A Real Conversation

Transparently analyzing a snippet of session dialogue, as a way to display a learning practice of my own.

When it comes to the technical craft of being a psychotherapist, there is often a choice point when in session with a client: when to be attuned to the present, and when to be critically analytical. My research says that the art to being one of the greats lies in gliding between the two.

As of August 2025, Otter.ai, a digital transcription service, is HIPAA compliant when it comes to clinical work. However, as a linguist, I maintain a habit of writing down quotes and phrases in real time. I find it allows me to attune to what is or to point out what’s omitted. People are often moved hearing me read their words back to them. Sometimes the most potent part of a session is simply for someone to really listen to what they said.

Below, I’m sharing a miniature case study. The case will include 1) client context, 2) a snippet of a real dialogue, and 3) my commentary. My intent is to share a learning practice of my own, which is how I use dialogue as a study method. I do this through listening and reading transcripts of renowned interviewers, as well as with dialogue from my own sessions. For me, this is a way to refine the craft of being attuned to the present and also strategic with the chess moves that a good conversation requires.

Client Context
This client and I have been working together for a year. When he contacted me, he was in his 9th month of psychedelic work, and looking for support in preparing for a ceremony. He shared that his intuitive sense was that his psychedelic work would be complete at 12 months. Initially, he wanted to work with me for around 3 months, as a way to adequately mark his completion with the plants, and his year of psychedelic ceremonies.

Over the last year, we’ve met monthly. The context has been integrating a recent psychedelic experience, preparing for an upcoming one or exploring tethers between the ceremonies. Since his 12 month mark, he has had a handful of additional psychedelic sessions with various practitioners, and medicines. As none of the providers or programs where he does his medicine work provides preparation or integration, he supplements his medicine experiences with our sessions.

Dialogue

Client: There’s more work to be done.

Me: More work or more pleasure?

Client: I get pleasure from doing the work and I do want to go deeper with it…I’ll just go with my gut…I suppose the desire to do more is to escape the integration…I don’t know this medicine, and I’m learning. I’m learning its power and getting to know it. People go into a learning space with medicine….I fully trust my gut.

Me: Does your gut have agency outside of medicine work?

Client: I know it’s where I’m supposed to be at the right time, I know it’s healing something.

Commentary

1. Given that psychedelic ceremonies and therapy are often deployed as a therapeutic and spiritual tools, it is often framed as work. It’s likely for this association that clients often overlook or underreport the pleasurable, blissful aspects of the experiences.

   So, I asked this question, “more work or more pleasure” to create space for the possibility that more of what’s desired is not only work. And he was able to add nuance to his paradigm when he identified that, “I get pleasure from doing the work”.

2. One of the mechanisms of psychedelics is that it seems to open access to new ways of knowing, specifically the fourth category of intuition. We can see this here when the client says, “I fully trust my gut”. One pattern I consistently see is that once people access this intuitive way of knowing, they seem to disproportionately value it. It’s incredible that psychedelics can open the aperture, but if clients then only make decisions from their intuitive sense of knowing, then actually the aperture remains narrow. The gift of the opening is to have access to more.

3. Once a person’s intuitive sense has been opened, they begin to identify as having a relationship with each of the plants, which is why interpersonal language surfaces. Some common examples of this includes: “sitting with the medicine”, “the medicine is calling me”, “I have questions for the plants”. In this snippet, “I want to go deeper with it” feels relational between he and the plants.

4. One of the areas where I see confusion for clients is that they approach psychedelics as a tool for finding answers; then, one of the answers they receive is that all the answers are within them. However, the setting in which they received that insight skews them towards feeling that they need to be in the presence of the medicine in order to hear. This is made further complicated for those who feel relational with the plants; the animistic tendencies increase complexity in discerning whether the enrichment comes from the internal or external relationship to life force. So, even when someone is merely in search of access to listening to themself, they end up receiving a lot of additional messaging, symbolism and content. This overload draws them to a circuit of unconsciously seeking to keep the loop of inquiry alive, even though they think they are in pursuit of closing it.

When I entered the profession of psychotherapy, I found I was offered many structured training opportunities, which lean theoretical. I’m interested in opportunities where I can be in study of the clients I collaborate with, letting their arcs guide me into new crevices of learning. Thus, creating ways to be in study of my own protocols, techniques and style of therapy allows for an applied, and multi-loop learning process. I’m intrigued to hear how other practitioners continue to self-study in informal, yet structured ways, as I’m confident there are endless approaches.