The Reemergence Of Psychedelic Medicine For Anxiety, Depression, and End-of-Life Care

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

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Hi, this is Lauren Fein, one of.

The producers of the Doctor's Pharmacy podcast.

Historically, humans have had a desire to change our consciousness, to alter our brain and our mood, whether it is with drugs, food, or activities like meditation and breath work.

Now, with reemerging research on psychedelic assisted.

Psychotherapy, there is promising evidence of the therapeutic benefits her mental health. In today's episode, we feature three conversations from the Doctor's Pharmacy about the role.

Of psychedelics in quieting the ego, reducing.

Anxiety, improving relationships, and more.

Dr. Hyman speaks with Dr. Anthony Bossis.

On the neurobiology of psychedelics, with Michael.

Pollan on the effects of psychedelics on.

Our relationships with nature and loved ones, and with Ram Dass on spiritual teacher.

Psychologist, and author Ram Dass's psychedelic experiences.

Let's dive in.

So the avenue of sort of psychedelic research was sort of started as a sort of almost a medical inquiry.

Yeah.

And got sidetracked. And now we're coming back into it. So is there an understanding of the biology of what's happening? Because it seems like, you know, we all have had in our lives a moment of mystical connection where there's in the moment of love, whether it's being on top of a mountain, whether it's just some spontaneous experience that is fleeting and short-lived that we can't get back to. But something's happening biochemically in our brain that's causing that. So what are the properties of these substances that do this? And what is the neurobiochemistry of these states? Do we know?

We know a bit. I'm not a neuroscientist, but I'll get to that in a second. But I like that you mentioned that we all have these experiences. So they've been called different things, peak experiences, mystical, numinous, and they occur naturally all the time. Children have them, we all have them, but you're right, little brief glimpses during meditation. -We were in rapture, we were rapture in our experience. -Yeah, I mean the foundation of religion, the saints and the mystics seem to have these naturally occurring, right? Meditation, being in nature, dancing, there's a host of activities that could trigger a peak or mystical experience. Abraham Maslow, the great American psychologist, called them peak experiences. and they were natural. There's a recent Pew study that shows that 49% of people report having mystical experiences in their lives. Just naturally. I mean, it's incredible. These medicines promote it in a very significant way, hours of the experience versus a few minutes. In terms of the neurobiology, we know that it activates upon a serotonergic receptor, which is the primary receptor for these medicines. When that receptor is blocked, the experiences don't happen. the same way. So it is serotonergic we modulate immediately.

Was it like super Prozac or?

Well, you know, we know very little about the neuroscience, but we know this, we know the serotonin. And there's now speculation, something called the default mode network gets quiet down, which is kind of this part of the, the brain that links to part of our mind that forms a sense of self, the so-called ego. And that quiets down, but other parts of the brain might be able to cross talk in a more direct way.

So, well, essentially, you know, we, we as humans think that everything we see, feel, smell, touch, hear is all that there is. But we know that there are many other sensory experiences that we don't have the bandwidth for, our spectrum of light, our spectrum of hearing, our spectrum of smell, our spectrum of temperature sensation. I mean, snakes can actually have this massive ability to detect temperature changes so they can see if there's something warm around them to go bite or eat. And yet, we think what we see is all there is. It's a very interesting thing. And so, maybe these drugs actually help us expand our sensory ability to kind of process information or see different things or relate to what we're doing differently.

It seems to do that, Mark. It's easy to talk about the biology a lot because we can see that as well in terms of fMRIs and PET scans. What I find remarkable is that it seems to, again, trigger something that's naturally occurring in humans.

And, did the MRI and functional things actually show changes?

They show parts of the brain light up that are similar to meditation studies as well. But again, I'm not the neuroscientist, but there are these overlapping parts of the brain that we think are linked with both experiences. But what I'm struck by is that we're wired for meaning, right? And these experiences, meaning making, transcendence, ineffability, sacredness, awe, unity, happen naturally. So something in our nature has us wired for these incredible experiences. They seem pro-ethical and pro-social, right?

I mean, you said something really important, which is they help you dissolve the ego.

The sense of, right, the meaning.

We live in a very structured view of the world most of the time, most of us with very limited understanding of our connection to everything else. So, it's almost like we live in this world where we're focused on our ego and our own life and our own needs and our own purpose and our own connections, but not really understanding the ways in which we're connected to everything that matters. And I think that's what these drugs seem to do. They seem to sort of break down and dissolve the ego, which can take decades of meditation. It's almost like a spiritual shortcut.

Yeah.

Is that a bad thing?

That's a bad thing. I think you described it very well actually.

I'm not gonna be in the cave for nine years in the dark.

Right, right, right, right. 20 years of meditation practice. It does remove the part of the mystical experience definition is it removes the observer observed kind of the boundaries, right? Yeah.

It's like that joke about this, there was that this this guy on a news show asked the Dalai Lama, have you heard about the, what kind of pizza the Dalai Lama likes? And he goes, one with everything. Right, right.

Exactly.

I didn't know what he was talking about. Right, right.

But that oneness with everything is really, I mean, in the cancer study, that was healing. I mean, it's part of this notion of transcendence, which is just incredible to hear the stories from these patients. They transcend this, whatever this me is, this body, right? And the attachments to identity, you know, you're a doctor, you're this, we're a man, begin to kind of dissolve or fade away. So then what's left? If we lose all these attachments to the body, to our identity, then what's left? And they experience that. And what they tell us, you know, often, is there's something more enduring within me, or outside.

Yeah.

Biology outside my... Because we don't know what generates consciousness, right?

Yeah.

It's the brain or if it's somehow out there and where this is a mediator for it. And to hear people with cancer whose body is beginning to fail and may stop functioning, death, that I'm not just this body.

Yeah.

I'm not this cancer. It's incredible.

I'm not my mind.

I'm not my thoughts. I'm not my emotions.

I'm not my body. I'm not this body. So this body is breaking down and stopping to work, but I'm not that I'm something else. And again, those spiritual insights we see in religion as well, in terms of pure awareness, or it's called different things, Brahman or Christ consciousness, a Buddha nature. But to hear a person dying of cancer say that, and that alleviates their fear of death, because I might be something more.

It's powerful.

What a gift, right? What a gift. It's really, we hear that over and over in terms of those. It's interesting too, the mediating factor in the research in a few of these studies, including the cancer study, is that the more robust the mystical experience, the greater increase in clinical outcome. In other words, the more they endorsed feelings of sacredness, transcendence, unity, ineffability, these core constructs of a mystical experience, the greater the decrease in depression, anxiety, something called demoralization, an awful experience when you're dying, hopelessness. So again, we're wary for these experiences when that the greater that experience, and then all have the mystical experience. There are different levels of- Is it dose dependent? We don't think so, to a degree it is. I'll get into that in a second. But that the greater that experience or when it's achieved, you get these clinical outcomes as well, which is remarkable. So that oneness with everything, you know, has kind of a 60s, you know, the pizza story right now. But to experience that briefly for a few hours and come back and then report their experience and then see these changes. So we saw changes in depression, anxiety, demoralization for up to six months and 80% of the patients and we're going to keep tracking them.

Yeah, and it's remarkable. It's not like, you know, going to a party or going to the Grateful Dead concert and taking some mushrooms. You're actually in a very specific therapeutic setting. And I'd love for you to share some stories and the experience of what people go through and how you set it up. You call it the set and the setting and why that's important and what people actually experience.

That's great. So it's really, and I'm glad you brought that up. It's important for the viewer to know that, there's a certain way we do this.

Because a lot of people take these drugs and they don't have those experiences. They might be at a party or, you know, it's like they're not necessarily.

Having that No, they may have panic experiences. Panic is the most common adverse effect. So importantly, we're so indebted to the prior researchers. The way we do the research now is the same as was done back in the 1960s. We have better research methods and statistical analyses. But the method builds upon these early pioneers. An important distinction, most medicines people take blood pressure, anti-anxiety, pain medicines, whatever they're taking, they take every day to maintain the desired effect. These studies, this medicine is used once.

One dose.

One dose out of your short half-life, so out of your system by the end of the day, before the day is over actually. And the experience can generate changes, significant changes for a period of time going out. I mean, there were people from the 60s who have followed up decades later and they still report it as the single most meaningful or spiritually significant experience of my life. So it's more like an experience study versus a drug study. The drug is a catalyst for that experience. Then the experience just seems to change us when we recalibrate what we are, so a sense of nature. In terms of the day, so we meet, let's say, the cancer study, we meet them and we spend four weeks getting to know them, meeting once a week, preparing them for the session. And the most important preparation is to let them know that the most important position to take during the experience is to let go into the unfolding changes in consciousness.

Don't try to control it.

Don't try to control or avoid something. Sort of like if a positive meditation, mindfulness, we say with the unfolding changes, and no matter what comes up, even something frightening, These people are dying, some of them. So death itself, dark images, difficult memories, move into it. Stay with it. You'll be safe. Go into the experience. And I've never seen an experience where it didn't change to a teachable or transformational moment. So by staying with it, it changes to something more, an insight, which in itself is remarkable. If they avoid it, It can create kind of panic or anxiety. So we spent four weeks getting to know them, trust and rapport is the single most buffer against adverse effect. So they feel safe in the room, they feel safe with us. Because you're with them in the room.

We're right there, I'll describe that.

We're in a living room, it's a gorgeous setting, nice rug and art and dim lighting. And so they're prepared for four weeks. Then the day of the session, they come in early. Again, the recommendation is trust yourself. Trust wisdom, trust consciousness, trust the medicine, trust the guides you're working with. So trust is really kind of cultivated. They take the capsule, which in this study were double blind, meaning the researchers nor the patient knew was it placebo or psilocybin. Yeah. And if it's psilocybin within an hour or so, it'll begin to have its effects. They spend the day lying on a a couch made into kind of a bed for the day, wearing headphones that play a gorgeous playlist of music, mostly classical.

Grateful Dead.

No Grateful Dead. It would be nice, but it's mostly classical and strings and kind of background instrumental music to serve as a trajectory for the experience in a way. And there were eye shades. And both are there to encourage you going within.

They're not talking to you, you're not talking.

Now, if they like, they could take them off, of course, and sit up and talk if they need to. They have to go to the restroom often, so we take take them out for the bathroom. But on the ideal days, they're saying very little. And part of the prep was, don't feel a need to report to us what's happening. Go into the experience. We're here watching your body and you're safe. But go into the experience and we'll talk tonight and more so the next day. So if we can, we turn off the intellect for the day and have them go into the experience. If they need to, we're there for reassurance. We're right there the entire time providing assurance. That may mean holding a hand or in a rough stretch or to reassure them they're safe. The peak stretch of this is about three hours where a lot happens for them internally. You don't really see it from observing them.

They just got the eye shades and the headphones on.

So you may see tears, they may be laughing, it's because it's joyful in many parts of it. It's glorious, they would say. It's also difficult at times. They may speak, and I write down what they're telling me so I can tell them later what they said and remind them what was that stretch about? It's moving, Mark, to see, to hear the stories.

So what happens after? Then you meet with them and- Then.

Around 4 or 5 o'clock, they're coming out of that state of awareness, back into ordinary consciousness. They do some question and answer for us, of course, it's research. And they go home at 5, 6 o'clock, back into ordinary consciousness. Then we have a series of meetings, it's called integration meetings, where we talk about the experience.

What do you hear?

Well, we hear remarkable stuff. So in the cancer study we hear, often you hear that consciousness may not stop at the body. So I'm not this body. So that's obviously profoundly mitigating yeah.

If this is all there is, then. Right, right. It's kind of Bleak, right?

However, some say that happens. It's his fate. When I die, I die. But they accept it. We spoke earlier about love comes up a lot, which is striking to hear. So we're scientists. And throughout this research, the Contemporary Studies at Charles Hopkins, UCLA, NYU. Going back to the, you know, half a century ago, this notion of love being spoken about so frequently is remarkable. And we hear that that was part of the experience that recalibrated their thoughts about death. And it's not just love for each other. So we hear three kinds of love, the way I try to categorize it. One is they have a kind of a pronounced loving kindness towards themselves, so they're dying. So forgiveness towards myself, towards others, a loving kindness to accept how they live their life. loving kindness towards others in their life, including throughout their lifespan, even difficult relationships, revisiting those relationships, offering forgiveness internally. And then what I find remarkable is this greater love that you hear in religion or meditation research, that love is the ground of being. It's a substance of existence. I like to use the word Greek word agape, right?

Yeah.

And they use this. over and from within that framework, there's a sense that I'm okay. No matter what happens, I'm fine. As dark as it gets.

They live in a bigger world than just the small s self. It's a big s connected.

I like to say it pulls a lens back from experience. So here we are in, you know, George Harrison's song, I Me, Mine, though, and everything's just around the ego. I could talk about it.

Well, the Beatles got it right. Love is all there is, right?

Beatles got it right. Love is all you need. and then it pulls it back where they see themselves in a much broader landscape. I mean, people see solar systems, people see the universe unfolding, and they see themselves in a much larger kind of fabric. Yeah. And it really recalibrates the sense of self in terms of what else we might be connected to. And also, people have other, a lot of biographical experiences, autobiographical or psychodynamic in nature, revisiting past relationships that were conflictual or traumas, and those being resolve by moving into those unfinished business. So there's just so many vignettes that come our way and it's remarkable. It's powerful.

So the people change the relationship of death to themselves, to their view of what matters.

What matters.

And it's a single dose that drives sort of long lasting change, which is pretty powerful. In the space of mental illness, and we are in an epidemic crisis of mental illness. Obviously, the opioid epidemic with killing 70, 000 people a year, depression, anxiety, bipolar. I mean, so many people suffer from deep mental illness and some varying degree of it. And we've all probably had moments of depression or anxiety in our life. How do you see this tool being used therapeutically? And, and where is this research going? And what have we learned so far? Because you've been focused on the death experience, but other people are working also in this space, right?

Yeah.

So a lot's happening. It's really, it's been called the Renaissance, but I, you know, I like these words, the reemergence of these medicines, this research. So there's a few main avenues where we might see clinical research, of course, one end of life, which, you know.

It'S easy to do.

It makes sense, right? So I've worked in palliative care. So part of my work has seen that we don't die well in America. We don't die well. We don't even talk about it until now we're making some progress. Palliative care and hospice is shifting the conversation. There's been conferences around the country and big events organized around death and dying. Let's talk about death and dying. We're all dying at some point, right?

From the minute you're born, you're dying.

From the minute you're born, you're dying. So we don't die well. And it's always important to note the first two indications coming out of the 60s research was end of life distress and addiction. These are the two main arteries of research. And Aldous Huxley being very important to the end of life research, the great literary writer who spoke about LSD being helpful in the end of life experience.

And he took huge doses of LSD at the end of his life.

Huxley took LSD many times when he was alive and healthy and allowed him to kind of cultivate his theory about the perennial philosophy that these experiences are at the core of all religions. And these entheogens can trigger that experience. What you're referring to is quite interesting. When he died, he had asked his wife Laura Huxley to administer LSD to him as he was dying.

Yes.

He scribbled it and presented it to her and she injected him. They had talked about it before. And as he died, she was reading to him from, so there's the Tibetan Book of the Dead, a very famous Tibetan manual about dying and the bardos and- Transition phases. Yeah, and she was reading from a version that was not published yet. by Timothy Leary, Ralph Metzner and Dick Alpert Ram Dass, a psychedelic version of that. And reading in a sense, go forward, go towards the light, go up, you're safe. And it's quite a, it's a poignant vignette she talks about. And then he passed away. Historical note, he passes away and she walks out of the bedroom and many people were in the living room at the house supporting her. He was very well a very famous figure.

And.

They were all huddled in a.

TV set, watching Kennedy be shot.

Exactly.

Yeah.

It was the same day. And she writes about that. She says, the above.

It was my birthday. I remember that day, 1963.

That was your birthday?

Yeah, I was four.

Yeah.

Yeah.

I'm like, why is everybody crying on my birthday?

She writes about a lot. She has a book called this Timeless Moment. and she writes about them saying they were both different in many ways, different backgrounds, and she writes about they were both dedicated their lives to kind of increasing love in the culture. It's quite touching. So he was a big figure. So in terms of the clinical work, and the life distress, we're all dying. Ideally could this be used in helpful ways? We create centers people go to, have the experience, then go back to their home. after hopefully a transformational experience about death and dying. Addiction. There are studies happening with alcoholism, one at NYU. There's a study beginning with MDMA, not psilocybin, which is a version of ecstasy. Exactly. With PTSD, post-traumatic stress disorder, we're seeing a new wave of research with psilocybin with major depression that's been untreatable, treatment resistant. At Hopkins, there was a wonderful study going on with smoking cessation, tobacco. People have the experience and then the decrease in their wanting to smoke has been relieved. So, the applications seem to be numerous. We're seeing all these possibilities.

Is there any emerging- Conclusions from some of the research around anxiety or PTSD or with ecstasy or MDMA or even with depression and psilocybin?

So PTC is just starting. So we'll see that there was a phase two study that showed efficacy and that allowed them to advance to this larger set of series of studies. So it does seem to work with MDMA. A little different. MDMA is not a classic hallucinogen, so I should frame that classic hallucinogen category is LSD, mescaline, psilocybin, DMT, and MDMA is what's called an empathogen.

You just said DMT. We're gonna come back to that.

Okay. Yeah. And then pathogen that the subjective experience is one of this incredible love and empathy. And that seems to also reset these traumatic experiences people are having from war or childhood trauma. So much of trauma is the body and the mind, both physically and emotionally, reacting to an event that's no longer happening.

And 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 psychiatry.

You said, we used to think these drugs made you crazy, but now they make you sane. And that 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 and drugs that alter your brain chemistry.

And we left the mind out.

Mind out, right.

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, a 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 your speak at South by Southwest, and you were talking about this part of the brain.

Called the default mode network.

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 the 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, it's sort of our ego.

Yeah.

I mean, you 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 and 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.

It'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, right? I mean, Oliver Sacks showed 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 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's just an illusion and that you're 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. That's 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 who 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 in understanding this. And he said, you, know, you have to understand that these separate diagnoses are really an 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 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, 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 habits. 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, you know, 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.

It's the stuff that survives.

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.

Yeah, I first sort of started learning about this when I took this class at Cornell called 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, you know, 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. So I'm 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 like, it was really the same experience. But who has 10 days to sit for 12 hours?

Well, you know, I think you're right. I think part of what psychedelics are is a shortcut. And, you know, and some people think for that reason it's cheating in some ways. And it, 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, I've heard that people get to that kind of state.

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 Kornfelds, Joan Halifax, Jack Kornfield, they all started with psychedelics.

That's where 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 Cabot's Mindfulness Institute at 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 kick start a meditation practice. 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. you know, like, it's, I mean, mental illness is, I don't know if you know this, but it's, it's the number one driver of indirect and direct costs in healthcare system. I did not, even more than heart disease and cancer. When you add in all the, 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 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.

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.

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 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 critical. So 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. 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, everybody- 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. 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.

Some crazy dude in there?

Yeah, some crazy dude in there. I mean, it was just like, it just, you know, my life wasn't broken, things were settled, and here I'm gonna blow things up. My wife, Judith, was like, she was like very nervous about it. She was like, I don't want you to change. It didn't enter her consciousness that I might change. Well, you were 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. And so potentially it drives a wedge. But 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 profound sense of gratitude.

That it was over or so?

Yes, that it was over. And then I still existed. Yeah, I had this, well, I can tell you about it later, but 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 had 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 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 and skeptical.

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

A lot right now is happening in this culture is this resurgence of the psychedelic culture as a therapy for PTSD, and we've had Michael Pollan on the podcast, Tony Bossis, we've talked about these issues. And, you know, he wrote a book called How to Change youe Mind. And, and that's one way is through psychedelics. But, and I think they have a role in, in Psychiatry and therapy and in Awakening. But what happened, it seems like back in the 60s was that, you know, no matter how much acid or how much mushrooms Richard Albert at the time took.

And he took a lot.

It took a lot. It didn't last. And he kept waking up to reality that was kind of a downer. So he was always trying to get high and always coming down.

And, well, that was the endemic problem with psychedelics, was you came down, right?

So he's like, I'm out of here. And he's somehow got to India. Can you share a little about the story of him? going to India. And there's a beautiful sort of description of how he was still his sort of, even though he was sort of long-haired and bearded and wore beads and a white robe, he was still so not in the moment. He met this guy who kept saying to him, who was this Lama Surya Das, who was another kind of Westerner young kid, but somehow got it. And he kept saying to him, Every time he was talking about what's coming next or what we're doing or the past or what is this or that, you're like, just be here now. Just be here now.

It wasn't Surya Das. It was about 19 at the time, a 19 year old surfer from Laguna Beach named- oh, okay.

Okay, sorry, I got that wrong.

Yeah.

How many Dases?

I can't keep track of them.

There's a lot of Dases. Das means servant. So basically we're all in the servant class.

Yeah, Ram Dass means servant of God, right? Ram is another word for God. Yeah.

Yeah, Ram Dass thought he was going on a Buddhist pilgrimage with Bhagwan Dass and walked around the Buddhist pilgrimage sites barefoot and begging for a while with an American Express card in his shoulder bag.

The only way to know.

At some point, Bhagavan Das said his visa had run out and he needed to go see his guru. And Ram Das was like, Guru, Shmuro, I'm a Buddhist. So he didn't want to go. But Bhagavan Das needed to go. So they drove up to the, sorry, that's my Audibon clock.

That's good, you're a temple.

You've got the real thing going. And they drove up to the foothills of the Himalayas and stopped at this little temple. And this old man in a blanket was sitting up in a little kind of a field. And there were people in white all around him. And Ram Das thought it was some kind of cult. And he really didn't want anything to do with it. And then Maharajji started, the old man was known as Maharajji, which is sort of an honorific that means great king. But you know, you're in a cab and Delhi and the cab driver says, oh Maharajji, where would you like to go?

It's very common.

And But he told Ram Dass things that he clearly knew about him, about Ram Dass, that there was no way he could know. So Ram Dass was taken aback, to say the least. And then something happened which he wrote about originally in Be Here Now, and we went into more detail in this memoir because he's really had, you know, he had the time to look back on it and understand what had happened a little better. And it was a major opening, not dissimilar to what had occurred with him when he first took psychedelics, but without drugs. and with this completely other effect on him, which was that his spiritual heart opened. I mean, this deep part of himself really awakened.

Yeah, I mean, it was a beautiful story of how he, you know, was thinking about his mother who had recently died and was very, you know, deep in his particular unique thoughts about it. And somehow the guru knew all about it, even though he didn't actually tell him. And it made him realize that he could know everything about him. And what was really beautiful about it was that in that moment, even with all his flaws and his darkness and his demons and his mishugas, basically, that this guy, this big old chubby guy in a blanket sitting on a stool, just loved him unconditionally. completely and fully despite all of his craziness. And I think that's sort of what we all want and seek. And we often think we get that from our parents, but usually we don't.

Yeah, Ram Dass didn't get it from his parents, at least not on that level of it. And that was what opened him up, was that love. And I think at first that he really thought it was was, you know, kind of the psychic powers that had, you know, blown him away. But as time went on, he really realized it was that heart space that they had entered together.

Well, it sort of speaks to if that was really true, and let's assume it is, and the Ram Das wasn't deluded or crazy. And that sort of brings up a whole set of questions around, gee, you know, what is human consciousness and how would one person know what another person is thinking or feeling or anything about their life or where they're going or what they're doing? And it seems like there's another level of awakening or brain function or access to some plane of knowing that somehow these masters have acquired. And yet despite all of that, the message from this guy, Neem Karoli Baba, who you and so many incredible people have been a student of, like Daniel Goleman, who's a friend who's been on the podcast, was a student of his as well. And he wrote Emotional Intelligence and Larry Brilliant is a doctor who ended up helping cure smallpox in India and worked for Google Foundation. And, you know, you've got Krishnadas, who's an incredible you know, spiritual, a musician and does chanting and does amazing work.

All over the world.

There's just so many and you who have actually come out of that, let's say, call it lineage, let's say.

Sort of a non-linear.

Yeah, it's sort of like a hodgepodge. And what was really amazing about reading about his teachings is that his message was so simple. It basically love everybody, feed everybody, serve everybody. It was like, yeah, there was no big like, you know, treaties or sutra or big text or it was just very, very simple. And when you dive deep into all of that, what does that mean? And, you know, I think to love everybody, serve everybody, I think we often forget also it includes, everybody includes you, yourself, right?

Yeah.

And usually the hardest one to love is yourself too. Yeah.

So can you talk a little bit about that and what that was and how that led to kind of the awakenings that a lot of you had and that Ram Dass had?

But being with him, I mean, he seemed very simple. And his conversations with people were.

So.

Kind of ordinary, especially with the Indian devotees and He was talking about people's kids and jobs and families and they'd come to him with illnesses and problems and he would talk to them about them. But when you asked him something, what seemed to us to be the deep esoteric stuff that we really wanted to.

Know.

How do you meditate? And he would say, meditate like Christ. And that kind of especially since probably about 50% of the Westerners around him were of Jewish background. So getting that one tossed your way was pretty interesting. And then somebody asked him, well, how did Christ meditate? and he said he lost himself in love.

So.

But you felt that kind of love coming from him. It was as if he were radiating it all the time. And it was that, that space that he created around him, it was as if he in this field of love. And everybody around him felt it. I used to think it was sort of personal and that I was feeling it and it was my experience. But a couple of times I looked up and I realized that everybody around him was feeling this. And it was just, you know, quite remarkable. And that was as much to the esoteric teaching is anything.

How did you and the others that were there become transformed by that love?

Well, he used to mostly he would create distractions that would keep us lost in other stuff. Like the first time when I arrived there with Danny Gollman and Krishnananda. and the first thing he did was sit us down and feed us. And the food at the ashram was spicy potatoes and puris, which are deep fried flatbread fried in butter and ghee. And I was so out there. I mean, I was probably half out of my body. And I think I ate three huge piles of potatoes on it, filling a leaf plate and 17 puris. And it almost grounded me. But that was how the love came through. He fed people. And that was the feed everyone part of it. And he would say things like, first bojan, then bojan, when bojan is food and having a meal. And especially with the villagers around the temple where he was, that was such a gift to them to, you know, have plentiful food coming their way, because it's very poor area. And it was just, you know, this kind of vehicle for love. And we learned to, you know, some of the devotional practices. Krishnadas has been teaching people chanting and the Hanuman Chalisa, which is, you know, this 40 verses in Hindi, which we actually all learned, which is pretty astonishing for a bunch of Westerners who my Hindi is still mostly of train and bus station variety. But we absorbed something that really was changed all of our lives. It's very, and it's very hard to express what it was or what it is because it's still working. So in India, there's this, this idea of what's called Prasad about food, which has nothing to do with nutrition whatsoever. which is the blessing that comes with the food. If you get food from a temple or from a high being or a saint or somebody, then it carries the blessing or the love or whatever the vibe is from that being. So in a sense, that Maharajji's way of transmitting what he had to give.

So, yeah, in many cultures, food is the way we show love, but it's often with bad consequences.

Ram Dass contrasted it with his Jewish mother also, which was different. Yeah. Because he got very fat as a kid because he was like trying to please his mother all the time.

Exactly. And the other thing I wanted to sort of touch on was sort of an extraordinary story that was in the book about how he brought a lot of acid with him. When Ram Dass went to India, he took a lot of acid and he gave it to Maharaji. He gave it to the teacher.

Yeah.

And tell us about what happened and.

The concept of first of all, I wasn't there. I'm not a first first person witness for especially the first time. And he was carrying with him some very special LSD that had been made by Alsle Stanley, who was the kind of underground chemist on the West Coast and also the Grateful Dead's sound engineer. It was the purest LSD. It was usually known as white lightning.

Oh, wow.

Okay.

And they were 300 milligram doses, which was kind of a pretty hefty dose for a grown person, which Ram Dass was.

So.

At some point Maharaji said, You have some medicine? And Ram Das thought he had a headache or something. He said, I'm sorry, I don't have any aspirin or any of that. And he said, no, the yogi medicine.

The yogi medicine.

So Ram Das brought out the LSD, and he had, I think, four doses left of the white light. and Maharaji tossed them one at a time into his mouth.

Three doses.

Four.

Four doses. Okay.

I think the first time was three doses. It was like 900 micrograms, which is, you know, enough to.

For an elephant.

Yeah. For an elephant or to send a grown man probably to the moon.

Yeah.

Nothing happened. And Ram Dass was really, I mean, he was worried for starters because he thought, oh, this old man, this is way too much for somebody this age. You start somebody this age out with a small dose and see what happens. And nothing happened.

Yeah, nothing happened.

And then he went back to the States.

And so he just sat there and nothing happened. He's like, I don't feel anything and everything's good or did he say anything?

He just did nothing changed. And Ram Dass had, you know, he had guided trips for hundreds of people and taken hundreds of doses himself. And he knew what tripping looked like.

Yeah. Incredible. Did he talk to him about that or did he say, what are you experiencing or is there any conversation? Well.

It wasn't that kind of conversation, but it was more of a just a demonstration that Maharaji was already there in some sense. And he didn't need it. But when he went back to the States, Ram Dass had sort of doubts about it, because he'd been sitting a little bit off to the side and he thought maybe Maharaji had thrown it over his shoulder. and scammed him, you know?

Yeah, yeah, I scammed him.

So when he went back the next.

Time.

Maharaji asked him again, he said, you, gave me some medicine last time. And Ram Das said, yeah. And he said, you, have any more? and he did. And this time he took four doses. Yeah, the same thing. And he very consciously placed each one on his tongue and swallowed it. And he said, can I have a little water with it? Yeah. And I said, yeah. And then he said, Will it make me crazy? And Ramdas said, well, probably. And so Maharaji kind of goes under his blanket for some time. And then he comes up and he looks completely nuts. His eyes are rolling and his tongue is rolling around. And then he stopped and he was just totally putting him on. I hope you enjoyed today's episode. One of the best ways you can.

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