented that the THC can trigger depersonalization and derealization, and sort of these dissociative awake states. And number two, as listeners to this podcast will know, as a psychiatrist here, I see a lot of people with mood and psychotic disorders get triggered into severe dissociation or even new onset psychosis from THC. So, Saj, when you first told me that you were using cannabis as a therapeutic tool to sort of break down trauma dissociation, that was completely fascinating to me. But, yeah, please, say more about how that looks.


Saj Razvi:

Yeah. Let's say [inaudible 00:22:11] the higher level view of it is that, cannabis is the drug that most people know at this point that's recreational easily available. People try it in high school. It's the dopey drug. It's the drug that may be and the best case scenario takes the edge off of anxiety symptoms. But we find that more so than any other medicine when people take that same plant and bring it into a different set and setting, a different context where we're going for mental health and trauma, it becomes a completely different animal.


Dr. Heacock:

And even able to, as you say, crack open dissociation.


Saj Razvi:

Yeah.


Dr. Heacock:

Which is so fascinating to me, because I think of THC as...


Saj Razvi:

As creating dissociation.


Dr. Heacock:

As promoting dissociation.


Saj Razvi:

Right, so that is a question. I think it's one of those things that can have so many different responses based on the experience, the interaction that it's being used in. I think that's true of all psychedelics. That's so much of, their outcome really depends on the context. We know, for example, that MDMA, the street drug ecstasy, which people can and thousands of people take every weekend and go clubbing with it. Very little therapeutic benefit in doing that, although it could be a wonderful experience on them. But take it in a therapy session, and it becomes an incredible tool for complex PTSD. I think something very similar of cannabis.

Dr. Heacock:

So is a cannabis session similar to an MDMA assisted psychotherapy session in that there are eye shades, and music and it's an interior experience?


Saj Razvi:

Yeah, it's an interior experience. And I think one of the things that we find is that, the world of mental health does not like cannabis because it really interrupts people telling their story. It interrupts top-down executive functioning, which in the world of trauma therapy, that may actually be a very useful thing. Because it's usually that top down executive functioning that creates the censorship that prevents the autonomic processing of trauma. So what we find is...


Dr. Heacock:

That said, so what you're saying is summarize that, is that the cannabis can... Basically can affect talk therapy? Can affect your ability to listen and reason, and work through cognitive stuff, higher level stuff. But you're saying that's, actually maybe perfect that it's working on lower level deeper mechanisms?


Saj Razvi:

Yeah.


Dr. Heacock:

And by inhibiting the more higher level top level mechanisms, that it's actually helpful because those are getting in the way?


Saj Razvi:

Exactly, exactly. I think we're addicted to these higher level cognitive functions and therapies. Talk therapy certainly is focused on that. And I think trauma so much a bottom up response of a more primitive response, that if we can get people to sort of get out of their own way, which I think that's the beauty of cannabis. It kind of interrupts all habitual functioning. Then, I think how and what's working here is just the natural response of the autonomic nervous system towards healing.


Dr. Heacock:

And do these sessions, are the people having THC edibles before they come in? Is it... Like, what's... How does that [crosstalk 00:25:25]?


Saj Razvi:

Well, the edibles are a little unpredictable. Because we don't know how long it will stay in somebody's system and how long it takes for it to turn on. So people will either smoke or vape, and that way five minutes later, they're having the drug effects.


Dr. Heacock:

The pure THC.


Saj Razvi:

It's really up to them based on the level of sort of intensity of the work that they want to accomplish. I'd say for sort of somebody not, who doesn't normally use cannabis, they probably want more of a blend of CBD and THC.


Dr. Heacock:

Yeah. Now in my work in the same, PTSD study that you're in, in the MAP study, I've yet to see a session "go badly'. I mean, if they go and they go all sorts of directions but they never derail. But with the cannabis, have you seen that where you get more dissociation, or more panic or that, yeah, that it's not therapeutic or?


Saj Razvi:

Yeah. I think it really is defined by how you define things going badly.


Dr. Heacock:

Panic might be what they need.


Saj Razvi:

Yeah, exactly.


Dr. Heacock:

[crosstalk 00:26:37] control panic.


Saj Razvi:

We're looking for bad trips. Nobody in any MDMA session that I was ever a part of comes out of that saying like, wow, that was easy or that was good. It was people always go through it. They go into intense reactivity and feeling states. I think that's case with cannabis as well. If some... I'll put it this way. That if we're working with somebody and they have a lot of material in these dissociated states, when they're coming out of it, it will look like panic. So the dissociation is clearing, and what's under the dissociation is flat out fear and panic.


Dr. Heacock:

Yeah.


Saj Razvi:

And so if people are having those responses that in our sort of framing of it or our model of it, that's actually a positive thing.

Dr. Heacock:

It's a breaking open the dissociation could look like bringing on a panic attack in your office. So just a huge sympathetic release, which can be good.


Saj Razvi:

Yeah, exactly.


Dr. Heacock:

Yeah, that makes sense.


Saj Razvi:

Exactly. Yeah, because the idea is that before somebody dissociates, it's not like the world was completely okay. And then all of a sudden, somebody dissociates. Things lead up to that dissociation. And typically, we will have those high stress panic responses before we dissociate, if possible.


Dr. Heacock:

What about ketamine? How might that be used in Innate Path, specifically with dissociation and the numb states of trauma?


Saj Razvi:

Yeah. This is a really interesting question, because I think many people at this point may be familiar with ketamine, especially with these ketamine treatment centers popping up. And I think there are two clear responses that ketamine has in a person's system. One is the anti depressant, the well documented antidepressant response. And I think that is a, almost pure biochemical response that people have to ketamine. And it's always a temporary response. But for people with treatment resistant depression, that could be extraordinary godsend. So, yay for that.


Saj Razvi:

How we're using it is for the second response that ketamine generates, which is a solid psychedelic response. So during the ketamine session, we will do psychotherapy with a person, and they'll be... What it creates is a dissociative numbing but one that allows people to look at things in their life, look at patterns from more of a 50,000 foot level. Or that you can see the most horrible things that have happened to you, and without protecting yourself from them. It's a very matter of fact kind of experience. And so some of the things that we find with that is that the people's defense mechanisms are very softened. People's...


Saj Razvi:

The things that their system would not... Let's say somebody who had, again, childhood neglect. And as an adult, they just cannot handle people being close to them, or nurturing them or even touch, let's say. But with ketamine, they can tolerate that. They can sort of re-learn that, oh, this is what nurturing feels like, this is what a corrective emotional experience feels like. And so, I think there's an incredible therapeutic opportunity with ketamine to re-pattern so much and so many things from childhood.


Dr. Heacock:

Again, is that typically eye shades and music, because you said there's some psychotherapy talk therapy with that too?


Saj Razvi:

Yeah. Eye shades for both, yes. Probably some music. But the thing to know about the music is that it's, it sets the tone, it's evocative, but it's not primary for us. We want the primary piece here to be the human interaction. Meaning that, these are human relational wounds that happened that created these responses and these symptoms in people. We think human relational wounds requires human relational healing, human relational contact. So I think that's one way that we might be different from a lot of what's happening in the psychedelic world, which is, taking psychological wounding, and then letting this trans personal experience with psychedelic medicines kind of do the heavy lifting.


Dr. Heacock:

Yeah. How do you decide at your clinic if someone is a better candidate for cannabis assisted work or ketamine assisted work?


Saj Razvi:

Yeah, we give them options. We tell them everything that we can about how these medicines look in sessions, and what we see with them. We don't decide for people, we let them decide on their own. The thing is that, people are certainly welcome to try either one. And typically, maybe people will go back and forth between them, because a big difference between the cannabis work and the ketamine work is that cannabis is, I think much more activating. It really cracks dissociation, like we were talking about.


Dr. Heacock:

Better than ketamine.


Saj Razvi:

Better than ketamine, and perhaps better than anything that I've seen.


Dr. Heacock:

Yeah, and I've heard you say that before. Again, it's totally fascinating me to hear that. What about cannabis compared with MDMA in terms of cracking dissociation?


Saj Razvi:

Again, the opportunity and pitfalls that I think cannabis just doesn't abide it. I don't know. I don't know why it just moves people into that high activated states looking at the same kind of material. But MDMA will take its sweet time. I think MDMA is a really great therapy drug, because the way that I think about it is that, it's an insistent dance partner but you can say no to it. You can say, no, I'm not going here. And a lot of people do. And I think that's one of the things that makes it nice for people in that they can really sort of choose to go into some of these things. But it's also some of the things that, it can still take some significant time to crack dissociation with MDMA.


Dr. Heacock:

In a theoretical world, if Innate Path had MDMA as an option, and hopefully, that will be the case at some point. It's sounding like you're still imagining that a significant percentage of people coming in the door with the sensitive trauma symptoms, the initial go to would be cannabis.


Saj Razvi:

I think it would be a split. I think one of the... That we haven't talked about this, but so a ketamine or a cannabis session typically is two hours in length. So that's two hours of the deep dive into your subconscious mind and processing it. A single MDMA session is eight hours in length, it's probably six of those being very active processing hours. And so the doors that can open over six hours are much more than the doors that get opened over two hours. So I think we can titrate the ketamine cannabis experience and much more, so then we can titrate an MDMA experience.


Saj Razvi:

One of the things that we saw in the clinical trials was that, people would have these really big MDMA sessions. Then because of the nature of that medication, you can't take it again for another month. Anyway, three to five weeks anyway. And during that period of time, they are they're raw. Things are just very open in their system, and we had to spend a lot, a lot of therapeutic time holding people together, supporting people...


Dr. Heacock:

In the MDMA studying between sessions. Yeah.


Saj Razvi:

In the MDMA study session between sessions. Yeah, a lot of therapeutic contact hours between the sessions. And I think what we find with ketamine and cannabis is because you can use them much more frequently. People will open the door, they'll still fall apart, but it'll be sort of a more gradual movement into being less functional, and then sort of coming out of it. As opposed to, all of a sudden things are open and then...


Dr. Heacock:

Yeah, that's really interesting. You've had a long life long story of pain and dissociation and eventual healing, but it's been a long road.


Saj Razvi:

Yeah, it's been a long road. I guess, I'll just start out by saying, you don't become a trauma therapist [inaudible 00:35:28]. You've got some personal [inaudible 00:35:31] stakes in the game.


Dr. Heacock:

Yeah, research is me search.


Saj Razvi:

Yeah, research is me search, that's a good way of putting it. Yeah, I would say that I'm in that category of a person that I have almost no physical trauma to my body. No severe beatings or anything like that. Mine is just complete, early, early, sort of really profound neglect. And this is the type of thing that they found in the 1940s when they were doing... When World War Two was happening, and there was this concern in British hospitals around bacteria and passing on diseases, that if, that they would have infants in orphanages dying and failing to thrive.


Saj Razvi:

What they eventually found out was, wow, like being touched and held, and attuned to and responded to, is incredibly necessary for a human organism. And so, I mean, that's an extreme that infants will just not thrive and die from it. But shorter than that, but still pretty profound is, what happens to somebody attachment style when they're not related to? What happens to their sense of other human beings and the world when they're not related to? Because that child's mind, that child's psyche is still forming just in isolation. I would say that, that's mostly my structure, and it comes from having a parent... By the way, I'll say that if it wasn't for dysfunctional, maladaptive parenting styles, the field of psychology wouldn't exist.


Dr. Heacock:

Right. Right. If like, what percentage of my patients would disappear if they didn't have a trauma history? A lot. I mean, I would still have some, but, yeah. It's such the root of so much.


Saj Razvi:

Yeah, there are organic brain diseases and things like that. But, yeah, so much of what causes people to enter into mental health really is sort of childhood trauma, and childhood development patterns and parenting styles.

Dr. Heacock:

And this neglect for you was happening during a key window?


Saj Razvi:

Oh, yeah, very key. So my parents... I'm Indian, my parents immigrated from India when I was two years old. And my parents were stressed, and my mom was depressed about doing it. Just a fact of growing up was like a, we had this drawer full of family photos. And my brother who's older than me had thousands of photos of him as an infant being bathed, all these things happening. And there literally is not a single photo of me as an infant, just not one. And I always thought that was strange as a kid, and I didn't know what to make of it.


Dr. Heacock:

But do you think you weren't wanted, or do you... There's that and, or mom was just so overwhelmed, or shut down or depressed?


Saj Razvi:

Yeah, I think the latter, just overwhelmed, shut down and depressed. I think her own trauma history was catching up to her. I think, she was... She came from a large Indian family and she was the eldest. And so when she was eight years old, she was sort of sent off to live with her grandparents who she didn't know. So, it was almost like being abandoned at eight. And so, I think that she had what I would call avoidant attachment, sort of avoidant of relationships, avoidant of feeling, avoidant of really making contact. And so, she couldn't give what she didn't have.

Dr. Heacock:

Could she give your older brother what he needed?


Saj Razvi:

I think my older brother got more of what he needed, but you could still see pieces that are missing in his system. Yeah.


Dr. Heacock:

I wonder how that manifested. I mean, do you imagine that, like a little baby, you just weren't being held, or loved, or talked to, or?


Saj Razvi:

Yeah, I think that was it. I think it's just like, well, here's the crib. Here's, you're just in this by yourself. So, there is a... I'll say this piece, and you can feel free to edit it. Okay, of course. And I say that because it's a theory piece, and then we can move back to personal. But there's a researcher, Allan Schore at the UCLA that is studying brain development in infants with secure attachment, and infants with an insecure unstable attachment. And so just, I'll just say that attachment is a formal psychological term for a process that happens between the ages of zero and two years old, where an infant is sort of bonding with its parent and recognizing whether the world is safe, the world is an okay place or it's not. So that's a core thing that's happening there.


Saj Razvi:

And we can tell so much about how this little kid's life is going to be as an adult, based on what attachment style they have. And to a large extent, attachment has been seen as immutable, and you can't change it. Anyway, Allan Schore is doing this research. And what he's finding is that, there's baby A who is well attuned to. And baby A has needs and starts crying for food, and for touch, and movement, and being changed and all these types of things. And every time one of those things comes up, baby A starts crying. And a more mature nervous system comes in and soothes the baby, like picking him up, feeding him, doing whatever, responding to their needs.

Saj Razvi:

And so, this happens thousands and thousands of times. In other words, baby gets upset. There's a response from the outside world, and then baby calms down. Eventually what happens there is that when this baby becomes a five-year-old, it starts to learn this. It internalizes that self-soothing mechanism, it's what's called auto regulation. Then when that baby's 12 years old, or when that baby's 20 years old, and things get upsetting in the world, life throws them a curve ball. They're able to just take three deep breaths and calm down. It's like this magic power that people with secure attachment have, that auto regulation. And guess what? Addicts don't have. Addicts, 100% of addicts do not have auto regulation on board. They are relying on something external to calm them down like the substance.


Saj Razvi:

Let's move to baby B, the insecure attached baby, where this baby has the same needs, the same upset that baby A had. But instead of somebody calming, because in this case the parent is stressed or depressed, or unavailable for whatever reason. And so the baby gets upset, gets more upset, gets ragingly upset, and eventually it does come down but it's not the relational calming that baby A had. It's not the human warm animal calming.


Dr. Heacock:

Was it the dissociative?

Saj Razvi:

Yeah, it's a dissociative, calming. Meaning that, behaviorally, baby A and baby B are both calm. But baby B took a very different pathway to that calming. And we can see that under these brain scans that Alan Schore did, that there's much more primitive circuitry that's lighting up in baby B's brain to calm it down. So...



Dr. Heacock:

And you were baby B?

Saj Razvi:

I was baby B.


Dr. Heacock:

So if we could go back and see you in your crib, eventually you would have been calm?


Saj Razvi:

I would have been calm, yeah.


Dr. Heacock:

But it wasn't a self soothing calm. It was a dissociative opioid flood numbing, sort of waiting to die like the zebra waiting to be killed. Sort of calm.


Saj Razvi:

Yes, it was a non relational calming. And so just imagine sort of this child's... Again, their psyche, their mind, their sense of other people in the world forming in that kind of isolation, in that kind of opioid induced non existence. So, it's a pretty profound thing that I think can happen early in life.


Dr. Heacock:

So how did that play out for you? Again, your mom's depressed, overwhelmed, feeding you, presumably change your diapers. But you are sobbing and screaming yourself into sympathetic overdrive, and then an in dissociative numbing alone. And then now you're starting to walk, you're leaving the crib, you're entering nursery school and elementary school. What was that like?


Saj Razvi:

Well, I mean, the thing is, it's a little hard to say because if it's the water you swim in, you don't know anything other than that. It's not like you have a contrast. So I can't say, Oh, this is what normal life felt like, and this is what my life felt like. I think, I was always inside of this space. So, I think I was just walking around pretty dissociated for many, many years of my life.


Dr. Heacock:

Not the, not feeling.


Saj Razvi:

Yeah, not feeling. An interesting point, though, and I see this with a lot of our patients is that if there's a connection that can be made. And so I made a connection to animals and pets, and found like, okay, Hey, there's something else good in the world. And that's not based in this dissociation and this is other being. And you can sort of find a connection point that it becomes incredibly meaningful. And so that's one of the things that I noticed, then I was like, oh, okay, there's...


Dr. Heacock:

As a kid, you were drawn to animals...


Saj Razvi:

Yeah.


Dr. Heacock:

... Because there was something just good, and warm and loving.


Saj Razvi:

[crosstalk 00:45:21] loving and warm, yeah. They were there. And I see this pattern well into my adult life where I had a very hard time expressing warmth, and emotion and love towards other human beings, and empathy towards other human beings. But when it came to animals, oh, my God, that was red carpet.


Dr. Heacock:

Yeah.


Saj Razvi:

I had a cat that, I had this idea in my head that over this, the lifespan of this cat, he's going to jump down from the counter that he gets up on a certain amount of times, because he only has a certain amount of jumps left in him. And so I made sure that after this cat would drink water from the sink, I would pick him up and put him on the ground because I didn't want them to use up his jumps [inaudible 00:46:04].


Dr. Heacock:

Aww. Wow.


Saj Razvi:

Yeah, it was off the hook. It was that impulse to connect and love something, and take care of something was and can only be directed towards animals in my system.


Dr. Heacock:

Yeah. As a kid, where were your friendships like your... Because I've seen that you were probably trying to connect with people on some degree [crosstalk 00:46:43]?


Saj Razvi:

Yeah. I mean, I could connect on the degree of like, I played a lot of sports and things like that. And actually, that I think that saved me in a lot of ways. So, I could do social sports and things like that. But when it came to any kind of intimacy, I don't think I was capable of it.


Dr. Heacock:

Was it scary, or was it just alien? Or, I'm imagining maybe people being interested in being your friend, or wanting to date you and you again, having this just numbed, broken attachment? I mean, how you experienced the people that would try to reach out and connect with you.


Saj Razvi:

Yeah. I think the only way that I can describe that is talking about some adult life experiences. And so, I guess when, as we're talking about, I just want to make an apology to all the four women that I dated over the years. And that this has been underneath, under the surface all this time. But initially, it would show up as like, I just couldn't care more or less if this person was there or not. I couldn't care. In fact, the closer somebody grew to me, the more that they would become identified as a family member. And for me, that was not a good thing, and for them, that was not a good thing.


Saj Razvi:

Because for some people that have really good experiences and patterning with their family, if to have their partner become a family member is a wonderful thing. Like, all the rules and the way of relating that you had in your family turns on with them. That also happened with me, which again is not such a good thing. So I would become critical or disdainful. I would... My system would start to sense this person getting close to this core wound, and would become defensive. Yeah, things like that.


Dr. Heacock:

Did you find yourself being unconsciously drawn, or constantly drawn to women who would sort of neglect you? Or almost had a cold distant attachment, because that felt familiar?


Saj Razvi:

I found both sides of the coin. One side of the coin would be finding women that would, are just hell bent at finding me. And like a caretaker women, that kind of thing. The flip side of the coin is looking for women that would I knew would betray me. Because this experience that, this core experience that happened in the most primordial formative relationship of my life, this relationship with my mom was at core a betrayal. Like, there's no other word for it.


Saj Razvi:

And so, one of the biggest pieces that I found myself, sort of being attracted to was women that were that, either were a solution to this because they were so solidly there. Or in which case, then I would still have reactions against that. Or women that were a complete reenactment of it, but there's no way around it. There's no way around, somehow this core relational patterning coming up in adult relationships.


Dr. Heacock:

Yeah. Do you remember in your teens and 20s and 30s, were you unhappy or depressed? Or were you more just kind of numb and unfeeling, or some combination thereof?


Saj Razvi:

I think I was a mixture of numb and happy. Yeah. There's a... Yeah, I think, I mean, just a quick story that I remember is like. So this strange version of non-attachment, non-contact was active throughout my entire childhood. I remember, I would watch probably six hours of TV straight every single day. And this is before computers.


Dr. Heacock:

Alone?


Saj Razvi:

Alone, yeah. And my parents were fine with like. I would come home and just lie on the couch, turn on the TV, and just be there until dinner. And so, it was... And at the head of our family table was a 25-inch TV. So, there was just no content in this family, and no awareness of contact. It came, I think if you have parents that didn't get it themselves, they're not going to notice anything weird about it.


Saj Razvi:

I remember being 17 and getting my first girlfriend, and my parents lost their mind, particularly my mom. Because I grew up in Islam, and they were moderate Muslims. But being moderate in Islam is still pretty hardcore. And so, just so basically, there was all this sense of like, what is this new thing that's here? This person actually cares about me, this person is actually regarding me well. I'm feeling these emotions and things like that, that I had never felt in my entire life. And so, I think a lot of people might have that with their first relationship, their first love.


Saj Razvi:

I had that plus, the recognition that other human beings exist. So there was a lot going on there, and it caused a lot of difficulty in my teen years and a lot of upset, a lot of blow ups. I was not the high performing Asian kid. I was just like, there was something in my system saying that this is, there's something deeply wrong here. And so lots of struggles, lots of fights with parents, and it seemed that it was a bridge that they couldn't cross.


Dr. Heacock:

I would imagine that as a kid, you could look around and say, Okay, we have a TV, we have cars. My parents are working, we have food, there shouldn't be any... There's nothing wrong. I haven't been beaten or sexually assaulted. There's nothing wrong. There's nothing. But something is actually, and in a lot of ways the most deeply important thing is wrong.


Saj Razvi:

Yeah.


Dr. Heacock:

How did you start to realize... I mean, at what point in your life did you start to put it together, Oh, this is what's wrong? It's what was missing, as you said in those zero to two in the crib when you weren't... You don't have conscious memories of that, but that, those, that lack of loving objects, that's the core of all the pain. How did you start to come to that realization?


Saj Razvi:

Yeah. I think we'd have to look much more until I got to graduate school. I started my psychology training program, not because I wanted to be a therapist, but because I thought human psychology was really interesting. Then probably about a semester into it, I looked at myself and realized that I was insane, that I had so much strange programming.


Dr. Heacock:

Do you remember what you first noticed as you started to look? How did the mirror to yourself when you say, I was insane? But what can you remember in graduate school? And when did you first have to think, Okay, this is not the way I should be thinking, or feeling or wired?


Saj Razvi:

Okay, so this is a good story. I was in this one particular training, and it was actually a, the same modality that we're using at Innate Path now. It was a group process. And so, the instructor came by. We were practicing saying no in this idea of, what is it like to draw a boundary? And do we go into a stress response? Or is it comfortable for us? Or what happens to us? I found that I could go... I could say no all day long to any situation and not have any reactivity. And I was like, Hey, I'm doing pretty good but... And so the instructor...


Dr. Heacock:

I'm a [inaudible 00:54:42].


Saj Razvi:

I'm a [inaudible 00:54:43]. The instructor looked at me and said, like, "Hmm, when we find people that are that good at drawing boundaries, we usually think that there's some kind of imbalance in the system." He said, "We'll try to imagine doing the other side. Try finding somebody, any relationship in your life that you would say yes to." And I looked at this person and I said, "Why would I ever say yes to anybody?"


Dr. Heacock:

Wow.


Saj Razvi:

Yeah. And Craig, I'll tell you, I was in graduate school for Psychology at this point. Probably, like a year in, and it did not occur to me that that was a strange thing to say.


Dr. Heacock:

As you said, you were swimming. You were fish swimming in your own water for so long, how could you know that?

Saj Razvi:

Yeah.


Dr. Heacock:

There's something seriously wrong with the water.


Saj Razvi:

Yeah. What do other people say yes? Yeah, that kind of thing. And so this is, these types of things operate so below the level of conscious awareness. Just like, I never bothered to think about my relationship to boundaries, and saying no and yes were. It was only during this exercise that I started recognizing, like, wait a minute, I don't... I don't have it. I cannot think of any single situation that I would say yes to. Which is, I think a hallmark of trauma, sort of a really broken impermeable boundary, like being over bounded or under bounded, one or the other


Dr. Heacock:

Then, I'm wondering if you think, okay, I got work to do. Or if you think, Oh, no, I'm broke. I'm so fundamentally broken.


Saj Razvi:

Yeah.


Dr. Heacock:

I mean, I could see where could go either way that you realize that it's the deepest level, there's something so...


Saj Razvi:

I think fortunately for me, I didn't realize it at the depth that [inaudible 00:56:28]. Otherwise, I might have been more downcast. No, I thought like, Oh, okay, I've got work to do. Oh, and the one other, I'll just mention this. The one other story that really got to me with this is of what I recognized that something was really going on was like, I was, I would consider in some ways a kind of a high performing speedy guy. And I had a girlfriend in Boulder. One day, she just kind of like slowed me down and was just like, "Stop. Stop doing all this stuff that you're constantly doing. Just like, look at me."

Saj Razvi:

And so, we made eye contact. It threw me into rage, just pure rage. Just making eye contact with this woman without distracting, without moving, without all these other things going on, and I had no idea. I mean, that my conscious mind had no idea what was going on with that, where that reaction was coming from. But clearly, it was a big bottom up response. And if you think about, sort of one of the ways that infants know of the existence of other people is through eye contact. They could play the peekaboo game, they love making eye contact with the parents, and I didn't get that. And I'm just getting that at this moment being 30, and getting that, all of a sudden brought up an enormous reaction.


Dr. Heacock:

Oh.


Saj Razvi:

Yeah.


Dr. Heacock:

And did... How long did it take to know what that was?


Saj Razvi:

It took a good long while, because the models of psychotherapy that I was studying didn't take account of it. You don't... Trans personal psychology looks at beyond the scope of individual egoic functioning, that's one thing. But most of psychology is, again, its top down talk therapy-based, that kind of thing. I don't think there was very many models to explain what was going on here. But fortunately, I was in Boulder, which Boulder along with San Francisco and Boston is one of this very innovative hubs for psychotherapy in the US. And so I got exposed to some different modalities that really did focus on this, what I would call more psycho biological response. Yeah.


Dr. Heacock:

How old were you when you started doing therapy?


Saj Razvi:

28.


Dr. Heacock:

28?


Saj Razvi:

Yeah.


Dr. Heacock:

Yeah. And what... So you started with somatic kind of therapies?

Saj Razvi:

No. I think, I initially did start with talk therapy. Yeah, there was a counselor at the college that I did some graduate work at that I would see. And we were doing a lot of talk therapy. So it's a lot of storytelling, a lot of connecting the dots, things like that.


Dr. Heacock:

Was that helpful?


Saj Razvi:

I guess, so. I mean, it was helpful in terms of, for helping my mind orient to certain things. I don't think it fundamentally changed anything in terms of the patterns and in terms of the reactivity. It just helped me understand me and myself more. So in so far as understanding is helpful, yeah.

Dr. Heacock:

Yeah. How and when did you start to be able to crack through the dissociation and...?


Saj Razvi:

Yeah.


Dr. Heacock:

Yeah. And it sounds like that moment of the eye-to-eye contact was the picture that like, that inner sympathetic rage, and... But when therapeutically, did you start to? When and how did that happen?


Saj Razvi:

Yeah. I think that was Around similar timeframe where... So I got involved in this work called trauma dynamics, which, again, is what we are using at Innate Path. And a much more nervous system-based model of looking at what's going on here sort of. Instead of trying to understand or tell stories, we're looking at just those types of reactions like I just mentioned there. And so I would say that I did a pretty solid two and a half, three years of some of the most high-end work in Boulder that I could find that was much more of this nervous system-based kind of thing.


Saj Razvi:

Because one of the things that I found with talk therapy was, I would walk out of there, and I'd have to take lots of notes and think about things and think about, okay, this is when this thing comes up, this is how I'm going to manage it. And I found with this nervous system response models, that there was no notes to take. You didn't have, necessarily a deeper understanding of anything. It's just your entire body would go through a way if it would go through a process come to the other side of it. And it felt like, ah, finally, this is getting at what whatever this thing is, is inside of me.


Saj Razvi:

So I would just... The overview of it is that, I probably did two and a half years of just that pure nervous system, releasing traumatic charge model. And so I thought I was like, Okay, this is really great. Then I realized that, well, just because I don't have trauma, it doesn't mean that I have this new... I still need to pattern what it's like to be raised by a competent parent. And so, I did a probably another year and a half to two years of really solid attachment work, self parenting work, self soothing work like...


Dr. Heacock:

Is that one-on-one with a therapist?


Saj Razvi:

Yeah. Yeah, both of those. There were two different therapists. One was much more a trauma dynamics somatic therapist, and the other person was a great gestalt therapist, Don Larson.

Dr. Heacock:

Yeah.


Saj Razvi:

You just shut up.


Dr. Heacock:

But neither one involved any substances [crosstalk 01:02:00] psychedelic assistant?


Saj Razvi:

No. Yeah. So and I thought like, okay, by the end of this, I was like, Okay, I'm doing and this feels good. I'm functional, I'm more stable here and everything like that. I don't know if I could still have been successful at doing a relationship, but life felt a lot better at that point and definitely more stable.


Saj Razvi:

Then, in 2014, so this is fast forward many years. I've been teaching this work, and having a full private practice. So, doing a lot. Then in 2014, I got involved in the MDMA trials as one of the clinical researchers. And as part of that, you go through your own MDMA session. And I will tell you, even after doing a lot of depth work, my first MDMA session just blew away everything. I mean, Craig, I don't want to say that in the sense that it invalidating what came before. But because I think that really set a good foundation.


Dr. Heacock:

That was scaffolding. Yeah.

Saj Razvi:

Yeah, it was scaffolding. But the depth at which the psychedelic work can take [crosstalk 01:03:13].


Dr. Heacock:

What do you what do you remember from that first MDMA session?


Saj Razvi:

Okay. Well, okay, so at the very first thing, because I didn't know what to expect at all. Again, I grew up Muslim, and so I didn't even have a drink until I was 24. Like, no altered states of consciousness, nothing like that. Which is ironic now, because I think altered states of consciousness are the way to go for really deep healing. There's some kind of an interesting 360 there.


Saj Razvi:

Okay. No, but my first experience with that is, I went in and I saw this like in the darkness because I'm wearing these eye shades. And I saw this little bit of light in my mind's eye, and the light was growing and it was getting bigger and bigger. And I was sort of making this motion with my hand that it was growing. Then finally, it was getting so big that basically my arms stretched out, and my arms couldn't contain how big this was. I was just recognizing like, Oh my god, this is love. This is, I am seeing love for the first time like this.


Saj Razvi:

It showed up in this way of like, Oh my God, nothing can exist outside of this. It's impossible to exist outside of this love that's just seems to be here. I mean, even horrible things, even Hitler couldn't. And I actually had that thought during the session, even Hitler cannot exist outside of this love. It's the nature of the world. It's the nature of existence is to love, and it's just like a glimpse into that piece. It was just extraordinary. I mean, it was just such a new thing to me.


Dr. Heacock:

In the next episode, part two of this exploration, Saj continues to explore the healing of his MDMA session. Then prepares himself for the deepest work of all, using high dose psilocybin to try to rewire his neglect and attachment trauma. A final ask to you, our listeners, we would love to hear what you like about Back From the Abyss. What you want to hear more of, maybe what you want to hear less of, which episodes have most spoken to you. So please go to our website BFTApodcast.com, and send us a message with your feedback. And please, rate us on iTunes right now. This will take less than a minute, and help us spread the stories far and wide.


438 views

1445 Holland St.  |  Lakewood, CO 80215  |     E: Julie@InnatePath.org

  • Innate Path Facebook
  • Innate Path YouTube

© 2020 by Innate Path

ip_logo_family_01-2.png