Joe Tafur, MD, shares his knowledge of ancient shamanic medicine to the modern research on psychedelics. He and Dr. Greg Lane explore the explosion in psychedlic research on treating emotional trauma such as PTSD and opening the doors of perception through disruption of the default node network.

Joe Tafur, M.D., is a Colombian-American family physician originally from Phoenix, Arizona. After completing his family medicine training at UCLA, Dr. Tafur spent two years in academic research at the UCSD Department of Psychiatry in a lab focused on mind-body medicine. After his research fellowship, over a period of six years, he lived and worked in the Peruvian Amazon at the traditional healing center Nihue Rao Centro Espiritual. There he worked closely with master Shipibo shaman Ricardo Amaringo and trained in ayahuasca shamanism. In his new book “The Fellowship of the River: A Medical Doctor’s Exploration into Traditional Amazonian Plant Medicine,” through a series of stories, Dr. Tafur shares his unique experience and integrative medical theories. To learn more about his work, visit drjoetafur.com and modernspirit.org.

Greg: Hello and welcome to the Pacific Center Podcast. My name is Dr. Greg Lane and I will be your host as we explore many interesting topics with many amazing people from a variety of professional backgrounds over the months and years ahead. The focus of this podcast will be the intersection of the traditional healthcare practices of various cultures and the modern scientific research on peak physical and cognitive performance. The show will be delivered in an interview format. A quick disclaimer: while we may be discussing some health-related issues and therapies, in no way will this be construed as medical advice. As always, if you’re seeking information or treatment for a medical condition, please consult with a licensed healthcare provider. Our guest today is Dr. Joe Tafur, founder of Nihue Rao, psychoneuroimmunology integrative medicine, family medicine, traditional amazonian plant medicine. Dr. Tafur is an integrative-minded family physician and founding partner of Nihue Rao Centro Espiritual. He is Colombian-American from Arizona, studied biology at UCLA, then med school at UCSD, completed family medicine residency at UCLA, then went on to do a post-doc in the department of psychiatry at UCSD, studying low-intensity high-light therapy and simultaneously psychoneuroimmunology. Dr. Tafur has been working in and around integrative medicine throughout and after his medical training, working on a variety of academic and community activities with traditional Chinese medicine and yoga practitioners, as well as energy healers. He’s been studying traditional Shipibo plant medicine for the past five years and is now apprenticing under Ricardo Amaringo at the Nihue Rao center. His primary interest at this time is in spiritual healing and in working to integrate practices like Amazonian shamanism and other traditional approaches with modern healthcare. Dr. Tafur’s book, The Fellowship Of The River, explores his extensive experience with ayahuasca and traditional medicine in the Amazon rainforest. And during his extensive work at the Peruvian healing center, Nihue Rao Centro Espiritual, Dr. Tafur studied traditional Amazonian plant medicine or TAPM and Shipibo shamanism under master ayahuasquero, Ricardo Amaringo. At the center, he learned how shamanic approaches can help to heal modern health problems like anxiety, depression, PTSD, migraine headaches, and digestive problems. Dr. Tafur continues to work in both allopathic and shamanistic medicine and is focused on connecting the worlds of academic medicine and spiritual healing. In his years at Nihue Rao Centro Espiritual, he collected a number of integrative case studies from which he developed his theories about bridging modern medical understanding in the profound world of shamanic healing, woven into the stories of his Amazonian adventures. Dr. Tafur has summarized these theories in his thought-provoking new book, The Fellowship Of The River: A Medical Doctor’s Exploration into Traditional Amazonian Plant Medicine. We’re going to be speaking with Dr. Tafur from his home in Arizona. Dr. Tafur, welcome, it’s so great to have you with us today!

Joe: Thank you, thank you very much. I’ll just like clear up one thing from the bio because it might be an older one but, you know, I’ve been involved in the Amazon since 2007 and then more intensely studying since 2011.

Greg: Oh, thank you for the clarification.

Joe: Yeah, no problem.

Greg: So let’s dive right in. Can you give us a brief history of, well, how did you get involved anyway with ayahuasca, and the region, and then larger scope here?

Joe: Yeah, so I went to UCSD for medical school in San Diego and I got depressed in medical school and I was having a hard time. And I was like, I kind of get into all those topics in the book, and I tried a few different things. My dad is a psychiatrist and I eventually, after kind of benefiting a little bit from this normal treatment but still not feeling quite well, I entered peyote ceremony in Arizona, had an opportunity to try peyote in a kind of spiritual ceremonial context and I had a really profound healing. And so, I felt a lot better and I became very curious about plant medicine and shamanism. And then, my family is from Colombia and I had heard about ayahuasca, or yage as they called in Colombia, and I had a family connection. My grandfather’s best friend was a botanist that had spent some time in the Amazon and so I was aware of that. And so, because of the kind of profound response that I had to peyote, and as I got to know more kind of medicine men or people that were working with peyote, I became very curious. I wonder what they’re doing down there, you know, with ayahuasca? And so, I wanted to go down and I had an opportunity to go with a friend and I, you know, I had a very impactful experience. And I was really taken by, personally, by the experience. But also, like, very impressed by the kind of healing work that I was seeing happening, you know, through this traditional kind of medical system and just the amazing results that I was observing. And so, I started going back, you know, and then for myself to kind of learn more about it. And then, eventually, I started taking groups down and kind of got closer to the shamans. And then, one of the shamans, Ricardo Amaringo, was interested in starting his own place and he invited myself and Cvita Mamic and a few other people to join him to start a new healing center, which was Nihue Rao. And so, then we did that.

Greg: And what year was that? How long have you been doing that?

Joe: New, it all opened in 2011. So, it’s like, really 2018. It’s really eight years because it’s still, you know, during the whole 2011, we started, we bought the property in 2010, started constructing building. So it’s been working for about eight years. But at the end of 2016, I stepped out as a business partner and I’m selling my shares of the center to Ricardo. But I still take groups there and consult with them.

Greg: Can you give us a sense of what Nihue Rao looks like? You said you sold shares, and what is it? A big piece of property?

Joe: It’s a big piece of property, anywhere else, like a 20-acre property in the forest, about an hour and a half outside of town, up against a very large national park. And so then, it’s a retreat center, kind of in a rustic construction style, traditional style with leaves, patched roofs, and rooms for people to stay in. But then, they also, you know, there’s showers and bathrooms. And there’s a maloca for the ceremony, a ceremonial space. And there’s also, like, little huts in the forest for people to do isolation, if they want. And there’s also, you know, there’s a space, an art maloca, a space for people to do creative work. And there’s also, you know, there’s a kitchen and a dining area and like all that kind of services that people have. And, you know, it’s a lot of land. There’s a soccer field and new, nice, plenty of places to hang out. And they have a website, nihuerao.com, with a lot of photos.

Greg: So it sounds beautiful, sounds idyllic.

Joe: Yeah, it’s very beautiful.

Greg: So when people come, do they stay for – is it a set period of time?

Joe: Yeah, it’s open-ended there. The center is running throughout the year. And some people come for a minimum of one week, more typical stay is ten days or maybe two weeks. And then there’s other people that stay for a month, or sometimes two months, or three months, or six months, or even a year. So, prolonged treatment.

Greg: So, how many people approximately have come through there since like 2000?

Joe: Probably, I don’t know, probably a thousand.

Greg: Oh, wow! Maybe, is it one of the bigger ones down there?

Joe: It’s one, I mean, it is one of the bigger ones there. There are some good sized ones but I think property-wise. And it’s been around, you know, it’s been functioning. So, yeah, I would say it’s one of the larger centers. It can hold probably about, you know, anywhere from like 15 to 20 people could be there at one time.

Greg: And are most people that come there, are they seeking treatment for particular disorders, conditions, or a combination of things? Just, they want to try it?

Joe: Yeah, I think. This place, the shamans that work there, Ricardo and his team, they’re serious about what they do. So they’re not so interested in like – and they don’t really think that’s respectful, you know – to try it, especially not in the conditions in which they’re providing. And so then, they don’t. So, that’s the minimum one-week stay, to try to minimize that. And then, it’s so far out of people’s way and they have to kind of reserve and go through a screening process. So most of the people there are looking for help. There are people that want to explore but in their exploration, usually inevitably, something comes up that they want to work on.

Greg: Okay, yeah. I mean, this kind of brings me to sort of – I don’t know how much you want to talk about the history of psychedelics and altered states in general, I don’t know if that’s going to be the best use of our time or not – but I just posed you the question, what is your take on the history?

Joe: Yeah. I mean, now, there’s Michael Pollan’s book out, How To Change Your Mind, which is a pretty comprehensive look at it. I have a little section of a chapter on that, which is basically, you know, we know there’s been traditional use of and different psychedelics all over the world for thousands of years. And then, so the obvious examples are, you know, there’s ayahuasca in South America and other related plants, and then there’s the peyote, and then there’s mushrooms, it’s quite widespread. And Mexico is a famous place where they had a kind of, they continue to have a tradition around psilocybin mushrooms. But then there’s mushroom use, traditional use i guess, throughout Europe and Asia, as well, in North Africa and in Africa and beyond. And then there’s iboga, you know, in West Africa. And so, those are some of the examples of what’s been going on for thousands of years. And as far as like modern western culture, or maybe just American society, it’s kind of in the early days. In the ‘40s and the ‘50s in Europe and North America, they discovered LSD and they isolated psilocybin from the mushrooms that were being used. And they isolated masculine, you know, from the peyote and they began to do research on it. And they were considered very promising substances to learn about neuroscience and brain chemistry and also, you know, human psychology and treatment of all kinds of forms of mental health problems. Initially, well, addiction was a big focus but then, you know, other things, trauma-related things. So then, that was going on in the ‘40s and the ‘50s, and into the ‘60s. And then, you know, LSD and things like that kind of leaked into the population at large and were kind of being used outside of the clinical setting. And then eventually, you know, that led to the whole thing, right? The psychedelic ‘60s and the hippies and everything, and that whole movement, which eventually kind of aggravated the authorities. And then, there were other concerns about just kind of reckless use, right? And it’s new to everyone so, you know, they’re just like challenging the establishment. And so, there was a counter movement from the government to shut it all down. And so like in the late ‘60s, pretty successfully in the late ‘60s and early ‘70s, they stopped all psychedelic research and clinical research with psychedelics. And then it started back up again. You know, there’s the group MAPS, that’s based in the Bay area right now. And there’s people that were trying to, in the ‘80s I guess – at some point, MDMA was being used in psychotherapy which, you know, kind of became the party drug “ecstasy” and that became illegal. And so then, there were a lot of people working to try to legalize that or find a legal pathway to bring back psychedelic psychotherapy. So that was brewing. And there’s other people trying to do things. And then it was in the ‘90s that the University of New Mexico, Rick Strassman, started doing research with DMT, which is like the big main psychedelic component of ayahuasca. And so, they started to reopen those kind of trials and eventually that led to research that’s now going on at a number of universities, including Johns Hopkins, and UCLA, and NYU, and Imperial College of London. And so, there’s a renaissance and psychedelic research, once again, and a second look at the responsible use in which there’s been benefits shown with things like anxiety, and depression, and PTSD, and addiction. And so then, meanwhile, like in the ‘90s probably, the South American people started. More and more people started going to Peru, for example, to explore ayahuasca. And then these centers started popping up and this ayahuasca tourism scene, you know? I think by 2000, it was a little more, there’s a few centers. And first time I went down there, 2007, there were some centers that were kind of larger scale and ready to receive people and working with translators and things like that to facilitate people’s experience. So it wasn’t just about, like, going out to the village and finding a shaman you know? It was like a place with the website that was inviting people and that’s how I went. And since then, like I said, all the psychedelic science research is going on. And then Iquitos, it’s blown up, there’s many centers where many people have gone.

Greg: It seems like we’re beginning to, like you said, we’re starting to see this renaissance in the use of psychedelics. In fact, we were talking before we got on on the air here about microdosing. Can you elaborate a bit on this whole sort of dichotomy between, I guess we would call that the recreational sort of personal use of things, where people are microdosing themselves with various substances – DMT, or psilocybin, or even LSD – versus the real, the guide-led therapeutic interventions that you’re talking about that are really, maybe, more profound?

Joe: Yeah. I guess it’s like, I mean, microdosing is going on with all these different substances. And, you know, I guess it’s more popular and being talked about in, like, peak performance kind of discussions. When really, most people, I think a lot of people that are microdosing are like trying to treat something, you know? I think that’s like, you know, a lot of people are like exploring that as an antidepressant kind of effect. And so, I don’t know. It’s kind of like been popularized as it’s like, “Oh yeah, peak performance.” But it’s kind of weird because I don’t know what that means exactly. Like, being better at something you don’t like? Or, what does that mean, you know? It’s like this, kind of, confused materialist approach. To me, I mean, I’m not against it because I think a lot of people, they gain benefit. And, you know, that’s out there and I don’t think it should be illegal. And so, that being said, and then there’s the recreational use which, you know, probably a lot of us have had recreational experiences – some of them have been a lot of fun, some of them are troubling, and some of them maybe have been very profound, right? And then in the case of something like ayahuasca, where there’s this traditional kind of plant medicine system that’s still, you know, working from this ancestral experience. There’s another level of perhaps, like, what can be done? And that’s why I explore, you know, because there’s a lot of people. Just to touch on one concept related – DMT – you know, so people have the DMT and they think, I mean, you work with Chinese medicine and all the stuff, and yes, you get this reductionist approach, right? You know, they’re like, “Oh, we have DMT.” And the only reason the Amazonians don’t smoke DMT is because they’re so primitive, right? They don’t have a laboratory, you know, to isolate versus like whole plant medicine. Herbal medicine, Chinese medicine would be the perfect example to discuss, you know, it’s not the same thing, having a molecule of glucose as eating a chocolate cake, right? Like, it’s just not. And it’s not the same thing as, you know, swallowing a handful of caffeine or drinking some tea, right? It’s not. And then THC is not the same as marijuana, etc., you know, and all the isolated things and multi-plant mixes. And so, that’s just one thing. But, you know, so this reductionist approach. And, you know, other people want to have access to something and they have access to that but like, with people smoking DMT, where I think a lot of people have reported a lot of amazing experiences and some people have reported, like, profound healing experiences. And some people reported problems, like managing these really severe or intense altered states. But I haven’t seen those people reporting the kind of healing like, for example, that’s described in the book. You know, where people are really making, like, real serious gains. Although, some people are. Like, let’s say with microdosing. I mean, in a way, it’s like a treatment, right? Like, what’s the difference between microdosing and taking prozac, you know? It’s like in the same ballpark. It’s different and you can get it yourself but it’s like, it’s a chemical treatment, you know? And ideally, you would be making some gains so that you wouldn’t necessarily need that, right? That’s what hope is. So it’s like, once you’re treated, you moved up to another stage. And like, Ken Wilbur talks about like, you know, there’s state changes and their stage changes. And not that you’re necessarily going to achieve that with ayahuasca, but there’s pathways within the tradition to try to make the most of it which is what we’re also seeing with the psychedelic-assisted psychotherapy, when they have these big trials for PTSD – that’s a very famous trial from MAPS, the MDMA trial. So, a lot of people are taking MDMA, you know, all over the place, right? They all partied with MDMA but they’re not getting the kind of results that these guys are getting. You know, these guys are only doing two or three sessions of MDMA, right? And so, it’s like part of the context of this advanced therapeutic approach. And so, that’s just a perfect example. That’s why I promote that a lot. It’s like, psychedelic-assisted psychotherapy is turning out to be way more effective than just psychedelics. And in that same sense, like traditional ceremonial context in which people explore ayahuasca or even mushrooms or whatever it is, is quite different. And what people might just get from their own experimentation, for the simple reason that – and Chinese medicine is a perfect example – you know, I’m a doctor, I can go take a short course in acupuncture and I’ll get the license and I can do it but it’s like, does that as an ignorance of the philosophy underlying Chinese medicine limit my practice? Well, in fact, yes it does. You know, it’s a fact and that’s based on experience of actual practitioners, right? So it’s that kind of discussion where experience teaches wisdom. And so, you know, I bring it up all the time. Architecture is like that, somebody didn’t just figure it out by themselves because they’re such a prodigy, you know? That was like received, the revelation and the message that they know how to do it. It’s like, actually, it’s built on hundreds and thousands of years of experience that allow us to live in the kind of buildings we live in today.

Greg: Yeah. I think that’s a really important point, well you made a couple of really important points. Obviously, the synthesis of DMT is definitely not the same as the whole plant structure and all the molecules and all of the interaction between the plant terpenes and flavonoids and whatever else is in there. And just, the magic of the whole plant, if you will. And then the guide aspect, the teacher aspect, and even the group, you know, if they’re in the group.

Joe: Oh, sure. You know, it’s very impactful, there’s no question. And that’s a lot of the part that’s missing for people and that’s what I think it can be so therapeutic for people in places like Nihue Rao and a kind of ayahuasca retreat center that’s run well, that’s run responsibly. You know, there’s a lot of ways you can go wrong. But, you know – I bring it up a lot – Melody, an African shaman, he says, “You know what’s missing in the west is they’re disconnected from nature, they’re disconnected from community, and they’re disconnected from spirit.” And so, those are three things that really, you know, he makes the argument that this is really disturbing to the mental health of the society.

Greg: Sounds like a bad place to be.

Joe: Sounds like USA, you know?

Greg: The western cultural.

Joe: Yeah, the western world, you know? So then, it’s hard on us as human beings. So once you get people into a natural setting, in a retreat center that’s healing – and we have this forest bathing research and all that kind of stuff – and then you get them in community because a lot of these problems are rooted in relationship problems, whether it’s childhood stuff and those kind of things, that affect people’s emotional development. So you sometimes need a social solution, you know, to help people work these things out and allow the social, kind of, community to create a network to allow people to explore things that alone is just too high voltage. And then the last part is like some kind of mystical where you know a simple concept like hope, you know, could actually be celebrated and not like, I don’t know, become this topic of some kind of intellectualization. It’s like, you want your children to hope, you know? So it’s like this, you allow the common sense, like I say, where the mystery – what’s mystical, what’s spiritual – I guess to me, it’s like those things which we experience that are beyond the understanding of our mind, but the key point is that we experience them. Like, that’s what we’re talking about. We’re not talking about some made-up thing. I’m talking about something that somebody went through and they lived it and it’s like, so in other words, we don’t have to deny a strange phenomenon happening to us in our own life. And in the western kind of scientific rational point of view, it’s like, well, that’s kind of the first step. It’s like all of a sudden, everyone’s going to throw away their subjective experience of this life, which is ultimately like very foolish and you wouldn’t do that in a dialogue with a loved one. People do but it’s ultimately considered very cold-hearted kind of approach to take with somebody, you know? And it’s going to hurt somebody, it’s going to cause problems if you can’t, like, try to have some kind of compassionate understanding to some of the mysteries that people experience.

Greg: You know, it sounds a little bit, like, what you’re saying is that these substances – ayahuasca, psilocybin – and I’ve read this and I’ve experienced it, they’re the keys to unlock the door a bit.

Joe: Yeah. You know, that’s what a lot of people say. So then, like in the case of ayahuasca, I think there’s a further therapeutic experience, you know, the purge. So this is considered, “Oh, that’s just primitive. I don’t want to purge, I don’t like purging. So, just smoke the DMT,” right? But it’s like, that kind of visceral response quite often is like a big part of people’s healing experience. You know, just like with the somatic experience therapy and transformational breathwork or other forms of somatic release, even acupuncture or a massage or whatever it is, but mobilizing energetics in the body and allowing something to shift and change or facilitating that, so there’s that aspect. Just to comment – because in the tradition down there, all over the Amazon, the tea is never named for the DMT-containing plant, it’s named for the ayahuasca. The ayahuasca is seen as the divine, as seen as the grandmother of it all. And the visions, you know, they can be informative and they can be revealing but the power of the medicine is not there, the healing is not there. So there’s a healing power, you know, in the vine itself. And so that distinguishes, a little bit in the sense that it’s not relying on the pure psychedelic experience, however the secondary experience is a very significant part of it. And then, it’s that key and that’s what they talk about for somebody who’s very, let’s say blocked, they never received any kind of cultural or family education about mystical experiences or about, like, opening your heart or overcoming your ego. And then all of a sudden, you know, they have a direct experience of that, maybe it’s just for a few hours but they become aware that it exists. And so, there’s that. And then there’s this, like, deconditioning aspect, you know? So Terence McKenna said a lot, like, this is a “deconditioning agent.” So in other words, how do you get somebody to open their mind and become aware of some part of themselves that they’ve kind of like scarred over, shut down? And all of a sudden, it opens these gates, you know, and you become aware of all kinds of things.

Greg: So what are those gates? You have training in psychoneurology. What are they? What are we seeing in the research?

Joe: Well, the research is talking about, like, one of the focus areas of the research that’s partially from several different people – one of the big schools, Imperial College of London, and with their research with psilocybin, and this has been replicated with ayahuasca and I think they’ve also been looking at the other substances – is there’s this talk of this “default mode network” in the brain. So there’s this default mode network which is a series of kind of networks that are communicating with each other. Imperial College of London, in one of their papers, they talk about it, like, maybe this is the neural correlate of the ego, you know? This is, again, the reason they say that is because when people have in their research study ego-dissolution experiences described, you know, they see dramatic shifts in the activity of this default mode network. And so, then they’re saying that this is like the experience of ego-dissolution which is associated with this thing, it’s kind of like a filter, you know? So what is it associated with, like, there’s more default network activity, or I mean, it’s a certain kind of activity so it’s further characterized than just more or less. There’s some qualities of it and so more of it, you know, when you have like overactive mental activity, a lot of rumination – like sense of yourself, sense of your own story, sense of your own time traveling in your mind, thinking about the past, the stories that are really strong with your concept of your own identity – they’re associated with activity or this kind of over-activity. Similarly, over-activity and default mode network has been noted in things like anxiety and depression, you know, with this overactive thinking and addiction and PTSD. And even things like – you know, my friends at USC, they’re looking at the formal network and in relation to meditation – so meditation has a similar effect on this default mode network, maybe more lasting with a regular practice. So with the same kind of idea, that it’s like relaxing this ego-mental kind of activity and then that allows for more free-flowing, like, sensory integration to come from the senses, from the outer world. So people are more aware, they’re not so stuck in their heads, as people would say. You know, they’re more aware and perceptive to the world around them. And there’s also more free-flow from the interoception, in other words, the sense of the internal feelings inside their body which are, you know, closely linked to the state of their health and their function. But also, variants are related to their emotions so then there’s a lot of emotional content that comes forward that is otherwise suppressed, you know? So then you can imagine a situation where and this is like theory but it’s related, it’s based on this evidence that’s being demonstrated that, let’s say, some heavy trauma where the system is just overwhelmed and really can’t afford to feel that feeling anymore, right? And so, you kind of scar over and you get this excess default mode network activity to kind of like close down, you know, gates and feelings within. And so then, one of the strange phenomena that happens is a lot of people, like, have repressed memories come back, often of trauma.

Greg: Yeah. So that’s interesting that you say that. And you know, I know that we talked a little bit earlier about purging, like in a lot of traditional cultures, they do this. They take some time and prepare the body, prepare the mind before they go in. And you know, it sounds like this default mode network now is sort of – we’re looking at that – is that found in multiple areas of the brain? Or is it just in the hippocampus?

Joe: No, it’s not just in the hippocampus. It’s like a kind of – you know, you’d have to look it up and I’m not a typical expert – but it’s multiple areas that are linked. Kind of like, it seems to me, like somewhere at the interface of the cortex and the limbic system, you know? So it’s like this prefrontal cortex and this other, you know, these other little parts. And the book I mentioned, I cite the papers for people who want to learn more about it. But it’s a very real thing, it’s a big focus. And it’s also a big focus of meditation research because it’s like, well, if depression and all these things are associated with this default mode network activity. You know, it’s funny because in the culture, if you have a culture that’s kind of like promoting dysfunctional default mode network activity, then you see these kind of epidemics of anxiety and depression. And then you see that somehow, like, these spiritual approaches are helpful, you know? Like this ego-dissolution activity is part of what opens things up, perhaps in some cases, to allow for certain stunted emotional processes to complete and resolve, you know? So then you allow, like, functioning is able to flow again, kind of like some blockage or stagnation that would have – you know, it would be multiple areas of the body involved – but this is part of it. So in the focus of neuroscience, like, that’s been a big hot topic. And this is really interesting with the meditation, that it’s just going together. And then there’s this one other extra piece, you know, that is also consistent. And like, a lot of the research and people’s experience in the psilocybin research is once you do this, once you kind of get people towards this ego-dissolution – you know, when we hear about this in meditation as well – then quite often, people have a mystical experience. It’s not like in the psilocybin research, just like, wow, that’s a very high percentage. So they’re saying, well, this is kind of how it works – like, turn off the default mode network and then all of a sudden, you kind of get this access to something else.

Greg: Yeah. It’s like you said, the deconditioning agent, the stack which is flipped off or on, however you want to describe.

Joe: Yeah. So it allows for, you know, so it’s this catalyst that allows for something to reorganize. And that’s one of the ways some people, and again, that’s like this whole larger context. Like, how do we help people reorganize in some effective way, like they’re doing with this psychedelic assisted psychotherapy, where they’re getting these high percentage results of lasting effects. And so it’s like, okay, so you prepare them just like we prepare the people to some degree in the Amazon tradition, like you said, with a vomitive and with a particular diet and try to like lay down the groundwork. You know, in Ayurveda, they do a lot of vomitives and enemas and all kinds of stuff like that, I’m sure. And then, you know, I’ve run into that in South Africa traditional medicine. They do a lot of vomiting and steam vapor baths and all that kind of stuff, which I think is all associated to the release of some of this emotional trauma, quite often.

Greg: Yeah, that’s sort of, that’s kind of why it seeped its way into America. And I don’t know about the rest of the western civilization, but this concept that it sort of exists in, this concept of detoxifying, right? I mean, living exactly everywhere, so it’s in our collective consciousness to a certain degree.

Joe: Yeah. We know we have to detoxify. And so, like, what the book is trying to say – and I think like Chinese medicine, for example, is very fluid and kind of like the emotional connection to physical disturbance – but the book is trying to make that connection, like within the western medical model. And say that, you know, like in Chinese medicine, where we have concepts like the Triple Warmer, this kind of holistic system that’s managing multiple dimensions of activity. And so then, that’s when we start, well, this default mode network. And then I get into, like, the psychoneuroimmunology stuff because that’s this whole mind-body research that’s kind of delineated this constellation of elements of your psychology that are connected to parts of the brain – let’s say, in the limbic system, the emotional brain – and the way that’s wired directly into your autonomic nervous system which is controlling digestion, and heart rate, and blood pressure, and all that kind of stuff, and these holistic kind of body responses like sweating, the expression of your emotions, whether it’s blushing or your stomach rumbling in response to some kind of anxiety or whatever, anxious diarrhea. So it’s like, this is where the emotions are expressed, from that western model. And then that is directly wired into the immune system and so we see these inflammatory responses to stress, for example, with cortisol levels changing and, you know, poor wound healing. As we kind of started out this conversation earlier, we were talking about the endocrine system, you know, hormonal imbalance, related with the cortisol and adrenaline being the most obvious examples with connections to this fight-or-flight, and stress, and emotional trauma. So we have PTSD, and you know, that’s what I’m trying to make the argument, like, this is a disease of the emotional body. So it’s not simply like a psychological problem, it’s not simply a brain disease. Like, all these elements are disturbed. A lot of these people have, you know, heart rate problems and blood pressure problems and inflammation problems in their blood and hormonal disturbances, a number of different kinds of hormonal disturbances. And so, it’s this idea of like, okay, so we can see now where multiple elements of the emotional body are disturbed. As I’m defining the emotional body, I’m saying this is the psycho-neuro-endocrine immunologic network, you know? So in other words, we could talk about Liver meridian and anger and stuff like that in Chinese medicine. But where can I point to in the body, in the western medical system, where it’s like, okay, obviously this person went through an emotional trauma, this is a combat veteran that went through war. And now we see disturbances in all these different systems that I’m describing, right? And then we can show that through a deep emotional healing process. Those resolve, not just in the brain, not just in the psychology, but some of these people’s cardiovascular function improves their inflammatory function, improves some of their hormonal functions. And so, it’s this diffuse thing. And so, I’m saying that’s a disease of the emotional body. Traditional medicine, like in the Amazon. And even in Chinese medicine, where you have like discussions of energetics flowing through the body and then you see how, at least that’s one area, where this energy can be connected to mystical things. It’s like, well, it’s a lot of times in this case of the emotional trauma we’re talking about. And what the shamans would say when they see somebody who has a problem like I said, of multiple elements of the emotional body, they say, “This is a spiritually ill person, this is what soul sickness looks like,” you know? And so, that’s kind of the argument that I make in the book. Like, you know when you see somebody who has that kind of disturbance, like Ricardo says – and you know, we’re not including Chinese medicine because I’m just an MD – it’s like, you know, pills or surgery are not going to fix that, right? Their problem is energetic and it involves, you know, kind of more subtle energies including whatever accumulates in their body in response to emotional toxicity, not just from their nutrition and whatever – pharmaceuticals, carcinogens – but from difficult experiences in their life and that accumulates in there. And how do we release that, and purge that, and process that so that they can kind of move past that? And then you see these physical improvements. Like in the book, I talk about a migraine headache case, you know, pretty dramatic resolution. And the Crohn’s disease case, and I know people can respond to Chinese medicine for those kind of problems as well. But once again, that approach is open to the possibility of this, like, these other energies being involved and more mystical or open-minded approaches to try to address that, you know, versus just trying to limit it to, “Oh a migraine is a brain disease.” And in the book, I draw on, I’m like, “Hey, they never taught me this in medical school,” but there’s a significant amount of research where they’re saying migraines might be a maladaptive stress response to childhood trauma, and I bring it up in the book. It’s like, the reason that crossed my mind – and I’m not saying it’s true in every case – but in some cases, and the cases that we were seeing down there, these people who grew up in very aggressive households where there was a lot of screaming and yelling and it made sense that they might have some kind of sensory, like, wires crossed from that overwhelming. And all of a sudden, the smell or the light or sound pushes them into this kind of maladaptive stress response. So then really, the nature of their problem is like rooted in that initial trauma. So how do we deal with that and process that? And, you know, at least in the case presented, you can see some really big changes.

Greg: Yeah, they really are diseases of the spirit. I mean, we see it clinically all the time. Everybody that comes in, even with shoulder pain or knee pain, you know, has some sort of a spiritual aspect of their disorder. I wanted to ask you, you know, you mentioned the veteran and I mean, our vets are coming back, right? Just completely far left of center, or right of center, however you want to describe. Serious diseases of the spirit. So how do we protect – you know, when we’re doing an ayahuasca journey or a psilocybin trip or whatever – what are the safety concerns, I guess? Or what are the dangers?

Joe: Yeah. Well, there’s a lot of dangers, you know? Like first of all, within the case of ayahuasca, which has these MAO-inhibitors, the monoamine oxidase inhibitors. So those are known to have potentially, you know, not necessarily – like, for sure that’s going to be toxic – but there’s potential drug interactions with that. So then, you know, we worry about people trying to make psychiatric medications with those drugs. And you could potentially push somebody into this, like, serotonin syndrome that could be very dangerous and even lethal. And so the idea that you need to really – and there’s a lot of other drugs that interact with MAO-inhibitors – you need to be very careful at that level, you know? Like, what else is being mixed in? And even there are some dietary concerns to consider – like, things you don’t want to mix with monoamine oxidase inhibitors – so there’s that. And then now you have, just like, the full-blown psychedelic and what’s that going to do to somebody? And then you have, you know, cardiovascular risks – if somebody known to be a risk of heart attack and stroke, and they might have a very intense trip or intense experience, and they could have a heart attack. You know, people have had heart attacks in ayahuasca, and in peyote, and other kinds of psychedelic experiences. Or even a stroke – like I mentioned, you know, blood pressure can go up and things like that. And then you have the concern about people who have a predisposition or previously had problems with psychosis – like schizophrenia, and bipolar in particular, people have had like manic episodes. So the psychedelics, in particular ayahuasca, can be destabilizing to those people and push them into a really problematic psychotic state or manic state, and I’ve witnessed this. And prolonged, days to weeks, and requires psychedelic intervention to bring them down. So that’s a real concern. So those are, like, always a big part of the screening. And then there’s just the mystery of like, you know, we don’t know exactly. There’s not a lot of studies to say, “Oh, mixing this medication or that medication,” and so there’s a lot of gray area there. Because some of these people are taking multiple meds, not just psych meds, but meds for other problems. So that all has to be considered. That being said, you know, somebody with PTSD – let’s say a war vet – they could definitely be pushed into some kind of, like, very fearful violent state, you know? And it’s happened. And so, you want to be dealing with, like, very advanced practitioners with a lot of the support in place to help these people. And so, you know, that’s kind of ultimately part of it, it’s like any kind of medical profession. Because you’ve done it before, right? You know when you’re seeing somebody and you can tell them, “Yeah, I’ve seen, I’ve helped somebody with this before.” And so that’s, like, the confidence that you draw from. And so, I know there’s a lot of excitement and there’s places that are focused on that and everybody wants to look. And so that, you know, it’s a potential and it’s just very powerful. And I think there’s a movie coming out, From Shock to Awe. You know, San Diego’s a big vet community and so there’s all that kind of stuff going on. So there is a lot of promise. And in the interim, you know, something that’ll be maybe softer for some of those people – and maybe less risk – will be the MDMA assisted psychotherapy, which is coming down the line. And the research studies expanding in the next year, with a plan to make it available in two years to patients. It’s gotten to that point where they’re in their final phase of trial with the FDA. Because of the results that they’re getting, they’re kind of getting fast-tracked and so that’ll be, you know, something huge. And so, that’ll be available to those guys and sometimes, you know, maybe some of them are going to benefit more from that, maybe some will benefit more from ayahuasca. And so, but when it comes to ayahuasca, you know, there’s legal concerns, really illegal in the United States, right?

Greg: Yeah, Schedule One?

Joe: Right, Schedule One, DMT. And so there’s, you know, there’s the Brazilian churches that have a DA exemption, a couple of them. And there’s other people looking for the exemption, are in the process of getting an exemption. And so then, you know, there’ll be more avenues, eventually. But then again, it’s back to this experience factor, you know? It’s like there’s one thing, like, fresh out of Chinese medical school or fresh out of medical school versus somebody that’s tried and true, right?

Greg: Yeah, it was, you know, even today. And it’s amazing that, you know, people are just having more open conversations about psychedelics, in general, these days. I think, you know, we’re almost at a tipping point. We’re not quite there yet, obviously.

Joe: Right, it is shifting.

Greg: Yeah, it’s shifting. I don’t know if you’ve seen this but I’m sure you have – what one of my students, I was talking to her today on a clinic shift earlier, and I said, “You look a little tired,” and she said, “I’m tired, we had a busy weekend, went to a concert.” I was like, “Oh, yeah? Did you party pretty hard?” And she said, “Yeah, I kind of, we did some mushrooms.” And I was like, wow, she did mushrooms at a concert? Like with thousands of people? I’m like, “Yeah, wow, that’s a totally different trip, man.”

Joe: It’s totally different. But that’s how a lot of people used to do it, you know, like that was it. Like, that’s a Grateful Dead show, you know, that’s a Phish show, it was Burning Man.

Greg: Yeah, you know everybody’s there.

Joe: Yeah, exactly. And so for me, I mean, I did when I was younger, you know? I had a few experiences like that with a lot of people, and that was the LSD and the whole hippies thing, you know, they were just doing it. But again, like once you kind of get in touch with the ceremonial aspect of the spiritual aspect, it’s hard to take it that way, right?

Greg: I was thinking, you know, the last time I did mushrooms – just completely candidly – was years ago when I was in my 20s and the thought of being at a concert, or indoors even, was just kind of horrifying, you know? I just went outside here at Torrey Pines Park, walking around in the pine trees, you know, watching the plants breathe.

Joe: A lot of people would prefer that, you know, I think just right off the bat. But then there’s this big kind of, you know, experience that a lot of people go for and that some of them have a blast. And yes, all the MDMA and all that kind of stuff and, you know, just partying. But, you know, the same risks are there. And that’s why, like – for example, MAPS, they run the Zendo Project at Burning Man, you know, they have kind of like a psychedelic emergency crew – so that’s part of like this tipping point, is the responsible use and not denying, like, “Hey, guess what? This could really put you into a problem and so you better make sure you have a solution to that problem if you’re going to take these risks.” And I think that a lot of those big festivals are addressing that now, like the Zendo Project and things like that. So it’s, you know, there’s a maturity around it that needs to be there for this kind of tipping point to move forward.

Greg: So you think the future looks bright?

Joe: I think it does, you know? I think it’s kind of like there’s this thing happening, my brother made the comment to me that – and a lot of people were saying this – like Michael Pollan, his book, I’ve been listening to it a little bit and, you know, he’s kind of like a baby boomer so he was like 12 or something in the late ‘60s, right? So he kind of missed it and he said he caught it when it was already like, “Don’t do drugs,” right? And so that’s what he really saw but he didn’t see it. And yet, like, so many people around him and a little bit older than him are experienced with stuff, you know? And so, that’s one factor, is that there’s a lot of people who are now in kind of the elder position in our society throughout the country that have tried this stuff, right? You know, it’s like very prevalent. And so that’s different from what they were dealing with their parents, right? Or just, like, “Well, what is this?” You know, “This is not good,” versus like, “Well, I tried it, it’s not that.” So there’s that factor. And then you see the factor that like MAPS is really big and open about, pushing in their policy movement is medicalization leads to legalization. So that was what their focus was with marijuana and they said they had a lot of polling data that showed that people who voted to legalize marijuana or even medical marijuana was, or I guess it was legalized marijuana, was not because they smoked but because they knew somebody that benefited from medical marijuana, right? And that’s what caused the shift. So then now, all the psychedelic research is going down that same road very openly, like we’ve learned this from the marijuana experience. So once the MDMA trial, you know, becomes what it is and already become, and the psilocybin trials right behind it. So they’ve got MDMA and psilocybin, like, on the train to become, I guess rescheduled or something, within two to three years. So then that’s going to be like households, like, “Yeah, I did psilocybin, at my psychedelic psychotherapy clinic.” And so then you don’t have to hide it, you know? It becomes a discussion, right? So those things are moving forward and I think a lot of the community is behind those things moving forward. And the old guard resistance, you know, when it comes to Schedule One, where these three categories – I’ll finish here in a second – but there’s these three criteria. I think it’s like, that they’re addictive, that they’re harmful, and that they have no known medicinal use, right? Do those are the legal criteria of which, like, none of these substances are meeting that criteria.

Greg: Right, none of that’s true.

Joe: Yeah. So it’s now the research. Because of this new research, the evidence is there to prove that that’s not true, right? And so, as the evidence continues, you know, it’s just like more and more promising. And as they touch the conservative elements of the society, like helping war veterans, like helping elders with end-of-life anxiety – which are two of the major focuses of the research right now – it’s like, it touches a lot of people, you know? They’re doing war vets, they’re doing police, they’re doing firefighters. So this is not, you know, “New Age targets,” it’s wider reaching.

Greg: Yeah, I guess in small doses. I was just thinking about useful uses for pediatric trauma, too. I guess you could, it could be applicable in very small doses too?

Joe: Sure. I mean, that’ll eventually, well, you see the kind of apparently liberal attitude towards psych medication and children, you know? That’s like, everywhere, right? Like they’re trying to figure out, you know, they give it to them first and then figure out, “Oh, should we do that?”

Greg: Yeah, Ritalin candy.

Joe: Yeah, Ritalin candy, or even antidepressants, or anxiety medications. Like, whatever, you know? They don’t want them to drink but they’ll give them that, right? And so eventually, you would see that there would be probably a place for that, you know? Especially, like, if to nip some early trauma in the bud, you know? Like maybe there’s a pathway for that but, again, very carefully and responsibly.

Greg: Yeah, anything we can do to help society become more kind and empathetic, I think.

Joe: Right. And so that’s one little plug I would make. Well, you know, first plug for the book, of course, Fellowship Of The River. But what’s come out of the book, and I think it lends itself a lot to the cause of Chinese medicine and the UCLA Center for East West Medicine. For instance, Dr. Hugh is very interested in these concepts, like the epigenetics is a big topic – we don’t have to get into it – but my point is, like, that was one of my realizations and one of the theories that I’m trying to get behind the book, is trying to culminate and look at this. It looks like probably the epigenetics are the ones that are responding to some of this, like, subtle energetic emotional shifts, you know? And making the argument for why this seems to be the case and how it relates to each one of the illnesses that’s proposed. And so we could see, like, obviously herbal medicine would have a lot of epigenetic possibilities, in general. But so now, the MDMA trial with PTSD from MAPS, which is now moving to this large scale trial, has agreed to allow us this organization that I’ve started with a non-profit called Modern Spirit to collect saliva samples on the people going through the study to look for epigenetic changes within elements of the psycho-neuro endocrine-immunologic system. Whether it’s, you know, white blood cells or something but finding the epigenetic changes that would be linked to their emotional healing. And so that’s happening, so we’re raising money for that modernspirit.org.

Greg: Well, Dr. Tafur, I think we’ve explored this topic greatly and I just really appreciate you taking the time and sharing your vast wealth of knowledge with listeners today. We’ll link to your website through our Pacific Center link. And I really have enjoyed the conversation today, thank you so much!

Joe: Yeah, thank you so much for your thoughtful approach, I appreciate it.

Greg: I hope I’ll join you down the Amazon sometime.

Joe: Yeah, let’s do it!

Greg: That would be fun, let’s do it! Take care.