{"id":373,"date":"2022-12-21T23:22:52","date_gmt":"2022-12-21T23:22:52","guid":{"rendered":"https:\/\/sluggerpost.com\/?p=373"},"modified":"2024-03-16T13:32:13","modified_gmt":"2024-03-16T13:32:13","slug":"the-heroic-dose-of-psychedelics","status":"publish","type":"post","link":"https:\/\/sluggerpost.com\/?p=373","title":{"rendered":"The \u201cheroic dose\u201d of psychedelics"},"content":{"rendered":"\n<p><strong>Dr. Matthew Johnson<\/strong><\/p>\n\n\n\n<p>These experiences are often called \u2018ineffable,&#8217; but as a scientist, I do my best to &#8216;F- it up\u2019 by trying to describe it as much as I can, so I\u2019ll go ahead and do that:<\/p>\n\n\n\n<p>Our society has been in a mental health crisis and it&#8217;s been stagnating.<\/p>\n\n\n\n<p>A large portion of people treat it with traditional antidepressants, don&#8217;t see benefit.<\/p>\n\n\n\n<p>Psychedelics are the only drug class that I know of where you have not just one or two,<\/p>\n\n\n\n<p>but lots of stories of people saying they took this thing one time and they say it had this profound impact on the course of their entire life.<\/p>\n\n\n\n<p>They really exploded on the scene in the 1960s and were associated with some really radical changes to society.<\/p>\n\n\n\n<p>That really scared a lot of people.<\/p>\n\n\n\n<p>I think now society is more ready to kind of accept these compounds and the whole picture of them.<\/p>\n\n\n\n<p>I&#8217;m Matt Johnson.<\/p>\n\n\n\n<p>I&#8217;m a Professor of Psychiatry at Johns Hopkins.<\/p>\n\n\n\n<p>I study drugs, principally, psychedelics.<\/p>\n\n\n\n<p>It&#8217;s hard to imagine a more interdisciplinary topic in the realm of drugs than psychedelics.<\/p>\n\n\n\n<p>They&#8217;ve apparently been used for time immemorial throughout many different cultures on the planet.<\/p>\n\n\n\n<p>Kary Mullis won the Nobel Prize inventing PCR, which revolutionized biology.<\/p>\n\n\n\n<p>He said he wouldn&#8217;t have been able to do that had he not had experience in taking psychedelics.<\/p>\n\n\n\n<p>You move into the arts and then, I mean, gosh,<\/p>\n\n\n\n<p>I mean who hasn&#8217;t heard of musicians and other artists claiming that psychedelics had a profound impact on their creativity?<\/p>\n\n\n\n<p>There&#8217;s the Beatles before LSD, and then there&#8217;s the Beatles after LSD- that&#8217;s a big shift.<\/p>\n\n\n\n<p>The initial big wave of that scientific interest for psychedelics was in the 1950s.<\/p>\n\n\n\n<p>So this was about a decade after Albert Hofmann had first discovered the psychoactive properties of LSD.<\/p>\n\n\n\n<p>There was a group in Maryland called the &#8220;Spring Grove Group.&#8221;<\/p>\n\n\n\n<p>A lot of early research there, particularly with cancer patients.<\/p>\n\n\n\n<p>But I would say one of the most important groups in the history of this work was led by Abram Hoffer and Humphrey Osmond in Saskatchewan, Canada.<\/p>\n\n\n\n<p>They were really the first group that I would say developed what we now call \u201cpsychedelic therapy.&#8221;<\/p>\n\n\n\n<p>There was this growing appreciation of some of the risks and the safeguards needed to minimize those risks, but not every investigator was aware of this.<\/p>\n\n\n\n<p>There was some unethical research, some wild research.<\/p>\n\n\n\n<p>There was controversy surrounding Timothy Leary, especially after he was fired from Harvard. Turn on, tune in, and drop out.\u2019 Psychedelics became so associated with the counterculture. Society was in a sense, traumatized. It all came to a halt.<\/p>\n\n\n\n<p>I mean, there were researchers that were running sessions and got the notices they just had to stop.<\/p>\n\n\n\n<p>The rug is pulled out for decades before there&#8217;s a reinitiation.<\/p>\n\n\n\n<p>The research that&#8217;s happening now, a lot of it is exploring medical applications.<\/p>\n\n\n\n<p>These are all drugs that can have a profound effect on one&#8217;s sense of reality, including one&#8217;s sense of self.<\/p>\n\n\n\n<p>I think kind of the only bet you can make is that if you have the dose high enough, something really interesting is gonna happen.<\/p>\n\n\n\n<p>You might find yourself in your &#8216;mind&#8217;s eye,\u2019 soaring in the heavens; the secrets of the Universe seemingly revealed to you.<\/p>\n\n\n\n<p>On the other hand, five seconds later it might collapse into what folks call a &#8216;bad trip,\u2019 where one could feel that they&#8217;re gonna die.<\/p>\n\n\n\n<p>It&#8217;s sort of this like massive shake up in one&#8217;s experience of reality.<\/p>\n\n\n\n<p>I&#8217;m floored when people with really substantial life experience will say things like,<\/p>\n\n\n\n<p>&#8216;This was the most meaningful experience of their life.&#8217;<\/p>\n\n\n\n<p>Compared to the intensity of the subjective effects, it&#8217;s remarkable how little impact these substances have on physiology.<\/p>\n\n\n\n<p>You know, your heart rate, your blood pressure- everything has its risk, to be clear.<\/p>\n\n\n\n<p>But compared to other drug classes, psychedelics are really robustly safe at the physiological level.<\/p>\n\n\n\n<p>My therapeutic research with psychedelics is primarily used<\/p>\n\n\n\n<p>&#8216;psilocybin,&#8217; which is the agent in magic mushrooms.<\/p>\n\n\n\n<p>The dose we now give to patients is anywhere from 30 milligrams to 40 milligrams, which Terence McKenna, who&#8217;s the famous psychedelic bard would refer to repeatedly as the &#8220;heroic dose.&#8221;<\/p>\n\n\n\n<p>If a microdose is over here and a recreational dose is over here, we&#8217;re way over here.<\/p>\n\n\n\n<p>When someone comes in for the day of their psychedelic session, they&#8217;ve already spent several hours with us on previous days preparing for the experience, developing that rapport.<\/p>\n\n\n\n<p>We know that all drugs are in part shaped by the context in which they&#8217;re given, but for the psychedelic substances, that&#8217;s particularly more so.<\/p>\n\n\n\n<p>So when you provide it in more of a warm, welcoming situation, you tend to get more meaningful reactions to the substance.<\/p>\n\n\n\n<p>When the experience unfolds the person is gonna lay down, wear eye shades, and headphones through which music is played.<\/p>\n\n\n\n<p>So the idea is: kinda get out of your normal, everyday, discursive analyzing intellect.<\/p>\n\n\n\n<p>We really just encourage them to trust, let go, and be open.<\/p>\n\n\n\n<p>Trust the overall process.<\/p>\n\n\n\n<p>Going into this type of treatment is not easy at all.<\/p>\n\n\n\n<p>Trust yourself that you&#8217;re robust:<\/p>\n\n\n\n<p>You&#8217;re gonna get through this experience.<\/p>\n\n\n\n<p>Let go.<\/p>\n\n\n\n<p>What does let go mean?<\/p>\n\n\n\n<p>Let go means whatever your preconceived notions of what this experience might be or what experience you should have, don&#8217;t let that get in the way for the experience that you will have.<\/p>\n\n\n\n<p>Don&#8217;t try to control it, and be open no matter where this takes you, go there.<\/p>\n\n\n\n<p>Whatever the experience is, take the orientation of:<\/p>\n\n\n\n<p>&#8216;This is what I need to deal with.&#8217;<\/p>\n\n\n\n<p>The range of experiences are just so broad.<\/p>\n\n\n\n<p>You can swing from a terrifying experience to this beautific, you know, sort of like, most amazing experience of your life.<\/p>\n\n\n\n<p>Some people could feel like they&#8217;ve reached the end of reality, this kind of plane of existence.<\/p>\n\n\n\n<p>Others say that they can feel the suffering across the entire planet.<\/p>\n\n\n\n<p>You know, sort of having this sort of experience of &#8216;universal empathy.&#8217;<\/p>\n\n\n\n<p>It&#8217;s all welcome.<\/p>\n\n\n\n<p>The laughter, the tears, everything in between.<\/p>\n\n\n\n<p>That&#8217;s exactly what this process is for.<\/p>\n\n\n\n<p>So the &#8216;integration phase&#8217; is where we&#8217;re discussing the experience with them, and the themes that come up are so varied.<\/p>\n\n\n\n<p>One of the aspects you could call &#8216;revealed truth,\u2019 and I call these &#8216;duh moments.&#8217;<\/p>\n\n\n\n<p>These are experiences where people will feel like they&#8217;ve learned something at such a fundamental level.<\/p>\n\n\n\n<p>I think of examples in our work we&#8217;ve done with cancer patients where, you know, oftentimes people will say, &#8220;I&#8217;m allowing this to create my own suffering.<\/p>\n\n\n\n<p>The cancer hasn&#8217;t killed me yet.<\/p>\n\n\n\n<p>I can still live life, but I&#8217;m letting it do this to me.&#8221;<\/p>\n\n\n\n<p>They knew it up here, they could tell you the words, but now they feel it in their bones- they feel it in their heart.<\/p>\n\n\n\n<p>People are reminded about this power they have to choose their own destiny.<\/p>\n\n\n\n<p>Some people come out of these sessions as participants and say that, you know, &#8220;One 6 hour experience with psilocybin is like a thousand hours of therapy.&#8221;<\/p>\n\n\n\n<p>But one of the pitfalls of this clinical work is that you&#8217;d be hard pressed to find a more intimate and vulnerable psychological intervention for a person.<\/p>\n\n\n\n<p>That&#8217;s just a situation that is ripe for abuses if we don&#8217;t have the right safeguards.<\/p>\n\n\n\n<p>Because of that vulnerability, because of the incredible gravity of these sessions, we need to even more tenaciously cling to clinical boundaries.<\/p>\n\n\n\n<p>We need to limit the use of therapeutic touch.<\/p>\n\n\n\n<p>A subtler form of abuse is just filling in the blanks for people- I call it the guru complex.<\/p>\n\n\n\n<p>People often confront big picture questions:<\/p>\n\n\n\n<p>What is the meaning of life?<\/p>\n\n\n\n<p>Does God exist?<\/p>\n\n\n\n<p>What&#8217;s the big picture of everything that&#8217;s going on?<\/p>\n\n\n\n<p>What am I?<\/p>\n\n\n\n<p>On those metaphysical questions, we really have to be silent.<\/p>\n\n\n\n<p>In the biggest picture, aside from psychedelic&#8217;s ability to treat one disorder or another,<\/p>\n\n\n\n<p>I think they&#8217;re just poised to really help us to understand the nature of psychiatric disorders.<\/p>\n\n\n\n<p>What commonalities do they have with each other that are somehow being addressed by psychedelic treatment?<\/p>\n\n\n\n<p>I kind of think of all of these disorders as different forms of addiction.<\/p>\n\n\n\n<p>So whether it&#8217;s to a substance like tobacco or alcohol, cocaine, or a way of thinking about yourself, it&#8217;s this narrowed mental and behavioral repertoire: reality used to be like this, and now your reality is like this.<\/p>\n\n\n\n<p>And psychedelics, when done well in the right setting, have the ability to just blow people out of that narrowed story.<\/p>\n\n\n\n<p>It holds a lot of promise in helping us figure out what it takes for the human being to be mentally healthy.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr. Matthew Johnson These experiences are often called \u2018ineffable,&#8217; but as a scientist, I do my best to &#8216;F- it up\u2019 by trying to describe it as much as I can, so I\u2019ll go ahead and do that: Our society has been in a mental health crisis and it&#8217;s been stagnating. A large portion of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":548,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"_links":{"self":[{"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/posts\/373"}],"collection":[{"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=373"}],"version-history":[{"count":1,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/posts\/373\/revisions"}],"predecessor-version":[{"id":374,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/posts\/373\/revisions\/374"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=\/wp\/v2\/media\/548"}],"wp:attachment":[{"href":"https:\/\/sluggerpost.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=373"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=373"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sluggerpost.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}