Welcome everyone, I’m Emily Senay, tonight’s
moderator.
You just saw these quotes from these noted
actors, musicians, authors and scientists,
and they all credit psychedelics with providing
them profound insights, really life changing
insights.
And as Oliver Sacks said, he once wrote, that
psychedelics revealed to him what the mind
is capable of.
And in fact that’s the definition of psychedelics,
the modern definition, meaning mind and soul
revealing.
Well these chemicals have actually been part
of the human story for much longer than recent
times, way before scientists elucidated their
chemical structures or even named them.
So tonight, before we meet our panelists and
get into the discussion, let’s get a little
introduction to this long, strange trip.
Humans have been using plants and fungus to
change the experience of consciousness for
a very long time.
9,000 year old cave paintings depict rituals
with psychedelic mushrooms.
Psychedelics are often used in religious ceremonies
as sacraments for divination and healing.
It wasn't until the mid 20th century that
science got with the program.
Early psychedelics research transformed neuroscience.
We began treating five patients for 26 days.
In clinical trials, psychedelics like LSD
showed extraordinary potential.
It's an important drug in treatment of mental
and emotional disorder.
These substances rose from obscurity to miraculous
promise in a matter of years.
Dangerous and deadly, disastrous consequences.
All of a sudden there are these scare stories
in the media.
Bizarre, fatal accident, permanent brain damage.
Hyped by the government.
There's propaganda.
Suicide, chromosomal abnormality.
Psychedelics were soon perceived as a threat
to public safety and global stability.
It's very dangerous, a very dangerous drug.
President Nixon went to the narcotics bureau
today to sign a drug bill.
And by the early seventies essentially the
research has stopped.
The golden age of psychedelic science was
over.
But this story began in 1943.
A young Swiss chemist name Albert Hoffman
is working at a pharmaceutical company in
Switzerland.
Tasked with formulating a new stimulant.
Hoffman quite inadvertently opened Pandora's
box.
He accidentally ingests what they called LSD
25, got it on his finger, maybe in his eye
and started feeling strange and he realized
there's something psychoactive in this one.
Three days later, he ingests some intentionally.
And realizes like, Oh shit, I'm losing it.
Hoffman was having the first acid trip in
the world.
So he and his lab assistant take one of the
most famous bicycle rides in history to his
house where he is separating from his body,
he's seeing himself from the ceiling.
Then he stepped out in his garden and everything
looked jeweled with dew as if it were the
first day of creation.
And that is how LSD was discovered, commemorated
on the April 19th as bicycle day.
Sandoz, the company Hoffman worked for, provided
LSD 25 for free to scientists around the world.
They basically unleashed this open source
research effort where they offered huge amounts
of it to any researcher basically with a nice
piece of stationary.
It was LSD that catalyzed our understanding
of neurotransmitters and receptors and also
the development of other psychiatric drugs.
Clinical researchers investigated LSD as a
treatment for a wide range of mental illnesses.
They looked at obsession, anxiety, depression.
They looked especially at alcoholism and had
a 50% success rate, which is quite remarkable.
Psychedelics became a standard tool in psychotherapy.
It would help people speed the process of
bringing their subconscious to where you could
discuss it where the therapist.
There was a lot of this going on in the fifties.
There was a dark side to the research as well,
both the military and the CIA saw great potential.
The squad are drugged with LSD.
The CIA got very interested.
First they thought LSD might be a mind control
agent or a truth serum.
Then they thought, well let's weaponize it.
Let's put it in the water supply.
Let's secretly give it to foreign leaders
to make them do and say stupid things.
So it was one crazy idea after another.
Awful, awful stuff.
But it's what was happening here at home that
doomed this research.
The drugs escaped the laboratory, and then
Timothy Leary gives them a big push.
Harvard psychologist, Timothy Leary, developed
a dubious curriculum of mind expansion and
personal truth through psychedelics.
A scandal erupts.
He's fired from Harvard and then decides to
become the LSD evangelist.
Turn on, tune in and drop out.
He's essentially saying everybody should use
this drug.
And the drug is taken up by the counter culture.
Richard Nixon was convinced that he was dealing
with a threat from psychedelics.
He called Timothy Leary the most dangerous
man in America.
The kids who take LSD aren’t going to fight
your wars, they’re not going to join your
corporations.
And here Timothy Leary and Richard Nixon were
in agreement.
So Nixon passed the controlled Substances
Act in 1970 and that listed psilocybin and
LSD as no accepted medical use and a high
potential for abuse, neither of which are
true.
And that's a remarkable event in the history
of science.
I don't know that you can point to another
time or episode where you had a very promising
line of inquiry that is simply stopped for
reasons that have nothing to do with the science.
And we lost 30 years of research.
Imagine what we would know now had we been
studying these compounds for those 30 years.
What we might've learned about depression,
anxiety and addiction, consciousness and how
the mind works.
Let's meet our panelists.
Our first participant is a psychiatrist working
to find better treatments for some of the
most debilitating illnesses affecting human
beings including depression, anxiety, and
addiction.
Please welcome Stephen Ross
Our next participant studies the brain and
the mind.
Professor of cognitive and computational neuroscience
at the University of Sussex in England.
He has published more than a hundred papers
on the nature of consciousness and the self.
Please welcome Anil Seth.
Our next participant wants to understand how
babies think and what that reveals about all
of us.
Professor of psychology and philosophy at
the University of California at Berkeley and
author of the bestselling book, the philosophical
baby, please welcome Alison Gopnik.
Finally, please welcome a researcher whose
ethnographic field work has brought him many
times to the Amazon Rainforest.
Associate professor of anthropology at McGill
University in Montreal, Eduardo Kohn.
So welcome everyone, and I think we need to
start with understanding what we're talking
about here.
And Stephen, I'm going to task you with this
to define if you can, what are psychedelics?
We know they're not marijuana.
We know they're not opioids.
What are they?
How do we define these drugs?
Well, they're a group of drugs that profoundly
alters consciousness.
They do it all by activating the subtype of
Serotonin receptor, the 2A receptor.
All of them do that.
If you block that receptor, they don't have
any psychoactive effects.
And they're unusual compared to the other
drugs of abuse in that they don't meet the
definition of an addictive drug.
And they're not addictive.
In fact, if anything, they have a potent anti-addictive,
uh, potential.
And what are the names of some of these drugs?
Would we know them as LSD, psilocybin?
Is there a list that qualifies as a psychedelic?
Well, the serotonergic hallucinogens or psychedelics,
there's two different sub categories.
There's the Indolealkylamines, these are drugs
like LSD, psilocybin, and DMT.
DMT is found in ayahuasca, and they look remarkably
similar to the endogenous neurotransmitter
Serotonin.
And then there's the phenylethylamines and
the prototypical here is Mescalin and these
are more amphetaminergic psychedelics and
their ring structure very closely resembles
norepinephrine.
So, so they work on those receptors in the
brain, is that correct?
All of them have a commonality of activating
the 2A receptor and that what's lead, that
causes their unusual psychological properties.
Okay.
We hear a lot about other drugs like MDMA,
which is also known as ecstasy and also ketamine.
Where do these fall into the psychedelic classifications.
Ketamine is probably the closest phenomenologically
to psilocybin but it has a much different
mechanism, it blocks a type of glutamatergic
receptor, the NMDA receptor, and it profoundly
alters consciousness too, but it's also a
dissociative anesthetic.
But there are commonalities in terms of the
experience and the brain function of ketamine
versus psilocybin.
Ketamine is actually the first psychedelic
that's available as a medicine for a treatment
resistant depression.
Uh, it recently was, was approved Janssen
pharmaceuticals.
MDMA is psychedelic-like, but it's a very
complex drug.
It's being used to treat PTSD.
There's, it has breakthrough status with the
FDA and probably will be made available as
a medicine in the coming years for complex
PTSD and it has a host of effects.
It affects the serotonergic system.
It causes increase in signaling Serotonin
and dopamine.
It actually has some addictive properties.
It also releases oxytocin and causes this
sort of bonding feeling and it also deactivates
the amygdala, so it puts people in a kind
of altered state where they feel bonded and
a sense of trust.
And in the MDMA PTSD research they're able
to then go back and talk about the trauma
and maybe sort of like rewrite it neutrally.
So if we could very, in a very pithy way,
define the difference between what makes a
psychedelic and some other drugs like marijuana
or or opioids.
Is there a central feature of the experience
that defines psychedelic?
Anybody can jump in on this.
Is there, how would you characterize the experience
that makes that unique?
That says that's a psychedelic,
well, the, the terminology is not great.
Psychedeila, psychedelic means mind manifesting.
It's unclear what that means, but the commonality
is that they all essentially dissolve the
sense of the ego and they can create a sense
of oneness.
They're consciousness expanding drugs and
they, they do it quite potently.
Anil you, you say these drugs do something
that no other drugs do.
Can we talk about what that is and this is
actually the neuroscience of how they function.
Yeah, there is a difference.
And I think that the big interest is we, we
know quite a lot as Stephen has said about
the pharmacology of the psychedelics, but
the effect on the phenomenology and how we
experience the world and the self is really
what’s striking, what’s distinctive.
And if, again, if you compare it to other
classes of drugs, you have things like marijuana,
which gives you this comforting haze.
You have cocaine, which gives you a laser
focus.
You might have the morphine, which gives you
a rush of pleasure and psychedelics don't
do any of these things.
They work more on your perception.
And people often talk about an initial sense
of discomfort as sort of patterns, normal
patterns of perception of the world and the
self are broken down and then there's this,
the phenomenological effect seems to be that
you really perceive things in a very different
way, whether it's features of the of the external
world, you can see patterns and things that
that weren't previously there.
You experience yourself in a very different
way too and as Stephen said, there's a breakdown
in the categories that often separate the
different ways in which we normally perceive
things.
So we might experience ourself as not the
unified separate entity that we do, or at
least we think that we do day to day.
I mean another question here is that we think
we perceive the world and the self in particular
ways and maybe we don't actually do this all
the time and that's the mind manifesting aspect
of psychedelics.
It can make clear that the repertoire of the
ways in which we can have conscious experiences
is very much larger than we might typically
be aware of, which, which as a, as a researcher
whose primary interest is in consciousness
itself is why they're so fascinating.
And, and what is happening in the brain there,
there, there is an effect on the brain that
increases randomness or, or there's an effect
that you can actually define, is that fair?
Well there’s many effects.
I mean, this is, I think is why there's so
much work to be done.
It's a very exciting area to be in because
we have this big, big explanatory gap, if
you’d like.
We know that these pretty much all the psychedelics
work pharmacologically on the Serotonin 2A
receptor.
We know where that receptor is distributed.
We know there are high concentrations in particular
parts of the brain in the visual cortex, in
parts of the brain that associate different
perceptual modalities.
Also in the gut, interestingly.
Um, and so we know that and we know the phenomenological
effects of these things.
Connecting the two, so what are the effects
of these targeted pharmaceuticals compounds
at the level of, of the brain dynamics and
brain organization.
That's what, that's what's interesting.
And this, uh, this is one example.
This is some work that we did in collaboration
with a research group at Imperial College
London, one of the first groups along with
students to study the, these compounds in
brain imaging.
And what we found in this particular experiment
was that the brain on, on psychedelics, this
is LSD and psilocybin, uh, becomes more random.
That's to say different, each part of the
brain, what you see in this picture is different
parts of the brain, the, the redder they are
the more random the activity is compared to
a baseline of no psychedelic.
And this is just one way of saying that on
psychedelics, the brain seems to be exploring
a larger repertoire of possible states and
that may underlie this kind of expanded space
of possible experiences that we have.
Amazing.
Alison, you look at this from a very different
perspective.
You understand how a child's mind works.
What he just said relates to some of the things
we've talked about earlier on before the show
in, in how the child's mind works.
Yeah.
So one of the things that we know from looking
at children and looking at brain development
is that we see in the course of development
a shift from a brain that looks more like
the brain that Anil is talking about.
A brain that has more local connections and
fewer long distance connections, um, to a
brain that an adult brain that's much more
structured and also much less flexible, much
less plastic.
So if you're thinking about children, what
you see is that you see an early period where
the brain and the mind are very good at learning.
Very good at exploring possibilities, good
at doing things like crazy, pretend play,
not very good at putting on your jacket and
getting to preschool in the morning and not
very good at actually going out and acting
effectively.
And what cognitive scientists have been thinking
about this is that there may be a real purpose
for this.
It's not just that the children are sort of
defective adults.
If you look in areas like, yeah, if you look
in areas like artificial intelligence, it
turns out that there's this basic tension
between what people sometimes call exploration
and exploitation.
There's a basic tension between trying to
have any kind of system that's good at exploring
possibility, that's good at creating new possibilities,
new alternatives and one that's good at focusing
and getting things done and acting in the
world.
And what evolution seems to do is to solve
this tension by giving us this long period
in our human childhood, it’s longer than
any other, where we can just be in this state
of very wide ranging exploration.
We can be noisy, we can be random, we can
do strange things, we can have imaginary companions
that seem, that seem vivid and real to us,
um, but we don't have to do very much.
And then we can use that kind of exploration
as adults to find new possibilities.
And one of the challenges of human adulthood
is that we seem to have some ways of going
back and forth between this adult state of
being very efficient but not so flexible and
this more childlike state of being very creative
and open, um, but not as efficient and psychedelic
substances seem to reinduce something like
that childhood state.
And there's actually some recent experiments
suggesting that at least some of these literally
open up windows of what neuroscientists call
plasticity, this kind of openness, uh, openness
to experience even in adults where normally
that kind of openness would be shut down.
Eduardo, you've, you've spent a lot of time
in the Amazon and you say that they've somehow
managed to achieve a balance between the two
tensions that Alison is talking about, flexibility
versus openness.
Tell us about your experience and what you
learned from them.
I want to come back to the term psychedelic,
which I think in traditional context is quite
a, quite inappropriate term.
Can think of the term, the etymology, psyche,
mind or spirit and deloan, manifesting, revealing,
um, Amazonians, um, use a series of technologies,
one of which is a psychedelic plant, a decoction
ayahuasca, uh, but other ones as well, such
as dreaming to, um, to find a way to be in
touch with what they consider, uh, the mind
of the forest.
Uh, uh, the mind-like qualities that one finds
in complex living ecosystems, um, and they
use that as a form of guidance and they do
so in such a way that what they do is they,
they kind of break down the sort of normal
everyday way of living, uh, uh, adult way
of living.
You could say, uh, they break down the way
in which we kind of get our marching orders
from the languages we speak.
We have our identity based on the, the way
that words hold who we are and they find a
way to, to communicate and be in touch with
a larger communicative field.
Um, part of this is quite practical, like
listening to bird calls and walking in the
forest and quite, and some of it's a bit more
esoteric, like remembering the interpreting
dreams and taking certain psychoactive psychedelic
substances.
But they do have, there's a ritualistic aspect
to it.
Is that right?
And, and, and they don't, it's not a, um,
it's, it's a well thought out program that
they have that's different than what we're
familiar with here.
And they do it through a ceremony
that's right there.
There are ceremonies to take psychedelic plants
and those are part of an ethical practice
that is, they use these to do something in
the world that's correct, to find the correct
path.
Um, so it usually involves finding, uh, using
this technique to fall back into a larger
realm of communication to understand a way
forward.
So it's, it's, it's done for a reason.
Often it has to do with, uh, healing individual
people who are sick, finding what the problem
is, finding, uh, solutions to communal problems,
to even larger problems.
We have some video from one of these ceremonies.
I think we can show that now.
This is the preparation of ayahuasca by a
woman who is very dear to me.
Her name is Mukutsawa from the Sapata community
of Nanchama Cocha.
She's cutting up and boiling, uh, the Banisteriopsis
Caapi vine along with Psychotria Viridis.
That's her son [inaudible], a spiritual leader
from the nation and they're beginning to take
the medicine now.
He says in there that the ayahuasca opens
a portal of knowledge where everything is
interconnected, our bodies, all living things.
And this is one of the themes that has already
come up a couple of times and is this concept
of the dissolution of the ego or this, this
oneness, losing the self.
Um, Anil, tell us about what, how that might
have some neuroscientific underpinnings.
It's, when we think about the self it's, it's
very easy to take the experience of self for
granted.
And if we think about perception, we think
about consciousness, it's often tempting to
think about this in terms of there’s a,
there's a world out there and we experience
it somehow through our senses, sense it.
And then we form perceptions and these perceptions
are a read out if you'd like that presented
to the self, whether it's the soul or an inner
homonculus or whatever we conceive of.
We tend to think of the self as the thing
that's doing the perceiving.
But what we're finding sort of independently
from, from these psychedelic explorations
is that the self is itself a perception.
The same mechanisms that allow us to perceive
the world are also involved in building up
the experience of what it is to be you or
me.
And that consists of many things, the experience
of my body, where it is in space, what is
part of my body and what isn't, uh, my sense
of agency and will over events, my identity
over time and just as we can use things like
optical illusions and fancy things to play
around with our, to realize that the way we
experience the world is a construction.
The same thing applies to the self.
And so what we refer to as ego dissolution
is a sort of internal disintegration, rearrangement
of the brain perceiving, uh, the self.
And that's-
Is this the so-called default mode?
That's, there's, I think it's related.
There's, there's often this um, I think this
slide is going to come up at least 600 times
this evening.
Uh, the default mode network is being asked
to do often a lot of work in neuroscience.
So this, this is a particular network of brain
regions that co-activates typically when you're
not doing anything else and they tend to have
an association with just mind wandering, uh,
when you're not focusing on the out, on the
outside world.
So people associate it with, with self perception
more than external perception.
Now it's, it's definitely a huge oversimplification
to say this.
That's where the self is.
That's where the soul is the default mode
network.
No, however, it's one of the sort of reliable
neuronal fingerprints of the typical experience
at integrated selfhood, uh, for us every day.
And one of the things we can see in the brain
in the psychedelic state is a reorganization
of the so called resting state networks.
These brain regions that tend to show correlations.
Um, normally, whether it's the default mode
or another one, we see a reorganization and
a breakdown of these typical networks.
Could that be an explanation for the experience,
the mystical experience that people have?
It's a step towards that explanation.
Yeah.
I mean, one of, one of the issues, one of
the problems I think we face in, in neuroscience
is it's very tempting to put somebody in a
brain scanner and then you see an area light
up, or maybe even a few areas in the network
and say, ah, that's, that's the area for jealousy.
That's the area for right wing political beliefs.
That's the area if you like tabasco.
And that is, you know, that's, that's not
how it works.
Um, there are neural, I, I'm, I, yeah, as
a firm materialist I believe every experience
that we have has a basis in the activity of
our, of our brain.
Uh, but it's not as simple as associating
a single area or a single network with a particular
experience.
But it does speak to the issue because we
can start to see, okay, how does our experience
change under psychedelics?
And then we look and we see, ah, these sorts
of things like the integrity of the default
mode network, uh, that in most other manipulations
remains intact.
I mean, you can see the Intact default mode
network even under cases of loss of consciousness.
If we start to see these things reorganize
and psychedelics, that's a big clue about
how, uh, how to understand the, the distinctive
phenomenology of psychedelics.
Um, Stephen, you're actually looking at mysticism
in religious leaders using psychedelics to
replicate or reproduce that.
Tell us about some of those studies.
Yeah, I'm leading the trial at NYU we're doing
in conjunction with Johns Hopkins and we're
administering several sessions of high dose
Psilocybin to religious professionals like
rabbis and priests and, and um, uh, it's always
the hardest question to answer what we're
doing in our lab because this one is just
weird and different.
It's not a therapeutic thing they were, they're
not a sick population, but the, the backdrop
has to do with this famous uh, there was a
famous experiment conducted in 1962 led by
Walter Pahnke who was at Harvard.
He was a psychiatrist and uh, in the divinity
school there.
His supervisor was Timothy Leary and he had
this idea that psychedelics, he looked at
different branches of mysticism and religion
and there seemed to be a commonality there.
And then he looked at indigenous use of psychedelics.
And they seem to like line up in terms of
the experience.
And his idea was that psychedelics could induce
a mystical experience and what would it do
to religious trainees?
So he took a bunch of religious, uh, trainees.
He put them all in the Marsh Chapel in 1962,
half got high-dose psilocybin and half got
a control niacin.
And what he found is that a very high percentage
of those that got psilocybin had full blown
mystical experiences and they went on to follow
these individuals over the next several decades
and found that the majority found that one
of the most spiritual and meaningful effects
of their lives that informed, um, you know,
the practice as a religious scholar.
In our, uh, work with psilocybin in cancer
we found that the mystical experience actually
mediated some of the effects, the antianxiety
antidepressant effects of psilocybin.
There was an older literature that suggested
that.
And so we're trying to see if religious professionals,
given their background, perhaps in experience,
uh, altered states or spirituality, can they
make nuance discriminations about the mystical
experience?
Can we learn something qualitatively about
their experience?
And the other more complicated thing.
And I have no idea whether this will actually
have any effect on religion.
Ultimately, we're not doing this at any way
to try to like dismantle organized religion.
We're just, um, we're just looking.
Uh, you know, the, another way of looking
is that it could strengthen people's faith
in religion or it could help people have spiritual
experiences that are outside the confines
of religion.
But the religious professionals we’re, we're
looking to see if they can unpack the mystical
experience better for us.
Eduardo, you have spent time in the Amazon
again with shamans and, and uh, the indigenous
people who are inducing a mystical experience
with almost a religious like, um, mission.
They have a message, uh, from your experience.
Tell us, take us through a little bit of that
and what they are trying to tell us.
Well, the Shamans that I work with in the
Amazon, and this is, uh, an image that of,
of a trip we were on just, uh, about 10 days
ago.
Um, they feel that the Sapata nation is a,
is a small nation.
They were a much larger nation before the,
the rubber boom of the 1920s, the early 1920s
that almost decimated their society and their
elders say, tell them that, um, that they're
in some ways the spokespersons of the spirit
life of the forest to the world.
And they have something to say.
And in fact, uh, we spent a lot of time talking
on that trip to the forest of what I'm supposed
to be saying here,
And what is that, what do they want us to
know?
They want to, they want us to know that, uh,
the world we live in is, is a, is a living
world where, uh, where mind is in a constant
state of emergence, but that world is under
threat.
And we need to do something to learn to connect
ourselves to that.
And in some ways, um, if, if we, you know,
as individuals may suffer from illnesses like
depression, in some sense we're entering into
a planetary depression where our, uh, less
expansive forms of thinking are, are leading
us to treat these living spaces as resources
and not the generation of a kind of emergent
mind.
And their message is to say, look, these are
the, these are places of possibility and to,
to, to, to, to continue to have a possibility
as a human species.
We need to be able to connect with these places
and to preserve the possibility of connecting
with those places.
That's their message.
Define the shaman and how, how they get to
that point, how they're able to, to convey
this message.
Well.
So shamans are, are an interesting kind of
a doctor and psychedelics for them are an
interesting kind of a medicine because we
usually think of doctors prescribing medicines
to patients.
Um, psychedelics are generally the kinds of
medicines that doctors take.
Um, that's what the, so oftentimes there are
many different ways of taking psychedelics
in the Amazon but one of the ways is that
the doctor, the shaman, takes the psychedelic
and the patient is there, uh, being healed
by the person who has taken the psychedelic,
not necessarily the way that we're often talking
about it here where we give it to the patient,
right?
Those boundaries are sometimes blurred, but
their, their goal is to connect, is to connect
with the, with this larger, to fall back to,
to let go of some of the structures of thought
that they usually hold us to fall back into
this much larger realm of possibilities.
And, and from there to find a direction forward
to see connections we might not otherwise
see.
And then, to act.
You worked with them to create a soundscape.
Let's listen to that and then you'll describe
what it is we're hearing.
So this is a, a soundscape of, um, deep in
the forest.
Uh, we've made recordings with various tape
recorders that, Mati, the spiritual leader
has one.
I have one.
A sound artist has one.
And uh, you hear, what you hear are the incredible
orchestra of a communicating universe.
Um, on top of that, there's also the shamonic
chant, uh, in, uh, recorded during an ayahuasca
ceremony.
And this is the sort of chamt that sort of
holds open the space of possibility in a,
in a world that is rapidly dissolving and
re, being recreated.
On top of that, you also hear, um, thousand
year old, uh, archeological instruments that
we brought to the Amazon from a museum collection.
There's a, there you can see one of the instruments
there.
Um, and we are making, um, a soundscape that
will allow people to hear how these instruments
and what they were used for.
These are instruments that were created in
rainforest settings to connect with the mind
to the forest.
Um, and we're trying to recreate that and
allow people to experience that.
One of the things we talked about a little
bit earlier, and maybe each one of you can,
can talk about this, is that we're talking
about, uh, uh, a sense of oneness, but it
can be achieved without psychedelics.
Isn't that so in, isn't that one of the things
that emphasized in the, um, in Ecuador and
with children?
It's not only psychedelics that can get us
there.
Is that fair to say, Allison?
Yeah, I think that’s a really important
point.
So what psychedelics are doing is, is taking
advantage of brain chemistry that we know
is already there.
And part of what that brain chemistry is doing
is providing, as Anil said, a much richer
range of states of consciousness than we typically
think of.
Uh, we were at a conference really recently
where there was a panel about altered states
of consciousness and someone quite sensibly
said, what's the altered supposed to be?
Um, you could argue that the state of consciousness
I think of as professorial consciousness when
we're sitting there at our desks and focusing
very carefully on just one thing.
Like that's a really weird altered state of
consciousness compared to most of the consciousness
we have most of the time.
But I think the more specific thing is that
there seem to be these states of consciousness
that track the kind of openness and flexibility
and plasticity, whether they're the result
of meditation or the result of various kinds
of religious practices or have been for a
long time connected with the use of these
substances.
And I think another important thing to say,
a point that Eduardo made is that those states
of openness just create a possibility.
They don't solve things.
What they do is provide people with a set
of possibilities and what happens, what they
learn, what they experience.
Those are the things that actually seem to
allow adults or communities to come to solutions
or for that matter, children to come to solutions
that they wouldn't be able to come to otherwise.
But it depends on what happens.
It depends on what you know, it depends on,
uh, it depends on what you learn.
And that's very vivid in the case of the substances
were what's called set and setting the context,
what's happening, the integration afterwards,
the sense of preparation beforehand.
Those all seem to be really crucial to the
experience.
Yeah.
That.
That's right.
I think the end of ayahuasca ceremonies often
emphasize that's when the work starts, right?
That integration.
How do you take advantage of the sense of,
of those experiences of the, of the openness,
the dissolution, the rearrangement and reorganization
that just provides material to, to, to later
work with.
And yeah, I think you're right that there
are of course other avenues to having different
kinds of non-professorial experience, but
it's also I think-
But, by the way, my recommendation is have
tea with four year olds, just hang out with
four year olds.
That's a very, very easy, legal psychedelic
experience.
But I think it's also, it's probably an exaggeration
to think that you can attain the same equivalent
experience by meditation or by breathing very
fast.
Well, in my lab we do funny stuff with strobe
lights.
It's really amazing to me actually, you shine
a fast 10 hertz, very bright strobe light.
You sit in front of it with your eyes closed,
you will start having visual hallucinations
very quickly, but they will not be of the
same suit.
And in fact, even within the different sorts
of psychedelics we've been talking about,
one of the, the mysteries there is, even though
they work on pretty much the same receptor
system, the phenomenology can be very different,
the phenomenology of ayahuasca can be very
different from the phenomenology of LSD or
psilocybin.
And so yeah, there are multiple ways to get
us out of the, the, the, the, the professorial
mode or whatever the mode that we're used
to experiencing things.
Uh, but, um, but that they do do different
things too.
Alison, you have two hats.
You are in the philosophy department and in
the psychology department, how does psychedelics
relate to what a philosopher would think about
the mind is, do we need philosophy if we have
psychedelics?
Can we do away with all of that?
Well, we always need philosophy.
But I think there's a, I think there's a really
interesting philosophical question that psychedelics
raise, which is one of the impressions that
people have.
What, what James talked about as the noetic
feeling is that the experiences that they
have are true.
They're significant, they're meaningful.
They're not just, you know, crazy hallucinations.
And most of the time if we took a substance
and we saw things really differently, we'd
say, well that's not real.
That's just a crazy hallucination.
And that's not the phenomenology that people
report with psychedelics.
So the question is, is there a way in which
taking a chemical could tell you something
about the truth, that seems kind of contradictory.
And I think there's two important ways in
which that actually could be true.
One of them is this point about plasticity,
about openness, about having a wider range
of possibilities.
And as I said, what you do with those possibilities,
how you make sense of those experiences might
vary, but at least being more open to new
experiences is an important mode by which
people can get at the truth as opposed to
being very reliant on the things that you
already know.
And I think the second point, which connects
to something that, uh, that Eduardo said,
um, as well, what Anil said is, you know,
most of the time we go around with something
that as scientists we know is a hallucination.
And that hallucination is that there is a
little homonculus inside of our head that's
telling us what to do.
That's very separate from the other people
around us and very separate from the natural
world that there's this, that the self, the
mind that's in a completely different, uh,
is a completely different kind of substance
that's cut off from other things.
And as scientists, we know that that's not
true.
We know that there's causal interactions between
ourselves and the natural world, that we're
part of the natural world.
But to actually feel that as opposed to just
kind of knowing it abstractly is difficult.
And one of the things that, uh, uh, one of
the effects that seems to be characteristic
of these substances is to dissolve some of
that hallucination.
And there's some sense in which that, you
know, one with everything, uh, uh, uh, cliche
is actually a better, truer picture of what
the world is like than, than the usual hallucination
we have about the guy inside of our head who's
telling us what to do.
Hallucination is a, is a, is a real hallucination.
It's an effect of how we as humans think,
We create a system of, mainly through this,
this form of reference, which is language-like
based that allows us to, to think ourselves
separate from our bodies, to think about tomorrow,
to think about something that happened in
the Amazon last week, to do all these kinds
of things.
And that's wonderful.
And that's what makes us who we are.
And yet if we get too much caught up in that,
we separate out from the whole rest of the,
the thinking metabolisms, the thinking communicative
systems that hold us.
Um, and I think one of the things that becomes
so interesting about psychedelics is they,
for a moment they sort of break down that
kind of a form of thought much the same way
as dreaming does in fact Amazonians um, put
as much importance to with, uh, to dreaming
as they do to psychedelics because they do
similar kinds of things.
They allow for another kind of reconnection
to many other kinds of thoughts that are less
sort of top-down.
Do they define depression or disconnection
in, in your experience in the Amazon?
Yeah.
Do they, do they experience the way we do?
I think that, I mean, I think that, um, all
humans, they are humans and adults, like everyone
else, they live in worlds of language, but
they do many kinds of things to break that
down.
So for example, most of the language that
we use are, is a very, you know, we have,
we tend to use language in its full capacity.
We use words like the word dog means dog in
English, but chien is, has a complete different
sound in French.
Um, their words in Amazonian, the Amazonian
languages have many words that are much more
imitative that, I mean they also are fully
symbolic, but they have this imitative aim,
uh, registers to described very precisely
things that happen in the world, like the
word tsupuh, which means, uh, the describes,
uh, uh, body making contact with and penetrating
water, right?
They have thousands of words like this, which
is one way to sort of break down the separation
that language creates.
And they're constantly developing these sorts
of things.
That sort of as a kind of, uh, it keeps things
like depression and anxiety at bay if you
think of depression and anxiety as ways of
living too much in these tracks of thought.
But, um, they do see, I mean they have other
kinds of what they, we might think of as mental
illnesses.
They have a kind of illness that people, people,
a real illnesses when you can't dream anymore,
when you are an unable to connect with the
communicative universe.
So hunters who somehow can no longer perceive
animals cannot be conscious of other kinds
of selves and persons in the forest.
Those are the illnesses for them.
The, the disconnect from this larger psychedelic
world.
Wow.
Wow.
Alison, you are also a psychologist and if
psychedelics mimic a child's mind, how a child's
brain works, can we as adults use psychedelics
to recapture some of that, uh, ability to,
that a child's mind has to learn so easily
and to process things and to constantly absorb?
Is, is a, is that a realistic,
Well, I think, I think it's important to say
that as we were saying before, you know, like
you don't want your department head to be
a three-year-old, generally speaking.
There's big advantages to having a sense of
self, to being able to project what you're
going to do in the future, um, to being able
to narrowly focus your attention away from
all the other things that are going on around
you.
To being able to act in this effective, in
this effective way.
And you can see this in the course of neural
development.
So you can see an early brain that's very
plastic that changes a lot where there's many,
many new connections being formed.
And then as development takes place, some
of the connections, the connections that are
used.
Yeah.
You can see here in the first six years what's
happening is many, many new connections are
being formed.
And then later on what's happening is the
connections that are used a lot become stronger
and more efficient.
Um, and the connections that aren't used are
what's called pruned.
Now pruning sounds bad, but it's actually
imperative you have to do that if you're going
to be a functioning adult.
So I don't want to, you know, obviously my
sympathies are sort of with the four year
olds, but uh, but you, the challenge of adulthood
is to be able to do both of those things.
And the challenge is that it's not really
possible to do both of those things at the
same time.
And you need to have social institutions or
social devices or individual devices that
let you move back and forth from one of those,
uh, from one of those states to the other.
And these substances seem to serve that function.
Moreover, I think there's a good argument
to be made, and Stephen can speak to this,
that some disorders like depression and anxiety
have the character of being sort of too far
in the direction of rigidity.
Um, self reflection, self consciousness, rumination
for example, is something that seems to play
a big role in depression where you're going
over the same thoughts or the same possibilities
again and again.
And the, the possibility of changing the fact
that something might not be terrible in the
external world just does, can't even kind
of get in because uh, because of the processes,
the kind of rigid processes of an adult and
those especially seem to be circumstances
as individuals or maybe as societies and communities
where these other kinds of practices, uh,
can, can help loosen things up.
And talk to us about randomness though.
And, and, and how, um, you know, how the,
how psychedelics affect neuro, the neuroscience
of what's happening in the brain and affect
randomness.
Yeah.
This, this gets us back to, I think we were
talking about a little bit earlier about connecting
the dots from what we know about the fine
grain pharmacology of psychedelics at the
serotonin receptor to their effect on the
large scale patterns of the brain that may
open up a larger repertoire.
I think Michael Pollen has that nice phrase
of shaking the snow globe.
So you can, you can put the brain in different
states that it wouldn't otherwise be in.
One way to try to measure that and to get
quantitative about it is to measure, uh, the,
the randomness, the diversity of brain activity.
This is, I think what's coming up here as
sort of the way we did this in our lab.
This is how to put a number on, on the complexity
of, of brain activity.
This would be something like maximally predictable.
I mean you see this repeated pattern of, of
ons and offs of blacks and whites.
In order to describe a pattern like that that's
so regular, you can do it very simply you
just say on, off repeat until the end of time.
And that's, that's a very simple thing.
This is sort of maximally completely random
now this is um, like white noise, snow on
your TV when it's not tuned to anything.
This is actually the hardest thing to communicate,
to transmit.
There's no predictable pattern at all.
You have to, you know, to replicate this,
you've got to replicate every, every point.
And most of the, most patterns in nature and
most patterns in things that we, we encounter,
we're somewhere in the middle.
If we think about what your perception is
right now, it's a mixture of randomness and
order and it's capturing that balance between
randomness and order that is quite difficult
to measure but be, it's also at this heart
of this balance between explore and exploit.
You want to explore, you want to move the
needle a little bit more towards randomness.
You want to exploit, you want to move the
needle a little bit more towards the structure
that you already have in place.
And so the idea is by using algorithms that
actually, the same algorithms that would tell
the difference between these three situations
here, it's actually the same algorithm that's
used when you compress an image in your camera
and send it by email.
We can, we can measure how under psychedelics
you are increasing, you're tipping the dial
a little bit more towards diversity and that's
something that is distinctly measurable.
I mean the other way to think about it is
that under psychedelics also you tend to tip
the balance a little bit more towards seeing
patterns in things rather than just seeing
things as they are.
I mean, we can all see faces in clouds.
We all have a tendency to project our unconscious
or conscious expectations or beliefs out there
into the world.
I like to think about perception as a kind
of controlled hallucination.
So all, all projecting things out and getting
sensory data back in that refine and restrainer
perceptions.
And this needle too moves a little bit in
psychedelics.
This is actually uh, Sussex campus where I
work and what we've done here is we've taken
a kind of panoramic video of campus and we've
used a machine learning algorithm, which is
very good at detecting or classifying objects
in scenes.
It's one of these so called deep convolutional
neural networks.
It's very good.
And what we do is we run it backwards.
So we tell the network there are dogs and
the network then updates the images.
And so it's not like just photoshopping dogs
on I mean dogs are coming out of everywhere.
The whole thing is suffused by dogs so it's
not actually, there’s dogs in the sky that
you know it's a few too many dogs around there
and it's, I'm not saying this is equivalent
to a psychedelic trip, but there are, you
know, some people say there are certain similarities
and the reason for doing this is A, it's,
it's a lot of fun but we can use it for open
days and things like this come to Sussex,
you’ll have fun, but it gives us a way of
getting, again, more details.
So what might be going on within the brain
that specifically leads to the sorts of phenomenology
and that if to the extent that that is similar
to a psychedelic experience we have, we have
a hypothesis from there that what's happening
is again it's, it's moving the needle but
this time the needle is moved towards, you're
more inclined, you seeing more patterns in
things there’s more top down activity in
the brain where your, your, your prior beliefs
or expectations are overwhelming the sensory
data so that you, your controlled hallucinations
become a little bit less controlled.
How do you actually measure that though in
the brain?
Um, this is, this is the challenge.
So for measuring just the randomness or diversity?
Yes, randomness.
That we can do, we've seen that already.
There are many ways we can try to measure
whether the, there's more kind of top down
projection in the psychedelic brain.
Um, this is an MEG scanner.
This is where we get some of our data from.
We don't collect it at Sussex.
I work with a group at Imperial College in
London who collect the data at London Cardiff.
Um, but it's, it's really it, the short answer
is we don't know yet.
I mean we can, we can try to, we have to somehow
fit computational models of brain dynamics
that, that are doing something similar to
that movie that I just showed you of Sussex
and see whether those computational models
also fit the psychedelic data quite well.
There's an overlap here between what people
are doing in what's now called computational
psychiatry.
So for instance, in, eh, there's often an
association made and I don't think it's a
particularly good association between psychedelics
and psychosis.
I mean, back in, in the beginning of this
research, psychedelics were often called,
were originally called psychomimetic drugs
that they, they were simulating psychosis
and, and maybe the extent to which they do
is in this hallucinogenic property.
And now in computational neuroscience we can
build models of how psychotic hallucinations,
uh, might be produced by the brain in terms
of these expectations having a overly strong
effect and we see they fit the data when we
put people in brain imaging.
And so trying to do that in the case of psychedelics
would be, would be one way to approach that
question.
But we're very much at the early stages of
that.
Very interesting.
So we really have to talk about how psychedelics
are becoming medicines, treatments for, um,
a variety of conditions.
Stephen, you've really, you've taken up the
mantle here, you're really on the cutting
edge.
Um, this has not been so easy to do, to pick
up the thread of psychedelics that were dropped
a number of years ago.
What, how did you get into it?
Uh, where are you now with this?
Um, describe a little bit of the, the, the
obstacles that you've faced when you wanted
to explore this.
Yeah, I got into this randomly.
I didn't know anything about it.
It was like not part of my medical training
at all.
Zero.
It wasn't part of my psychiatry residency
training and it wasn't part of my, uh, addiction
fellowship at NYU.
The only thing I heard where some of the urban
legends about it and all of the negative stuff.
But, um, what I didn't find out was that they
were a huge part of psychiatry.
And in 2006, a colleague of mine, just one
day started talking to me about ayahuasca.
I didn't know what ayahuasca was, he told
me that they were celebrating Albert Hoffman's
birthday, hundredth birthday, and why would
anybody do that?
And um, so he said no, Psychedelics were,
you know, I think they are a big part of psychiatry
and you, you didn't have to look very hard,
hidden in plain sight.
I couldn't believe that it was a huge part
of psychiatry for about 25 years from the
fifties and seventies.
There were over 40,000 research participants
and what really got me is the most studied
indication with the best data was LSD treatment
of alcoholism, and me being an addiction expert
and alcohol being arguably the worst drug
of them all from a public health perspective,
that really captured my attention.
And um, so, but I thought, well, so what,
I mean that's an interesting thing, but it
turns out that psychedelics had restarted
in the early nineties, Rick Strassman started
it off.
Even though Richard Nixon declared war on
drugs and enacted the controlled substance
act, there was always a route to do research
with psychedelics and Rick Strassman got
that going.
And then Charlie Grove at UCLA and Roland
Griffiths at Johns Hopkins, Francisco Marin
at University of Arizona started like bringing
it back.
And Charlie Grove, I went to UCLA for medical
school and he really encouraged me in 2006,
you should do this and you should do an extension
of our psilocybin advanced cancer trial.
But meanwhile that wasn't so easy practically.
Is that fair to say?
Well, you have to get what's called a schedule
one license.
It took two full years to get the license.
It was incredibly difficult.
I've been working with the DA a long time
as the head of our substance abuse division,
but there were administrative hurdles.
I didn't think we would get very far.
I thought leadership would say no way.
But most of the leaders at NYU, um, kept allowing
this to go on, except we hit a brick wall
at Bellevue, my hospital that I totally love,
where the head of the hospital said, we're
not, I'm not going to let you give psychedelics
to dying African Americans in this hospital.
He cited Tuskegee and just said, we're not
going to get in the media in a negative way.
And so I was kind of heartbroken that my sort
of beloved hospital did that.
But then the NYU dental school reached out
to us and I didn't know we had a dental school
at the time.
Those dentists, I think that's the only psychedelics
study to ever take place in a dental college.
Wow.
Now you're talking about psilocybin, but a
lot of the original research that was mentioned
in the introductory package used LSD, but
so, so how do you use psilocybin today?
What, what happened to LSD?
Almost all of the research from the fifties
and seventies was with LSD.
Very, very little was with psilocybin, but
in the modern era, when I looked at the data,
I said, okay, we got to start with LSD and
alcoholism.
The data is incredibly robust there.
There was a meta analysis in 2012 of 536 participants
between five randomized control trials and
it showed there was a clear treatment effect
of single dose LSD, but LSD would have been
a nonstarter.
Those three letters are incredibly evocative.
People think LSD, psychosis, jumping off of
buildings, danger, bad chromosomal damage,
and LSD for alcoholism would have created
enormous cognitive dissonance.
So there was a strategy to try psilocybin,
which is a gentler drug.
It didn't have the political baggage and there
was a further strategy to study advanced cancer
and people who were dying and there had been
an older, that was the second most studied
indication after alcoholism so we decided
to use psilocybin to treat end of life cancer
distress.
Okay.
So that's it.
So, so it's, it's really a very specific population
that it's been studied in recently, not, not
the older studies.
And that is, describe what those patients
are facing.
In the modern era, by far the most studied
indication is advanced cancer related psychological
and existential distress.
There have been three randomized controlled
trials between UCLA, Johns Hopkins and NYU,
it includes 92 participants.
And between the three groups, what we found
collectively is that single dose psilocybin
produces rapid anti-anxiety and antidepressant
effects that were a very large magnitude.
In fact, after one day of getting single dose
psilocybin, those in the psilocybin group,
80% no longer met criteria for cancer depression,
and that endured at seven weeks and at the
end, uh, at the end of the trial, eight months
later.
Compared to the placebo group where there,
you know, it was a 20%, uh, had, were in remission.
Um, and so we also found that, you know, single
dose to last at least seven weeks, but possibly
longer than that is, is a kind of breakthrough
in psychiatry.
We don't have anything that works rapidly
except ketamine.
It degrades over a week.
So to have something that can work so quickly
and last so long, you know, could have enormous
benefit.
And in addition, we found psilocybin improved
quality of life.
It decreased existential distress.
We measured cancer related demoralization
and hopelessness.
I think we have a graph that shows the, that
really illustrates pretty well the difference
that, that you're talking about.
Um, so tell us what this is.
Yeah, so, so you can see that the typical
antidepressants, if you test antidepressants
in the general population of people that have
major depression, it's actually now that a,
the data from pharma that was suppressed has
been published.
It's the 60% is lower.
These are people that are responding, maybe
more like 53 and the placebo is a little bit
higher, maybe 45.
So for severe depression, antidepressants
tend to work, for other forms they don’t.
Their medicines take a while to work, they
have, they can have enormous side effects.
Um, in cancer related depression the meta
analysis show that the antidepressants don't
work any better than placebo.
It's about a 40%.
So if our finding is real that one day after
getting it 80% are in remission compared to
40%, if they responded several weeks, um,
you know, it could have, um, you know, big
implications in the treatment of people, you
know, facing end of life distress who are
depressed and anxious.
We actually were able to interview two of
the participants who were in that study on
um, using psilocybin and I think we can take
a look at that.
I was diagnosed with ovarian cancer, stage
1C.
My first thought was, now I know what I'm
going to die of, which couldn't have been
true anyway.
You still never know.
I felt a lump in my neck that came out positive
for Hodgkin's lymphoma.
My life was just consumed by fear that this
is coming back.
Things just really spun out of control.
I was given the psilocybin.
I took the pill.
I was in a space where nothing existed except
me.
I became aware that this is probably what
death would feel like.
I'm still with my soul, but I'm not here anymore
and it sort of gave me a lot of confidence
because it really wasn't that bad.
It kind of gave me peace of mind because I
had such a tremendous fear of this unknown
that was death.
I saw a large lump under my ribs and it was
not the cancer.
It was my fear.
I just screamed (bleep) you, who the (bleep)
do you think you are?
Get Out.
It was my real fear and it went away.
I banished it.
I saw this black smoke come out of my body
in like a mushroom cloud.
I was thinking from now on, there is no more
fear of death or cancer to terrorize me.
I'm healed.
I have everything to look forward to.
And then I started to have very deep, deep
feelings.
The only way I could describe it, even though
I'm an atheist and I still am, was just bathed
in God's love.
It was untainted.
It was just pure happiness, pure harmony.
It's beautiful.
I felt a different reality.
It's almost like hope.
we actually have Octavian Mihai and Dinah
Bazer here this evening, I think right up
here in the front row, you’re both here?
Octavian, where are you now?
How are you doing?
Thank you for coming and sharing your story.
Yeah.
Thank you for having me.
Uh, I'm doing great.
Uh, my cancer is cured basically.
It's been over five years now.
Yeah and I feel incredible.
I mean, I haven't had any more anxiety.
Um, I'm just living life normally.
And do you credit that with the, the drug?
Absolutely.
I mean it, it basically all ended the moment
the session ended.
And it never came back?
No.
Amazing.
Really amazing.
Dinah thank you for your explicit honesty
in the piece.
How are you doing?
Um, I'm doing great.
I have other anxieties.
I mean, the state of the world is not really
what I would wish for my grandchildren.
Well, we’ve all got to work on that though.
I'm not afraid of cancer.
I have not been since that experience.
It's been nine years for me since I was diagnosed
and treated.
So I've been in remission all that time.
And um, I was suffering such terrible fear
and anxiety for the two years until I had
the psilocybin.
And I just, I just don't think about it anymore.
I don't think about cancer.
I don't think about, I had ovarian, I don't
think about that coming back.
I've had a few little episodes where I had
genuine concern for my health and I went to
the doctor and had it checked out and I was
fine, and I didn't freak out, you know, it
was just, well, let's just see what this is.
So very, very different.
Had, had you tried other therapies before
this?
I had not, except maybe eating a lot of candy.
And you credit it as Octavian does with the
single dose.
Absolutely.
Yes.
Yeah.
And what would you say to someone in your,
in, in a position such as you, or who were,
who was having the types of thoughts you were
having?
I wish that this drug were available therapeutically.
Absolutely.
And I know people that are in that situation
now and I really feel for them and I wish
they could have this.
Yeah, I agree with that.
I actually, um, before I tried this, I actually
tried Xanax, which was the typical thing.
Someone, you know, the doctor was prescribed
to me, uh, to kind of like help me with the
anxiety and I have to say it really wasn't
working.
Yeah.
Except for those like six hours or so while
it was in my system.
After that, I would just wake up and it would
all just be back to normal.
So, um, yeah, that's, that's something I tried
and that really didn't work.
So I really think that it would be important
for this to, to become available because it's
pretty much, in my opinion, the only thing
that's actually getting to the cause of the
problem.
Thank you both so much.
Really very interesting.
So, so right now the most of the research
currently being done that's finished was in
patients who had cancer.
Is that correct?
But we know that there are many other conditions
such as, you know, PTSD, alcoholism, opioid
abuse, um, and of course depression itself.
And I think we have a graph here that shows,
um, exactly how common it is.
300 million people globally.
Uh, the World Health Organization says it's
a leading cause of disability worldwide and
just here in the US it costs $210 billion
annually.
So when we're talking about rolling out these
drugs and looking at these different, um,
conditions, if you can, for depression, where
are we with using these drugs in depression,
on not just in depression related to cancer
and opioids and alcoholism and PTSD, so on
and so forth.
Can you break that down?
Yeah, there's a big push now to develop psilocybin
to treat major depression.
It's uh, 10% of the US population.
It's one of the biggest causes of global disability.
And, um, the, the data from the cancer work
was taken up by several companies.
One is the Usona Institute, the other is Compass
and they've gone to regulatory agencies.
In fact, the FDA has granted compass breakthrough
status to study psilocybin and treatment resistant
depression.
The only data was a small trial done at Imperial
College by Robin Carhart-Harris that didn't
have a control group.
So the data on depression's very small, it
potentially is very promising in that area
and we're about to be involved in a multicenter
trial using psilocybin to treat major depression.
And um, I think that it's a great idea to
sort of go in that direction.
What I like about psychedelics is that they
are being tried on very difficult to treat
disorders that do not have good treatments
and of life existential distress.
There is zero pharmacologic treatments for
that.
The treatments for depression tend to not
work that well.
They have lots of side effects.
Addiction is in the other areas I mentioned.
Um, the most studied indication was alcoholism
with the LSD.
In the modern era, um, that's been taken up
by our group at NYU, uh, is doing a trial
that by Michael Bogenschutz using psilocybin
assisted therapy to treat alcoholism.
We're almost done with, with that trial another,
uh, 20 participants to go.
And we'd done it about a year.
Matt Johnson's leading a trial at Johns Hopkins
using psilocybin to treat tobacco addiction.
That trial, it's also nearing the end.
There's a trial at the University of Alabama
lit by Peter Hendricks studying psilocybin
to treat essentially crack cocaine addiction
in African American individuals.
And there's promising data there.
There's a trial at the University of Madison,
Wisconsin that just started, about to start
using psilocybin treat opiate addiction.
And our lab is also moving in the direction
of opiate addiction as we have this horrible
crisis.
So there's so many different directions to
go and it keeps opening up.
Hopkins a has designed a trial using psilocybin
to treat anorexia, the most fatal psychiatric
condition with no medications.
So it's, there's so many different directions
to go therapeutically.
Um.
So we're at the beginning.
Would you say?
We're at the beginning, but I predict over
the next five years, psychiatry will be radically
transformed because I think I would predict
in three to five years MDMA will be rescheduled
and made available for PTSD.
And I think psilocybin soon after that, so
in five years, um, you know, practitioners
will be able to use ketamine, MDMA and psilocybin
in highly regulated settings for very difficult
to treat disorders and I think that will radically
change psychiatry.
Well, I want to come back to deliver a few
key caveats on, on what we're talking about,
but Eduardo I want to ask you a question.
You have seen this in a very different setting.
Does it surprise you at all that, that psychedelics
are now sort of, uh, possibly becoming key
treatments for some of the major illnesses
that were, we have.
No, it doesn't, it doesn't surprise me at
all.
I mean, I think psychedelics, one can see
the potential of them even in, in traditional
settings.
Um, you can also see that, um, that, you know,
I think there, there are lots of things that
are interesting that are happening here.
One, there is a, uh, a fascination with psychedelics,
right?
Um, there's of course the hard scientific
interest in them because of all the reasons
you've laid out, but we're also sort of fascinated
by this thing and I think that that fascination
with psychedelics, although in many ways positive
is also, is also a symptom of something.
It's a symptom of a kind of disconnection
that we feel and I don't necessarily feel
that taking psychedelics is the cure to it.
Something else.
It's finding other ways to be connected.
So I see, I see, uh, possibilities and risks
at the same time.
Um, Denver recently decriminalized magic mushrooms,
there is a trend, uh, to so called micro-dosing,
apparently popular in Silicon Valley and on
Wall Street, uh, where I guess, do they call
them yuppies still?
I don't know.
Um, um, use this to sort of get ahead, get
an advantage.
They're more creative but, but I think I need
to ask each of you there.
This is first of all, what are the risks involved
in psychedelics and how really should they
be used?
Um, should people freelance on this stuff
now?
What's your, what's your take on it?
Eduardo, I want to start with you.
Well, I, I'd like to go back to that video
that we saw at the very beginning.
In some ways the reason why psychedelics are
so threatening to society.
In some ways is a positive thing.
Um, they do, they can disrupt the order and
there is something wrong with the order today.
It's interesting that the Amazon, um, is a,
is an area politically that has never been
fully under the state.
And it's interesting that Amazonians are coming
up with solutions for problems that in some
ways are created, have been created by states,
uh, the environmental crisis, the climate
change.
So there's something interesting, uh, disruptive
about psychedelics, which I think we have
to in some ways accept even though it is a
dangerous game.
Um, but I think there are other, there are
many dangerous, I mean there's a, there's
a real problem with, uh, in the Amazon of
ayahuasca tourism, this fascination with this
leading people to go into the Amazon disrupting
traditional-
Meaning people traveling there.
What, what is that exactly?
Ayahuasca tourism is a, is a phenomenon.
It's very strong.
It’s much stronger in Peru than it is in
Ecuador with a lot of people searching for,
feeling that this is the solution to their
problems and bringing lots of problems to
those areas because of that.
Now of course, um, Amazonian folks who deal
traditionally with the ceremonial use of these
plants are not stingy about this.
There are moments and places where it's important
for them that other people can be open to
this, but it has to be done on their terms.
And, uh, this is not, um, something that can
be done that's sort of at a mass scale.
Yeah.
I find that the tourism really interesting,
Alison, thoughts on, on, um, how they should
be used, how we should look at it.
And also some of your caveats regarding what
it means to have a child like mind and obviously
separating out that none of this is being
used in children at all.
Um, explain, explain the difference there
that we're talking about.
Yeah, so I think, I think a theme that comes
up again and again is that, um, I mean there
are some specific dangers.
People who are prone to psychosis for instance,
can have very negative experiences.
Um, um, so it is extremely important that
people be screened beforehand.
Um, I think both in the kinds of settings
that Eduardo was talking about and in the
kind of settings that Stephen is talking about,
the preparation beforehand and the integration
afterwards and the fact that this is happening
in a controlled kind of way is, is absolutely
crucial for, uh, for it to, to have positive
effects rather than negative effects, rather
than to have risks.
But also I think that the, the point is of
the point of opening up these possibilities
is then to do the adult work of actually implementing
something that's different.
Of actually changing and having possibility
as we know.
I mean, children are wonderful because they're
open to possibilities, but they can have experiences
that shape them in wonderful ways and they
can have experiences that shape them in, in
terrible ways too, um, and I think that's
true as well for adults in these circumstances.
So figuring out what the right kind of cultural
tradition, and part of the trouble is, we
don't have good cultural traditions for, for
dealing with, uh, for dealing with these substances
or for dealing with these experiences in general.
And I think there's some anxiety that what
happened in the 60s could happen again because
we don't have the right kinds of contexts
and traditions to, to, to make these things
happen.
And the kind of therapeutic uses that Stephen
is talking about are a really good model for
very careful and controlled kinds of, uh,
kinds of uses of the substances.
Uh, Stephen, I'll ask you, there are some
contraindications.
Um, if people are listening to what we're
talking about tonight, tell us what some of
those are regarding other medications they
might be taking.
Yeah, psychedelics are definitely not for
everyone.
They're not miracle magic drugs that should
be used by everybody.
Um, they have real risks.
There are some medical risks.
So psilocybin is remarkably safe from a physiologic
perspective, um, although it can mildly increased
blood pressures.
So we really, we rule out people with hypertension
or you know, history of serious heart problems.
Um, the main problem, the adverse effects
are in the psychological realm.
Uh, as Alison was saying, these are not drugs
that people with psychosis should be taking.
They can exacerbate psychosis or occasion
the first onset of psychosis in a teenager
that were to use it.
So, uh, we rule those people out.
They’re not for people that are psychologically
unstable.
Um, and so you really-
Other medications?
There can be medication interactions.
I mean, so for instance, I don't think many
people know about this.
All these people going to use ayahuasca who
are on antidepressants, um, antidepressants,
serotonergic antidepressants and ayahuasca
can interact to cause a condition called Serotonin
Syndrome because there's an MAO inhibitor.
And so I, I worry that if people get the idea
that psychedelics, they can use them even
if they're trying to use them medicinally.
Um, outside of a kind of structured therapeutic
setting, I think bad things can happen and
I, and I agree that history could repeat itself.
This could go from miracle drug to demonic
drug and I think we have to look to the history
of all this so that we're careful to not repeat
the same mistakes.
Anil?
I think the thing that's coming out is freelancing
is probably not the best way to approach,
uh, the renewed interest in psychedelics.
I mean if I, if I think on the, on the positive
side if I project a few years out into the
future, I really can see both in the basic
science sense that research with psychedelics
becomes a core part of our attempts to understand
perception, consciousness and self in general,
part of the toolbox that one of the most important
parts of the toolbox that we can use to systematically
manipulate, uh, conscious experiences and
then study the neurobiological basis of that.
And then in the clinical realm too, I mean
I just to echo something that Stephen said,
typically if you're trying to find a pharmacological
treatment for something, there are three criteria
that you think about.
Is it toxic, is it going to kill you?
Is it addictive?
Does it affect the system in question?
You want the answer to the first two questions
to be no and the third question to be yes,
and the psychedelics ticks all those boxes.
Plus there seem to be plausible mechanistic
reasons why it might have an effect.
So for something like depression was mentioned,
depression can be characterize to some extent
as repetitive ruminative thinking.
So the idea that you can open up new ways
of thinking, break the ruts, shake the snow
globe.
That's at least a plausible starting point.
It's of course not a fully fledged theory
of the psychopharmacology of depression, but
it's a starting point.
And the fact that maybe you only need one
trial rather than loads.
I mean that's another great point.
Of course, this is also why the pharmaceutical
industry has been less, maybe not so keen.
We can't make many money out of it for Christ’s
sake.
You want a drug that costs a lot, that people
take every day.
That's not the psychedelic way.
So I think there's a lot of positives, but
uh, as well as the pharmacological interactions,
I think, I just want to echo this thing about
ayahuasca and SSRIs, uh, it's, it's really
important that, that those do interact but
set and setting is, is critical.
And so yeah, the back to where we started,
the signature effect of psychedelics is that
the malleable way with which they affect our
experiences of the world and the self.
You can take an antibiotic, it doesn't matter
what you take, it's going to have the same
effect on your system.
Maybe much the same for some other psychoactive
drugs, but the effects of psychedelics depends
so much on the context you're in.
Which is why we have the, the shamans in the
Amazon.
Why we have the white coat shamans in the
psychedelic trials of Stephen, to be guided
through these experiences in a way that allows
you to integrate them later on after the event.
That's where the risks, that's where the caveats
are.
That's why freelancing is not so good but
done the right way.
I, I'm really excited about, uh, where we
might be in a few years time.
Give me, give me your, your picture of a few
years from now.
Where do you think this is going?
In the neuroscience I think we'll have connected
the dots a lot more as Alison said we’re
at the beginning.
We know the pharmacology and we know to phenomenology
and some of the large scale stuff we would
be able to answer one of the questions you
asked me earlier about for instance, how is
it, why is it that the psychedelics have the
specific effects they do on, on phenomenology,
on the dissolution of the ego, on seeing patterns
in clouds or, or, or, or, or seeing life where
we don't experience in the connectedness of
all things.
We'll be able to connect those dots much more,
much more, um, strongly.
And I do think that barring some disaster
barring some overreach, which causes the whole
thing to be shut down again, there are increasing
numbers of groups, uh, having, getting licenses
to try well-controlled clinical interventions
and I see that becoming much more embedded,
much more widely available.
I think that the application to depression,
uh, will become a big, a big focus and I'm
pretty positive.
You had a message to deliver from the, from
your travels.
Can you repeat that message and tell me where
you think things are going to be in the next
few years?
The call from the Amazon is to live psychedelically,
which does not necessarily mean taking psychedelic
drugs.
It means living in full recognition that what
life is about is to be in a state of emergent
mind, connecting with the emergent mind that
holds us and to learn that that's where, that's
where that life force comes from.
That's the message that they're wanting to
transmit.
Alison, project into the near future where,
where do you see this going?
Well, I think as Anil said it holds tremendous
promise for actually understanding things
that have been challenging forever in cognitive
science.
Like a understanding how consciousness works.
Understanding this very basic question of
how our experience is connected to what's
going on in our minds, in our brains, understanding
the sort of computers that are inside of our
skulls.
But I also think that there's at least potential
for both clinical changes and perhaps for
changes in our attitudes towards things like
our relationship to nature.
Which seem like particularly important attitudes
to change at this particular, at this particular
point in our history.
And I should, I should maybe add, we have
the great hope that we have new generations
of children, new grandchildren who are, who
are showing up, who just independently will
give us the possibility of making those connections
and making those kinds of changes.
And I think you can already see that.
You can already see that happening.
Stephen, are we going to be writing prescriptions
for these in the next five years?
Are we going to see a major revolution in,
um, treatment of mental illness with the psychedelics?
I think so.
I, I, we need to do more research.
We need to replicate these findings.
They're almost too good to be true.
And so we have to do, you know, really good
science and then follow the data to find the
truth.
But my prediction is that the terminal cancer
work will put psilocybin over the line within
the next five years, the FDA is incredibly
open to all of this.
And, um, I think depression and addiction
in parallel also gonna get, get close.
Um, if it's rescheduled, you're not gonna
be able to go to CVS and get it, they're gonna
be mandated through the FDA, through the REMS
program that can only be used in licensed
clinics by licensed therapists.
We, I created a NYU psychedelic psychotherapy
training program about a decade ago because
it's such a unique form of training.
I think people will have to, you know, go
through those.
And, um, but I think it will dramatically
transform psychiatry.
I think it will transform the care of dying
people who have this demoralization, existential
distress that have nothing and die in a sort
of pain and a horrible death that, that, that's
my biggest hope for it.
Um, in terms of the, the cancer work that
we've done, but I, I'm very hopeful to transform
the care of addiction as well.
Terrific.
I want to thank Eduardo, uh, Alison and Anil
and Stephen for this discussion this evening.
Thank you all for coming.
