[00:00:21] Raad Seraj: Today, my guest is Dr. Joseph Zamaria, who is a licensed and board certified clinical psychologist and an associate clinical professor in the Department of Psychiatry and Behavioral Sciences at the UCSF School of Medicine. At UCSF, he serves as a clinician and researcher in clinical trials, examining the potential of psychedelic assisted psychotherapy to treat a range of conditions, including racial trauma.

[00:00:41] Raad Seraj: Outside of his activities at UCSF, he's a fellow of the American Academy of Clinical Psychology and serves on the advisory board of the Fireside Project. He's also on the faculty of the UC Berkeley Center for the Science of Psychedelics, serving as a lead instructor for psychotherapy and clinical science.

[00:00:56] Raad Seraj: Joe, welcome. So glad to have you here.

[00:00:58] Joe Zamaria: It's a pleasure to be here. Thank you. 

[00:01:00] Raad Seraj: No, the pleasure is all mine. I always fumble call calling you Joe because the first time I saw you on Twitter, your name was Joseph Zamaria, and I having spent time in the Middle East, I immediately thought, okay, that's probably Syrian.

[00:01:11] Raad Seraj: And I was right. You're at least part Syrian. And so I have a hard time calling it Joe because that's, that's a super wide way of calling somebody just as I'm ready to Joe, but we'll go with Joe for now. Yeah. Okay, so you have this unique perspective. The first time we caught up, you said that you integrated these three different streams of thinking or perspectives, which is really special to me in that you're a psychonaut, an experienced psychonaut, you're obviously a person of color, but also you're practicing clinician.

[00:01:36] Raad Seraj: In my mind, you're not only a practicing clinician, you're pushing the boundaries of what I think the application of Psychedelics of psychotherapy could be it's very exciting, particularly as a person of color. So I want to start out the interview by just asking you, how did you come to have these three very, I don't want to say distinct, but they, they are very independent streams in a way in terms of lived experiences.

[00:01:58] Raad Seraj: So Psychonaut, Person of color, which I guess to some degree you can't help it. But also a clinician. 

[00:02:04] Joe Zamaria: Yeah. Yeah. And I think there is probably a through line between each of those routes, each of those avenues that feel like an important facet of who I am, I think being a person of color, being a minoritized person, at least in the place that I'm from, that I grew up and so on I think it leads one to traumatized, perhaps at times, but also curious.

[00:02:26] Joe Zamaria: So this can open the door to, for example, a career in a healing profession. It's often, there's this idea of a wounded healer, somebody who has been through their own suffering and then is going back and serving other people. And it's not that I'm just serving people of color. I'm often serving people of color, but I'm serving all kinds of people.

[00:02:44] Joe Zamaria: But but I think probably. Early painful experiences that I had as a sensitive person and then on top of that being feeling minoritized and feeling othered probably encouraged me towards a career in a healing profession could be doctor, nurse, acupuncturist, psychologist, chaplain any sort of profession where you're understanding difficulty that somebody else is going through and trying to empathize with them about that.

[00:03:12] Joe Zamaria: And then I think to weave in. The psychedelic piece too. I don't know if this is true for everybody. Lots of people experience pain. Lots of people are identify as a minority or have been minoritized by the culture that they live in. Maybe not necessarily would seek out psychedelics, but I don't know.

[00:03:30] Joe Zamaria: I guess I've always been a curious person and I could, I don't know if now's the time to jump into it, but the first time I ever encountered psychedelics is very deeply curious about them. And, yeah. My curiosity was very much satisfied because it's a very obviously rich, overwhelming, powerful experience.

[00:03:46] Joe Zamaria: All the things you could say about psychedelic experience. But I still thought those two avenues were dissociated from each other, being a psychonaut and being a clinician. I got into psychedelics before I got into professional psychology. I, it was while I was an undergraduate and I was studying psychology and I wasn't so sure I was going to go into.

[00:04:05] Joe Zamaria: clinical psychology as a profession. But when I started graduate school a few years after, probably three years after my first psychedelic trip I didn't think that those worlds were going to connect at all. And it was, this was just, this was the mid late aughts. So this was like, just as the current renaissance of research was just starting to make itself known where they were these seminal papers coming out of predominantly Johns Hopkins University here in North America.

[00:04:32] Joe Zamaria: And also NYU, then a few other studies here and there, there was Rick Strassman's work in the nineties with DMT but the, what really put the research into psychedelics, the current, the contemporary chapter of research on my when I became alert to it, it was those articles coming out in the mid late aughts, and then I thought, oh, maybe there's a connection here to be made between this path.

[00:04:54] Joe Zamaria: I'm already going down Being a, a clinician a researcher and a therapist, and my passion outside of school by extracurricular passion for psychedelics. Maybe there's a way for those to weave together. And now looking at how psychedelics can be helpful in treating racial trauma. You'll throw in that third piece too of Oh, it all it's like a, it's like a rope that's woven together by all these little strands and it's producing a thicker rope, but they all come together.

[00:05:18] Joe Zamaria: They have come together in my life. I think as of late. 

[00:05:20] Raad Seraj: No, I love it. You made this comment wounded and curious. I'm curious about how does somebody go from wounded to curious? And we're obviously going to talk about your meaningful psychedelic experience, but that phrasing is interesting to me.

[00:05:34] Joe Zamaria: Yeah, I think I think in some cases they can go hand in hand, because I think to be wounded, I guess I'm self identifying as being wounded, but I guess I am. But to be wounded, you have to have gone through maybe adversity or stress or trauma or something like that, which a lot of people have, but okay.

[00:05:51] Joe Zamaria: But I think also, so that's about the lived experience of somebody who's experienced. something that's wounding, but I think temperamentally, like the, by temperament, like the way you're, we're born into the world, genetics, basically that also primes people to be recipients of, Trauma or not, because like your makeup, your psychological makeup and resilience have something to do with if maybe I'm jumping ahead a little bit about what is trauma and how to define trauma, but to the same event can happen to two different people and we wouldn't define it as traumatic based on what the event is.

[00:06:27] Joe Zamaria: Say a bad accident or a crime or something. Whatever. We don't define it by the event We define it by the impact on the individual So somebody for whatever reason they were just more resilient to that event May not have scarred them in the same way that for someone else who's less resilient and it's no discredit to that person for being Like lessers.

[00:06:43] Joe Zamaria: I'm saying it like it's a moral failure or something. It's not at all but The way that it lands for somebody if they're more sensitive or more receptive to It can create a bigger dent, a bigger impact. I have a hypothesis, a pet hypothesis, which is that I'm temperamentally sensitive. I just know that I am and I'm more emotional and more, I'm just sensitive, more aware of things.

[00:07:05] Joe Zamaria: Especially in the emotional sphere, then I don't know, maybe an average person I meet who's similar to me or something other who's otherwise similar to me. So I think that also, I think in individuals who are sensitive. They tend to be creative and curious, really. They make great artists or great scientists or, they're really like, like very sensitive people who aren't just going to steamroll over the details and are really going to pay attention.

[00:07:29] Joe Zamaria: That's there's an innate curiosity there that I think goes hand in hand with being very sensitive and then very impacted by traumas. So I think those things go hand in hand, they're wounded, being wounded and being curious. Yes. Great answer. I think and one more, one more piece.

[00:07:44] Joe Zamaria: Can I add one more piece? Just that I think the curiosity too has something to do with a desire to not feel wounded any longer. So probably, I didn't, I probably didn't know this as an undergrad. I probably started to know it as a graduate student, but that studying psychology, yeah, it's a nice, it's an interesting thing to study.

[00:08:01] Joe Zamaria: Maybe you can get a job out of it, but I was probably driven more by some desire to try to understand myself and painful experiences I had that were difficult to Makes sense of with whatever paradigm I had before I was studying psychology. I 

[00:08:15] Raad Seraj: love that you added that part because I completely agree with you.

[00:08:18] Raad Seraj: I think, one way to describe sensitivity is also openness and openness is inherently curious. But yeah, this, I think this aspect of willingness to change or willingness to integrate or always looking to integrate information. Whether that's, emotional information or environmental information as well as empirical information is really key here, I think, when you talked about you never thought your experience as a psychonaut, whatever Align with your work as a clinician.

[00:08:52] Raad Seraj: The place that my mind immediately went to, having spoken to lots of psychiatrists and psychologists, is that, or psychiatrists in particular, is that they, some of them choose not to do psychedelics because of this, old adage of, hey, it might bias my thinking. And I understand that's a real concern, but the counter evidence to that is that can you really appreciate music as much if you, or can you appreciate music more if you play an instrument?

[00:09:19] Raad Seraj: Something like that, maybe that's a weak analogy, but I think I've heard that analogy being made. How do you think about that? 

[00:09:25] Joe Zamaria: Yeah, it's a good it's a really good question I've heard this come up before too because there's I don't want to say a debate But there's a obvious trend in the world of psychedelic research that some people who research psychedelics are very open and out about the fact that they have partaken and that they have used psychedelics and others are more KG about it.

[00:09:45] Joe Zamaria: They're more buttoned up about it. And I don't have any judgments about what people choose to disclose about their history, but the idea that, okay, so if I'm a, if I've used a bunch of psychedelics and I'm a psychedelics enthusiast, and then I research psychedelics, is that going to bias my results?

[00:10:02] Joe Zamaria: You could make the case. Yes. and I could see the results that I want to see. But the same could be true of almost any facet of, let's even just say within psychiatry, let's just say I was very helped by conventional psychotherapy and then I want to become a psychotherapy researcher. Am I very biased then because I'm I've been so helped by conventional psychotherapy or by psychiatric drugs.

[00:10:24] Joe Zamaria: Let's say a psychiatrist prescribed me an SSRI for depression. And I was, it turned my life around and really helped me and then I wanted to go be a researcher, pharmacological researcher. Could I be objective there? Maybe yes and no, but there's, I don't think there's ever a perfect situation where we're unbiased and we're not people bringing our own allegiance to the research.

[00:10:47] Joe Zamaria: So it's if you're really strict and linear about it, it's it's very frustrating because you can never just have a totally clean slate. But on the other hand, it's just, I enjoy the complexity and the music and the beauty of life. And I think yeah, it's, I guess it's important to look with objectivity about critique of one's work.

[00:11:04] Joe Zamaria: If I'm really enthusiastic about it and somebody says there's a blind spot here, or you're overstating this or that, I, I would like to be receptive to that and to try to practice looking at it from different vantage points. 

[00:11:14] Raad Seraj: Totally. I think there's this aspect of I feel like this kind of this kind of thinking, this kind of like uneven judgment placed on any on psychedelics in particular presupposes that psychedelics alters you fundamentally so that you can't think straight anymore.

[00:11:30] Raad Seraj: Right? Which is, it's strange to me, majority of psychiatrists and psychologists are white. And then if you hear somebody says psychology is racist, it's And then there's a counter. It's no, we're not racist because, oh, look at all the people who are helping, it's let's pin that notion evenly across all the other biases, right?

[00:11:47] Raad Seraj: I'm not saying it is racist, but I'm saying, if you're going to place these soft judgments and assumptions then we have to do it across the board. But even discounting that, what the hell is a peer review process for if not to counter biases? Totally. Yes. I think we can get into that conversation a bit, but I always think about this sort of tension and all tension is good.

[00:12:09] Raad Seraj: Ultimately, I like that. We're having this debate because we haven't figured out and science at the day. I think there's a larger replica replicability crisis in science where I think these kind of aspects are coming into play more and more as we as old research and old data is proving to be completely wrong about the assumptions of human nature and stuff like that. But since you brought it up, maybe this is the right time. Tell me about your experience with psychedelics. Did you, were you born and raised in the Bay Area? 

[00:12:38] Joe Zamaria: No, I was not. I was born in Detroit, Michigan. And I grew up in like suburban Detroit.

[00:12:43] Joe Zamaria: I moved to New Jersey for college and I stayed there for a little while. And then I came back to Michigan and then I moved to the Bay Area in 2008 to start graduate school. 

[00:12:53] Raad Seraj: Before we go to that, let's talk a little bit about your parents. You have Syrian heritage. I'm curious about how that thread ties into your life.

[00:13:00] Joe Zamaria: Yeah. Yeah. I have my father is an immigrant from Syria. My mother is from originally from Detroit. She's a mixed race woman. She has African and European ancestry. But yeah. My, my dad is a, is an immigrant from Syria. And it was when I think about it, actually, it was a little, even more than being part Syrian, what was odd was being multi like bicultural and multiracial. So that was that actually like I have friends who grew up with, two parents who were Syrian immigrants and there was a little bit, it's not that their life was easy or integrating into American culture or themselves being bicultural because they're come from Syrian parents growing up in North America. That I'm not trying to say that's easy. But there was a, there's a simplicity there that you know, that your family of origin is exclusively Syrian. So for me, it was a little more confusing. My dad did try to help us, like he definitely take on bits, parts of the culture.

[00:13:58] Joe Zamaria: Like we visited Syria when I was a kid. Definitely food, eating tons of Syrian food, whether my dad made it or grandmother's visiting or something. And the language. He tried to help us with the language. I have a little bit of spoken Arabic. I could never get the script. My brother was a little more talented with that than I but yeah, I think what it did going back to the very beginning of our conversation about feeling minoritized and feeling traumatized and feeling like a healer and a psychonaut.

[00:14:25] Joe Zamaria: It's at a very early age, I quite felt like I was other I grew up in a very white suburb of Detroit, Michigan called gross point. And at the time, at least eighties, nineties, it didn't feel there, there were, there are a lot of Arabs in Southeast Michigan, but not in gross point exactly.

[00:14:44] Joe Zamaria: And then also they didn't really look like me, those Arab immigrants because or Arab people who were. Children of immigrants. Because I, because of my mixed race heritage. So even amongst a bunch of Arabs, I didn't necessarily fully fit in. But I think it gave me these first experiences of I felt other, I felt, weird and strange and alone and very lonely.

[00:15:04] Joe Zamaria: And again, all these experiences swirling together through childhood and adolescence, I think bred me to be curious about what is happening in my mind as I was experiencing these things. And how can I affect these things? How can I influence them or heal them or whatever? And so my first experiences with Understanding myself to be Syrian, probably my very first experiences before our school were pleasant because it was around food and family and stuff, but once I, by the time I was in school, it was probably more about being different and other, and it was more of a painful experience.

[00:15:38] Raad Seraj: Yeah, it's interesting. I as well, even though I am not biracial Pretty Bangladeshi in the sense that, I, my, both of my parents are Bangladeshi. Having grown up in different parts of the world, I never really fit in any particular culture. Don't certainly don't fit in Bangladesh in the sense that I'm, like Western educated in a way, but also in a place like Saudi Arabia going to English school in Saudi Arabia that was also made for lower income kids.

[00:16:04] Raad Seraj: So traditionally think of international schools in Middle East, you're like, Oh, yeah, off. I wasn't that. Have this sort of worldview of somebody that's gone to a really good school, but don't really fit in Bangladesh don't really fit in Saudi, definitely, because they make sure you don't fit in there.

[00:16:19] Raad Seraj: And how come in Canada, it, I feel like I guess I feel more Canadian than I can hold any other identity, per se, because Canada, there's no overwhelming sense of what being Canadian is. Which is its biggest strength in my mind, because it's a very big country with very diffuse or, not many people live here.

[00:16:36] Raad Seraj: Whereas in the U. S. I feel like you have to be American first. At least that's my perception as a Canadian. But it's always oh, American and maybe you get to pick something else. I don't know if you share that opinion or not, but here it's like kind of So my point is I certainly understand what it feels like to tick many boxes and having this sort of racial, cultural, mishmash, very ambiguous identity and until perhaps you learn how to integrate all those little pieces, which kind of brings me to psychedelics and how did that start?

[00:17:09] Raad Seraj: Because as a person of color, I always find the how you find psychedelics that journey to be really interesting. So I'm curious about your journey. 

[00:17:17] Joe Zamaria: Yeah. Interestingly enough, the first time I ever used psychedelics was, it was on my 22nd birthday. I Was in Michigan and I was hanging out with my brother who was visiting from Chicago.

[00:17:29] Joe Zamaria: Interestingly enough, this is an important aside, my brother who looks and sounds like me and he was arrested illegally in Chicago. Because he was running to get on a train. He was trying to catch one of their, one of the trains, and they, he had psilocybin mushrooms in his backpack when they arrested him, and they confiscated the mushrooms, threw him in jail.

[00:17:52] Joe Zamaria: No shortage of racial slurs, of course. Oh my god. He eventually, he hired a lawyer, and they threw it out because they illegally searched and seized without really due. Without any cause. So that was who that happened. Obviously after he gave me the, these this these mushrooms, but I had been a little curious.

[00:18:10] Joe Zamaria: I had a few, I didn't really use a lot of drugs in college. I was an athlete in college and we were trying to, we were training all the time and then also we've got drug tested. So even, using Smoking weed or something was rare and having the off season or something, people drank alcohol, but that was about it.

[00:18:27] Joe Zamaria: so I was not really like a big drug user or an experienced psychonaut or anything. But I had a small amount of mushrooms that my brother gave me on my 22nd birthday. And it really piqued my interest. It was enough that I was very interested. And I had some friends in college who were also very curious, also not really drug users, but one guy found a journal that his parents kept when they were in college and read through it and they were writing all about their psychedelic trips.

[00:18:52] Joe Zamaria: And he said, this is amazing. We have to try this. So I was probably the most, it's funny now cause I've gone all in my half. My career is based around psychedelics at this point. But at the time I was the most apprehensive. I was saying, Oh, this, I want, I really want to know that this is safe, that we're doing it properly.

[00:19:07] Joe Zamaria: And we spent a lot of time on Erowid and reading trip reports and trying to figure out how to do it as properly and as safely as possible. 

[00:19:14] Raad Seraj: Why were you apprehensive? But yeah, that was like your athlete. Or because of stigma or what's the reason 

[00:19:20] Joe Zamaria: it Was honestly because of, I guess you could call it stigma, but the the I'm blanking on the word that you would use for this sort of thing.

[00:19:28] Joe Zamaria: Like the misinformation that has been spread about psychedelics. I'm like, oh, it will scramble my brain and make me like have hallucinations forever. Or even the fact that I thought it would make me have hallucinations. I wasn't like, like there's, that, that could mean depending on the drug, it can mean very different things.

[00:19:42] Joe Zamaria: Something that's a genuine. deliriant, like datura root, jimson weed. These things produce, this is, these are deliriant hallucinogens. They can produce really illusions, things that aren't even there. Like you see something crawling across the window that doesn't even exist. And with psychedelics, it's a very different kind of change to your visual domain.

[00:20:05] Joe Zamaria: Close your eyes. You get some pretty interesting visions and visuals. And, but but yeah, so I, I think I just thought I just conflated all these sort of drugs together. I thought they were toxic. I thought there was a point when they could cause death. I thought that they would, literally burn holes in my brain, all of these myths that got spread from the kind of the backlash after the sixties.

[00:20:27] Joe Zamaria: They, infiltrated me. I'm a, I'm still of the gen, like the dare generation. Growing up in the eighties with the, I don't dunno if you had it in Canada, but the DARE campaign, dare to keep your kids off drugs. It was like very Reagan era abstinence around drugs. And so I think I was just influenced by that culture too.

[00:20:44] Joe Zamaria: So my apprehension is something to do that I was like, I want to know, this is not harming me. I was anxious about that. 

[00:20:49] Raad Seraj: Did you or your brother, either of you sense that being minorities, you are also going to be disproportionately affected by the war on drugs? 

[00:21:00] Joe Zamaria: My brother witnessed that firsthand, and I think he was indeed profiled just because of his appearance.

[00:21:05] Joe Zamaria: I think my own relationship to my raciality shape has morphed over time. And I think at that time that I first started using psychedelics, I was a little bit more dissociated from my racial identity. I wasn't at all in conversation with the parts of me that have African ancestry. And I tried to minimize The parts of me that had Caucasian ancestry and I hid behind things like, I don't know how this is in Canada.

[00:21:31] Joe Zamaria: It's changing actually in the United States, but for the longest time, if you're Middle Eastern North African you're considered by the census, you're considered Caucasian, you're considered white, even though you look different and you're treated differently and stuff. Really? We're like, yeah, we're lumped.

[00:21:45] Joe Zamaria: If you see it like the federal census in the United States, it will lump. If you're Afghan or Iranian or Arab or Tunisian or whatever, you'll be Caucasian. Is it because Jesus is white?

[00:21:56] Joe Zamaria: Jesus had blue eyes and blonde hair, so he wasn't our kind of white. Of course. If you look at the pictures, all those famous paintings, he's very He doesn't lie, right? The church doesn't lie, definitely. Yeah, he's very Germanic features. Yeah, but yeah, so I think at that time I didn't I was dissociated from my own racial identity.

[00:22:13] Joe Zamaria: So I don't think I was thoughtful about how it would be different for me. I've had enough conversations with people of color over the years and the various apprehensions they have about different sectors of the psychedelic world that feel either dangerous or exclusionary. And it makes a lot more sense to me.

[00:22:32] Joe Zamaria: But that's just at the time when my early twenties, I wasn't thoughtful about that. Yeah, 

[00:22:37] Raad Seraj: It's interesting how our sense of selves and even for me, like I, I had denied depending where I was. Because all these identity heads were so politicized and it wasn't so much racial.

[00:22:48] Raad Seraj: It was, Hey, don't tell people how poor of a background you come from. Oh, Hey, don't say, tell people you're Bangladeshi by citizenship because nobody like, nobody understands where Bangladesh is from. It's considered to be poor, destitute, blah, blah, blah, blah. Or 9 11. Don't say you're Muslim. Don't say you're Muslim.

[00:23:06] Raad Seraj: Stuff like that. I had my own problem with religion, but that's on the side. I don't have any issues saying it out loud and proudly right now, but back then definitely trying to hide it, suppress it, make sure you're just, as a, you're seen as Western as possible in both in your value sets and your outlook and perhaps even the way you dress and stuff like that.

[00:23:24] Raad Seraj: What would you say psychedelics and repeated psychedelic use after what do you think it brought to your life? Both in terms of the person you are today and the work you do. what sort of integration and what sort of values does it bring to you? 

[00:23:39] Joe Zamaria: Yeah. Yeah. After that first psychedelic trip with my brother on my 22nd birthday, I spent, I used a lot of psychedelics in my twenties and thirties, and it corresponded with I'll zoom out and say that when I was in, when I was in college around the time, and I was using psychedelics at that towards the end of my time in college, I was a double major.

[00:23:58] Joe Zamaria: I was psych and philosophy. And I always thought I was going to go to law school and there was a little bit of that thread in my family wasn't so stark as I've heard in other families, but reminiscent of what I hear from my friends who come from Asian immigrants or maybe Middle Eastern immigrants of that's be a doctor, lawyer, engineer.

[00:24:17] Joe Zamaria: And I didn't have the acumen, I think, to be an engineer and, I wasn't sure about becoming a physician either, but I had heard from a very early age, it was a very loquacious person and a very argumentative person. So I was told you should be a lawyer. So I just assumed I was going to be a lawyer.

[00:24:35] Joe Zamaria: I enjoyed studying philosophy in undergrad and a lot of philosophy majors go to law school because it's the basis is logic and critical thinking, creating an argument and so on. And so it's intuitive for. If you're a philosophy major, there's not a whole lot, there's maybe not many jobs that will look kindly upon that degree in spite of the fact that it's, I think it's a useful degree, but you can basically you can go get a PhD in philosophy or you can go to law school.

[00:24:58] Joe Zamaria: So I was on this track to go to law school. And I remember I was spending time with lawyers and getting ready to apply. And I just, the more I understood about the legal field, the less, I think it was a direct result of all the psychedelics I was using, but it made less sense to me.

[00:25:13] Joe Zamaria: It wasn't enough, no disregard to the legal field. I think it's a great, honorable, fine, necessary Profession. I just, I started to see clearly that it wasn't congruent with my person. That became, as I stated, started using more psychedelics, that became more clear. And I said what the hell else can I do?

[00:25:30] Joe Zamaria: I have a double major psychology philosophy. I guess I could study psychology. And then I started spending more time with psychologists and looking into. graduate school in psychology and that felt very congruent with the changes that were occurring in my mind then, somewhat due to psychedelics use. So I felt like my mind was growing and psychology was a paradigm with which I could understand my mind and how it was growing.

[00:25:56] Joe Zamaria: And then, continuing to be, use psychedelics heavily through graduate school. Heavily is relative, but, and I was always using them, I think safely and wisely and thoughtfully, I had a lot of psychedelic experiences while I was in grad school and it synergized.

[00:26:11] Joe Zamaria: with what I was learning in school and how I was understanding human behavior and the human mind and things like trauma, clinical phenomenon, like phenomena, like trauma that I was starting to see. It's just artists, it started to coalesce together and it started to make more sense, especially when then I could actually apply my career to psychedelics and formerly studies psychedelics.

[00:26:33] Joe Zamaria: And then, yeah, I think. It's along with that. I've spent when I was in graduate school. I don't know if it's this way anymore to get a doctorate in psychology. But when I was in school, my program required you had to get at least one year of personal therapy, weekly personal therapy. You couldn't get your doctorate if you didn't fulfill that standard.

[00:26:51] Joe Zamaria: I think it's an extremely good standard. I think some programs now really encourage it, but don't require it. Wow. Okay. Yeah. Yeah. And I think the idea is like, how could how could I possibly be of utility to a patient? Yeah. Yeah. If I haven't, A, been in their shoes, been on the receiving, been on the other chair, been in the patient's chair, and know how, vulnerable and scary they're going to therapy can be.

[00:27:14] Joe Zamaria: And also, you work out your own, I have issues. I have blind spots and stuff that also can cloud my clinical judgment. So working through that can be really helpful. And then it's a great way to learn too, because you see an expert in, and hopefully if you hire somebody who's good, you see somebody who's proficient in, in practice and you say, Oh, and when they did that thing, it really didn't work for me when they did this thing.

[00:27:35] Joe Zamaria: It really worked. So I think it's a great standard to have. psychology grads, grad students required to attend therapy. But that, I went well beyond one year of therapy. I did spend many years in therapy. I recently started with a new therapist about a year less, a little less than a year ago.

[00:27:52] Joe Zamaria: Study who practices a type of therapy called internal family systems therapy is excellent. therapy for healing from trauma. It it coalesces really nicely with psychedelic therapy. A lot of psychedelic therapists are very interested in IFS. therapy. But basically, Rod, what I'm getting at is like a lot of psychedelics use and a lot of therapy.

[00:28:10] Joe Zamaria: It was just like excavating all this stuff from my mind and allowing me to become more intimate with my mind and my quirks and my history and intergenerational trauma and my relationships and my typical defensive patterns and things. It just allowed me to become a lot more intimate with myself, which is what I think a lot of people say when they use psychedelics.

[00:28:27] Joe Zamaria: But on top of that, synergizing with going to regular therapy and formally studying psychology. I felt like the effect was very, it was very powerful. 

[00:28:35] Raad Seraj: So what I'm hearing is I think psychedelics allowed you to not only have an acute awareness of, let's just say your inner world, but also allowed you to synthesize this person that you are by calling in and stitching together all the different parts.

[00:28:49] Raad Seraj: Cause ultimately I feel, and this is not necessarily just psychedelics, but I think any sort of Contemplative practice was meditation, whether it's dance or whatever you want to call it, allows you through long term to not only recognize the conflict in words and all the tensions will have different parts of you, but also to hold them without judgment.

[00:29:09] Raad Seraj: And is the suppression and the tension that is unresolved is what causes issues, I think, long term, with most people. 

[00:29:16] Joe Zamaria: I think that's so absolutely true. I'm surprised you are not a psychologist. You're not a therapist, because I started on drugs to become 

[00:29:23] Raad Seraj: one, I think. It's really 

[00:29:26] Joe Zamaria: It's a I think that's so true, and I think There are there's a principle there, which is really beautiful, which carries on to larger spheres of humanity.

[00:29:36] Joe Zamaria: So basically, yeah, if I think some part of myself is shitty and I want to throw it in a compartment, stuff it in the basement, stuff in the closet, stuff in the attic. I'm not integrated. I'm not a whole person and I'm operating. Think how much effort I'm applying to dissociate that part of myself from me.

[00:29:51] Joe Zamaria: And then I'm also not a complete person showing up for you. I have to figure out what is that part of me? Is it a Is that part very angry? I need to figure out what that part's angry about, or there's that part really grief stricken. Am I just always sad and depressed? And I've tried to shut that part out and try to act happy and stuff.

[00:30:07] Joe Zamaria: It's no, I need to go address what's the painful thing there. So integrating, just like you're saying. bringing together all the disparate parts, I think is the one of the definitions of psychological health. And I think that's true on concentric circles outward through humanity within a family, within a community, within a nationalistic government or some other larger community structure.

[00:30:29] Joe Zamaria: It's like when I hear that, some countries don't talk to other countries. Oh we don't negotiate with them or something. I understand. I'm not trying to I, I'm sociopolitics is not my expertise, but I, it does seem. Troubling to me from as a human being to see some humans say we are not going to talk to those other humans.

[00:30:47] Joe Zamaria: I think it breeds extremism. And so if a group of people aren't being addressed by a majority group, they're going to say, okay, screw that. We're going to do something more extreme here. We're going to do something scarier here. I think our minds can do that too. If I say, I'm sure I don't like to feel angry.

[00:31:02] Joe Zamaria: I don't like to feel rageful. I'm going to. chain it up like a dog and put it in the crate in my basement. I think it's going to create some problems down there too. Just like a dissociated fat faction of humanity is going to create problems if they don't feel a sense of 

[00:31:15] Raad Seraj: belonging. That's such an interesting way of putting it.

[00:31:17] Raad Seraj: I actually never thought of it that way. Lack of integration or Inner suppression causes extremism between different parts of you. That's a really interesting way of putting it. I'm going to switch gears a little bit because I do want to spend and give attention to the time and the time it deserves to the sort of your work, which I think Does cover a lot of what you said already and as I mentioned in the intro I think it's also pushing the edge of where psychedelic therapy can go and for who and in what way How do you build a more compassionate caring system?

[00:31:49] Raad Seraj: And models of care particularly for people who have been historically marginalized and continue to be marginalized But before we get into that, I think it's really important to define at least from your perspective What certain terms mean and in the world of mental health? Partly because my belief is partly because it's such a gray area and if you add psychedelics to it There's lack of standards There's like how who is equipped to be a psychedelic therapist or even a trip sitter and so on a lot of Words like trauma PTSD get thrown around and I'm not trying to minimize anybody's pain But I think at least the clinical realm we should define what they mean So before we talk about, the world of psychiatry and psychedelics of psychotherapy for racial trauma Let's talk about first of all What is PTSD?

[00:32:34] Raad Seraj: Tell us also what the DSM is. I think that's really interesting. And then tell us a little bit what, Monica Williams, who is renowned in this field and who you work with very closely. She, I pulled this from one of the articles you shared with me, is that she said the history of psychology and psychiatry is racist.

[00:32:53] Raad Seraj: Tell us a little bit about why that, why she said that and why that is true. So I know it's a lot. It's a loaded question, but terms, definition of terms, and then why is psychiatry, psychology racist? 

[00:33:04] Joe Zamaria: Sure. Sure. I guess what I will talk about first is what I think trauma is, and then I'll talk about what I think PTSD is, and then we can get to the fields of psychiatry and psychology.

[00:33:13] Joe Zamaria: So trauma when we think about it when we're describing our physical bodies... In San Francisco, our general hospital, San Francisco General Hospital is a level one trauma hospital. So that means they can feel the worst of the worst, gunshot wounds and things like that. Trauma refers to a wounding, a breaking apart of something.

[00:33:32] Joe Zamaria: If I cut my hand with a knife while I'm chopping vegetables or something, I've somewhat traumatized my hand. There's a break there. There's a breakdown of the integrity of my hand, right? So I think the same concept can be true psychologically where there is an insult or injury that creates some kind of disintegration of the normal makeup of the person's mind prior to that occasion. And so trauma was first I think there have been, since time immemorial, people have found ways to poetically and maybe clinically describe trauma. I'm just going to talk about it within, 20th century North America, let's say.

[00:34:14] Joe Zamaria: After World War One, which was like, at the time, it was just the most ghastly war that could have possibly been. People were, the people who fought in that war were used to an era of wearing big, bright things and, going off to war and having an adventure and riding a horse. Not that war in the 18th century, 17th century, 16th, it was pretty, I'm sure it was hell also. But I think World War I was so dark and ghastly, they were using chemical weapons and fighting in trenches and there was untold slaughter. People were returning home from that combat really messed up. They were really messed up and they at the time they called it shell shock and so what it probably looked like was some syndrome of being depressed or shut down or emotionally reactive or abusive or addicted to alcohol or things of that sort.

[00:35:04] Joe Zamaria: And our understanding if you'd go from and that's by no means the beginning of the conversation, but it's a beginning that I choose to start in is like World War One and shell shock through World War Two and they started talking about battle fatigue, but same idea. Some people going through really harrowing wartime experiences and coming back not the same. So you see that thread of trauma is existing here. Something's happening and they're not the same. And then I think it was post Vietnam War, it was actually a colleague at UCSF who coined PTSD and helped it to be added to the DSM, which is the Diagnostic and Statistical Manual of Mental Disorders. It's currently in its fifth edition. This is a document that's produced by the American Psychiatric Association. It's a library, a lexicon of disorders. of types of psychiatric distress that people can experience. I think some people find this document somewhat helpful. I think most people find it somewhat limited.

[00:36:01] Joe Zamaria: I 

[00:36:02] Raad Seraj: think it's helpful. What do they call it, the statistical manual? That's the part I always like. 

[00:36:05] Joe Zamaria: Yeah, because it's, it discusses the statistics involved with each of the disorders. So we'll say, when the, so each defined disorder within the manual purportedly they've done a lot of research on to determine, is this a true syndrome and how prevalent is it and how does it respond to treatment?

[00:36:25] Joe Zamaria: So these are the statistics. One out of a hundred people have OCD or whatever. That's a statistic. So it gives you the statistics of. the disorder in addition to the descriptive, phenomena of the disorder. Like I think psychiatrists use it more than other mental health professionals, but other mental health professionals use it too.

[00:36:43] Joe Zamaria: It's somewhat helpful for communicating to insurance companies that you're like treating this particular condition, which has a code associated with it. I think clinically it's quite limited. Especially as a psychotherapist or a psychologist, there's so much more deep full ways of understanding human behavior and human functioning besides the DSM.

[00:37:03] Joe Zamaria: But going back to our understanding of trauma, it's, it was largely understood through the eyes of a person who was engaged in warfare, a veteran. That was how we in our culture understood trauma. Certainly though, that person who comes back from war, who's traumatized, if they abuse their wife or their kids. That's trauma too, but that was identified as trauma later. The foot in the door was understanding warrior's experience. And later we realized that it was, you don't have to be in a war zone to have experienced trauma. So over time, the definition of trauma kind of morphs and changes.

[00:37:38] Joe Zamaria: Let me briefly define trauma and then just talk about what is like the cultural baggage along with the PTSD diagnosis. In my field, we talk about two different qualities of trauma, two different types of trauma. We would say capital T trauma, lowercase T trauma. It's a cute way to talk about it.

[00:37:54] Joe Zamaria: But capital T trauma would be like a singular overwhelming, intense, perhaps life threatening event that affects somebody. You were driving a car, you crashed a car, you should barely survive, that's a big T trauma. Especially if life was like normal up until that point, and then you had this bad accident, then that's a big T trauma.

[00:38:14] Joe Zamaria: You go to a war zone, and then you engage in combat, and you get wounded, or you wound somebody, or kill somebody, or you see a friend get wounded or killed. That's capital T trauma. Singular index event could be a crime, could be whatever. And so when the DSM is talking about PTSD, that's what it's talking about. It's talking about a syndrome that follows after an index, a singular index trauma like that. And there's very tight criteria about how those index trauma are defined. For example, you, it cannot be through media exposure. If I'm five, and I watch a whole bunch of very violent movies, and it traumatizes me, that cannot count as PTSD because the prerequisites to meet the diagnosis of PTSD don't account for that kind of secondhand media experience. Has to be like firsthand or maybe secondhand through some, like a really like a close loved one who was like almost killed or something like that.

[00:39:08] Joe Zamaria: And so this has relevance to minoritized people because every time a black person is killed and they show it on repeat 24 seven, there's not a, so just look at that, that there's not a place for that to land in the psychiatric lexicon. Some, somebody who's black who's viewing that could say, I'm fucked up from this.

[00:39:24] Joe Zamaria: Yeah. And a psychiatrist will say you weren't there in person, so I can't give you a diagnosis of PTSD. I don't think an average psychiatrist would be that callous about it, but still, look at the system that's in place. It cannot read that experience that somebody who is minoritized may be having because of its own limitations.

[00:39:41] Joe Zamaria: so And then even if you A little T 

[00:39:43] Raad Seraj: trauma If they did give you the diagnosis try getting insurance or coverage and stuff like that after, right? That's also 

[00:39:49] Joe Zamaria: another problem. Exactly. You have, you'd have to fudge something or fabricate something just so that, and I'm sure lots of ethical clinicians do that just to make sure that their person can, their patient can get treatment.

[00:39:59] Joe Zamaria: But yeah, it's just the fact that there has to be a loophole is evidence that Minoritized experience isn't central. It's not part of the standard, so that's big T trauma, a singular traumatic event. 

[00:40:12] Joe Zamaria: There's also lowercase T trauma. And this would, we also would refer to this as complex trauma, but this would mean like repeated trauma of varying degrees.

[00:40:22] Joe Zamaria: It could be very intense or very not intense somebody who comes from a household and they were, let's say they were physically abused every day or sexually abused every day. That's so important, but it could be happening, it could be a daily occurrence, not a one time occurrence.

[00:40:33] Joe Zamaria: Or much more subtly, domineering or withholding or slightly neglectful parents, it's not going to create the same kind of impact as like childhood sexual abuse. But it's still going to have an impact if your parents never said, I love you, or your mom didn't pick you up when you cried or whatever, like things like that over time and time again, it's going to affect.

[00:40:52] Joe Zamaria: Remember, we're talking about trauma is something that irreparably, I don't want to say irreparably, but decisively changes the makeup of a person. So you can think of a capital T trauma as like A single blow that severs something and lowercase t trauma is like abrasion wear and tear over time that eventually set, but the severing is what is important here, right?

[00:41:14] Joe Zamaria: So PTSD is just a thin slice of how we could understand trauma and people who have been through trauma may not have PTSD, but they may have any other number of psychiatric diagnoses like dissociative disorders or depression or substance use disorders can affect people in other ways besides PTSD. 

[00:41:29] Raad Seraj: And one of the other things that I, as in my understanding is that the definition of PTSD or depression or things like that, or anxiety, perhaps I'm not sure about anxiety, but I've definitely heard about depression and PTSD is that.

[00:41:40] Raad Seraj: When your social relationships are become dysfunctional as well, right? So your relationship to others are impacted by the sort of inner chaos caused by, whether it's like accumulation of, small T traumas or a big T trauma.

[00:41:56] Joe Zamaria: Exactly. Yeah. And I think that's true of any of, I think it's true of anxiety. I think it's true of any psychiatric disorder that if it's, if there's so much turmoil in my own mind, it is, excuse me, it is going to affect my other relationships and. How I relate to other people. Using PTSD as an example, imagine a veteran who's come back from war.

[00:42:14] Joe Zamaria: PTSD is characterized by either syndromes of hypo arousal or hyper arousal. Hypo being, not enough arousal, hyper being too much arousal. So you can think of like arousal, like our general level of stimulation and awareness and so on. There's like a, there's a sweet spot in the middle that we wanna be in.

[00:42:33] Joe Zamaria: If I'm hyper aroused. That's like the traumatized person, the veteran, whomever, who is very emotional and reactive and jumpy. And maybe in the movies, you tap them on the shoulder and they throw you over their shoulder. That's hyper aroused. But you also see people who have a syndrome of PTSD who are hypo aroused.

[00:42:52] Joe Zamaria: They're depressed, numb, shut down, not really, you might see a movie about somebody who's been in a war and they have the thousand foot. stare in their face and they can't really muster up much feeling and they just maybe they're, maybe they numb by using alcohol to filter out experience, to drown out experience.

[00:43:10] Joe Zamaria: So both of these syndromes are possible with PTSD and you can imagine how that would affect a relationship. If somebody, if imagine a dad is so emotional and checked out, he's just in front of the TV drinking beer and he can't say anything about how he feels, how's that going to affect the family system.

[00:43:24] Joe Zamaria: Or a parent who is. Jumpy and overreactive and emotional and always on edge. How's that going to affect the family system, their partner, their children, whomever? 

[00:43:34] Raad Seraj: Absolutely. I'm cognizant that we don't have a whole lot of time left and there's so much to talk about. This is such a meaty topic to get into.

[00:43:41] Raad Seraj: I want to perhaps spend the rest of the time talking about the work you're doing. And I, again, I think you're working with some of the best minds in this space about how do you understand racial trauma. But also where does psychedelics come in before we talk about the application of psychedelics and designing perhaps better clinical trials or having better models of care Tell me a little bit about how do you actually diagnose or measure or quantify?

[00:44:09] Raad Seraj: What racial trauma is what are the tools that we're developing knowing that the DSM has been lacking? 

[00:44:15] Joe Zamaria: Yeah, it's a great question. And I think there is Probably a split amongst clinicians about what sorts of methods they use. I'm talking mainly about clinical psychologists psychotherapists Maybe psychiatrists what sort of methods are they using to diagnose their patients?

[00:44:31] Joe Zamaria: some people swear by Paper and pencil questionnaires that have some sort of empirical validity and give you some sort of standardized score that says And this is often what's used in clinical research like for PTSD. There's the caps It's the clinician administered PTSD scale caps is what it stands for and so that gives you a standardized number and tells you gives you a rough idea of like how acute some of these PTSD symptoms are and of course where this is tricky though is You could be a 75 out of 100, I could be a 75 out of 100, but you may be very hypo aroused and I may be very hyper aroused.

[00:45:05] Joe Zamaria: So we our, the way we look to other people can be very different. So there's a way that a standardized score flattens out individual difference. But it, but on the other hand, it does give you a shorthand of okay, 75 out of 100, that's pretty severe PTSD. For racial trauma.

[00:45:20] Joe Zamaria: Okay. Sorry. Sorry. Actually. So there's others other clinicians who maybe look more subjectively about what their patients are telling them if their patients are saying it's too hard to live. I can't go on like this. I keep having nightmares about the thing, that's another way of gleaning information.

[00:45:38] Joe Zamaria: And if those things change over the course of treatment, we can have a good sense that, that therapy is working. Like oftentimes I'll see patients for PTSD in my practice or complex trauma or other manifestations of trauma and things like panic attacks and nightmares and things will start to stop.

[00:45:54] Joe Zamaria: they'll start to go away. They're still troubled by their events that occurred to them. But there's other, I'm not necessarily giving them a piece of paper and saying, how many panic attacks did you have this week? How many panics? I'm not necessarily doing it in a numerical statistical way.

[00:46:09] Joe Zamaria: So there's a difference there. With racial trauma, there are scales that have been or are being developed to help clinicians if they want one of those quantitative scales. In fact, Monica Williams and colleagues developed something called, I think it's called the racial trauma scale. anD so that could be used by a clinician.

[00:46:28] Joe Zamaria: I don't know much about the scale I don't know if it's self administered, or the clinician interviews the patient and fills it out, or, there's different ways that these sort of things can be done but I'm aware of the racial trauma scale that she, that Williams and colleagues developed.

[00:46:41] Joe Zamaria: Things that I would be looking at is the narrative that my patient is bringing to me. And if they're say, if if they are somebody who is minoritized, whether or not they're a person of color, but certainly if they're a person of color I'm listening for how their experience has been in this country and this continent.

[00:46:59] Joe Zamaria: I'm listening to what they're telling me and also what maybe they're not really telling me, but maybe showing me about their experiences of being a racialized person. And I'm trying to connect the dots about through, through asking them too, asking them questions about did this event that occurred to you, or did being the only brown person in a white place or whatever, did the, how did that affect you?

[00:47:17] Joe Zamaria: How did that shape you? And then we might track changes together as they become more integrated. Earlier today we were talking about being integrated. Treatment for racial trauma, what it can't do is stop racism. That's just going to keep happening unless until we become more enlightened somehow.

[00:47:32] Joe Zamaria: But what it can do is it can prevent somebody from internalizing all this toxic messaging about being a racialized person. So if somebody is the only brown person in a white space and everybody says, you're weird, you're brown, you're ugly, you're bad. Somebody, especially a kid, they can internalize that and they can say I'm weird. I'm ugly. I'm brown. I'm bad. This is just who I am. And that creates syndromes that make creates addiction and depression and trouble with relationships and emotional dysregulation. So the goal of treating racial trauma would be to help somebody not necessarily internalize those things, be able to recognize that it's toxicity is being spewed at you, but you don't have to swallow it as much.

[00:48:08] Joe Zamaria: You don't have to be unconscious to swallowing. It makes you resilient. Wait 

[00:48:12] Raad Seraj: a second. By giving yourself self awareness and regulation, emotional regulation. 

[00:48:17] Joe Zamaria: I think that's right. Yeah. I think that's right. So anyway, so in short, that's, I would look, I wouldn't necessarily want to use the racial trauma scale to assess for trauma.

[00:48:26] Joe Zamaria: Some clinicians would. I would. I would go off of how they're talking to me when we start treatment together and how we develop collaboratively our treatment goals and how they look over time. How are they becoming more whole, more integrated, more at peace, at least internally, even though the external world can be certainly very tumultuous.

[00:48:44] Raad Seraj: So where do psychedelics fit in here? Is there a particular application of psychedelic psychotherapy here? Or are we saying that look, psychedelics have generally can help anyone with PTSD. We just haven't looked at, administering it to people of color or racialized people. 

[00:49:01] Joe Zamaria: Yeah. I think different psychedelics can help differently with treating trauma.

[00:49:06] Joe Zamaria: MDMA is a psychedelic, which at least in the United States, it's on the cusp of FDA approval. We keep hearing, Oh, it's going to be next year. It's going to be next year. But I really do think it'll be probably be sometime in 2024. Don't quote me on that though but MDMA I think is understood in psychotherapeutic and psychiatric spheres as being the frontline medication to help.

[00:49:28] Joe Zamaria: with trauma. But I think things like ketamine and classic psychedelics like psilocybin could be helpful too. I think the VA is now interested in looking at psilocybin to treat trauma in addition to MDMA. So each drug helps a little differently. So yes, I think generally they are helpful for healing and for trauma.

[00:49:44] Joe Zamaria: And I think for racial trauma. If you look at, I think it's since the nineties, since the current era of psychedelic research started back up, something like over 80%, maybe even 90 percent of participants in clinical trials with psychedelics have been white, which is not representative of the population in the United States.

[00:50:05] Joe Zamaria: So it's like there's a lot of reasons why people of color may not participate in research like this. There may be cultural baggage around it. There may be cultural suspicion around engaging in medical research, especially given the sins of medical research that have occurred within our country against minoritized people, against people of color.

[00:50:24] Joe Zamaria: So there's a lot of complicated reasons why somebody might not just. Sign up for a study for psychedelic assisted therapy. Other reasons may be economic. I know it's not a one to one comparison that being a person of color means that you're economically disenfranchised and being a person who's white means you're not economic disenfranchised.

[00:50:44] Joe Zamaria: We know that's not true, but economic hardship disproportionately affects people of color. And if you're getting paid 50 a day to come in and spend all day in a clinic to get tested. And, and you work a shift job or you work at hourly job and you can't, you don't have vacation, you don't have sick.

[00:51:02] Joe Zamaria: That's good. That's a much harder if you have a cushy job, you can take a vacation day or it doesn't really matter. You don't even have to take a day off. You can it's much easier to go in and say, yeah, sure I'll take 50 bucks to take some mushrooms. So there's barriers preventing people of color from getting into the, but some research by Monica Williams and others has looked at, it's like survey based research asking people of color, have you used psychedelics and what do you think of it?

[00:51:23] Joe Zamaria: And they do seem to be very helpful for people of color in the ways that they're helpful for non people of color, but also in, in terms of concretizing crystallizing a racial identity. to me. But you, but I think it's. Been shown to be the case by Williams and one, at least one of her papers and colleagues that psychedelic use for people of color can be helpful in all the ways that it normally is helpful. It can be helpful in the development and establishment of a strong racial identity. And it can be helpful after a racial or an instance of racism. Somebody has experienced some acute racism and then use it has used psychedelic at least in the research that I'm thinking of that Williams has done.

[00:52:10] Joe Zamaria: They're saying this was helpful. It helped me process or work through it or get it out of my system or something, so I think there's unique possibilities with people of color and psychedelics. 

[00:52:19] Raad Seraj: Great segue to my last question because we only have a few minutes left.

[00:52:23] Raad Seraj: Joe, I'm wondering you as a, and again I consider you as a leader in this particular application and field. What questions should psychiatry. Be pondering considering the MDMA and I shared this opinion with you in that I do expect it to be legalized somewhere in 2024. What questions? What sort of potential is there?

[00:52:44] Raad Seraj: What possibilities are there with these tools and knowing the Increasing awareness of mental disorders, particularly in marginalized communities. What are these sort of questions we should be pursuing? 

[00:52:56] Joe Zamaria: So the other questions we should be pursuing are, how are psych We didn't get to the question about like psychiatry and psychology being inherently racist, but maybe we can touch on it, but that like How are our systems failing minoritized people?

[00:53:11] Joe Zamaria: So how are, how is conventional psychiatry or conventional psychotherapy failing people of color? Why are, and then we can go back to this question of why are people in psych, why are people of color not signing up for psychedelic studies? And it's the research team is like mostly white and the rooms are decorated in this very either new age or sterile sort of way, and it's not congruent with their culture.

[00:53:36] Joe Zamaria: And maybe the therapists are, maybe the clinical team is white or isn't properly representative. of the communities that they're trying to treat and so on. And so I have a bigger question, which is how can we create a clinic or a research study that meets the needs of people who are not nor, their needs are not normally met by conventional academic medicine?

[00:54:01] Joe Zamaria: And there are some racial trauma clinics popping up around the United States. And for example, they staff, if they're treating the black community in their neighborhood or in the city, they're staffed by black clinicians and they're run by black managers and supervisors and stuff. So it's it's representative of who they're trying to.

[00:54:19] Joe Zamaria: to work with. And so I think at a, at the, just at a minimum, if a re, if an academic center was were to be interested in launching a trial to treat. racial trauma with psychedelics. I would very much hope, I would think it would be necessary for the clinical team to be representative of that culture that they're trying to, of that community that they're trying to treat.

[00:54:41] Joe Zamaria: And I would hope also leadership like the investigator running the study or the clinic director or the medical director, whomever is also representative of that culture. Cause I think there's intangible ways that will create tangible and intangible ways where that will create more safety and allow.

[00:54:57] Joe Zamaria: Participants to be a little more interested in engaging in research like that. 

[00:55:01] Raad Seraj: Fantastic. This has been extremely educational. Joe, thank you so much for spending the time with us. There's so many, so much more to talk about, but unfortunately the podcast only allows for so much time. It's been wonderful from getting to randomly connect with you on Twitter to now this I'm excited to follow along and all the work you're doing.

[00:55:20] Joe Zamaria: I'm super happy to be here. Glad to meet you. I think what you're doing with the podcast is great work. I think what you're doing generally is great work, but I'm really excited about the podcast. And I'm it's been an honor to be to be here. 

[00:55:28] Raad Seraj: Thanks Joe, I really appreciate that.

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