“The mission of Mind Body Health & Politics is to expand consciousness, stimulate thought, enhance mental and physical health, and encourage community.” — Dr. Richard L. Miller
A leading psychedelic researcher shares findings from his studies on adverse effects to inform guidelines and safety protocols
As a young psychologist in the 1950s, I saw the promising early research into psychedelic therapy. But a cultural backlash soon led to the criminalization of these substances. By the 1970s, the research had ground to a halt.
For decades, researchers had to lobby their own governments for permission to perform basic science. Beginning in the 2000s, however, a few pioneering researchers started to resume clinical trials against strong headwinds.
My first book, Psychedelic Medicine, documents those early studies, which paved the way for today’s renaissance, which is being led by a new generation of research talent. My guest this week, Dr. Robin Carhart-Harris, was born in 1980, meaning he was going through medical school just as the renaissance was beginning. He became a full professor at 40, and at 43, is already one of the most-cited researchers in the world.
Tune in for this healthy conversation at TalkRadio.nyc
In this episode of Mind, Body, Health, & Politics, Dr. Miller is joined by guest Dr. Robin Carhart-Harris as they will be discussing the psychedelic renaissance and the overall timeline of its research, amongst other similar topics. To start the episode, Dr. Miller asks why Dr. Harris decided to come and live in America along with discussing some of Dr. Harris’ research on psychedelics.
As the interview continues, Dr. Harris moves on to discuss post psychedelics anxiety, which he discovered while he was researching psychedelics. They discuss primarily the different results that were found in his research and determine how much anxiety was present in the studies that were conducted.
After a quick ad break, we return to Dr. Miller and Dr. Harris discussing what psychedelic research they would like to be done that is not currently being studied. They continue to compare different research methods and studies from the '60s to the current situation in psychedelic research.
As the episode comes to an end, Dr. Miller and Dr. Harris finish the interview by talking about the legalization of psychedelics and the potential effects of political positions in the United States. They also talk about the vulnerability and suggestibility of psychedelic testing for research.
Welcome to Mind Body Health and Politics. I'm your host, Dr. Richard Lewis Miller. The mission of Mind Body Health and Politics is to enhance your physical and emotional well-being and encourage community. I say encourage community because I believe strongly that human beings are tribal animals and we do our best, we fulfill ourselves,
In the foremost ways, we express ourselves as the beings we are. We do all these things when we live in community. Small numbers of people who know each other, definitely by name or at least by face if it's a larger community. I hope you consider that.
I hope you look at your life and think of it in terms of who you have in your community and how you might want to build your community. Today on Mind Body Health and Politics we have the privilege of having one of the world's foremost scientists with us, Dr Robin Carhart-Harris.
I've mentioned before that we've gone through a 50 year period of political repression, suppression really, of psychedelic science and we're coming out of it. 50 years in a wasteland, 50 years Not quite a wasteland, that may be too dramatic, but it felt like it because I went through it.
And during that time there were persistent scientists who kept pushing at the government for a little permission. Let us have a little, give us a little crumb, let us do a little something. And these were courageous people because there are areas in the sciences which if you study can be career killers.
Psychedelic science was one of them, hypnosis is one of them, and human sexuality is another one, well known for being career killers. But Robin and a small cohort of people around the world persisted, and so the man we have with us today has done groundbreaking science, groundbreaking research. Welcome to Mind Body Health and Politics, Robin.
Thank you, Richard. It's a pleasure to be with you.
Robin, what do we do to get you to the United States after you're having this magnificent career in England and you're teaching at Imperial College? You're at the height of academia. Tell us a little on the personal side. How'd you make it across the moat?
Well, you know, I always felt welcome over here. A lot of nice words, a lot of nice people I met that tempted me over. A few key people helped make it a reality. The likes of Adam Ghazali helped bring me into UCSF.
Michael Pollan, who I got to know quite well around the time he was writing his book. And afterwards, I put a little feeler out saying, you know, Michael, if ever anything pops up in your neck of the woods, I'd quite fancy it. And, and things started happening around that.
So, and of course, the promise of, of sunny California had a fair bit to do with it as well.
And it was, I imagine, a major logistical change in terms of building a laboratory after you spent time and built the systems that you wanted in England, correct?
That is correct. Yeah, it's taken time, but we're dosing now, I'm pleased to say. It's taken about two years. I know even from colleagues in the US that it can take that long to set up essentially clinical trials, clinical studies with psychedelics. So
Yep, it's a long road to even get the approvals to do the work, but we're through most of that now. We're certainly dosing at the moment, but things are very good here.
Things were good in London, but I was very fortunate to have a great team and we developed some momentum and I could pass things over to my colleagues and they've carried things going.
So there are still trials that I very much helped set up that are still running that are going to splash into the public domain probably next year. So that feels good as well.
Robin, research has been happening more recently as you know because you've been leading it.
There's a concern in the field of psychedelic science, I'm sure you've heard about it, I know you're aware of it, that in our enthusiasm for this renaissance after half a century of suppression of science, there's a concern, one, that it may catch on too quickly with the public and we'll see people using these psychedelics
in ways that'll bring back echoes of the 1960s, which became a scary time, mostly because of the media, not because of what was actually going on, but the end result was scary times for people with regard. So there's one concern about the public, and then there's also a concern
about even those who are going to be treated by professional people and trained guides.
And the concern there is to what extent are we in the psychedelic science community going to be transparent about what the pharmaceutical companies call side effects, which is a sanitized way of saying unwanted complications of medicine, which is what I call it, or adverse effects.
They do everything they can to hide those, and the question for us is, how transparent are we going to be about unwanted complications? And you've done some research in that very area, and I'd like you to talk about that research right now, please.
Sure. Well, gosh, You know, it's, these are potent interventions. And we started doing them, doing these, giving these interventions in vulnerable populations, personally, around 20, let's see, 2014, 15, we started our research in treatment resistant depression. And
I'm not sure people would necessarily be aware of it but that was the first trial at least published that was a trial with a in this modern era with a psychedelic therapy in a population of people with a diagnosis of depression across the board.
There was the cancer work pioneering work by the likes of Charlie Groves that had been published already in End of Life Distress where there were anxiety and depressive symptoms but they weren't a cohort of people all with clinically diagnosed major depressive disorder and certainly not treatment resistant depression where they'd all failed
um at least two different medications and most of them psychotherapy in the current depressive episode so it was a tough population and we went in with um high ideals as is often the case um and and generally got very good results um on average um very good in terms of getting people into remission who weren't responding to anything else
A conversation for Mind Body Health doesn't capture the complex cases and we had some you know we had let's see we had i mean one individual um jumps to mind uh who um in his second session after a relatively positive first session with 10 milligrams psilocybin going to the second session a week later 25 milligrams
And he had a experience that it took a little bit of time for him to really describe what had happened, but he felt he'd had a recollection of some physical abuse from his father, trying to smother him, trying to kill him as a child. And he was confused about the
Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris had a complex relationship with his mother, who was negative about the father they divorced. And so there was a literal split there. But his He sort of split his emotions in favor of his father and his attachment to his father.
So to have this vision was very disturbing and inconsistent with that, you know, positive feelings towards his father. So this is the kind of example of complexity in the process, where rather than it be a very positive, euphoric, blissful experience with, you know, fully conscious content,
playing out that that isn't surprising in any way you know it might be sort of pondering on the loss of a loved one where you you knew that you'd lost them and you you're in the process of letting go um this was more of a surprise you know it was material that if real um he'd repressed from his conscious awareness and now it had come up
and and it was difficult and he didn't know what to do with it so you know and if you if you put it into numbers his depression score for a let's see I think maybe two weeks or so after the dosing session actually increased after an initial drop it jumped right up
And that was him processing this difficult material. And so I think people need to understand that that's why we do this work with thorough psychological support, why we do things like advise against self medicating with psychedelics. You know, I could say something a little bit flippant, like, people can get away with that.
But getting away with it isn't really Good enough. Because these complex experiences and cases do happen. And when they do, even though they might be outliers, you know, anomalies, when they do happen, They're very real and important for people, and they can really set them back. And sometimes, you know, very serious things can happen.
In Andy's case, I can name him because he has spoken publicly about that experience.
Robin, couldn't we say that that could have been, I don't know what the end result was, But that could have been an extremely positive experience if the therapist who was with the person who uncovered the trauma or the sexual trauma was able to then use the reliving of the emotional experience
as a therapeutic activity in order to release him from the shame and guilt and what other anxieties whatever else he had that were stuffed into that little box for so many years and of course in some way putting pressure on the whole psychological system because it's not as if
Part of us is unaware totally that we've got something stuffed into a box somewhere unless one wants to believe that we're capable of 100% suppression without any antenna sending out messages. Is that clear?
Yeah, well, it is, I would say that's the ideal, is that you have therapists available before, during and after, who have done their own deep work, are sufficiently experienced and trained to deal with such things as the recovery of repressed trauma. In Andy's case, it wasn't, it wasn't
a memory of sexual abuse but it was a very serious physical abuse. Yes, yes. We assume it was real but there's this very delicate and tricky question partly linked in with some of the history around depth psychotherapy psychoanalysis specifically around you know controversy and questions around recovery of memories and whether
Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris and a psychiatrist who were his guides. But it wasn't clear and compelling to any of us whether the experience was real or not. Also, real in the sense of having literally happened.
Yes, I understood. Rather than suppressed, imagined insult.
And I think what happened because, you know, to my knowledge, the clinical psychologist and the psychiatrist hadn't had training in depth psychotherapy. And so it wasn't really clear to any of us quite what the procedure was for this case. You know, Andy's account was told to us only after the event as well.
He didn't relay it in real time as it was playing out.
um and so it was a very tricky case and we sort of learned on the job you might say and I think now these days people might be a little wiser to these to these experiences to these possibilities and I think going forwards we might do a better job in the training around the possibility of such things.
Yeah you see where I'm coming from as a clinician myself is that at some point in treating a person I'd like to help them get to the most bothersome thing in their psyche to the stuff that's the scariest because that's the stuff that's probably causing the most trouble and if these psychedelic medicines
give me a tool to reach in with the patient and access that material, then that's not an adverse effect unless the person isn't treated properly and that material is allowed to come out without guidance and then they're sort of stuck with this shocking stuff, which is an adverse effect, right?
Well, I agree, but it's one of those cases that highlights where the skills and the expertise of the therapists really truly come into play in those very complex cases. So I guess that flippant remark that you can get away with it, I think that's true in the majority of cases until you hit
these complex cases, and then the skills and the experience and the expertise really matters. Which means perhaps, you know, going forward, have some access, which is the kind of thing that we brought in in subsequent trials, access to a very experienced mentor figure, you know, who has seen it all.
and can provide supervision of our guide team so that you know we're better educated and can lean on that experience when such complex and difficult cases.
And also to be able to lean on your research because that story is an important story about a particular kind of person of which there are many.
So I could foresee that story influencing, for example, the little piece of paper that's all rolled up tiny that you get with your medication and you unroll it someday and it lists many characteristics which, if you have, this is not the medicine for you just like we do with other medicines.
But right, what you're doing is adding to our body of knowledge about various cases. You also brought us some very, I know that you acknowledged that it was a small N, but you brought us some significant information about post psychedelic experience anxiety. Tell us about that, Robin.
Yeah, well, that was kind of off the back of, you know, there was some journalistic work on complex cases with psychedelic therapy, some of it, you know, in ceremonial context, but also some of it in trials as well. Specifically, it was the hot period around the power trip series.
And it just got me thinking and reflecting and I thought that it would be good practice to place the focus of things on negative responses, in a sense to do something positive with a difficult time and see what we could learn. I guess it was a period of self-reflection, thinking what have we missed, you know,
and maybe we'd find out if we very consciously and intentionally looked at negative psychological responses. So that was the motivation and then we did a survey project initially to get a bunch of cases and then we invited in a sense the most interesting, the most complex, the most serious.
We invited those individuals to do interviews with two of our staff And those interviews were pretty lengthy, about an hour, I think, on average, and I just went into the minutiae of the cases to see if we could glean any principles about contributing factors. And there are a few things came through.
One was that, yes, the most prevalent aspect of worsening mental health presentation was anxiety. I can't quite remember the proportion, but it was in the range of maybe 70-80% of the cases were reporting it was anxiety specifically that had increased after the psychedelic experience.
I think actually since I thought I saw in one of your studies it said 87%
Really? Well, that could have been it. That could have been it. And actually, it's replicated recently, Jules Evans and his team have done some similar work. And again, it was that symptom domain. I mean, anxiety is kind of like the most generic sort of negative space of of mental health presentation, the most common.
And so, you know, maybe it's that and you know, if it's more severe, it's often on top of the anxiety, there might be something more specific, you know. But anxiety was the most prevalent in both of those studies, where both of those studies focused the telescope, the microscope, specifically on negative psychological responses. Did we learn anything new?
is a very good question. Because we want to know it. Yeah, it mostly reinforced what we already suspected around certain setting that these cases were much more likely if they occurred without anyone supervising the session, like a sober sitter or guide. Most of them had happened in conjunction with a so-called bad trip or challenging psychological experience.
There was some intriguing things that we've since also replicated. One was young age as a factor, and we've seen that in other more quantitative
analyses, young age seems to be an elevated risk factor, not knowing dosage, not knowing purity, taking too high a dose, when you have some impression of what the dose is, but you know, suspecting a kind of overdosing in a sense, in the sense that the effects were too strong, too intense for the individual.
Let's see, was there anything else? Some mixing of drugs as well. I mean, this work was done. It's very sort of real world naturalistic. It's not from control studies. It's from taking psychedelics in the so called wild. There are grades of wildness if you want.
As well as grades of the stuff itself.
Yeah, quite impurity and so on. So You know, it kind of highlighted some risk factors that we already suspected, but I think the exercise was worthwhile because it gets it more into the conversation.
And, you know, as I think we're doing right now with all the increased interest, increased investment, a lot of journalistic interest and hype that goes with that, the conversation can get a little too positive and perhaps not sufficiently well Unveiling the Complex World of Psychedelic Science
They think they can cure whatever, you know, psychopathology, mental illness with just the drug itself and then they can run into quite serious trouble sometimes. So, you know, it was useful in that respect for just bringing a bit of balance into the conversation around psychedelics and their therapeutic potential.
Robin, I interviewed a man the other day named Justin Townsend who has a center in Jamaica where he administers psilocybin three different doses over a week-long period to people who come and spend the week. And they do it in groups of 12.
And they start with 3 to 5 grams and then the second time they take 7 to 9 or even 10 grams and then the third time they may take as many as 15 grams of psilocybin. And he's collecting some information.
He says that the research that we scientists are doing around the world has a big question mark over it because it's being done in rooms in buildings.
And the very setting which the scientists are saying is so important is a negative for all that research because he would never think of putting somebody in a room, laying them down on a bed, having two people sit there, and then give them a psychedelic medicine. because it's an improper administration of the medicine.
What do you think about that?
Well, I've got a few thoughts. One is that in a treatment study to give three doses within a week would feel excessive. It would feel too much drug within a short period of time, perhaps too much emphasis on drug.
and not enough on the supportive psychotherapy and processing which sometimes I think for good reasons for safety and deep work needs a bit of time needs a little bit of you know lay off the the drug and do a bit more contemplation and working through. I suspect it's being done for financial and pragmatic reasons.
Well, they're doing therapy sessions in between the days that they're taking the psilocybin and then they have some kind of group process that goes on afterwards on Zoom, but I think they also encourage people very strongly to get hooked up with a therapist to do the rest of the ongoing work.
But the question I thought was a very interesting one was his questioning our administration process because of where it takes place.
Yeah, well, I guess I'm questioning his practice.
Well, maybe they're both questionable. We need something even better. I don't know. Right.
Well, to be fair, I think it's quite fair and reasonable to say we know nothing of their results, as in we know nothing of their evidence. We know nothing of the transparency in their process. So while we can speak to the science that's being published, we publish in quite a bit of detail the procedure and protocol.
We do publish, you know, all types of the responses in quite a lot of detail. So there's very good transparency and clarity there. And the important point is, you know, the results are pretty impressive and have catalyzed All of the current interests, you know, Michael Pollan's book being resting on the published science and so on.
So it doesn't seem clear from the data from the evidence that the environments that we provide for people which are very supportive. There's music listening throughout, mental health professionals, you know, before, during and after looking after people. We have very nice aesthetics in the low lighting and aspects of nature brought into the controlled environment.
It's not clear from the actual evidence. that it's a problem. So you know I guess when you have a retreat with 13 or so people getting doses up to 15 grams did I hear?
But I think I sent us on a red herring talking about his program because I'm not meaning to or to test the efficacy. I'm more interested in that one particular point about the nature of our setting for science because I can, why I resonated to his
to his comment, Robin, is because I've been self-experimenting with psychedelics for over 50 years, and I've experimented with just about every one imaginable, and I doubt very much if I would ever take a psychedelic in a room with a bed and just a room, maybe with a window, and stay in the room the whole time.
I mean, I might as an experiment, but in terms of the way I typically do it, I want a very pleasant atmosphere. I want to be able to look at nature if I open my eyes. I want to see the ocean if I open my eyes. I want to be able to feel expansive
And if I want to go into a room kind of situation, I close my eyes and put eye shades on and go deep inside, but I still prefer to do it in a quiet naturalistic setting than sort of what we call a room.
Yeah, I think, honestly, to be honest, Richard, I think there's too much projection on this room as something problematic. It's quiet, the music's beautiful, played on a good sound system, and the lighting is low, and there is nature.
Do you call it pleasant? Is it a pleasant color?
I think it's more that the patients would call it pleasant. I mean, it's created, curated, with a lot of good, supportive intentions.
Well, that's important information, because he may have a view based on what's been shown on television, which is a pretty sterile room in a building at Johns Hopkins, and it looks really sterile, and that's not a good image.
You're painting more of a, you know, like the room you're in or the room I'm in right now, which are what you might call cozier, a little more user-friendly.
I don't know. Yeah, I'm not sure what rooms have been seen, but I've seen the Hopkins one. It's pretty nice. It's probably nicest still when they dim the lights truly for a session, you know, I saw it sort of daytime lighting and so on.
But they're a very, you know, experienced and professional team that have published great results. So again, I'm a scientist and I'm giving it to you straight. The evidence is pretty compelling for this, for this room. I mean,
In terms of adverse events, it is a fair question to ask, you know, are those more likely when you're dosing very high, a larger number of people without the same ratio of professional psychological support to patient or participant or I am.
And again, sorry, but I have to say it, I wonder whether sometimes it's being done for a, you know, economic reasons, rather than quality care for an individual to be dosing 12-13 people with 15 grams of magic mushrooms, for example, these big doses done within a week period feels Dr.
Robin, 50 more years I've been around these things. I've never heard of anybody doing 15 grams of mushrooms before. That's a dramatic number in my book. Seven to eight is considered heroic by many people, right?
Yeah, heroic is putting a positive spin on it. Well said. One person's heroic is another's reckless, perhaps. But yeah, that's very intensive, a very intensive treatment.
What was the range of doses you all used?
Well, it's become relatively fixed around 25 milligrams psilocybin. So we don't know well enough. People often claim a certain milligram of psilocybin to grams of mushroom translation, but the work hasn't been done well enough for us to make that translation reliable. So the kind of thing that you hear is that it's
um 25 milligrams psilocybin pure psilocybin might equal something like three and a half grams of yeah that's what i think i've heard from uh nick cozzi you know nick yeah well nick's good yeah yeah yeah so he's the kind of person you might want to trust on yes he's a close friend
Right, and there's quite a bit of variability is the problem. He might have told you that as well that, you know, different strains of mushrooms is quite unreliable. The concentration of psilocybin and psilocin in the mushrooms, that creates a bit of a problem. So you have this large
error margin when people are dosing with mushrooms, which is a bit of a problem. So to be going up into such massive doses there, I wonder how strong those mushrooms are in terms of the psilocybin content.
Point well taken. It's a point very well taken. So what's a higher dose in milligrams of the psilocybin that you use.
Psilocybin, well it seems to hit a kind of asymptote to sort of plateau around about 30 milligrams where you're not really getting and much more of the intensity of the sort of positive therapeutic aspects of the experiences and a lot of emphasis there on these mystical or spiritual type experiences.
Emotional breakthrough is more the kind of way that we frame it you know among colleagues. You tend to hit a kind of plateau with that experience around 30 milligrams. And then if you go above, you start to bring in, you start to trade in terms of getting more confusion with the experience.
So yeah, we think 25-30 is kind of the sweet spot. And if you give any more than that 25-30 milligrams psilocybin is your You go above that, you just risk having people who are sort of disorganized in thought, confused, and aren't necessarily getting the more positive aspects of the experience, including the insight.
You know, the psychological insight isn't necessarily facilitated by going above those doses that are pretty high.
Would you hazard a guess on a dosage appropriate specifically used for creativity?
It's tricky, you know, because the evidence for enhancements in creativity is a bit mixed. We've got a lot of anecdotes and cases there, but it's a very hard thing to test in the studies, so I know that's not a clear response.
But I'm waiting to see a really well done study that does actually show enhancements in creativity in relation to the psychedelic experience. So I don't know, I mean the big doses 25-30 milligrams do promote psychological insight.
Typically we score that the next day or participants score it, but they can also do it, you know, one week later or a month later. But we have seen in predictive models that, yes, the big doses promote, well, they promote emotional breakthrough, then that promotes psychological insight. So the evidence for creativity, I think most of it
I think if we're being really fair and quite strict as we should be scientifically, then I think it's fair to describe it more as an interesting hypothesis than something really well established. Part of the tricky issue is that it's very difficult to test creativity, to kind of squeeze it into a study.
When it happens it's usually more a thing that sort of happens all of a sudden almost or seems to. So it's quite hard to pin down and study and maybe that's why the evidence, the clear evidence for psychedelics promoting creativity is a bit thin on the ground.
But you know, we do have clear and quite compelling evidence of psychedelics promoting psychological insight. So a deeper awareness of oneself, one's The causes of one's mental health challenges and psychedelic therapy experiences fostering experiences of insight seem to be very important for then advancing people's Mental Health and Improving It I think the hypothesis is interesting.
It's just designing a good study to really demonstrate it. I'm aware of, you know, Jim Fadiman's work in the in the 60s around that hypothesis. But again, I think if it was to be tested these days, it would probably be tested in a slightly different way to try and demonstrate the effect.
So yeah, more work to be done there, I think.
What research would you like psychedelic science to be doing that needs to be done? What's on your list?
One jumps straight to mind and it's absurd that it hasn't been tested so far. You can kind of explain it but it's still absurd in a sense which is that we assume that psychedelic therapy is a combination treatment
You know, it's implicit to psychedelic scientists in the know, like me, that you must provide psychological support for the experience. It's not a drug alone treatment.
It's very much as we were talking about earlier with the setting and I got a little bit defensive about our rooms, you know, because they are, they're created, curated in very much with, you know,
Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the Complex World of Psychedelic Science with Dr Robin Carhart-Harris Unveiling the
Then you have to have the context right, you know, you have to have the support around it and you have to have the right safe environment. So, we hold that assumption very strongly but haven't tested it.
And I said, you know, it's absurd but also quite explainable because none of us have wanted to sort of jeopardize safety in a sense by dialing down on that good quality of support. But what that leaves us with is a untested assumption.
And when you don't, when you fail to test strong assumptions like that, and assumptions that are there universally across all of the modern trials with psychedelic therapy, then people start to doubt the assumption because it hasn't been tested. And that's what's happening right now. So people think that maybe you can dial down on the therapy.
And when it's expensive, which it is,
they want to dial it down because they want to dial down that that sort of extra expense they would like yeah i think it can be c all of the above i think the assumption that science is making is correct for the vast majority of people but i think the question that's being raised is applicable to a smaller percentage of people
such as myself. I have benefited both from taking psychedelics with a therapist and then having sessions afterwards. And I have benefited by taking psychedelics all by myself. And I have learned things that have been helpful in my life, dramatically helpful in my life, in both circumstances. And I wouldn't put one before the other
But I would say that going into these sessions, I was a trained psychologist. I've had a lot of experiences. I had a lot of personal psychotherapy. I had practiced meditation. I had practiced centering and breathing. So I had a lot of tools to use But I'm not the only one.
There's a percentage of us that I think fall into this category. And so those who are questioning the scientific assumption have a good question with regard to this particular percentage of which I can't tell you how many there are of us.
But I know there are some because I have friends who have done the same thing that I have and they too have benefited dramatically.
The reason why I raise it and it sort of ties in with your introduction is that, you know, if the messaging is that the supportive context maybe doesn't matter that much, then we go to a situation maybe a little bit more like in the 60s where, you know, some of the simple messaging is, you know, just take the drugs, tune in and drop out.
Yes, that's right.
That's right and that's why I said the vast majority of people I think fit in with what science is suggesting.
Yeah and I think we're on the cusp of you know major sort of societal changes around psychedelics with changes in policy then It very much brings this question to the fore that should we legalize psychedelics?
Should people be able to go down to, you know, Oakland and score a big dose of magic mushrooms just with a little donation and take them home or take them wherever they want? downtown at the weekend and expect to have really positive psychological responses.
And we know that that's a very risky message and policy that could easily crash and collapse the whole thing. So it's really with that in mind, I guess people could look on some of my messaging and say, oh, he's trying to gatekeep this space. But that's, you know, you don't want it to go awry.
And when it's on the cusp of scaling up massively, it's already scaling up in the last 10 years. I think there's some stats on first time use of psychedelics going up. I think.
Oh, I saw that on double the number of people in one year in psilocybin from 3% to 6% of the American population. But I think what you're talking about, Robin, is a line between protection and parental. To what extent do we want to treat the public as children and to what extent are we protecting them?
To what extent, I raise the question, to what extent does a person have a constitutional right to take anything that grows in the ground or is made in a lab so long as they don't hurt another human being?
Yeah, but you know, children are very vulnerable and require a degree, a degree... I didn't say children.
I wasn't including children.
No, but just... By any means. But as an analogy, you know, bringing up the analogy.
Oh, the one about treating them as children. Yeah, I see what you mean.
Yeah, yeah, yeah. And they are vulnerable. You know, people under psychedelics are very vulnerable. So I guess very vulnerable. Yeah. So it's with that in mind that some degree of protection, I think is probably responsible, especially when we are thinking about going from zero to, you know, 100 in a very short space of time, like going from
I have a question, Robin. Do you think that the psychedelics will have an effect, and I'm asking you this personally, really, than you as a scientist,
Do you see psychedelics having an effect on people's political positions?
Oh gosh, you know I'm such a scientist that it's so easy to default to the scientific position and I sort of feel like I have to because I know a little bit in that space because you know as a scientist you turn a hunch into a test. And so that's what we did.
So sure, we've had the hunch and heard the idea that psychedelics might liberalize people and, you know, move them on the political spectrum, perhaps away from conservatism towards liberalism.
So we tested it, and typically the axes for political perspective are conservatism on the right, I guess, to liberalism on the left, and then you've got another axis, libertarianism versus authoritarianism. What we found across two or three studies is a more reliable movement towards libertarianism away from authoritarianism, whether it's a little unpredictable
as to whether you do truly move people towards liberalism. So that was kind of surprising. So it's more reliable, it seems that you move people towards a kind of libertarianism, anti authoritarianism, which I thought was interesting. You know, do I think that's real now on more of a sort of qualitative level? What's my sort of feeling?
Yeah, I think there probably is an intrinsic directionality that we've sampled there that people do gravitate towards being more free thinking. And Yeah, and less sort of conformist after psychedelic experiences. I imagine it's very dependent on context on social factors. So, but I think there's there's likely something, something there.
Yes, I do. Let's talk about vulnerability and suggestibility or hyper suggestibility. Has there been some research done on that indicating that people under the influence of psychedelics are more easily persuaded or more easily suggestible? In other words, can they be more easily taken over if they were duped into taking these things? You know where I'm going.
Yeah, I do. Yeah. Yeah. So there is some evidence on that a few different studies. There were some in the 60s. We took some inspiration from that when I was working in London and brought a suggestibility paradigm test into an LSD study that we did. And we did see an enhancement in imaginative suggestibility.
So what we did in that was we described scenarios that you were meant to imagine and sort of act out. So we said, for example, put your hands out, I'm going to be loading on heavy dictionaries onto your hands.
and then you could see if people's hands dropped down as they're being you know told having this scenario suggested to them and there was an enhancement when the LSD was on board versus placebo. So it does seem that people are more suggestible and under psychedelics.
The other thing is that we've seen in our treatment trials that those who are most suggestible have the best response to psychedelic therapy as well. We showed that recently with psilocybin therapy for depression. So suggestibility, which ties in very much with plasticity. Plasticity, the dictionary definition is the ability to be shaped or molded. So it means malleability.
and suggestibility is very close I think to that shape ability of a mind you know and psychedelics seem to promote that under the drug and those who are most plastic and suggestible at baseline are also actually those who show the best response to psychedelic therapy.
That really is a statement about the taking of psychedelics in groups because there can be a group influence on a person that's a suggestible person, which is very different than taking it alone. But of course, for financial reasons alone, Group Therapy is being looked at.
And by the way, I didn't mention, I think your point is very well taken before about economic motivation for some of these places that are springing up. There's no question about that. And some of the prices are really like, you know, off the chart. And that is going on. I'm going to move on to something else.
You want to say a few words about harm reduction?
Yeah, happy to. Well, gosh, you know, I guess having played a little role in the way things are upticking with psychedelic science and medicine, you know, I guess I've become more conscious of how I want it to go and where I think it's vulnerable. And so,
You know, when I think that people can get hold of psychedelics very freely and maybe don't always do it in a well informed way, that bothers me. Rewind about three years or so, I created a bunch of harm reduction videos.
I looked into different ways in which I'd make that material available and in the end just essentially gave it away, put it up on my website. Open source? Entirely open source, no paywall whatsoever. I don't make any special claims on it. I can't even say that it's solidly evidence-based. I mean, it's arisen from the research I've done.
But I haven't tested that material and seen how it's impacted on people. So I'm not going to claim I'm certainly not going to over claim about how good it is. But it's in my mind, it's, I think I probably am sufficiently well informed having done a number of trials, worked very closely with
different mentors, either underground therapists or the likes of Bill Richards, you know, having done therapy, psychedelic therapy for a number of years, who I consulted when creating this material. I think it's probably a well enough informed about as more or less about as good as anything that's sort of freely available in the public domain.
And so I just wanted people to have it. Because I worry a little bit and I would rather that more people educate themselves about how to have a psychedelic experience in a responsible way, trying to mitigate risk.
So that's why I did it and I put into it a lot of tips kind of around psychedelics rather than necessarily specifically about psychedelics. So there's a lot of, there's a lot of sort of Buddhism in there, secular Buddhism.
I borrowed a lot of quotes from the likes of Thich Nhat Hanh, Jack Kornfield, Stephen Batchelor, which are more sort of like Unveiling the Complex World of Psychedelic Science
You know, if a loved one who had never taken a psychedelic before is vulnerable and goes into this, you know, I sort of created this material with those people in mind that I'd rather they have access and yeah.
You referenced that these harm reduction videos are on your website. So tell us just a little bit about your website, then I've got another question I want to ask.
Yeah, you know, something I had to do, I had to get it done. So I did carhart-harrislab.com. You know, I'm very fortunate in the position I have at UCSF that I have that freedom, I can I can do this.
So I put my papers on there, I list all my collaborators, I provide a little bit of background, I put all these open source videos on there, there's about 25 of them. Yeah, I put some like archive interviews that I've done, if it's all right with you, Richard, I might put this up, but I'll ask permission.
You know, so I just link in things that are already in the public domain online, and it becomes a kind of hub for for that material.
Yeah. Robin, I'd be honored if you put this interview on your website, and I certainly will put it on mine, as you know. Based on your research to date, make a few statements to the psychedelic guides who are listening to this interview. What do you want to tell them?
Well, honestly, they could tell me a lot, you know, I am not a psychedelic guide. I'm a scientist. So, you know, they're doing the heart work in a sense, I'm doing more of the head work. So, I take a lot from them.
And, you know, I think we can learn from each other, maybe that would be my message is that, you know, as I want to learn from you, and I do, I do get this vibe from, from trained therapists and training therapists that
that they want to learn from me too so yes there's a reciprocity there that I very much value I've even found that when I have gone more into the You know, places where there's a longer heritage.
I was very lucky to go to the Amazon and sit in, kind of as the resident scientist, in a pretty authentic Shipibo-led ceremony. There was a someone singing, a Shipibo person singing in Shipibo during the session, singing the Ikaros, this is Ayahuasca, and also a, you know, curandero leading who was working with the
It was fascinating, but my point was that when we spoke, I can't speak Spanish, but it was translated. I'd like to think that there was a really quite sweet mutual respect where I was very genuinely respectful of the way they were doing things and intrigued.
They were also intrigued about what I knew, you know, having looked in the brain. And so I really liked that. I really hope that that kind of reciprocity and sharing is something that we can maintain going forwards. Sometimes, you know, I wonder whether the scientist is seen as a sort of archetype, You know, maybe cold, unfeeling.
There's maybe some truth in that to an extent, in that a scientist tries to be objective. But, you know, there could be a projection that the scientist could also be hostile or an enemy to the therapeutic process, and that would be so far wide of the mark. So, you know, I guess trust and reciprocity requires
an openness to really understand where each party is coming from. And so maybe there's something around that theme of trying to understand each other, each other's agenda and approach and so on and learn from each other.
Thank you. In Amanda Fielding's digital imaging of the brain on LSD, which I'm sure you've seen, we all have. Yeah. From a science perspective, what are we to make of that difference between the brain on LSD and the brain not on LSD? A dramatic representation. And what do we do with it?
Well, we try and understand it. I know that pretty well.
Yeah. Help us. Help us understand it. Sure.
Well, so I mean, we did a few brain imaging studies and the one that you're thinking about is probably the one with fMRI. You know, you learn different things from different modalities, we use fMRI, MEG, EEG, but you know, the image that really
people seem to get a lot from was the one with the two circles and the communication going on between systems in the brain. And it is a finding that we've seen again and again. We saw it more recently with DMT. I'm now seeing that other teams are seeing something quite similar.
There's going to be a paper coming from a team in Maastricht. What is it? What is it? Okay. So, you know, really it is two principles that could be collapsed into one. First, the two principles, one is network or system disintegration under drug.
So a number of brain systems or networks that do different things ordinarily, like take the visual system for seeing things, processing visual input, the motor system for moving the body, and then higher level systems for like a higher level abstract cognition.
Those systems break down within themselves, the bits that make up the system become sort of decoupled from each other under drug, but they also, in decoupling from the regions that they usually speak to within their given system, they start to breach their given system and start to talk more freely to other regions in the brain, including regions belonging to systems that they ordinarily don't talk to so much.
And there's a kind of, there is a kind of shift or drift away from the constraints of brain anatomy. where the functional connectivity, the communication in the brain that we see in the brain activity starts to move away from some of its hard anatomical constraints. Now let's try and say it a little bit more simply.
It is as if the quality of communication in the brain becomes more global, more varied, I call it more entropic, That's formerly true as well. So it's harder to predict. It's richer, more complex, and more open and more flexible.
So these are all descriptors that, that kind of arise from from the actual data, and how we understand it functionally, opening up of brain activity and communication in the brain.
Are you getting that data from administrations of psilocybin, LSD, or something else?
You saw it first with psilocybin. That's the two circles. Went into Michael Pollan's book in the centerfold. I think those two circles were under psilocybin. It's much more color across the brain. We saw it under LSD in a few different ways. We've seen it with DMT. I don't know if anyone else has looked at another psychedelic.
We didn't see it under MDMA. Interestingly, when we did, We did not, no.
You did not?
Yeah, so it could be a signature of the classic psychedelics.
Yes, yes. So given all those extremely positive consequences of taking the medicine that you just described, I mean, those were really glorious descriptions of what's happening with the brain in terms of contacting more areas, breaching moats, moving around.
It's almost like a person who's Greek suddenly learns six other languages and can go out into the world and communicate. With all that positive, wouldn't we want to take it
on a regular basis without necessarily having problems, pathology or things that we want to treat and heal, but simply to gain all those descriptions that you shared with us.
Well, they do sound kind of positive. I can see why people, you know, let me be here. Flexible, who wouldn't want a flexible mind? Open, who wouldn't want an open mind, you know? There's a useful qualifier to say that there is some data that maybe, maybe acute psychotic states would show some of this quality as well.
An infant brain shows this quality and it tends to go away as we mature into adulthood.
and you know the likes of Wordsworth's wax lyrical about the romance of sort of the infant mind you know heaven lies about us in our infancy and so on so um so that's positive but I guess my point is that what would it be to inhabit a permanently tripping mind and brain state.
And I would just caution that maybe, maybe it's not all, you know, not all positive.
Well, you know, Amanda took 100 micrograms a day for 90 days in her youth. And she's still functioning. She is, isn't she? Yeah, you know, and Christian Bache took 93 journeys with LSD, every one of them over 500 micrograms, and he published on that. So those people, I think Amanda's closer to what we're talking about.
She wanted to find out what it was like doing it every single day, even though, I don't know if she knew at the time about depleting her serotonin
and perhaps other neurotransmitters and I don't know so you know it was a one-person experiment but I think it raises an interesting question because certainly people are taking all other kind of medicines in this world on a regular basis they are ranging you know a wide variety of things in fact one time one time I went to the hospital when I was I think about 82 years old
and they gave me an interview and the nurse was in shock that I didn't take any prescription medicines. She said she'd been working there 35 years and she'd never run into anybody who wasn't taking prescription medicines, which I thought was interesting.
Yeah, yeah.
So, well, you see where I'm coming from in terms of, I mean, I, you know, it's, we're talking about sort of risky, it's a risky kind of conversation, because it could be seen as advocating for something the pharmaceuticals try to do, which is get us to take something on a regular basis as an annuity.
Yeah, yeah, I mean, you know, maybe some of the benefits that you could get from psychedelic therapy. I have seen people that I very much respect turning more to spiritual practice,
Yeah, the likes of Ram Dass and Jack Kornfield, where there wasn't a reliance on psychedelics, it's more like the psychedelic experiences that provided some insight, and then it was picked up and developed more with patient practice than necessarily going to the drug again.
Not to rule out the drug, but just to sort of maybe put more of the emphasis and the focus on the development of wisdom and self-inquiry.
And then we might see Fadiman's approach or what he has revealed as sort of a compromise, which is the microdose.
Which is very interesting, yeah. I can see the logic behind how lubricating the mind a little bit could... Exactly.
We're going to have research coming up on the microdose
Yeah, yeah, there's going to be more and more at the moment. It's a bit mixed out there. Jury's out a little bit, but we shall see. I think that there's some interesting results that will favour the efficacy of microdosing coming through. You know, it's another approach. It's another way of doing it. And
I do hear the rationale and the case, you know, motivating that approach. So let's see, I suspect that the way microdosing will work best is when it is still twinned with something. I'm not so sure you can bypass any real psychological work and just rely on the very low doses done repeatedly.
So I suspect it's more that the micro doses promote some plasticity, twin that with some kind of psychological work or some training, and then the two in combination can work very well and improve people. That's what I suspect.
What do you think of Rupert's work on morphic residents?
Interesting. But I don't understand it well enough. I don't know what the mechanisms are underneath it.
I find it fascinating. I don't know quite what to make of it. But I interviewed him here on Mind Body Health and Politics many years ago, and we talked about it. And since you're from England, of course, that's why, you know, I mentioned it to you. But I find it fascinating.
Robin, it's a distinct pleasure having you here today. Thank you for coming.
Thank you Richard, I've enjoyed it very much.
And thank you all, gentle listeners, for being with us today on another broadcast of Mind Body Health and Politics. I remind you we come to you
with a new show every Tuesday at 9 o'clock in the morning and everything is on the archive mindbodyhealthpolitics.org and along with the material on Robin Carhart-Harris' website everything on our website is open source no fee to you
So, until next time, this is Dr. Richard Lewis Miller reminding you that good health is worth fighting for and it's essential for life, liberty, and the pursuit of happiness.
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