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Integrative Psychiatry

Microbiome and Social Equity Part 2 of 2

By February 8, 2024No Comments

The microbiome is a vast community of microorganisms such as bacteria, fungi, and viruses residing on and within the human body. Combined, these microbes possess more than 100 times the amount of genetic information than the human host that they are in relationship with. In turn, this genetic material corresponds to the functional roles of these microbes: what they metabolize, how they metabolize, and resulting products that are secreted in the body. Human body systems, such as the immune system, cardiovascular system, hormonal system, and nervous system, are affected by the combination of abundance and diversity of microbes; neurological and psychological health are intimately connected to the stability of these systems. It is also important to note that microbes and human hosts influence each other in a feedback loop; human genetics and environment play a critical role in which microbes thrive, and the interactions between microbes further affects functional impact.

Microbiome as Mediator

Describing a healthy microbiome is challenging because microbiome fingerprints, like other physiological profiles, are inherently unique to each person. In general, it is thought that a more diverse microbial profile provides ecological checks and balances, competing with one another to prevent pathogen dominance, aiding digestion and creating diverse metabolic products, and regulating the immune system. Microbial diversity can be optimized through proper nutrition, connection with natural spaces and community, reduced toxin exposure, and stress management. While mental health professionals and medical clinicians can emphasize personalized actionable lifestyle changes, not all modifications are accessible or possible to everyone. This is where advocacy for policy-making comes in, at the intersection of politics, ecology, and healthcare; human physiology is, in fact, dependent on the larger environment dictating the microbes that facilitate health and dis-ease.

Nutritional Disparities: Diets high in fiber and low in processed foods are associated with gut microbiota diversity and improved health outcomes. However, access to fresh, nutritional foods varies greatly across the United States, mediated by food insecurity and the historically oppressive origins of food deserts. Promoting universal access to healthy foods and nutritional education may help support microbiome equity. Because eating patterns can be tied to trauma and psychological wellbeing, social objectives may need to go beyond simply providing dietary resources.

Industrialization and Urbanization: Industrialization in agriculture has negatively impacted the microbial composition of soil, producing less nutrient-dense foods. Similarly, urbanization has led to a loss of interaction with environmental microbes through reduced access to natural settings. Decreased air and water quality expose individuals to harmful chemicals, while increased noise and light pollution affects biological rhythms. Poor housing conditions can also expose individuals to environmental toxins and mold. Addressing environmental quality (air, water, etc.) and substandard housing conditions may be a starting point for microbiome equity, and some researchers have suggested incorporating microbiome-inspired green infrastructure into urban planning.

Stress: Chronic stress is prevalent throughout lower socioeconomic status and marginalized communities. Lifestyle modifications like managing sleep, exercising, and practicing meditation have been shown to support microbiome health, yet these interventions are often challenging to achieve. Implementing stress reduction programs and encouraging community support systems may mitigate the negative impacts of stress on the microbiome. At a public policy level, supporting psychological and physical safety by increasing access to public transportation, healthcare, and improving environmental quality may decrease barriers to stress management.

Conclusion

The microbiome may be likened to a bridge between the social determinants of health and health inequities. While there is a lot of work needed to address health disparities, on both a precision medicine and policy level, we can start the conversation by recognizing the role of microorganisms in mediating the impact of social, political, and economic forces.

For more info, check out the Microbes and Social Equity working group!

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.