22 Aug 2018

Michael Pollan: Psychedelic drug trips, research and therapy

From Afternoons with Jesse Mulligan, 3:10 pm on 22 August 2018

Psychoactive substances are experiencing a scientific resurgence with evidence showing their value in treating depression and addiction, author Michael Pollan says, but they also pose risks.

Food writer Michael Pollan has spent his career looking at how the natural world converges with human culture, but has mostly explored plants and food.

Psilocybin mushrooms, known as magic mushrooms

Psilocybin mushrooms, known as magic mushrooms Photo: Flickr

He says his latest book, How To Change Your Mind: What The New Science Of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, And Transcendence, takes a slightly different approach, but does follow a similar theme.

"We use plants not only for beauty, to construct our homes, to nourish us, for sweetness, but we also use them to change our consciousness, which turns out to be an almost universal human desire along with the desire for sex, the desire for food."

His book is a bit more personal this time. Not all the drugs are plants, and he actually used some of the psychoactive substances he writes about, reporting back these deeply personal experiences as part of his findings.

The origins of LSD

Pollan tells Afternoons' Jesse Mulligan psychoactive substances - particularly LSD and psilocybin aka magic mushrooms - have had a bad reputation and stigma around them, but that wasn't always the case.

He says research into the subject is getting serious again, but an earlier period of research began shortly after LSD was first accidentally discovered by Swiss chemist Albert Hofmann.

Albert Hofmann in 1993, at the 50th anniversary of the discovery of LSD in Lugano, Switzerland.

Albert Hofmann in 1993, at the 50th anniversary of the discovery of LSD in Lugano, Switzerland. Photo: Public Domain

"He was actually looking for a drug to help women during childbirth, I believe to deal with bleeding.

"He was using a fungus actually as the basis of his explorations, that's the ergot fungus which infects grain, and there was a lot of folk wisdom that that fungus could be used to treat bleeding during childbirth.

"So he was taking that basic molecule and creating derivatives from it, variations on it, and the 25th of those he called LSD25 - lysergic acid diethylamide 25 … and he accidentally ingested a little bit of it."

Dr Hofmann noticed that he was having a psychoactive experience, so tried a slightly bigger dose of 250 micrograms.

"This was in 1943 in the middle of the war and he's in his lab and he realises he's going crazy, or thinks he's going crazy.

"He asks his lab assistant to escort him home, it was the war so there was gasoline rationing, so he took one of the most notorious bicycle rides, tripping his brains out.

"The doctor came and said 'there's nothing wrong with you, your pupils are a little dilated.

"A lot of the experience was terrifying, he felt himself leaving his body, observing it from the ceiling; the furniture had come to life and it was kind of menacing … but as the experience kind of crested and faded he had a very ecstatic experience when he walked out in his garden and he 'felt like Adam on the first day of creation', he said."

1950s psychoactives studies

Dr Hofmann had found something strange, so the pharmaceutical company he was working for decided to carry on the research, and did so in a wide-ranging and unorthodox way.

"Something very unusual, which was to essentially crowdsource a global research initiative and they basically offered LSD 25 to any researcher or therapist, who would basically agree to report back what they discovered.

"This led to a very lively period of research for about 15 years all through the '50s."

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Photo: 123rf

"There was a lot of very promising serious research, it was legal and many psychiatrists thought that this was potentially a new wonder drug to treat mental illness and addiction."

However, the 1960s saw a dramatic change in how the drug was perceived, as people began taking it recreationally and it became a drug of choice.

There was a kind of moral panic backlash to it, with some of it perhaps justified. Pollan says psychoactive drugs are powerful, and there are risks to be considered.

"I'm not for everyone taking psychedelics, I see them as having great value for many people and they really deserve the scientific attention they're getting but make no mistake: they're powerful and people should not be careless about them," Pollan says.

"They're not physiological risks, the drugs are remarkably non-toxic, and non addictive - they're not habit forming.

"The risks are psychological, though, and for people at risk for schizophrenia for example they [the drugs] can trip people off and give them a psychotic break.

"People at a risk of serious forms of mental illness - schizophrenia, personality disorder, things like that ... they should stay away from the drugs.

"People do have bad trips also, and these can be truly horrifying, but the effect of those tend to pass pretty quickly when you come down.

"They're usually panic attacks that feel like psychosis, and sometimes they're misdiagnosed as psychosis."

New renaissance of psychedelics research

Pollan says the image of LSD and other psychoactive drugs changed, and there remains a stigma about them, but in the '90s there was a push to begin robust scientific studies on psychoactives again.

One of the early findings that kicked off some of the research came from Roland Griffiths, a prominent drug researcher who was interested in cognition and science's understanding of it.

"He was a very serious Hindu meditator and something happened that made him very curious about altered states of consciousness.

"That really launches the modern period of research with a paper he published in 2006 that found that actually a high-dose psilocybin experience could occasion - was the verb they used - a mystical experience.

"William James' definition of a mystical experience: which is one where your sense of self dissolves, and you experience a merging with a larger entity, your sense of time and space are distorted, and you have often a very ecstatic experience follows this merging of the self with something larger.

"You have what's called the noetic quality, the sense that what insights you have - what you perceived - were not subjective experiences, they were objectively true.

"It's an experience that is at the heart of many religions, but the fact that you could induce it with a drug was quite remarkable."

How could psychoactives be used to treat illness?

Pollan says there's some evidence these experiences can be used to treat things like depression, addiction, anxiety and obsessive disorders.

"There's a lot of interesting theories. One of them is that yes, you're resetting your brain, you're jogging it out of old patterns … another is that all of the disorders or forms of mental illness that it seems to be helpful for are characterised by a kind of mental rigidity."

He says one of the most exciting findings is that in fMRI studies of LSD or psilocybin, rather than activating and stimulating the brain, the drug appears to suppress the brain's default mode network.

"At the top of the heirarchy, it's the 'orchestra conductor' as one researcher called it … is crucially involved in your sense of self," Pollan says.

"It's where self reflection takes place, it's where you construct the story of who you are based on what you've done and your objectives. It's where you can have time travel - where you can think about the past or future - and it's where theory of mind takes place which gives you the ability to imagine mental states in others."

"If the ego has an address, it's there."

Pollan says that seems to be how the treatment affects people suffering from those types of illness.

"The ego is very important, it gets a lot done … it gets my book written, but it also torments us.

"The ego traps us in habits, the ego defends us against new material coming in, against strong emotion, against the reality of other people and their own needs. It builds walls.

"So, getting a temporary reprieve from the ego can be liberating, especially to people who are getting stuck, and that appears to be what helps."

The therapeutic method

Pollan says the process for using the drugs for treatment has been refined.

"It's very important to draw a distinction between the way these drugs were used in the 60s and are still used so-called 'recreationally', and the way that they're used in a therapeutic context," he says.

He says most research uses psilocybin, rather than LSD.

"It acts very much like LSD, it acts on the same receptor network on the brain, but its duration is much shorter, it's about half as long an experience … a 12-hour experience is very awkward to study.

"There's that and then … LSD still carries a huge social stigma."

28072016 Photo: Rebekah Parsons-King. Stock image illustrating loneliness, depression, isloation in men, for Insight.

Psychedelic drugs like psilocybin and LSD may be good for treating mental illness like depression, obsession and anxiety because it interrupts the internal looping messages we tell about ourselves, Michael Pollan says.  Photo: RNZ / Rebekah Parsons-King

He says the study or treatment usually includes having two guides with the subject.

"You establish a bond with them and they tell you what to expect, and they give you what they call a set of flight instructions and that's essentially what to do if you have a bad trip or you feel like you're about to and you get anxious.

"The main advice is surrender to whatever happens because resistance is futile and if you fight whatever scary things you're seeing or the dissolution of your sense of self you'll get very anxious.

"Go with it, trust your mind and float downstream as John Lennon memorably put it."

The subject takes the drug then goes to a specially fitted room.

"Not like a hospital room even though you're in a medical complex, but it looks like a very cosy den or a living room … And you wear headphones and eyeshades, and the idea there is the headphones block out any kind of noise that might distract you and also provide a kind of playlist.

"They force you to go inside and to have a very internal journey where you can deal with whatever problems or objectives that you've set for yourself.

"The guides are there, they're very non-interventionist. They're really there to offer a helping hand if you need to get up and go to the bathroom, or if you get really terrified they'll hold your hand and they'll usually have a kind of antidote … though they've never had to use that, that I know of.

"It takes about six hours, you go home and you're asked to write up everything that happened, and the next day you come back for what's called the integration session … that's where the therapist - because that's what these guides are - help you to make sense of what happened and extract any kind of lessons from the experience that you can apply to your life."

He says that last stage is perhaps underrated, but is very important.

"The psychedelic experience can be very confusing and coy … this material that comes up, these images, these encounters with people, this isn't a product of the drug. The drug is only an activator.

"These are materials that have arisen from your unconscious or your subconscious and so they have some value and they're worth making sense of."

'They no longer have a sense of self'

Pollan says the experience can be shaking, but sometimes that can be valuable, which is perhaps how the process is useful as a treatment.

"The turning off, temporary suspension of activity in this network correlates in the reports of volunteers with an experience that their ego has completely dissolved: they no longer have a sense of self, which is very hard to imagine.

"I had one of these experiences on one of my journeys and I did experience the complete dissolution of my ego but I experienced it from this other kind of disembodied awareness this other perspective that was astonishing."

He says the experience can be beneficial. 

Michael Pollan's 'How to Change Your Mind'

Michael Pollan's 'How to Change Your Mind' Photo: Supplied

"Most movingly, I think, the people who are facing death. People with cancer diagnoses who are depressed and anxious and fearful.

"This has been published. Peer-reviewed studies have found this - in about 80 cancer patients, about two thirds of them registered statistically significant reductions in both their anxiety and their depression, which is quite remarkable.

"This experience seems to kind of either give them a sense that there is a kind of consciousness that will survive their death in some cases.

"In others it expands their notion of what their self is, so that their sense of self is more than just this bag of skin. Rather, it's all of nature, it's their family, it's their offspring."

However, again, there are some provisos.

"You need to have a strong ego to let your ego go, in a way.

"I wonder too about young people using drugs - before their sense of identity is fully formed, to experiment with completely dissolving it is questionable."