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71 - Journey Clinical - How to decentralize treating depression

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Journey Clinical is a “decentralized Ketamine Clinic” (Jonathan) and the “Shopify for psychotherapists” (Myriam). It can hardly get any more interesting, we think! The principle of decentralization is becoming strong in our society and will be even more in the future. In the way cryptocurrency is disrupting our traditional currencies and presents a decentralizing force, the healthcare system shows similar signs of decentralization.


The company Journey Clinical, Jonathan Sabbagh, and Myriam Barthes, my guests today, are very good examples. VCs named their company one of the top 15 startups in the psychedelic field, as Business Insider reports in 2021.

Journey Clinical is a turnkey telehealth platform that enables licensed psychotherapists to include legal, evidence-based Psychedelic Assisted Psychotherapies (PAP) in their practice, starting with Ketamine-Assisted Psychotherapy (KAP). Their novel decentralized clinic model provides member psychotherapists with unprecedented access to a KAP-trained medical team, as well as a robust care management platform designed to deliver personalized treatment plans for enhanced clinical outcomes.


  • Over 1M+ licensed mental health professionals in the U.S. now have access to transformative psychedelic therapies to expand their practice and significantly improve patient outcomes.
  • Myriam describes the new clinical system as a triangle. In the first corner is the patient, in the second the journey clinical doctor, who is able to describe and administer the ketamine, in the third corner is the Journey Clinical member psychotherapist, vetted and often independent, who works with the patient after the treatment.
  • Jonathan describes the company as a “one-stop-shop where all the required treatments get offered to you”. This means, as a patient, you would not have to run around to physicians, psychiatrists, or therapists, who would eventually contradict each other in their diagnosis or where at least one party would not be open to Ketamine Assisted psychotherapy.
  • JC is your new psychedelic house doctor. Trustworthy, but independent from an often innovative un-friendly national healthcare system, if that even exists in the country you live.
  • Jonathan and Myriam are both Swiss and married to each other, which makes this an interesting company, I think. And I mean being Swiss and married to each other. ;)


Both have a background in finance and both have experienced how their lives have transformed with psychedelics. Jonathan, working in hedge funds, suffered from a heavy burnout and undiagnosed PTSD and addiction condition, he looked into ayahuasca and MDMA experiences. Myriam is a firm believer in plant medicine, she had her own psychedelic healing story.


We talk about...


  • How therapists join the network, can access educational videos, then join peer consultation groups, and then can start referring patients to the Ketamine therapy
  • How Ketamine can support tapering off antidepressants that patients will still need to take
  • How repressed feelings and underlying topics of patients made their way to the top during COVID, which amplified peoples crisis and depression even more
  • How with a few Ketamine Assisted Psychotherapy sessions things start to bubble up
  • How a modern psychedelic clinic can look like very soon


Transcript


Anne Philippi 0:09
Hi, and welcome to a new episode of the new health club show. The principle of decentralization is becoming obvious in our society and will be even stronger in the future. In the way cryptocurrency is disrupting our traditional currencies and presents a decentralizing force. The healthcare system shows similar signs of decentralization, the company journey clinical meaning Jonathan Subak, and million bat. My guests today are a very good example of how this is happening in the health sector. VCs named Journey clinical as one of the top 15 startups in the psychedelic field as Business Insider reports in 2021. Journey clinical working with clinicians from Harvard and MAPS is creating the first decentralized ketamine clinic and a new psychedelic field. So psychotherapists are able to offer treatments in their own practice. While journey clinical managers to pharmacology behind the scenes offering ketamine assisted psychotherapy. Miriam describes the new clinical system as a triangle. In the first corner is the patient in the second the journey clinical doctor who was able to prescribe and administer ketamine. In the third corner is the journey clinical member psychotherapist vetted and often independent, who works with the patient after the treatment. And Jonathan describes the company as a one stop shop, where all the required treatments get offered to you. Which means as a patient, you would not have to run around to physician psychiatrist or therapist who would eventually contradict each other in their diagnose. Or at least one party would not be open to ketamine therapy, which might be a disadvantage for the patient in the end, journal clinical works as your new psychedelic in house doctor, trustworthy but independent from an often innovation unfriendly national healthcare system, if that even exists in a country where you live. Jonathan and Miriam are both Swiss and married to each other, which makes this an interesting company. And I mean being Swiss and married to each other makes it interesting. Both have a background in finance and both have experienced how their lives have transformed with psychedelics. Jonathan working in hedge funds suffered from a heavy burnout and undiagnosed PTSD and addiction condition. He looked into an Ayahuasca MDMA experience, worked on himself, and finally was able to change his life six years ago. Miriam is a firm believer in plant medicine, and she had her own psychedelic healing story which she talks about in a podcast. We talk about how therapists Join the journey Clinical Network, can access educational videos, then join peer consultation groups and then can start referring patients to the ketamine therapy. We address how ketamine can support tapering of antidepressants that patients still need to take, how repressed feelings and underlying topics of patients made their way to the top during COVID, which amplified people's crisis and depression even more. And how were the few ketamine assisted psychotherapy sessions things start to bubble up that was suppressed for a very long time. And of course, we talked about how the modern psychedelic clinic can look like very soon. Please enjoy the show. Jonathan and Miriam. Yeah, amazing to have Journey Clinical on the show. I have to be honest, I just realized in a couple of days researching about the company, what a super interesting, and very, very needed concept you guys actually are approaching. I mean, I always knew that you guys were superstars already in the field, because everybody knows you. And everybody introduces me to you. But I mean, I just of course, I saw you in the cattlemen field and connecting therapists to ketamine treatments or to clinics. But honestly, now that I read, I mean, there's not that much available, I have to say, so far online, but I mean, I think this is the number one topic actually that nobody really seems to address. So that how, actually, let's say normal therapists can get into the psychedelic game and kind of open themselves up to secondary treatment. So but it's better You guys explained us, please,

Jonathan Sabbagh 5:03
Sure thing, your thank you very much. And thanks for having us. It was lovely to meet you. In person, I think you hit the nail on the head. Essentially what we looked at was how to best support mainstream adoption of psychedelic therapies. And what we found was that the best distribution network was psychotherapist, both small practices or medium practices and independent therapists. And we started to consider what were the main barriers to entry from mainstream adoption. And what we found was that it was essentially access to partnering with medical teams that took on the medical aspects of psychedelic assisted psychotherapy, there's very few doctors out there that do it. And those relationships can be strained, tenuous, hard to form, and therefore they're forced to refer out. And we feel that the best way aside from some simple distribution, also, the best way to administer these treatments, is as an adjunct to therapy within the context of, you know, a therapeutic alliance with an existing therapist. And so what we've created is a telehealth platform that enables psychotherapist to incorporate psychedelic assisted psychotherapy. And when I say that, I mean legal psychedelics. So that's ketamine now, but it will be MDMA, psilocybin, you know, what else we'll be coming down the FDA approval in the next few years. And, you know, what we do is take on all the medical aspects, so we take on eligibility, prescriptions. Outcome monitoring, the way it works, is psychotherapists refer their patients back to us, or we refer patients back to them, we, we take them in for a one hour intake, we take full medical psychiatric history, we'll send them a little bit of ketamine at home, they come back for those adjustment, and we see them at a minimum four times a year. So we're really, you know, that's on the patient side, on the therapists side, we support a collaborative care model, where, you know, we'll help them essentially build bespoke treatment plans at scale. So it's a care management system, and that concept, and that's the decentralized clinic model, if you like, and, you know, on top of that we're telehealth platform. So they get access to a whole suite of offerings once they join our network. You know, we've got online education that foods designed for us, we've got a variety of offerings, like pure consultation, you know, we help them out with resources. So it's really like a one stop shop where they can plug in and start offering the treatment. What we're not is a online ketamine clinic. Essentially, when we looked at drivers of mainstream adoption of psychedelic assisted psychotherapy, we found that there's three buckets, there is policymakers like maps, although one could argue that they're now also a drug company drug that companies like compass or you Sona and education, and there is no industry where companies like these successfully, fully verticalized all the way to the patients. And so what we offer, essentially, as a delivery mechanism for these treatments that enable the psychotherapist to become a distribution network, and that pushes mainstream adoption.

Anne Philippi 8:11
Okay, so just to break this down. So let's say your classic psychotherapist, and you start reading, okay, now psychedelics will come into the therapy game. And you say like, Okay, I would like to offer this in my practice, or at least have a possibility for my patients, if they say, I would like to look into ketamine, because I read everyday in New York Times about it, for example, which really has increased a few like, in the last couple of months, especially in terms of cattlemen. So, and then they could get in touch with you, and you would say, okay, so how would you guys take over then their requests, or their their their engagement, their wish for engagement?

Myriam Barthes 8:57
It's a fairly straightforward process, and it's intended to be easy to use, and so wants to join the network, we offer them first, our online educational videos, they join peer consultation groups, and then they start referring patients. And so in that way, the patient referral process is very straightforward. We take it over from there.

Anne Philippi 9:21
So that means if they refer the patient but doesn't mean the patient would, like you described earlier would first of all have a treatment at home, or would be referred to a other Katelyn clinic that does also maybe our ketamine like to intravenous variation. How would that look like?

Jonathan Sabbagh 9:40
So we are the doctor. Doctors work for journey clinical, so we employ a whole medical team, you know, our medical stuff is composed of you know, our medical director is an MD PhD from Harvard who ran a MDMA site our lead clinician is From maps, she is also a professor at Georgetown University, and is a clinician at an upstate New York site. So we're, we're essentially, we've structured our whole medical stuff. And so that's how we guarantee access to a medical team, because we are the medical team. So

Myriam Barthes 10:15
you can circle back from the patient referral, right? Once they send a patient, it's in our hands, to see the patient for an intake session, in the intake session, they go through the medical history, the psychiatric history, and other areas. And at the end of the session, only then is the decision of the treatment plan and dosing. And what is right for the patient decided.

Jonathan Sabbagh 10:40
We become their in house doctor.

Anne Philippi 10:43
Okay, just to in house psychedelic doctor, basically,

Jonathan Sabbagh 10:47
I think more Think of us as like, you know, like, if you look at systems like like healthcare systems, that's how we operate a systems level. So they plug into like, almost like a larger hospital system, where they have medical protocols. And we're with a very robust, essentially care management system that enables them to plug in very safely, you know, administer these treatments in a controlled setting, so that they can expand their offering in their practice. So we take on that aspects instead of having them to form an idiosyncratic relationship with a doctor that they found that creates a dependency, if you know, they're going to keep that relationship going. It's also expensive, we're also very cheap, by the way, substantially below market. So thanks to our model, we're able to reduce costs for patients as well, which is a big deal.

Anne Philippi 11:35
It's interesting, you bring it up with the dependency of doctor I mean, that whole topic has become something that we hear often where people who are actually interested in that kind of treatment, I'm not gonna say they worry about this, but it's such an important relationship to that person who will become your doctor. I mean, and if that relationship is not working very well, then people will also pull back from from the treatment sometimes I feel so. But I find interesting that you guys have also these, the way of using lozenges that people can take at home. So and that's for I think for a lot of I mean, in America, this is already like a kind of an almost like a non model. But in Europe, this is still kind of wait, so they bring psychedelics at home they sent us maybe explain a little bit how this looks like when the lozenges come to your doorstep

Jonathan Sabbagh 12:33
An important question. So one thing to understand is very important is that we only support people that are in a therapeutic relationship with journey members and journey members, just so you understand. We only work with licensed mental health professionals, we don't work with coaches, we don't work. So that's already a huge layer. So even earlier on when you were referring to the relationship with the doctor, I'm not sure how it works in Europe. But here in America, psychotherapist can't prescribe medication, so they partner with a doctor, but the doctor only takes care of medication management, they don't do the therapy part. And so the psychotherapist are administering the psychotherapy, right. And so what we're supporting essentially as enabling the psychotherapist to offer an administer, not administer, but facilitate this psychedelic assisted psychotherapy possession, in their practice. So you go to your therapist, you go in their office, or maybe you have a remote session, and you do a cap session with your therapist in that context. That's what we're supporting. In Germany clinical, what we're not supporting is, you know, just sending ketamine to people and then doing self led sessions at this point. And you know, the way we look at it is essentially, people are in a therapeutic relationship with a journey, clinical member, psychotherapist, and you know, they'll get a little bit of ketamine, they'll do a few sessions, but we'll be with their psychotherapist, we, on the back end of that have follow up consultations, to assure that the outcomes are good, that the dose is correct. We also have ongoing communication with the psychotherapist to monitor that the therapy is going well and that we're supporting the therapeutic framework that they're envisioning for this patient. And so that's what we're doing. So it's very different from simply sending ketamine to people at home, and then taking it and then doing an integration session with their therapist. We're essentially allowing the psychotherapist to facilitate the cap session.

Myriam Barthes 14:27
This ties back into this idea of a decentralized clinic. This is what this really means. And you can visualize it as a triangle, and each corner of the triangle one, the first one represents the patient in the middle. And then on one side, you have the journey clinician doctor who prescribes ketamine and does the medical aspect of the treatment. And on the other side, you have the member psychotherapist, and so this is a collaborative care model and that triangle tends to help visualize that decentralized clinic model.

Anne Philippi 15:02
You see so many words that trigger very interesting questions. And for example, like the centralized model would be the one where the whole oxycontin thing has happened in like in that show that's, that's on right now about the oxycontin scandal like dope sick. And it's a centralized model of healthcare. But for a couple of doctors engaged in this big pharma, let's say, medication, then for the patient is big, it becomes impossible, kind of to change very quickly, his direction or her direction. So that's why it's super interesting to work on a decentralized idea of this, I think I mean, because like, like we said earlier, like often people have for a very long time, they have their doctor, and it's this relationship that makes them trust in them for over like 1020 years. So and I think this is totally disrupted right now, because so many weird things also happen in that relationship, sometimes.

Myriam Barthes 16:04
A way to support small businesses, that that's a nice plus of this approach is that you support independent practitioners more practices, and you help them grow. And that's part of this idea of decentralization.

Anne Philippi 16:19
Yeah, like Jonathan, I read this one article about you, where you talked about your personal journey that led you to psychedelics. Maybe you want to quickly talk about this before we asked Miriam, how she got into this.

Jonathan Sabbagh 16:35
So we're both Swiss, and we're married, which is an interesting part of our dynamic. My background is in finance, I spent 20 years working in hedge funds, where I did multiple things I was in an analysis sales, I manage international teams, but I also built two businesses from the ground up. And I actually had a small stint in crypto. And when I was building that first business, I suffered a pretty substantial burnout, which turned out to be the result of undiagnosed complex post traumatic stress disorder. And, you know, I really spent most of my life depressed and having addiction issues. And at that point, really, it turned out that I got on there, a lot of medication, a lot of therapy until about six years ago, now, I was introduced to Ayahuasca. And you know, I did 20 Plus traditional ceremonies, I started working with ketamine assisted psychotherapy, for the past two, maybe two and a half years now. And all that was very transformative for me, it allowed me to get off medication to normalize my life, even normalize my substance use. So through a combination of psychotherapy, harm reduction, and psychedelics and other tools. You know, to be fair, it's important to note that, you know, I'm also a yogi, I meditate, like, these are all tools. And that, you know, aside from that, it prompted a career pivot, I felt a calling to be of service and decided to go back to school and study clinical psychology. And while I was in school, I started to feel the need to integrate my background as an entrepreneur with my goal of being a psychedelic therapist. And that's kind of the genesis of how journey came to be.

Myriam Barthes 18:15
My, my journey, I would say, first of all, I like to call it more of like, a healing journey. And I think psychedelics are a part of it. That's not all, all it is, I think there is a lot of other parts such as, like, you know, nutrition, and music and other like healing parts. And so, when I think about my, my healing journey really started in 2012, I had a car accident in New York City. And, you know, the doctor suggested surgery for my back for my neck, for my knees, etc, I turned down all of the recommendations and decided that there was there were other ways of healing was a lot of physical therapy for a number of years, that really helped regain range of movements. And then there was some physical pain that was leftover, and that I really couldn't, I saw a lot of doctors, there was really no way to get rid of it. And Jonathan suggested, you know, when not to try psychedelics, you never know, at this point that might help. And tried psychedelics, it was completely transformative, my pain, like physical pain went away. And I, to this day, I don't entirely know how things work. But after that happened, and when Jonathan, you know, came up with the idea of like, why don't we help this field, it felt very, very natural to want to be of service and to help. And and the idea was really, how do we expand access? How do we make these treatments accessible for people who don't necessarily want to go into the woods with their friends that actually want to remain in their lives and access this treatment and help remove some of the stigma also around it. And so that that's some of the motivation that I bring to you Are you?

Anne Philippi 20:00
Okay? And then of course, the very important question that many people would have is, how is it to work together as a married couple? I mean, it must be incredible, right?

Myriam Barthes 20:17
you know, it's a little bit psychedelic, I have to say,

Anne Philippi 20:21
Oh, good.

Myriam Barthes 20:25
You know, we were talking to one of our investors, who pointed out that founders that are married, have different challenges than founders who just met or friends. And so some of the things that we already have, for example, are trust, and establish communication in ways that work for us. And we don't have to develop from scratch. The flip side of that, is that sometimes, you know, we disagree as far as life goes. And I think, you know, bringing a professional container, which is different than the personal container, with disagreement and coming to mutually beneficial conclusions that can help drive growth in the business, we tend to bring a bit more emotions into it because of the relationships. So it's a really fun, fun journey all around. And I don't I wouldn't do it any other

Anne Philippi 21:21
Really? Okay, yeah...

Jonathan Sabbagh 21:23
it's my favorite thing. To work with my wife, I love it. Really amazing. And I love spending time with my wife. I think she's a wonderful person. And, you know, but of course, it's really challenging sometimes, like, you know, you live together, and we live in the same space. And we work in, although we're taking an office now, but until now, we were working at home. So that was also intensive, no, it's hard sometimes to understand where work begins and ends. And where we get to be partners, and husband and wife again. And so that's a practice I think, you know, it's it's relearning a new type of relationship and integrating a new relationship in our existing relationship. And so in that context, is work. And you know, we have support, we have a business coach, we would therapy, we have, like people that we are, that are mentors that are that have been through a similar dynamic that help us as well, and we can talk to, and it really takes a village to sort of work through this. It's like you have a support team. And you know, I think, I think it's a it's, it's a reasonable metaphor for what it is to build a venture backed startup is like, you know, athletes, and it's an athletic, physical, mental, emotional journey. And so, when you're doing that with your partner, it's wonderful because you, you trust each other. And that's a big, big deal. And you have aligned goals and vision, you know, but then everything else that comes with it's, it's your partner, so you know, you can say everything, you it can be harsher, it can be more dynamic. So, we look through that, and we're growing with this experience. And, ultimately, at least I personally feel we are a stronger couple for it at the end. Yeah.

Myriam Barthes 23:18
Yeah. And for the anecdote, we started to build journey clinical on lockdown during COVID.

Anne Philippi 23:27
Yeah, you can be sure if things work out after, I feel like a couple of companies started in exactly like March, April 2020. And is still there. So yeah, but let's, let's quickly come back to ketamine. Because what I wanted to ask you is something that becomes a little more visible now also here in Berlin and ketamine practices, is that people who are on medication, of course, would like to do psilocybin but of course, there's the possible and vacation so they'd say, the, this model of using ketamine as something to taper off the medication, and then basically, to bring the patient actually off medication with the help of cattlemen, so the patient could eventually do other secondary treatments to really kind of work deeper into depression. So it's something that you guys observed, and this becomes like a stronger, almost like trend, or was it something that was always there that people kind of did, but nobody's really talked about it.

Jonathan Sabbagh 24:38
I think that this is a dangerous misconception, to be honest, that people believe that. You know, psychedelics are a panacea that are going to solve everything and that people are not going to need medication that's just simply not true. medication works and works for certain psychedelics are very useful in certain contexts, but not for everybody. And so that is a notion that needs to anchor in every the way we approach psychedelic treatments. And you know, we'd like to believe that it is going to solve everything but that's just not what's up. In that context. Ketamine is an extremely effective treatment for people who have anxiety and depression, suicidality. PTSD, it's even proving to be very effective for people with substance use. People at Columbia are doing some awesome work on that. And so it is, you know, can be at certain doses as well psychedelic. The simple neurological impact of ketamine on the brain as an antagonist to NMDA receptors is very effective, it helps regulate the glutamate. So the medical, pure medical aspects of ketamine, you know, works and a lot of the studies that are mostly on IV infusions are a symptom to show that the inclusion of psychotherapy, you know, we believe that the dissociative aspects of ketamine promote cathartic events that really helped work through whatever underlying causes are causing psychiatric issues, and working with a therapist to not only bring those up, but integrate them on the back of that is essential to promoting long term behavioral changes. And so in that context, ketamine is, you know, very effective for depression, for anxiety, for suicidality. It, you know, MDMA is shown to be extremely promising for PTSD, but also for, you know, marriage counseling. You know, psilocybin seems to be very effective for depression. So all these treatments, as we come on, where we've got a whole suite of, of compounds that are gonna probably essentially end up being a matrix, that's how we look at you know, this is your, this is your condition, this will work well, and, you know, maybe combining them even as we go forward. So that's, I think, the world in which we're heading and also a whole slew of new drugs that are being developed, that take the properties of psychedelics, you know, some are looking to make it shorter, some are looking to focus on certain properties. So it's going to be a fascinating time. But it's important to keep in mind that some people are still going to need antidepressants, some people are still going to need benzodiazepines. You know, it's not for everybody, and I think we as a company, are very anchored in that notion.

Anne Philippi 27:20
Okay. But if you read up on on ketamine, that it's often, let's say, in articles saying that, okay, you could do ketamine while you're on antidepressants, because it works on different receptors, whereas you cannot do, for example, go on a high dose psilocybin trip, while you're on antidepressants. So can you talk a little bit about how ketamine is, I mean, I feel it's a very, almost like very flexible drug or like substance that salts a drug. And I mean, it's also like, because I did therapy with with ketamine in, in late 2021, because I couldn't leave the country in 2020, because I couldn't leave the country to go back to Netherlands so and I found it like, almost like an analytical support of connecting dots, actually. So So let's, let's say ketamine, LSD, seemed to be a more rational way of working on things, but that's just my personal experience. And the psilocybin experiences often like works at a completely different level. So what is your take on ketamine, if you would have to describe it to somebody that really just doesn't, I mean, just write about it and wants to do it because they want to actually also leave medication because that's something that is very strong. In the last year that we have a lot of people requesting, what can I do to get off medication?

Jonathan Sabbagh 28:51
I'll throw the science and then talk with the experience if that's okay. So basically, there's a theory called the glutamate theory of depression, where if glutamate is not, which is a neurotransmitter, not well regulated in your central nervous system, it's one of the physiological causes of depression, right? What ketamine does is that it's an antagonist to the neuro receptor that gets the glutamate, NMDA. And so like, if you think of like neuro receptors, it's like a key when it becomes antagonists. It locks that neural receptor, and what happens is that the neurotransmitter glutamate, which is put out by you know, the neurons, it doesn't just get lost, it gets reabsorbed, right, and so that helps regulate glutamate in the central nervous system. And so that is actually very effective at pretty immediately treating people who are feeling depressed and suicidal and anxious. So if you look at treatment resistant populations, who've done IV infusions, actually, within 24 hours of the treatment you have like 54% that become like instantly respondent To, you know ketamine as an infusion, that's tremendous, right? So that's one part of how ketamine works from an experiential component. If you know I think ketamine is a dissociative anesthetic, and so if you were to compare ketamine to say, you know, a psilocybin experience or an Ayahuasca experience, which can sometimes be like really involved and very overwhelming. Ketamine, I felt at least this is my personal experience is a little, you know, less hot or a little more distant. So it's kind of like if you're watching all this from afar, it also depends on dose very much if you're doing low dose ketamine, and you're having a psychoanalytic session. And what psychoanalytic versus psychedelic means, just for context is psychoanalytic is where you're taking a low dose of, you know, ketamine, say, with your psychotherapist, and you're having a talk therapy session, psychedelic resembles more than model of what maps is doing, where you take a larger dose of psychedelics go inward for a while, and then work on the integration after. And so you know, that will very much influence how the experience is going to be right. And so if you have a psychoanalytic session, it will probably lower defenses. That's what psychedelics do. And when I mean defenses, we have defense mechanisms. Within that are created throughout our life to cope with situations psychedelics tend to be defense lowering drugs. And so when you're having a psychoanalytic session on the lower dose, it may be easier to, you know, access parts of yourself that you felt blocked, and have realizations or cathartic moments. And when you're having a psychedelic session on a higher dose of ketamine, let's say you take a high dose of im ketamine, for example, you might experience clearly a psychedelic experience. And so in that context, you know, things can pop up, that can be very emotional. And there, you'll work on integration. After that we, our therapist, another experience that I've personally have, and it's kind of my personal theory about this, is because ketamine is a dissociative anesthetic, you you sort of feel this embodied very easily. With it, right, you feel that you know, even your physical or in the sense of your own body, it goes away very fast, especially when you're going on higher doses. And so, and this is something we've actually observed in our members. Yeah, is that maybe you can actually touch on that after like two of the experiences or accounts of some of our members. But, you know, when you're coming back for like, coming down, if you like, from the experience, there's a sense of like, Rhian body moments where you're, you know, when you're coming out of anesthesia, because it is an anesthetic, right, you start to feel your body again, more and more. And so what that tends to do is have cathartic moments happen on the end of the sessions when people come to and I, one of the reasons, I think, at least it's been my experience, is that I think that it creates a bottom up process where essentially gets you out of dissociation as you're feeling dissociated. And so that really brings up a lot of, of emotions gets you in touch with things that you're repressing or dissociating from. And I've personally experienced that in a very powerful way, where, as I've practice, really cap, I've started to try to be more and more present with that moments of re embodiments. And so that has really brought up for me an opportunity to come out of dissociation and really feel my emotions. And I think that's, maybe you want to share a little bit of the insights that we've got from some of our members and these experiences.

Myriam Barthes 33:39
Yeah, I mean, this, this actually has been this real embodiment has been shared. And people have noticed that quite a lot. We're in the moment of starting to feel your fingers again, and your your entire body, this is where a lot of the catharsis happened, and this is the moment that can be used in psychotherapy, to then work through the content that has come up. What we have also seen with some of our members, psychotherapist is, and this is typically after one or two sessions, is that people were fairly stuck, like that has been like a common theme of people being stuck, especially with COVID not feeling well, you know, depressed, anxious, as well as just stuck in general with their jobs or their relationships. And after the session, you know, for a year, perhaps all of this material is there, but kind of repressed and not talked about, and after one or two cap session, which is fairly fast. All of a sudden, the patients start to bring content around, you know, my job is not working, my relationship is not working, I don't understand. And so all of a sudden this like year of being stuck, all of this content starts to come out and you can work and they do a lot of integration session because all of a sudden, they have all these material that can be worked through and the patient tend to report like feeling a little lighter and like more excited about life, and more joy. And so it's pretty powerful to see that, especially at that kind of speed where for the therapist also, who tends, you know, during COVID, they a lot of them tended to be a little bit burnt out. Because they had a lot of demands, people were feeling horrible, they were trying to be a support system, it was taking a toll on their, their practice. And so this gives them a lot of hope. That, you know, as a practitioner, all of us and and they have more tools, and they can offer and they can bring themselves to the to the session with more energy. And they're excited again, about, you know, the prospect of like seeing their patient advance and heal and feel better. Like the impact is, it's not even linear, it's a little bit more like exponential impact, after again, like very few sessions. And so imagine if you combine this, you add more psychotherapy, that means you can start, you know, talking about each topic one at a time. And over time. I mean, it's quite substantial. The impact.

Anne Philippi 36:06
Yeah, I mean, I feel like in 2020, especially in this year, without vaccine nation, I couldn't cry, I didn't cry one single time, because I was so controlled the whole time. And then it took a high dose of suicide. Like that, but it was that bad. So, but I mean, you were talking already about COVID? Because that would be my next question, because the numbers of people suffering from depression would actually as four times higher than before COVID. So is this something that people when people approach you in terms of treatment, specifically talking about their extreme difficulty in that time?

Myriam Barthes 36:52
In most instances, it's it's a long standing, I think COVID has been an amplifier of whatever the feelings are, you know. And so I don't think from what I've seen is specifically from COVID, but it's been like, oh, you know, over the last 10 years, I haven't been feeling great, but I have been awful in the last three years. So I think that the level of impairments is substantially different.

Jonathan Sabbagh 37:17
I mean, there is there is however, date, that there is 100 million people - there was 50 million people pre pandemic, there's 100 million people now - suffering from depression, anxiety in America, that's America alone. That's 1/3 of the population. And that's just tremendous. So we're looking at a real mental health crisis right now. And you know, these are, I mean, what we see is that the therapist, the joiner network, are actually almost always full. And so there's a need for new psychotherapist, as soon as they start to add these treatments to their practice, they become like overbooked. So we have like a backlog of patients already like that we're referring to people. And so that's been, you know, very impressive, very fast. And so that means, unfortunately, and quite sadly, that we're facing huge repercussions to something that is probably traumatized. Millions of people,

Myriam Barthes 38:07
I think we don't know yet. I think we've been like, paralyzed a little bit by fear, with very primal instincts on I need to stay alive. This is the dominant feeling over, you know, a year or a little bit more. And so I think, like the acceptance of what has happened, and what is still happening, is going to take a little bit more time. And I wouldn't be surprised if there's a lag where, you know, maybe in six months, maybe in a year, this is really one will start people kind of start to talk about what has been happening and how difficult this time has been. So I think I think we don't know it yet.

Jonathan Sabbagh 38:43
Yeah, I mean, I think that COVID has, you know, created trauma. And most of us, like, essentially, we're all hyper vigilant, we have things of powerlessness. You know, we are reliving moments like it's like, it's it's, it's, there's a there's a huge conflict with people on how to protect themselves. Like it creates a lot of dynamics that are have, you know, deeply affected our society. And I think Mira was absolutely right, when she's saying that we don't really know the clear repercussions of what this has done.

Anne Philippi 39:17
To the world. Yeah. Today, I read this article in Germany in 2021. The last time that in a year that many people died was right after the war. So it and that's like, almost like you experience in a country. Something like the end of war. I mean, it's not exactly the same, but it might have a similar PTSD moment afterwards, in a way

Jonathan Sabbagh 39:43
that I think that all of us have experienced this differently. You know, I mean, our parents, you know, and I'm very grateful for them. I live in a small town in Switzerland, and so that was a lot safer. Life was not as affected. And that's great. I think people in larger cities had a very different experience. You know, I know that for us in New York, you know, seeing New York empty and then having portable morgues and riots and stuff was like, super intense. I'm sure you had something similar. You're in Berlin, right? In Berlin, so I'm sure that was also like every large city like lived something that was very, like densely populated areas, versus more rural areas had different dynamics. And I think that that alone is going to dictate how how we all come out of this.

Anne Philippi 40:30
Yeah. And here, it's a very strange thing also happened, that kind of right wing movements in Germany merged with the anti Vaxxer movement. So that's another interesting development coming out of this. So it's a very weird mixture of events happening, rather. But I mean, let's quickly come back to the company, because I mean, of course, we could, we don't want to forget the very interesting company. So and how do you see this light growing in the next couple of years? What is your vision to what why should this be in a couple of years?

Jonathan Sabbagh 41:05
Yeah, I mean, you know, so we are essentially a high growth company, we've raised two rounds of financing in the last six months, we'll probably do another one, hopefully soon. And, you know, so essentially, what we're looking to be as the number one platform in the US to empower people to provide these treatments in their practice. And I think we're going to be growing our tech offering, we're going to be growing all the services that come to our members, we're going to evolve with the FDA for incorporating new treatments, we're gonna expand our medical protocols to facilitate multiple modes of treatment. So I think, you know, we're in a really, really exciting time, I think that we're providing an innovative solution. And, you know, I do want to come back on one thing that you were sort of like talking about earlier on when you talk about oxycodone, which turned out to be a huge problem here in the US. And I think that what we're doing here is really different, because, you know, we're supporting a container with a psychotherapist doctor that really supports a very specific means of treatment. And so we're not a good option to score drugs. It's very onerous, very expensive, there's better ways to do it. And so that also provides another degree of safety, which I think will hopefully make also the regulators and the drug companies comfortable to work with us.

Anne Philippi 42:23
When I think it's very, I mean, especially if you watch that show on Hulu, Dope Sick, where it's really explained how this could even happen. I mean, I think it's super interesting. It also could happen because it happened in a very old system that is not decentralized. So that's like pretty much everything else in this world right now. Right? I mean, so that's a...

Jonathan Sabbagh 42:45
...world of psychedelics, ultimately, being, you know, psychotherapist, or in their practice, and they have, you know, EMDR, CBT, psychedelics, it's a tool, it's accessible as an adjunctive therapy. And we're the ones who are helping them incorporate that.

Myriam Barthes 43:01
And we're in such early days of adoption, like, we think about an adoption curve, like this is the innovators at this point who are using it. And so I think there's so much room to tap into, you know, more traditional psychotherapist who are not already part of the movement, I think, there's so much education knowledge that can be transferred to these people to then again, expand access. And I think like, this is what we're all like, as a movement working towards is to make these medicine accessible to everybody, because we all know how much they can help with healing. And so I think the growth is, you know, foreign journey for the movement for the planet. Like I think the growth is just on so many level, that we're excited to be part of the early days of making this happen.

Anne Philippi 43:51
What is your favorite substance that you're most fascinated by? Besides ketamine, of course.

Jonathan Sabbagh 43:55
I personally, am extremely excited about MDMA and psilocybin coming online. And I'm actually excited about being able to combine those at some point, I think that the combination of those two is pretty amazing. What I'm personally excited about is the opportunity of what's to come. And so there's so many new things coming along, and there's no reason why these things won't overlap, and the creativity that we're going to be able to bring to these treatments and saying, you know, you know, MDMA and psilocybin are a great mix. And for people who have, you know, depression or trauma or you know, they work very well together. And so maybe that's something that we'll be able to be available in this context, you know, legally which is great. Personally, that's what I'm very, very excited about.

Myriam Barthes 44:39
I'm excited about, I like plants so much. I like all types of herbs, like and I'm talking like from rosemary to time, like very simple herbs. So everything that has to do with like, put like plants, everything that grows in the soil. I think they have these medicines have like a way of working And that is quite special. And so I'm really excited about all of the plant medicines.

Anne Philippi 45:06
Okay? So in your perspective, what is the best way to actually look at a sick convince but talk to patients who might be interested in using psychedelics, but might be too scared or to kind of, you know, entertaining the old narrative, and they're in their minds about like the 60s and the hippie drug? So why, in other words, what do you think is the most important way to address this in a in a mainstream context? For patients?

Jonathan Sabbagh 45:39
I think that's a very important question. And the answer always, to me is education, appropriate education, and, you know, having a reasoned dialogue and using, you know, concepts that are rooted in science, and that'll help people who are maybe less inclined to adopt these treatments to get a little more comfortable. And there's a lot of data out there today, thankfully, which is showing the efficacy of these treatments, and the safety of these treatments. And so I think the media has done an amazing job over the last few years to really support our movement in a wonderful way. And, you know, aside from Michael Pollan's book, there's been a lot of this constant articles in the press every day, this shows on television, that there's a growing interest. And I think it's been actually extremely encouraging to see the increased demand on the patient side, to have their therapist be able to adopt these, these treatments. So I think that continued, like, a reason that measured dialogue, rooted in science, to help people get more and more comfortable with this modality of care will help expand mainstream adoption. But you know, I, I want to caveat that with one thing, I think that, you know, indigenous populations, Oh, yeah. Like, like supporting indigenous populations, the fringe, I mean, we I personally benefited from, you know, traditional ceremonial settings. And so those, those people, and those offerings are very important to remember and have benefited us and should be also preserved.

Myriam Barthes 47:16
Yeah, I think I think that's really important. And I think this is, you know, when emerged, the science with ancient traditions, I mean, some of these medicines have been around forever, for as far as humanity has existed. And so I think, finding a place which is like a middle way of science, which is, you know, our current medical model and what society responds to, and, you know, being inclusive of ancient tradition, I think this is actually some of the power of psychedelic medicines, and that we have a responsibility to really bring that forward. And you know, when you're asking your question, one thing that came to me was, you publish science up front, and then people have their first experience with let's say, capa therapist in their office. And then it shifts because it's no longer a cognitive experience, it becomes an emotional experience. I think after a first session, it shifts from the cognitive to the emotional type, simply feeling better, like, you know, waking up in the morning, feeling good about yourself wanting to engage with life wanting to be present. That is enough. And so I think that the question, and this is even what I'm thinking about for journeys, how to get people to their first cap session, because from there, you don't have any more work to do. Like they, they know they've experienced it, because it's no longer the cognitive part, it becomes, it's a full body experience. And from there, they feel better, they have better, you know, of course, with the psychotherapist, you start to build better relationships, you start to take better care of yourself, you start to take

Anne Philippi 48:50
the hope at least. But I mean, what I think what you mean, it's like once you had one experience, even one that whatever it's going to be in mostly the cattlemen in your case. It is I mean, I think just the realization that there is a completely different way of looking into the world is just you can Did you can't just erase that anymore. I think. So and then hopefully, if that experience was one where you felt safe, and were guided, and not like a weird, let's say, horror party experience, where you're running around Amsterdam, and on truffles or something. So hopefully not that, but if you had a good experience and a good set and setting, I think that is something that most people so far, never met anybody was in Yeah, it was good. But now I'm going back to this horrible life where I feel like nobody would ever want to come back to this, right. I mean,

Jonathan Sabbagh 49:46
I mean, I think it's also important to have a system of understanding who these treatments are appropriate for. And so that will drive positive outcomes because some people will not have a positive experience. potentially, like it might not be appropriate for them, it is appropriate for a large amount of people. But that's also what we do. That's what therapists do. And that's part of an important function to make sure that people who do this safely, and that's why I am I do sort of like drill down on being rooted in science and outcomes. And being a pragmatic approach reasonable approach to understanding how to administer these treatments safely and reassuring them with, you know, we're here to support you've got a support system, the dynamic of having a therapist involved, I think, is just tremendous, because that is a person who's supporting a very important container, the the patient therapists relationship is very, very important. And so you know, supporting those dynamics will help people have a much better experience. And I think the more this is communicated, the more environments and these containers are provided to the public, the more they educate themselves about it, the more people will adopt these treatments.

Anne Philippi 50:56
Okay. Yeah, thanks so much. I mean, no, as you see, we could talk forever about this whole. I mean, it's because I find it so interesting that it's no longer just the substances, like everything else, becomes connected to this emergence of secondary because I feel more and more more than two years ago, I feel

Jonathan Sabbagh 51:16
it's so cool to watch an infrastructure emerge, I think, is what really is amazing. Like, you've got all these components of a of an industry that are starting to come up and, you know, working together, and I think that's really fascinating.

Anne Philippi 51:32
So thanks for being on the show. And you it would be amazing. There was no doubt about it. So thanks for doing this and talk to you very soon, hopefully. Yeah, thank

Jonathan Sabbagh 51:44
you so much for having us. This was a ton of fun. It was our first podcast together. So that was interesting and fun is Oh, and you know, hope to speak again soon and see you in person.