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Rick Doblin: Psychedelics | Lex Fridman Podcast #202


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The following is a conversation with Rick Doblin,
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founder and executive director
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of the Multidisciplinary Association
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for Psychedelic Studies, MAPS.
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He is one of the seminal figures
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in both the cultural history
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and the cutting edge science of psychedelics.
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He was there along with the biggest characters
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throughout this fascinating history of psychedelics,
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and he is here to tell the story.
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Quick mention of our sponsors,
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Check them out in the description to support this podcast.
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As a side note, let me say
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that exploring the places the human mind can go
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can help us understand where it comes from,
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how it works, and how to engineer mental journeys,
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whether that's through life experiences,
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chemical substances, brain computer interfaces,
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or interactions with artificial intelligence systems.
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On a personal level, I think the dissolution of the ego
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for stretches of time is a powerful tool
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for understanding yourself.
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A lot of things can do this,
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including jiu jitsu, literature, meditation,
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but psychedelics is definitely, or at least arguably,
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one of the most powerful, from psilocybin to DMT.
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I'm excited that people like Rick
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are leading the scientific research
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that reveals the efficacy and the safety of these substances
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so that their proper dosage and usage protocols
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can be understood and people like me
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can safely and effectively use them,
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not just for recreation,
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but for rigorous exploration of my own mind.
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This is the Lex Friedman Podcast,
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and here is my conversation with Rick Doblin.
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Could you give an introduction to psychedelics,
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like a big, bold, whirlwind overview?
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What are psychedelics?
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What are the kinds of psychedelics out there?
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In whatever way you think is meaningful.
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All right, well, when I started MAPS,
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the Multidisciplinary Association for Psychedelic Studies,
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it was very important for me that psychedelic be in the name.
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And the way in which the original meaning of psychedelic,
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it's mind manifesting.
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It was created by Humphrey Osmond
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in a dialogue with Aldous Huxley.
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And so psychedelic means mind manifesting.
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And so we interpret that very broadly
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to mean dreams are psychedelic.
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Anything that kind of brings things to the surface,
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holotropic breath work, hyperventilation is psychedelic.
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So most people think psychedelic
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is only about certain kind of chemical substances,
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either natural or synthetic,
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but we've got a much broader view of that.
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Meditation can be psychedelic in some ways,
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but our primary focus is on the drugs,
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is on the medicines or the, you might call them,
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some people might call them spiritual tools or sacraments.
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There's sort of two general categories of those.
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One are what are called the classic psychedelics,
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and those are the ego dissolving,
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sort of merged into unitive states.
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Those are like LSD, psilocybin, mescaline, ayahuasca,
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ibogaine, DMT, things like that.
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And then there is MDMA, which some people even argue
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is not a psychedelic.
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They'll say it's an empathogen or an intactogen,
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it's about touching within or empathy.
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It doesn't do the same kind of ego dissolution
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that the classic psychedelics do,
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but it brings material to the surface
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and it changes the way we process information.
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And so I think you can quibble about whether it's,
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it's certainly not a classic psychedelic,
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but I think MDMA is also a psychedelic.
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Marijuana, I would say, is a psychedelic.
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Marijuana is closer to the classic psychedelics
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than it is to MDMA.
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One point I like to make is dreams,
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because then everybody can relate to that.
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Dreams are psychedelic.
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Dreams bring emotions, feelings, ideas, concepts,
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in symbolic form a lot of times,
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or just in raw emotions to the surface.
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So when people hear the word psychedelic,
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often they are frightened by it.
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It's about loss of control.
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And it is, to an extent, loss of conscious control,
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particularly with the classic psychedelics.
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And we know with dreams
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that we can have frightening dreams, nightmares,
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but I think that anchoring the concept of psychedelic
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in dreams is really helpful for people to know
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that it's kind of a natural state
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and that there are other ways that you can catalyze it
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than by going to sleep,
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and that for thousands of years,
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substances have been used in that way.
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So you mentioned this idea of bringing something
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to the surface, which is really interesting.
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So can you maybe elaborate the surface
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and what is there in the depths of things
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and how does ego dissolution fits into that?
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Well, Aldous Huxley talked about the brain
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as a reducing valve,
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that we have an enormous amount of information.
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So right now there's an air conditioning sound
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in the background,
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but that's not crucial to what you and I are doing,
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talking to each other, so we kind of tune that out.
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There's all sorts of sights and sounds.
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There's incoming information
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in all the different sense modalities,
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and we have to figure out what's important to us.
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And so the mind, in a way, focuses a lot on
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what are our core needs?
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And we filter all the incoming information
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that we get towards focusing on what our core needs,
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and we can even get to Abraham Maslow
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and the hierarchy of needs about survival needs,
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belonging needs, esteem needs, go on.
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So I think what I mean by bringing things to the surface
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is that we tend to not focus on a lot of things
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that are coming, but we also push away
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things that are difficult emotionally,
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difficult cognitively.
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We all know that we're on this very short trajectory
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from birth to death,
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but we're not constantly thinking about dying,
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although that can actually be helpful
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to focus us on what's really important.
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Traumas are often suppressed.
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Conflicts, we see in America and around the world
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a kind of rise of irrationality
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where people push away their logic
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in order for their emotional tribal needs to be met.
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A lot of people are suffering from early childhood traumas
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of a different kinds or abandonment issues
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or anything.
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So we tend to focus on just what we need to survive
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and what we need for work and esteem.
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And so psychedelics, by dissolving this ego control
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or by with MDMA kind of strengthening our sense of self
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and our sense of self acceptance,
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we can bring in other information
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that have previously been too complicated or too painful.
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You don't think of psychedelics
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as conjuring up something new.
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It is more revealing something that is already there.
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I think that's a very crucial thing.
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So yes, Sasha Shulgin who sort of the godfather of MDMA,
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he sort of rediscovered it
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and brought it back into use.
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He talked about his first experience was with mescaline.
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His first psychedelic experience was with mescaline
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and he had a tremendous experience.
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But what he said about it was he was having
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a human experience that the mescaline was helping him access
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rather than that he was having a mescaline experience.
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So that it's not like you pop a pill
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and you always have the same kind of experience
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as everybody else.
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The experience is not contained in the pill.
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The pill opens you up
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and you have an experience of yourself.
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Sometimes these are experiences
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that we've never consciously had.
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But we can say right now that we know
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that our body below the level of our conscious awareness
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has all these self healing mechanisms.
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And we don't modulate them
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to a large extent by conscious control.
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I mean, eventually we are learning more about the mind body
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and we learn about the placebo effect,
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how what we think is the case.
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But I think that there's experiences
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that are below our level of conscious awareness,
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particularly once we're adults
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that are more of these unit of mystical experiences,
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sense of connection.
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I think kids are like this a lot.
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We kind of come from the void, you could say,
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and you're born and you have
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a different way of processing information.
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One interesting point about that has to do with ketamine,
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which is been approved as ketamine for depression,
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but it's used for anesthesia.
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And roughly one 10th the anesthetic dose
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is a psychedelic dose.
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And when it's used in anesthesia,
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there's what's called the emergent phenomena.
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So this is, you get enough ketamine for,
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you can be operated on, you're not in pain,
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you're not really there, your ego's knocked out,
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but you can still breathe.
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But as the operations get over
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and then people metabolize the ketamine,
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there's a process that they call the emergent phenomena.
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It's like as you're emerging from this tranquilized state,
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and that's where you pass through the psychedelic phase.
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And they don't prepare people for that.
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And what we see is that a lot of adults
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have difficult times with that,
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but children don't seem to have those problems.
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Children are a little bit more already in this kind of state.
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And so ketamine is used quite frequently
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in children now for anesthesia.
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So all of that is to say to your question
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that I think the psychedelics
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reveal things that are within us.
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Some things that are how we process information
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back when we were children.
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Other things that we've never thought of before
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that are sort of baked into our consciousness.
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There's one drug, 5MeO DMT.
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It's this toxin from a Sonoran toad
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that many people consider it to be the most powerful
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of all the psychedelics.
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And it kind of knocks the ego structures completely out of it
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and we experience something different,
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but it's something I think that's always within us.
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It's at a deeper layer.
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So we knock out some of the higher cognitive functions
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and then we experience things in a different way.
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So my sense is that these are human experiences
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that the psychedelics bring us to.
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Yeah, it's really profound.
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And DMT is a really interesting example.
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So Terence McKenna has talked about these machine elves.
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And there's this, I think from the people I've heard speak
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about the experience,
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there's a sense that you are traveling elsewhere
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to meet entities, whether they're elves or not.
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So in your sense, you're not traveling elsewhere.
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You're just revealing something that's within
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and maybe it's a particular mechanism
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of revealing what's already within.
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Yeah, and I knew Terence.
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I spent a lot of time talking with Terence
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and I do not ascribe to a lot of things that he was saying.
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He was a tremendous entertainer and I think he did a lot
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of really good things and focused us
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on the power of psychedelics.
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But I think I've never seen these quote machine elves.
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I think culture is more determinative
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of what people experience under psychedelics,
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your preconceptions, than we give it credit for.
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And so I think there's a lot of priming that you could say
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that people receive by stories from their culture.
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With ayahuasca, it's about jaguars and Amazonian animals.
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And so I think these machine elves are this construct
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of Terence that other people do see.
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There's actually some people that are very interested
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in doing a study and that they're well funded
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and moving toward it to keep people on an IV infusion
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of DMT for them specifically to see,
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do they contact machine elves or aliens
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and what kind of information do they bring back
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from these other selves, other places or other entities?
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One question is, who are we?
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Are we connected to everything in the universe?
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We certainly know in many cases,
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you talk about waves or particles, the quantum approach.
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So I don't interpret experiences that we have
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of some entity that's somehow or other
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deep in our consciousness that's not us.
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It's a part of who we are.
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So I tend to interpret it in that way.
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The question is, how big are we?
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And how many ideas are within us
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that can be revealed by changing the perspective?
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You mentioned physics.
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What physicists, especially mathematical physicists
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or mathematicians do is they reveal truths
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by taking a slightly different perspective on a problem
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that reveals the simplicity of how it actually works
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in totally new ways.
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That's what Einstein did.
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Like every progress in physics
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and certainly every progress in mathematics
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requires you to take a different perspective.
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And then perhaps that's exactly what psychedelics are doing.
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It's not that they're contacting aliens that are elsewhere.
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It may be revealing the connection between us
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and other living life forms,
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or actually it might be revealing
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a totally new perspective on what life is
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or what consciousness is and giving us a glimpse at that
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even though our cognitive capabilities are limited
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to fully grasp and understand it.
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So it's just giving us an inkling of that somehow.
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And it seems perhaps a little ridiculous
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not from a scientific perspective
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in the sense that we don't have a good physics of life
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or physics of intelligence or physics of consciousness,
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but getting a glimpse of that
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is giving us a little bit of maybe an intuition
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of which way to head to build such a physics.
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Yeah, yeah, I think so.
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I think that there's this other concept
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I guess I would like to talk about briefly,
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this Jungian collective unconscious,
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this idea that somehow or other everything
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that has ever happened is still accessible,
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maybe not with as much data
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or as much resolution,
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but that there's wave resonances.
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So that I do believe that we can have experiences
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as part of this human collective unconscious
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that we're not from our own life.
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Yeah.
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And that we can, it's like the holographic realities
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and that there is a way to gather information
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that can be accurate about other times and places
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through depth investigations of our own consciousness.
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But I think what I tend to believe
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is that it's because there's emotional resonances
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between where we're at now in this life
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and other kind of experiences
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that people have had before.
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And we always hear about everybody
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who talks about past lives,
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they're always kings and queens.
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So I think that's again,
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you filter things what you want to be true.
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But I do think that there is a way to access information
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beyond what we've taken in in our own temporal existence
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through our own five senses.
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In some ways, I really find that compelling,
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the notion that that information is already there
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and you're simply just moving the attention of your mind
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to different parts of that.
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Yeah, I mean, we have that with the radio.
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I mean, you got a frequency, you turn all this information,
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you could actually say right now in the space between us,
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we have the whole world's knowledge
link |
00:17:21.640
that's up on the internet.
link |
00:17:23.080
It's right here.
link |
00:17:24.560
But we don't see it. We just have to tune in.
link |
00:17:26.480
Yeah.
link |
00:17:28.580
What are the interesting differences,
link |
00:17:31.680
would you say, between the various psychedelics
link |
00:17:34.560
that you mentioned, ayahuasca, DMT, acid, LSD,
link |
00:17:38.140
marijuana, mescaline, PCP, psilocybin, MDMA?
link |
00:17:42.720
You mentioned a few of them that are really interesting.
link |
00:17:44.800
We'll talk about scientifically some of the different
link |
00:17:47.800
studies that have been conducted on each,
link |
00:17:49.960
but sort of at the high level.
link |
00:17:52.440
What are some interesting differences?
link |
00:17:54.160
Well, one of the big ones that people make a big deal of
link |
00:17:57.300
that I think is completely misplaced
link |
00:17:59.920
is some are from nature, some are from the lab.
link |
00:18:03.080
So there's this kind of like romantic thought
link |
00:18:05.400
that if it's from nature, it's good.
link |
00:18:06.960
If it's from the lab, it's somehow tainted by humanity.
link |
00:18:10.600
And therefore, some people are like
link |
00:18:13.960
all for plant psychedelics.
link |
00:18:15.480
We see the policy changes that have been happening
link |
00:18:19.060
in a couple of cities, Cambridge, Somerville,
link |
00:18:23.280
not far from where we're at now,
link |
00:18:24.720
where they decriminalize plant medicines.
link |
00:18:27.320
So they call it decriminalizing nature.
link |
00:18:30.640
So I think that there is,
link |
00:18:32.800
from my perspective,
link |
00:18:37.360
certain things from nature are poison,
link |
00:18:40.160
certain things from the lab are spiritual,
link |
00:18:44.800
even if they don't show up in nature, like LSD.
link |
00:18:47.600
Now there is something, LSD is lysergic acid diethylamide.
link |
00:18:51.560
There is lysergic acid amide, LSA,
link |
00:18:54.800
which comes from morning glory seeds.
link |
00:18:56.320
So it's very similar.
link |
00:18:57.620
But at the same time, I'd say,
link |
00:19:02.260
I don't buy into that distinction
link |
00:19:03.740
that there's some fundamental preference.
link |
00:19:06.260
One of the things that Terence McKenna,
link |
00:19:07.860
since we talked about him,
link |
00:19:09.460
he talked about how if it's from nature, it's good.
link |
00:19:12.500
And if it's not, we should be suspect.
link |
00:19:16.540
Of course, he had a lot of great LSD experiences.
link |
00:19:18.580
But actually Terence, in 1984,
link |
00:19:22.060
we were at Esalen with a bunch of other people.
link |
00:19:24.820
This was before the crackdown on MDMA.
link |
00:19:28.800
And this was some of the underground therapists
link |
00:19:31.540
and the above ground researchers
link |
00:19:32.940
who were trying to talk about how to protect MDMA
link |
00:19:36.340
from this eventual crackdown.
link |
00:19:37.720
And Terence was like, forget about it.
link |
00:19:40.300
It's from the lab.
link |
00:19:41.940
It's dangerous.
link |
00:19:42.760
We have thousands of years of history,
link |
00:19:44.140
all these other things.
link |
00:19:45.220
And what do we know about MDMA and blah, blah, blah.
link |
00:19:48.460
I was like, Terence, you're so unscientific.
link |
00:19:51.460
Another way to say it is, and I just said,
link |
00:19:54.300
we need a study of the safety of MDMA.
link |
00:19:58.100
And so then Dick Price, who started Esalen,
link |
00:20:01.820
I said, I'll put a thousand, Dick Price, he put a thousand.
link |
00:20:04.180
So Terence was actually the catalyst
link |
00:20:06.100
for the first study with MDMA.
link |
00:20:07.860
Just because he was so frustrating
link |
00:20:10.580
about how plants are okay.
link |
00:20:11.900
And if it's from the lab, it's bad.
link |
00:20:14.740
So that's one distinction.
link |
00:20:16.500
The other distinction is that he was a scientist.
link |
00:20:19.780
The other distinction is this sense of classic psychedelics
link |
00:20:26.420
versus things like MDMA.
link |
00:20:27.620
So to what extent do they dissolve the ego?
link |
00:20:31.020
And you could say, to what extent do they cause visions?
link |
00:20:34.460
The 5HT2A serotonin receptor subtype,
link |
00:20:39.060
which is responsible for a lot of that
link |
00:20:41.540
where these drugs are activating.
link |
00:20:45.460
Now, mescaline of all the psychedelics,
link |
00:20:48.380
chemically, it's the most similar to MDMA.
link |
00:20:51.100
It's a phenethylamine, which is MDMA.
link |
00:20:53.980
So in the 50s, there was the, 53, I think it was,
link |
00:20:57.720
the Army Chemical Warfare Service
link |
00:21:00.180
wanted to look at drugs for interrogations,
link |
00:21:03.360
mind control, nonlethal incapacitants.
link |
00:21:05.780
They did a study in eight substances.
link |
00:21:10.980
These were now toxicity studies in animals.
link |
00:21:13.740
And on the one side was methamphetamine,
link |
00:21:15.620
and the other was mescaline, and MDMA was in the middle,
link |
00:21:18.740
chemically.
link |
00:21:19.920
So mescaline of these psychedelics
link |
00:21:23.500
tends to have the warmth that MDMA has.
link |
00:21:27.440
It's not as ego dissolving quite as some of the others.
link |
00:21:30.580
I mean, it's the main active ingredient in peyote.
link |
00:21:32.620
It is very psychedelic, very visual.
link |
00:21:36.500
Another distinction with these different drugs
link |
00:21:39.260
is how long they last.
link |
00:21:41.160
And a lot of that has to do with the route of administration.
link |
00:21:45.080
So for example, if you smoke DMT,
link |
00:21:49.100
it takes 10, 15 minutes, and you're,
link |
00:21:52.300
within seconds, you're off in another world.
link |
00:21:54.540
Similarly, 5MeO DMT, very rapid.
link |
00:21:59.620
When you take DMT in the form of ayahuasca,
link |
00:22:03.140
where it's mixed with another substance
link |
00:22:05.740
that makes it so that it's orally active,
link |
00:22:08.420
then it's a couple hours.
link |
00:22:10.360
So LSD is eight, 10, 12 hours sometimes.
link |
00:22:16.640
Psilocybin is more like five or six hours,
link |
00:22:18.880
or four to six hours.
link |
00:22:21.280
MDMA is similar.
link |
00:22:23.720
It's one reason why in our research,
link |
00:22:25.960
we give an initial dose of MDMA,
link |
00:22:28.080
and then two hours later,
link |
00:22:28.960
we give half the initial amount to extend the plateau,
link |
00:22:32.440
because we want it to last longer
link |
00:22:34.800
for people to be in this therapeutic state.
link |
00:22:37.100
So that's another distinction is how long these drugs last.
link |
00:22:42.300
Another distinction is which of them
link |
00:22:44.360
come from a religious context,
link |
00:22:47.180
have a religion built around them.
link |
00:22:49.280
We have this sense that some people are saying
link |
00:22:52.180
that 5MeO DMT and the Sonoran Toad,
link |
00:22:54.820
that they have this long history of indigenous use,
link |
00:22:57.420
but they don't, that's all modern,
link |
00:22:58.780
it's made up, and it's kind of a new approach.
link |
00:23:01.940
However, there was thousands of years of use
link |
00:23:05.100
of psilocybin mushrooms in religious contexts.
link |
00:23:09.260
From 1600 BC to 396 AD,
link |
00:23:14.700
the world's longest mystery ceremonies,
link |
00:23:17.100
the Eleusinian Mysteries,
link |
00:23:19.900
sort of the heart of Greek culture,
link |
00:23:21.240
the heart of Western culture,
link |
00:23:22.500
that was a psychedelic potion called Kikion
link |
00:23:25.780
that seems like it's very much like an LSD like substance.
link |
00:23:29.520
Aragat on grain and LSD comes from Aragat.
link |
00:23:36.920
So I think that there are a lot of ways
link |
00:23:39.640
to look at these different substances.
link |
00:23:41.120
Another distinction is which one of them
link |
00:23:45.000
are being researched right now in scientific context
link |
00:23:48.280
and which are not.
link |
00:23:50.100
And because of the rise of all these for profit companies
link |
00:23:52.720
and everybody's looking for what they can patent,
link |
00:23:54.800
what they can claim, the land grab,
link |
00:23:57.440
more and more there are companies
link |
00:24:01.200
looking at every different kind of psychedelics.
link |
00:24:04.360
The ones that are most important
link |
00:24:06.400
that are not being researched, Mescaline,
link |
00:24:09.080
but now there's a company to do Mescaline,
link |
00:24:11.080
the Jernico Lab, Ibogaine,
link |
00:24:14.000
which is crucial for opiate addiction.
link |
00:24:17.160
There's a new company, a branch of this company,
link |
00:24:21.400
Atai, that's gonna be looking at Ibogaine.
link |
00:24:23.720
So I'd say the rise of the for profit companies
link |
00:24:27.480
is making it so that there's just gonna be
link |
00:24:30.200
an enormous amount of investigations
link |
00:24:32.520
into all these different psychedelics.
link |
00:24:36.000
But what we're gonna see is the development
link |
00:24:39.680
of new psychedelics that we don't know anything about
link |
00:24:41.760
that have not existed yet
link |
00:24:42.840
because a lot of these for profit companies
link |
00:24:45.480
are gonna wanna invent and patent
link |
00:24:48.280
and have composition of matter patents on new molecules.
link |
00:24:51.880
So I think we'll see a lot of that happening too.
link |
00:24:53.680
That's really fascinating.
link |
00:24:54.520
I mean, there's a lot of doors you've opened
link |
00:24:57.520
and we're gonna walk through all of them,
link |
00:24:58.960
including the research and so on,
link |
00:25:00.380
but on this one little tangent
link |
00:25:03.680
of the future of psychedelics,
link |
00:25:06.480
so engineering new psychedelics,
link |
00:25:08.640
can you comment on maybe the chemistry
link |
00:25:12.120
and the biology of how psychedelics work
link |
00:25:14.200
and where is the space of possible engineering
link |
00:25:17.480
of psychedelics and what kind of things
link |
00:25:19.080
might they unlock in terms of the possible places
link |
00:25:24.560
our mind would be able to go
link |
00:25:26.580
and the effects of that of improving health,
link |
00:25:32.360
but maybe at the basic level of chemistry
link |
00:25:35.760
and the space of what could be engineered?
link |
00:25:39.000
Well, you reminded me,
link |
00:25:41.200
I'll get to exactly what you said,
link |
00:25:42.540
but you reminded me of a talk I heard
link |
00:25:45.760
by Buckminster Fuller shortly before he died.
link |
00:25:49.160
And what he talked about is how technology
link |
00:25:52.960
was making things ever smaller,
link |
00:25:57.200
that we are able to pack more and more information
link |
00:25:59.800
into smaller and smaller spaces
link |
00:26:02.440
and that we're developing technologies
link |
00:26:04.560
of communications with people,
link |
00:26:06.880
we now know the internet and things like that.
link |
00:26:08.780
But what he said is that he thought the eventual evolution
link |
00:26:13.280
of this sort of research would move
link |
00:26:16.680
from this miniaturization to telepathy.
link |
00:26:21.680
Yeah.
link |
00:26:22.840
And that was like a shocking thing
link |
00:26:24.640
for somebody like scientific like that to say that.
link |
00:26:27.760
So will we unlock those parts
link |
00:26:31.440
where I talked about the collective unconscious?
link |
00:26:33.760
Will we be able to more consciously explore those areas?
link |
00:26:39.280
So I think that that's a possibility.
link |
00:26:42.080
There was Stan Groff,
link |
00:26:44.200
who's the world's leading LSD researcher
link |
00:26:47.720
and has been my mentor, his wife Brigida.
link |
00:26:51.640
They were talking about stories that they had heard
link |
00:26:54.200
about MDMA that people take
link |
00:26:59.440
and then on top of that, they do 5MEO DMT.
link |
00:27:02.760
And so you get this ego dissolution,
link |
00:27:05.360
but underneath it, you have this sense of ego,
link |
00:27:09.240
sort of sense of self safety, of self acceptance,
link |
00:27:14.320
kind of grounds it.
link |
00:27:15.260
So Stan was like, that's the future of psychiatry,
link |
00:27:19.240
that you can watch without the terror
link |
00:27:21.680
of the ego dissolution,
link |
00:27:22.960
the sense that you're losing your mind
link |
00:27:24.600
or you're going crazy or you're dying,
link |
00:27:26.240
or that you have this grounded sense of safety
link |
00:27:29.920
while you're dissolving your normal sense
link |
00:27:32.160
of how you see things.
link |
00:27:33.840
And being able to engineer in a fine tuned way
link |
00:27:37.300
that exact experience, maybe fine tuned to the person,
link |
00:27:41.020
as opposed to sort of this manual potion
link |
00:27:43.240
that's through experiment.
link |
00:27:46.960
Although I don't know about fine tuning things
link |
00:27:48.760
to the person in the sense that
link |
00:27:50.680
we believe there's this inner healer,
link |
00:27:52.320
this kind of inner healing intelligence.
link |
00:27:55.080
We talked about it, the body repairs itself.
link |
00:27:57.980
So I think we more need to create safety for people
link |
00:28:03.860
and then what emerges will be customized
link |
00:28:06.200
to what they need to be looking at
link |
00:28:07.480
from this inner healing intelligence.
link |
00:28:09.160
At the same time, we will move to,
link |
00:28:12.400
we hear so much about the new approaches to oncology
link |
00:28:18.560
where you do genetic analysis of different kinds of tumors
link |
00:28:23.260
and then you have certain kind of chemotherapy agents
link |
00:28:25.960
and you do like personalized chemotherapy.
link |
00:28:27.980
I think we will have more like
link |
00:28:29.840
personalized psychedelic therapy,
link |
00:28:32.040
but it'll be more like a sequence of different drugs
link |
00:28:34.680
that people go through over an extended period of time
link |
00:28:37.440
and then you kind of customize what's next
link |
00:28:40.320
and sometimes you'll combine different drugs together
link |
00:28:42.560
like this 5MeO DMT and MDMA
link |
00:28:45.440
or a lot of times people do LSD MDMA combinations
link |
00:28:48.920
or psilocybin MDMA combinations.
link |
00:28:52.720
Chemistry is not my strength.
link |
00:28:56.720
I'm more into clinical applications and policy,
link |
00:29:01.200
but I can say that from what I've learned
link |
00:29:03.760
from reading from others and research done by others
link |
00:29:06.920
that different psychedelics have an impact
link |
00:29:10.540
on different neurotransmitters,
link |
00:29:12.440
different other parts of energies in the brain.
link |
00:29:16.400
The default mode network is what's considered
link |
00:29:20.480
to be like our sense of self and it's part of the brain
link |
00:29:25.780
that sort of is what I described before,
link |
00:29:27.240
scanning the world and filtering information
link |
00:29:30.260
for what's really important to us
link |
00:29:33.400
and both focusing us on things
link |
00:29:36.260
and also helping us to ignore a lot of things.
link |
00:29:40.440
And the classic psychedelics all weaken the energy
link |
00:29:43.840
in this default mode system
link |
00:29:45.920
and therefore you get this flood of information
link |
00:29:48.000
that you're not normally paying attention to
link |
00:29:49.840
and then you start seeing in the more creative waves
link |
00:29:52.840
or more connected, you actually move to
link |
00:29:56.360
beyond the verbal kind of thinking
link |
00:29:57.980
into sort of symbolic thinking a lot of times
link |
00:30:01.400
and that's where you sometimes get
link |
00:30:03.840
these mystical sense of connection, how it's all one
link |
00:30:06.620
and you get the sense also of how big the universe is
link |
00:30:12.560
and how small each one of us is.
link |
00:30:15.520
So there's a lot of work that Sasha Shulgin
link |
00:30:18.520
and Albert Hoffman who invented LSD
link |
00:30:20.940
and first synthesized psilocybin
link |
00:30:22.320
on what they call structure activity relationships.
link |
00:30:24.960
What is the structural molecule
link |
00:30:27.300
and then how do you predict what that new molecule
link |
00:30:31.000
that never existed before is going to do
link |
00:30:33.320
once you actually take it?
link |
00:30:35.520
And you can get close, but you never really know
link |
00:30:40.680
until you actually take the drug.
link |
00:30:43.020
And the way that Sasha ran his experiments
link |
00:30:47.480
is that he would take the drugs himself first in low doses
link |
00:30:51.920
and he would sort of step up the doses
link |
00:30:55.000
to have more experiences.
link |
00:30:56.000
If he thought it was valuable,
link |
00:30:56.960
he'd share it with his wife, Ann,
link |
00:30:58.720
but then what they would do is
link |
00:31:01.280
if they both thought it was valuable,
link |
00:31:02.560
they had a group of 12 people
link |
00:31:04.920
that they were with for many, many years
link |
00:31:07.360
and they would distribute these new drug to these 12 people
link |
00:31:10.800
and they would get the different perspectives.
link |
00:31:13.560
And he felt that 12 was like a minimum number
link |
00:31:15.920
because we're so unique how each of us see things,
link |
00:31:18.840
but then you kind of get a little bit of a consensus
link |
00:31:21.040
on how a lot of people are gonna see it
link |
00:31:22.560
and then if that 12 people were positive about it,
link |
00:31:25.580
then they would turn it over to Leo Zeph,
link |
00:31:27.360
who we called the secret chief,
link |
00:31:29.240
the leader of the underground psychedelic therapy movement
link |
00:31:31.320
and then he would start exploring it in therapy.
link |
00:31:34.760
So there's still a lot of mysteries
link |
00:31:38.320
as far as structure activity relationships
link |
00:31:40.560
and it's not gonna be the case that people go into the lab
link |
00:31:43.400
and they tinker with molecules
link |
00:31:45.400
and they know exactly what they're gonna get.
link |
00:31:48.760
And a lot of it has to do with
link |
00:31:51.560
not so much chemistry as morphology.
link |
00:31:54.840
You could say the shape of the molecule
link |
00:31:56.720
and how does that interact with receptor sites.
link |
00:31:59.560
And so we're getting better at modeling all of that.
link |
00:32:03.400
And how does that interaction relate
link |
00:32:04.800
to the morphing of the human experience
link |
00:32:08.280
and deeply understanding that perhaps
link |
00:32:11.040
there's no equations yet for that kind of thing.
link |
00:32:13.200
You really have to build up intuition by experiencing it.
link |
00:32:17.240
And over time and sort of subjective self report,
link |
00:32:20.620
like trying to build an understanding
link |
00:32:22.960
of the effects of the different chemistries.
link |
00:32:24.800
Yeah, you can have approximate ideas, but to know exactly.
link |
00:32:29.280
So when I first tried MDMA, which was 1982
link |
00:32:34.080
and this was after I had done lots of LSD
link |
00:32:37.400
and mescaline and mushrooms,
link |
00:32:41.200
I was shocked at how different it was
link |
00:32:44.600
than these other substances and yet how profound it was.
link |
00:32:49.280
So are there whole new kind of categories
link |
00:32:52.120
of classes of drugs that we're not aware of
link |
00:32:54.600
that would be not so much this like eco dissolution
link |
00:33:00.120
or emotional?
link |
00:33:01.960
Well, what MDMA does is reduces activity in the amygdala,
link |
00:33:05.880
the fear processing part of the brain.
link |
00:33:08.220
So it's not just chemistry, but it routes energy
link |
00:33:11.160
throughout the brain in a different way.
link |
00:33:12.680
It increases activity in the prefrontal cortex.
link |
00:33:15.880
So you think more logically,
link |
00:33:17.600
that I think has an enormous impact on the effect of MDMA.
link |
00:33:21.680
The other thing it does is it increases connectivity
link |
00:33:25.200
between the amygdala and the hippocampus.
link |
00:33:26.760
So it helps facilitate processing of things
link |
00:33:30.340
into longterm memory.
link |
00:33:32.820
And with PTSD, trauma is like never in the past,
link |
00:33:35.440
it's always about to happen.
link |
00:33:36.520
So will we one time develop drugs
link |
00:33:39.560
that would even be specific to certain kinds of memories?
link |
00:33:43.520
We're working with a woman, Rachel Yehuda,
link |
00:33:46.400
who is at the Bronx VA,
link |
00:33:50.120
and she's done some studies
link |
00:33:52.320
that are with the epigenetics of trauma.
link |
00:33:55.320
So she's worked with Holocaust survivors and their children,
link |
00:33:58.800
and she has identified epigenetic mechanisms
link |
00:34:03.560
by which trauma is passed
link |
00:34:05.120
from generation to the generations.
link |
00:34:07.400
Sort of like set points for anxiety,
link |
00:34:10.120
fear, certain things like that.
link |
00:34:11.760
But the question is, can you actually transmit memories
link |
00:34:16.080
from one generation to the next?
link |
00:34:18.720
Now, this is not DNA changes
link |
00:34:24.360
which happen over a very long period of time
link |
00:34:26.520
and evolutionary scale.
link |
00:34:28.760
But within one lifetime, within some experiences,
link |
00:34:31.680
your epigenetics, what turns on the genes
link |
00:34:34.240
or turns off certain genes, that can be impacted.
link |
00:34:37.160
And that's what we know now can be transmitted
link |
00:34:39.560
from generation to generation,
link |
00:34:41.880
either by the father or the mother
link |
00:34:43.560
through the sperm or the egg.
link |
00:34:45.820
So it's pretty remarkable.
link |
00:34:48.720
So what Rachel's gonna try to do is MDMA research for PTSD
link |
00:34:53.460
and look at these epigenetic markers before and after
link |
00:34:56.400
and see if they change as a consequence of therapy.
link |
00:35:00.280
So will we develop one day certain kind of chemicals
link |
00:35:05.440
that will be able to bring certain kind of memories
link |
00:35:08.080
to the surface?
link |
00:35:10.400
That's not inconceivable.
link |
00:35:12.600
The epigenetic angle is fascinating,
link |
00:35:14.960
that there'll be these epigenetic perturbations
link |
00:35:17.600
that lead to memories living
link |
00:35:19.840
from one generation to the other
link |
00:35:22.840
and then bringing those memories to the surface
link |
00:35:25.200
and using that as signal to understand
link |
00:35:30.280
what exactly the psychedelics bring to the surface and not.
link |
00:35:34.640
Yeah, yeah.
link |
00:35:35.480
Now, the other portion of that though is culture.
link |
00:35:38.240
I mean, culture is where we store all these memories
link |
00:35:40.680
and in the stories that we get passed out.
link |
00:35:44.200
Especially with a lot of shared,
link |
00:35:46.000
you talk about the Holocaust or World War II,
link |
00:35:48.880
where it's deeply ingrained in the culture,
link |
00:35:53.560
the impact of those events
link |
00:35:55.360
and sort of in aggregate the different perspectives
link |
00:35:57.680
on that particular event create a set of stories
link |
00:36:01.440
that you can plug into.
link |
00:36:03.120
And then they kind of resonate with some aspect of you
link |
00:36:06.560
that creates a memory that's connected to,
link |
00:36:09.560
like when I think about World War II and the Holocaust,
link |
00:36:12.080
I think about my own family,
link |
00:36:13.760
but in some sense,
link |
00:36:15.700
it's also resonating with stories of many others.
link |
00:36:19.000
So it's like somehow the two echo each other
link |
00:36:22.040
and I'm just providing my own little flavor on top.
link |
00:36:24.960
The meat of the stories
link |
00:36:26.760
are probably those that are shared with others.
link |
00:36:29.280
It's plugging into the collective unconscious.
link |
00:36:32.320
That's really fascinating,
link |
00:36:34.760
really plugging into like precisely
link |
00:36:38.720
plugging into particular memories
link |
00:36:40.680
as a way to deal with trauma and PTSD, that kind of thing.
link |
00:36:47.960
Yeah, I'll just add that the most important dream
link |
00:36:51.120
of my life ever was of a Holocaust survivor
link |
00:36:54.180
telling me that he was miraculously saved from death
link |
00:37:02.320
and he knew that he was saved for a particular purpose,
link |
00:37:04.780
but he never knew what that purpose was.
link |
00:37:06.560
So in the dream, I'm seeing him on his deathbed
link |
00:37:08.360
and then he shows me whatever happened to him
link |
00:37:11.600
during the Holocaust.
link |
00:37:13.560
And then we're back in the room on his deathbed
link |
00:37:16.360
and he says, well, I know what my purpose was now.
link |
00:37:20.520
And I'm like, oh, great, what was it?
link |
00:37:22.100
He says, it's to tell you to be a psychedelic therapist
link |
00:37:24.440
and to study psychedelics
link |
00:37:25.740
and bring back psychedelic research.
link |
00:37:28.440
And I thought to myself, I've already decided to do this.
link |
00:37:31.920
You can lay this on me.
link |
00:37:33.080
I can say yes and then you can die in peace.
link |
00:37:35.240
And then he died in front of my eyes in the dream.
link |
00:37:38.160
So I think that that kind of cultural transmission
link |
00:37:43.040
that I got from when I was really young,
link |
00:37:45.680
then manifested in this dream.
link |
00:37:47.500
And that was this story about how people
link |
00:37:51.800
can be incredibly vicious
link |
00:37:55.240
and can be very motivated by irrational factors.
link |
00:37:58.920
And so I just feel that this kind of
link |
00:38:02.400
multi generational transmission of this story
link |
00:38:05.680
of the irrational being a murderous factor
link |
00:38:10.800
and something I needed to respond to was deeply ingrained.
link |
00:38:15.400
And I would say my guess is more culturally
link |
00:38:19.960
than this epigenetic mechanism.
link |
00:38:22.080
Yes.
link |
00:38:23.440
Yeah, but your sense is that whatever stimulated
link |
00:38:27.240
a certain part of human nature in World War II,
link |
00:38:32.240
especially Nazi Germany, but also in Stalinist Soviet Union,
link |
00:38:37.680
still is within us, within all of us.
link |
00:38:40.280
Just like what we're saying,
link |
00:38:44.520
we embody quite a lot of things.
link |
00:38:47.000
Yeah.
link |
00:38:47.840
And one of those is whatever the capacity for evil
link |
00:38:53.680
seems to be one of those things.
link |
00:38:56.400
Yeah, there's a quote from Carl Jung
link |
00:38:58.880
from just a few years before he died.
link |
00:39:03.360
What he says, and I'll just paraphrase it is
link |
00:39:05.980
that we need to understand psychology.
link |
00:39:10.200
We need to understand who man is,
link |
00:39:14.220
that the greatest danger to us is man.
link |
00:39:18.360
There are no other dangers really that impact our species.
link |
00:39:23.760
And then he goes on to say that
link |
00:39:25.920
we are the source of all coming evil.
link |
00:39:30.120
Now this was 15 years or so after World War II.
link |
00:39:34.000
But yeah, and I'd say one of the most important
link |
00:39:36.320
psychedelic experiences of my life was a DMT experience.
link |
00:39:39.240
Also Terrence was there, Ralph Metzner,
link |
00:39:43.120
Andy Weil, a few others.
link |
00:39:44.880
And we were sitting around at Esalen smoking DMT.
link |
00:39:50.800
And under the influence of DMT,
link |
00:39:53.440
which now this was the first time I've ever smoked DMT,
link |
00:39:57.720
I had this super rapid fraction of a second,
link |
00:40:01.260
like dissolving of everything that I,
link |
00:40:03.520
well, first off I saw a horizontal line,
link |
00:40:06.200
then I saw a vertical line, then it turned into a color,
link |
00:40:09.060
red, then it was red, then it turned into cubes,
link |
00:40:11.440
then it turned into like an MC Escher kind of like,
link |
00:40:14.220
I don't know, you know, didn't make logical sense.
link |
00:40:17.040
And then I was gone.
link |
00:40:18.700
And then it was just this period of five, 10 minutes
link |
00:40:23.340
of just feeling part of this enormous wave
link |
00:40:26.560
of billions of years of evolution,
link |
00:40:29.080
how I had this sense that in my innermost sense
link |
00:40:32.740
of who I am uniquely individually,
link |
00:40:35.920
this inner voice that's talking to me
link |
00:40:37.800
that I didn't develop English,
link |
00:40:40.000
that it's like a gift to me from millions of people.
link |
00:40:43.520
So that even in my most innermost sense, it's not just me.
link |
00:40:48.680
It's the product of everything that came before me.
link |
00:40:51.060
I'm part of this bigger system.
link |
00:40:53.640
And then I just thought, wow,
link |
00:40:55.080
just how many billions of years does it take
link |
00:40:57.240
to reach this point of self awareness and all this?
link |
00:40:59.820
And it was glorious, beautiful.
link |
00:41:01.080
And then I had this thought,
link |
00:41:03.400
and this is where this kind of intellectual honesty,
link |
00:41:06.860
I guess you could say, I just thought,
link |
00:41:08.120
well, if I'm part of everything
link |
00:41:09.360
and everything's part of me,
link |
00:41:11.040
then it's not just the good parts,
link |
00:41:12.880
that Hitler's part of me too.
link |
00:41:15.080
And that was just this shock, like a stone sunk,
link |
00:41:19.120
and I just was very moody for the whole next day.
link |
00:41:22.800
But it was that acknowledgement
link |
00:41:24.800
that each of us carries these potentials,
link |
00:41:27.440
and what we activate is what matters,
link |
00:41:29.460
but what our potential are is the whole full range of things.
link |
00:41:34.120
I don't know if you can comment
link |
00:41:35.200
about the DMT trip itself and what it's like,
link |
00:41:39.000
starting from the very basic geometric shapes
link |
00:41:42.080
and then launching yourself into the context
link |
00:41:46.080
of the enormity of space and time in the human history.
link |
00:41:52.400
Is there anything else to be said
link |
00:41:54.040
about that kind of visually or physically
link |
00:42:00.240
or emotionally about that journey?
link |
00:42:02.760
What it's like, that brief journey that reveals so much?
link |
00:42:07.900
Well, I was with a group of people.
link |
00:42:10.040
The way we were doing it was each of us would smoke DMT,
link |
00:42:14.800
have 10, 15 minutes experience while we closed our eyes,
link |
00:42:17.600
and everybody else was just chatting,
link |
00:42:19.320
and then the person who did the DMT would come back
link |
00:42:21.840
and tell their story of what happened.
link |
00:42:24.240
And then we'd think about it for a bit
link |
00:42:26.000
and then pass the pipe to the next person.
link |
00:42:27.600
And so this was like a whole evening.
link |
00:42:30.920
So even the, sorry to interrupt,
link |
00:42:32.320
even the conversations themselves then
link |
00:42:34.100
is part of the experience.
link |
00:42:35.840
Exactly, yes, yes, because it's also what you bring back.
link |
00:42:39.240
I mean, I think that's particularly for therapy.
link |
00:42:42.280
It's not so much about what the experience is,
link |
00:42:45.240
but it's what you bring back and what do you integrate.
link |
00:42:48.720
And then also, how do you learn how to do these things
link |
00:42:52.560
on your own without the drugs?
link |
00:42:54.560
There is this way, because we're saying
link |
00:42:56.340
it's sort of a core human experience,
link |
00:42:58.360
the drug is the mediator, but can we do this on our own?
link |
00:43:01.920
And once you've seen it and felt it,
link |
00:43:04.440
then you have a little bit better sense
link |
00:43:06.000
to recreate it on your own.
link |
00:43:08.240
Although, I've had dreams where I've been doing LSD
link |
00:43:11.860
and tripping and it was just incredible.
link |
00:43:14.560
It was, I was tripping in my dreams,
link |
00:43:17.320
but I had not taken LSD.
link |
00:43:19.760
So there's this way in which we do that.
link |
00:43:22.020
So I would say that from the DMT experience,
link |
00:43:26.040
the sense of safety, that's what I was trying to get at
link |
00:43:28.160
with this, the group of us and this group of friends
link |
00:43:30.760
trying to do this common exploration,
link |
00:43:32.500
that if you have this sense of safety,
link |
00:43:34.880
you're incredibly vulnerable
link |
00:43:38.200
because you are giving up your awareness really
link |
00:43:43.080
of what's happening around you.
link |
00:43:44.840
I think there's, what we're finding is that
link |
00:43:49.440
in our psychedelic research for PTSD
link |
00:43:54.860
and what we see with the vaccines,
link |
00:43:56.480
that even African Americans are reluctant
link |
00:43:59.200
to volunteer for vaccines because they haven't had
link |
00:44:02.560
that sense of safety from the medical establishment.
link |
00:44:05.700
They don't volunteer for psychedelic therapy even as much.
link |
00:44:10.500
So the overlay has to be this sense of safety
link |
00:44:14.280
as you become vulnerable and looking inside, you're not.
link |
00:44:18.300
I was just actually told about how there's a lot of work
link |
00:44:22.180
being done inside prisons to teach mindfulness.
link |
00:44:25.520
And so one of the,
link |
00:44:29.840
Charlene who's my assistant is trying to do work
link |
00:44:32.280
on helping people in prison with trauma,
link |
00:44:36.400
potentially one day with MDMA or meditation or mindfulness.
link |
00:44:39.520
But one of the exercises was teaching people to,
link |
00:44:42.840
okay, here's how you deal with stress,
link |
00:44:45.020
just close your eyes and deep breathe.
link |
00:44:46.800
And what Charlene was saying is people don't close their eyes
link |
00:44:49.400
in prison, you don't feel safe to do that.
link |
00:44:52.360
So all that is just to say is that the context
link |
00:44:57.840
is the most important factor.
link |
00:44:59.780
So while I'll talk about the DMT experience,
link |
00:45:02.240
the context was this supportive sense of safety
link |
00:45:07.160
that I could be completely vulnerable
link |
00:45:09.120
and out of any kind of controlled women,
link |
00:45:12.920
I think often are less safe in this way than men
link |
00:45:16.820
because of all the sexual assaults.
link |
00:45:20.760
But what it can do by taking the ego orientation offline
link |
00:45:26.920
to some extent, it opens you up to much more.
link |
00:45:29.960
And to make a bigger point of that,
link |
00:45:33.720
we could say that it's very similar
link |
00:45:35.920
to the Copernican revolution.
link |
00:45:38.060
And people thought that the earth
link |
00:45:40.060
was the center of the universe
link |
00:45:41.720
and the inquisition murdered people that questioned that.
link |
00:45:47.240
Father Bruno burned at the stake.
link |
00:45:48.840
Actually, one of the things he said,
link |
00:45:50.440
I think that's worth all these years later saying
link |
00:45:54.280
is that when the inquisition sentenced him
link |
00:45:58.880
to burn at the stake for espousing this idea
link |
00:46:02.040
that the earth was not really the center of the universe,
link |
00:46:05.720
he said to the inquisition, he said,
link |
00:46:08.400
your fear in sentencing me is greater
link |
00:46:11.320
than my fear in being sentenced.
link |
00:46:15.280
That their worldview was so rigid
link |
00:46:18.120
that they had to wipe out anybody that would question it.
link |
00:46:21.720
And so this idea of psychedelics displacing our ego
link |
00:46:26.720
is the center of the universe.
link |
00:46:28.640
And to realize that we are just rotating
link |
00:46:31.320
about on something much bigger than our individual life.
link |
00:46:35.040
Our ego is designed almost to protect this body
link |
00:46:38.520
while we're alive.
link |
00:46:40.280
And you can understand all the good reasons why that is,
link |
00:46:44.040
but it also disconnects us from this bigger reality.
link |
00:46:47.520
And so the psychedelics, DMT,
link |
00:46:49.080
by knocking this sort of ego orientation
link |
00:46:52.480
or the default mode network offline,
link |
00:46:55.640
you open up to the bigger sweeps of history.
link |
00:47:00.600
So in that place of safety and vulnerability
link |
00:47:03.560
in that fascinating group of people,
link |
00:47:06.000
when their ego was dissolved in this way,
link |
00:47:08.080
did they have similar experiences?
link |
00:47:09.960
Is there different places that their minds went?
link |
00:47:12.240
Yeah, so once I had this kind of shattering experience
link |
00:47:17.460
that Hitler's part of me,
link |
00:47:19.640
no one else in the group had that.
link |
00:47:21.440
Probably a lot of them have maybe had that before
link |
00:47:24.080
or they realized that they're not just the good,
link |
00:47:28.440
the white hat, good people and that they're all good
link |
00:47:31.520
and we got to fight against the bad people.
link |
00:47:35.360
So no, people will go in different places.
link |
00:47:37.200
And not only that, if you do it again,
link |
00:47:39.360
you'll go into a different place
link |
00:47:40.480
than you went to the first time.
link |
00:47:42.520
Unless you have not resolved the issue.
link |
00:47:45.000
So I had a sequence of LSD trips that were very difficult,
link |
00:47:48.520
but it was like coming to the same sort of conundrum,
link |
00:47:52.720
the same challenge that I was unable to overcome.
link |
00:47:57.280
This idea of letting go and really fully dissolving,
link |
00:48:01.640
letting the ego fully go.
link |
00:48:02.980
And I would have this sequence of trips
link |
00:48:04.840
over a couple of months where I would reach this point
link |
00:48:07.320
where I was too scared to move forward
link |
00:48:08.800
and I would just be holding on.
link |
00:48:11.880
So there are repeated themes sometimes.
link |
00:48:15.360
What Stan Groff has said, which I find very beautiful,
link |
00:48:18.280
is that the full expression of an emotion
link |
00:48:21.720
is the funeral pyre of that emotion.
link |
00:48:25.240
And what that means is if you can fully let in something,
link |
00:48:29.200
then the essence of life has changed,
link |
00:48:32.600
is that it moves on, that everything's in motion.
link |
00:48:35.640
And if you can fully experience it,
link |
00:48:37.320
even if it's a sense that you're gonna be trapped
link |
00:48:39.400
in eternity in this hellish state,
link |
00:48:42.640
if you surrender to that, that's the way out.
link |
00:48:46.200
This full experience of something
link |
00:48:48.160
is this funeral pyre of that emotion.
link |
00:48:52.220
And so that runs against a lot
link |
00:48:54.720
of what modern psychiatry is doing too,
link |
00:48:56.320
which is to suppress symptoms.
link |
00:49:00.360
Instead of supporting people
link |
00:49:01.640
to kind of explore these insecurities
link |
00:49:03.920
so that then they can contain them
link |
00:49:06.300
and then they can move on.
link |
00:49:09.080
So yeah, resistance is not a way to make progress.
link |
00:49:13.680
Right, right.
link |
00:49:15.060
Although one of the reasons
link |
00:49:17.860
why we do the supplemental dose during the MDMA
link |
00:49:21.380
or why there's advantages in a 10 hour LSD experience
link |
00:49:26.140
is that you have a lot of opportunities
link |
00:49:28.540
to come up against this resistance
link |
00:49:31.060
that may be too difficult to deal with
link |
00:49:32.940
and then you kind of push it aside
link |
00:49:34.680
and then a couple hours later you come back to it
link |
00:49:36.580
or you come back to it.
link |
00:49:37.580
Press snooze every once in a while if you're not ready.
link |
00:49:40.500
It's hard to do that.
link |
00:49:41.460
I think with MDMA, you can negotiate.
link |
00:49:45.140
That's, I think, a part of its safety in a sense.
link |
00:49:48.140
You can have this like, oh, I should be talking about this
link |
00:49:50.860
or I'm feeling this, but it's too much for me now.
link |
00:49:53.740
You can push it away.
link |
00:49:54.700
But with the classic psychedelics,
link |
00:49:57.080
this kind of membrane between the conscious
link |
00:49:59.500
and the unconscious,
link |
00:50:00.940
that once you take the drug and it weakens this membrane
link |
00:50:04.940
and things are coming up,
link |
00:50:07.500
it's very difficult to negotiate with it.
link |
00:50:10.660
The key to successful classic psychedelic trips is surrender.
link |
00:50:18.100
You've talked about that you first began
link |
00:50:20.060
to reconsider the negative health myths around psychedelics
link |
00:50:24.260
when you learned that the book One Flew Over the Cuckoo's Nest
link |
00:50:27.860
was written by Ken Kesey when he was in part
link |
00:50:30.580
under the influence of LSD.
link |
00:50:32.640
So how do you think LSD helped him, Ken Kesey,
link |
00:50:36.180
in writing that incredible book?
link |
00:50:39.540
Yeah, there's a process that's called semantic priming.
link |
00:50:45.060
And so what that means is that I say night, you say day.
link |
00:50:49.380
There's kind of normal patterns of kind of,
link |
00:50:52.420
you say one word, what kind of words come to you next?
link |
00:50:56.660
And so they've done some research.
link |
00:50:58.500
They, meaning scientists, have done some research
link |
00:51:01.280
where you give people a psychedelic
link |
00:51:04.720
and then you do this semantic priming.
link |
00:51:07.420
And what you find is they have a wider range of associations
link |
00:51:12.060
than they normally would
link |
00:51:13.340
when they're not under psychedelics.
link |
00:51:15.780
So I think for Ken Kesey,
link |
00:51:18.900
he was able with psychedelics to get
link |
00:51:24.140
a deeper kind of emotional connection
link |
00:51:26.400
to some of these states of mind
link |
00:51:28.300
that people were in this mental institution
link |
00:51:31.680
and that he could explore them more in depth
link |
00:51:35.580
and more eloquently.
link |
00:51:37.420
And also one of the things he talked about
link |
00:51:40.080
was the fog machine,
link |
00:51:41.840
was how people's minds were sort of clouded
link |
00:51:46.340
by the people that ran the institution
link |
00:51:48.440
and the fog machine would be coming in.
link |
00:51:51.120
So I think the imagery and the metaphors
link |
00:51:56.420
that he used a lot in the book
link |
00:51:58.580
could come to him during LSD experiences.
link |
00:52:00.980
And then now he wasn't doing very,
link |
00:52:05.700
when you're writing, you have to be literate.
link |
00:52:10.500
You have to be able to write.
link |
00:52:13.420
So it would be more like beginning and ends of LSD trips
link |
00:52:16.320
instead of at the peak.
link |
00:52:17.740
But I think you would get a lot of these,
link |
00:52:20.740
the feeling tones or the images, the metaphors,
link |
00:52:23.240
I think he would get these extent,
link |
00:52:26.220
also LSD lasts so long, you can get these extended focus
link |
00:52:30.180
and you can really elaborate on images.
link |
00:52:34.060
And so much of psychedelic experiences
link |
00:52:37.860
are poetic and metaphorical.
link |
00:52:40.420
I mean, you could take veterans
link |
00:52:43.700
who've never read a book of poetry in their lives.
link |
00:52:49.580
And under the influence of MDMA,
link |
00:52:52.020
just what they describe, the imagery
link |
00:52:54.260
and the way they describe their experiences,
link |
00:52:56.580
metaphorical, poetic, it's incredible.
link |
00:53:00.500
And so I think that Ken Kesey was able to channel
link |
00:53:06.460
what LSD did to his mind in a way
link |
00:53:09.660
that most people couldn't do,
link |
00:53:13.060
that he did because he was trying to write this novel
link |
00:53:15.500
and because he was so brilliant.
link |
00:53:17.940
Yeah, I mean, we'll talk about psychedelics
link |
00:53:22.940
and treating, in bringing some of trauma to the surface
link |
00:53:28.300
and dealing with all those kinds of things,
link |
00:53:29.640
but there's something also to the opening up of creativity
link |
00:53:34.780
for whether it's for writing purposes
link |
00:53:37.380
or for in my world for engineering, for invention,
link |
00:53:41.940
innovation and invention itself is a very,
link |
00:53:44.940
is a deeply creative process.
link |
00:53:47.300
And it's fascinating to think with the aid of psychedelics,
link |
00:53:53.660
what kind of ideas can be brought to life?
link |
00:53:57.300
Yeah, well, we have the whole phenomena
link |
00:53:59.060
of a lot of the people in Silicon Valley
link |
00:54:00.900
and else microdosing psychedelics
link |
00:54:02.680
in order to have a little touch more
link |
00:54:05.300
of this creative approach to things.
link |
00:54:07.620
I would love it to see if it was,
link |
00:54:10.260
that's more like Terrence McKenna territory,
link |
00:54:12.460
correct me if I'm wrong,
link |
00:54:13.460
but I would love to sort of more scientific
link |
00:54:16.100
to where there'll be the rigor
link |
00:54:17.860
of saying how to do it effectively,
link |
00:54:21.220
how to sort of understand sort of not just almost,
link |
00:54:30.820
to take the full journey of creative exploration
link |
00:54:35.020
and to do it for prolonged periods of time,
link |
00:54:39.260
for years, lifelong kind of part of your life
link |
00:54:43.140
of how it empowers creativity.
link |
00:54:46.020
I think, of course, you start with helping people
link |
00:54:53.340
deal with trauma, and then the next step
link |
00:54:55.900
is people who have moved past their trauma
link |
00:55:00.620
and are trying to do something,
link |
00:55:02.300
create something special in their life.
link |
00:55:04.400
How can then psychedelics empower that?
link |
00:55:07.220
Yeah, now, that also,
link |
00:55:08.700
just to not shy away from anything controversial,
link |
00:55:11.980
that gets us to this idea of psychedelics for vision quest,
link |
00:55:17.220
particularly for younger people.
link |
00:55:19.420
You know, when you're sort of moving
link |
00:55:21.660
into this adulting kind of phase
link |
00:55:23.460
and you have to figure out
link |
00:55:24.500
what are you gonna do with your life,
link |
00:55:27.540
there's so many options.
link |
00:55:29.780
A lot of people, of course, feel constrained
link |
00:55:31.860
that they have very few options,
link |
00:55:33.280
but I think this idea of psychedelics
link |
00:55:36.660
as a way to help you find your calling
link |
00:55:40.180
or find your vision or find your unique leverage point,
link |
00:55:44.240
I think we'll see that more and more
link |
00:55:45.580
as our culture evolves and gets healthier
link |
00:55:48.420
around the use of psychedelics.
link |
00:55:49.860
So it's both the science,
link |
00:55:52.420
having the rigor of understanding how to do it safely
link |
00:55:55.020
and the culture catching up
link |
00:55:56.740
to the fact that this is both safe and very useful.
link |
00:56:03.540
Yeah, although I would question this idea of safety.
link |
00:56:07.580
So we can understand physiological risks
link |
00:56:11.340
and we can minimize them.
link |
00:56:13.100
And I think there's very minimal physiological risks
link |
00:56:16.180
from the classic psychedelics, virtually none,
link |
00:56:18.460
or for even MDMA under safe conditions.
link |
00:56:23.740
Psychological risks are harder to address,
link |
00:56:29.660
but we can do that through the sense of safety and support.
link |
00:56:32.980
But I think there's a level of risk there
link |
00:56:37.520
that we shouldn't overlook.
link |
00:56:39.820
And so to make a drug into a medicine,
link |
00:56:42.700
what we have to do is prove to the satisfaction
link |
00:56:45.200
of the FDA and other regulatory agencies
link |
00:56:47.740
that things are safe and efficacious.
link |
00:56:50.360
But even though they use those words,
link |
00:56:52.420
proving safety and safe and efficacious,
link |
00:56:55.820
it's in relationship to the disease
link |
00:56:57.940
that you're trying to treat
link |
00:56:59.180
and you accept a certain amount of risk.
link |
00:57:01.760
So it's the risk benefit ratio rather than pure safety.
link |
00:57:06.760
Yeah, absolutely.
link |
00:57:10.360
Let me ask you about Ken Kesey a little bit longer
link |
00:57:13.560
because fascinating him being.
link |
00:57:16.680
He was also part of Project MKUltra.
link |
00:57:19.760
Yeah, yes.
link |
00:57:21.320
What was Project MKUltra
link |
00:57:23.000
and what lessons we should take away from it?
link |
00:57:27.640
Well, MKUltra was a program by the CIA.
link |
00:57:33.600
What they were looking at was,
link |
00:57:35.600
can you take these drugs, these psychedelic drugs,
link |
00:57:39.400
and weaponize them in different ways
link |
00:57:43.120
for interrogation, for true serums,
link |
00:57:45.200
for exposing somebody before they give a big talk
link |
00:57:49.620
to something like LSD and then they can't talk
link |
00:57:52.460
or make a fool of themselves?
link |
00:57:53.680
Or can you spray LSD over the battlefield
link |
00:57:57.460
and have everybody tripping and drop their weapons
link |
00:57:59.560
and then you just walk up and nobody dies
link |
00:58:02.080
and you've won the battle?
link |
00:58:04.660
So it's a fascinating concept.
link |
00:58:07.240
Yeah, they call it nonlethal incapacitance
link |
00:58:09.800
and I think that's how it's.
link |
00:58:11.840
One way to win a war is to enforce peace.
link |
00:58:16.120
To get everybody not caring about the war, but yes.
link |
00:58:19.040
Well, I think Gandhi said something even better,
link |
00:58:21.120
which is that the true way to win a war
link |
00:58:22.840
is to turn your enemy into your friend.
link |
00:58:24.520
Yes, that's a beautiful way to put it.
link |
00:58:26.520
Yeah, but MKUltra was really nefarious
link |
00:58:29.920
and it was part of our military and it was done in secret
link |
00:58:32.220
and they would dose people against their will.
link |
00:58:36.600
I mean, one of the most infamous things
link |
00:58:41.400
was that they had a house of prostitution in San Francisco
link |
00:58:44.560
and they would have one way mirrors, all this stuff
link |
00:58:47.800
and then they would just dose people with LSD
link |
00:58:50.880
and they would have the prostitutes dose these guys with LSD
link |
00:58:53.960
and observe what they would do and how they would act.
link |
00:58:56.120
And the CIA actually for a while
link |
00:58:58.840
was dosing each other secretly
link |
00:59:01.580
and that there's a famous case of this fellow Olson
link |
00:59:04.000
that either jumped out of a window or was pushed,
link |
00:59:08.640
he might've been killed.
link |
00:59:10.560
He was a CIA guy and they gave him LSD
link |
00:59:13.880
and then they're trying to see can they break him down
link |
00:59:17.140
and get him to tell secrets.
link |
00:59:18.480
And I think he felt uncomfortable with what happened to him
link |
00:59:21.000
while he was under the influence of LSD
link |
00:59:22.560
and whether he was pushed or not,
link |
00:59:26.560
I don't know if we'll ever know.
link |
00:59:28.360
But MKUltra was violating people's human rights.
link |
00:59:35.160
It was done in secret and the irony of it
link |
00:59:41.720
is that Ken Kesey is one of the people,
link |
00:59:45.640
one of the main early people that got LSD in this context
link |
00:59:49.240
and then he was one of the main people
link |
00:59:51.520
that helped inspire the hippies to use psychedelics
link |
00:59:54.380
to oppose the Vietnam War.
link |
00:59:56.160
So I think the CIA kind of in many cases,
link |
01:00:01.520
things get out of their control,
link |
01:00:03.460
what they think they can do
link |
01:00:04.480
and it turned in to be a disaster for them.
link |
01:00:08.580
I think there was some thought
link |
01:00:09.840
that some of the people at the CIA had
link |
01:00:11.640
is that if you can turn people inside,
link |
01:00:14.400
take drugs and they just focus on their internal experience,
link |
01:00:16.660
they're not gonna be involved politically.
link |
01:00:18.680
It's a way to sort of take people offline.
link |
01:00:21.720
And what I don't think they counted on
link |
01:00:23.360
is that when you're offline
link |
01:00:24.600
and you have these unit of special experiences
link |
01:00:27.720
and you realize how we're all connected,
link |
01:00:29.520
then why do you wanna go out and kill these Vietnamese
link |
01:00:32.780
and put one dictator over another dictator,
link |
01:00:37.880
dictators on both sides in North Vietnam and South Vietnam?
link |
01:00:40.840
Why are we doing that?
link |
01:00:42.760
So MKUltra has just a very disreputable.
link |
01:00:48.480
We're learning more and more about what they did
link |
01:00:51.120
and one of the unintended consequences was Ken Kesey
link |
01:00:53.920
and not only that, but then the Grateful Dead
link |
01:00:56.320
who began at the acid tests that Kesey was helping
link |
01:01:00.160
to organize and out of that emerged,
link |
01:01:04.000
you could say just this incredible psychedelic culture.
link |
01:01:08.680
And you look at the bands that began in the 60s
link |
01:01:12.720
and which ones have really survived to this day
link |
01:01:17.160
and the Grateful Dead has survived longer
link |
01:01:20.140
than most any other band.
link |
01:01:22.300
I mean, some of them have died and all,
link |
01:01:23.560
but it was like the tightness,
link |
01:01:25.220
the sort of telepathy we talked about before
link |
01:01:27.600
that they could just get so tuned in to each other
link |
01:01:31.240
and each other's energies and they could do improvisations
link |
01:01:34.080
and they can do this incredible work
link |
01:01:36.120
that I think the sustainability of the Grateful Dead
link |
01:01:40.160
as a group was a testament
link |
01:01:43.880
to the power of the LSD experiences
link |
01:01:46.380
and that might've never happened if not for MKUltra.
link |
01:01:48.880
But can we talk about the darkness a little bit?
link |
01:01:56.160
So Ted Kaczynski, the Unabomber was allegedly part
link |
01:01:59.800
of the MKUltra studies while at Harvard.
link |
01:02:03.680
Do you think this is true?
link |
01:02:05.160
Do you think it had an impact
link |
01:02:06.440
on him psychologically, intellectually and so on?
link |
01:02:09.520
I do think it's true and I do think it had an impact.
link |
01:02:12.200
So we talked before about are these drugs somehow
link |
01:02:16.320
or other producing a certain kind of drug experience
link |
01:02:20.200
or do they bring out what's within?
link |
01:02:23.040
So we have this experience, yeah, on the one hand,
link |
01:02:26.040
Ken Kesey and he sort of took positive things out of this.
link |
01:02:30.020
On the other hand, we can get this opposition
link |
01:02:36.480
to the modern world, to technology
link |
01:02:38.400
and to the point of creating bombs to try to go after it.
link |
01:02:42.180
So that the experience is not in the drug,
link |
01:02:45.360
it's this interaction between the drug,
link |
01:02:48.280
the person, the context.
link |
01:02:50.580
And so we can heal people with psychedelics
link |
01:02:55.720
or people can be driven crazy with psychedelics.
link |
01:02:59.360
It depends again on the context.
link |
01:03:01.920
And so I think both these things can be true.
link |
01:03:05.360
And I think it was really good
link |
01:03:06.560
that you kind of highlighted this,
link |
01:03:08.120
that there is this polarities and that it's not in the drug,
link |
01:03:13.040
it's in the other factors and it's who they were beforehand
link |
01:03:17.200
and then how you use that experience.
link |
01:03:19.000
So all that's to say is if we put LSD in the water
link |
01:03:22.240
and everybody were to get it,
link |
01:03:23.840
it doesn't mean that all of a sudden
link |
01:03:25.280
everybody's gonna have a mystical experience
link |
01:03:27.000
and then that's all we need to do
link |
01:03:29.320
and humanity is spiritualized or end war and all of this.
link |
01:03:32.600
It's not about the drug.
link |
01:03:35.520
And that actually is why for me,
link |
01:03:38.960
we've also talked about engineering new psychedelics
link |
01:03:43.000
and all the people that are gonna be trying
link |
01:03:44.920
for profit companies to develop and patent new psychedelics.
link |
01:03:48.040
For me, the most important challenge
link |
01:03:50.240
is new cultural contexts that can create legality,
link |
01:03:55.640
safety, support for the existing psychedelics
link |
01:03:59.320
that we already have.
link |
01:04:00.960
I mean, we have so much incredible tools
link |
01:04:04.480
in these existing psychedelics
link |
01:04:06.320
that it's more about creating context for them
link |
01:04:09.840
to be used in safe medical or personal growth
link |
01:04:12.680
or recreational even with harm reduction,
link |
01:04:14.640
all these different ways.
link |
01:04:15.480
That's more important to me than finding some new molecule
link |
01:04:18.560
that's somewhat similar or somewhat different
link |
01:04:20.520
but it can be patented.
link |
01:04:22.560
So it's the social context.
link |
01:04:24.440
So I do believe that Ted Kaczynski was part of NKUltra
link |
01:04:28.880
and I think it affected him in a negative way
link |
01:04:31.840
and that's a cautionary tale that it's not in the drug,
link |
01:04:36.120
it's in the context.
link |
01:04:37.520
The context, the person, still it feels like if viewed
link |
01:04:44.680
from a therapy perspective, perhaps there was a way
link |
01:04:47.760
to use psychedelics to help Ted Kaczynski find a path
link |
01:04:52.680
out of the darkness.
link |
01:04:53.960
I think so and I think that this is where I think MDMA
link |
01:04:58.640
comes in in a way that MDMA is, he felt very isolated
link |
01:05:03.640
and very much out of society in some ways.
link |
01:05:08.000
MDMA stimulates oxytocin, which we haven't mentioned,
link |
01:05:12.200
which is the hormone of nursing mothers,
link |
01:05:14.080
of love and connection.
link |
01:05:15.680
It provides a lot of this sense of self acceptance
link |
01:05:18.800
and safety and wanting to be in a relationship.
link |
01:05:21.560
There's Gould Dolan is a neuroscientist at Hopkins.
link |
01:05:24.920
She's given octopuses MDMA, they're solitary creatures
link |
01:05:30.080
except mating season, which is not very often
link |
01:05:32.920
but you give them MDMA and they become more interested
link |
01:05:35.240
in hanging out with other octopuses.
link |
01:05:37.480
So I think this, for people that have had difficult
link |
01:05:40.960
psychedelic experiences, MDMA helps them integrate them.
link |
01:05:45.200
We've worked with people that had a difficult LSD experience
link |
01:05:48.640
40 years before and are still able to get back to that
link |
01:05:52.240
under the influence of MDMA and work out some
link |
01:05:54.480
of the conflicts that they weren't able to resolve
link |
01:05:58.680
all those decades before.
link |
01:06:00.320
So I think that psychedelics could have been helpful
link |
01:06:04.720
in a different context for Ted Kaczynski.
link |
01:06:07.720
But the other big part of it is that people have to be
link |
01:06:11.840
willing to cooperate with the experience.
link |
01:06:14.200
We talked about resistance.
link |
01:06:16.120
So people can resist these things.
link |
01:06:18.000
It's the saying is you can bring a horse to water
link |
01:06:21.440
but you can't make them drink.
link |
01:06:22.920
This is about how people have to be willing
link |
01:06:25.400
to go to these spaces.
link |
01:06:26.920
So one of the essence of our therapeutic approach
link |
01:06:30.180
is that we help people to heal themselves,
link |
01:06:33.640
that we are not giving them the healing.
link |
01:06:36.560
It's a flip on the power dynamics that existed,
link |
01:06:41.680
you would say in the fifties and sixties,
link |
01:06:43.120
my dad was a doctor and the doctors were gods
link |
01:06:45.520
and whatever they said was right.
link |
01:06:47.600
And we no longer, of course, believe that.
link |
01:06:50.180
But for a while, psychoanalysis with Freud,
link |
01:06:54.400
that they gave the interpretation to the patient.
link |
01:06:56.920
The patient couldn't help themselves
link |
01:06:58.200
but they would do the free associations
link |
01:06:59.840
and the psychoanalyst would see these conflicts
link |
01:07:02.280
and would be the one that does the healing,
link |
01:07:04.960
would give this interpretation and that would open things up.
link |
01:07:07.680
So I think it's this idea of empowering people
link |
01:07:11.000
to heal themselves.
link |
01:07:12.860
And so if Ted Kuznicki had been in a therapeutic setting
link |
01:07:16.600
with psychedelics and if they'd had something
link |
01:07:19.800
like MDMA available or MDA,
link |
01:07:23.760
which was popular during the sixties,
link |
01:07:25.520
which is a more like MDMA LSD combination,
link |
01:07:28.160
the outcomes might've been different.
link |
01:07:31.700
Let's take a step into the world of studies.
link |
01:07:35.700
Timothy Leary, who was he
link |
01:07:38.660
and what were the most important ideas
link |
01:07:41.500
you've learned from him?
link |
01:07:43.460
Well, I did have the opportunity to get to know him personally
link |
01:07:48.300
and to spend some time with him.
link |
01:07:50.300
Timothy Leary, well, let's start with Nixon saying
link |
01:07:55.300
he's the most dangerous man in America.
link |
01:07:58.640
That's a good place to start.
link |
01:08:00.520
Yeah.
link |
01:08:01.720
And why did Nixon say that?
link |
01:08:03.360
It's because of this turn on, tune in, drop out.
link |
01:08:11.640
Timothy Leary was just an incredible advocate
link |
01:08:14.320
for think for yourself, question authority.
link |
01:08:18.800
Those were the things he said all the time.
link |
01:08:19.960
Think for yourself, question authority.
link |
01:08:21.480
He was a rebel.
link |
01:08:23.080
He was kicked out of West Point.
link |
01:08:25.440
He was a psychologist who was at Harvard for three years
link |
01:08:30.760
from 60 to 63.
link |
01:08:34.040
Before he got to Harvard,
link |
01:08:35.760
he had an experience with mushrooms in Mexico.
link |
01:08:41.920
And he said he learned more in that experience
link |
01:08:44.840
than he'd had in his entire academic career before then
link |
01:08:47.320
about how the human mind works.
link |
01:08:49.300
And so he came to Harvard wanting to do research
link |
01:08:53.480
into psychedelics.
link |
01:08:56.600
And he did some very important studies, both of which,
link |
01:09:01.200
well, one was called the Good Friday Experiment,
link |
01:09:03.520
which was whether psychedelics in religiously inclined
link |
01:09:06.920
people taking psilocybin in a religious setting,
link |
01:09:09.860
whether it could produce a mystical experience.
link |
01:09:12.060
That took place at Marsh Chapel at the Boston University.
link |
01:09:15.140
Because it's a little bit subjective,
link |
01:09:18.000
where you can say entirely subjective,
link |
01:09:19.600
what people describe happens to them.
link |
01:09:23.000
He wanted to do another study,
link |
01:09:24.800
which would be a more objective measure,
link |
01:09:26.640
and that was called the Concord Prison Experiment.
link |
01:09:28.640
And that was the thought, if you can give people
link |
01:09:32.280
psilocybin mystical sense of connection type experiences
link |
01:09:35.740
while they're in prison, when they get out,
link |
01:09:38.000
they'll be more pro social and they'll have reduced
link |
01:09:41.120
recidivism.
link |
01:09:43.340
So Tim did that.
link |
01:09:44.440
He also did the naturalistic studies
link |
01:09:46.560
of giving loads of people psilocybin
link |
01:09:48.140
and sort of writing down what their experiences were,
link |
01:09:50.500
the range of experiences.
link |
01:09:52.400
Later on in his time at Harvard,
link |
01:09:56.720
they started doing LSD.
link |
01:09:58.900
And LSD is more cerebral, longer lasting,
link |
01:10:02.280
not as reassuring in a way as psilocybin.
link |
01:10:04.920
Sometimes he used to say that if they never got into LSD,
link |
01:10:08.680
they'd still be at Harvard with the psilocybin.
link |
01:10:12.480
So he was a great American psychologist,
link |
01:10:14.820
but then he got tired of the psychology game,
link |
01:10:19.680
you could say, or he would say that.
link |
01:10:22.040
He got more and more interested in cultural change
link |
01:10:27.700
and various musicians and artists
link |
01:10:30.640
and all sorts of people started coming to him
link |
01:10:32.160
for the psychedelic experience that they are in a way
link |
01:10:34.720
for creativity, for other things.
link |
01:10:36.240
So he started hanging out with all sorts of famous people
link |
01:10:40.680
or creative people and he stopped going to classes a lot.
link |
01:10:47.200
And Ram Dass, Richard Alpert had given LSD to a student
link |
01:10:54.920
that Ram Dass was courageous enough to admit
link |
01:10:59.640
that he had a sexual interest in.
link |
01:11:02.560
They weren't supposed to give it undergraduates.
link |
01:11:04.440
That was about the only time that they ever did it.
link |
01:11:06.320
And psychedelics just getting more and more controversial
link |
01:11:09.980
even in the early 60s, eventually got kicked out of Harvard
link |
01:11:13.320
and then he became kind of a cultural icon
link |
01:11:16.280
for the counterculture and was hounded by the police
link |
01:11:23.000
and Nixon and spent a lot of time in jail.
link |
01:11:24.880
I mean, he's an incredible person.
link |
01:11:28.160
One thing that Ram Dass said is that Richard Alpert,
link |
01:11:33.240
Ram Dass said, I'm a rascal, but Leary's a scoundrel.
link |
01:11:37.280
What's the distinction?
link |
01:11:39.880
Rascals like in good fun.
link |
01:11:41.560
A scoundrel is like, you can't quite trust them, I think.
link |
01:11:47.360
I think that.
link |
01:11:48.200
It's a spectrum of sorts.
link |
01:11:50.040
Yeah, I think that Leary was someone
link |
01:11:52.120
who a little bit got addicted to media attention.
link |
01:11:57.160
But I think that overall he gets blamed a lot
link |
01:12:01.280
for the backlash against the 60s,
link |
01:12:04.000
the shutdown of psychedelic research.
link |
01:12:05.680
I think that he is unfairly blamed for a lot of that.
link |
01:12:10.160
I think when you look back at the 60s,
link |
01:12:13.480
the common narrative is that it was
link |
01:12:15.800
because psychedelics going wrong.
link |
01:12:17.760
People took psychedelics, they weren't prepared,
link |
01:12:19.580
they had emotional breakdowns, they weren't psychotic,
link |
01:12:21.780
they killed themselves, they did this or that,
link |
01:12:24.280
different problems of people taking psychedelics
link |
01:12:27.120
in context that they didn't feel fairly safe in
link |
01:12:31.540
or just they weren't prepared
link |
01:12:33.020
or they didn't know how much they were taking
link |
01:12:34.480
or all this.
link |
01:12:35.320
So the backlash was because psychedelics going wrong.
link |
01:12:39.440
But I think the real reason, while that did happen,
link |
01:12:42.680
I think the real reason is psychedelics going right
link |
01:12:45.560
and people having this sense of connection.
link |
01:12:48.160
And then the opposite of what the CIA was hoping
link |
01:12:50.960
that it would kind of turn people inward
link |
01:12:54.240
and take them away from political struggles,
link |
01:12:56.320
it actually motivated people.
link |
01:12:58.960
Once you actually have these psychedelic experiences,
link |
01:13:02.200
your attitude towards death changes also
link |
01:13:05.040
this idea of death becoming an intrinsic part of life,
link |
01:13:09.080
it's a natural cycle, it's not so much.
link |
01:13:12.160
So I think people realize that,
link |
01:13:15.560
while there's this billions of years of evolution,
link |
01:13:18.840
infinity, whatever that means in terms of time,
link |
01:13:21.420
that we're here for a very limited time
link |
01:13:22.920
and they end up wanting to use their time well,
link |
01:13:24.800
they have a lessened fear of death
link |
01:13:26.720
and they wanna build this paradise on earth here now
link |
01:13:29.800
instead of later.
link |
01:13:31.200
So a lot of people really did get motivated
link |
01:13:35.200
to challenge the Vietnam War,
link |
01:13:36.880
to work on the environmental movement,
link |
01:13:38.440
civil rights movement, women's rights movement,
link |
01:13:40.560
anti militarism.
link |
01:13:42.320
And it was that challenge to the status quo
link |
01:13:44.640
that caused the backlash.
link |
01:13:46.360
So Leary is someone who in 1990,
link |
01:13:50.540
we had the maps I started in 86.
link |
01:13:52.960
So in 1990, we had this conference
link |
01:13:56.040
to raise money out in California
link |
01:13:57.760
and Leary was there and Ram Dass was there
link |
01:13:59.600
and Ralph Metzner was there and Andy Weil was there
link |
01:14:01.760
and Terrence McKenna was there
link |
01:14:02.840
and Dennis McKenna was there and all these.
link |
01:14:04.800
But there was one point where Tim was speaking
link |
01:14:09.800
and afterwards I was asking him some questions.
link |
01:14:11.920
And I said, do you have any advice for us
link |
01:14:15.240
on how to work with the government
link |
01:14:17.120
and how to bring these psychedelics forward?
link |
01:14:19.600
That's what we're trying to do.
link |
01:14:20.760
I've got this nonprofit for it.
link |
01:14:22.720
We're trying to do this research.
link |
01:14:23.980
What is your advice on how to bring this forward
link |
01:14:27.080
and how to work with the government?
link |
01:14:29.280
And he said, fuck the government.
link |
01:14:31.920
He said, I am so far past asking for permission
link |
01:14:36.440
for anything, but I'm glad that you're doing it.
link |
01:14:40.720
And then he held up my hand like passing the torch.
link |
01:14:44.040
So it was, and that's one of my favorite photographs
link |
01:14:47.400
of me and Tim where he's sort of like,
link |
01:14:48.880
but it was after this, fuck the government.
link |
01:14:50.680
I'm so far past asking for permission for anything,
link |
01:14:53.160
but I'm glad that you are.
link |
01:14:54.840
Now I did follow ups to the Good Friday experiment
link |
01:14:57.760
and I did follow ups, 25 year follow up
link |
01:14:59.880
to the Good Friday experiment,
link |
01:15:01.040
about a 34 year follow up
link |
01:15:02.420
to the Concord Prison experiment.
link |
01:15:05.880
What I discovered in some ways I would say
link |
01:15:08.200
is the key to the 60s, what I just told you,
link |
01:15:10.400
but in the follow up to the Good Friday experiment
link |
01:15:12.820
that I did in the 80s for my undergraduate thesis
link |
01:15:16.100
at New College in Sarasota, Florida,
link |
01:15:18.640
I eventually found 19 out of the 20 people.
link |
01:15:21.040
It was just, that was an enormous challenge
link |
01:15:23.620
because their names were all lost
link |
01:15:24.960
and it just took forever years and years and years
link |
01:15:27.320
to find them all.
link |
01:15:29.080
But I discovered that those people
link |
01:15:30.640
that had the psilocybin experience
link |
01:15:32.200
in the midst of 25 years later with Nancy Reagan
link |
01:15:35.900
and Ronald Reagan, and if there ever were there
link |
01:15:38.260
a social pressure to disavow the validity
link |
01:15:41.160
of the psychedelic experience, that was then.
link |
01:15:43.960
And instead they affirmed it,
link |
01:15:47.120
that they thought with all of this years of hindsight,
link |
01:15:51.120
now looking back, they thought it was
link |
01:15:52.380
a valid mystical experience.
link |
01:15:53.920
But I discovered that one of the persons
link |
01:15:59.240
who had the psilocybin had this experience
link |
01:16:03.680
during the Good Friday service
link |
01:16:05.680
that Reverend Howard Thurman was the minister.
link |
01:16:09.080
He was Martin Luther King's mentor
link |
01:16:11.040
and Reverend Howard Thurman was the minister
link |
01:16:12.800
at Boston at Marsh Chapel.
link |
01:16:16.240
Martin Luther King got his PhD at Boston University.
link |
01:16:20.480
And Howard Thurman had spent time with Gandhi.
link |
01:16:24.320
And so he was really kind of this hidden person
link |
01:16:26.820
behind the civil rights movement
link |
01:16:28.260
about nonviolence as their strategy.
link |
01:16:31.120
But he was interested in the political implications
link |
01:16:33.600
of the mystical experience.
link |
01:16:34.540
So he permitted this experiment to take place.
link |
01:16:37.600
And there were 20 divinity students
link |
01:16:39.520
from Andover Newton in the basement
link |
01:16:41.180
and 10 experimenters, all the people on religion
link |
01:16:44.060
and psychology, like Houston Smith and Walter Huston Clarke
link |
01:16:47.840
and Leary and Ramdas, Mr. Others were there
link |
01:16:50.520
as a support part of it.
link |
01:16:51.980
And the sermon was like three hours later.
link |
01:16:54.520
We actually have, three hours long,
link |
01:16:56.440
we actually have the original sermon
link |
01:16:58.560
from the Good Friday experiment
link |
01:16:59.880
from Howard Thurman up on our website.
link |
01:17:02.240
It's incredible.
link |
01:17:03.320
But part of it was tell people there's a man on the cross.
link |
01:17:06.280
And this one person sort of heard that
link |
01:17:09.280
and he thought, okay, I gotta do that.
link |
01:17:12.400
Howard Thurman was such a dynamic speaker.
link |
01:17:14.160
He said, I gotta tell people there's a man on the cross.
link |
01:17:16.780
And so he said, what am I doing here
link |
01:17:18.180
in this basement chapel listening to this service?
link |
01:17:20.720
I gotta go tell people there's a man on the cross.
link |
01:17:22.200
So he went, they thought he was just going to the bathroom,
link |
01:17:24.540
but he ran out the door.
link |
01:17:25.380
He's running down Commonwealth Avenue
link |
01:17:27.480
and Houston Smith and Tim Leary go after him.
link |
01:17:31.440
And he had thought that since he should tell somebody,
link |
01:17:34.560
he should tell the president, like why not?
link |
01:17:38.320
But then he realized, well, the president's in Washington.
link |
01:17:40.380
I'm here in Boston.
link |
01:17:42.400
I'll just tell the president of the university.
link |
01:17:44.320
So anyway, he's running down the street
link |
01:17:46.120
and Leary and Houston Smith go after him.
link |
01:17:48.800
And he doesn't want to go back inside.
link |
01:17:50.120
They finally get him.
link |
01:17:50.960
He's not hit by a car,
link |
01:17:53.560
but they end up giving him a shot of Thorazine.
link |
01:17:57.280
What's Thorazine?
link |
01:17:58.200
Thorazine is like a major antipsychotic drug.
link |
01:18:02.240
It's a horrible drug, but it knocks people out,
link |
01:18:07.020
tranquilizes them.
link |
01:18:08.680
We would never do that today.
link |
01:18:11.060
We don't abort a difficult experience like that.
link |
01:18:14.280
But in any case, they hid that.
link |
01:18:15.620
That was not part of the writeup of this experiment.
link |
01:18:20.040
So what they did is in a sense,
link |
01:18:22.320
a little bit exaggerated the benefits.
link |
01:18:24.640
It later became out three years later after the experiment
link |
01:18:27.340
or four years in Time Magazine,
link |
01:18:28.680
it said everybody that got psilocybin
link |
01:18:30.400
had a mystical experience.
link |
01:18:32.400
Say it wasn't true, not everybody.
link |
01:18:34.060
Eight out of the 10 did, but not all 10, not this guy.
link |
01:18:37.520
And they minimize the risks.
link |
01:18:40.960
So there was a bit of that.
link |
01:18:41.960
I think Tim was reckless in that way.
link |
01:18:43.960
It was underplayed the risks and overpromised the benefits.
link |
01:18:48.440
And then the Concord Prison experiment,
link |
01:18:51.240
it turned out that Tim had fudged the data completely
link |
01:18:56.000
and it wasn't really successful.
link |
01:18:57.920
So I fault him for that.
link |
01:19:00.360
The outside world was doing the opposite.
link |
01:19:02.320
It was exaggerating the risks and blocking research.
link |
01:19:06.160
So he felt justified to fudge the data
link |
01:19:09.360
because the outside world was fudging in a sense,
link |
01:19:12.280
the response to the.
link |
01:19:13.920
Yeah, yeah, exactly.
link |
01:19:15.280
Yeah, so that presents a very nice context.
link |
01:19:21.680
Fuck the government, but I'm glad that somebody
link |
01:19:26.200
is fighting the good fight from within
link |
01:19:28.520
and doing it the right way, which is where you are.
link |
01:19:32.920
So the 80s, let me ask, what is MAPS,
link |
01:19:38.200
the Multidisciplinary Association for Psychedelic Studies
link |
01:19:42.000
and what is its mission throughout the years,
link |
01:19:45.240
throughout the decades?
link |
01:19:46.360
Yeah, so MAPS is a nonprofit organization.
link |
01:19:49.960
I created it as a nonprofit pharmaceutical company.
link |
01:19:53.920
I created it in 86 after DEA,
link |
01:19:57.180
the Drug Enforcement Administration,
link |
01:19:58.760
criminalized MDMA in 1985.
link |
01:20:01.560
And that was after they started trying to do that in 1984.
link |
01:20:05.800
And as I mentioned, this Terence McKenna is sponsoring,
link |
01:20:09.640
motivating us to do this safety study.
link |
01:20:12.280
So we did that in preparation for this eventual crackdown
link |
01:20:15.440
because MDMA was called Adam, used as a therapy drug,
link |
01:20:18.960
but it was also beginning to be sold as ecstasy
link |
01:20:21.760
as a party drug.
link |
01:20:22.600
And that was taking place in public settings and bars.
link |
01:20:25.560
And so it was inevitable that the crackdown would happen.
link |
01:20:29.000
And so I had a nonprofit connected to Buckminster Fuller,
link |
01:20:32.760
Earth Metabolic Design Lab,
link |
01:20:35.100
that we used to support this lawsuit against the DEA
link |
01:20:38.680
to block them from criminalizing MDMA.
link |
01:20:41.160
We were winning in the court of public opinion
link |
01:20:43.520
and winning in the court.
link |
01:20:45.120
The DEA freaked out
link |
01:20:46.280
and the emergency scheduled MDMA in 85.
link |
01:20:49.680
The handwriting was on the wall
link |
01:20:51.040
that they were not gonna permit
link |
01:20:52.520
the therapeutic use to continue
link |
01:20:54.280
because it gets in the way of the narrative of the drug war
link |
01:20:56.480
and these are terrible drugs.
link |
01:20:58.320
So in 86 is when I started MAPS as a nonprofit pharma
link |
01:21:02.760
because the strategy that I realized is that
link |
01:21:05.600
Americans are open to medicines,
link |
01:21:10.420
that tools to ease suffering,
link |
01:21:13.100
that was the opening wedge,
link |
01:21:14.540
the opening door to changing attitudes.
link |
01:21:17.300
And it would be through science.
link |
01:21:18.740
I would say that my religion is more science
link |
01:21:21.700
than anything else.
link |
01:21:23.260
And culture and religion are metaphorical,
link |
01:21:28.400
but often too much they become literal.
link |
01:21:31.040
But I felt that through science, through medicine,
link |
01:21:34.400
there would be a way to bring these drugs
link |
01:21:36.820
back to the surface.
link |
01:21:37.900
And the mission was always this mass mental health,
link |
01:21:42.340
this idea that what we need is to spiritualize humanity.
link |
01:21:46.660
Einstein said the splitting of the atom
link |
01:21:49.180
has changed everything except our mode of thinking.
link |
01:21:52.240
And hence we drift towards unparalleled catastrophe,
link |
01:21:56.220
which shall be required if mankind is to survive
link |
01:21:59.300
is a whole new mode of thinking.
link |
01:22:01.180
So what is that new mode of thinking?
link |
01:22:05.560
My presumption is that it's more of this mystical sense
link |
01:22:10.720
of thinking that we're all connected.
link |
01:22:12.920
And then if we realize that we're all connected,
link |
01:22:14.800
we're not gonna blow up the world.
link |
01:22:16.360
So a lot of people say that if we could just give LSD
link |
01:22:20.080
all to the world leaders, that would be,
link |
01:22:22.920
then they'd have these spiritual experiences,
link |
01:22:24.520
the world would be better.
link |
01:22:25.360
But I actually had a ketamine experience
link |
01:22:27.200
the day after that DMT experience I described
link |
01:22:29.600
with the inner Hitler.
link |
01:22:31.480
This ketamine experience was,
link |
01:22:34.520
I was above and behind Hitler as he was giving a speech,
link |
01:22:37.280
like the Nuremberg rallies kind of thing.
link |
01:22:40.220
And I was trying to think, how do I get into his head?
link |
01:22:42.280
How do I undo what he wants to do?
link |
01:22:44.560
How can we deal with him?
link |
01:22:46.280
And I realized this whole new thing
link |
01:22:48.960
about the Heil Hitler salute.
link |
01:22:50.520
And he would like push energy out
link |
01:22:53.240
and then everybody would do the salute back to him.
link |
01:22:55.600
And so it's like the one to the many
link |
01:22:57.180
and the many to the one,
link |
01:22:58.020
giving all these people giving away their power
link |
01:23:00.040
and then how it would just sort of ratchet up in intensity
link |
01:23:03.240
like these vibrations.
link |
01:23:04.960
And I realized there's no way to get into his head.
link |
01:23:07.480
This idea we've talked about before
link |
01:23:08.800
about you have to be willing.
link |
01:23:10.980
So what that sort of helped me understand
link |
01:23:13.680
is that the strategy has to be mass mental health.
link |
01:23:16.800
It's not about changing a few leaders.
link |
01:23:18.540
We need to change the mass of humanity
link |
01:23:21.280
to this new mode of thinking, this new spiritual way.
link |
01:23:24.280
So MAPS was a nonprofit pharmaceutical company
link |
01:23:28.680
focused on psychedelics.
link |
01:23:30.600
Big Pharma wasn't doing this work.
link |
01:23:32.120
Government wasn't funding it.
link |
01:23:33.920
So the only source of funds
link |
01:23:35.160
I thought would be through nonprofit donations.
link |
01:23:37.200
And that's been true up until just a couple of years ago
link |
01:23:39.160
now that we have the rise of these for profits.
link |
01:23:41.440
But that's because we've cleared out
link |
01:23:42.560
the regulatory obstacles.
link |
01:23:45.000
We've got more scientific data about the benefits
link |
01:23:47.600
funded through philanthropy.
link |
01:23:49.320
We've changed public opinion
link |
01:23:51.240
and there's a lot less zeal for the drug war.
link |
01:23:53.840
So all of those things have changed.
link |
01:23:55.280
But at the time it was mass mental health was the goal.
link |
01:23:58.960
Two tracks, one was drug development,
link |
01:24:01.600
the other was drug policy reform.
link |
01:24:03.800
So then it's not just available to people
link |
01:24:05.960
that have a clinical diagnosis,
link |
01:24:07.360
but people who are personal growth
link |
01:24:10.560
or they should have access to it as well.
link |
01:24:13.960
I did not know at the time that no drug
link |
01:24:16.560
had ever been made into a medicine by a nonprofit.
link |
01:24:20.480
That was really good I didn't know that.
link |
01:24:23.160
I might've been a little bit more daunted.
link |
01:24:26.040
And actually that didn't happen for 13 more years.
link |
01:24:28.440
It happened in 1999.
link |
01:24:30.600
And that was the abortion pill, RU46,
link |
01:24:34.200
that was approved in Europe, but it's controversial.
link |
01:24:36.760
Nobody, no pharmaceutical company would take it.
link |
01:24:39.400
And it was John D. Rockefeller the third
link |
01:24:41.480
through the population council
link |
01:24:42.760
with the major donor being Warren Buffet.
link |
01:24:45.600
And the Rockefellers and the Buffets
link |
01:24:48.560
and some of the Pritzkers were involved in funding this.
link |
01:24:51.360
So that was the first nonprofit.
link |
01:24:54.160
But the MAPS was designed as from the very beginning,
link |
01:25:00.600
not academic research into psychedelics,
link |
01:25:03.440
but drug development.
link |
01:25:04.640
And that's a fundamental distinction.
link |
01:25:06.360
And that's why I think we're years ahead now
link |
01:25:08.600
with everybody else in terms of making
link |
01:25:11.120
a psychedelic assisted therapy into a medicine.
link |
01:25:13.780
Because our goal from the very beginning was not knowledge,
link |
01:25:16.840
not academic research, it was practical.
link |
01:25:19.040
It was drug development.
link |
01:25:20.080
How do we create new social structures?
link |
01:25:22.440
How do we create legal access to these things?
link |
01:25:25.120
Now, in December of 2014,
link |
01:25:28.400
we created the MAPS Public Benefit Corporation.
link |
01:25:31.880
So MAPS is a nonprofit, but in our 35 years,
link |
01:25:36.680
we've raised about $110 million in donations.
link |
01:25:41.600
What I didn't know when I started MAPS,
link |
01:25:43.800
and it took me quite a few years,
link |
01:25:46.520
I didn't even know this till about eight, nine years ago,
link |
01:25:50.440
was that in 1984, Ronald Reagan had signed a bill
link |
01:25:54.840
to create incentives for developing drugs
link |
01:25:57.140
that were off patent.
link |
01:25:58.840
So MDMA was invented by Merck in 1912.
link |
01:26:02.040
It's in the public domain.
link |
01:26:03.720
These incentives are called data exclusivity,
link |
01:26:06.320
which means that if you make a drug into a medicine
link |
01:26:08.360
that has no patent protection,
link |
01:26:10.260
nobody can use your data for a period of time
link |
01:26:13.440
to market a generic.
link |
01:26:14.660
And that will effectively be,
link |
01:26:16.520
well, it's five years, you do pediatric studies,
link |
01:26:18.880
you get six months extension,
link |
01:26:20.520
and we are being required, if we succeed in adults,
link |
01:26:24.120
to work with adolescents with PTSD.
link |
01:26:26.520
It blocks a generic competitor
link |
01:26:28.140
from applying till that five and a half years is over,
link |
01:26:30.840
takes FDA at least six months to review.
link |
01:26:33.140
So more or less six years of data exclusivity,
link |
01:26:35.940
10 years in Europe is data exclusivity.
link |
01:26:38.820
So the story then became to the donors
link |
01:26:42.300
that you're not gonna have to give us money forever
link |
01:26:45.240
because we can make money selling MDMA,
link |
01:26:48.300
but we wanna do two revolutionary things, you could say.
link |
01:26:51.700
One is psychedelic assisted psychotherapy,
link |
01:26:53.800
but the other is marketing drugs.
link |
01:26:56.440
When you market it with the profit maximization motive,
link |
01:26:59.740
we end up in the extreme getting the distortions
link |
01:27:02.480
that we have in America,
link |
01:27:03.520
where we have the most expensive healthcare system
link |
01:27:06.720
in the world per capita,
link |
01:27:07.840
but our outcomes are down like 40 or 50 among the countries,
link |
01:27:11.000
our average outcomes.
link |
01:27:11.880
We don't have, third of the people or so
link |
01:27:13.900
don't have insurance, and it's just very inequitable.
link |
01:27:17.360
So what we're trying to do
link |
01:27:19.440
is show a different way to market drugs.
link |
01:27:22.640
And it's a modification of capitalism
link |
01:27:24.560
that's called the benefit corporation,
link |
01:27:26.640
where you maximize public benefit, not profit.
link |
01:27:29.560
You still make a profit.
link |
01:27:31.320
So selling MDMA for a profit
link |
01:27:33.420
is not something we could keep inside the nonprofit
link |
01:27:36.560
because it's taxable, it's a business.
link |
01:27:39.480
So we've created the MAPS Public Benefit Corporation,
link |
01:27:42.740
which is 100% owned by the nonprofit.
link |
01:27:45.120
So we have a nonprofit that owns a pharma company.
link |
01:27:49.520
And the mission of that pharma company
link |
01:27:51.240
is to maximize not profit,
link |
01:27:53.680
but maximize benefit for society.
link |
01:27:55.620
Yeah, yeah.
link |
01:27:56.720
Although there still will be profits,
link |
01:27:58.720
and the profits that we're gonna make
link |
01:28:00.760
are going to be used towards the mission of MAPS,
link |
01:28:03.940
which is again, is this mass mental health
link |
01:28:05.920
and ending the drug war.
link |
01:28:08.040
And in fact, we've hired the Boston Consulting Group
link |
01:28:10.600
to help us plot our commercialization strategy.
link |
01:28:15.360
And so there is some suggestions based,
link |
01:28:18.040
there's so many different assumptions in this,
link |
01:28:19.920
the number of therapists that we train,
link |
01:28:22.040
the price that we set for the MDMA,
link |
01:28:24.480
whether insurance companies will cover it.
link |
01:28:27.440
But there's the possibility of somewhere in the range
link |
01:28:30.680
of three quarters of a billion dollars in profits
link |
01:28:33.760
during this period of data exclusivity,
link |
01:28:36.160
just from the US and we're talking about
link |
01:28:40.720
trying to do this research around the world as well.
link |
01:28:42.960
So that's what the Benefit Corporation is.
link |
01:28:45.120
The Benefit Corporation is our pharmaceutical arm.
link |
01:28:47.360
We're about 130 people now,
link |
01:28:50.000
somewhere in that fluctuates,
link |
01:28:51.720
but one third of them are in the nonprofit.
link |
01:28:54.140
We do harm reduction, psychedelic harm reduction.
link |
01:28:57.880
We help create programs for people
link |
01:29:02.000
with difficult psychedelic experiences
link |
01:29:04.480
at Burning Man, at festivals all over the world,
link |
01:29:06.680
even in cities we're now negotiating with the police,
link |
01:29:11.040
the city of Denver, because Denver has made the mushrooms
link |
01:29:14.200
the lowest enforcement priority.
link |
01:29:16.680
Oregon has passed the Oregon psilocybin initiative.
link |
01:29:18.960
So in those areas where maybe more people
link |
01:29:21.500
are gonna gravitate to do psychedelics,
link |
01:29:23.060
we want there to be harm reduction
link |
01:29:24.640
so that we don't have bad stories coming up
link |
01:29:27.600
that would change that.
link |
01:29:29.120
So MAPS does the psychedelic harm reduction.
link |
01:29:31.040
We do public education.
link |
01:29:32.560
We do a lot of it.
link |
01:29:33.400
That's what you and I are doing right now.
link |
01:29:35.120
We're doing that now.
link |
01:29:38.240
But also research towards.
link |
01:29:40.280
Well, the research now is done in the Benefit Corp.
link |
01:29:42.960
In the Benefit Corp.
link |
01:29:43.800
Yeah, so what happens is people donate to MAPS,
link |
01:29:46.120
get a tax deduction, MAPS transfers the money,
link |
01:29:48.480
or you could say invests in the Benefit Corp.
link |
01:29:50.840
Yes.
link |
01:29:51.680
The Benefit Corp will do the research
link |
01:29:53.000
and then MAPS is the sponsor,
link |
01:29:55.640
but then we will license the sale of MDMA
link |
01:29:57.640
to the Benefit Corp, so.
link |
01:29:58.720
Got it, but the research is done with an eye
link |
01:30:01.240
towards creating something that has a big impact
link |
01:30:03.480
versus just research for knowledge's sake.
link |
01:30:06.120
Yeah, yeah, because I'm interested in political change.
link |
01:30:13.080
The other part of it, which is that the brain
link |
01:30:16.640
is the most complex thing we know in the universe.
link |
01:30:21.040
It's endless.
link |
01:30:22.400
I mean, when are we gonna really, like this idea of,
link |
01:30:24.600
will we figure out telepathy?
link |
01:30:26.000
Will we figure out tapping into the collective unconscious?
link |
01:30:28.760
What is the extents of our brain?
link |
01:30:31.160
How does the brain actually work?
link |
01:30:32.320
Do you ask chemistry questions?
link |
01:30:33.880
So if it's just the pursuit of knowledge,
link |
01:30:36.480
that is an endless thing.
link |
01:30:37.920
And how does that end the drug war?
link |
01:30:39.440
How does that help people directly?
link |
01:30:41.120
So that's why we're focused on drug development
link |
01:30:43.720
more than mechanism of action.
link |
01:30:45.800
Before I ask you about one,
link |
01:30:48.520
but several really exciting studies,
link |
01:30:51.880
let me ask sort of a personal question for me.
link |
01:30:54.760
So if I wanted to get psychedelics
link |
01:30:59.080
from the MAPS Public Benefit Corporation
link |
01:31:04.240
and explore my own mind, how do I get to do that?
link |
01:31:10.040
And when?
link |
01:31:10.880
You won't be able to.
link |
01:31:12.000
You'll never be able to.
link |
01:31:12.840
This is very unfortunate.
link |
01:31:14.400
Because the reason is because the Benefit Corp
link |
01:31:17.160
is designed as a pharmaceutical company.
link |
01:31:20.120
So we can only work on clinical indication.
link |
01:31:23.800
So let's say you come to me and you just say,
link |
01:31:25.840
oh, I'm really depressed.
link |
01:31:27.080
Can I get MDMA to overcome my depression
link |
01:31:30.560
or overcome my PTSD?
link |
01:31:32.880
We'll have to do research in those indications.
link |
01:31:35.760
And by when you say me, you mean like a doctor.
link |
01:31:38.200
So this would be prescribed in theory by doctors.
link |
01:31:40.560
Well, this would go through a doctor and a prescription.
link |
01:31:43.560
Okay, let me ask another question.
link |
01:31:46.480
To further answer,
link |
01:31:47.320
so that's where the drug policy arm comes in,
link |
01:31:49.600
the drug policy reform.
link |
01:31:51.160
So you should be able to get access to psychedelics
link |
01:31:54.520
for your own personal growth.
link |
01:31:56.560
But that's not medicine.
link |
01:31:59.160
So that's why we need to medicalize,
link |
01:32:02.160
to have things covered by insurance,
link |
01:32:04.600
to change people's attitudes, the public attitudes.
link |
01:32:07.440
And then we get this subsequent drug policy reform.
link |
01:32:11.720
And we're talking about it
link |
01:32:12.840
in terms of licensed legalization.
link |
01:32:14.720
So my view is you should get a license to do psychedelics,
link |
01:32:18.280
you get a little education stuff,
link |
01:32:19.880
and then you should be able to buy it
link |
01:32:21.160
and do it on your own.
link |
01:32:22.000
So let me rephrase the question in more specifically.
link |
01:32:24.160
So when can I, if I happen to have ailments of some kind
link |
01:32:29.080
where the doctor decides that psychedelics could help,
link |
01:32:31.880
when would you be a loose estimate for you
link |
01:32:35.160
of when a doctor will be able to prescribe to me
link |
01:32:37.720
something from MAPS Public Benefit Co.
link |
01:32:41.480
And then when for my personal growth and creativity,
link |
01:32:45.000
would I be able to get something?
link |
01:32:46.360
So like, just looking out, this isn't like guaranteed,
link |
01:32:49.160
but like your vision, your hope for,
link |
01:32:53.160
yeah, for psychedelics in society.
link |
01:32:56.000
Well, the end of 2023, so two and a half years from now,
link |
01:32:59.960
we anticipate FDA approval
link |
01:33:02.240
for the prescription use of MDMA for PTSD.
link |
01:33:05.840
Because the FDA does not regulate the practice of medicine,
link |
01:33:11.680
there is what's called off label prescription.
link |
01:33:14.720
What that means, the label is what it's approved for.
link |
01:33:16.840
So the label will say, oh, this is approved for PTSD.
link |
01:33:20.320
But let's say you come and anything else, social anxiety
link |
01:33:23.200
or whatever, you can go to the doctor,
link |
01:33:24.720
they can give it to you.
link |
01:33:26.360
It might not be covered by insurance,
link |
01:33:27.920
they have to be a little bit careful about malpractice.
link |
01:33:30.560
But I think the end of 2023
link |
01:33:32.640
is when you will be able to do that.
link |
01:33:34.880
Now, there's actually another program, very limited,
link |
01:33:38.800
called Expanded Access, which is compassionate use,
link |
01:33:42.640
which means that, and we have approval for 50 people
link |
01:33:45.640
for compassionate use right now, we think that'll grow.
link |
01:33:48.960
So that's gonna open up in about two months.
link |
01:33:51.320
And so those are people with PTSD,
link |
01:33:53.680
they have to be treatment resistant,
link |
01:33:55.080
nothing has worked for them.
link |
01:33:56.120
And they can access MDMA
link |
01:33:58.480
while we're doing the phase three studies.
link |
01:34:01.920
But they have to pay for it themselves.
link |
01:34:04.280
The sponsor has to pay for all the research.
link |
01:34:06.320
But Expanded Access, because there's no control group,
link |
01:34:09.760
everybody gets the MDMA, people can pay for it themselves.
link |
01:34:12.960
And we think that'll start in a couple months.
link |
01:34:15.320
But it's very limited, it's limited to certain cities.
link |
01:34:17.760
There's also a program called Right to Try,
link |
01:34:20.520
which is passed through Congress.
link |
01:34:23.000
It's similar to this idea of compassionate use,
link |
01:34:26.080
but it cuts the FDA out of it.
link |
01:34:28.280
And patients can negotiate directly with pharma companies
link |
01:34:32.960
to get access to their drugs.
link |
01:34:35.520
That's starting to happen, I think, in Canada now,
link |
01:34:38.800
they're letting people have compassionate access
link |
01:34:41.200
to psilocybin for life threatening illness,
link |
01:34:44.160
because there has been studies with psilocybin
link |
01:34:46.560
for cancer patients and others with life threatening illness.
link |
01:34:49.720
As far as your question about when will you be able
link |
01:34:51.800
to access this for personal growth outside of medicine?
link |
01:34:56.840
I'll take that to mean fully legally,
link |
01:34:59.000
where you can just go buy pure drugs somewhere,
link |
01:35:00.960
when will that happen?
link |
01:35:02.240
We already are starting to see the decriminalization
link |
01:35:05.640
in certain areas of plant psychedelics.
link |
01:35:09.240
And we see overall drug decrim, like that passed in Oregon,
link |
01:35:13.440
so that any drug is now, it's not legal,
link |
01:35:16.040
you can't really fully set up clinics to offer it to people
link |
01:35:20.720
or there's no legal supply like that,
link |
01:35:22.640
but it's decriminalized.
link |
01:35:24.240
So my sense of things is based a lot on watching
link |
01:35:27.480
what happened with medical marijuana
link |
01:35:28.960
and marijuana legalization.
link |
01:35:30.160
So we're sitting here in Massachusetts
link |
01:35:31.800
where marijuana is legal,
link |
01:35:33.600
but what happened first was medical marijuana.
link |
01:35:36.240
So what we see is that medicalization,
link |
01:35:40.000
by demonstrating that under certain contexts,
link |
01:35:43.320
the risks are much less than the benefits,
link |
01:35:47.640
and then there are benefits,
link |
01:35:49.320
and then people hear stories about people
link |
01:35:51.440
that have gotten better,
link |
01:35:53.000
and then that changes their minds,
link |
01:35:54.520
and then eventually that builds up to why are we throwing
link |
01:35:57.080
people in jail for this?
link |
01:35:57.920
Just the culture, yeah.
link |
01:35:59.200
Yeah, so I think that what we're gonna have 2023
link |
01:36:02.520
is MDMA approved by the FDA, chances are.
link |
01:36:07.040
Psilocybin will be a year or two after that.
link |
01:36:09.800
Then what we're gonna need is a decade
link |
01:36:11.600
of psychedelic clinics that are gonna roll out
link |
01:36:14.120
across America, also other countries as well,
link |
01:36:17.920
thousands of these psychedelic clinics.
link |
01:36:20.040
We already have hundreds of ketamine clinics
link |
01:36:23.560
that are ketamine for depression.
link |
01:36:26.120
More and more people are realizing that ketamine,
link |
01:36:28.200
when it's used with therapy, it's better than when it's not.
link |
01:36:31.520
But the therapists wanna be psychedelic therapists.
link |
01:36:34.120
They don't wanna be a ketamine therapist or an MDMA therapist.
link |
01:36:36.720
So they'll be cross trained.
link |
01:36:38.360
So we will have a decade of these thousands
link |
01:36:40.480
of psychedelic clinics and all these stories
link |
01:36:42.360
of people getting better.
link |
01:36:43.200
And 2035 is when I think that we will move
link |
01:36:46.400
to licensed legalization, which is when you will
link |
01:36:49.800
have the option of just going somewhere
link |
01:36:52.960
once you've done this educational stuff.
link |
01:36:55.440
Potentially, I also think it would be better
link |
01:36:58.040
to have the opportunity for people to go for free,
link |
01:37:02.080
paid for by tax money, to these clinics,
link |
01:37:04.360
and you have your first experience
link |
01:37:05.760
with psychedelics under supervision.
link |
01:37:08.080
And you know what you're getting into.
link |
01:37:09.720
You've, you know, to ask the questionnaire,
link |
01:37:12.840
what the risks are with the drugs,
link |
01:37:14.120
then you get your license.
link |
01:37:15.760
So 2035 is when I think that'll happen.
link |
01:37:18.000
And the clinics will be sites of these initiations.
link |
01:37:20.880
Yes.
link |
01:37:21.840
And so it'd be a safe environment, just like you said,
link |
01:37:23.760
all the things that are actually maximize the likelihood
link |
01:37:27.240
of a pleasant experience and all those kinds of things.
link |
01:37:30.120
It is a frustratingly slow process.
link |
01:37:32.520
And the FDA being part of that process is very frustrating.
link |
01:37:36.600
But of course there's benefits,
link |
01:37:40.000
but boy, I wish it could move a lot faster.
link |
01:37:44.000
Yeah, well, one thing that I've learned
link |
01:37:45.800
from being a parent is that when you have little kids,
link |
01:37:52.640
it seems like they'll be with you forever.
link |
01:37:55.320
But then when they grow up and they go to college
link |
01:37:58.280
and they leave, do you look back and like,
link |
01:37:59.760
where did that 20 years go?
link |
01:38:01.800
Yeah.
link |
01:38:02.640
You know, so we're still dealing with the legacy
link |
01:38:05.240
of the civil war and slavery in America.
link |
01:38:08.000
So actually a 20 year plan is not that long.
link |
01:38:11.560
So while we say it's frustratingly slow, and it is,
link |
01:38:17.680
I mean, it's 50 years since the psychedelic sixties.
link |
01:38:21.400
And right now it's 36 years since MDMA was criminalized.
link |
01:38:29.000
And you think about all those people that committed suicide
link |
01:38:31.600
from PTSD or from anything else.
link |
01:38:34.240
And all those people that could have been helped
link |
01:38:36.840
if the DEA had accepted the Administrative Law Judge
link |
01:38:40.440
recommendation that MDMA stay in schedule three.
link |
01:38:42.920
It's tremendously sad.
link |
01:38:45.320
At the same time, culture evolves slowly.
link |
01:38:48.360
You know, you read the Bible or you read all this stuff,
link |
01:38:50.420
we're not that different from people thousands of years ago.
link |
01:38:53.260
So how are we gonna really evolve enough
link |
01:38:56.880
over the next couple of decades
link |
01:38:58.440
so we don't destroy the planet and don't kill each other?
link |
01:39:01.520
That's why I think psychedelics have an important role
link |
01:39:04.600
to play, that's why I've devoted my life to psychedelics.
link |
01:39:07.800
And it is frustratingly slow.
link |
01:39:09.600
And what I said to myself is our whole effort
link |
01:39:13.360
has not been fast enough.
link |
01:39:15.340
Can we talk a little bit about PTSD and MDMA?
link |
01:39:18.600
There's this fascinating paper came out
link |
01:39:22.720
on a fascinating study that you're a part of.
link |
01:39:26.520
That's a phase three study.
link |
01:39:27.920
Can you describe what the study is?
link |
01:39:29.580
Can you describe what phase three means?
link |
01:39:31.780
Can you describe what the findings are
link |
01:39:35.000
and why it's in fact so important and impactful?
link |
01:39:39.020
Yeah, this study came out May 10th in Nature Medicine.
link |
01:39:41.840
So one of the highest impact factors in medicine,
link |
01:39:44.680
journals, it was tremendous.
link |
01:39:46.160
So to make a drug into a medicine,
link |
01:39:48.780
the first thing you need to do is what are called
link |
01:39:52.360
nonclinical or preclinical studies,
link |
01:39:54.240
meaning safety established in animals.
link |
01:39:57.040
What does the drug do?
link |
01:39:58.440
What are the side effects in animals?
link |
01:40:00.080
Where do you see the risks?
link |
01:40:01.240
And then you negotiate with FDA to do phase one studies.
link |
01:40:05.600
And phase one studies are where you move
link |
01:40:07.440
from animals to humans.
link |
01:40:09.280
And those are more safety studies
link |
01:40:11.960
and trying to describe what the drug does
link |
01:40:14.500
so that you can determine
link |
01:40:16.160
if there is potential medical value there.
link |
01:40:19.120
Certain drugs like cancer drugs are so toxic
link |
01:40:24.120
that you don't have phase one studies in healthy volunteers.
link |
01:40:29.120
That's like phase one slash two,
link |
01:40:31.440
where you bring in the patients,
link |
01:40:33.840
but you still are doing sort of dose response
link |
01:40:35.880
safety studies, but you use patients.
link |
01:40:38.640
But most phase one studies are healthy volunteers.
link |
01:40:41.640
Phase two are where you start bringing in the patients
link |
01:40:45.440
and you start experimenting with various different things.
link |
01:40:48.400
The purpose of phase two is really just to design phase three.
link |
01:40:52.120
Now, again, I'm sort of putting out of the picture
link |
01:40:55.480
in another area is mechanism of action.
link |
01:40:57.240
How do these drugs work?
link |
01:40:58.680
Phase two, you're trying to figure out what they do,
link |
01:41:02.800
who your patient population is, what are the risks,
link |
01:41:05.400
who do you include, who do you exclude,
link |
01:41:07.800
what are the doses, what is your treatment,
link |
01:41:10.520
what are your measures.
link |
01:41:13.560
In our case, it was how do you do a double blind study?
link |
01:41:18.160
That was a big part of phase two.
link |
01:41:20.240
That's a big challenge for psychedelic drugs.
link |
01:41:22.800
Any kind of drugs that have a real strong effect,
link |
01:41:25.880
how do you do a double blind study?
link |
01:41:27.480
The double blind, sorry to interrupt,
link |
01:41:28.960
would mean that the patient should not be aware
link |
01:41:33.480
whether it's a placebo or not.
link |
01:41:35.800
And the researcher.
link |
01:41:36.960
And the researcher is not aware.
link |
01:41:39.160
And so for that lack of awareness,
link |
01:41:41.000
when the effect is really strong,
link |
01:41:42.320
it's very difficult to do on both the researcher
link |
01:41:44.160
and the patient side.
link |
01:41:45.680
Yes, and sometimes they talk about triple blind.
link |
01:41:49.200
So the other part is the raters
link |
01:41:51.280
that evaluate the symptoms and before and after.
link |
01:41:54.080
So you ideally want triple blind.
link |
01:41:55.880
You want the patients, the researchers,
link |
01:41:58.880
and the evaluators of the outcomes, all of them,
link |
01:42:02.200
not to know what the drug, whether it was drug or placebo,
link |
01:42:05.320
and that's to reduce experiment or bias.
link |
01:42:10.200
And then you move to phase three,
link |
01:42:12.040
once you've figured out how to design the phase three studies.
link |
01:42:15.560
And phase three are the large scale multiple studies
link |
01:42:18.800
multi site, placebo controlled, double blind studies,
link |
01:42:23.000
where you must prove safety and efficacy
link |
01:42:25.520
in order to get permission to market the drug.
link |
01:42:29.760
Now, for us, when we started MAPS in 86,
link |
01:42:34.000
as I said, it was one year after the criminalization
link |
01:42:36.040
of MDMA in 85, we had five different protocols
link |
01:42:39.880
that were rejected by the FDA for studying with MDMA.
link |
01:42:43.960
And these were all various phase one studies.
link |
01:42:46.800
They came from Harvard, from UC San Francisco,
link |
01:42:49.240
from the University in Arizona,
link |
01:42:51.360
and Albuquerque, New Mexico, all over.
link |
01:42:53.840
And they were all rejected.
link |
01:42:55.640
1992, six years after we started,
link |
01:42:59.040
we got the first permission for phase one.
link |
01:43:02.720
And that took us through much of the 90s.
link |
01:43:05.560
Again, things are slow because we have to raise the money
link |
01:43:08.160
through donations.
link |
01:43:09.320
And then in 1999 is when we started the work with PTSD.
link |
01:43:14.320
And that then took us till November 29th, 2016,
link |
01:43:22.720
which is when we had the end of phase two meeting with FDA.
link |
01:43:25.920
So it took 30 years from the start of MAPS
link |
01:43:29.200
to the end of phase two meeting with FDA.
link |
01:43:31.960
And what we had discovered during phase two
link |
01:43:35.520
was several different key points.
link |
01:43:38.960
The drugs that are available right now for PTSD,
link |
01:43:42.440
the SSRIs, Zoloft and Paxil,
link |
01:43:45.320
that have been approved by FDA and regulators in Europe
link |
01:43:47.960
as well, the European Medicines Agency, for PTSD,
link |
01:43:52.200
they work better in women than in men,
link |
01:43:54.600
and they failed in combat related PTSD.
link |
01:43:58.560
All right, so what we learned is that MDMA assisted therapy
link |
01:44:02.000
works just as well in men or women,
link |
01:44:03.880
and it works in combat related PTSD.
link |
01:44:06.480
It works in regardless of the cause of PTSD.
link |
01:44:09.280
We also discovered that even though there are stories
link |
01:44:12.960
that people take MDMA at raves and they dance all night
link |
01:44:16.080
and they overheat and they get hypothermia
link |
01:44:18.040
and they die from overheating, which is true
link |
01:44:20.400
and can happen from pure MDMA,
link |
01:44:23.200
or that sometimes people have heard about
link |
01:44:25.400
needing to cool down and so they drink water
link |
01:44:29.080
and then while they're dancing all night
link |
01:44:31.440
and then they drink too much water
link |
01:44:32.840
and then they dilute their blood
link |
01:44:34.280
and they die from hyponatremia.
link |
01:44:36.520
So there are risks of MDMA, but we discovered
link |
01:44:39.440
that in a therapeutic setting,
link |
01:44:41.040
we can control all those risks,
link |
01:44:42.680
those things don't happen at all.
link |
01:44:44.960
So we discovered safety, we could demonstrate safety.
link |
01:44:49.680
We also figured out that our measure, the CAPS,
link |
01:44:53.680
the Clinician Administrative PTSD Scale,
link |
01:44:55.920
that it's the gold standard all over the world
link |
01:44:58.320
for measuring PTSD symptoms,
link |
01:44:59.840
it's what the FDA and the EMA require.
link |
01:45:02.440
We discovered that it was a good measure for us
link |
01:45:04.760
and that we could show changes in that.
link |
01:45:07.880
The other big thing that we learned is that,
link |
01:45:11.400
and we haven't mentioned this yet,
link |
01:45:13.040
but the work in the 50s and 60s with LSD and psilocybin
link |
01:45:16.800
and the modern research over the last 20 years
link |
01:45:19.000
with psilocybin and classic psychedelics
link |
01:45:20.840
has demonstrated that there's a link
link |
01:45:23.120
between this mystical experience,
link |
01:45:24.960
this unit of mystical experience and therapeutic outcomes
link |
01:45:28.280
for the treatment of addiction,
link |
01:45:29.560
for working with people with life threatening illnesses
link |
01:45:32.320
that for OCD, for Obsessive Compulsive Disorder,
link |
01:45:36.760
that there's with the classic psychedelics,
link |
01:45:39.800
both in the 50 years ago and then the research now
link |
01:45:42.600
has been that there's a link between the depth
link |
01:45:45.240
of the mystical experience and therapeutic outcome.
link |
01:45:48.680
What we discovered is that that's not the case for MDMA,
link |
01:45:52.320
that people do score fairly high
link |
01:45:55.000
on the scales of mystical experience,
link |
01:45:56.960
not as high as they do with the classic psychedelics,
link |
01:45:59.240
but they do score pretty high on average.
link |
01:46:02.480
And a significant number of them have over the cutoff
link |
01:46:06.360
for what would be considered a full mystical experience.
link |
01:46:09.120
So enough to say that we could look at a correlation
link |
01:46:11.840
and we didn't find any.
link |
01:46:13.600
The other thing that we discovered,
link |
01:46:15.120
and this was more humbling, I would say for me personally,
link |
01:46:20.000
is that my dissertation at the Kennedy School,
link |
01:46:22.400
a big part of it was on the,
link |
01:46:24.440
it's about the regulation of the medical use
link |
01:46:26.240
of psychedelics in marijuana.
link |
01:46:27.840
A big part of my dissertation was how to do
link |
01:46:29.680
the double blind study.
link |
01:46:31.760
And I thought I'd solve the problem
link |
01:46:33.200
and I persuaded my dissertation committee
link |
01:46:35.560
that I'd solve the problem.
link |
01:46:37.480
And the solution was therapy with low dose MDMA
link |
01:46:41.240
versus therapy with full dose MDMA.
link |
01:46:43.960
And everybody knows that they're gonna get MDMA,
link |
01:46:46.840
most of these people have never done it before,
link |
01:46:49.040
they'll be confused about is it full dose or low dose.
link |
01:46:52.640
And then the challenge is to pick a dose
link |
01:46:56.200
that's high enough so that there is this confusion,
link |
01:47:00.080
but not so high that it's so therapeutic
link |
01:47:02.120
that we can't tell the difference between the groups.
link |
01:47:04.800
So we studied zero, meaning inactive placebo,
link |
01:47:09.360
25 milligrams, 30 milligrams, 40 milligrams,
link |
01:47:12.120
50 milligrams, 75 milligrams, 100 milligrams,
link |
01:47:14.680
125 and 150.
link |
01:47:18.120
What we discovered is that my dissertation was wrong
link |
01:47:21.960
and that there is no good solution
link |
01:47:24.320
to the double blind problem.
link |
01:47:26.280
What we found is that, to our surprise actually,
link |
01:47:31.320
was that 75 milligrams was an effective dose.
link |
01:47:34.840
We didn't think that.
link |
01:47:36.880
I mean, the normal dose is like,
link |
01:47:39.120
full dose is like 125 milligrams, something like that.
link |
01:47:42.720
But 75 milligrams was an effective dose.
link |
01:47:45.560
And we discovered that the lower doses,
link |
01:47:48.000
so I was half right, you could say,
link |
01:47:50.160
the doses of 25, 30, 40, 50,
link |
01:47:53.440
they could produce enough confusion
link |
01:47:57.040
that you could say that they were successful at blinding,
link |
01:47:59.440
not perfectly, but enough confusion
link |
01:48:02.080
so that people, therapists, couldn't know for sure
link |
01:48:05.120
so that there was this reduction of bias, you could say.
link |
01:48:09.680
But what we discovered, again, to our surprise,
link |
01:48:14.120
was that the low doses made people uncomfortable.
link |
01:48:17.400
They stimulated them, but they didn't reduce the fear.
link |
01:48:23.400
And so people still got better
link |
01:48:25.920
with the therapy with low dose MDMA.
link |
01:48:28.080
But if we gave them therapy with inactive placebo,
link |
01:48:31.800
they did even better
link |
01:48:33.840
than if we gave them therapy with low dose MDMA.
link |
01:48:37.360
So we call it an anti therapeutic effect.
link |
01:48:41.320
I don't mean to imply that they got worse,
link |
01:48:43.520
but it made people uncomfortable.
link |
01:48:45.440
People didn't like it.
link |
01:48:47.360
But we would still help them make some progress.
link |
01:48:49.840
So we had the blinding,
link |
01:48:51.520
but what it meant by reducing the effect of therapy
link |
01:48:54.720
with inactive placebo is that it would make it easier
link |
01:48:57.480
for us to find a difference between the two groups.
link |
01:49:01.080
And so the real question is,
link |
01:49:02.760
if you can do it with therapy, why bother add a drug?
link |
01:49:07.240
So we went to the FDA,
link |
01:49:09.160
and so this was what we discovered during phase two.
link |
01:49:12.000
We went to the FDA at this end of phase two meeting,
link |
01:49:15.120
and we said, we can give you blinding,
link |
01:49:17.600
but it will make it easier for us
link |
01:49:20.240
to find a difference between the two groups.
link |
01:49:22.040
And so we suggest that we do therapy with inactive placebo
link |
01:49:26.320
versus therapy with full dose MDMA.
link |
01:49:29.440
That will cause a problem
link |
01:49:30.920
because most people will be able to tell what they've got.
link |
01:49:34.320
What Tom Loughran, a doctor
link |
01:49:36.920
who used to be head of psychiatry products at FDA
link |
01:49:39.400
is our main advisor.
link |
01:49:41.640
So the first thing he said
link |
01:49:42.880
is that the double blind fails in practice a lot,
link |
01:49:45.480
even with SSRIs,
link |
01:49:47.360
because there's certain side effects
link |
01:49:49.400
that you have with these drugs.
link |
01:49:50.720
And the doctors who are doing these research
link |
01:49:52.640
when you're reporting your side effects,
link |
01:49:55.240
they can say, oh, that's probably,
link |
01:49:56.400
you got the active drug instead of the placebo.
link |
01:49:58.280
So the double blind is in theory is terrific,
link |
01:50:01.800
but in practice, it doesn't always work quite as well.
link |
01:50:05.760
And so what Tom said is that there are two main approaches
link |
01:50:10.160
that they think are important to reduce bias.
link |
01:50:13.240
The first one is easy to do.
link |
01:50:15.160
It's called random assignment.
link |
01:50:17.800
So sometimes there are studies
link |
01:50:19.720
where you'll treat a bunch of people with something
link |
01:50:24.200
and some fraction of them will get better and some won't.
link |
01:50:26.720
And then you say, okay, all those who didn't get better,
link |
01:50:29.160
who volunteers to get this new treatment?
link |
01:50:31.800
And then you give them the new treatment,
link |
01:50:33.200
but the people that volunteer
link |
01:50:34.320
are more likely to wanna get better.
link |
01:50:36.000
They're not representative sample of everybody that has.
link |
01:50:39.680
So when you have random assignment,
link |
01:50:41.680
everybody is similarly motivated
link |
01:50:43.880
and meets the same inclusion, exclusion criteria.
link |
01:50:47.280
So that's what we told,
link |
01:50:48.680
of course we need random assignment.
link |
01:50:50.400
The other part was when the bias double blind
link |
01:50:54.040
doesn't work as well,
link |
01:50:55.760
then the system of independent raters
link |
01:50:59.800
is especially important of how you do that.
link |
01:51:03.000
So we have over a pool of raters, over 20 of them,
link |
01:51:08.000
and we do this monthly interrater reliability tests
link |
01:51:11.880
to make sure that they evaluate this,
link |
01:51:15.200
so that they're given a videotape of a PTSD patient
link |
01:51:17.640
and then they're supposed to rate them
link |
01:51:19.640
according to their symptoms.
link |
01:51:20.800
And then we sort of make sure
link |
01:51:22.760
that we've got this calibrated rater pool
link |
01:51:25.840
and it's all done by Zoom, by telemedicine,
link |
01:51:28.760
and they're randomly assigned to the next person
link |
01:51:30.880
that needs a rating.
link |
01:51:32.600
So they said 20 raters.
link |
01:51:34.280
So we've got like 20 raters
link |
01:51:35.800
and what we wanna do is make it so that each rater
link |
01:51:40.280
sees each patient only once, maybe twice,
link |
01:51:43.640
but not tracking them through the study.
link |
01:51:47.120
So that tries to reduce the bias in the raters
link |
01:51:49.440
that they don't know where this person is in the study.
link |
01:51:54.760
And so there's a fellow, Bob Temple,
link |
01:51:59.040
who's like the old wise man at the FDA.
link |
01:52:01.280
He's been there since 1972.
link |
01:52:03.680
He was in charge of the Office of Science Policy
link |
01:52:05.880
and they brought him into the final meeting of this process
link |
01:52:09.840
where we are trying to design phase three.
link |
01:52:11.880
So once FDA said, yes, you can go to phase three,
link |
01:52:14.640
that was November 29th, 2016,
link |
01:52:17.840
we then negotiated for eight months
link |
01:52:20.320
on the design of phase three
link |
01:52:21.760
and all of the other information that FDA is gonna need.
link |
01:52:25.320
This process of design.
link |
01:52:28.920
To the extent that I have any artistic creativity,
link |
01:52:31.920
it's in protocol design.
link |
01:52:34.520
I really love that.
link |
01:52:35.760
So you enjoy this process.
link |
01:52:36.960
I love it.
link |
01:52:37.800
I love it because it's always trade offs
link |
01:52:39.480
and I acknowledge that we are all biased.
link |
01:52:44.840
And so how do you,
link |
01:52:46.080
there's something beautiful about the scientific process
link |
01:52:49.600
designed to get you to the truth.
link |
01:52:52.720
Especially when that scientific process
link |
01:52:54.520
is trying to get to the truth of the human organism,
link |
01:52:57.080
which is so complicated.
link |
01:52:58.760
So it's very difficult to dissect,
link |
01:53:01.960
to get the strong effects.
link |
01:53:04.360
And when you're analyzing,
link |
01:53:06.320
when you have like raters, they're watching a video.
link |
01:53:11.920
Removing subjectivity from that is very, very challenging.
link |
01:53:15.480
Yeah, very much so.
link |
01:53:18.800
And so we came to this agreement with FDA though
link |
01:53:21.640
that we would use this independent rater pool.
link |
01:53:25.840
And so we learned in phase two again,
link |
01:53:30.840
that the double blind,
link |
01:53:31.880
there was no solution to the double blind problem.
link |
01:53:34.000
And both the FDA and the European Medicines Agency
link |
01:53:37.040
in the end agreed that the best design
link |
01:53:39.680
was therapy with inactive placebo
link |
01:53:41.800
versus therapy with full dose MDMA,
link |
01:53:43.800
accepting the fact that most people will be able to tell
link |
01:53:47.120
whether they got nothing or they got full dose MDMA.
link |
01:53:50.240
Most therapists will be able to tell the difference,
link |
01:53:52.400
but that makes a harder test for us
link |
01:53:55.880
to show a difference between the two groups
link |
01:53:57.760
because we're giving them inactive placebo
link |
01:54:00.120
and not the anti therapeutic effect of low dose MDMA.
link |
01:54:03.960
So once we started phase three,
link |
01:54:06.080
so then we were able to start in 2018 phase three.
link |
01:54:10.520
And the paper in Nature Medicine that just came out
link |
01:54:13.680
was the results of our first phase three study.
link |
01:54:18.160
We came to agreement with FDA
link |
01:54:20.240
that we would do two phase three studies,
link |
01:54:22.680
each would have 100 persons in them.
link |
01:54:25.960
And what the FDA said to us is that they thought
link |
01:54:29.240
that we could prove efficacy with smaller numbers
link |
01:54:33.520
than they wanted to see for safety.
link |
01:54:36.400
The reason they said that is it in phase two,
link |
01:54:38.880
we had a large effect size.
link |
01:54:41.360
So from a statistical point of view,
link |
01:54:43.440
the bigger of an effect that you're looking for,
link |
01:54:47.040
the fewer number of people you need
link |
01:54:49.080
to get statistical significance.
link |
01:54:51.360
When you're trying to find small differences,
link |
01:54:53.320
you need large numbers of people
link |
01:54:54.800
to sort of work out the noise.
link |
01:54:59.800
So we came to agreement on two 100 person phase three studies.
link |
01:55:05.280
And the idea is that it's very possible
link |
01:55:07.480
that the first study would show the efficacy
link |
01:55:11.160
because the effect is so strong.
link |
01:55:13.120
Yeah, yeah, and the second, but also safety as well.
link |
01:55:16.120
So one of the things we also realized
link |
01:55:19.600
when you work with a highly stigmatized drug
link |
01:55:22.400
in the midst of still the drug war and prohibition
link |
01:55:26.920
that we need highly sympathetic subjects
link |
01:55:31.280
and we need to make the best case we can,
link |
01:55:34.020
which means we need to work with the hardest cases
link |
01:55:37.040
so that this is really needed.
link |
01:55:38.400
And so we end up enrolling people.
link |
01:55:40.920
The first study was chronic severe PTSD.
link |
01:55:45.040
And unlike many studies of PTSD,
link |
01:55:47.280
we enroll people that have previously attempted suicide.
link |
01:55:50.640
Wow.
link |
01:55:51.480
So we have multiple people
link |
01:55:53.040
that have tried to kill themselves
link |
01:55:54.560
that we felt like if we were to exclude them,
link |
01:55:57.520
what are we doing?
link |
01:55:58.440
Those are the people that need it the most.
link |
01:56:00.520
So we came to this agreement with FDA.
link |
01:56:04.320
We're gonna work with chronic severe PTSD patients,
link |
01:56:09.120
including those that had attempted suicide.
link |
01:56:11.600
And we would do these two 100 person studies.
link |
01:56:14.840
And we also negotiated what's called an interim analysis.
link |
01:56:19.760
So what that means is that
link |
01:56:22.240
when the study is underway,
link |
01:56:26.800
and often big, big studies,
link |
01:56:28.640
they have this kind of interim analysis
link |
01:56:30.360
where what you do is,
link |
01:56:31.600
and for us, we negotiate when we had 60% or 60 people
link |
01:56:35.120
had reached the primary outcome measure
link |
01:56:37.440
and all 100 had been enrolled,
link |
01:56:39.880
then we would take a look at the data.
link |
01:56:42.040
And if the statistical analysis that we did
link |
01:56:46.960
was showing based on a certain effect size that we chose
link |
01:56:52.680
based on what we saw in phase two,
link |
01:56:55.040
the interim analysis
link |
01:56:56.080
is for what's called sample size reestimation.
link |
01:56:59.240
So what it means is if the results aren't as good
link |
01:57:01.200
as you thought they would, you can add more people.
link |
01:57:04.080
And then you'll get statistical significance.
link |
01:57:07.720
It means that your effect isn't as strong as you thought.
link |
01:57:10.440
It'll be harder to get insurance to cover it,
link |
01:57:12.360
but FDA will still approve it
link |
01:57:14.400
because FDA also believes that these are group averages.
link |
01:57:18.760
There may be some people that will later figure out
link |
01:57:20.760
respond better than others.
link |
01:57:22.480
So they'll approve it if it's statistically significant,
link |
01:57:25.080
even if it has a low effect size.
link |
01:57:27.240
The SSRIs have low effect size.
link |
01:57:30.120
So we did the interim analysis in March of 2020.
link |
01:57:35.840
And what we discovered to our delight
link |
01:57:38.080
was that we did not need to add any subjects.
link |
01:57:41.760
That's all we were told.
link |
01:57:42.800
We weren't told like, what is the results?
link |
01:57:45.800
We were just told all we were gonna get is a number, zero,
link |
01:57:48.680
or you need to add X numbers of people to the study
link |
01:57:50.960
to get statistical significance.
link |
01:57:53.200
That's right around the time that COVID hit
link |
01:57:55.400
and lockdowns happened.
link |
01:57:56.720
And we ended up negotiating with FDA
link |
01:57:59.240
that we would end the study with 90 people instead of 100.
link |
01:58:04.800
It took a while for us to end up doing that.
link |
01:58:06.680
So the paper that we just published
link |
01:58:08.360
is on the results of 90 people.
link |
01:58:10.960
I think it was 46 in the MDMA group,
link |
01:58:13.280
44 in the placebo group.
link |
01:58:16.960
And what we discovered was that the study worked better
link |
01:58:21.400
than we had even hoped.
link |
01:58:23.280
So the first thing is that
link |
01:58:25.520
you look at statistical significance.
link |
01:58:27.240
You have to get 0.05,
link |
01:58:28.560
which basically means a nickel out of a dollar,
link |
01:58:30.600
a one in 20 chance that the difference
link |
01:58:33.160
between the two groups is due to some random factor
link |
01:58:36.320
rather than to your intervention.
link |
01:58:38.200
And in this case, the placebo group gets therapy
link |
01:58:42.920
and then with inactive placebo
link |
01:58:44.800
and then the group gets MDMA with active placebo.
link |
01:58:49.200
So you have to get 0.05.
link |
01:58:52.200
There's another measure
link |
01:58:53.800
that the FDA uses sometimes called robust,
link |
01:58:56.840
which means one in a thousand,
link |
01:58:59.520
instead of one in 20, one in a thousand.
link |
01:59:01.600
And if you get a robust results, 0.001,
link |
01:59:06.680
and you meet some other criteria,
link |
01:59:09.440
they might agree to approve the drug
link |
01:59:11.520
on the basis of just one phase three study instead of two.
link |
01:59:15.120
Because when you think about it,
link |
01:59:16.600
a one in 20 chance for your first phase three study,
link |
01:59:20.160
a one in 20 chance for your second phase three study,
link |
01:59:23.200
you multiply that together, it's one in 400, 0.025.
link |
01:59:28.120
So that's pretty good.
link |
01:59:32.680
So robust 0.001 is even better
link |
01:59:35.760
than two independent phase three studies, each at 0.05.
link |
01:59:41.160
What we ended up getting was one in 10,000, 0.0001.
link |
01:59:46.560
Outrageous, incredibly.
link |
01:59:49.400
So that's a measure of both the difference
link |
01:59:51.440
between the two groups and the variability.
link |
01:59:53.560
And so what it meant is that we had minimal variability,
link |
01:59:58.600
that most people who got the MDA
link |
02:00:00.400
got quite a large amount of benefit from it.
link |
02:00:03.480
And most people who got the placebo
link |
02:00:05.160
were more or less in the same range as well.
link |
02:00:07.320
That's really exciting, by the way.
link |
02:00:08.920
I mean, I suppose it's exciting
link |
02:00:13.520
from a perspective of approval by the FDA.
link |
02:00:16.440
Maybe perhaps that's the way you're seeing it,
link |
02:00:18.280
but it's also exciting because it has a chance
link |
02:00:22.960
to help people that are truly suffering, yeah.
link |
02:00:26.000
Well, if we can get one in 10,000
link |
02:00:29.040
in the first phase three study,
link |
02:00:31.360
chances are we can get one in 20 in the second.
link |
02:00:34.440
So it's really gonna be about safety for us
link |
02:00:36.960
in the second phase three study.
link |
02:00:39.800
Now, you can have a large P value, a large significance,
link |
02:00:45.720
but you could have an effect that's not very significant.
link |
02:00:49.720
It's not clinically significant.
link |
02:00:51.160
You can have statistical significance
link |
02:00:52.840
without clinical significance.
link |
02:00:55.400
And as I said, the more people you get in the study,
link |
02:00:58.040
you can find smaller and smaller differences
link |
02:00:59.960
between two groups.
link |
02:01:02.040
Now, we showed that we had a very large effect size.
link |
02:01:07.320
So effect size is based on...
link |
02:01:10.280
That scale you mentioned?
link |
02:01:11.480
Well, the scale of the effect size
link |
02:01:13.560
is based on standard deviations.
link |
02:01:17.320
So an effect size of one means that your results
link |
02:01:20.400
are one standard deviation away from the norm.
link |
02:01:23.320
That's considered very large.
link |
02:01:26.320
The SSRIs, because they were like 0.3, 0.4 effect size,
link |
02:01:32.240
that's considered small effect size.
link |
02:01:34.120
Medium is starting to be around 0.6
link |
02:01:36.920
and 0.8 and above are large effect sizes.
link |
02:01:41.400
We had what's called placebo subtracted effect size.
link |
02:01:45.680
There's two different ways to look at it.
link |
02:01:46.880
Placebo subtracted means you kind of look at the difference
link |
02:01:49.440
between your two groups.
link |
02:01:51.600
And what that is for us, since one group had therapy
link |
02:01:54.480
and one had therapy plus MDMA,
link |
02:01:56.240
the placebo subtracted effect size
link |
02:01:58.880
is basically the effect of just the MDMA
link |
02:02:02.000
because you've kind of washed out the therapy.
link |
02:02:03.600
That was 0.91.
link |
02:02:05.240
So we had a large effect size, which was different.
link |
02:02:08.440
Wow, so 0.91 over just the therapy, so over the placebo.
link |
02:02:13.040
Yeah. Wow.
link |
02:02:13.960
Now, when we do the within group,
link |
02:02:17.440
meaning the group that just got the MDMA plus therapy,
link |
02:02:21.560
look at their baseline and their outcomes.
link |
02:02:23.920
That's another way to look at it.
link |
02:02:25.320
And that's what's gonna actually happen in practice
link |
02:02:27.440
because people are gonna get MDMA plus therapy.
link |
02:02:30.880
That's 2.1 effect size.
link |
02:02:32.680
Two standard deviations away from the norm
link |
02:02:35.000
is enormous effect size.
link |
02:02:38.200
The other part is that we had no effect by site,
link |
02:02:44.040
which is very important.
link |
02:02:44.960
So we had 15 sites, two in Israel, two in Canada,
link |
02:02:47.720
11 throughout the United States.
link |
02:02:50.800
The FDA looks at, is there a side effect?
link |
02:02:53.320
Because what that might mean is
link |
02:02:54.600
maybe you've got all your patients
link |
02:02:56.280
or most of your patients going to this one site,
link |
02:02:58.240
which is these highly experienced therapists
link |
02:03:01.000
and they're like hippies from way back
link |
02:03:03.160
and they're super experienced with psychedelics
link |
02:03:05.120
and they're getting great results,
link |
02:03:07.360
but nobody else gets good results.
link |
02:03:09.240
So we had no effect by site.
link |
02:03:11.080
That's incredible.
link |
02:03:12.320
That we've been able to train all these new therapists.
link |
02:03:14.920
We had about 80 therapists working at all these 15 sites.
link |
02:03:20.320
We also discovered that there's a group
link |
02:03:23.560
that's considered to be very difficult to treat,
link |
02:03:26.960
which is called the dissociative subtype.
link |
02:03:29.960
So when people are traumatized,
link |
02:03:32.960
one of the ways to psychologically survive that
link |
02:03:37.720
is you dissociate.
link |
02:03:38.960
It's like you're not there.
link |
02:03:41.040
When you do that though, it's hard to come back
link |
02:03:43.480
because when you come back,
link |
02:03:45.000
then you get all these painful memories and fearful.
link |
02:03:47.520
And so the extreme of that
link |
02:03:50.320
is called dissociative identity disorder,
link |
02:03:53.120
kind of like schizophrenia, almost dissociative identity.
link |
02:03:56.440
So we let people in who are on the dissociative subtype
link |
02:04:01.080
and those are considered to be the hardest to treat
link |
02:04:03.120
because the theory is that you need to be ego intact.
link |
02:04:07.720
As I said, the mystical experience is not correlated
link |
02:04:10.200
with therapeutic outcomes.
link |
02:04:11.240
And you need to be talking about what traumatized you
link |
02:04:13.800
and working through that and expressing it,
link |
02:04:15.800
letting it out, not keeping it in.
link |
02:04:18.000
So the dissociative subtype seems like it's harder
link |
02:04:22.520
for them to get back into the event
link |
02:04:24.480
because they're so dissociated.
link |
02:04:26.240
What we showed is that those people did even better
link |
02:04:29.040
on average than everybody else.
link |
02:04:31.400
So that MDMA is integrative.
link |
02:04:33.200
It helps people who are so separate
link |
02:04:36.920
that they make even more rapid progress.
link |
02:04:39.080
So it's almost like the MDMA made it more difficult
link |
02:04:41.960
for them to dissociate.
link |
02:04:43.440
Yes.
link |
02:04:44.280
Yeah, or you could say it made it easier
link |
02:04:45.760
for them to remember.
link |
02:04:47.200
Yes, exactly.
link |
02:04:48.280
To reverse the dissociation.
link |
02:04:49.520
Yeah.
link |
02:04:50.360
And we find that MDMA enhances memory for the trauma
link |
02:04:54.600
so that you can have these unconscious memories
link |
02:04:57.600
or memories that you cannot remember
link |
02:04:59.440
or that you've suppressed so much,
link |
02:05:00.920
but they distort your view.
link |
02:05:02.560
Your filter of the world is distorted
link |
02:05:04.720
by these fearful memories that the world can't be trusted.
link |
02:05:07.400
People can't be trusted.
link |
02:05:08.400
It's always about to happen.
link |
02:05:10.040
So we find that MDMA increases memory for the trauma,
link |
02:05:13.640
but by reducing the fear,
link |
02:05:15.280
then the memories can come to the surface.
link |
02:05:16.880
Then you can process them, let out the emotions,
link |
02:05:18.960
cry, scream, shake, whatever.
link |
02:05:21.480
And then through this MDMA effect
link |
02:05:24.480
on the amygdala and the hippocampus,
link |
02:05:26.040
it helps you store these memories into longterm storage
link |
02:05:29.400
so that they're not always about to happen.
link |
02:05:31.320
They're in the past.
link |
02:05:32.600
They're part of your story, but they're not the whole story.
link |
02:05:35.320
So we discovered that the dissociative subtype works better.
link |
02:05:38.640
Now, none of this would be enough unless safety.
link |
02:05:42.800
So from a safety perspective,
link |
02:05:45.000
what we discovered is that there was one woman in the study
link |
02:05:48.040
that attempted to kill herself twice during the study.
link |
02:05:52.040
There was another woman that was so worried
link |
02:05:57.200
that she might kill herself,
link |
02:05:58.400
that the therapy brought these things to the surface
link |
02:06:00.480
that she's been pushing away,
link |
02:06:01.600
that she checked herself into a hospital
link |
02:06:03.920
in order to avoid self harm.
link |
02:06:06.800
At the end of the study,
link |
02:06:08.200
what we learned is both of them were in the placebo group.
link |
02:06:11.840
We didn't have anybody in the MDMA group
link |
02:06:14.280
attempt to kill themselves.
link |
02:06:16.920
So the MDMA is really helpful
link |
02:06:21.080
for giving people a sense of hope
link |
02:06:24.160
and that they can somehow process this.
link |
02:06:27.120
Now, it's not to say that nobody will ever commit suicide.
link |
02:06:30.800
That's our big concern in the second phase three study.
link |
02:06:34.200
As I said, it's more gonna be about safety
link |
02:06:36.000
than about efficacy.
link |
02:06:37.000
We think we'll get the efficacy,
link |
02:06:38.360
but we're very concerned about safety.
link |
02:06:42.200
Because we had problems in the first phase three study
link |
02:06:46.320
of somebody trying to kill herself twice
link |
02:06:47.760
in the placebo group,
link |
02:06:49.960
it's the background for having PTSD.
link |
02:06:52.920
So there'd have to be a disproportionate number of people
link |
02:06:55.480
in the MDMA group try to kill themselves
link |
02:06:57.400
or succeed in killing themselves
link |
02:06:58.800
than in the placebo group for the FDA to say,
link |
02:07:01.440
oh, this MDMA, it's too dangerous.
link |
02:07:04.320
We don't think that's gonna happen.
link |
02:07:05.920
So the other findings from safety
link |
02:07:11.120
is that the side effects are transitory.
link |
02:07:13.240
They're minor, they're sweating or jaw clenching
link |
02:07:17.760
or a slight temperature increase.
link |
02:07:19.760
And everybody that's been to a rave knows about it.
link |
02:07:23.040
Take an ecstasy, there are some side effects.
link |
02:07:26.200
But they're minor, they're transitory
link |
02:07:27.640
and there has been this massive problem
link |
02:07:30.920
of during the eighties, the nineties,
link |
02:07:33.440
NIDA, the National Institute on Drug Abuse
link |
02:07:34.920
was trying to say that MDMA was neurotoxic
link |
02:07:37.760
and that you take it
link |
02:07:38.840
and it's gonna cause nerve terminal degeneration.
link |
02:07:41.200
It's gonna be major brain damage.
link |
02:07:42.960
It's gonna be significant functional consequences.
link |
02:07:45.400
And back then they were saying that MDMA is too dangerous.
link |
02:07:48.520
It should never even be researched.
link |
02:07:49.960
Nobody should even get it once
link |
02:07:51.400
because it's poison and brain damage.
link |
02:07:54.120
Well, we no longer believe that, that was exaggerated.
link |
02:07:57.560
That was in service of the drug war.
link |
02:08:00.840
But we've done in phase two neurocognitive tests
link |
02:08:04.520
before and after in two of our different sites
link |
02:08:07.320
and showed no decline in cognitive functioning.
link |
02:08:09.880
So we don't think that there's any neurotoxicity happening
link |
02:08:14.680
and the doses that we use.
link |
02:08:16.760
There's no obvious functional consequences.
link |
02:08:18.800
People are getting better.
link |
02:08:20.240
And the other thing that we've learned in phase two
link |
02:08:24.160
and that we still have to learn from this study.
link |
02:08:25.720
So what we showed is the durability of the effect.
link |
02:08:29.400
We showed that 32% of the people
link |
02:08:32.160
that got the therapy without MDMA
link |
02:08:34.440
at two months after the last experimental session
link |
02:08:36.880
no longer had PTSD.
link |
02:08:38.840
Just with the therapy, which is phenomenal
link |
02:08:41.160
because these are on average 14 years PTSD,
link |
02:08:44.200
one third had PTSD over 20 years.
link |
02:08:48.000
And just with the therapy,
link |
02:08:51.120
32% no longer had PTSD at the two months.
link |
02:08:54.640
However, those people that got MDMA, it was 67%.
link |
02:08:58.440
No longer had PTSD, more than twice as good.
link |
02:09:02.320
In phase two and in phase three,
link |
02:09:04.840
we're also gonna do the 12 month followup.
link |
02:09:07.600
That's not for the FDA.
link |
02:09:09.320
That's not for approvability.
link |
02:09:10.760
That's more for insurance companies
link |
02:09:12.400
because this is expensive, a lot of therapy time.
link |
02:09:15.360
If it fades, if it's great results initially
link |
02:09:18.080
but then it fades after six months, what's the point?
link |
02:09:20.880
And what we showed in phase two
link |
02:09:24.880
is that people keep getting better.
link |
02:09:28.960
At the two month followup, they're doing pretty well
link |
02:09:31.960
but at the 12 month followup, they're even better.
link |
02:09:34.960
So it's durable.
link |
02:09:35.960
People have learned how to process trauma.
link |
02:09:38.440
They keep getting better.
link |
02:09:39.280
So we've not reached that point in this phase three study
link |
02:09:41.680
where everybody's got their one year followup.
link |
02:09:43.440
But we have also done three and a half year followups
link |
02:09:46.320
to some of the groups that were in phase two
link |
02:09:48.840
and showed that it was durable.
link |
02:09:50.600
And we're doing a long term followup now
link |
02:09:53.040
to many of the people in phase two,
link |
02:09:55.280
some of them treated 15 years ago.
link |
02:09:57.640
So that's all more for the insurance companies.
link |
02:09:59.960
So basically what we found in the paper
link |
02:10:02.800
that we just published is that it was highly efficacious,
link |
02:10:05.360
highly significant, no effect by sight,
link |
02:10:07.920
works in the hardest cases and the safety record was great.
link |
02:10:13.120
That's an incredible success.
link |
02:10:14.640
And that's really exciting, especially given
link |
02:10:17.640
that the people who've committed, who attempted
link |
02:10:21.720
to commit suicide were let into the study.
link |
02:10:23.920
And so these are people who are truly suffering.
link |
02:10:30.120
I mean, that's incredibly exciting.
link |
02:10:36.120
And I mean, just to speak to the frustration
link |
02:10:38.360
why things can't move faster,
link |
02:10:39.920
but for what it is, it's incredibly exciting.
link |
02:10:44.920
Is there other studies of this nature
link |
02:10:48.160
that you foresee enabling that same kind
link |
02:10:51.160
of positive impact, whether it's MDMA
link |
02:10:53.480
for other things like treating addiction,
link |
02:10:55.360
or maybe it's psilocybin for other conditions?
link |
02:10:59.400
Is there something else that's promising?
link |
02:11:01.160
Yeah, I think that what we've discovered
link |
02:11:05.800
I don't think is unique to MDMA.
link |
02:11:08.920
So it's MDMA assisted psychotherapy.
link |
02:11:12.360
MDMA is ideal for PTSD.
link |
02:11:15.560
Maybe it won't work as well for OCD or other things.
link |
02:11:18.920
It was very strategic why we chose MDMA
link |
02:11:21.040
and why we chose PTSD.
link |
02:11:23.640
But I don't think that the results that we've got
link |
02:11:26.400
are so unique to MDMA assisted therapy.
link |
02:11:29.160
I think that psilocybin assisted therapy
link |
02:11:31.320
is gonna be great for people
link |
02:11:33.720
with life threatening illnesses,
link |
02:11:35.560
cancer who are anxious about dying.
link |
02:11:37.920
It looks like it's really good
link |
02:11:39.480
in the treatment of addiction.
link |
02:11:41.040
Again, these are in combination
link |
02:11:44.480
with sort of the psilocybin tobacco
link |
02:11:47.120
is cognitive behavioral therapy with psilocybin.
link |
02:11:51.480
I think that it's gonna be a little bit more difficult,
link |
02:11:54.000
psilocybin for depression.
link |
02:11:55.680
I don't know if it'll be quite as good.
link |
02:11:58.400
There are some biological aspects sometimes to depression,
link |
02:12:01.880
but I think that there'll be really good results
link |
02:12:03.480
for psilocybin for depression.
link |
02:12:04.880
I think it'll be approved.
link |
02:12:05.960
It's considered a breakthrough therapy by the FDA.
link |
02:12:09.080
Ibogaine is phenomenal for opiate addiction,
link |
02:12:12.320
helping people go through withdrawal
link |
02:12:14.000
and then giving them this chance
link |
02:12:15.800
to deal with the material that drives them for addiction.
link |
02:12:21.000
There was Ben Sessa, Dr. Ben Sessa in England
link |
02:12:23.600
did MDMA for alcohol use disorder.
link |
02:12:26.440
And that was really great, the results he got.
link |
02:12:28.640
And it's the case that he ended up
link |
02:12:31.760
basically treating people for trauma.
link |
02:12:33.440
It's the trauma that people run,
link |
02:12:35.320
the emotional challenges that people run from
link |
02:12:37.680
into quieting that pain through drug addiction or alcoholism.
link |
02:12:43.000
So trauma is behind a lot of addiction.
link |
02:12:44.960
I think that we are going to see a revolution in psychiatry
link |
02:12:50.680
and that there will be a lot of conditions
link |
02:12:54.760
that have left a lot of people still suffering
link |
02:12:59.320
that psychedelic assisted therapy,
link |
02:13:01.240
different psychedelics, different approaches.
link |
02:13:03.080
But I think that we will see a lot of hope
link |
02:13:06.360
for psychiatry and psychotherapy
link |
02:13:08.040
and that psychedelics would be a big part
link |
02:13:09.720
of changing the practice of psychiatry and psychotherapy.
link |
02:13:13.680
Yeah, this is really to me fascinating.
link |
02:13:15.820
So I actually, when I was younger,
link |
02:13:19.180
for the longest time, wanted to be a psychiatrist.
link |
02:13:21.920
So I was excited by psychotherapy,
link |
02:13:24.740
but then I perhaps incorrectly, maybe you can correct me,
link |
02:13:28.160
but became more and more cynical
link |
02:13:30.600
because it felt like it was more about prescribing drugs
link |
02:13:33.520
than psychotherapy.
link |
02:13:34.560
I'm not going to correct you.
link |
02:13:36.360
I mean, right now, there is a crisis in psychiatry
link |
02:13:39.760
that there are so many psychiatrists that are so fed up
link |
02:13:42.440
because they have been pharmaceuticalized.
link |
02:13:45.740
They meet people for 15 minutes,
link |
02:13:47.400
they adjust their medications.
link |
02:13:49.200
This is the way they make the most money,
link |
02:13:51.360
but they've lost the art of talking to people.
link |
02:13:55.760
And that's why we see that so many young psychiatric
link |
02:13:58.600
residents are so thrilled by psychedelics
link |
02:14:02.920
that they really want to get back to treating people
link |
02:14:05.640
as individuals, not just a bunch of chemicals.
link |
02:14:08.320
Yeah, that's truly fascinating.
link |
02:14:09.600
Because the reason it was appealing to me,
link |
02:14:11.640
it was a way to study the human mind
link |
02:14:14.760
and to see ways through talking
link |
02:14:18.400
that you can make people feel better,
link |
02:14:23.600
make people better, make people suffer less.
link |
02:14:28.000
And that was really exciting at the time.
link |
02:14:30.920
I ended up then going to AI because then
link |
02:14:33.680
I can understand the mind from that angle.
link |
02:14:35.680
But it's exciting that that could be also
link |
02:14:42.120
revolutionized the field of psychotherapy,
link |
02:14:43.900
take it from its back to its origins,
link |
02:14:47.040
to where a psychiatrist would be a scholar of the mind.
link |
02:14:51.160
Yeah, well, Freud talked about dreams
link |
02:14:53.880
as the railroad to the unconscious.
link |
02:14:56.440
And there was a lot of,
link |
02:14:57.600
you really spent a lot of time with people.
link |
02:15:00.920
Now, right before he died, in his last book,
link |
02:15:05.800
Freud wrote something, and again,
link |
02:15:07.580
this will be a rough paraphrase,
link |
02:15:09.400
but he said that in the future,
link |
02:15:11.520
we may learn about the energies of the brain
link |
02:15:15.680
and there'll be ways with chemicals to influence that
link |
02:15:18.480
that will help the therapeutic process.
link |
02:15:21.880
Yeah.
link |
02:15:22.720
So you could say he was ahead of his time.
link |
02:15:27.760
Yeah.
link |
02:15:28.600
This study paints a fascinating picture of a future
link |
02:15:33.600
where first for medical applications,
link |
02:15:35.760
but then also in general, psychedelics of various forms
link |
02:15:39.300
could be used by the broader society.
link |
02:15:42.300
Forgive the perhaps ridiculous question,
link |
02:15:44.540
but if much of society, including our politicians,
link |
02:15:49.540
are taking psychedelics and dissolving their ego
link |
02:15:56.500
and going through this whole process,
link |
02:15:58.460
how do you think the world may look different
link |
02:16:01.940
in 20, 30, 50 years?
link |
02:16:04.740
Ah, okay, so I said that I think
link |
02:16:08.100
licensed legalization happens in 2035.
link |
02:16:11.040
Yes.
link |
02:16:12.860
And I think by 2050, we will have enough people,
link |
02:16:17.860
hopefully, spiritualized.
link |
02:16:22.100
We're also talking about,
link |
02:16:24.680
we hear so much in terms of climate change
link |
02:16:27.280
about net zero carbon.
link |
02:16:29.980
So our goal is net zero trauma.
link |
02:16:33.020
When do we have a world with net zero trauma?
link |
02:16:35.700
I mean, right now, we have two sites in Israel.
link |
02:16:39.580
So we help a few people,
link |
02:16:41.220
but the recent war with Gaza has traumatized
link |
02:16:44.820
millions of people on both sides.
link |
02:16:46.800
So we are a long way away from net zero trauma.
link |
02:16:52.060
But that's the hope, and that's, I think, possible.
link |
02:16:56.360
I think humanity as a whole
link |
02:17:01.460
is like lemmings heading over a cliff
link |
02:17:04.620
with climate change and with the nuclear proliferation
link |
02:17:09.660
and just the religious hatreds
link |
02:17:11.740
and the more the retreat to authoritarianism
link |
02:17:13.940
and fundamentalism and tribalism.
link |
02:17:17.120
So I think that there's a very good chance, though,
link |
02:17:20.020
that psychedelics used wisely.
link |
02:17:22.700
So it's not just make psychedelics legal
link |
02:17:25.060
and everybody takes them,
link |
02:17:26.380
as you talked about Ted Kaczynski.
link |
02:17:28.420
It's the context that people take it in.
link |
02:17:31.260
But I think that there's a reasonable chance
link |
02:17:35.340
that enough people can,
link |
02:17:38.320
sort of, you could say, clean their filters
link |
02:17:42.420
to see people as more similar to them than different,
link |
02:17:48.620
not to label them as the enemy.
link |
02:17:50.500
Stan Groff, again, had this beautiful phrase
link |
02:17:52.460
about transparent to the transcendent.
link |
02:17:56.580
That's what, so for our ego,
link |
02:18:00.380
can we be transparent to the transcendent?
link |
02:18:02.900
Can the filter that we look through the world at
link |
02:18:05.800
be cleaned to, you could say,
link |
02:18:08.420
cleansing the doors of perception?
link |
02:18:10.460
Can it be cleaned to the point where we can see
link |
02:18:12.500
the humanity in everybody and see that,
link |
02:18:17.420
one way to say this is that,
link |
02:18:19.580
can we get to the point where religions
link |
02:18:21.180
are seen as like languages?
link |
02:18:23.260
Where we all have this need to communicate,
link |
02:18:25.880
there's thousands of different languages,
link |
02:18:28.500
we don't say that this language
link |
02:18:29.820
is fundamentally better than this language,
link |
02:18:32.220
this language is the only right language,
link |
02:18:33.620
everybody must speak English
link |
02:18:34.960
and Russian is bad or German is better.
link |
02:18:38.020
Maybe we'll get to that point that religions are like that,
link |
02:18:41.060
that there are different cultural backgrounds,
link |
02:18:42.700
different symbol systems,
link |
02:18:44.020
different saints and heroes and messiahs and all this,
link |
02:18:47.060
but that, yeah, Jesus is the son of God,
link |
02:18:50.060
but so is everybody.
link |
02:18:52.380
Or the Jews are the chosen people, but so is everybody.
link |
02:18:55.860
So can we get there?
link |
02:18:57.540
I think that we can.
link |
02:18:59.380
And I think that we need to,
link |
02:19:00.980
to survive the challenges that we're facing.
link |
02:19:03.900
And the hope is that by bringing psychedelics
link |
02:19:08.100
as tools forward and trying to bring the context around them
link |
02:19:14.140
to be one of responsibility
link |
02:19:15.720
rather than just profit maximization
link |
02:19:18.580
and just get as many people to do them
link |
02:19:20.680
from all these for profit companies,
link |
02:19:23.460
can we, and then also drug policy reform
link |
02:19:26.620
and embed knowledge in the society,
link |
02:19:28.420
can we get to honest drug education?
link |
02:19:31.060
DARE, the Drug Awareness Resistance Education,
link |
02:19:36.580
is fundamentally twisted.
link |
02:19:39.140
But it's the program that's used in a lot of schools now.
link |
02:19:42.780
So can we get honest drug education,
link |
02:19:44.620
pure drugs, harm reduction,
link |
02:19:47.060
and knowledge about therapeutic uses
link |
02:19:49.340
and on the one hand,
link |
02:19:51.860
and more of these thousands of psychedelic clinics?
link |
02:19:55.420
I'm hopeful and that's our goal.
link |
02:19:59.100
But in this landscape of pharma companies,
link |
02:20:04.020
they make a lot of money.
link |
02:20:05.820
Some people are worried about the impact
link |
02:20:07.820
of those, you know, of big pharma
link |
02:20:10.740
on the landscape of human trauma.
link |
02:20:13.020
Yeah, yeah.
link |
02:20:14.100
So there's, of course, some companies could do good,
link |
02:20:17.540
but that's not inherent,
link |
02:20:20.100
like many of these companies are not optimizing for good,
link |
02:20:24.780
they're optimizing for profit.
link |
02:20:26.380
Exactly, exactly.
link |
02:20:27.460
Does this rise of for profit pharma companies worry you?
link |
02:20:31.860
How do you navigate it?
link |
02:20:33.660
Do we still have for profit companies
link |
02:20:35.580
that basically do what MAPS does,
link |
02:20:39.460
which is like fight the good fight
link |
02:20:41.420
for the benefit of humanity?
link |
02:20:42.820
Like how do we proceed in this,
link |
02:20:45.420
in landscape where drugs can make a lot of money?
link |
02:20:49.580
Well, I am concerned.
link |
02:20:52.100
Overall, I think the rise of the for profit companies,
link |
02:20:55.660
we have to realize is a sign of success,
link |
02:20:58.460
that we have overcome the regulatory prohibitions,
link |
02:21:04.260
we've overcome a lot of the public attitudes
link |
02:21:06.620
that are against it, we've demonstrated some success.
link |
02:21:09.780
So the rise of the for profit companies
link |
02:21:12.140
are a sign of the progress that we've made.
link |
02:21:13.940
On the other hand, turning things over
link |
02:21:15.860
to profit maximizing companies,
link |
02:21:19.100
the big concern is that they're gonna try
link |
02:21:20.980
to minimize the amount of therapy
link |
02:21:24.900
and make it so the cost is less,
link |
02:21:26.740
so insurance companies are more likely to cover it
link |
02:21:28.940
and then that they just sell the most drugs.
link |
02:21:32.060
The other thing we've seen as an example of this
link |
02:21:34.500
is S ketamine by Johnson and Johnson for depression.
link |
02:21:37.740
And it's done by a profit maximizing company.
link |
02:21:40.700
They don't know anything about psychedelic psychotherapy
link |
02:21:43.180
or psychotherapy at all.
link |
02:21:44.900
And so they've gotten approval for S ketamine
link |
02:21:48.460
on the basis of it's just a pharmacological treatment
link |
02:21:51.980
and it's not delivered with therapy,
link |
02:21:54.980
the results fade pretty quickly,
link |
02:21:57.100
so you need to get more ketamine.
link |
02:21:59.860
And so it's designed in a way to maximize the profits
link |
02:22:02.820
for the pharmaceutical company,
link |
02:22:04.980
but it doesn't maximize patient outcomes.
link |
02:22:07.780
What we're seeing though in these various clinics
link |
02:22:10.420
that are being set up is that a lot of people are realizing
link |
02:22:14.100
that it works better with therapy.
link |
02:22:17.620
And so the clinics are run by people that are therapists
link |
02:22:20.660
so that when they provide therapy,
link |
02:22:22.980
they're making more money and then you need less ketamine.
link |
02:22:26.500
Also ketamine itself, S ketamine is a isomer of ketamine
link |
02:22:31.540
that's been patented for depression
link |
02:22:33.540
and they sell it for hundreds of dollars,
link |
02:22:35.020
but ketamine itself
link |
02:22:37.140
is one of the world's essential medicines.
link |
02:22:39.300
It's off patent, it's been around for a long time,
link |
02:22:41.580
it was the main battlefield anesthetic in Vietnam.
link |
02:22:44.580
And it's only a few bucks because it's generic.
link |
02:22:47.380
So a lot of the ketamine clinics are saying,
link |
02:22:49.740
great, thank you, Johnson and Johnson,
link |
02:22:51.860
you've helped demonstrate that ketamine is good
link |
02:22:53.940
for depression, but we're not gonna buy it from you.
link |
02:22:56.300
We're gonna buy it for a few bucks
link |
02:22:58.060
and we're gonna add therapy to it.
link |
02:23:00.660
Now there's a bunch of ketamine mills you could say
link |
02:23:02.700
that are just prescribing the ketamine
link |
02:23:05.180
and people are making a lot of money there.
link |
02:23:07.140
So I am worried about that.
link |
02:23:09.380
I think the best thing that we can do
link |
02:23:11.300
is create an alternative narrative,
link |
02:23:15.620
a different kind of example.
link |
02:23:16.940
We can lead by example.
link |
02:23:18.060
We can't make for profit companies
link |
02:23:20.300
into benefit corporations unless they wanna do that.
link |
02:23:23.620
We can't make them to really maximize patient outcomes.
link |
02:23:28.420
But if we create an example of something that's different,
link |
02:23:32.500
the hope is that people will gravitate towards that
link |
02:23:36.100
and some of the other companies.
link |
02:23:37.860
Like even now we have Exxon and other these companies,
link |
02:23:41.220
oil companies saying, oh, we're big
link |
02:23:42.660
into alternative energy and we're, you know.
link |
02:23:45.860
And that starts with companies that show an example
link |
02:23:48.860
that then communicates to the public
link |
02:23:51.060
that this is something exciting
link |
02:23:53.140
and then they demand the same of Exxon and so on.
link |
02:23:56.380
The public demands it and you could say the same thing
link |
02:23:58.780
for the public demanding the big pharma
link |
02:24:03.500
to optimize for benefit versus optimize for profit
link |
02:24:08.340
and maybe giving power to the therapists,
link |
02:24:11.060
more power to the therapists, more power to the doctors
link |
02:24:13.540
that ultimately want.
link |
02:24:16.420
I think incentives are interesting,
link |
02:24:21.020
but I think doctors ultimately care more
link |
02:24:25.220
because they're in direct contact with humans.
link |
02:24:27.380
They want to make people better.
link |
02:24:29.020
It's not, you know, sure they wanna make money,
link |
02:24:31.340
but they ultimately want to make people feel better
link |
02:24:33.860
because they get to look at people
link |
02:24:35.420
and it's so joyful to make people feel better
link |
02:24:38.460
at the end of the day.
link |
02:24:39.300
So giving more power to them is also perhaps
link |
02:24:43.060
one of the ways that you then incentivize
link |
02:24:46.940
the pharma companies that are trying to do good
link |
02:24:51.660
because the doctors will choose those companies.
link |
02:24:53.820
Yeah, now the other part of this is drug policy reform.
link |
02:24:57.300
So that if we make it so that you can buy MDMA
link |
02:25:00.020
for 10 or 20 bucks on your own
link |
02:25:03.140
and we've trained people on here's our therapeutic method,
link |
02:25:06.500
here is our ways for peer support,
link |
02:25:09.440
then people have an alternative from buying it
link |
02:25:13.380
from the pharma companies.
link |
02:25:15.020
So most of the for profit companies
link |
02:25:18.340
have come to this conclusion
link |
02:25:20.300
that drug policy reform is bad for their business model.
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02:25:25.580
I think they're making a fundamental mistake.
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02:25:28.300
And I think the reason is that
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02:25:30.380
the more that we de stigmatize this,
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02:25:32.300
the more that we sensitize people to this is an approach,
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02:25:35.720
even when people can get it on their own
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02:25:37.860
and do it with their friends or do it with themselves,
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02:25:40.700
there's gonna be even more people that say,
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02:25:42.720
oh my God, I've got real serious issues.
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02:25:44.860
I would rather go to trained professionals
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02:25:47.780
covered by insurance.
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02:25:49.720
And I think it'll increase the business,
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02:25:52.580
but most of the for profit companies don't see it that way.
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02:25:56.140
And so as a nonprofit that owns a benefit corp,
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02:26:00.780
we're not trying to maximize sales or profits.
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02:26:03.700
But I do believe that drug policy reform
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02:26:06.740
creates this alternative access point for people
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02:26:10.180
and that will help keep the for profits in check
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02:26:12.800
to some extent as well.
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02:26:15.820
I love it.
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02:26:18.580
Let's put on your wise visionary hat
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02:26:22.460
and ask when you look to young folks,
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02:26:25.980
is there advice you can give to young people today,
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02:26:28.900
whether in high school or college about career, about life?
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02:26:33.900
You've lived quite a nonlinear
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02:26:36.820
and fascinating life yourself.
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02:26:39.020
Is there advice you can give
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02:26:40.220
either on career or more generally on life?
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02:26:43.820
Well, I would say what people often hear is that,
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02:26:51.580
we're not actually here for that long a period of time.
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02:26:55.960
And the world is on fire.
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02:26:59.700
And whether humanity survives is not clear.
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02:27:03.020
And how many species are we gonna kill
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02:27:05.740
before we figure out not to do that anymore?
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02:27:08.440
So I would advise you to really try to
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02:27:15.060
develop a combination of what do you need
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02:27:17.760
in terms of income for your own survival,
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02:27:20.400
but what does the world need in terms of
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02:27:25.680
help to make the world better?
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02:27:27.580
And Howard Thurman, who we talked about,
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02:27:30.880
who ran the Good Friday experiment, the minister there,
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02:27:33.740
he said, he's got a famous quote attributed to him.
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02:27:36.300
He says, and this is exactly it to young people.
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02:27:40.180
He said, there's nothing particular that you should do,
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02:27:43.900
but find what makes you come alive
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02:27:46.300
because what the world needs is people
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02:27:48.180
that have come alive and are passionate.
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02:27:52.300
So I would say that be aware of this trap
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02:27:57.300
that you need vast resources, that you need all this stuff.
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02:28:03.900
I keep thinking of the super wealthy people
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02:28:07.460
in first class on the Titanic,
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02:28:09.980
as the Titanic is sinking.
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02:28:12.100
Their money's not gonna help them.
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02:28:13.940
The Earth is like Titanic.
link |
02:28:15.980
We're sinking, we're destroying the planets,
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02:28:18.100
destroying the environment.
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02:28:18.940
So you need a certain amount of money to be comfortable
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02:28:23.940
to be able to do that.
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02:28:25.740
You need to be comfortable to not be
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02:28:28.260
at that edge of survival,
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02:28:29.440
because once you're at that edge of survival,
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02:28:31.060
it's hard to think about anything else.
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02:28:32.420
But I'd say to young people,
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02:28:36.940
to the extent that you're able to do this,
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02:28:39.040
and again, student debt and all this kind of stuff
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02:28:41.300
is a big problem there too,
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02:28:42.740
but really just try to find this combination
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02:28:48.540
of what the world needs and what you need.
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02:28:50.220
The other thing to say to young people is
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02:28:52.660
that life is a lot shorter than you think,
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02:28:57.600
and a 20 year plan is not really that long.
link |
02:29:00.400
So if it takes you 20 years to get in a position
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02:29:03.120
to do what you wanna do, go for it.
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02:29:07.280
Have longterm plans.
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02:29:08.820
The other part that was so important for me
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02:29:11.400
to keep doing what I've been doing,
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02:29:14.360
basically now it's 49 years
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02:29:17.320
that I've sort of been devoting my life
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02:29:18.880
on psychedelics since I was 18.
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02:29:20.440
But when I started, I didn't think it would ever work.
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02:29:23.620
I just thought this is the only idea I have
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02:29:25.500
in this crazy world, this is what I wanna work on.
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02:29:29.220
Luckily, I had support from my family
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02:29:30.980
that took care of my survival needs, so I could do that.
link |
02:29:34.660
But I realized that if my happiness
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02:29:37.860
was dependent upon accomplishments,
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02:29:40.940
that I might never be happy,
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02:29:42.760
that I was able to reframe happiness in terms of effort.
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02:29:47.760
So if I'm trying hard to get stuff to be better,
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02:29:54.120
whether it's better or not,
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02:29:55.480
I can be happy at the end of each day, I tried.
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02:29:58.640
And so I think you try to separate out
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02:30:01.600
the goals that you have and your happiness
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02:30:03.720
to whether you're trying hard.
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02:30:06.520
The other thing I would say
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02:30:08.080
is that everybody has this humanity within them.
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02:30:13.000
So be very careful about dividing the world
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02:30:14.940
into us and them, and try to...
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02:30:20.880
So one of the things that I've done
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02:30:23.600
that has taken a long time,
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02:30:27.760
because I feel like drugs are illegal.
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02:30:31.040
I always felt like the police were the predator
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02:30:33.540
and I'm the prey.
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02:30:35.040
Yes.
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02:30:36.480
But now we're working with the police,
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02:30:38.100
and the police have tremendous trauma
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02:30:39.980
from the work that they do.
link |
02:30:41.080
We have one police officer who is now going,
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02:30:43.400
he's a full time police officer,
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02:30:45.240
he's also a psychotherapist.
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02:30:47.880
And he's going through our training program
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02:30:50.120
to learn how to give MDMA therapy to other police officers.
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02:30:53.880
And I met his police chief a couple of times,
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02:30:56.680
he got permission from his police chief
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02:30:58.760
to go to the second part of our training program,
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02:31:01.080
which is where we give MDMA to therapists
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02:31:03.720
who volunteer as a patient.
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02:31:06.320
So we have just a couple of weeks ago,
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02:31:08.360
dosed the police with MDMA.
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02:31:11.360
And so I think this idea of those people
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02:31:13.760
that are on the quote, other side,
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02:31:16.080
try to see through that to their humanity,
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02:31:19.760
to what their pains and suffering,
link |
02:31:21.320
what their struggles are, to the extent that you can.
link |
02:31:24.920
And that I think, and build long term relationships.
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02:31:28.480
You never know what's gonna come around 20 years from now.
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02:31:32.640
So you help some people try to keep these relationships
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02:31:35.320
going 20 years from now, something could come.
link |
02:31:38.160
And also be persistent.
link |
02:31:47.600
I think that's been the key to success.
link |
02:31:49.960
I mean, once the FDA or DEA figured out
link |
02:31:52.720
we're not going anywhere,
link |
02:31:53.800
they're gonna have to deal with us,
link |
02:31:55.760
then we started getting some progress.
link |
02:31:57.840
So a mix of patience and stubbornness
link |
02:32:00.520
that gets things done.
link |
02:32:02.320
Is there something you've figured out
link |
02:32:05.440
through your journey with psychedelics
link |
02:32:08.400
about some of the big why questions about life?
link |
02:32:11.920
Like, what the heck's the value of love?
link |
02:32:18.200
Why does it suck so much that we die?
link |
02:32:21.720
And for some of us, maybe it's the Russian in me,
link |
02:32:25.440
but it's quite terrifying, the notion of it.
link |
02:32:28.080
Or the biggest why question of them all,
link |
02:32:30.080
which is what's the meaning of it all?
link |
02:32:33.040
Well, yeah, what I've discovered is
link |
02:32:35.640
that we don't need answers to those questions.
link |
02:32:40.560
That the fact that we can feel happy,
link |
02:32:46.400
that we can love, that we can have moments of happiness,
link |
02:32:50.160
that's enough.
link |
02:32:52.640
Figuring out these big questions, you can get lost in that.
link |
02:32:56.160
And we all can come up with our answers.
link |
02:32:58.840
What's the meaning of life?
link |
02:33:00.600
Why is there life?
link |
02:33:01.880
Why is there consciousness?
link |
02:33:02.920
But I don't know that we need those answers.
link |
02:33:06.000
What we know is that we're social creatures,
link |
02:33:10.120
that other people can make us happy by certain things,
link |
02:33:14.720
we can make other people happy, that one life is enough.
link |
02:33:17.800
So this other part about why is it so tragic that we die?
link |
02:33:23.160
I don't think it's tragic that we die.
link |
02:33:25.320
So first off, if you believe in this collective unconscious,
link |
02:33:27.800
but we have an impact that lasts.
link |
02:33:32.480
But I think that for me at least,
link |
02:33:35.160
I've been of the view that we should be grateful for death,
link |
02:33:40.520
that death makes life precious,
link |
02:33:42.600
that if we had an infinite amount of time,
link |
02:33:46.120
I mean, I'm a bit of a procrastinator about stuff,
link |
02:33:49.200
particularly things that are really hard to do
link |
02:33:52.280
and you just don't do it.
link |
02:33:54.200
And then like, where'd the day go?
link |
02:33:55.400
I was gonna do this.
link |
02:33:56.240
So if we had infinite life, we never died,
link |
02:33:59.320
and would life be precious?
link |
02:34:03.440
Would we do anything?
link |
02:34:04.400
I don't think so.
link |
02:34:05.280
So my parents gave every Jewish new year,
link |
02:34:11.160
they would make their new year's card.
link |
02:34:14.000
And one of the quotes was fantastic.
link |
02:34:16.360
It was just, we have to make up for the brevity of life
link |
02:34:20.320
with the intensity of life.
link |
02:34:22.480
Oh man, that is good.
link |
02:34:24.520
Well, the end makes things precious.
link |
02:34:29.080
Death makes life precious.
link |
02:34:30.600
The end of this conversation makes it precious,
link |
02:34:34.480
and which is a great way to end, Rick.
link |
02:34:38.200
I wanted to talk to you for a long time.
link |
02:34:40.760
I share, you were very excited about the study.
link |
02:34:43.280
I can now understand exactly why this is really promising.
link |
02:34:46.920
This is really exciting, gives me hope about the future,
link |
02:34:50.240
even if it doesn't come fast enough.
link |
02:34:53.720
But like you said, I have to be patient and stubborn.
link |
02:34:56.560
Thank you so much for wasting
link |
02:34:58.360
all your valuable time with me today.
link |
02:34:59.960
It's truly an honor to meet you and talk to you.
link |
02:35:01.760
Not a waste at all.
link |
02:35:02.840
I really appreciated this time together.
link |
02:35:06.840
Thank you for listening to this conversation
link |
02:35:08.400
with Rick Doblin, and thank you to Theragun, ExpressVPN,
link |
02:35:12.480
Blinkist, and Asleep.
link |
02:35:14.640
Check them out in the description to support this podcast.
link |
02:35:17.920
And now let me leave you with some words
link |
02:35:19.640
from Terrence McKenna.
link |
02:35:21.520
Nature loves courage.
link |
02:35:23.120
You make the commitment, and nature will respond
link |
02:35:25.760
to that commitment by removing impossible obstacles.
link |
02:35:29.280
Dream the impossible dream,
link |
02:35:30.840
and the world will not grind you under.
link |
02:35:33.160
It will lift you up.
link |
02:35:34.680
This is the trick.
link |
02:35:36.040
This is what all the teachers and philosophers
link |
02:35:38.680
who really counted, who really touched the alchemical gold,
link |
02:35:42.880
this is what they understood.
link |
02:35:44.640
This is the shamanic dance in the waterfall.
link |
02:35:47.480
This is how magic is done,
link |
02:35:49.320
by hurling yourself into the abyss
link |
02:35:51.440
and discovering that it's a feather bed.
link |
02:35:54.600
Thank you for listening, and hope to see you next time.