Specialized Care for Those Confronting Climate Change and Other Existential Risks*
Integrative Psychiatry
Integral Psychedelic Therapy
Ketamine-Assisted Psychotherapy (KAP)
joined in a (inter)personalized course of treatment and resilience training with Dr. Alex Trope
*AI, Attention/Information Environments, Planetary Boundaries, Systems Collapse, Authoritarianism/War/Weapons Proliferation, and other X-risks
I work with clients at the convergence of altered states of climate and expanded states of consciousness
to help transform:
EXISTENTIAL DISTRESS
(climate anxiety and anxiety about other collective existential risks, ecological grief, burnout and apathy, solastalgia, pre-traumatic stress, doomerism, carbon obsessions-compulsions, climate-related family planning and parenting concerns)
into
Eco-Resilience
(social connectedness and solidarity with other climate and X-risk realists; risk awareness and preparedness in equipoise with mindfulness and gratitude; deep rest and blessed unrest in mutual support; preventing psychological collapse and group-think by holding open existential dialectics)
AND
Eco-Integrity
(cultivating health by integrating multiple levels of human and more-than-human meaning into a coherent whole; experiencing the integrity of your life and life form as an interdependent part of a wider Life-producing universe; turning to purpose amid personal and planetary peril)
Alex Trope, MD, MSc
Psychiatrist, Psychedelics Specialist (National Psychedelics Association; Psilocybin-Assisted Group Therapy; KRIYA Ketamine Research Institute)
Climate and Mental Health Expert-Advocate (Founder at Climate Psychiatry Alliance & the UCSF Department of Psychiatry Climate Change and Mental Health Task Force)
Crisis-Engaged Contemplative (always in training; Niroga Yoga Teacher Training alum (RYT-200); student of MBSR and Dzogchen/Mahamudra)
Are We a Good Match?
Relationship is everything when it comes to the process of therapeutic change. No matter my qualifications or expertise, the work my clients and I do is fundamentally based on the equal relationship of one person to another, seeking integrity within ourselves amid a supermassive web of living and non-living systems. If you find the structure of my practice appealing and can afford to adhere to it in terms of time and financial commitments; if you are not put off by aspects of my personality or identity that I expose through the writing and other content of this website; and if you are willing to create deep intentions and set realistic resolutions around desired changes to your psychological, interpersonal and health-related habits, then please reach out to me directly (not via a family member) with the form at the bottom of this page.
A SummARy Of MY Specialized PRACTICE
I’m currently licensed for clients residing in California.
I work with high-functioning adults who are employed in or dedicate a significant portion of their personal time studying or engaging collective crises like climate change, digital information manipulation, or another aspect of the overall “meta-crisis” of current peak civilization/humanity.
I am private pay (see fees and billing below) and telehealth-based (though Ketamine-Assisted Psychotherapy are always in-person).
My fees are transparent (below) and non-negotiable.
If we mutually agree that we seem like a good match for each other, our work together will take place within the boundaries of a time-specific, goal-oriented yet wide-ranging personal and interpersonal learning process (between me and you, between you and your social connections, between you and the non-human world).
This evolving therapeutic process is called Eco-Integrity and Expanded States Practice: it involves integrative psychiatry and integral therapy, as well as psychedelic preparation, activation and integration during Ketamine-Assisted Psychotherapy sessions, and a commitment to dedicate time to contemplative, creative, body-based, nature-based or other personal health practices during client’s own time.
Fees Structure
A “Course” of Treatment
Inspired by the academic calendar and learning process, clients allot 9-10 months for weekly 50-minute appointments, with expected “assignments” of their choosing to be done 1-4 times per week outside of this appointment time (spending between 5-25mins on a contemplative, creative, athletic, interpersonal, political or other health promoting practice). I offer additional appointments for reviewing non-psychotherapy aspects of care: reviewing labs and other biometric data, medication management/refills, focused coaching on a chosen health-promoting practice.*
For a 9 month course, expect an investment of $12,000-$18,000 depending on how many weeks of the roughly 36 available to us we take off (for vacation, unexpected events, scheduling discrepancies on both of our parts).
Initial/Introductory Meeting (15 minutes): FREE
Intake & Screening Process (2-3 hours): FREE* (done by you on your own time with forms and questions that require focus and reflection).
*Must be totally complete and returned to me for review to proceed to Initial Consultation. The cost of my extensive review of your Intake/Screening documents are baked into the Initial Consultation fee.
Initial Consultation (75 minutes): $1200
Follow-Up Appointment (50 minutes): $450
Follow-Up Appointment (25 minutes): $300
Focused Consultation
FOR CHallenging OR Adverse Experiences with PSYCHEDELIC and other NON-ORDINARY States of Consciousness.
I am clinically experienced in the full spectrum of states of consciousness:
from the ordinary
(waking, sleeping, dreaming, daydreaming)to the voluntary but non-ordinary
(as induced by substances or intense/immersive practices such as meditation, yoga, breath work, extreme sports, wilderness, monastic vow, social/sensory/dietary deprivation during retreats)to the non-ordinary and non-voluntary
(psychotic, mood-related, anxious, obsessive-compulsive, trauma/stressor-related, dissociative and other states as defined by the psychiatric profession (DSM 5)—as well the misuse or abuse of psychedelics and other intense/immersive practices in one-to-one relationships or in high-control groups or retreat settings)
I take a non-pathological approach to non-ordinary states, meaning I focus my consultation and treatment recommendations on parsing out the negative, positive, neutral or ambivalent parts of these states from the point-of-view of the client, while attuning to unconscious or interpersonal parts the person may be unaware of, to help the client come to terms with and move on from their adverse experiences with new knowledge and empowerment.
Initial Consultation + Follow-Up Appointment fees are same as those listed in Standard “Course” of Treatment.
Details of My Specialized Practice/Program
I am a psychiatrist based in the United States, currently licensed in California.
(I may consider obtaining licensure in Oregon, Colorado, Pennsylvania or New York if there is enough interest from well-matched clientele).
I work primarily with adults 18 years or older.
(I will consider consultation for adolescents aged 15 and up, especially if already under the care of a Child & Adolescent Psychiatrist, who requests consultation to distinguish and work with eco-distress apart from psychiatric disorders).
I am currently a part-time, private-pay, telehealth-only practice.
I use digital tools for screening, standard appointments, weekly psychotherapy sessions, and prescribing through online, delivery pharmacies.
I have designed my practice to meet the needs of high-performing students, entrepreneurs, professionals and other leaders immersed in climate-related or X-risk fields (in business, social entrepreneurship, academia, politics or media) that want to continue their world-saving work with less burnout, existential distress and psychiatric impairment.
My practice can include standard psychiatric medication management and diagnosis, but it goes far beyond this managed-care, insurance-based standard—in terms of depth, breadth and structure.
Within the structure of the Eco-Integrity and Expanded States practice, I work with clients to formulate goals-based, practice-oriented plans to address the root causes of existential distress and mental health problems. These plans may include focusing on factors beyond your personal psychology and health behaviors (like fossil fuel pollution, propaganda and political manipulation), but they will all be generally focused on empowering you to build direct experience and trust in Life itself: a creative, dynamic stability born from having access to a repertoire of environmentally-attuned, sustainable states of mind-body that match the changing world around you. Given the cascading chain of existential challenges brought about by extractive technologies (whether fossil fuels or social media), the need for climate and other X-risk-focused leaders to expand, explore and skillfully navigate a wider repertoire of states of consciousness is immense.
MOST IMPORTANTLY
As a school nerd, who found inspiration in the yearly cycle of school, I structure my time with clients on, essentially, an academic calendar:
I am currently taking clients on a rolling basis, creating explicitly time-limited “courses” of psychotherapy weaved into integrative health strategies and contemplative practices, and in June (starting June 2024), each client will “graduate” and go out into the wider world. My practice will have a summer vacation/semester, during which I will focus on providing group-based psychedelic experiences to “alumni” and other allies in the climate and X-risk communities through state-based, research-based and/or FDA-approved pathways for psilocybin, MDMA and ketamine use.
This time-limited practice is iterative and evolving, continually drawing upon the lessons of climate change and the knowledge of people—like my clientele—who are working to transform modern cultures, sciences, politics and economies into life-promoting systems.
As opposed to classical open-ended talk therapy—where years-long treatment is often the norm, enduring psychological change is assumed to be slow, and discussion of explicit goals or timelines might be avoided—the paradigms informing my practice assume that time is of the essence, change (whether good or bad) can happen rapidly, and that “beginning with the end in mind” is crucial to get where we want to be in the time we have (by highlighting and monitoring the outcomes a client is truly seeking to get from the significant time and money they will spend). This perspective matches the Intergovernmental Panel on Climate Change’s summary of climate science showing “rapid, far-reaching and unprecedented changes in all aspects of society” will occur this century, either because leaders, lawmakers and businesses do what is necessary to rapidly decarbonize economies and revitalize our biosphere’s integrity [positive unprecedented changes], or because polluters and other profiteers continue to obstruct solutions by rigging political and economic systems [negative unprecedented changes].