How Do Psychedelics Help You Reach Enlightenment or At Least Happiness? with Michael Pollan

Coming up on this week's episode of the Doctor's Pharmacy.

We used to think these drugs made you crazy. Yeah. But now they make you sane.

Right?

Welcome to the Doctor's Pharmacy. This is Dr. Mark Hyman. That's Pharmacy with an F-F-A-R-M-A-C-Y, a place for conversations that matter. Today's guest is Michael Pollan. You all know very well from his work on food, which we're not going to talk much about today. But he is the author of a book that really changed my thinking about the food and food system called the Omnivore's Dilemma. He wrote Botany of Desire. desire. He's gotten lots of New York Times bestsellers. His new book called How to Change youe Mind, what the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence is an extraordinary book. It's like a journey through history and a journey through the mind in a way that I think will change our thinking forever about how to use plant substances and various kinds of compounds in novel ways to treat things that we're not very good at treating in medicine. So I'm so glad to have you here, Michael. No, it's great to be here, Mark. Named Time Magazine's 100 most influential people in the world, and you certainly influenced me. You've got a great book called Cooked, too, which I read, great Netflix special people should watch called Cooked. So we're gonna talk about your journey through your trip, the psychedelic trip, through the world of psychedelics and the research. So, you know, your book is an extraordinary narrative about how we started on the journey of exploring psychedelics and psychiatry, how we stopped and now there's a resurgence of interest in treating all these recalcitrant conditions that conventional medication just doesn't really work very well with. Depression, anxiety, addiction, addiction, cigarette smoking, alcohol, and even death, even death. So what inspired you to start writing about psychedelics as opposed to food?

Yeah. So it seems like a kind of radical shift, and in some ways it is. But they're continuities too. I've always been interested in our relationship to plants. That's been my obsession. I've been a gardener since I was a little kid. And in Botany of Desire, which you mentioned, I was looking at how plants advance themselves by gratifying our desires. And one of them is for food, obviously, another is for beauty. But another, and a kind of idiosyncratic one, is our apparently universal desire to change consciousness.

Yeah.

And in Botany of Desire, I looked at cannabis. I've written on opium. I always try to alter our brain and our mood, right?

Why? You know, and why is that adaptive?

Caffeine, alcohol, sugar. Exactly. Every culture, every culture has some, with one exception, the Inuit, where nothing good grows. Every culture has some plant or fungus they use, mushroom, to change consciousness. And it could be in a very mild way, like caffeine, although I think caffeine is a pretty profound drug in its own way. or it could be to relieve pain, as we do with opium and opiates. And then you've got these more radical ones that give us really disruptive psychedelic experiences. So that's been a longstanding interest, and it's part of my wider interest in nature and our engagement with the natural world. And then I came across this research that was going on at NYU and at Johns Hopkins.

Yeah, we had Tony Boss on the show here.

Oh, great. Tony's great. He's a good friend. I just saw him a couple weeks ago in Portland. And, you know, this was such a striking study. And we have so little to offer people who have a cancer diagnosis. I mean, we have oncology, obviously, but to help them deal with their fear and anxiety and, you know, morphine doesn't help with that. And it just dulls people. And they were administering psilocybin in a guided session. So it's very different than the way you might use it recreationally.

I'm going to go to Grateful Dead concert.

A therapist prepares you very carefully for what to expect, sits with you the whole time, helps you integrate the experience. experience later. And they were getting these remarkable results. You know, something like 80% of the volunteers had statistically significant reductions in depression and anxiety. And I started talking to them, and they had the most amazing stories of personal transformation, of spiritual insight, and many of them lost their fear of death or of recurrence. And I got really curious about this, and so decided that there was a book to do. I was also-- yeah, you wrote the.

Trip doctor in New York magazine. Yeah, yeah.

For the magazine. For the trip treatment. And that was my introduction to the subject. And that's when I decided, oh, God, I just barely scratched the surface. But as you suggested, one of the big surprises was that this research had been going on and had been very productive all through the 50s and into the 60s.

Yeah, you wrote there's like a thousand studies on 40,000 subjects.

Subjects, yeah. And six international conferences on LSD in that 50s 15 year period. So it was a big deal. Cary Grant took like 56 guided trips. Yeah, yeah. And a great many people on the West Coast especially were getting psychedelic therapy. Psychiatrists were giving people moderate doses of LSD. It was called psycholytic therapy. Just kind of loosen them up and make their unconscious material more available and make them less defensive.

The original microdosing.

In a way it was. It was somewhere between micro and macro. It was like 75 micrograms. And so this was news to me. a lot of people, I thought psychedelics were a creature of the 60s. And in fact, they're really a creature of the 50s that went awry in the 60s. And we had this backlash essentially beginning in the mid 60s and the research was stopped. And it's just resumed.

Yeah, it was the whole turn on, tune in, drop out Timothy Leary advice that kind of derailed it.

Yeah, I mean, the drugs had gotten into the counterculture. They were very disruptive. They were, you know, Nixon thought that they were sapping the will of American boys to fight in Vietnam, and he may well have been right.

And he was like, Timothy Leary's the.

Most dangerous man in America. Yeah. Which is amazing, although he had two most dangerous men in America. He said Daniel Ellsberg was also the most dangerous man in America. Oh, yes, dangerous man in America. Pentagon Papers. Yeah, exactly. So I started writing about this Renaissance and looking at it from several different perspectives. I mean, the therapeutic perspective, the neuroscientific perspective, trying to figure out how it works. and then a personal perspective. I decided there was no way to write about this work without having my own psychedelic experiences, which believe it or not, I hadn't had till I was in my late 50s.

That's hard to believe as a guy who grew up in the late 60s and 70s, how did you escape the party? I missed the party. You must have been like that really anxious kid who didn't ever want to take any drugs, was afraid he was.

Gonna go crazy, right? That was me. Because of all the bad press. I had read all the scare stories and I would you know, I realized this. Yeah, bad trips, psychotic breaks, people thinking they could fly and jumping off buildings, staring at the sun till they went blind. There was a lot of disinformation out there. And yeah, I didn't think I was sturdy enough for it.

So it's something that has been in existence across cultures thousands of years, whether it's ayahuasca ceremonies or the mushrooms in Mexico and the Curanderos who did it there. I mean, there was so much of this across cultures. I read a fascinating book called the Cosmic Serpent, which I might have read, which talks about ayahuasca and the biology of how it affects our perception. And actually, I don't know if it's true or not, and it came across this, but everywhere in these cultures is this image of a double helix, like the DNA. and he suggested maybe- this is Michael Harner. Yeah, they were actually seeing the photons, perceiving the photons of light that get emitted from the DNA through this liberating of our neurotransmitters that affect this. So that some of this happens at birth and death, we release these sort of endogenous molecules that help us sort of see the light, so to speak.

Yeah.

But this is a way of sort of getting a bypass there.

Yeah, I mean, I don't know if that's true or not. It's very provocative. There's, there is a school of thought that the brain produces its own DMT in the pineal gland.

Dimethyltryptamine.

Right. And it's been found in very small amounts in rats. You know, you can't sample the living brain easily for chemicals. And, and there has been, though, some recent research where they asphyxiate rats and induce cardiac arrest. And there are these flushes of neurotransmitters that are released. I think they found serotonin, dopamine. I don't know that they found DMT though. So it might explain there's a lot of likeness between the DMT experience and the near-death experience that people report. This sense of leaving your body and being able to observe yourself from another perspective happens in both cases. So all that's very provocative. I mean, I think that we're really just on the threshold of learning what these drugs have to teach us about the brain and the mind. And I think the next 10 years are going to be amazing in, in psychedelics.

Well, you, you said something very provocative. You said, we used to think these drugs made you crazy. Yeah. But now they make you sane.

Right.

And that, you know, Psychiatry went from brainless to mindless. Meaning we didn't really focus much on the brain of psychiatry with Freud. It was all about your mother. And then we started focusing only on the brain through neurochemistry and drugs that alter your brain chemistry.

And we left the mind out.

The mind out, right.

So, behaviorism. Yeah. And it's true. And what psychedelic research will lead to, I think, is a reintegration of brain and mind. You really need both. this is obviously a chemical effect, but it's also a psychological effect. When you're using this therapeutically, you're not just administering a drug per se, you're administering a kind of experience. And the best predictor for success, whether you're treating depression, anxiety, addiction, is that people have this so-called mystical experience, which is characterized by a sense of your ego dissolving, sense of merging into something larger, your defenses are completely down and you feel very connected to nature or the universe or other people. And this sense of well-being, this transcendence of space and time, it's a very specific, well-defined phenomenon that is, you know, throughout religious history, but can be induced by a high dose of psilocybin or-.

It was like a spiritual bypass a little bit.

In a way, it is. It is. I mean, you know, It's interesting, the American researchers all talk about it in spiritual terms. The English researchers are a little more allergic to that vocabulary. They talk about it more in psychodynamic terms, but I think they're talking about the same thing.

Well, what's interesting, I heard you speak at South by Southwest and you were talking about this part of the brain called the default mode network. And you said something that sort of just caught my attention, which is that in very experienced meditators like Tibetan monks who've been in a cave for nine years, they are able to have the same effect on their brain on functional MRIs as those people who take psilocybin or LSD. It suppresses this part of the brain that's sort of our ego.

Yeah. I mean, it's, you know, Can we talk about that? Yeah. Well, this is one of the most interesting findings in the kind of basic science around psychedelics. They began putting people into MRI machines and administering LSD and psilocybin, and they wanted to see what was going on in their brains, what was activated, what was deactivated. Their expectation was that there would be general activation, because there's such fireworks, right, that people report in the experience. The big surprise was there was a deactivation of this default mode network, which is a group of tightly linked structures connects the prefrontal cortex to the posterior singular cortex to a deeper, older structures involved in memory and emotion.

Pretty impressive for a journalist in all those brain parts.

I still struggle with brain anatomy, frankly.

It's like, neuroanatomy, that's not easy. It's not easy at all. There's just like a big mush of.

This jello thing, but there's so much anatomy in it, it's so specific. And our thinking now about the brain is it is very networked. It's not about individual parts do very specific things. They're all linked in very interesting ways and the linkages are just as important. So the default mode network is involved in self-reflection, theory of mind, the ability to impute mental states to others, a time travel, the ability to think about the future and the past, which you really need to construct an identity. I mean, Oliver Sacks showed us if you don't have a memory, you don't have an identity. And the so-called autobiographical self, which is the function of kind of building the story of who we are out of what happens to us. And that appears to happen in the posterior cingulate cortex. So yeah, to the extent that the ego has an address, it would be in the default mode network. And this is basically, it's not completely turned off, but it's down regulated. And when they also did similar fMRIs of meditators, long-term meditators with 10,000 hours of experience, they found the same pattern, the deactivation of the default mode network, which makes sense in that both involve ego dissolution, right? I mean, you're transcending your ego in meditation if you're very experienced and quieting the self-chatter. I mean, because the default mode network is where you go to mind wander, worry, all that.

Well, that's it. I mean, it's exactly, I think you're hitting on something that's so key, which is that suffering, comes from identifying with your ego, and that the liberation of suffering, according to the Buddhist tradition, is realizing that that is just an illusion, and that you are not really separate, and that the meditation is a technique to help you actually realize that.

-And break that attachment to your worries or everything, really. And that attachment is the basis of suffering. Yeah, I mean, the Buddhists figured this out a really long time ago. -Amazing. -And now, you know, neuroscience is moving.

In a very similar direction. So we've got this new idea that you proposed in the Washington Post and in your book about this grand unified theory of mental illness. That how does this one drug or this one actually plant compound affect all these disparate disorders like depression, anxiety, addiction, and obsession?

I was very skeptical of that. I said, you know, this sounds like a panacea. Why does it work on so many different things? And I mentioned this to Tom Insel, the psychiatrist, he used to be head of the National Institute of Mental Health. He's a great guy. He is a great guy and he was very helpful to me and understanding this. And he said, you know, you have to understand that these separate diagnoses are really a artifact of the insurance industry and the fact that we need a different diagnosis for all these things. He said, all those things, depression, anxiety, addiction, obsession, may be manifestations, different manifestations of a similar brain malfunction. And the thinking on the part of the psychedelic researchers is that all these are products of a stuck brain, of a brain that is caught in loops of rumination and the repetition of destructive patterns of thought. And if you think about it, they're all habits of one kind or another. It's telling yourself the same destructive story over and over again. You know, I'm unworthy of love. I can't get through the day without a cigarette. You know, I'm worthless, whatever it is. And what the drugs seem to do, it's like if you had a steel structure, they introduce heat and they allow it to become more flexible. They help you anneal it. And they're really good at getting people to break out of the grooves of destructive patterns of thought. And that's why I say in the book at some point that maybe psychedelics are wasted on the young because it's as we get older, It's as we get older that we get stuck in these patterns. We all develop these algorithms for dealing with life, and they may be efficient, but they can also be quite destructive.

Well, a lot of mental illness also is connected to a sense of isolation and loneliness and separateness and loneliness. And in a way, these drugs often will give you a sense of deep connection with life, with others, with with meaning, with purpose in ways that other drugs just don't do. And what's interesting is that these drugs don't work by ongoing effects because you take one dose and you got six months of benefit. And it doesn't make sense from a medical point of view except for the fact that it links to this experience. Experience.

Yeah. No, that's why it really is the experience. And we know that experiences change brains. I mean, look at trauma, right? Trauma changes brains.

Yes.

All experience is learning, and learning changes the brain. And you can think of it as Roland Griffith has proposed as a reverse trauma, a powerful positive experience that can reset the brain in the way a trauma does too. It is, you know, I think it's, I just think it opens up a whole new way of thinking about behavior change. And I think that that is something we really struggle with. Adults have a lot of trouble changing how, I mean, we know from the food area, getting adults to change their habits around food is really hard. They really get locked in. And the disconnection that you're talking about, I think is key. But what disconnects us? It's the ego. The ego builds walls. The ego defends us. And as it gets overactive, look, egos are great. They do a lot of very positive things. Yeah. You need it.

They survive.

They're very adaptive. There's a reason evolution gave us an ego. But they also cut us off. They also cause us to objectify the other. And in depression, you have an overactive default mode network and ego that is turned inward, is punishing you, and to be relieved of that dictator sometimes is exactly what people need.

I first sort of started learning about this when I took this class at Cornell. call Plants and Humans. It was kind of a fluff class, but it was fascinating across agriculture, but also across this whole place and the intersection of consciousness and plant medicines and ritual and ceremony. And I became fascinated and I read Doors of Perception by Aldous Huxley about his journey with mescaline. And, you know, I started experimenting with these in a very sort of ritualistic setting, usually in nature, with a couple of close friends where we really sort of dropped in. It wasn't like taking mushrooms and going to Grateful Dead concert. And it was profound. It really, it gave me that sort of quick, like, view of a world that I hadn't really seen before, you know, had read about, thought about, but never directly experienced. And it, I think it really impacted My view of humanity, my view of my place in the world, my view of death, my fear of success or not success, it really helped dissolve that ego separation in a way that kind of was a profound shift for me. And I studied Buddhism. That was my major in college.

Really?

Studying the psychology of consciousness at the same time. And I took 10-day meditation retreats. And I remember, after one 10-day meditation retreat where you're meditating like 12 hours a day, I came out and I literally felt like I was tripping. I literally, everything was like sparkling, all my senses were enlivened, I felt connected to everything in nature, everything was moving. It was really the same experience, but who has 10 days to sit for 12 hours?

Well, I think you're right. I think part of what psychedelics are is a shortcut. And some people think for that reason it's cheating in some ways. and you have to work harder to get to the same place with meditation. But it's a very similar place. I mean, I've heard other people, I've never done a long meditation retreat. I'd be really curious to try. Yeah. But I've heard that people get to that kind of state.

And I don't get a sore back and sore knees and all that too.

But I don't think it's an accident that all the prominent American Buddhists, the people who brought Buddhism to America beginning in the 70s, the Jack Kornfields, Joan Halifax, John C. Avant Zinn. They all started with psychedelics.

That's when Richard Alpert, who was Ram Dass, started.

Oh yeah, no, the links are strong and now we know the links are in the brain also. Judson Brewer, who's a really interesting psychiatrist at Brown, who runs John C. Avant Zinn's Mindfulness Institute at the medical school there. He was the one who saw the similarity between these brain scans of the default mode network and he really believes that someday we might use psychedelics to kickstart a meditation practice. Yeah. That it kind of primes the brain for that kind of consciousness. And I know in my own case, having had these psychedelic experiences, I became a much more successful or happy meditator. I was just much better at kind of going to that place where I could quiet my thoughts than I was before. So I think the links are really interesting.

And what's so important is that this is an area of medicine which we really suck at. I mean, mental illness is, I don't know if you know this, but it's the number one driver of indirect and direct costs in healthcare system.

I did not know that.

Even more than heart disease and cancer. When you add in all the years of disability and lost productivity, because it happens off throughout people's life, whereas heart disease and cancer may happen later in terms of loss of quality of life years, and the total loss of productivity and engagement in society, it's the biggest cost driver. And it creates so much suffering. And there's nothing that really works.

And it's getting worse.

It's getting worse. And we have the opioid epidemic, all these things. And these drugs seem to be, or I want to call them drugs or plant medicines, seem to be able to be a solution. And it feels like we can't get there fast enough.

Yeah, look, we do have a crisis in mental health care. And if you compare mental health care to any other branch of medicine, It's achieved much less. I mean, you know, when you think about oncology, cardiology, infectious disease, we have extended lifespans, reduced suffering in significant ways. And you can't say that about mental health care. And we treat symptoms, by and large, with the psychiatric drugs we have. The drugs we have have often terrible side effects. People don't like taking them. They have to take them every day for the rest of their lives. and in many cases they don't work.

They make you gain weight and become impotent.

Yeah, no, they have, oh, they're just, you know.

That'll make you depressed.

And then they're hard, yeah, and they're hard to get off, too. Yeah. They're, you know, getting off an SSRI puts you at enormous risk for suicide. Yeah. So we need new tools, we need innovation. There hasn't been much innovation in this space since the 90s. And along comes this new slash old, treatment. I mean, these are all public domain chemicals and plants that appears. I mean, I think there's more work to be done to prove it. They still need to do the big phase three trials. But based on the, the pilot studies in the phase two trials, there's a really strong signal here that we've got something important. And, boy, do we need it.

Yeah, it's so, it's so critical. So you, you, as part of your research for your book, having been a scared hippie in the 60s, in the 70s, decided to take a dive and take a trip. several multiple trips using many of these compounds. How was that for you? What did you learn? How are you different? And what did it do to help you understand this landscape?

Well, I did it out of, you know, deep curiosity because I was talking to these people and they were having these transformative and spiritual experiences. And I was, like, kind of jealous and. And curious as to what that was like. But I also, it's kind of like what I like to do as a writer. I put my, you know, when I wrote about the cattle industry, I wrote about a cow. Yeah, I remember that. I built a house to write about architecture. Yeah. And so I like putting myself in that place where I can write about an experience that I'm having for the first time. There's a quality of wonder you can capture the first time you do something that you can never capture again. So even though they're more experienced Psychonauts than me, they've done it. They've been there, they've done that. It's just not as, I'm hoping I capture something unique. by writing about it first time kind of late in life. So, but I was very reluctant to do it at the same time. I was very nervous about it. I didn't know what I would discover.

I thought, you know. Some crazy dude in there.

Yeah, some crazy dude in there. I mean, it was just like, it just, you know, my life was, wasn't broken, things were settled, and here I'm gonna blow things up. My wife, Judith, was like very nervous about it, you know. She was like, I don't want you to change. didn't enter her consciousness that I might change my mind.

Well, you're writing a book on how.

To change your mind. Yeah, I know. I think that put her off. In the end, she became incredibly supportive, but she had this initial reluctance. I mean, you're in a long-term relationship. She didn't want to do it. I let her speak for herself on that. You're in a long-term relationship and suddenly someone's going to have a big experience on their own and you're not. So potentially it drives a wedge. her thinking changed about that. The experiences were all fascinating. Several of them were incredibly useful and transformative in terms of my understanding of myself and nature, especially. One of them was terrifying, and I wouldn't wish on anyone, although even that ended with a profound sense of gratitude.

So that it was over or so.

Yes, that it was over, but. And then I still existed. Yeah, I I had this. Well, I can tell you about it later, but the. The. The really good experiences were about relationships. I had an LSD trip, guided LSD trip with an underground guide who was a wonderful man who I. great trust in. And it wasn't a particularly high dose LSD experience. It was like 150 micrograms. And it was all about people in my life. One after another kind of presented themselves to me. And I was thinking about my son and I was thinking about my wife and my parents and feeling this surge of love and just, you know, we don't stop. We take our relationships for granted. And it was just this afternoon of of connection, feeling this very strong connection with it was wonderful. And, you know, I had the classic LSD insight that love is the most important thing in the universe.

Pretty much it's true.

But it is true. At the same time, it's a hallmark sentiment, but it's also true. And I think that's part of our lives that we develop this, you know, coat of irony and we're afraid of strong sentiment.

Especially as a journalist, it's to be objective.

Right. And we're very skeptical and ironic. And so, you know, and I wrote about the struggle of writing about that. How do you convey the power of that feeling when it sounds so banal? And, but the line between profanity and banality sometimes is very fine.

Yeah.

On a psilocybin trip I had without a guide in a very safe place like yours in nature, I understood my relationship to plants in a way I hadn't before. I'd all, you know, I wrote a book with whose subtitle was A Plant's Eye View of the World. I had this idea and it was more of an intellectual conceit that plants have their own subjectivity. We shouldn't think of them as mute objects. They're working on us at the same times we work on them, which is true in a co-evolutionary sense. But it suddenly became true in a direct emotional felt sense, and that the plants in my garden were returning my gaze. They were all conscious in some sense, not like us, but I shouldn't just treat them as mute objects. and I felt profoundly, I've never felt more a part of nature. I think most humans feel a little distance, even when we're having a positive nature experience, that we're different, that we have a relationship to nature, which is a bizarre idea.

That we're not part of it.

Yeah, yeah. And I felt completely part of it for the first time in my life. And that was a profound feeling. I was just one species among many. And then I had a guided psychedelic trip that really changed my understanding of my ego. I was working with a guide on the East Coast who created an environment where I felt safe enough to really let go. And it was a pretty high dose psilocybin trip. And I saw my ego just burst into a little cloud of post-it notes. And then was spread out on the ground like a coat of paint. And it was like me and I was fine with it. But I don't know who this new I was that was fine with it. And it remains a real mystery that this new perspective emerged on my life that wasn't ego. It was perfectly objective. It was untroubled, perfect equanimity. I don't know what it was to this day. I mean, Aldous Huxley would have said it was the mind at large. It was some kind of collective consciousness. I don't know. But I learned during that experience that not to be afraid about the death of the ego, that there is another ground on which we can stand, that the ego is part of our mind, but it's not the only part and we're not identical to it. Now, 10 years of psychotherapy, you could probably get to that perspective on your ego, but this was one afternoon.

Pretty cheap.

Yeah, it was really cheap.

You think about the amount of money we spent in psychiatry, this is a cheap solution. You know, you're talking, it really made me think of my learnings in the Buddhist psychology, which is really about understanding that you're not your thoughts, you're not your mind, that there's a level of pure consciousness that's outside of that.

Yes. And everything plays within that arena. And that's... -You don't have to... -Yeah.

Because if you're identified with your physical being and your body, you suffer. It's painful.

It's fear.

And you're... I remember a couple years ago, I got very sick. I had mold in my house, and I had an antibiotic for root canal that gave me C. Diff. And I got. I'd lost 30 pounds. I was in bed for five months. I literally couldn't function.

And I. It started with the mold.

It started with a mold. Yeah, it was caught. It was just a whole litany of things. I broke my arm, and my system just collapsed, and I was in bed for five months and couldn't do anything. Thank God my wife was there taking care of me, but it was.

I was.

I could. get that I was not my emotions. I was not my mind because that wasn't working anymore. I was not my body because that wasn't working anymore. But there was this other thing going on. And it was a very mystical experience, even though it was miserable.

Yeah.

I was nauseous.

But you were able to detach for.

A lot of this. Yeah.

And I think it was those experiences. Could you meditate during this?

I couldn't meditate. I was just completely gone. But I had this awareness, like this, and they call it, you know, this pure mind bodhicitta in the Buddhist tradition. It's like you have this consciousness that you don't identify with this bag of flesh and bones that we are, and you're connected in a way to something bigger and more meaningful.

And I think that's- It's very similar. It's very interesting. It does show you another space in which to exist mentally.

Has it changed your life in any way after, like in terms of- In.

Some ways, I feel like, I mean, I'm back to baseline in a lot of ways, and it's been several years since I've had one of these experiences. But I do feel I have a little more perspective and that I can catch out my ego and just realize, oh, I can turn down the volume on that. I don't have to listen to that. And that's one character in my mind. It's not the only one. And that's really useful, I think. And if you ask my wife this question, she feels that I've changed in subtle but meaningful ways that I'm more patient, more open. The example she cited that was interesting, because a lot of people asked me the question you just did, is so how have you changed? And of course, your partner knows better than anybody else. It's hard to judge it in yourself. But she said that the death of my father, which happened a year ago, January, she thought I handled that very differently than I would have before. And that I was very present. I came to New York and moved into the apartment for the last 10 days and I was with him every day and I wanted to be there. I really wanted to be present. And death is one of the things we defend ourselves against. It's one of the things our ego is busy, shutting us off from. But I felt like I could say everything I needed to say. I was as available to him as I possibly could be for this very difficult but also very moving period of time. And my guess is before I'd had these experiences and spent so much time interviewing these cancer patients perhaps, I would have found ways to not be there quite that much and to kind of protect myself from the pain, the emotional pain of that. So I think she's right. I mean, that feels intuitively correct. And I do credit the psychedelic experiences for that.

Yeah, I haven't seen you since you wrote the book. And there's some difference in the quality of your energy. I can't really describe it, but it is a sense of openness and connection and it's great. It's awesome.

So, you know, there are moments when I've been like, feeling, you know, being interviewed or criticized for my work or something. And I remember there was somebody, somebody got up at a conference and was giving me a lot of grief for, you know, not enough women in my book. You know, we're in that moment and that comes up. And I'm listening to her talk and I'm in front of a group of people at Esalen and I'm like, Wow.

Where it all started.

Where it all started.

The room where it happened.

Yeah. and I'm thinking, God, I'm not being defensive. I don't feel defensive. I'm going to let her talk and I'm going to answer it and I'm not going to get defensive.

And that's awesome. Okay, that's helpful.

Yeah.

So let's talk about some of this research because it's not just about getting at peace with death. It's not just about depression, anxiety, but other things that are super hard to treat like addiction. Addiction is one of them.

And even post-traumatic stress disorder, which is so rampant. and things we haven't tried yet. Like, I think there is enormous potential to treat eating disorders.

Yeah.

And eating disorders are, you know, one of the toughest psychiatric indications. It has the lowest rate of success with therapy, the highest mortality of any psychiatric illness. And we have very, we have really poor tools. And it is another form of a rigid mind that needs to be loosened, a habit of thought. getting trapped in loops and false stories about yourself, about your body image. So I think the addiction work is really exciting. It's been done so far with cigarette smokers at Johns Hopkins. It's in process now, a second study. Alcoholics at NYU, big study, I think 200 and some odd patients. And hard cases, this is Bellevue. These are, you know, street alcoholics and people who are really tough cases. and cocaine addicts at University of Alabama that had terrific success. The thinking on addiction is that... Well, there's two...

Didn't the founder of AA actually have a psychedelic experience? Yeah, Bill W. And then wanted to actually include it in AA and LSD.

And the board said, I don't think this goes with our brand. Yeah, Bill W. had gotten sober on It wasn't technically a psychedelic. It was Belladonna, which is a deliriant, another plant medicine. But then he had LSD therapy in the fifties, and he thought this could really help people get sober. And he was right. And there was a lot of research. One of the most exciting areas of research in the fifties was alcoholism. And there was a meta-analysis done a couple of years ago, and it looked like they were having success in about.

50% of cases, which is really impressive.

Considering it's about 10% to 15%. That's right. no, it was very impressive. And so that's an important indication that is being worked on right now. What seems to happen is that addicts acquire this new perspective on their life. And people talk to me about, like, the camera was pulled back further on the scene of my life than it ever had before. And I looked and I saw what I was doing, smoking, drinking, and I realized I'm killing myself and how stupid that is. And even though that's a pretty banal insight, It has a kind of stickiness during the psychedelic experience. Whatever insights people have feel more like revealed truths than opinions. And that makes them really sturdy. And this is something William James talked about in describing the mystic experiences.

He said, the varieties of religious experiences.

Yes. Yeah, the first American psychologist, toward the end of the 1800s, he said that there was a quality to mystic experience called the noetic quality. And that was this idea that this is absolute knowledge. This is a state of knowledge, not just of thought. And that seems right. The people who I interviewed just kind of came to these conclusions and then could actually live by them. And many of us have insights that we're eating poorly, we have these bad habits and they want to break them and maybe tomorrow or the next day we manage to put it off and we just bracket the insight. Here it just kind of takes hold. So that's very interesting. The other way to look at it too, and Steve Ross, who's the doc at NYU who's involved with the alcoholism study, is that in alcoholism or addiction, your connection to people atrophies as your connection to the substance dominates your life. And you're more connected to the bottle than you are to your family. You will do, you know, you will let that, you'll sacrifice them for that new relationship. And that it restores the human connection in a way that allows you to break the connection with the inanimate thing or the dopamine charge you're getting, whatever it is. So, I don't know that we know the whole psychological mechanism at work, but it seems to be having high rates of success. It's often combined with cognitive behavioral therapy to help with the cravings.

Is it a biological phenomena too, where it resets the brain?

I don't know. I don't know the answer.

It may.

I mean, a lot of people talk about rebooting the brain and that this is like unplugging your computer and plugging it back in and that things... Wipes the hard drive. Wipes the hard drive.

Yeah.

One of the things that happens is when the default mode network, which is also a communications hub in the brain, when that goes offline, the brain gets temporarily rewired. And there's an image in the book that shows the wiring in a sober brain and the wiring in a psychedelic brain, and it's radically different. In the psychedelic brain, brain networks that don't ordinarily talk to one another start talking to one another. So dots are being connected in completely new ways temporarily. and this may be the kind of resetting that allows people to break out of these destructive patterns.

Do those trials look at people who are acutely addicted and whether it stops withdrawal?

You know, it doesn't, well, let's see. With alcoholism, I have to go back and check. I forget whether, I don't know, they don't get dry before they do the.

Because if you stop drinking, you can get seizures.

Yeah, if you're an alcoholic. So I'm not sure how they're dealing with that. In the case of the opiate addicts, they're using something called ibogaine, which is an African shrub. And that work is not going on in this country. There's a lot of it going on in Mexico right now. Ibogaine- Is there research or just clinical? It's clinical. I don't know of any research project now. There are people who are proposing it. The problem with ibogaine is it's a really heavy drug. It implicates your heart and when you have to be on a heart monitor the whole time you're doing it, it lasts like 36 hours. But it has the advantage of not only giving you the powerful mystical experience, but something about the chemical deals with the cravings. You lose your cravings. Well, not only that, you lose withdrawal.

So, that's right. I mean, you don't go from being a heroin addict and having to go through withdrawal, you literally stop that process.

Yeah. And that's kind of fascinating.

It's fascinating from a brain chemistry point.

Of view, what's actually happening.

And I don't think we know. What happens to the neuroreceptors?

Right. Brain chemistry. Yeah. No, we don't know. And how is the dopamine system getting reset that it has what it needs? And so anyway, there's a lot more to be learned here. It's very promising given the opiate crisis that we have. Yeah.

I mean, why wouldn't we look at that here? Well, I think 70,000 people a year are dying.

Yeah.

And how many millions are actually using? Oh, yeah. Why wouldn't we want to look at that? It's a good question.

I don't know. I mean, I think there are people proposing it. I think so many of the resource, well, one thing it's important to keep in mind that there is no federal money for this research. It's all privately funded. And this is, I think this is a scandal. I mean, I think there's a strong enough signal here that we've got powerful medicines to help with a crisis we have in mental health.

And the government- It's like Thomas Insel would be on this game.

You would think, and he is now that he- but he's no longer head of the National Institute of Mental Health.

Sure he knows a few people.

Yeah, but as you know, the budget for all psychiatric research is tiny compared to the medical budget in general. And I think the government probably thinks it's still too controversial. So anyway, there's not quite enough resources to do everything we need to do. I agree. I think given the opiate crisis, Ibogaine is really important to look at. I think it scares everybody because it's such an intense drug.

You do it in a medical setting and you're wired up. Mexico, they have clinics with anesthesiologists and.

Cardiologists and hook you up with IVs. Withdrawal is a medical crisis too. And so anyway, I haven't really delved into Ibogaine and most of the work is in Mexico, but there are clinics doing it and they often combine it with 5-MeO-DMT.

The toad.

The toad. Which apparently helps people at the end of the experience to kind of consolidate what they've learned. I find that hard to believe because I had a terrifying experience on the toad. Yeah. That was my least happy experience. So this is the smoked venom of the Sonoran desert toad.

How would anybody figure that out?

I am so impressed with this story. Get this toad. Yes. Yes, the venom is toxic, but if I smoke it, it'll be fine. And no toads are harmed in the making of the psychedelic. You can milk them, essentially, the venom, and then they produce more of it.

It's very- Smoking a toad, okay.

Yeah, so you're smoking these crystals, the dried venom, and you smoke the crystals and you have only one puff and you are just shot out of a cannon. The sensation is so destabilizing. Not only do you have a loss of sense of ego, but you have a loss of a sense of space and time and matter. It's all gone. It's just this pure storm of energy that is your brain, but it's the whole world. And it was just absolutely terrifying. But the best thing about it is it only lasts about 10 minutes. Although it felt like an eternity. And then you gradually reassemble and you see reality reassemble and it's like, ah, there's time, there's space, space, there's matter, and isn't life great? And I have a body. That was the sense of gratitude I got from it.

So the best part of it was that it was over.

But I mean, as terrifying experiences do, they give us an appreciation for normal experience. And I felt, most of us have expressed gratitude for being alive. I felt gratitude that there was anything. There's not nothing.

Interesting. Now, you also write about a different category of mental illness, which is trauma and post-traumatic stress and the use of some of these substances.

MDMA, which is ecstasy. Yeah. And it's a very different drug. Some people consider it a psychedelic, some don't. It doesn't work on the same receptor networks. It does implicate serotonin, but also it seems oxytocin, which is the hormone that mother's. Right. It's about the attachment hormone. Right. When they're next to you.

After you make love with someone, your.

Oxytocin, your levels rise. Yeah. And the thinking here is it's already in phase three trials. It's pretty far along for treatment.

Those are human clinical trials, basically. Yes.

Oh yeah, and big groups. And this is to treat people with PTSD, either from war or from sexual abuse, for whatever cause.

Which is one in four people.

It's an astonishing number. And that's why I think it's a very exciting area of therapy. So it works a little different. You're guided in the same way. The drug doesn't give you a radically altered state of consciousness in that you're not seeing things that aren't there, but it seems to disarm the amygdala and your fear, your fight or flight response, in a way that allows you to take out very difficult memories and be very kind of clinical about them. And I've seen tapes of these soldiers, they'll kind of go under for a long time and be thinking, and then suddenly they'll start talking to the therapist and they'll describe this horrible scene that traumatized them, and they'll do it in an absolutely affectless way. And it seems, the episode seems to lose some of its charge being told, being taken out, told that way, and then reconsolidated as a memory. And you do this a couple times, and it seems to take the edge off of it in a way that allows people to go on with their lives. Because what happens with a traumatic memory is you can't control it. It pops up in your mind, and whenever it pops up, all the associated emotions come up too, and you're re-traumatized. to have the memory without the emotions allows you to kind of get some perspective on it. Fascinating. At least that's how I understand it. And I've talked to a lot of people who've had this, this, it helps them get through it. Yeah, it helps them get through it. And they, they're, many of them are no longer on the, there's a scale for, you know, a PTSD and they're off the scale.

Yeah, I have a friend who's, was in war zones in Africa and, you know, just the worst places you can imagine. and every night he suffers from night terrors and it's just such a debilitating condition.

Well, the VA is spending a huge amount of money treating PTSD. It's so common, especially in veterans.

And are they interested in this?

They're nervous about it. They're starting to kind of dip their toes in and Rick Dobbin at MAPS, which is the organization that's been conducting the trials, is in conversations with people. I think they're just a little nervous about the politics. But what's interesting is that the people on the far right have been supportive of this research because it can help the soldiers, people like Rebecca Mercer, who's a big Trump supporter. Steve Bannon has spoken very positively about MDMA therapy. So this may create the kind of political cover that allow the VA to really step in.

We need to like at the next G20 summit meeting have all the leaders take some MDMA, maybe psilocybin and hang out.

That was actually Rick Doblin's idea in the 80s. He actually arranged to send, I don't know how many ecstasy pills to the arms negotiators in the Soviet Union. Well, I mean, in your book, you.

Tell a funny story of how Timothy Leary gave Alan Ginsberg his first psilocybin trip. And he tried to call with Kennedy and Krushchev and Mao Zedong.

Yeah, he said, He was gonna solve world peace. Well, there is this sense and, you know, and many of the researchers feel that, like, this isn't just to treat individuals, this could treat a sick civilization. And if enough people had access to this, we could repair our relationship to the natural world, we could reconnect with people not like ourselves and transcend our tribalism.

So much divisiveness, right?

Yeah, and that's a, you know, that's an appealing idea. I think how you put it into effect is really challenging. I mean, you're not going to give these drugs to everybody. You're not going to put it in the water supply.

When you think about it, you know, we spend so much money on psychiatric care and illness. You know, this is a thing that is non-patentable, but doesn't cost very much.

Yeah.

That almost eliminates or reduces the need for psychotherapy. It's not like you can do psychoanalysis four days a week for 25 years like Woody Allen.

Yeah.

And it's a threat in a sense to the establishment because it's like, well.

Who'S going to make money from it? Yeah, no, the business model is a real challenge, 'cause from the pharmaceutical side, as you suggest, you have these public domain chemicals and mushrooms that anybody could grow. And you're only gonna need one or two pills.

Yeah, one or two dozen.

And so the pharmaceutical industry is only interested in drugs you take every day. And so how are they gonna make money? And then on the psychotherapy side, it's an intense amount of psychotherapy for the period of the preparation, the session and after. It's days of psychotherapy, but then it's over. So it's gonna force everybody to rethink. It's also important to understand it's not a drug therapy, it's this package. It should not be called psychedelic medicine. It should be called psychedelic assisted psychotherapy. And you need the whole package. And we don't have anything else like that. You mentioned there's a company that's putting all that together, right? There is. Compass Pathways. Yes, is a, English pharmaceutical company. They're doing trials of treatment resistant depression with psilocybin, both in this country and in Europe, in like eight countries in Europe. And they're trying to sell a package that they will offer to clinics and to National Health Services that comes with training, training modules for the therapists, the drug. And, and they think they can make it more economical, especially where you've got national health, where you don't have to worry about how much money the pharmaceutical companies are making. And we'll see, we'll see if they can do it. I mean, they've got to get through these phase three trials, but they've raised a lot of capital and it's a small company. My guess is as soon as they prove they can do it, they'll be gobbled up by a big pharmaceutical company, because that's what passes for innovation in that field. But it's important to know that we have this crisis and if you talk to people in pharmaceuticals, they're not even researching psychiatric medicines. They're disinvesting in CNS drugs, central nervous system drugs.

And they're among the most prescribed drugs that we have in the top two or three usually every year.

And so I don't understand why they would not be intensely interested in coming up with some new drugs for this. But, you know, this is a different paradigm and it's going to take it could revolutionize things and it's going to take some new thinking on how to make it work, you know, to the extent it needs to make profits.

Have you talked to the folks at the NIH or FDA? What is their perspective on this?

I've talked to people at FDA and I've been struck by how supportive they've been. No obstacles have been put in the way of these researchers yet. In fact, the FDA has encouraged them to go big. When they came and presented the phase two trials for the cancer anxiety studies, thinking they wanted to get approval for phase three to treat more cancer patients for depression and anxiety, the FDA said, wait a minute, you've got a signal here that this is going to be effective with depression. Why don't you go ahead and do your cancer anxiety, but why don't you do another trial for major depression? So that apparently was the FDA's idea. Wow. they're not resisting. And I think they feel the desperate need for new tools also, and I think that may be encouraging them. But I thought there'd be a lot of political resistance. The FDA's policy is that they're gonna treat psychedelics like any other drug. If you've got a good proposal, you can study it.

Well, it's interesting. Probably a lot of people now in leadership positions in business- have had experience. Right, 'cause they're all children of the 60s and the 70s. Well, that's where now leaders are like, wait a minute, I did that, it wasn't so bad.

And yeah, I think you do have people in charge of our major institutions. Look, I've talked to two former heads of the American Psychiatric Association who've talked to me about their own psychedelic experiences and how it influenced their interest in the mind. So there are a lot of people coming out of the closet too and talking about this openly. And- yeah, I mean, are you worried.

About publicly writing about doing legal stuff? Like, is this gonna knock on my door or what?

Well, the book is very carefully lawyered. I mean, I had two lawyers read it and I was, you know, I was less nervous about myself. I knew that if I changed the time and the place, the jurisdiction of these experiences, that it was not a usable confession, 'cause there's a statute of limitations. It's not that long. So basically, if I said, you tried.

It in college, I'm not coming after you.

Yeah, you're so fine. And so I'm vague about where it happens and I'm vague about when it happens. I was more concerned about my guides. You know, there are these underground therapists They're very devoted people.

Now your angels, but the...

And many of them are, there are some MDs doing this work, and there are some trained therapists, and they're doing this at great risk to their own freedom and their medical licenses or therapeutic licenses. So it was very important I protect them and disguise just enough details about them that they were safe. And Knock on Wood so far, none of them have had problems and they're all very pleased to have been part of the, you know, to be written about.

It seems like there's a sea change because Colorado just knows something's going on.

Yeah. And Oakland is going to have a vote June 4th in the city council about doing the same thing, which is amazing. So yeah, something's happening. The culture has moved more in the last year than I ever thought possible. you know, I don't take credit for that. I think that what we do as journalists is kind of like, hopefully have pretty good antenna about where the culture is moving and we ride these waves. And, but I feel a wave building around this and that, that in five years, it's gonna look, the landscapes look very different and that these will be accepted medicines and, and people will be talking about these transformative experiences in a way they now are closeted.

It's amazing. And we're just beginning, really, right?

It's really early days. And there's so much basic science to be done. There's so many more indications to be trialed. Andrew Weil believes they can help with psychosomatic illness, things like allergy, which is really interesting. You know, he's very strong on the mind-body connection, and he thinks there's a whole area of autoimmune disease that needs to be looked at with this. So, yeah, exciting possibilities.

That's how he became who he was. He was a Harvard med student who got interested in mushrooms and psychedelics and went to South America and took a lot of drugs and wrote about it.

His first book was actually from chocolate to morphine. Actually, his first book was the Natural Mind. Chocolate to Morphine Came Later. The Natural Mind is a book about drugs. Oh, yeah. And it's really interesting. I read it. And Andy hasn't been talking very much about psychedelics in the last 30 years or so, but he is now. We just did an event together. He mocked my mere seven trips and went on about his dozens and dozens of trips and claims he was cured of sunburn by psychedelics. Wow. That he was very fair and could not go in the sun without getting a really bad sunburn. But after psychedelics, no problem. And now he lives in the desert.

And some of the take homes of this is like, it's not a panacea.

No, it's not a panacea. But there is a group of people ailments that are on one end of the spectrum, this of mental rigidity, of mental stuckness, and everything in that area seems to be susceptible to this intervention. At the other end of the spectrum, you have things like personality disorder and schizophrenia. That's probably not going to help because these drugs introduce a certain amount of entropy into a stuck mind. And at that end of the spectrum, the mind has enough entropy. It needs more order. But this is the end where there's too much order. Yeah, so not a panacea, but very good for these products of the stuck brain.

And you talk about it as disabusing us of the luxury of mindlessness, which is the way we mostly live, which is not really present. And it sort of forces you to have an experience that can shift your quality of life, really.

You know, I think that as valuable as this, that these medicines may be for people who are suffering with serious mental illness, they have a value for all of us. We're all dealing with mortality. We're all dealing with disconnection. We're all dealing with some kind of addiction.

It's a spectrum, right? It is a spectrum.

Yeah, we're not, you know, we're not different from those people. We're just on a different point in the spectrum. So, and I think that's a huge challenge. How do you make these medicines available to well people? And do you legalize them? I'm not sure. It's not like cannabis. It's a much stronger experience. It does have psychological risks.

And you talk about set and setting being important.

So important.

Where you do it, who you do it with, is important.

And the mindset you have, the intention you have going into it. All these things matter. So I really believe the safest way to approach it is with a guide. And because also some people need to be disqualified from taking it. If you have any risk of schizophrenia in your family, you really shouldn't take it. Certain psychiatric meds, you shouldn't be on. If you're on SSRIs, the psychedelics, they won't hurt you, but they don't work because it's occupying the same receptor. So it's much less casual than cannabis. I mean, it really takes- It's not a party drug. It's definitely not a party drug.

What's fascinating is that it's safe. It's not toxic. There's no side effects. There's no lethal dose. I mean, you can go buy a bottle of Tylenol in the CVS and take it and you're dead.

Yeah, that's true.

Whereas you can swallow 400 mushrooms.

They have not found a lethal dose, which is amazing. And it's also not addictive.

So these are not addictive. It's safe.

There's no toxic dose.

Yeah, no, the risks are almost good. Too good to be true. It does.

I mean, you know, they're so targeted and there's so few molecules involved. You know, LSD doses are, it's like, I don't know of another drug that you take. Micrograms. Micrograms. But the risks are practical. You could do something stupid because you're impaired and you could walk out into traffic. And there are psychological. People do have bad trips and bad trips are terrifying. And in a recent survey of people who've had bad trips, 8% of them sought psychiatric help. within the first year after. So that's, you know, that's not nothing. And so I think people have to approach it with a sense of deliberateness, reverence for the power of these medicines and not treat it as a casual experience.

I mean, historically, they've always been used in ritual, in ceremony, as a rite of passage, as a way-- and always.

With an elder, a shaman, or a curandera, who knows the territory and can help people. But you're right, it's always with ceremony, it's with intention and on special occasions, not done regularly.

Right, right. Not like, hey, that's a friend over in Saturday.

Let's get some. Yeah.

So you quote Dennis of Groff, who was a psychedelic psychiatrist at Esalen. And he said, what the telescope was for astronomy in the microscope, for biology, psychedelics will be for the understanding of the human mind.

Yeah. When I first read that, I thought, that's kind of overstating it, don't you think? But I don't think it's so crazy anymore. I do think these are powerful tools for understanding the mind. And we have so few. Consciousness is beyond the reach of science as we know it has been. You can't measure it. I mean, you can measure the lack of it, but you can't measure it really. And so you depend on people's reporting. on phenomenology. But here we have a tool that by altering consciousness brings it into this observable space. You know, one way to understand any complex system is to disrupt it, like a particle accelerator, right? Just disrupts the particle and forces it to reveal its secrets. Something similar is possible with psychedelics.

Yeah, it's an exciting moment, sort of this resurgence of research and interest. It almost seems to me that it's the medicine for our times because we have so much disconnection and also we have so much strife and division and separation. Well, look, I see so much of our crisis politically and also environmentally and climate change. They're all connected.

They're all connected.

Maybe we should put in the water.

It's not fluoride. And somebody told me last night the chlorine would ruin the LSD. So bad idea. But, you know, I think a lot of what eludes us is the result of egoistic thinking, the kind of thinking that allows us to both objectify nature and objectify other people. Tribalism is kind of collective egotism, right? And that we're different, we're better, and they're mere objects. And LSD and psilocybin reminds you that you're more like other people than unlike, that we are all in this together, and that we are also in this together the natural world. And it's exactly the lesson that we need to hear right now. So true.

Thank you, Michael, for bringing this to our attention. How to Change youe Mind with the New Science of Psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. Remember that transcendence? Yeah, very important. It's a great book. Everybody should pick it up. It's like a gripping adventure novel through the landscape of the mind and the history of psychedelics and the future. of where we're going.

So thank you, Michael. Thank you, Mark.

Always a pleasure to talk to you. Yeah. You've been listening to the doctor's Pharmacy. I hope you've enjoyed the conversation with Michael Pollen. If you like this conversation, please share with your friends and family on social media. We'd love to hear from you. Please leave a comment and you can.

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