Psilocybin vs. Ketamine with Dori Lewis, LPC

In this episode of the Psychedelic Medicine Podcast, Dori Lewis, MA, MEd, LPC-S returns to discuss the differences between psilocybin and ketamine. Dori is the Clinical Director of Elemental Psychedelics and Owner/Operator of Reflective Healing in Fort Collins Colorado. As a clinician, she blends transpersonal psychology, depth work, and psychedelic-assisted therapy within a model that centers the therapeutic relationship. To date, she has stewarded over 100 ketamine therapy sessions, more than 200 mushroom sessions, and numerous group ceremonies.

In this conversation, Dori explores how clinicians and facilitators can thoughtfully decide when ketamine or psilocybin may be the more appropriate therapeutic option, emphasizing that the two medicines are complementary rather than competing approaches. She explains how factors such as current medications, trauma history, substance use, prior experience with altered states, therapeutic readiness, and available social support all shape this decision. Throughout the discussion, Dori argues that ketamine often serves as an accessible and effective introduction to psychedelic-assisted therapy, while psilocybin may be especially valuable for addressing grief, attachment and religious trauma, and deeper existential questions when paired with sufficient preparation, integration, and a strong therapeutic relationship.