Ep. 493 You’re Not Broken – The Most Powerful Way to Heal Trauma & Rewire Your Nervous System with Dr. Michael Sapiro

I am honored to connect with Mike Sapiro today. He is an ordained Zen Buddhist monk, poet, clinical psychologist, psychedelic psychotherapist, author, meditation teacher, and researcher, in addition to being a transformational coach for world-class musicians, athletes, veterans, scientists, authors, and playwrights.

In our conversation, Mike talks about truth medicine and explains how trauma is a disconnection from the present moment, clarifying how the nervous system responds to chronic stress or trauma, and how midlife transitions can reactivate unhealed wounds. We explore how culture, ancestry, parenting, and epigenetics shape conditioning, and examine the roles of ego, psychedelics, and surrender in the healing process. We also discuss what it means to lead with the heart, integrity, and humility, and tackle the emotional weight of regret, remorse, and shame. Mike also recommends some simple yet powerful daily practices to help us heal.

This conversation with Mike Sapiro is truly invaluable. I loved his book, Truth Medicine, and I know the wisdom in both the book and this episode will resonate deeply with many of you.

IN THIS EPISODE, YOU WILL LEARN:

• The healing benefits of framing trauma as a disconnection from the present moment

• Understanding and addressing the causes of undesirable behaviors, and addressing the hurt and conditioning that drive them

• How chronic stress and trauma impact the nervous system

• How societal pressures and constant connectivity contribute to stress and a sense of disconnection

• The value of psychedelics for accessing new perspectives and insights

• How midlife transitions can reactivate unhealed wounds

• The benefit of involving the heart, psyche, and cosmos in the therapeutic process

• Why trusting, letting go, and surrendering are essential for psychedelic therapy 

• How integrity and humility can lead to profound healing and transformation within the therapeutic process

• Mike shares some small, consistent actions that can help build trust and self-care 

Bio:

Michael Ryoshin Sapiro, PsyD, is an ordained Zen Buddhist monk and poet, clinical psychologist, psychedelic psychotherapist, author, meditation teacher, and researcher. He is also a transformational coach for world-class musicians, athletes, former special operations veterans, scientists, CEOs, authors, and playwrights. 

Over the last two decades, he has served and reached thousands of people in a variety of settings: therapy, workshops, international retreats, hosting a nationally syndicated radio show called Radio Awakened, keynote addresses, and being featured on podcasts. In the last several years, his work has been featured on over 20 well-known podcasts, and he is a co-host for global mental health summits put on by Wisdom for Life, landing in over 70 countries and reaching hundreds of thousands of people. He is featured in a documentary by Brandow Kapelow called “An Act of Service” on ketamine treatment for first responders that was featured by The New York Times. He currently works extensively with first responders in therapy, offering ketamine-assisted psychotherapy, leading retreats, and running calls with them. He believes that unconditional love, speaking one’s truth, and authenticity are the medicines for good health and a thriving life. His work is dedicated to personal awakening for the sake of collective transformation. 

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“When we are disconnected from the present moment, it is really hard, or maybe even impossible, to thrive.”

– Dr. Michael Sapiro

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Connect with Dr. Michael Sapiro

• On his website

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• Purchase a copy of Truth Medicine

Transcript:

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. 

[00:00:29] Today, I had the honor of connecting with Mike Sapiro, who's an ordained Zen Buddhist monk, poet, clinical psychologist, psychedelic psychotherapist, author, meditation teacher and researcher. He's also a transformational coach for world class musicians, athletes, veteran scientists, authors and playwrights. And today, I had the opportunity to talk to him about Truth Medicine.  

[00:00:53] We discussed how trauma is a disconnection from the present moment, what happens to our nervous system under chronic stress or trauma, the impact of midlife transitions for reactivating unhealed wounds, the role of conditioning through culture, ancestry, parenting and epigenetics, the impact of ego as well as psychedelics and how so much of therapeutic interventions are about surrendering, how we can lead with our heart as well as integrity and humility, the impact of regret, remorse and shame and lastly, small but powerful daily practices that he recommends that can help us heal. This is a truly invaluable conversation. I really loved Mike's book called Truth Medicine and I know that for many of you the information in this podcast and book will resonate deeply. 

[00:01:44] I've been really looking forward to this conversation and like I mentioned to you before we started recording because you have such a unique background and maybe really starting from that place, were you a Buddhist monk first before you went down the psychotherapy kind of pathway? You know what got you interested? And to me after reading your book, I feel like there's so much beautiful intertwining of your backgrounds coming together and really bringing to fruition a very unique vision and voice in the space. 

Michael Sapiro: [00:02:15] For me, my work comes out of my life. Of course, I have information I've gained through studies and training and apprenticeships, but it's really through the muck and the mess of my own life and coming through the hardships and going back into the hardships with new perspectives and new tools that my work comes out of the service I do. I was interested in Buddhism when I was a teenager. I had done psychedelics very early in my life around 15 and had very mind opening and reality bursting experiences that showed me there's so much more than we are seeing at a surface level and also there's more depth to people than they're presenting. I just happened to see that. 

[00:02:58] But I needed a cosmology. I needed a container to help me train in what I was seeing and also to give me structure. I was a very wild child, I guess, in some way and so, Buddhism really did that early on, started giving me structure and a container. So, I had lived in a temple when I was 24, maybe for a year before I went to Peace Corps Thailand and did the monkhood there for a little bit, and then came back to the States and taught yoga, worked with the community, but realized what the community was asking me was really deeper than I could offer. So that's when I became a psychologist. I spent six years in training. So, that's an overview of maybe how some of those paths converged. 

Cynthia Thurlow: [00:03:42] No, I always find it so interesting. I mean, I think that's part of the blessing of having a podcast, is I get to ask all the questions, all the questions that form in my mind as I'm getting to know someone, as I'm getting to know their work prior to meeting with them. And so, we were talking before we started recording about how we explore trauma in this podcast, as I have learned about the impact of trauma on my trajectory of my life. You know, what brought me to being in a field where I'm of service to others, how that's helped me heal as an individual. You describe trauma as a disconnection from the present moment. And how does this framing actually help us heal? 

Michael Sapiro: [00:04:22] I would say it's a disconnect from ourselves in the present moment and the present moment itself. So, there's two facets of that for me when I'm working with people and myself. Are we here right now where life is being lived, or are we in our past? Are we worried about future? And then we're missing the vitality of here now is very full and rich of sensations and sounds and flavors and tastes. Not all the things in the present moment are pleasant. There's pain in there, and there's lots of feelings that aren't comfortable. But it's where life is lived most richly, and we're looking for thriving. And so, when we're disconnected from this present moment, it's really hard or maybe even impossible to thrive, because what's thriving other than feeling vibrant and alive and it happens right here in the moment connected to body. 

[00:05:10] So, trauma disconnects us from the present moment because we're scared often, I'm scared a lot, and I'm like, “Oh, am I going to have bad things happen to me. Am I going to have things taken away from me? or we're depressed.” I don't like what happened. I don't like myself for what happened. And our energy goes down and now we're ruminating. I mean, that's a disconnect. And then the second piece is we're disconnected from ourselves. We don't like what we're feeling. We don't like how we are. We don't like what we're thinking. Our perspective of ourself is negative in general. Not everybody in the world, but we're disconnected from loving and being with this thing that we're living in with. And that's a depressing way of being and it's also traumatizing the way we treat ourselves. 

[00:05:51] So, I would say those two things are often most presenting themselves.

Cynthia Thurlow: [00:05:56] Well, it's interesting to me when we explore people being disconnected from their bodies, being disconnected mentally, physically, spiritually. What are some of the most common reasons or manifestations of people feeling that sense of disconnect? Is it overt utilization of recreational drugs or alcohol or shopping addiction or a porn addiction? What are some of the vices that you see in your patients that are a direct reflection of just feeling this overall disease? I'm specifically saying disease opposed to dis ease. Dis ease with getting to know themselves better. 

Michael Sapiro: [00:06:33] Well, I like to answer that backward. What's the reason they're using porn and shopping and food. Those are strategies of soothing. We need some dopamine or we need to soothe ourselves. And so, we're doing all the things. I actually, when I'm talking with people, it doesn't matter. And I use hand gestures. If you're doing this, this and this and this, whatever, [Cynthis laughs] it's like, “[clears throat], that's what we're doing.” And all of us equally are avoiding the pain of untended wounds, all of us. So that's where I go to. If people want to come in and stop certain behaviors, I'm not going to focus on those behaviors. It's the wrong thing to put our mind and heart's attention to from my perspective, what pain are we avoiding? What do we want to numb out? 

[00:07:22] Usually, it's untended grief. It's shame. When we're shamed, we just keep stuffing our face. And then we're shamed, we're stuffing our face. And so instead of looking at the behavior of this, why don't we look at what can't we tolerate, which is hurt, how we've been treated, how we've treated ourselves, how we might have treated other people. And so why don't we just look at that right away instead of wait a long time to get there. Let's just look at that. What are we avoiding? What can't we tolerate? What hurts us a lot. 

Cynthia Thurlow: [00:07:52] And I think that's a really important distinction and something that really stood out to me as I was going through your book. I think that so much of the work I know, certainly when I had patients, as an example, I worked in cardiology and we never wanted our patients to continue smoking. So, we would do hypnosis, all these different patches and medications to get them off of smoking when the smoking was largely, probably driven. I mean, of course there's a habit piece, there's a habituality to it, but might have really been triggered by so many other things. And I think about, even within my personal life, both my parents have addictions. And I know that the addictions are deeply rooted in these very uncomfortable feelings that many people are either capable or unwilling to actually start working on. Because that work is so much more rewarding, but also can be so much more challenging.

Michael Sapiro: [00:08:42] Way more difficult. And people are often surprised how much work it is to do the work I'm doing. I don't like it. I literally got upset with my therapist yesterday. “I'm tired. I'm tired of [crosstalk] me.”

[laughter] 

[00:08:55] But the truth is that's the work to liberate, to heal, to be more functional, to be more tender caring to ourself. And it's a lot of work. Most of my firefighters would rather run into a burning, this is literal, run into a burning building than go into the burning psyches. Like, “No, I don't want to be in here. I don't want to look back. I'm done with that.” No, you're not. It shows up everywhere in your life. Everything we've experienced in our past, all of us listening, influences the way we are in the present moment. There's no way out of it. 

[00:09:27] So, if we're not looking for the context and we're not healing what happened, we're just projecting the same habits into the present moment and into the future. The future is going to look pretty much the same as your past if we don't make a shift. So, let's say people are coming in to drink less or to smoke less, just to follow up with the behaviors we're talking about. I ask, “When did you start doing that?” Let's just follow the thread 12, 14. Why? What was going on? “My dad beat me, my mom left. My mom died. I was bullied in school.” Okay, that's a gem. Let's take that gem and now dissect it. Go into the hurt, the wounds, and the conditioning, and let's start working on that, because it's showing up here in your life right now. 

[00:10:10] But people who are willing to do that work definitely transform, grow, evolve. The work itself evolves them.

Cynthia Thurlow: Absolutely. 

Michael Sapiro: [00:10:19] It mutual, yeah. 

Cynthia Thurlow: [00:10:20] I always look at therapeutic interventions as you're peeling an onion. Each layer that gets peeled back, there's something else to address. And so, I jokingly say on the podcast, I will be in some form of therapeutic intervention for the rest of my life. Because each time I feel like I'm like, “Oh, I finally am dealing with X, Y, or Z,” and it's like, “Oh, no, no. There is five other things that have been uncovered.” And so, it's this journey. And I think for a lot of individuals, they think if they go to therapy for three months, six months, one year, that they're fixed. 

[00:10:52] And I've come to find that what I typically experience and understand is that it then opens up other possibilities to get to know yourself better, to better understand your behaviors or what has happened to you throughout the course of your lifetime. And so perhaps we can talk about what's happening to our nervous system when we're dealing with chronic stress or trauma. You mentioned the firefighters. They'd rather go into a burning building than deal with their stuff. But what is actually going on within our bodies that perpetuates some of these symptoms that drive behaviors as we're trying to, in many instances, our bodies are trying to cope, and we're trying to find solutions to a problem. But what is actually going on physiologically? 

Michael Sapiro: [00:11:38] Well, our brain wants to survive, and our bodies are on guard for danger. So, our bodies are constantly on guard when we live a life of trauma or high stress. First of all, it's ironic that our lifestyles now, especially in the west, it's like they're provoking us into fighting. Because we have to earn, we have to succeed. A lot of our worth is dependent on how much we produce. That affects the body. That affects our nervous system. It's constantly working and in overdrive. And I'm not just talking first responders. All of us are conditioned to overwork. And then what happens is we have adrenal fatigue and we have no cortisol in the morning anymore. Our waking cortisol is depleted. So, we wake up really tired and not really having this energy. 

[00:12:29] So, then we take those energy drinks which are really just stimulation. Now we're getting overstimulated again. We're spending days drinking Red Bull and all the things or whatever they're called nowadays. And over half of overusing caffeine to try to feel stimulated, to do the overworking. It's a tremendously dysfunctional cycle many of us are in. And, there's just basic science of the body. The hormones are being put out, too much adrenaline, cortisol responses we're talking about. But really, it's a mind frame of it's not enough and I have to keep going. And my worth is not only that because the bills are high, but my worth is dependent on this. 

[00:13:15] So, we have this really disempowering mind frame that I'm not enough and I discovered in myself and I wrote it in the book. My dad put a black hole on me and he said, “When you fill this, I'll finally love you.” 

Cynthia Thurlow: [00:13:33] Wow. 

Michael Sapiro: [00:13:34] But I recognize there's no bottom to a black hole. There's nothing I can do that will get his approval. So, I've been living my life trying to get approval for somebody who has a stipulation that can't ever be met. Most of us have that. And that drive is driving us to depletion and driving our nervous systems to being in the sympathetic mode all the time. It's exhausting to be us for the lot, and so we want to recognize all of that and start making changes. 

Cynthia Thurlow: [00:14:04] Well, and it's so interesting because there's a book called Rushing Woman’s Syndrome. I believe it's Libby Weaver's book. But for so many women, I will sometimes recommend that book. And, and you're correct. We are driven. Whether it's our traditional westernized culture where we have accessibility of information 24/7. We could DoorDash just about anything. We don't even have to leave our homes. We can just live our lives from being inside all day long. And I think that it's the unrelenting pressures of society. And depending on where people live, they may feel extra pressure just from the environment that they live within. 

[00:14:43] And so, I think that, at least from my perspective, one of the things that I have found, not just in working with thousands of patients, but just even for myself personally, middle age is an opportunity, I always say, whether it's menopause, andropause, perimenopause. The word pause is so important. It forces many of us to reflect on our lives and to think about how these midlife transitions can reactivate unhealed wounds. So maybe someone thinks, “Oh, I've done enough therapy. I should be good.” They may find as they are navigating and all the changes that are happening physiologically in our bodies as we're getting older.

[00:15:20] I find for a lot of women they're finding their voice. Women are suddenly looking at their spouse and saying, “I don't really like you very much.” [laughs] Thankfully, that hasn't been my personal experience, but certainly in a lot of my patients and friends, they've woken up and said, “I'm not happy with my spouse or my relationship or my relationships with others or maybe my job.” For you, do you see a lot of patients that experience a reactivation of their traumas or their previous life experiences as they're navigating midlife? 

Michael Sapiro: [00:15:52] Yes. And I think it's happened all along, and they're not quite aware of it and how their systems are impacted by the perpetual projection of their past and the traumas and the wounds. I'm sucking it up, pulling the bootstraps, or I'm fine, it's good enough. But there's always something a little off or there's something where they're not really feeling the thriving. That's mostly what I recognize. And especially women who are coming for this kind of treatment, maybe they've come out of the church, and maybe they left the church a long time ago, but never really allowed themselves to be themselves because of the training that they're sinful for who they are. That's a dominant trend, especially where I live is there's a religious oppression that can happen to a person, especially a woman and not able to fully identify, this is me, this is who I like. 

[00:16:45] There's a wildness, maybe there's a primal-ness, maybe there's a playfulness that I didn't get to experience or is actually pushed down. And now they're like, “I don't know who I actually am, and I want to know who I am.” But they come in going, I don't like the husband, the job, but that's not what we focus on. Those are external features of the internal world projected onto the screen of their reality. Maybe they don't like their husband or spouse or whomever, but the truth is they don't really know themselves or haven't supported themselves in becoming who they really are or really want to be. 

[00:17:19] My work is helping people identify, who are you really? What does your heart say? And most people talk, “What do you mean? What does the heart say?” “Oh, you haven't slowed down and listened, have you? Do you know how to slow down? Do you know how to listen? Do you know how to see visions and dreams?” Most people haven't been in touch with that part of themselves because they've been working too hard to prove themselves or prove other people's ideas of themselves. 

Cynthia Thurlow: [00:17:47] It's so true. And I feel like a lot of the women that I interact with now, they've been so busy pleasing everyone else for so many years that it's only when they slow down, if they're capable of that. And I do think there's definitely a group of women who are not capable or willing to slow down. But for those that are, it gives them an opportunity to explore who they are as individuals, how they really feel about things without the influence of-- When we're growing up, we have parental influences and friend influences, but maybe they're truly for the first time in their adult lives, experiencing exactly what they're interested in, and that might be really new and novel for them. 

Michael Sapiro: [00:18:29] Yeah, this is the basis of my work, actually, is like, have you ever really sat and listened or talked to yourself? Have you discovered the gems inside you? And most people, when they come, they come with blame and resentment toward others. And of course, others have done things to us that are painful, hurtful, all the ways that push us into a small package. But the truth is, when we start digging, why haven't you done that for yourself? Why haven't you been an advocate or an ally to yourself? And then we start discovering, well, I wasn't allowed to be. I actually was punished if I voiced my opinions verbally, physically, and sexually, they could be traumatized into becoming quiet and complacent. And then there's resentment later in life because they're not feeling the space to express themselves. 

[00:19:21] But at that part of their life, it's on them, not on other people or circumstances. For the most part-- I'll say that for the most part. And so, our job is multi-layered. We do have to be able to express those feelings of resentment and we have to do the work on healing where we came from. But for me, most importantly is giving our heart a voice. That's the most important piece. Giving our heart a voice to express itself in visions and ideas, in movements. There's all kinds of ways the heart's like, “Please do this, take me on a date. I don't like this. I like that. I never knew. Literally, I never knew.”

Cynthia Thurlow: [00:20:05] So, at a very basic level, when you start your work, let's just say middle-aged woman, just to give some context, what are some of the beginning or foundational elements that you will utilize to help them find their voice, their heart's voice? How do you go about doing that? 

Michael Sapiro: [00:20:23] I ask, what's wrong in your life? Why are you here? [laughs] You know, that's the basic, what do you want? And many people go, “I don't want this, I don't want that and I don't want this.” So, the first thing I do is I don't really care what you don't want because that's facing backwards. We need to turn you around and give me something you do want. Mostly it's peace, freedom, agency, expression, fun. These are things, then we can go, “Okay, so now you have peace and freedom.” What does freedom mean? We'll discover what I want to be able to express myself and live the life I kind of always wanted to. That's amazing. Let's go toward that. But then really, why haven't you been? So, the next question is, what's in your way? 

[00:21:06] And that's where people start blaming and showing the context around them instead of going, I haven't supported myself, I get to that place. Why haven't you supported yourself? Well, I don't deserve it. I got to put my kids and husband first. I got to put my job first. Well, who taught you that? Why? And we start going down till we keep following the threads, until you find the place where they were conditioned. You are not enough and you're not as important as you think. And people go, “Okay and then they shrink.” It looks like that. It's different of course, per context. But we need to find where they were conditioned out of being themselves. I do that within a session. 

[00:21:47] I mean, it's just because it's all of us showing up and why don't we just go to that place where we’re made compact and not made to feel like we matter or to feel like the only way we matter is if we work hard enough. The only way we get love is if we please other people. We got to find that as fast as we can to start working on that. 

Cynthia Thurlow: [00:22:10] And where does most of that come from? I mean, when you're working with women in particular, just even from-- as you were saying that, I'm always reflecting, where did my conditioning come from? Obviously, your family, your parents, the messages you receive, some subliminal, some were overt, helping find your worth as you are navigating the world. Are there some common themes in the patients that come to you in terms of like where they're conditioning? Where does that start for them? It probably is as unique as they are, but I'm just curious where that stems from. 

Michael Sapiro: [00:22:43] There's a saying in Thailand, “Same, same but different.” We are all the same. We have differences, but we're all the same. I'm talking to me. You're talking to you. We have a little bit different background and heritage, but it looks very similar for us, at least in the West. When I lived in Asia, there were different conditions and patterns and habits that made Thai people a certain way versus American people a certain way. And so, culture plays a huge impact on shaping our personas and our personalities and our drives. But so does ancestry. What my grandparents went through, what your grandparents went through have shaped us through DNA and through behaviors and patterning of parenting that shaped us before you’re even born. 

[00:23:32] So, we're working on ancestry and epigenetics, which is the passing through of experiences and knowledge through the DNA system that is inherent in us. So, if we have a circumstance, you and I will be faced with the same circumstance, my grandparents experience will be triggered in me, which will see the circumstance different than your grandparents being triggered in you. So, we're working on that level. We're working on our cultural influences. And then we have parenting behaviors and parenting values and it's usually the behaviors that show the most. You can say I love you, but if you're getting hit, it's a mixed message that doesn't make sense anymore. And this is all negative. Remember, it could be positive and strength based. I'm also taking the strengths of my ancestors who lived through the Holocaust. 

[00:24:23] I'm also taking my parents passions and humor with me as I go. I'm taking their tenacity. So, it's both-- and it's both the negative and the positive always impacting us. But where is it where we live, almost is there an independent nature that we have that's just ours? Is there an essence that's just ours? I think so. And we tend to discover that in the psychedelic work and in deep meditation, we discover something pure and original that's just ours. And so, it's touching that and bringing that forward, as well as identifying all of the conditions. 

Cynthia Thurlow: [00:25:05] And do you feel like there are-- obviously there are limitations to traditional talk therapy? Is that how you got interested? I know you mentioned that you had experiences with psychedelics as a teen. So, you had already had that experience. But as a clinician, watching your patients evolve with their own journey, do you feel like adding in the benefits of psychedelic therapy allows them to progress in a way that would have been very hard to do with traditional talk therapy? 

Michael Sapiro: [00:25:33] I think so. Yes, I've seen it. I'm opponent for traditional work, and I don't mean traditional talk therapy. Doing the work inside, the deep work. And if the psychedelics get us to do that, and I see it happening quicker than doing talk therapy, then I appreciate that. But it's not right for everybody. Not everybody is medically cleared, not everybody is psychiatrically cleared to do psychedelics. It's not for everybody equally. But I will say, having worked many years in the psychedelic field doing retreats and individual work, because your defenses are dissolving, because you stop lying to yourself and thus to me, your therapist, you start speaking truthfully because you're disinhibited. You're not thinking the same way you normally think your ego can't hold. It dissolves. It comes in. It dissolves. It comes in. 

[00:26:28] So, what that leaves is a few things. When your ego is dissolved and you're not in control, your heart has space to talk for you. Finally, it's like, “Shut up.” And now it's like, “Oh, I can act in your mind camp.” It's not dominant. Two things happen. Your heart has space to express itself, and your psyche shows you all kinds of things you've been repressing. And then the universe and the cosmos, whatever that means, something much greater than the personal shows up in the work too. And now you have access to things that are way beyond your normal perceptions of reality. You might have spirits and ancestors show up. You might see planets and stars. You might have experience of things that you are closed down to in a normal day and that information also heals and evolves us. 

[00:27:21] So, the psychedelic allows us to have the heart, the psyche and the cosmos involved in our therapy. 

Cynthia Thurlow: [00:27:28] So, outside of the context of using psychedelics, the ego has a protective mechanism, as I'm understanding it, but with the utilization of psychedelic therapy, it allows the ego to be quieted so that you can fully experience. And let me be fully transparent with my community. I have not done psychedelics. I'm just interpreting this from a cerebral perspective and making sure that I'm understanding it properly. 

Michael Sapiro: [00:27:51] The ego is we need it. It's not an enemy. It's just conditioned based on everything we've been talking about. And so, the ego is one of our primary functions of being, is dominant in our life. Making decisions doesn't always make great decisions for us because it's conditioned in its habits. And we're there because we want new habits. So, if we're doing the same work with the old habits, nothing's going to change if I'm working with you, but your ego's doing the same thing. It keeps defending its position. How are we going to make headway with you? The thing is the ego-- that part of us is protecting us, but it's not doing it well anymore. And so, I need it to have some flexibility, some elasticity, a way to get new perspective in built into it. 

[00:28:46] If the ego is a puzzle right now, it's limited, let's see that it's actually unlimited. And psychedelic therapy gives us new pieces of the puzzle that we integrate back into the ego. Now you know you're bigger than your traumas. You know your heart can speak louder than your mind sometimes. Now you know you have more creativity than you thought you did. These are new pieces of your puzzle that the ego can get. So, now you have a healthier, more stable and creative ego than you did before.

Cynthia Thurlow: [00:29:14] And how do we know if we're ready for psychedelic therapy? Obviously, you have to work with a practitioner provider that does that initial assessment, but you had alluded to earlier that there's people that are appropriate for psychedelics and there are people that are not. So, maybe speaking to that, how you and your practice go about determining the appropriateness of therapy and readiness of therapy.

Michael Sapiro: [00:29:38] Well, ketamine is fairly safe, it's a great medicine that's been used with children in ERs and paramedics use ketamine when they need to in the field. So, for the most part, it's a safe medicine. And the nurse at the clinic is going to evaluate for any hypertensive disorders or issues, any strokes you've had, anything because it's a hypertensive medication, so you're going to have a higher blood pressure during your experience. So, we're looking for kinds of like the physiology. Does it work with the medicine? Then we're doing a mental health screening. Are you acutely suicidal or are you prone to schizophrenia and psychotic thinking? Do you have active mania right now? These are not great conditions to go on any psychedelic medication. 

[00:30:27] So, of course, right now, in the wild west, everybody's doing anything whenever they want it, which it's always been that way, really, anyway. And I'm not-- I did that growing up. I did whatever I could find and try and experiment. And these, some of the medicines, like mushrooms have been around as long as mushrooms have been around, and deer and dogs and people have been munching on them and having experiences that are different than their normal waking life. But if we want to do psychedelic therapy, we want to make sure the medicine's right for you. So, we do screening, and then I'm really assessing. Are you able to give up control? Are you willing to surrender? And I hear the audience, “Hell, no.” 

[laughter]

[00:31:10] I hear it. I just felt some people going, “No.” Well, that's what it takes. The medicine is letting go. The medicine is not ketamine or shrooms or MDMA, really, those are substances. The medicine is trusting and surrendering and letting God take you somewhere or letting a river take you somewhere, however you want to put it. And that's the scariest thing of all for people with trauma. But that's the most important thing for healing and empowerment and growth. 

Cynthia Thurlow: [00:31:39] Well, and it's interesting because the concept of letting go for so many people is terrifying. 

Michael Sapiro: [00:31:45] Yeah, of course. 

Cynthia Thurlow: [00:31:46] It's absolutely terrifying. And this is why I think it's important to work with a provider that you trust so that you can let go. I think that's an important thread. Like, as I'm listening to you, I'm saying, yes. And this is why you need to work with someone who's knowledgeable, who you've built trust and rapport with, so you can have that journey and be able to come out on the other side and feel like, “Okay, I have gone through this experience or experiences.” And I feel like with this person, I feel trust and I feel alignment. And therefore, I can let go of all our stuff. Like, there's no other way to put it. We've all got stuff. There's no one that's special out there that has no stuff. 

[00:32:27] But I think, one of the reoccurring things that I consider is that trust piece, how critically important it is. Do you feel like that is what for many people is maybe a missing link before they come to you? That maybe in the past they didn't have a sense of trust and an ability to let go or surrender, you surrender to the process. 

[00:32:47] And guess who the trust is with.

Cynthia Thurlow: [00:32:50] Themselves.

Michael Sapiro: [00:32:52] 100%. We don't trust others because they've hurt us, but we don't trust ourselves. We make such poor decisions in general sometimes. We're like, “How can I trust you? You keep getting me high. And I don't actually want to get high. I do because I love getting high,” [Cynthia laughs] but it's not good for me. Why do you keep doing that? Well, I don't trust you because you're doing that. And the other side says, I don't trust you, you can't handle the feelings. 

Cynthia Thurlow: [00:33:18] Isn't that the truth? When I think about and I reflect over 25 years of working with patients, the uncomfortable feelings, that is what people are trying to numb or deflect or not experience. It's because it's too painful. 

Michael Sapiro: [00:33:33] Yeah. And so, what are they doing? they're numbing in all the ways. But that's because I don't trust myself. We don't trust ourselves to handle it. I know you can't handle that grief. So, I'm going to have you drink tonight. Oh, I know you feel really shitty about yourself today. You get to drink tonight. Instead of going, I trust you to handle these emotions. I trust you to talk to a friend, call your therapist. I trust you to cry like a baby on the floor, which I did last Saturday, because I trust myself when I'm feeling grief, I can handle it instead of want to do all the drugs like I used to do, that it was like that. Wow, euphoria feels so much better than grief. But truthfully, then I'm numbed and now I don't feel the thing. 

[00:34:14] And so, I have learned how to trust that I can caretake and nurture and tend to myself so that when it's really hard. I got me. I'm teaching people how to have their own backs and how to trust themselves. 

Cynthia Thurlow: [00:34:32] And I think that's so important because maybe in a society where we do a good job of identifying people that are at risk, people that need to be in traditional or less traditional modalities to move through experiences they've had throughout their lifetime. But what I find so interesting about psychedelic therapy, again, having not done it, but just been an observer, because that's how my brain works. I have to observe before I proceed. What I find really interesting and ketamine is a great example. Like, we used it for analgesia in the ER plenty of times. And what's interesting is, I always come at it from a clinician perspective, like, how does it work and what's going on? 

[00:35:11] But I think what's even more significant is that the neuroscience of psychedelics is certainly demonstrating to me as well as many others that there's a whole world of therapeutic interventions that maybe those of us that trained in traditional allopathic medicine were just never availed of. You know, there were many, many years where, we were told that these drugs, they don't have any benefits and yet the science is certainly suggesting otherwise. Now for you, within your practice, are you also working with MDMA and other psychedelic therapies? Like, how do you go about choosing what psychedelic therapy is most appropriate for each individual? I'm assuming that it's a clinical decision making. You may have a gestalt. As you meet someone, you're like, that person would be great for this modality. 

Michael Sapiro: [00:36:01] Yeah. And most of the stuff is illegal, so, I work at a ketamine clinic because it's accessible and we can use it off label. I do retreats out of country in places where medicines are legal to use or decriminalized and legal. And so, if that's the hard part about it right now MDMA is available in clinical trials. You have to either go to research hospitals or universities, the same as UCSD and USC they're looking at psilocybin. Oregon and Colorado, with a certification, you're able to do some of these things. So, we have to go to the places where you're allowed to use them. 

[00:36:46] And that's why I do lead retreats out of country so that I can do some of that work. But I'll talk about medicines and people. It is about what are they looking for, what are they looking to gain, heal, how are they wanting to grow, what kind of experience? Each medicine does something different, of course, in our system, in our neurology and then the body, but psychologically and in the psyche, each medicine does something very different too. So, we want to assess where are you at and what are you looking for in your life. And then you would start pairing up the medicine. The hope is that the person you're going to is also trained in those different medicines and not just willy nilly. 

[00:37:28] Oh, let's toss this at you because I heard it's really good for that thing that's, you want someone who's really steeped in the tradition of that medicine and has training and apprenticeship in that medicine. So those are all kind of caveats to this work. 

Cynthia Thurlow: [00:37:41] I think it's really important and it really goes back to if you're choosing to take that path, making sure you're working with someone who's incredibly knowledgeable. Because what my perception is like, I'll use ayahuasca as an example. I'm sure there are some incredibly talented individuals who use ayahuasca appropriately and judiciously. 

Michael Sapiro: [00:38:01] Yeah. 

Cynthia Thurlow: [00:38:02] But what I've heard, and I've heard this from physician friends who've gone through this experience. So, I feel like this is someone who's looking at it from different angles. There are also people out there who don't know what they don't know. And they're creating retreats where people are I don't want to use the word harm, but they might put themselves in a position where they're not utilizing therapy in the most therapeutic way or they're not getting as much out of the experience as they could if it was led by someone who is being more conscientious. I'm trying to be as nonjudgmental as possible. 

Michael Sapiro: [00:38:34] Is good. Yeah, yeah. I think you're saying it skillfully. 

Cynthia Thurlow: Yes. 

Michael Sapiro: [00:38:37] And I think one of the ways that sound loudest to me about who might be right is ironically, they're the quietest. 

Cynthia Thurlow: [00:38:46] Yes. 

Michael Sapiro: [00:38:46] The people I know in the field who are legitimately trained in either the forests or with shamans or with people who have led consciousness and transformation sciences for decades and decades. Because you don't all have to go toward the shaman path. That is a path that's not everybody's path. But those who are really trained and apprenticed and living authentically and sincerely, they're quietly doing their work. And those who are really blasting it out and sorry, my judgments are around the Instagram stuff and Instagram shamans and coaches. That doesn't feel the same to me as the people I have been with for many decades who are quietly just working. I hope I'm one of those people. I don't want to put time into social media, into trying to get followings. 

[00:39:37] I want to do the work. And if this podcast helped people do the work, then we're doing our job. I'm not promoting me here. I'm promoting the inner work that it takes to have these transformations and the people doing good medicine work are also revering the work and the medicine, not really themselves. 

Cynthia Thurlow: [00:39:57] I think that's important. I would always say that arrogance is loud, confidence is quiet. And I tell that to my teenage boys on occasion when-- they'll be emulating someone and I'll say, “Listen, if that person is really good at what they do, they don't have to tell you they're really good at what they do. 

Michael Sapiro: [00:40:16] Yeah, I have a lot of tattoos. I'm actually pretty covered. And I remember one of the studios I was getting worked on, there was a picture of an old someone in his 80s, still tattooing. And he was a really famous tattooist and he was known for not talking at all. And underneath on the poster it says, “My work speaks for itself.” That has always stuck with me. That inspired me. How can my work speak for itself? I know I have the gift of gab too, so part of my job is talking and sharing, but how does the work itself is what brings the attention and the light. So that's how I want to operate. And the people I know in the world doing that's who inspires me too. 

Cynthia Thurlow: [00:40:59] Yeah, it's so interesting being in a space where there are well-meaning people that abound and then you've got some bad players that are out there. I was at an event over the weekend and a couple names came up in conversation with this group and I said, “Oh, I've met all those people and these two are legit.” And this other one, if you meet this individual in public, they're nothing what their persona sounds like or looks like.” And I said, “I always aim that if someone were to meet me on the street, they would have the same impression of me on social media, on the podcast, as if they met me on the street. Like, I'm no different. I am just who I am.” 

[00:41:35] And I think for those of us in our areas of expertise, if we are leading with integrity and leading with just pure heart, and we go back to the heart piece, I think if you lead with heart, then good things will come your direction. I think when people are without making this a divisive conversation, there are people out there that just have different intentions, and it's just not in alignment with how I run my business or see myself. 

Michael Sapiro: [00:42:01] This is for our audience, not just for our conversation. What I notice about me is, what I notice in my clients is two things when you lead with your heart, like, actually let the heart lead for you. One of my Buddhist teachers said-- Ajahn Chah, you get to a place in your practice where your heart tells you itself what to do. And the second thing we're talking about integrity, is cleaning up our mistakes. That's something that I had a hard time working on for a lot of my life, but now have come to understand a spiritual life is an ethical life. I didn't really know that. I thought a spiritual life was a life of bliss and awakening and high insight.

[00:42:47] And so, I wasn't cleaning up my mistakes. I wasn't really looking too carefully at my behaviors. And that's just the same for my clients. When they really start looking, they're like, “I've transgressed my own boundaries. I've transgressed my own values and my morals and the way I treat myself,” and that's a huge thing and other people, of course. And so that's a humility that I think this work brings us to. And when we're talking about people out in the field, those who have done their work are actually humble because they're like, “I have messed up so many times, and I'm really hurt that I've done that, and I don't want to do that again.” That's the same as what my clients come toward. I don't want to hurt myself anymore, and I don't want to hurt other people for sure. 

[00:43:29] And that's the beauty of this path, is that it cleans us up from the inside. And then the heart can shine, really shine. 

Cynthia Thurlow: [00:43:36] I think that's really beautiful. And when you're working with your patients and whether they're utilizing ketamine-assisted therapy or not. What is the potential for awakening in middle age? What is the potential for someone referred to it recently, the messy middle. How do we go about finding ourselves again at this stage of life? 

Michael Sapiro: [00:43:59] I made a face because you didn't see it, but you were like, how do we-- as there waking in middle age? I'm like, “There's no age. We're children sometimes and then some other times we're grownups.” Most of us are learning how to mature. One of my biggest lines that I use to people even in their 70s, I'm like, “Well, it just seems like you need to grow up a little bit, you know.

[laughter] 

[00:44:21] And because our inner child, our inner teen is acting out for us, middle age means nothing. We have the opportunity in every moment to recognize what we're doing, how we're doing it, to clean it up and to let our values be the guide for us. It doesn't matter how old. 

[00:44:38] I have people in their 80s coming that are like, “I wish I would have done this in my 50s or my 30s, this work.” And then I have people in their 20s going, “I'm so glad I'm doing this now.” Now the older folk have more access to experience and maybe wisdom, maybe not, but more experience. And I think people are more attached to their ways of being as they get older. So, you're asking that are people-- Yeah, you're addicted to your emotions that you like and you're pushing away as ones you don't and you're self-righteous on the way you are, are you willing to let that go for a better way of being? And those who are really open to being different and thriving will do whatever it takes. But you have to let go of the attachment you have on who you think you are. 

Cynthia Thurlow: [00:45:25] Oh, that's so good. Do you find that, you know, you mentioned age is irrelevant and so yes, I can imagine you have a span of experience of working with young people, middle-aged people, older people. Do a lot of people express regret with how they've lived their lives, whether it's been spiritually, emotionally, physically is regret something that people focus in on at any stage of life? 

Michael Sapiro: [00:45:49] Yes, but not as much as shame. What I actually want to go toward is remorse. Remorse is a really heavy but beautiful and useful emotion. Regret is a cognitive experience. I wish I didn't do that. That's a cognitive experience is a thought I regret doing that. The remorse is the feeling is the sadness for having done something which was out of alignment with our values or morals that hurt people or ourselves. I want that, that's juicy. You can work with that feeling is what's nurturing and healing. And then we also tend, we tend to it. Remorse is good. Regrets, okay. You know, it's better than shame. Most people come in with shame. I'm ashamed of myself for doing these things. And out of shame we punish. Regrets a halfway stage toward remorse then. 

[00:46:39] It's like, okay, now I regret that I did that. Good. So, what's the emotional component there though? I want you to feel it. So, yeah, of course we have regrets. I have so many of them. As I get older, I have more. 

Cynthia Thurlow: [00:46:53] I feel like it's a human experience. I certainly-- and I heard it more from my older patients, especially people who were at the end of their lives, they knew that they were at the end of their life and they would express things. Sometimes they felt comfortable telling me, but maybe not their loved ones. And so that always sat with me, just the concept of regret, which as you appropriately stated, is an emotion. And then you're hoping that they're evolving to getting to a place of remorse. But to your point, I think shame is really powerful. And I feel like shame for most of us. And I say this just from my perspective of the women I've worked with over the years, shame goes along with that punishment piece. 

[00:47:33] And whether it's they feel ashamed about a choice they made and now they're either going to binge or they're going to restrict food or they're going to self-flagellate themselves emotionally. And I feel like she shame is probably not focused in or dialed in enough. It's like we just don't do a great job talking to our patients about it. I just say this as a traditional allopathic trained NP and yet I now recognize on the other side of things, like we need to be talking about this. We need to normalize conversations like this so that people can get the help that they need and deserve. 

Michael Sapiro: [00:48:06] Yeah, I would love if people move toward from shame to regret and remorse. So, I'm going to say that again. So, the listeners go, “What does that mean? And how do I actually get there?” Because shame is the source of our punishing behaviors. And any of us, me included, all the things I've done to hurt myself came out of shame and I deserve it. 

Cynthia Thurlow: [00:48:28] That's powerful. That's really powerful. To end our conversation today what are some small but yet powerful daily practices that we can do that can help with truth and healing within ourselves? 

Michael Sapiro: [00:48:46] I would love to encourage everyone to start being honest with themselves, but until that becomes a way of being we have to have practices that get us there. So, some practices are waking up and asking, what do you want from today? And let yourself be honest that way. “Oh, hey, I really don't want to work today. I hear you. I don't either.” [Cynthia laughs] You know, we got to. But I'm glad you actually told me that. Thank you. Okay, what else would you like? You know, check in with ourselves. What would make today something where you felt like you've taken care of yourself? Is there a good meal you want? Is there a movie you want to watch? None of us date ourselves very well, even if we're married. 

[00:49:28] I'm encouraging people to start having a relationship with ourself every day. Waking up and going, “What is important to me today? Well, I want to meditate, I want to exercise.” You know, even if you haven't done it, hearing yourself say it, and then can you do something? What we need is a behavior. Otherwise, you're just more lying. “Oh, I know you want to do that, but I never do it.” So, you're not actually trustworthy. We're tying everything in, if you want to be trustworthy, you got to follow through on the things you're telling yourself you'll do. Even a little bit's okay. So, if you want to learn how to do meditation, just do five minutes, put on a timer, go to insight timer, put on a five-minute thing. 

[00:50:12] As soon as you get out of bed, you do a five-minute meditation. I can talk about strategies for days, but what I really want to talk about is committing to yourself in small ways so that you have a relationship with yourself over time that you're like, “I'm good with myself.” I mean, there's so many things, but I think that's what came to mind for this conversation. 

Cynthia Thurlow: [00:50:34] No, it's so beautiful and it's so. It seems so simple, but it's so significant and profound to have that conversation with ourselves. Well, Mike, I so love this conversation. I enjoyed your book. Please let listeners know how to connect with you outside of this podcast. How to get access to your book or learn more about your work. 

Michael Sapiro: [00:50:51] Yeah, do you have the book there by any chance?

Cynthia Thurlow: [00:50:54] I do, I have it right next to me. 

Michael Sapiro: [00:50:55] Oh I would just love them to see.

Cynthia Thurlow: [00:50:56] Truth Medicine.

Michael Sapiro: [00:50:57] This is my book. If you like what you're hearing and you feel a connection in that book really details these teachings. And I narrated the audio, so you're welcome to listen to that. Honestly, that's the best way of connecting because I wrote it with my heart and I narrated it with my heart. So that's a good way. And then and my website has some stuff michaelsapiro.com and of course, Instagram. I put a lot of poetry and pictures of my dog. [laughs] That's what is important to me. So, really, right now, the book and listening and taking care of yourselves would be the way to connect with me. Because if anything I said today woke you up, then we're doing work together. 

Cynthia Thurlow: [00:51:41] Thank you so much for your time. This has been a pleasure. 

Michael Sapiro: [00:51:43] Thank you so much. 

Cynthia Thurlow: [00:51:46] If you love this podcast episode, please leave a rating and review. Subscribe and tell a friend. 

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