Are you feeling stuck in unhealthy thought patterns? Have you forgotten what’s important in life? It’s time to reset and shift the way you see the world and yourself. In this episode, Dr. Sam Zand, Co-founder of Better U, delves into a nervous system reset and practical strategies on how to deal with stress and trauma. He explores the transformative benefits of therapy and doing a digital detox. He also talks about the interesting idea of the “view effect” and how it can be used as a cheat code to open up more consciousness and awareness. He also touches on using technology as a tool to enhance your wellbeing. Dr. Sam emphasizes the benefits and importance of getting back to our rhythms, clearing our minds, and purifying our hearts. This episode is filled with magical stories of community connection, and how life can get in the way of relationships. Tune in and explore the many ways you can rewire your mind and rediscover your inner rhythm.
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Rewire Your Mind And Reconnect With Your Inner Rhythm With Dr. Sam Zand
I’m sitting down with Dr. Sam Zand and looking forward to the many directions this conversation can go in. One thing that we started talking about that might not be super related to the main focus of this episode, but I think it can help get us there in some interesting ways. Sam and I were talking about social media and very lightly mentioned how when you don’t use social media or even a digital device a lot, you can feel a bit disconnected, but in a positive way. I was saving this question, Sam, for the interview because you said that you don’t have cell service and I’m curious, was that a conscious effort? Did that happen accidentally? What does that look like for you not having cell service?
It’s an interesting place to start. Let’s dive in. Thanks for having me. I’m a psychiatrist. I moved from my practice in Las Vegas to Puerto Rico in the jungle, where we have a wellness center. It’s a beautiful property on the river. Wake up, have a river plunge, meditation, breath work, yoga, bring people out here to do Ketamine, group and equine therapy. A lot of the reason we set it up here in Puerto Rico in the middle of the mountains is to disconnect to have that digital detox.
It wasn’t intentional that I don’t have cellular service, but it just so happens that we can’t capture any cell service in this property. We do have Starlink. They’re the area where guests can come and use their Wi-Fi, but the villas where they stay don’t have Wi-Fi or cellular service, which is honestly more of a luxury in this day and age.Not having cell service is a luxury. Click To Tweet
To be able to set up your arrangements at home, come out here and stay for 3, 5 or 7 days and choose when to let society interfere with your healing and your happiness rather than have that in your pocket at all times. It’s a magnificent reset. A lot of our guests intentionally lock up their cell phones and don’t even look at them for five days. Personally, before I even moved here, I used to go on a river trip every year whitewater rafting, where you camp for five nights and there is never any cell service. It’s truly a five-day detox. It’s probably the healthiest thing that I make sure to keep up with every year. It’s definitely intentional and, I think, nourishing for the soul to disconnect a little bit.
I can see the benefits of the five-day. For you, since you’re in immerse in the space with not having that much of a choice, as you put it, it sounds like it’s an ongoing thing. You happen to have access to the internet when you need it. In other words, what’s the difference between doing something temporarily for a five-day detox versus that’s your whole lifestyle and how long have you been doing this too? What has that been like over that period of time?
The option of having Wi-Fi almost takes away our peak sense of sometimes we have to get into the river. We have to get into the trees and escape the property a little bit, too, because there’s always that temptation to go and check the email. You start to realize it more than anything. You start to notice how impulsive that habit is to grab your phone, then have to pause and say, “I don’t have a cellphone. What am I even doing?” Unlearning that habit.
We’ve all become cyborgs and for better or worse, in mental health, we’re not talking enough about electronic hygiene. We’re not talking enough about how electronics can help you with your mental health. They can harm you and help the decline of distraction, dopamine desensitization and all these things that we’re aware of. It’s become part of who we are. Not having cell reception for parts of the day probably makes a lot of my colleagues upset because it’s hard to get in touch with me. It definitely helps with my own mental health.
First of all, I love the term electronic hygiene. I don’t think I’ve ever heard that before but that might be a new go-to for me. Thanks to you. I was telling you about haven’t used social media very much and am very light. I don’t have the apps on my phone anymore. That’s a big deal for me with my lifestyle, but that was like a gateway or a first step towards my overall electronic hygiene because that was the majority of what I was doing on my devices. When I stepped away from social media, I noticed the dopamine connection there.
I went through a feeling of withdrawal. I didn’t know what to do as much with my time and that pointed out how much it was taking up for me and it was a big wake-up call. Now I’m better able to be mindful of my phone usage or device in general because I don’t have that same reason that I used to have. I would say, “I’m going to check for messages. I’m going to go check to see how some post I put up is doing. I’m going to go on there for entertainment.” Once I took all that away, I noticed a few things.
One was that I felt less connected to my phone in a very positive way. Now it’s mostly to check more important things. I use my phone when I’m away from my computer to check emails, if there’s a text message or something coming through, or to do basic things like various apps. Even with the basic apps, I realized I was overusing, like checking the weather all the time like, “Do I need to check the weather multiple times a day?”
I like to look at finances like stocks, my savings or my how much high-yield savings account interest I get. I love looking at that stuff, but I don’t need it. Stepping away from social media made that need versus want more clear for me. Did you feel the same way given that these devices don’t have as much power or purpose without the internet connection?
I remember when I was young and I had my Game Boy and all these electronics that would still take our attention. Now we’ve evolved much past that if it doesn’t have strong bandwidth Wi-Fi. If we can’t watch our 4K videos, then it’s not worth anything. What happened for me when I stepped away from constant interaction with the phone is I started to notice those phases of my life when I was most stressed.
I was most impulsively on my phone. whether you’re as justified, I’m checking my work emails or I’m doing something cerebral like playing chess, you end up realizing how detrimental those habits can be when you’re in the car and you can’t even get off your phone and it’s like, “Let me play chess while I’m driving.” That’s a very destructive habit. You’re not paying attention enough to the game or to the road and that transforms the way that you think in general. An inability to focus and concentrate and a desire to kind of always let the mind be busy doing something takes us away from that ability to be meditative, reflective, observant and present. I think we’ve all been there.
You mentioned the weather app and the stocks. Everyone has their thing. I think if we can separate that time and allocate a little bit of time in the day for that rather than making it the impulsive habit that controls us, start to notice that there are things that were much more present too being outside and enjoying the actual weather rather than looking at it on an app.
Something else that you’re pointing about your experience is when you’re in a community and they’re on equal terrain in the sense of not having a cellular connection. That makes it a lot easier when you don’t have a choice to do something or you’re with other people choosing not to do something. When you pointed out the distraction of how I can monitor myself pretty well, but when I’m around other people and I see them on a device, it makes it very tempting to get on a device, too or it makes you feel a little bit isolated. Especially if you’re with one person and they’re on a device, the connection is dropped. I know you spend so much time talking and supporting people with their relationships. I’m curious if you’ve noticed how relationships can improve when we are more connected and not reliant or distracted by devices.
There’s a great story I could tell. I’ve been here in Puerto Rico, helping some of the locals. A big thing about what happens here on the island is the power grid and the hurricanes. People go through devastating times with no running water and no electricity. When Hurricane Maria happened in 2018, they went nine months without electricity. That’s nine months without your cell phone, Wi-Fi and email.
While I’ve heard many devastating stories about how difficult that time was, I’ve also heard some pretty magical stories about how everyone in the community started to appreciate being together again and not being on their electronics. Think about the five-day detox for me. Is this transformative? How about a nine-month detox? All of a sudden, I was talking to a young adult who said they were all leaving each other’s notes in each other’s mailboxes and telling each other, “Let’s meet at 5:00 PM at so-and-so’s house.” Everyone would get a note in their mailbox.
Gatherings were more connected. They were camping on each other’s housetops on their roofs. Enjoying time and nature. Enjoying time cooking with a fire source rather than an electricity source. All of that, in some way, is healing. Not to say we all need to move to the campground and get rid of our electronics, but to balance that appropriately to have that time.
I work with a lot of couples who talk about one of the major stressors in their life. It’s not intentional, but it’s that they’re busy. Life gets in the way, work, family, pressures, kids, but how much of that busyness is manufactured by us because we’re giving access and we think we have to respond to everything right away in a society where we’ve lost our sovereignty, freedom and our ability to be there for ourselves because the whole world has access to us.We've lost our ability to be there for ourselves because the whole world has access to us. Click To Tweet
Many years ago, mental health issues were much less about not having my own me time because we had that. Now you can’t go a few minutes without somebody trying to get your attention. Whether it’s a text, email, an advertisement, a notification or an iPhone software upgrade, which is something there for you waiting to grab your attention. Our attention is one of the most precious commodities that we have that we overlook. We’re seeing it now. Attention is monetized because of this phase that we’re in society. If people can understand how valuable their attention is and how they’re giving it away to anybody, we can start to manipulate the energy that we bring into our lives to the places that need more attention and live more fulfilled lives.
That attention side of things is a huge reason why I decided to pause my relationship with social media indefinitely because it started to feel concerning. I feel like it’s growing. It’s becoming a bit out of hand as much as there are benefits to using social media. Even the term social media doesn’t feel like quite the right term anymore because it’s not social in the way I want it to be social.
We used to say social network and it was a network of people we could be connected to, have conversations with and support each other with. That’s what I want. It’s become harder and harder to feel connected to people because of social media. Even taking that time away, I don’t know what’s going on in people’s lives as much as I used to. That sometimes feels a little odd to me.
I don’t know some of the things that are happening in the world anymore because I’m not as connected to them. I’m not gathering as much information. That could be with personal relationships too. I had to hear from my mother on the phone that my cousin is pregnant. She probably announced that on social media, but I didn’t see it.
However, it goes back to what you were saying instead. It’s like the old school way of hearing things where my mother told me something because she probably heard it from someone. I prefer that. That feels more connected. I would rather get a more direct message from somebody. I would rather get that message in my mailbox and get invited over because the convenience of social media is also an issue for me. It’s become convenient. I feel like it’s impacted our connection with one another. Do you feel that too?
Absolutely. In social media, the one saving grace as we get to connect with many people in such a quick way is when we share our albums and we’re caught up with family members. It’s similar avenues in the past where you send someone a postcard and send mass postcards. We did these things in society. Now we are able to do it a much quicker and much higher resolution.Social media is like sending mass postcards. Click To Tweet
The downside where connection is still positive is that we’re using it passively and not understanding that it is largely weaponized in many ways. Not always negatively, but as an advertising or marketing tool, sometimes politically and sometimes fear-mongering. There are comparisons, facades and trying to boast and brag about how amazing our vacation is or how delicious our meals look. We’re living this multidimensional life in a 2D world now.
With all of that, not to mention the instant gratification and the pleasure addiction pathway, pornography, fear tactics and all the things that come up that are there to grab our attention and keep it, we are losing connection. We are losing the ability to tell stories to catch up with each other and learn perspectives rather than hop on a message board.
Sometimes what ends up happening with those message boards is you hyper-focus on a community where maybe there are only 30 people in the world that agree with this extreme thought that you have and now you’ve found your validation in a way where normally society shapes people because you get to mix with many different opinions, cultures and perspectives. You talk to your colleagues at the water cooler and now we don’t. We sit here on video.
We get together at the family function or have different opinions. Now we get to go and either troll the opinions we don’t like or align with opinions we like. There’s not a lot of diversity in thought. It’s polarizing more so. It’s not like it’s bad. Technology’s not bad. The application of it is what we have to be careful of.
It is on all of us to safeguard that. We have a lot of programming within our practice, where one of the first things we do is go over electronic hygiene. We go over notifications on the phone and blue light sleep hygiene patterns. What are we doing with our electronics right when we wake up and right when we go to bed? Are we putting it away, plugging it into the bathroom instead of on the nightstand? These are the things that are important.
Also, using the tools because every technology has excellent an application as well. Can we organize our lives? Can we set reminders to tell the people we care about how much we love them? Can we learn things? Can we be creative? Can we focus on self-care and self-love through our devices? That’s what we’re doing with our app and our programs. When people dive into the app, they get to see modules and work on their breathwork. Instead of waking up to a world full of stressors, they wake up to a nice meditation. Those are the things that technology can be used to our advantage as well.
That sounds nice. I want to live in that world. It’s a lot of work, sadly. Something that I think also breaks my heart about the state of things is we’re often told that technology is going to solve our problems, but it seems that it gets added a lot of problems. I’m curious if that’s come up in your work too.
The fact that you had to add an electronic hygiene element to your work in itself is saying A) That’s often the starting point. We have to get over that obstacle, hurdle or move through something to start, perhaps a place where we used to start from or to get to the point where we used to start from. I’m curious about your work with psychiatry and the whole mental health scope of your work. Have you noticed a big shift in recent times that now you have something brand new that you have to handle with clients that you didn’t have to deal with?
In my young career, we’ve all started learning through this space where social media is within the forefront and our smartphones. We’ve become cyborgs. What time in human history? It’s a special time that we’re in. We can connect with anybody in the world. We have omnipotent knowledge at our fingertips. We zoom out and look at that societally. I don’t think it’s good or bad, right or wrong. It just is.
It’s our evolution as a human species. What is that going to look like in 20 to 40 years? It is even more interesting when we do achieve this singularity technology is not just in our hands but part of who we are. If you look back to earlier forms of technology and how that has shifted society, we had to learn from them. When the TV came out, it was cool. It was a special thing that happened and then all of a sudden, we realized, “We have these couch potatoes.” We sit around and watch TV all day. We all do it, but how many couch potatoes do we even have left?
Most people are now on their phones and you see the curvature of the cervical spine shifting down as a society as well. There are these multifaceted evolutionary patterns that are happening that we need to be present. As a psychiatrist, it’s my role to talk about these things that are affecting all of us. It’s one of the perks of the work is I get to see societally what’s impacting us all because seeing 20 or 30 people a day allows you to dive in and say, “What is going on on a humanistic level, not just on an individual level?”
Now you look back at the TV and it’s almost like the TV’s there to bring the family back together like, “Let’s all sit down and watch a program together rather than be in our rooms on our phones and computers.” You see these shifts in technology. It’s not the technology that’s bad, but how do we get ahead of safeguarding it, making sure that we’re not falling into the damaging part of this evolution?
I appreciate the way you’re phrasing that and the neutrality that you’re approaching it from is important. That’s something I’m trying to lean more on is, I feel like a lot of us want to be prescribed something. We want to be told if something’s good or bad for us, right or wrong for us, that black-and-white thinking versus maybe the gray area and maybe finding the balance between something that’s helpful or hurtful. Changing our perspectives can also be a big shift.
You mentioned how we have much knowledge at our fingertips. I’m curious how that impacts you because many of us can Google our symptoms and self-diagnose ourselves. Sometimes that’s helpful, sometimes maybe not. What has your experience been like working with people that probably have already done a ton of research on their own before they meet you? Does that hinder your ability to support them?
The Google age of everyone, everyone becoming their own WebMD, it’s a beautiful thing. This knowledge isn’t protected knowledge that only doctors should have. Everybody should educate themselves about their health and ultimately, my role as a physician is to educate and power and guide someone towards making their own healthiest decision. Whatever they’ve googled, let’s talk about it because clearly, you’ve put in some work.Everyone should learn about their health and a doctor’s role is to educate and guide someone to the best possible decision for their health. Click To Tweet
I think that’s a positive thing to be able to say, “I read a little bit of research. I come to you because you’re the professional. Can you help me piece this all together?” The key component is that whatever you read online, it’s not about you. It’s giant statistical numbers about large populations and you are a unique individual has evolved like a snowflake that is unique toward every other one falling in the sky.
We have to now look at ourselves and understand rather than trying to put people in a box and say, “Let me pull up the DSM. You suffer from a major deb aggressive disorder.” No, that’s not the way that we practice. We try to look at everybody through the bio-psychosocial spiritual model and understand what are the physical factors that are contributing. What are some of the mental, psychological factors? What are some of the environmental things that are happening externally that are affecting you mentally and emotionally?
Also, exploring our spiritual health and understanding our system of beliefs and how we align with these mysteries, wonders and odds of the universe. How do we relate our own beliefs in the way that we think about those things? None of that can be googled. You’ve got to piece it all together. I enjoy my work far less. I’m looking at diagnoses and giving people medications far more. It’s almost like an artistic exploration of why we are the way we are, this chemical soup that we present and have these behaviors, thoughts and feelings. Why is that so? You can’t Google that yet. Maybe one day. ChatGPT, “Why am I the way I am?” They’ll give you the answer.
I love that you integrated ChatGPT because that’s where my mind went too. AI is fascinating. AI is also a great part of this conversation because it shows the limitations that machine learning has and maybe it will become more sophisticated. That could be a great tool because you can get answers very quickly. Your role of being able to help each individual find what works for them is key. Many people start with this one size fits all way of approaching life.
From my perspective of the wellness space, especially in the content world, I started to notice how cookie-cutter the advice was. It was like, “Do this and you’ll get that.” It was this formulaic approach to well-being. I discovered through my personal experience most of that advice did not work for me then I ended up feeling like, “Something was wrong with me. I was failing. I wasn’t doing it right because why was it working for others but not me?” Someone like you is refreshing because I need a more customized approach, not just what is happening for everybody else. I started to wonder how many people are served by cookie-cutter advice in one size fits all approaches. Is that working for some people or most people?
We are learning about psychiatry and sometimes, when I introduce myself as a psychiatrist, I have to gauge someone’s reaction because I get this sideways look like, “You’re one of those people who are over-prescribing populations and getting everybody hooked on controlled substances.” I get it. I get why people have this feeling that we’re over-diagnosing and over-prescribing because that was the prominent tool that we used for the last many years in an industry that’s super young. 50 to 70 years might sound like a long time, but in medicine, that’s a very young industry. Cardiology has been around for hundreds of years. Psychiatry, more the serotonin hypothesis and all of these things that we’ve based our care on weren’t as factual and correct as we thought.
We knew they were built on hypotheses and on trying to guess why things are happening because we don’t have a full scientific understanding of the brain, let alone what governs our emotional habits. In psychiatry, I always say the etymology Psyche comes from the Latin word meaning mind, the Greek word meaning soul. Iatry is the healer. In many ways, I consider our profession to be healers of the soul.
You can’t take an MRI or an X-ray of the soul. You can’t take a blood test and figure out, “There are some dopamine deficits here. Let’s add this medication.” We’re getting away from what psychiatry used to be. Not to make it bad. That’s something I struggled with early in my career. You gave me a beautiful compliment, that I try to look at things from a neutral perspective. That wasn’t always the case. I was a rebellious resident when I was doing my Psychiatry training. I almost got kicked out of my program a few times because I’ve been fathomed that this is how we’re showing up for society.
We’re locking people in psych wards and getting them out when they tell us, “I no longer want to kill myself.” Those things were very jading for a young physician to see. Luckily, I was able to refine my approach and instead of looking down upon the industry of Psychiatry, I looked forward to the growth and evolution and started to ride the current for where I was going.
Where starting to see hopefully more and more that it’s less of what the standard of care of medicine is. It is a disease-state model. Meaning you have to come in and get diagnosed with a disease than get help. If you’re not sick, I can’t help you. Your insurance won’t pay for it. What do I do? It’s this is a disorder treatment algorithm that we work from.
What psychedelic medicine has taught us is that we can look at everybody through the lens of enhancing self-exploration, enhancing self-awareness and learning more about ourselves. In doing so, we are highlighting the areas of our life that need more attention, care, nourishment and perhaps need more balance and harmony. We get away from the all-or-nothing thinking, putting people in a box and assigning labels. We open up this blank canvas of getting to know ourselves and our association with the universe. Professional guidance and mind-expansive medicine sometimes help to be able to get out of our own way and open up new possibilities.
I feel very grateful and in awe of the work that you’re doing and also quite ignorant. I don’t have a lot of personal experience with psychedelics. I’ve only tried one, which was mushrooms, many years ago. I guess I haven’t felt that drawn to them in general. I’m not very drawn to substances like drugs and alcohol. They don’t have that much appeal to me.
I’ve thought of that as mostly a positive, but then part of me is thinking maybe, “It’s a little bit of a limitation because since I haven’t felt very interested in it, I haven’t explored a lot.”I’m very curious about psychedelics, but not enough to pursue them. I want to learn more about Ketamine, which is something I know you specialize in. I don’t know much about it at all. Can we start at the basics of what Ketamine is? How do you use it? What do you use it for? What are the benefits?
First, I commend you for not being like most of human history. We’ve always had some kind of substance societally, whether it was the advent of caffeine through coffee and tea of different cultures or the advent of alcohol thousands of years ago. There have always been some substances. What’s interesting is that psychedelics have been there since the age of the dawn of man as well.
We’ve seen it in most mental health historical studies. Usually, a shaman or a healer is using some kind of psychedelic substance, usually plant-based, that helps not only the person or the subject to open up their mind, but in fact, the history of psychedelic medicine, the shaman would take the psychedelic that their mind would open up and they can understand their subject better and be able to guide them and heal them in a more profound and more spiritually aligned way.
What’s fascinating about all that is that’s ancient cultural medicine, then there was Eastern medicine that had similar approaches then. We have western medicine, which is only a hundred years old. Rockefeller and Freudian ways have defined our mental health strategies and approach. Rockefeller was the advent of Psychopharmacology saying, “We need medications that are regulated, then Freud came around and said, “We need more psychoanalysis.”
Those two things came together and now we have modern psychiatry. In the ‘60s and ‘70s, Ketamine was invented as a molecule for operative anesthesia and it’s a derivative of PCP, which can sound scary. If you think about PCP in the ‘50s, we use it for operations for anesthesia and sedation because it disconnects your body from your mind. Unfortunately, you have to tie the person down because they also get aggressive.
That wasn’t working in the ‘50s. In the ‘60s, they invented a derivative called Ketamine that had the same disconnect between body and mind without aggression. This was used in the battlefields. From 1955 to 1975, we had the Vietnam War. Interestingly enough, the doctors who were using Ketamine on the soldiers observed that afterward, those soldiers had less of a PTSD or stress response compared to others who had not used Ketamine.
In the ‘60s and ‘70s, psychiatrists were all over Ketamine and, amongst other substances, LSDs creation and in the 1900s, psilocybin being natural and accessible. Carl Jung, one of our founding forefathers of modern mental health had a lot of psychedelic trips. If you ever read The Red Book, I’m not even sure he was sober for any of those writings.
We’ve seen this in history, but what’s fascinating and what your readers may have heard now in society is that it’s coming back. Psychedelic medicine has become mainstream in many ways. It all started in 2019 with a medication called Spravato. This is a derivative of Ketamine called esketamine. It’s a nasal spray indicated for a major depressive disorder that’s treatment-resistant. For anybody who’s tried and failed antidepressants, they get to try the nasal spray form of Ketamine. Insurance covered it.
I can remember back in 2018. I was seeing a patient. He came to me and said, “I left my psychiatrist.” I said, “Why?” He said, “He kept trying to gimme Ketamine.” I thought, “Who is this person? Should we report it?” I didn’t know anything about Ketamine at the time because it wasn’t until 2019 it got FDA approved in that formulation.
When I learned that and started to use it in our offices, it was a night and day difference for a few reasons. One is we were all used to the medication model of, “Take this pill every single day, and that’s it. Forget about your problems. Things are going to get better. I’ll see you in a month. Tell me how it goes.” Thirty percent of those who took that pill usually felt a little better, 30% felt worse and 30% were in the middle.
That’s generally that 1/3 rule that we’ve seen that even over time with traditional psychotropics, we see like antidepressants have a burnout. Usually, 30% of people that have improved drops to about 10% after a year. This is sad and unfortunate. For psychiatrists like myself, for people to come in and put their hope in wanting to feel better to go home with a medication with 1 in 10 chance of them feeling better.
If I was a primary care doc and you came in for high blood pressure and I gave you a medication that gave you a 1 in 10 chance of your blood pressure lowering, you’d probably be upset with me. I understand all of the animosity towards these psychiatric methods. With psychedelic medicine and namely Ketamine, we have this new model that has introduced us to something fascinating about the brain.
Do you remember the old anecdote, “Don’t kill a brain cell. They don’t grow back?” Does that sound familiar? We used to say that all the time. If you fall on your head, “You killed some brain cells and they’re not going to grow back.” This is what we thought about the brain. This was common talk and knowledge. Many years ago, we realized this is not true. The brain, like the rest of our body, regenerates and can create new neurons and new pathways.
Why this is important, is because psychedelic medicine taught us that when you take something like Ketamine or Psilocybin and you look at a functional MRI, all of a sudden, the brain lights up and you’re growing new neural pathways. What happens there is you get to deviate from your normal rigid beliefs of life and you get to see things from a new perspective. Rather than taking medication every single day to change the chemicals in the brain, this treatment is done once or twice a week. It’s experiential. It’s something you go through and you get to see your life almost from a more objective perspective.
It’s quite meditative at a low dose. At high doses, it can become a little pseudo-psychedelic and weird. However, the guidance that we provide to go into the session with preparation, breathwork and relaxation and to come out of the session with some kind of therapeutic journaling, guidance or conversation has been a night and day change for the way people deal with the stressors in their life, traumas in their past and with the relationships in their life. This is why I’m excited about this modality and it has become the vast kind of majority of the attention I’m putting into this space.
You have me very intrigued and excited. I’m like, “I want to try this right now,” but there’s then the question mark. Let’s say I’m interested. I can vouch for that and maybe the readers are feeling that way too, feeling curious then. Where do you start? At a point where only certain medical professionals like yourself are specializing in offering this or is it widely available? What’s the accessibility for the average person right now? That’s going to depend on where you live, I imagine. where are the barriers and how does someone navigate that?
It’s such an important question. I studied Public Health and Epidemiology at Johns Hopkins. A big part of my practice is not only just helping people in maybe my community or in an affluent population but being able to help everybody. One of the pillars of our practice is to say, “Whatever we’re doing as far as care, we can’t disclude anyone.” When Spravato came out, it was something that was pretty cool because your insurance covers it.
You have to qualify, though, meaning you have to have tried and failed antidepressants. I get a lot of people to come to me and say, “I don’t want to try antidepressants. Can you please try something else with me?” They wouldn’t qualify for that. Their insurance would say, “No, we’re not going to pay for this $2,000 medication until you try some of these cheaper ones first, unfortunately.”
If your insurance doesn’t cover it, you’re out of pocket and become expensive and inaccessible. With that, I started to think about, “How can we bring this Ketamine therapy modality in this healing to a much greater population?” Through COVID, there was an exemption where you didn’t have to meet your patient in person to be able to write them a controlled substance. If it was for their mental health, transportation issues and they can’t get to the office, all these things that were happening in COVID opened up more access.
We created a company called Better U. We specialize in the at-home Ketamine therapy model, where you check in with your psychiatric provider online. You have all your questions answered and a medical and psychiatric review done to make sure you’re a good candidate because there are people who are not good candidates for this treatment.
We do all of that screening. We touch base with your primary care physician if we need to. From there, there’s a whole team of people to hold your hand and guide you. If you’re new to this modality, you work with an integration guide who checks in with you and makes sure that your space is prepared. There’s a common cliché called Set And Setting when you’re getting into this type of work where you have to have the right mindset going into it and you have to have the right environment, the right setting to be able to feel safe and go through the healing, growth and the whole journey ahead. We have an integration guide that preps all of that. We have the member portal. They can log into the app and learn how to start the work before they do their first treatment.
The medication comes in the mail with a blood pressure monitor, a meditation mask and headphones. It’s a very intentionally guided process, then you have your peer support, someone in your family in your house, a roommate, a friend, a loved one who can hold space and sit with you and they go through our training to understand how they can be there for you. You do your treatment.
It’s oral absorption. Take a lozenge. It’s like a little candy, hold it in your mouth for about 15 to 20 minutes and then afterward, it absorbs through the mucosal membranes. You could spit it right out. You have your eye mask and headphones and go on this peaceful meditative journey. It lasts about 30 to 45 minutes or maybe 1 hour. Afterward, you come back. What many people relate is they feel this nervous system reset.
They feel refreshed and relaxed. You can see it on their face. It almost looks like the tension has melted off, then. As we gain more and more experience, once or twice a week for 1, 2, 3 months, you start to do some of the programmings before and after the treatments. You start to rewire the unhealthy thought patterns we all hold, the unhealthy behavioral and emotional patterns you start to imprint and cement those new neural pathways through journaling, talk therapy, and self-reflection. That starts to become the new you.
This is the journey if anybody’s interested. It’s as simple as finding a practitioner like myself or a company like ours who is bringing this work to a very accessible place. Prior to that, there are infusion clinics and IV clinics where you come in. You either get an injection of Ketamine or put it in the vein. These are expensive. When they started many years ago, sometimes, it was $1,500 a treatment. Now I see them maybe about $750 a treatment. We offer them for about $500 based in different markets for people who still want to come into the office.
Our home treatments have dropped to about $100 to $120 per session. Whilst that still rules out some people, I get it that not everybody can still afford $100 a session. It’s much cheaper than the $500, $750 or $2,000 that it used to be. We’re finding ways more and more to be there for others and start a foundation so that people can apply for a scholarship if they can’t afford the care. That is the goal. As long as you don’t have uncontrolled cardiovascular risks like high blood pressure, or uncontrolled seizures, you’re not psychotic or acutely manic, those are the things that we look out for pregnant, planning or breastfeeding. There are some things that we have to be careful about.
For 70% to 80% of the population and they’re healthy enough to give us a try, they don’t have to be sick. There doesn’t have to be anything wrong with you. I don’t think there’s anything wrong with any of us. You don’t have to be diagnosed with some kind of disorder. Come in as long as we can find some appropriate diagnosis, like some form of anxiety or depression, that’s the standard of care for PTSD, then we can say, “Let’s see what else this opens up for your life.” Instead of focusing on what’s wrong with you, we start to focus on what’s right with you.
You’ve sold me. Sign me up. This sounds cool. I love the way you outlined it. You answered every possible question, including your transparency with the cost, which I think is top of mind for a lot of people. You mentioned there’s that access point of someone feeling like they can’t afford it, but it reminds me of other therapeutic things that I might spend money on, like a massage.
My favorite massage practitioner or bodyworker is about $150 per session. It’s therapeutic. It’s something that’s giving me physical relief and maybe working on some of the emotional release as well. It’s in the context of something like that, a pretty affordable treatment, you can approach that as, “What am I spending money on right now? Where’s my money going? What are my priorities? What do I need to work on?”
I love that you offer the scholarship. That’s heartwarming and important because, for some people, that is a ton of money and not something that they can spend at all. It might not be a matter of when. It’s just not available. I would love to know about the Puerto Rican experience because this sounds like this is reaching a broader part of the population. What about people that want to come to do a multi-day experience with you? Tell me what that looks like.
There are a lot of different levels of care and while I think that the at-home model and the cocoon and comfort of your own home is always a fantastic way to start this work, it’s a very gentle introduction to psychedelic therapy. Sometimes there’s a greater benefit when we get to leave our daily routines and habits, be somewhere beautiful and peaceful, submerge in nature and reconnect in almost a spiritual way as well. Doing the work myself very candly, I talk about, I’ve gone through some anxious spells and Ketamine’s helped me reset and remind me what’s important in my life.
In this line of work, there are many legal hurdles and different work conflicts, situations and sometimes, that gets the priority that gets my mind shared and I get anxious right when I do the work myself, especially in a beautiful place where I can step away from those work stressors and those habitual patterns that are stressful and overwhelming at times.
It allows you to prioritize what’s important. For me, anytime I’m stressed out, it brings to the surface that all I need to be fulfilled is to be able to give back and help others to focus on that love, compassion and empathy. These tend to be these humanistic things that come up when we leave our society, electronics and our daily work. We end up at the side of the river after a psychedelic, immersive experience.
There’s nothing left but understanding how beautiful and amazing the world is and how connected everything is. In some ways, there’s a similar analogy, “You don’t have to go to a jungle retreat. You can just go on vacation. Get away for the weekend and all of a sudden, you feel refreshed, reset and renewed. You can probably go camping a few miles away from your home, find a nice campground, and be out of that daily grind.”
There is a much more grandiose version of this that’s coined the overview effect for astronauts who leave the Earth. They say when they go into outer space and look back down on the Earth, there is this spiritual feeling that overcomes them, that shows them from a zoomed-out lens what humanity is, what ecosystem we live in, and how it’s all connected.
It’s something that astronauts describe as once in a lifetime and experience that’s shifted the way they saw life, the world and themselves. This can be done with the power of medication. It’s interesting. People who have a lot of advanced work in meditation and transcendental breathwork. You’re achieving this very observant-like state of mind.
A lot of them come to me and say, “This feels like a cheat code. It feels like everything I’ve been practicing to become a very good meditator, all I had to do is try a low-dose Ketamine session. My answer is, “If it’s available and it’s the benefits outweigh the risks,” we should all try to find that way of meditatively looking at our lives from a new perspective. We can enhance that by being submerged in nature. It advances the ability to come back to our lives and interact with those same stressors in a much healthier way.
Having that guidance and structure is a big key. As soon as you said vacation, I thought, “I feel like the average person goes on vacation and it’s hard to disconnect or it’s attempting to jam-pack your vacation with things to do.” I think about this each weekend. I’ve tried to set a boundary of no work for myself and also realized I want to rest on the weekend. I don’t want a jam packet full of personal things.
I’ve done that a few times and thought, “The weekend’s already over. I didn’t really rest. Now I’m jumping back into my intensive week. Where did that time go?” Sometimes, I truly need to disconnect, which is challenging without boundaries or guidance. Since you mentioned camping, there’s a little bit of a difference there because I got into camping many years ago and it’s a whole different experience than what I would usually consider a vacation.
Vacations to me would be like going somewhere to someone’s house or a hotel, but camping, it’s hard to feel distracted. I guess all camping is in nature and there are often boundaries there. Most campsites have quiet hours. You have to be quiet after 10:00 PM. You might not have as much access to light. You get to experience your sleep rhythm in a different sense because you’re not sitting in front of a computer.
Ideally, you probably after sunset wondering, “There’s nothing else to do except look at the stars and then go to sleep.” That has had a huge impact on me. I’m glad that you threw that in there. How wonderful the experience you’re creating sounds, the closest I’ve ever had to that was going on a retreat in Costa Rica, in the jungle and right by the ocean.
We had the therapeutic impact of being either next to or in the ocean bead in the jungle and all the different sounds. Yet with that, there was still Wi-Fi in Costa Rica. I think that might have been part of my data plan for my cell phone companies. I was still able to use everything like normal and even though there were benefits, it was hard to disconnect. Your experience sounds a little bit more powerful in that sense of when you’re forced to disconnect, maybe it’s easier to get the benefits of it.
Unfortunately, not everybody has that luxury. We have kids, work and things that we have to constantly check for. Many of us think that we can’t turn our phones off for 1 hour, let alone 1 day. It only takes a category 5 hurricane to come through and take out electricity for 9 months for people to remember how special it is to not have that electricity and go back to the most beautiful show in the world is, looking at the sky at night and telling stories over a fire. The thing that stood out from what you said was getting back to our rhythms. We have many rhythms that are important to us. Look at life the way that the sun patterns are days and the moan patterns are waves.The most beautiful show in the world is looking at the sky at night. Click To Tweet
All of these are rhythms that happen in nature, the seasons and we’ve gone away from humanistic rhythms that are important. The biggest one is our circadian rhythm. Falling asleep when the sun goes down and waking up with the sun. It’s not realistic to most people. Being out here in the jungle is not much to do when the sun goes down. You get back to that circadian rhythm. You get back to the social rhythms of gathering for meals and hikes together.
You get back to spiritual rhythms where spirituality is a big part of our medicine, but we don’t talk about religion or preach anything. It’s to hold space for everybody’s own private, intimate exploration and to be able to tell a non-denominational prayer together. A lot of society has lost that ability to align with speaking out to the world and gratitude and being able to clear our minds and purify our hearts by holding hands and sharing a beautiful mantra out loud that allows us to get back into those rhythms.
When it comes to mental health, we’re getting away from the serotonin hypothesis and from, “Take this pill. It’s going to fix everything.” We understand it’s the habitual things that happen every day and start with our core, who we are and why we are. That’s the work that you don’t need to go to a jungle retreat. You don’t need to hop in a spaceship and look at Earth from miles away. You can have a deep meditation. If you’re not a good meditator, you can have a low-dose Ketamine session and get that same reset, get that same ability to disconnect from those patterns that are holding you down a little bit that are clouding your vision and start to create the rhythms for yourself.
I couldn’t think of a better way to end our conversation than that note because it summarizes everything that you’re passionate about you shared and leaves us on a note of, “Here are our options. Which one is going to work best for you?” That’s why I feel like your approach to care is figuring out, “What do we have and which one we’re going to start with? Which one is going to give us the results that we want?”
I think many people want to feel reconnected, re-grounded and re-rhythmed. Maybe re-rhythmed is a new way of looking at it, getting back into those rhythms that are more innate to us and less external. That’s certainly what I’m after. We started this conversation off with easy to get disconnected from ourselves because of all this external noise. I love technology, and I’m grateful for it, but I’ve started to set those boundaries because I want to get focused within so then I can use technology in a way that aligns with me and not the other way around where technology is dictating everything I’m feeling on the inside.
Meditation is such a beautiful tool for us, and it sounds like Ketamine can be powerful. Spending time in nature as well is one of the greatest healers. You’ve covered it all. I feel the impact of speaking with you and I hope the listener has had a similar experience listening. You have a comforting, peaceful, and neutral way of approaching life that opens up many doors and helps us find the path that’s going to work for us as individuals. Thank you much for what you’ve shared here and the work that you do in your day-to-day life.
I love what I do. I feel like it’s such a privilege. I was given a lot of love in my life and attention. When we do trauma counseling and help people heal, a lot of that work brings up inner traumas and things of ourselves. A lot of us need to go through our own work, but I was privileged growing up that all the love I was given, I feel like it’s my responsibility to keep sharing that if we can lead with love, empathy, and compassion if we can use that as medicine to be loving to each other when you go see your doctor and feel that compassion, that’s the care that I think we all need. Often in medicine especially, you feel like you’re being hearted around through the system.
Being able to connect with someone who’s holding space for you so that ultimately you can alt space for yourself and increase that self-awareness and increase that self-love. I always say our relationship with the world begins with our relationship with ourselves. That’s the work. I would encourage anybody thinking about maybe venturing into this kind of mental health journey, whether through journaling, meditation and self-care.
Whether it’s through seeing a professional, a therapist, a psychiatric provider or dabbling into psychedelic medicine, whatever that path is, we like to meet everyone where they are and safely guide them to more education so they can make that decision and find that fulfillment that they’re looking for. Thank you for having me on and being able to talk about these things. It’s important for us to be able to connect and understand what’s important. Remind ourselves that time away from our stressors and our electronics and all the worries that are manufactured can allow us to build that time together with ourselves and the people we love in our universe that is how we help people get better.
Do you offer consultations as a starting point for someone trying to figure out what path they might want to take with you?
If anybody wants to reach out and have a free consultation with one of our care concierges, it would be educational, not clinical to learn, ask questions, and then you can go ahead and sign up to see a clinician, whether it’s the psychedelic therapy journey through the at-home Ketamine program with Better U or it’s general outpatient mental health, bread and butter, working on our emotional and mental health. Our company Anywhere Clinic can help with any of those needs, whether it’s therapy, med management, or holistic strategies. If anybody wants to make the journey out to Puerto Rico, we have our Metamorphosis Resort where we can come and do the deep, immersive work.
Thanks for this wonderful conversation. I’m grateful for your time.
It’s been a pleasure. Thank you so much.
- Dr. Sam Zand
- The Red Book
About Dr. Sam Zand
As a practicing psychiatrist and the Chief Medical Officer of Better U, Dr. Sam Zand utilizes his expertise in neuroplasticity to help patients address the root cause of their problems and establish new ways of thinking. After initial psychedelic medicine research at Johns Hopkins University, Dr. Zand began treating patients clinically with ketamine in 2019. He now teaches psychedelic medicine rotations to psychiatry residents and medical students and is an advocate and spokesperson for the FDA-approved esketamine, Spravato. He is trained in general psychiatry, addiction recovery, and psychotherapy, and has a passion for psychedelic therapy, crisis intervention, relationship counseling, and integrated spiritual therapy.
In addition to being a co-founder of Better U, Dr. Zand is also the owner and CEO of a national telepsychiatry service, Anywhere Clinic. He has merged his passions for lifestyle medicine, performance coaching, and entrepreneurship to establish platforms that build leaders and medical healers. He assisted in Crisis Intervention Training for the Las Vegas Metropolitan Police Department, helped create mental skills departments for professional sports teams and corporations, and has worked with industry leaders, corporate executives, and pro athletes. Dr. Zand is passionate about increasing education to end the stigma that surrounds mental health topics, advancing the integration of psychiatry and spirituality, and making clinically proven, innovative new therapies more accessible for all.
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