Rick Doblin: Psychedelics | Lex Fridman Podcast #202
the following is a conversation with rick doblin founder and executive director of the multidisciplinary association for psychedelic studies maps he is one of the seminal figures in both the cultural history and the cutting edge science of psychedelics he was there along with the biggest characters throughout this fascinating history of psychedelics and he is here to tell the story quick mention of our sponsors theragun expressvpn blinkist and sleep check them out in the description to support this podcast as a side note let me say that exploring the places the human mind can go can help us understand where it comes from how it works and how to engineer mental journeys whether that's through life experiences chemical substances brain computer interfaces or interactions with artificial intelligence systems on a personal level i think the dissolution of the ego for stretches of time is a powerful tool for understanding yourself a lot of things can do this including jiu jitsu literature meditation but psychedelics is definitely at least arguably one of the most powerful from psilocybin to dmt i'm excited that people like rick are leading the scientific research that reveals the efficacy and the safety of these substances so that their proper dosage and usage protocols can be understood and people like me can safely and effectively use them not just for recreation but for rigorous exploration of my own mind this is the lex friedman podcast and here is my conversation with rick goblin could you give an introduction to psychedelics like a big bold whirlwind overview what are psychedelics what are the kinds of psychedelics out there in whatever way you you think uh is meaningful all right well when i started maps the multi-disciplinary association for psychedelic studies it was very important for me that psychedelic being the name and the way in which the original meaning of psychedelic it's mind manifesting it was created by humphrey osmond in dialogue with aldous huxley and so psychedelic means mind manifesting and so we interpret that very broadly to mean dreams or psychedelic anything that kind of brings things to the surface holotropic breath work you know hyperventilation is psychedelic so most people think psychedelic is only about certain kind of chemical substances either natural or synthetic but we've got a much broader view of that meditation can be psychedelic in some ways but our primary focus is on the drugs it's on the medicines or the you might call them some people might call them spiritual tools or sacraments um there's sort of two general categories of those one are what are called the classic psychedelics and those are the ego dissolving sort of merged into unitive states those are like lsd psilocybin mescaline ayahuasca ibogaine dmt things like that and then there's mdma which some people even argue is not a psychedelic they'll say it's an pathogen or an intactogen it's about touching within or empathy it doesn't do the same kind of ego dissolution that the classic psychedelics do but it brings material to the surface and and it changes the way we process information and so i think you can quibble about whether it's a it's certainly not a classic psychedelic but i think mdma is also a psychedelic marijuana i would say it's a psychedelic marijuana is closer to the classic psychedelics than it is to mdma one point i like to make is dreams because then everybody can relate to that dreams are psychedelic dreams bring emotions feelings um ideas concepts in symbolic form a lot of times or just in raw motions to the surface so when people hear the word psychedelic often they are frightened by it it's about loss of control and it is to an extent loss of conscious control particularly with the classic psychedelics but you know and we know with dreams that we can have frightening dreams nightmares but i think that um anchoring the the concept of psychedelic and dreams is really helpful for people to know that it's kind of a natural state and that there are other ways that you can catalyze it than by going to sleep and that for thousands of years substances have been used in that way so you mentioned this idea of bringing something to the surface which is really interesting so can you maybe elaborate the surface and what is there in the depths of things and how does ego dissolution fits into that all right well aldous huxley talked about uh the brain as a reducing valve that we have an enormous amount of information so right now there's an air conditioning sound in the background but that's not crucial to what you and i are doing talking to each other so we kind of tune that out you know there's all sorts of sights and sounds there's incoming information in all the different sense modalities and we have to figure out um what's important to us and so the mind in a way focuses a lot on what are our core needs and and we filter all the incoming information that we get towards focusing on what our court needs and we can even get to um abraham maslow in the hierarchy of needs about survival needs belonging needs esteem needs go on so i think what what i mean by bringing things to the surface is that we tend to not focus on a lot of things that are coming but we also push away things that are difficult emotionally difficult cognitively you know we all know that we're on this very short trajectory from birth to death but we're not constantly thinking about dying [Music] although that can actually be helpful to focus us on what's really important traumas are often suppressed conflicts we see in america and around the world the kind of rise of irrationality where people push away their logic in order for their emotional tribal needs to be met a lot of people are suffering from early childhood traumas of a different kinds or abandonment issues or anything so we we tend to focus on just you know what we need to survive and what we need for work and esteem and so psychedelics by dissolving this ego control or by with mdma kind of strengthening our sense of self and our sense of self acceptance we can bring in um other information that have previously been too complicated or too painful you don't think of psychedelics as conjuring up something new it is more revealing something that is already there i think that's a very crucial thing so um yes um um sasha shulgin who um sort of the um godfather of mdma you know he sort of rediscovered it and brought it um back into use he talked about his first experience was with mescaline his first psychedelic experience was with mescaline and he had a tremendous experience but what he said about it was he was having a human experience that the mescaline was helping him access rather than he was having a mescaline experience so that it's not like you pop a pill and you always have the same kind of experience as everybody else the the experience is not contained in the pill the pill opens you up and you have an experience of yourself sometimes these are experiences that we've never consciously had but we can say right now that we know that our body below the level of our conscious awareness has all these self-healing mechanisms and we we don't modulate them to a large extent by conscious control i mean eventually we we are learning more about the mind body and we learn about the placebo effect how what we think is the case but but i think that there's experiences that are below our level of conscious awareness particularly once we're adults that are more these unit of mystical experiences sense of connection you know i think kids are like this a lot we kind of come from the void you could say and you're born and you you have um a different way of processing information what one interesting point about that has to do with ketamine which is uh you know been approved s ketamine for depression but it's used for anesthesia and roughly one-tenth the anesthetic dose is a psychedelic dose and when it's used in anesthesia there's what's called the emergent phenomena so this is you get enough ketamine for um you can be operated on you're not in pain you're not really there your ego's knocked out but you can still breathe but as the operations uh get over and then people metabolize the ketamine there's a process that they call the emergent phenomena it's like as you're emerging from this tranquilized state and that's where you pass through the psychedelic phase and they don't prepare people for that and what we see is that a lot of adults have difficult times with that but children don't seem to have that with those problems children are a little bit more already in this kind of state and so ketamine is is used quite frequently in children now for anesthesia so all of that is to say to your question that um i think it these psychedelics reveal things that are within us some things that are how we process information back when we are children um other things that we've never thought of before that are sort of baked into our consciousness um you know there's one um drug 5-meo dmt it's this toxin from a sonoran toad that many people consider it to be the most powerful of all the psychedelics and it kind of knocks the ego structures completely out of it and we experience something different but it's something i think that's always within us it's at a deeper layer so we knock out some of the higher cognitive functions and then we experience things in a different way so my sense is that these are human experiences that the psychedelics bring us to yeah it's really profound but and that's a dmt is a really interesting example so uh terence mckenna has talked about these machine elves right and there's this um i think from the people i've heard speak about the experience there's a sense that you are traveling elsewhere to meet entities whether they're elves or not so in your sense you're not traveling elsewhere you're just revealing something that's within and maybe it's a a particular mechanism of revealing what's already within yeah and i knew terence i spent a lot of time talking with terence and i do not um ascribe to a lot of things that he was saying he was tremendous entertainer and i think he did a lot of really good things and focused us on you know the power of psychedelics but i think um i've never seen these quote machine elves i think culture is more determinative of what people experience under psychedelics your preconceptions than um than we give it credit for and so i think there's a lot of um priming that you could say that people receive by stories from their culture um you know with ayahuasca it's about jaguars and amazonian animals and so i i think these machine elves are this uh construct of terrans that other people do see there's actually some people that are very interested in doing a study and they're they're well-funded and moving toward it to keep people on an iv infusion of dmt for them specifically to see do they contact machine elves or aliens and what kind of information do they bring back from these other cells other places or other entities one question is you know who are we are are we connected to everything in the universe we certainly know in many cases you talk about waves or particles you know the quantum approach so i don't interpret um experiences that we have of some entity that's you know somehow or other deep in our consciousness that's not us it's a part of who we are so i tend to interpret it in that way the the question is how big are we yeah i mean that that's uh and how many ideas are within us that can be revealed by changing the perspective you mentioned physics one of the what physicists mathematical physicists or mathematicians do is the they reveal truths by looking at a by taking a slightly different perspective on a problem that reveals the simplicity of how it actually works in totally new ways that's what einstein did that's what like every progress in physics and certainly every progress of mathematics requires you to take a different perspective and then perhaps that's exactly what um psychedelics are doing it's not that they're contacting aliens that are elsewhere it may be revealing the connection between us and other living life forms or actually might be revealing a totally new perspective on what life is or what consciousness is and giving us a glimpse at that even though our cognitive capabilities are limited in to fully grasp and understand it so it's just giving us an inkling of that somehow and it seems perhaps a little ridiculous not from a scientific perspective in the sense that we don't have a good physics of life or physics of intelligence or physics of consciousness but getting a glimpse of that it's giving us a little bit of um maybe an intuition of uh which way to head to uh to build such a physics yeah yeah i think so i think that there's this um other concept i guess i would like to talk about briefly this jungian collective unconscious this idea that somehow or other everything that has ever happened is still accessible maybe not with as much data or as much resolution but that there's you know wave resonances so that i do believe that we can have experiences as part of this human collective unconscious that we're not from our own life yeah and that that we can it's like the holographic realities and that that that there is a way to gather information that can be accurate about other times and places um through depth investigations of our own consciousness but i think what what i tend to believe is that it's because there's emotional resonances between where we're at now in this life and you know other kind of um experiences that people have had before and you know we always hear about uh everybody who talks about past lives they're always kings and queens you know yeah so i think that's you know that's again you filter things what you want to be true but but i do think that there is a way to access information beyond what we've taken in in our own temporal existence through our own five senses in some ways i really find that compelling the notion that that information is already there and you're simply just moving the attention of your mind to different parts of that yeah i mean we we have that with the radio i mean you know you've got a frequency you turn all this information you could actually say right now between the space between us we have the whole world's knowledge that's up on the internet yeah it's right here yeah but we just have to tune in yeah what are the interesting differences would you say between the various psychedelics that you mentioned ayahuasca dmt acid lsd marijuana mescaline pcp cell cybin mdma all you mentioned a few of them they're really interesting we'll we'll talk about scientifically some of the the different studies that have been conducted on each but sort of at the high level what are some interesting differences well one of the big ones that people make a big deal of that i think is completely misplaced is some are from nature some are from the lab right so there's this kind of like romantic thought that if it's from nature it's good if it's from the lab it's somehow tainted by humanity and you know therefore some people are like all for plants psychedelics we see the policy changes that have been happening in a couple cities uh cambridge somerville right not far from where we're at now where they decriminalize plant medicines so they call it decriminalizing nature so i i think that there is from my perspective certain certain things from nature or poison certain things from the lab are spiritual even if they don't show up in nature like lsd now there is something lsd is lysergic acid diethylamide there is lysergic acid amide lsa which comes from morning glory seeds so it's very similar but at the same time i'd say i don't buy into that distinction that there's some fundamental preference one of the things that terence mckenna since we talked about him he talked about how if it's from nature it's good and if it's not you know we should be suspect um of course he had a lot of great lsd experiences but actually terrance in 1984 we were at eslin with a bunch of other people this was before the crackdown on mdma and this was some of the underground therapists and the above-ground researchers were trying to talk about how to protect mdma from this eventual crackdown and terence was like forget about it you know it's from the lab you know it's dangerous we have thousands of years of history all these other things and you know what do we know about mdma and blah blah blah i was like terence you're so um um unscientific bullshit another way to say it is and and i just said you know we need a study of uh the safety of mdma and so then dick price who started um aslan i said i'll put a thousand dick prices he'd put a thousand so terence was actually the catalyst for the first study with mdma wow um just because he was so frustrating about how plants are okay and you know if it's from the lab it's bad yeah um so that's one distinction um the the other distinction is this um sense of uh classic psychedelics versus things like mdma so to what extent do they uh dissolve the ego and you could say to what extent do they cause visions the 5-ht-2a serotonin receptor subtype which is responsible for a lot of that where these drugs are activating now masculine of all the psychedelics chemically it's the most similar to mdma it's a phenethylamine which is mdma so in the 50s there was the 53 i think it was the army chemical warfare service wanted to look at drugs for interrogations mind control non-lethal incapacitance they did a study in eight substances these were now toxicity studies in animals and on the one side was methamphetamine and the other was mescaline and mdma was in the middle chemically so mescaline of the psychedelics tends to have the warmth that mdma has it's not as ego-dissolving quite as some of the others i mean it's the main active ingredient in peyote it is very psychedelic very visual another distinction with these different drugs is how long they last and a lot of that has to do with the route of administration so for example if you smoke dmt it takes 10-15 minutes and you're within seconds you're off in another world um similarly 5-meo dmt very rapid when you take dmt in the form of ayahuasca where it's mixed with another substance that makes it so that it's orally active then it's a couple hours so lsd is uh 8 10 12 hours sometimes psilocybin is more like five or six hours or four to six hours mdma is similar it's one reason why in our research we give an initial dose of mdma and then two hours later we give half the initial amount to extend the plateau because we want it to last longer for people to be in this therapeutic state so that's another distinction is um you know how long these drugs last another distinction is which of them come from a religious context they have a religion built around them we have this um sense that some people are saying that 5-mo dmt and the sonoran toad that they have this long history of indigenous use but they don't that's all modern it's made up and it's kind of a new approach however there was thousands of years of use of psilocybin mushrooms in religious contexts um from um 1600 bc to 396 a.d the world's longest mystery ceremonies the elusionian mysteries you know sort of the heart of greek culture the heart of western culture that was a psychedelic potion called kikion that seems like it's very much like an lsd-like substance um air got on grain and you know lsd comes from aragon so i think that there are a lot of ways to look at these different substances another distinction is um you know which one of them are being researched right now in scientific context and which are not and because of the rise of all these for-profit companies and everybody's looking for what they can patent what they can claim the land grab you know more and more there are companies looking at every different kind of psychedelics the ones that are most important that are not being researched mescaline but now there's a company to do masculine a journey collab ibogaine which is crucial for opiate addiction there's a new company a branch of this company a thai that's going to be looking at ibogaine so i'd say the rise of the for-profit companies is making it so that there's just going to be an enormous amount of investigations into all these different psychedelics but what we're going to see is the development of new psychedelics that we don't know anything about that have not existed yet because a lot of these for-profit companies are going to want to invent and patent and have composition of matter patents on new molecules so i think we'll see a lot of that happening too that's really fast i mean there's a lot of doors you've opened and we're going to walk through all of them including the research and so on but on this one little tangent of um the future of psychedelics so engineering new psychedelics can you comment on maybe the the chemistry and the biology of how psychedelics work and where is the space of possible engineering of psychedelics and what kind of things might they unlock in terms of the possible places our mind would be able to go and the the effects of that of improving health but maybe at the basic level of chemistry and the space of what could be engineered well you you reminded me it's not i'll get to exactly what you said but you reminded me of a talk i heard by buck mr fuller shortly before he died and what he talked about is how technology was making things ever smaller you know that we are able to pack more and more information into smaller and smaller spaces and that we're developing technologies of communications with people you know we now know the internet and things like that but what he said is that he thought the eventual uh evolution of this sort of research would move from this miniaturization to telepathy yeah and so it's like a shocking thing for somebody like scientific like that to say that yeah um so will we unlock those parts where i talked about the collective unconscious will we be able to more consciously explore those areas so i think that that's a possibility there was stan groff who's you know the world's leading lsd researcher and has been my mentor his wife brigitta they were talking about stories that they had heard about um mdma that um people take and then on top of that they do 5-meo dmt and so you get this ego dissolution but underneath that you have this sense of um ego sort of um sense of self safety of self acceptance kind of grounds it so stan was like that's the future of psychiatry that you can watch without the terror of the ego dissolution the sense that you're losing your mind or you're going crazy or you're dying or you know that you have this grounded sense of safety while you're dissolving your normal sense of how you see things and being able to engineer in in a fine-tuned way that that exact experience may be fine-tuned to the person yeah as opposed to sort of this manual potion that's uh through through uh well i don't experiment although i don't know about fine-tuning things to the person in the sense that um we believe there's this inner healer this kind of you know inner healing intelligence we talked about it the body repairs itself you know so um i think we more need to create safety for people and then then what emerges will be customized to what they need to be looking at from this inner healing intelligence at the same time we will move to uh you know we we hear so much about um the new approaches to oncology where you know you you do um genetic analysis of different kind of tumors and then you have certain kind of chemotherapy agents and you do like personalized chemotherapy i think we will have more like personalized psychedelic therapy but it'll be more like a sequence of different drugs that people go through over an extended period of time and then you kind of customize what's next and sometimes you'll combine different drugs together like this 5mu dmt and mdma or a lot of times people do lsd mdma combinations or psilocybin mdma combinations um chemistry and um it's not my strength i'm i'm more into clinical applications and policy but but i can say that um from what i've learned from reading from others and research done by others that you know different psychedelics have an impact on different neurotransmitters different other parts of energies in the brain the default mode network is what's considered to be like our sense of self you know and it's this it's part of the brain that's sort of is what i described before scanning the world and filtering information for what's really important to us and both um focusing us on things and also helping us to ignore a lot of things and the classic psychedelics all weaken the energy in this default mode system and therefore you get this flood of information that you're not normally paying attention to and then you start seeing in more creative ways or more connected you actually move to beyond the verbal kind of thinking into sort of symbolic thinking a lot of times um and that's where you sometimes get these uh mystical sense of connection how it's all one and you get the sense also of how big the universe is and how small each one of us is so there's a lot of work that sasha shulkin and albert hoffman who invented lsd and first synthesize psilocybin and what they call structure activity relationships what is the structural molecule and then how do you predict what that new molecule that never existed before is going to do once you actually take it and you can get close but you never really know until you actually take the drug and the way that sasha ran his experiments is that he would take the drugs himself first in low doses and he would sort of you know step up the doses to have more experiences if he thought it was valuable he'd share it with his wife anne but then what they would do is if they both thought it was valuable they had a group of 12 people that they were with for many many years and they would distribute these new drug to these 12 people and they would get the different perspectives and he felt that 12 was like a minimum number you know because we're so unique how each of us see things but then you kind of get a little bit of a consensus on how a lot of people are going to see it and then if that 12 people were positive about it then they would turn it over to leo zeff who he called the secret chief the leader of the underground psychedelic therapy movement and then he would start exploring it in therapy so there's um still a lot of mysteries as far as structure activity relationships and it's not going to be the case that people go into the lab and they tinker with molecules and they know exactly what they're going to get and a lot of it has to do with the not so much chemistry as morphology you could say the shape of the molecule and how does that interact with receptor sites and so we're getting better at modeling all of that and how does that interaction relate to the the the morphing of the human experience and deeply understanding that perhaps there's no equations yet for that kind of thing you really have to build up intuition by experiencing it and over time and sort of subjective self-report like trying to build an understanding of the effects of the different chemistries yeah yeah you can you can have approximate ideas but to know exactly so you know when i first tried mdma which was 1982 and this was after i had done lots of lsd and masculine and mushrooms um i was shocked at how different it was than these other substances and yet how profound it was so are there whole new kind of categories of classes of drugs that we're not aware of that would be not so much this like eco-dissolution or emotional well what mdma does is uh reduces activity in the amygdala the fear processing part of the brain so it's not just chemistry but it it routes energy throughout the brain in a different way it increases activity in the prefrontal cortex so you think more logically though that i think has an enormous impact on the effect of mdma the other thing it does is it increases connectivity between the amygdala and the hippocampus so it helps facilitate um processing of things into long-term memory um and with ptsd trauma is like never in the past it's always about to happen so will we one time develop drugs that would even be specific to certain kind of memories we're working with a woman rachel yehuda who is at the bronx va and she's done some studies that are with the epigenetics of trauma so she's worked with holocaust survivors and their children and she has identified um epigenetic mechanisms by which trauma is passed from generation to the generations sort of like set points for anxiety fear certain things like that but the question is can you actually transmit memories from one generation to the next now this is not um dna changes which happen over a very long period of time in the evolutionary scale but within one lifetime within some experiences your epigenetics what turns on the genes or turns off certain genes that can be impacted and that's what we know now can be transmitted from generation to generation either by the father or the mother through the sperm or the egg so it's it's pretty um remarkable so what what rachel's going to try to do is mdma research for ptsd and look at these epigenetic markers before and after and see if they change as a consequence of therapy so will we develop one day certain kind of chemicals that will be able to bring certain kind of memories to the surface um that's not inconceivable the epigenetic angle is fascinating that there will be these epigenetic perturbations that lead to memories living from one generation to the other and then bringing those memories to the surface and using using that as signal to understand what exactly the psychedelics bring to the surface and not yeah yeah now the other portion of that though is culture i mean culture is where we store all these memories and in the stories that we get passed down especially with a lot of shared you talk about the holocaust or world war two where it is um it's deeply ingrained in the culture the impact of those events and sort of in aggregate the different perspectives on that particular event create a set of stories that you can plug into and then they kind of resonate with some aspect of you that creates a memory that's connected to like when i think about world war ii and the holocaust i think about my own family but in some sense it's also resonating with stories of many others so it's like somehow the two echo each other and i'm just providing my own little flavor on top the the meat of the stories are probably those that are shared with others it's plugging into the collective unconscious that that's um that's really fascinating really plugging into like precisely plugging into particular memories as a way to uh to to uh deal with trauma and ptsd that kind of thing yeah i'll just have that the most important dream of my life ever was of a holocaust survivor telling me that he was miraculously saved from death and he knew that he was saved for a particular purpose but he never knew what that purpose was so in the dream i'm seeing him on his deathbed and and then he shows me whatever happened to him during the holocaust you know and then um we're back in the room on his deathbed and he says well i know what my purpose was now and i'm like oh great what was it he said let's tell you to be a psychedelic therapist and to study psychedelics and bring back psychedelic research and i thought to myself i've already decided to do this you can lay this on me i can say yes and then you can die in peace and then he died in front of my eyes in the dream so i think that that kind of cultural um transmission that i got from when i was really young you know then manifested in this dream and that was this story about how people can be um incredibly vicious and can be very motivated by irrational factors and so i i just feel that this this kind of multi-generational transmission of the story of the irrational you know being a murderous factor and something i needed to respond to was deeply ingrained and i i would say my guess is you know more culturally than this epigenetic mechanism yes yeah but your sense is that whatever stimulated a certain part of human nature in uh world war ii especially not to germany but also in stalinist soviet union still is within us within all of us just like we were saying uh you know um we embody quite a lot of things yeah and one of those is whatever the the capacity of for evil i seems to be one of those things yeah there's a quote um from carl jung from just a few years that before he died what he says and i'll just paraphrase it is that we need to understand psychology we need to understand who man is that the greatest danger to us is man there are no other dangers really that impact our species and then he goes on to say that we are the source of all coming evil now this was 15 years or so after world war ii but yeah and and i'd say one of the most important psychedelic experiences of my life was a dmt experience also terence was there ralph metzner andy weil a few others and we are um sitting around ed eslin smoking dmt and under the influence of dmt which now this was the first time i've ever smoked emt um i had this super rapid fraction of a second like dissolving of everything that i well first off i saw a horizontal line then i saw a vertical line then it turned into a color red than it was red then it turned into cubes then it turned into like an mc-escher kind of like i don't know you know didn't make logical sense and then i was gone and then it was just this period of five ten minutes of just feeling part of this um enormous wave of um billions of years of evolution how i had this sense that in my innermost sense of who i am uniquely individually this inner voice that's talking to me that i didn't develop english that that it's like a gift to me from millions of people that so that even in my most innermost uh sense it's not just me it's it's the product of everything that came before me i'm part of this bigger system and then i just thought wow just how many billions of years does it take to reach this point self-awareness and all this and it was glorious beautiful and then i had this thought um and this is where this kind of um intellectual honesty i guess you could say i just thought well if i'm part of everything and everything's part of me then it's not just the good parts that hitler's part of me too yeah and that was just this shock like a stone sunk you know and i just was very moody for the whole next day but it was that acknowledgement that each of us carries these potentials and what we activate is what matters but what what our potential are is the whole full range of things i don't know if you can comment about the dmt trip itself and what it's like starting from the very basic geometric shapes and then launching yourself into the context of the enormity of space and time in the human history is there anything else to be said about that kind of um visually or physically or emotionally about that journey what is what it's like that brief journey that reveals so much well i was with a group of people the way we were doing it was um you know each of us would smoke dmt have 10 15 minutes experience while we closed our eyes and you know everybody else was just chatting and then the person who did the dmt would come back and tell their story what happened and and then we'd think about it for a bit and then pass the pipe to the next person and so this was like a whole evening you know and so even the starting to interrupt even the conversations themselves then is part of the experience exactly yes yes because it's also what you bring back right i mean i think that's particularly for therapy you know it's not so much about what the experience is but it's what you bring back and what do you integrate and then also um how do you learn how to do these things on your own without the drugs there is this way because we're saying it's it's sort of a core human experience the drug is the mediator but can we do this on our own and once you've seen it and felt it then you have a little bit better sense to recreate it on your own although you know i've had dreams where i've been doing lsd and tripping and it was just incredible it was i was tripping in my dreams but i had not taken lsd so there's this way in which we do that so i i would say that from the dmt experience the sense of safety that's what i was trying to get at with this group of us and this group of friends trying to do this common exploration that if you have this sense of safety you're incredibly vulnerable because you are giving up your um awareness really of what's happening around you i think there's what we're finding is that in our psychedelic research for ptsd um and what we see with the vaccines that that even african americans are reluctant to volunteer for vaccines because they haven't had that sense of safety from the medical establishment they don't volunteer for psychedelic therapy even as much so the overlay has to be this sense of safety as you become vulnerable and looking inside you're you're not um i i was just actually told about how there's a lot of work being done inside prisons to teach mindfulness and you know so one of the um charlene who's my assistant is trying to do work on um helping people in prison with trauma potentially one day with mdma or meditation or mindfulness but one of the exercises was you know teaching people to okay here's how you deal with stress you know just close your eyes and deep breath and what charlene was saying is people don't close their eyes in prison you know you don't feel safe to do that so um all that is just to say is that um the context is the most important factor so while i'll talk about the dmt experience the context was this supportive sense of safety that i could be completely vulnerable and out of any kind of um control women i think you know often or less safe in this way than men because of all the sexual assaults um but what it can do by taking the ego orientation um offline to some extent it opens you up to much more and and to make a bigger point of that um we could say that um it's very similar to the copernican revolution and you know people thought that the earth was the center of the universe and you know the the inquisition murdered people that questioned that father bruno burned at the stake actually one of the things he said i think that's worth all these years later saying is that when the inquisition sentenced him to burn at the stake for espousing this idea that the earth was not really the center of the universe he said to the inquisition he said your fear in sentencing me is greater than my fear in being sentenced that their world view was so rigid yeah that they had to wipe out anybody that would question it and and so this idea of psychedelics displacing our ego as the center of the universe and to realize that we are just rotating about on something much bigger than our individual life you know our ego is is designed almost to protect this body while we're alive and you can understand all the good reasons why that is but it also disconnects us from this bigger reality and so the psychedelics dmt by knocking this sort of ego orientation or the default mode network offline you open up to the the bigger sweeps of history so in that place of safety and vulnerability in that fascinating group of people when their ego was dissolved in this way did they have similar experiences is there different places that their minds went yeah so you know once i had this kind of shattering experience that hitler's part of me yes you know no one else in the group had that probably a lot of them have maybe had that before or they they realize that they're not just you know the good the white hat good people and that they're all good and they're you know we've got to fight against the bad people you know so no people will go in different places and not only that if you do it again you'll go into a different place than you went to the first time unless you have not resolved the issue so i had a sequence of lsd trips that were very difficult but it was like coming to the same sort of conundrum the same challenge that i was unable to overcome this idea of letting go and really fully dissolving letting the ego fully go and and i would have this sequence of trips over a couple months where i would reach this point where i was too scared to move forward and i would just be holding on so there are there are repeated themes sometimes what stan groff has said which i find very beautiful is that the full expression of an emotion is the funeral pyre of that emotion and what that means is if you can fully let in something then the essence of of life has changed is that it moves on that everything's in motion and if you can fully experience it even if it's a sense that you're going to be trapped in eternity in this hellish state if you surrender to that that's the way out you know this full experience of something is this um funeral part of that emotion and so that runs against a lot of what modern psychiatry is doing too which is to suppress symptoms and to and to instead of supporting people to kind of explore these insecurities so that then they can contain them and then they can move on so yeah resistance is not a way to make progress right um although in one of the reasons why we do the supplemental dose during the mdma or why there's advantages in a 10 hour lsd experience is that you have a lot of opportunities to come up against this resistance it may be too difficult to deal with and then you kind of push it aside and then a couple hours later you come back to it or you come back to it press news every once in a while if you're not ready it's hard to do that i think the with mdma you can negotiate that's i think a part of its safety in a sense you can have this like oh i should be talking about this but i we're feeling this but it's too much for me now you can push it away but with the classic psychedelics this kind of membrane between the conscious and the unconscious that um once you take the drug and it weakens this membrane and things are coming up um it's very difficult to negotiate with it the the cl the key to successful uh classic psychedelic trips is surrender you've talked about that you first began to reconsider the negative health myths around psychedelics when you learned that the book one flew over the cuckoo's nest was written by ken gizzy when he was in part under the influence of lsd so how do you think lsd helped him ken keys in writing uh that incredible book yeah um there's a a process that's called semantic priming and so what what that means is that i i say um night you say day you know there's kind of normal patterns of kind of you say one word what kind of words come to you next and so they've done some research they meaning scientists have done some research where you give people a psychedelic and then you do this semantic priming and what you find is they have a wider range of associations than they normally would when they're not under psychedelics so i think for ken kesey um he was able with psychedelics to get like um a deeper kind of emotional connection to some of these states of mind that people were in the instant this mental institution and that he could explore them more in-depth and more eloquently and and and also one of the things he talked about was the fog machine was you know how um people's minds were sort of clouded by the people that ran the institution and this the fog machine would be coming in so i think the um imagery and the metaphors that he used a lot in the book could come to him during lsd experiences and and then now he wasn't doing um you know very when you're writing you have to be literate uh you have to be able to write you know so it would be more like beginning and ends of lsd trips instead of at the peak but i think you would get a lot of these um the feeling tones or the images the metaphors i think he would get these extent also lsd lasts so long you can get these extended focus and you can really elaborate on um images and um so much of psychedelic experiences are poetic and metaphorical i mean you can take um you know veterans who've never um read a book of poetry in their lives you know and under the influence of mdma just what they describe the imagery and the way they describe their experience is metaphorical poetic it's incredible and so i think that ken kesey was able to channel these what lsd did to his mind in a way that most people couldn't do that he did because he was trying to write this novel and because he was so brilliant yeah the i mean we'll talk about psychedelics and treating in uh bringing some of trauma to the surface and dealing with all those kinds of things but there's something also to the opening up of creativity for whether it's for writing purposes or for for in my world for engineering for invention innovation and invention itself is a very it's a deeply creative process and it's fascinating to think with the aid of psychedelics what kind of ideas can be brought to life yeah well we have the whole phenomena of a lot of the people in silicon valley and else microdosing psychedelics in order to have a little touch more of this creative approach to things i would love it to see if it was that's more like terence mckenna territory correct me if i'm wrong but i would love to serve more scientific to where there will be the rigor of saying how to do it effectively you know how to sort of understand sort of um not just almost um you know to take the full journey of creative exploration and to do it for prolonged periods of time you know um for years you know lifelong kind of part of your life of hot it empowers creativity i i think of course you start with um helping people uh deal with trauma and then the next step is people who have moved past their trauma and are trying to do something create something special in their life how can then psychedelics empower that yeah now that also just to not shy away from anything controversial yes um that has to that gets us to this um idea of psychedelics for vision quest particularly for younger people you know when you're sort of moving into this adulting kind of phase and you have to figure out what are you going to do with your life there's so many options a lot of people of course feel constrained that they have very few options but i think this idea of psychedelics as a way to help you find your calling or find your vision or find your unique leverage point i think we'll see that more and more as our culture evolves and gets healthier around the use of psychedelics it says both the science uh having the rigor of understanding how to do it safely and the culture catching up to the fact that this is uh both safe and uh like very useful yeah although i would question this idea of safety um so so we can understand physiological risks and we can minimize them and i think there's very minimal physiological risks from the classic psychedelics virtually none or for even mdma under safe conditions psychological risks are harder to address but we can do that through the sense of safety and support but i think there's um a level of risk there that we shouldn't overlook and so you know to make a drug into a medicine what we have to do is prove to the satisfaction of the fda and other regulatory agencies that things are safe and efficacious but even though they use those words proving safety and safe and efficacious it's in relationship to the disease that you're trying to treat and you accept a certain amount of risk so it's the risk benefit ratio rather than pure safety yeah absolutely let me ask you about kankeezy a little bit longer because the fascinating human being he was also part of project mk ultra yeah yes what was project mk ultra and what uh lessons we should take away from it well mk ultra was a program by the caa you know what they were looking at was can you take these drugs these psychedelic drugs and weaponize them in different ways um for interrogation for true serums for um you know exposing somebody before they give a big talk to something like lsd and then they you know can't talk or make a fool of themselves or can you spray lsd over the battlefield and have everybody tripping and drop their weapons and then you just walk up and you know nobody dies and you've won you know the battle so so it's a fascinating concept yeah they call it non-lethal incapacitance and i think that's how uh one way to win a war is uh to enforce peace to get everybody not caring about the war but yes well i think gandhi said something even better which is that the true way to win a war is to turn your enemy into your friend yes that's a beautiful way to put it yeah um but mk ultra was really nefarious and it was part of our military and it was done in secret and um they would dose people against their will i mean one of the most infamous things uh was that they had a house of prostitution in san francisco and they would um have one-way mirrors all this stuff and then they would just dose people with lsd they would have the prostitutes dose these guys with lsd and and observe what they would do and how they would act and um the ca actually for a while was dosing each other secretly and that there's a famous case of this phil olsen that [Music] either jumped out of a window or was pushed he might have been killed um he was a cia guy and they gave him lsd and then they're trying to see can they break him down and get him to tell secrets and i think he felt uncomfortable with what happened to him while he's under the influence of lsd and um whether he was pushed or or not i don't know if we'll ever know but uh mk ultra was [Music] violating people's human rights it was done in secret and the irony of it is that ken kesey is one of the people one of the main early people that got lsd in this context and then he was one of the main people that helped inspire the hippies to use psychedelics to oppose the vietnam war so i think the cia kind of in many cases things get out of their control what they think they can do and it turned into be [Music] a disaster for them i think there was some thought that some of the people at the cia had this that if you can turn people inside you know take drugs and they just focus on their internal experience they're not going to be involved politically it's a way to sort of take people offline and what i don't think they counted on is that when you're offline and you have these unit of spiritual experiences and you realize how we're all connected then why do you want to go out and kill these vietnamese and put a one dictator over another dictator dictators on both sides in north vietnam and southeast why are we doing that so mk ultra has um just very disreputable uh we're learning more and more about what they did and one of the unintended consequences was ken kesey and not only that but then the grateful dead who began at the acid test that gizi was helping to organize um and out of that emerged you could say just this incredible um psychedelic culture and you look at the bands that began in the 60s yes and which ones have really survived to the this day and um you know the grateful dead has survived longer than most any other band i mean some of them have died and all but but it was like the tightness the the sort of telepathy we talked about before that they could just get so tuned in to each other and each other's energies and they could do improvisations and they could do this incredible work that i think the the the sustainability of the grateful dead as a group was a testimony testament to the power of the lsd experiences and that might have never happened if not for mk ultra but uh can we talk about uh darkness a little bit so yeah yeah ted kaczynski the unabomber was allegedly part of the mk ultra studies while at harvard uh do you think this is true do you think it had an impact on him psychologically intellectually and so on i do think it's true and i do think i it had an impact so um we talked before about are these drugs somehow rather producing a certain kind of drug experience or do they bring out what's within so we have this experience yeah on the one hand ken kesey and he sort of took positive things out of this um on the other hand um you know we can um get this uh opposition to the modern world to technology and to the point of uh creating bombs to try to go after it so that the experience is not in the drug it's this interaction between the drug the person the context and so we can heal people with psychedelics or people can be driven crazy with psychedelics it depends again on the context and so i think it's both these things can be true and i think it was really good that you kind of highlighted this that there is this um polarities and that it's not in the drug it's in the the other factors and it's who they were beforehand and then how you use that experience so all that's to say is if we put lsd in the water and everybody we're going to get it it doesn't mean that all of a sudden everybody's going to have a mystical experience and then that's you know all we need to do and humanity is spiritualized or end war and all of this it's it's not about the drug and that that actually is why for me um we've also talked about um engineering new psychedelics and all the people that are going to be trying for-profit companies to develop and patent new psychedelics for me the most important challenge is new cultural contexts that can create legality safety support for the existing psychedelics that we already have i mean we have so much incredible tools in these existing psychedelics that it's more about creating context for them to be used in safe medical or personal growth or recreational even with harm reduction all these different ways that's more important to me than finding some new molecule that's somewhat similar somewhat different but you know it can be patented so it's the social context so i i do believe that ted kaczynski was part of nk ultra and i think it affected him in a negative way and that's a cautionary tale that it's not in the drug it's in the context the context the person still it feels like um if viewed from a therapy perspective perhaps there was a way to use psychedelics to help ted kaczynski find a path out of the darkness i i think so and i think that um this is where i think mdma comes in in a way that mdma is um you know he felt very isolated and very much out of society in some ways mdma stimulates oxytocin which we haven't mentioned which is the hormone of nursing mothers of love and connection it provides a lot of this sense of self-acceptance and safety and and wanting to be in relationship there's google dolan is a neuroscientist at hopkins she's given octopuses mdma they're solitary creatures except mating season which is not very often and but you give them mdma and they become more interested in hanging out with other octopuses so i think this um for people that have had difficult psychedelic experiences um mdma helps them integrate them we've worked with people that had a difficult lsd experience 40 years before and are still able to get back to that under the influence of mdma and work out some of the conflicts that they weren't able to resolve all those decades before so i think that psychedelics could have been helpful in a different context for ted kazinski but the other big part of it is that people have to be willing to cooperate with the experience we talked about resistance so people can resist these things it's uh you know the saying is you can drink bring bring a horse to water but you can't make them drink yeah this is about how people have to be willing to go to these spaces so one of the essence of our therapeutic approach is that we help people to heal themselves that we are not giving them the healing it's it's a flip on the power dynamics that existed um you would say in the 50s and 60s my dad was a doctor and the doctors were gods and you know whatever they said was right and you know we no longer of course believe that but um for a while psychoanalysis with freud you know that they gave the interpretation to the patient the patient couldn't help themselves but they would do the free associations and then psychoanalysts would see these conflicts and would would be the one that does the healing would give this interpretation and that would open things up so i i think it's this idea of empowering people to heal themselves and so if ted kazinsky had been in a therapeutic setting with psychedelics and if they'd had something like mdma available or mda which was popular during the 60s which is a more like mdma lsd combination the outcomes might have been different let's take a step into the world of studies timothy leary who was he and what were the most important ideas you've learned from him well i did have the um opportunity to get to know him personally and to spend some time with him timothy leary [Music] well let's start with nixon saying he's the most dangerous man in america that's a good place to start yeah yeah and and why did nixon say that it's because of this uh tune in you know tur turn on tune in drop out [Music] timothy leary was just an incredible advocate for um think for yourself question authority those were things he said all the time think for yourself question authority he was a rebel he was kicked out of west point um he was a psychologist who um was at harvard for three years from 60 to 63. before he got to harvard he had an experience with mushrooms in mexico and that he said he learned more in that experience than he had in his entire academic career before then about how the human mind works and so he came to harvard wanting to do research into psychedelics and he did some very important studies both of which well one was called the good friday experiment which was whether psychedelics in religiously inclined people taking psilocybin in a religious setting whether it could produce a mystical experience that took place at mars chapel at the boston university because it's a little bit subjective or you could say entirely subjective what people describe happens to them he wanted to do another study which would be a more objective measure and that was called the concord prison experiment and that was the thought if you can give people psilocybin mystical sense of connection type experiences while they're in prison when they get out they'll be more pro-social and they'll have reduced recidivism um so tim did that he also did the naturalistic studies of giving loads of people psilocybin and sort of writing down what their experiences were the range of experiences later on in his time at harvard he just they started doing lsd and lsd is more cerebral longer lasting not as reassuring in a way as psilocybin sometimes he's to say that if they never got into lsd they'd still be at harvard with the psilocybin so he was a great american psychologist but then he got tired of the psychology game you could say or he would say that he got more and more interested in cultural change and various musicians and artists and all sorts of people started coming to him for the psychedelic experience that they are in a way for creativity for other things so he started hanging out with all sorts of famous people or you know creative people and um he stopped going to classes all a lot and um rom das richard alpert you know had um given lsd to a student that um romness was courageous enough to admit that he had the sexual interest in uh they weren't supposed to give it undergraduates that was about the only time that they ever did it and psychedelics just getting more and more controversial even in the early 60s eventually got kicked out of harvard and then he became kind of a cultural icon for the counter-culture and was hounded by the police and nixon and spent a lot of time in jail i mean he's an incredible person one thing that ramdas said is that richard albert ramdas said i'm a rascal but leary's a scoundrel what's the distinction um rascal's like in good fun a scoundrel is like you can't quite trust them i think um um idea yeah it's a spectrum of sorts yeah i think that leary was someone who a little bit got addicted to media attention yeah but i i think that um overall he gets blamed a lot for the backlash against the 60s the shutdown of psychedelic research i think that he is unfairly plain for a lot of that um i think when you look back at the 60s my son that the common narrative is that it was because psychedelic's going wrong people took psychedelics they weren't prepared they had emotional breakdowns they went psychotic they killed themselves they did this or that different problems of people taking psychedelics in um context that they didn't feel preferably safe in or or just they weren't prepared or they didn't know how much they were taking or all this that so the the backlash was because psychedelics gone wrong but i think the real reason well that did happen i think the real reason is psychedelic's going right and people having this sense of connection and then the opposite of what the cia was hoping that it would kind of turn people inward and take them away from political struggles it actually motivated people once you actually um have these psychedelic experiences your attitude towards death changes also this idea of death becoming an intrinsic part of life it's a natural cycle it's not so much so i think people realize that you know while there's this billions of years of evolution you know infinity whatever that means in terms of time that we're here for a very limited time and they end up wanting to use their time well they have a lessened fear of death and they want to build this paradise on earth here now instead of later so a lot of people really did get motivated to challenge the vietnam war to work on the environmental movement civil rights movement women's rights movement anti-militarism and it was that challenge to the status quo that caused the backlash so leary is someone who um in 1990 we had a now maps i started in 86 so in 1990 we had this conference to raise money out in california and leary was there and ram dust was there and ralph metzner was there and andy wilde was there and terence mckenna was there and dennis mckenna was there and all these but there was one point where um tim was speaking and afterwards i was asking him some questions and i said do you have any advice for us on how to work with the government and and how to bring these psychedelics forward that's what we're trying to do i've got this non-profit for it you know we're trying to do this research what is your advice on how to bring this forward and how to work with the government and he said fuck the government he said i am so far past asking for permission for anything but i'm glad that you're doing it and then he held up my hand like you know like passing the torch wow so it was and that's one of my favorite photographs of me and tim where he's sort of like but it was after this fuck the government i'm so far past asking for permission for anything but yeah i'm glad that you are now i did follow-ups to the good friday experiment and i did follow-ups 25-year follow-up to the good friday experiment about a 34-year follow-up to the concord prison experiment what i discovered in some ways i would say is the key to the 60s what i just told you but in the the follow-up to the good friday experiment that i did in the 80s for my undergraduate uh thesis at new college in sarasota florida i eventually found 19 out of the 20 people it was just that was an enormous challenge because their names were all lost and it just took forever years and years and years to find them all um but i discovered that those people that had the psilocybin experience in the midst of uh 25 years later with nancy reagan and ronald reagan and if there ever were there a social pressure to disavow the validity of the psychedelic experience that was then and instead they um affirmed it that they thought with all of this years of hindsight now looking back they thought it was a valid mystical experience but i discovered that one of the persons who had the psilocybin had this experience during the good friday service that um reverend howard thurman was the minister he was martin luther king's mentor and reverend howard thurman was the minister at boston merc at mars chapel uh martin luther king got his phd at boston university and howard thurman had spent time with gandhi and so he was really kind of this hidden person behind the civil rights movement about non-violence as their strategy but he was interested in the the political implications of the mystical experience so he permitted this experiment to take place and there were 20 divinity students from andover newton in the basement and 10 experimenters all the people on religion and psychology like houston smith and walters and clark and leary and rhonda mr others were there as a support part of it and the sermon was like three hours later we actually have three hours long we actually have the original sermon from the good friday experiment from howard thurman up on our website it's incredible but part of it was tell people there's a man on the cross and this one person sort of heard that and he thought okay i got to do that i got to the howard thurman was such a dynamic speaker he said i gotta tell people there's a man on the cross and so he said what am i doing here in this basement chapel listening to the service i got to go tell people to manage correct so he went they thought he was just going to bathroom but he ran out the door he's running down commonwealth avenue and houston smith and tim leary go after him and um he had thought that since he should tell somebody he should tell the president like why not but then he realized well the president's in washington i'm you know here in boston i'll just tell the president of the university so anyway he's running down the street and and leary and houston smith go after him and he doesn't want to go back inside they finally get him he's not hit by a car um but they end up giving him a shot of thorzine what's dorizine thorazine is like a major antipsychotic uh drug it's a tren it's it's a horrible drug uh but it knocks people out tranquilizes them we would never do that today um you know we don't abort a difficult experience like that yeah but in any case they hid that that was not part of the um write-up of this experiment so what they did is in a sense a little bit exaggerated the benefits it later became out three years later after the experiment or four years in time magazine it said everybody that got psilocybin had a mystical experience like saying it wasn't true not everybody eight out of the ten did but not all ten not this guy and they uh minimized the risks so there was a bit of that i think tim was reckless in that way it was underplayed the risks and over promised the benefits and then the concord prison experiment it turned out that um tim had fudged the data completely and it wasn't really successful so i i fought him for that the outside world was doing the opposite it was exaggerating the risks and blocking resources he felt justified to fudge the data yeah because the outside world was fudging in a sense the the response to the yeah yeah exactly yeah so so that that presents a very nice context um fucked the government but i'm i'm glad that somebody is fighting the good fight from within and doing it the right way which is where you are so the 80s let me ask what is uh maps the multidisciplinary association for psychedelic studies and what what is its mission throughout the years throughout the decades yeah so uh maps is a non-profit organization i created it as a non-profit pharmaceutical company i created an 86 after a dea the drug enforcement administration criminalized mdma in 1985 and that was after they started trying to do that in 1984 and as i mentioned this uh terence mckenna is sponsoring you know motivating us to do this safety study so so we did that in preparation for this eventual crackdown because mdma was called adam used as a therapy drug but it was also beginning to be sold as ecstasy as a party drug and that was taking place in public settings and bars and so it was inevitable that the crackdown would happen and so i had a non-profit connected to buckminster fuller earth metabolic design lab that we use to support this lawsuit against the dea to block them from criminalizing mdma we were winning in the court of public opinion and winning in the court the dea freaked out and the emergency scheduled mdma in 85 the handwriting was on the wall that they were not going to permit the therapeutic use to continue because it gets in the way of the narrative of the drug war and these are terrible drugs so in 86 is when i started maps as a non-profit pharma because the the strategy that i realized is that americans are open to medicines you know that tools to ease suffering that was the opening wedge the opening door to changing attitudes and it would be through science i would say that my religion is more science than anything else yes and you know culture and religion are metaphorical but often too much they become literal but but i felt that through science through medicine um there would be way to bring these drugs back to the surface and the mission was always this mass mental health this idea that what we need is to spiritualize humanity einstein said the splitting of the atom has changed everything except our motive thinking and hence we drift towards unparalleled catastrophe which shall be required if mankind is to survive is a whole new mode of thinking so what is that new mode of thinking i my presumption is that it's more of this mystical sense of thinking that that we're all connected and then if we realize that we're all connected we're not going to blow up the world so a lot of people say that you know if we could just give lsd all to world leaders that would be you know then they'd have these spiritual experiences the world would be better but i actually had a ketamine experience the day after that dmt experience i described with the inner hitler this ketamine experience was um i was above and behind hitler as he was giving a speech like the nuremberg rallies kind of thing and i was trying to think how do i get into his head how do i undo what he wants to do how can we deal with him and and i realized this whole new thing about the heil hitler salute and you know he would like push energy out and then everybody would do the salute back to him and so it's like the one to the many and the many to the one giving all these people giving away their power and then how it would just sort of ratchet up in intensity like these vibrations and and i realized there's no way to get into his head this idea we've talked about before about you have to be willing yes right so what that sort of helped me understand is that the strategy has to be mass mental health it's not about changing a few liters we need to change the mass of humanity to this new mode of thinking this new spiritual way so maps was a non-profit pharmaceutical company focused on psychedelics big pharma wasn't doing this work government wasn't funding it so the only source of funds i thought would be through nonprofit donations and that's been true up until just a couple years ago now that we have the rise of these for-profits but that's because we've cleared out the regulatory obstacles we've got more scientific data about the benefits funded through philanthropy we've changed public opinion and there's a lot less zeal for the drug war so all of those things have changed but at the time it was mass mental health was the goal two tracks one was drug development the other was drug policy reform so that it's not just available to people who have a clinical diagnosis but people who are personal growth or you know they should have access to it as well i did not know at the time that no drug had ever been made into a medicine by a non-profit that was really good i didn't know that i might have been a little bit more daunted and actually that didn't happen for 13 more years it happened in 1999 and that was the abortion pill ru-46 that was approved in europe but controversial nobody no pharmaceutical company would take it and it was john d rockefeller iii through the population council with the major donor being warren buffett oh wow and the rockefellers uh and the buffetts and some of the pritzkers were involved in funding this so that was the first non-profit but but the the maps was designed as from the very beginning not academic research into psychedelics but drug development and that's a fundamental distinction and that's why i think we're years ahead now with everybody else in terms of making a psychedelic assisted therapy into a medicine because our goal from the very beginning was not knowledge not academic research it was practical it was drug development how do we create new social structures how do we create legal access to these things now in december of 2014 we created the maps public benefit corporation so maps is a non-profit but you know in our 35 years we've raised about 110 million dollars in donations what i didn't know when i started maps and it took me um quite a few years i didn't even know this until about eight nine years ago was that in 1984 ronald reagan had signed a bill to create incentives for developing drugs that were off patent so mdma was invented by merck in 1912. it's in the public domain these incentives are called data exclusivity which means that if you make a drug into a medicine that does no patent protection nobody can use your data for a period of time to market a generic and that will effectively be well it's five years you do pediatric studies you get six months extension and and we are being required if we succeed in adults to work with adolescents with ptsd it blocks a generic competitor from applying for for until that five and a half years is over takes fda at least six months to review so more or less six years of data exclusivity 10 years in europe is data exclusivity so the story then became to the donors that you're not going to have to give us money forever because we can make money selling mdma but we want to do two revolutionary things you could say one is psychedelic assisted psychotherapy but the other is marketing drugs when you market it with the profit maximization motive we end up in the extreme getting the distortions that we have in america where we have the most expensive health care system in the world per capita but our outcomes are down like 40 or 50 among the countries our average outcomes we don't have a third of the people or so don't have insurance and it's just very inequitable so what we're trying to do is show a different way to market drugs and it's a modification of capitalism it's called the benefit corporation where you maximize public benefit not profit you still make a profit so selling mdma for a profit is not something we could keep inside the nonprofit because it's taxable it's it's a business so we've created the maps public benefit corporation which is a hundred percent owned by the nonprofit so we have a non-profit that owns a pharma company and and the mission of that former company is to maximize not profit but maximize benefit for society yeah yeah although there still will be profits and the profits that we're going to make are going to be used towards the mission of maps which is again is this mass mental health and ending the drug war and and in fact we've hired the boston consulting group to help us plot our commercialization strategy and so there is some suggestions based there's so many different assumptions in this the number of therapists that we train the price that we set for the mdma whether insurance companies will cover it but there's the possibility of somewhere in the range of three-quarters of a billion dollars in profits during this period of data exclusivity just from the u.s you know and we're talking about the trying to do this research around the world as well so that's what the benefit corporation is the benefit corporation is our pharmaceutical arm we're about 130 people now somewhere in that fluctuates but one-third of them are in the nonprofit we do harm reduction psychedelic harm reduction we help you know create programs for people with difficult psychedelic experiences at burning man at festivals all over the world even in cities we're now negotiating with the um police the city of denver because denver has made the mushrooms the lowest enforcement priority you know we oregon has passed the oregon psilocybin initiative so in those areas where maybe more people are going to gravitate to do psychedelics we want there to be harm reduction so that we don't have bad stories coming out that would change that so maps does the psychedelic harm reduction we do public education we do a lot of it that's what you and i are doing right now we're doing that now so but and but also research towards well the research now is done in the benefit corp in the benefit yeah so so what happens is people donate to maps get a tax deduction maps transfers the money or you could say invests in the benefit corp yes the benefit corp will do the research and then maps is the sponsor but then we will license the sale of mdma to the benefit corp so got it but but the research had done with an eye towards creating something that has a big impact versus just research for knowledge sake yeah yeah because um i'm interested in political change um you can the other part of it and which is that the brain is the most uh complex thing we know in the in the universe it's gonna it's endless i mean when are we gonna really like this idea of will we figure out telepathy will we figure out tapping into the collective unconscious what is the extents of our brain you know how does the brain actually work do you ask chemistry questions you know so if it's just the pursuit of knowledge that is an endless thing and how does that end the drug war how does that help people directly so that's why we're focused on drug development more than mechanism of action before i ask you about a one but several really exciting studies let me ask sort of a personal question for me so if i wanted to get psychedelics from the maps public benefit corporation and uh explore my own mind um how do i get to do that uh and when you won't be able to you'll never be able this is very unfortunate because the the reason is because the benefit corp is designed as a pharmaceutical company so we can only work on clinical indication so let's say you you come to me and you just say oh i'm really depressed can i get mdma to overcome my depression or overcome my ptsd you know we'll have to do research in those indications um and by when you say me you mean like a doctor so this would be prescribed in theory by doctors so this would go through a doctor yes and a prescription okay let me uh let me ask another question to further answer the so so that's where the drug policy arm comes in the drug policy reform so you should be able to get access to psychedelics for your own personal growth yes but that's not medicine so that's why we need to medicalize to have things covered by insurance to change people's attitudes the public attitudes and then we get this subsequent drug policy reform and and we're talking about it in terms of licensed legalization so my view is you should get a license to do psychedelics you get a little education stuff and then then you should be able to buy it and do it on your own so let me rephrase the question more specifically so when can i if i happen to have um ailments of some kind where the doctor decides that psychedelics could help when would you be a loose estimate for you of when a doctor would be able to prescribe to me something from uh maps public benefit co and then when for my personal growth and creativity would i be able to get something so like just looking up this isn't like guaranteed but like your vision your hope yeah um for yeah for for academics in society well the end of 2023 so two and a half years from now we anticipate fda approval for the prescription use of mdma for ptsd because the fda does not regulate the practice of medicine there is what's called off-label prescription what that means the label is what it's approved for so the label said this is approved for ptsd and but let's say you come in anything else social anxiety or whatever you can go to the doctor they can give it to you it might not be covered by insurance they have to be a little bit careful about malpractice if they're but i think the end of 2023 is when you will be able to do that now there's actually another program very limited called expanded access which is compassionate use which means that and we have approval for 50 people for compassionate use right now we think that'll grow so that's going to open up in about two months and so those are people with ptsd they have to be treatment resistant nothing has worked for them and they can access mdma while we're doing the phase three studies wow and but they have to pay for it themselves we're not the sponsor has to pay for all the research but expanded access because there's no control group everybody gets the mdma people can pay for it themselves and we think that'll start in a couple months but it's very limited it's limited to certain cities there's also a program called right to try which is um passed through congress it's it's it's similar this idea of compassionate use but it cuts the fda out of it and patients can negotiate directly with pharma companies to get access to their drugs that's starting to happen i think in canada now they're letting people have compassionate access to psilocybin for life-threatening illness because there has been studies with psilocybin for cancer patients and others with life-threatening illness as far as your question about when will you be able to access this for personal growth outside of medicine i'll take that to mean you know fully legally where you can just go buy pure drugs somewhere when will that happen you know we already are starting to see the decriminalization in certain areas of plants psychedelics and we see overall drug drug crim like that passed in oregon so that any drug is now it's not legal you can't really fully set up clinics to offer it to people or there's no legal supply like that but it's decriminalized so my sense of things is based a lot on watching what happened with medical marijuana and marijuana legalization so we're sitting here in massachusetts where marijuana is legal but what happened first was medical marijuana so what we see is that medicalization by demonstrating that under certain contexts the risks are much less than the benefits and then there are benefits and then people hear stories about people that gotten better and then that changes their minds then eventually that builds up to why are we throwing people in jail shifts to culture yeah yeah so i think that what we're going to have 2023 is mdma approved by the fda chances are psilocybin will be a year two after that then what we're going to need is a decade of psychedelic clinics that are going to roll out across america also other countries as well thousands of these psychedelic clinics we already have hundreds of ketamine clinics that are ketamine for depression um more and more people are realizing that ketamine when it's used with therapy it's better than when it's not um but the therapists want to be psychedelic therapists they don't want to be a ketamine therapist or an mdma therapist so those the cross-trained so we'll have a decade of these thousands of psychedelic clinics and all these stories of people getting better in 2035 is when i think that we will move to licensed legalization which is when you will have the option of just going somewhere once you've done this educational stuff potentially i also think it would be better to have the opportunity for people to go for free paid for by tax money to these clinics and you have your first experience with psychedelics under supervision and you know what you're getting into you've you know to ask the questionnaire what the risks are with the drugs then you get your license so 2035 is when i think that'll happen and the clinics will be sites of these initiations yes and so be a safe environment just like you said all the things that are actually uh maximize the likelihood of a pleasant experience and all those kinds of things it is a frustratingly slow process and the fda being part of that process is very frustrating that of course there's there's benefits but uh boy well i wish you could move a lot faster yeah well one thing that i've learned from being a parent is that when you have little kids it seems like they'll be with you forever but then when they grow up and they go to college and they leave you look back and like where did that 20 years ago you know so we're still dealing with the legacy of the civil war and slavery in america yeah so actually a 20-year plan is not that long so while we say um it's frustratingly slow and it is you know i mean it's 50 years since uh the psychedelic 60s and you know when right now it's um you know it's 36 years since mdma was criminalized and you think about all those people that committed suicide from ptsd or from anything else and all those people that could have been helped if the dea had accepted the administrative law judge recommendation that mdma stay in schedule three it's it's tremendously sad at the same time culture evolves slowly you know you read the bible or you read all the stuff we're not that different from people thousands of years ago so how are we going to really evolve enough over the next couple decades so we don't destroy the planet and don't kill each other that's why i think psychedelics have an important role to play that's why i've devoted my life to psychedelics and it is frustratingly slow and what i said to myself is our whole effort has not been fast enough can we talk a little bit about ptsd and mdma there's this fascinating uh paper came out on a fascinating study that you're a part of that's a phase three study can you describe what the study is can you describe what phase three means can you describe um what the findings are and why it's in fact so important and impactful yeah this study came out may 10th in nature medicine so one of the highest impact factors in medicine journals it was tremendous so to make a drug into a medicine the first thing you need to do is what are called non-clinical or pre-clinical studies meaning safety established in animals what does the drug do what are the side effects in animals where do you see the risks and then you negotiate with fda to do phase one studies and phase one studies where you move from animals to humans and those are more safety studies and trying to describe what the drug does so that you can determine if there is potential medical value there certain drugs like cancer drugs are so toxic that um you don't have phase one studies in healthy volunteers it's like phase one slash two where it's you you bring in the patients but you still are doing sort of dose response safety studies but you use patients but most phase 1 studies are healthy volunteers phase 2 are where you start bringing in the patients and you start experimenting with various different things the purpose of phase two is really just to design phase three now again i'm sort of putting out of the picture in another area's mechanism of action how do these drugs work phase two you're trying to figure out what they do who your patient population is what are the risks who do you include who do you exclude what are the doses what is your treatment what are your measures in our case it was um you know how do you do a double blind study that was a big part of phase two that's a big challenge for psychedelic drugs any kind of drugs that have a real strong effect you know how do you do a double blind study a double blind side to interrupt would mean that the patient should know should not be aware whether it's a placebo or not and the research and the researcher does not is not aware and so for that lack of awareness when the effect is really strong is very difficult to do on both the researcher and the patient side yes and sometimes fascinating they talk about triple blind so the other part is the raters that evaluate the symptoms and before and after so you ideally want triple blind do you want the patients the researchers and the evaluators of the outcomes all of them not to know what the drug whether it was drug or placebo and that's to reduce experiment or bias so and then then you move to phase three once you've figured out how to design the phase three studies and phase three are the large-scale multi-site placebo-controlled double-blind studies where you must prove safety and efficacy in order to get permission to market the drug now for us when we started maps in 86 as i said it was one year after the criminalization of mdma in 85 we had five different protocols that were rejected by the fda for studying with mdma and these were all various phase one studies they came from harvard from uc san francisco from the university of in arizona and albuquerque new mexico all over and they were all rejected 1992 um six years after we started we got the first permission for phase one and that took us through much of the 90s again things are slow because we have to raise the money through donations and and then in 1999 is when we started the work with ptsd and that then took us till november 29 2016. which is when we had the end of phase 2 meeting with fda so it took 30 years from the start of maps to the end of phase 2 meeting with fda and what we had discovered during phase 2 was several different key points the drugs that are available right now for ptsd the ssris zoloft and paxil that have been approved by fda and regulators in europe as well the european medicines agency for ptsd they work better in women than in men and they failed in combat related ptsd all right so what we learned is that mdma-assisted therapy works just as well in men or women and it works in combat related ptsd it works in regardless of the cause of ptsd we also discovered that even though there are stories that you know people take mdm at raves and they dance all night and they overheat and they get hypothermia and they die from overheating which is true and can happen from pure mdma or that sometimes people have heard about needing to cool down and so they drink water and then while they're dancing all night and then they drink too much water and then they dilute their blood and they die from hyponatremia so there are risks of mdma but we discovered that in a therapeutic setting we can control all those risks those things don't happen at all so we discovered safety we could we could demonstrate safety we also figured out that our measure the caps the clinician-administered ptsd scale that it's the gold standard all over the world for measuring ptsd symptoms it's what the fda and the e may require we discovered that it was a good measure for us and that we could show changes in that the other big thing that we learned is that um and we haven't mentioned this yet but the work in the 50s and 60s with lsd and psilocybin and the modern research over the last 20 years with psilocybin and classic psychedelics has demonstrated that there's a link between this mystical experience this unit of mystical experience and therapeutic outcomes for the treatment of addiction for working with people's life-threatening illnesses you know that for ocd for obsessive-compulsive disorder that there's with the classic psychedelics both in the 50 years ago and then the research now has been that there's a link between the depth of the mystical experience and therapeutic outcome what we discovered is that that's not the case for mdma that people do score fairly high on the scales of mystical experience not as high as they do with the classic psychedelics but they do score pretty high on average and a significant number of them have over the cutoff for what would be considered a full mystical experience so enough to say that we could look at a correlation and we didn't find any the other thing that we discovered and this was more humbling i would say for me personally is that my dissertation at the kennedy school a big part of it was on the it's about the regulation of the medical use of psychedelics and marijuana big part of my dissertation was how to do the double-blind study and i thought i'd solve the problem and i persuaded my dissertation committee that i'd solved the problem and the solution was therapy with low-dose mdma versus therapy with full-dose mdma and everybody knows that they're going to get mdma most of these people have never done it before they'll be confused about is at full dose or low dose and then the challenge is uh to pick a dose that's high enough so that there is this confusion but not so high that it's so therapeutic that we can't tell the difference between the groups so we we studied zero meaning inactive placebo 25 milligrams 30 milligrams 40 milligrams 50 milligrams 75 milligrams 100 milligrams 125 and 150. what we discovered is that my dissertation was wrong and that there is no good solution to the double-blind problem um what we found is that to our surprise actually was that 75 milligrams was an effective dose oh wow we didn't think that i mean the normal doses like full dose is like 125 milligrams something like that but 75 milligrams was an effective dose and we discovered that the lower doses so i was i was half right you could say the the doses of 25 30 40 50 they they could produce enough confusion that you could say that they were successful at blinding not perfectly but enough confusion so that people therapists couldn't know for sure so that so that there was this reduction of bias you could say but what we discovered again to to our surprise was that the low doses made people uncomfortable they they stimulated them but they didn't reduce the fear and so people still got better with the therapy with low-dose mdma but if we gave them therapy with inactive placebo they did even better than if we gave them therapy with low-dose mdma so we we call it an anti-therapeutic effect well i don't mean to imply that they got worse but it made people uncomfortable people didn't like it you know but we would still help them make some progress so we had the blinding but what what it meant by reducing the effect of therapy with inactive placebo is that it would make it easier for us to find a difference between the two groups and so the real question is if you can do it with therapy why bother at a drug so we went to the fda and and so this was what we discovered during phase two we went to the fda at this end of phase two meeting and we said we can give you blinding but it will make it easier for us to find a difference between the two groups and so we suggest that we do therapy with inactive placebo versus therapy with full dose mdma that will cause a problem because most people will be able to tell what they've got yeah what um tom lawforn a doctor who used to be head of psychiatry products at fda is our main advisor so the first thing he said is that the double blind fails in practice a lot even with ssris because there are certain side effects that you have with these drugs and the doctors who are doing these research when you're reporting your side effects they can say oh that's probably you got the active drug instead of the placebo so the double blind is in theory is terrific but in practice it doesn't always work quite as well yes and so what tom said is that there are two main approaches that they think are important to reduce bias the first one is easy to do it's called random assignment so you know sometimes there are studies where you know you'll you'll treat a bunch of people with something and some fraction of them will get better and some won't and then you say okay all those who didn't get better who volunteers to get this new treatment and then you give them the new treatment but the people that volunteer are more likely to want to get better they're not representative sample of everybody that has these so when you have random assignment everybody is similarly motivated and has meets the same inclusion exclusion criteria so that's what we talked of course we need random assignment the other part was when the bias double blind doesn't work as well then the system of independent raiders is especially important of how you do that so we have over a pool of raiders over 20 of them and we do this monthly in inter-rater reliability tests to make sure that they um you know evaluate the so that they're given a videotape of a ptsd patient and then they're supposed to rate them according to their symptoms and then then we sort of make sure that we've got this calibrated raider pool and it's all done by zoom by telemedicine and they're randomly assigned to the next person that needs a rating so they said 20 raiders yeah so we've got like 20 raiders and um we want what we want to do is is make it so that each raider sees each patient only once maybe twice but but not tracking them through the study so that guys to reduce the bias in the raiders that they they don't know where this person is in the study yes um and then and so there's a fellow um bob temple who's like the old wise man at the fda he's been there since 1972 he was in charge of the office of science policy and they brought him into the final meeting of this um process where we are trying to design phase three so once fda said yes you can go to phase three that was november 29 2016. we then negotiated for eight months on the design of phase three and all of the other information this is fascinating it's gonna need this process of design ah it was you know to the extent that i have any uh artistic creativity it's in protocol design i really love that so you enjoy this process i love it i love it because it's always trade-offs and it's um yeah it's you know and i acknowledge you know that we are all biased and so how do you there's something beautiful about the scientific process designed to get you to the truth um especially when that scientific process is trying to get to the truth of the human organism which is so complicated so it's very difficult to uh to dissect to do to get the the the strong effects and when you're analyzing when you have like raiders they're they're watching a video there's removing subjectivity from that is very very challenging yeah very very much so um and so we came to this agreement with fda though that we would um use this uh independent raider pool and and so we learned in in phase two again that the double blind there was no solution to the double blind problem and and both the fda and the european medicines agency in the end agreed that the best design was therapy with inactive placebo versus therapy with full dose mdma accepting the fact that most people will be able to tell what whether they got nothing or they got full dose mdma most therapists will be able to tell the difference but that makes a harder test for us to show a difference between the two groups because we're giving them inactive placebo and not the anti-therapeutic effect of low-dose mdma so once we started phase three so then we were able to start in 2018 phase three and the paper in nature medicine that just came out was the results of our first phase three study we came to agreement with fda that we would do two phase three studies each would have 100 persons in them and what the fda said to us is that they thought that we could prove efficacy with smaller numbers than they wanted to see for safety the reason they said that is that in phase two we had a large effect size so from a statistical point of view the bigger of an effect that you're looking for the fewer number of people you need to get statistical significance when you're trying to find small differences you need large numbers of people to sort of work out the noise um so we were we came to agreement on two 100 person phase three studies uh and the idea is that it's very possible that the the first part the first study would show the efficacy because the effect is so strong yeah yeah and the second but but also safety as well so so you know one of the things we also realized when you work with a highly stigmatized drug in the midst of still you know the drug war and prohibition that we need highly sympathetic subjects and we need to make the best case we can which means we need to work with the hardest cases so that this is really needed and so we end up enrolling people the first study was chronic severe ptsd and unlike many studies of ptsd we enroll people that have previously attempted suicide wow so we have multiple people that have tried to kill themselves that we felt like um if we were to exclude them what are we doing those are the people that need it the most so we we came to this agreement with fda we're going to work with chronic severe ptsd patients including those that had attempted suicide and we would do these two 100 person studies and we also negotiated what's called an interim analysis so what that means is that when the study is um underway um and often big big studies they have this kind of interim analysis where what you do is and for us we negotiated when we had 60 or 60 people had reached the primary outcome measure and all hundred had been enrolled then we would take a look at the data and if the statistical analysis that we did was showing you know based on a certain effect size that we chose based on what we saw in phase two the interim analysis is for what's called sample size re-estimation so what it means is if the results aren't as good as you thought they would you can add more people and then you'll get statistical significance it means that your effect isn't as strong as you thought it'll be harder to get insurance to coverage but fda will still approve it because fdl also believes that these are group averages there may be some people that will later figure out respond better than others so they'll approve it if it's statistically significant even if it has a low effect size the ssris have low effect size so we did the interim analysis in march of 2020 and what we discovered to our delight was that um we did not need to add any subjects that's all we were told we weren't told like what is the results we were just told all we were going to get is a number zero or you need to add x numbers of people to the study to get the statistical significance that's right around the time that covet hit and lockdowns happened and we ended up negotiating with fda that we would end the study with 90 people instead of 100. it took a while for us to end up doing that so the paper that we just published is on the results of 90 people i think it was 46 in the mdma group 44 in the placebo group and what we discovered was that the study worked better than we had even hoped so the first thing is that you look at statistical significance you have to get 0.05 which basically means a nickel out of a dollar a 1 in 20 chance that the difference between the two groups is due to some random factor rather than to your intervention and in this case the the placebo group gets therapy and then with inactive placebo and then the group gets mdma with active placebo so you have to get .05 there's another measure that the fda uses sometimes called robust which means one in a thousand instead of one in twenty one in a thousand and if you get a robust results .001 and you meet some other criteria they might agree to approve the drug on the basis of just one phase three study instead of two because when you think about it a one in 20 chance for your first seconds to a phase three study a one in 20 chance for your second phase three study you multiply that together it's one in four hundred point zero um two five um that's pretty good so robust .001 is even better than two independent phase three studies each at .05 what we ended up getting was one in ten thousand point zero zero zero one outrageous yeah you know incredibly so that's a measure of both the difference between the two groups and the variability and so what it meant is that we had minimal variability that most people who got to mba got quite a large amount of benefit from it and most people who got the placebo were more or less in the same range as well that's really exciting by the way i mean [Laughter] mean i i i suppose it's exciting from a perspective of approval by the fda maybe perhaps that's the way you're seeing it but it's also exciting because it's it has a chance to help people that are truly suffering yeah well if we can get one in uh 10 000 in the first phase three study chances are we can get one in 20 in the second so it's really going to be about safety for us in the second phase three study yeah now you can have a large p value a large significance but you could have an effect that's not very significant it's not clinically significant you can have statistical significance without clinical significance and as i said the the more people you get in the study you can find smaller and smaller differences between two groups now we showed that we had um a very large effect size so effect size is based on um that scale you mentioned well well the scale of the effect size is based on standard deviations so an effect size of one means that your results are one standard deviation away from the norm that's considered very large the the ssris because they have they were like .3.4 effect size that's considered small effect size medium is starting to be around 0.6 and 0.8 and above are large effect sizes we had what's called placebo subtracted effect size there's two different ways to look at it placebo subtracted means you kind of look at the difference between your two groups and and what that is for us since one group had therapy and one had therapy plus mdma the placebo subtracted effect size is basically the effect of just the mdma because you've kind of washed out the therapy that was 0.91 so we had a large effect size which was different wow over so 0.91 over the just the therapy so over the placebo yeah wow now when we do the within group meaning the group that just got the mdma plus therapy look at their baseline and their outcomes that's another way to look at it and that's what's going to actually happen in practice because people are going to get mdma plus therapy that's 2.1 effect size two standard deviations away from the norm is enormous effect size yeah the other part is that we had no effect by sight which is very important so we had 15 sites two in israel two in canada 11 throughout the united states the fda looks at is there a side effect because what that might mean is maybe you've got all your patients or most of your patients going to this one site which is these highly experienced therapists and they're like you know hippies from way back and they're super experienced with psychedelics and you know and they're they're getting great results but nobody else gets good results so we had no effect by sight which means that's incredible that we've been able to train all these new therapists we had about um about 80 therapists working at all these 15 sites we also discovered that there's a group that's considered to be very difficult to treat which is called the dissociative subtype so when people are traumatized one of the ways to psychologically survive that is you dissociate it's like you're not there when you do that though it's hard to come back because when you come back then you get all these painful memories and fearful and so um the extreme of that is called dissociative identity disorder kind of like schizophrenia almost dissociative identity you're so we let people in who are on the dissociative subtype and those are considered to be the hardest to treat because the the theory is that you need to be ego intact as i said the mystical experience is not correlated with therapeutic outcomes and you need to be talking about what traumatized you and working through that and expressing it letting it out not keeping it in so the dissociative subtype seems like it's harder for them to get back into the event because they're so dissociated what we showed is that those people did even better on average than everybody else so that mdma is integrative it helps people who are so separate that they make even more rapid progress so it's almost like them dma made it more difficult for them to dissociate yes yeah or you could say it made it easier for them to remember yes exactly to reverse the dissociation yeah and we find that mdma enhances memory for the trauma so that you can have these unconscious uh memories or memories that you cannot remember that you've suppressed so much but they distort your view your filter of the world is distorted by these fearful memories that the world can't be trusted people can't be trusted it's always about to happen so we find that mdma increases memory for the trauma but by reducing the fear then the memories can come to the surface then you can process them let out the emotions cry scream shake whatever and then through this mdma effect on the amygdala and the hippocampus it helps you store these memories into long-term storage so that they're not always about to happen they're in the past they're part of your story but they're not the whole story so we discovered that the dissociative subtype works better now none of this would be enough unless safety so from a safety perspective what we discovered is that there was one woman in the study that attempted to kill herself twice during the study there was another woman that was so um worried that she might kill herself that the therapy brought these things to the surface that she's been pushing away that she checked herself into a hospital in order to avoid self-harm at the end of the study you know what we learned is both of them were in the placebo group we didn't have anybody in the mdma group attempt to kill themselves so the mdma is really helpful for giving people a sense of hope and and that they can somehow process this now it's not to say that nobody will ever commit suicide and that's our big concern in the second phase iii study as i said it's more going to be about safety than about efficacy we think we'll get the efficacy but we're very concerned about you know safety because we had um problems in the first phase three study of somebody trying to kill herself twice in the placebo group you know it's it's the background for having ptsd so there'd have to be a disproportionate number of people in the mdma group try to kill themselves or succeed in killing themselves then in the placebo group for the fd to say oh this mdma it's too dangerous it brings we don't think that's going to happen so those are the other findings are that this from safety is that the side effects are transitory they're minor they're they're um you know sweating or jaw clenching or you know slight temperature increase and you know ev everybody that's been to a rave knows about you know taking ecstasy you know there are some side effects but they're minor they're transitory and there has been this massive problem of um during the 80s the 90s nida the nationalists on drug abuse was trying to say that mdma was neurotoxic and that you take it and it's going to cause nerve terminal degeneration it's going to be major brain damage it's going to be significant functional consequences and back then they were saying that mdm is too dangerous it should never even be researched nobody should even get it once because it's poison and brain damage well we no longer believe that that was exaggerated that was um you know in service of the drug war but we've done in phase two neurocognitive tests before and after in two of our different sites and showed no decline in cognitive functioning so we we don't think that there's any um neurotoxicity happening and the doses that we use there's no obvious functional consequences people are getting better and the other thing that we've learned in um phase two and that we still have to learn from this study so what we showed is that um is the durability of the effect we showed that um 32 percent of the people that got the therapy without mdma at two months after the last experimental session no longer had ptsd just with the therapy which is phenomenal because these are on average 14 years ptsd one-third had ptsd over 20 years and just with the therapy 32 no longer had ptsd at the two months um however those people that got mdma it was 67 percent no longer had ptsd you know more than twice as good in phase two and in phase three we're also going to do the 12-month follow-up that's not for the fda that's not for approvability that's more for insurance companies because this is expensive a lot of therapy time if it fades you know if it's great results initially but then it fades after six months what's the point and what we showed in phase two is that um people keep getting better at the two-month follow-up they're doing pretty well but at the 12 month follow-up they're even better so it's durable people have learned how to process trauma they keep getting better so we've not reached that point in this phase three study where everybody's got their one year follow-up but we have also done three and a half year follow-ups to some of the groups that were in phase two and showed that it was durable and we're doing a long long-term follow-up now to everybody to many of the people in phase two some of them treated 15 years ago so that's all more for the insurance companies so basically what we found in the paper that we just published is that it was highly efficacious highly significant no effect by sight works in the hardest cases and the safety record was great that's an incredible success and that's really exciting especially given that uh the people who've committed who attempted to commit suicide were let into the study and so these are is the people who are truly suffering um i mean that um that's incredibly exciting and i mean just to speak to the frustration why things can't move faster but um but for what it is it's incredibly exciting is there other studies of this nature that you foresee enabling that same kind of positive impact whether it's mdma for other things like treating addiction or maybe it's psilocybin for uh for other conditions is there something else that's promising yeah i i think that um what we've discovered i don't think is unique to mdma so it's mdma assisted psychotherapy mdma is ideal for ptsd you know maybe it won't work as well for ocd or other things you know it's very strategic why we chose mdma and why we chose ptsd but i i don't think that the results that we've got are so unique to mdma assisted therapy i think that psilocybin assisted therapy is going to be great for people with life-threatening illnesses cancer you know we're anxious about dying it's looks like it's really good in the treatment of addiction um again these are in combination with sort of the psilocybin tobacco was cognitive behavioral therapy with psilocybin um i think that it's going to be a little bit more difficult psilocybin for depression i don't know if it'll be quite as good you know there are some biological aspects sometimes to depression but i think there'll be really good results for psilocybin for depression i think it'll be approved it's considered a breakthrough therapy by the fda ibogaine is phenomenal for opiate addiction helping people go through the withdrawal and then giving them this chance to deal with the material that they've that drives them for addiction um there was ben sessa dr ben sessa in england did mdma for alcohol use disorder and that was really great the results he got and it's it's the case that he ended up basically treating people for trauma it's the trauma that people run the emotional challenges that people run from into quieting that pain through drug addiction or alcoholism so trauma is behind a lot of addiction i i think that we are going to see a revolution in psychiatry and that there will be a lot of conditions that have left a lot of people still suffering that psychedelic assisted therapy different psychedelics different approaches but i think that we will see a lot of hope for psychiatry and psychotherapy and that psychedelics would be a big part of changing the practice of of psychiatry and psychotherapy yeah this is really to me fascinating so i i actually um when i was younger for the longest time wanted to be a psychiatrist so i was excited by psychotherapy but then i uh perhaps incorrectly maybe you can correct me but became more and more cynical because it felt like it was more about prescribing drugs than psychotherapy i'm not going to correct you that's i mean right now it's like there is a crisis in psychiatry that there are so many psychiatrists that are so fed up because they have been pharmaceuticalized yes they meet people for 15 minutes they adjust their medications this is the way they make the most money yeah but they've lost the art of talking to people yes it's it's true and that's why we see that so many young psychiatric residents are so thrilled by psychedelics that they really want to get back to treating people as individuals not just a bunch of chemicals yeah that's truly fascinating because the reason it was appealing to me it was a way to to study the human mind and to see ways through talking that you can make people feel better make people better you know make people suffer less and that that was really exciting at the time i ended up then going to ai because then i can understand the mind from that angle but um it's exciting that that that could be also revolutionized the field of psychotherapy take it from its uh back to its origins to where um a psychiatrist would be a scholar of the mind yeah well you know freud talked about dreams as the royal road to the unconscious and there was a lot of we you you really spent a lot of time with people now um right before he died um in in his last book freud wrote something and again this will be a rough paraphrase but he said that in the future we may learn about the energies of the brain and there'll be ways with chemicals to influence that that will help the therapeutic process yeah [Laughter] so you could say he was uh he was ahead of his time yeah this study paints a fascinating picture of a future where first for medical applications but then also in general psychedelics of various forms could be used by the broader society forgive the perhaps ridiculous question but if much of society including our politicians are um taking psychedelics and dissolving their ego and going through this whole process how how do you think the world may look different in 20 30 50 years ah okay so um i i said that i think licensed legalization happens in 2035 yes right so um and i think by 2050 um we will have enough people hopefully spiritualized we're also talking about um we hear so much in terms of climate change about you know net zero carbon so our goal is net zero trauma when do we have a world with net zero trauma i mean right now you know we have two sites in israel so we help a few people but the recent war with gaza has traumatized millions of people on both sides so we are a long way away from net zero trauma um but that's the hope and that's i think possible i think humanity as a whole um is like lemmings heading over a cliff with climate change and with the nuclear proliferation and just the the religious hatreds and the more the retreat to authoritarianism and fundamentalism and tribalism so i i think that there's a very good chance though that psychedelics used wisely so it's not just makes psychedelics legal and everybody takes them and you know as you talked about ted kaczynski you know it's the context that people take it in but i think that there's um a reasonable chance that enough people can sort of you could say um clean their filters uh to see people as um more similar to them than different not to label them as the enemy stan groff again had this beautiful phrase about um transparent to the transcendent the death that's what yeah so for our ego can can we be transparent to the transcendent because can the filter that we look through the world at be cleaned to um you could say cleansing the doors of perception you know can it be clean to the point where we can see the humanity in everybody and see that um one way to say this is that can we get to the point where religions are seen as like languages where we all have this need to communicate there's thousands of different languages you know we don't say that this language is fundamentally better than this language this language is the only right language everybody must speak english and russian is bad or german is better you know maybe we'll get to that point that that religions are like that that their different cultural backgrounds different symbol systems different um saints and heroes and messiahs and all this but that you know yeah jesus is the son of god but so are we so is everybody you know or yes you know the jews are the chosen people but so is everybody so can we get there i think that we can and i think that we need to to survive the challenges that we're facing and the hope is that by bringing psychedelics as tools forward and trying to bring the context around them to be one of responsibility rather than just profit maximization and just you know get as many people to do them from all these for-profit companies you know can we and then also drug policy reform and embed knowledge in the society can we get to honest drug education you know dare the drug awareness resistance education you know is fundamentally twisted i mean but it's the program that's used in a lot of schools now so can we get honest drug education pure drugs harm reduction and knowledge about therapeutic uses and um on the one hand and and more of these thousands of psychedelic clinics um i'm hopeful um and that that's our goal but in this landscape of um pharma companies they make a lot of money some people are worried about the impact of those com you know uh a big pharma on the landscape of human trauma yeah yeah and so there's of course some companies could do good but that's not inherent like um many of these companies are not optimizing for good they're optimizing from profit exactly exactly does this uh rise of for-profit pharma companies were eu how do you navigate it do we still have for-profit companies that basically uh do what uh maps does which is like fight the good fight for the benefit of humanity like what like how do we proceed in this in landscape or work where drugs can make a lot of money well i am concerned overall i think the rise of the for-profit companies we have to realize is a sign of success that we have overcome the regulatory prohibitions we've overcome a lot of the public attitudes that are against it we've demonstrated some success so the rise of the for-profit companies are a sign of the progress that we've made on the other hand turning things over to profit maximizing companies the big concern is that they're going to try to minimize the amount of therapy and make it so the cost is less so insurance companies are more likely to cover it and then that they just sell the most drugs the other thing we've seen as an example of this is s ketamine by johnson johnson for depression and it's done by a profit maximizing company they don't know anything about psychedelic psychotherapy or psychotherapy at all and so they've gotten approval for s-ketamine on the basis of it's just a pharmacological treatment and it's not delivered with therapy the results fade pretty quickly so you need to get more ketamine and so it's designed in a way to maximize the profits for the pharmaceutical company but it doesn't maximize patient outcomes what we're seeing though in these various clinics that are being set up is that a lot of people are realizing that it works better with therapy and so the clinics are run by people that are therapists so that when they provide therapy they're making more money and and then you need less ketamine also ketamine itself s ketamine is a isomer of ketamine that's been patented for depression and they sell it for hundreds of dollars but ketamine itself is one of the world's essential medicines it's off patent it's been around for a long time it was the main battlefield anaesthetic in vietnam and it's only a few bucks because it's generic so a lot of the ketamine clinics are saying great thank you johnson johnson you've helped demonstrate that ketamine is good for depression but we're not going to buy it from you we're going to buy it for a few bucks and we're going to add therapy to it now there's a bunch of ketamine mills you could say that are that are just prescribing the ketamine and then people are making a lot of money there so i am worried about that i think the best thing that we can do is create an alternative narrative a different kind of example we can lead by example we can't make for-profit companies into benefit corporations unless they want to do that we can't make them to you know really maximize patient outcomes but if we create an example of something that's different the hope is that um people will gravitate towards that and some of the other companies like even now we have exxon and other these uh companies oil companies saying oh we're big into alternative energy and we're you know and that starts with companies that show an example that uh then communicates to the public that this is something exciting and then they demand of the same of exxon and so on the public demands and you could say the same thing for the public demanding the the big pharma to uh to optimize for benefit versus optimize for profit and maybe giving power to the therapists more power to the therapist more power to the doctors that ultimately uh want i think incentives are interesting but i think doctors ultimately care more because they're in direct contact with humans they want to make people better it's not you know sure they want to make money but they ultimately want to make people feel better because they get to look at people and it's so joyful to make people feel better at the end of the day so giving more power to them is also perhaps one of the ways that you then incentivize uh the the pharma companies that are trying to do good because the doctors will choose those companies yeah now the other part of this is drug policy reform right so that if we make it so you can buy mdma for 10 or 20 bucks on your own and we've trained people on here's our therapeutic method here is our ways for peer support then people have an alternative from buying it from the pharma companies so most of the for-profit companies have come to this conclusion that um drug policy reform is bad for their business model i think they're making a fundamental mistake and i think the reason is that the more that we destigmatize this the more that we sensitize people to this is an approach even when people can get it on their own and do it with their friends or do it with themselves there's going to be even more people that say oh my god i've got real serious issues i would rather go to trained professionals covered by insurance and i think it'll increase the business but most of the for-profit companies don't see it that way and so as a non-profit that owns a benefit corp we're not trying to maximize sales or profits so that but but i do believe that drug policy reform creates this alternative access point for people and that will help keep the for-profits in check to some extent as well i love it uh is there um let's put on your wise visionary hat and ask when you look to young folks is there advice you can give to young people today whether in high school or college about career about life you've lived quite a non-linear and fascinating life yourself is there advice you can give either on career or more generally in life well i i would say what what people often hear is that um you know we're not actually here for that long a period of time um and so to the a and the world is on fire and whether humanity survives is not clear and whether how many species are we going to kill before we figure out not to do that anymore so i would advise you to really try to develop a combination of what do you need in terms of income for your own survival but what does the world need in terms of um help to make the world better and you know howard thurman who he talked about who who ran the good friday experiment the minister there he said he's got a famous quote attributed to him he says um and this is exactly it to young people he said um you know there's nothing particular that you should do but find what makes you come alive because what the world needs is people that have come alive and are passionate so i i would say that beware of this uh trap that you need um vast resources that you need all this stuff you know uh you know i i keep thinking of the super wealthy people in first class on the titanic you know as the titanic is sinking you know their money's not going to help them the the earth is like titanic you know we're sinking we're destroying the planets destroying the environment so it's um you need a certain amount of money to be comfortable to not be at that edge of survival because once you're at that edge of survival it's hard to think about anything else but but i'd say to young people to the extent that you're able to do this and again student debt and all this kind of stuff is a big problem there too but really just try to find this combination of what the world needs and what you need the other thing to say to young people is um life is a lot shorter than you think that and a 20-year plan is not really that long so if it takes you 20 years to get in a position to do what you want to do go for it you know have long-term plans the the other part that was so important for me to um keep doing what i've been doing basically now it's um 49 years that i've sort of been devoting my life on psychedelics since i was 18. when i started i didn't think it would ever work i just thought this is the only idea i have in this crazy world you know this is what i want to work on luckily i had support from my family that took care of my survival needs so i could do that but i realized that if my happiness was dependent upon accomplishments that i might never be happy that i was able to reframe happiness in terms of effort yeah so if i'm trying hard to get stuff um to be better whether it's better or not i can be happy at the end of each day i tried and so i think you you try to separate out the goals that you have and your happiness to whether you're trying hard the other thing i would say is that everybody has this humanity within them so be very careful about dividing the world into us and them um you know and try to so so one of the things that i've done um that has um taken a long time because you know i feel like um you know drugs are illegal i always felt like you know the police were the predator and i'm the prey yes you know but now we're working with the police and the police have tremendous trauma from the work that they do we have one police officer who is now going he's a full-time police officer he's also a psychotherapist and he's going through our training program to learn how to give mdma therapy to other police officers and i met his police chief a couple times he got permission from his police chief to go to the second part of our training program which is where we give mdma to therapists who volunteer as a patient so we have just a couple weeks ago dosed the police with mdma yeah and so i think this idea of those people that are on the quote other side try to see through that to their humanity to what their pains and suffering what their struggles are to the extent that you can and that i think and and build long-term relationships you you never know what's gonna um come around 20 years from now so you you help some people try to keep these relationships going 20 years from now something could could come and um and also um be persistent you know yeah i think that's that's been the key to success i mean once the fda or dea figured out we're not going anywhere they're gonna have to deal with us then we started getting some progress it's a mix of patience and stubbornness that gets things done is there something you've figured out through your journey with psychedelics about some of the big why questions about life like oh like what the heck's the value of love um why does it suck so much that we die and uh and for some of us maybe it's the russian and me but it's quite terrifying the notion of it or the biggest why question of them all which is what's the meaning of it all well um yeah what i've discovered is that um we don't need answers to those questions you know that the fact that um we can feel happy you know that we can love that we can have moments of happiness that's enough you know figuring out these big questions you can get lost in that and um you we all can come up with our answers what's what's the meaning of life why why is there life why is there consciousness but um i don't know that we need those answers what we know is that we're um social creatures that um we people other people can make us happy by certain things we can make other people happy that one life is enough so this other part about uh why is it so um tragic that we die yeah um i i don't think it's tragic that we die so first off if you believe in this collective unconscious but but but we have an impact that lasts but i i think that for me at least i've been of the view that um we should be grateful for death that death makes life precious that if we had an infinite amount of time you know i mean i'm i'm a bit of a procrastinator about stuff particularly things that are really you know hard to do and you just you know you just don't do it and then like where'd the day go i was gonna do that so so if we had an infinite life we never died um know would life be precious would we do anything i don't think so so my parents um gave um you know every jewish new year they would they would make their uh new year's card and and one of the quotes was fantastic it was just uh we have to make up for the brevity of life with the intensity of life oh man that is good well the end makes things precious death makes life precious the end of this conversation makes it precious and uh which is a great way to end eric it's i wanted to talk to you for a long time i share you were very excited about the study i can now understand exactly why this is really promising this is really exciting gives me hope about the future even if it doesn't come fast enough but like you said had to be patient and stubborn thank you so much for wasting all your valuable time with me today it's truly an honor to meet you and talk to you not a waste at all i really appreciate it this time together thank you for listening to this conversation with rick doblin and thank you to theragun expressvpn blinkist and asleep check them out in the description to support this podcast and now let me leave you with some words from terence mckenna nature loves courage you make the commitment and nature will respond to that commitment by removing impossible obstacles dream the impossible dream and the world will not grind you under it will lift you up this is the trick this is what all the teachers and philosophers who really counted who really touched the alchemical gold this is what they understood this is the shamanic dance and the waterfall this is how magic is done by hurling yourself into the abyss and discovering that it's a feather bed thank you for listening and hope to see you next time