https://youtubetranscript.com/?v=5o87S6GtVn8
Welcome everybody to another voices with Reveki. This is going to be a very interesting one because we’re going to be moving between reflecting on theory and practice and the relationship between practice and four-e cog psi and so I’m really looking forward to this discussion. I’m joined with Terry Dentry and Cameron Duffy and I’m going to turn things over to Terry. She’s going to introduce herself and how she and I came to collaborate together and the nature of our collaboration. Then she will introduce Cameron and then we will take it from there. So take it away, Terry. All right, thanks John. It’s always wonderful to speak with you and thank you for this opportunity to have this chat about how we actually got on this journey together which I’m hoping is just the start of a long journey because we’ve got quite a lot of things to untangle yet about what we’re doing together. So my background, I’m actually a PhD graduate so I finished my PhD about three years ago now in interprofessional practice which is actually the study of how different practitioners from different modalities come together and learn how to actually work together in a teamwork environment. So you have a physical practitioner and a mental health practitioner coming together. So part of that study obviously came about that I was working with a team of practitioners working with refugee and asylum seekers who had chronic pain and PTSD and along the journey of that practice we obviously got to the end of that and I wrote up my study and looked at how the outcomes were for those particular patients and in the study we’d done something that was quite novel which of course you do which was to bring the practitioners together in joint therapeutic sessions which is when the practitioners are in the same room at the same time with the patient. Now it doesn’t happen very often in practice because it’s very difficult to do but when you do do it what happened in this study was something quite magic. So these particular patients who are of course the most vulnerable and suffering from you know quite debilitating chronic pain as well as other mental health modalities were able to work through that and understand the mind-body connection which of course we now are saying to understand much more deeply with 4-A cognition and were able to use that to actually understand their chronic pain and move forward in their care to a point where they self-graduated and no longer required care. Now this is quite an amazing thing for these particular patients but what I was also interested in was the ones that didn’t move forward. So it was about a 50-50 split the ones that actually were able to take this on board and actually work with the practitioners and really understand mind-body and really understand what it means for them and then there were ones who were absolutely not moving forward and there were ones in between that were understanding it for a short time and then obviously going back to insisting on surgery and physical ways of actually dealing with their pain. So after I’d finished my PhD studies I wasn’t really satisfied that I actually knew the answer as to why this happened and I was presenting my work at a couple of different conferences and people would say to me why did this happen and I would I the closest I could come to before I met you John was to say it was trust there was a therapeutic trust environment that was obviously changing there somehow and that was making a difference. Then I was introduced to your work through colleague of ours Shill and Coyne who we both know from Story Grid who uses your work a lot in story methodology and so I was doing some work with Sean and through Story Grid and he introduced me to your work through the practice of story and I was that sounds like something that’s really going to help answer my question as to what really happened with these patients and how we could really help them in a different way and so I reached out to you and you are such a generous person you said yeah sure let’s come talk about it. So we did that I would think that was about a year ago now if you remember it was just out of the blue hey John can you talk to me about this and of course in your wonder of generous nature you said yeah let’s have a chat. Now from that we’ve developed two papers together we’ve submitted those recently so one of them is about that journey that the clients went through the patients went through I’m going to change that word backwards and forwards because Australia and other parts of the world use it differently so patient and client. So the patients obviously went through a particular journey where they were working with new knowledge coming in so the four P’s obviously came into play there where they’re now participating and learning through a different perspective with these practitioners and actually they’re for taking on a different way of understanding the information that wasn’t what they weren’t getting when there was only one practitioner so that was one part of the journey and the other part of the journey was what was happening with those practitioners so how were they learning to work together when they didn’t have the same language they didn’t have the same understanding of what was actually happening they weren’t looking at the same symptoms in that patient they were coming from a very different reference of their relevance realisation so they had to learn how to work together and join in those problem spaces to help that patient in a much more holistic way. So that was the two papers we’ve put together and of course just they were just touching touching the surface of what this is just saying like four E and and of the four P’s and all this new way that we’ve got of actually understanding ourselves understanding how this works is really helping us to really get under the under the covers of what’s really happening here and I’ve invited Cam along to come and work with me as well on this and have us chat with us because Cam and I know each other through Voicecraft which is a wonderful group here in Melbourne a philosophy group here in Melbourne and we’ve been talking about this for some time Cam is a practitioner and he works with patients obviously who have several of these things that they need to work through in their holistic way and Cam is a very holistic practitioner and he’s now been using this framework with his patients so he’s going to talk to us about that. So I’m just going to interrupt for a sec and just remind everybody who’s listening the four E’s for four E cognitive science is the idea that cognition is inherently embodied embedded in its environmental and sociocultural context enacted it’s something we do through our sensory motor loop with the world and it’s extended we not only think in our head we think through the world especially through the cognition of other people and distributed cognition the four P’s is the proposal that there are four kinds of knowing there is propositional knowing knowing that something is the case procedural knowing how to do something perspectival knowing what it is like to be in a particular situation and then there’s participatory knowing which is knowing by being what who are you and what are you in a particular situation. Okay so now that I’ve gone over the four E’s and the four P’s I’m going to turn things over to Cameron and let him introduce himself and how he came to be here and how his work and my work and Terry’s work intersect. So take it away Cameron. Thank you John. So what I’m involved in is basically a dual diagnosis program at the moment along with psychedelic integration counseling so dual diagnosis often refers formally to a mental health type condition that is impacting someone along with in this case an addiction like substance use disorder like condition as well and so there can also be physical health issues along with those as well and I’ve also been involved in specialist programs which I’ve spoken to Terry about that have looked at treating people that have just a lot of complexities and chronic pain has been one of them so that’s been part of many of my discussions with Terry in terms of how her research might converge with my practice experience and specialist programs. I also came across your work John through my friend Tim Adelans hosting some events actually where your awakening from the meaning crisis episodes were screened and so we I would do my practice during the day then go over and watch those with him and others and then we’d just do some processing around your work and eventually that also led to meeting Terry and I’ve also been really looking for an epistemic framework to make use of with regard to I guess the philosophy of psychedelic integration and I found the four P’s been really key there and you know the four E’s are kind of extending into I guess the way we go about being humans in the world and all that so it’s been quite enriching and there’s a lot of other philosophy that it’s part of my background as well but that’s a bit of a summary for now. Well I know Tim as well so yeah so can you say a little bit more about what you mean by psychedelic integration? Sure well someone who’s had a kind of a transpersonal or psychedelic experience which has become more and more part of clinical programs, university research and people obviously exploring these experiences themselves for health reasons sometimes, sometimes motivated by an interest in various forms of self-transcendence, you know the spiritual element of this or the metaphysical domain and you know that kind of union with a life-death process there’s just a lot there and a whole canon obviously of shamanic references from various parts of the world, various cultures and the healing aspect of that intertwined with the more philosophically interesting element of that is what’s captivated a lot of people and so that can be a very challenging thing to come back from into this culture which is you know as you’re aware there’s a lot going on with regard to kind of materialism and physicalism and very reductionist paradigms that health services might be implicitly utilizing when they’re working with these people right and so fusing philosophy with psychotherapy and also the embodied elements of all of this incorporating different cultural frameworks has been really key really to actually understanding what is going on and actually how to help people actually assimilate a sense of who they are and how they fit into the world and you know what it means that this kind of psychotechnology can be utilized for such powerful experiences you know how do we actually come to terms with that as individual beings and as we come together in culture to actually talk about what is possible and what we can do with this and you know how it transforms us. So a couple of things come to mind thank you that was very clear so yeah I agree that you know this is an important and interesting sort of scientifically interesting problem about how people can process and integrate these transformative experiences in such a way that they’re not anomalous or disruptive or make them feel alienated or absurd or alone or all kinds of ways in which the attempt to integrate this can go massively awry. I think it’s also interesting that while across cultures you mentioned shamans and other such groups and I know this is a contested term but typically in other places at other times religions helped to deal with that framework and helping guide people through the integration process and make sense of it and make sense of how they then have changed and how that change in who they are and what they are fits into a deeper understanding of the world view etc. So I take it that many of these people are that come to you they don’t find any help from the existing religious institutions is that a fair question? Yeah in fact the psychiatric system is often part of the problem the issue here as well right okay please say more about that yeah right okay yeah so do I understand you they’re trapped between religious frameworks that really don’t seem viable for them and a psychiatric framework that is actually in that way you were talking about that that physicalist reductionist kind of framework that’s also not helpful to them so they’re caught between these two non-helpful alternatives which are and our culture tells them well those are the two alternatives you got and too bad for you I don’t mean to sound cruel because I’m not but is that a good way of framing the problem? Yeah that’s that’s a bit of a summary yeah exactly but it’s quite it’s quite confusing philosophically I think yes yes we’re so implicit the way we make use of metaphysical assumptions sometimes with as practitioners you know as socialized practitioners and so there is that set of tension of who’s actually going to understand me you know who this is an insane experience in some sense who’s actually not going to pathologize the transpersonal element of it right so how how has my work helped relieve that give people let’s say it a third option between those two failed attractors? Well you you explore a lot of themes I mean synoptic integration in general I think is really key here and conciliance like thinking and it’s absolutely key when it comes to I think understanding what their psychedelic experience is and how to actually use frameworks and you’re kind of bridging quite a lot there you’re you know bringing into kind of an academic framework how we can actually as Terry mentioned earlier use the same language here and it’s a really practical starting point when it comes to constructive dialogical engagement you know right with someone. So Terry did you want I see you nodding did you want to say something to that? Oh no I just see it as I this is we’ve had Cam and I’ve had quite a few conversations down this same sort of way and I think where my work comes from back go step step back to just chronic pain and chronic pain can mean so many things it can mean physical pain it can mean IBS it can mean chronic fatigue it can mean you know it can mean you know carpal tunnel syndrome it can mean you know rheumatoid arthritis they’re all classified as chronic pain because we just don’t have definitions of what these things are and so when I’ve kind of been looking at this coming back to just pain is actually a way of simplifying it and thinking well we all go through pain we every one of us has chronic pain we are stuck in a paradigm where we believe that pain through our narrative bias we believe that pain to be part of an old injury that hasn’t healed part of something that has come on to us because something else happened we go through lots of these we’ve we’ve got a historical way of believing this dualism of the mind body separation that pain unlike mental health mental health has actually made leaps and bounds in understanding where depression comes from and parasitic processing and our adaptive process we’re saying to understand that complex adaptive process a lot better because we we we do have a way of internalizing it and believing that things like depression anxiety addiction are coming from us but we don’t we don’t give that then to chronic pain we we then forget and we we go oh no but that’s something different but it’s not something different and so quite often I have this conversation with people and they’re like wow what but it’s not something different chronic pain is very similar to depression and this is why they quite often happen together this is why we have them together so but we all learn to enact and see the world through our chronic pain and work through it and expect it to be healed from something externally until we start to embrace it and understand it as not something that we should have shame about or something that we feel is an injustice that’s been done to us and still we start until we start to understand pain in the same way we’re starting to understand depression we’re not going to move forward in pain we’re just not going to break through that barrier of understanding where it comes from and so the work that Cameron’s doing is taking that down the track and actually looking at you know that combination that very complex combination that people often have and how psychedelics can actually help to open us back up to it to an answer but until you you can’t embrace that until you go back and say you know what it’s actually embedded it’s actually something that I have it’s part of my world it’s extended part of my world which is still part of me until we can understand that we’re not going to start moving forward on pain so that’s why I always like to take people back just to just think about back pain for a moment now just think about do you know that numbers always help us so in the US right now 20% of the US population has lower back pain right now there’s a lot of people right there’s a lot of people you can’t tell them that they all had the same kind of injury like they all went through a similar kind of part of their lifestyle where they all came across this same injury and but their narrative tells them that they have but they haven’t what’s happening is a much more complex reality of adaptive processing that is creating a chronic pain right so and obviously there are ways and there’s been volumes and this is the breakthroughs in this have been made over and it’s like reinventing the wheel when you go back and actually look at that 100 years ago Freud was saying it’s 50 years ago you know there were other people writing volumes of books on this and then it keeps getting buried underneath pharmacology or the medical model we start to go no no no no but chronic pain is an external thing that happens to us there’s nothing external that happens to us your forefathers told us anything it’s that it’s us we are us the world is us so we’ve got to start looking at that and and this is the whole mind body component of the chronic pain that original study that i said brought me to this work what was it why was it when people understood the mind body connection they started to relieve their pain right they start to relieve their pain now a lot of people say it’s unlearning their pain but it’s not about unlearning it we know there’s neural networks that cause cytokine storms that can create the pain that’s something we understand a bit more about that actually happens but we still think it’s something else that’s doing it to us we’re still not accepting the fact that it’s actually everything that is relevant to us is how it’s working so everything that’s part of our current environment everything that’s part of our world everything we extend our world out to and in the way we’re enacting through that world is part of that experience and the pain is part of that experience so let me see if i can make some connections here because this is fascinating so both of you are pointing to the fact that there are important i don’t know what to call them processes or events that can people can find themselves within and that our current world view frameworks actually prevent people from properly responding to what’s happening in those events and and what you are saying especially terry is you know something that would be unexpected that if we get people to change how they’re understanding we give them the proper sort of ways of thinking about the relationship between mind and body and mind and world we can actually make a significant difference in their chronic pain yes that’s exactly what i’m saying yes and so and it took cameron are you also saying if we could properly help people integrate psychedelic experiences we could use them to also enhance the kind of thing that terry’s trying to do they could they could help get them to i don’t know what i want to say reformulate renovate their their metaphysics their world view but in a way that actually helps them enact things differently and then that goes into what terry’s saying about how we can help them deal with the chronic pain if they’re willing to undergo that sort of world view transformation am i getting the connection correct is that is that is that right yeah that’s a yeah it’s a great way of kind of looking at it i think at this stage you know there’s so much there there’s so much there in the relational dynamics and how that can really help people and terry’s research and program has really i guess elucidated some real key issues there and you know as a practitioner and looking at the research as you know the therapeutic relationship and you might you know refer to polyvagal theory we understand quite a lot now when it comes to these connections including the the health of the body and how all this comes together and also at a deeper level with the metaphysics as you mentioned world view being connected with a sense of intelligibility inherent intelligibility in the body there’s a lot there that can come together in dialogue and really consolidate that sense of self-efficacy that we want to help develop in people so they can actually learn what it means to transform through things like chronic pain and actually you know emerge from that quite empowered through these ideas coming together and i guess the the connectedness of how that can actually occur in professional settings so so this of course is fascinating thrilling for me now there was one other dimension and i want to make sure we don’t drop this thread you and terry you emphasize this but i think cameron you also alluded to it the the 4e4p thing also gives practitioner ways of coordinating with each other so that they can help facilitate the kind of thing we’re talking about with respect to the clients patients so could you both say a little bit more about that because i know that’s part of the the the two papers that you and i worked on terry yes so maybe i’ll jump in first cam because we’ll just go back to the papers to start with so this is a practice that is actually is worldwide the the the area of interprofessional practice is about this it’s about helping practitioners to work together in a way that they are with each other so they learn to they learn about each other they learn from each other and then they learn with each other and that’s kind of the paradigm that they learn to do now it’s really difficult it’s really difficult this particular this you know in professional practice is now part of most of anyone who’s who’s becoming a health practitioner will have this as part of their first year study part of their second year study part of their third year study part of their honours study and then they go out into practice and it doesn’t happen so the work i was doing was actually looking at what happens when you’re in practice what would happen if you had very experienced practitioners who’d already been in the field for five years and they would actually work in this way and they actually you know had the skills of interprofessional practice and they put them into practice what would it then look like and so that study that i was very privileged to be part of and study um did that the actual practitioners had been in the field for for many years and then we brought in a way of actually helping them to understand these ways of working together and it’s much much more difficult than we could even go there’s books about this there’s lots and lots of volumes of books about how hard is it but you know they’ve we’ve taught them a different way we’ve taught just take two different types you know modalities so a mental health practitioner has a scope of practice where they look at what is relevant to them and they’ve got it boundaries around it so they look at only those areas and then a physical health practitioner has their own scope of practice has their own language has their things that they look for when they’re looking at how they can help the person so bringing them together and having them holistically work with a with a patient one all together is you know they have to really create almost a new language they have to be a new self it was quite transformational so the paper we wrote together was all about the transformation those practitioners have to go through to decide to become an interprofessional practitioner will i become someone who works across scopes of practice or will i remain where i am and become the very best practitioner i can in my own scope of practice it’s a decision they have to make it’s a really difficult decision that they have to go forward and decide to do but we need these practitioners to do it and it’s been in my experience in working with students and working with practitioners there’s a lot of fear involved as well in in going forward and learning to work together and practitioners like ham have actually become more holistic practitioners in themselves rather than working with another practitioner coming together and i think we we probably need both to happen but we have we have when you look at what’s required what people need when you’re talking about actual people’s needs they they need social work they need you know they need all these other ways of people caring for them other than just a counselor or just a physio they need all sorts of practices we’ve got so much depth of knowledge of what how we can help people you can’t have a single practitioner understand all of that so at some point you know we are trying to help practitioners become better at working together but we’re almost breaking our own model in doing that and creating this new model where they’re working together as well as working apart and then working together and you know every practitioner I talk to he says it’s wonderful I want to be more interprofessional I want to work with others I want that in my practice but you know some of the barriers are that we don’t pay them that way patients don’t pay that way they might come into clinics they don’t pay they have two practitioners work with them we haven’t trained them to work together we haven’t we’ve got very very different language bases very different understandings of how things work and so it was when I was introduced to obviously you know looking at the four e’s again let’s go back to that was like that was the framework that we can start to use to talk about how all these different ways of looking at helping someone actually integrate together and so it gives it gives practitioners a way of of actually interacting with each other and talking about things on a similar framework as well as then incorporating patients into that conversation so you know it’s um yeah it’s it’s uh it where the biopsychosocial model doesn’t work it’s like it’s all the things that were wrong with that model that keeps separating it keeps those in three different domains of practice before is bring it together so you know I really sort of work from the holistic way of working from within the patient first then to extending it out into the environment thank you for watching this youtube and podcast series is by the verveki foundation which in addition to supporting my work also offers courses practices workshops and other projects dedicated to responding to the meaning crisis if you would like to support this work please consider joining our patreon you can find the link in the show notes so there’s just so many different ways that we can we can now start to think about these things in different ways but the practitioners need to learn differently and the patients need to learn differently and society needs to learn differently we’ve got so many things that we really need to recalibrate rethink through the way that we are seeing these things in the way we’re framing them so I take it that this is what was what you were invoking common when you talked about the synoptic integration that that I’ve talked about how the you know the different disciplines have their own language and their own ontology and their own methods of gaining evidence their own methods of intervening in the world and what you’re doing in cognitive science is you’re trying to find a bridging language so that they can all like transformatively impact each other and generate insight and criticism for each other that’s and I call that synoptic integration and so in my understanding you you’re in the in the in the interprofessional practice you’re actually trying to get something like that too you’re trying to find a bridging language a way of thinking so these different worlds you know there’s different right we’re speaking different languages and using different you know ontologies and different methods can find a way that they can meet uh can find a way that they can meaningfully talk to each other is that is that is that what you met with the synoptic integration how it applies in this situation yeah I think things are heading in that direction in terms of you know as as terry mentioned there’s so much research we can make use of as as professionals I think um the so-called psychedelic renaissance really challenges us to actually come together like this because we do need an integrative kind of framework and language that we can all use I mean doesn’t matter what profession we’re from we need to be able to communicate to look at transformational processes you know we need to be able to treat people in the context of actual transformation and um the the four p’s especially I think is really helpful when it comes to understanding something as complex as psychedelic transformation where there’s so many elements of it there’s so many layers and levels of that we need to integrate uh and that so then actually extends into the the four e’s as well and yeah I spent a while just trying to you know figure out how to um put this into language as part of a kind of uh you know what psychedelic therapists or uh psychedelic integration practitioners what they might work with and so when I came across you know your work on that and the four p’s uh I thought oh this is this is in place this is really efficient we can we can use this and it relates to you know the empirical research and so a lot of things just came together there and it just is quite efficient I think when it comes to keeping things uh quite straightforward for practitioners and yet it does extend quite you know in whatever direction we wish to extend it in as well right I mean so I’m deeply appreciative of the point both of you are making because um I’m sometimes given the criticism well what’s the use of these big picture frameworks right uh like right and and it’s like and the and and the the implied assumption behind that as well because they’re very far removed from practice but what both of you are arguing is no there are there are important kinds of practice that actually need these big frameworks because synoptic integration and the generation of shared languages is actually an important part of the practice is that a fair thing to say would you would you would you agree with that yeah absolutely and I would say it’s from both sides so um synoptic integration can also be seen from the patient’s point of view that they need to integrate the information coming to them right so they also need to do that themselves so if the information’s coming to them from disparate places individually at different times and places it’s very easy to dismiss that information and not to take it in but in the practice in the study that I was working on as I keep saying to people two practitioners in the same room at the same time made a lot of difference because that patient had two practitioners speaking with them from different ways at the same time about their one holistic problem and the patient was doing the synoptic integration of the relevance of the information coming to them and how then it resonated with them they were seeing through it seeing from one side through to the other seeing from the other side through back and then how that would work for them so that they were doing it themselves as well so it’s a it makes a difference where you are receiving the information how you’re receiving information as to how do you integrate it so whether you’re participating in that information coming to you where that knowledge then can either be integrated or can be dismissed we don’t just add more you know to our current belief system takes a lot to shake that current belief system right right right well first of all I mean uh like I said I’m uh uh I’m very grateful for um the case that both of you are making obviously I think I’m in agreement with it but the fact that you’re indicating um you know the how bringing 4e and 4p’s and notion of synoptic integration and stuff like that um can be so facilitary of something that pretty directly ameliorates the suffering of human beings and I think that’s a concrete very specific and uh worthy goal so that I think I think we’ve addressed that very well I’d like now I’d like to allow both of you to zoom out a little bit more what more do you want to so let’s say we’ve got that sort of built now in our discussion together uh you know the common base of found a what more do you want to like what where do you want to go what do you want to extend what do you want to add to that what do you want to draw this is your opportunity uh to to to do that um and perhaps call to other people uh attention and perhaps even participation so how what would you like to say more so I I definitely see this as just being the tip of the iceberg obviously there’s so many things that we can go into first of all we can look at how did we get here and how do we make how do we make this change how do we adopt this as a way and a framework of actually thinking about this you know this problem this for me this chronic pain problem which is a universal problem how do we think about it differently but we’ve got we also can use it to go back upstream because we can say why is this happening why are we getting chronic pain why are these things happening and we’ve done a lot of work you know there’s a lot of work going on with um why depression you know um is something that that might come to be why addiction um might come to be and we know that they’re both from complex you know adaptive processing that has a purpose we’re not going to get rid of it it’s got a purpose and we have to understand it but then that is something we need to we need to incorporate chronic pain in those discussions I never hear the words chronic pain being discussed whenever we’re having those discussions about these particular complex processes we always assume chronic pain is something else so that is part of the conversation the next part of the conversation is an obvious one which is how do we help people how do we now we have an understanding where it’s coming from what do we do and the answer is that ecology of practices that we’re already talking about that you obviously put together a lot of those in aftersocrates a lot of that ecology of practice and what Cameron’s talking about with psychedelic practice those ecology of practices are there for chronic pain too chronic pain is part of us those practices are also the same practices we need to learn to adopt to get through and help us work through chronic pain so so let me let me uh stop here because uh I think there’s something really interesting because you mentioned the history and it occurred it occurs to me that the the history of those other things also went through these stages the initial approach to depression was a very it’s you know a sort of totally inside maybe even a biochemical thing and the the same thing we went out with anxiety and the same thing with addiction and it’s only recently that we got the work of people like Mark Lewis who give us a 4e understanding of addiction that actually sits better with the data and so it looks like you’re saying uh you’re basically saying let’s do that history faster now instead of waiting like that took that took a lot of time and a lot of work and a lot of effort can we uh can we do what can we do now to speed that up so we can get the chronic pain people to say well look it’s like what it’s like depression it’s like addiction let’s not let’s get out of those those you know those very blinkered frameworks that really held us back in depression really held us back in addiction and let’s move into a much more facilitatory framework uh uh and and that’s what I’m hearing you say does it does that does that land does that make sense absolutely I think we’ve got to take what we’ve already learned exactly we’re going through we haven’t got another hundred years to wait for chronic pain to catch up right it’s time that we kind of move forward as quickly as we can and I think the time is right we’re actually at a point now where we’ve seen in the last 10-20 years how um taking more uh drugs pharmacology kind of interaction with for pain we can’t numb it there’s nothing we can do we’ve gone to as far as we can go with trying to numb pain and say we can just take it away we now need to start addressing it as pain itself and start going back to the way that pain’s actually interacting with us and interacting with our lives rather than the numbing of the pain so I think you know this is a this is a time in history where we’ve learned this lesson a number of times in the last 10-20 years that we just can’t keep trying to numb the pain we need to it just leads to far more other problems no one’s ever numbed the pain out it doesn’t work it just leads to other issues of addiction and depression so we need to find other ways and the only way we’re going to find other ways is to really accelerate this work and start looking at it holistically so so that brings up one other point I know Carmen probably wants to say something but it’s it seems to me that and I know there’s evidence to this and you’ve indicated there’s causal relationship between these three phenomena they’re often co-morbid together right the depression the addiction the chronic pain and so there’s also the possibility that this framework would allow us to like zoom out and talk about and help to address the way those things are co-morbid and maybe reinforcing each other at affording each other what would you say about that Terry? Well there’s a thing that’s called the symptom imperative where you you might have there’s a reason why they’re co-morbid there’s a reason why it’s quite likely if you have one you’re likely to have others in your lifetime but not usually at exactly the same time usually it’s what people in and out so usually you’ve got some chronic pain you might get through that and then you’ll hit into some depression or some other type of pain so the unconscious is telling us there’s something or this you know adaptive processing is telling us that there’s something that the body needs to attend to it’s a signal a huge signal that our body is not in the right place but we are you know we are still coming to one we’re working with one and then we’re not addressing another one and so something else bounces in its place and we everyone’s got a history of that I’ve got a history of that I can give you a long list of all the things that I’ve had this then this oh yeah then I had this oh then I had this then I had this like we’ve all got this long possession and when you start to link them in your mind and go they’re all the same thing really there was I’ll give you one one example I a couple of years ago I had very very bad jaw pain so TMJ and I had been in a car accident many years ago 30 years ago where I did damage my jaw and then the pain comes and goes over the years but a couple of years ago it got to a point where it was really really really painful and I ended up going to see some practitioners about it and they told me I was going to probably have to have surgery but you know there was a process we could go through we could try a few things first right now today I have no TMJ pain whatsoever and I’ve had no surgery so it’s the pain’s been released but I see it now and when I talked to Cameron about it he said oh yeah a lot of my patients have TMJ I thought it was unique to me but it’s interesting that it’s actually one of those it’s another one of those things that can re you know appear in our long history of things that that we end up having to deal with you know and I you know personally I’ve had to go back and re-look at what are the traumas that I’ve been through in my life earlier and this you know I haven’t really worked through those well they are signaling it’s signaling we are just going through there’s just this cycle that we keep going through until we deal with it until we kind of come to terms with it understand it properly you know and really understand how we’re working what is it that we’re actually doing and then try and you know help ourselves through that Right. Cameron would you like to add on to this? Yeah it’s worth noting on just to sort of join in with what Terry’s mentioned trauma you know as many will be aware it can be a very confusing thing for people to experience it really does experience it really does collapse kind of the identity structure it really really leads to a lot of autonomic activity and dissociation all kinds of things can result from that and it can be so confusing for people to experience and then trying to understand and you know people really do need a relational context to kind of build back up a sense of co-regulation and a sense of what on earth happened and how do I reintegrate my psyche and you know what comes along with that is often so many issues when we look at an overactive stress response potentially gut issues gut health issues there’s a lot there that you know if you go to different practitioners they’re going to say oh this is for this whereas you know if we do pull back and actually understand that all these things are linked to you know often psychological trauma there’s so much progress we can make I think as practitioners and as treating people and there’s so much they can learn as well I think from all of this you know because it is kind of universal thing that you know people have this experience and it just changes the mode of being right it really does diminish agency and the way we respond to that as health practitioners and as health services we’ve got a real ethical responsibility to make use of all the information and augmenting frameworks available to really assist people in a sense that that could happen to any of us really and you know so it’s an ethical imperative that we do the best we can using the technologies that we’ve got using the the right kind of coordinated care responses and therapeutic awareness that we’ve got and at a deeper level I think what is going to be really key here is coming back to and you’ve spoken on this recently John coming back to this Axis Monday you know actually redeveloping that sense redeveloping that sense that we are deeply connected to life-death process and we can graduate an understanding of ourselves and each other that further encourages an emergence through the participatory dialogical process so there’s an evolution of treatment I think towards a greater depth of understanding of ourselves and that is really going to consolidate the integration from you know stabilization and exploration of meaning to a real integration of what can consolidate our sense of interconnected and supported nature you know when it comes to communities and you know the way we address health issues and allow ourselves to actually utilize the transformational process that is there for us to the degree to which we’re willing and able to actually recognize it and able to communicate together about what it means and what is possible you know and accordingly I’m so glad that was recorded that was quite eloquent Cameron thank you that was that was really powerful so a question to both of you and I and you know and Terry this of course follows from the work you did for your PhD and the work you did on these papers so when difficulty right we’ve talked about synoptic integration between the practitioners and maybe within a practitioner and between the practitioners and the patients right and within the patient but of course there’s also the problem that you know we we’re talking about something that has to negotiate a and you’ve both alluded to this a different relationship to the scientific world so one of one of the one thing that could happen although I think we’ve made good arguments why it shouldn’t be adopted is people could just dismiss this right they could dismiss this and say well there’s no science behind it you can’t actually make me you know believe any of this is the case so what would you say what would you say to that rather hostile critic I am not that hostile critic what would you say to them so this is again just repeat if that was to happen it would be repeating history so this has happened over and over there is scientific evidence there’s a lot of background there’s a lot of research that’s been gone on to show that this is the case that chronic pain is part of our actual makeup and our psyche and it’s part of our adaptive processing it’s not something that’s happening to us from the outside world there’s a lot of people there’s a lot of medical people there’s a lot of neuroscientists that have actually put their name to this and actually done a lot of work on it but it keeps there has been there’s a history of it being beaten down about every 20 years someone will come out and actually go into this holistic way of looking at pain incorporated into into our whole selves and then we’ll be beaten down by no no no but of course that can’t be right because it comes from an injury it comes from something else and then go on that track and it kind of gets beaten out and we all go back to thinking that it can’t be we need to get past that it’s like you were saying we’ve been through this with depression we need to an addiction we’ve been we need to get past this this barrier of us slipping back into our accept our dualism dualism way of thinking that for some reason something happening in our body is not the same as something happening to us something’s coming from the outside it’s coming from somewhere else and there’s something that we can just you know the therapies that we’ve got at the moment and are just not coping just not coping the numbers of people with pain is just escalating the way that’s reacting is escalating and we do really need to do something differently and this is something we can do differently and really think about in a different way and the evidence is there the the research is there people have shown over and over and over that hundreds and thousands of people have been helped by actually understanding just this concept and then applying it back to themselves so that is there we need to just move forward with this we need to get it out a little bit more we need to help practitioners understand then it’s not telling someone it’s all in your head which is the beaten down process it can’t just be all in that’s it’s my leg hurts it can’t be all in my head it’s not a process of just beating it down and saying it’s all in your head that must be we can dismiss that because that’s nonsense it will will go back to the the physical way of thinking about pain we’ve got to overcome that just something being in your head is not also not the answer it is part of a very complex adaptive process and it’s part of living it’s part of what we do we have to understand pain as just being a part of who we are and a part of what we need to understand to allow us to go forward to live not live with it we can all live without pain if we understand what it is and what it’s doing that’s a very strong answer and the fact that you know you’re we’re not getting we’re not only getting you know the improvement of of how practitioners are giving therapy or how patients are receiving the therapy like you said there’s increasing evidence that the framework that people are defaulting to doesn’t work and it doesn’t even work in terms of the evidence and the arguments and like you said people are largely coming around to this now with respect to depression and addiction i think there’s still a battle going on about addiction but it’s now people are moving this way to understanding this there’s the 4e approach to both of those and i think you’re right i think the case is mounting for that approach to pain as well so i think you gave a very strong answer there terry thank you for that come on did you want to add anything to that yeah just to affirm that um yeah a lot a lot of my research and i actually wrote a thesis on psychedelic transformation 2008 and the scientific you know empirical domain of that was very much you know what you for formally just an optic integration you know from the quantum to all the directionality of the scales of architecture of you know structure and functional you know biological apparatus and so it just seems like some personalities and some disciplines and you know some cultures really focus on this and integrating the research and others are less likely to for various reasons so the intrinsic motivation i think is really important here when it comes to you know what you know what is you know what we can actually bring together and how that can actually be helpful for each of us as well as our cultures you know the health of our cultures and the meaning making process of our cultures as well indeed so there would be therefore some deep connections and continuity between what you were talking about here which is largely in a therapeutic context and also developing uh you know uh practices for helping the culture at large so this what you what you’re unfolding here isn’t just going to stay sort of i don’t mean i don’t mean this uh so simplistically but i’m just looking for a term it’s not supposed to stay just in the clinic right it’s supposed to what you’re suggesting is this could give us some very powerful insight to address the broader issues that are actually wrapped up in people’s uh health care is that is that am i getting you correctly yeah absolutely um one of the things that fascinates me the most about uh psychedelic or entheogenic transformation as it seems to couple the healing process with a deep transformation in one’s philosophical comprehension right right so that that is one of the most fascinating things for me you know someone with a you know health practice background and a philosophy background and an experiential shamanic background it all kind of comes together and it’s um and i know this has been a big topic amongst you and you and your peers john uh how this is intertwined with the meaning crisis and yes what can be developed from here um yeah it’s very interesting and really key i think that at a level of understanding we we do recognize the information the research and the philosophical frameworks that can really contextualize that in terms of the transformational processes and empowering people you know to actually understand their self-healing capacities under the right conditions so thank you that sort of affords me asking this question which like i uh you know talking about 4e talking for 4p talking about all of this so it’s sense making and meaning uh making and relevance realization all of these are deeply interwoven in everything we’re talking about here um is that correct yeah absolutely it’s um you know it’s part of the human experience and um from a holistic perspective it can all come together and that’s what i’m seeing myself and you know it was it was it was great to hear about terry’s research and you know the insights that she’s developed from that because um there are certain frustrations you can have when you work in the system and you try and help people and um you know there is almost a siloing sometimes of people from different professions and the potential that could happen if we all just come together and actually do this in a manner that could be a bit more integrative of a lot of converging lines of evidence and you know the shared language there’s there’s a lot there i think that there’s potential and um and you know just talking to terry about this it’s it’s been a very enlightening experience uh bringing our worlds together in a way that’s what i’m seeing myself and um yeah so terry uh is this part of what happens when the patients make that switch um like you were talking about when they start sort of uh reinterpreting that’s not even quite the right word but the mind body relationship the mind world relationship is it also that there but how like are they now making sense and sense making in a different way than they used to and is that part of the therapeutic process yeah absolutely you can think of it as being the insight problem so they were using the wrong strategy and now they’re using a much better strategy and now that’s leading to nexus of new insight and of course that’s why you know we call the paper nurturing wisdom because that’s exactly what’s happening so it’s almost like this magic breakthrough that we they they have all these things they’re trying to deal with they’re getting the wrong information they’re using the wrong strategy over and over and over and over it’s a spiraling thing that they go through and then all of a sudden they start to understand a new strategy a new way a new way of actually understanding how this might work for them and it’s it starts to open up they start to open up and see things in a different way so it’s absolutely it’s the same as an insight problem it is an insight problem do you ever do you get any feedback from them i know this will be this wasn’t proper part of your study but do you ever get any feedback from them that you know that that new way of sense making and realizing what’s relevant and etc is transferred out to other domains in their life like maybe into their personal relationships or something like that do you get do you get any feedback that once they’ve sort of as they get this this breakthrough around how they are framing pain and they get better at framing in general and do you do you see that transferring to like this you know i’m starting to make sense of my relationship differently and i’m you know or does that happen as well well i think there’s more research that needs to be done a much more longitudinal research but definitely the patients that i was with and i interviewed them after so two years and three years after they’ve actually been part of this process they were the ones that actually had the breakthrough were so well they were so happy they were telling me such wonderful things about things that were happening in their life they really you could tell that they’ve made huge breakthroughs in the things that they were trying to do in life so yeah i i think absolutely it translates through to to everything else that you’re doing i know in myself it has i’ve been through the same journey so even just going through and understanding this and you know looking at it myself you turn it back in on yourself as you always do it’s like oh my life is different you know the last the last 12 months two years of my life has completely been different because i see things differently and i’m not using the same strategies i was using before so you know i mean that’s probably the best longitudinal study i’ve got is myself but i think there’s a lot of research that can be done on that and i wouldn’t be surprised if it completely opens up the way people see the the rest of the way they’re interacting with the world as well right right right so that and that that sort of feeds into what what comran is saying about how this sort of reaches into some very deep frameworks that people are bringing to sort of their whole of their lives not just the specific issue of them dealing dealing with the chronic pain so what what what is the future what uh let’s talk a bit about how do you want to go for what more both of you what more research what what research do you want to do comran what what do you want to see happening like what what what are the next steps in like what’s the next thing to to further this argument but also to further the you know the the the power to ameliorate people’s suffering and to enhance their portion what’s next next would you like to go first terry well i’m going to say john the obvious is that i’m going to come to toronto and talk to you about this in some more detail that’s the yeah i really this is something that needs a lot more discussion and i think there’s lots of ways that we can go with but i think it’s something that needs to be more understood on a much more open and more global sort of scale i think we have to overcome the the the way that people can kind of easily dismiss this kind of you know new information and say well that’s just something as you were bringing up before we need to move past that we need to work obviously with practitioners but we need to just work with people it needs to be something that um you know is not something that is uh i’m going to use the word shame again because it’s people kind of collapse down and say i don’t want to talk about that but it is something we can talk about and it’s actually we have a we have a thing here in australia called are you okay day and it’s a day where you just are absolutely encouraged to talk to people and say are you okay today and i think it’s just a wonderful way of actually encouraging people to have these conversations and i think the more that we can actually help people to understand how you know this work this this framework this new way because it is a new way it’s totally different to the old way it is a new way it’s a very new integrated way of thinking about ourselves if we can encourage people to understand it a little bit better and then they talk to other people about it a little bit better then we’re going to move a long way forward much faster thank you terry cameron what would you like to say about that well i’m very focused on fusing philosophy with psychotherapy and incorporating all the physical health elements that i think much of what we’ve spoken about here allows us to understand it’s very much intertwined and so um a lot of this also goes back to what uh dr stan graff referred to as inner healing intelligence and so you know as we become more conscious of um what’s going on within ourselves and how that relates to our you know agent arena context uh there’s just so much to to learn about integrate and uh consolidate both individually and you know interpersonally as communities there’s a lot to come together um when it comes to uh consciousness and therapeutic growth and so i’m quite excited about the potential uh with some of these topics that we’ve discussed earlier okay well i think we’ll we’ll bring this first uh meeting or perhaps we’ll have others uh to a close but i always like to have my guests have the last word you can decide what order you want to do it in um and it doesn’t have to be summative it can be it doesn’t have to be cumulative it can be um it can be reflective it can be provocative what what what what what final thing um this is kind of like the reverse of the elevator pitch what final thing do you want to leave our listeners with so i hope much of what we’ve discussed here it you know the whole point here is that it’s inspiring you know it’s very affirmative of you know what can happen when we connect both with information uh with with each other uh and really develop the potential here and so um i think it’s just really interesting how the way we communicate and uh how this might evolve into a kind of philosophical language and who knows where that might go it might go in a Whiteheadian direction it might go in who knows what direction um you know there’s so many things that this can open up into and so i just hope it’s um if anything inspiring to people and it gives them a sense of hope that um health treatment can evolve and is along with consciousness well i want to thank both of you i mean this has been inspiring to me uh to i mean to have people uh of uh you know of both of your caliber take up my work and then translate it into situations where there’s both theoretical and therapeutic uh you know significant effect um i i’m very grateful and i wanted to thank both of you very much it’s very uh inspiring encouraging and uh i’m really glad we got to have this conversation together and of course terry i look forward to when we can uh when we can meet and talk and um well like you said and i think this i’m going to end on that this is the beginning of a conversation that needs to grow and expand so let’s people who are watching this consider trying to help that process of getting other people to consider and to to talk about this and reflect on it so thank you very much both terry and camera