OPEN Foundation

Interviews

Anonymous donation on Reddit ‘changed everything’ for MDMA research

March 23, 2022 / Articles, Interviews, MDMA, Videos / By

When MAPS founder Rick Doblin was in Amsterdam for our event on MDMA research, he sat down with journalist Thijs Roes for a wide-ranging conversation. One of the topics they touched upon, was how recent MAPS funding had gotten off the ground.

In 2017, MAPS was a much smaller organisation. With no help from any government and no large funds available to them, MAPS had to get by on relatively small donations. Until an anonymous Reddit user called Pine suddenly announced that he had millions of dollars available to support causes that would otherwise be overlooked. She (or he) had bought bitcoins for an incredibly low price, and had had an epiphany while on Ketamine-therapy: the best way to live life was to help other people, and give as much the newly gained wealth away.

“MDMA-assisted psychotherapy will be a gift to the world from the psychedelic and cryptocurrency communities,” Rick Doblin wrote earlier. And in the interview he says the grant “changed everything for us”. Pine ended up giving $5 million dollars to make MDMA-assisted therapy a reality. MAPS is now in phase 3 studies to get MDMA approved and legal for clinical therapy.

Rick Doblin will be speaking at icpr-conference.com – the leading scientific psychedelic conference of Europe, held from September 22 until 24.

Ido Hartogsohn on the influence of society on the psychedelic experience

December 6, 2021 / Articles, Interviews, Psychopharmacology, Publications, Sociology / By
collective set and setting
Ido Hartogsohn is one of the first and few researchers to focus on psychedelic research from a social technological perspective. The assistant professor from the Science, Technology and Society program at Bar Ilan University in Israel has just published a new book called American Trip, in which he explores how the social conditions of the 1960s shaped the American psychedelic experience itself. 
In his recently published book he inquires how the LSD experience was shaped by the social conditions and predominant values of the fifties and sixties, portraying LSD as a “psychopharmacological chameleon” dependent on culture. With this move, he expands the traditional meaning of set & setting in psychedelic therapy to include the broader contexts in which these substances are used. He calls this the “collective set and setting”: the broader cultural and social contexts in which these substances are used. 
His work brings a sociological perspective that invites us to rethink psychedelic drugs beyond their mere pharmacological properties.
How do your views challenge conventional understandings of drug effects in pharmacology?
One of the defining ideas of pharmacology is an often implicit notion which scholar Richard DeGrandpre termed pharmacologicalism: the assumption that a drug is exclusively defined by its inherent pharmacological qualities – that it has one type of discrete effect independent of any variables.
The closer we look at the effects of drugs, the more we see that they do not work like that at all. The effects of drugs, not just psychedelics, can change radically depending on the social and physical environment.
Think of the example of US soldiers returning from Vietnam in the 1970s. The American army tried numerous plots to help these soldiers kick their heroin habit while they were in Vietnam, but all of these ultimately failed. Then, as the soldiers returned home, suddenly 90% of them were able to kick the habit spontaneously, without going through any kind of treatment.
Once the setting changed we could see that – even in the case of the supposedly most rigid, inflexible and essentially physical drugs, effects were highly dependent on the set and setting of use.
This is something that pharmacological discourse has been reluctant to acknowledge over the years. It makes sense because once you acknowledge that, it complicates drug trials and discussions around drugs. It forces us to think about not only the very chemical product that we give to patients but how we give it to them and the whole clinical environment. It also forces us to forsake these very naive ideas of drugs as magic bullets that have one specific effect and one specific and highly discrete application.
The cultural malleability of psychedelic experiences has great implications for drug policy. How do you think that prohibitionism and anti-drug propaganda could have infiltrated the very experiences of psychedelic users?
There is this classic study by the sociologist Richard Bunce about the dramatic increase of bad trips at the end of the 1960s as authorities were pushing different scare theories such as the idea that LSD creates chromosome damage or that it will “fry your brain”. All of that stuff was completely debunked later on but once you have these ideas percolating inside the culture, they can easily penetrate people’s experiences. Given this type of ‘collective set and setting’, levels of paranoia shot up among users. Experiences that could be interpreted as quite benign and pleasant turned in a way that is very scary.
This kind of effect is something anthropological literature was predicting already a decade earlier. In the late 1950s, anthropologist Anthony Wallace argued that psychedelic users in the West were more liable to have negative experiences than those that had them in traditional or indigenous societies. Societies, like in the West, that conceive of hallucinations as something that is inherently dangerous and meaningless increase the chance for harmful experiences.
I believe that there have been so many psychedelic trips gone awry as a result of prohibition; so much mental energy that has been squandered; so many positive experiences of users over the years that took a bad turn when they for example encountered police during a trip or were somehow perturbed by the ideology, propaganda and policy of the war on drugs.
So, if we are to take a harm reduction approach to drug use, what can we do to improve the collective set & setting of psychedelic use today and in the future?
One of the most beautiful things that is happening today in the so-called “psychedelic renaissance” is this burgeoning culture of set and setting: the growing awareness of the importance of preparation, intention, and integration – of knowing your substance, your set and your setting.
Psychedelic users today are much more “psychedelically literate” than the ones in the 1960s, and that’s a result of a very rich culture of discourse and practice informed by the idea of set and setting. So we now have safezone organizations which provide for example psychedelic first aid or peer support in festivals like Burning Man or Boom; we have online trip-sitting services run by volunteers; books and websites guiding about the principles of safe and transformative psychedelic voyaging, and there are more and more studies that aim to study how set and setting work.
These are all very hopeful signs that the appreciation of the importance of set and setting is more and more widely recognized in the field of psychedelics, for the broader community as well as for the clinical community.
Governments that want to approach this subject from a progressive perspective need to realize that outmoded, ideologically rigid approaches to drug use fail their citizenry and ultimately the entire society. Governments are betraying their role when they prosecute users. What they should be doing is helping the general public get the know-how, the information and the resources that could help minimize harmful experiences and maximize the potential for safe, positive and meaningful experiences.
You argue that the placebo effect can be understood as a form of meaning response, in which clinical improvement follows from the mere manipulation of meaningful cues in the therapeutic process. Accordingly, the meaning-enhancing properties of psychedelics turn them into some kind of “super-placebo”. What would be the consequences of this reconceptualization for current clinical trials with psychedelics and their placebo-control methodologies?
Over the years the pharmaceutical industry has been invested in the attempt to minimize or eliminate placebo effects. If you are selling a drug like they are, you probably want to give a decisive answer about its effects. But once [the placebo-effect] enters the picture, it appears much more uncertain what the drug actually accomplishes by itself.
After clinical trials, we see that the efficacy of that same drug diminishes from year to year of use in the market, or from culture to culture, because of the changes in the placebo response and in the meaning attributed to the drug. We can therefore see that drug effects are much more fluid than we are led to believe.
Medical anthropologist Daniel Moerman draws our attention to the fact that placebo response can more intelligibly be conceived as just meaning response. When you bring this insight into contact with the field of psychedelics something quite interesting emerges, because one of the main effects of psychedelics is to enhance the perception of meaning.
This then raises the possibility that psychedelics may enhance the placebo response by enhancing our perception of meaning. This potential of psychedelics to enhance placebo really holds a valuable alternative to the classic pharmacological model and an opportunity to think about how meaning intervenes in therapeutic processes.
I don’t think that we are about to see the end of the blind trials paradigm anytime soon. But rather than looking for an objective response to a drug and leaving it at that, we would achieve better results if we focused our energy at examining the nexus between drug, set and setting, to optimize the overall therapeutic process in a way that transcends commonplace flat and impoverished conceptions of the drug responses.
You have approached psychedelics from a science and technology studies (STS) perspective. What has that taught you?
When you look at LSD and psychedelics in general, you have a technology whose effects are highly malleable. Depending on the set and setting, a hallucinogenic agent like LSD can be a psychotomimetic (psychosis mimicking) and it can be therapeutic. It can be anxiety-inducing and it can be mentally soothing.
The effects of LSD are so radically transformed in relation with user’s mindsets and settings that you could argue that LSD, as a technological artifact, is recreated every time it is used. This recognition leads to the concept of psychedelics as a technology that is culturally and socially constructed in a radical way.
One of the main takeaways that I am trying to convey in my book is the idea of a “psychedelic technology”. Going back to the very meaning of the word psychedelic as “mind-manifesting”, the category of “psychedelic technology” would then refer to technology that is shaped in accordance with the mind-set and the environment (hence the idea of an ecodelic) of the user. This is an interesting way to think about technology that is a radical extension of the social constructivist way to think about technologies in the field of STS.
My perspective on psychedelics later shifted to the STS idea of co-production, the question of how the effects of LSD and other psychedelics are shaped and formed by social values, norms and conditions, and how LSD and other psychedelics simultaneously bring about changes in social and cultural movements creating a kind of positive feedback loop, an idea that I explore in my book.
What will be the major takeaways that potential attendees of ICPR might expect from your talk or about your book?
One of the main things my book tries to do is to really expand our understanding of set and setting in order to transcend that more narrowly defined, individualized concept of set and setting. I think the book makes clear that no factor in the individual, specific or concrete set and setting of a psychedelic experience is independent of the larger social and cultural picture, and so I try to answer the question how our collective historical and social forces worked to shape the psychedelic experience in the West since the 1960s and to this day.
Ido Hartogsohn talk at ICPR 2020 will explore the relationship between set and setting, meaning-enhancement and placebo as a central axis on which the psychedelic experience can be interpreted and understood.

Janis Phelps on training the first psychedelic therapists

December 6, 2021 / Articles, Interviews, Psychiatry, Psychology, Publications / By
Professor Janis Phelps PhD
Janis Phelps is the founder and director of the CIIS Center for Psychedelic Therapies and Research, which conducts the first academically accredited, professional certificate training programme for psychedelic-assisted therapy and research. 
At ICPR 2020, Dr. Phelps will address her experience in setting up a licensed training program for people working in research and therapy with psychedelics. 

You founded the first licensed training program for psychedelic therapists. How did this come about ?
The genesis of this program came about in 2014 at a Heffter Research Institute board meeting, where one of the trustees of our college heard the dire need for psychedelic therapists to be trained.
Our university has been training about 250 therapists a year in 6 different programmes for over 30 years. Stan Grof, Ralph Metzner and other psychedelic researchers have been teaching at CIIS for decades. CIIS trustees gave us seed money for a 3-year grant. I was the founder and creator of the programme, and the opportunities for this were very rich.
We wanted to bring in indigenous ways of knowing as well as the approach typically used in the research protocols for both psilocybin and MDMA.
What are the challenges you faced in this process ?
Well, we were creating something in a vacuum. There were no guidelines yet for how to do this, because no-one had done it before. For a year, I consulted with researchers, underground and above-ground therapists, and in related areas such as hospice care centres and emergency rooms, on how to work with people in altered states.
To devise the programme, we drew from anthropology, clinical and transpersonal psychology, psychoanalysis and ceremonial uses. The challenge was to try to integrate all these in the best possible way.
However, we chose to emphasise the research approach for now, because of the need for therapists to be in FDA-approved clinics. This is a compromise we made, but the upside is that now our graduates get hired by these research entities and they’re opening clinics that will be ready to use MDMA and psilocybin in the next couple of years.
Things seem to be progressing quite fast these days. Are you sometimes concerned they may be going too fast?
I’m concerned about the decriminalisation movements in the US. They’re going quicker than I’m comfortable with. The general public is not sufficiently aware of the hazards and the benefits of the use of plant medicines. Even physicians and nurses don’t know enough, and neither do school teachers.
So we’re working on scaling up our programme to include the general public and give them information online for free: interactions with medications, incompatibilities with certain psychological difficulties, how parents can talk to their kids about psychedelics, etc. I’m concerned there might be another backlash like we had in the sixties if these medicines are not used responsibly.
My other concern is that we’re training only 75 people a year, about 300 so far. MAPS has only trained about 250. We need thousands of therapists trained. I’m concerned that when the medicines get rescheduled, there won’t be enough therapists, with resulting insufficient access to the medicines for patients. So we’re looking to scale it up and develop affiliations with other universities.
What have you taken away from this whole adventure so far?
I’ve been delighted to witness the integrity of the therapists and medical doctors wanting to come into this space. They want to see healing happen, they’re concerned about what’s happening on the planet in terms of politics, genocides and global warming.
They know that psychedelics are not the only way for people to heal, of course, but the kind of therapy we can do is augmented tremendously by the use of plant medicines. I see them changing psychiatry and psychology for nothing but the good.
On average, the professionals who apply for the programme have 15 years of licensed practice, so they’re quite experienced in their work. Some were retired medical doctors who reactivated their license in order to do this work. I also witnessed our students building community with each other, creating associations, building salons, and it’s very exciting to see this flourish across the United States, into Canada, South America and the EU. I realised once again how desperate people are for community. And finally, it’s been wonderful to meet the new generation, I’m very happy to pass the hat to younger people.
Dr. Phelps’ talk at ICPR 2020 will be titled: “Training future psychedelic therapists”

Is MDMA a psychedelic?

December 6, 2021 / Articles, Interviews, MDMA, Psychopharmacology, Publications / By

In conversation with Rick Doblin and Torsten Passie

Is MDMA a psychedelic or not? And what makes it so well suited for therapy? In this conversation between Rick Doblin, Torsten Passie and Joost Breeksema, the use of MDMA in a therapeutic setting is discussed in-depth.

According to Doblin, MDMA’s potential for healing PTSD-patients differs from the ‘classic’ psychedelics, which usually need a mystical experience or something similar to ego-dissolution in order to show similar results as MDMA. With MDMA, patients feel a sense of safety approaching their trauma ‘with their ego intact’, as Doblin puts it.
Then again, Doblin prefers to use the term broadly, and includes breath-working techniques and dreaming as psychedelic. In this conversation, both guests dive into the intricacies of MDMA therapy. According to both experts, MDMA can be seen as part of psychedelics if the term is used broadly.
Rick Doblin has dedicated his life to making therapeutic MDMA a reality. Ever since 1986, his non-profit association called MAPS has been instrumental in advancing the science of psychedelics and MDMA in particular. Their research into the application of MDMA in therapy received Breakthrough Status from the FDA and he is now in phase 2 and 3 of clinical studies with MDMA-assisted psychotherapy in both Europe and the United States.
Torsten Passie is a Visiting Professor at Harvard Medical School (Boston, USA). His extensive research at Hannover Medical School covers the psycho-physiology of altered states of consciousness and their healing potential, including clinical research with hallucinogenic drugs (cannabis, ketamin, nitrous oxide, MDMA, psilocybin). He is an internationally known expert on altered states of consciousness and the pharmacology of hallucinogenic drugs. He talks about the intricacies of psychedelic therapy, medicalization and how to integrate psychedelics into mainstream health care.
Both Torsten and Rick will present at ICPR 2020, and we’ll have panels on all these topics. A preview of what is to come in this conversation.

Remembering Jordi Riba – Pioneering ayahuasca researcher

December 6, 2021 / Articles, Ayahuasca, Interviews, Other, Publications / By

We are deeply saddened by the loss of pharmacologist dr. Jordi Riba, probably the most prominent psychedelic researcher in Catalunya and Spain, and a true pioneer in the biomedical study of ayahuasca.
Jordi was a true explorer who conducted his scientific quest for discovery and information in the same way 15th-century discoverers explored territories on unknown continents: without navigation, but with great dedication and perseverance. He became intrigued by the effects of ayahuasca at a time when research into psychedelics was ignored by most of the scientific community, and actively opposed by governments in many countries. Despite these obstacles, he managed to bring ayahuasca to his Barcelona research clinic and published an unprecedented controlled, dose-ranging study on freeze-dried ayahuasca almost 20 years ago. Since then he has published close to 40 scientific research papers on ayahuasca, greatly advancing psychedelic research and significantly contributing to the re-emerging interest in therapeutic applications of psychedelics.
Jordi Riba was a prominent speaker at all previous editions of ICPR. The first time OPEN met with Jordi was in 2010, right before the Mind Altering Science conference. It was the first conference OPEN had ever organized. As novices in this field, we invited several experts, and to our own amazement, many of them, including Jordi, accepted our invitation. We even managed to find a hotel that would accommodate our speakers for free. Jordi Riba and his colleague José Carlos Bouso were the first to arrive in Amsterdam, and they headed directly to the hotel. Before long, they called us and stated politely but in no uncertain terms that thank you very much, we will not be staying here. Flabbergasted, we apologized and tried frantically to find an alternative hotel. Inexperienced as we were, we had not visited the hotel before accepting their offer, but sure enough, the “Hemp Hotel” was aimed at cannabis tourists; the shabby couches in the lobby were full of stoned tourists, the hemp smoke thick enough to cut with a knife, and the receptionist absolutely clueless that the hotel was reserved for our speakers. Luckily, we found them a decent hotel and by all accounts, the conference was a success. This anecdote was typical for Jordi – a polite and serious gentleman researcher from Spain who would not abide crappy hotels. He would go on to speak at all of our conferences throughout the years, and would have been present at ICPR 2020, had circumstances been different.
Looking back on fifteen years of ayahuasca research in an interview with OPEN, he shared many of the complexities – technically, culturally, and pharmacologically – of studying such a culturally embedded and variable plant mixture. To address some of these, he managed to create standardized, freeze-dried and encapsulated ayahuasca, which he administered to volunteers in various doses in his Barcelona lab. In addition to the pharmacodynamics and pharmacokinetics of ayahuasca, he used neuroimaging techniques to study the brew’s effects on humans, and used in vitro techniques to investigate the effects on a cellular level. At his last lecture at ICPR 2016, he presented ground-breaking findings, showing that the harmala alkaloids, harmine and tetrahydroharmine, induce neurogenesis, which not only provided further evidence that ayahuasca’s effects were due to more than just DMT, made available orally, but that the beta-carbolines present in the brew had important, therapeutically relevant effects of their own. It is unfortunate that throughout most of his career he conducted his research without much scientific support or resources while overall recognition of his work only emerged towards the end of his career. But Jordi accepted irony easily and embraced satire, as he was a man full of wit and humour. It’s quite telling that Don Quixote was among his favourite novels.
During the final years of his career Jordi resigned from Sant Pau Hospital while facing an existential crisis. He felt very lucky to be surrounded by warm-hearted family, friends and colleagues and had every intention to find his way back to academia. He loved the free haven of questioning and exploring minds, driven by curiosity, without prejudice, bias or agenda. Jordi Riba’s passing was sudden and tragic, and we can only remember his curiosity, scientific diligence and wry sense of humor with fondness. He will be sorely missed.

Can MDMA help to treat addiction? Q&A with Ben Sessa

February 7, 2022 / Addiction, Articles, Interviews, MDMA / By
Until now, MDMA has mostly been studied in the context of treating PTSD and helping with autism. Psychiatrist Ben Sessa is now conducting the world’s first clinical study using MDMA-assisted psychotherapy to treat alcohol addiction, at the University of Bristol. According to him MDMA can be effective to treat addiction issues, because it “brings a particular emphasis on empathy and connection with the positive, loving part of the self, and that’s why it’s good for trauma.”
You often say that 2/3 of people with addictions have been traumatised or abused. Do you think there is addiction without trauma?
It depends on how you define trauma. There’s what I call ‘big T trauma’ and ‘little t trauma’. Not all people with addictions have suffered severe physical or sexual abuse. But if you ask people what was their experience of childhood, a vast majority of them will say it was cold: they didn’t feel loved or wanted, their parents weren’t really there for them. Those experiences fit in with what you’d call emotional abuse. Most people don’t recognise it as such, but they’re left feeling somewhat empty by it. It’s the most common factor in people with addictions.
Given this knowledge about where addiction comes from, why are most conventional treatments largely unsuccessful?
It’s a very difficult illness to treat, because of the availability of drugs and alcohol, the problem of social deprivation and poverty, homelessness and poor housing, racism, exclusion, poor education, lack of childcare, etc. If I had a magic wand and could instantly cure an addiction patient, but then sent them back to their dire home situation with transgenerational lack of hope, poverty and exclusion, they’re just going to pick up their addiction again. So it’s a very multidisciplinary problem with multiple factors that cause and maintain it, and we need to address all those factors.
Why then do psychedelics seem to do better in the treatment of addictions than conventional treatments?
Because underlying addiction, and many if not most chronic mental disorders, is rigidity. Stuck rigid mental narratives about self and the world, which arise early in life as a results of early experiences, in other words, the very core building blocks of our personality, which stay with us for life. The majority of mental health treatments, and certainly all the medicines we use, like SSRI’s, don’t do anything to those narratives, they just paper over the cracks and treat the overlying symptoms. In my experience, psychedelics are the best new form of pharmacology that we’ve come across that has the potential to actually tackle those narratives and allows people to build them up in a new, more positive way.
You’re currently conducting a study with MDMA to treat alcohol addiction. This is the first time MDMA is used for that indication. Why did you choose MDMA over psilocybin?
I was always interested in doing an MDMA study. Five years ago, I was in communication with MAPS about an MDMA/PTSD study. But then I got an offer from a rich benefactor which allowed me to do whatever I wanted. As I was working in addictions at the time, I decided to branch away from PTSD. I was acutely aware of alcoholism as being the number one addiction problem with a massive clinical and personal burden, and a very difficult one to treat. I also liked the fact that no-one else had ever suggested MDMA for addiction. Since trauma appears to be a big part of addictions, and MDMA has been shown to work in trauma treatment, it seemed to make sense that MDMA could work for addictions.
Do you think MDMA therapy and psilocybin therapy share the same paradigm?
They clearly have massive overlaps and similarities, for instance the fact of using a non-ordinary state of consciousness as an augmentation of psychotherapy. People would argue that MDMA isn’t a psychedelic, or at least not a classic one. However, I do think it fits into the same paradigm and I consider it a psychedelic psychotherapy tool. There are clearly also some big differences. With MDMA, you don’t get the ego dissolution that occurs on high doses of classic psychedelics. What you do get is a particular emphasis on empathy and connection with the positive, loving part of the self, and that’s why it’s good for trauma. The barrier to addressing trauma for many patients is this brick wall they hit, that prevents them from believing that they are worthy, after often spending decades believing they’re not. MDMA has this greater capacity than psilocybin to put you in a predominantly loving and warm state.
Where’s your MDMA/alcohol study at right now?
We have 14 participants, we finished dosing at the beginning of December, and we’re following everyone up to 9 months from the date of initial detox, so that will be until June. We’re assessing and analysing the data, and we’re writing the papers, which will be published in the first half of this year. This is a safety and tolerability study, with no placebo control group, which is what you have to do when using a new drug in a new condition for the first time. Obviously, we’re also looking at the subjects’ drinking behaviour and maintenance of abstinence and we’ll report on that, and the results look extremely promising. With conventional therapy, about 80% of patients go back to drinking in the next few months, and so far we have about 17% of people who went back to drinking again.
In his talk at ICPR 2020, Ben Sessa will elaborate on his MDMA/alcohol study and sketch future perspectives of psychedelic therapy research.

Alicia Danforth on ethical challenges in psychedelic medicine

December 6, 2021 / Articles, Background articles, Interviews, Publications, Sociology / By

Alicia Danforth, PhD, is a licensed clinical psychologist and researcher and has participated in three major studies on psychedelic-assisted therapy, the latest of which is still unpublished. She began her work in clinical research with psychedelic medicines as a coordinator and co-facilitator on the pilot study of psilocybin treatment for existential anxiety related to advanced cancer. More recently, she was an investigator for the first study of MDMA-assisted therapy for the treatment of social anxiety in autistic adults.
Your first study with psychedelics was about end-of-life anxiety, the second one was about social anxiety, and this latest one also has to do with anxiety to some extent. Is there a thread regarding anxiety in your research work?
I didn’t set out to go that way. The first study had to do with anxiety facing the end of life, yes. But to be candid, social anxiety wasn’t the initial focus of the autism research. I had made the false assumption that autistic individuals lack empathy, which isn’t more than an outdated cliché that I mistakenly took at face value. My initial thinking was that MDMA is an empathogen, so it might help this population experience empathy.
Once I started interviewing autistic adults for my dissertation, I found out that they were quite empathic in many domains of empathy, and they told me what they were struggling with is social anxiety. The desire to connect was there, but the ability to read social cues and to know how to integrate into a group conversation or initiate a friendship is what they needed help with. That’s how working with social anxiety as an indication came about.
So with hindsight, yes, you could say that anxiety is a thread that has run through most of the clinical work that I’ve been involved with. Anxiety disorders are the most common mental health diagnoses in the United States, and they have been a good match so far with psychedelics-assisted therapy.
Your latest research with psychedelics is about psychological distress in long-term AIDS/HIV survivors. Can you tell us more about this new study?
I want to clarify that I’m not one of the investigators on this study, I’m a lead clinician. I co-facilitated the therapy groups and the psilocybin treatment sessions. Dr. Brian Anderson initiated this study at UCSF. San Francisco has been a hub of HIV medicine, and Brian became aware that there’s an underserved population of long-term survivors who acquired the HIV virus back in the 1980’s or early 1990’s. As a result of losing so many of their friends and because of the impact of HIV on their lives and on the community, they were living with a high degree of demoralization.
Dr. Anderson wanted to explore if treatment with psilocybin-assisted therapy could help improve overall quality of life and reduce anxiety and depression symptoms. The first phase has been completed, the data are analyzed, and a manuscript has been prepared. All I can say right now is that the outcomes were encouraging.
One way in which this study was very innovative is that we worked with a group therapy model, where the participants prepared as a group, and then each one had an individual psilocybin-assisted therapy session, and they came back together to do their integration work as a group. We’re frequently asked if everyone took the psilocybin all together, and they did not. I don’t think we’re quite there yet, but I couldn’t help but wonder what that might be like someday.
At the upcoming ICPR 2020 conference in April, you’ll speak about ethical challenges within psychedelic medicine. Can you explain its importance?
It’s no secret that psychedelics present unique challenges when it comes to ethical considerations and boundaries. These substances place people in profound altered states of consciousness, and with that shift can come increased suggestibility and vulnerability. We’re working with such novel treatment paradigms that we need novel approaches to how the individuals who are entrusted with the roles of therapist or guide should be vetted, trained, and supervised.
Could you elaborate?
Well, it became very apparent to me that there are certain personality types that are drawn to situations in which they’re in close proximity to people who are vulnerable and open. They seek to manipulate and have a very unhealthy relationship with power. Back in the 60’s and early 70’s, when people were working with these substances in controlled and uncontrolled settings, there were problems with individuals who would transgress boundaries. And today, we’re plunging headlong into a new era where billions of dollars are accruing to throw money at this enterprise; there’s such a rush to do it quickly.
But, we don’t have the structures in place to keep the participants in research settings -and eventually customers in commercial settings- safe from abuses of power. So, I’ve started proposing that we need to look at other medical professions where they have to accommodate similar levels of vulnerability, such as anesthesiologists, pediatricians and gerontologists. We need to agree on which methods we’re going to have to employ to train and supervise peers. We don’t have a good system for winnowing out individuals who seek to do this work who have clinically significant narcissistic traits or psychopathy. How are we going to gatekeep? If we don’t talk about this responsibility and address it, we’re at risk of running into trouble again.
Alicia Danforth’s talk at ICPR 2020 will be entitled: “Getting Our House in Order: Advancing the Ethics of Psychedelic Medicine and Psychotherapy from Storming to Norming”

Lecture: Michael Pollan on psychedelics

December 6, 2021 / Articles, Background articles, Books, Events, Interviews, Public Lectures, Publications / By

On Monday December 10th, OPEN is hosting an event with best-selling author Michael Pollan. On this evening, he will discuss his own research into psychedelics, and the implications of the latest scientific findings for therapy, consciousness and personal transformation.
In his newest book ‘How to change your mind‘, best-selling author and journalist Michael Pollan investigates the science of psychedelics, and their relation to consciousness, therapy and transformation. Pollan is best known for his award-winning writing on food, such as ‘The Omnivore’s Dilemma’ and ‘Food Rules’. His style of ‘immersive journalism’ is ideally suited to explore the world of psychedelics, and he reluctantly experiments with LSD, psilocybin mushrooms and 5-MeO-DMT to find out what psychedelics are all about. In addition he interviews many neuroscientists and therapists.
The result is a fascinating journey through the history of psychedelics, moving from promising psychedelic treatment for alcoholism and death anxiety in the fifties to present-day neuroscience research, and the renewed interest in therapy for depression, addiction and trauma. Can psychedelics help us to improve our relationship towards ourselves and our surroundings? Come and find out on December 10th.
Doors open at 19:30, and the program starts at 20:00. Address: Tivoli/Vredenburg, Vredenburgkade 11, Utrecht.
Tickets are in limited supply and can be bought here.
After the lecture, you will be able to purchase the recent Dutch translation of ‘How to change your mind’. Michael Pollan will be available to sign your books.

 

[Interview] Alicia Danforth: Helping autistic adults navigate the social world with MDMA-assisted therapy

December 6, 2021 / Articles, Background articles, Interviews, Interviews, MDMA, Publications, Research / By

AliciaResearch with autistic children and teens was a promising and controversial research area during the first wave of research with psychedelic substances. The first investigator to pick up this thread again in the current era was Alicia Danforth. She currently studies the effects of MDMA-assisted therapy on social anxiety in adults on the autism spectrum in a study led by Charles Grob.

How did you begin doing this work?

It’s not a typical story. I made a mid-career transition. When I was working as a project manager in software development, I was out with co-workers one night, and they were talking about doing ecstasy at raves. I was intrigued, because the ones who had already done it spoke about it so favourably. But it also made me nervous, because I had been exposed to all the propaganda, and I thought that maybe my programmers were going to destroy their brains. It was important for me to research ecstasy and be able to let them know why they should not be doing it. So I got a copy of Julie Holland’s book, Ecstasy: The Complete Guide. I had a transformational moment when I read the testimonies written by young men who she identified as having had a schizophrenia diagnosis. They talked about what their experiences with ecstasy had done for them, how it gave them hope, how it helped them feel that they might be able to have an experience of connecting to others and feeling more normal. Something that was dormant in me became fully awake in that moment. I could not accept that a substance that millions of people have used and that has helped so many of them who don’t have other effective support and treatment was illegal and could not be studied by researchers in reputable institutions.

So I called Dr. Holland and told her that I wanted to help educate people and promote scientific inquiry. She directed me to Rick Doblin at MAPS, who referred me to Dr. Charles Grob at the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center. It was one of these synchronous life events, because I had just taken a job a mile or so away from Dr. Grob’s office, and he was doing end-of-life anxiety research with psilocybin at the time. I approached him as somebody with no qualifications whatsoever, just to help out as a volunteer, to support what he was doing. We considered options and discovered that I could help him with PowerPoint presentations. In an age where people gave their presentations on their laptops, he was still using a 35mm slide carousel…! Working for him gave me an opportunity to immerse myself in the literature, in the history and in the science, and at every step I became more intrigued and inspired to do more. After about two years, his research assistant on the psilocybin study needed to relocate, and they had a staffing gap. They thought they might have to stop the study, because they didn’t have anybody else available, until Rick suggested hiring me as a study coordinator. By that time, I had acquired some experience working in harm reduction at Burning Man and similar events, where I was providing volunteer peer support for people having distressing experiences with altered states, and I had discovered that I had the temperament for the work. I had been in some extreme situations, I could handle freakouts. I had been a journalist before, interviewing people about their stories, listening to people describe their life experience, and as a project manager I was good with budgets, schedules, resourcing, and task lists. Everything combined, it became apparent that I could be a good fit for the research team. I couldn’t provide any psychotherapy during that study, because I wasn’t trained as a therapist, so I refrained from doing anything that I wasn’t qualified to do.

I think the most valuable and essential factor that I brought to the team was that I was female, because the other two facilitators were male, and it’s important to have adequate gender balance. People near death frequently yearn for a mother figure. I also did various things like setting up the room in advance, bringing in flowers, decorating, helping create that sense of comfort and safety, attending to things like hydration. I got trained in using the machine that monitored vital signs. I would provide active listening, or a hand to hold or a light meal, taking a lot of session notes and things like that… but I did not provide psychotherapy.

After that psilocybin study with Charles Grob, you went on to study psychology at the Institute of Transpersonal Psychology, where you wrote your dissertation on ecstasy use in adults on the autism spectrum. Where did your initial interest in autism come from?

Five months after I started on the psilocybin study, I was diagnosed with breast cancer. My cancer was aggressive, but I caught it before it metastasised. But that brush with death brought up all sorts of existential issues for me. I figured that if I lived, I was going to become a licensed psychologist and do what I could to continue contributing to psychedelic science. I actually brought homework to the haematology lab and studied with an IV in my arm. It was motivating! I was in my early forties at the time, and I chose the Institute of Transpersonal Psychology because of Stan Grof’s affiliation with the origins of transpersonal psychology and because some of the core faculty there had been involved in the first wave of psychedelic research. If I were younger, I would have gone to a much larger, more prestigious APA-credited school. When younger people ask me what recommendations I have, I say: go to the best school and get the most solid credentials that you can. But at my advanced age as a student, I needed to land where I could write the dissertation I intended to write. And getting a transpersonal education was valuable for the clinical work I’m doing now with non-ordinary states of consciousness.

As for my interest in autism… Around the time I started volunteering for Dr. Grob, he invited me to attend a salon for people with an interest in psychedelics science. It took place once a month, and all sorts of chemists, and activists, and people with various other backgrounds came. At my first meeting, I met Gary Fisher. He was a psychologist in California who had worked in the sixties with children on the autism spectrum with LSD and psilocybin. His work fascinated me. He was a very warm, engaging, and creative person. That encounter planted the seed. Then, when it came time to determine my dissertation topic, I just knew at that point that I didn’t want to focus on cancer in any way, I didn’t even want to hear the word anymore at that point nearing the end of my own treatment. I reflected deeply on which other populations were underserved, grappled with difficult to treat mental health issues, and had no effective treatment options. In one of these reverie moments, I thought: What happens when people with an Asperger’s diagnosis take ecstasy? It seemed like this big revelation at the time, but when you think about it, it’s kind of an obvious question.

The Internet had become a major hub of a diverse and growing autism community, so I took a look at what people were saying on the web. One of the first accounts I read was about a young man who had put two and two together, and tried ecstasy to help him with his social challenges. He intentionally went to a party, took the ecstasy and was having a great time. But then everybody started getting drunk and sloppy, and he wasn’t comfortable with this chaos, so he went to a night club. When it closed, he was so deflated that he went out into the street at night, just hoping to connect with someone. And there again, I had a moment when my heart was responding to an account of someone’s pain that seemed unnecessary: why is this young man, who only wants human connection, reduced to roaming the streets at night? This is just flat out wrong. As a society, we need to know more about how to respond and support people who want to connect but lack the skills to do that naturally. So I decided to give it my best effort to try to build bridges in autism communities and learn all I could so I could interview people with a reasonable degree of certainty that they were telling me the truth. As a first step, I decided to do an inductive, mixed methods study with an emphasis on qualitative data. I learned from autistic adults what they struggle with and what they want. Then, I documented what they shared as objectively as I could by applying the Thematic Content Analysis method.

What did you learn?

The qualitative data summaries are very interesting to read. I made graphs to show the high percentages of people who said things like: “I’m more at ease in social settings”, or, “I’m better able to express my emotions”. Some of the tables look a little too good to be true. The data are reported accurately, but due in part to self-selection bias, individuals who had positive experiences are more likely to report. I had concerns that negative experiences might be underreported. I would leave out some of the questions about favourable effects and try to get more information about the negative experiences to maintain a balanced account. However, there simply was only a small percentage of negative reports.

Some individuals are clearly non-responders. We’ve seen that in clinical research, and there are theories about different enzymes and genes affecting metabolism. As more research is accumulated, I think there will be some determinable percentage of people who are atypical metabolisers, maybe around 10-15%. For example, they are the type who will do MDMA from the same batch as a group of others, but when everybody is cuddled up in a love puddle, they might feel as if they had a strong cup of coffee without the strong empathogenic effects. When you talk to these individuals, they’ll often say that they need to receive higher doses of anaesthetics or have other atypical responses to medications.

The themes that emerged from the – mainly qualitative – dissertation research data clustered around five constellations, I call them the “five C’s” as a memory aid. The types of changes reported were often around courage (or  confidence), that’s the first C. I like to use a Wizard of Oz analogy.  That change can be like the Cowardly Lion finding his courage: as if you had your courage, but were somehow detached from it, and now you own it and can use it again. You feel that increase in courage in an embodied sense: “I was brave”, “I could dance”, “I could flirt”, “I could say what I was always afraid to say”, or “I could call people to initiate something social”. The next C is communication: After Dorothy and the scarecrow oiled the Tin Man, he could gesture and speak more freely. There’s an increased ease in communication and a better ability to listen. A lot of people said they felt as if they could interpret body language or as if they could participate better in non-verbal means of communication. Another C is connection: such as connections with family members, understanding and relating to people they have significant connections to differently, being more open to physical intimacy, or feeling connected in a group instead of feeling so isolated. More than one individual has described this newfound sense of connection as being similar to how the Tin Man becomes aware of his heart that was always there. The fourth C: beyond connection there can be a sense of communion, that sort of deep sharing, maybe with some spiritual overtones. Feeling a part of something larger, unitive consciousness or some peak experience of feeling deep empathy. The final C was the most surprising finding: clarity (or calm). Clarity of mental and emotional processes. This effect was something that seemed more unique to this population, in comparison to neurotypical reports . A lot of interviewees made statements such as, “My brain was quiet for the first time in my life.” Or: “I could focus on one thing at a time”. “My inner world was clear”. “I had laser focus, my thoughts straightened out”. This last theme was the one that stood out for me, the one I wasn’t expecting based on prior accounts I had read.

Isn’t it difficult for autistic people to break the law by using MDMA, which is illegal? Isn’t that a barrier for them?

Autistic adults are such a heterogeneous population, everybody is so unique, that I tend to not think in stereotypes anymore. Yes, if you imagine a pie chart representing all autistic adults, there is a certain large segment who prefer to follow the rules in most instances. Another, related segment is made up of people who identify strongly with their cognition, their thoughts are, in a sense, the Self for them. So the idea of doing anything that might alter or impair cognitive processes is a deterrent. But those boundaries don’t apply to everybody. There are a lot of people on the spectrum who are paying attention to the science. For instance, when I was asking them about the quality of the MDMA they ingested, I was surprised at how many of the younger respondents said that they used the Marquee Reagent uptake test. They were very savvy. So science is science, and if the data are telling a different story, then they’re going to go with the facts. Also, enough people are having their own real-world experiences that influence how they’re thinking about MDMA. They may see friends who had a wonderful experience and were changed after that. Some people go for it, some people refrain.

On to your own clinical study, that was supported by this dissertation. You’re studying the effects of MDMA-assisted therapy on social anxiety in autistic adults. Why can’t these people be helped by other, more conventional methods – especially for social anxiety, for which there are many medicines?

There is some research literature that suggests that the receptors for benzodiazepines, for example, respond atypically in autistic brains. There are structural brain differences, and there’s no such thing as a uniform autistic brain. And it makes sense, if you slow down and think about it: conventional psychodynamic therapy has not shown to be particularly effective for people on the spectrum. Unfortunately, historically the blame has been put on the autistic clients, assuming that they can’t relate or express themselves. But I’ve come to shift my focus to the clinicians who have not invested the effort it takes to learn about or really appreciate what it’s like to be autistic. So I’ve come to think of the barriers to therapy as mutual challenges with understanding. Speaking in broad stereotypes, a lot of autistic clients are very pragmatic. They want tools to address a problem they have in the here and now. They might be less interested in talking about what happened to them when they were five, at least not initially. This process of working with archetypes and analogies and metaphorical concepts may not be as effective for them. There may be challenges going both ways with establishing an essential, empathic therapeutic rapport.

In our study, we’re using psychoeducation in mindfulness skills, based on dialectical behavioural therapy (DBT), developed by Marsha Linehan. DBT was developed to promote effectiveness in interpersonal relationships, emotion regulation and distress tolerance, which are social adaptability skills that are often challenging for adults on the spectrum, so we thought this type of therapy would be a good fit. It’s so fundamental, and it’s helpful across so many domains. We’ve adapted the  mindfulness module, and applied it in a research setting, because it’s a practical life skill. There are data that show mindfulness therapies are effective for individuals on the spectrum, and it creates a vocabulary that we can use during sessions to help them navigate altered states, so that when they are in a state of consciousness that’s ineffable, or they’re experiencing the novel states of mind for the first time, we can continue dialoguing with them by asking questions like: “What is your reasonable mind doing now? And describe what the emotional mind is doing. If you don’t know what to do right now, just observe your experience. And when you’re ready, describe what you observe”. All of our study participants are MDMA-naive, and we’re seeing indications that mindfulness concepts can help them navigate the MDMA experience, especially the first time.

Regarding neuropsychology, some of the most promising recent findings are about GABA receptors. Whereas dopamine is similar to the gas pedal on a car that revs things up, GABA is like a brake pedal that quiets things down. Recent research findings have suggested that autistic brains have the same amount of GABA available as typically developing brains, but the receptors work differently, so the brake pedal isn’t as easy to apply. This makes it more difficult to filter out extraneous sensory input, to focus. Just adding GABA doesn’t help, because the difference is not related to amount, but to utilisation. I think the GABA research might someday be shown to be relevant to why MDMA might be helpful for autistic brains in ways that are unique to that population, but much more research is required first.

You mentioned Gary Fisher before. How do you view the whole body of research with autistic children and teens from the sixties, and what did you learn from it?

I learned that the methodology would never be approved today. Some of the studies were horrifying! They would take very young, non-speaking children, put them in a room, and look at them through a one-way mirror after giving them large doses. They could not provide informed consent, they could not verbalise their experiences, they couldn’t ask for help. So I don’t advocate replicating those studies.

However, when you look at the aggregated data, there were more positive outcomes than adverse responses, and that was reflected in behaviours that were reported: smiling, laughing, gazing, seeking physical contact, initiating play. In fact, for most populations, set and setting are going to have an influence on outcomes: some people are going to have a difficult experience with larger doses no matter what you do, and some people a going to experience euphoric states. Gary Fisher was trained in classical psychoanalysis and psychodynamic approaches. He had his research staff take LSD as part of their training, in order to bond as a team, and to be able to have more empathic resonance with the study participants. He took a much more humanistic, psychodynamic approach as opposed to the classic medical model of monitoring parameters and behaviours. He saw the importance of supportive psychotherapy and forging therapeutic relationships between facilitators and subjects.

MDMA was never used in the first wave of psychedelic research. Why did you choose MDMA over any other, more ‘classic’, psychedelic?

Because of MDMA’s reputation for having prosocial effects in clinical and non-clinical settings. Before starting my psychology training, I mistakenly believed that individuals with an Asperger’s diagnosis could not experience empathy because that’s what I was taught. That incorrect assumption was kind of a catalyst, but I’ve changed my thinking about autism and empathy. Empathy is a broad umbrella term that covers many domains of human cognitive and affective experience. These days, I’m interested in Markram and Markram’s research about the Intense World Theory. In some instances, there may be an overpresence of some aspects of empathy with autism. I can tell you, from establishing connections with autistic adults, that many of them are quite empathic. Often they’re challenged because they feel too much. For others, it’s difficult to understand what someone else might be thinking or feeling, but if someone they care about is hurting, they hurt, or if someone else’s inner experience is explained to them, they can care about what someone else is feeling. In some cases, they’re less likely to pick up on subtle, non-verbal cues. So there’s a broad spectrum of ways people experience empathy, and I’m not on a crusade to implant empathy with a pill. But there are also other ways in which MDMA-assisted therapy might be supportive. For example, experiencing the pleasant sensations of being touched, which can be a challenging area for a lot of people on the spectrum, or being better able to express oneself verbally, especially about affective states. Findings from other studies indicate that MDMA has multiple effects that might be helpful. So let’s apply the scientific method, collaborate with autism communities, and find out if that’s the case for autistic adults or not.

Almost all the participants have been treated now. Can you give us some preliminary results?

Because it’s a small safety and feasibility pilot study and because it’s a sponsored study, the sponsor [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][MAPS, ed.] has an obligation to monitor early outcomes to determine if we’re doing any harm. Looking at the outcomes from early participants, the data were suggesting that we could continue safely and that early trends were towards positive outcomes. That’s really all I know, however, because the researchers are still blinded to the primary outcome measure scores. We do monitor some of the other assessments. For safety reasons, we review secondary outcome measures for conditions such as mood, stress, and anxiety. We’re also looking at factors such as self-esteem, alexithymia (the inability to identify emotions or express them in words), emotion regulation, emotion expression,… There may be outcomes other than social anxiety scores that support future studies, at least we hope so. But that’s all I can say for now, unfortunately.

What’s your general impression of how the sessions went?

Generally, the completed sessions have gone very well. We have had no serious adverse events, and no events requiring any medical intervention. The heart rate and blood pressure measurements have never been alarming. An important thing to understand is that we’re working in lower dose ranges, in part because some of the input from the dissertation research suggested that at least some individuals on the autism spectrum may be more sensitive to the effects of MDMA, and higher doses might be too stimulating and induce stress. This is a dose-finding study, so we don’t make the assumption that what’s optimal for a typically developing brain is best for an autistic-style brain. The first group of six subjects got 75mg with an escalation to 100mg, and the second group of six subjects started at 100mg, and if they tolerated that well, they went up to 125mg. Everyone has been able to tolerate the escalation, and nobody had the type of distressing medically adverse experience that would prevent us from raising the dose.

Overall, what we’ve observed has been positive and encouraging so far. The responses span a broad range, from individuals who have a “non-responder” minimal kind of reaction, to others who have had more transformative experiences. It’s possible that some subjects might respond positively to placebo because they have not had prior psychotherapeutic help. We unblind at six months for this study, to determine who’s eligible to go on to Stage 2, so I do know in some, but not all, instances who got placebo and who got MDMA, and we’ve seen a broad range of responses. So it all comes down to the data. We’ll have most of our initial outcome data for Stage 1 in August of 2016. As for publication, my best guess would be early 2017 at the earliest.

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[Interview] Nicolas Langlitz: An Anthropologist in Psychedelia

February 7, 2022 / Anthropology, Articles, Interviews / By

The anthropologist as experimental subject. Courtesy of N. Langlitz

‘Neuropsychedelia: The Revival of Hallucinogen Research since the Decade of the Brain’, Nicolas Langlitz’s 2013 book on the resurgence of psychedelics research, offers a fascinating analysis of how psychedelics have once again become the object of human subject laboratory research. Langlitz identifies the ‘Decade of the Brain’ (think of the excitement over the human genome project in the 1990s) as legitimating a new framework for researching psychedelics, promising ‘moksha in the age of soma’. The book tracks psychopharmacological developments since the 1990s through two key sites – Franz X. Vollenweider’s human lab in Zurich and Mark A. Geyer’s animal lab in San Diego. Langlitz’s ethnographic material is interwoven with historical analysis and questions about psychedelics, technological mediation and mysticism, to offer a compelling account of how we have arrived at the present moment. Neuropsychedelia is a wonderful and insightful read for those interested in the growing field of psychedelics research, its origins and its stakes.

What surprised you when doing the research?

I started out from the assumption that there were these very different interpretations of psychedelic drug action: there is the notion of the ‘hallucinogen’ – drugs provoking hallucinations, a complete rupture with reality. It’s a misnomer because people hardly ever experience true hallucinations with psychedelics, but it informs the practice of model psychosis research. Then there was the psycholytic interpretation, especially in European psychotherapy, which assumed that these drugs provided access to the unconscious. The conceptualisation as ‘psychedelics’ is still running strong. It assumes that these substances allow us to commune with a cosmic mind that is infinitely larger than our individual minds. I had assumed that people would organise themselves in camps around these different interpretations. Philosophically, they really seemed quite incommensurable to me. So I was struck that every time I brought up this rationale for my research, of understanding how they’re navigating through these incommensurabilities, people shrugged and told me that they could entertain all these interpretations at the same time.

Why was that?

Psychedelics are not drugs doing just one thing. Their action is so contingent on the context in which they’re being used. They are actually opening up different things to different people. They can also close things down, as in the case of psychotic reactions, which do occur. Moreover, it’s a matter of dosage: the difference between psychedelic and psycholytic therapy has always been related to the amount of drugs that therapists administered to their clients. The different interpretations also have to do with different facets of these substances, and not just with the people who are looking at them. Psychedelics appear to have more faces than standard pharmacology would allow for.

Your chapter ‘Enacting Experimental Psychoses’ wonderfully conveys some of this. I think one often hears the difference between psycholytic and psychedelic experiences as being one of dosage, whereas the difference between mystical experience and psychotic experience is put down to quite entrenched differing presuppositions.

I’m sure that the difference between psycholytic and psychedelic experiences cannot be entirely reduced to dosage either. It will also be determined by diverging therapeutic philosophies that people with a psychoanalytic background will bring in comparison to people with a background in transpersonal psychology, for example.

More generally, anthropologists face the problem that people are often incoherent. We all entertain different beliefs, and unless you have an academic incentive to make them coherent so you can defend them at a conference, we live pretty well with our incoherent beliefs. If you’re using ethnography to pursue a philosophically-oriented anthropology, this can be puzzling or even frustrating, but it also makes this kind of fieldwork interesting. There are tensions between people’s different concepts, and you can explore these tensions through conversations. This kind of fieldwork is not just about obtaining data from so-called informants who already know the lay of the land. Instead I share questions with my interlocutors that are vital questions for them as much as for me, and we work through them together. In the case of Neuropsychedelia – especially the work I did in the Vollenweider lab – this worked beautifully. Two of the people I met there are still among my closest friends.

Could you say a little more about the incoherence you found in interpretations of the effects of psychedelics?

The substances are multi-faceted entities which allow for different uses and effects. Because the psychoactive effects of the drug are not just caused by the substance, but are emerging from its interactions with different people’s brains, different people’s personal situations and beliefs, with the settings in which the drug is taken, etc., you actually get a multiplicity of psychoactive effects. I don’t want to celebrate logical incoherence. I just think that what appears to be incoherent at first glance can be explained if you think about the way in which these substances work.

Do you understand the project of explaining them as one of ‘making them coherent’?

Yes. I think you can ultimately provide a coherent explanation for why people have different experiences with these substances. And you don’t have to think about it in terms of the idea that we’re living in multiple worlds or natures as some of my fellow anthropologists claim these days.

I enjoyed reading about your exchanges with the head of the Swiss lab, Franz Vollenweider. The way in which you come back to him at the end of the book to me suggested a respect, curiosity and affection for him. The same goes for some of the other characters. Is there anything more that you were looking for in them than interlocutors to think through these questions and tensions with?

First, the ways in which people relate to these psychedelics are quite intimate. Thinking more deeply with others about the experiences they produce requires relations of friendships. Friendship is really an epistemic precondition for this kind of intellectual work.

There is also an ethnographic dimension to these relations. I’m writing about people. I’m working through intellectual positions and contradictions by assigning them to different characters in the book. For me it was important to be generous regarding their different views, partly because initially they all seemed to hold a grain of truth. I think I empathised quite well with people in the field, even though they did not always empathise with each other. They had profound disagreements about what to make of these substances, which also provoked interpersonal tensions. I saw my role as that of a diplomat who can move between different camps and give everybody a sympathetic hearing.

Ethnographically, I was also interested in what place psychedelic drugs can have in our lives. So that’s not just a question about how to conceptualise these substances, but also about the practices and lives that people are actually living. The last chapter of Neuropsychedelia titled ‘Mystic Materialism’ is about the fraught relationship between science and personal experience. Many researchers went into psychedelic science because of their personal acquaintance with these drugs. But their own experiences are systematically marginalised in contemporary psychopharmacology.

Someone who crops up in the book in different guises is the German sociologist Max Weber (1864-1920). You work through his distinction between mystical and ascetic kinds of religious ethics. Then there’s the story of modernity’s disenchantment and science’s bureaucratisation that is threaded through the book. And finally the question of what it means for scientists to pursue a vocation. Were these just all separately useful concepts to pick up, or was there a reason that Weber kept coming back?

Weber struggled with the tensions inherent to modernity, which he saw turning into an iron cage, both in the form of bureaucratisation and in the form of a science that narrows its research problems down to very well-defined but ultimately meaningless questions. Questions such as whether a given substance activates the 5HT2A or 5HT1A receptor are extremely relevant to understanding its mechanism of action, but they don’t help you to solve the bigger questions of life which these drugs evoke experientially. I’ve tried to not refer to Weber as a theorist of modernity, but to weave him into the historical narrative itself. For example, by visiting Ascona in the 1910s, he interacted with a countercultural community in the Swiss Alps half a century before the term ‘counterculture’ was coined. This Heidelberg professor was trying to explore life beyond the ‘iron cage’ of the university apparatus. Following Weber’s analysis, the 1960s counterculture placed its psychedelic mysticism in opposition to the Protestant ethic of capitalism. So Weber is a presence throughout the history of this psychedelic research.

You discuss two virtues at the end of the book – diligence and surrender. It almost feels like the culmination of the book is advice to approach psychedelics on those terms. Could you say something about them?

In 1918, Weber urged every student at the University of Munich to search for the demon that holds the fibers of his very life. He also warned that nothing was gained from yearning alone and advised students to meet the demands of the day. I think this work ethic is very much in line with the revival of psychedelic research, which has broken with the countercultural ethos of Leary’s slogan “turn on, tune in, and drop out.” My plea for diligence is meant as a check against the excesses of mysticism.

By contrast, surrender is a virtue that is part of a mystical outlook. Instead of trying to transform the world in a high modernist spirit, you’re basically accepting that this is what the world is. It’s an anti-activist spirit. Surrender is important in relation to psychedelics because if you’re having a difficult experience with these drugs the only way out is not to struggle harder but to surrender – to give yourself up and to allow the experience to take over, and as you relax you basically manage to get out of the difficult situation again. I’m not at all saying that we should never try to make the world a better place, but sometimes acceptance would be wiser.

To develop friendships in this field is to develop friendships when the stakes are sometimes quite high as to how psychedelics and psychedelic-taking practices are understood and thought about. And a lot of that is because people have hopes about its legalisation – either under the form of medicalisation or wider availability. Often in the pharmacological and the broader scientific scholarships, research tends to have a kind of an ‘off-limits’ boundary-making around what should and shouldn’t be talked about openly in terms of personal experiences. How did you approach this issue?

There is always a political dimension to this research. However, neither Vollenweider’s nor Geyer’s lab was particularly politicised. People were primarily driven by curiosity, not activism. We had that in common. Of course, the field is larger than these two labs. Other people are a lot more passionate and outspoken about their political goals. But something I see in anthropology, where activism is well accepted, is that it can stifle and curtail intellectual conversations. So I was very happy to be able to work with people who didn’t have a strong agenda.

Personal experiences were still a slightly touchy subject, but they weren’t off limits. For example, I conducted an interview with Hans Jakob Dietschy, the government official in charge of controlled substances during the 1990s, and his scientific collaborator, the pharmacology professor Rudolph Brenneisen. At one point, they told me about a fight they had had about Brenneisen’s decision to serve as a test subject in his doctoral student’s psilocybin experiment. This anecdote was provided voluntarily but off the record. Since it fit very well into my discussion of the delegitimation of self-experiments, I used it anyways and sent them the whole subchapter of my PhD thesis to ask whether they would give me permission to use the episode if I presented it in its wider historical context. Both were perfectly fine with that.

Of course, there are also things that cannot be related publicly. But that’s not a problem specific to research on controlled substances. Ethnographers enter into communities as outsiders, gain their members’ trust, and then write about these people. If you spend longer periods of time in any group of human beings, you always learn some secrets that should remain secret. Institutional Review Boards are not well equipped to protect the anthropologist’s subjects against breaches of such secrecy. This largely remains a matter of the ethnographer’s ethos. If I feel unsure whether I can mention something, I usually ask people whether it would be okay or show them what I wrote. I was often surprised when people had no problems at all with what had seemed a spicy issue to me, but reacted quite sensitively to things which had seemed rather innocuous to me, for example, if they felt that I had overinterpreted the findings of their latest article.

In the history of science, the experimentalist has always had a greater authority than the fieldworker. How do you see the authority of the anthropologist in the psychedelic sciences?

The anthropologist’s authority is based on experience. And on the time it costs to conduct long-term fieldwork, to cultivate personal relations. But I don’t think that such ethnographic authority carries over into clinical and pharmacological research, if that’s what you mean by psychedelic sciences. I have been trying to get psychopharmacologists to think more seriously about supplementing placebo-controlled trials by culture-controlled trials or other methodologies that take into consideration set and setting. But it’s almost impossible to change a field from the outside and, at the end of the day, anthropologists who don’t go native remain outsiders.

Do you see conflicts between the projects of anthropologists and scientists in this field?

My project is different from but not antagonistic to the projects of the scientists I’ve been working with. If you look at what they publish and at what I publish, these writings are not alike without being incommensurable. We even share a lot of questions. These are not necessarily the questions that psychopharmacologists answer through their experiments and journal article publications, but they are questions psychedelic researchers discuss over lunch and afterhours.

This convergence of interests has to do with the fact that my anthropological work is not primarily ethnographic. I was interested in the psychedelic experience, in what these drugs are doing to humans and what humans are doing with these drugs. Writing about people – which is what ethnography means – was a necessary part of working through these questions. Because it is people who have these ideas, it is people who use these drugs in particular ways. But my ultimate aim is a more philosophical one. I’m trying to understand what psychedelic experiences are to human beings, how we come to have them and why we value them.

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30 April - Q&A with Rick Strassman

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