In this episode, Dr. WaiFung Tsang, DClinPsy joins to discuss the intersection of psychedelics and neurodiversity. Dr. Tsang is a clinical research psychologist from Hong Kong, musician, and student of Shipibo curanderismo. He is the co-founder of Onaya, an organisation dedicated to bridging Indigenous tradition and Western science, and research advisor for psychedelic veteran charity Heroic Hearts Project.

In this conversation, Dr. Tsang explores the emerging intersection of psychedelics and neurodiversity, reframing neurodivergence as a context-dependent spectrum shaped by biology, culture, and lived experience. Drawing on clinical work with autistic individuals, veterans, and athletes, he discusses how psychedelic states may temporarily induce experiences similar to neurodivergence—heightening sensory processing, altering cognition, and expanding perception—and how these states manifest differently for neurodivergent individuals. The conversation highlights early anecdotal evidence and preliminary research suggesting potential benefits for social connection, attentional regulation, and emotional processing, while emphasizing the need for more rigorous studies. Dr. Tsang also underscores the importance of thoughtful accommodations in psychedelic settings, noting that many best practices for supporting neurodivergent participants—clear structure, sensory tools, and intentional environments—ultimately improve outcomes for all participants.

In this episode, you'll hear:

• How neurodiversity and neurodivergence are defined across cultural and clinical contexts
• The overlap between autistic sensory processing and psychedelic perceptual states
• Why psychedelics may shift autistic experiences toward more cognitive or structured processing
• Early findings on psychedelics and ADHD, including impacts on attention, impulsivity, and mental "chatter"
• The role of MDMA and other psychedelics in enhancing social connection and reducing social anxiety
• How group settings and shared ceremonies may uniquely benefit neurodivergent individuals
• Practical considerations for making psychedelic experiences more accessible and sensory-informed
• Why many "neurodivergent accommodations" are simply good practice for all participants

Quotes:

"Every autistic individual is so different and every autistic individual can be so vast and varied in their presentation." [8:57]

"For the autistic participants that come and join in our studies, we have a tendency to see a lot of more cognitive experiences or cognitive-based experiences." [15:57]

"One thing we have been finding is especially people who are autistic can benefit more from the community aspect within psychedelic experiences." [20:05]

"[In Shipibo ceremonies] there's no touching, no talking—it's very autistic friendly. You get to be in your own space. You get to be together but not be together." [35:16]

Links:

Dr. Tsang on Instagram

Dr. Tsang on LinkedIn

Onaya website

Onaya Science website

Onaya on Instagram

Onaya on LinkedIn

United Freedom Collective on Instagram

United Freedom Collective on Spotify

Heroic Hearts Project website

Psychedelic Medicine Association

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In this episode Amy Della Rocca, PMHNP joins to discuss Spravato, the FDA-approved prescription esketamine nasal spray, and its place in the field of psychedelic medicine. Amy is a psychiatric nurse practitioner and the Clinical Director of Marpa, a Spravato treatment center in New York.

In this conversation, Amy offers a grounded and practical look at Spravato as one of the most accessible forms of psychedelic medicine currently available, especially for patients with treatment-resistant depression who may be priced out of intravenous or intramuscular ketamine treatments. She explains how insurance coverage, prior authorizations, and the 2025 shift allowing Spravato to be used as monotherapy have expanded access, while also walking through what treatment actually looks like in practice - from REMS monitoring and nasal spray administration to maintenance schedules and the importance of outside therapeutic support. Throughout, Amy emphasizes that Spravato can produce a wide spectrum of psychedelic effects, that it should not be dismissed as a "lesser" medicine because it is FDA-approved or pharmaceutical, and that the most effective treatment happens in a relational container that balances medical safety, emotional support, and realistic expectations about what the medicine can and cannot do.

In this episode, you'll hear:

• What Spravato is and how it differs from other forms of ketamine treatment
• How insurance coverage, Medicaid, and copay assistance can make psychedelic care more financially accessible
• Which two diagnoses Spravato is approved to treat
• Why the 2025 approval of Spravato as a monotherapy meaningfully changed patient eligibility
• What a typical Spravato session looks like, including dosing, REMS monitoring, and maintenance treatment
• Why therapy, integration support, and external community can strongly influence treatment outcomes
• How patients' experiences can range from subtle relaxation to deeply psychedelic states
• Why stigma within psychedelic spaces can invalidate ketamine experiences - and why Amy argues that needs to change
• What makes a patient a good candidate for Spravato treatment
• How clinicians can carefully work with complex cases, including suicidality, trauma histories, and bipolar depression

Quotes:

"Generally we have Medicaid covering [Spravato treatments]. We have no co-pays on that or maybe it's a five-dollar co-pay. With some insurances, if there's a big deductible, they will have to pay the deductible like other treatments." [6:38]

"In 2025, the FDA changed that requirement [to be on an antidepressant to receive Spravato treatments]. And now Spravato is… approved for monotherapy. So, as you know, so many of the people that are coming to us are not taking daily antidepressants because they've had terrible side effects. Or… they've felt worse, it increased their [suicidal ideation] or, you know, whatever it was. And so to have them still have to take one just felt like the wrong thing to do." [8:34]

"I would say 30% of the patients continue [regular Spravato treatments] on some level—40% maybe of maintenance. And that can be every two weeks; it can be every week. There are plenty of folks that find that the glutamate activity of this medicine helps them more than anything they've ever taken and so they end up tapering off of other meds and continue to get weekly sessions with us." [14:28]

"This treatment feels, in a way, like a half-treatment without outside therapy" [15:25]

Links:

Amy on LinkedIn

Marpa Minds website

Journey Clinical website

Psychedelic Medicine Association Course: Managing Medical Risk in Patients Seeking Psilocybin Therapy

Previous episode: Ending Pill Shaming: How Psychedelics and Pharmaceuticals Can Both Support Healing with Erica Zelfand, ND

Previous episode: Ketamine Therapy Explained: The Science Behind Mental Health Treatment with Dr. Jason Wallach

Psychedelic Medicine Association

Porangui

In this episode, Michelle Weiner, DO, MPH returns to share her expertise on low-dose ketamine for chronic pain. Dr. Weiner is double board-certified in Interventional Pain Medicine, Physical Medicine, and Rehabilitation. She is founder of Neuropain Health delivering personalized integrative care treating the root cause of pain and suffering, both physical and emotional, using a multidisciplinary biopsychosocial approach with many years of clinical experience with ketamine-assisted therapy.

In this conversation, Dr. Weiner reframes chronic pain as more than a symptom of tissue damage, describing it instead as a complex sensory and emotional experience shaped by the brain, nervous system, and a person's broader life context. She explains how chronic pain can become entrenched through maladaptive neural network patterns, fear, stress, and identity-level beliefs, and argues that effective treatment must move beyond symptom suppression toward a biopsychosocial model that addresses suffering, function, and quality of life. Drawing on her clinical work, Dr. Weiner discusses how low-dose ketamine, when paired with preparation, integration, pain reprocessing therapy, somatic work, and functional movement, may help create a window of neuroplasticity that allows patients to interrupt rigid pain patterns and reconnect with their own capacity for healing.

In this episode, you'll hear:

• How Dr. Weiner understands chronic pain
• The "triple network model" of neuropsychiatric conditions and how Dr. Weiner applies this to thinking about chronic pain
• Why imaging, injections, and medications often fall short once pain has become chronic and centrally mediated
• The gate control theory of pain and how this relates to possible mechanisms of ketamine treatments of pain
• How ketamine may support chronic pain treatment by creating a temporary window of neuroplasticity that can be used for deeper therapeutic change
• What pain reprocessing therapy is and why Dr. Weiner sees it as a first-line intervention for many chronic pain conditions
• Patient stories from Dr. Weiner's practice where belief change was a key component of healing pain

Quotes:

"Over time, when [pain] becomes chronic, it's no longer trying to alter the physical body, it's actually trying to reprocess what's happening in the brain." [3:47]

"Ketamine for me started to become more interesting because I realized that this wind-up phenomenon that is so responsible for a lot of people's chronic pain can actually start to be reversed when we start using medications [like ketamine] that can change the balance of glutamate and GABA [neurotransmitters]." [14:26]

"So I just started to think, how can we use the lowest dose of ketamine to create neuroplasticity, guide them in a way that they're able to move and shift the story, and then that's how you can create long term change. [18:51]

"The key is to understand that we are our own healers. If we're not involved in actively participating in our treatment, then we're relying on someone else outside of us and that's not really a long term plan." [29:20]

"More with ketamine is definitely not better. When people feel so disconnected and so separate from themselves, they can experience more fear. And I think that's important to have that sweet spot where they're able to get that time out. They're not really feeling their pain, they're not in their ordinary mind and their conscious thoughts and they're able to have the brain connect in a different way and experience things differently, which then creates hope and allows them to really wake up and say, 'oh, there there are other options out here for me.'" [30:11]

Links:

Dr. Weiner's recent article "Treating chronic pain with low dose ketamine and adjunct therapies within a biopsychosocial approach: a case series"

Dr. Weiner's website: Neuropain Health

Dr. Weiner on Instagram

Dr. Weiner on LinkedIn

Previous episode: Ketamine-Assisted Psychotherapy for Chronic Pain with Michelle Weiner, DO, MPH

Psychedelic Medicine Association

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