In his latest book, How to Change Your Mind, Michael Pollan writes of his own consciousness-expanding experiments with psychedelic drugs like LSD and psilocybin, and he makes the case for why shaking up the brain’s old habits could be therapeutic for people facing addiction, depression, or death.
On the difference between recreational and therapeutic use of psychedelics.
Michael Pollan: There’s a real distinction between the typical recreational use of psychedelics and the way they are now being used in a therapeutic context. It is a guided trip. You’re not alone. You’re in a room, you’re stretched out on a bed or a couch, you’re listening to a very carefully curated playlist that’s meant to structure or support the experience. You’re prepared by your guide, who’s telling you what to expect. During the session, they’re there with you to take care of your body so you can let your mind wander. And then after the experience, they help you integrate it. The stories [that you have] are very vivid but you don’t necessarily understand it. And they help you bring insight from the experience and apply it to the conduct of your life, much as any psychotherapist would do.
On the science of psychedelics.
Robin Carhart-Harris: Psychedelics seem to work on a particular kind of serotonin receptor. There’s at least 14 of these different receptors, and they each tune the brain in a different way. Serotonin comes in as the common key, but these receptors are like different locks if you will.
There’s one particular one—the 2A subtype—which seems to be key in how psychedelics work, because if you block it, then people won’t have a psychedelic experience. It’s a really nice grounding finding in the science of psychedelics. Despite all the sort of mystical stuff that can be conjured up by these compounds [and suchlike], we can trace it all back to a particular molecule in our brains in a particular protein.
On the effects of psychedelics on brain activity.
Michael Pollan: Many scientists assumed that when you give a psychedelic to the brain it would lead to an explosion of activity, much like the fireworks people report. But in fact when Robin [Carhart-Harris] imaged the brain of people who were tripping on psilocybin, he found this surprising finding that activity in this one particular network called the default mode network went down. And this is a network that’s critically involved in really our concept of self. It’s where we go to mindwander, time travel takes place there—thinking about the future and the past—self reflection, worry, and theory of mind, the ability to impute mental states to others.
On new areas of the brain communicating.
Robin Carhart-Harris: As the brain develops and we develop and mature, our thinking becomes more sophisticated, more specialized, more analytical. And all the systems start to parcellate off and specialize. What happens on psychedelics is that there’s a kind of de-specialization in a way, and the brain sort of operates in this more sort of rudimentary, freer, more hyper-associative and plastic kind of way.
Ira Flatow: And the point is made that that’s sort of reversing us into a childlike state, where children are more receptive to new information, and maybe that’s why when you’re on psychedelics you’re [looking at the world] with new eyes.
Robin Carhart-Harris: And you’re exceptionally vulnerable like a child, and you’re exceptionally sensitive to your environment in your context. Children are great learners.
On how to conduct reliable research.
Robin Carhart-Harris: There’s no perfect solution. The effects of psychedelics are so obvious. When you are given a high enough dose of a psychedelic you very quickly realize that’s what you’ve been given. So you can’t give a standard placebo because you know that you haven’t had anything.
You could try what we call an active placebo, another psychoactive drug that changes consciousness, but not in the same way as a psychedelic. You could try lower doses of psychedelics so the people have the expectation that they’re going to get a psychedelic, but that serves as a control.
One thing to add is that you know the placebo effect and expectancy might actually be part of what these drugs work on anyway, in terms of enhancing psychological expectations. So, in the context of therapeutic work it might be part of the treatment model.
Michael Pollan: These drugs are so strange in many ways that they’re hard to fit into the paradigms we have for doing science and for doing therapy. For example, it isn’t just the molecule that is the therapeutic agent here; it’s the experience people have under the influence of the molecule, and that experience is shaped by lots of other factors including the therapist, the trust and the therapist, the room that they’re in, the expectations they bring to the session. So it’s messy, but in a very exciting way I think.
On using psychedelics to treat depression and addiction.
Michael Pollan: Basically, what seems to happen on a high dose is ego dissolution—your sense of self vanishes, or at least is softened in profound ways. And you realize that one of the things your ego is doing is patrolling the borders of self and other, of you and other people, you and nature, and erecting these walls. And that when those walls come down, incredible things happen in the mind.
For one thing, you do have this flood of information from the world that comes in that you might not have been aware of… Also, your ego defends you against unconscious material, and all sorts of things emerge from your unconscious and your memory. There’s also a wonderful or terrifying—depending on whether you surrender to it or fight it—sense of merging with an entity larger than yourself, whether it is nature [or] other people. And when these gates open, what rushes in very often is a sensation of love and connectedness. And a lot of the problem if you’re depressed or [addicted] is your connections to the world and other people have been frayed. And those connections are re-established.
Even though it is only temporarily the case, these are memories you bring forward into your life. I talked to one patient that Robin [Carhart-Harris] treated, an American living in London who had been depressed continually since 1991. [The depression] lifted for a month, and even though the depression came back she now had this destination. This objective that there is this other consciousness and it’s worth working to get there.