Mary and the Mushroom: Psilocybin, Chronic Depression and Me (10)

Why You Might Want to Read Pollan’s Book Before You Dose. A Rather-Long Book Review.

How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence, by Michael Pollan (Penguin Press, May, 2018. Also available on Audible)

Anyone who has read Michael Pollan’s writing knows that he not only brings an inimitable perspective to subjects that range across the environment, nature, and food, he does so with a virtuosic literary flair. While his approach is authoritative and science-based, his books are as much aesthetic pleasures as they are troves of compelling information. These attributes are part of the appeal of his most recent work, How to Change your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.

The book opens with a line from Emily Dickinson – “The soul should always stand ajar” – and Pollan invites us to put that advice to use by exploring a world with which most of us (even most “acid heads,” I would guess) are unfamiliar. His opening paragraph is as much a hook as an introduction.

“Midway through the twentieth century,” he begins, “two unusual new molecules, organic compounds with a striking family resemblance, exploded upon the West. In time, they would change the course of social, political and cultural history, as well as the personal histories of the millions of people who would eventually introduce them to their brains. As it happened, the arrival of these disruptive chemistries coincided with another world historical explosion – that of the atomic bomb. There were people who compared the two events and made much of the cosmic synchronicity. Extraordinary new energies had been loosed upon the world; things would never be quite the same” (p. 1).

It’s a paragraph that may strike the reader as hyperbolic, but thanks to Pollan’s fine blend of compelling writing, intriguing facts and riveting anecdotes, his exploration of the world of psychedelics consistently lives up to this initial promise.

How to Change your Mind unfolds in six chapters that cover, among other subjects: the social history of psychedelic use (from the time of the Aztecs to the present); the natural history of “magic mushrooms” and other true psychedelics; a review of the scientific literature relating to these substances; a discussion of the chemical makeup of psychedelics and current research into what effects they may have on the brain; the drugs’ philosophical and mystical dimensions; the political issues that have plagued the entire field of psychedelic use and study and may threaten them again in future; and, perhaps most importantly in this bat-shit crazy era of human history, the promise offered by these drugs to address depression and addiction and to expand our knowledge about the nature of human consciousness.

Pollan personalizes his story by explaining what drew him to write a book about psychedelics and what happened when he (a “healthy normal,” as he calls himself) tried them out for the first time. And for the second time. And the third. He also offers anecdotes relayed to him by others who have taken psychedelic trips.

Perhaps most relevant to my own decision to participate in a clinical study of psilocybin is the material in Pollan’s book relating to the treatment of depression and anxiety. He details the massive clinical evidence that has accrued to date showing the beneficial effects, which can last for months or years or even longer, of one or two psychedelic treatment sessions on those experiencing chronic and/or serious existential depression, addiction and certain other (non-psychotic) forms of mental-health disturbance.

The protracted effects of a well-managed single dose suggest that these benefits cannot be attributed to the chemical itself, and some of the most fascinating content in this book is the discussion of current research into what effect these substances may be having on the brain. Scientists now believe that psychedelics must cause a “temporary dissolution of the ego,” allowing the wiping away of certain debilitating thinking patterns and allowing new, more positive patterns to be built.

The mind-boggling range of interrelated topics that are covered in this book (I can’t begin to convey the vastness of its scope) to my mind makes this essential reading for anyone with any serious interest in the subject of psychedelics. In this post, I talk about some some of the many issues Pollan raises – not in an attempt to offer a condensed version of the book (which would be impossible anyway), but rather out of a hope that the reader’s interest will be piqued enough that they will find a copy of the book and read it for themselves.

The Context

As many of us know, in the early 1960s Harvard professors Timothy Leary, Richard Alpert (who later renamed himself Ram Dass) and others became so enthusiastic about the potential of LSD to save the world that they decided to try to turn on everybody, or at least an entire generation. The effort had several disastrous outcomes – not because of the drug itself but because of the way it was distributed, mostly underground, and used. The fallout put psychedelics out of legal reach for research or individual use for decades.

Although many who tried LSD at the time had wonderfully transformative experiences or just garden-variety amazing trips, others had more negative and newsworthy outcomes. These ranged from disastrous judgement calls (there were incidences of accidental deaths, suicides and cases of long-term psychosis), through accounts of hallucinations that terrified the trippers, to events that mostly horrified disapproving onlookers and the media – such as kids running naked through the streets. The love of humanity and nature engendered by these substances also led to a widespread disinclination among users to march off to fight a war in Viet Nam. Within a few years, alarm about psychedelic drugs had risen to such a level that President Richard Nixon declared war on them, Harvard fired Leary and Alpert, and all research into this intriguing substance was made illegal. It would be thirty years before clinical investigations into the positive aspects of psychedelics could be resumed – legally, at least.

Disabusing Myths

As it turns out, the actual research from the 1950s and 60s and the extensive clinical investigation since the late 1990s clearly indicate that psychedelics are physically safe. “It is virtually impossible to die from an overdose of LSD or psilocybin… and neither is addictive” (p. 11). Tryptamine, the organic compound that causes the psychedelic effect, is not only not toxic, but it works differently on the brain from substances that do lead to addiction. “What is striking about this whole line of clinical research,” Pollan writes, “is the premise that it is not the pharmacological effect of the drug itself but the kind of mental experience it occasions involving the temporary dissolution of one’s ego that may be the key to changing one’s mind.” (Pollan points out that other drugs that are not true psychedelics, some of which are now being used in clinical settings to relieve depression, and all of which are available on the street – such as MDMA [aka “molly” or “ecstasy”] and ketamine [Special K, KitKat] – can be addictive.)

Research is also showing that with screening and supervision, psychedelics are almost always psychologically safe. The incidences of “bad trips” (which can indeed be terrifying from all reports, and are one of my big worries about my impending dose), can almost always be averted or at least mitigated by attention to set and setting. The “psychotic breaks” that emergency doctors unfamiliar with the drugs identified in those (few) people who were admitted to their care after taking LSD back in the 1960s are now believed to have been primarily panic attacks – which are also less likely to happen when dosing takes place in a safe setting in the presence of a knowledgeable guide. Again there are usage warnings: people with psychosis in their family history and young people who are predisposed to schizophrenia may not be good candidates for psychedelic use.

“Set and setting” are so crucial to the successful therapeutic use of psychedelics that early on, Johns Hopkins developed a set of “flight instructions” that are given to research participants in advance of their treatment doses in order to help them avoid bad trips – or to transform bad trips into good ones. These instructions basically involve trusting that you’re going to be okay, letting go, and remaining open to the experience, and they have become part of the standard protocols of clinical studies into psychedelics everywhere – as has the mixed tape of music that Johns Hopkins researchers developed for participants to listen to while they are tripping.

Psychedelics are highly “suggestible,” which means that setting expectations for a psychedelic experience ahead of time is an extremely important step. (This is the “mindset,” or “set,” part of “set and setting.”) It seems, for example, that those who anticipate a mystical experience in which they feel as though they have made contact with a divine being or a deceased loved one are far more likely to have these kinds of experiences than are people whose intentions are (again, by way of example) to learn more about the self or about the nature of consciousness.

Clinical Evidence

The evidence that psychedelics have a dramatic role to play in the treatment of mental-health issues including chronic depression, end-of-life despair and PTSD includes a 2016 publication from New York and Johns Hopkins universities showing clinically significant reductions in measurable incidences of depression and anxiety in 80% of cancer patients. When researchers applied for funding from the FDA in 2017 to extend a study into the effects of these substances on cancer patients, the results they had already amassed were so impressive that FDA staff asked them to expand the next phase to include depressed patients who did not have cancer. As Pollan points out, they made this request “seemingly undeterred by the unique challenges posed by psychedelic research, such as the problem of blinding, the combining of therapy and medicine, and the fact that the drug in question is still illegal” (p. 375). Similar initiatives have occurred in Europe, where there is also serious concern about the pervasiveness of depression in the general population and the inadequacy of current resources and medications to adequately address the situation.

Way back in the 1950s, before psychedelics became illegal, there was already growing evidence that these substances could help people with addictions. Pollan takes an interesting detour in his historical account to report on a highly successful program in Weyburn, Saskatchewan in the early to mid- 1950s – involving Aldous Huxley among others – that made LSD standard treatment for alcoholism in that province. Even before that, indigenous people in North America were using peyote to treat the rampant alcoholism that had accompanied the European invasion of the “New World.” Since the 1990s, research in the addictions field has resumed both underground and above ground, and is showing promising results, with up to 50% of participants in one Johns Hopkins study having quit smoking following a psychedelic session compared to 10% to 35% who used other treatment options.

Even “healthy normals” who have taken standard therapeutic doses of psilocybin or LSD in settings that approximate the ones being used in clinical studies have reported such benefits as increased focus and greater creativity. In small doses, psychedelics have shown a benefit to the fitness of animals, and the implications for humans in this context are also being investigated.

The Spiritual Element

As well as temporarily dissolving the ego (or “shaking the snow globe” as one scientist quoted by Pollan put it), psychedelics have occasioned what many have described as “mystical experiences.” Science is exploring theories about what makes this happen. This is in itself quite an amazing turn of events: we now have researchers focusing their traditional methods of investigation on efforts to discover what causes phenomena that have zero anchors in reality – such as convictions of the existence of higher powers in which people may have faith, but can show no concrete proof. Obviously, the only way to approach this topic in a way that has scientific resonance is to explore the physical side of it. What effect does tryptamine (which is, as explained above, the psychoactive component of psilocybin, LSD, ayahuasca and other true psychedelics) have on the brain that might lead to hallucinations and mystical experiences?

Many studies in England, the U.S., Canada and other countries are now focussed on the effect of tryptamine on the brain’s default mode network (DMN), which “forms a critically and centrally located hub of brain activity that links parts of the cerebral cortex to to deeper and older structures involved in memory and emotion” (p. 301). Wikipedia describes the DMN, which scientists who study the brain did not even know existed until about 2001, as “being active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering. It can also be active during detailed thoughts related to external task performance. Other times that the DMN is active include when the individual is thinking about others, thinking about themselves, remembering the past, and planning for the future.” Scientists are able to get the DMN to “light up” during functional magnetic resonance imaging (fMRI) when subjects are asked certain questions about their selves or given feedback about something they have done (such as receiving “likes” on social media), and with other prompts that involve identification of the sense of self. For this reason, neuroscientists sometimes refer to the DMN as “the Me network.”

The positive effects of the DMN on human thinking and behaviour are multifold. The network essentially acts as a conductor of the orchestra in our brain, whose instruments carry out functions such as smelling, seeing, adding, subtracting, etc. It organizes the instruments in a way that prevents all their necessary activity from leading to cacophonous collisions that would send us into madness. However, the DMN can also create patterns of repetitive thinking that are unproductive, causing our minds to wander around and around dark alleyways (wearing deeper and deeper ruts in our mind) that can lead some of us into cycles of depression and addictive behaviours that we seem unable to escape.

Pollan provides a comprehensive report on the recent history and current thinking related to the DMN, all of which – thanks to his strong writing – is truly interesting. The long and the short of it is that some neuroscientists now think that during psychedelic trips, the DMN or “me network” is knocked out of commission, leading to the dissolution of the ego. This allows the brain to stop processing input as it traditionally does, on the basis of memories and learned emotions, and instead to respond in a way that some have compared to how babies and young children see the world: with amazement and pleasure. Because the DMN is not doing its usual job of telling us “this is impossible,” perhaps tryptamine also lets us encounter visions that we interpret as gods and monsters.

Psychedelics can make even the most cynical of us into fervent evangelists of the obvious. (Pollan, p. 251)

Pollan explains it all much better than I do here, but in short, psychedelics may wipe out the ruts we have created in our thinking, allowing us to see trees and flowers as if for the first time, to love those we love as though experiencing love for the first time, and just generally to become much more open and creative in our ways of interpreting the world. And they may do this simply by taking the default mode network out of commission for a few hours. Herein lies a scientific interpretation that may also explain some magic.

The Psychonauts

There is no doubt that the spiritual component of psychedelics is what is attractive and notable to many who are exploring altered states of consciousness through the use of psychedelics. Indeed, it was for their mystical properties – not to get “high” as one does with alcohol or cannabis – that almost every aboriginal group in the world made use of psychoactive drugs from early times. And it was their mystical effect on users that made LSD seem so dangerous to governments in the 1960s – people who had experienced an explosive love for humanity and the world around them as a result of using psychedelic drugs were no more interested in becoming cogs in the capitalist machine than they were in going off to war. (I imagine that this is not a selling point for psychedelics within the industrial complex.)

Interestingly, it was thanks to a paper published in the journal Psychopharmacology addressing the whole mystical side of psychedelics that revived research interest in the use of psychedelics in therapeutic settings fifteen years ago. Entitled “Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance,” it was the result of a study by a highly regarded neuroscientist named Roland Griffiths, a researcher who had grown bored with his previous work after having had a spiritual experience himself on psychedelics.

This aspect of psychedelic use is still of major interest to many, and groups have been established to foster and explore the spiritual experience. Unlike most religious experiences, the contact with higher powers precipitated by LSD and other psychedelics is direct – you don’t need an intercessor (religious leader, shaman, etc.) to tell you about the immutable revelations; you experience them yourself. (I imagine that this is not a selling point for psychedelics among would-be cult leaders – including not only religious leaders, but also some politicians.)

Pollan writes about a whole range of figures from both within and outside of the world of science who are interested in and knowledgeable about the mystical facets of psychedelics – including the aforementioned Roland Griffiths, as well as Bob Jesse (another of the authors on the Psychopharmacology paper and founder of the Council on Spiritual Practices), Rick Doblin (founder and executive director of the Multi-Disciplinary Association for Psychedelic Studies, [MAPS]), Terrance McKenna (creator of the “Stoned Ape Theory” of the evolution of human cognition, including language), and Paul Stamets, a self-taught mycologist who is central to the movement to increase human awareness of the power, ubiquitousness and benefits to the planet of the range of mushroom species (not just those containing psilocybin).

Back to the Neuroscience

“If, as Freud said, dreams are the royal road to the unconscious, is it possible that psychedelic drugs are a superhighway to the unconscious?” (M. Holden, 1980, as quoted in “The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs,” by Robin Carhart-Harris, Robert Leech, et al.)

I personally found it reassuring that despite all of his research and personal “travels” using psychoactive drugs, Michael Pollan has not turned into a mystic, or completely relinquished his atheism (although he does confess to having “communed directly with a plant for the first time” on his first, unguided trip), but those who are interested in the spiritual aspects of these drugs will find lots of non-judgemental and interesting material in his book.

However, I am at this point more interested in living in the world than lifting off from it on any kind of permanent basis. In fact, one of my big worries about my upcoming trip has been that I will lose my groundedness and sense of purpose, both of which I value highly. So it is reassuring to know that the direct effect of psychedelics on the default mode network is temporary, lasting only as long as the drug is having its most intense effects, which is typically between 6 and 8 hours. Psychedelics do not make people permanently delusional.

The lack of permanent physical change to the brain as a result of psychedelic use is of great interest to scientists. Since the nature of the psychedelic journey does not make people want to have trips on a regular basis (or even more than once, in many cases), and since the effects may wear off within months or years, clinical trials such as the one I am involved with now are working to figure out how to extend the benefits of these trips by means of follow-up integration sessions, meditation, and other non-pharmacological means. (I imagine the fact that only one dose is typically administered is not a big selling point for Big Pharma.)

In Conclusion

This review is so long that I am tempted to just throw the whole thing in the trash despite the hours it has taken me to write it, because I doubt others will be bothered to read the whole thing. Even if they did, their time would be better spent in opening Pollan’s actual book and digging in. But I read How to Change Your Mind far more closely than I would have otherwise because I wanted to to write about it, and that was of great benefit to me. Writing this review, or dissertation, or whatever it is, was also beneficial. It would be a better a literary artifact, and become a more appropriate length for readers of this blog, if I now embarked on a great deal of trimming and restructuring, but I have other things to do.

There are unfinished threads I still want to write about that have arisen from my ingestion of so much material on matters psychedelic – I am concerned abut the future role of these drugs in therapeutics and other consciousness-expanding settings, and specifically about how their potential benefits may be eroded yet again by the machinations of Big Pharma, governments and even therapists themselves who may see little benefit to themselves in the relief experienced thanks to psychedelics by ordinary humans, but I’ll write about that next time.

In the meantime, people who are asking other people and/or the Internet to tell them more about psychedelics, as well as people like me who are contemplating a one-off full-dose psychedelic tour of the inside of their brains, will benefit from reading Pollan. How to Change Your Mind is an extraordinarily rich and interesting resource.

6 responses to “Mary and the Mushroom: Psilocybin, Chronic Depression and Me (10)

  1. Susan Zimmerman

    Mary, write and write and write! I can’t read this now but believe me I will read every word. I have been in such a slough for a long time and this gives me hope. Plus, your writing is clear and beautiful, a pleasure to read. Susan

  2. Eunice Scarfe

    I just finished reading every word as well, Mary — just after watching my copy of Pollan walk out the door with a friend who had seen a recent article in the Globe and Mail, as had I — and I wondered whether the Globe article was based on the research project you’re in. Your blog can’t help but be appreciated by everyone who reads it. It didn’t seem long at all, largely because the subject is so new and so fascinating — and because your analysis and critique and clarity are equal to if not possibly superior to that of the author of the book (heretical to say, since all things Pollan are revered in my household). Do you know anything about the work of Gabor Mate? I’m so glad for your blogs, thank you!

    • Thanks, Eunice. Kind words! I read Mate’s In the Realm of the Hungry Ghosts many years ago and thought it was great. He is very impressive. Not sure about the G&M article: there’s so much out there now on the subject that I can’t keep up. There are also many studies underway at the moment — I know of three in Toronto.

  3. All of your blogs are fascinating – and yes, I read every word. I have been on anti-depressants for close to 20 years. The dosage goes up and (despite my asking) never down.

    • Thanks, Caterina! I hear your pain re the antidepressants — although I’m sure glad they have existed for the past few decades. This psychedelic avenue sound so promising that I am really hoping it becomes widely available soon.

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