EP 152: Psychedelic-Assisted Therapy & Integrative Medicine | Andrew Weil MD

Welcome to Radical Responsibility, the podcast dedicated to ridding the world of blame and shame, where we explore the issues you care about from a unique perspective. 100% ownership for each and every circumstance we face in life, day in and day out. Hi, welcome to the Radical Responsibility podcast. This is Fleet Maul, your host and today I'm having a conversation with the internationally renowned Andrew Wilde, one of the original holistic physicians, probably the biggest name in holistic medicine, integrative medicine, who's been working to transform the world of medicine since the 1970s, at least if not sooner. Educated at Harvard University, he's now based at the University of Arizona and we had a profound conversation about the current state of medicine and how we can transform that and the role of some of the newest technologies in that. So give it a Listen. Andrew Weil, M.D. one of a kind so let's begin with your background and journey into holistic and integrative medicine as well as your early experiences with psychedelics. I understand that you first experienced mescaline quite early on, in the psychedelic era of the 60s.

Yes, it was actually in 1960, so that was some time ago. And my first three books, which you did not mention were, were about drugs and consciousness, starting with the Natural Mind that was published in 1972. You asked first about my interest in integrative medicine and healing. I think these go way back to childhood. I have a lifelong interest in plants, something I got from my mother, which she got from her mother. That led me to be a botany major as an undergraduate at Harvard. And I came under the mentorship of Richard Schultes, who was the director of the Harvard Botanical Museum and one of the great explorers of the Amazon and a great interest in psychedelic plants. And that started me on a career interest in medicinal plants, which I have used a lot in my own practice. I also was fascinated for as long as I can remember with mind body interactions. Eventually that led me to study hypnosis and learn about other mind body therapies which I find tremendously useful. I got very disillusioned with medicine as I learned it. I saw it do too much harm and I really learned nothing about how to keep people healthy. So I dropped out of medicine. I traveled around the world for a number of years, looked at healers, shamans, alternative practitioners and gradually put together my own system which I first called natural and preventive medicine and then came to call integrative medicine. My interest in mind altering substances also, I think goes way back to I read a newspaper article about mescaline. I think in 1959, right before I entered college, it was about supposedly the death of a college student from mescaline. And as soon as I read it, I knew I wanted to take it. So I found out a way to get some from a chemical company. And I tried it a number of times in the early 1960s. Had variable experiences, but one very powerful one that made me aware that there was more out there than I was learning and my academic studies. And you know, since that time in my travels, I've worked with a lot of shamans who used psychedelic plants. You know, I've tried most of the major psychedelics and I also knew really all the principles in this movement from Albert Hoffman, mentioned Richard Schultes, Albert and Leary, Sasha Shulgin. You know, I. These were all friends and people that I knew quite well.

Wow, that's quite a. Quite a journey. My journey with psychedelics began in 1966, which seemed like it was early on, but there had already been a lot going on. And you must have also been aware of all the clinical research that went on before it was all suppressed and before these drugs were made Schedule one.

Yes, some of the very early research was with terminal cancer patients at Springboard Hospital in Maryland with very positive results that had guided session. This is particularly with LSD that was being used, allowed patients to come to terms with approaching death. They need less pain medication to be comfortable with families. Very, very positive results. Albert and Leary conducted a study with prisoners at the Concord State Reformatory in Massachusetts, also with very positive results with lower recidivism rates and so forth. So all this was exciting, but as you know, that all came to a very sudden end and mid-1960s, culminating with the Federal Controlled Substances act in 1970.

Yeah, absolutely. And I'm very aware of that study that was done with prisoners. I've been very involved in prison work and criminal justice work for a long time. And you know, back then, from what I've read, there were many people, or at least some people were saying that the psychedelic assisted therapies of some kind or medicine is really the future of psychiatry. And they were saying that back in the late 50s and early 60s, before this was all suppressed.

Yes, Stan Grof was one of the major ones, another friend of mine. And I have to say, and I think you will agree that psychiatry as it's now practiced is really bankrupt. It has come to rely entirely on medications which are just not very good. They don't work. And I think the results that can be obtained with psychedelic assisted therapy are much better.

Well, I'm going to ask you a very specific question about that and dig into that a little bit. But first I'd like to explore something else. So. And this could from your very early experiences, your personal experiences with psychedelics going forward. One of the most profound experiences that many of us have and report through psychedelics is the realization that our entire world is animate. That the rocks and the trees, the earth, that it's what we may have previously considered inanimate. Like we're a being in this large space with lots of objects, inanimate things, that we realize that there's nothing inanimate. And the same energy that's flowing through us is flowing through everything in the world. And we're part of this alive, energetic matrix with the same spirit energy that enlivens all of us. And that a very profound experience certainly was for me. I wonder if you could talk about the shift in consciousness that can come about to having had that experience.

Well, let me first describe one such experience. I was in a canyon in Arizona and I was psychedelicized. I don't even remember which particular substance, but it was fabulous. And I was lying on a rock and I began to feel energy surging through my body. And I saw it as a kind of multicolored corpuscular flow and it was in everything. But I then began to see that it was also in the rock that I was lying on and the plants and the trees and everything. And it's. And I had the feeling that this was self aware, this energy. And my sense is that this is the fundamental energy of the universe and it's consciousness. So I've always since then felt that consciousness is primary.

It's not a product of brain biochemistry or electrical activity. In fact, I think consciousness organizes matter into more complex forms, including the brain. This idea is now called panpsychism. And it's been anathema to materialistic scientists. But I'm happy to say it's gaining traction in the world today and people are taking it seriously. To me, that makes everything much more interesting.

Well, absolutely. And I think, you know, it certainly dovetails with some of the deep science and quantum physics and things like that. And you know, this idea that the consciousness is somehow just an epiphenomena of the brain and, you know, when we die, the lights go out and that's it. You know, based on kind of deterministic.

Reduction of science and in the world over, human beings have been pointing to a very, very different experience that we can actually experience personally. And I love what you said not only is there this matrix of energy and light moving through everything, including the rocks, and I've had that experience as well, but that energy is actually self aware.

Yes.

Which means we don't need to be the subject of all that, that everything in our experience, it's all self aware.

Now it seems to me, and I bet you will agree with this, that psychedelics really are our only chance of avoiding destruction. We are on a march to destruction as a species. I have a feeling that psychedelics are the only thing out there that might save us. Because the more people that have this kind of experience and come to see that they are connected with nature and with everything in this fundamental way that's going to change behavior. And it will take a transformation of consciousness and behavior to get us off of this course that we're on.

Well, there's no doubt that we need a transformation in consciousness. And there's the famous Albert Einstein quote that you can't solve the problems with the same mind or consciousness that created them. And there was a lot of enthusiasm back in the 60s that if we could just get all the power people to take some lsd, the world would change. It didn't quite work out that way. But today, you know, in doing the research for this summit, I've been very humbled and impressed and inspired that, you know, all this time, since the suppression of the 60s and 70s, a lot of people have kept going and new generations have come in and there's many, many, many nonprofits and organizations and people really trying to do it right this time. And I think there's a possibility of. And with psychedelics, assisted therapy seem to be one of the real door openers. But there is a much better possibility for transformation now because I think there's really thoughtful people wanting to do it right this time.

And there's a tremendous momentum toward making these substances available. Before the pandemic, when I was traveling a lot and speaking everywhere I went, no matter what the subject I was talking about, whether it was integrative medicine, healthy aging, nutrition, I got questions about psychedelics. Where can we get them? How can we use them? How can we find people who can guide us? The interest in this is overwhelming. And you see this in mainstream publications. Vogue magazine had a cover story on mushrooms. Not that long ago, town and country, of all places had an article titled why is everyone smoking toad venom? You know, characters in TV series are microdosing. I mean, it's out there. It's becoming mainstream in the culture, it really is.

And people often Referencing this as a psychedelic renaissance. And.

There are risks, and maybe we'll talk about some of those. And we really want to do it right and not create the kind of backlash that perhaps happened in the 60s, because there's a lot of stuff kind of going on underground and there's always a risk of inflation and different things when people get involved in this and take roles in guiding others in this. But in terms of psychedelic assisted therapy in particular. So today on day four of the summit, we're focused on therapeutic approaches and dosing and protocols for safe delivery of psychedelic assisted therapies. And I'd like to explore other daily themes with you as well, especially preparation and integration and different therapeutic applications and so forth. But in terms of today's particular theme, I'm wondering if from, you know, as a healer trained in both evidence based medicine and in preventing, having been a leader and a pioneer in preventive medicine and holistic and integrative medicine, what might be some of the core principles that could guide us towards doing this right, with the therapeutic part of it, at least the clinical part of it, approaching this in a way that it is really going to create the optimal benefit and the kind of transformation of psychiatry and mental health care that we would hope for?

Well, the first challenge is that people in this field have to realize that the experience, what we call the psychedelic experience, is a product not just of the drug, but also upset and setting of. Of expectation and environment. And it is absolutely critical to arrange, set and setting in ways that maximize the positive potential of the substance. So that requires well trained guides. The therapists have to be themselves experienced in these substances to know how to do this in the right way. And I'm very happy to see that there are institutions now that are beginning to train people in this field. Our center at the University of Arizona is developing an academic course for health professionals in psychedelic medicine that will be available soon. But that's a first challenge that I see out there. Second, of course, is to get these things out scheduled. One, you know, as long as they're there, they're not available for therapeutic use. That has to happen sooner or later.

Well, one of the issues also, I mean, in order to create the safe protocols around this, so the clinical trials, I mean, there is ketamine assisted therapy out there being done in clinics and by private practitioners. But in terms of MDMA moving off schedule, one, hopefully psilocybin following that. But currently, while the clinical trials are being done, the process is incredibly expensive. You have MDs and licensed psychologists and therapists involved and a big team done in specialized settings. And so the question of, you know, how do we bring this to scale in a proper way and train people well enough and also realizing, you know, kind of building in the humility because a lot of these psychiatric medicines, I mean, not only do they, you know, kind of shift our reality and consciousness in many different ways, but they, they, they can lead to being very empathic and open hearted and, and really facilitate connecting with each other and, and you know, for any of us who are involved as guys or therapists, we, you know, to whatever extent we have or haven't done with all our shadow stuff, we don't something, you know, it can easily go awry on, you know, with issues of transference and countertransference if people aren't really well trained. And so, you know, I'm just curious about how as we begin to bring this to scale, I mean, I think Rick Doblin said we're going to have to train 10,000 therapists or something like that, you know, so it seems kind of daunting to do this, right.

Well, it has gone awry in the past as you know, and there are many examples which have not worked out well. So I guess this just comes down to being careful selection of people for this training and then ensuring that people are monitored and that the training is really good. So I hope it works that way. You know, I think there's the potential here is tremendous and it just takes care and thought well.

And there are good programs being developed, training programs, certainly the MAPS training. I'm glad that your institute is developing a training ciis, California Institute of Integral Studies and Naropa University and others in Naropa there are, which is my alma mater. So I'm very happy. Yeah. That they're doing that. So I'd like to circle back though to the field of psychiatry and its evolution. So it wasn't terribly long ago that mental illness might have been considered a character defect or a curse or a moral issue. And then we kind of moved into the era where it was seen as an issue of brain chemistry, an imbalance in brain chemistry. And I remember even in my early training back in the 70s, I always thought it kind of seems like a chicken or the head thing. How do you know that the symptomology was created by the brain chemistry? How do you know the brain chemistry wasn't created by something else that's causing us to feel depressed or anxious or whatever it is? And so, but you know, that's where psychiatry went with all these SSRIs and many other types of drugs and medication to adjust people's brain chemistry and then having to do that on a maintenance basis and you know, well, I'll let you talk about how well or not well these drugs work, but it looks like we're possibly making a shift with the assistance of psychedelic medicines to instead of treating the brain chemistry to actually treating the underlying traumas that produce these mental challenges to begin with.

Well, I hope that that is happening. It is desperately needed. The word psychiatry comes from Greek and it means soul doctoring. I mean, what a wonderful concept. It's ironic that psychiatry, of all the medical specialties, is the one that has become most mired in materialistic thinking, in which all disorders of mood and thought are seen as products of disordered brain chemistry. And there's only one way of dealing with that, which is by giving psychiatric medic. These drugs which are so widely used are incredibly ineffective. If you look through psychiatry journals, you would think, look at these ads, you think that there would be no more depression or anxiety disorders. But in fact the drugs don't work very well. The serotonin hypothesis of depression, I think has really run its course. And correcting serotonin levels in the brain is simply not the way to get a handle on depression. And these drugs also have significant toxicity. The recent research showing that how effective psilocybin can be in managing drug resistant depression is very encouraging. And I think it is time for this shift to occur. It has to happen. But we have a long way to go at the moment.

I wonder with your background if we could just maybe, I don't want to get too nerdy about this, but just a little bit into the, maybe the.

The, I guess the biochemistry here of the psychedelic effect. So these psychedelic drugs, they do on short term impact serotonin receptors. There are other receptors involved as well, and dopamine effects from some. And there are the triptamine class, the psychedelics which seem to often have stronger hallucinogenic effects. And then there's the phenylethylamine, which have the stronger empathic effect, although there's a lot of overlap, I think. But. So what do you think is happening in terms of how we're adjusting things in the brain to create these openings or possibilities of a good therapeutic environment? We'll get into set and setting in a moment. But what's happening at the level of the pharmacology or the biochemistry that allows us to do this in a way that's different from the way psychiatry has Been trying to mess with brain chemistry for quite a while.

Well, until relatively recently we really did not know the mechanisms of action of these substances. And it's a fairly recent discovery that they interact with a particular type of serotonin receptor, the serotonin 2A receptor. But I don't think we yet know. And that receptor is involved in a wide range of experience of appetite regulation, pleasure, a whole lot of things. I don't think we yet know exactly how activation of that receptor translates into experience. The serotonin selective reuptake inhibitors, which are the ones that are so widely used in psychiatric medicine, increase serotonin at neural junctions. That's a very different kind of action. And one of the problems with using drugs like that is if you give them over time the homeostatic reaction, the body is counteractive so the body will begin making less serotonin and dropping serotonin receptors. If you keep people on these things for a year or more, they wind up being more depressed than they were to begin with. And it's very hard to go. I don't think anything of that sort happens with the psychedelics and also with say the use of psilocybin and treating drug resistant depression. It's not something you take on a regular basis over long periods of time, can be relatively short exposures to it with very long lasting effects.

There has been some talk about, there's the world of microdosing and I don't think we have very good research on it yet. And it ranges from people who are microdosing and integrating that with other spiritual practices to kind of explore mind and you know, and then there is some idea that following, you know, doing a larger dose, macro dose if you will, in psycho, in psychotherapy, psychiatric assisted psychotherapy for let's say depression or something, that, that and there are some of the clinical trials have shown all those remarkable effects and remarkable long lasting effect still. Eventually many relapsed with depression. I think the early psilocybin studies in the UK and so forth. So some thought that maybe microdosing could extend the benefit and then you would be kind of maintaining something with a microdose of. And there's probably not a lot of research on that. But I'm just curious about your thoughts about that.

There's not, I really have no answer for that. I don't know enough about it. But I have a question for you. You know there have been a of lot, there's been a lot written about the potential of psychedelics to increase spiritual awareness. Some of the Work at Johns Hopkins, showing people who have been atheistic who now really have a sense of something out there larger than themselves. When reports of this sort of thing were happening in the early 60s and the early days, a number of spiritual leaders were very upset by this and said that these could not be genuine experiences, that they were somehow artificial. It always seemed to me that the way you judge this is by the effect on a person's life and that there's no way to categorize these things as being not genuine.

Absolutely. And my early psychedelic experiences, they were a lot. And it was a mixed bag back in the 60s and 70s. Some of it was spiritual exploration done in a good way. Some of it was partying and general craziness. I then ended up living in South America for quite a long time, going very deeply with. With San Pedro, with which is a masculine cactus. And all of that really completely changed my life and the course of my life in really good ways. And at the same time I saw a lot of shadow stuff going on in my life. And I got involved in meditation training from early on. So it's hard to say what some of the tipping points were that eventually got my life going in a genuine direction of deep transformation. But there's no question that psychedelics played a strong role in that. Especially even just those initial experiences. And I had a number of them were very profound. Realizing that I was simply part of this self aware matrix of life and energy and spirit and in a completely interconnected way. And I guess it didn't have that in a completely powerful enough way not to still get pulled into some of my shadow stuff as my life went on, but it still changed everything. I could never believe the same things I've been told growing up about reality. I could never believe those things again. So, you know, I think maybe it's the. It's the interface of psychedelic experiences that people who are not suffering with forms of mental illness explore for some reason. And then finding some way to integrate that with a path as well as the people going through various forms of therapy, finding some way to integrate their path. And that kind of will bring up a question that I'd have for you. And this is really exploring the whole notion. You've referenced set and setting several times and we've known for a long time that set and setting can be really largely determinant of a psychedelic experience. And someone can have not experienced much at all on a very powerful psychedelic, or have mind blowing experiences, have very positive experiences, or have what classically what's called a bad trip. And it has a lot to do with setting, setting. So I wonder if we could explore that. But also just the whole notion of good preparation and then follow up integration, both in the short term and the long term. And maybe thinking about that from the perspective of integrative medicine.

Well, let me give you one example from the early days and this is from probably my freshman year at Harvard. So 1959, 1960, few people had even heard of any of these substances. And I knew one case, this is a party where somebody dosed people with LSD without their knowledge. And, and the people had no expectations. And when they felt the drug working on them, their interpretation of it was that they were getting food poisoning. I mean really interesting. They had no significant psychological experience.

So I am a great believer in the power of set and setting to mold pharmacology. And it's therefore incumbent on people doing this kind of therapy to arrange circumstances to get the maximum positive of potential.

And all I can tell you is that just takes great sensitivity and training.

And what about the integration part? People may have experience. I've watched a lot of the films of the clinical trials and some people may have these kind of being blasted out kind of into sort of outer space beyond kind of ego experiences, profound connectedness and so forth. And others are dealing with a lot of trauma and shadow stuff coming up. But they appear to be able to witness it from a different place and come through the sessions and reflect back on them with a lot of insight and courage rather than being re traumatized. So the experiences can be all over the map. But it seems like the lasting benefits are going to have to do with some process of integration of how they integrate this in their life and how it becomes a platform for then dealing with some of the undealt with stuff we all have our underlying traumas and our shadow things that we haven't dealt with in life. So how can this be a spring board into really from an integrative medicine perspective, deepening our health and well being, or from a spiritual perspective, really evolving and doing that deeper work?

Well, I think that is the challenge. I can tell you that my own experiences really helped me form my ideas about health and healing in medicine. For one thing, they convinced me that what's inside my head and what's outside my head are connected in a very powerful way and that it's possible to change things outside by changing things inside. And I think that for me has enormous significance in dealing with physical illness. And I've seen again and again that People can change, especially chronic illness. And so to me, that is a tremendous possibility. I'm a little disappointed to see that most of the therapeutic interest in psychedelics today is focused on mental emotional disorders, because I think there's tremendous potential in physical medicine as well that a single psychedelic experience can give a person the real experience, that they can live without some chronic discomfort that they've been living with. And even to have a moment of seeing that can motivate them to find ways to make that last longer.

Did I read about you? Or maybe I read this somewhere else. Dealing with some kind of chronic pain or back pain or something and having the experience of being without it and. And beyond the experience, you weren't free of it, but then you realized you could be free of it if you did the work.

Yeah, it had to do with. I was learning yoga when I was 28, and there was one posture that I could not master, the plow, where you lie on your back, touch your feet behind your head. I could get my toes about a foot from the floor and had excruciating pain in my neck. And no matter how much I practiced that, I couldn't do it. So I was on the point of giving up. I just thought I was too old and stiff. And then one day I took LSD with some friends. It was a beautiful spring day. I felt terrific and flexible. I thought, gee, well, I'm feeling this way, I ought to try it. And I was lowering my feet. I thought I had a foot to go. And they touched the ground. I couldn't believe it. There was no pain. It was remarkable. The next day I tried to do it again and I could get to a foot from the ground. And I had horrible pain in my neck. But now I knew it was possible. And before that, I did not believe it was possible if I had not had that experience of would have given them. And I think to me that's a model for what these can do. They can show you possibilities. They may not tell you how to maintain those possibilities, but they can motivate you to find ways to maintain them.

So continuing along those lines now there is a lot of work being done to help prepare people for end of life. And that work was going on back in the 60s, early on with Stan Groth and others as well. But now there's work being done, I think, with ketamine, also with psilocybin, and.

I guess helping ease fear of death and anxiety around that for people.

But how might you imagine it being used in medicine with people who are suffering from chronic illnesses or forms of cancer or.

Chronic pain or even some kind of dementia. I'm just, I suppose once these things come off schedule, one physicians could begin exploring different ways to work with them beneficially, not only for these mental emotional challenges, but also for physical ones as well.

Yeah, I'd love to see that. A short while ago, the head of palliative care at the University of Arizona came to me and she said it just killed her that psychedelics were not available for her to use in end of life care because of her own experiences with them. She knew how valuable they could be. So I really hope that they become therapeutically available. In the early work that was done at Spring Grove Hospital, the method was to have several sessions of therapy to prepare a person for the experience, then have the experience and then have follow up sessions to integrate it. A very high percentage of people who did this needed less pain medication. They were comfortable with the idea of approaching death, able to be with their families comfortably for the first time. Those are tremendous results. I think in terms of physical medicine, you know, I would pick cancer is a tough one. I wouldn't start there. You know, I would start with things like autoimmunity, allergy and chronic pain, where I think there's a very high chance of changing the actual course of the physical disease.

Something like fibromyalgia, which seems to impact a lot of people. These kind of immune disorders that create a lot of chronic pain for people.

Absolutely. I mean there's, we know that how much the immune system is influenced by mental state. And this can give you a very dramatic experience of interpreting what's going on in your body in a different way.

Well, we've kind of been exploring this a little bit already, but maybe you could speak to some of your hopes or even your kind of blue sky vision for psychedelic assisted therapy, and then how that might fit into the overall landscape of integrative medicine, which hopefully is the direction medicine will be going in.

Absolutely. By the way, we have a program called Integrative Medicine and Residency which is a 200 hour curriculum embedded in residency training. It's been accepted by 100 residencies in the US and one of them is in psychiatry. So we are beginning to train psychiatrists in an integrated model. And there's enormous interest in using psychedelics and getting training for it. So I do see this happening. As I said, the first challenge we got to get these out of schedule one. So that's going to take an act of congress and that requires enough public pressure on legislators to make that change, then we have to have these training protocols in place and there have to be guidelines. Are there people who shouldn't take psychedelics? What about people who have had psychotic experience, for example, or have very severe trauma in the past? How do you prepare them for that? You know, we need guidelines of that sort and we're not there yet. I think it's coming. But my. They're going to be available. People want them to be available. The therapists want to be able to use them. It's going to happen.

Well, in the efforts, what I've read about the efforts to reschedule MDMA and psilocybin, that there will be a lot of guidelines in place and they're being developed and, and so forth. And I'm curious about. I know with other medications, often once a medication is approved by the fda, then physicians are free to prescribe it off label, I think is the term and use it for other than its intended purposes. Now, from what I'm reading, it sounds like the approval for these psychedelic medicines may be a little more restrictive than that. I don't know. But I'm curious about your thoughts about that whole off label phenomena in medicine and how that might apply.

Well, I think it's a good thing that doctors have that freedom to use medications in that way. You know, I have a fairly dim view of most of the medications that are out there. Both not just psychiatric medications, but in general. And for all of the regulations we have in place that has not kept a great many worthless and dangerous drugs off the market, I think the manufacturers consistently exaggerate their benefits and downplay their risks, often with the collusion of medical journals. You know, this is a whole. A big problem that we have. Not to mention the huge profits generated by them. I don't know how psychedelics will fare in this environment. You know, there is real concern about the profit incentive and all these businesses jockeying for position, thinking they're going to make great amounts of money. A number of the companies hired chemists to make analogs that they can patent of psychedelics. There are questions of cultural appropriation. Are we taking these, ripping these off from indigenous cultures? How do we compensate them? A lot of questions out there and I don't have answers to them. I don't know how all this will play out.

Yeah, there are a lot of complex questions and I do think we need to approach this all really, really thoughtfully and really respectfully. And I wonder if it resonates with you. I'm kind of circling back to day One of the summit, where we try to set the context of honoring the origins of psychedelic medicines with indigenous people. And some came out of the laboratory, but many were plant medicines coming from that indigenous people have been using for millennia. And of course, there's some people even think some of the major religions began with entheogens. That's highly speculative, but some people think so.

But there's that sense of the sacred. And so two questions I wonder. And one of our speakers, Belinda Ariazzo, uses the term sacred reciprocity. And so I'm wondering if that resonates with you, the sense of the sacred, the awe, the not knowing, the mystery, as well as. Maybe that's one part of the question. The other half of the question is from your long career in body mind medicine.

How you would define mind and then maybe consciousness.

Well, first of all, I think mind and body cannot be separated. I think there are two poles of an underlying reality. And anything that goes on in one sphere goes on in the other sphere. And that connection can be taken advantage of to promote healing, for example. And that's where these substances can be very, very useful tools. In terms of the sacredness of these substances, I think that's something to be acknowledged and honored and their cultural origins as well. You know, probably one of the first substances that's going to be made available is mdma, because the research data there are so strong. And the pressure to have treatment, treatment for ptsd, which is an enormous economic and medical problem, is so great. I think that will happen. And that is a product of a laboratory. You know, it really does not have connections to indigenous cultures, although the molecule has some relation to other substances. So I don't know how we go about that. But to me, that is also a really sacred substance because the, the effects of it are remarkable in terms of creating empathy, of changing how people relate to each other. And that's one of the things that has to change if we're going to avoid the kind of destructive course that you know.

Well, this has been really fascinating and.

A really rich addition to our dialogue here for the summit. And so I want to thank you for that. To begin with, I'm curious about your current focus in your practice and your research and, and with your institute with the Andrew Weil center at Arizona University for Integrative Medicine. Just kind of, where's the direction of your work going and what are you up to?

Well, our center is really focused on training of health professionals, physicians, nurse practitioners, allied health professionals. We have a very intensive two year fellowship training for physicians and nurse practitioners. We've graduated almost 3,000 from that and they're in practice all over the country and in other countries we have this residency curriculum. My goal is to see this become universal in medicine and you know, have this new paradigm in place in which people understand the reality of the non physical aspects of human beings and can take advantage of the mind body connection and are willing to use all treatments that show reasonable evidence for efficacy and are not going to hurt people. And I would encourage include psychedelics in that category.

And you've written a lot on food as well. It seems like if we're going to talk about preventive medicine, we got to talk about what we intake, right? Where, where we start, what do we, what are we feeding the body with? And that's been a tremendous emphasis of yours.

That was a subject that has been so neglected in conventional medical education. The total instruction in nutrition that I got in four years at Harvard Medical School was 30 minutes, which was grudgingly allowed to a dietitian in one hospital I worked at in Boston to tell us about special diets we could order for patients. And that really has not changed a lot. You know, when nutrition is taught in medical schools, it's taught as biochemistry and it's forgotten as soon as the biochemistry exams are over. So there's a tremendous need to get physicians up to speed about how dietary choices impact health. That's something I've been working for.

You know, that kind of points to a risk maybe with psychedelics assisted therapy that in, in trying to bring healing to people suffering from severe depression, anxiety disorders, addictions and so forth, that, that this is seen as kind of a magic pill again, another kind of reductionist medical approach. And, and we don't also do everything we could do for that person to help them change their diet and change their lifestyle and, and do all the other things that would contribute to them being able to reclaim their lives and live a healthy, rewarding life. You know, other just give them the psychedelic assisted therapy and send them back to their life without any training in how to live a good life and how to take care of yourself. That would seem to be a real loss.

Yeah, and that's the essence of really the integrative philosophy is that these are complex methods that look at all aspects of lifestyle. Also one of the mistakes made in the early days because I think the people who understood psychedelic experience from their own own experience knew how these worked and the importance of sentence setting. And then other people who did not know that looked at them as Magic bullets and tried to reproduce the results and didn't get them. And that, you know, conflict of evidence in the literature is one thing that turned people away from their use.

Yeah, for sure. And I had a medical appointment recently, my annual wellness visit, and bless her heart, my position. I was asking her about doing some deeper blood work and wanting to really, you know, kind of see what was going on in my body in a much deeper level. And she was like really questioning me. And I was talking about, you know, checking for testosterone levels and, you know, mercury levels and other things and going into some deeper scan stuff. And she was like, well, I practice evidence based medicine. Got a little upset with me. But it is a, it is a challenging kind of wall around that world.

In my view, the evidence based medicine movement in its most extreme forms is exactly analogous to religious fundamentalism. It's scientific fundamentalism. In some institutions you cannot give a lecture if you don't submit in advance your remarks and have them vetted by the Evidence Based Medicine Committee, which looks to see if you can reference them in journals approved by the Evidence Based Medicine Committee. I mean, that's thoughtfully so not good. What I have always taught is I'd like to see people use a sliding scale of evidence that works like this. The greater the potential of a treatment to cause harm, the stricter the standards of evidence it should be held to for efficacy.

That makes a lot of sense. That definitely makes a lot of sense. Well, thank you so much for everything you've shared with us today, Dr. Weil, and for all your brilliant work over all these years, incredible contributions to the direction we all hope to go in with preventive medicine and integrative medicine and the tremendous promise of these psychedelic assisted therapies. So thank you so much.

I enjoyed it and look forward to talking to you again.

Thank you.

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