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Integrative Psychiatry

Microbiome and Social Equity Part 1 of 2

By February 2, 2024No Comments

The Microscopic Universe Within All of Us

The human body is a complex ecosystem teeming with trillions of microorganisms that make the microbiome. Emerging research provides more and more evidence for the important health implications of eubiosis, or microbial balance, across different body niches like skin, lung, oral, and gut microbiomes. We now know that these microbiomes, valuable players on their own, work in parallel to influence multiple body systems and brain functioning. Scientists are beginning to uncover the intricate relationship between the gut microbiome and social determinants, revealing how these microscopic inhabitants mediate the impact of the social environment on biological underpinnings of whole-body health and wellbeing. Understanding the gut microbiome through a sociological context may help support a more integrated view of health in the United States, highlighting community-based solutions as well as individual treatments.

One particularly powerful body niche, the gut microbiome, resides within the gastrointestinal tract and plays a fundamental role in digestion, metabolism, and overall health. The gut microbiome has gained a lot of attention due to its association with a host of inflammatory, metabolic, and cardiovascular diseases, as well as its effects on mental health. Considering that the gut microbiome is rapidly manipulated by diet, many clinicians are excited about orienting toward the gut microbiome as a direct target of lifestyle intervention.

One of my favorite quotes from microbiome researcher Rob Knight goes something like, “When we focus solely on human genetic studies, we ignore the 99% of genes that we can change.” I might even take this sentiment further. When we focus solely on lifestyle or medication treatments for the benefits of human biology, we ignore all the physiological interactions that take place as a result of altering microbial composition and functioning.

Social Determinants of Health

Social determinants of health are non-medical factors that impact health and wellbeing. They encompass a wide range of factors, including socioeconomic status, access to healthcare, and exposure to discrimination and stress. These determinants are not distributed equally in society, leading to health inequities. For example, historical and systemic discrimination embedded in U.S. policy has tended to create identity-based and cultural separation of communities; within these communities, there is more or less access to unprocessed foods, safe water, green spaces, and places to exercise. It may be supportive to consider socially-influenced environmental factors that impact nutrient intake, exposure to noise, light, and air pollution, interaction with “beneficial” microbes, and blood pressure (and nervous system) regulation. Trauma- and stress-related disorders are another social justice issue; marginalized groups that experience oppression and pervasive stressors like microaggressions show higher rates of gut imbalances. Additionally, the microbiome is “social,” in that microbes can pass from person to person. Social structures may support the transmission of pathogenic or symbiotic bacteria.

Conclusion

As we acknowledge relationships between the microbiome and wellbeing, we are reminded that health is profoundly intertwined with the dynamic interplay between political, economic, and societal forces. Embracing this complexity paves the way for a more comprehensive and inclusive approach to mental healthcare, where both individual and societal factors are considered in prevention and treatment. 

Stay tuned for Part 2 of this “Microbiome and Social Equity” post to learn more about how the microbiome mediates health through social determinants of health!

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.