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Karen Sprinkel Ancelet, LMFT - Guest
Karen Sprinkel Ancelet, LMFT is a licensed psychotherapist with more than 30 years of clinical experience, practicing in California, Colorado, Oregon, Washington, and Michigan. She specializes in trauma-informed care and integrates a broad range of evidence-based modalities, including EMDR, Brainspotting, Somatic Experiencing, Internal Family Systems (Level 3), and HeartMath. Karen is also a Ketamine-Assisted Psychotherapy (KAP) provider with advanced psychedelic training through MAPS, Fluence, and Three Cups. She graduated with a Certificate in Psychedelic-Assisted Therapies and Research from CIIS. In addition to her clinical practice, she serves as a consultant, educator, Certified Clinical Trauma Professional, and Continuing Education provider. A pivotal chapter in Karen’s life was her time living in Asia, where she conducted her master’s research on trauma healing following violent crimes in Tibet, Southeast Asia, and the United States. Deeply impacted by these findings, she returned to Asia for several years to further her exploration. Today, Karen weaves together the ancient wisdom of meditation and mindfulness with contemporary approaches such as EMDR, Brainspotting, Flash, EFT, IFS, and Somatic Experiencing to guide and support her clients in their healing journey. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Keith Sutton, Psy.D.: (00:24)
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. At the Institute for the Advancement of Psychotherapy, we provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in an evidence-based approach, with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically; our Center for Couples, where all the therapists are using emotionally focused couples therapy; and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma; and our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D.: (01:31)
In the institute, we have our licensed, experienced therapists, and for those in financial need, we have an associated nonprofit, Bay Area Community Counseling, where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about trainings, treatment, and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D.: (02:19)
Today I'll be speaking with Karen Sprinkle Ancelet licensed marriage and family therapist with more than 30 years of clinical experience, who is practicing in California, Colorado, Oregon, Washington, and Michigan. She specializes in trauma-informed care and integrates a broad range of evidence-based modalities, including eye movement to sensitization reprocessing, brain spotting, somatic experiencing, internal family systems and HeartMath. Karen is also a Ketamine assisted psychotherapy provider with advanced psychedelic training through maps, fluence, and three cups. She graduated with a certificate in psychedelic assisted therapies and research from California Institute of Integral Studies. In addition to her clinical practice, she serves as a consultant educator, certified clinical trauma professional and continuing education provider. A pivotal chapter in Karen's life was her time living in Asia, where she conducted her master's research on trauma healing following violent crimes in Tibet, Southeast Asia and the United States. Deeply impacted by these findings, she returned to Asia for several years to further her exploration. Today, Karen weaves together the ancient wisdom of meditation and mindfulness with the contemporary approaches such as EMDR, brainspotting Flash, E-F-T-I-F-S, and Somatic experiencing to guide support her clients in the healing journey. Let's listen to the interview.
Keith Sutton, Psy.D.: (03:42)
Hi, Karen. Welcome.
Karen Sprinkel Ancelet, LMFT: (03:44)
Thank you for having me, Dr. Sutton.
Keith Sutton, Psy.D.: (03:46)
Yeah, definitely. Yeah, you can call me Keith. No problem. Well, this is wonderful. So I learned about your work. I was reaching out to our community in the Bay Area in San Francisco Bay area. So I was looking for somebody thatyou know, does somatic experiencing. You know, I was kind of hearing about people who are different doing trainings on somatic experiencing, and your name came up and I went and looked at your website and saw you were doing lots of really interesting things, integratingthere was also some, some work with ketamine. I think correct me if I'm wrong, some internal family systems work integration, somatic experience, I think EMDR. And, so I just was really interested in learning more about the work that you're doing. Because I'm also somebody that integrates and really draws from all these different areas, and particularly trauma is, you know, an, an area of interest. So yeah. Soand before we get into the work you're doing, I always like to find out from people, you know, how they got to doing what they're doing, kind of their evolution of their thinking, how they got to this kind of, the work they're doing and integrating and so on.
Karen Sprinkel Ancelet, LMFT: (04:52)
Well, let's see. Well, why I became a therapist in the first place is kind of the question.
Keith Sutton, Psy.D.: (04:57)
Well, either that or just how you, like what led, what led you to kind of put all this together to then integrate all these different things that you're integrating.
Karen Sprinkel Ancelet, LMFT: (05:05)
Got it. Great. Okay. Yeah, well, I mean, there's kind of, the way I look at it, there's kind of two different things I'm integrating. So I'm integrating all of the trauma approaches, which I would like to call them the, the efficient approaches. And also integrating this kind of spiritual philosophical playing here. Right. And so, the first one I'm going to, well actually let me speak to the second one, philosophically, whether we view that as spiritual metaphysical philosophy, belief systems, I was really taken aback in my master's degree when I was working with survivors, the surviving family members of murder, right? And their loved one was killed by a serial killer.
Keith Sutton, Psy.D.: (05:54)
Oh, geez.
Karen Sprinkel Ancelet, LMFT: (05:54)
And it was the first organization in the United States that was created specifically for the loved ones of homicide victims. And it was, it was event created in Washington State. So it was after Ted Bundy, the I-5 killer, the Green River Killer. And I was in my master's degree at the same time. So I was this new therapist. But I was really passionate about everything I was studying. And I got to this point where I was like, there isn't anything clinically that I can offer these families. Like truly there was nothing at the time. This was in the nineties. And so at that point, I was like, oh, there has to be something deeper than just clinical. Right? Yeah. So that's where I started to kind of integrate, okay, what is there beyond just clinical psychotherapy? So I started to go on this kind of personal spiritual quest, and I would like to call it a clinical quest too, of the nature of suffering. Why do bad things happen? Why do bad things happen to good people? Why is there such a thing as a serial killer that even exists in our world? Right. And so I kind of had to embark on that discovery myself before I felt like I could really hold space. For folks that had experienced the worst of the worst of the worst. Sure. I couldn't just use a cognitive behavioral technique or, you know, let's talk about the thought and the behavior. It's this thing. So that, that brought me to studying Buddhism. Brought me to the east, and I spent, I went through Naropa to study Buddhist studies. And that changed my world. So I started to interview and meet Tibetan refugees who had also lost a family member to murder, but how they were healing was dramatically different than here in the west. So I started to do kind of a comparative analysis of like, what is it, what is it about, kind of like their philosophical frame here. Right? Because they didn't have psychotherapy in Tibetan Nepal. Like, so what is it? So obviously one of the things was collective, there was the collective trauma and the collective healing, but simultaneously there was this frame that suffering is part of life. And in the Judeo-Christian perspective, and I did this comparative analysis is, okay, sure we have that, but we don't emphasize that, right? We don't really emphasize that suffering is going to be part of your life path. We're not raised as children, like, okay, you're going to have suffering events, let's help you to be resilient and transform through those suffering events.
Keith Sutton, Psy.D.: (08:47)
Sure.
Karen Sprinkel Ancelet, LMFT: (08:47)
So rather here in the west, when we have a terrible thing happen, we tend to personalize it like there's something wrong with us, or there's something wrong with our world, and we get really black and white in our thinking. Anyways, that's what came out of my first kind of integration model of like, okay, we need clinical work. We need the therapeutic alliance. And to a client, I will say, what is your belief in life? What is your belief in suffering? Do you believe that suffering is part of life? And we actually start therapy from that. Because I view that as foundational, right? Because if, if someone says, no, suffering shouldn't exist, suffering's not part of life. It's like, okay, well let's have a conversation and let's stretch out our therapy because suffering does exist. And so that, that I would say is kind of the first part of the integration. The second part.
Keith Sutton, Psy.D.: (09:45)
I like that, you know, this aspect of kind of the, rather than being emotionally avoidant and just trying to have the good feelings, the acceptance of suffering in the full range of the human experience.
Karen Sprinkel Ancelet, LMFT: (09:57)
Exactly. Exactly. Because we're not going to get far in therapy if someone believes that a bad event's not going to happen to them again.
Keith Sutton, Psy.D.: (10:06)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (10:07)
It's like, okay, bad events will happen, but how do you want to be. Right? And then the second integration started to happen just as a trauma therapist in the world where I started to study all these different trauma approaches, but also started to get feedback from all folks, all different variety of folks that had dramatically different opinions about the same approach. And it really came out of an incest survivor support group that I ran for eight years. And the demographics were relatively the same of each member. The, the sexual abuse history Administrator was relatively the same socioeconomic status, relatively the same cultural background, relatively the same diagnostic code, all the same, right? There PTSD with dissociative, you know, tendencies or dissociative identity disorder, or dissociative spectrum disorder, right? We're talking severe trauma. And in the incest survivor support group, one member loves somatic experiencing. Another member couldn't stand it, said, don't ask me any question about my body. I hate those questions. Right. And never want to go see that nasty person again. And then someone loved EMDR and the next person thought it was ineffective, right? And some person loved brainspotting, someone else didn't find it useful. So it's like, I started really scratch my head of, okay, there's gotta be something more besides just the diagnosis of PTSD. There has to be something more than just a diagnosis of a dissociative spectrum disorder. What else is happening in the individual, in the human mind, body and spirit that we have a tendency to heal in different ways. So then I started to actually do my own kind of collective data analysis, you know, and then I started to find that folks that had kind of a dominant kind of mental processing.Preferred a certain type of modality or approach those that had just more of like a somatic symptoms. Referred a somatic approach, but not necessarily there's other factors too.
Keith Sutton, Psy.D.: (12:26)
Sure.
Karen Sprinkel Ancelet, LMFT: (12:26)
And then of course, those that had more of like a spiritual or meaning making mind, they needed to have that kind of approach. But they all had PTSD. So that's why I said, okay, like, someone's gotta write about this. I felt really called to like, put together a book and have a new kind of diagnostic criteria of trauma mind, trauma body and trauma spirit. And although it may seem like pretty common sense, it's never been written about before.
Keith Sutton, Psy.D.: (12:55)
Yeah.
Karen Sprinkel Ancelet, LMFT: (12:56)
So I was like, okay, I have the, all these trainings, I have all these approaches, I have all these certifications. Let me just put it together and have a suggested roadmap for the client, or just any individual that wants to find a really integrative and efficient way to heal.
Keith Sutton, Psy.D.: (13:17)
Great. So you're kind of looking at like client factors and kind of their type of experience with trauma and how that might match to particular approaches?
Karen Sprinkel Ancelet, LMFT: (13:30)
Exactly.
Keith Sutton, Psy.D.: (13:31)
Yeah. Great.
Karen Sprinkel Ancelet, LMFT: (13:33)
Well, I should probably add that one of the things I'm extremely passionate and thus bias about is I really have a strong belief in efficiency. Like, it's, it's, it's kind of, I've been this way my whole life.
Keith Sutton, Psy.D.: (13:47)
Sure.
Karen Sprinkel Ancelet, LMFT: (13:47)
Like, I'm always like, it's one of my value structures. It's like most sufficient at anything. Right? So I view that with, with mental health too. It's like, okay, why are we keeping folks in therapy for four years. If we can get them graduated in five months. Right?
Keith Sutton, Psy.D.: (14:02)
Yeah, Definitely. Yeah, no, definitely right there with you. And I think that's oftentimesright. The question is how do we help the person in the most expedited, you know, kind of financially, you know way that, that, you know, so that they're not yet spending years and tons of money or so on. Efficient economic way to help them to, to get move on with their life and create lasting change.
Karen Sprinkel Ancelet, LMFT: (14:27)
Exactly. Yes. Lasting change.
Keith Sutton, Psy.D.: (14:29)
Yeah rather than just kind of symptom reduction for a short period.
Karen Sprinkel Ancelet, LMFT: (14:33)
Exactly. And I can, I can clearly tell that this is something you feel very passionate about as well, given that you want to grow and learn anything that you can to help your clients.
Keith Sutton, Psy.D.: (14:43)
Yeah, definitely. And I think particularly too with trauma, there are so many different approaches. And like you're saying, some things work for some people, some things don't work for others, and trauma's a difficult... It's difficult. It's hard in some areas to resolve for some people. Some people move through things differently quickly, especially when there's complex trauma. Right. There's a lot more that goes into it. So, there are so many, and I, yeah, I've got I was impressed by all the different kind of approaches, because there's so many that I'm wanting to learn. I know a number of different trauma approaches. And particularly too, you alsohad talked about the using the, the ketamine. And I think also there wastraining or guidance around psilocybin. I'm wondering if you can also talk about some of those approaches and, any of the other approaches that you kind of are using and integrating and how you're conceptualizing.
Karen Sprinkel Ancelet, LMFT: (15:41)
Yeah. No, it's an outstanding question because it goes in line with what we just talked about, about efficiency, right. Well, let me start with a disclaimer that I don't want to promote any illegal use of psychedelics.
Keith Sutton, Psy.D.: (15:56)
Of course.
Karen Sprinkel Ancelet, LMFT: (15:56)
But, and also a personal disclosure. I was a purist until three years ago because I'm a Buddhist practitioner. I lived for years in the East, and I really believe that for one, to have kind of a deeper integrative spiritual practice that it needs to be without a substance. So I was actually a purist and I was a little bit biased and judgmental against psychedelics. So, I'm actually a great person to answer this question because come full circle on the other side of it or half circle, I guess would be the term. So, three years ago I started to study the MDMAresearch. And I was like, okay, there's something here. Like what, what is happening with this molecule that's helping folks with this complex trauma or this very significant event within three dosage journeys, like feel relatively, relatively cured.
Keith Sutton, Psy.D.: (17:01)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (17:03)
There's really something here. And so I started to read about it and the neuroscience of it and how it kind of softens the amygdala so we can actually look at the fear. We can actually look at the event, and then we actually go through the event. Because as we know, a lot of trauma is the fear of facing it, right? And so I was like, okay, I need to go study this. And so I got into the actual very last MAPS training that existed.
Keith Sutton, Psy.D.: (17:29)
Oh, wow.
Karen Sprinkel Ancelet, LMFT: (17:29)
Where they went to the phase three, you know, the, they promoted their research and went to the senate hearings and all that stuff. I was the only person at that maps training that had not tried MDMA. So, I felt really naive. Right. And really inexperienced there. And I also had not at that point, tried ketamine. Because I was still a purist, but I was like, okay, but I want to do this for my clients. And then I started to realize, okay, I need to know what my clients are going to go through. So I need to actually undertake some of these psychedelics myself. Right. So, I became a believer that it can actually heal trauma. And so then I personally tried ketamine and it was life shifting for me.
Keith Sutton, Psy.D.: (18:16)
Wow.
Karen Sprinkel Ancelet, LMFT: (18:17)
Totally life shifting. I mean, the way to think of it, there was two things. One is the very thing that I feared was lifted from doing the psychedelics. So, I had this fear of what I would witness in the spiritual realms.
Keith Sutton, Psy.D.: (18:37)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (18:38)
And actually doing the psychedelics brought me to not fear that anymore. So, it was kind of ironic in that way. Right.
Keith Sutton, Psy.D.: (18:46)
Yeah.
Karen Sprinkel Ancelet, LMFT: (18:46)
And then there was just kind of like this subtle, I would say it was more gradual, but just a subtle of just, oh, I am who I am. Like, it's just, I am who I am. Like, there wasn't like this profound like, aha moment. But it was like, oh, like any tiny residual insecurities or imposter syndrome, or putting myself out in the world, it was just kind of like slowly, you know, just kind of went into the background and then disappeared.
Keith Sutton, Psy.D.: (19:14)
Yeah.
Karen Sprinkel Ancelet, LMFT: (19:14)
So I was like, okay, there is definitely something here. Because I'm not someone that had like profound issues anymore. But it still lifted stuff for me. So I immediately became certified in ketamine, and I right away started to offer ketamine to my clients. So, it's been about three years now, I've been offering ketamine to clients. And then I decided to get further training. And so I did a harm reduction training through Fluence, and I just graduated from CIIS's psychedelic. So I'm certified as a true psychedelic therapist. So, there's, as you know, there's only a few states that actually legalized psilocybin. And it's prettyregulated. You know, like, so for example, in Oregon, you can only get it at clinics. You can't just go to an individual provider's office, so on and so forth. Right. So what I can talk about today is the ketamine, because that's what's legal here.
Keith Sutton, Psy.D.: (20:14)
Sure.
Karen Sprinkel Ancelet, LMFT: (20:18)
But doing the ketamine combined with a trauma approach is miraculous.
Keith Sutton, Psy.D.: (20:25)
Wow.
Karen Sprinkel Ancelet, LMFT: (20:26)
Now that being said, I like to tell clients it's not a magic pill either.
Keith Sutton, Psy.D.: (20:30)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (20:31)
I get a lot of phone calls like, oh, I just want to try ketamine once and see what it's like. I'm like, no, first of all, you have to meet criteria. Not everyone can just try ketamine. And secondly, it's not a one and done. It's actually a treatment. So usual course of treatment, six to eight dosage sessions about every two to four weeks. And the studies have shown, usually by the fourth, sixth or eighth session, there is a true lifting of whatever symptom it was. Whether it's treatment resistant depression, anxiety, OCD or PTF.
Keith Sutton, Psy.D.: (21:04)
Wow. That's incredible. Yeah. I know somebody that's gone through the treatment and really found it very impactful. It didn't completely fix things, but it was really, had a significant shift and really moved them forward in the work that they were doing. Yeah. So, I'm interested in, exactly, this idea of like how to find the most effective, efficient kind of way to help someone. And I guess maybe can you talk about, I guessI don't want you to have to compare and value like kind of weigh the different ones, but I mean, again, having this kind of training in all these different modalities, I guess, is there any ways that you think about. Yeah, I'm, so I'm thinking of doing some training in somatic experiencing. I'm trained in EMDR, I'm CBT family systems mostly. You know, all these kind of other aspects, you know, I'm debating on brain spotting and art. You know, and all these kind of things. I don't know if you can speak to kind of, I don't know if it's the strengths of the different ones or the, the utility of the different kind of approaches or so on. And I think, I think you can talk about the MDMA and the psilocybin and so on. Right. And kind of, you've got certification from California Institute of Integral Studies. I know they have a great training program or so on. I know it can't be used in therapy with folks presently in California. There are other places and so on. But yeah, I'd love to kind get your thoughts on, on like, you know, especially for practitioners that are maybe earlier in their career or wanting to further their work with trauma. Like how do they decide where, which direction to go?
Karen Sprinkel Ancelet, LMFT: (22:50)
Oh my gosh. It's like, this is such an outstanding question and I get asked it a lot. I'm sure you do as well.
Keith Sutton, Psy.D.: (22:55)
Oh, yeah, totally.
Karen Sprinkel Ancelet, LMFT: (22:57)
So yes, I'm very passionate about this, so I might talk for too long, so please interrupt me, if I go for to long.
Keith Sutton, Psy.D.: (23:05)
You got like over half an hour, so I'm sure this is a big topic.
Karen Sprinkel Ancelet, LMFT: (23:09)
Okay. Okay. Well, first of all, in that passion, in the book I wrote, I did create a questionnaire. And the questionnaire is called the trauma type questionnaire. And in the book, I also have different, like, I kind of excel graphs about like, if you're more dominant trauma mind, then you try this approach. And this is why if you're more dominant trauma body, try this approach and this is why. So on and so forth. As a clinician though, and again, I think you and I are probably similar in our value structure, I believe that master's degrees at minimum, and definitely PhDs and society programs all need to be restructured. I think all everyone that graduates from those programs should have level one in all of these dominant modalities. Right. You know, the fact that we, you know, I would say proudly that I probably have like equivalent of two PhDs with all the certifications I've done. Right because each certification's a three year commitment, three year hours in education and consultations and money and all that stuff. Right. And level one, in each of them is highly valuable. I believe truly that every clinician should have level one in one of the somatic approaches, whether it's SE, sensory motor or Hakomi. And I can get into each of those and how to compare them. But I believe going back to the clinician that's new, I think every clinician should have level one in one of those three. I also believe every clinician should have level one in either EMDR or brain spotting. And they're similar. And I can also get into how they're different. And I also believe that every clinician in the world should have level one and internal family systems. And if not, IFS then voice dialogue or ego state. Right. And, and the reason why is those three larger themes of how we as a human body hold trauma differently and hold life differently. Like some of us truly are more verbal, mental thinkers, and some of us are really feelers. Right. Really kinesthetic. Some of us are really deeply, meaning making humans. So we all, we as clinicians, need to hold the person in front of us by how they hold themselves. Right? We can't, like, we love CBT, so we're going to use CBT with this client who doesn't really want to think and behave a certain way. They just want to feel, right? So if it's a new clinician in the world, I would say, if at all possible, try level one in those three areas. If you can't get into one of them, then go with your passion. But be very honest with the clients you serve, that this is your passion, not that it's the way. Because I see that time and time again, and I'm always so sad and shocked actually, when, even when I see other trauma therapists saying, this is the way to heal your trauma, and it's like, oh my gosh. Like almost the opposite of what to say to a trauma survivor. Right. Their choice. Right.
Keith Sutton, Psy.D.: (26:31)
Exactly. Autonomy.
Karen Sprinkel Ancelet, LMFT: (26:33)
Autoomy. Right. And if you want to go see a different provider while you're working with me with this approach, absolutely. Whatever's going to help you heal. And that brings us to a kind of a little second caveat I need to mention before getting into these specific approaches. All of these are really not psychoanalytic or psychodynamically held anymore. And historically, you know, once we get into folks that are above the age of 40, 50 and older, as clinicians in the world are trained, they are going to have that structure. Right. Psychodynamic or psychoanalytic. Which is very much only one therapist to treat the client. And that about 20 years ago, I was like that, first of all, how egotistical in some ways.
Keith Sutton, Psy.D.: (27:26)
Sure.
Karen Sprinkel Ancelet, LMFT: (27:28)
And secondly, what if it's not working for the clients. Yeah.
Keith Sutton, Psy.D.: (27:34)
Yeah, I talk about with my clients, I'm not the end all be all right. Like if we're not progressing, maybe trying another person. Right. because there can be different matches, all these different kind of things, different approaches.
Karen Sprinkel Ancelet, LMFT: (27:45)
Exactly. Right. And so, when we get into which training to take, it's like, if you can't get in, do all three of those, then follow your passion. But just tell your clients that I'm really into, you know, somatic approaches. They're really effective for me. So I got level one trained in se, but if we're not making headway in six months or a year, don't worry. I have referrals to an IFS therapist or referrals to an EMDR therapist for you. Right. And hold it as your passion rather than it being the way. So I like to have that conversations with new clinicians as well. Do you want me to get into psychedelics now or get into comparing the different clinical approaches first?
Keith Sutton, Psy.D.: (28:33)
Whatever, however you think, yeah, whatever makes more sense.
Karen Sprinkel Ancelet, LMFT: (28:37)
Okay. Well let me, I'll come psychedelics and then we'll go back to the clinical approaches. Sure. So psychedelics, we're in the Renaissance now, right? I mean, everyone's talking about psychedelics.
Keith Sutton, Psy.D.: (28:52)
Yeah.
Karen Sprinkel Ancelet, LMFT: (28:52)
It's becoming more mainstream, which is amazing. Really, really amazing. But like anything that's becoming mainstream, there's a lot of misconceptions about it. And on either end of the spectrum. But we have one misconception, which is that it's a magic pill. The magic bullet.
Keith Sutton, Psy.D.: (29:10)
Mm-hmm sure.
Karen Sprinkel Ancelet, LMFT: (29:11)
Which is that you just need to go do MDMA once and you're healed. Right. Or try ketamine a couple times you'll be healed. Right. That's one misconception. The other misconception is the other extreme, which is kind of like the Matthew Perry situation. Where folks are terrified and like, oh my God, I'm, you're going to become addicted. I heard that.
Keith Sutton, Psy.D.: (29:30)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (29:30)
Doctor wants you do ketamine and you're going to become addicted. You're going to die. Like Matthew Perry died and it's like, whoa, whoa, whoa, whoa, whoa. No. First of all, he didn't die of ketamine. He died from drowning and he was not using ketamine in a mental health setting.
Keith Sutton, Psy.D.: (29:48)
Sure.
Karen Sprinkel Ancelet, LMFT: (29:49)
Or health provider. Right. He was getting it underground. It's like, it's like literally it's non-comparable.
Keith Sutton, Psy.D.: (29:56)
Yeah.
Karen Sprinkel Ancelet, LMFT: (29:56)
So it's first having that conversation, it is like, it's not dangerous. It's a very thorough intake process to make sure you meet not only criteria, but that your body can handle it. So there are some rule outs, right. Like certain heart conditions and certain psychosis, cannot try certain psychedelics, unfortunately. And then in the other extreme, I definitely have to have the conversation of what kind of therapeutic background have you had, because I don't feel comfortable starting you with ketamine unless you've actually been in therapy.
Keith Sutton, Psy.D.: (30:34)
Sure. How much work have you done, or what kind of work?
Karen Sprinkel Ancelet, LMFT: (30:37)
Right. Yeah. So the first two years I offered ketamine, and I only did it with my clients. Right. Because they, obviously they've been in therapy. This past year, I have taken more referrals, you know and there's a couple people I've said no to because they were, "oh, I just want to try ketamine, and I heard it's really good" and they've never been to therapy. Yeah. Right. And I was like, "No, it doesn't work like that." Right. So there has to be a foundation there in order to try psychedelics in my belief system, and we're trained this way too. There has to be, I would call it phase one therapy, like the individual has to know their mental landscape. They have to have a good understanding of their childhood traumas, the psychodynamics of their family structure or the system of their family structure. Right. And they're kind of the core belief systems they have in the world. Like those are foundational.
Keith Sutton, Psy.D.: (31:37)
Sure.
Karen Sprinkel Ancelet, LMFT: (31:38)
Like if someone doesn't have that basic structure, they don't have ego structure yet. Because psychedelics blow out ego structure.
Keith Sutton, Psy.D.: (31:48)
Sure.
Karen Sprinkel Ancelet, LMFT: (31:49)
So if one doesn't have a base ego structure, they're going to become decompensated.
Keith Sutton, Psy.D.: (31:54)
Hmm.
Karen Sprinkel Ancelet, LMFT: (31:54)
Or sorry. Well, yeah. We could say decompensated. Their psychedelics like, they need to really have a foundational understanding of their ego structure, but there has to be some level of either mindfulness or flexibility. So all of that being said, these are the conversations I have in intake with folks. And mindfulness or flexibility because there's some folks that have never practiced mindfulness. But if I kind of have a challenge question with them, like a challenging mathematical formula, and I say, well, what do you believe about now in quantum theory, they believe that Einstein's theory might not be true. And if they say, oh, well they haven't proven it yet. And it's like, okay, there's not flexibility here.
Keith Sutton, Psy.D.: (32:43)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (32:44)
Right. But if they say, yeah, that's interesting. I'm like, okay, there's flexibility. And then I'll say to them, okay, when you're going to undertake a psychedelic journey, it might be like that. It might be that you come out of it and you're like, oh my God, I don't know what just happened. I don't even know how to think.
Keith Sutton, Psy.D.: (33:03)
Yeah.
Karen Sprinkel Ancelet, LMFT: (33:04)
Can you be okay with that? Right. And then at that point, usually folks are like, oh my God, that kind of scares me, but I think I want to try. Or they're like, oh God, no, I don't like that. I feel I'll lose control. Or others are like, oh yeah, let's go for it. You know? Yeah. So those questions are pretty foundational before starting any psychedelic journey.
Keith Sutton, Psy.D.: (33:27)
Their mindset.
Karen Sprinkel Ancelet, LMFT: (33:29)
The mindset.
Keith Sutton, Psy.D.: (33:29)
As well as yeah, kind of all these different aspects, like you're saying, you know, structures because needing some of that to kind of hold you, or if you're going to go through the ego death experience, kind of having something that's already built up as well as yeah, that openness it sounds like too.
Karen Sprinkel Ancelet, LMFT: (33:47)
Exactly. There has to be both. Yeah. And then as far as kind of like, which path to take, and you probably know there's, there's kind of like an above ground and then a below ground path in psychedelics.
Karen Sprinkel Ancelet, LMFT: (34:01)
Right. And above ground is like people that are certified, like myself and, and do ketamine assisted psychotherapy. And they might have referrals, but they themselves usually don't offer the substances or the molecules that are not legal.
Keith Sutton, Psy.D.: (34:17)
Yes.
Karen Sprinkel Ancelet, LMFT: (34:18)
And then there's the underground practitioners that usually either are sub licensed or don't have an active license and they actually have years of experience of doing this.
Keith Sutton, Psy.D.: (34:28)
Sure.
Karen Sprinkel Ancelet, LMFT: (34:28)
But sometimes they don't have the mental health training.
Keith Sutton, Psy.D.: (34:30)
Yeah.
Karen Sprinkel Ancelet, LMFT: (34:31)
So it, again, it it's like, it's like this, and you have that conversation as well and then we can get into the indigenous cultures and the ceremonial cultures. Right. And then there's the whole ceremonial indigenous process and, and someone going to Peru and trying, you know, ayahuasca and things like that.
Keith Sutton, Psy.D.: (34:52)
Yeah.
Karen Sprinkel Ancelet, LMFT: (34:52)
So there's, there's so many choices now. And so it has to be just very mindful and thought through. And as far as which kind of molecule to start with or who you recommend for which one? There's probably people that are more experienced than me in answering that.
Keith Sutton, Psy.D.: (35:14)
Sure.
Karen Sprinkel Ancelet, LMFT: (35:15)
But what I can say, I'm a little biased, but I believe everyone, and a lot of people feel this too, should start with ketamine. Ketamine is the softest, most gentle way of starting to recognize that your mind is not necessarily your mind. Right. There it is like a little ego death.
Keith Sutton, Psy.D.: (35:39)
Sure.
Karen Sprinkel Ancelet, LMFT: (35:39)
And there's, and there's this kind of really peaceful disembodiment from one's body And so it's not so jarring. Sure. It's like this kind of floaty feeling. And, and some people describe it that no eastern traditions, like they really got to know their subtle body I'm like, oh, I really have an energy body. I really have a subtle body.
Keith Sutton, Psy.D.: (36:00)
Yeah.
Karen Sprinkel Ancelet, LMFT: (36:01)
It's like this beautiful like relationship building moment, right. Of like, oh, there's something besides my physical body. There's something besides my thoughts in my mind.
Keith Sutton, Psy.D.: (36:12)
Sure.
Karen Sprinkel Ancelet, LMFT: (36:14)
So Ketamine usually offers that. So that's why ketamine would be the first suggested molecule. After that is usually MDMA. Because MDMA, even though it's kind of more like a stimulant amphetamine kind of feeling.
Keith Sutton, Psy.D.: (36:28)
Yeah.
Karen Sprinkel Ancelet, LMFT: (36:29)
It's so heart opening That it usually is a lovely experience. It's usually like it can be ego disillusionment, but not as much, it's less of hallucinogen and it's more just so heart opening and loving and having this greater respect for being a human being. And living on earth and the cosmos. So it's...
Keith Sutton, Psy.D.: (36:58)
Connectedness.
Karen Sprinkel Ancelet, LMFT: (36:59)
Connectedness. So it's really mind expanding. So when you have those two as foundations, so you've had this experience of leaving your body and you've, and a little bit of ego disillusionment. And then you've had this experience of mind expanding. Then the next recommended molecule would be psilocybin. And what's so ironic too is that most people think psilocybin is the one to start with. because That's natural.
Keith Sutton, Psy.D.: (37:31)
Yeah. Interesting.
Karen Sprinkel Ancelet, LMFT: (37:32)
Yeah. And of course you probably know there's so many different types of mushrooms, right. There's so many different, it's like wine. There's so many. And so someone says, oh yeah, I had magic mushrooms. It's like, well, what kind, you know, how many milligrams?
Keith Sutton, Psy.D.: (37:50)
Yeah. How much, yeah.
Karen Sprinkel Ancelet, LMFT: (37:52)
Yeah, exactly. And so someone might be out with a friend and take some magic mushrooms and they have a terrorizing experience, right? So that's why it's usually recommended as the third step, not the first one.
Keith Sutton, Psy.D.: (38:06)
Yeah.
Karen Sprinkel Ancelet, LMFT: (38:07)
Now there are mushrooms that can be just really sema, sorry, somatically peaceful. Right. And that would be more kind of like ketamine. That's when people have these great experiences. There's some that are very visual and people see the trees talking to them And that's really amazing and beautiful. But the risk of the magic mushroom bringing some scary things is higher than ketamine and MDMA.
Keith Sutton, Psy.D.: (38:34)
Sure. Got it.
Karen Sprinkel Ancelet, LMFT: (38:35)
Yeah. And then after psilocybin, then it, it's kind of variable if someone wants to go to LSD or to five M-E-O-D-M-T So LSD would be more people that want hallucinations and visuals. Five, M-E-O-D-M-T in my experience is a lot of like Buddhist practitioners or high meditators.
Keith Sutton, Psy.D.: (38:59)
Yeah.
Karen Sprinkel Ancelet, LMFT: (39:00)
Just five M-E-O-D-M-T is very nothingness.
Keith Sutton, Psy.D.: (39:08)
Hmm.
Karen Sprinkel Ancelet, LMFT: (39:09)
Like, it's a false sense of nothing.
Keith Sutton, Psy.D.: (39:12)
And it's short acting too, isn't it? Right. The DMT, it's not like a, you take it and then you're on a four or five hour trip.
Karen Sprinkel Ancelet, LMFT: (39:19)
Exactly it's short acting. But that brings me back now to clinical and trauma approaches and different mental health approaches. The other thing I didn't mention, the reason why I started to get interested in going to study MDMA was not only because of the benefits to PTSD, but as a trauma therapist in the Bay Area, I was getting all these referrals for people that had traumatizing experiences from psychedelics.
Keith Sutton, Psy.D.: (39:46)
Ah.
Karen Sprinkel Ancelet, LMFT: (39:47)
I was like oh no, what is going on here? Somewhere in the underground and somewhere above ground. so, a lot of people said, oh, it must have been the underground, non-licensed mental health practitioner.
Keith Sutton, Psy.D.: (39:58)
Sure.
Karen Sprinkel Ancelet, LMFT: (39:58)
Always. Sometimes it literally is just the molecule sometimes it's sudden settings, sometimes it is the practitioner, sometimes it's traumas that resurface.
Keith Sutton, Psy.D.: (40:09)
Yeah.
Karen Sprinkel Ancelet, LMFT: (40:10)
Sometimes it's seeing a demon that you've never even thought of before.
Keith Sutton, Psy.D.: (40:16)
Sure.
Karen Sprinkel Ancelet, LMFT: (40:16)
It's whole variety of different things. And DMT or five M-E-O-D-M-T has caused a lot of folks to come in for trauma treatment afterwards. As has psilocybin into my practice. Yeah. So coming back to full integration. Right. This is why I personally believe in above ground psychedelic use. At the training mental health practitioner. And I actually just wrote my final capstone paper on the importance of it, of it being trauma informed Psychedelic treatment.
Keith Sutton, Psy.D.: (40:53)
Sure.
Karen Sprinkel Ancelet, LMFT: (40:54)
The practitioner has at least, you know, somatics, you know, MBMR, brain spotting or some IFS to help that client come back to themselves after they've had a potentially traumatic or terrorizing experience with psychedelics Yeah. You know, most people have great experiences.
Keith Sutton, Psy.D.: (41:15)
Sure.
Karen Sprinkel Ancelet, LMFT: (41:17)
Life changing shifting experiences, but there's a small percentage that have really destabilizing experiences. You just want to prevent that.
Keith Sutton, Psy.D.: (41:24)
Yeah. You gotta be thinking about that.
Karen Sprinkel Ancelet, LMFT: (41:27)
Yeah, exactly. So that's kind of the overview, but I'm happy to get into like each approach and how they're different.
Keith Sutton, Psy.D.: (41:35)
Yeah. I'd be interested in your thoughts on yeah somatic experiencing, MDR, yeah, hakomi. Like how do you think about them in different ways, especially since you, you have the breadth and depth of knowledge of these.
Karen Sprinkel Ancelet, LMFT: (41:48)
Yeah, yeah. Okay. It's always so complicated to answer to this question...
Keith Sutton, Psy.D.: (41:59)
I'm sure, I'm sure you also probably don't want to talk, talk negatively about one and...
Karen Sprinkel Ancelet, LMFT: (42:03)
Exactly. Right.
Keith Sutton, Psy.D.: (42:05)
Comparing or, or Yeah. How do you, how do you put it in the way that you think about it.
Karen Sprinkel Ancelet, LMFT: (42:09)
Yeah. Because I truly have deep respect for each of them, and I can see why each of them became an approach of itself. I mean, some of them are so similar, you know? Yeah. A little bias about like, why didn't that person just say it's this approach with this low edge to it.
Keith Sutton, Psy.D.: (42:26)
Sure. Sure.
Karen Sprinkel Ancelet, LMFT: (42:28)
So let's start with that. So, with that being said, somatic experiencing, sensory motor and hakomi, in my opinion, are almost all the same thing. Are they each equally profoundly useful for someone living in a trauma body? Absolutely. Absolutely. And so I would just say to the clinician, watch a short video of each of them. And do you like the hakomi's teacher's perspective, you know, Pat Ogden, how is she describing it? You know, Janina Fisher, how she's describing her TIS model, you know, Peter Levine, how he's describing somatic experiencing, and just kind of see which video resonates the most. But the foundation of all three of them is the exact same. Literally it's the exact same. And the year one approaches are almost the exact same too, when you're getting into your two or advanced models in each of them, there might be some subtle differences in the approaches that they try, you know, where like sensory motor is much more about the developmental motor stages versus somatic experiencing is more of the the motor stages, the involuntary movements that were blocked at the time of the index trauma Right. But they both can do each others too.
Keith Sutton, Psy.D.: (43:59)
Sure.
Karen Sprinkel Ancelet, LMFT: (44:00)
Right. So I would say with those three, it's really about which foundational teacher you resonate with the most. Yeah. I was on the fence when I did se about whether to keep going after level one. Full transparency, I only kept going to get the certification. Level two was good. Level three or the advanced is really more hands on And I knew I likely was not going to be doing much hands-on. I usually refer out for hands-on, but I
Keith Sutton, Psy.D.: (44:39)
Little hands-on touching body,
Karen Sprinkel Ancelet, LMFT: (44:40)
Literal hands on. Yeah. It's where you learn to put, like, you cup your hand over the kidney area, or you hold people's feet or ankles at a certain position. Right. And so, and, and that's great. And it, it is truly healing for some folks, but just with my own comfort level. I usually, if it's someone needs that, I usually refer them to a hands-on SE practitioner.
Keith Sutton, Psy.D.: (45:05)
Yeah.
Karen Sprinkel Ancelet, LMFT: (45:05)
Which often are body workers. I respect the TIS model of sensory motor. I respect like viewing parts through fight, flight, freeze, you know, all that. So I think that's really beneficial. But I think you can get that from level one foundational stuff. Hakomi is really beautiful to have someone just really, really trust their body's organic intelligence. But that's also SE so they're so similar, you know, and, and they both have that kind of organizing principle of your body knows how to heal. Let's, let's just, let's just watch it And I'm, I have a really keen eye and I'm going to be watching where your body is moving involuntarily. Right. And I might be able to see something you're not seeing. And the most common thing is this thing, you know, when the most common thing is the shoulders going like this, you know?
Keith Sutton, Psy.D.: (46:05)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:05)
When you just have a client like, oh, just slow that down or make it really fast on purpose. Stuff almost always comes up.
Keith Sutton, Psy.D.: (46:13)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:14)
And that is in all three of those models. Right. So that's where there's so similar and it really is nuance about what is just more resonant. Yeah. I really believe they're, they're all three equally effective.
Keith Sutton, Psy.D.: (46:33)
Sure.
Karen Sprinkel Ancelet, LMFT: (46:35)
Well, that's the somatics. Of course there's other somatics, but those are the three kinda larger ones. Okay. So when it comes to actually desensitizing traumas, I actually have not been trained in prolonged exposure. That's one I still have not actually done training in, but I know enough about it just by reading.
Keith Sutton, Psy.D.: (46:56)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:57)
Obviously I'm certified in EMDR and brain spotting. I've done all the levels of brain spotting training. I'm a consultant. They are so profoundly similar and so profoundly different. So I can, I do understand why David Grand branched off and made his own approach. Yeah. when I first started to hear about it, I was like, ah, that's the same thing as the mdr. I don't get it. Right. But when I did the training, I was like, okay, there's enough of a difference. Yeah. How I like to explain it to clients or clinicians. Okay, I'll try to wrap this up. Is if you like to go internal and really visualize, especially if you're a good visualizer, EMDR might be more your cup of tea. If you, there's a lot of unconscious stuff and you actually don't know why you're feeling this. Right. It's more like developmental trauma or you don't, you don't actually have a memory, but you keep feeling this.
Keith Sutton, Psy.D.: (47:59)
Sure.
Karen Sprinkel Ancelet, LMFT: (47:59)
Then I call for brain spotting. Because brain spotting is basically watching for the involuntary gaze spot. Yes. Or fluttering in your eyes or pupil dilation. And then having the client stop at that point with the bilateral sounds and keep looking at that point And usually stuff comes out of the subcortical brain to get processed.
Keith Sutton, Psy.D.: (48:20)
Yeah.
Karen Sprinkel Ancelet, LMFT: (48:20)
Yeah. Okay. So getting now into parts I've never been trained in voice dialogue. I do have ego level one of the ego state, and of course I'm certified in IFS level three too. But I know a little bit about voice dialogue. I think, I think parts is foundational too, right. Just how I think we need to have somatics as foundation. We need to have some desensitization ability as a clinician. Also need to have some foundation of parts and if people don't like parts language, no problem. Just change the language to aspect or this feeling Right. And I have a couple clients that hate the language of parts. It's like, you don't have to use the language of parts to do parts work. IFS, the reason I like IFS a little bit more than voice dialogue and ego state is just personal bias because I'm a Buddhist and it, to me it's very similar to like mindfulness Buddhist practice. Buddhist psychology.
Keith Sutton, Psy.D.: (49:29)
Yeah.
Karen Sprinkel Ancelet, LMFT: (49:29)
Because it's pretty much about Buddha nature. Like self, like self-energy is the same thing. Right. And it's very mindful and where ego structure and voice dialogue can be, but it's more based on bringing the client back to their ego. Rather than the sense that there's even something kind of beyond the ego. That we can tap into. So IFS the further you get in the training, it really, and since you're a systems thinker and family systems. Totally. Probably know already that, that IFS was founded on family systems.
Keith Sutton, Psy.D.: (50:05)
Yeah. No, Dick, we had him on the on the podcast and also we brought him out to do a conference for the association family therapist, Northern California. And yeah. So it's, it really helped me also, you know, sometimes I felt like the inner child stuff was a little woo woo, but like really doing the IFS and understanding that those younger parts and right. How they get triggered, the emotional flashbacks and really bringing that self in to be able to reparent to allow that younger part to be, to be a child and not have to take over those adult responsibilities really makes sense and makes sense to a lot of clients. And yeah. That was really helpful in my, my thinking.
Karen Sprinkel Ancelet, LMFT: (50:46)
Oh, I'm so glad and I'm so glad that Dick came and spoke to your team. That's amazing.
Keith Sutton, Psy.D.: (50:51)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (50:54)
So then, you know, so you know how brilliant it is and yet how simple it is, and that's why it's brilliant. Because it's actually quite simple, right. Just like somatic work can actually be quite simple and it's really about us going back to befriending ourselves and how we have this self-organizing system of parts. And just like in somatic work, we have a self-organizing body And IFS. It's like we have a self-organizing system of parts, let's just get them and balance.
Keith Sutton, Psy.D.: (51:23)
Yeah. Well, like I think with EMDR, it's oftentimes we're just creating the space for the mind to do the work that it knows what it needs to do. Maybe as a therapist we might use some cognitive interweaves to kind of help along a little bit, but it's really oftentimes the mind being able to... Right. Kind of do that work to put things together. So yeah. Similar with the IFS, like even just after the weekend training and I brought one of my couples in, he did a live demonstration and I began using, you know, just you know, just that little bit has been profound in the work that I've done with other clients and bringing IFS in and that IFS informed
Karen Sprinkel Ancelet, LMFT: (52:01)
Totally. Right. It's that, going back to that philosophical thing I talked about in the beginning, it's like once a client gets IFS, they're like, oh my God, I actually get to talk to myself and I can talk to this feeling as it comes up. It's like for some clients it's like mind blowing. It shifts their entire paradigm of how they've held themselves. You know, and I mean, for those of us already knew parts, it's maybe not as profound, but it's still effective. And so, for me with I-F-S-I-F-S level one, as you know, is really about the system of knowing your own internal parts. Once you get, if FS two and three, you start getting into the system within the system. Then when you get to level three or more, you're starting to get into larger systems. So we don't even see. Right. And like how can we relate to that? But it's so it can become quite spiritual. Right. And quite and quite profoundly deep. So that's why IFS works for all levels of client's, emotional intelligence or spiritual experiences. Right. Like you, you can introduce IFS to day one, first session of a newbie client who has never done any mental treatment or for someone that's been in treatment for 20 years. Right. And maybe they had a spiritual experience, they don't understand how to hold it. And then you use IFS with it and it's like, oh yeah, it doesn't have to take me over. I can just talk to the devil I saw in my psilocybin journey and ask the devil what it wanted and what is its role for me? Yeah.
Keith Sutton, Psy.D.: (53:43)
Yeah. How it's trying to help.
Karen Sprinkel Ancelet, LMFT: (53:45)
How's it trying to help me? Right. And if it's not trying to help me, oh, I get to choose to ask it to leave my system.
Keith Sutton, Psy.D.: (53:51)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (53:52)
Yeah.
Keith Sutton, Psy.D.: (53:52)
And I'm curious too about some of the top down work. I know like, you know, Janina Fisher talks about like kind of engaging the prefrontal cortex and she uses kind of parts and so on. Where I'm thinking about, you know, the Pete Walker's Complex PTSD, surviving to thriving, which sometimes just even recommending that book to a client becomes life changing. Just even knowing like, oh my gosh, like I didn't even know this was a thing. So yeah, I'm kind of curious about those pieces. because I think definitely the bottom up is imperative, you know, whether it's somatic, EMDR, IFS, like all this bottom up processing. How do, Is there a way that you think of the top down processing with trauma C-P-T-S-D?
Karen Sprinkel Ancelet, LMFT: (54:40)
Yes. Yes. First of all, I totally agree about Janina Fisher's model, and I love Pete Walker's book. I have all my clients read it. So I have like some must reads for my clients. So, Victor's, Man Search for Meanings, it's one of those must reads, you know, and then Pete Walker's is good if someone has never done trauma work before. Of course I have my own book too, if they're interested.
Keith Sutton, Psy.D.: (55:02)
Sure. Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (55:05)
So prefrontal cortex engagement is obviously very important because we need to be able to have cognitive meaning of everything that's happened to us recognize our thoughts and how they impact us. In my book, about three quarters of the way through, I talk about something called the over competent override. And for me, that is the hallmark of what differentiates between surviving, like doing your trauma work, surviving, not letting it impact you anymore to actually thriving. And that takes a lot of actually prefrontal cortex work and, and, and self-inquiry into, okay, why have I become a therapist? Why did I invent this podcast in this center. Where I want all these clinicians to get the best and most effective training as possible. Who would I be in the world if I didn't do all that. And then how you answer that question would help me and you together have inquiry into, are you in an over competent override in your life, or are you thriving? Right. Because if someone's like, oh my God, I can't, I can't imagine not being a therapist. I would be devastated. It's like, oh, what? Why would you be devastated, do you think? Well, they say it just gives me meaning. I mean, who would I be if I wasn't a therapist? It's like yeah. So, and then that, that's getting into the spiritual and like ego.
Keith Sutton, Psy.D.: (56:44)
It's like the, yeah the ego that's built up on, you know, versus Buddhism, the idea of right, kind of being able to let go of that ego and being able to exist without.
Karen Sprinkel Ancelet, LMFT: (56:57)
Exactly. Yeah. And, and then that point, I actually might recommend a certain like, brain spotting approach or some psychedelics. because It's like, we need this individual to have that unity consciousness experience. Right. Or the higher self experience, whatever you want to call it. Where oh my God, guess what? They're probably not going to be remembered too much in a hundred years. Yeah. And they're remember too much for what therapy model they used. And can they be okay with that?
Keith Sutton, Psy.D.: (57:28)
I feel like I'd be geeking out on like accounting or something, or like just whatever it is be like, you know, wanting to learn more and understand. Just, yeah. It's just interesting. Very cool.
Karen Sprinkel Ancelet, LMFT: (57:43)
So you definitely have a growth mindset and I think, yes.
Keith Sutton, Psy.D.: (57:47)
Yeah. Yeah. Well, you know what? This has been amazing. Love the work that you're doing. Love the way you're thinking. Yeah. I'm always, you know, kind of thinking of like, yeah, how do we find kind of, what is the best, what is the, you know, somebody that's trying to get trained, like what are the elements, right. To get that overall training? Because each approach has its own limitations. And really, you know, being able to fill in those gaps with these different pieces I think is so important. Because yeah, if you're just stuck in, this is what I do and this is the best thing for it, it's, it's not the best thing for everybody. And, and needing to write different tools for different kind of scenarios, and especially with something such as complex as trauma that's one of the areas I think it's so, important. So thank you so much for taking the time. This is great. I really love the work you're doing. And I'll link your website and your book and yeah, it's, it's great to hear. Thank you.
Karen Sprinkel Ancelet, LMFT: (58:43)
Thank you, Keith. And again, truly thank you for being a human being in the world that has a growth mindset and wants to keep growing and learning no matter what. Even when you have kids at home. You have all these clients you want to keep growing and making sure other people grow.
Keith Sutton, Psy.D.: (58:58)
Yeah, definitely. Well, wonderful. Take care. Bye-Bye.
Keith Sutton, Psy.D.: (59:03)
Thank you for joining us today. If you'd like to receive continuing education credits for the podcast you just listened to, please go to therapyonthecuttingedge.com and click on the link for CE. Our podcast is brought to you by the Institute for the Advancement of Psychotherapy, where we provide trainings for therapists in evidence-based models through live and online workshops, on-demand workshops, consultation groups, and online one-way mirror trainings. To learn more about our trainings and treatment for children, adolescents, families, couples, and individual adults, with our licensed experience therapists in-person in the Bay Area, or throughout California online and our employment opportunities, go to SFIAP.com. To learn more about our associateships and psych assistantships and low fee treatment through our nonprofit Bay Area Community Counseling and Family Institute of Berkeley, go to sf-bcc.org and familyinstituteofberkeley.com. If you'd like to support therapy for those in financial need and training and evidence-based treatments, you can donate by going to BACCs website at sfbcc.org. BACC is a 501(c)(3) nonprofit to all donations are tax deductible. Also, we really appreciate your feedback. If you have something you're interested in, something that's on the cutting edge of the field of psychotherapy, and you think therapists out there should know about it, send us an email. We're always looking for advancements in the field of psychotherapy to create lasting change for our clients.
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. At the Institute for the Advancement of Psychotherapy, we provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in an evidence-based approach, with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically; our Center for Couples, where all the therapists are using emotionally focused couples therapy; and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma; and our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D.: (01:31)
In the institute, we have our licensed, experienced therapists, and for those in financial need, we have an associated nonprofit, Bay Area Community Counseling, where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about trainings, treatment, and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D.: (02:19)
Today I'll be speaking with Karen Sprinkle Ancelet licensed marriage and family therapist with more than 30 years of clinical experience, who is practicing in California, Colorado, Oregon, Washington, and Michigan. She specializes in trauma-informed care and integrates a broad range of evidence-based modalities, including eye movement to sensitization reprocessing, brain spotting, somatic experiencing, internal family systems and HeartMath. Karen is also a Ketamine assisted psychotherapy provider with advanced psychedelic training through maps, fluence, and three cups. She graduated with a certificate in psychedelic assisted therapies and research from California Institute of Integral Studies. In addition to her clinical practice, she serves as a consultant educator, certified clinical trauma professional and continuing education provider. A pivotal chapter in Karen's life was her time living in Asia, where she conducted her master's research on trauma healing following violent crimes in Tibet, Southeast Asia and the United States. Deeply impacted by these findings, she returned to Asia for several years to further her exploration. Today, Karen weaves together the ancient wisdom of meditation and mindfulness with the contemporary approaches such as EMDR, brainspotting Flash, E-F-T-I-F-S, and Somatic experiencing to guide support her clients in the healing journey. Let's listen to the interview.
Keith Sutton, Psy.D.: (03:42)
Hi, Karen. Welcome.
Karen Sprinkel Ancelet, LMFT: (03:44)
Thank you for having me, Dr. Sutton.
Keith Sutton, Psy.D.: (03:46)
Yeah, definitely. Yeah, you can call me Keith. No problem. Well, this is wonderful. So I learned about your work. I was reaching out to our community in the Bay Area in San Francisco Bay area. So I was looking for somebody thatyou know, does somatic experiencing. You know, I was kind of hearing about people who are different doing trainings on somatic experiencing, and your name came up and I went and looked at your website and saw you were doing lots of really interesting things, integratingthere was also some, some work with ketamine. I think correct me if I'm wrong, some internal family systems work integration, somatic experience, I think EMDR. And, so I just was really interested in learning more about the work that you're doing. Because I'm also somebody that integrates and really draws from all these different areas, and particularly trauma is, you know, an, an area of interest. So yeah. Soand before we get into the work you're doing, I always like to find out from people, you know, how they got to doing what they're doing, kind of their evolution of their thinking, how they got to this kind of, the work they're doing and integrating and so on.
Karen Sprinkel Ancelet, LMFT: (04:52)
Well, let's see. Well, why I became a therapist in the first place is kind of the question.
Keith Sutton, Psy.D.: (04:57)
Well, either that or just how you, like what led, what led you to kind of put all this together to then integrate all these different things that you're integrating.
Karen Sprinkel Ancelet, LMFT: (05:05)
Got it. Great. Okay. Yeah, well, I mean, there's kind of, the way I look at it, there's kind of two different things I'm integrating. So I'm integrating all of the trauma approaches, which I would like to call them the, the efficient approaches. And also integrating this kind of spiritual philosophical playing here. Right. And so, the first one I'm going to, well actually let me speak to the second one, philosophically, whether we view that as spiritual metaphysical philosophy, belief systems, I was really taken aback in my master's degree when I was working with survivors, the surviving family members of murder, right? And their loved one was killed by a serial killer.
Keith Sutton, Psy.D.: (05:54)
Oh, geez.
Karen Sprinkel Ancelet, LMFT: (05:54)
And it was the first organization in the United States that was created specifically for the loved ones of homicide victims. And it was, it was event created in Washington State. So it was after Ted Bundy, the I-5 killer, the Green River Killer. And I was in my master's degree at the same time. So I was this new therapist. But I was really passionate about everything I was studying. And I got to this point where I was like, there isn't anything clinically that I can offer these families. Like truly there was nothing at the time. This was in the nineties. And so at that point, I was like, oh, there has to be something deeper than just clinical. Right? Yeah. So that's where I started to kind of integrate, okay, what is there beyond just clinical psychotherapy? So I started to go on this kind of personal spiritual quest, and I would like to call it a clinical quest too, of the nature of suffering. Why do bad things happen? Why do bad things happen to good people? Why is there such a thing as a serial killer that even exists in our world? Right. And so I kind of had to embark on that discovery myself before I felt like I could really hold space. For folks that had experienced the worst of the worst of the worst. Sure. I couldn't just use a cognitive behavioral technique or, you know, let's talk about the thought and the behavior. It's this thing. So that, that brought me to studying Buddhism. Brought me to the east, and I spent, I went through Naropa to study Buddhist studies. And that changed my world. So I started to interview and meet Tibetan refugees who had also lost a family member to murder, but how they were healing was dramatically different than here in the west. So I started to do kind of a comparative analysis of like, what is it, what is it about, kind of like their philosophical frame here. Right? Because they didn't have psychotherapy in Tibetan Nepal. Like, so what is it? So obviously one of the things was collective, there was the collective trauma and the collective healing, but simultaneously there was this frame that suffering is part of life. And in the Judeo-Christian perspective, and I did this comparative analysis is, okay, sure we have that, but we don't emphasize that, right? We don't really emphasize that suffering is going to be part of your life path. We're not raised as children, like, okay, you're going to have suffering events, let's help you to be resilient and transform through those suffering events.
Keith Sutton, Psy.D.: (08:47)
Sure.
Karen Sprinkel Ancelet, LMFT: (08:47)
So rather here in the west, when we have a terrible thing happen, we tend to personalize it like there's something wrong with us, or there's something wrong with our world, and we get really black and white in our thinking. Anyways, that's what came out of my first kind of integration model of like, okay, we need clinical work. We need the therapeutic alliance. And to a client, I will say, what is your belief in life? What is your belief in suffering? Do you believe that suffering is part of life? And we actually start therapy from that. Because I view that as foundational, right? Because if, if someone says, no, suffering shouldn't exist, suffering's not part of life. It's like, okay, well let's have a conversation and let's stretch out our therapy because suffering does exist. And so that, that I would say is kind of the first part of the integration. The second part.
Keith Sutton, Psy.D.: (09:45)
I like that, you know, this aspect of kind of the, rather than being emotionally avoidant and just trying to have the good feelings, the acceptance of suffering in the full range of the human experience.
Karen Sprinkel Ancelet, LMFT: (09:57)
Exactly. Exactly. Because we're not going to get far in therapy if someone believes that a bad event's not going to happen to them again.
Keith Sutton, Psy.D.: (10:06)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (10:07)
It's like, okay, bad events will happen, but how do you want to be. Right? And then the second integration started to happen just as a trauma therapist in the world where I started to study all these different trauma approaches, but also started to get feedback from all folks, all different variety of folks that had dramatically different opinions about the same approach. And it really came out of an incest survivor support group that I ran for eight years. And the demographics were relatively the same of each member. The, the sexual abuse history Administrator was relatively the same socioeconomic status, relatively the same cultural background, relatively the same diagnostic code, all the same, right? There PTSD with dissociative, you know, tendencies or dissociative identity disorder, or dissociative spectrum disorder, right? We're talking severe trauma. And in the incest survivor support group, one member loves somatic experiencing. Another member couldn't stand it, said, don't ask me any question about my body. I hate those questions. Right. And never want to go see that nasty person again. And then someone loved EMDR and the next person thought it was ineffective, right? And some person loved brainspotting, someone else didn't find it useful. So it's like, I started really scratch my head of, okay, there's gotta be something more besides just the diagnosis of PTSD. There has to be something more than just a diagnosis of a dissociative spectrum disorder. What else is happening in the individual, in the human mind, body and spirit that we have a tendency to heal in different ways. So then I started to actually do my own kind of collective data analysis, you know, and then I started to find that folks that had kind of a dominant kind of mental processing.Preferred a certain type of modality or approach those that had just more of like a somatic symptoms. Referred a somatic approach, but not necessarily there's other factors too.
Keith Sutton, Psy.D.: (12:26)
Sure.
Karen Sprinkel Ancelet, LMFT: (12:26)
And then of course, those that had more of like a spiritual or meaning making mind, they needed to have that kind of approach. But they all had PTSD. So that's why I said, okay, like, someone's gotta write about this. I felt really called to like, put together a book and have a new kind of diagnostic criteria of trauma mind, trauma body and trauma spirit. And although it may seem like pretty common sense, it's never been written about before.
Keith Sutton, Psy.D.: (12:55)
Yeah.
Karen Sprinkel Ancelet, LMFT: (12:56)
So I was like, okay, I have the, all these trainings, I have all these approaches, I have all these certifications. Let me just put it together and have a suggested roadmap for the client, or just any individual that wants to find a really integrative and efficient way to heal.
Keith Sutton, Psy.D.: (13:17)
Great. So you're kind of looking at like client factors and kind of their type of experience with trauma and how that might match to particular approaches?
Karen Sprinkel Ancelet, LMFT: (13:30)
Exactly.
Keith Sutton, Psy.D.: (13:31)
Yeah. Great.
Karen Sprinkel Ancelet, LMFT: (13:33)
Well, I should probably add that one of the things I'm extremely passionate and thus bias about is I really have a strong belief in efficiency. Like, it's, it's, it's kind of, I've been this way my whole life.
Keith Sutton, Psy.D.: (13:47)
Sure.
Karen Sprinkel Ancelet, LMFT: (13:47)
Like, I'm always like, it's one of my value structures. It's like most sufficient at anything. Right? So I view that with, with mental health too. It's like, okay, why are we keeping folks in therapy for four years. If we can get them graduated in five months. Right?
Keith Sutton, Psy.D.: (14:02)
Yeah, Definitely. Yeah, no, definitely right there with you. And I think that's oftentimesright. The question is how do we help the person in the most expedited, you know, kind of financially, you know way that, that, you know, so that they're not yet spending years and tons of money or so on. Efficient economic way to help them to, to get move on with their life and create lasting change.
Karen Sprinkel Ancelet, LMFT: (14:27)
Exactly. Yes. Lasting change.
Keith Sutton, Psy.D.: (14:29)
Yeah rather than just kind of symptom reduction for a short period.
Karen Sprinkel Ancelet, LMFT: (14:33)
Exactly. And I can, I can clearly tell that this is something you feel very passionate about as well, given that you want to grow and learn anything that you can to help your clients.
Keith Sutton, Psy.D.: (14:43)
Yeah, definitely. And I think particularly too with trauma, there are so many different approaches. And like you're saying, some things work for some people, some things don't work for others, and trauma's a difficult... It's difficult. It's hard in some areas to resolve for some people. Some people move through things differently quickly, especially when there's complex trauma. Right. There's a lot more that goes into it. So, there are so many, and I, yeah, I've got I was impressed by all the different kind of approaches, because there's so many that I'm wanting to learn. I know a number of different trauma approaches. And particularly too, you alsohad talked about the using the, the ketamine. And I think also there wastraining or guidance around psilocybin. I'm wondering if you can also talk about some of those approaches and, any of the other approaches that you kind of are using and integrating and how you're conceptualizing.
Karen Sprinkel Ancelet, LMFT: (15:41)
Yeah. No, it's an outstanding question because it goes in line with what we just talked about, about efficiency, right. Well, let me start with a disclaimer that I don't want to promote any illegal use of psychedelics.
Keith Sutton, Psy.D.: (15:56)
Of course.
Karen Sprinkel Ancelet, LMFT: (15:56)
But, and also a personal disclosure. I was a purist until three years ago because I'm a Buddhist practitioner. I lived for years in the East, and I really believe that for one, to have kind of a deeper integrative spiritual practice that it needs to be without a substance. So I was actually a purist and I was a little bit biased and judgmental against psychedelics. So, I'm actually a great person to answer this question because come full circle on the other side of it or half circle, I guess would be the term. So, three years ago I started to study the MDMAresearch. And I was like, okay, there's something here. Like what, what is happening with this molecule that's helping folks with this complex trauma or this very significant event within three dosage journeys, like feel relatively, relatively cured.
Keith Sutton, Psy.D.: (17:01)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (17:03)
There's really something here. And so I started to read about it and the neuroscience of it and how it kind of softens the amygdala so we can actually look at the fear. We can actually look at the event, and then we actually go through the event. Because as we know, a lot of trauma is the fear of facing it, right? And so I was like, okay, I need to go study this. And so I got into the actual very last MAPS training that existed.
Keith Sutton, Psy.D.: (17:29)
Oh, wow.
Karen Sprinkel Ancelet, LMFT: (17:29)
Where they went to the phase three, you know, the, they promoted their research and went to the senate hearings and all that stuff. I was the only person at that maps training that had not tried MDMA. So, I felt really naive. Right. And really inexperienced there. And I also had not at that point, tried ketamine. Because I was still a purist, but I was like, okay, but I want to do this for my clients. And then I started to realize, okay, I need to know what my clients are going to go through. So I need to actually undertake some of these psychedelics myself. Right. So, I became a believer that it can actually heal trauma. And so then I personally tried ketamine and it was life shifting for me.
Keith Sutton, Psy.D.: (18:16)
Wow.
Karen Sprinkel Ancelet, LMFT: (18:17)
Totally life shifting. I mean, the way to think of it, there was two things. One is the very thing that I feared was lifted from doing the psychedelics. So, I had this fear of what I would witness in the spiritual realms.
Keith Sutton, Psy.D.: (18:37)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (18:38)
And actually doing the psychedelics brought me to not fear that anymore. So, it was kind of ironic in that way. Right.
Keith Sutton, Psy.D.: (18:46)
Yeah.
Karen Sprinkel Ancelet, LMFT: (18:46)
And then there was just kind of like this subtle, I would say it was more gradual, but just a subtle of just, oh, I am who I am. Like, it's just, I am who I am. Like, there wasn't like this profound like, aha moment. But it was like, oh, like any tiny residual insecurities or imposter syndrome, or putting myself out in the world, it was just kind of like slowly, you know, just kind of went into the background and then disappeared.
Keith Sutton, Psy.D.: (19:14)
Yeah.
Karen Sprinkel Ancelet, LMFT: (19:14)
So I was like, okay, there is definitely something here. Because I'm not someone that had like profound issues anymore. But it still lifted stuff for me. So I immediately became certified in ketamine, and I right away started to offer ketamine to my clients. So, it's been about three years now, I've been offering ketamine to clients. And then I decided to get further training. And so I did a harm reduction training through Fluence, and I just graduated from CIIS's psychedelic. So I'm certified as a true psychedelic therapist. So, there's, as you know, there's only a few states that actually legalized psilocybin. And it's prettyregulated. You know, like, so for example, in Oregon, you can only get it at clinics. You can't just go to an individual provider's office, so on and so forth. Right. So what I can talk about today is the ketamine, because that's what's legal here.
Keith Sutton, Psy.D.: (20:14)
Sure.
Karen Sprinkel Ancelet, LMFT: (20:18)
But doing the ketamine combined with a trauma approach is miraculous.
Keith Sutton, Psy.D.: (20:25)
Wow.
Karen Sprinkel Ancelet, LMFT: (20:26)
Now that being said, I like to tell clients it's not a magic pill either.
Keith Sutton, Psy.D.: (20:30)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (20:31)
I get a lot of phone calls like, oh, I just want to try ketamine once and see what it's like. I'm like, no, first of all, you have to meet criteria. Not everyone can just try ketamine. And secondly, it's not a one and done. It's actually a treatment. So usual course of treatment, six to eight dosage sessions about every two to four weeks. And the studies have shown, usually by the fourth, sixth or eighth session, there is a true lifting of whatever symptom it was. Whether it's treatment resistant depression, anxiety, OCD or PTF.
Keith Sutton, Psy.D.: (21:04)
Wow. That's incredible. Yeah. I know somebody that's gone through the treatment and really found it very impactful. It didn't completely fix things, but it was really, had a significant shift and really moved them forward in the work that they were doing. Yeah. So, I'm interested in, exactly, this idea of like how to find the most effective, efficient kind of way to help someone. And I guess maybe can you talk about, I guessI don't want you to have to compare and value like kind of weigh the different ones, but I mean, again, having this kind of training in all these different modalities, I guess, is there any ways that you think about. Yeah, I'm, so I'm thinking of doing some training in somatic experiencing. I'm trained in EMDR, I'm CBT family systems mostly. You know, all these kind of other aspects, you know, I'm debating on brain spotting and art. You know, and all these kind of things. I don't know if you can speak to kind of, I don't know if it's the strengths of the different ones or the, the utility of the different kind of approaches or so on. And I think, I think you can talk about the MDMA and the psilocybin and so on. Right. And kind of, you've got certification from California Institute of Integral Studies. I know they have a great training program or so on. I know it can't be used in therapy with folks presently in California. There are other places and so on. But yeah, I'd love to kind get your thoughts on, on like, you know, especially for practitioners that are maybe earlier in their career or wanting to further their work with trauma. Like how do they decide where, which direction to go?
Karen Sprinkel Ancelet, LMFT: (22:50)
Oh my gosh. It's like, this is such an outstanding question and I get asked it a lot. I'm sure you do as well.
Keith Sutton, Psy.D.: (22:55)
Oh, yeah, totally.
Karen Sprinkel Ancelet, LMFT: (22:57)
So yes, I'm very passionate about this, so I might talk for too long, so please interrupt me, if I go for to long.
Keith Sutton, Psy.D.: (23:05)
You got like over half an hour, so I'm sure this is a big topic.
Karen Sprinkel Ancelet, LMFT: (23:09)
Okay. Okay. Well, first of all, in that passion, in the book I wrote, I did create a questionnaire. And the questionnaire is called the trauma type questionnaire. And in the book, I also have different, like, I kind of excel graphs about like, if you're more dominant trauma mind, then you try this approach. And this is why if you're more dominant trauma body, try this approach and this is why. So on and so forth. As a clinician though, and again, I think you and I are probably similar in our value structure, I believe that master's degrees at minimum, and definitely PhDs and society programs all need to be restructured. I think all everyone that graduates from those programs should have level one in all of these dominant modalities. Right. You know, the fact that we, you know, I would say proudly that I probably have like equivalent of two PhDs with all the certifications I've done. Right because each certification's a three year commitment, three year hours in education and consultations and money and all that stuff. Right. And level one, in each of them is highly valuable. I believe truly that every clinician should have level one in one of the somatic approaches, whether it's SE, sensory motor or Hakomi. And I can get into each of those and how to compare them. But I believe going back to the clinician that's new, I think every clinician should have level one in one of those three. I also believe every clinician should have level one in either EMDR or brain spotting. And they're similar. And I can also get into how they're different. And I also believe that every clinician in the world should have level one and internal family systems. And if not, IFS then voice dialogue or ego state. Right. And, and the reason why is those three larger themes of how we as a human body hold trauma differently and hold life differently. Like some of us truly are more verbal, mental thinkers, and some of us are really feelers. Right. Really kinesthetic. Some of us are really deeply, meaning making humans. So we all, we as clinicians, need to hold the person in front of us by how they hold themselves. Right? We can't, like, we love CBT, so we're going to use CBT with this client who doesn't really want to think and behave a certain way. They just want to feel, right? So if it's a new clinician in the world, I would say, if at all possible, try level one in those three areas. If you can't get into one of them, then go with your passion. But be very honest with the clients you serve, that this is your passion, not that it's the way. Because I see that time and time again, and I'm always so sad and shocked actually, when, even when I see other trauma therapists saying, this is the way to heal your trauma, and it's like, oh my gosh. Like almost the opposite of what to say to a trauma survivor. Right. Their choice. Right.
Keith Sutton, Psy.D.: (26:31)
Exactly. Autonomy.
Karen Sprinkel Ancelet, LMFT: (26:33)
Autoomy. Right. And if you want to go see a different provider while you're working with me with this approach, absolutely. Whatever's going to help you heal. And that brings us to a kind of a little second caveat I need to mention before getting into these specific approaches. All of these are really not psychoanalytic or psychodynamically held anymore. And historically, you know, once we get into folks that are above the age of 40, 50 and older, as clinicians in the world are trained, they are going to have that structure. Right. Psychodynamic or psychoanalytic. Which is very much only one therapist to treat the client. And that about 20 years ago, I was like that, first of all, how egotistical in some ways.
Keith Sutton, Psy.D.: (27:26)
Sure.
Karen Sprinkel Ancelet, LMFT: (27:28)
And secondly, what if it's not working for the clients. Yeah.
Keith Sutton, Psy.D.: (27:34)
Yeah, I talk about with my clients, I'm not the end all be all right. Like if we're not progressing, maybe trying another person. Right. because there can be different matches, all these different kind of things, different approaches.
Karen Sprinkel Ancelet, LMFT: (27:45)
Exactly. Right. And so, when we get into which training to take, it's like, if you can't get in, do all three of those, then follow your passion. But just tell your clients that I'm really into, you know, somatic approaches. They're really effective for me. So I got level one trained in se, but if we're not making headway in six months or a year, don't worry. I have referrals to an IFS therapist or referrals to an EMDR therapist for you. Right. And hold it as your passion rather than it being the way. So I like to have that conversations with new clinicians as well. Do you want me to get into psychedelics now or get into comparing the different clinical approaches first?
Keith Sutton, Psy.D.: (28:33)
Whatever, however you think, yeah, whatever makes more sense.
Karen Sprinkel Ancelet, LMFT: (28:37)
Okay. Well let me, I'll come psychedelics and then we'll go back to the clinical approaches. Sure. So psychedelics, we're in the Renaissance now, right? I mean, everyone's talking about psychedelics.
Keith Sutton, Psy.D.: (28:52)
Yeah.
Karen Sprinkel Ancelet, LMFT: (28:52)
It's becoming more mainstream, which is amazing. Really, really amazing. But like anything that's becoming mainstream, there's a lot of misconceptions about it. And on either end of the spectrum. But we have one misconception, which is that it's a magic pill. The magic bullet.
Keith Sutton, Psy.D.: (29:10)
Mm-hmm sure.
Karen Sprinkel Ancelet, LMFT: (29:11)
Which is that you just need to go do MDMA once and you're healed. Right. Or try ketamine a couple times you'll be healed. Right. That's one misconception. The other misconception is the other extreme, which is kind of like the Matthew Perry situation. Where folks are terrified and like, oh my God, I'm, you're going to become addicted. I heard that.
Keith Sutton, Psy.D.: (29:30)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (29:30)
Doctor wants you do ketamine and you're going to become addicted. You're going to die. Like Matthew Perry died and it's like, whoa, whoa, whoa, whoa, whoa. No. First of all, he didn't die of ketamine. He died from drowning and he was not using ketamine in a mental health setting.
Keith Sutton, Psy.D.: (29:48)
Sure.
Karen Sprinkel Ancelet, LMFT: (29:49)
Or health provider. Right. He was getting it underground. It's like, it's like literally it's non-comparable.
Keith Sutton, Psy.D.: (29:56)
Yeah.
Karen Sprinkel Ancelet, LMFT: (29:56)
So it's first having that conversation, it is like, it's not dangerous. It's a very thorough intake process to make sure you meet not only criteria, but that your body can handle it. So there are some rule outs, right. Like certain heart conditions and certain psychosis, cannot try certain psychedelics, unfortunately. And then in the other extreme, I definitely have to have the conversation of what kind of therapeutic background have you had, because I don't feel comfortable starting you with ketamine unless you've actually been in therapy.
Keith Sutton, Psy.D.: (30:34)
Sure. How much work have you done, or what kind of work?
Karen Sprinkel Ancelet, LMFT: (30:37)
Right. Yeah. So the first two years I offered ketamine, and I only did it with my clients. Right. Because they, obviously they've been in therapy. This past year, I have taken more referrals, you know and there's a couple people I've said no to because they were, "oh, I just want to try ketamine, and I heard it's really good" and they've never been to therapy. Yeah. Right. And I was like, "No, it doesn't work like that." Right. So there has to be a foundation there in order to try psychedelics in my belief system, and we're trained this way too. There has to be, I would call it phase one therapy, like the individual has to know their mental landscape. They have to have a good understanding of their childhood traumas, the psychodynamics of their family structure or the system of their family structure. Right. And they're kind of the core belief systems they have in the world. Like those are foundational.
Keith Sutton, Psy.D.: (31:37)
Sure.
Karen Sprinkel Ancelet, LMFT: (31:38)
Like if someone doesn't have that basic structure, they don't have ego structure yet. Because psychedelics blow out ego structure.
Keith Sutton, Psy.D.: (31:48)
Sure.
Karen Sprinkel Ancelet, LMFT: (31:49)
So if one doesn't have a base ego structure, they're going to become decompensated.
Keith Sutton, Psy.D.: (31:54)
Hmm.
Karen Sprinkel Ancelet, LMFT: (31:54)
Or sorry. Well, yeah. We could say decompensated. Their psychedelics like, they need to really have a foundational understanding of their ego structure, but there has to be some level of either mindfulness or flexibility. So all of that being said, these are the conversations I have in intake with folks. And mindfulness or flexibility because there's some folks that have never practiced mindfulness. But if I kind of have a challenge question with them, like a challenging mathematical formula, and I say, well, what do you believe about now in quantum theory, they believe that Einstein's theory might not be true. And if they say, oh, well they haven't proven it yet. And it's like, okay, there's not flexibility here.
Keith Sutton, Psy.D.: (32:43)
Sure, sure.
Karen Sprinkel Ancelet, LMFT: (32:44)
Right. But if they say, yeah, that's interesting. I'm like, okay, there's flexibility. And then I'll say to them, okay, when you're going to undertake a psychedelic journey, it might be like that. It might be that you come out of it and you're like, oh my God, I don't know what just happened. I don't even know how to think.
Keith Sutton, Psy.D.: (33:03)
Yeah.
Karen Sprinkel Ancelet, LMFT: (33:04)
Can you be okay with that? Right. And then at that point, usually folks are like, oh my God, that kind of scares me, but I think I want to try. Or they're like, oh God, no, I don't like that. I feel I'll lose control. Or others are like, oh yeah, let's go for it. You know? Yeah. So those questions are pretty foundational before starting any psychedelic journey.
Keith Sutton, Psy.D.: (33:27)
Their mindset.
Karen Sprinkel Ancelet, LMFT: (33:29)
The mindset.
Keith Sutton, Psy.D.: (33:29)
As well as yeah, kind of all these different aspects, like you're saying, you know, structures because needing some of that to kind of hold you, or if you're going to go through the ego death experience, kind of having something that's already built up as well as yeah, that openness it sounds like too.
Karen Sprinkel Ancelet, LMFT: (33:47)
Exactly. There has to be both. Yeah. And then as far as kind of like, which path to take, and you probably know there's, there's kind of like an above ground and then a below ground path in psychedelics.
Karen Sprinkel Ancelet, LMFT: (34:01)
Right. And above ground is like people that are certified, like myself and, and do ketamine assisted psychotherapy. And they might have referrals, but they themselves usually don't offer the substances or the molecules that are not legal.
Keith Sutton, Psy.D.: (34:17)
Yes.
Karen Sprinkel Ancelet, LMFT: (34:18)
And then there's the underground practitioners that usually either are sub licensed or don't have an active license and they actually have years of experience of doing this.
Keith Sutton, Psy.D.: (34:28)
Sure.
Karen Sprinkel Ancelet, LMFT: (34:28)
But sometimes they don't have the mental health training.
Keith Sutton, Psy.D.: (34:30)
Yeah.
Karen Sprinkel Ancelet, LMFT: (34:31)
So it, again, it it's like, it's like this, and you have that conversation as well and then we can get into the indigenous cultures and the ceremonial cultures. Right. And then there's the whole ceremonial indigenous process and, and someone going to Peru and trying, you know, ayahuasca and things like that.
Keith Sutton, Psy.D.: (34:52)
Yeah.
Karen Sprinkel Ancelet, LMFT: (34:52)
So there's, there's so many choices now. And so it has to be just very mindful and thought through. And as far as which kind of molecule to start with or who you recommend for which one? There's probably people that are more experienced than me in answering that.
Keith Sutton, Psy.D.: (35:14)
Sure.
Karen Sprinkel Ancelet, LMFT: (35:15)
But what I can say, I'm a little biased, but I believe everyone, and a lot of people feel this too, should start with ketamine. Ketamine is the softest, most gentle way of starting to recognize that your mind is not necessarily your mind. Right. There it is like a little ego death.
Keith Sutton, Psy.D.: (35:39)
Sure.
Karen Sprinkel Ancelet, LMFT: (35:39)
And there's, and there's this kind of really peaceful disembodiment from one's body And so it's not so jarring. Sure. It's like this kind of floaty feeling. And, and some people describe it that no eastern traditions, like they really got to know their subtle body I'm like, oh, I really have an energy body. I really have a subtle body.
Keith Sutton, Psy.D.: (36:00)
Yeah.
Karen Sprinkel Ancelet, LMFT: (36:01)
It's like this beautiful like relationship building moment, right. Of like, oh, there's something besides my physical body. There's something besides my thoughts in my mind.
Keith Sutton, Psy.D.: (36:12)
Sure.
Karen Sprinkel Ancelet, LMFT: (36:14)
So Ketamine usually offers that. So that's why ketamine would be the first suggested molecule. After that is usually MDMA. Because MDMA, even though it's kind of more like a stimulant amphetamine kind of feeling.
Keith Sutton, Psy.D.: (36:28)
Yeah.
Karen Sprinkel Ancelet, LMFT: (36:29)
It's so heart opening That it usually is a lovely experience. It's usually like it can be ego disillusionment, but not as much, it's less of hallucinogen and it's more just so heart opening and loving and having this greater respect for being a human being. And living on earth and the cosmos. So it's...
Keith Sutton, Psy.D.: (36:58)
Connectedness.
Karen Sprinkel Ancelet, LMFT: (36:59)
Connectedness. So it's really mind expanding. So when you have those two as foundations, so you've had this experience of leaving your body and you've, and a little bit of ego disillusionment. And then you've had this experience of mind expanding. Then the next recommended molecule would be psilocybin. And what's so ironic too is that most people think psilocybin is the one to start with. because That's natural.
Keith Sutton, Psy.D.: (37:31)
Yeah. Interesting.
Karen Sprinkel Ancelet, LMFT: (37:32)
Yeah. And of course you probably know there's so many different types of mushrooms, right. There's so many different, it's like wine. There's so many. And so someone says, oh yeah, I had magic mushrooms. It's like, well, what kind, you know, how many milligrams?
Keith Sutton, Psy.D.: (37:50)
Yeah. How much, yeah.
Karen Sprinkel Ancelet, LMFT: (37:52)
Yeah, exactly. And so someone might be out with a friend and take some magic mushrooms and they have a terrorizing experience, right? So that's why it's usually recommended as the third step, not the first one.
Keith Sutton, Psy.D.: (38:06)
Yeah.
Karen Sprinkel Ancelet, LMFT: (38:07)
Now there are mushrooms that can be just really sema, sorry, somatically peaceful. Right. And that would be more kind of like ketamine. That's when people have these great experiences. There's some that are very visual and people see the trees talking to them And that's really amazing and beautiful. But the risk of the magic mushroom bringing some scary things is higher than ketamine and MDMA.
Keith Sutton, Psy.D.: (38:34)
Sure. Got it.
Karen Sprinkel Ancelet, LMFT: (38:35)
Yeah. And then after psilocybin, then it, it's kind of variable if someone wants to go to LSD or to five M-E-O-D-M-T So LSD would be more people that want hallucinations and visuals. Five, M-E-O-D-M-T in my experience is a lot of like Buddhist practitioners or high meditators.
Keith Sutton, Psy.D.: (38:59)
Yeah.
Karen Sprinkel Ancelet, LMFT: (39:00)
Just five M-E-O-D-M-T is very nothingness.
Keith Sutton, Psy.D.: (39:08)
Hmm.
Karen Sprinkel Ancelet, LMFT: (39:09)
Like, it's a false sense of nothing.
Keith Sutton, Psy.D.: (39:12)
And it's short acting too, isn't it? Right. The DMT, it's not like a, you take it and then you're on a four or five hour trip.
Karen Sprinkel Ancelet, LMFT: (39:19)
Exactly it's short acting. But that brings me back now to clinical and trauma approaches and different mental health approaches. The other thing I didn't mention, the reason why I started to get interested in going to study MDMA was not only because of the benefits to PTSD, but as a trauma therapist in the Bay Area, I was getting all these referrals for people that had traumatizing experiences from psychedelics.
Keith Sutton, Psy.D.: (39:46)
Ah.
Karen Sprinkel Ancelet, LMFT: (39:47)
I was like oh no, what is going on here? Somewhere in the underground and somewhere above ground. so, a lot of people said, oh, it must have been the underground, non-licensed mental health practitioner.
Keith Sutton, Psy.D.: (39:58)
Sure.
Karen Sprinkel Ancelet, LMFT: (39:58)
Always. Sometimes it literally is just the molecule sometimes it's sudden settings, sometimes it is the practitioner, sometimes it's traumas that resurface.
Keith Sutton, Psy.D.: (40:09)
Yeah.
Karen Sprinkel Ancelet, LMFT: (40:10)
Sometimes it's seeing a demon that you've never even thought of before.
Keith Sutton, Psy.D.: (40:16)
Sure.
Karen Sprinkel Ancelet, LMFT: (40:16)
It's whole variety of different things. And DMT or five M-E-O-D-M-T has caused a lot of folks to come in for trauma treatment afterwards. As has psilocybin into my practice. Yeah. So coming back to full integration. Right. This is why I personally believe in above ground psychedelic use. At the training mental health practitioner. And I actually just wrote my final capstone paper on the importance of it, of it being trauma informed Psychedelic treatment.
Keith Sutton, Psy.D.: (40:53)
Sure.
Karen Sprinkel Ancelet, LMFT: (40:54)
The practitioner has at least, you know, somatics, you know, MBMR, brain spotting or some IFS to help that client come back to themselves after they've had a potentially traumatic or terrorizing experience with psychedelics Yeah. You know, most people have great experiences.
Keith Sutton, Psy.D.: (41:15)
Sure.
Karen Sprinkel Ancelet, LMFT: (41:17)
Life changing shifting experiences, but there's a small percentage that have really destabilizing experiences. You just want to prevent that.
Keith Sutton, Psy.D.: (41:24)
Yeah. You gotta be thinking about that.
Karen Sprinkel Ancelet, LMFT: (41:27)
Yeah, exactly. So that's kind of the overview, but I'm happy to get into like each approach and how they're different.
Keith Sutton, Psy.D.: (41:35)
Yeah. I'd be interested in your thoughts on yeah somatic experiencing, MDR, yeah, hakomi. Like how do you think about them in different ways, especially since you, you have the breadth and depth of knowledge of these.
Karen Sprinkel Ancelet, LMFT: (41:48)
Yeah, yeah. Okay. It's always so complicated to answer to this question...
Keith Sutton, Psy.D.: (41:59)
I'm sure, I'm sure you also probably don't want to talk, talk negatively about one and...
Karen Sprinkel Ancelet, LMFT: (42:03)
Exactly. Right.
Keith Sutton, Psy.D.: (42:05)
Comparing or, or Yeah. How do you, how do you put it in the way that you think about it.
Karen Sprinkel Ancelet, LMFT: (42:09)
Yeah. Because I truly have deep respect for each of them, and I can see why each of them became an approach of itself. I mean, some of them are so similar, you know? Yeah. A little bias about like, why didn't that person just say it's this approach with this low edge to it.
Keith Sutton, Psy.D.: (42:26)
Sure. Sure.
Karen Sprinkel Ancelet, LMFT: (42:28)
So let's start with that. So, with that being said, somatic experiencing, sensory motor and hakomi, in my opinion, are almost all the same thing. Are they each equally profoundly useful for someone living in a trauma body? Absolutely. Absolutely. And so I would just say to the clinician, watch a short video of each of them. And do you like the hakomi's teacher's perspective, you know, Pat Ogden, how is she describing it? You know, Janina Fisher, how she's describing her TIS model, you know, Peter Levine, how he's describing somatic experiencing, and just kind of see which video resonates the most. But the foundation of all three of them is the exact same. Literally it's the exact same. And the year one approaches are almost the exact same too, when you're getting into your two or advanced models in each of them, there might be some subtle differences in the approaches that they try, you know, where like sensory motor is much more about the developmental motor stages versus somatic experiencing is more of the the motor stages, the involuntary movements that were blocked at the time of the index trauma Right. But they both can do each others too.
Keith Sutton, Psy.D.: (43:59)
Sure.
Karen Sprinkel Ancelet, LMFT: (44:00)
Right. So I would say with those three, it's really about which foundational teacher you resonate with the most. Yeah. I was on the fence when I did se about whether to keep going after level one. Full transparency, I only kept going to get the certification. Level two was good. Level three or the advanced is really more hands on And I knew I likely was not going to be doing much hands-on. I usually refer out for hands-on, but I
Keith Sutton, Psy.D.: (44:39)
Little hands-on touching body,
Karen Sprinkel Ancelet, LMFT: (44:40)
Literal hands on. Yeah. It's where you learn to put, like, you cup your hand over the kidney area, or you hold people's feet or ankles at a certain position. Right. And so, and, and that's great. And it, it is truly healing for some folks, but just with my own comfort level. I usually, if it's someone needs that, I usually refer them to a hands-on SE practitioner.
Keith Sutton, Psy.D.: (45:05)
Yeah.
Karen Sprinkel Ancelet, LMFT: (45:05)
Which often are body workers. I respect the TIS model of sensory motor. I respect like viewing parts through fight, flight, freeze, you know, all that. So I think that's really beneficial. But I think you can get that from level one foundational stuff. Hakomi is really beautiful to have someone just really, really trust their body's organic intelligence. But that's also SE so they're so similar, you know, and, and they both have that kind of organizing principle of your body knows how to heal. Let's, let's just, let's just watch it And I'm, I have a really keen eye and I'm going to be watching where your body is moving involuntarily. Right. And I might be able to see something you're not seeing. And the most common thing is this thing, you know, when the most common thing is the shoulders going like this, you know?
Keith Sutton, Psy.D.: (46:05)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:05)
When you just have a client like, oh, just slow that down or make it really fast on purpose. Stuff almost always comes up.
Keith Sutton, Psy.D.: (46:13)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:14)
And that is in all three of those models. Right. So that's where there's so similar and it really is nuance about what is just more resonant. Yeah. I really believe they're, they're all three equally effective.
Keith Sutton, Psy.D.: (46:33)
Sure.
Karen Sprinkel Ancelet, LMFT: (46:35)
Well, that's the somatics. Of course there's other somatics, but those are the three kinda larger ones. Okay. So when it comes to actually desensitizing traumas, I actually have not been trained in prolonged exposure. That's one I still have not actually done training in, but I know enough about it just by reading.
Keith Sutton, Psy.D.: (46:56)
Yeah.
Karen Sprinkel Ancelet, LMFT: (46:57)
Obviously I'm certified in EMDR and brain spotting. I've done all the levels of brain spotting training. I'm a consultant. They are so profoundly similar and so profoundly different. So I can, I do understand why David Grand branched off and made his own approach. Yeah. when I first started to hear about it, I was like, ah, that's the same thing as the mdr. I don't get it. Right. But when I did the training, I was like, okay, there's enough of a difference. Yeah. How I like to explain it to clients or clinicians. Okay, I'll try to wrap this up. Is if you like to go internal and really visualize, especially if you're a good visualizer, EMDR might be more your cup of tea. If you, there's a lot of unconscious stuff and you actually don't know why you're feeling this. Right. It's more like developmental trauma or you don't, you don't actually have a memory, but you keep feeling this.
Keith Sutton, Psy.D.: (47:59)
Sure.
Karen Sprinkel Ancelet, LMFT: (47:59)
Then I call for brain spotting. Because brain spotting is basically watching for the involuntary gaze spot. Yes. Or fluttering in your eyes or pupil dilation. And then having the client stop at that point with the bilateral sounds and keep looking at that point And usually stuff comes out of the subcortical brain to get processed.
Keith Sutton, Psy.D.: (48:20)
Yeah.
Karen Sprinkel Ancelet, LMFT: (48:20)
Yeah. Okay. So getting now into parts I've never been trained in voice dialogue. I do have ego level one of the ego state, and of course I'm certified in IFS level three too. But I know a little bit about voice dialogue. I think, I think parts is foundational too, right. Just how I think we need to have somatics as foundation. We need to have some desensitization ability as a clinician. Also need to have some foundation of parts and if people don't like parts language, no problem. Just change the language to aspect or this feeling Right. And I have a couple clients that hate the language of parts. It's like, you don't have to use the language of parts to do parts work. IFS, the reason I like IFS a little bit more than voice dialogue and ego state is just personal bias because I'm a Buddhist and it, to me it's very similar to like mindfulness Buddhist practice. Buddhist psychology.
Keith Sutton, Psy.D.: (49:29)
Yeah.
Karen Sprinkel Ancelet, LMFT: (49:29)
Because it's pretty much about Buddha nature. Like self, like self-energy is the same thing. Right. And it's very mindful and where ego structure and voice dialogue can be, but it's more based on bringing the client back to their ego. Rather than the sense that there's even something kind of beyond the ego. That we can tap into. So IFS the further you get in the training, it really, and since you're a systems thinker and family systems. Totally. Probably know already that, that IFS was founded on family systems.
Keith Sutton, Psy.D.: (50:05)
Yeah. No, Dick, we had him on the on the podcast and also we brought him out to do a conference for the association family therapist, Northern California. And yeah. So it's, it really helped me also, you know, sometimes I felt like the inner child stuff was a little woo woo, but like really doing the IFS and understanding that those younger parts and right. How they get triggered, the emotional flashbacks and really bringing that self in to be able to reparent to allow that younger part to be, to be a child and not have to take over those adult responsibilities really makes sense and makes sense to a lot of clients. And yeah. That was really helpful in my, my thinking.
Karen Sprinkel Ancelet, LMFT: (50:46)
Oh, I'm so glad and I'm so glad that Dick came and spoke to your team. That's amazing.
Keith Sutton, Psy.D.: (50:51)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (50:54)
So then, you know, so you know how brilliant it is and yet how simple it is, and that's why it's brilliant. Because it's actually quite simple, right. Just like somatic work can actually be quite simple and it's really about us going back to befriending ourselves and how we have this self-organizing system of parts. And just like in somatic work, we have a self-organizing body And IFS. It's like we have a self-organizing system of parts, let's just get them and balance.
Keith Sutton, Psy.D.: (51:23)
Yeah. Well, like I think with EMDR, it's oftentimes we're just creating the space for the mind to do the work that it knows what it needs to do. Maybe as a therapist we might use some cognitive interweaves to kind of help along a little bit, but it's really oftentimes the mind being able to... Right. Kind of do that work to put things together. So yeah. Similar with the IFS, like even just after the weekend training and I brought one of my couples in, he did a live demonstration and I began using, you know, just you know, just that little bit has been profound in the work that I've done with other clients and bringing IFS in and that IFS informed
Karen Sprinkel Ancelet, LMFT: (52:01)
Totally. Right. It's that, going back to that philosophical thing I talked about in the beginning, it's like once a client gets IFS, they're like, oh my God, I actually get to talk to myself and I can talk to this feeling as it comes up. It's like for some clients it's like mind blowing. It shifts their entire paradigm of how they've held themselves. You know, and I mean, for those of us already knew parts, it's maybe not as profound, but it's still effective. And so, for me with I-F-S-I-F-S level one, as you know, is really about the system of knowing your own internal parts. Once you get, if FS two and three, you start getting into the system within the system. Then when you get to level three or more, you're starting to get into larger systems. So we don't even see. Right. And like how can we relate to that? But it's so it can become quite spiritual. Right. And quite and quite profoundly deep. So that's why IFS works for all levels of client's, emotional intelligence or spiritual experiences. Right. Like you, you can introduce IFS to day one, first session of a newbie client who has never done any mental treatment or for someone that's been in treatment for 20 years. Right. And maybe they had a spiritual experience, they don't understand how to hold it. And then you use IFS with it and it's like, oh yeah, it doesn't have to take me over. I can just talk to the devil I saw in my psilocybin journey and ask the devil what it wanted and what is its role for me? Yeah.
Keith Sutton, Psy.D.: (53:43)
Yeah. How it's trying to help.
Karen Sprinkel Ancelet, LMFT: (53:45)
How's it trying to help me? Right. And if it's not trying to help me, oh, I get to choose to ask it to leave my system.
Keith Sutton, Psy.D.: (53:51)
Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (53:52)
Yeah.
Keith Sutton, Psy.D.: (53:52)
And I'm curious too about some of the top down work. I know like, you know, Janina Fisher talks about like kind of engaging the prefrontal cortex and she uses kind of parts and so on. Where I'm thinking about, you know, the Pete Walker's Complex PTSD, surviving to thriving, which sometimes just even recommending that book to a client becomes life changing. Just even knowing like, oh my gosh, like I didn't even know this was a thing. So yeah, I'm kind of curious about those pieces. because I think definitely the bottom up is imperative, you know, whether it's somatic, EMDR, IFS, like all this bottom up processing. How do, Is there a way that you think of the top down processing with trauma C-P-T-S-D?
Karen Sprinkel Ancelet, LMFT: (54:40)
Yes. Yes. First of all, I totally agree about Janina Fisher's model, and I love Pete Walker's book. I have all my clients read it. So I have like some must reads for my clients. So, Victor's, Man Search for Meanings, it's one of those must reads, you know, and then Pete Walker's is good if someone has never done trauma work before. Of course I have my own book too, if they're interested.
Keith Sutton, Psy.D.: (55:02)
Sure. Yeah. Yeah.
Karen Sprinkel Ancelet, LMFT: (55:05)
So prefrontal cortex engagement is obviously very important because we need to be able to have cognitive meaning of everything that's happened to us recognize our thoughts and how they impact us. In my book, about three quarters of the way through, I talk about something called the over competent override. And for me, that is the hallmark of what differentiates between surviving, like doing your trauma work, surviving, not letting it impact you anymore to actually thriving. And that takes a lot of actually prefrontal cortex work and, and, and self-inquiry into, okay, why have I become a therapist? Why did I invent this podcast in this center. Where I want all these clinicians to get the best and most effective training as possible. Who would I be in the world if I didn't do all that. And then how you answer that question would help me and you together have inquiry into, are you in an over competent override in your life, or are you thriving? Right. Because if someone's like, oh my God, I can't, I can't imagine not being a therapist. I would be devastated. It's like, oh, what? Why would you be devastated, do you think? Well, they say it just gives me meaning. I mean, who would I be if I wasn't a therapist? It's like yeah. So, and then that, that's getting into the spiritual and like ego.
Keith Sutton, Psy.D.: (56:44)
It's like the, yeah the ego that's built up on, you know, versus Buddhism, the idea of right, kind of being able to let go of that ego and being able to exist without.
Karen Sprinkel Ancelet, LMFT: (56:57)
Exactly. Yeah. And, and then that point, I actually might recommend a certain like, brain spotting approach or some psychedelics. because It's like, we need this individual to have that unity consciousness experience. Right. Or the higher self experience, whatever you want to call it. Where oh my God, guess what? They're probably not going to be remembered too much in a hundred years. Yeah. And they're remember too much for what therapy model they used. And can they be okay with that?
Keith Sutton, Psy.D.: (57:28)
I feel like I'd be geeking out on like accounting or something, or like just whatever it is be like, you know, wanting to learn more and understand. Just, yeah. It's just interesting. Very cool.
Karen Sprinkel Ancelet, LMFT: (57:43)
So you definitely have a growth mindset and I think, yes.
Keith Sutton, Psy.D.: (57:47)
Yeah. Yeah. Well, you know what? This has been amazing. Love the work that you're doing. Love the way you're thinking. Yeah. I'm always, you know, kind of thinking of like, yeah, how do we find kind of, what is the best, what is the, you know, somebody that's trying to get trained, like what are the elements, right. To get that overall training? Because each approach has its own limitations. And really, you know, being able to fill in those gaps with these different pieces I think is so important. Because yeah, if you're just stuck in, this is what I do and this is the best thing for it, it's, it's not the best thing for everybody. And, and needing to write different tools for different kind of scenarios, and especially with something such as complex as trauma that's one of the areas I think it's so, important. So thank you so much for taking the time. This is great. I really love the work you're doing. And I'll link your website and your book and yeah, it's, it's great to hear. Thank you.
Karen Sprinkel Ancelet, LMFT: (58:43)
Thank you, Keith. And again, truly thank you for being a human being in the world that has a growth mindset and wants to keep growing and learning no matter what. Even when you have kids at home. You have all these clients you want to keep growing and making sure other people grow.
Keith Sutton, Psy.D.: (58:58)
Yeah, definitely. Well, wonderful. Take care. Bye-Bye.
Keith Sutton, Psy.D.: (59:03)
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