Building Inclusive and Authentic Therapy Spaces with Gerald Joseph

Gerald Joseph (00:00):

I think I had the idea, right? Wow. I have this license, I have all my ducks in a row, I'm telehealth. I am putting ads out on Yelp and Facebook and Instagram and on Psychology Today. And I just thought that people would just start coming in and I gave myself a year and I was like, wow, no one is really coming. I mean, I did have some free consultations and things like that, but I realized it does take a lot of work. It takes networking, it takes time, it takes strategy. And now that I'm approaching a year and a half now, I've realized, okay, this is what I have to do.

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Michael Fulwiler (00:47):

This is Heard Business School where we sit down with private practice owners and industry experts to learn about the business of therapy together. I'm your host, Michael Fulwiler. This week I'm joined by Gerald Joseph, also known as The Capital Therapist. He is a licensed social worker, EMDR therapist and advocate for psychedelic-assisted therapy. In our conversation, we dive into Gerald's journey from fashion to therapy, why authenticity matters in creating spaces where people can be themselves without fear of judgment, especially folks in the queer community. He's such a light and I'm excited for you to meet him. Here's my conversation with my friend, Gerald Joseph. Enjoy. Gerald Joseph, welcome to the show.

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Gerald Joseph (01:34):

Hi, Michael. So happy to be here.

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Michael Fulwiler (01:36):

Very excited. I've been looking forward to this interview since we really launched this podcast. I'm so grateful for you and for our relationship. We met on Twitter and you're one of the only people that I've actually met in person and taken that relationship offline.

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Gerald Joseph (01:54):

Wow. No, that's so special.

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Michael Fulwiler (01:57):

And one thing I love about you, Gerald, is just the way that you show up authentically. It's really inspiring for me. And I want to start by asking you, is that something that comes naturally for you or is that something that you've had to work on?

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Gerald Joseph (02:11):

I feel a mixture. A mixture of both. So I can even go back to high school, for example. I was definitely the social kid where I was very out there and outgoing. And then I definitely feel an undergrad where I came out at 18. So just coming out and just the discovery of that and of my identity, and I really feel that's when I really blossomed and just embraced authenticity.

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Michael Fulwiler (02:39):

Yeah, I'm sure it's a process. I'd love to talk about that if you're open to it. What was that experience for you and how was that received?

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Gerald Joseph (02:48):

So coming out, it was difficult at first. So I came out my freshman year of college, 18 told parents I was getting a piercing and they were just wanting to get more in depth and it just blossomed into saying this is who I am. And people suspected even previously, but I can definitely share between having an on-campus LGBT Resource Center at the time, a good support system. That's what really allowed for me to feel supported and cared for. And then as far as family, they're very loving and supportive right now. But of course it was difficult at first.

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Michael Fulwiler (03:28):

Definitely. And was therapy something that you were doing at the time? Were you exposed to therapy and mental health care at that point? As a client?

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Gerald Joseph (03:38):

I was. So that process actually led me into receiving mental health care. So thankfully the resource center, they were directly connected with the mental health counseling services on campus and actually still keep in touch with that therapist to this day from time to time. So it's just been a beautiful relationship and I never foresaw myself even becoming a therapist at that time.

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Michael Fulwiler (04:04):

Yeah, I want to get into that, but before we get into that, you were actually interested in the fashion industry before social work. And so I know you worked at Urban, you worked at West Elm. So tell me about that and what changed for you and why you decided to move into the mental health industry.

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Gerald Joseph (04:25):

So I was always just attracted towards a visual merchandising and being creative. In undergrad, I was working retail and I was studying art history and I was creating inspiration boards for Urban Outfitters and just wanting to become a fashion buyer for the brand. So I had interviewed about the company, made it to the final round, and I was really excited about the potential of moving to Philadelphia. And I didn't get the role and I was completely bombed. I was essentially quite hurt because I was like, wow, they really liked me and I really felt like I connected with the brand and with the people and just telling my story and just creating these projects for them. And I moved back home and worked for West Elm and I was even interviewing companies in the Atlanta area and New York. And fast forward a couple months later, I actually was dating a social worker and through dating him had these stereotypes. I was like, oh, social workers, they don't make money or eating soup, for example. Although soup is really good, I like soup, right? It's a comforting food, but just a lot of stereotypes that I was holding against social work and therapy. And he definitely changed that perspective for me.

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(05:49):

And I soon after I was wanting to work with children on the spectrum as a behavioral health tech, and I ended up getting into my master's program and here

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Michael Fulwiler (06:03):

I am. Yeah, here you are. I know it's been a journey. So your master's program was through the University of North Dakota, and when I saw that, my reaction was you moved to North Dakota. That's such a big change from Florida, but you were explaining it to me. It was an online program, right?

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Gerald Joseph (06:21):

Yes, yes.

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Michael Fulwiler (06:22):

Was there any kind of in-person component to it or was it completely virtual?

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Gerald Joseph (06:26):

Yeah, so actually I have flown out to North Dakota. So the campus was in the city of Grand Forks, which is actually quite beautiful and very beautiful campus. So your first two years you do have to fly out for a week and you're fully immersed into the campus and just meeting with your cohort and professors and just engaging in SIM labs. So it was a really, really great experience even way before pandemic and

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Michael Fulwiler (06:53):

Yeah, you go get your master's in social work, was clinical work something that you wanted to do or were there other aspects of social work like case management that you were more interested

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Gerald Joseph (07:03):

In? Yes, great question. I actually feel I like all aspects of social work, and I feel then just the reason why I chose social work compared to counseling, for example, or even becoming a psychologist is because I just like how versatile the degree is. So I sought case management, I've sought positions in case management, and I just really view working within systems and just treating the whole person and being an advocate. So that leads me to just advocacy, whether it's psychedelic medicine or human rights, you name it.

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Michael Fulwiler (07:39):

Yeah, I definitely want to talk about that. So after, do you get your master's in social work? Did you work for a hospital or were you working in community mental health? What did you do after grad

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Gerald Joseph (07:51):

School? During grad school, I guess I'll hush back a little bit. So during grad school I was working for a health insurance company and working for that health insurer, I was a care coordinator, so that's where I was doing just very basic assessments and just making sure members under that health plan were being linked to, whether it's social services or nursing. And then soon after that I was laid off and I was in the middle of grad school. My program was three and a half years, so this may have been my just say year two, year one and a half towards year two. And I was laid off and it was very sudden. But thankfully I had a partner at the time and I felt very supported and I was able to immediately jump ship. And I actually found a role in DC and it was the first role ankle where I was in the community, but I only worked there for three days and I was miserable. I was miserable because I was commuting two hours and just trying to do balance grad school. And then I quit that job and I've never quit a job before. And I quit that job and I received a call about two or three days later from quitting that job and it was for a local health system. And ever since then I've been connected with that health system and it's been a blossoming career within case management and now as a therapist for that health system.

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Michael Fulwiler (09:23):

I know that during this time you're also wanting to get licensed and private practice is a goal, but that was a process. I know just externally seeing that you took the exam multiple times and you got so close but just didn't pass and then took it again and just again, you were just right there. What was that experience like for you?

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Gerald Joseph (09:50):

It was a lot. This was during 2020, the pandemic and very stressful. So working for the health system and facing with patients with COVID and patients are dying and just mentally supporting them while also trying to pass the licensing exam. It was a lot of stress and there were moments where it was demoralizing and frustrating, and I just found myself wanting to just be vocal and just spreading the news and the word on the experience, just basically storytelling. I know I'm a clinician and a mental provider and just that whole experience was, it felt like a huge burden on top of the external and the online community and just my in-person community. And then a lot of advocacy behind, I finally felt once I did pass, like, wow, what a relief.

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Michael Fulwiler (10:49):

Definitely. I mean as someone who knows you and considers you as a friend, I was rooting for you and the fact that I knew that you were going through this and I know that you're a good therapist and your skills as a clinician are not defined by this test is antiquated in a lot of ways. And so to see you get so close and not pass, it made me root for you. And so I think that that speaks to what I mentioned earlier about your authenticity, and I think this is a great takeaway for folks who are listening, that when you show up authentically online, you build relationships and people root for your success. And maybe there's people who don't, right? And those aren't your people and that that's okay. I think you have to be secure enough in yourself that if you are putting yourself out there, there's going to be people who don't receive you.

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(11:49):

And that's okay, but I just wanted to recognize that you were so open. And I think what that does is it also gives permission for other people to be open and share their experiences. I imagine there's a lot of folks who had a similar experience, but they didn't talk about it. Maybe they were embarrassed by it and they felt really alone in that experience. So there's something to be said about community support. And I'm curious now looking back, what's your perspective on the licensure exam and whether or not we should continue to have that be something that is required. Do you think that social workers and mental health professionals should need to pass a licensure exam in order to get licensed, or should their education and their hours be enough?

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Gerald Joseph (12:41):

I definitely think it should model after, for example, med students. I think it should be connected towards once you're in school, that way information is still fresh and connected. But no, I don't think whether it's for positions or getting into the work, I don't think that there should be a license or exam. I think once a person is in grad school and they're actively connected and in order to get your master's or PhD, you name it, there should be an examination component. However, I don't believe there should be licensing exams.

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Michael Fulwiler (13:17):

Yeah, I think somewhat of a hot take, but I've seen it online especially the advice that I've heard with the social work exam is like you should answer it in the way that a white therapist would answer it. And so it's like you're not even answering it authentically, you're just trying to beat the test. Was that advice that you received

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Gerald Joseph (13:37):

It? It definitely was because especially for me as a queer, black queer clinician trying to answer certain questions where I personally would not call the police immediately, I would want to build rapport and just develop a plan. And even to this day, I still share that with clients. If I see that they are exhibiting suicidal ideation or the risk is quite acute, we will talk about it. And I just want to see what is going to be best in their interest. So employing harm reduction perspectives, what's going to be best for them to keep them safe while also protecting myself as a clinician. So I see both sides of the coin.

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Michael Fulwiler (14:23):

That makes sense. I think the counter argument is, well, there needs to be some type of way to evaluate clinicians in the same way that doctors at their board exams and lawyers take the bar. But it sounds like you're thinking is that if it's closer to school, maybe it's part of the grad program versus you go to graduate school, then you do 3000 hours, then you take this test three years later, you're just in a totally different mindset at that point.

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Gerald Joseph (14:51):

Exactly. Exactly. Yeah, no, I definitely think it should be connected towards the program. And then afterwards you get your hours, you're in supervision and you're free.

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Michael Fulwiler (15:05):

And we have such a shortage of therapists, like the demand for therapy far exceeds the supply of therapists, yet we make it so difficult in this country to become a therapist. So something needs to change there.

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Gerald Joseph (15:22):

Definitely. Yes. I even recall being in grad school, and most of my program was majority white. And even professionally, there are various therapist events that I walk into, and there's just a handful of melanated minoritized individuals. So I do hope to see a shift where we can even incentivize persons of color to become a therapist

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Michael Fulwiler (15:49):

In those spaces. Do you feel like you can be your authentic self in the way that you are, say, online or with friends, or do you feel like you need to tone things down?

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Gerald Joseph (15:59):

Yes. I think it's something that I still battle with myself to this day. I often sugar keep professionalism. It's rooted in white supremacy, and I was even in just full transparency and even preparing for this podcast, I was like, wow, what do I want to wear today?

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Michael Fulwiler (16:21):

Well, we were texting and I was like, you got to bring a fit.

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Gerald Joseph (16:25):

Yeah, exactly. So I was like, okay, this feels cute, right? Yeah. But I mean, there are certain spaces where I'm just like, okay, for example, I love crop tops. I love, but I also love button downs and dresses and skirts. So I'm very fluid with my style and just how I come up. And when I go into certain spaces and professional events, I'm just like, oh, wow, are gender nonconforming people? Are they included? Is there space for expression? So I think that's just something that I do battle with, especially in a field that has a history of being rigid. And it's something that I've challenged, I've challenged even in various systems that I've worked with. In order for me as a clinician to be comfortable, I should be able to express myself and feel comfortable because how am I going to provide great care along with having clients, patients be their authentic selves, and to feel comfortable if I'm not comfortable? Right.

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Michael Fulwiler (17:30):

Have there been times when people have made comments to you at work about the clothes that you wear or have you had experiences?

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Gerald Joseph (17:41):

Yes, yes. No, I definitely, I've received messaging before where a supervisor had message, and the intent may not have been bad, but the intent, the way it landed for me, it was bad. It was like, Gerald isn't a address today. And for me, when I received that message, when it was meant to go to a higher leader, I was just like, what is the reason behind this? Why are they monitoring me? Why are they monitoring me and why I'm in a dress? I talked it out with them and I even shared with them how it landed for me. And we were able to have conversation and we were both able to acknowledge I have done so much work within myself for me to even feel comfortable to express that in both personal and professional capacities.

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Michael Fulwiler (18:32):

And if someone feels uncomfortable with the way that you present or show up, that's really a them problem, right?

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Gerald Joseph (18:40):

Yeah.

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Michael Fulwiler (18:41):

It's not a you problem as long as you're not being disrespectful or whatever, but it's really, that's something that they need to work on, and it's not something that you need to change. And I do think that for clients, it is important that they see a therapist or they see a clinician who looks like them and they can relate to. And if therapists and clinicians are not being their authentic self, then it impacts the way that they show up for their clients and the way that their clients can connect with them. So I do think it is really important.

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Gerald Joseph (19:12):

I agree, yes, because my identities are at the forefront and I aim to support my community first, and of course adjacent communities. I am here for all people. I'm here for the community, especially being an urban therapist in the nation's capital. Given the external the climate, I still want to show we are here fighting, we are here. I'm part of a collective where authenticity and transparency and just saying, Hey, you're safe with me. That is so important for me right now.

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Michael Fulwiler (19:46):

And this is really important because I've had conversations with their opposed who have told me that they feel like it's important for them to be more of a blank slate, that they worry about transference if they self-disclose. And my observation is that therapists with that perspective take more of a psychoanalytic approach, perhaps kind of maybe more of an old school approach towards how they kind of show up. And if that works for them and the clients that they see it, then that's great. But what I'm hearing from you is for the community that you serve and the clients that you work with, it is important for you to show up as yourself. It makes them feel safe, and they are able to put their guard down. Is that accurate?

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Gerald Joseph (20:36):

Very much. And I actually encourage clients, if they ever have a question, they can always ask me. So if they ever see a post store, if they even have a question as far as how I show up in the space, they can always ask me. I try to keep that open door, be an open book, because it is a relationship, and if I see where it's clinically appropriate, I will disclose. And that's just how I was trained to be an instrument, to be that tool of creating safety, creating inclusion, creating warmth.

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Michael Fulwiler (21:15):

And it creates an opportunity, right, to build a rapport with that client, whether you answer their question or you kind of reflect it back on them and say something like, well, what would it mean to you if I said this? Something like that. And that can create an opportunity to go deeper. So I think it's really important that we don't avoid those questions or clients don't feel like they can ask their therapists who they voted for or how they feel about certain issues.

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Gerald Joseph (21:39):

It all has influence. It all has influence, whether it's within the therapist's room, the clinical space, or on both the therapist or the client. So these are important things to keep in mind, and that's why I just aim to just show up authentically, whether it's digitally or out in the community where I've attended protest events. And I am very vocal as far as the current administration and the way that things are going. And if clients ever have questions, I just want them to know this is where I'm at. And if I do notice, for example, if I'm working with someone that is on the more conservative side, I'll let them know of my stance and I will gladly refer them out because their safety is going to be important. So I do see this as a dual, a dual relationship, dual. Well, not a dual relationship, but

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Michael Fulwiler (22:36):

Yeah, we don't want a dual relationship. We don't want that. But no, I know what you're saying. It's not coming from a place of judgment. If someone has different beliefs than you, that's okay. You may not be the right therapist for them. And that's also okay. And I think that, so maybe it's like there's a dichotomy there of there's sort both things are true and that is okay, which could be at odds with some therapists who believe, well, as a therapist we should try to help everyone. If someone's reaching out to us, we should not work with them because they have different beliefs than we do. And so I'm curious your response to that.

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Gerald Joseph (23:20):

I think for me, especially when we think of clinician burnout, so for example, on the public, I love children. I love playing with my friend's kids and being supportive for kids. And I do have a history of working with children, but clinically in this age, I do not like working with children. For me as a clinician, I will gladly refer a child out for care and support. So it's the same whether it's politically or even if someone is a homophobe or just part of an oppressed class, they're just actively engaging in oppression. If I notice where, hey, this is going to affect the therapeutic relationship, I think it's important for clinicians to keep that in mind where that can impact you, and it's important to create a plan where you can safely transfer that person.

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Michael Fulwiler (24:21):

Yeah, that makes sense. Because it sounds like it's not in the client's best interest to work with you. You're not going to be an effective therapist if you can't connect with them. And so it's better for them to work with someone else, and you're not just turning them away and saying, sorry. I think that's the important piece here, right, is yes, I will work with you. Here's a list of referrals. Here's some great other therapists. I think that would be a better fit. Exactly. They're still able to get care,

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Gerald Joseph (24:54):

But it just may not be with you. And that's right. And that is completely okay. It's a hundred percent. Okay,

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Michael Fulwiler (25:01):

So you get licensed finally. Yes. Finally. Finally, we were all celebrating, all excited for you. And then is private practice the next step and kind of what you had the next goal that you had for yourself?

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Gerald Joseph (25:18):

It was even when I was trying to, even going through that licensure process, I always had that ideation of private practice. I always had that goal. And I guess in a way, I've always been inspired by Oprah having multiple streams of revenue, and I've always just wanted to have my own business. So even going back to high school, I took entrepreneurship classes and I've just always had that mindset of like, okay, this is what I really want to do, and just try to form my own niche, my own style to practice clinically. And that's why eventually I came up with the capital therapist and just being able to learn and grow, and I'm still learning and growing. It's definitely been a journey. It's been a journey, Michael, but it's been so beautiful and I'm very happy that I've launched it.

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Michael Fulwiler (26:14):

I'm happy too for you. Thank you. Yeah, I remember working on a concept for a logo for you first. I love the name capital therapist as a therapist who is in DC. I think it's great. I remember I have workshopping this logo concept where the Washington Monument was the I in capital therapist, but it looked pretty phallic, right? Yes. Which maybe that's okay. I don't know, but maybe we do. I don't know. So we moved away from that idea, but I was thinking about that the other day and laughing about it,

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Gerald Joseph (26:49):

And then cherry blossoms and things like that. But yeah, no, I do like the logo and even how the current logo and just how abstract and fun it is.

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Michael Fulwiler (27:00):

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Gerald Joseph (28:11):

Yeah, full transparency. It's been hard as fuck. It's been so fucking hard. And the reason why it's been so hard is because I think I had the idea, right? Wow, I have this license, I have all my ducks in a row, I'm telehealth. I am putting ads out on Yelp and Facebook and Instagram, and I'm on Psychology Today. And I just thought that people would just start coming in. And I gave myself a year and I was like, wow, no one is really coming. I mean, I did have some free consultations and things like that, but I realized it does take a lot of work. It takes networking, it takes time, it takes strategy. And now that I'm approaching a year and a half now, I've realized, okay, this is what I have to do. So first it started, okay, I'm going to start on platforms where it's more accessible.

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(29:12):

So I advertise on platforms where I can advertise, having a sliding scale and truly being able to reach the communities that align with me and my background. So my background is supporting Medicaid, the uninsured and clientele that may not traditionally afford therapy. And I've noticed where these are communities that truly need the support, and I've been able to draw and provide care for them through psyching scale. And I've recently gotten paneled. And so it's just been a process and it's coming. And there are definitely moments where I'm just, ah, but it's much better now that I have a grasp on things.

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Michael Fulwiler (30:00):

I think it's really important to normalize, right? Because some therapists, they work at a group practice, maybe they're in community mental health, they're building their private practice on the side, they leave, they go into private practice, clients come with them, and within a month or two, they're full. And that's the experience of some therapist, but that's not the experience of all therapists. And I think that it's easy to see posts on social media about therapists talk about, oh, I made six figures in my first year, or I filled my caseload in six weeks. And it's like, if you see that and that's not what you're experiencing, I think that can be really hard to be like, oh, am I doing something wrong? Am I a bad therapist?

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Gerald Joseph (30:44):

Hundred percent.

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Michael Fulwiler (30:44):

For folks who are listening who are in private practice or going into private practice, and it hasn't been as easy as social media makes it seem, I think it can be validated and hopefully comforting to know that it can be difficult, and it does take time. The thing that I always say about marketing is that it's really an investment. It's a long game. I think it's easy to want to take the shortcuts and get the wins in the short term, but in the longterm, I think building that referral network, putting yourself out there, networking, building your reputation, all of those things, that's going to keep your practice full. Because sure, you could spend a bunch of money on Google ads or Facebook ads and maybe get clients that way, but as soon as stop running those ads now, where are those clients coming from?

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(31:35):

And so I think you're doing all the right things, and I know we've talked about it too, and your website and profiles and all of that. And I think a part of it too is experimentation. You set your fee and if it's too high, you can lower it. Or I'm going to try private pay, and I'm struggling to get clients because clients really are wanting to use their insurance. So I'll get paneled and I'll take insurance, and maybe in the future I'll come off of insurance. But it's okay in the short term to do those things. And so I think there's no one right way. I think something we also talked about too is the importance of owning your own website. And even just having a Squarespace site that is your, I describe it, it's your real estate on the internet, right?

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Gerald Joseph (32:24):

Yeah.

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Michael Fulwiler (32:24):

It's your 24/7 employee. It's always on. So just those kinds of things I think can make a big difference,

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Gerald Joseph (32:31):

Truly. And I've had even just opportunities, whether it's professional development or even just ways to even tap into other databases for clientele, they reach out to me through my website. So I have definitely seen the benefits of, as you just shared, owning your own website and just having your domain and well laid out website. It has been phenomenal.

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Michael Fulwiler (33:02):

You also have a specialization in psychedelic assisted therapy, which I am fascinated by. I remember the last time I was in DC, we got drinks and we talked about it. And as we were talking, I was thinking, I remember thinking, and I don't know if I said this or not, but I remember thinking, I wish this conversation was being recorded because this is so fascinating, something that I want to share and for people to learn. And so I'd love to chat about it if you're open to it. Maybe we could start by your first experience or exposure to psychedelic assisted therapy. Was it something that you experienced personally, or is it something that you learned about in a more professional context in terms of a therapeutic

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Gerald Joseph (33:45):

Intervention? Yes. Yes. So I can definitely share my own experiences with psychedelics. Sorry, I had just recreational use. So just imagine just college kids wanting to have fun and getting a grab of mushrooms and just tripping out. So I just remember a couple times being in college and having just securing a bag of mushrooms and being started by a group of friends, and we went on experiences. And one profound experience, I don't mind sharing it involved. Two friends of mine, one friend had recently come out to their family, and then another friend was actively grieving the loss of their sibling. And then for me, I was still, so this was my sophomore year of college, and I was still processing the after effects as far as coming out. And just that long-term process of coming out, because I always share with people, we're always coming out, especially if you're part of the lgbtq plus community, you're always coming out.

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(34:51):

So it's not just like one and done. You walk into spaces and you're always coming out. So yeah, this journey that my friends and I, we went on, it was just very profound and beautiful, and we were just all supportive of one another and still just touches me in so many ways. And soon after that experience, I actually had stopped using psychedelics for a while. And it wasn't until the pandemic, I was seeing information of psychedelics being used and a therapeutic context professionally and in clinical spaces and research. And it just caught my eye, especially with so much suffering and have my own personal experience with psychedelics. And I was just like, Hey, let me look more into this. So I actually ended up bringing up during clinical supervision, and I felt so supported by my supervisor at the time and just by my peers being able to share my own experiences because there, there's so much stigma and there's still stigma, and I still experience it as a clinician where due to the war on drugs where psychedelics are seen as taboo and there just needs to be education about them. These are important tools. They're powerful tools, but they're important. And they do have a place when it comes to healing and providing support, or even just recreational use.

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Michael Fulwiler (36:22):

They're somewhat new in western therapy. But in eastern medicine, my understanding is psychedelics. This goes back thousands of years. This isn't something that's new. There's a lot of history here. So I'm curious, how then did you approach integrating psychedelic assisted therapy into your clinical practice? I know that you completed a program through the Integrative Psychiatry Institute.

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Gerald Joseph (36:56):

Yes, in Boulder. In Boulder, Colorado, which was a phenomenal experience in training. So it's a year long program, so studied various psychedelic compounds and interactions with classical pharmacology, drugs, and how to apply psychedelics in various contexts. So legally, ketamine is used, and within the psychedelic community, individuals view ketamine, strictly medical nons, psychedelic, but that's up for debate. I personally do view ketamine as a psychedelic, just like various strains of cannabis can actually be psychedelic legally. And in a therapeutic context, I work with a physician and we provide ketamine in a therapeutic context. And then in dc, so in DC, psychedelics are decriminalized, and there's a local store where I've provided education and support to the community as well as my contact information where I do employ harm reduction techniques, where I could prepare individuals for psychedelic experiences. So if they do procure mushrooms or other substances on the street utilizing harm reduction principles to keep them safe, and then we will process afterwards. So we'll integrate their experience and making sure that they're safe. And that's the one thing that I learned during my training. You don't want to make any sudden moves. So let's say during a psychedelic experience, having a notion, I need to move to California, you don't want to make any sudden moves, right?

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(38:37):

So just being able to process, right, process the experience, process, the feelings, the thoughts associated with that experience, and keeping people safe.

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Michael Fulwiler (38:48):

What are some of the risks of psychedelic assisted therapy and clients having psychedelic experiences?

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Gerald Joseph (38:56):

I can say in a therapeutic context. So as far as on psychedelic assisted therapy, it's always either in a medicalized environment, so keeping individuals safe, and you do have to be assessed by psychiatrists. So psychiatrists is going to try and minimize as much risk as possible. However, with ketamine, it's a dissociative. So some of the risks can be dissociation, people may not feel like as if they're in their body. And then ketamine, abuse can also lead to renal issues and just additional complications physically. So that's why it's really important to have a psychiatrist to have medical professionals on standby for support when it comes to dosage and working with clients. Now, I can say on the streets, so in a community context, whether it's substances like M-D-M-A-L-S-D, psilocybin, mushrooms, very psychedelic classes, if a person has a history or a family history of say, schizophrenia or psychosis, right? There can be an increased likelihood of having a psychotic episode. So that's why it's really important to understand. And then also, I love that there's more and more resources being created. So for example, there's the fireside project where individuals can contact 24/7 a hotline and get support. So let's say someone is at a festival or they're with their friends, they can contact this hotline 24 7 for support. So that's what I fully believe in both contexts, whether it's recreational or in therapeutic infrastructures being built and created for safety.

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Michael Fulwiler (40:50):

The family history piece is super important. I know I've shared this with you. I have a family history of schizophrenia, so that's made me hesitant to use psychedelics or even kind of experiment or explore because I don't know what that experience is going to be like for me. And so I think that one, just doing that assessment, but also just assessing comfort level, I imagine so much of your experience is influenced by your state of mind and how you're feeling. And if you're going to this experience feeling super anxious, then I compete to a bad experience. And is it common for clients to have a bad experience using psychedelics? Is that something that you, not obviously talking about specific clients, but is that something that you talk about in the training and program of this may happen and what to do?

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Gerald Joseph (41:43):

The language, it's called the container. So we always want to make sure the container is safe. So the container's, the space, so that is the space where the work is happening. So certain therapists, they'll create almost like a ceremony where there can be an altar and there's candles and there's flowers, and the client will bring an intention. So they'll bring what they intend to do with the work with the medicine, and they may bring photographs or things that are important for them, things that are grounding in various spaces. There may be yoga mats and just trying to make the space as comfortable as possible. But I've also been in the more medicalized environment where you do have a couch or you have a recliner and there's heart monitors and just various instruments for safety. Some clinics may have cameras for safety. Supportive touch is also encouraged, but you always want to gain consent. That's of critical obtaining consent from the client. But yes, I always love to just ground individuals and just be intentional before getting into the work.

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Michael Fulwiler (42:58):

What kinds of things is psychedelic assisted therapy helpful for treating? Are there certain presenting concerns or certain types of challenges that clients face where psychedelic assisted therapy can be helpful?

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Gerald Joseph (43:16):

Yes. Yes. Psychedelic assisted therapy can be helpful to treat. For example, PTSD, the Veteran Affairs has engaged in extensive research with ease of MDMA to treat PTSD. So psychedelics can be used for PTSD, they can be used for treatment resistant depression, various mood disorders, anxiety. There's research coming out of Hopkins regarding eating disorders and psychedelic use and body dysmorphia. Historically, going back to the eighties, psychedelics were even used in couples therapy. So MDMA, they call MDMA the love drug because it's in pathogen.

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Michael Fulwiler (43:54):

I remember hearing about that. Yeah,

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Gerald Joseph (43:56):

Yeah, yeah. So couples that are experiencing hardship, right? They actually fall in love again depending on the space and just with the medicine. So I've heard all sorts of stories from clinicians working with couples and empty may use. So yeah, psychedelics can treat various conditions, is just really important. The assessment piece and the actual space piece.

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Michael Fulwiler (44:22):

For folks who are listening who are interested in learning more about psychedelic assisted therapy and getting maybe kind of an introductory training, is there a book or a program or an organization that you would recommend at least as just a starting point?

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Gerald Joseph (44:40):

Definitely, yeah. So one organization that's in the forefront of my mind is in a community organization based in the San Francisco Bay area where they aim to make training affordable, and that's alchemy. So I highly recommend Alchemy as far as therapists getting trained and affordable. I also recommend IPI. There's the CIS California Institutes Integrated Studies. They're considered the Harvard of psychedelic training. Very competitive though as far as literature, I recommend reading the Psychedelic Explorers Guide by Dr. James Fatman. He is a psychologist, studied out of Sanford, and grew up during the height of the sixties and counterculture, and studied very psychedelics and created his own microdose protocol that I frequently recommend and advise as far as safe use Michael Pollan. So Michael Pollan, how to Change Your Mind. So as a journalist, he's done his own research and engage in his own use of psychedelics, so there's a lot of information out there. There's maps as far as a professional organization. Yeah, so definitely recommend. I was

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Michael Fulwiler (45:56):

Thinking of Michael Pollen. I remember reading his book, omnivores Dilemma, which is about kind of the food system in this country, and just being really blown away by it. It really questions how you think about food and how it's produced in the United States, but I know more recently, he's also become more interested in psychedelics, and he's become a speaker and an advocate, and so definitely recommend his work. You also practice EMDR. And so is EMDR associated with psychedelic assisted therapy and integrated, or is it just a separate modality in terms of your practice?

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Gerald Joseph (46:37):

Very new. However, I do view it quite important as part of stabilization, so with PTSD, so whether it's with the preparation phase, so just preparing, so just creating a state for support that people can always refer to. So let's say someone is a 10, being able to lower that level of disturbance, whatever it is that an individual wants to focus on before they actively do their own work or they work with a physician under a psychedelic state and myself, that's important. And then of course, they reprocessing after that experience. So lots of development as far as EMDR or various therapies and psychedelics, but I think it's quite promising. I think therapists can use various interventions, whether it's being psychodynamic or gestalt or relational psychoanalysis. I think it's going to be quite interesting where this goes in the next 10 years.

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Michael Fulwiler (47:37):

Definitely. As someone who is not a therapist but works with therapists, I am excited about the approaches that are being developed, whether it's psychedelic assisted therapy, EMDR, the use of AI and artificial intelligence and artificial reality as well. There's some pretty amazing things being done with virtual reality and working with kids on the autism spectrum. And so I think it's going to be very interesting to see how the field continues to change and evolve over the next five to 10 years.

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Gerald Joseph (48:12):

Yes, yes. And scientists, researchers are creating psychedelics for, it doesn't even involve the compounds for the visual effects, so it's just reducing. So it is going to be really interesting where this science goes.

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Michael Fulwiler (48:27):

Hopefully conversations like this continue to normalize the use of psychedelic assisted therapy. I know that it's something that still is very stigmatized, and so I think it's important that you're talking about it. I'm glad we're having this conversation. We're coming towards the end, unfortunately, and we like to wrap up these conversations with a few rapid fire questions. So these are some fun ones. Aren't you ready? I'm ready. What's your favorite item in your closet right now?

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Gerald Joseph (48:58):

Ooh, that's a really tough one. Okay. My favorite item in my closet right now, hoodies, because we're kind of in that time of the year where it's still kind of cool, but it's also warm, so mixed weather. So yeah, I like a good hoodie,

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Michael Fulwiler (49:15):

Same, love a cozy hoodie.

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Gerald Joseph (49:17):

Yeah.

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Michael Fulwiler (49:18):

Sex and the city character you most identify with.

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Gerald Joseph (49:24):

I feel if you asked me two years ago, I definitely would've been Carrie. I still feel I have my Carrie moments, but I feel I'm more like Charlotte. I do feel more of a Charlotte right now. Love that.

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Michael Fulwiler (49:36):

Can you expand on that?

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Gerald Joseph (49:37):

Yeah, no, I feel like I'm Charlotte in the way where very intentional as far as navigating the DC dating scene. I'm just more of business, but then also fun. And I like that about Charlotte. She means business. She can be a little out there as far as maybe a little spacey, but she's also very fun and I love that about her.

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Michael Fulwiler (50:01):

Such a timeless show. My wife and I will put it on when we don't have anything else to watch. And it's always so good. Biggest misconception that people have about psychedelic assisted therapy?

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Gerald Joseph (50:13):

That it is the end all be all. People think that psychedelics are going to just transform my life and just like various medicines. So for example, if someone is a diabetic and they're taking a medicine, that medicine may not work for them. So I think we have to use caution as far as saying, okay, this medicine can treat everything and that may not be the case.

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Michael Fulwiler (50:38):

One thing you want therapists to take away from this conversation?

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Gerald Joseph (50:43):

Have fun. Have fun, be yourself. I think it's so important, especially in today's climate, it's very heavy. The external is so heavy, and we have to find ways to restore ourselves, rejuvenate ourselves, and feel connected with ourselves so we can be the best for our clients.

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Michael Fulwiler (51:05):

You are the embodiment of that.

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Gerald Joseph (51:06):

Thank you. All good. Because life is short, right? Life is short, and I appreciate you sharing that because I do want to embody being fun and authentic and despite the pressure of the external and going back to what I mentioned with being a therapist, right? It's hard. So we have to have fun.

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Michael Fulwiler (51:27):

Absolutely. Gerald, thank you so much for coming on the show. One of the reasons why I wanted to bring you on the show is I think that more people need to know about you and know who you are. I think that you're such a light, and so go follow Gerald on social media. Where can folks connect with you?

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Gerald Joseph (51:45):

Yes, people can connect with me on the capital therapist, so I am on Instagram, the capital therapist, look me up. I'm also on LinkedIn, so you can just look up my name, Gerald Joseph or follow me on Twitter or Blue Sky. I also use my names on Gerald Joseph on those sites as well. So yes, please connect everyone and thank you, Michael, for this opportunity. It's been great.

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Michael Fulwiler (52:13):

Yeah, definitely recommend follow Gerald. See some great outfits, some great dancing videos. Always just really great vibes and energy. Exactly. Thank you so much, drew. Thank you, Michael. 

Thanks for listening to this episode of Heard Business School, brought to you by Heard, the financial management platform for therapists. To get the class notes for this week's episode, go to joinheard.com/podcast. And don't forget to subscribe on YouTube, Apple, Spotify, or wherever you listen to podcasts. We'll see you in the next class.