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    Psychedelic psychotherapy 
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    Psychedelic psychotherapy - The ethics of medicine for the soul

    Psychedelic drugs are known to have profound psychological effects on people. These substances are now being evaluated in clinical trials in the US as aids to psychotherapy. The use of these substances in Transpersonal Psychology is thought to help patients by inducing spiritual experiences that lead to improved mental health. Some people challenge the claim that authentic spiritual experiences can be induced by drugs and still others question whether spirituality and religion have any place in medicine at all. The potential emergence of the use of psychedelics in medicine calls for a consideration of these and many other concerns.

    A hallucinogen is defined as any agent that causes alterations in perception, cognition, and mood as its primary psychobiological actions in the presence of an otherwise clear sensorium. Another word for hallucinogen is psychedelic, which comes from the Greek to wander in the mind, and is perhaps more accurate since hallucinogenic drugs dont actually produce true hallucinations, rather they engender illusions that are not normally mistaken for reality, but understood as an effect of the drug. The majority of the currently known psychedelic drugs are classified as Schedule I compounds, which means that they are considered to be substances that have no accepted medical use in the U.S. and have a high abuse potential.

    The assertion that psychedelics have no accepted medical use is a matter of contention that has been gaining a larger audience for the past couple decades. Since the first large push for the use of psychedelics in research and medicine in the 1950s and 1960s, psychedelics have largely been shunned from the medical community. Most recent evidence on the efficacy of using psychedelics in medicine has come from studies outside the U.S. or from reports of their underground use that necessarily surface to the publics attention as anecdotes. Now, however, the question of whether psychedelic drugs have any valid medical use is being revisited. More serious consideration is being given to psychedelic psychotherapy, which uses psychedelics as catalysts of transcendent experiences in order to break down psychological barriers to communication and recovery. The director of the Drug Policy Program at UCLA, Mark Kleiman, said that theres obviously been a significant shift at the regulatory agencies and the Institutional Review Boards. There are studies [with psychedelic drugs] being approved that wouldnt have been approved 10 years ago. Part of the reason for this change is due to organizations like the Multidisciplinary Association for Psychedelic Studies (MAPS) and the Heffter Organization, which sponsor and promote studies of the medical applications of these drugs. According to an article by John Horgan, the main goal of Rick Doblin, the founder of MAPS, is to see psychedelics legally recognized as medicines. But he also hopes that someday healthy people may take these substances for psychological or spiritual purposes. The paragraph finishes: After all, drugs such as Prozac and Viagra are already prescribed not just to heal the ill but also to enhance the lives of the healthy.

    With at least four different FDA approved studies on the medical applications of psychedelic drugs currently being run in the US, it seems likely that our medical professionals and our society as a whole will soon have to face the ethical questions that accompany the practice of psychedelic psychotherapy. The paper will not discuss issues of legality, but will instead focus on psychedelics effects on peoples spirituality as a possible mechanism for affecting their health, and on the question of the authenticity of a psychedelic-induced spiritual experience.

    Psychological mechanisms of psychedelic therapy

    When asked if he could see a future role for psychedelics in our Euro-American culture, Albert Hofmann, the discoverer of LSD, responded Absolutely! ... The pathway for this is through psychiatry, but not the psychoanalytic psychiatry of Freud and not the limited scope of modern biological psychiatry. Rather, it will occur through the new field of transpersonal psychiatry. He followed this by saying What transpersonal psychiatry tries to give us is a recipe for gaining entrance into the spiritual world. The idea of mixing spirituality with medicine is for most people in Western society a foreign concept, and while many people pray for a loved ones health to improve, there exists the distinction in our vernacular between healing, which is seen as more spiritual or holistic, and curing, which is accomplished through medicine. In order to understand the ethical issues behind psychedelic psychotherapy we need to have a better understanding of how psychedelic psychotherapy can affect people?s notions of meaning and the imperishable self as well as their ability to relate to other people.

    Psychedelic-induced altered states of consciousness (ASCs) tend to include a certain list of common elements, one of which is a significant change in meaning and significance. Changes in meaning and significance can be found not only in how a patient views the world, but also in how they think of the content of their therapy. Two of the main protagonists of the field of transpersonal therapy were Stanislav Grof and Abraham Maslow, who both thought that a person could attain their optimal psychological health through altered states of consciousness. ASCs were thought to catalyze a therapeutic response, possibly by adding significance to therapy for the patient. In the report from a man who used ayahuasca, a hallucinogenic concoction made from a vine, to treat his colon cancer, the man talks about the thoughts that he had during his trip and says when the vine reveals such things, the impact is far more profound.

    Psychedelics seem to be able to amplify the significance and meaning of thoughts, or at least bring people closer to certain kinds of thought. Myron Stolaroff, cofounder of the International Foundation for Advanced Study in Menlo Park, California believes that the great value in these chemicals is that, in some way still not scientifically explained, they dissolve the boundaries to the unconscious mind, which allows one to then experience the great relief of being in touch with all aspects of ones being. The joy and thrill of being totally alive comes from having complete access to all of ones feelings. The possibility of uncovering repressed thoughts and uniting a persons fragmented mind sounds appealing, but Vivian Rakoff, the emeritus professor of psychiatry at the university of Toronto cautions us that every few years, something comes along that claims to be what Freud called the royal road to the unconscious. Transpersonal psychotherapy may be just another empty hope, but nevertheless, Rakoff says that research in psychedelic psychotherapy should be
    allowed to continue.

    Some of today?s current medical studies with psychedelics that are seeking to re-examine psychedelic drugs therapeutic potential focus on their use in palliative care. Thousands of studies on the use of psychedelics in psychotherapy were published back in the 1950s and 60s before these drugs were scheduled. But many believe that these early studies do not, meet the standards of modern psychotherapy research, and that cautious reexamination of their [the psychedelics] therapeutic potential may be in order.

    One such study is being run by Charles Grob, MD at the Harbor-UCLA Medical Center, and another is headed by John Halpern of Harvard University McLean Hospital. Both studies are looking to validate older studies that showed how the terminally ill were able to come to decrease their pain and anxiety about death through transpersonal psychotherapy. Sherwood, Stolaroff and Harmon explain how transpersonal psychotherapy might mitigate existential ills associated with the dying process with the following:

    There appears to emerge a universal central perception, apparently independent of subjects previous philosophical or theological inclinations, which plays a dominant role in the healing process...

    Much of the psychotherapeutic changes are seen to occur as a process of the following kind of experience:

    The individuals conviction that he is, in essence, an imperishable self rather than a destructible ego, brings about the most profound reorientation at the deeper levels of personality. He perceives illimitable worth in this essential self, and it becomes easier to accept the previously known self as an imperfect reflection of this. The many conflicts which are rooted in lack of self acceptance are cut off at the source, and the associated neurotic behavior patterns die away.

    This recognition of existing as an imperishable self and not the ego that is usually dissolved or partially dismantled during the psychedelic trip is what comforts the dying. It supposedly abates their fear of death by letting them believe that their entire self will not cease to exist after death, but only their physical self.

    Another perspective on the use of psychedelics by the dying comes from Joanne Lynn, president of Americans for Better Care of the Dying. She says that even in antiquity, some groups thought is was especially important to take whatever their local psychedelic was... when confronting mortality, whether its to see into the hereafter, improve spiritual growth or just numb yourself to the reality. But she followed this by saying its sometimes poetic, sometimes majestic, but often mundane work to wrap up one?s life. I think its unlikely theres a pill that will make that go away.

    A psychedelic pill might not make the mundane work of reconciling with ones family go away, but it might make it easier. Elizabeth K., psychiatrist and author of over 14 books on coping with dying believed that simply prompting patients to express [their] many thoughts, feelings, and concerns would be helpful to them...

    Such discussions could address concrete problems and relieve the patient of responsibilities and burdens that prevented the patient from dying in peace. Considering the report by Eric Kast, M.D. that LSD is... capable of improving the lot of dying individuals by making them more responsive to their environment and family, one can see how psychedelics might be able to facilitate this process of prompting patients to express themselves.

    If the interaction between a patient and their loved ones is important for the patients well being, then it might also be pertinent to consider the well being of the loved ones as a factor in a patients treatment. One study that measured factors affecting the global quality of life (QoL) of both cancer patients and their spouses found meaningfulness to have highest correlation with QoL in both groups. The study concluded by calling for greater attention to the existential domain in palliative care, both when measuring and when trying to improve quality of life for these patients... This call for increased attention to existential concerns was echoed in another study that found that patients with an enhanced sense of psycho-spiritual well-being are able to cope more effectively with the process of terminal illness and find meaning in the experience.


    This idea that spirituality is related to QoL and meaning in life would suggest that transpersonal psychotherapy using psychedelics possibly mediates its effects on meaning in life, and hence QoL, by inducing authentic spiritual experiences. Given the findings that spirituality is positively related to quality of life, social support, effective coping strategies and negatively related to perceived stress, uncertainty, and psychological distress, psychedelic psychotherapy should find applications in a number of different diseases from HIV to major depression. Its only fair to mention that the studies quoted above do not qualify whether they consider drug-induced spirituality as a valid form of spirituality. Because spirituality is such a broad term, we will not assume that any form of spirituality is meant to be excluded from any measurement of spirituality unless specifically stated so by the author.

    One form of spirituality that people in Western society today are mostly familiar with is indirect rather than direct spiritual experience; they are more familiar with reading about these experiences (i.e. in scripture) than having them themselves. Some people believe that psychedelics can allow people to have such direct experiences, and for some, such as Albert Hofmann, it is important to have the experience directly. But not everyone is comfortable with the idea of obtaining spirituality from a pill. Drug-induced spirituality can be viewed as spurious and artificial or too easy and too fast. These are all valid concerns, but it is interesting to view them in the context of medicine. Few people would say that an ill person who takes a pill and gets better has only achieved artificial health. Many medications are marketed as fast acting, but no one asks whether a man with athletes foot should be made to wait and suffer for a certain amount of time before he is allowed to experience relief. The difference between peoples? attitudes towards taking a pill to improve a deficiency in health and making a pill to fill a lack of spirituality probably lies in the idea that health is biological and physical, whereas spirituality is mental and metaphysical, but didnt we establish before that spirituality and biological health can be interrelated?

    If spirituality can be utilized to improve biological health, why can?t biological measures be taken to improve spiritual health? Why should it matter whether a persons spirituality or originated in a pill or a prayer if both types of spirituality can be shown to improve quality of life and give life meaning? It shouldnt; but for some it does because drug-induced spirituality destroys some of the comforts of dualism. The spirit or soul is a comforting concept because it is an entity which cannot be touched by the harshness of the material world around us. The concept of the soul allows for the belief that we do not lose everything upon dying, that part of us may continue. To think that a material substance, a pill, could not only alter a persons mind but their soul can be threatening to the perceived rarefaction of the soul. But as Sherwood et al. explain above, psychedelics are thought only to dismantle the ego, leaving the essential self (the soul) exposed yet untouched; in other words, the soul is revealed, but not altered. This experience could actually leave people that take comfort in body-soul dualism feeling just as secure as before if not more so since they would have had a view of the soul, unobstructed by the ego, to convince themselves of its durability.

    Even if it were agreed upon that psychedelics can cause authentic spiritual experiences, there remains the concern, as Steven Hyman, a professor of neurobiology at Harvard Medical School, states it: one worries that insights gained under... different cognitive states with illusions may seem strange and distant from the vantage of our ordinary life. Hyman is restating the problem of applying insights obtained in an altered state of consciousness to changing who we are in our ordinary state of consciousness. But this problem is a product of our culture, not a psychological fact. The content of dreams that some people may refer to as illusory or meaningless are considered to be real by some cultures. Whos never heard of people interpreting their dreams and using them as guides for how to act in their waking lives? No one knows why we dream so it is impossible to say whether insights gained in dreams are or arent applicable to ordinary waking consciousness, no matter how strange they may seem. Wed like to think that there must be some significance to dreams since we spend about one third of our lives asleep, potentially dreaming, and since we even dream when we are awake via daydreams. So while Hymans concern is a valid one, it really only gives us more reason to rigorously investigate the potential of altered states of consciousness on our ordinary life.


    Psychedelics are powerful drugs that have great potential to help as well as harm. This paper discusses the use of psychedelics in transpersonal psychotherapy and the ethical issues that accompany their employment as medicines. After examining how these drugs are thought to work in psychotherapy and their ability to cause authentically spiritual experiences, we should be better prepared to make informed decisions about the use of these drugs that not only affect ones body, but ones mind or even soul. US law says that psychedelics have no medical application, but depending on the results of a handful of current studies this may soon change. Because, compared to many other drugs, psychedelics are relatively benign physiologically, many arguments against their use are moral, not medical, objections. And as Francis, points out: We are... unwilling to take a clear stand on drugs solely on the basis that they are bad for the soul. Whether a drug is good or bad for the soul and a persons spirituality is a tough question to ask, but that does not make it impossible to answer. The soul aside, how drugs affect consciousness is a tough question in and of itself. Like any other state of consciousness, the psychedelic mind-state is poorly understood, but its implications for human spirituality and psychiatric health nonetheless warrant a thorough investigation, which in view of their potential benefits could even be seen as unethical not to pursue.

    Why psychedelic psychotherapy works

    Jerry Brown, Ph.D., and Julie Brown

    Steve Jobs loved LSD. The legendary Apple co-founder said, taking LSD was one of the two or three most important things he had ever done in his life. Jobs credited the multiple use of LSD as a major reason for his success and ability to Think Different, which became Apples motto.

    Jobs was not the only visionary who attributed enhanced intellectual capacity to ingesting an entheogen. Cambridge Universitys Francis Crick, co-discoverer of the DNA structure, was another. Crick revealed, when speaking with a close friend, that he had actually perceived the double-helix shape while on LSD. The list of brilliant LSD users who have come out of the psychedelic closet includes physicist Richard Feynman; Microsoft founder Bill Gates; and neuroscientist John C. Lilly.

    None of this should come as a surprise, given the success of an earlier study in proving that psychedelic drugs significantly enhance problem-solving abilities. In 1966, a research team, which included psychologist James Fadiman and engineer Willis Harmon, conducted a Psychedelics in Problem-Solving Experiment. The researchers administered low doses of mescaline (a moderately light dose compared to doses used to induce mystical experience) to professional people (i.e., engineers, mathematicians, architects) who were highly motivated to solve a problem they had been working on for three months or more without success. Virtually all of the subjects reported making significant breakthroughs and producing solutions that were validated by independent tests and, eventually, commercial acceptance of their solutions. This promising line of inquiry was abruptly terminated by the Food and Drug Administration, which banned further research on human subjects as part of the then-growing political backlash to the 1960s psychedelic movement.

    Second coming of psychedelics

    Today this problem-solving research and other potential medical and scientific benefits of psychedelics are being revisited by researchers at some of the nations leading universities, such as Johns Hopkins, Harvard and the University of California. In an article titled The Second Coming of Psychedelics, journalist Don Lattin describes this renewed interest in sacred medicine. Paving the way for this resurgence of government-approved research is the Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit research and educational organization that develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.

    In recent years, rigorous research has been conducted on entheogens, such as ayahuasca, LSD, mescaline and psilocybin, and on the empathogen Ecstasy. The goal is to evaluate their effects on addiction, cluster headaches, depression, trauma, cancer, epilepsy, death and dying, as well as to explore their value in the study of consciousness and mystical experience. The implications of this new science of psychedelics for brain research and psychiatry, and for religion and spirituality, have been documented in numerous articles and books. A resurgence in the study of entheogens is well underway.

    Why psychedelic-assisted psychotherapy works

    We would like to share our thoughts on why psychedelic-assisted psychotherapy is proving to be highly effective as a healing modality.

    Psilocybin has been used in traditional healing rituals for thousands of years. However, for more than 40 years it has been illegal in the U.S.

    But recent findings are tearing down the barriers surrounding psychedelic research, as it has been clinically shown that they have the ability to ease depression and soothe anxiety in patients dealing with serious illness and impending death. Two separate studies discovered that a single, moderate-to-large dose of psilocybin was able to help alleviate profound distress among cancer patients.

    Lifting the taboo on psychedelic research

    Harvard psychology professor Timothy Leary infamously sparked an aggressive promotion of LSD in the 1960s that would ultimately lead to the loss of his teaching position and a federal ban, the Controlled Substance Act of 1970, on all research on psychedelics.

    This research blackout came to an end in 1999, when Roland Griffiths of Johns Hopkins initiated a new series of studies on psilocybin. He has since become known as the grandfather of the psychedelic renaissance and a 21st-century pioneer in the field. Unlike Leary, however, he does not aspire to be a guru or shaman. Rather, as a clinical pharmacologist and author of over 300 studies on mood-altering substances, Griffith prefers the path of scientific caution.

    Griffith claims his initial curiosity about psychedelics came from his own mindfulness meditation practice. His interest was further sparked when he administered psilocybin to volunteers and found that two-thirds of the participants called their psychedelic journey among the most significant experiences of their lives.

    Today, Griffiths touts the use of psychedelic-assisted psychotherapy for its ability to treat a variety of debilitating conditions, such as depression in terminally ill patients, post-traumatic stress syndrome among war vets, and alcohol and tobacco dependence.

    Griffiths says:

    There is something about the core of this experience that opens people up to the great mystery of what it is that we dont know. It is not that everybody comes out of it and says,
    Oh, now I believe in life after death. That neednt be the case at all. But the psilocybin experience enables a sense of deeper meaning, and an understanding that in the largest frame everything is fine and that there is nothing to be fearful of.

    There is a buoyancy that comes of that which is quite remarkable. To see people who are so beaten down by cancer, and they start actually providing reassurance to the people who love them most, telling them it is all okay and there is no need to worry, when a dying person can provide that type of clarity for their caretakers, even we researchers are left with a sense of wonder.

    Why are psychedelics so effective?

    Researchers know how, but they do not know why, psilocybin has worked in these settings. One theory is that psilocybin interrupts the circuitry of self-absorbed thinking that is so pronounced in depressed people, making way for a mystical experience.

    Dr. Robin Carhart-Harriss group at Imperial College in London is doing neuro-imaging studies. These studies suggest that the positive effects of psychedelic-assisted psychotherapy are explained by changes in something in the brain called the default mode network.

    It turns out that this network is hyperactive in depression. Interestingly, in both meditation and also with psilocybin this network becomes quiescent. This may correlate with the experience of clarity, of coming into the present moment, which is the key to getting out of self-absorbing thinking and to experiencing feelings of inter-connectedness.

    Normally, information is exchanged in the brain using various circuits, or what one researcher describes as informational highways. On some highways, there's a steady stream of traffic. On others, however, there are rarely more than a few cars on the road. Psychedelics appear to drive traffic to these underused highways, opening up dozens of different routes and freeing up some space along the more heavily used ones ̶ thereby facilitating an expanded sense of awareness and access to new perspectives among participants in psychedelic therapy sessions.

    Moment of absolute clarity

    Our theory of why psychedelic-assisted psychotherapy works correlates closely with the findings of these brain imaging studies.

    What we are seeing here are neural representations of major shifts in awareness. When you have a mind-expanding experience, you can transition from fear and anxiety to confident self-empowerment. This, in turn, provides a serene sense of well-being that is essential to both emotional and physical healing.

    In this context, we can begin to understand how psychedelic-assisted psychotherapy can provide fast and effective treatment for a variety of patients suffering from addiction, depression and trauma. By fast, we are referring to positive results coming from one or two sessions, as opposed to the months and even years that traditional psychotherapy requires.

    By contrast, Dr. Stephen Ross, the lead investigator and chief of addiction psychiatry at N.Y.U., points out that antidepressants can take weeks to show benefit. Cancer patients with anxiety and depression need help immediately, he said, especially if you consider that they are at elevated risk for completed suicide.

    In a word: the moment of absolute clarity is the treasure that entheogens hold!
    Last edited by mr peabody; 21-09-2018 at 07:18.
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    Bluelighter mr peabody's Avatar
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    Can ibogaine help in psychotherapy?

    One ibogaine treatment session has been described as "10 years of psychoanalysis in a single night."

    - PTSD, Complex PTSD
    - Processing childhood trauma
    - Loss and grief
    - Learning forgiveness & peace
    - Unprocessed or repressed memories & experiences
    - Facing fears & phobias
    - Bringing the subconscious to the conscious
    - Perspective into one's deeper programs & thought patterns

    Forms of depression, anxiety and trauma influence the lives of us all at some point of our lives. This is all part of the human condition.

    A common thread that Dr. Some has noticed in “mental” disorders in the West is “a very ancient ancestral energy that has been placed in stasis, that finally is coming out in the person,” thus, mental disorders are spiritual emergencies, spiritual crises, and need to be regarded as such to aid the healer in being born... "If these ancestors are not healed, their sick energy will haunt the souls and psyches of those who are responsible for helping them. In indigenous cultures all over the world, young people are initiated into adulthood when they reach a certain age. The lack of such initiation in the West is part of the crisis that people are in here," says Dr. Some. He urges communities to bring together “the creative juices of people who have had this kind of experience, in an attempt to come up with some kind of an alternative ritual that would at least begin to put a dent in this kind of crisis.”

    Ibogaine is used to treat PTSD, depression, anxiety, ADHD, eating disorders and many other mental, emotional, spiritual and physical disorders. Ibogaine can help to address the root cause of the disorder as well as cleaning the mind of its unwanted and limiting negative programming, restoring you to the clarity of your pre-trauma state. A complete mind, body, spirit ‘reset’ is often described.

    It can eliminate the initial emotional pain that may have caused you to seek painkillers, alcohol, sleeping pills, anti-depressants, binge eating or other hard drugs. Your emotional body is temporarily relieved so that you can witness and process past traumas in a near-instant without getting caught up in old triggers and fears. Some say that taking journeys with other plants medicines for ten years would not be equal to one iboga journey. "Ibogaine took me away from a cycle of self (and my loved ones) destruction. It gave me the chance to reset my existence as a human being."

    Ibogaine has been found to increase levels of glial cell line-derived neurotrophic factor, or GDNF, which promotes the survival and replenishment of many types of neurons. A single dose of ibogaine can increase GDNF expression for weeks, depending on dosage. Ibogaine is also highly lipophilic and remains in body fat for months, gradually being released, further extending its influence on GDNF expression.

    - Ibogaine facilitates the deep exploration of one’s own persona and mind. The investigation is carried out by the user themselves, allowing them to choose and control what they want to deal with. Nobody knows you like you know yourself!

    - The use of ibogaine has been found to provide the majority of users with the ability to explore and openly talk about previously undisclosed and repressed personal problems. This effect has been shown to last for at least a week or so, with many users reporting a continued/ongoing ability to objectively assess and discuss deeply rooted issues.

    - In an ibogaine experience, the body is physiologically and chemically open so that when the memory comes and it is re-experienced viscerally, the chemical correlation of the insight are also experienced physiologically. Ibogaine is able to unlock the door to the unconscious mind and can assist in the healing of depression, clearing phobias and fears, and other personality disorders.

    - Ibogaine can offer the chance to revisit childhood and other past memories, providing the opportunity to meet/reconnect/make peace with people that have died.

    - Ibogaine also works to re-balance the brain chemistry, level out dopamine, serotonin, endorphins and adrenaline, and restore users to the clarity of the pre-trauma state.

    Whether you suffer from a mood disorder is in your hands to determine and examine it with your doctor. However an ibogaine therapy treatment can effectively induce a level of mental clarity which in turn helps relieving the depression and anxiety symptoms completely and directly, offering powerful insight for you to access fundamental understandings, hence achieving meaningful degrees of relief.


    History of ketamine in psychotherapy

    A number of international psychiatric investigators have utilized treatment with ketamine to create cathartic effects in psychotherapy.

    In Iran, ketamine psychotherapy was shown to be very effective in treating various psychiatric disorders. These investigators administered ketamine to 100 psychiatric patients with different mental health and psychosomatic diagnoses, including depression, anxiety, phobias, obsessive-compulsive neurosis, conversion reaction, hypochondriasis, hysteria, tension headaches, and ulcerative colitis. They reported that 91 participants were doing well after six months, and 88 remained well after one year. These investigators concluded that “ketamine’s abreactive or cathartic effect was related to its mind-expanding qualities;” however, they did not further specify their findings in clinical language.

    In Argentina, Fontana used ketamine as an adjunct to antidepressive psychotherapy in order to facilitate regression to a prenatal level through a disintegration and death experience, which
    was followed with a progression experience that was seen as similar to a rebirth. He emphasized the advantages of ketamine, which made it possible to achieve deep levels of regression.

    In Mexico, Roquet was the first clinician to employ ketamine psychedelic psychotherapy History of Ketamine in Psychotherapy in a group setting. He combined psychoanalytical techniques with the healing practices of Mexican Indian ceremonies and created a new approach to psychedelic psychotherapy that he called "psychosynthesis” (not to be confused with the same term used by Assagioli). He mainly used this procedure to treat neurotic patients, although he described some success with personality disorders and selected psychotic patients.

    One of us (Krupitsky) first began using ketamine in the former Soviet Union in 1985 for treatment of alcoholism. He developed Ketamine Psychedelic Therapy (KPT) and treated more than 1,000 patients without complications. In one of his many controlled studies, nearly 70% of his ketamine-treated patients remained abstinent from alcohol during a one-year follow-up, in contrast to only 24 percent abstinence achieved in a control group treated with more traditional therapy. In a comprehensive clinical research review on this subject, Krupitsky concluded that KPT is a safe and effective treatment for alcoholism and other drug dependencies, such as heroin and ephedrine, as well as effective for treatment of post-traumatic stress disorder, reactive depression, neurotic disorders, and avoidant personality disorders, and somewhat effective for the treatment of phobic neurosis, obsessive-compulsive neurosis, and histrionic personality disorder.

    Krupitsky and his colleagues recently conducted a double-blind randomized clinical trial comparing the relative effectiveness of high to low dose administrations of ketamine for the psychotherapeutic treatment of heroin addiction; two-year follow-up data indicated that high dose ketamine was more effective. The study reported that “high dose KPT produced a significantly greater rate of abstinence in heroin addicts within the first 24 months of follow-up than did low dose KPT.”

    The authors also concluded that “high dose KPT brought about a greater and longer-lasting reduction in craving for heroin, as well as greater positive change in non-verbal unconscious emotional attitudes.” It appears the study’s data represent both a lower rate of recidivism and a higher degree of psychological integration.Recent changes in the regulations governing such research in Russia have now brought Krupitsky’s pioneering research efforts to a halt.

    There was also an intriguing study at the University of Cambridge in the UK, in which ketamine was used to treat compulsive behavior in young women with anorexia nervosa with good results, although the publication of this study does not clearly indicate that the clinicians used a psychotherapeutic model. The study used infusions of ketamine to treat 15 patients with a long history of eating disorder, all of whom were chronic and resistant to several other forms of treatment. Nine responders showed prolonged remission when treated with ketamine infusions. There have also been various lone practitioners in other countries, usually family doctors or psychiatrists, who have used ketamine to treat psychological/psychiatric problems.

    Ketamine-Enhanced Psychotherapy

    Inspired by Krupitsky, one of us (Kolp) engaged in the clinical treatment of alcoholic clients using what he called Ketamine-Enhanced Psychotherapy. His approach was explicitly meant to replicate Krupitsky’s pioneering work and to extend it into another cultural context, the US (note: Kolp is a bi-cultural Soviet-American psychiatrist, who was originally trained as a Soviet psychiatrist, immigrated to the United States in 1981 and was re-trained as an American psychiatrist). As with Krupitsky’s KPT technique, Kolp’s KEP treatment explicitly relied on the transpersonal effects of ketamine to facilitate psychotherapeutic change. Both researchers have recently published their combined observations on clinical and empirical research of the effectiveness of ketamine-enhanced psychotherapy for treatment of alcoholism. Once more, although most psychedelic drugs are illegal to use in the US even by physicians, ketamine is a notable exception because it is readily available to physicians as an anesthetic that can be legally used off-label for psychiatric treatment. Consequently, Kolp employed ketamine in his private psychiatric practice in the US from the fall of 1996 through the spring of 1999, administering it to more than 70 clients. Several of us also recently published Kolp’s empirical observations of the effectiveness of his KEP for treatment of alcoholism.

    During this same period of time, Kolp had an opportunity to administer KEP to two patients with end-stage cancer. This paper summarizes these patients’ responses and provides Kolp’s informal retrospective observations on ketamine’s effectiveness for treatment of existential anxieties in terminally ill people. We emphasize that these clinical administrations were not conducted in a formal research context and this paper provides the informal retrospective observations on ketamine’s effectiveness for treatment of existential anxieties in terminally ill people. However, in light of the recent resurgence of psychedelic research in the US and our plans, as a research team, to now seek institutional review board approval and grant funding for formally pursuing studies on ketamine’s effectiveness in a number of clinical applications including the treatment of death anxiety, a reporting of Kolp’s clinical observations is seen as warranted.


    There has been surging interest in the use of ketamine as a potential therapeutic agent for affective disorders, particularly depression. Even a single-dose of ketamine may cause rapid antidepressant effects in otherwise treatment-resistant cases of bipolar and major depression. Remarkably, this also includes the acute reduction of suicidal ideation. Recent neuroimaging studies support potential anti-anhedonic and anti-depressant effects, demonstrating its ability to alter glucose metabolism in regions implicated in mood disorders. Repeated ketamine doses may improve depressive symptoms comparable to—and perhaps even more rapidly than—electroconvulsive therapy, and it may even be successful in treating ECT-resistant depression. Despite its observed promising antidepressant effects, however, more rigorous investigation is needed to establish its clinical use as an antidepressant. The current evidence is limited by bias, small sample sizes, and limited data on important cofounding variables. In fact, a recent Cochrane Review determined that the efficacy of ketamine as an antidepressant may be limited beyond 1 week.

    Post-Traumatic Stress Disorder (PTSD)

    One of the newer applications of ketamine is its role as a potential treatment for Post-Traumatic Stress Disorder (PTSD), although studies examining this remain limited. For instance, Feder et al. (2014) found that ketamine may reduce symptom severity of PTSD more rapidly than midazolam; however, they did not exclude previously depressed patients, and the observed results may have been due—in part—to ketamine’s known antidepressive effects. A case reported by Donoghue et al. (2015) describing ketamine-induced remission of PTSD and disruptive symptoms in a child similarly provides inconclusive evidence for effects of ketamine specific to PTSD. While it is postulated that ketamine may be useful in preventing the development of PTSD through the induction of stress resilience, more research is clearly needed to better define ketamine’s effects on PTSD.

    Models of schizophrenia

    Since its discovery, ketamine has been observed to produce symptoms similar to those of schizophrenia. As a result, researchers have used these drugs extensively as models to study schizophrenia. While it now appears that overlaps in symptoms and even receptor effects are insufficient to explain the complex neuropathology of schizophrenia, ketamine has undoubtedly facilitated and stimulated research efforts into understanding schizophrenia.
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    Large Hadron Collider (LHC) at CERN

    Falling apart, merging together: Psychedelic psychotherapy

    A terminal cancer diagnosis can inspire fierce bravery in some patients. Though there is no way to fight the disease, they accept their fate and embrace their final days with gusto
    or spiritual peace. They may be sad, but they are not clinically depressed. Others, however, sink into themselves. They cannot see a point to the time they have left.

    “They struggle for months with their worries, disabled by their fear of death,” said George Greer, a psychiatrist and the medical director of the Heffter Research Institute. Heffter, with headquarters in Santa Fe, supports research into psychotherapy for terminal cancer patients that utilizes the drug psilocybin. Greer and his colleagues are also involved in psilocybin therapy research for alcohol, nicotine, and drug addiction. Psilocybin is a psychedelic substance that, when properly synthesized, dosed, and taken in a controlled setting, shows great success in treating a range of psychological problems.

    Greer’s work and the Heffter Research Institute are included in Changing Our Minds: Psychedelic Sacraments and the New Psychotherapy, by Don Lattin, recently published by Santa Fe’s Synergetic Press. Changing Our Minds is part journalistic memoir and part advocacy expos? that weaves together the many threads of the psychedelic therapy movement — which has its origins in the 1950s, when some doctors began using LSD, or “acid,” in psychoanalysis. (Actor Cary Grant is perhaps the era’s best-known recipient of this experimental therapy.) Research in those days also showed LSD’s promise in the treatment of alcoholism. Lattin tells the stories of numerous scientists, psychiatrists, therapists and counselors, arranging history in a somewhat nonlinear fashion. The book touches here and there on Albert Hoffman’s invention of LSD in the 1940s, Timothy Leary and Richard Alpert’s Harvard Psilocybin Project in the early ’60s, and many other non-household but nevertheless important names in the field.

    Psychedelics made the leap from the lab to the street in the early 1960s, and by mid-decade in California, “a promising novelist named Ken Kesey gathered a Dionysian troupe of Merry Pranksters and put on a series of parties called ‘Acid Tests,’ where revelers dosed themselves and danced to a new band called the Grateful Dead,” Lattin writes. The backlash against what was perceived by many as a hallmark of the hedonistic hippie drug culture came first in the form of government regulations over academic and medical research and eventually as an outright ban on possession by the public. By 1970, “a new federal law ignored the findings of research scientists and declared LSD and psilocybin medically useless and easy to abuse.” MDMA emerged later, but it faced a similar fate — its recreational use characterized by the government and media as a social ill while its positive therapeutic uses were ignored or denied.

    Greer moved to Santa Fe from San Francisco in the 1980s with his wife, a psychiatric nurse. They were already involved in psychedelic psychotherapy, and began meeting others in town who were also waiting for the dark ages imposed upon their work to end. In the early 1990s, the FDA quietly changed its mind about its Nixon-era attitude towards psychedelic drug research, and studies were allowed to resume — albeit with no government funding. All money for psychedelic studies still must come from private sources, according to Greer. Heffter, founded in 1993, and the Multidisciplinary Association for Psychedelic Studies (MAPS), founded in 1986, fill this niche by reviewing research proposals and then raising money for the studies they want to support. MAPS also performs educational outreach, harm reduction at music festivals, and advocacy for the legal use of recreational psychedelics. Heffter, founded by doctors and scientists, is a pure research organization. In addition to medical uses for psilocybin, Heffter has also been involved in studying the psychological and spiritual effects of psilocybin on healthy people who meditate as well as on members of clergy.

    When used in the treatment of alcohol and addiction, Greer and other medical professionals claim, psychedelics hasten the process of a drinker or addict “hitting bottom,” which is the term often used for when an addict finally admits he or she has a problem and wants to get sober. Psychedelics open the door to a mystical, bird’s-eye view of one’s own life, in which emotional problems are transcended, replaced by a greater understanding of one’s self and one’s place in the connected whole of the universe. After a psychedelic therapy session or two, patients crave the addictive substance less and its importance in their lives declines. The effects of such sessions on the terminally ill are similar — psychedelic therapy alleviates their existential suffering. “They experience a shift in outlook about who they are, and about the meaning of life and death,” Greer said.

    Post-traumatic stress disorder (PTSD) patients in studies funded by MAPS report a reduction in nightmares, flashbacks, and intrusive thoughts after taking MDMA — known colloquially as Ecstasy or Molly — in guided therapy sessions. Changing Our Minds describes such a session from beginning to end with an Iraq war veteran named Nigel McCourry, led by researchers Michael and Annie Mithoefer. The rare glimpse inside an experience that is usually private is an unusual therapy session, to be sure, but there are no wild hallucinations or giggle fits. Contrary to MDMA’s reputation as a party drug and the behavior it stimulates, McCourry does not become helplessly sexual or need to dance. He closes his eyes, listens to New Age music over headphones, and lets his mind drift. He discusses what comes up with his doctors.

    The Mithoefers had “already completed an initial study of MDMA-assisted psychotherapy with 20 volunteers suffering from PTSD, most of them victims of child sexual abuse, adult rape and assault,” Lattin writes. “Eighty percent of the twenty patients in that pilot study had no PTSD symptoms two months following the completion of the treatment, compared to 25 percent who got a placebo pill.” McCourry was part of a second study, this one of veterans, that also showed positive results. “People with PTSD have increased activity in the amygdala, the fear center in the brain,” Michael Mithoefer says in the book. “They have a lot of trouble trusting and developing a therapeutic alliance. They can be suspicious and expect people to betray them. They might read expressions on a therapist’s face as not being safe. Something like MDMA can turn down that distortion and make them less likely to reject therapy.”

    Current studies on psychedelic psychotherapy are approved by the FDA and are considered as “Phase 2” of a three-phase testing process. Phase 1 tests, performed decades ago, established that these drugs do no lasting harm to humans. Phase 2 uses a limited number of participants to prove that a drug has the efficacy to treat a specific problem. Phase 3 allows researchers to broaden their sample sizes and test hundreds of subjects for better data. Greer said FDA approval for Phase 3 testing of MDMA and psilocybin therapy is likely only a couple of years away — and when it comes, psychedelic psychotherapy will have a home in Santa Fe, where a number of therapists are already interested in trying it with their patients.

    Changing Our Minds includes chapters on other kinds of psychedelic therapy, including ayahuasca and ibogaine. Ibogaine, a root from West Africa, has a long-acting psychedelic effect similar
    to LSD. Because it also blocks opiate withdrawal, in countries where it is legal, like Mexico, it is used to help heroin addicts get clean. Research has shown some danger of neuro- and cardiac toxicity with ibogaine, Greer said, and there have been some deaths among addicts who are in ill health, but scientists are working on a safer, non-psychedelic version. Ayahuasca, used in religious ceremonies, is a brewed mixture of Amazonian jungle plants, mainly the vine Banisteriopsis caapi, and either chacruna or chagropanga, both of which contain the psychedelic substance DMT. Though DMT is chemically similar to psilocybin, Greer said because it is a plant rather than a “pure drug,” it is difficult to study. Ayahuasca tea is legal for ingestion in the United States only by members of the Uni?o do Vegetal (UDV) church, but an ayahuasca tourism economy has sprung up in South America to capitalize on American and European interest in having profound mystical experiences. Many of the experts cited in the book warn against traveling to a foreign country and putting your physical and psychological safety in the hands of strangers trying to make a buck, or even those who are well-intentioned healers but who know nothing about you.

    Lattin is careful not to come across as evangelizing the unconstrained recreational use of any of the drugs he writes about. He covers opposing points of view among researchers, psychiatrists, and other practitioners and proponents of psychedelic psychotherapy. Some want it strictly monitored in medical and scientific settings, while others believe enough is already known about the drugs’ effects to render spending years giving control groups placebos a waste of time and money. Lattin also discusses the potential downsides of psychedelic psychotherapy — as in when a therapist abuses his power over a patient who is in a suggestive state, or when people with delusions of grandeur use the drugs to manipulate others, such as in cultic environments.

    Psychedelic psychotherapy is not recommended for everybody. It is not an easy experience and requires a patient’s willingness to “surrender, to let themselves merge or fall apart,” Greer said. Screening processes help researchers make sure they are not treating anyone with a personal or family history of schizophrenia or manic episodes, as there is some evidence that the drugs can trigger such an episode in someone who is predisposed to them. Other conditions that might disqualify someone from a study are high blood pressure and brain tumors that impair cognitive function. Greer said that "not every terminal cancer patient is a candidate for this kind of therapy. Though both psychedelics and terminal cancer diagnoses are known to bring on sudden spiritual transformation in people suddenly acutely aware of their mortality, Heffter and MAPS studies are for patients “who are not able to get to such a place on their own and are
    experiencing significant anxiety over their prognosis.”

    For those who are skeptical that a “drug trip” can have lasting psychological healing power, Greer explained that psychedelics open up additional areas of consciousness while preventing other parts of the brain from engaging in their usual running commentary on day-to-day life. While under the influence of psychedelics, people have what researchers refer to as a mystical or peak experience, which Greer described using such terms as ineffability, positive mood, and feelings of unity.

    “Psychedelics change the pattern that your brain is in when you’re in your normal personality,” he said. “The mind gets quiet and lots of other things can happen. We have the brain wiring to do this — otherwise it wouldn’t be possible at all. People who have these peak experiences are statistically more likely to have this transformational outlook on themselves and on life and death. There was one woman who was a lifelong atheist and she said that during her session she experienced God — though she was still an atheist. She said it wasn’t something she could put into words, that it was beyond language.”


    A brief history of psychedelic psychiatry

    In the 1950s a group of pioneering psychiatrists showed that hallucinogenic drugs had therapeutic potential, but the research was halted as part of the backlash against the hippy counterculture.

    On 5th May, 1953, the novelist Aldous Huxley dissolved four-tenths of a gram of mescaline in a glass of water, drank it, then sat back and waited for the drug to take effect. Huxley took the drug in his California home under the direct supervision of psychiatrist Humphry Osmond, to whom Huxley had volunteered himself as “a willing and eager guinea pig”.

    Osmond was one of a small group of psychiatrists who pioneered the use of LSD as a treatment for alcoholism and various mental disorders in the early 1950s. He coined the term psychedelic, meaning ‘mind manifesting’ and although his research into the therapeutic potential of LSD produced promising initial results, it was halted during the 1960s for social and political reasons.

    Born in Surrey in 1917, Osmond studied medicine at Guy’s Hospital, London. He served in the navy as a ship’s psychiatrist during World War II, and afterwards worked in the psychiatric unit at St. George’s Hospital, London, where he became a senior registrar. While at St. George’s, Osmond and his colleague John Smythies learned about Albert Hoffman’s discovery of LSD at the Sandoz Pharmaceutical Company in Bazel, Switzerland.

    Osmond and Smythies started their own investigation into the properties of psychedelics and observed that mescaline produced effects similar to the symptoms of schizophrenia, and that its chemical structure was very similar to that of the hormone and neurotransmitter adrenaline. This led them to postulate that schizophrenia was caused by a chemical imbalance in the brain, but these ideas were not favourably received by their colleagues.

    In 1951 Osmond took a post as deputy director of psychiatry at the Weyburn Mental Hospital in Saskatchewan, Canada and moved there with his family. Within a year, he began collaborating on experiments using LSD with Abram Hoffer. Osmond tried LSD himself and concluded that the drug could produce profound changes in consciousness. Osmond and Hoffer also recruited volunteers to take LSD and theorised that the drug was capable of inducing a new level of self-awareness which may have enormous therapeutic potential.

    In 1953, they began giving LSD to their patients, starting with some of those diagnosed with alcoholism. Their first study involved two alcoholic patients, each of whom was given a single 200-microgram dose of the drug. One of them stopped drinking immediately after the experiment, whereas the other stopped 6 months later.

    Several years later, a colleague named Colin Smith treated another 24 patients with LSD, and subsequently reported that 12 of them were either “improved” or “well improved” as a result of the treatment. “The impression was gained that the drugs are a useful adjunct to psychotherapy,” Smith wrote in a 1958 paper describing the study. “The results appear sufficiently encouraging to merit more extensive, and preferably controlled, trials.”

    Osmond and Hoffer were encouraged, and continued to administer the drug to alcoholics. By the end of the 1960s, they had treated approximately 2,000 patients. They claimed that the Saskatchewan trials consistently produced the same results – their studies seemed to show that a single, large dose of LSD could be an effective treatment for alcoholism, and reported that between 40 and 45% of their patients given the drug had not experienced a relapse after a year.

    At around the same time, another psychiatrist was carrying out similar experiments in the U.K. Ronald Sandison was born in Shetland and won a scholarship to study medicine at King’s College Hospital. In 1951, he accepted a consultant’s post at Powick Hospital near Worcester, but upon taking the position found the establishment to be overcrowded and decrepit, with patients being subjected to electroshock treatment and lobotomies.

    Sandison introduced the use of psychotherapy, and other forms of therapy involving art and music. In 1952, he visited Switzerland where he also met Albert Hoffman, and was introduced to the idea of using LSD in the clinic. He returned to the U.K. with 100 vials of the drug – which Sandoz had by then named ‘Delysid’ – and, after discussing the matter with his colleagues, began treating patients with it (in addition to psychotherapy) towards the end of 1952.

    Sandison and his colleagues obtained results similar to those of the Saskatchewan trials. In 1954 they reported that “as a result of LSD therapy, 14 patients recovered (av. of 10 treatments),
    1 was greatly improved (3 treatments), 6 were moderately improved (av. of 2 treatments) and 2 not improved (av. of 5 treatments).”

    These results drew great interest from the international mass media, and as a result, Sandison opened the world’s first purpose-built LSD therapy clinic the following year. The unit, located on the grounds of Powick Hospital, accommodated up to 5 patients who could receive LSD therapy simultaneously. Each was given their own room, equipped with a chair, sofa, and record player. Patients also came together to discuss their experiences in daily group sessions. (This backfired later, however: In 2002, the National Health Service agreed to pay a total of 195,000 pounds sterling in an out-of-court settlement to 43 of Sandison’s former patients.)

    Meanwhile in Canada Osmond’s form of LSD therapy was endorsed by the co-founder of Alcoholics Anonymous and the director of Saskatchewan’s Bureau on Alcoholism. LSD therapy peaked in the late 1950s and early 1960s, and was widely considered to be “the next big thing” in psychiatry, which could supersede electroconvulsive therapy and psychosurgery. At one point, it was popular among Hollywood superstars such as Cary Grant.

    Two forms of LSD therapy became popular. One, called psychedelic therapy, was based on Osmond and Hoffer’s work, and involved a single large dose of LSD alongside psychotherapy. Osmond and Hoffer believed that hallucinogens are beneficial therapeutically because of their ability to make patients view their condition from a fresh perspective.

    The other, called psycholytic therapy, was based on Sandison’s regime of several smaller doses, increasing in size, as a adjunct to psychoanalysis. Sandison’s clinical observations led him to believe that LSD can aid psychotherapy by inducing dream-like hallucinations that reflected the patient’s unconscious mind and enabling them to relive long-lost memories.

    Between the years of 1950 and 1965, some 40,000 patients had been prescribed one form of LSD therapy or another as treatment for neurosis, schizophrenia, and psychopathy. It was even prescribed to children with autism. Research into the potential therapeutic effects of LSD and other hallucinogens had produced over 1,000 scientific papers and six international conferences. But many of these early studies weren’t particularly robust, lacking control groups, for example, and likely suffered from what researchers call publication bias, whereby negative data are excluded from the final analyses.

    Even so, the preliminary findings seemed to warrant further research into the therapeutic benefits of hallucinogenic drugs. The research soon came to an abrupt halt, however, mostly for political reasons. In 1962, the U.S. Congress passed new drug safety regulations, and the Food and Drug Administration designated LSD as an experimental drug and began to clamp down on research into its effects. The following year, LSD hit the streets in the form of liquid soaked onto sugar cubes; its popularity grew quickly and the hippy counterculture was in full swing by the summer of 1967.

    During this period, LSD increasingly came to be viewed as a drug of abuse. It also became closely associated with student riots anti-war demonstrations, and thus was outlawed by the U.S. federal government in 1968. Osmond and Hoffer responded to this new legislation by commenting that “it seems apt that there is now an outburst of resentment against some chemicals which can rapidly throw a man either into heaven or hell.” They also criticised the legislation, comparing it to the Victorian reaction to anaesthetics.

    The 1990s saw a renewed interest in the neurobiological effects and therapeutic potential of psychedelic drugs. We now understand how many of them work at the molecular level, and several research groups have been performing brain-scanning experiments to try to learn more about how they exert their effects. A number of clinical trials are also being performed to test the potential benefits of psilocybin, ketamine and MDMA to patients with depression and various other mood disorders. Their use is still severely restricted, however, leading some to criticise drug laws, which they argue are preventing vital research.

    Huxley believed that psychedelic drugs produce their characteristic effects by opening a “reducing valve” in the brain that normally limits our perception, and some of the new research seems to confirm this. In 1963, when he was dying of cancer, he famously asked his wife to inject him with LSD on his deathbed. In this, too, it seems that he was prescient: Several small trials suggest that ketamine alleviates depression and anxiety in terminally ill cancer patients and, more recently, the first American study to use LSD in more than 40 years concluded that it, too, reduces anxiety in patients with life-threatening diseases.
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    Psychedelics and their role in treating mental health disorders

    Psychedelics such as LSD, magic mushrooms, mescaline etc. have garnered renewed interest in the scientific world because of the possible role they could play in mental health problems. Ketamine remains the only psychedelic at present that is used clinically as an anesthetic agent. The others are all classified under banned drugs.

    There have been numerous studies recently where these drugs have been tried in treatment of mental health disorders such as addictions, depression and post-traumatic stress disorder etc. These agents have shown promise in persons in whom most of the conventional therapy has failed.

    Researchers at Imperial College London are now all set to start major clinical trials to see if any of these psychedelics can be actually helpful in treatment of depression when compared to a standard drug used for treatment of depression. In their trial the team of researchers would compare magic mushroom compound psilocybin and a SSRI (selective serotonin re-uptake inhibitors) antidepressant, escitalopram. The trial is expected to run for at least 2 years. Dr Robin Carhart-Harris, study leader said that there is a “revolutionary potential” of these psychedelic drugs and this is not an exaggeration.

    The team of researchers explains that these psychedelic drugs have been in scientific interest for the last few decades. They were initially used in the 1950s and 60s for some of the mental health problems before they fell into disrepute mainly because of the abuse liability, recreational use and risk of dependence and addiction. Over a thousand studies had been conducted during that time. Soon fear of moral degeneration and overdosage related risks took over and these drugs were made illegal in America in 1968. The United Nations too convened on the status on 1971 that stopped scientific research on these drugs. Member states made these drugs illegal and classified them as Schedule 1 drugs or drugs that have no known medicinal benefits. This sealed their fates even in scientific research. Next few decades saw no research on these drugs. It is only recently that there is renewal of interest in the psychedelics especially in PTSD and depression that is refractory to standard treatments.

    In the mid-2000s these drugs underwent a “scientific renaissance” after Johns Hopkins University in the US started work on them. Psilocybin was being studied in 1990s mainly because laws governing its use in research were not as stringent as with others. Psilocybin showed that there was a reduction in symptoms of depression in 80 percent of the patients with terminal cancers who suffered from depression. This agent could also help people quit smoking more effectively than currently used therapy. Dr Carhart-Harris has been working with psychedelics for the last five decades and more and he and his team last year found that psilocybin can help “reset” the brains of people with depression and help cases of “untreatable depression”. His paper published in the journal Scientific Reports showed that two areas of the brain including the amygdala and a network of neurons are affected. The amygdala helps an individual to process emotions and feelings while the network of neurons help coordinate different parts of the brain. Dr Carhart-Harris says that it could be that the psilocybin can “heat up” and “reset” the brain to remove the rigidly held “self destructive patterns of thought”. Along with cognitive behavioral therapy, he explained, the brain could be “recalibrated”.

    Some of the problems with the use of psychedelics are the fear and anxiety bad trips may cause. There may be a sense of losing control that might trigger anxiety and even psychotic breaks, warn experts. During the trials pure, medical-grade drugs would be used under strict medical supervision and support and it is hoped that the negative effects may be lesser. One of the major problems with the use of these drugs is the temporary nature of their efficacy. They seem to lose their ability to provide relief after continued use say experts.

    Until now the studies conducted pitted the effects of psychedelics against placebo. This latest trial would be the first to try it against an established antidepressant, say researchers. Dr James Rucker, a clinical lecturer at the Institute of Psychiatry at King's College London, is soon to start his study to establish the safety of psilocybin. Once the drug is established to be safe, it could go on to become licensed and finally be prescribed by doctors. According to Dr. Rucker, this could take at least five years or longer to happen.


    Psychedelics: A paradigm shift for psychiatry

    In the UK, 1 in 4 people are affected by mental illness. 1 in 3 teenage girls suffer from an anxiety or depressive disorder, and suicide is the leading cause of death in the young. Nearly 50% of the population will develop a mental health disorder at some point during their lifetime, and the World Health Organization has declared that depression is the leading cause of disability. Mental illness costs the UK economy an estimated 100 billion pounds every year.

    The number of antidepressants prescribed in England has more than doubled in the last decade, with the most common treatment being SSRIs. Of the 30% of patients who receive no benefit from current pharmacological treatment, up to 15% will go on to kill themselves.

    Against this backdrop, it is surprising that no major breakthrough in drug development for depression and other psychological disorders has happened in the past three decades, since the discovery of SSRIs.

    In the last 20 years, research from the Beckley Foundation and others has found that psychedelics such as psilocybin can produce dramatically higher rates of efficacy than any other available treatments. As tools to aid psychotherapy, they work immediately, after a single or a few doses, with benefits lasting weeks, months or years, with no negative or long-term side-effects.

    As part of the Beckley/Imperial Psychedelic Research Program, in 2016 we investigated the effects of psilocybin-assisted psychotherapy in treatment-resistant depression. The patients we recruited had suffered from moderate-to-severe depression for an average of eighteen years, and had received no relief from conventional medicines or psychotherapy. A first session with a small dose of psilocybin confirmed that the compound was well-tolerated by each patient. In another session shortly after, a larger dose – with more intensely felt psychoactive effects – was given. Two clinicians stayed with the patients in a softly lit, comfortable room, allowing the patients to experience a mostly uninterrupted journey, with occasional ‘check-ins’ to make sure they were doing well.

    A week after the second session, all patients showed a reduction in depression severity, with 67% of them meeting criteria for complete remission. These impressive results were robust over time: at three-months 42% of all patients remained depression-free, and more than half displayed significant improvements in depression severity relative to their pre-psilocybin scores.

    Since the 1960’s I have been greatly interested in the mechanisms underlying the changing states of consciousness brought about by psychedelics. Our fMRI studies with psilocybin and LSD investigated the changes in blood supply within the brain as well as neuronal connectivity. In doing so we have begun to reveal the mechanisms underlying the significant promise of these compounds as tools to aid psychotherapy.

    One of the most striking effects we observed was a decrease in blood supply and thus activity within the Default-Mode Network (the DMN), a collection of widespread brain regions that work together to coordinate the activity of diverse areas of the brain, in doing so controlling our conscious experience and maintaining our sense of self. When the DMN disintegrates under LSD or psilocybin, the inhibitory control it normally exerts over the other areas of the brain weakens, allowing for a dramatic increase in global connectivity, allowing regions to communicate with distant partners with which they typically do not talk. As well as producing the subjective experience of ‘ego dissolution’, this process leads to the emergence of a more complex, less predictable, and more flexible state of consciousness. In this state, long-lasting changes can take place, repressed memories can be accessed, and the maladaptive thought processes of depression and other psychological disorders can be reset, like a computer being rebooted.

    The potential for psychedelic-assisted psychotherapy does not stop at treating depression. Dysfunction of the DMN is implicated in a whole host of other mental health conditions, including addiction, obsessive-compulsive disorder, anxiety, and PTSD, among others. What characterizes them all is an excessive pattern of thought or behavior becoming rigid and entrenched, almost impossible to break out of despite an awareness of their destructiveness. An experience of a ‘peak state’, brought about by a psychedelic, provides a chance for an individual to see the inner self and the outer world afresh, affording an opportunity to begin anew.

    Although a deeper understanding of brain mechanisms underlying this treatment has only been made possible by modern neuroimaging techniques, the potential for psychedelics to heal in this way is not a recent discovery. LSD was considered a wonder-drug when it first appeared in the 1950’s. Hundreds of published papers and thousands of patient reports testified to its promise for new treatments for a wide range of illnesses. A recent meta-analysis of the best-controlled studies conducted in the 1960’s using LSD for alcohol use disorder – a condition which, to this day, has notoriously poor treatment outcomes– found a single session to be more successful in treating alcohol dependence than daily doses of acamprosate or naltrexone, our current go-to pharmacological interventions. Bill Wilson, the founder of Alcoholics Anonymous, wanted to include LSD-therapy in the treatment program for alcohol dependence, understanding that the subjective effects of LSD – which we now know to be caused by the disintegration of the DNM and an increased plasticity of the brain state– can help to achieve a change in perspective that allow recovery to begin.

    Psychedelic-assisted psychotherapy can create a truly revolutionary paradigm-shift in psychiatry. This is not some far-off medical advance visible on the horizon, awaiting some technological breakthrough before becoming feasible. Psychedelic-assisted therapy could be made available in clinics right away, were it not for repressive regulation. But the psychedelics remain among the most heavily restricted compounds in the world: in the UK, they are Schedule 1 drugs under the Misuse of Drugs Act and Misuse of Drugs Regulations. Both classifications categorize the psychedelics as having no medical use, as well as being extremely dangerous.

    It is now clear that both of these accusations are demonstrably untrue. The foregoing examples provide a brief introduction to their therapeutic potential. Our studies have found that, when administered by skillful clinicians in controlled environments, psychedelics present no significant risk and are not addictive. Meanwhile, recent population studies –analyzing information from more than 120,000 people – have found no link between psychedelic use and mental health problems.

    Modern psychiatry is failing huge numbers of people. The research undertaken in the last decade has suggested many areas where psychedelics could be invaluable for alleviating the suffering of mental health issues. And yet, further research is constantly obstructed by legislation that makes it prohibitively expensive, extremely time-consuming, or impossible for researchers to access the materials we need at affordable prices.

    The hesitance of some towards reforming these regulations is easily enough understood. An entire generation has been told that psychedelics are harmful to health, that they are toxic and dangerous. But a more informed attitude is possible – indeed it is already endorsed by many, if not most. The potentially deadly opiate family contains morphine, a useful painkiller.

    Amphetamines can be prescribed as a treatment for ADHD, or become a drug of potential abuse when taken recreationally as a stimulant. With the appropriate clinical oversight, a compound’s therapeutic benefits can vastly outweigh its risks. By moving psychedelics from Schedule 1 to Schedule 2, where morphine and amphetamines currently sit, doctors can prescribe them to those in need, and further research can be carried out much more easily.

    Our approach to these drugs has so far been characterized by patterns of thought and behavior that have become rigid and entrenched, hard to break out of despite an awareness of their destructiveness. Let us put health, and the reduction of suffering ahead of political expediency and rigid-thinking: the time to act is now.
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    Psychedelics and the full-fluency phenomenon

    The healing potential of psychedelics for depression, PTSD, addiction, anxiety, and to some extent, cluster headaches, has been thoroughly documented by anecdotal testimonies, and increasingly by scientific research. Based on my personal experience and anecdotal reports that I’ve read online, one area worth deeper investigation is psychedelics for the treatment of speech disfluency: stuttering. Little is known about the etiology of stuttering, and a cure remains undiscovered for this disorder, which affects more than 70 million people worldwide. It’s unfortunate that the alleviation of disfluent speech through the use of psychedelics is not more widely known, so, as someone who stutters, I’d like to shine a light on how using psychedelics have helped do so for myself and others.

    I first discovered the potential psychedelics have for treating stuttering during an experience with psilocybin mushrooms. For the length of the trip, I was able to speak as fluently and effortlessly as I ever have – more than I ever have. A helpful analogy for understanding this is, as one person who stutters put it, “I imagine that for the non-stammerer, language must be a little like thin air, a medium so compliant that most of the time you forget you’re moving within it. But for the stammerer, speaking is like moving through water – you are constantly aware of language because it constantly resists you.”

    This resistance in one’s own speech creates wariness in any situation where social interaction is bound to occur, requiring a demanding amount of mental effort anticipating and attempting to avoid stuttering in these situations. However, while under the influence of the mushrooms, an amazing change had occurred: I was neither stuttering, nor cycling through potentialities in my mind for word or phrasing substitutions. For those brief hours my mind was at ease, and my speech flowed not as though I were treading water, but as if I were floating freely through air.

    This was a profound experience at the time, because my stuttering had recently become more severe and was increasingly disrupting my life. Then, as if by magic, the mushrooms I ate that night induced a phenomenon of full-fluency that I had never imagined possible. It showed me that I have the ability within me to speak fluently, and that I only need to discover how to unlock the full potential of my speech.

    This ignited a curiosity and passion within me to discover why psilocybin mushrooms so effectively increased my speech fluency, and whether other psychedelics could similarly do so. I was already open to experimenting with psychedelics prior to this experience, but thereafter I discovered a primary intention for engaging in further self-experimentation. Since then, I have found that, in addition to psilocybin, MDMA also reliably induces this full-fluency phenomenon.

    That is, for me, anyway.

    Curious if my experience was unique, I sought to discover whether the full-fluency phenomenon I had experienced was a one-off anomaly, or a shared phenomenon among other people who stutter.

    After scouring through numerous articles and internet forums, I compiled a fair amount of additional anecdotal evidence, which, to my surprise, largely supports my own experience. Like me, the full-fluency phenomenon has been experienced by many other people who stutter while using psilocybin and MDMA, and unlike me, while using LSD as well.

    One main distinction I’ve identified during my search, is that MDMA much more reliably induces the full-fluency phenomenon than either LSD or psilocybin. From the accounts I’ve compiled, not a single person who stutters experienced disfluent speech while under the influence of MDMA. As for psilocybin and LSD, they were less reliable in inducing the full-fluency phenomenon; for every two people that did experience full-fluency, one person did not.

    This inconsistency suggests that the full-fluency phenomenon may be dependent upon dose, mechanistic action of the substance in the brain, or physiological differences between individuals. Likely, it depends on all three. This, however, has yet to be definitively answered.

    Self-experimentation with these substances by people who stutter have led to individual discoveries of the full-fluency phenomenon, and the aggregation of these anecdotal reports has led me to believe that it is a shared phenomenon among the stuttering population. What’s left to discover now is how these substances induce the full-fluency phenomenon in people who stutter, which can only be accomplished through formal scientific research.

    As the renaissance in psychedelic research continues, it’s my hope that these anecdotal reports will pique an interest and inspire researchers to investigate this phenomenon. Just as PTSD, depression, and anxiety have been successfully treated through psychedelic-assisted psychotherapy, stuttering could similarly follow this model with psychedelic-assisted speech therapy.

    There’s also potential for immediate recovery from stuttering following a single high dose experience. One well told account of this comes from Paul Stamets, the renowned mycologist, whose stuttering stopped altogether following his first psilocybin mushroom experience. To sustain such a high increase in fluency after the effects of the drug wear off is rare, but Paul’s story gives testimony to the possibility for it to occur.

    For someone who stutters, any possibility to speak more fluently is worth consideration, and for scientists who conduct research related to stuttering, consideration should be taken to study this full-fluency phenomenon. Let it be known that the healing potential of psychedelics extends to yet another disorder that is currently treated with little success conventionally: stuttering.
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    Brain scans show how cannabis extract may help people with psychosis

    Cannabidiol reduces the brain activity linked to hallucinations, delusions and other forms of psychosis, research has found

    Brain scans have revealed for the first time how a substance found in cannabis plants may help people with psychotic disorders by dampening down abnormal brain activity that arises in the patients.

    A single dose of cannabidiol, an non-intoxicating extract of the plant, reduced unusual patterns of neural behaviour linked to hallucinations, delusions, and other symptoms of psychosis, researchers found.

    The impact of the substance has raised hopes that medical preparations of pure cannabidiol, or new drugs based on the compound, may be turned into effective treatments for young people who develop psychosis but do not respond to existing therapies.

    The most common treatments for psychosis today work on a brain chemical called dopamine, but no new drugs have been developed for the condition since they were discovered in the 1950s. “These results will clearly pave the way for developing a novel class of antipsychotic treatments,” said Sagnik Bhattacharyya, who led the research at King’s College London.

    Cannabis plants produce more than 100 active compounds known as cannabinoids. The most potent, and the substance responsible for the cannabis “high”, is THC. In the past two decades, cannabis with high levels of THC – about 15% – has come to dominate the market in the UK and elsewhere.

    While high strength cannabis is suspected of raising the risk of mental health problems in some frequent cannabis users, cannabidiol or CBD appears to have opposite, antipsychotic properties. In cannabis, there is too little CBD to have much beneficial effect, but researchers have long wondered whether doses of pure CBD may help to protect against psychosis.

    “We knew from previous studies that CBD had antipsychotic effects, but we didn’t know how it worked,” said Bhattacharyya.

    To find out, the researchers recruited 33 people who had all sought help for mild or occasional psychotic symptoms, such as hearing voices or having paranoid delusions. A single dose of cannabidiol was given to 16 of them, while the remaining 17 received an identical-looking placebo.

    The scientists then watched how the volunteers’ brains behaved as they performed simple tasks in a magnetic resonance imaging machine. While in the brain scanner, the participants were asked to say whether pairs of words, such as ‘baby’ and ‘cries’ were related or not, and later, to recall the word that completed a pair when prompted by the scientists.

    When the researchers compared scans from the different patient groups, and with scans from age and sex-matched healthy people, they found that the patients with psychotic symptoms had abnormal patterns of activity in three distinct brain regions, all of which are involved in psychosis. But in patients who had a single dose of CBD, the unusual brain activity appeared to be dampened down, making their scans more similar to those of health individuals. Details of the work are published in JAMA Psychiatry.

    “This was just a single dose of CBD and that is not going to treat or cure psychosis,” said Bhattacharyya. “But this shows us that CBD at least has an effect on abnormal brain activity that is consistent with it being an antipsychotic.”

    The King’s College researchers are now launching the first large scale trial to investigate whether pure, medical grade CBD is an effective treatment for young people who are at high risk of developing psychosis. The trial, which is expected to start recruiting early next year, is backed by the Medical Research Council and the National Institute for Health Research.

    “If the trial shows it has efficacy, then the next step will be to get through the regulatory hurdles os using CBD in the clinic to treat patients,” said Bhattacharyya. “One shouldn’t get the impression that it’s OK to start prescribing CBD tomorrow.”
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    Psychedelic psychotherapy is coming: Who will be included?

    New study finds widespread exclusion of minorities in psychedelic research.

    Recently, there has been much excitement in the potential of psychedelic-assisted psychotherapy to address a multitude of mental health conditions, including depression, post-traumatic stress disorder, addiction, end-of-life anxiety, and other conditions. The non-profit organization Multidisciplinary Association of Psychedelic Studies (MAPS) has been at the forefront of these efforts, funding studies to demonstrate the efficacy of psychedelics for mental health, including MDMA-assisted psychotherapy for people with PTSD. As a result, FDA approval of MDMA for the treatment of PTSD may soon become a reality. However, not everyone has been included or represented in this momentous process.

    The crowd is cheering as the psychedelic train pulls into the station, its inviting doors flung wide open. One by one, people with a multitude of ailments are stepping onboard – people with PTSD, anxiety, depression, and many other conditions. Yet, though there are many who need seats, the only people holding tickets are White.

    As noted by Dr. Nicholas Powers, the dominant, pervasive image of the psychedelic community is that of White affluence. This is thought to be rooted in the glorification of 1960s and 70s White hippie drug use as a “counterculture” as opposed to an illicit act. People of color have not been meaningfully included in this community. Other factors uniquely impacting people of color include prohibitive costs and lack of access to substances, negative stereotypes about people of color and drug use, and criminalization of people of color through the War on Drugs.

    However, the use of non-ordinary states of consciousness for medicinal purposes is neither novel nor modern, and actually dates back thousands of years to the spiritual practices of indigenous communities all over the world. For many indigenous people, psychedelic use is considered a both a sacred and healing act — something that requires the guidance of a highly trained spiritual leader (shaman), and entails psychoactive rituals that bring humans closer to the spiritual world, in an effort to treat both physical, psychological, and spiritual ills. Understanding the indigenous roots of psychedelic medicine within the historical origins of psychedelic-assisted psychotherapy is an crucial reference point, given that modern psychedelic medicine has struggled to include people of color and is only now beginning to acknowledge the importance of their inclusion.

    The psychedelic train is pulling out of the station, and people are giddy with excitement, waving as the train beings to move. The train itself is painted with bright colors, but there is little color within. White faces are pressed against the windows from the inside while everyone else watches from afar. Black and brown people, including the elderly, young people, veterans, and the disabled are left standing on the platform as the train chugs away.

    Western medicine’s exploration of psychedelics for treatment purposes can be divided into two distinct periods, the “first wave,” occurring between 1950 and 1985, when synthetic psychedelic compounds were just being discovered, and the “second wave” beginning around the late 1990s and continuing to today, with a renewed focus on high quality research.

    The initial “rediscovery” of psychedelics as medicine by Western science first occurred during a period in which biomedical options in psychiatry were limited, as psychopharmacology had not yet become mainstream practice. Newly synthesized psychedelics were not considered controlled substances, and therefore their clinical and research use was fairly unrestrained. Given that psychoanalysis was a mainstay of treatment, initial research on psychedelic medicine examined whether psychedelic drugs could improve the process of psychotherapy, accelerating the treatment of psychological disorders. Yet ultimately, the widespread use of these substances, serious ethical violations (i.e., administration to physically-restrained subjects, sexual abuse between therapists and clients), major methodological flaws in research, and concerns over safety led to defunding of research and eventually the designation of psychedelics as illegal substances. While many researchers and patients continued to espouse the therapeutic benefits of psychedelic-assisted therapy, this area of investigation was shut down for decades.

    Several important factors contributed to the resurgence of psychedelic medicine in the late 1990s. Foundational research during the second wave was conducted, consisting of animal and basic science studies. With the creation of MAPS by Dr. Rick Doblin in 1986, researchers were no longer reliant upon government funding and could pursue FDA drug development. The medicinal potential for scheduled substances was also no longer novel, given that research into both cannabis and ketamine had been underway since 1975. Coupled with the fact that many psychiatric illnesses still lacked effective drug treatments, these factors paved the way for today’s second wave of psychedelic research.

    Yet despite promising initial results, research has often been limited to small, mostly White samples, limiting the generalizability of findings and excluding people of color from potential therapeutic benefits.

    To determine if the existing data on psychedelic treatments is sufficiently applicable to all people of color, we conducted an international review of inclusion across ethnic and racial groups in current published psychedelic-assisted psychotherapy studies, spanning the second wave of studies from 1993-2017.

    As reported in this month’s issue of BMC Psychiatry, we found that the White-centric focus of psychedelic drug use continues in medical research, with extremely low rates of participation by people of color in studies worldwide. Of the 18 studies of psychedelic-assisted psychotherapy that met criteria for inclusion in our investigation (n = 282 participants), 82.3% of the participants were non-Hispanic White, whereas only 2.5% were Black/African American, 2.1% were of Latino/Hispanic origin, 1.8% were of Asian origin, 4.6% were of indigenous origin, 4.6% were of mixed race, 1.8% identified their race as “other,” and the ethnicity of 8.2% of participants was unknown.

    These numbers are low when compared to the proportional amounts needed to represent the population, even when considering country-specific differences, making it unclear if current psychedelic-assisted psychotherapy protocols are effective and safe for people of color. The inclusion rates are low even compared to national rates for minority participation in US biomedical research.

    One factor contributing to low representation is the lack of cultural inclusivity within the research community itself. Historically, psychedelic research has been predominated by White men and there have been few people of color in positions of leadership. This is not only an issue of representation within the field but also of acknowledging the contributions of indigenous people and people of color in advancing the field, and directly involving these communities in the design, recruitment, and implementation of clinical trials. Only by including researchers with specific expertise in culturally-informed methods will we be able to improve representation and better understand the specific issues relevant to those communities that are resulting in their exclusion from research and the broader psychedelic mental health community.

    Given the long history of discriminatory drug enforcement practices in the United States, the stigma of drug use itself must also be addressed. White people have the privilege of publicizing psychedelic use with lesser consequences than people of color. Even if the psychedelics are administered in a legal, health-oriented setting, people of color may still feel they are playing out the stereotype of being drug users that engage in questionable or illicit activities. Further stigmatization may arise from within those communities, as people of color seeking psychedelic therapies may be criticized for engaging with the White medical establishment.

    While several efforts are currently underway to address these concerns, it will take the acknowledgement and efforts of both those without and those with privilege and power to change the field. Psychedelic psychotherapy is coming and we all need to be onboard.
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    Why psychedelic drugs are entering the world of psychiatry

    We’ve heard it over and over again: drugs are bad. But a group of medical researchers are challenging the stigma around mind-altering substances – and discovering they could hold the key to tackling a whole range of mental health issues.

    At any given time, there’s a mere handful of people truly tapped into the zeitgeist. In music right now it’s Kendrick Lamar; in fashion Virgil Abloh; in film it’s Dwayne Johnson.

    You can add author Michael Pollan to the list. His 2006 book The Omnivore’s Dilemma was part of a seismic shift in which readers and eaters began questioning where their food came from, how it was produced and who was fucked over along the way (the farmers, the animals, the planet) in order to get it to your plate.

    By the time the 10th anniversary edition was released, it had sold more than two million copies. But this year, he shifted his focus from the stomach to brain with How to Change Your Mind – The New Science of Psychedelics and cemented his rep as a writer at the very edge of public consciousness.

    The starting point was the concept of microdosing – a red-hot trend in Silicon Valley and beyond – where the most lateral of thinkers are taking small amounts of LSD, which generate ‘subperceptual’ effects that can improve mood, productivity and creativity.

    A smart drug for smart people, if you believe the hype.

    Pollan characteristically built on this by replacing the microdosing with macrodosing. By which we mean he took drugs. Many, many drugs. In quantities that make people, according to the New York Times, “feel the colours and smell the sounds”.

    Whether or not he knew it at the time, he ever so slightly wedged open the doors of perception when it comes to psychedelic drugs and their potential benefits. In so doing, he has tapped into a burgeoning movement in which, primarily, ‘recreational’ drugs, such as LSD, mushrooms, marijuana, ketamine and MDMA, are showing glimpses of clinical promise where conventional medications are not.

    It’s in the field of mental health that the results are most apparent. Which is just as well because for all the increasing openness we have about discussing this scourge, the numbers are not decreasing. Quite the opposite.

    In April this year, mental-health technology group Medibio polled 3500 Australian workers from 41 organisations across a range of industries and found that 36 per cent had depression and 33 per cent had anxiety. In contrast, the 2007 stats list anxiety at 14 per cent and depression at six per cent.

    A part of this leap is undoubtedly down to the fact that people are more comfortable discussing these issues and seeking help. That’s a very good thing. However, it’s equally clear that the current approach of counselling combined with the most common medications – selective serotonin reuptake inhibitors (SSRIs) like Lexapro – doesn’t work for everybody.

    Nothing does and nothing ever will, but in labs around the world, the go-to party drugs for everyone from bush-doofers to EDM aficionados are throwing up results that are beginning to overshadow their tarnished reputations.

    One of these is MDMA, which was invented in 1912 by a German pharmaceutical company to help medications that control bleeding. It first entered the dance party scene in the mid-’80s and quickly became as much a part of these events as tolerating Armand Van Helden, gurning wildly and finding conversations with complete strangers to be fascinating.

    Manufactured under dubious circumstances at best, there are clearly risks involved with recreational use. But transfer the setting from club to clinic and a different picture emerges. Especially as a potential treatment for people with post-traumatic stress disorder (PTSD). In a study conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS) in the United States, 56 per cent of 107 subjects no longer qualified for PTSD after treatment with MDMA-assisted psychotherapy, measured two months following treatment.

    At the 12-month follow up, 68 per cent no longer had PTSD.

    “Most subjects received just two to three sessions of MDMA-assisted psychotherapy. All participants had chronic, treatment-resistant PTSD, and had suffered from PTSD for an average of 17.8 years,” says MAPS director of strategic communications Brad Burge.

    A separate study conducted this year by the Medical University of South Carolina on an admittedly small group of 26 first responders and military personnel concluded, “Active doses (75mg and 125mg) of MDMA with adjunctive psychotherapy in a controlled setting were effective and well-tolerated in reducing PTSD symptoms.”

    There’s a bit to unpack in these qualified conclusions, most notably the terms “with adjunctive psychotherapy” and “controlled setting”. “It’s important to keep in mind that MDMA will not be a take-home drug,” says Burge. “MDMA-assisted psychotherapy is a supervised treatment – it happens in a clinic or therapist’s office, with a medical review and therapeutic supervision. This is not ‘take two and call me in the morning’. Patients would never get a prescription for MDMA to fill themselves at the local pharmacy. Unlike all other medications for PTSD, with MDMA-assisted psychotherapy, patients only take the drug two or three times over a 10-week course of psychotherapy – and research suggests that the benefits last.”

    He adds that "though the drug has side effects such as possible anxiety, lack of appetite, increased body temperature and nausea for the four to six hours it’s in your system," Burge says, “They are not as extreme or long-lasting as SSRIs” which millions of Australians take daily. “Also, nobody in the completed trials reported dependence or continued use of MDMA after participation in the trial.”

    MDMA’s benefits are, according to Burge, not restricted to the treatment of PTSD. “It has also shown promise in early research as an adjunct for psychotherapy for anxiety associated with life-threatening illnes and social anxiety in autistic adults. It is now [also] being studied in alcoholism treatment as well as cognitive-behavioural conjoint therapy (aka couples therapy).”

    At the very least, he expects it to be approved by the US Food and Drug Administration for PTSD therapy by 2021.

    Closer to home, Dr Gillinder Bedi, a senior research fellow at both The University of Melbourne and Orygen, The National Centre of Excellence in Youth Mental Health, advocates a cautious approach in the MDMA-as-therapy debate.

    “The slow progression of MDMA-assisted psychotherapy from the subcultural margins towards approval has been driven by the belief of those advocating for it,” she says. “Without this motivated community, MDMA would likely not have been developed as a medication. The downside of this robust advocacy base is that it can lead to rather extreme claims, such as being labelled ‘penicillin for the soul’. In addition to well-designed studies that control for experimenter bias, there is a need for researchers and clinicians outside the MDMA-advocacy community to be involved in the ongoing development of this research direction.”

    Clearly there are more questions than answers right now, many of them practical. “For instance, should prescribing be limited to physicians with specific qualifications?” asks Bedi. “What training should be required for those conducting the psychotherapy? How should the drug be handled and stored by pharmacists? This suggests a need for stringent training and oversight of MDMA-assisted therapy.”

    Then, there’s the proven human factor where not everyone will play by the narcotic rules. Case in point: Modafinil.

    A report by the University of Melbourne’s Brain, Mind and Markets Laboratory found that the anti-narcolepsy drug was the go-to helper for certain finance professionals and students who want to maintain their focus during long hours in the library or plundering the markets. Some is sourced online. Some comes from Australian doctors in a trend known as off-label prescribing. And if Modafinil – known as ‘Viagra for the mind’ – is in demand, wait until your local GP has pure Molly at his or her disposal.

    “Approval of MDMA will lead to off-label prescribing, with doctors prescribing the drug for conditions other than PTSD,” says Bedi. “This could include a range of conditions, such as depression and substance-use disorders.”

    This is just one of myriad red flags. Burge says MDMA’s therapeutic acceptance has been hamstrung by several additional factors. “Recreational use and abuse has been one source of the stigma, but an even greater cause of the stigma has been the misinformation, bad science, and political posturing that policymakers have engaged in for decades,” she says.

    In political terms, the issue of psychedelics as therapy is an easy knee-jerk for neo-cons.

    ‘This government is spending your tax money on street drugs’ is a convenient and divisive headline, sure to prompt enough harrumphs across the media landscape. There have also been enough tragic high-profile cases, such as that of Sydneysiders Anna Wood and Sylvia Choi – both of whom died after taking ecstasy at dance parties – to place the discussion forever on the back burner. Strike one.

    In response, researchers likes Burge are quick to point out that there is a monumental difference in the purity and dosage of the MDMA being sold on the street (and cut with any number of harmful fillers) compared with that used in clinical studies. Then, there’s the financial factor. Specifically, the issue of patents, which tend to run to 20 years in the pharmaceutical industry.

    The theory goes that this amount of time generally allows the manufacturer of the drug to recoup their R&D costs and accrue a reasonable profit before generic, lower-cost varieties are made available to the public. The problem, as far as big pharma is concerned, is that the patent on MDMA ran out some time before World War II. Which means that any significant potential turnover arising from exclusivity is immediately off the table. Strike two.

    What’s more, unlike your standard SSRI anti-depressants, which require ongoing use (and is therefore more profitable), many of these patent-free psychedelics need only a handful of doses to provide relief. With both potential volume and profit thus diminished, Burge says you have distinct “lack of interest” on the part of for-profit pharmaceutical companies. Strike three. Attitudes are slowly changing in the pharmaceutical community and Burge is confident that “within the next 10 years, we’ll see psychedelics enter psychiatry as the first new class of psychiatric drug in the last 30 years”.

    However, it’s unlikely that many Australians will be able to access legal therapeutic MDMA any time soon. Considering how long it took to convince them of the medicinal benefits of marijuana, no local politicians are waving the psychedelic flag just yet. Those who might benefit right now have to be lucky enough to qualify for one of the few small local clinical trials.

    In this respect, organisations the Sydney’s Black Dog Institute are creating some world-firsts but these options are still few and far between. Writing in April’s Australian Psychologist journal, doctors Stephen Bright and Martin Williams warned that Australia was being left behind the rest of the world on the research front. Bright noted that there is “a lot of academic conservatism” in Australia towards research involving drugs which are best known as illegal stimulants, adding that there was “a vested interest in maintaining the current paradigm”.

    And it’s not just MDMA in the firing line. Everyone’s favourite horse tranquiliser, ketamine, is also prompting words like “astounding” from medical researchers not given to hyperbole. In 2016, the University of New South Wales’ Professor Colleen Loo began a randomised double-blind three-year trial into the effectiveness of the drug as a depression treatment for people who have not responded to other medications.

    The 16 subjects were all over 60 and Loo found that half showed no signs of depression after a single dose. “I was a bit sceptical with all the reports coming out from overseas,” Loo told Triple J, “I thought, ‘I’m just not sure if I believe this, it’s unbelievable’. And I must say, the first person we treated – I still remember the very first person – he and I looked at each other and he said, ‘I don’t believe it’, and I said, ‘Neither do I’. He’d been depressed for literally 10 years and had failed more than 10 medications. He said, ‘The fact I can receive one treatment and be well after one day is just unbelievable’.”

    A 25-year-old speaking under an assumed name told the same program that after 10 years of living with depression he “felt backed into a corner and held hostage to depression that I didn’t want to be fighting so much anymore”.

    In an approach guaranteed to alarm psychedelic proponents and provide ammunition to critics, he bought some ketamine off the dark web and began experimenting. Successfully, it turned out. “My life outlook is much more positive now,” he said. “It’s allowed me to take back my life in a sense. From years of having to put life on hold, I found that it was a lot more worthwhile and cost-effective than spending my life on antidepressants.”

    Much like MDMA, the popularity of ketamine on the black market makes it vulnerable to exploitation and misuse – which is why almost every researcher GQ interviewed spent a great deal of the conversation issuing caveats.

    Yet, away from the world of dance parties and K-holes, it has the potential to save lives in the most immediate and drastic sense of the term. In the first study into esketamine (a part of the ketamine molecule) conducted by a drug company (in this case Johnson & Johnson) with Yale University, 68 people at risk of imminent suicide were treated with the drug. The authors found it not only led to a “significant” improvement in depressive symptoms within 24 hours but also leveled off at around 25 days – which is roughly the time it takes for antidepressants to kick in to full capacity in the body.

    Commenting on the data, England’s often-conservative Royal College of Psychiatrists said that it brought the drug “a step closer to being prescribed on the NHS”. Because Australian doctors have access to ketamine as an anaesthetic and pain reliever, authorities fear it too may be prescribed ‘off label’ without enough research into the long-term consequences (if any) of its use in suicide prevention.

    Israeli-American writer Ilana Masad was given ketamine by her psychiatrist in an attempt to counter her stubborn depression. Writing for The Fix, an online publication devoted to addiction and recovery, she revealed, “Shortly before my first ketamine treatment, I became suicidal for the first time in my life. If I hadn’t started ketamine treatments when I did, I don’t know whether I’d be here writing this article now.”

    While the likes of MDMA and ketamine made their way into public consciousness from the ’80s onwards, those wanting to take a trip in the psychedelic ’60s turned to LSD.

    ‘Acid’ is also experiencing its own contemporary resurgence and according to an analysis published in the Canadian Medical Association Journal, there are studies being done on the use of lysergic acid diethylamide as a treatment for post-traumatic stress disorder and anxiety.

    A more natural alternative may be found in psilocybin – the active hallucinogen in magic mushrooms. Johns Hopkins University researchers gave the drug to 51 cancer patients also suffering from mental-health issues like anxiety or depression. Six months on, it was found that about 80 per cent of participants continued to show clinically significant decreases in depressed mood and anxiety, with about 60 per cent showing symptom remission into the normal range.

    Researchers stressed that the drug was given in tightly controlled conditions in the presence of two clinically trained monitors and said they do not recommend use of the compound outside of such a research or patient-care setting. But what’s most astounding about this was that the results were again achieved in a single dose.

    Another natural compound, ibogaine, is also gaining clinical attention. A psychoactive found in plants from the Apocynaceae family, it’s being examined as a potential therapy for those battling drug dependence.

    Make no mistake; this is dangerous gear with severe side-effects including hallucinations, seizures, fatal heart arrhythmia and brain damage in patients with prior health problems. In 2014, 33-year-old West Australian Brodie Smith died on the first morning of what was supposed to be a four-day ibogaine treatment program in Thailand. He was trying to kick his dependence on illegal drugs. And yet, there are several studies that suggest that ibogaine, under appropriate conditions, could well be a habit-breaker.

    As reported in Scientific American, in May 2016 a meta-analysis examining 32 studies, mostly in mice and rats, found that ibogaine reduced self-administration of cocaine, opioids and alcohol.

    An earlier study from 2015 discovered noribogaine, the substance that ibogaine breaks down to when ingested, reduced self-administration of nicotine in addicted rats by 64 per cent.

    Californian company Savant HWP has now progressed to secondary trials for a synthetic ibogaine compound, called 18-MC, which mimics the anti-addiction properties without the trippy side-effects. The potential benefits for Australia are obvious as opioid prescriptions here increased from 10 million per year in 2009 to 14 million per year at the end of 2017 – that is an increase of 40 per cent over the past eight years. Worth a look, then.

    With new applications and (again) appropriate safeguards for once demonised substances, be they chemical or naturally occurring, in place, Burge believes we are on the threshold of a giant leap forward in the way we treat our troubled minds and bodies.

    If Australia’s growing acceptance of marijuana as a legitimate treatment in palliative care, epilepsy, chronic pain and multiple sclerosis is anything to go by, it’s clear that we are no longer as attached to the notion that because a drug can be misused it should automatically be sidelined and vilified.

    “The resistance to this notion is definitely fading,” says Burge, “and it fades more with every new study that’s completed. Researchers from multiple organisations and institutions around the world are showing real therapeutic benefits from psychedelic-assisted therapy, especially MDMA and psilocybin and also ibogaine, for specific mental-health conditions. That data, and the overall very supportive attitude of policymakers and regulators around the world, are resulting in what’s been called a renaissance in psychedelic research.”

    Unsurprisingly, it’s Pollan who best articulates the here and now.

    “What excites me is the potential of these medicines to help people for whom we don’t have a lot to offer. Mental-health care worldwide has not been that effective. We still deal with very high rates of mental illness, and that’s all getting worse,” he says. “So the idea that we might have a tool that could help with a whole range of different problems – from addiction and depression to obsession and anxiety – that’s very exciting.”

    They will not offer a silver bullet in the fight against mental-health issues – nothing ever has. But by reducing the stigma around psychedelics, there is now increasing evidence that these treatments may offer new hope to those at the very precipice of despair. Seems it might be time to open our minds.
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    San Luis Obispo

    The hidden world of underground psychedelic psychotherapy in Australia

    John puts The Passion of the Christ soundtrack on the stereo and lies on the single bed in this Melbourne house. He's a 37-year-old engineer working in the renewable energy sector, and not at all savvy about street deals, so he bought his dose of cactus, which contains mescaline, on the dark web. He takes it without ceremony, then talks to his therapist about how he's been feeling. When he starts to feel a vague effect of the drug in his thighs, John puts on his eye shades and waits for the first wave to hit.

    This is underground psychedelic psychotherapy, using illegal substances and facilitated by therapists known only through cautious word of mouth. While most people are unaware it exists, it's been going on globally since the 1950s. That's when clinical trials into the possible uses of psychedelics began, before being curtailed by LSD being made illegal.

    Now trials are underway again, in the US and UK in particular, including using MDMA (not strictly a psychedelic) for PTSD, LSD for anxiety, psilocybin for depression — and advocates believe it could transform mental health care. The most optimistic researchers hope that regulated psychedelic-assisted therapy will start rolling out slowly in 2021 with approval from bodies such as the FDA.

    But not everyone wants to wait, or to be dictated to by government bodies and pharmaceutical companies.

    What happens in an underground session?

    John is in his 11th year of treatment, which has included holotropic breathwork and regular psychoanalysis.

    "When I started I was on the brink of suicide," he says. "It stems from sexual, physical and emotional abuse when I was two to three years old." A hypnotherapist referred him to a therapist known for treating trauma. John had no idea that his new therapist facilitated psychedelic sessions. "He uses whatever works for the individual," John explains. "It might be talking therapy, meditation or relaxation techniques. Given I'd had recreational experience with psychedelics, it's something he put forward."

    With the aid of psychedelics, John says he can access memories quicker than with regular therapy. A $150 session last anywhere between 30 minutes for DMT, to five hours for MDMA and 14 hours for mescaline. The hard work comes in the ensuing sessions, when he and the therapist integrate what he experienced during the trip. As John points out, it's far from fun. He's concerned that news stories about trials make out psychedelic psychotherapy to be a quick fix. On a TV show The Doctors, for instance, a woman who took part in a clinical trial of MDMA-assisted therapy claims her PTSD was "cured" in three sessions.

    Quality control could fall by the wayside

    Dr Prash is a medical doctor and neuropsychiatry fellow at The Alfred Hospital, Melbourne. Four years ago he gave his first talk to the Alfred's psychiatry department about advances in psychedelic-assisted psychotherapy, and he's impatiently awaiting regulation. "I don't plan on being in conventional psychiatry for the rest of my life," he says. "The psychedelic sphere is where I see promise for the future." Dr Prash can understand the rise in underground practice. "The more that the Australian population reads stories about trials in other parts of the world, the more they'll get frustrated at the lack of access," he says. His concern is that anything forced underground becomes adulterated.

    "We saw that with prohibition in the 1920s and the war on drugs in the current day," he says. "In the case of medical cannabis, regulation took ages, and by that point people thought, 'I'll just give my child cannabis.' But you're not necessarily going to choose the right compound for the right problem."

    Legal consequences of underground sessions not clear

    Facilitating underground sessions is risky for therapists, particularly if they're registered with the Australian Health Practitioner Regulation Agency (AHPRA). Technically they're not breaking the law because they're not supplying the substance, but if something went wrong it's not clear what the legal consequence would be. Ethically, it could be argued that they're not acting in the best interest of their profession just by being there. "If you were called up to the medical board or the health practitioners board of AHPRA then you would be judged by your peers about what is considered to be a good standard of care," Dr Prash explains.

    A spokeswoman for the Psychology Board of Australia, which operates through AHPRA, says: "If a practitioner is placing the public at risk, National Boards and AHPRA would want that concern raised with us. Psychologists must only provide psychological services within the boundaries of their professional competence. This includes working within the limits of their education, training, supervised experience and appropriate professional experience; basing their service on established knowledge of the discipline and profession of psychology, and complying with the law of the jurisdiction in which they provide psychological services."

    It's risky for patients too, who place a lot of trust in their therapist. In California, six women accused the founder of the Interchange Counseling Institute of sexual assault after taking hallucinogens. Patients with a family disposition towards psychosis would likely be discounted from regulated psychedelic psychotherapy, but these precautions are not guaranteed with underground sessions. Similarly, some medical conditions are prohibitive: in 2014, West Australian man Brodie Smith died in a Thai rehab centre when having his methamphetamine dependence treated with ibogaine.

    Then there's the issue of seasoned "trip sitters" upgrading themselves to therapists and tackling a friend's trauma. "That's one of the biggest problems," Dr Prash says. "They might measure the dose by what they've read around clinical trials, but the purity of street MDMA could be 20 per cent. Other adulterants potentially include meth." Dr Prash thinks that even if the TGA approves psychedelic psychotherapy in Australia, the earliest clients are likely to be from the severe end of the spectrum, such as end-of-life patients who might be treated by psilocybin. "That's the first area that stigma recedes from," he explains.

    The efforts to get trials approved in Australia

    Some medical professionals and researchers worry that unsanctioned practice will jeopardise regulation later on. As psychiatrist Nigel Strauss points out: "If there's some terrible outcome where someone dies or develops psychosis, that's bad news for the rest of us trying to initiate scientific studies." Dr Strauss has a long interest in PTSD, having worked with the survivors and families of the Port Arthur massacre and the Black Saturday bushfires. "I'd always thought that the available treatments were not really adequate," he says, "so I had a look at the evidence that was coming out of MAPS and was impressed by the early results."

    He now advocates for clinical trials to be held in Australia. He and Dr Martin Williams of Psychedelic Research in Science and Medicine put in a submission to Deakin University in December 2015 for a PTSD study using MDMA. It was blocked at the last moment by a professor worried that the research would attract adverse media coverage. "These drugs are stigmatised and there are frequent headlines about young people overdosing in clubs on ecstasy," Dr Strauss says. "Universities are fragile places: they're financially dependent and under pressure. It's a generational thing as well — I think if the people making the decisions were 30 years younger, we might have more hope."

    Dr Strauss thinks trials will begin in Australia in the next five years, but acknowledges the difficulty of integrating psychedelic use into the paradigm of science. "It's up to scientists and psychiatrists who have an understanding of consciousness to find a way," he says. "I'm interested in evolving a system where there could be more synergy between the two."

    Ben Sessa is a Bristol-based medical doctor already carrying out MDMA trials to treat alcohol dependence. "There's a massive amount of knowledge within it so it's not to be sniffed at," he says, "because anecdotally the experiences can direct researchers to new avenues. But it's not going to help getting new drugs licensed. That has to be done in the way that the regulatory authorities want you to do it, based on studies."

    Dr Prash has a similar view. "If it's underground then it doesn't have the kind of vigour that the mainstream scientific model requires, and then it's not going to get much purchase anywhere," he explains. It would be no more useful than the anecdotal evidence that we're all already aware of. It can't be peer reviewed and the validity of your results cannot be assessed."

    In decades to come, perhaps we will see the MAPS vision of psychedelic centres that aren't restricted to people tackling mental health issues. But in the near future, progress will be slow. John is concerned that certain drugs will be mandated for certain conditions, as if one size fits all. He also wonders how client-practitioner boundaries will be flexible enough. "This isn't an hour-long session where the therapist says, 'Time's up,'" he says. "Sometimes afterwards I won't feel good so I'll hang about until I feel safe."

    Dr Sessa acknowledges: "Quite a lot of people say to me, 'Why do you bother trying to license these drugs? There are plenty of good underground therapists' — and that's true. But there are 70,000 untreated cases of PTSD in the UK, and the majority of those people don't want to break the law. They're the population that I'm interested in increasing access for, so you have to beat the man at his own game."
    Last edited by mr peabody; 07-09-2018 at 09:33.
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    Taking a Walk on the Dark Side

    If the wheels fall off Psychedelic Renaissance 2.0, it will be because of its greatest enthusiasts, not its sceptics. How can we help ourselves succeed?

    Psychedelic medicines are back in the research labs and in the news, after forty years in sleep mode. A second psychedelic renaissance is afoot.

    And the news is good!

    A growing stream of new studies from leading institutions over the past decade shows the increasingly clear promise of psychedelic medicine in the treatment of some of the biggest mental health challenges of our age: PTSD, depression, anxiety, addictions and end-of-life distress.

    For those who have already benefitted personally from psychedelic medicines, and for those professionals who seek to work legally with clients in need, this new influx of supportive research and public interest is especially gratifying.

    After nearly 50 years of struggle and waiting, we may well see our dream finally come true.

    Let’s celebrate how far the psychedelic movement has now come, and continue to focus our imaginations on that bright tomorrow. We’ll soon be using a whole new class of badly needed medicines to tackle issues that today’s current treatments just do not effectively address. And maybe we’ll even have centers where citizens can go for a psychedelic experience that will enhance creativity, problem solving or spirituality.

    So let’s be optimistic! We can do this together! Keep thinking positively, and we’ll reach our goal!


    No, that’s not the way it will happen. In fact, unbridled optimism may well spell the demise of Psychedelic Renaissance 2.0 just as it contributed to the downfall of 1.0 in the late 60s.

    Let me explain.

    Cognitive science has taught us some rather important things since 1.0 about how the way we think about reaching our goals affects our success in actually realizing them.

    We’ve long known that it helps to think positively about our goals. Negative thinking has a nasty way of becoming self-fulfilling prophecy. It can sap our energy and enthusiasm. It can take the wind out of our sails, setting us up for depression and anxiety.

    But we’ve more recently learned that wishing, dreaming, and thinking positively alone is not going to be enough for us to attain our goal.

    In her 2014 book “Rethinking Positive Thinking: Inside the New Science of Motivation” Dr. Gabrielle Oettingen at New York University looks critically at the standard wisdom that optimistic thinking in itself is the path to success in goal attainment, that it’s optimism and dreams that excite us and inspire us to act.

    Optimism, pure and simple, it turns out, does not motivate people; instead, as Dr. Oettingen shows in several experiments, it creates a sense of relaxation and complacency.

    It’s as if in dreaming or fantasizing about something we want, our minds are tricked into believing we have already attained the desired goal.

    And there appears to be a physiological basis for this effect. Studies show that just fantasizing about a wish lowers blood pressure, while thinking of that same wish — and then considering not getting it — raises blood pressure. It may feel better to daydream of success, but it leaves us less energized and less prepared for action.

    Oettingen explores an alternative: motivating people to act toward their goals by leading them to directly confront the real risks and pitfalls that stand in their way. In addition to envisioning the bright desired future, she leads them to fully acknowledge the dark side of the dream: all the ways in which things could go awry. She developed a technique she calls mental contrasting.

    In one study, she taught a group of third graders a mental-contrast exercise: They were told to imagine a prize they would receive if they finished a school assignment, and then to imagine several of their own behaviors that could prevent them from winning. A second group of students was instructed only to fantasize about winning the prize. The students who did the mental contrast – who took the walk on the dark side – outperformed those who just dreamed.

    Apparently, being mindful not just of our dreams, but also of the real obstacles or threats that we or the world place in their way, is a more effective way of meeting goals such as better eating habits, improved exercise, and greater control over alcohol intake.

    Oettingen hones her mental contrasting exercise into an empirically validated practical tool. She calls it WOOP: “wish, outcome, obstacle, plan.”

    Wish generously for the outcomes. Wish globally. Then focus your wish, make it more specific.

    Get clear on why you want what you do. What are the anticipated outcomes that make your goal important?

    Then list all the ways in which things could most likely go wrong. Itemize the obstacles, the threats or the pitfalls anticipated on the road ahead. Focus mainly on the things that could go wrong because of what you might mistakenly do. i.e. the things that you have some control over. Dare to stare those demons in the face!

    Make a specific plan for overcoming each obstacle or threat, so that if and when it arises, we have a pre-meditated strategy for dealing with it.

    Now, how does this program apply to us, and our goals concerning psychedelic medicine? Well, so far we’ve been pretty good at fleshing out the bright side of our vision: a variety of pharmaceutical-grade psychedelics available in specialized safe settings, care provided by trained psychedelic professionals for appropriately screened individuals.

    But now it’s time for the heavier lifting: what about the dark side? What could most likely go wrong with our psychedelic agenda? What might derail us in reaching our goal? What are the most likely threats, obstacles, quicksands, trolls, dangers or pitfalls? How might we undo ourselves again if we’re not careful?

    One way to begin to answer this question is to ask what went wrong the first time. What kinds of incidents raised the public fear level to the point that Richard Nixon, the American president at the time, would denounce Timothy Leary, the era’s most prominent evangelist of psychedelics, as “the most dangerous man in America”?

    Here, we could make our list from the news headlines of the time: several suicides, some psychiatric tragedies, some scandalous incidents involving eroded sexual or professional boundaries. These were serious incidents that should not be minimized. But they were also isolated incidents that were often sensationalized and misrepresented. The biggest tragedy of 1.0 is that these news stories about the abuse of psychedelics obscured the tremendous scientific story unfolding about their appropriate use. Yes, the mishaps may have been few-and-far-between. But it didn’t take many of them to pull the wheels off the bus.

    We will, of course, do what we can to prevent such unfortunate incidents from becoming part of 2.0’s history. If they do occur we must acknowledge them and call them out. But more importantly, we need to head these incidents off well before they occur.

    There’s an even more important focus for our vigilance than the incidents themselves. Since it is so often mistaken thinking that leads to tragic behavior, we need to be mindful about the kind of thinking that leads to those psychedelic tragedies. What were the dark-side beliefs that greased the skids to tragic behavior? Let’s shift our attention from the old misguided meme of “dangerous psychedelics” to “dangerous thinking” about psychedelics. Some of these faulty beliefs are easy to spot:

    Psychedelics are safe

    Yes, we know they’re very safe when used by properly screened individuals in the context of a protected setting under the guidance of trained professionals. At a poorly planned rave? All bets are off! And in certain settings, containing mistrust, conflict, confusion or danger, psychedelics can be deadly. Risk also increases as their use strays from the therapeutic toward the recreational.

    They’re good for everyone

    Psychedelics do appear to benefit many people. But some, with certain major mental health issues or medical contraindications, should never use them.

    More is better

    Research to date shows that many patients require more than one psychedelic session for optimum treatment results. But we also know that overuse or abuse of psychedelics can play a role in the onset of some true DSM mental disorders. And we also know that psychedelic induced peak experience has real therapeutic value only when those experiences are properly digested and “integrated” into one’s daily life so as to achieve lasting change. This “psychedelic psychotherapy” process takes time, depending on the person and the material they are trying to understand and accept. It might well take months. Over-use is inevitably counter-productive. As the 60s philosopher Alan Watts said, “When you get the message, hang up the phone”.

    Those mushrooms are magic!

    Yes, psychedelic substances do have some special properties that affect perception and cognition. But the important thing about the therapeutic use of psychedelics is that it’s not about what the medicine does to you, it’s the emotional work that you are willing and able to do with the medicine’s assistance: that’s what leads to the lasting changes. In the most productive cases, that work begins well before the medicine session, and continues well after it.

    The path to happiness lies within

    Yes, it is true that “going within” with psychedelics can result in experiences of profound peace, bliss, emotional or spiritual ecstasy, healing or redemption. But it’s an empirical fact that human beings are fundamentally social creatures, and our lasting happiness depends on our relationships with others; we all need love, friendship, and a sense of acceptance and place within community. Yes, it is true that psychedelic experiences may lead to profound healing in our relationships with others, to the letting down of emotional walls and the opening of hearts. But psychedelic experience is no substitute for human connection. Looking for happiness by simply going within is bound to disappoint if it is not balanced by our recognition that we need ongoing human warmth and connection to make life truly satisfying.

    Each of these five dark-side beliefs above contains just enough truth to make them dangerous. They are often held out of sheer ignorance, and are relatively correctable. We can help enthusiasts who mistakenly hold them by pointing to the science that can set them straight.

    But there are two additional beliefs that are more insidious than these first five, beliefs whose prominence today would pose a grave threat to our goal of psychedelic medicine for Canadians. These next two are harder to spot, and they cannot be easily dispelled by simply pointing to research fact. Unlike the five above, they are philosophical beliefs rather than empirical ones.

    Psychedelic experience leads us to find our “true self”

    Psychedelic exploration can lead to “ego loss” or “ego death” – a temporary dissolution of sense of self in which the individual melts into a cosmic oneness, often experienced as merging with the divine. (This experience sounds strikingly similar to the Hindu idea of enlightenment: the discovery that atman, the individual self, is actually Brahman, the divine universal self underlying all things.) This so-called peak or “mystical” experience can play a very important role in personal healing with psychedelics. Many who experience it become less self-aggrandizing, egocentric, and egotistical. They become more open, tolerant and compassionate in a lasting way.

    But some misconstrue this experience, falling into the mistaken belief that if our true self is the divine, we should try to rid ourselves of our “false” self, our ego.

    However, our ego-self is our interface with others. Without it, we are helpless in the world we share with others, and are unable to exercise discernment, agency and efficacy, the very qualities we now need to move toward our goals for psychedelic medicine. Without ego we are incapable of real interpersonal relationship. We’re defenseless, and vulnerable to the machinations of others.

    Rather than disparage the ego or seek to annihilate it, we need to build healthy ego-selves, real selves that can stand up for ourselves and take care of business, but also treat others with respect and compassion. It may be that our deep self is indeed identical to the cosmic Godhead, and that our ego is some kind of “surface” self. But that doesn’t mean that the ego is any less real a self than the divine self. Balanced psychedelic veterans agree with the truth shared by many spiritual traditions: In addition to being the thousand-petal lotus flower, we are equally truly other possible selves, perhaps a magician, a warrior, a lover, or a sovereign. Each aspect or facet of self contributes to the rich unity of who we really are. The goal following psychedelic experience is not to spend as much more time as possible in some “true-self” egoless state, but to develop a self in the material world that has solidity, agency and efficacy, openness to other selves, and compassion for others. The true message from mystical experience seems to be that we can come to honour all facets of self, not just the lotus flower. The ultimate step in spirituality is to come to fully honour our incarnated humanity, to live fully and joyfully through our embodied egos. So keep that warrior-self handy; you’re going to need her (or him)! Sometime soon! There will be plenty of time later for that egoless state.

    Psychedelic experience yields a truth that trumps science

    The science around psychedelics is now getting pretty clear: it seems to be a brute clinical fact not only that many patients experience profound healing and growth through psychedelic experience, but that a good measure of that transformative healing comes through having mystical, or “noetic” experiences – ones in which subjects have the sense that deep personal, emotional, metaphysical or spiritual truths are being revealed to them.

    This juxtaposition of scientific thinking and mystical experience creates an interesting cognitive tension that runs right through the center of our understanding of psychedelics. Scientific thinking leads to the development of the psychedelic medicines themselves in a chemist’s laboratory. Research on the effects of those psychedelics aspires to reach “evidence-based” conclusions through a “scientific method” using conceptual tools such as randomized controlled trials (RCTs), double-blind placebo design, statistical and phenomenological analysis. Scientific thinking leads to the development of the psychedelic medicines themselves in a chemist’s laboratory. Research on the effects of those psychedelics aspires to reach “evidence-based” conclusions through a “scientific method” using conceptual tools such as randomized controlled trials (RCTs), double-blind placebo design, statistical and phenomenological analysis. But mystical experience involving “revealed truths” plays a really big role in the actual personal healing or growth.

    Most of us can find a place of comfortable balance in this cognitive polarity between science and mysticism, where these two perspectives become integrated into a kind of binocularity that adds a sense of richness and depth to our understanding of our lives and our world. Science has its rightful place in its own domain – the empirical, or observable world. Science does not tell the complete story of reality; it has nothing to say about the domains of spirit or metaphysics, nor should we expect it to. But, operating within its rightful domain, science does its job pretty well. And vice-versa; the deeply intuitive truths coming from mystical experience pertain to another much older and deeper realm of human experience. Mystical truth is silent with respect to the world of empirical science, but it provides the deep personal meanings, understandings and interpretations of the human condition that are necessary for healing and living fully.

    However, some thinkers about psychedelic experience are not able to find this natural balance between these two domains, and their thinking falls to one pole or the other. It lapses into a kind of fundamentalism. Some become so stuck in the scientific mindset that it becomes scientism; they reduce, devalue or dismiss mystical experience as mere fantasy, illusion, delusion or psychosis. Others, conversely, get so entranced by mystical experience that the findings from psychedelic experience lead to a demeaning, disrespect or even repudiation of science. They allow mystical truth to overrule science.

    And here is exactly where big-time risk creeps in. The more we honour intuitive mystical truth at the expense of empirical science the more we stray toward disregard of the cautions, practice standards and protocols established for safe use by scientific researchers, the more we are likely to see the precepts of professional ethics, boundaries and accountability as too limited, or no longer relevant, or somehow not fully applying to us anymore. When intuitive truth trumps science, the door opens to cult thinking, to authoritarianism, to the rise of a new priestly caste of psychedelic savants, and to a climate in which emotionally and spiritually hungry people are vulnerable to exploitation. Psychedelic experience can indeed lead to the growth of humility, authenticity and compassion. But among evangelists who hold this mistaken belief, it can lead to hubris on steroids.

    If the wheels come off of 2.0, it won’t be because of what the researchers in the labs tell us. The science has already advanced to the point where it is reasonable to believe that future research will much more likely to confirm the current promise of psychedelic psychotherapy than to diminish it. No, the biggest risks to our venture come from our movement’s most enthusiastic and evangelical proponents – underground psychedelic therapists and voyagers who hold these mistaken beliefs that pave the way for tragic results. So let’s be vigilant for these seven deadly-thinking sins, and vocally resist them when they appear.

    Psychedelic experience, and our thinking about it, contains many paradoxes. Isn’t it a delightful paradox that the ingestion of a particular molecule that affects certain neurons can lead to the deep conviction that the world consists of so much more than just molecules and neurons! It’s also a paradox that the more psychedelic voyagers ignore or evade the dark side of their process, the more that dark side is likely to find them. This is true similarly on the collective level regarding our shared dreams of a psychedelic future: it’s a paradox that taking a walk on that dark side – facing up to the things that could go wrong and the beliefs that could most likely take us there – increases our likelihood of reaching our goals and confirming our optimism. Let us embrace this paradox as we move forward.

    Last edited by mr peabody; 09-09-2018 at 02:56.
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    Ketamine and Quantum Psychiatry

    Karl Jansen, Stanislav Grof, Rick Strassman, Sylvia Thyssen, Lester Grinspoon, James B. Bakalar, Dale Pendell, Jon Atkinson, Louise Theodosiou, Kevin Brunelle, Dave Cunliffe

    The word 'psychedelic' was invented by an English psychiatrist (Humphry Osmond) and means 'mind-revealing'. A psychedelic drug may tell us more about how the mind constructs reality, personality and a sense of meaning and sacredness. It is sometimes said that ketamine is not a psychedelic drug because it has anaesthetic properties not seen with LSD, DMT, psilocybin and mescaline. Nevertheless, it can access all of the realms of consciousness mapped out by psychiatrist Stanislav Grof on the basis of LSD research. Ketamine is mentioned in (for example) Psychedelics Encyclopedia, Psychedelic Drugs Reconsidered and The Essential Psychedelic Guide.

    Ketamine is relatively safe when used in hospitals. There is a wide margin between the top end of the medical range and a lethal dose. Psychedelic doses are usually only 10-25% of surgical doses, given by the same route for the same person. At these levels, it behaves more like a stimulant than a sedative and does not usually suppress the breathing or heart rate, although exceptions do occur. The higher brain is switched on rather than shut down. This state is different from being unconscious, where the light-bulb is turned off and if the person goes too far they may stop breathing. There are cases of accidental injections with 10 times the amount required for surgery, with no obvious, lasting ill-effects. When ketamine is taken outside a medical setting, the main dangers arise from the physical incapacity it produces.

    Dose, how the drug is taken, set and setting have an influence on the experience. 'Set' refers to the personality, past experiences, mood, motivations, intelligence, imagination, attitudes, what is going on in his or her life and the expectations of the person. Expectations are affected by what people hear and read about the drug. 'Setting' refers to the conditions of use, including the physical, social and emotional environment and the other people present. Empathy with the person giving the drug is a very important factor, even with an anaesthetic.

    Near-Death and Near-Birth Experiences

    A 'near-death experience' (NDE) is a report of leaving the physical body, and sometimes going through a tunnel towards 'the light'. Ketamine can reproduce all aspects of the NDE, including the conviction of being dead, having a telepathic communion with God, seeing visions, out-of-body trips, mystical states, entering other realities, re-experiencing old memories, and a life review which may have therapeutic value Most NDE's occur in people who are not physically near death.

    An NDE can be therapeutic. After-effects can include an enhanced joy in living, reduced fear of death, increased concern for others, reduced levels of anxiety and neurosis, reduced addiction, improved health and a resolution of various symptoms. Positive changes can also follow ketamine -induced NDE's (K-trips) which occur within a therapeutic alliance, in an appropriate set and setting. This is called death-rebirth psychotherapy.

    Where do these experiences originate? I have written at some length about the physical basis for them in the past. In this article I will consider more speculative suggestions that the brain can act as a transceiver, converting energy fields beyond the brain into features of the mind, as a television converts waves in the air into sound and vision. Advances in quantum physics suggest that certain drugs, and the conditions which produce NDE's, may 're-tune' the brain to provide access to certain fields and 'broadcasts' which are usually inaccessible. This re-tuning is said to open doors to realms which are always there, rather than actually producing those realms, just as the broadcast of one channel continues when we change channels.

    The Quantum Mind

    Some people believe that ketamine is a mental modem which can potentially connect the mind to 'everything else', allowing a peek behind the curtain at the inner workings of this and other realities. In the old Newtonian universe, the mechanical view declared that all possible forms of energy and fields had already been discovered; that the ordinary, everyday perception of space, time and matter and energy was the only scientifically correct reality; that all people were separate from each other and the rest of the universe; and that consciousness could not exist without a living brain.

    Some of these declarations can be reassessed in the light of new discoveries in physics. A subatomic particle can be in many different places at once. When a photon changes in one place and time, it's 'linked photon' changes simultaneously, even if it is on the other side of the universe. It's as if there was no space between them at all. This means that some physical boundaries could be arbitrary. A messy explanation for this is tachyon theory, faster-than-light particles which carry messages between the photons. Bell's theorem is more attractive. This involves a hyperspace where all realities exist at a single point, so no messages are required.

    If entry can be gained to the quantum realm, awareness (the 'disembodied eye') might travel through different realities without the body itself going anywhere.

    It was like a cosmic assembly line that was constantly churning out the alternate universes that some physicists theorise about in which every conceivable possibility becomes an actual reality. I even had brief flashes in which I experienced some of these alternate realities as they sprouted forth out of this cosmic womb...quick glimpses into what felt like other incarnations, other lives I could have led, darting journeys through seas of pure information. (Trey Turner, 100 mg ketamine i.m.)

    A person is not a photon, and it is a real quantum leap to go from the subatomic world to human events. Nevertheless, to improve our understanding of psychedelic experience we may need to reconsider some of the material which has been dismissed as hallucinations, psychosis, suggestibility, stupidity and fraud. Hallucination is only another descriptive term - it doesn't really explain anything. 'Quantum' based explanations for certain mental states have started to appear, and we should be wary of dismissing these new theories out of hand. Some of the most significant advances were opposed by the most renowned scientists of the day. Einstein himself opposed quantum physics, declaring that God did not play at dice. Einstein described this physics as 'absurd, bizarre, mind-boggling, incredible, beyond belief...' and 'the system of delusions of an exceedingly intelligent paranoiac, concocted of incoherent elements of thought'. However, Einstein was wrong. The 'system of delusions' worked very well, and its 'psychotic' advocates won many Nobel prizes. Subatomic particles could indeed behave as if time and space were non-existent.

    It was next observed that there are similarities between quantum processes and human thought processes. Leading physicists suggested that consciousness may involve quantum events, with profound implications for understanding certain altered states of being. Professor Stephen Hawking, who sits in Newton's former chair at Cambridge, believes that the universe has no boundaries in space or time, and is made up of super-strings which vibrate in 'extra dimensions', balancing vibrations in the usual dimensions: positive and negative energies cancelling each other to produce the our universe, based on a 'new' kind of symmetry called 'super symmetry'. The latest atom smasher may provide evidence of this super symmetry, producing the world's most expensive Yin-Yang symbol. Has the division between physicists and psychedelic mystics become one of whether instruments or the mind itself is used to make the same observations about 'the ground of being'? The language of LSD trips can resemble the language of the older quantum physics, involving white light and dancing particles, but new reports in physics journals use terms which are much closer to 'the language of ketamine'. Super-string theory is being supplanted by the discovery of whole groups of extended objects called p-branes . These may be viewed as types of membranes, with a string being a one-brane as its only dimension is length. There are other types of 'branes' with far more dimensions. Becoming an across-the-universe membrane is a typical ketamine effect. Before p-brane theory was widely known, ketamine and isolation tank explorer John Lilly MD wrote:

    At the highest level of satori from which people return, the point of consciousness becomes a surface or a solid which extends throughout the whole known universe. This used to be called fusion with the Universal Mind or God. In more modern terms you have done a mathematical transformation in which your centre of consciousness has ceased to be a travelling point and has become a surface or solid of consciousness...It was in this state that I experienced 'myself' as melded and intertwined with hundreds of billions of other beings in a thin sheet of consciousness that was distributed around the galaxy. A 'membrain.

    Thus transpersonal events may be possible within the new physics, if subatomic events are involved in consciousness. Ketamine may be a drug which 're-tunes' the brain to allow awareness to enter the quantum sea. If this is indeed the case, then we may have to regard some of the reports of eternity, infinity, multiple universes and linkage with other beings as phenomena demanding a more sophisticated explanation than a brief dismissal as 'hallucinations and mental illness' requiring no further consideration.

    Ketamine Psychedelic Therapy (KPT)

    Over the past 15 years, ketamine has been given to over 1,000 patients in St. Petersburg as an aid to psychotherapy, mainly to assist in the treatment of alcoholism in well-planned trials with proper clinical control groups. The scientific rigour of these studies is impressive. Long-term follow-up of patients has been very encouraging, and the treatment has been extended to heroin addicts and some forms of neurosis. Not a single patient has had complications such as prolonged psychosis, flashbacks or non-prescribed use of ketamine. This work has been carried out by psychiatrist Dr. Evgeny Krupitsky and his team. Evgeny is Chief of the Laboratory, and was recently awarded an honorary Doctor of Science. He spent a year with the ketamine research team at Yale, sponsored by the conservative National Institute of Drug Abuse.

    Sessions are supervised by two physicians, a psychotherapist and an anesthetist. A return to normal usually began after 45 minutes to an hour, with a recovery period of 1- 2 hours.

    In addition to very good rates of sobriety at one and two year follow-up compared to the control group, on tests of personality change there are significant improvements in many scales including depression, anxiety and ego strength. People become more confident about their own ability to control their lives and to accept responsibility. Non-verbal emotional attitudes are brought to the surface and made known, resulting in less conflict between verbal /conscious and non-verbal/unconscious attitudes involving alcohol, the personality and other people.

    There was also a shift in values towards creativity, self improvement, spiritual contentment, social recognition, achievement of life goals, independence, and improvement of family and social life. Life became more meaningful, and the ability to live according to that meaning increased. KPT can reconnect the ego with denied parts of the self. It can also lead to a perception of reconnection with 'wider fields' such as the family, community, planet and universe in general - a form of spiritual experience. Changes in spirituality were assessed using scales designed to measure spiritual change in the Alcoholics Anonymous approach, and the Life Changes Inventory developed to assess the outcome of NDE's.

    We try to assist in the patient's psychological integration of the spiritual transformation which can result from the psychedelic experience. The uniquely profound and powerful experience often helps them to generate new insights that enable them to integrate new, often unexpected meanings, values and attitudes about the self and the world. (Krupitsky and Grinenko, 1997)

    'I saw the Light' conversions have long been linked with spontaneous recovery from addiction and criminality. All of the 12-step programs, such as Alcoholics Anonymous, have a spiritual orientation and require acceptance of the guidance of a 'higher power'. This may be seen as part of the psyche or a separate entity, depending on personal belief.

    Death-Rebirth Psychotherapy

    An NDE can be a pivotal turning point, encouraging significant and positive life changes. People who attempt suicide have a subsequent risk of making further attempts which is at least 50 -100 times greater than the normal population. In contrast, suicide attempts which result in NDE's are followed by a reduced risk of further attempts, despite an increased belief in an after-life. Of those who survived a jump from the Golden Gate bridge and had an NDE, none went on to completed suicide, and all were united in their support for a barrier to prevent further attempts. These findings suggested that the artificial induction of NDE's by relatively safe means, within a therapeutic alliance in an appropriate set and setting, might have positive benefits in some people.

    The Back Pages

    Throughout human history, altered states of being have played a part in healing. The roles of priest and doctor came together in one person (e.g. shaman, 'witch-doctor' etc.) who entered 'mental realms', perhaps aided by psychoactive plants, to speak with spirits for the good of the people. Sometimes, they took the ill person into these realms with them.

    The belief that inducing such states for therapeutic purposes was a mis-guided idea of the 1960's, now abandoned due to lack of efficacy and unacceptable risks, is incorrect. This was not a minor curiosity of the lunatic fringe. From 1950 to 1970, more than 1,000 peer-reviewed publications appeared on the clinical use of LSD, in over 40,000 patients. The aims included strengthening the therapeutic alliance, diagnosis, gaining access to memories, and improving insight and the relief of symptoms. Conditions treated included anti-social behaviour, alcoholism, obsessional neurosis, and the psychological problems of the dying. Many of the professionals involved were not at all radical, or even liberal, in outlook. This large enterprise came to a sudden halt when LSD was placed in class A/schedule 1.

    New treatments have frequently been greeted with widespread and inappropriate use, and extravagant claims. They then sink to their proper place in the medical cupboard. In some cases, this can be affected by political, social and ideological factors. The only psychedelic drug which can be used in medicine is ketamine, where it may be used to prevent pain in the body but is not licensed for the treatment of pain in the mind.

    In the normal course of events, treatment involving psychedelic drugs would have eventually found its proper place, after the extravagant claims phase had passed, with the usual list of possible adverse effects, indications and contra-indications, cautions and precautions, advocates and opponents -as exist for all forms of treatment. Psychedelic drugs, however, became caught up in an intense ideological battle. The result was that not only did all therapeutic use come to an abrupt halt after 20 years, but almost all research projects were also suppressed. This did not happen because a serious new side-effect emerged, or because there was absolutely no evidence of efficacy. The complete ban on psychedelic drug research appears to have arisen from issues which are largely ideological. Ketamine provides an example of the processes involved. It has been given to millions of patients, and there are numerous reviews affirming its safety (when used in a controlled medical context) and value. In most countries it is not even a controlled drug. Nevertheless, if a research proposal is made involving 10% of the normal anaesthetic dose, to be given to healthy informed volunteers, and the word 'psychedelic' appears anywhere in the proposal, there is immediate and grave concern amongst ethical committees where anaesthetic trials may proceed with relative ease. It is difficult to explain this anomaly using scientific and health concerns. These anomalies have led to suggestions that this era has a taboo against having certain aspects of the mind revealed. Ketamine may provide an example of this taboo: a relatively safe medicine which is suddenly seen as unsafe because it is described as a psychedelic drug rather than a dissociative anesthetic. Nevertheless, research with this substance is proceeding in several countries and may eventually lead to the development of a 'quantum psychiatry', just as Freudian psychiatry , which saw psychic energy as a head of steam in the mind, took its cue from Newton's mechanical outlook 100 years earlier.
    Last edited by mr peabody; 15-09-2018 at 11:26.
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