Latest / Get Real with Jim Weiss / The Science of Psychedelics with Robin Carhart Harris

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The Science of Psychedelics with Robin Carhart Harris · Get Real with Jim Weiss

0:00
Speaker 1: Hi everyone. I am psyched for you all to listen
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Speaker 1: to my psychedelic conversation with really one of the leading
0:08
Speaker 1: lights from UCSF. Robin is one of those guys. Once
0:11
Speaker 1: you hear him talk, you're going to really feel the
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Speaker 1: promise and you know some of I would say the
0:17
Speaker 1: trepidation of what I believe is going to be a
0:21
Speaker 1: revolution in mental health care and treatment of disorders of
0:28
Speaker 1: the brain relative to how people go to the doctor
0:34
Speaker 1: think about treatment and maybe even I don't want to
0:38
Speaker 1: say cure because I don't think we can cure some
0:40
Speaker 1: of these things, but these will be more I think natural,
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Speaker 1: more tolerated treatments for depression, anxiety, schizophrenia, post traumatic dress syndrome,
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Speaker 1: and many many other problems that we've really had a
0:55
Speaker 1: hard time with traditional medicine treating, like gorge and stories.
1:01
Speaker 1: How does a kid from Southern England end up in psychedelics?
1:08
Speaker 2: Well, what there was in the south of England was
1:11
Speaker 2: electronic dance music or rave music. It was out of
1:15
Speaker 2: acid house and so i'd be even before my teens,
1:21
Speaker 2: I was into Prodigy. They had a big hit I
1:24
Speaker 2: think in nineteen ninety two a Space, and you know
1:28
Speaker 2: that would be playing at the youth club, and I've
1:30
Speaker 2: got an older brother, and so he would be a
1:33
Speaker 2: step ahead in terms of coolness, and you know, friends
1:37
Speaker 2: with older friends, and so you get a trickle down
1:41
Speaker 2: from the subcultures. I was intrigued about drugs, I think
1:46
Speaker 2: because of the closeness of drugs to rave culture.
1:51
Speaker 1: So that drew you into the field. In twenty fourteen,
1:54
Speaker 1: you were the first scientists in forty years to legally
1:58
Speaker 1: test LSD. I'm patience. Why was it stalled for so long?
2:04
Speaker 1: Why is it taking off now?
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Speaker 2: I mean, the underground awareness was always there. Sure, there
2:09
Speaker 2: was a pushback with the War on drugs and not
2:12
Speaker 2: really kicking in from nineteen seventy with Nixon's War on Drugs. Okay, yeah,
2:17
Speaker 2: and so that put a stop on it all and
2:20
Speaker 2: it sort of fell into deep freeze. But people still
2:23
Speaker 2: knew about it. You know, Terence McKenna's doing this thing
2:25
Speaker 2: through the seventies and and he's got an audience, but
2:29
Speaker 2: it's very niche. But yeah, scientists interested in the mind
2:35
Speaker 2: and brain knew that there was there there and they
2:39
Speaker 2: wanted to work in this space, but it was hard,
2:42
Speaker 2: and so you have a few pioneering scientists. You have
2:45
Speaker 2: Rick Strassman looking at DMT in the eighties, you have
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Speaker 2: some German scientists actually wanting to work with mescaline and
2:55
Speaker 2: doing some research there, and then solocybin Swiss scientists. So
3:00
Speaker 2: there was some renegade pioneers. And I came along in
3:05
Speaker 2: the two thousands wanting to do a PhD on fMRI research.
3:12
Speaker 2: But my PhD happen in Bristol, and it happened with
3:15
Speaker 2: a guy called David Knat who's quite well known. He
3:18
Speaker 2: was the so called drug star in the UK, the
3:21
Speaker 2: chief scientific advisor to the UK government on drug policy.
3:24
Speaker 2: He was sacked, they say for telling the truth. He
3:27
Speaker 2: gave me my opportunity. I wanted to do this fMRI
3:29
Speaker 2: research and I wanted to see how LSD works in
3:34
Speaker 2: the brain. We came in with a more dynamic measure. fMRI,
3:38
Speaker 2: like I said, was really heating up around that time
3:41
Speaker 2: as an amazing tool and remains that way to see
3:45
Speaker 2: deeply into the brain. So if you can scan a
3:48
Speaker 2: person many many times, you've got the opportunity to make
3:53
Speaker 2: mappings between their experience or behavior and what's going on
3:57
Speaker 2: in their brain, and then you can sort of reverse
4:00
Speaker 2: engineer in a sense you can infer from the brain
4:03
Speaker 2: activity what they're experiencing. And so that's been happening for
4:07
Speaker 2: a few years, you know, using brain activity to predict
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Speaker 2: what people are imagining, what they're dreaming, you know, what
4:15
Speaker 2: they're viewing in terms of a movie. And we've leveraged
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Speaker 2: that too in our research now in California using fMRI
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Speaker 2: nine hours of tripping in the scanner per person and
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Speaker 2: we can look at the brain activity predict to predict
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Speaker 2: what they're experiencing. And I wanted to understand the depths,
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Speaker 2: the depths of the mind, and these were the tool.
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Speaker 2: Sure there was the recreational thing and that opened the door,
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Speaker 2: but that was the drawer. It was like, I'm not
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Speaker 2: a natural academic or I wasn't, but this deeply fascinates me.
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Speaker 1: We've worked together through our friend Kristin Nash and you
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Speaker 1: know all that so well, I want to just have
5:02
Speaker 1: you teach us a little bit. Let's get clear on
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Speaker 1: the category. So we hear about LSD, psychedelics, philocybin Will
5:11
Speaker 1: we see categories at Madison like we see in traditional biopharmer.
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Speaker 2: The term psychedelic in my view, is used to generally
5:19
Speaker 2: people lump in say ketamin, and I think ketamin can
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Speaker 2: be psychedelic, like, OK, but it's not the main thing
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Speaker 2: it does I think.
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Speaker 1: Is that natural or no synthetic?
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Speaker 2: I thought, yeah. But a classic psychedelic would be psilocybin
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Speaker 2: LSD probably the prototypical psychedelic in that the term itself
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Speaker 2: only arrived after LSD was discovered and developed and we
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Speaker 2: knew about its remarkable potency and subjective effects. So you
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Speaker 2: could say that's the definitive psychedelic. Mescaline there was on
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Speaker 2: that before LSD and that was there, you know, in
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Speaker 2: the in the fifties influencing things or this Huxley took
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Speaker 2: masculine when he rode about his trip in the Doors
6:13
Speaker 2: of Perception. That came around the time that we came
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Speaker 2: up with the term psychedelic, Humphrey Osmond. So yeah, there's
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Speaker 2: These are the classic psychedelics. They do have a common pharmacology.
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Speaker 2: They work on the brain in a particular way. They
6:32
Speaker 2: stimulate a particular serotonin protein or receptor. It's called the
6:38
Speaker 2: serotonin two A receptor, and we call them the classic
6:41
Speaker 2: psychedelics LSD. Psilocybin d MT would be another which occurs
6:46
Speaker 2: or is included in ayahuasca, this Amazonian bo So that
6:51
Speaker 2: would be another classic prescribing. So you would be seeing
6:55
Speaker 2: your physician and set you know, meeting criteria for depression.
7:02
Speaker 2: This is probably will what will move first in terms
7:05
Speaker 2: of legalization. And you've got a diagnosis and yeah, or
7:13
Speaker 2: you have an existing diagnosis and you've tried other medications,
7:17
Speaker 2: this is probably actually what will move first. It will
7:19
Speaker 2: be treatment resistant depression. And so you've tried a bunch
7:24
Speaker 2: of SSRIs maybe or even as few as two, and
7:28
Speaker 2: you meet criteria for treating does.
7:30
Speaker 1: That arise for everyone's prozac and lexapro and stuff like that,
7:36
Speaker 1: and then maybe even more.
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Speaker 2: Yeah, there's quite a lot of that type, but they're
7:41
Speaker 2: all a variation of the same essentially.
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Speaker 1: So just you know, we have a client. Real Chemistry
7:47
Speaker 1: is a company that I founded chairman. A client of
7:51
Speaker 1: ours is Compass Pathways. Do you work with them? Have
7:55
Speaker 1: you consulted with them? Just for people know that?
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Speaker 2: So very early on background, well, they were founding. So
8:03
Speaker 2: one of the sort of inspirations for their founding was
8:06
Speaker 2: our depression trial Treatment Resistant Depression Trial, back published in
8:10
Speaker 2: twenty sixty and so I advised them on what became
8:16
Speaker 2: their Phase two B work. Yeah, but then I sort
8:23
Speaker 2: of dropped away. They brought in other advisors and I
8:27
Speaker 2: haven't advised them for a while, but early on I did,
8:31
Speaker 2: and they leveraged our findings from our initials.
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Speaker 1: And what do you their data has been announced, what
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Speaker 1: do you think.
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Speaker 2: Of what I've seen? The top line I mean by efficacy,
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Speaker 2: so by how much it's improving depressive symptoms. It's not
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Speaker 2: as emphatically good as some of the previous trials, the
8:47
Speaker 2: smaller trials, if you want, maybe that's partly a product
8:51
Speaker 2: or just how it goes. When the trials get bigger,
8:54
Speaker 2: there's more pressures to get through the recruitment. Maybe the
8:57
Speaker 2: therapeutic model is a little dial down. There's not the
9:00
Speaker 2: same kind of quality of psychological support, so that could
9:04
Speaker 2: explain some of it. But another side, I mean, that's
9:07
Speaker 2: that's sort of the negative. But the positive is they
9:09
Speaker 2: found separation between you know, the high target dose and
9:13
Speaker 2: lower doses, including a placebo dose. So it's come through
9:19
Speaker 2: as they needed it too to get approval, and everyone
9:24
Speaker 2: really is expecting that.
9:25
Speaker 1: That open And do we need that first one to
9:28
Speaker 1: break us into the space, because I feel like I've
9:33
Speaker 1: talked about immunotherapy and for cancer and dozens of other modalities,
9:39
Speaker 1: and it's like once we break that seal, Yeah, with
9:43
Speaker 1: one things begin to happen. I mean GLP ones is
9:47
Speaker 1: a good example that even fifteen twenty years ago, I
9:52
Speaker 1: think they knew you lost weight, but we were. It
9:55
Speaker 1: took a long time to get us here.
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Speaker 2: Yeah, that's that's the ward moment, and probably Compass will
10:02
Speaker 2: be first. I think you Sonar will be close as well.
10:04
Speaker 2: Pslocybin therapy for depression more broadly, Compass specifically on treatment
10:10
Speaker 2: resistant depression. It's palocybin in both cases. Yeah, and yeah,
10:15
Speaker 2: we need that watershed moment, and then others will follow,
10:21
Speaker 2: LIKECOS who were a company that span out of maps,
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Speaker 2: the Multidisciplinary Association with Psychedelic Studies always a mouthful headed
10:29
Speaker 2: up by Rick Doblin. They got so close with MDMA
10:33
Speaker 2: assisted psychotherapy for post traumatic stress disorder, but the regulators
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Speaker 2: looked at that, the FDA, and they looked at that
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Speaker 2: and they declined giving them approval based on a few reasons.
10:50
Speaker 1: Yeah.
10:50
Speaker 2: I think that was a product of its time and
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Speaker 2: also the like the residue of critique and this kind
11:00
Speaker 2: of compound skepticism in a sense that cause the advisors
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Speaker 2: to the FDA to be especially critical. There was a
11:09
Speaker 2: bit of lobbying as well in the background around a
11:13
Speaker 2: couple of cases of sort of bad practice here is
11:17
Speaker 2: bad practice in the space that weren't involved in the
11:21
Speaker 2: trial itself, but still kind of blemish things in a
11:23
Speaker 2: major way.
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Speaker 1: Were the clinicians that do that in the safe space?
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Speaker 1: Is that psychiatrists or no psychologists or shamans? I mean,
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Speaker 1: how does this work?
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Speaker 2: Yeah? Were't They shouldn't call themselves sharmans, and they won't
11:37
Speaker 2: be psychiatrists typically, so that the psychiatrists might be overseeing sessions.
11:43
Speaker 2: They usually see extreme cases of mental illness and and
11:47
Speaker 2: sort of manage them psychiatrists. But most mental health treatment
11:52
Speaker 2: happens earlier on in primary care, you know, with your
11:55
Speaker 2: physician writing a prescription. Yeah, and nurses you know, who arguably.
12:02
Speaker 1: Have a better heroes of the world.
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Speaker 2: They're here, absolutely, you have that fantastic you know, bedside
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Speaker 2: manner and big heart that you know. They are professional
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Speaker 2: careers and this model needs care. Even psychotherapists more generally
12:19
Speaker 2: clinical psychologists, counselors. I think they're going to be fantastic,
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Speaker 2: and I think they're going to embrace this because many
12:29
Speaker 2: people are drawn into that profession because they want to care.
12:33
Speaker 2: That's what they want to do.
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Speaker 1: We were going to go down this road, but it
12:36
Speaker 1: seems like a perfect time to bring it up. We're
12:39
Speaker 1: on the verge of a breakthrough here. You know, there
12:42
Speaker 1: could be approved drugs in the space. Are we worried
12:45
Speaker 1: about people using these off label? You know some of
12:49
Speaker 1: this off label are unsupervised. Maybe that's already happening. What
12:54
Speaker 1: are the watchouts, what are the concerns, What are you
12:57
Speaker 1: worried about?
12:58
Speaker 2: Yeah, I'm worried about that. It's easy to hear some
13:02
Speaker 2: of this and not hear the details and just take
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Speaker 2: from it that psychedelics are good. And actually I've been
13:09
Speaker 2: feeling kind of low. I just need to get me
13:11
Speaker 2: some psychedelics.
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Speaker 1: And they're easy to get, right, they are.
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Speaker 2: In certain parts of the world. Yeah, and actually, you know,
13:19
Speaker 2: things like male order more generally. I mean, I think
13:22
Speaker 2: it is easy, easy in terms of access, even though
13:26
Speaker 2: it's illegal and there are loopholes. You know, in the
13:30
Speaker 2: Bay Area, there are all these churches you can go in,
13:32
Speaker 2: become a member and get your mushroom chocolates that way.
13:37
Speaker 2: Some of these churches have over one hundred thousand members like.
13:41
Speaker 1: The one I know about that all right, Well in Hopeland,
13:43
Speaker 1: we won't put that website up here today, and.
13:47
Speaker 2: They sell their products and you know, the information on
13:52
Speaker 2: dosage is vague, hard to understand. There aren't any warnings
13:57
Speaker 2: typically on the labels, and so it's very easy, you know.
14:01
Speaker 2: And I think we're right to think that young people
14:03
Speaker 2: are especially vulnerable there because they're naturally you know, explorative,
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Speaker 2: I was, and intrigued. There's a kind of innocence to
14:15
Speaker 2: that in a sense.
14:16
Speaker 1: I think some bad stuff can happen, and some.
14:18
Speaker 2: Bad stuff can happen, So you know, they could take
14:21
Speaker 2: a dose that's too high in a context that isn't
14:25
Speaker 2: conducive to a therapeutic process. The experience could be nightmarish, hellish,
14:32
Speaker 2: they the bad trip, they could freak out, They could
14:36
Speaker 2: harm themselves, even if they think they're having a fantastic
14:41
Speaker 2: time and a communing with you know, heavenly realms. They
14:45
Speaker 2: could jump from a height. And I mean this is
14:48
Speaker 2: not happened. Its tragically, it's happened, and young people they're
14:54
Speaker 2: not supervised, and it happens because that reality testing is impaired.
14:58
Speaker 2: I mean, there are other things that are in high aced,
15:01
Speaker 2: like the release of strong emotion, that kind of cathartic model,
15:06
Speaker 2: you know, releasing this deep emotion and memories come back,
15:11
Speaker 2: and that can be very healing if that happens in
15:15
Speaker 2: a supportive context. But in the wrong context, you know,
15:18
Speaker 2: that can actually be the source of the bad trips,
15:21
Speaker 2: some dark stuff that's happened in your past or just
15:24
Speaker 2: naturally in your psyche. Because we're all human beings, you know,
15:28
Speaker 2: with a collective history and a suf and yeah, that
15:32
Speaker 2: plays out in the wrong context and people can injure
15:37
Speaker 2: themselves and it can be fatal, and it's happened. So yeah,
15:43
Speaker 2: I'm worried about that. I mean, that's one particular scenario
15:46
Speaker 2: where I'd be worried. Another would be that this is
15:50
Speaker 2: a treatment that I see as being fundamentally a combination treatment.
15:55
Speaker 2: What do I mean by that? It's not just a drug?
15:59
Speaker 1: Yeah, because we see this in cancer too, right, you
16:02
Speaker 1: combine a lot of therapies. Yeah.
16:05
Speaker 2: In fact, I partly leverage yeah oncology treatment when I
16:10
Speaker 2: use that term combination treatment. So yeah, it's it's not
16:14
Speaker 2: just one thing. It's in a sense psychotherapy.
16:20
Speaker 1: Is this your set and setting study, So you talk
16:23
Speaker 1: about experience of the compound, but also the context that
16:27
Speaker 1: you take it in. Yes, is that part of it.
16:30
Speaker 2: So we're doing a study controlling context as a variable,
16:33
Speaker 2: and that hasn't been done before.
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Speaker 1: Really, what's the context is that, like you're lying on
16:40
Speaker 1: a couch, or you're in a dark room, or what
16:43
Speaker 1: is that You're in a cave? What's happening?
16:46
Speaker 2: So typically you're in a study and you might go
16:49
Speaker 2: to research unit, a clinical research unit, and you know,
16:53
Speaker 2: if you're lucky and you work in San Francisco at
16:55
Speaker 2: UCSF like me, it might be a brand new space.
16:58
Speaker 2: And this is pretty impressive the architecture.
17:01
Speaker 1: Because I think didn't Anderson Cooper do this on sixty minutes? Right?
17:07
Speaker 2: He might have leak of mine? Yeah, not at UCSF,
17:13
Speaker 2: probably over at Hopkins that might have been matchod Right
17:15
Speaker 2: it's a few years back.
17:17
Speaker 1: Yeah, I feel like.
17:20
Speaker 2: Yeah. But anyway, you go to this this place and
17:22
Speaker 2: it's very clinical and it's white walls and stethoscopes on
17:27
Speaker 2: the wall and some kind of bed, basic sort of
17:31
Speaker 2: clinical examination bed there, and to most people's eyes, you'd
17:36
Speaker 2: be like, well, this is a nice modern doctor's office.
17:40
Speaker 2: But the lights are pretty bright. There's a clock on
17:43
Speaker 2: the wall ticking away. That would be a standard context.
17:47
Speaker 2: But what we do in psychedelic therapy is a little different.
17:50
Speaker 2: You know, we soften it up. We have a mattress
17:53
Speaker 2: on the floor with a lovely patterned soft blanket over it,
17:58
Speaker 2: maybe a weighted blanket as well. That give people a
18:01
Speaker 2: nice sense of security. We have sent in the air,
18:07
Speaker 2: and we have music plays.
18:09
Speaker 1: I was going to ask about music. We've just had
18:11
Speaker 1: Renee Fleming on the podcast and I'm working with her
18:16
Speaker 1: and now hopefully a couple other musicians are, you know,
18:20
Speaker 1: on a program called Music as Madison or Music in
18:23
Speaker 1: the Mind.
18:24
Speaker 2: So music plays, music plays, and as you're saying, you know,
18:28
Speaker 2: music is a therapy in itself. It's used in that
18:31
Speaker 2: way right, and it's very powerful, and the model with
18:35
Speaker 2: psychedelics is that we can enhance that power. It's a
18:40
Speaker 2: catalyst of context in a sense. Context is long been
18:46
Speaker 2: known to be very powerful and potent. Some of that's
18:49
Speaker 2: wrapped up with a placebo phenomenon. You know that just
18:53
Speaker 2: being with a doctor and feeling a caring intention has
18:58
Speaker 2: therapeutic effects many different factors priming, you know, being given
19:05
Speaker 2: positive messages about how this can help. Yeah, so all
19:10
Speaker 2: these different sort of general factors, nonspecific factors, context factors
19:16
Speaker 2: can drive therapeutic outcomes.
19:21
Speaker 1: And then we're studying all that.
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Speaker 2: We're studying all that, and you know, my study is
19:25
Speaker 2: really dialing in on that and controlling some of that
19:29
Speaker 2: in kind of a simple way. We have two levels
19:33
Speaker 2: for context, a enriched version that mimics the conditions of
19:37
Speaker 2: psychedelic therapy. So all the stuff I was describing with
19:39
Speaker 2: a mattress on the floor, then I sent in the air.
19:43
Speaker 2: It's all done at UCS. We've got great space for it.
19:47
Speaker 2: So that's the enriched and then the uno rich was
19:49
Speaker 2: the first version I described the clinical space the stethoscope
19:52
Speaker 2: on the wall. I mean that's what we used to
19:55
Speaker 2: Many people have different associations around an environment like that.
19:59
Speaker 1: Yeah, some hate it.
20:01
Speaker 2: Yeah, I might be associated with the trauma of some
20:03
Speaker 2: illness that they've had. So you know, generally we overlook
20:09
Speaker 2: these subtle, implicit contextual factors, and psychedelics are great for
20:15
Speaker 2: bringing a lot of you know, under the surface implicit
20:19
Speaker 2: things into consciousness. So many and I think they do
20:23
Speaker 2: that with the role of context in medicine very cool.
20:28
Speaker 1: Well, sometimes you work with psychedelics outside the lab or
20:32
Speaker 1: the clinical setting. How do you think about the difference
20:35
Speaker 1: between clinical and I mentioned shaman led settings. My wife,
20:41
Speaker 1: you know, went to a shaman when she was going
20:43
Speaker 1: through her cancer treatment, and I always thought that was
20:46
Speaker 1: good and positive. I know other people who go and
20:49
Speaker 1: get really positive reinforcement and you know, kind of surprising.
20:55
Speaker 1: What can science learn from those traditions and where do
21:00
Speaker 1: science need to be careful? Yeah, you know, or is
21:03
Speaker 1: that part of your contacts that the shaman.
21:06
Speaker 2: Led Well, well, it takes some inspiration, I would say,
21:09
Speaker 2: maybe indirectly or you know, but that's the oldest form
21:14
Speaker 2: of medicine, goes back so far, and I think we
21:19
Speaker 2: still have some of the elements, and psychedelics bring some
21:23
Speaker 2: of the elements back, sort of excavating that history in
21:28
Speaker 2: a sense and bringing some of it back. I mean,
21:30
Speaker 2: there are aspects of shamanism that do conflict, you might say,
21:36
Speaker 2: with modern medicine and modern science. There might be some
21:40
Speaker 2: supernaturalism in there. So yeah, we could romanticize and say
21:47
Speaker 2: it's all great and good, but yeah, you might say
21:50
Speaker 2: there are some problematic ideas, say things around exorcism. We
21:55
Speaker 2: just need to exercise this demon that has got into
21:58
Speaker 2: your soul. You could accept that on a kind of
22:02
Speaker 2: poetic metaphorical level, you know, maybe it's like exercising the shadow,
22:07
Speaker 2: as colun would say, aspects of the psyche that are
22:11
Speaker 2: dark that you'd rather not you know, necessarily make conscious.
22:18
Speaker 2: So yeah, but yeah, maybe some of the magic, I mean,
22:22
Speaker 2: magic in itself is a powerful context. And so some
22:29
Speaker 2: of that magic, let's say, maybe in the poetic sense,
22:33
Speaker 2: I think can be beneficial, but if overdone and oversold,
22:40
Speaker 2: I think it can be problematic. I mean, there could
22:43
Speaker 2: be context, and we've got some evidence of this as
22:46
Speaker 2: sort of transferring in beliefs, you know about let's say
22:52
Speaker 2: religious beliefs. This can happen with psychedelics. I mean, people
22:58
Speaker 2: are opened up, they've become very plastic, very malleable, and
23:03
Speaker 2: so they're vulnerable to then the in a sense, the
23:06
Speaker 2: implantation of certain assumptions and beliefs, and you don't want that.
23:10
Speaker 2: That's bad practice in my view, But I would say
23:14
Speaker 2: that that has happened and could happen. I think in
23:17
Speaker 2: modern medicine, I think we're better principled around such boundaries.
23:22
Speaker 2: I'd like to think that that would be less likely.
23:25
Speaker 2: So there are pros and cons, I would say, to
23:27
Speaker 2: what we've learned and how we do things in modern
23:29
Speaker 2: medicine with that strong alliance with science and maybe some
23:35
Speaker 2: of the artistry that comes from shamanism and that long hair.
23:41
Speaker 1: And we've got to keep studying, you know, right, we
23:44
Speaker 1: have to study it in well controlled studies to make
23:49
Speaker 1: sure this is real.
23:51
Speaker 2: Are not yeah, even things like yeah, assumptions, beliefs or
23:57
Speaker 2: the ritual. I mean, I think the healing ritual as
24:01
Speaker 2: it's called, is a legitimate aspect of medicine and therapeutic action.
24:07
Speaker 2: And it's been shown, for example, in say acupuncture, that
24:11
Speaker 2: the way that that's delivered makes a huge difference, really
24:15
Speaker 2: makes all the difference to efficacy, you know, the care effect,
24:21
Speaker 2: your manner with a patient again makes all the difference
24:25
Speaker 2: to therapeutic outcomes. And I don't think that that's magic
24:31
Speaker 2: and supernaturalism and problematic. That's just that's what you want
24:36
Speaker 2: as part of real world practice. So I think it's
24:41
Speaker 2: absolutely fine and right and best to leverage that.
24:45
Speaker 1: So what are the brain scans revealing with psychedelics that
24:49
Speaker 1: aren't seen with the SSRIs and convert like, what's happening? Yeah,
24:55
Speaker 1: you know, is there really something very different going on?
24:58
Speaker 2: Yeah, the differences are pretty stark. I mean, one example
25:01
Speaker 2: is that we put people in the scanner and we
25:04
Speaker 2: show them faces of people, just static faces. But those
25:10
Speaker 2: faces might be showing different emotions or they are they
25:13
Speaker 2: might be showing a happy emotional stay or a fearful
25:19
Speaker 2: emotional stay, or they might be quite neutral. And when
25:23
Speaker 2: we've done that, we've we've found that actually the SSRI
25:26
Speaker 2: had the bigger effect. In this case, people have been
25:29
Speaker 2: on the SSRI for six days, sorry, six weeks. In
25:33
Speaker 2: one day, they were just taking their final dose of
25:36
Speaker 2: that that, you know, more or less six week course,
25:39
Speaker 2: and they're in the scanner around sort of peak plasma concentration,
25:42
Speaker 2: peak blood concentration of the final dose of the SSR.
25:46
Speaker 2: We show them the faces, and their brain response is
25:48
Speaker 2: blunted across the board to all the different emotions, you know,
25:53
Speaker 2: including the neutral faces. And so we think that that
25:58
Speaker 2: accounts for this so called emotion blunting phenomenon or on.
26:01
Speaker 1: So many things, I mean, grief, fear of death. How
26:06
Speaker 1: do psychedelics tackle these deeper emotions? Do they get at
26:10
Speaker 1: those they do.
26:12
Speaker 2: So I think there's a common action which is about
26:17
Speaker 2: this reconnection. It's yeah, recovering a sense of of what's
26:23
Speaker 2: most important in life, getting regaining a sense of perspective.
26:29
Speaker 2: You know, if we have a terminal diagnosis, we'll be
26:31
Speaker 2: obsessing about that, understandably, you know, terrified of that. We
26:39
Speaker 2: lose someone that we love and we can't believe they've gone,
26:46
Speaker 2: and that's you know that there's something telling in that
26:50
Speaker 2: I can't believe, I can't accept they're gone. They live
26:54
Speaker 2: on in us. There's a kind of attachment that continues. Understandably,
27:01
Speaker 2: you know, it's human nature. But the sort of ruminations
27:06
Speaker 2: that that that reinforced that are what can if it
27:11
Speaker 2: if it's protracted, if it goes on and on and
27:14
Speaker 2: on and is the source of say, suicidal depression, then
27:17
Speaker 2: then it's not it's not it's not good, right, And
27:20
Speaker 2: so to recover from that would be a process of
27:24
Speaker 2: acceptance of letting go, and then with that comes to
27:31
Speaker 2: the reconnection. So there's so many disorders that that have
27:35
Speaker 2: this kind of reinforcement thing going on. You know, whether
27:40
Speaker 2: it's through say you discover a drug it feels good
27:44
Speaker 2: to be on it, you get hooked on it, and
27:47
Speaker 2: then to not be on it, you feel destabilized and anxious,
27:50
Speaker 2: so you need the drug again. So you've reinforced things
27:53
Speaker 2: that way, and you've gone down this narrow path now
27:56
Speaker 2: like your life is all about that next fix.
28:02
Speaker 1: Is that something we have to worry about with psilosign.
28:05
Speaker 2: No, it's not really No. I mean people don't take
28:09
Speaker 2: psychedelics in that Moorish way. Typically they don't crave them.
28:15
Speaker 2: If they take them regularly, it might be ayahuasca retreats,
28:19
Speaker 2: and then what are they craving?
28:21
Speaker 1: You know?
28:21
Speaker 2: And how problematic is it? I think it can be
28:23
Speaker 2: problematic in certain context. But even microdosing, you know, taking
28:27
Speaker 2: tiny little doses of psychedelics, it's not an addictive thing
28:32
Speaker 2: in an obvious way.
28:34
Speaker 1: Well, what's the difference between macro doosing and microdosing.
28:37
Speaker 2: Well, macrodising is big doses where you have a profound
28:41
Speaker 2: altered state of consciousness, can be heaven and hell. It's
28:45
Speaker 2: very intense. It might be the most intense experience of
28:49
Speaker 2: your whole life. And there's something in that potentially you know,
28:56
Speaker 2: transformative experience that defines, yeah, what's happened. Microdosing is almost
29:02
Speaker 2: like a sort of skipping of the trip. It's almost
29:06
Speaker 2: a bypassing of it. You know, I don't want the
29:10
Speaker 2: heaven and heal thing. Could I get a little bit
29:12
Speaker 2: of this plasticity thing and do it semi regularly and benefits.
29:19
Speaker 2: Plasticity means changeability. So there's a lot of misunderstanding around
29:24
Speaker 2: around plasticity, but in its most base but in its
29:30
Speaker 2: most basic sense, it means the ability to change, to
29:33
Speaker 2: be shaped or molded. So if you're more plastic, more
29:37
Speaker 2: sensitive to you to the context that you're in, So
29:40
Speaker 2: that should make sense, you know, combination treatment drug catalyzing context,
29:47
Speaker 2: and well that would work if the drug made you
29:49
Speaker 2: more plastic, and that's the logic that that's what this
29:52
Speaker 2: model is. But yeah, plasticity is changeability. And yeah, so
29:58
Speaker 2: you know, if you if you go down a path
29:59
Speaker 2: of becoming hooked on a drug, let's say it's I
30:02
Speaker 2: don't know, cocaine or an opiate or alcohol, then the
30:06
Speaker 2: psychedelic can bring you back from that. It can be
30:09
Speaker 2: an antidote to that what I call canalization. Borrowing from
30:14
Speaker 2: you know, people before me, of course, but Henri Bergson,
30:18
Speaker 2: the French philosopher, came up with that sort of metaphor
30:21
Speaker 2: of a canal, you know, that's rotted, entrenched, and all
30:26
Speaker 2: the movement in that space is only in one direction.
30:30
Speaker 2: It's very narrow the degrees of freedom. There's very little freedom.
30:33
Speaker 2: You become canalyzed, you become stuck. And that's true of
30:37
Speaker 2: so much of mental illness. It's probably the main thing,
30:40
Speaker 2: the definitive thing of mental illness, is that canalization and
30:45
Speaker 2: psychedelics do the opposite, and actually formerly the opposite of
30:48
Speaker 2: canalyization is plasticity. Canalyization is an inability to change, and plasticity,
30:54
Speaker 2: as I've just said, is the ability to change. So
30:57
Speaker 2: that's the antidote. The caveat the cat is that when
31:00
Speaker 2: you do the plasticity thing, is openness and flexibility necessarily
31:08
Speaker 2: absolutely the thing that you want. Or could you take
31:12
Speaker 2: a person who's developed canalization, let's say, as a defense
31:16
Speaker 2: mechanism to survive in this difficult world. Are you taking
31:21
Speaker 2: their defense mechanism away and making them very vulnerable again
31:26
Speaker 2: and tender in a context where they can't sustain that?
31:31
Speaker 2: So that's that's some of the.
31:32
Speaker 1: New people who are living on the street, I mean, yeah, yeah,
31:35
Speaker 1: in particular and that's why. Yeah, it might make the
31:38
Speaker 1: whole thing.
31:39
Speaker 2: Yeah, where they're almost medicating given the context, like it's awful,
31:45
Speaker 2: it's it's hell out there, you know, history of abuse,
31:48
Speaker 2: maybe it's ongoing and the drugs are just their way
31:52
Speaker 2: to get by.
31:53
Speaker 1: Right. You have a book coming out How Psychedelics Work,
31:58
Speaker 1: Illuminating the Hidden Mind, and what do you hope people
32:01
Speaker 1: will understand differently after reading it? I mean we're really
32:05
Speaker 1: I mean it's kind of profound, this error we're going into.
32:10
Speaker 1: I mean, we now have the world where you can
32:13
Speaker 1: inject yourself and now take an oral pill and lose weight.
32:17
Speaker 1: So that's huge patient agency. Right now, Hormones are in
32:23
Speaker 1: the hands of estheticians and you know, people that you
32:28
Speaker 1: can go get botox from. We've already had all that,
32:32
Speaker 1: but now hormones are reaccepted and you can almost self
32:36
Speaker 1: medicate in and around that. And now there's this, you know,
32:42
Speaker 1: floodgate that could open. Is there something you're warning about
32:49
Speaker 1: or like AI, you know, there's the pro and the
32:52
Speaker 1: con people like or is this you know a more steady, Yeah,
32:58
Speaker 1: middle ground message.
33:00
Speaker 2: I want it to be a middle ground message that
33:03
Speaker 2: covers both angles. You know, it will cover that these
33:08
Speaker 2: can be medicines and they can transform people's lives. They
33:12
Speaker 2: can save people's lives. But yeah, in the worst of scenarios,
33:15
Speaker 2: they could also take people's lives, you know, say through
33:19
Speaker 2: suicide or injury.
33:21
Speaker 1: I mean that's pretty rare, right or not well, in
33:27
Speaker 1: the wrong context.
33:28
Speaker 2: Yeah, it speaks to the power of the intervention. You know,
33:31
Speaker 2: nuclear weapons or just that physics you know, can be
33:34
Speaker 2: used to power, yeah, power stations, or it could be
33:39
Speaker 2: used as a weapon. So yeah, that analogy has been
33:42
Speaker 2: used before, and it's I think it's a pretty good one.
33:47
Speaker 2: There is a unique power in this thing, in this experience,
33:53
Speaker 2: and really, you know, socially, we want to harness that
33:58
Speaker 2: power in the best way. So the motivation is educational
34:03
Speaker 2: and it comes from a place of like I came
34:06
Speaker 2: into this beginner's mind obviously I hadn't tripped, I knew
34:10
Speaker 2: nothing about psychedelics, and then I turned on. I was
34:14
Speaker 2: in my teens, and my reaction was, what the hell
34:18
Speaker 2: was that? I want to understand it. And that's the
34:21
Speaker 2: path I've been on, and this book is a product
34:24
Speaker 2: of that path. It's like, I think I've worked some
34:27
Speaker 2: stuff out. You know, all models are wrong some are useful.
34:30
Speaker 2: I've got some models. Maybe they're useful, and maybe if
34:34
Speaker 2: there's one theme that I wanted to get in that subtitle,
34:38
Speaker 2: which has changed a little bit, but the original one
34:40
Speaker 2: is the one you read out. Illuminating the Hidden Mind
34:43
Speaker 2: is that there's another dimension in a sense, to experience
34:47
Speaker 2: to the mind that often we're blind to. There is
34:51
Speaker 2: a hidden mind, and psychedelics can illuminate it, and that's amazing.
34:57
Speaker 2: And for me that was the initial hook was like, Wow,
35:02
Speaker 2: all of that is in my head. It's mind blowing
35:09
Speaker 2: that I didn't know it was that, and then it's
35:12
Speaker 2: and then studying it, you know, I guess the main
35:15
Speaker 2: psychological school that has really embraced that would be psychoanalysis
35:22
Speaker 2: depth psychology. Whether we associate it with certain people, you know,
35:26
Speaker 2: often critique to say Sigmund Freud or maybe less so
35:31
Speaker 2: Carl Jung, but the principle is that there is a
35:35
Speaker 2: vaster mind in all of us that we're not conscious of.
35:40
Speaker 2: And that's the amazing thing. And I think when people
35:44
Speaker 2: experience that and are stunned by that, they can often
35:49
Speaker 2: go to funny places that that I would maybe caution
35:54
Speaker 2: them to go to, like supernatural explanations or they fill
35:59
Speaker 2: that explanatory gap with something.
36:02
Speaker 1: Is it a Pandora's box that you're.
36:04
Speaker 2: Opening, Well, yeah, it could be, but this is.
36:07
Speaker 1: Your mind that you didn't know I was there.
36:09
Speaker 2: Yeah, and I guess i'd want to bring a yeah,
36:15
Speaker 2: a resource for understanding it that isn't just made up.
36:24
Speaker 2: I don't know. It could be a bit sci fi e.
36:26
Speaker 2: There's this other dimension. It's populated by these super intelligent
36:31
Speaker 2: d d MT entities, these machine ls. This is a
36:34
Speaker 2: whole meme at the moment, and I don't think it's compelling.
36:39
Speaker 2: I mean, it's really really out there, but it it
36:43
Speaker 2: gets a lot of views. I mean people are drawn
36:45
Speaker 2: to it. I think they sort of want to believe,
36:48
Speaker 2: which is true more generally with human beings throughout history.
36:51
Speaker 2: We want to we want some kind of belief system.
36:55
Speaker 1: Or they So this could be an important book, right, I.
36:58
Speaker 2: Mean i'd like it to be. And you know, people
37:01
Speaker 2: might hear all this and they might be, oh, he's
37:03
Speaker 2: wanting to you know, kill all the magic, and I
37:06
Speaker 2: would say, far from it. And I would say read
37:09
Speaker 2: the book and you'll know that that's not it. Because
37:13
Speaker 2: there is a celebration of spirituality of ritual, of ceremony,
37:21
Speaker 2: of community, which is the theme that I end on.
37:25
Speaker 2: I would say it's a theme of celebrating the soul,
37:29
Speaker 2: singing a song to the soul. You know that it's
37:32
Speaker 2: it's real and we can know it, and that's the
37:36
Speaker 2: thing that we refer to. Yeah, when when we think
37:42
Speaker 2: about this, this deep hit of mind, it's it's the soul.
37:45
Speaker 2: Do I think it's an ethereal immaterial thing? Again, not
37:50
Speaker 2: in a supernatural sense, but but kind of in a sense.
37:54
Speaker 2: I mean there are things that are immaterial, that are
37:59
Speaker 2: sort of ideas that are principles, say mathematics. You know
38:04
Speaker 2: that's right.
38:05
Speaker 1: I won't take the magic out of the mushrooms. I
38:08
Speaker 1: would say, just put them in perspective, maybe answer why
38:11
Speaker 1: are they magic?
38:13
Speaker 2: I would say, we will. We can still be just
38:16
Speaker 2: as you know, jaw droppingly in awe of this, without
38:23
Speaker 2: needing a story. People would say, yeah, but you've got
38:26
Speaker 2: your bringing in the science story. I'd say, no, No,
38:29
Speaker 2: science is a method. It's just a way to scrutinize things.
38:33
Speaker 2: And they probably come back and say, yeah, but it's
38:35
Speaker 2: actually scientist And I'd say why whatever?
38:39
Speaker 1: Right? That sounds like really getting deep there. But anyway,
38:42
Speaker 1: I mean, we could probably talk about this, we could
38:46
Speaker 1: do a whole retreat, right I'm sure you're doing them.
38:49
Speaker 1: But all this work's happening right here in San Francisco,
38:52
Speaker 1: you see us. F Is there anything? I've got a
38:56
Speaker 1: little lightning round and maybe I'll start art with that one.
39:02
Speaker 1: What are you trying to get real honest about right now,
39:06
Speaker 1: either for yourself or about the space?
39:09
Speaker 2: I would say the depth of the mind, that it's
39:13
Speaker 2: not shallow, and people have said it is and they're
39:17
Speaker 2: it's too strong to say they're lying to you. I
39:20
Speaker 2: just think that they're blind spotted to themselves. And the truth.
39:26
Speaker 2: I think it's a very deep and so important essential
39:30
Speaker 2: truth that the mind is deep, and we can realize that.
39:34
Speaker 1: And by minding it and understanding it, we can help
39:38
Speaker 1: some people. And He'll help people.
39:40
Speaker 2: So people celebrate it, you know, the heaven and hell
39:43
Speaker 2: of it. So it's not all you know, sweetness and
39:47
Speaker 2: light in there that's there, Carl Jung, let us know
39:51
Speaker 2: that there's as much light as there is darkness in shadow.
39:56
Speaker 2: But by knowing shadow, as Carl Jung said, that's the
39:59
Speaker 2: source of But you know what people like to call
40:01
Speaker 2: enlightenment is knowing the shadow and shining a light there.
40:06
Speaker 2: And so I think that can be immensely beneficial to
40:11
Speaker 2: how a species and what we do on this planet.
40:14
Speaker 1: Right, I think this peptide plus hormones plus psychedelic I
40:18
Speaker 1: think they're all going to play a role in evolving.
40:22
Speaker 2: Yeah, I don't understand the peptide stuff, And yeah, I
40:25
Speaker 2: mean there's there's a bio hacking thing going on there is. Yeah,
40:30
Speaker 2: drugs and medicines work that way. They hack into something,
40:33
Speaker 2: you know, some system or mechanism that the body already has.
40:36
Speaker 2: With psychedelics, the drugs are hacking into a change mechanism
40:40
Speaker 2: that we already have. Sometimes it gets activated by crisis,
40:45
Speaker 2: let's say, a near death experience. It can get activated.
40:49
Speaker 2: But the drugs are a bio hacked.
40:50
Speaker 1: But I think, you know, relative to how I think
40:52
Speaker 1: about the podcast, a lot of these things are about
40:55
Speaker 1: preventing the event, you know, using these things more prevented
40:59
Speaker 1: to and more health orient you know, longngevity and health
41:05
Speaker 1: are really the key is health.
41:09
Speaker 2: And that's very true with psychedelics, is that it's not
41:12
Speaker 2: just a reactive thing. Oh I'm ill now I need
41:14
Speaker 2: to get better. But it can be this can improve
41:19
Speaker 2: your resilience, your flexibility. You could endure more because you're
41:25
Speaker 2: able to be more nimble when adversity naturally happens. So
41:28
Speaker 2: that's part of it too. So there is this preventative
41:31
Speaker 2: aspect to this approach.
41:33
Speaker 1: Well, we'll see there's a lot more to do and
41:34
Speaker 1: a lot more to come, for sure. So just some
41:37
Speaker 1: lighthearted things. And I don't know if you're going to
41:40
Speaker 1: combine it with your you know, psilocybin experiences. But what's
41:45
Speaker 1: the best vacation you've ever taken.
41:48
Speaker 2: I went to the Amazon once to be the sort
41:52
Speaker 2: of token scientist for somebody else's iyaouascar experience. I never
41:56
Speaker 2: got to drink, but I was just yeah, core, but
42:01
Speaker 2: I had the time in my life. I just I
42:03
Speaker 2: was just giddy in that in the magic of the jungle,
42:07
Speaker 2: the life, and yeah, I was just blown away by
42:11
Speaker 2: that that place.
42:12
Speaker 1: Cool.
42:13
Speaker 2: Have you been back, No, I'd love to go back.
42:16
Speaker 1: Yeah, I haven't done the Amazon, but you know, it's
42:19
Speaker 1: I hear, a really cool place. And then you talked
42:21
Speaker 1: about music. How important to this? I always asked this
42:24
Speaker 1: one because it's big for me. What album is If
42:28
Speaker 1: there was one that would be the soundtrack for your life.
42:32
Speaker 2: Man, that's a hard one. I mean, a beautiful album
42:39
Speaker 2: that I listened to a lot, sort of early twenties
42:42
Speaker 2: probably would be Massive Attack Blue Lines. I'm not sure
42:46
Speaker 2: why that came out, but it's not long. I think
42:49
Speaker 2: it's forty five minutes. So it was like, you know,
42:52
Speaker 2: it was the two sides of a cassette. I think
42:55
Speaker 2: thirty minute. Yeah, I was maybe it was about an hour. Anyway,
42:59
Speaker 2: it's short. Every song is a banger, right, It's just
43:04
Speaker 2: like one after the other. And so I think sometimes
43:07
Speaker 2: artists find the flow that's very much a team effort.
43:11
Speaker 2: You know, a lot of voices coming in might be
43:14
Speaker 2: like soulful kind of gospel, or it might be the rap.
43:20
Speaker 2: And yeah, I just something about that. I mean it's
43:25
Speaker 2: very it's very British in a sense, and you know,
43:28
Speaker 2: specifically a sort of Bristol thing as well.
43:30
Speaker 1: Yeah, Massive Attack, I mean, I think we're going to
43:34
Speaker 1: create a new trend out of this. We need to
43:37
Speaker 1: Massive Attack when we open the show, right, Kate, I
43:41
Speaker 1: think so, yeah, Look, it was really good hanging out.
43:46
Speaker 1: I hope we get to do it more. Yeah, I
43:48
Speaker 1: mean I guess, you know, ultimately, at the end of
43:51
Speaker 1: the day, what do you want our listeners and everybody
43:54
Speaker 1: else to think about psychedelics and you know, how can
43:59
Speaker 1: we help tell a more balanced story about them?
44:04
Speaker 2: Yeah, I mean there is there is a there there.
44:07
Speaker 2: And what do I mean by that? I mean it
44:09
Speaker 2: could be the medicinal value, could even be the bad
44:14
Speaker 2: trip thing. I mean, that's not made up, that's not
44:17
Speaker 2: scare stories, that's real. And it could be that those
44:21
Speaker 2: psychoanalysts were onto something and they got marginalized in psychology
44:26
Speaker 2: and science, but they were actually right the unconscious mind
44:29
Speaker 2: if you want, it's real and we can study it scientifically,
44:33
Speaker 2: and these would be the tool I think to do that.
44:36
Speaker 1: Well, we're in a new frontier. Yeah, so thanks for
44:39
Speaker 1: being one of those astronauts.
44:42
Speaker 2: Thanks Jim, Sorry, pleasure, Thanks for hanging out.
44:44
Speaker 1: Robin, Hey, everyone, thanks for watching. I really appreciate that
44:48
Speaker 1: you take the time to listen to this and tune in,
44:52
Speaker 1: so please subscribe, follow I've got a lot of amazing
44:55
Speaker 1: guess you're gonna learn a lot and you're gonna feel
44:58
Speaker 1: a lot better because you did it.