back to indexRick Doblin: Psychedelics | Lex Fridman Podcast #202
link |
The following is a conversation with Rick Doblin,
link |
founder and executive director
link |
of the Multidisciplinary Association
link |
for Psychedelic Studies, MAPS.
link |
He is one of the seminal figures
link |
in both the cultural history
link |
and the cutting edge science of psychedelics.
link |
He was there along with the biggest characters
link |
throughout this fascinating history of psychedelics,
link |
and he is here to tell the story.
link |
Quick mention of our sponsors,
link |
Theragun, ExpressVPN, Blinkist, and Asleep.
link |
Check them out in the description to support this podcast.
link |
As a side note, let me say
link |
that exploring the places the human mind can go
link |
can help us understand where it comes from,
link |
how it works, and how to engineer mental journeys,
link |
whether that's through life experiences,
link |
chemical substances, brain computer interfaces,
link |
or interactions with artificial intelligence systems.
link |
On a personal level, I think the dissolution of the ego
link |
for stretches of time is a powerful tool
link |
for understanding yourself.
link |
A lot of things can do this,
link |
including jiu jitsu, literature, meditation,
link |
but psychedelics is definitely, or at least arguably,
link |
one of the most powerful, from psilocybin to DMT.
link |
I'm excited that people like Rick
link |
are leading the scientific research
link |
that reveals the efficacy and the safety of these substances
link |
so that their proper dosage and usage protocols
link |
can be understood and people like me
link |
can safely and effectively use them,
link |
not just for recreation,
link |
but for rigorous exploration of my own mind.
link |
This is the Lex Friedman Podcast,
link |
and here is my conversation with Rick Doblin.
link |
Could you give an introduction to psychedelics,
link |
like a big, bold, whirlwind overview?
link |
What are psychedelics?
link |
What are the kinds of psychedelics out there?
link |
In whatever way you think is meaningful.
link |
All right, well, when I started MAPS,
link |
the Multidisciplinary Association for Psychedelic Studies,
link |
it was very important for me that psychedelic be in the name.
link |
And the way in which the original meaning of psychedelic,
link |
it's mind manifesting.
link |
It was created by Humphrey Osmond
link |
in a dialogue with Aldous Huxley.
link |
And so psychedelic means mind manifesting.
link |
And so we interpret that very broadly
link |
to mean dreams are psychedelic.
link |
Anything that kind of brings things to the surface,
link |
holotropic breath work, hyperventilation is psychedelic.
link |
So most people think psychedelic
link |
is only about certain kind of chemical substances,
link |
either natural or synthetic,
link |
but we've got a much broader view of that.
link |
Meditation can be psychedelic in some ways,
link |
but our primary focus is on the drugs,
link |
is on the medicines or the, you might call them,
link |
some people might call them spiritual tools or sacraments.
link |
There's sort of two general categories of those.
link |
One are what are called the classic psychedelics,
link |
and those are the ego dissolving,
link |
sort of merged into unitive states.
link |
Those are like LSD, psilocybin, mescaline, ayahuasca,
link |
ibogaine, DMT, things like that.
link |
And then there is MDMA, which some people even argue
link |
is not a psychedelic.
link |
They'll say it's an empathogen or an intactogen,
link |
it's about touching within or empathy.
link |
It doesn't do the same kind of ego dissolution
link |
that the classic psychedelics do,
link |
but it brings material to the surface
link |
and it changes the way we process information.
link |
And so I think you can quibble about whether it's,
link |
it's certainly not a classic psychedelic,
link |
but I think MDMA is also a psychedelic.
link |
Marijuana, I would say, is a psychedelic.
link |
Marijuana is closer to the classic psychedelics
link |
than it is to MDMA.
link |
One point I like to make is dreams,
link |
because then everybody can relate to that.
link |
Dreams are psychedelic.
link |
Dreams bring emotions, feelings, ideas, concepts,
link |
in symbolic form a lot of times,
link |
or just in raw emotions to the surface.
link |
So when people hear the word psychedelic,
link |
often they are frightened by it.
link |
It's about loss of control.
link |
And it is, to an extent, loss of conscious control,
link |
particularly with the classic psychedelics.
link |
And we know with dreams
link |
that we can have frightening dreams, nightmares,
link |
but I think that anchoring the concept of psychedelic
link |
in dreams is really helpful for people to know
link |
that it's kind of a natural state
link |
and that there are other ways that you can catalyze it
link |
than by going to sleep,
link |
and that for thousands of years,
link |
substances have been used in that way.
link |
So you mentioned this idea of bringing something
link |
to the surface, which is really interesting.
link |
So can you maybe elaborate the surface
link |
and what is there in the depths of things
link |
and how does ego dissolution fits into that?
link |
Well, Aldous Huxley talked about the brain
link |
as a reducing valve,
link |
that we have an enormous amount of information.
link |
So right now there's an air conditioning sound
link |
in the background,
link |
but that's not crucial to what you and I are doing,
link |
talking to each other, so we kind of tune that out.
link |
There's all sorts of sights and sounds.
link |
There's incoming information
link |
in all the different sense modalities,
link |
and we have to figure out what's important to us.
link |
And so the mind, in a way, focuses a lot on
link |
what are our core needs?
link |
And we filter all the incoming information
link |
that we get towards focusing on what our core needs,
link |
and we can even get to Abraham Maslow
link |
and the hierarchy of needs about survival needs,
link |
belonging needs, esteem needs, go on.
link |
So I think what I mean by bringing things to the surface
link |
is that we tend to not focus on a lot of things
link |
that are coming, but we also push away
link |
things that are difficult emotionally,
link |
difficult cognitively.
link |
We all know that we're on this very short trajectory
link |
from birth to death,
link |
but we're not constantly thinking about dying,
link |
although that can actually be helpful
link |
to focus us on what's really important.
link |
Traumas are often suppressed.
link |
Conflicts, we see in America and around the world
link |
a kind of rise of irrationality
link |
where people push away their logic
link |
in order for their emotional tribal needs to be met.
link |
A lot of people are suffering from early childhood traumas
link |
of a different kinds or abandonment issues
link |
So we tend to focus on just what we need to survive
link |
and what we need for work and esteem.
link |
And so psychedelics, by dissolving this ego control
link |
or by with MDMA kind of strengthening our sense of self
link |
and our sense of self acceptance,
link |
we can bring in other information
link |
that have previously been too complicated or too painful.
link |
You don't think of psychedelics
link |
as conjuring up something new.
link |
It is more revealing something that is already there.
link |
I think that's a very crucial thing.
link |
So yes, Sasha Shulgin who sort of the godfather of MDMA,
link |
he sort of rediscovered it
link |
and brought it back into use.
link |
He talked about his first experience was with mescaline.
link |
His first psychedelic experience was with mescaline
link |
and he had a tremendous experience.
link |
But what he said about it was he was having
link |
a human experience that the mescaline was helping him access
link |
rather than that he was having a mescaline experience.
link |
So that it's not like you pop a pill
link |
and you always have the same kind of experience
link |
as everybody else.
link |
The experience is not contained in the pill.
link |
The pill opens you up
link |
and you have an experience of yourself.
link |
Sometimes these are experiences
link |
that we've never consciously had.
link |
But we can say right now that we know
link |
that our body below the level of our conscious awareness
link |
has all these self healing mechanisms.
link |
And we don't modulate them
link |
to a large extent by conscious control.
link |
I mean, eventually we are learning more about the mind body
link |
and we learn about the placebo effect,
link |
how what we think is the case.
link |
But I think that there's experiences
link |
that are below our level of conscious awareness,
link |
particularly once we're adults
link |
that are more of these unit of mystical experiences,
link |
sense of connection.
link |
I think kids are like this a lot.
link |
We kind of come from the void, you could say,
link |
and you're born and you have
link |
a different way of processing information.
link |
One interesting point about that has to do with ketamine,
link |
which is been approved as ketamine for depression,
link |
but it's used for anesthesia.
link |
And roughly one 10th the anesthetic dose
link |
is a psychedelic dose.
link |
And when it's used in anesthesia,
link |
there's what's called the emergent phenomena.
link |
So this is, you get enough ketamine for,
link |
you can be operated on, you're not in pain,
link |
you're not really there, your ego's knocked out,
link |
but you can still breathe.
link |
But as the operations get over
link |
and then people metabolize the ketamine,
link |
there's a process that they call the emergent phenomena.
link |
It's like as you're emerging from this tranquilized state,
link |
and that's where you pass through the psychedelic phase.
link |
And they don't prepare people for that.
link |
And what we see is that a lot of adults
link |
have difficult times with that,
link |
but children don't seem to have those problems.
link |
Children are a little bit more already in this kind of state.
link |
And so ketamine is used quite frequently
link |
in children now for anesthesia.
link |
So all of that is to say to your question
link |
that I think the psychedelics
link |
reveal things that are within us.
link |
Some things that are how we process information
link |
back when we were children.
link |
Other things that we've never thought of before
link |
that are sort of baked into our consciousness.
link |
There's one drug, 5MeO DMT.
link |
It's this toxin from a Sonoran toad
link |
that many people consider it to be the most powerful
link |
of all the psychedelics.
link |
And it kind of knocks the ego structures completely out of it
link |
and we experience something different,
link |
but it's something I think that's always within us.
link |
It's at a deeper layer.
link |
So we knock out some of the higher cognitive functions
link |
and then we experience things in a different way.
link |
So my sense is that these are human experiences
link |
that the psychedelics bring us to.
link |
Yeah, it's really profound.
link |
And DMT is a really interesting example.
link |
So Terence McKenna has talked about these machine elves.
link |
And there's this, I think from the people I've heard speak
link |
about the experience,
link |
there's a sense that you are traveling elsewhere
link |
to meet entities, whether they're elves or not.
link |
So in your sense, you're not traveling elsewhere.
link |
You're just revealing something that's within
link |
and maybe it's a particular mechanism
link |
of revealing what's already within.
link |
Yeah, and I knew Terence.
link |
I spent a lot of time talking with Terence
link |
and I do not ascribe to a lot of things that he was saying.
link |
He was a tremendous entertainer and I think he did a lot
link |
of really good things and focused us
link |
on the power of psychedelics.
link |
But I think I've never seen these quote machine elves.
link |
I think culture is more determinative
link |
of what people experience under psychedelics,
link |
your preconceptions, than we give it credit for.
link |
And so I think there's a lot of priming that you could say
link |
that people receive by stories from their culture.
link |
With ayahuasca, it's about jaguars and Amazonian animals.
link |
And so I think these machine elves are this construct
link |
of Terence that other people do see.
link |
There's actually some people that are very interested
link |
in doing a study and that they're well funded
link |
and moving toward it to keep people on an IV infusion
link |
of DMT for them specifically to see,
link |
do they contact machine elves or aliens
link |
and what kind of information do they bring back
link |
from these other selves, other places or other entities?
link |
One question is, who are we?
link |
Are we connected to everything in the universe?
link |
We certainly know in many cases,
link |
you talk about waves or particles, the quantum approach.
link |
So I don't interpret experiences that we have
link |
of some entity that's somehow or other
link |
deep in our consciousness that's not us.
link |
It's a part of who we are.
link |
So I tend to interpret it in that way.
link |
The question is, how big are we?
link |
And how many ideas are within us
link |
that can be revealed by changing the perspective?
link |
You mentioned physics.
link |
What physicists, especially mathematical physicists
link |
or mathematicians do is they reveal truths
link |
by taking a slightly different perspective on a problem
link |
that reveals the simplicity of how it actually works
link |
in totally new ways.
link |
That's what Einstein did.
link |
Like every progress in physics
link |
and certainly every progress in mathematics
link |
requires you to take a different perspective.
link |
And then perhaps that's exactly what psychedelics are doing.
link |
It's not that they're contacting aliens that are elsewhere.
link |
It may be revealing the connection between us
link |
and other living life forms,
link |
or actually it might be revealing
link |
a totally new perspective on what life is
link |
or what consciousness is and giving us a glimpse at that
link |
even though our cognitive capabilities are limited
link |
to fully grasp and understand it.
link |
So it's just giving us an inkling of that somehow.
link |
And it seems perhaps a little ridiculous
link |
not from a scientific perspective
link |
in the sense that we don't have a good physics of life
link |
or physics of intelligence or physics of consciousness,
link |
but getting a glimpse of that
link |
is giving us a little bit of maybe an intuition
link |
of which way to head to build such a physics.
link |
Yeah, yeah, I think so.
link |
I think that there's this other concept
link |
I guess I would like to talk about briefly,
link |
this Jungian collective unconscious,
link |
this idea that somehow or other everything
link |
that has ever happened is still accessible,
link |
maybe not with as much data
link |
or as much resolution,
link |
but that there's wave resonances.
link |
So that I do believe that we can have experiences
link |
as part of this human collective unconscious
link |
that we're not from our own life.
link |
And that we can, it's like the holographic realities
link |
and that there is a way to gather information
link |
that can be accurate about other times and places
link |
through depth investigations of our own consciousness.
link |
But I think what I tend to believe
link |
is that it's because there's emotional resonances
link |
between where we're at now in this life
link |
and other kind of experiences
link |
that people have had before.
link |
And we always hear about everybody
link |
who talks about past lives,
link |
they're always kings and queens.
link |
So I think that's again,
link |
you filter things what you want to be true.
link |
But I do think that there is a way to access information
link |
beyond what we've taken in in our own temporal existence
link |
through our own five senses.
link |
In some ways, I really find that compelling,
link |
the notion that that information is already there
link |
and you're simply just moving the attention of your mind
link |
to different parts of that.
link |
Yeah, I mean, we have that with the radio.
link |
I mean, you got a frequency, you turn all this information,
link |
you could actually say right now in the space between us,
link |
we have the whole world's knowledge
link |
that's up on the internet.
link |
But we don't see it. We just have to tune in.
link |
What are the interesting differences,
link |
would you say, between the various psychedelics
link |
that you mentioned, ayahuasca, DMT, acid, LSD,
link |
marijuana, mescaline, PCP, psilocybin, MDMA?
link |
You mentioned a few of them that are really interesting.
link |
We'll talk about scientifically some of the different
link |
studies that have been conducted on each,
link |
but sort of at the high level.
link |
What are some interesting differences?
link |
Well, one of the big ones that people make a big deal of
link |
that I think is completely misplaced
link |
is some are from nature, some are from the lab.
link |
So there's this kind of like romantic thought
link |
that if it's from nature, it's good.
link |
If it's from the lab, it's somehow tainted by humanity.
link |
And therefore, some people are like
link |
all for plant psychedelics.
link |
We see the policy changes that have been happening
link |
in a couple of cities, Cambridge, Somerville,
link |
not far from where we're at now,
link |
where they decriminalize plant medicines.
link |
So they call it decriminalizing nature.
link |
So I think that there is,
link |
from my perspective,
link |
certain things from nature are poison,
link |
certain things from the lab are spiritual,
link |
even if they don't show up in nature, like LSD.
link |
Now there is something, LSD is lysergic acid diethylamide.
link |
There is lysergic acid amide, LSA,
link |
which comes from morning glory seeds.
link |
So it's very similar.
link |
But at the same time, I'd say,
link |
I don't buy into that distinction
link |
that there's some fundamental preference.
link |
One of the things that Terence McKenna,
link |
since we talked about him,
link |
he talked about how if it's from nature, it's good.
link |
And if it's not, we should be suspect.
link |
Of course, he had a lot of great LSD experiences.
link |
But actually Terence, in 1984,
link |
we were at Esalen with a bunch of other people.
link |
This was before the crackdown on MDMA.
link |
And this was some of the underground therapists
link |
and the above ground researchers
link |
who were trying to talk about how to protect MDMA
link |
from this eventual crackdown.
link |
And Terence was like, forget about it.
link |
It's from the lab.
link |
We have thousands of years of history,
link |
all these other things.
link |
And what do we know about MDMA and blah, blah, blah.
link |
I was like, Terence, you're so unscientific.
link |
Another way to say it is, and I just said,
link |
we need a study of the safety of MDMA.
link |
And so then Dick Price, who started Esalen,
link |
I said, I'll put a thousand, Dick Price, he put a thousand.
link |
So Terence was actually the catalyst
link |
for the first study with MDMA.
link |
Just because he was so frustrating
link |
about how plants are okay.
link |
And if it's from the lab, it's bad.
link |
So that's one distinction.
link |
The other distinction is that he was a scientist.
link |
The other distinction is this sense of classic psychedelics
link |
versus things like MDMA.
link |
So to what extent do they dissolve the ego?
link |
And you could say, to what extent do they cause visions?
link |
The 5HT2A serotonin receptor subtype,
link |
which is responsible for a lot of that
link |
where these drugs are activating.
link |
Now, mescaline of all the psychedelics,
link |
chemically, it's the most similar to MDMA.
link |
It's a phenethylamine, which is MDMA.
link |
So in the 50s, there was the, 53, I think it was,
link |
the Army Chemical Warfare Service
link |
wanted to look at drugs for interrogations,
link |
mind control, nonlethal incapacitants.
link |
They did a study in eight substances.
link |
These were now toxicity studies in animals.
link |
And on the one side was methamphetamine,
link |
and the other was mescaline, and MDMA was in the middle,
link |
So mescaline of these psychedelics
link |
tends to have the warmth that MDMA has.
link |
It's not as ego dissolving quite as some of the others.
link |
I mean, it's the main active ingredient in peyote.
link |
It is very psychedelic, very visual.
link |
Another distinction with these different drugs
link |
is how long they last.
link |
And a lot of that has to do with the route of administration.
link |
So for example, if you smoke DMT,
link |
it takes 10, 15 minutes, and you're,
link |
within seconds, you're off in another world.
link |
Similarly, 5MeO DMT, very rapid.
link |
When you take DMT in the form of ayahuasca,
link |
where it's mixed with another substance
link |
that makes it so that it's orally active,
link |
then it's a couple hours.
link |
So LSD is eight, 10, 12 hours sometimes.
link |
Psilocybin is more like five or six hours,
link |
or four to six hours.
link |
It's one reason why in our research,
link |
we give an initial dose of MDMA,
link |
and then two hours later,
link |
we give half the initial amount to extend the plateau,
link |
because we want it to last longer
link |
for people to be in this therapeutic state.
link |
So that's another distinction is how long these drugs last.
link |
Another distinction is which of them
link |
come from a religious context,
link |
have a religion built around them.
link |
We have this sense that some people are saying
link |
that 5MeO DMT and the Sonoran Toad,
link |
that they have this long history of indigenous use,
link |
but they don't, that's all modern,
link |
it's made up, and it's kind of a new approach.
link |
However, there was thousands of years of use
link |
of psilocybin mushrooms in religious contexts.
link |
From 1600 BC to 396 AD,
link |
the world's longest mystery ceremonies,
link |
the Eleusinian Mysteries,
link |
sort of the heart of Greek culture,
link |
the heart of Western culture,
link |
that was a psychedelic potion called Kikion
link |
that seems like it's very much like an LSD like substance.
link |
Aragat on grain and LSD comes from Aragat.
link |
So I think that there are a lot of ways
link |
to look at these different substances.
link |
Another distinction is which one of them
link |
are being researched right now in scientific context
link |
and which are not.
link |
And because of the rise of all these for profit companies
link |
and everybody's looking for what they can patent,
link |
what they can claim, the land grab,
link |
more and more there are companies
link |
looking at every different kind of psychedelics.
link |
The ones that are most important
link |
that are not being researched, Mescaline,
link |
but now there's a company to do Mescaline,
link |
the Jernico Lab, Ibogaine,
link |
which is crucial for opiate addiction.
link |
There's a new company, a branch of this company,
link |
Atai, that's gonna be looking at Ibogaine.
link |
So I'd say the rise of the for profit companies
link |
is making it so that there's just gonna be
link |
an enormous amount of investigations
link |
into all these different psychedelics.
link |
But what we're gonna see is the development
link |
of new psychedelics that we don't know anything about
link |
that have not existed yet
link |
because a lot of these for profit companies
link |
are gonna wanna invent and patent
link |
and have composition of matter patents on new molecules.
link |
So I think we'll see a lot of that happening too.
link |
That's really fascinating.
link |
I mean, there's a lot of doors you've opened
link |
and we're gonna walk through all of them,
link |
including the research and so on,
link |
but on this one little tangent
link |
of the future of psychedelics,
link |
so engineering new psychedelics,
link |
can you comment on maybe the chemistry
link |
and the biology of how psychedelics work
link |
and where is the space of possible engineering
link |
of psychedelics and what kind of things
link |
might they unlock in terms of the possible places
link |
our mind would be able to go
link |
and the effects of that of improving health,
link |
but maybe at the basic level of chemistry
link |
and the space of what could be engineered?
link |
Well, you reminded me,
link |
I'll get to exactly what you said,
link |
but you reminded me of a talk I heard
link |
by Buckminster Fuller shortly before he died.
link |
And what he talked about is how technology
link |
was making things ever smaller,
link |
that we are able to pack more and more information
link |
into smaller and smaller spaces
link |
and that we're developing technologies
link |
of communications with people,
link |
we now know the internet and things like that.
link |
But what he said is that he thought the eventual evolution
link |
of this sort of research would move
link |
from this miniaturization to telepathy.
link |
And that was like a shocking thing
link |
for somebody like scientific like that to say that.
link |
So will we unlock those parts
link |
where I talked about the collective unconscious?
link |
Will we be able to more consciously explore those areas?
link |
So I think that that's a possibility.
link |
There was Stan Groff,
link |
who's the world's leading LSD researcher
link |
and has been my mentor, his wife Brigida.
link |
They were talking about stories that they had heard
link |
about MDMA that people take
link |
and then on top of that, they do 5MEO DMT.
link |
And so you get this ego dissolution,
link |
but underneath it, you have this sense of ego,
link |
sort of sense of self safety, of self acceptance,
link |
kind of grounds it.
link |
So Stan was like, that's the future of psychiatry,
link |
that you can watch without the terror
link |
of the ego dissolution,
link |
the sense that you're losing your mind
link |
or you're going crazy or you're dying,
link |
or that you have this grounded sense of safety
link |
while you're dissolving your normal sense
link |
of how you see things.
link |
And being able to engineer in a fine tuned way
link |
that exact experience, maybe fine tuned to the person,
link |
as opposed to sort of this manual potion
link |
that's through experiment.
link |
Although I don't know about fine tuning things
link |
to the person in the sense that
link |
we believe there's this inner healer,
link |
this kind of inner healing intelligence.
link |
We talked about it, the body repairs itself.
link |
So I think we more need to create safety for people
link |
and then what emerges will be customized
link |
to what they need to be looking at
link |
from this inner healing intelligence.
link |
At the same time, we will move to,
link |
we hear so much about the new approaches to oncology
link |
where you do genetic analysis of different kinds of tumors
link |
and then you have certain kind of chemotherapy agents
link |
and you do like personalized chemotherapy.
link |
I think we will have more like
link |
personalized psychedelic therapy,
link |
but it'll be more like a sequence of different drugs
link |
that people go through over an extended period of time
link |
and then you kind of customize what's next
link |
and sometimes you'll combine different drugs together
link |
like this 5MeO DMT and MDMA
link |
or a lot of times people do LSD MDMA combinations
link |
or psilocybin MDMA combinations.
link |
Chemistry is not my strength.
link |
I'm more into clinical applications and policy,
link |
but I can say that from what I've learned
link |
from reading from others and research done by others
link |
that different psychedelics have an impact
link |
on different neurotransmitters,
link |
different other parts of energies in the brain.
link |
The default mode network is what's considered
link |
to be like our sense of self and it's part of the brain
link |
that sort of is what I described before,
link |
scanning the world and filtering information
link |
for what's really important to us
link |
and both focusing us on things
link |
and also helping us to ignore a lot of things.
link |
And the classic psychedelics all weaken the energy
link |
in this default mode system
link |
and therefore you get this flood of information
link |
that you're not normally paying attention to
link |
and then you start seeing in the more creative waves
link |
or more connected, you actually move to
link |
beyond the verbal kind of thinking
link |
into sort of symbolic thinking a lot of times
link |
and that's where you sometimes get
link |
these mystical sense of connection, how it's all one
link |
and you get the sense also of how big the universe is
link |
and how small each one of us is.
link |
So there's a lot of work that Sasha Shulgin
link |
and Albert Hoffman who invented LSD
link |
and first synthesized psilocybin
link |
on what they call structure activity relationships.
link |
What is the structural molecule
link |
and then how do you predict what that new molecule
link |
that never existed before is going to do
link |
once you actually take it?
link |
And you can get close, but you never really know
link |
until you actually take the drug.
link |
And the way that Sasha ran his experiments
link |
is that he would take the drugs himself first in low doses
link |
and he would sort of step up the doses
link |
to have more experiences.
link |
If he thought it was valuable,
link |
he'd share it with his wife, Ann,
link |
but then what they would do is
link |
if they both thought it was valuable,
link |
they had a group of 12 people
link |
that they were with for many, many years
link |
and they would distribute these new drug to these 12 people
link |
and they would get the different perspectives.
link |
And he felt that 12 was like a minimum number
link |
because we're so unique how each of us see things,
link |
but then you kind of get a little bit of a consensus
link |
on how a lot of people are gonna see it
link |
and then if that 12 people were positive about it,
link |
then they would turn it over to Leo Zeph,
link |
who we called the secret chief,
link |
the leader of the underground psychedelic therapy movement
link |
and then he would start exploring it in therapy.
link |
So there's still a lot of mysteries
link |
as far as structure activity relationships
link |
and it's not gonna be the case that people go into the lab
link |
and they tinker with molecules
link |
and they know exactly what they're gonna get.
link |
And a lot of it has to do with
link |
not so much chemistry as morphology.
link |
You could say the shape of the molecule
link |
and how does that interact with receptor sites.
link |
And so we're getting better at modeling all of that.
link |
And how does that interaction relate
link |
to the morphing of the human experience
link |
and deeply understanding that perhaps
link |
there's no equations yet for that kind of thing.
link |
You really have to build up intuition by experiencing it.
link |
And over time and sort of subjective self report,
link |
like trying to build an understanding
link |
of the effects of the different chemistries.
link |
Yeah, you can have approximate ideas, but to know exactly.
link |
So when I first tried MDMA, which was 1982
link |
and this was after I had done lots of LSD
link |
and mescaline and mushrooms,
link |
I was shocked at how different it was
link |
than these other substances and yet how profound it was.
link |
So are there whole new kind of categories
link |
of classes of drugs that we're not aware of
link |
that would be not so much this like eco dissolution
link |
Well, what MDMA does is reduces activity in the amygdala,
link |
the fear processing part of the brain.
link |
So it's not just chemistry, but it routes energy
link |
throughout the brain in a different way.
link |
It increases activity in the prefrontal cortex.
link |
So you think more logically,
link |
that I think has an enormous impact on the effect of MDMA.
link |
The other thing it does is it increases connectivity
link |
between the amygdala and the hippocampus.
link |
So it helps facilitate processing of things
link |
into longterm memory.
link |
And with PTSD, trauma is like never in the past,
link |
it's always about to happen.
link |
So will we one time develop drugs
link |
that would even be specific to certain kinds of memories?
link |
We're working with a woman, Rachel Yehuda,
link |
who is at the Bronx VA,
link |
and she's done some studies
link |
that are with the epigenetics of trauma.
link |
So she's worked with Holocaust survivors and their children,
link |
and she has identified epigenetic mechanisms
link |
by which trauma is passed
link |
from generation to the generations.
link |
Sort of like set points for anxiety,
link |
fear, certain things like that.
link |
But the question is, can you actually transmit memories
link |
from one generation to the next?
link |
Now, this is not DNA changes
link |
which happen over a very long period of time
link |
and evolutionary scale.
link |
But within one lifetime, within some experiences,
link |
your epigenetics, what turns on the genes
link |
or turns off certain genes, that can be impacted.
link |
And that's what we know now can be transmitted
link |
from generation to generation,
link |
either by the father or the mother
link |
through the sperm or the egg.
link |
So it's pretty remarkable.
link |
So what Rachel's gonna try to do is MDMA research for PTSD
link |
and look at these epigenetic markers before and after
link |
and see if they change as a consequence of therapy.
link |
So will we develop one day certain kind of chemicals
link |
that will be able to bring certain kind of memories
link |
That's not inconceivable.
link |
The epigenetic angle is fascinating,
link |
that there'll be these epigenetic perturbations
link |
that lead to memories living
link |
from one generation to the other
link |
and then bringing those memories to the surface
link |
and using that as signal to understand
link |
what exactly the psychedelics bring to the surface and not.
link |
Now, the other portion of that though is culture.
link |
I mean, culture is where we store all these memories
link |
and in the stories that we get passed out.
link |
Especially with a lot of shared,
link |
you talk about the Holocaust or World War II,
link |
where it's deeply ingrained in the culture,
link |
the impact of those events
link |
and sort of in aggregate the different perspectives
link |
on that particular event create a set of stories
link |
that you can plug into.
link |
And then they kind of resonate with some aspect of you
link |
that creates a memory that's connected to,
link |
like when I think about World War II and the Holocaust,
link |
I think about my own family,
link |
but in some sense,
link |
it's also resonating with stories of many others.
link |
So it's like somehow the two echo each other
link |
and I'm just providing my own little flavor on top.
link |
The meat of the stories
link |
are probably those that are shared with others.
link |
It's plugging into the collective unconscious.
link |
That's really fascinating,
link |
really plugging into like precisely
link |
plugging into particular memories
link |
as a way to deal with trauma and PTSD, that kind of thing.
link |
Yeah, I'll just add that the most important dream
link |
of my life ever was of a Holocaust survivor
link |
telling me that he was miraculously saved from death
link |
and he knew that he was saved for a particular purpose,
link |
but he never knew what that purpose was.
link |
So in the dream, I'm seeing him on his deathbed
link |
and then he shows me whatever happened to him
link |
during the Holocaust.
link |
And then we're back in the room on his deathbed
link |
and he says, well, I know what my purpose was now.
link |
And I'm like, oh, great, what was it?
link |
He says, it's to tell you to be a psychedelic therapist
link |
and to study psychedelics
link |
and bring back psychedelic research.
link |
And I thought to myself, I've already decided to do this.
link |
You can lay this on me.
link |
I can say yes and then you can die in peace.
link |
And then he died in front of my eyes in the dream.
link |
So I think that that kind of cultural transmission
link |
that I got from when I was really young,
link |
then manifested in this dream.
link |
And that was this story about how people
link |
can be incredibly vicious
link |
and can be very motivated by irrational factors.
link |
And so I just feel that this kind of
link |
multi generational transmission of this story
link |
of the irrational being a murderous factor
link |
and something I needed to respond to was deeply ingrained.
link |
And I would say my guess is more culturally
link |
than this epigenetic mechanism.
link |
Yeah, but your sense is that whatever stimulated
link |
a certain part of human nature in World War II,
link |
especially Nazi Germany, but also in Stalinist Soviet Union,
link |
still is within us, within all of us.
link |
Just like what we're saying,
link |
we embody quite a lot of things.
link |
And one of those is whatever the capacity for evil
link |
seems to be one of those things.
link |
Yeah, there's a quote from Carl Jung
link |
from just a few years before he died.
link |
What he says, and I'll just paraphrase it is
link |
that we need to understand psychology.
link |
We need to understand who man is,
link |
that the greatest danger to us is man.
link |
There are no other dangers really that impact our species.
link |
And then he goes on to say that
link |
we are the source of all coming evil.
link |
Now this was 15 years or so after World War II.
link |
But yeah, and I'd say one of the most important
link |
psychedelic experiences of my life was a DMT experience.
link |
Also Terrence was there, Ralph Metzner,
link |
Andy Weil, a few others.
link |
And we were sitting around at Esalen smoking DMT.
link |
And under the influence of DMT,
link |
which now this was the first time I've ever smoked DMT,
link |
I had this super rapid fraction of a second,
link |
like dissolving of everything that I,
link |
well, first off I saw a horizontal line,
link |
then I saw a vertical line, then it turned into a color,
link |
red, then it was red, then it turned into cubes,
link |
then it turned into like an MC Escher kind of like,
link |
I don't know, you know, didn't make logical sense.
link |
And then I was gone.
link |
And then it was just this period of five, 10 minutes
link |
of just feeling part of this enormous wave
link |
of billions of years of evolution,
link |
how I had this sense that in my innermost sense
link |
of who I am uniquely individually,
link |
this inner voice that's talking to me
link |
that I didn't develop English,
link |
that it's like a gift to me from millions of people.
link |
So that even in my most innermost sense, it's not just me.
link |
It's the product of everything that came before me.
link |
I'm part of this bigger system.
link |
And then I just thought, wow,
link |
just how many billions of years does it take
link |
to reach this point of self awareness and all this?
link |
And it was glorious, beautiful.
link |
And then I had this thought,
link |
and this is where this kind of intellectual honesty,
link |
I guess you could say, I just thought,
link |
well, if I'm part of everything
link |
and everything's part of me,
link |
then it's not just the good parts,
link |
that Hitler's part of me too.
link |
And that was just this shock, like a stone sunk,
link |
and I just was very moody for the whole next day.
link |
But it was that acknowledgement
link |
that each of us carries these potentials,
link |
and what we activate is what matters,
link |
but what our potential are is the whole full range of things.
link |
I don't know if you can comment
link |
about the DMT trip itself and what it's like,
link |
starting from the very basic geometric shapes
link |
and then launching yourself into the context
link |
of the enormity of space and time in the human history.
link |
Is there anything else to be said
link |
about that kind of visually or physically
link |
or emotionally about that journey?
link |
What it's like, that brief journey that reveals so much?
link |
Well, I was with a group of people.
link |
The way we were doing it was each of us would smoke DMT,
link |
have 10, 15 minutes experience while we closed our eyes,
link |
and everybody else was just chatting,
link |
and then the person who did the DMT would come back
link |
and tell their story of what happened.
link |
And then we'd think about it for a bit
link |
and then pass the pipe to the next person.
link |
And so this was like a whole evening.
link |
So even the, sorry to interrupt,
link |
even the conversations themselves then
link |
is part of the experience.
link |
Exactly, yes, yes, because it's also what you bring back.
link |
I mean, I think that's particularly for therapy.
link |
It's not so much about what the experience is,
link |
but it's what you bring back and what do you integrate.
link |
And then also, how do you learn how to do these things
link |
on your own without the drugs?
link |
There is this way, because we're saying
link |
it's sort of a core human experience,
link |
the drug is the mediator, but can we do this on our own?
link |
And once you've seen it and felt it,
link |
then you have a little bit better sense
link |
to recreate it on your own.
link |
Although, I've had dreams where I've been doing LSD
link |
and tripping and it was just incredible.
link |
It was, I was tripping in my dreams,
link |
but I had not taken LSD.
link |
So there's this way in which we do that.
link |
So I would say that from the DMT experience,
link |
the sense of safety, that's what I was trying to get at
link |
with this, the group of us and this group of friends
link |
trying to do this common exploration,
link |
that if you have this sense of safety,
link |
you're incredibly vulnerable
link |
because you are giving up your awareness really
link |
of what's happening around you.
link |
I think there's, what we're finding is that
link |
in our psychedelic research for PTSD
link |
and what we see with the vaccines,
link |
that even African Americans are reluctant
link |
to volunteer for vaccines because they haven't had
link |
that sense of safety from the medical establishment.
link |
They don't volunteer for psychedelic therapy even as much.
link |
So the overlay has to be this sense of safety
link |
as you become vulnerable and looking inside, you're not.
link |
I was just actually told about how there's a lot of work
link |
being done inside prisons to teach mindfulness.
link |
And so one of the,
link |
Charlene who's my assistant is trying to do work
link |
on helping people in prison with trauma,
link |
potentially one day with MDMA or meditation or mindfulness.
link |
But one of the exercises was teaching people to,
link |
okay, here's how you deal with stress,
link |
just close your eyes and deep breathe.
link |
And what Charlene was saying is people don't close their eyes
link |
in prison, you don't feel safe to do that.
link |
So all that is just to say is that the context
link |
is the most important factor.
link |
So while I'll talk about the DMT experience,
link |
the context was this supportive sense of safety
link |
that I could be completely vulnerable
link |
and out of any kind of controlled women,
link |
I think often are less safe in this way than men
link |
because of all the sexual assaults.
link |
But what it can do by taking the ego orientation offline
link |
to some extent, it opens you up to much more.
link |
And to make a bigger point of that,
link |
we could say that it's very similar
link |
to the Copernican revolution.
link |
And people thought that the earth
link |
was the center of the universe
link |
and the inquisition murdered people that questioned that.
link |
Father Bruno burned at the stake.
link |
Actually, one of the things he said,
link |
I think that's worth all these years later saying
link |
is that when the inquisition sentenced him
link |
to burn at the stake for espousing this idea
link |
that the earth was not really the center of the universe,
link |
he said to the inquisition, he said,
link |
your fear in sentencing me is greater
link |
than my fear in being sentenced.
link |
That their worldview was so rigid
link |
that they had to wipe out anybody that would question it.
link |
And so this idea of psychedelics displacing our ego
link |
is the center of the universe.
link |
And to realize that we are just rotating
link |
about on something much bigger than our individual life.
link |
Our ego is designed almost to protect this body
link |
while we're alive.
link |
And you can understand all the good reasons why that is,
link |
but it also disconnects us from this bigger reality.
link |
And so the psychedelics, DMT,
link |
by knocking this sort of ego orientation
link |
or the default mode network offline,
link |
you open up to the bigger sweeps of history.
link |
So in that place of safety and vulnerability
link |
in that fascinating group of people,
link |
when their ego was dissolved in this way,
link |
did they have similar experiences?
link |
Is there different places that their minds went?
link |
Yeah, so once I had this kind of shattering experience
link |
that Hitler's part of me,
link |
no one else in the group had that.
link |
Probably a lot of them have maybe had that before
link |
or they realized that they're not just the good,
link |
the white hat, good people and that they're all good
link |
and we got to fight against the bad people.
link |
So no, people will go in different places.
link |
And not only that, if you do it again,
link |
you'll go into a different place
link |
than you went to the first time.
link |
Unless you have not resolved the issue.
link |
So I had a sequence of LSD trips that were very difficult,
link |
but it was like coming to the same sort of conundrum,
link |
the same challenge that I was unable to overcome.
link |
This idea of letting go and really fully dissolving,
link |
letting the ego fully go.
link |
And I would have this sequence of trips
link |
over a couple of months where I would reach this point
link |
where I was too scared to move forward
link |
and I would just be holding on.
link |
So there are repeated themes sometimes.
link |
What Stan Groff has said, which I find very beautiful,
link |
is that the full expression of an emotion
link |
is the funeral pyre of that emotion.
link |
And what that means is if you can fully let in something,
link |
then the essence of life has changed,
link |
is that it moves on, that everything's in motion.
link |
And if you can fully experience it,
link |
even if it's a sense that you're gonna be trapped
link |
in eternity in this hellish state,
link |
if you surrender to that, that's the way out.
link |
This full experience of something
link |
is this funeral pyre of that emotion.
link |
And so that runs against a lot
link |
of what modern psychiatry is doing too,
link |
which is to suppress symptoms.
link |
Instead of supporting people
link |
to kind of explore these insecurities
link |
so that then they can contain them
link |
and then they can move on.
link |
So yeah, resistance is not a way to make progress.
link |
Although one of the reasons
link |
why we do the supplemental dose during the MDMA
link |
or why there's advantages in a 10 hour LSD experience
link |
is that you have a lot of opportunities
link |
to come up against this resistance
link |
that may be too difficult to deal with
link |
and then you kind of push it aside
link |
and then a couple hours later you come back to it
link |
or you come back to it.
link |
Press snooze every once in a while if you're not ready.
link |
It's hard to do that.
link |
I think with MDMA, you can negotiate.
link |
That's, I think, a part of its safety in a sense.
link |
You can have this like, oh, I should be talking about this
link |
or I'm feeling this, but it's too much for me now.
link |
You can push it away.
link |
But with the classic psychedelics,
link |
this kind of membrane between the conscious
link |
and the unconscious,
link |
that once you take the drug and it weakens this membrane
link |
and things are coming up,
link |
it's very difficult to negotiate with it.
link |
The key to successful classic psychedelic trips is surrender.
link |
You've talked about that you first began
link |
to reconsider the negative health myths around psychedelics
link |
when you learned that the book One Flew Over the Cuckoo's Nest
link |
was written by Ken Kesey when he was in part
link |
under the influence of LSD.
link |
So how do you think LSD helped him, Ken Kesey,
link |
in writing that incredible book?
link |
Yeah, there's a process that's called semantic priming.
link |
And so what that means is that I say night, you say day.
link |
There's kind of normal patterns of kind of,
link |
you say one word, what kind of words come to you next?
link |
And so they've done some research.
link |
They, meaning scientists, have done some research
link |
where you give people a psychedelic
link |
and then you do this semantic priming.
link |
And what you find is they have a wider range of associations
link |
than they normally would
link |
when they're not under psychedelics.
link |
So I think for Ken Kesey,
link |
he was able with psychedelics to get
link |
a deeper kind of emotional connection
link |
to some of these states of mind
link |
that people were in this mental institution
link |
and that he could explore them more in depth
link |
and more eloquently.
link |
And also one of the things he talked about
link |
was the fog machine,
link |
was how people's minds were sort of clouded
link |
by the people that ran the institution
link |
and the fog machine would be coming in.
link |
So I think the imagery and the metaphors
link |
that he used a lot in the book
link |
could come to him during LSD experiences.
link |
And then now he wasn't doing very,
link |
when you're writing, you have to be literate.
link |
You have to be able to write.
link |
So it would be more like beginning and ends of LSD trips
link |
instead of at the peak.
link |
But I think you would get a lot of these,
link |
the feeling tones or the images, the metaphors,
link |
I think he would get these extent,
link |
also LSD lasts so long, you can get these extended focus
link |
and you can really elaborate on images.
link |
And so much of psychedelic experiences
link |
are poetic and metaphorical.
link |
I mean, you could take veterans
link |
who've never read a book of poetry in their lives.
link |
And under the influence of MDMA,
link |
just what they describe, the imagery
link |
and the way they describe their experiences,
link |
metaphorical, poetic, it's incredible.
link |
And so I think that Ken Kesey was able to channel
link |
what LSD did to his mind in a way
link |
that most people couldn't do,
link |
that he did because he was trying to write this novel
link |
and because he was so brilliant.
link |
Yeah, I mean, we'll talk about psychedelics
link |
and treating, in bringing some of trauma to the surface
link |
and dealing with all those kinds of things,
link |
but there's something also to the opening up of creativity
link |
for whether it's for writing purposes
link |
or for in my world for engineering, for invention,
link |
innovation and invention itself is a very,
link |
is a deeply creative process.
link |
And it's fascinating to think with the aid of psychedelics,
link |
what kind of ideas can be brought to life?
link |
Yeah, well, we have the whole phenomena
link |
of a lot of the people in Silicon Valley
link |
and else microdosing psychedelics
link |
in order to have a little touch more
link |
of this creative approach to things.
link |
I would love it to see if it was,
link |
that's more like Terrence McKenna territory,
link |
correct me if I'm wrong,
link |
but I would love to sort of more scientific
link |
to where there'll be the rigor
link |
of saying how to do it effectively,
link |
how to sort of understand sort of not just almost,
link |
to take the full journey of creative exploration
link |
and to do it for prolonged periods of time,
link |
for years, lifelong kind of part of your life
link |
of how it empowers creativity.
link |
I think, of course, you start with helping people
link |
deal with trauma, and then the next step
link |
is people who have moved past their trauma
link |
and are trying to do something,
link |
create something special in their life.
link |
How can then psychedelics empower that?
link |
Yeah, now, that also,
link |
just to not shy away from anything controversial,
link |
that gets us to this idea of psychedelics for vision quest,
link |
particularly for younger people.
link |
You know, when you're sort of moving
link |
into this adulting kind of phase
link |
and you have to figure out
link |
what are you gonna do with your life,
link |
there's so many options.
link |
A lot of people, of course, feel constrained
link |
that they have very few options,
link |
but I think this idea of psychedelics
link |
as a way to help you find your calling
link |
or find your vision or find your unique leverage point,
link |
I think we'll see that more and more
link |
as our culture evolves and gets healthier
link |
around the use of psychedelics.
link |
So it's both the science,
link |
having the rigor of understanding how to do it safely
link |
and the culture catching up
link |
to the fact that this is both safe and very useful.
link |
Yeah, although I would question this idea of safety.
link |
So we can understand physiological risks
link |
and we can minimize them.
link |
And I think there's very minimal physiological risks
link |
from the classic psychedelics, virtually none,
link |
or for even MDMA under safe conditions.
link |
Psychological risks are harder to address,
link |
but we can do that through the sense of safety and support.
link |
But I think there's a level of risk there
link |
that we shouldn't overlook.
link |
And so to make a drug into a medicine,
link |
what we have to do is prove to the satisfaction
link |
of the FDA and other regulatory agencies
link |
that things are safe and efficacious.
link |
But even though they use those words,
link |
proving safety and safe and efficacious,
link |
it's in relationship to the disease
link |
that you're trying to treat
link |
and you accept a certain amount of risk.
link |
So it's the risk benefit ratio rather than pure safety.
link |
Let me ask you about Ken Kesey a little bit longer
link |
because fascinating him being.
link |
He was also part of Project MKUltra.
link |
What was Project MKUltra
link |
and what lessons we should take away from it?
link |
Well, MKUltra was a program by the CIA.
link |
What they were looking at was,
link |
can you take these drugs, these psychedelic drugs,
link |
and weaponize them in different ways
link |
for interrogation, for true serums,
link |
for exposing somebody before they give a big talk
link |
to something like LSD and then they can't talk
link |
or make a fool of themselves?
link |
Or can you spray LSD over the battlefield
link |
and have everybody tripping and drop their weapons
link |
and then you just walk up and nobody dies
link |
and you've won the battle?
link |
So it's a fascinating concept.
link |
Yeah, they call it nonlethal incapacitance
link |
and I think that's how it's.
link |
One way to win a war is to enforce peace.
link |
To get everybody not caring about the war, but yes.
link |
Well, I think Gandhi said something even better,
link |
which is that the true way to win a war
link |
is to turn your enemy into your friend.
link |
Yes, that's a beautiful way to put it.
link |
Yeah, but MKUltra was really nefarious
link |
and it was part of our military and it was done in secret
link |
and they would dose people against their will.
link |
I mean, one of the most infamous things
link |
was that they had a house of prostitution in San Francisco
link |
and they would have one way mirrors, all this stuff
link |
and then they would just dose people with LSD
link |
and they would have the prostitutes dose these guys with LSD
link |
and observe what they would do and how they would act.
link |
And the CIA actually for a while
link |
was dosing each other secretly
link |
and that there's a famous case of this fellow Olson
link |
that either jumped out of a window or was pushed,
link |
he might've been killed.
link |
He was a CIA guy and they gave him LSD
link |
and then they're trying to see can they break him down
link |
and get him to tell secrets.
link |
And I think he felt uncomfortable with what happened to him
link |
while he was under the influence of LSD
link |
and whether he was pushed or not,
link |
I don't know if we'll ever know.
link |
But MKUltra was violating people's human rights.
link |
It was done in secret and the irony of it
link |
is that Ken Kesey is one of the people,
link |
one of the main early people that got LSD in this context
link |
and then he was one of the main people
link |
that helped inspire the hippies to use psychedelics
link |
to oppose the Vietnam War.
link |
So I think the CIA kind of in many cases,
link |
things get out of their control,
link |
what they think they can do
link |
and it turned in to be a disaster for them.
link |
I think there was some thought
link |
that some of the people at the CIA had
link |
is that if you can turn people inside,
link |
take drugs and they just focus on their internal experience,
link |
they're not gonna be involved politically.
link |
It's a way to sort of take people offline.
link |
And what I don't think they counted on
link |
is that when you're offline
link |
and you have these unit of special experiences
link |
and you realize how we're all connected,
link |
then why do you wanna go out and kill these Vietnamese
link |
and put one dictator over another dictator,
link |
dictators on both sides in North Vietnam and South Vietnam?
link |
Why are we doing that?
link |
So MKUltra has just a very disreputable.
link |
We're learning more and more about what they did
link |
and one of the unintended consequences was Ken Kesey
link |
and not only that, but then the Grateful Dead
link |
who began at the acid tests that Kesey was helping
link |
to organize and out of that emerged,
link |
you could say just this incredible psychedelic culture.
link |
And you look at the bands that began in the 60s
link |
and which ones have really survived to this day
link |
and the Grateful Dead has survived longer
link |
than most any other band.
link |
I mean, some of them have died and all,
link |
but it was like the tightness,
link |
the sort of telepathy we talked about before
link |
that they could just get so tuned in to each other
link |
and each other's energies and they could do improvisations
link |
and they can do this incredible work
link |
that I think the sustainability of the Grateful Dead
link |
as a group was a testament
link |
to the power of the LSD experiences
link |
and that might've never happened if not for MKUltra.
link |
But can we talk about the darkness a little bit?
link |
So Ted Kaczynski, the Unabomber was allegedly part
link |
of the MKUltra studies while at Harvard.
link |
Do you think this is true?
link |
Do you think it had an impact
link |
on him psychologically, intellectually and so on?
link |
I do think it's true and I do think it had an impact.
link |
So we talked before about are these drugs somehow
link |
or other producing a certain kind of drug experience
link |
or do they bring out what's within?
link |
So we have this experience, yeah, on the one hand,
link |
Ken Kesey and he sort of took positive things out of this.
link |
On the other hand, we can get this opposition
link |
to the modern world, to technology
link |
and to the point of creating bombs to try to go after it.
link |
So that the experience is not in the drug,
link |
it's this interaction between the drug,
link |
the person, the context.
link |
And so we can heal people with psychedelics
link |
or people can be driven crazy with psychedelics.
link |
It depends again on the context.
link |
And so I think both these things can be true.
link |
And I think it was really good
link |
that you kind of highlighted this,
link |
that there is this polarities and that it's not in the drug,
link |
it's in the other factors and it's who they were beforehand
link |
and then how you use that experience.
link |
So all that's to say is if we put LSD in the water
link |
and everybody were to get it,
link |
it doesn't mean that all of a sudden
link |
everybody's gonna have a mystical experience
link |
and then that's all we need to do
link |
and humanity is spiritualized or end war and all of this.
link |
It's not about the drug.
link |
And that actually is why for me,
link |
we've also talked about engineering new psychedelics
link |
and all the people that are gonna be trying
link |
for profit companies to develop and patent new psychedelics.
link |
For me, the most important challenge
link |
is new cultural contexts that can create legality,
link |
safety, support for the existing psychedelics
link |
that we already have.
link |
I mean, we have so much incredible tools
link |
in these existing psychedelics
link |
that it's more about creating context for them
link |
to be used in safe medical or personal growth
link |
or recreational even with harm reduction,
link |
all these different ways.
link |
That's more important to me than finding some new molecule
link |
that's somewhat similar or somewhat different
link |
but it can be patented.
link |
So it's the social context.
link |
So I do believe that Ted Kaczynski was part of NKUltra
link |
and I think it affected him in a negative way
link |
and that's a cautionary tale that it's not in the drug,
link |
it's in the context.
link |
The context, the person, still it feels like if viewed
link |
from a therapy perspective, perhaps there was a way
link |
to use psychedelics to help Ted Kaczynski find a path
link |
out of the darkness.
link |
I think so and I think that this is where I think MDMA
link |
comes in in a way that MDMA is, he felt very isolated
link |
and very much out of society in some ways.
link |
MDMA stimulates oxytocin, which we haven't mentioned,
link |
which is the hormone of nursing mothers,
link |
of love and connection.
link |
It provides a lot of this sense of self acceptance
link |
and safety and wanting to be in a relationship.
link |
There's Gould Dolan is a neuroscientist at Hopkins.
link |
She's given octopuses MDMA, they're solitary creatures
link |
except mating season, which is not very often
link |
but you give them MDMA and they become more interested
link |
in hanging out with other octopuses.
link |
So I think this, for people that have had difficult
link |
psychedelic experiences, MDMA helps them integrate them.
link |
We've worked with people that had a difficult LSD experience
link |
40 years before and are still able to get back to that
link |
under the influence of MDMA and work out some
link |
of the conflicts that they weren't able to resolve
link |
all those decades before.
link |
So I think that psychedelics could have been helpful
link |
in a different context for Ted Kaczynski.
link |
But the other big part of it is that people have to be
link |
willing to cooperate with the experience.
link |
We talked about resistance.
link |
So people can resist these things.
link |
It's the saying is you can bring a horse to water
link |
but you can't make them drink.
link |
This is about how people have to be willing
link |
to go to these spaces.
link |
So one of the essence of our therapeutic approach
link |
is that we help people to heal themselves,
link |
that we are not giving them the healing.
link |
It's a flip on the power dynamics that existed,
link |
you would say in the fifties and sixties,
link |
my dad was a doctor and the doctors were gods
link |
and whatever they said was right.
link |
And we no longer, of course, believe that.
link |
But for a while, psychoanalysis with Freud,
link |
that they gave the interpretation to the patient.
link |
The patient couldn't help themselves
link |
but they would do the free associations
link |
and the psychoanalyst would see these conflicts
link |
and would be the one that does the healing,
link |
would give this interpretation and that would open things up.
link |
So I think it's this idea of empowering people
link |
to heal themselves.
link |
And so if Ted Kuznicki had been in a therapeutic setting
link |
with psychedelics and if they'd had something
link |
like MDMA available or MDA,
link |
which was popular during the sixties,
link |
which is a more like MDMA LSD combination,
link |
the outcomes might've been different.
link |
Let's take a step into the world of studies.
link |
Timothy Leary, who was he
link |
and what were the most important ideas
link |
you've learned from him?
link |
Well, I did have the opportunity to get to know him personally
link |
and to spend some time with him.
link |
Timothy Leary, well, let's start with Nixon saying
link |
he's the most dangerous man in America.
link |
That's a good place to start.
link |
And why did Nixon say that?
link |
It's because of this turn on, tune in, drop out.
link |
Timothy Leary was just an incredible advocate
link |
for think for yourself, question authority.
link |
Those were the things he said all the time.
link |
Think for yourself, question authority.
link |
He was kicked out of West Point.
link |
He was a psychologist who was at Harvard for three years
link |
Before he got to Harvard,
link |
he had an experience with mushrooms in Mexico.
link |
And he said he learned more in that experience
link |
than he'd had in his entire academic career before then
link |
about how the human mind works.
link |
And so he came to Harvard wanting to do research
link |
into psychedelics.
link |
And he did some very important studies, both of which,
link |
well, one was called the Good Friday Experiment,
link |
which was whether psychedelics in religiously inclined
link |
people taking psilocybin in a religious setting,
link |
whether it could produce a mystical experience.
link |
That took place at Marsh Chapel at the Boston University.
link |
Because it's a little bit subjective,
link |
where you can say entirely subjective,
link |
what people describe happens to them.
link |
He wanted to do another study,
link |
which would be a more objective measure,
link |
and that was called the Concord Prison Experiment.
link |
And that was the thought, if you can give people
link |
psilocybin mystical sense of connection type experiences
link |
while they're in prison, when they get out,
link |
they'll be more pro social and they'll have reduced
link |
He also did the naturalistic studies
link |
of giving loads of people psilocybin
link |
and sort of writing down what their experiences were,
link |
the range of experiences.
link |
Later on in his time at Harvard,
link |
they started doing LSD.
link |
And LSD is more cerebral, longer lasting,
link |
not as reassuring in a way as psilocybin.
link |
Sometimes he used to say that if they never got into LSD,
link |
they'd still be at Harvard with the psilocybin.
link |
So he was a great American psychologist,
link |
but then he got tired of the psychology game,
link |
you could say, or he would say that.
link |
He got more and more interested in cultural change
link |
and various musicians and artists
link |
and all sorts of people started coming to him
link |
for the psychedelic experience that they are in a way
link |
for creativity, for other things.
link |
So he started hanging out with all sorts of famous people
link |
or creative people and he stopped going to classes a lot.
link |
And Ram Dass, Richard Alpert had given LSD to a student
link |
that Ram Dass was courageous enough to admit
link |
that he had a sexual interest in.
link |
They weren't supposed to give it undergraduates.
link |
That was about the only time that they ever did it.
link |
And psychedelics just getting more and more controversial
link |
even in the early 60s, eventually got kicked out of Harvard
link |
and then he became kind of a cultural icon
link |
for the counterculture and was hounded by the police
link |
and Nixon and spent a lot of time in jail.
link |
I mean, he's an incredible person.
link |
One thing that Ram Dass said is that Richard Alpert,
link |
Ram Dass said, I'm a rascal, but Leary's a scoundrel.
link |
What's the distinction?
link |
Rascals like in good fun.
link |
A scoundrel is like, you can't quite trust them, I think.
link |
It's a spectrum of sorts.
link |
Yeah, I think that Leary was someone
link |
who a little bit got addicted to media attention.
link |
But I think that overall he gets blamed a lot
link |
for the backlash against the 60s,
link |
the shutdown of psychedelic research.
link |
I think that he is unfairly blamed for a lot of that.
link |
I think when you look back at the 60s,
link |
the common narrative is that it was
link |
because psychedelics going wrong.
link |
People took psychedelics, they weren't prepared,
link |
they had emotional breakdowns, they weren't psychotic,
link |
they killed themselves, they did this or that,
link |
different problems of people taking psychedelics
link |
in context that they didn't feel fairly safe in
link |
or just they weren't prepared
link |
or they didn't know how much they were taking
link |
So the backlash was because psychedelics going wrong.
link |
But I think the real reason, while that did happen,
link |
I think the real reason is psychedelics going right
link |
and people having this sense of connection.
link |
And then the opposite of what the CIA was hoping
link |
that it would kind of turn people inward
link |
and take them away from political struggles,
link |
it actually motivated people.
link |
Once you actually have these psychedelic experiences,
link |
your attitude towards death changes also
link |
this idea of death becoming an intrinsic part of life,
link |
it's a natural cycle, it's not so much.
link |
So I think people realize that,
link |
while there's this billions of years of evolution,
link |
infinity, whatever that means in terms of time,
link |
that we're here for a very limited time
link |
and they end up wanting to use their time well,
link |
they have a lessened fear of death
link |
and they wanna build this paradise on earth here now
link |
So a lot of people really did get motivated
link |
to challenge the Vietnam War,
link |
to work on the environmental movement,
link |
civil rights movement, women's rights movement,
link |
And it was that challenge to the status quo
link |
that caused the backlash.
link |
So Leary is someone who in 1990,
link |
we had the maps I started in 86.
link |
So in 1990, we had this conference
link |
to raise money out in California
link |
and Leary was there and Ram Dass was there
link |
and Ralph Metzner was there and Andy Weil was there
link |
and Terrence McKenna was there
link |
and Dennis McKenna was there and all these.
link |
But there was one point where Tim was speaking
link |
and afterwards I was asking him some questions.
link |
And I said, do you have any advice for us
link |
on how to work with the government
link |
and how to bring these psychedelics forward?
link |
That's what we're trying to do.
link |
I've got this nonprofit for it.
link |
We're trying to do this research.
link |
What is your advice on how to bring this forward
link |
and how to work with the government?
link |
And he said, fuck the government.
link |
He said, I am so far past asking for permission
link |
for anything, but I'm glad that you're doing it.
link |
And then he held up my hand like passing the torch.
link |
So it was, and that's one of my favorite photographs
link |
of me and Tim where he's sort of like,
link |
but it was after this, fuck the government.
link |
I'm so far past asking for permission for anything,
link |
but I'm glad that you are.
link |
Now I did follow ups to the Good Friday experiment
link |
and I did follow ups, 25 year follow up
link |
to the Good Friday experiment,
link |
about a 34 year follow up
link |
to the Concord Prison experiment.
link |
What I discovered in some ways I would say
link |
is the key to the 60s, what I just told you,
link |
but in the follow up to the Good Friday experiment
link |
that I did in the 80s for my undergraduate thesis
link |
at New College in Sarasota, Florida,
link |
I eventually found 19 out of the 20 people.
link |
It was just, that was an enormous challenge
link |
because their names were all lost
link |
and it just took forever years and years and years
link |
But I discovered that those people
link |
that had the psilocybin experience
link |
in the midst of 25 years later with Nancy Reagan
link |
and Ronald Reagan, and if there ever were there
link |
a social pressure to disavow the validity
link |
of the psychedelic experience, that was then.
link |
And instead they affirmed it,
link |
that they thought with all of this years of hindsight,
link |
now looking back, they thought it was
link |
a valid mystical experience.
link |
But I discovered that one of the persons
link |
who had the psilocybin had this experience
link |
during the Good Friday service
link |
that Reverend Howard Thurman was the minister.
link |
He was Martin Luther King's mentor
link |
and Reverend Howard Thurman was the minister
link |
at Boston at Marsh Chapel.
link |
Martin Luther King got his PhD at Boston University.
link |
And Howard Thurman had spent time with Gandhi.
link |
And so he was really kind of this hidden person
link |
behind the civil rights movement
link |
about nonviolence as their strategy.
link |
But he was interested in the political implications
link |
of the mystical experience.
link |
So he permitted this experiment to take place.
link |
And there were 20 divinity students
link |
from Andover Newton in the basement
link |
and 10 experimenters, all the people on religion
link |
and psychology, like Houston Smith and Walter Huston Clarke
link |
and Leary and Ramdas, Mr. Others were there
link |
as a support part of it.
link |
And the sermon was like three hours later.
link |
We actually have, three hours long,
link |
we actually have the original sermon
link |
from the Good Friday experiment
link |
from Howard Thurman up on our website.
link |
But part of it was tell people there's a man on the cross.
link |
And this one person sort of heard that
link |
and he thought, okay, I gotta do that.
link |
Howard Thurman was such a dynamic speaker.
link |
He said, I gotta tell people there's a man on the cross.
link |
And so he said, what am I doing here
link |
in this basement chapel listening to this service?
link |
I gotta go tell people there's a man on the cross.
link |
So he went, they thought he was just going to the bathroom,
link |
but he ran out the door.
link |
He's running down Commonwealth Avenue
link |
and Houston Smith and Tim Leary go after him.
link |
And he had thought that since he should tell somebody,
link |
he should tell the president, like why not?
link |
But then he realized, well, the president's in Washington.
link |
I'm here in Boston.
link |
I'll just tell the president of the university.
link |
So anyway, he's running down the street
link |
and Leary and Houston Smith go after him.
link |
And he doesn't want to go back inside.
link |
They finally get him.
link |
He's not hit by a car,
link |
but they end up giving him a shot of Thorazine.
link |
Thorazine is like a major antipsychotic drug.
link |
It's a horrible drug, but it knocks people out,
link |
tranquilizes them.
link |
We would never do that today.
link |
We don't abort a difficult experience like that.
link |
But in any case, they hid that.
link |
That was not part of the writeup of this experiment.
link |
So what they did is in a sense,
link |
a little bit exaggerated the benefits.
link |
It later became out three years later after the experiment
link |
or four years in Time Magazine,
link |
it said everybody that got psilocybin
link |
had a mystical experience.
link |
Say it wasn't true, not everybody.
link |
Eight out of the 10 did, but not all 10, not this guy.
link |
And they minimize the risks.
link |
So there was a bit of that.
link |
I think Tim was reckless in that way.
link |
It was underplayed the risks and overpromised the benefits.
link |
And then the Concord Prison experiment,
link |
it turned out that Tim had fudged the data completely
link |
and it wasn't really successful.
link |
So I fault him for that.
link |
The outside world was doing the opposite.
link |
It was exaggerating the risks and blocking research.
link |
So he felt justified to fudge the data
link |
because the outside world was fudging in a sense,
link |
the response to the.
link |
Yeah, yeah, exactly.
link |
Yeah, so that presents a very nice context.
link |
Fuck the government, but I'm glad that somebody
link |
is fighting the good fight from within
link |
and doing it the right way, which is where you are.
link |
So the 80s, let me ask, what is MAPS,
link |
the Multidisciplinary Association for Psychedelic Studies
link |
and what is its mission throughout the years,
link |
throughout the decades?
link |
Yeah, so MAPS is a nonprofit organization.
link |
I created it as a nonprofit pharmaceutical company.
link |
I created it in 86 after DEA,
link |
the Drug Enforcement Administration,
link |
criminalized MDMA in 1985.
link |
And that was after they started trying to do that in 1984.
link |
And as I mentioned, this Terence McKenna is sponsoring,
link |
motivating us to do this safety study.
link |
So we did that in preparation for this eventual crackdown
link |
because MDMA was called Adam, used as a therapy drug,
link |
but it was also beginning to be sold as ecstasy
link |
And that was taking place in public settings and bars.
link |
And so it was inevitable that the crackdown would happen.
link |
And so I had a nonprofit connected to Buckminster Fuller,
link |
Earth Metabolic Design Lab,
link |
that we used to support this lawsuit against the DEA
link |
to block them from criminalizing MDMA.
link |
We were winning in the court of public opinion
link |
and winning in the court.
link |
The DEA freaked out
link |
and the emergency scheduled MDMA in 85.
link |
The handwriting was on the wall
link |
that they were not gonna permit
link |
the therapeutic use to continue
link |
because it gets in the way of the narrative of the drug war
link |
and these are terrible drugs.
link |
So in 86 is when I started MAPS as a nonprofit pharma
link |
because the strategy that I realized is that
link |
Americans are open to medicines,
link |
that tools to ease suffering,
link |
that was the opening wedge,
link |
the opening door to changing attitudes.
link |
And it would be through science.
link |
I would say that my religion is more science
link |
than anything else.
link |
And culture and religion are metaphorical,
link |
but often too much they become literal.
link |
But I felt that through science, through medicine,
link |
there would be a way to bring these drugs
link |
back to the surface.
link |
And the mission was always this mass mental health,
link |
this idea that what we need is to spiritualize humanity.
link |
Einstein said the splitting of the atom
link |
has changed everything except our mode of thinking.
link |
And hence we drift towards unparalleled catastrophe,
link |
which shall be required if mankind is to survive
link |
is a whole new mode of thinking.
link |
So what is that new mode of thinking?
link |
My presumption is that it's more of this mystical sense
link |
of thinking that we're all connected.
link |
And then if we realize that we're all connected,
link |
we're not gonna blow up the world.
link |
So a lot of people say that if we could just give LSD
link |
all to the world leaders, that would be,
link |
then they'd have these spiritual experiences,
link |
the world would be better.
link |
But I actually had a ketamine experience
link |
the day after that DMT experience I described
link |
with the inner Hitler.
link |
This ketamine experience was,
link |
I was above and behind Hitler as he was giving a speech,
link |
like the Nuremberg rallies kind of thing.
link |
And I was trying to think, how do I get into his head?
link |
How do I undo what he wants to do?
link |
How can we deal with him?
link |
And I realized this whole new thing
link |
about the Heil Hitler salute.
link |
And he would like push energy out
link |
and then everybody would do the salute back to him.
link |
And so it's like the one to the many
link |
and the many to the one,
link |
giving all these people giving away their power
link |
and then how it would just sort of ratchet up in intensity
link |
like these vibrations.
link |
And I realized there's no way to get into his head.
link |
This idea we've talked about before
link |
about you have to be willing.
link |
So what that sort of helped me understand
link |
is that the strategy has to be mass mental health.
link |
It's not about changing a few leaders.
link |
We need to change the mass of humanity
link |
to this new mode of thinking, this new spiritual way.
link |
So MAPS was a nonprofit pharmaceutical company
link |
focused on psychedelics.
link |
Big Pharma wasn't doing this work.
link |
Government wasn't funding it.
link |
So the only source of funds
link |
I thought would be through nonprofit donations.
link |
And that's been true up until just a couple of years ago
link |
now that we have the rise of these for profits.
link |
But that's because we've cleared out
link |
the regulatory obstacles.
link |
We've got more scientific data about the benefits
link |
funded through philanthropy.
link |
We've changed public opinion
link |
and there's a lot less zeal for the drug war.
link |
So all of those things have changed.
link |
But at the time it was mass mental health was the goal.
link |
Two tracks, one was drug development,
link |
the other was drug policy reform.
link |
So then it's not just available to people
link |
that have a clinical diagnosis,
link |
but people who are personal growth
link |
or they should have access to it as well.
link |
I did not know at the time that no drug
link |
had ever been made into a medicine by a nonprofit.
link |
That was really good I didn't know that.
link |
I might've been a little bit more daunted.
link |
And actually that didn't happen for 13 more years.
link |
It happened in 1999.
link |
And that was the abortion pill, RU46,
link |
that was approved in Europe, but it's controversial.
link |
Nobody, no pharmaceutical company would take it.
link |
And it was John D. Rockefeller the third
link |
through the population council
link |
with the major donor being Warren Buffet.
link |
And the Rockefellers and the Buffets
link |
and some of the Pritzkers were involved in funding this.
link |
So that was the first nonprofit.
link |
But the MAPS was designed as from the very beginning,
link |
not academic research into psychedelics,
link |
but drug development.
link |
And that's a fundamental distinction.
link |
And that's why I think we're years ahead now
link |
with everybody else in terms of making
link |
a psychedelic assisted therapy into a medicine.
link |
Because our goal from the very beginning was not knowledge,
link |
not academic research, it was practical.
link |
It was drug development.
link |
How do we create new social structures?
link |
How do we create legal access to these things?
link |
Now, in December of 2014,
link |
we created the MAPS Public Benefit Corporation.
link |
So MAPS is a nonprofit, but in our 35 years,
link |
we've raised about $110 million in donations.
link |
What I didn't know when I started MAPS,
link |
and it took me quite a few years,
link |
I didn't even know this till about eight, nine years ago,
link |
was that in 1984, Ronald Reagan had signed a bill
link |
to create incentives for developing drugs
link |
that were off patent.
link |
So MDMA was invented by Merck in 1912.
link |
It's in the public domain.
link |
These incentives are called data exclusivity,
link |
which means that if you make a drug into a medicine
link |
that has no patent protection,
link |
nobody can use your data for a period of time
link |
to market a generic.
link |
And that will effectively be,
link |
well, it's five years, you do pediatric studies,
link |
you get six months extension,
link |
and we are being required, if we succeed in adults,
link |
to work with adolescents with PTSD.
link |
It blocks a generic competitor
link |
from applying till that five and a half years is over,
link |
takes FDA at least six months to review.
link |
So more or less six years of data exclusivity,
link |
10 years in Europe is data exclusivity.
link |
So the story then became to the donors
link |
that you're not gonna have to give us money forever
link |
because we can make money selling MDMA,
link |
but we wanna do two revolutionary things, you could say.
link |
One is psychedelic assisted psychotherapy,
link |
but the other is marketing drugs.
link |
When you market it with the profit maximization motive,
link |
we end up in the extreme getting the distortions
link |
that we have in America,
link |
where we have the most expensive healthcare system
link |
in the world per capita,
link |
but our outcomes are down like 40 or 50 among the countries,
link |
our average outcomes.
link |
We don't have, third of the people or so
link |
don't have insurance, and it's just very inequitable.
link |
So what we're trying to do
link |
is show a different way to market drugs.
link |
And it's a modification of capitalism
link |
that's called the benefit corporation,
link |
where you maximize public benefit, not profit.
link |
You still make a profit.
link |
So selling MDMA for a profit
link |
is not something we could keep inside the nonprofit
link |
because it's taxable, it's a business.
link |
So we've created the MAPS Public Benefit Corporation,
link |
which is 100% owned by the nonprofit.
link |
So we have a nonprofit that owns a pharma company.
link |
And the mission of that pharma company
link |
is to maximize not profit,
link |
but maximize benefit for society.
link |
Although there still will be profits,
link |
and the profits that we're gonna make
link |
are going to be used towards the mission of MAPS,
link |
which is again, is this mass mental health
link |
and ending the drug war.
link |
And in fact, we've hired the Boston Consulting Group
link |
to help us plot our commercialization strategy.
link |
And so there is some suggestions based,
link |
there's so many different assumptions in this,
link |
the number of therapists that we train,
link |
the price that we set for the MDMA,
link |
whether insurance companies will cover it.
link |
But there's the possibility of somewhere in the range
link |
of three quarters of a billion dollars in profits
link |
during this period of data exclusivity,
link |
just from the US and we're talking about
link |
trying to do this research around the world as well.
link |
So that's what the Benefit Corporation is.
link |
The Benefit Corporation is our pharmaceutical arm.
link |
We're about 130 people now,
link |
somewhere in that fluctuates,
link |
but one third of them are in the nonprofit.
link |
We do harm reduction, psychedelic harm reduction.
link |
We help create programs for people
link |
with difficult psychedelic experiences
link |
at Burning Man, at festivals all over the world,
link |
even in cities we're now negotiating with the police,
link |
the city of Denver, because Denver has made the mushrooms
link |
the lowest enforcement priority.
link |
Oregon has passed the Oregon psilocybin initiative.
link |
So in those areas where maybe more people
link |
are gonna gravitate to do psychedelics,
link |
we want there to be harm reduction
link |
so that we don't have bad stories coming up
link |
that would change that.
link |
So MAPS does the psychedelic harm reduction.
link |
We do public education.
link |
We do a lot of it.
link |
That's what you and I are doing right now.
link |
We're doing that now.
link |
But also research towards.
link |
Well, the research now is done in the Benefit Corp.
link |
In the Benefit Corp.
link |
Yeah, so what happens is people donate to MAPS,
link |
get a tax deduction, MAPS transfers the money,
link |
or you could say invests in the Benefit Corp.
link |
The Benefit Corp will do the research
link |
and then MAPS is the sponsor,
link |
but then we will license the sale of MDMA
link |
to the Benefit Corp, so.
link |
Got it, but the research is done with an eye
link |
towards creating something that has a big impact
link |
versus just research for knowledge's sake.
link |
Yeah, yeah, because I'm interested in political change.
link |
The other part of it, which is that the brain
link |
is the most complex thing we know in the universe.
link |
I mean, when are we gonna really, like this idea of,
link |
will we figure out telepathy?
link |
Will we figure out tapping into the collective unconscious?
link |
What is the extents of our brain?
link |
How does the brain actually work?
link |
Do you ask chemistry questions?
link |
So if it's just the pursuit of knowledge,
link |
that is an endless thing.
link |
And how does that end the drug war?
link |
How does that help people directly?
link |
So that's why we're focused on drug development
link |
more than mechanism of action.
link |
Before I ask you about one,
link |
but several really exciting studies,
link |
let me ask sort of a personal question for me.
link |
So if I wanted to get psychedelics
link |
from the MAPS Public Benefit Corporation
link |
and explore my own mind, how do I get to do that?
link |
You won't be able to.
link |
You'll never be able to.
link |
This is very unfortunate.
link |
Because the reason is because the Benefit Corp
link |
is designed as a pharmaceutical company.
link |
So we can only work on clinical indication.
link |
So let's say you come to me and you just say,
link |
oh, I'm really depressed.
link |
Can I get MDMA to overcome my depression
link |
or overcome my PTSD?
link |
We'll have to do research in those indications.
link |
And by when you say me, you mean like a doctor.
link |
So this would be prescribed in theory by doctors.
link |
Well, this would go through a doctor and a prescription.
link |
Okay, let me ask another question.
link |
To further answer,
link |
so that's where the drug policy arm comes in,
link |
the drug policy reform.
link |
So you should be able to get access to psychedelics
link |
for your own personal growth.
link |
But that's not medicine.
link |
So that's why we need to medicalize,
link |
to have things covered by insurance,
link |
to change people's attitudes, the public attitudes.
link |
And then we get this subsequent drug policy reform.
link |
And we're talking about it
link |
in terms of licensed legalization.
link |
So my view is you should get a license to do psychedelics,
link |
you get a little education stuff,
link |
and then you should be able to buy it
link |
and do it on your own.
link |
So let me rephrase the question in more specifically.
link |
So when can I, if I happen to have ailments of some kind
link |
where the doctor decides that psychedelics could help,
link |
when would you be a loose estimate for you
link |
of when a doctor will be able to prescribe to me
link |
something from MAPS Public Benefit Co.
link |
And then when for my personal growth and creativity,
link |
would I be able to get something?
link |
So like, just looking out, this isn't like guaranteed,
link |
but like your vision, your hope for,
link |
yeah, for psychedelics in society.
link |
Well, the end of 2023, so two and a half years from now,
link |
we anticipate FDA approval
link |
for the prescription use of MDMA for PTSD.
link |
Because the FDA does not regulate the practice of medicine,
link |
there is what's called off label prescription.
link |
What that means, the label is what it's approved for.
link |
So the label will say, oh, this is approved for PTSD.
link |
But let's say you come and anything else, social anxiety
link |
or whatever, you can go to the doctor,
link |
they can give it to you.
link |
It might not be covered by insurance,
link |
they have to be a little bit careful about malpractice.
link |
But I think the end of 2023
link |
is when you will be able to do that.
link |
Now, there's actually another program, very limited,
link |
called Expanded Access, which is compassionate use,
link |
which means that, and we have approval for 50 people
link |
for compassionate use right now, we think that'll grow.
link |
So that's gonna open up in about two months.
link |
And so those are people with PTSD,
link |
they have to be treatment resistant,
link |
nothing has worked for them.
link |
And they can access MDMA
link |
while we're doing the phase three studies.
link |
But they have to pay for it themselves.
link |
The sponsor has to pay for all the research.
link |
But Expanded Access, because there's no control group,
link |
everybody gets the MDMA, people can pay for it themselves.
link |
And we think that'll start in a couple months.
link |
But it's very limited, it's limited to certain cities.
link |
There's also a program called Right to Try,
link |
which is passed through Congress.
link |
It's similar to this idea of compassionate use,
link |
but it cuts the FDA out of it.
link |
And patients can negotiate directly with pharma companies
link |
to get access to their drugs.
link |
That's starting to happen, I think, in Canada now,
link |
they're letting people have compassionate access
link |
to psilocybin for life threatening illness,
link |
because there has been studies with psilocybin
link |
for cancer patients and others with life threatening illness.
link |
As far as your question about when will you be able
link |
to access this for personal growth outside of medicine?
link |
I'll take that to mean fully legally,
link |
where you can just go buy pure drugs somewhere,
link |
when will that happen?
link |
We already are starting to see the decriminalization
link |
in certain areas of plant psychedelics.
link |
And we see overall drug decrim, like that passed in Oregon,
link |
so that any drug is now, it's not legal,
link |
you can't really fully set up clinics to offer it to people
link |
or there's no legal supply like that,
link |
but it's decriminalized.
link |
So my sense of things is based a lot on watching
link |
what happened with medical marijuana
link |
and marijuana legalization.
link |
So we're sitting here in Massachusetts
link |
where marijuana is legal,
link |
but what happened first was medical marijuana.
link |
So what we see is that medicalization,
link |
by demonstrating that under certain contexts,
link |
the risks are much less than the benefits,
link |
and then there are benefits,
link |
and then people hear stories about people
link |
that have gotten better,
link |
and then that changes their minds,
link |
and then eventually that builds up to why are we throwing
link |
people in jail for this?
link |
Just the culture, yeah.
link |
Yeah, so I think that what we're gonna have 2023
link |
is MDMA approved by the FDA, chances are.
link |
Psilocybin will be a year or two after that.
link |
Then what we're gonna need is a decade
link |
of psychedelic clinics that are gonna roll out
link |
across America, also other countries as well,
link |
thousands of these psychedelic clinics.
link |
We already have hundreds of ketamine clinics
link |
that are ketamine for depression.
link |
More and more people are realizing that ketamine,
link |
when it's used with therapy, it's better than when it's not.
link |
But the therapists wanna be psychedelic therapists.
link |
They don't wanna be a ketamine therapist or an MDMA therapist.
link |
So they'll be cross trained.
link |
So we will have a decade of these thousands
link |
of psychedelic clinics and all these stories
link |
of people getting better.
link |
And 2035 is when I think that we will move
link |
to licensed legalization, which is when you will
link |
have the option of just going somewhere
link |
once you've done this educational stuff.
link |
Potentially, I also think it would be better
link |
to have the opportunity for people to go for free,
link |
paid for by tax money, to these clinics,
link |
and you have your first experience
link |
with psychedelics under supervision.
link |
And you know what you're getting into.
link |
You've, you know, to ask the questionnaire,
link |
what the risks are with the drugs,
link |
then you get your license.
link |
So 2035 is when I think that'll happen.
link |
And the clinics will be sites of these initiations.
link |
And so it'd be a safe environment, just like you said,
link |
all the things that are actually maximize the likelihood
link |
of a pleasant experience and all those kinds of things.
link |
It is a frustratingly slow process.
link |
And the FDA being part of that process is very frustrating.
link |
But of course there's benefits,
link |
but boy, I wish it could move a lot faster.
link |
Yeah, well, one thing that I've learned
link |
from being a parent is that when you have little kids,
link |
it seems like they'll be with you forever.
link |
But then when they grow up and they go to college
link |
and they leave, do you look back and like,
link |
where did that 20 years go?
link |
You know, so we're still dealing with the legacy
link |
of the civil war and slavery in America.
link |
So actually a 20 year plan is not that long.
link |
So while we say it's frustratingly slow, and it is,
link |
I mean, it's 50 years since the psychedelic sixties.
link |
And right now it's 36 years since MDMA was criminalized.
link |
And you think about all those people that committed suicide
link |
from PTSD or from anything else.
link |
And all those people that could have been helped
link |
if the DEA had accepted the Administrative Law Judge
link |
recommendation that MDMA stay in schedule three.
link |
It's tremendously sad.
link |
At the same time, culture evolves slowly.
link |
You know, you read the Bible or you read all this stuff,
link |
we're not that different from people thousands of years ago.
link |
So how are we gonna really evolve enough
link |
over the next couple of decades
link |
so we don't destroy the planet and don't kill each other?
link |
That's why I think psychedelics have an important role
link |
to play, that's why I've devoted my life to psychedelics.
link |
And it is frustratingly slow.
link |
And what I said to myself is our whole effort
link |
has not been fast enough.
link |
Can we talk a little bit about PTSD and MDMA?
link |
There's this fascinating paper came out
link |
on a fascinating study that you're a part of.
link |
That's a phase three study.
link |
Can you describe what the study is?
link |
Can you describe what phase three means?
link |
Can you describe what the findings are
link |
and why it's in fact so important and impactful?
link |
Yeah, this study came out May 10th in Nature Medicine.
link |
So one of the highest impact factors in medicine,
link |
journals, it was tremendous.
link |
So to make a drug into a medicine,
link |
the first thing you need to do is what are called
link |
nonclinical or preclinical studies,
link |
meaning safety established in animals.
link |
What does the drug do?
link |
What are the side effects in animals?
link |
Where do you see the risks?
link |
And then you negotiate with FDA to do phase one studies.
link |
And phase one studies are where you move
link |
from animals to humans.
link |
And those are more safety studies
link |
and trying to describe what the drug does
link |
so that you can determine
link |
if there is potential medical value there.
link |
Certain drugs like cancer drugs are so toxic
link |
that you don't have phase one studies in healthy volunteers.
link |
That's like phase one slash two,
link |
where you bring in the patients,
link |
but you still are doing sort of dose response
link |
safety studies, but you use patients.
link |
But most phase one studies are healthy volunteers.
link |
Phase two are where you start bringing in the patients
link |
and you start experimenting with various different things.
link |
The purpose of phase two is really just to design phase three.
link |
Now, again, I'm sort of putting out of the picture
link |
in another area is mechanism of action.
link |
How do these drugs work?
link |
Phase two, you're trying to figure out what they do,
link |
who your patient population is, what are the risks,
link |
who do you include, who do you exclude,
link |
what are the doses, what is your treatment,
link |
what are your measures.
link |
In our case, it was how do you do a double blind study?
link |
That was a big part of phase two.
link |
That's a big challenge for psychedelic drugs.
link |
Any kind of drugs that have a real strong effect,
link |
how do you do a double blind study?
link |
The double blind, sorry to interrupt,
link |
would mean that the patient should not be aware
link |
whether it's a placebo or not.
link |
And the researcher.
link |
And the researcher is not aware.
link |
And so for that lack of awareness,
link |
when the effect is really strong,
link |
it's very difficult to do on both the researcher
link |
and the patient side.
link |
Yes, and sometimes they talk about triple blind.
link |
So the other part is the raters
link |
that evaluate the symptoms and before and after.
link |
So you ideally want triple blind.
link |
You want the patients, the researchers,
link |
and the evaluators of the outcomes, all of them,
link |
not to know what the drug, whether it was drug or placebo,
link |
and that's to reduce experiment or bias.
link |
And then you move to phase three,
link |
once you've figured out how to design the phase three studies.
link |
And phase three are the large scale multiple studies
link |
multi site, placebo controlled, double blind studies,
link |
where you must prove safety and efficacy
link |
in order to get permission to market the drug.
link |
Now, for us, when we started MAPS in 86,
link |
as I said, it was one year after the criminalization
link |
of MDMA in 85, we had five different protocols
link |
that were rejected by the FDA for studying with MDMA.
link |
And these were all various phase one studies.
link |
They came from Harvard, from UC San Francisco,
link |
from the University in Arizona,
link |
and Albuquerque, New Mexico, all over.
link |
And they were all rejected.
link |
1992, six years after we started,
link |
we got the first permission for phase one.
link |
And that took us through much of the 90s.
link |
Again, things are slow because we have to raise the money
link |
through donations.
link |
And then in 1999 is when we started the work with PTSD.
link |
And that then took us till November 29th, 2016,
link |
which is when we had the end of phase two meeting with FDA.
link |
So it took 30 years from the start of MAPS
link |
to the end of phase two meeting with FDA.
link |
And what we had discovered during phase two
link |
was several different key points.
link |
The drugs that are available right now for PTSD,
link |
the SSRIs, Zoloft and Paxil,
link |
that have been approved by FDA and regulators in Europe
link |
as well, the European Medicines Agency, for PTSD,
link |
they work better in women than in men,
link |
and they failed in combat related PTSD.
link |
All right, so what we learned is that MDMA assisted therapy
link |
works just as well in men or women,
link |
and it works in combat related PTSD.
link |
It works in regardless of the cause of PTSD.
link |
We also discovered that even though there are stories
link |
that people take MDMA at raves and they dance all night
link |
and they overheat and they get hypothermia
link |
and they die from overheating, which is true
link |
and can happen from pure MDMA,
link |
or that sometimes people have heard about
link |
needing to cool down and so they drink water
link |
and then while they're dancing all night
link |
and then they drink too much water
link |
and then they dilute their blood
link |
and they die from hyponatremia.
link |
So there are risks of MDMA, but we discovered
link |
that in a therapeutic setting,
link |
we can control all those risks,
link |
those things don't happen at all.
link |
So we discovered safety, we could demonstrate safety.
link |
We also figured out that our measure, the CAPS,
link |
the Clinician Administrative PTSD Scale,
link |
that it's the gold standard all over the world
link |
for measuring PTSD symptoms,
link |
it's what the FDA and the EMA require.
link |
We discovered that it was a good measure for us
link |
and that we could show changes in that.
link |
The other big thing that we learned is that,
link |
and we haven't mentioned this yet,
link |
but the work in the 50s and 60s with LSD and psilocybin
link |
and the modern research over the last 20 years
link |
with psilocybin and classic psychedelics
link |
has demonstrated that there's a link
link |
between this mystical experience,
link |
this unit of mystical experience and therapeutic outcomes
link |
for the treatment of addiction,
link |
for working with people with life threatening illnesses
link |
that for OCD, for Obsessive Compulsive Disorder,
link |
that there's with the classic psychedelics,
link |
both in the 50 years ago and then the research now
link |
has been that there's a link between the depth
link |
of the mystical experience and therapeutic outcome.
link |
What we discovered is that that's not the case for MDMA,
link |
that people do score fairly high
link |
on the scales of mystical experience,
link |
not as high as they do with the classic psychedelics,
link |
but they do score pretty high on average.
link |
And a significant number of them have over the cutoff
link |
for what would be considered a full mystical experience.
link |
So enough to say that we could look at a correlation
link |
and we didn't find any.
link |
The other thing that we discovered,
link |
and this was more humbling, I would say for me personally,
link |
is that my dissertation at the Kennedy School,
link |
a big part of it was on the,
link |
it's about the regulation of the medical use
link |
of psychedelics in marijuana.
link |
A big part of my dissertation was how to do
link |
the double blind study.
link |
And I thought I'd solve the problem
link |
and I persuaded my dissertation committee
link |
that I'd solve the problem.
link |
And the solution was therapy with low dose MDMA
link |
versus therapy with full dose MDMA.
link |
And everybody knows that they're gonna get MDMA,
link |
most of these people have never done it before,
link |
they'll be confused about is it full dose or low dose.
link |
And then the challenge is to pick a dose
link |
that's high enough so that there is this confusion,
link |
but not so high that it's so therapeutic
link |
that we can't tell the difference between the groups.
link |
So we studied zero, meaning inactive placebo,
link |
25 milligrams, 30 milligrams, 40 milligrams,
link |
50 milligrams, 75 milligrams, 100 milligrams,
link |
What we discovered is that my dissertation was wrong
link |
and that there is no good solution
link |
to the double blind problem.
link |
What we found is that, to our surprise actually,
link |
was that 75 milligrams was an effective dose.
link |
We didn't think that.
link |
I mean, the normal dose is like,
link |
full dose is like 125 milligrams, something like that.
link |
But 75 milligrams was an effective dose.
link |
And we discovered that the lower doses,
link |
so I was half right, you could say,
link |
the doses of 25, 30, 40, 50,
link |
they could produce enough confusion
link |
that you could say that they were successful at blinding,
link |
not perfectly, but enough confusion
link |
so that people, therapists, couldn't know for sure
link |
so that there was this reduction of bias, you could say.
link |
But what we discovered, again, to our surprise,
link |
was that the low doses made people uncomfortable.
link |
They stimulated them, but they didn't reduce the fear.
link |
And so people still got better
link |
with the therapy with low dose MDMA.
link |
But if we gave them therapy with inactive placebo,
link |
they did even better
link |
than if we gave them therapy with low dose MDMA.
link |
So we call it an anti therapeutic effect.
link |
I don't mean to imply that they got worse,
link |
but it made people uncomfortable.
link |
People didn't like it.
link |
But we would still help them make some progress.
link |
So we had the blinding,
link |
but what it meant by reducing the effect of therapy
link |
with inactive placebo is that it would make it easier
link |
for us to find a difference between the two groups.
link |
And so the real question is,
link |
if you can do it with therapy, why bother add a drug?
link |
So we went to the FDA,
link |
and so this was what we discovered during phase two.
link |
We went to the FDA at this end of phase two meeting,
link |
and we said, we can give you blinding,
link |
but it will make it easier for us
link |
to find a difference between the two groups.
link |
And so we suggest that we do therapy with inactive placebo
link |
versus therapy with full dose MDMA.
link |
That will cause a problem
link |
because most people will be able to tell what they've got.
link |
What Tom Loughran, a doctor
link |
who used to be head of psychiatry products at FDA
link |
is our main advisor.
link |
So the first thing he said
link |
is that the double blind fails in practice a lot,
link |
because there's certain side effects
link |
that you have with these drugs.
link |
And the doctors who are doing these research
link |
when you're reporting your side effects,
link |
they can say, oh, that's probably,
link |
you got the active drug instead of the placebo.
link |
So the double blind is in theory is terrific,
link |
but in practice, it doesn't always work quite as well.
link |
And so what Tom said is that there are two main approaches
link |
that they think are important to reduce bias.
link |
The first one is easy to do.
link |
It's called random assignment.
link |
So sometimes there are studies
link |
where you'll treat a bunch of people with something
link |
and some fraction of them will get better and some won't.
link |
And then you say, okay, all those who didn't get better,
link |
who volunteers to get this new treatment?
link |
And then you give them the new treatment,
link |
but the people that volunteer
link |
are more likely to wanna get better.
link |
They're not representative sample of everybody that has.
link |
So when you have random assignment,
link |
everybody is similarly motivated
link |
and meets the same inclusion, exclusion criteria.
link |
So that's what we told,
link |
of course we need random assignment.
link |
The other part was when the bias double blind
link |
doesn't work as well,
link |
then the system of independent raters
link |
is especially important of how you do that.
link |
So we have over a pool of raters, over 20 of them,
link |
and we do this monthly interrater reliability tests
link |
to make sure that they evaluate this,
link |
so that they're given a videotape of a PTSD patient
link |
and then they're supposed to rate them
link |
according to their symptoms.
link |
And then we sort of make sure
link |
that we've got this calibrated rater pool
link |
and it's all done by Zoom, by telemedicine,
link |
and they're randomly assigned to the next person
link |
that needs a rating.
link |
So they said 20 raters.
link |
So we've got like 20 raters
link |
and what we wanna do is make it so that each rater
link |
sees each patient only once, maybe twice,
link |
but not tracking them through the study.
link |
So that tries to reduce the bias in the raters
link |
that they don't know where this person is in the study.
link |
And so there's a fellow, Bob Temple,
link |
who's like the old wise man at the FDA.
link |
He's been there since 1972.
link |
He was in charge of the Office of Science Policy
link |
and they brought him into the final meeting of this process
link |
where we are trying to design phase three.
link |
So once FDA said, yes, you can go to phase three,
link |
that was November 29th, 2016,
link |
we then negotiated for eight months
link |
on the design of phase three
link |
and all of the other information that FDA is gonna need.
link |
This process of design.
link |
To the extent that I have any artistic creativity,
link |
it's in protocol design.
link |
I really love that.
link |
So you enjoy this process.
link |
I love it because it's always trade offs
link |
and I acknowledge that we are all biased.
link |
And so how do you,
link |
there's something beautiful about the scientific process
link |
designed to get you to the truth.
link |
Especially when that scientific process
link |
is trying to get to the truth of the human organism,
link |
which is so complicated.
link |
So it's very difficult to dissect,
link |
to get the strong effects.
link |
And when you're analyzing,
link |
when you have like raters, they're watching a video.
link |
Removing subjectivity from that is very, very challenging.
link |
Yeah, very much so.
link |
And so we came to this agreement with FDA though
link |
that we would use this independent rater pool.
link |
And so we learned in phase two again,
link |
that the double blind,
link |
there was no solution to the double blind problem.
link |
And both the FDA and the European Medicines Agency
link |
in the end agreed that the best design
link |
was therapy with inactive placebo
link |
versus therapy with full dose MDMA,
link |
accepting the fact that most people will be able to tell
link |
whether they got nothing or they got full dose MDMA.
link |
Most therapists will be able to tell the difference,
link |
but that makes a harder test for us
link |
to show a difference between the two groups
link |
because we're giving them inactive placebo
link |
and not the anti therapeutic effect of low dose MDMA.
link |
So once we started phase three,
link |
so then we were able to start in 2018 phase three.
link |
And the paper in Nature Medicine that just came out
link |
was the results of our first phase three study.
link |
We came to agreement with FDA
link |
that we would do two phase three studies,
link |
each would have 100 persons in them.
link |
And what the FDA said to us is that they thought
link |
that we could prove efficacy with smaller numbers
link |
than they wanted to see for safety.
link |
The reason they said that is it in phase two,
link |
we had a large effect size.
link |
So from a statistical point of view,
link |
the bigger of an effect that you're looking for,
link |
the fewer number of people you need
link |
to get statistical significance.
link |
When you're trying to find small differences,
link |
you need large numbers of people
link |
to sort of work out the noise.
link |
So we came to agreement on two 100 person phase three studies.
link |
And the idea is that it's very possible
link |
that the first study would show the efficacy
link |
because the effect is so strong.
link |
Yeah, yeah, and the second, but also safety as well.
link |
So one of the things we also realized
link |
when you work with a highly stigmatized drug
link |
in the midst of still the drug war and prohibition
link |
that we need highly sympathetic subjects
link |
and we need to make the best case we can,
link |
which means we need to work with the hardest cases
link |
so that this is really needed.
link |
And so we end up enrolling people.
link |
The first study was chronic severe PTSD.
link |
And unlike many studies of PTSD,
link |
we enroll people that have previously attempted suicide.
link |
So we have multiple people
link |
that have tried to kill themselves
link |
that we felt like if we were to exclude them,
link |
what are we doing?
link |
Those are the people that need it the most.
link |
So we came to this agreement with FDA.
link |
We're gonna work with chronic severe PTSD patients,
link |
including those that had attempted suicide.
link |
And we would do these two 100 person studies.
link |
And we also negotiated what's called an interim analysis.
link |
So what that means is that
link |
when the study is underway,
link |
and often big, big studies,
link |
they have this kind of interim analysis
link |
where what you do is,
link |
and for us, we negotiate when we had 60% or 60 people
link |
had reached the primary outcome measure
link |
and all 100 had been enrolled,
link |
then we would take a look at the data.
link |
And if the statistical analysis that we did
link |
was showing based on a certain effect size that we chose
link |
based on what we saw in phase two,
link |
the interim analysis
link |
is for what's called sample size reestimation.
link |
So what it means is if the results aren't as good
link |
as you thought they would, you can add more people.
link |
And then you'll get statistical significance.
link |
It means that your effect isn't as strong as you thought.
link |
It'll be harder to get insurance to cover it,
link |
but FDA will still approve it
link |
because FDA also believes that these are group averages.
link |
There may be some people that will later figure out
link |
respond better than others.
link |
So they'll approve it if it's statistically significant,
link |
even if it has a low effect size.
link |
The SSRIs have low effect size.
link |
So we did the interim analysis in March of 2020.
link |
And what we discovered to our delight
link |
was that we did not need to add any subjects.
link |
That's all we were told.
link |
We weren't told like, what is the results?
link |
We were just told all we were gonna get is a number, zero,
link |
or you need to add X numbers of people to the study
link |
to get statistical significance.
link |
That's right around the time that COVID hit
link |
and lockdowns happened.
link |
And we ended up negotiating with FDA
link |
that we would end the study with 90 people instead of 100.
link |
It took a while for us to end up doing that.
link |
So the paper that we just published
link |
is on the results of 90 people.
link |
I think it was 46 in the MDMA group,
link |
44 in the placebo group.
link |
And what we discovered was that the study worked better
link |
than we had even hoped.
link |
So the first thing is that
link |
you look at statistical significance.
link |
You have to get 0.05,
link |
which basically means a nickel out of a dollar,
link |
a one in 20 chance that the difference
link |
between the two groups is due to some random factor
link |
rather than to your intervention.
link |
And in this case, the placebo group gets therapy
link |
and then with inactive placebo
link |
and then the group gets MDMA with active placebo.
link |
So you have to get 0.05.
link |
There's another measure
link |
that the FDA uses sometimes called robust,
link |
which means one in a thousand,
link |
instead of one in 20, one in a thousand.
link |
And if you get a robust results, 0.001,
link |
and you meet some other criteria,
link |
they might agree to approve the drug
link |
on the basis of just one phase three study instead of two.
link |
Because when you think about it,
link |
a one in 20 chance for your first phase three study,
link |
a one in 20 chance for your second phase three study,
link |
you multiply that together, it's one in 400, 0.025.
link |
So that's pretty good.
link |
So robust 0.001 is even better
link |
than two independent phase three studies, each at 0.05.
link |
What we ended up getting was one in 10,000, 0.0001.
link |
Outrageous, incredibly.
link |
So that's a measure of both the difference
link |
between the two groups and the variability.
link |
And so what it meant is that we had minimal variability,
link |
that most people who got the MDA
link |
got quite a large amount of benefit from it.
link |
And most people who got the placebo
link |
were more or less in the same range as well.
link |
That's really exciting, by the way.
link |
I mean, I suppose it's exciting
link |
from a perspective of approval by the FDA.
link |
Maybe perhaps that's the way you're seeing it,
link |
but it's also exciting because it has a chance
link |
to help people that are truly suffering, yeah.
link |
Well, if we can get one in 10,000
link |
in the first phase three study,
link |
chances are we can get one in 20 in the second.
link |
So it's really gonna be about safety for us
link |
in the second phase three study.
link |
Now, you can have a large P value, a large significance,
link |
but you could have an effect that's not very significant.
link |
It's not clinically significant.
link |
You can have statistical significance
link |
without clinical significance.
link |
And as I said, the more people you get in the study,
link |
you can find smaller and smaller differences
link |
between two groups.
link |
Now, we showed that we had a very large effect size.
link |
So effect size is based on...
link |
That scale you mentioned?
link |
Well, the scale of the effect size
link |
is based on standard deviations.
link |
So an effect size of one means that your results
link |
are one standard deviation away from the norm.
link |
That's considered very large.
link |
The SSRIs, because they were like 0.3, 0.4 effect size,
link |
that's considered small effect size.
link |
Medium is starting to be around 0.6
link |
and 0.8 and above are large effect sizes.
link |
We had what's called placebo subtracted effect size.
link |
There's two different ways to look at it.
link |
Placebo subtracted means you kind of look at the difference
link |
between your two groups.
link |
And what that is for us, since one group had therapy
link |
and one had therapy plus MDMA,
link |
the placebo subtracted effect size
link |
is basically the effect of just the MDMA
link |
because you've kind of washed out the therapy.
link |
So we had a large effect size, which was different.
link |
Wow, so 0.91 over just the therapy, so over the placebo.
link |
Now, when we do the within group,
link |
meaning the group that just got the MDMA plus therapy,
link |
look at their baseline and their outcomes.
link |
That's another way to look at it.
link |
And that's what's gonna actually happen in practice
link |
because people are gonna get MDMA plus therapy.
link |
That's 2.1 effect size.
link |
Two standard deviations away from the norm
link |
is enormous effect size.
link |
The other part is that we had no effect by site,
link |
which is very important.
link |
So we had 15 sites, two in Israel, two in Canada,
link |
11 throughout the United States.
link |
The FDA looks at, is there a side effect?
link |
Because what that might mean is
link |
maybe you've got all your patients
link |
or most of your patients going to this one site,
link |
which is these highly experienced therapists
link |
and they're like hippies from way back
link |
and they're super experienced with psychedelics
link |
and they're getting great results,
link |
but nobody else gets good results.
link |
So we had no effect by site.
link |
That's incredible.
link |
That we've been able to train all these new therapists.
link |
We had about 80 therapists working at all these 15 sites.
link |
We also discovered that there's a group
link |
that's considered to be very difficult to treat,
link |
which is called the dissociative subtype.
link |
So when people are traumatized,
link |
one of the ways to psychologically survive that
link |
is you dissociate.
link |
It's like you're not there.
link |
When you do that though, it's hard to come back
link |
because when you come back,
link |
then you get all these painful memories and fearful.
link |
And so the extreme of that
link |
is called dissociative identity disorder,
link |
kind of like schizophrenia, almost dissociative identity.
link |
So we let people in who are on the dissociative subtype
link |
and those are considered to be the hardest to treat
link |
because the theory is that you need to be ego intact.
link |
As I said, the mystical experience is not correlated
link |
with therapeutic outcomes.
link |
And you need to be talking about what traumatized you
link |
and working through that and expressing it,
link |
letting it out, not keeping it in.
link |
So the dissociative subtype seems like it's harder
link |
for them to get back into the event
link |
because they're so dissociated.
link |
What we showed is that those people did even better
link |
on average than everybody else.
link |
So that MDMA is integrative.
link |
It helps people who are so separate
link |
that they make even more rapid progress.
link |
So it's almost like the MDMA made it more difficult
link |
for them to dissociate.
link |
Yeah, or you could say it made it easier
link |
for them to remember.
link |
To reverse the dissociation.
link |
And we find that MDMA enhances memory for the trauma
link |
so that you can have these unconscious memories
link |
or memories that you cannot remember
link |
or that you've suppressed so much,
link |
but they distort your view.
link |
Your filter of the world is distorted
link |
by these fearful memories that the world can't be trusted.
link |
People can't be trusted.
link |
It's always about to happen.
link |
So we find that MDMA increases memory for the trauma,
link |
but by reducing the fear,
link |
then the memories can come to the surface.
link |
Then you can process them, let out the emotions,
link |
cry, scream, shake, whatever.
link |
And then through this MDMA effect
link |
on the amygdala and the hippocampus,
link |
it helps you store these memories into longterm storage
link |
so that they're not always about to happen.
link |
They're in the past.
link |
They're part of your story, but they're not the whole story.
link |
So we discovered that the dissociative subtype works better.
link |
Now, none of this would be enough unless safety.
link |
So from a safety perspective,
link |
what we discovered is that there was one woman in the study
link |
that attempted to kill herself twice during the study.
link |
There was another woman that was so worried
link |
that she might kill herself,
link |
that the therapy brought these things to the surface
link |
that she's been pushing away,
link |
that she checked herself into a hospital
link |
in order to avoid self harm.
link |
At the end of the study,
link |
what we learned is both of them were in the placebo group.
link |
We didn't have anybody in the MDMA group
link |
attempt to kill themselves.
link |
So the MDMA is really helpful
link |
for giving people a sense of hope
link |
and that they can somehow process this.
link |
Now, it's not to say that nobody will ever commit suicide.
link |
That's our big concern in the second phase three study.
link |
As I said, it's more gonna be about safety
link |
than about efficacy.
link |
We think we'll get the efficacy,
link |
but we're very concerned about safety.
link |
Because we had problems in the first phase three study
link |
of somebody trying to kill herself twice
link |
in the placebo group,
link |
it's the background for having PTSD.
link |
So there'd have to be a disproportionate number of people
link |
in the MDMA group try to kill themselves
link |
or succeed in killing themselves
link |
than in the placebo group for the FDA to say,
link |
oh, this MDMA, it's too dangerous.
link |
We don't think that's gonna happen.
link |
So the other findings from safety
link |
is that the side effects are transitory.
link |
They're minor, they're sweating or jaw clenching
link |
or a slight temperature increase.
link |
And everybody that's been to a rave knows about it.
link |
Take an ecstasy, there are some side effects.
link |
But they're minor, they're transitory
link |
and there has been this massive problem
link |
of during the eighties, the nineties,
link |
NIDA, the National Institute on Drug Abuse
link |
was trying to say that MDMA was neurotoxic
link |
and that you take it
link |
and it's gonna cause nerve terminal degeneration.
link |
It's gonna be major brain damage.
link |
It's gonna be significant functional consequences.
link |
And back then they were saying that MDMA is too dangerous.
link |
It should never even be researched.
link |
Nobody should even get it once
link |
because it's poison and brain damage.
link |
Well, we no longer believe that, that was exaggerated.
link |
That was in service of the drug war.
link |
But we've done in phase two neurocognitive tests
link |
before and after in two of our different sites
link |
and showed no decline in cognitive functioning.
link |
So we don't think that there's any neurotoxicity happening
link |
and the doses that we use.
link |
There's no obvious functional consequences.
link |
People are getting better.
link |
And the other thing that we've learned in phase two
link |
and that we still have to learn from this study.
link |
So what we showed is the durability of the effect.
link |
We showed that 32% of the people
link |
that got the therapy without MDMA
link |
at two months after the last experimental session
link |
no longer had PTSD.
link |
Just with the therapy, which is phenomenal
link |
because these are on average 14 years PTSD,
link |
one third had PTSD over 20 years.
link |
And just with the therapy,
link |
32% no longer had PTSD at the two months.
link |
However, those people that got MDMA, it was 67%.
link |
No longer had PTSD, more than twice as good.
link |
In phase two and in phase three,
link |
we're also gonna do the 12 month followup.
link |
That's not for the FDA.
link |
That's not for approvability.
link |
That's more for insurance companies
link |
because this is expensive, a lot of therapy time.
link |
If it fades, if it's great results initially
link |
but then it fades after six months, what's the point?
link |
And what we showed in phase two
link |
is that people keep getting better.
link |
At the two month followup, they're doing pretty well
link |
but at the 12 month followup, they're even better.
link |
People have learned how to process trauma.
link |
They keep getting better.
link |
So we've not reached that point in this phase three study
link |
where everybody's got their one year followup.
link |
But we have also done three and a half year followups
link |
to some of the groups that were in phase two
link |
and showed that it was durable.
link |
And we're doing a long term followup now
link |
to many of the people in phase two,
link |
some of them treated 15 years ago.
link |
So that's all more for the insurance companies.
link |
So basically what we found in the paper
link |
that we just published is that it was highly efficacious,
link |
highly significant, no effect by sight,
link |
works in the hardest cases and the safety record was great.
link |
That's an incredible success.
link |
And that's really exciting, especially given
link |
that the people who've committed, who attempted
link |
to commit suicide were let into the study.
link |
And so these are people who are truly suffering.
link |
I mean, that's incredibly exciting.
link |
And I mean, just to speak to the frustration
link |
why things can't move faster,
link |
but for what it is, it's incredibly exciting.
link |
Is there other studies of this nature
link |
that you foresee enabling that same kind
link |
of positive impact, whether it's MDMA
link |
for other things like treating addiction,
link |
or maybe it's psilocybin for other conditions?
link |
Is there something else that's promising?
link |
Yeah, I think that what we've discovered
link |
I don't think is unique to MDMA.
link |
So it's MDMA assisted psychotherapy.
link |
MDMA is ideal for PTSD.
link |
Maybe it won't work as well for OCD or other things.
link |
It was very strategic why we chose MDMA
link |
and why we chose PTSD.
link |
But I don't think that the results that we've got
link |
are so unique to MDMA assisted therapy.
link |
I think that psilocybin assisted therapy
link |
is gonna be great for people
link |
with life threatening illnesses,
link |
cancer who are anxious about dying.
link |
It looks like it's really good
link |
in the treatment of addiction.
link |
Again, these are in combination
link |
with sort of the psilocybin tobacco
link |
is cognitive behavioral therapy with psilocybin.
link |
I think that it's gonna be a little bit more difficult,
link |
psilocybin for depression.
link |
I don't know if it'll be quite as good.
link |
There are some biological aspects sometimes to depression,
link |
but I think that there'll be really good results
link |
for psilocybin for depression.
link |
I think it'll be approved.
link |
It's considered a breakthrough therapy by the FDA.
link |
Ibogaine is phenomenal for opiate addiction,
link |
helping people go through withdrawal
link |
and then giving them this chance
link |
to deal with the material that drives them for addiction.
link |
There was Ben Sessa, Dr. Ben Sessa in England
link |
did MDMA for alcohol use disorder.
link |
And that was really great, the results he got.
link |
And it's the case that he ended up
link |
basically treating people for trauma.
link |
It's the trauma that people run,
link |
the emotional challenges that people run from
link |
into quieting that pain through drug addiction or alcoholism.
link |
So trauma is behind a lot of addiction.
link |
I think that we are going to see a revolution in psychiatry
link |
and that there will be a lot of conditions
link |
that have left a lot of people still suffering
link |
that psychedelic assisted therapy,
link |
different psychedelics, different approaches.
link |
But I think that we will see a lot of hope
link |
for psychiatry and psychotherapy
link |
and that psychedelics would be a big part
link |
of changing the practice of psychiatry and psychotherapy.
link |
Yeah, this is really to me fascinating.
link |
So I actually, when I was younger,
link |
for the longest time, wanted to be a psychiatrist.
link |
So I was excited by psychotherapy,
link |
but then I perhaps incorrectly, maybe you can correct me,
link |
but became more and more cynical
link |
because it felt like it was more about prescribing drugs
link |
than psychotherapy.
link |
I'm not going to correct you.
link |
I mean, right now, there is a crisis in psychiatry
link |
that there are so many psychiatrists that are so fed up
link |
because they have been pharmaceuticalized.
link |
They meet people for 15 minutes,
link |
they adjust their medications.
link |
This is the way they make the most money,
link |
but they've lost the art of talking to people.
link |
And that's why we see that so many young psychiatric
link |
residents are so thrilled by psychedelics
link |
that they really want to get back to treating people
link |
as individuals, not just a bunch of chemicals.
link |
Yeah, that's truly fascinating.
link |
Because the reason it was appealing to me,
link |
it was a way to study the human mind
link |
and to see ways through talking
link |
that you can make people feel better,
link |
make people better, make people suffer less.
link |
And that was really exciting at the time.
link |
I ended up then going to AI because then
link |
I can understand the mind from that angle.
link |
But it's exciting that that could be also
link |
revolutionized the field of psychotherapy,
link |
take it from its back to its origins,
link |
to where a psychiatrist would be a scholar of the mind.
link |
Yeah, well, Freud talked about dreams
link |
as the railroad to the unconscious.
link |
And there was a lot of,
link |
you really spent a lot of time with people.
link |
Now, right before he died, in his last book,
link |
Freud wrote something, and again,
link |
this will be a rough paraphrase,
link |
but he said that in the future,
link |
we may learn about the energies of the brain
link |
and there'll be ways with chemicals to influence that
link |
that will help the therapeutic process.
link |
So you could say he was ahead of his time.
link |
This study paints a fascinating picture of a future
link |
where first for medical applications,
link |
but then also in general, psychedelics of various forms
link |
could be used by the broader society.
link |
Forgive the perhaps ridiculous question,
link |
but if much of society, including our politicians,
link |
are taking psychedelics and dissolving their ego
link |
and going through this whole process,
link |
how do you think the world may look different
link |
in 20, 30, 50 years?
link |
Ah, okay, so I said that I think
link |
licensed legalization happens in 2035.
link |
And I think by 2050, we will have enough people,
link |
hopefully, spiritualized.
link |
We're also talking about,
link |
we hear so much in terms of climate change
link |
about net zero carbon.
link |
So our goal is net zero trauma.
link |
When do we have a world with net zero trauma?
link |
I mean, right now, we have two sites in Israel.
link |
So we help a few people,
link |
but the recent war with Gaza has traumatized
link |
millions of people on both sides.
link |
So we are a long way away from net zero trauma.
link |
But that's the hope, and that's, I think, possible.
link |
I think humanity as a whole
link |
is like lemmings heading over a cliff
link |
with climate change and with the nuclear proliferation
link |
and just the religious hatreds
link |
and the more the retreat to authoritarianism
link |
and fundamentalism and tribalism.
link |
So I think that there's a very good chance, though,
link |
that psychedelics used wisely.
link |
So it's not just make psychedelics legal
link |
and everybody takes them,
link |
as you talked about Ted Kaczynski.
link |
It's the context that people take it in.
link |
But I think that there's a reasonable chance
link |
that enough people can,
link |
sort of, you could say, clean their filters
link |
to see people as more similar to them than different,
link |
not to label them as the enemy.
link |
Stan Groff, again, had this beautiful phrase
link |
about transparent to the transcendent.
link |
That's what, so for our ego,
link |
can we be transparent to the transcendent?
link |
Can the filter that we look through the world at
link |
be cleaned to, you could say,
link |
cleansing the doors of perception?
link |
Can it be cleaned to the point where we can see
link |
the humanity in everybody and see that,
link |
one way to say this is that,
link |
can we get to the point where religions
link |
are seen as like languages?
link |
Where we all have this need to communicate,
link |
there's thousands of different languages,
link |
we don't say that this language
link |
is fundamentally better than this language,
link |
this language is the only right language,
link |
everybody must speak English
link |
and Russian is bad or German is better.
link |
Maybe we'll get to that point that religions are like that,
link |
that there are different cultural backgrounds,
link |
different symbol systems,
link |
different saints and heroes and messiahs and all this,
link |
but that, yeah, Jesus is the son of God,
link |
but so is everybody.
link |
Or the Jews are the chosen people, but so is everybody.
link |
So can we get there?
link |
I think that we can.
link |
And I think that we need to,
link |
to survive the challenges that we're facing.
link |
And the hope is that by bringing psychedelics
link |
as tools forward and trying to bring the context around them
link |
to be one of responsibility
link |
rather than just profit maximization
link |
and just get as many people to do them
link |
from all these for profit companies,
link |
can we, and then also drug policy reform
link |
and embed knowledge in the society,
link |
can we get to honest drug education?
link |
DARE, the Drug Awareness Resistance Education,
link |
is fundamentally twisted.
link |
But it's the program that's used in a lot of schools now.
link |
So can we get honest drug education,
link |
pure drugs, harm reduction,
link |
and knowledge about therapeutic uses
link |
and on the one hand,
link |
and more of these thousands of psychedelic clinics?
link |
I'm hopeful and that's our goal.
link |
But in this landscape of pharma companies,
link |
they make a lot of money.
link |
Some people are worried about the impact
link |
of those, you know, of big pharma
link |
on the landscape of human trauma.
link |
So there's, of course, some companies could do good,
link |
but that's not inherent,
link |
like many of these companies are not optimizing for good,
link |
they're optimizing for profit.
link |
Does this rise of for profit pharma companies worry you?
link |
How do you navigate it?
link |
Do we still have for profit companies
link |
that basically do what MAPS does,
link |
which is like fight the good fight
link |
for the benefit of humanity?
link |
Like how do we proceed in this,
link |
in landscape where drugs can make a lot of money?
link |
Well, I am concerned.
link |
Overall, I think the rise of the for profit companies,
link |
we have to realize is a sign of success,
link |
that we have overcome the regulatory prohibitions,
link |
we've overcome a lot of the public attitudes
link |
that are against it, we've demonstrated some success.
link |
So the rise of the for profit companies
link |
are a sign of the progress that we've made.
link |
On the other hand, turning things over
link |
to profit maximizing companies,
link |
the big concern is that they're gonna try
link |
to minimize the amount of therapy
link |
and make it so the cost is less,
link |
so insurance companies are more likely to cover it
link |
and then that they just sell the most drugs.
link |
The other thing we've seen as an example of this
link |
is S ketamine by Johnson and Johnson for depression.
link |
And it's done by a profit maximizing company.
link |
They don't know anything about psychedelic psychotherapy
link |
or psychotherapy at all.
link |
And so they've gotten approval for S ketamine
link |
on the basis of it's just a pharmacological treatment
link |
and it's not delivered with therapy,
link |
the results fade pretty quickly,
link |
so you need to get more ketamine.
link |
And so it's designed in a way to maximize the profits
link |
for the pharmaceutical company,
link |
but it doesn't maximize patient outcomes.
link |
What we're seeing though in these various clinics
link |
that are being set up is that a lot of people are realizing
link |
that it works better with therapy.
link |
And so the clinics are run by people that are therapists
link |
so that when they provide therapy,
link |
they're making more money and then you need less ketamine.
link |
Also ketamine itself, S ketamine is a isomer of ketamine
link |
that's been patented for depression
link |
and they sell it for hundreds of dollars,
link |
but ketamine itself
link |
is one of the world's essential medicines.
link |
It's off patent, it's been around for a long time,
link |
it was the main battlefield anesthetic in Vietnam.
link |
And it's only a few bucks because it's generic.
link |
So a lot of the ketamine clinics are saying,
link |
great, thank you, Johnson and Johnson,
link |
you've helped demonstrate that ketamine is good
link |
for depression, but we're not gonna buy it from you.
link |
We're gonna buy it for a few bucks
link |
and we're gonna add therapy to it.
link |
Now there's a bunch of ketamine mills you could say
link |
that are just prescribing the ketamine
link |
and people are making a lot of money there.
link |
So I am worried about that.
link |
I think the best thing that we can do
link |
is create an alternative narrative,
link |
a different kind of example.
link |
We can lead by example.
link |
We can't make for profit companies
link |
into benefit corporations unless they wanna do that.
link |
We can't make them to really maximize patient outcomes.
link |
But if we create an example of something that's different,
link |
the hope is that people will gravitate towards that
link |
and some of the other companies.
link |
Like even now we have Exxon and other these companies,
link |
oil companies saying, oh, we're big
link |
into alternative energy and we're, you know.
link |
And that starts with companies that show an example
link |
that then communicates to the public
link |
that this is something exciting
link |
and then they demand the same of Exxon and so on.
link |
The public demands it and you could say the same thing
link |
for the public demanding the big pharma
link |
to optimize for benefit versus optimize for profit
link |
and maybe giving power to the therapists,
link |
more power to the therapists, more power to the doctors
link |
that ultimately want.
link |
I think incentives are interesting,
link |
but I think doctors ultimately care more
link |
because they're in direct contact with humans.
link |
They want to make people better.
link |
It's not, you know, sure they wanna make money,
link |
but they ultimately want to make people feel better
link |
because they get to look at people
link |
and it's so joyful to make people feel better
link |
at the end of the day.
link |
So giving more power to them is also perhaps
link |
one of the ways that you then incentivize
link |
the pharma companies that are trying to do good
link |
because the doctors will choose those companies.
link |
Yeah, now the other part of this is drug policy reform.
link |
So that if we make it so that you can buy MDMA
link |
for 10 or 20 bucks on your own
link |
and we've trained people on here's our therapeutic method,
link |
here is our ways for peer support,
link |
then people have an alternative from buying it
link |
from the pharma companies.
link |
So most of the for profit companies
link |
have come to this conclusion
link |
that drug policy reform is bad for their business model.
link |
I think they're making a fundamental mistake.
link |
And I think the reason is that
link |
the more that we de stigmatize this,
link |
the more that we sensitize people to this is an approach,
link |
even when people can get it on their own
link |
and do it with their friends or do it with themselves,
link |
there's gonna be even more people that say,
link |
oh my God, I've got real serious issues.
link |
I would rather go to trained professionals
link |
covered by insurance.
link |
And I think it'll increase the business,
link |
but most of the for profit companies don't see it that way.
link |
And so as a nonprofit that owns a benefit corp,
link |
we're not trying to maximize sales or profits.
link |
But I do believe that drug policy reform
link |
creates this alternative access point for people
link |
and that will help keep the for profits in check
link |
to some extent as well.
link |
Let's put on your wise visionary hat
link |
and ask when you look to young folks,
link |
is there advice you can give to young people today,
link |
whether in high school or college about career, about life?
link |
You've lived quite a nonlinear
link |
and fascinating life yourself.
link |
Is there advice you can give
link |
either on career or more generally on life?
link |
Well, I would say what people often hear is that,
link |
we're not actually here for that long a period of time.
link |
And the world is on fire.
link |
And whether humanity survives is not clear.
link |
And how many species are we gonna kill
link |
before we figure out not to do that anymore?
link |
So I would advise you to really try to
link |
develop a combination of what do you need
link |
in terms of income for your own survival,
link |
but what does the world need in terms of
link |
help to make the world better?
link |
And Howard Thurman, who we talked about,
link |
who ran the Good Friday experiment, the minister there,
link |
he said, he's got a famous quote attributed to him.
link |
He says, and this is exactly it to young people.
link |
He said, there's nothing particular that you should do,
link |
but find what makes you come alive
link |
because what the world needs is people
link |
that have come alive and are passionate.
link |
So I would say that be aware of this trap
link |
that you need vast resources, that you need all this stuff.
link |
I keep thinking of the super wealthy people
link |
in first class on the Titanic,
link |
as the Titanic is sinking.
link |
Their money's not gonna help them.
link |
The Earth is like Titanic.
link |
We're sinking, we're destroying the planets,
link |
destroying the environment.
link |
So you need a certain amount of money to be comfortable
link |
to be able to do that.
link |
You need to be comfortable to not be
link |
at that edge of survival,
link |
because once you're at that edge of survival,
link |
it's hard to think about anything else.
link |
But I'd say to young people,
link |
to the extent that you're able to do this,
link |
and again, student debt and all this kind of stuff
link |
is a big problem there too,
link |
but really just try to find this combination
link |
of what the world needs and what you need.
link |
The other thing to say to young people is
link |
that life is a lot shorter than you think,
link |
and a 20 year plan is not really that long.
link |
So if it takes you 20 years to get in a position
link |
to do what you wanna do, go for it.
link |
Have longterm plans.
link |
The other part that was so important for me
link |
to keep doing what I've been doing,
link |
basically now it's 49 years
link |
that I've sort of been devoting my life
link |
on psychedelics since I was 18.
link |
But when I started, I didn't think it would ever work.
link |
I just thought this is the only idea I have
link |
in this crazy world, this is what I wanna work on.
link |
Luckily, I had support from my family
link |
that took care of my survival needs, so I could do that.
link |
But I realized that if my happiness