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  • [Johns Hopkins Psilocybin Research Project:]

  • [Studies of Mystical Experience and Meditation]

  • [in Healthy Volunteers, and Palliative Effects]

  • [in Cancer Patients]

  • [Roland R. Griffiths, PhD April 21, 2013]

  • Well, thank you very much for being here. I woke up this morning

  • feeling really gratitude-filled, not only for the opportunity

  • to participate in this research, but to the organizers of this meeting:

  • MAPS and Beckley Foundation, the Heffter Research Institute,

  • the Council on Spiritual Practice, and particularly Rick Doblin,

  • who did just a terrific job in pulling this together. And gratitude

  • also to the larger community that comes together. So what I want

  • to do today is talk about our program at Johns Hopkins

  • looking at mystical experience in healthy volunteers. This is our

  • psilocybin research project. And just start by commenting

  • that support for this has been provided by grants from various

  • different entities, including the Heffter Research Institute,

  • Council on Spiritual Practices, the Beckley Foundation,

  • the Riverstyx Foundation, Betsy Gordon Foundation,

  • the Cormac family and the National Institute on Drug Abuse.

  • Our research is being conducted

  • at the Bayview campus of Johns Hopkins School of Medicine,

  • and I also want to underscore that I'm just a figurehead

  • up here for a very dedicated and competent research team.

  • There are actually ten of us here at the meeting today, nine

  • of whom have given presentations already, and we have, I think,

  • six others from the team, not all full-time, back in Baltimore.

  • But in addition to me there's Bill Richards who's been our

  • chief clinical mentor, and he gave a spectacular talk yesterday

  • reflecting on his 25 years of experience of doing research with

  • psychedelic drugs; Matt Johnson, who's been with us since 2004

  • and who's my kind of scientific alter ego at Hopkins, he's been

  • very involved in all of the psilocybin research throughout

  • the time that we've been doing it; Katherine MacLean, who's

  • joined us recently, and joined the faculty, comes with a particular

  • interest in meditation, which is a focus of some of our research

  • and of interest to me; Mary Casamano and Brian Richards,

  • who spoke yesterday about managing difficult experiences;

  • Mary probably has the distinction of being someone who's guided

  • more approved psychedelic sessions than any other individual

  • in the last couple decades: hundreds of sessions;

  • and then Al Garcia-Romeu and Matt Bradstreet are post-docs.

  • Al's been working on the psilocybin smoking cessation project.

  • Matt has just headed up an interesting survey study on challenging

  • experiences. He presented a poster, and Al talked about his work,

  • I think, on Friday. Maggie Kleindienst keeps our unit together.

  • She's our liaison to FDA, DEA, our IRB, and she manages

  • and coordinates all of our studies. Bob Jesse, who has been

  • involved from the inception of this work with healthy volunteers

  • and the interest in mystical experience. So we initiated

  • the development of our first study back in 1999, so it's been a while,

  • and initially recruitment and the studies proceeded really

  • quite slowly, partly because of funding, partly because of logistics.

  • But we've completed two very major studies, one in healthy volunteers

  • and a survey study, and we've spun off at least seven publications

  • at this time, but things are picking up. So there's a number of

  • ongoing studies, some of which I'll mention today: effects of

  • psilocybin in beginning meditators. We're just initiating study of

  • psilocybin effects in long-term meditators. Psilocybin treatment in

  • psychologically distressed cancer patients: that's a study that's

  • ongoing, and I'm choosing not to talk about it because Charlie Grob

  • and Steve Ross and Tony [Bossis] have all talked about their trials,

  • but I do want to put in a plug, that we're actively recruiting.

  • We need another 15 volunteers. We have a travel grant program,

  • so we can bring people in nationally, and so if you know of anyone

  • who has some existential distress around the cancer diagnosis,

  • please let them know of our study. The website is cancer-insight.org,

  • and if they go to that website there's plenty of information

  • about the study and how to enroll. Finally, the final ongoing study

  • that Matt Johnson'll be talking about later this afternoon

  • is a pilot study of psilocybin facilitation of smoking cessation,

  • which is a really fascinating study with very interesting results.

  • So to date, we've run 190 volunteers over 460 sessions.

  • So we've gained pretty substantial experience with these compounds,

  • and this is all moderate to high dose, 20-30mg/70kg, so these are

  • high-dose sessions. Briefly, by way of background, psilocybin

  • is a naturally occurring tryptamine alkaloid. It's the principal

  • psychoactive component in the Psilocybe genus of mushroom.

  • Mushrooms have been used for thousands of years within in various

  • cultures in structured or divinatory settings. So there's this long

  • historical use, medical and sacred use of these compounds.

  • The classic hallucinogens, this is our best working definition

  • of it. The classical hallucinogens are a structurally diverse group

  • of compounds, bind 5HT(2A) serotonin receptors, and produce

  • a unique profile of changes in thought and perception and emotions,

  • often including profound alterations in the perception of reality,

  • that are rarely experienced except in dreams, naturally-occurring

  • mystical experiences, and acute psychoses.

  • So psilocybin is a tryptamine and DMT is also a tryptamine.

  • There's a phenethylamine serotinergic or classic hallucinogens

  • such as mescaline and DMT. One other comment about background:

  • considerable research was conducted with psilocybin and the

  • classic hallucinogens back in the '50s and '60s, and as we all know,

  • subsequently, research for these compounds went dormant for

  • two or three decades, depending on what laboratories were working.

  • But the substantial work was shut down for close to four decades,

  • and it was in response to the widespread medical use and concern

  • about potential harms, and in my opinion the antics of Timothy Leary,

  • which really undermined a scientific approach to studying

  • these compounds. But we had a cultural trauma surrounding

  • research with these compounds that's really unprecedented,

  • as far as I'm concerned, in science generally. So this is an overview

  • of what I want to talk to you about this morning. I'm going to

  • describe our two published studies in healthy volunteers

  • characterizing mystical experiences, go on to two ongoing

  • studies in meditators, one in novice meditators and one we're

  • just about to undertake in long-term meditators, and then I'll

  • talk about two web-based anonymous surveys in which we've

  • been looking at the effects of psilocybin when people ingest

  • mushrooms in non-research settings, and very briefly with some

  • conclusions, implications, and future directions. So the two published

  • studies in healthy participants: both studies used double-blind

  • crossover designs. The first study, 36 participants, two or three

  • sessions at two-month intervals compared a high dose of psilocybin

  • with a high dose of methylphenidate or Ritalin. The design effectively

  • obscured to volunteers and monitors exactly what drugs were

  • being tested. The second study: 18 participants, five sessions

  • at one-month intervals, comparing placebo, 5, 10, 20, 30 milligrams

  • of psilocybin administered in mixed sequence across sessions.

  • Actually, it was mixed but half got ascending, half got descending with

  • intermixed placebo so they didn't know that.

  • The participants in these studies were recruited from the local

  • community through flyers and newspaper advertisements.

  • The study participants were medically and psychiatrically

  • healthy, without histories of hallucinogen use. We did this

  • intentionally to reduce the possibility that we'd have selection bias,

  • that people didn't differentially come into the study who had had

  • good effects with psilocybin and then confound what kind of

  • generalities we could draw from that. The volunteers didn't receive

  • monetary compensation for participation.

  • So, the participants: just one comment. I'm going to intermix the

  • description of the methods and results for these first two studies,

  • because they're really so similar, so what I'm doing here now is

  • providing demographics for both of the studies combined

  • rather than try to parse those apart. So the mean age of these

  • 54 volunteers in these 2 studies was 46 years, half female,

  • highly educated, most employed full-time, part-time. We had

  • physicians, psychologists, counselors, pastoral counselors,

  • business owners, consultants, a wide variety primarily of

  • professional-level people. In terms of religious, spiritual

  • activities, all 54 indicated at least intermittent participation

  • in religious or spiritual activities, such as religious services,

  • prayer, meditation, church choir. We did this partly because it's

  • consistent with the long historical use of these compounds

  • sacramentally, and also to reduce what we thought might be

  • some inherent variability. So volunteers...our basic way that we

  • approached these studies is very similar to that's already been described

  • by these other research teams. Our volunteers meet with monitors

  • for up to 8 hours of contact time prior to the first session,

  • and the purpose of this is to establish good rapport, and trust,

  • because the thought is that that's going to minimize adverse effects

  • to psilocybin. Studies are conducted in aesthetic living-room-like

  • environment. This is a laboratory's unlike any other that we have

  • in our psychopharmacology research unit. This over-showed slide

  • at this juncture, I think it's been showed ten times over the course of

  • this meeting, shows what happens on session days. So people come in

  • at 8 in the morning, they take a capsule, they're in the presence

  • of two guides or monitors throughout the day. They're asked to

  • lay on the couch, wear eyeshades and headphones through which

  • they listen to a program of music. The guides are there to provide

  • reassurance if anxiety or fear come up. That could just be

  • verbal reassurance or touch to the shoulder or holding a hand.

  • But it's our intention to let people have their own experience,

  • and we ask them to go inward. So this isn't guided in any psycholytic

  • kind of sense of how some of these sessions have been

  • conducted in the past at lower doses, because we're interested

  • in these high-dose sessions. So this shows time course of

  • monitor ratings. This is from the dose effects study. Just showing

  • the very orderly time- and dose-dependent effects of psilocybin.

  • Onset's occurring 30 to 60 minutes, peaking at 2-3 hours, and

  • decreasing toward baseline. Even 5 milligrams under this condition

  • is really quite active, which surprised us. Self-reported

  • effects of psilocybin: it wasn't surprising to us, and I'm sure

  • not to you, that psilocybin increased measures previously

  • shown to be sensitive to hallucinogen drugs. So there are perceptual

  • changes such as visual illusions, greater emotionality, such as

  • increased joy, peacefulness, sometimes fear and anxiety--

  • I'll come back to that--and cognitive changes such as sense of meaning,

  • sometimes some paranoia. But we think that at least for me, for sure,

  • the most interesting effect that we had was that in most volunteer

  • studies psilocybin produced these large increases in these

  • self-rated questionnaires designed to measure naturally occurring

  • mystical experiences. This shows the results of the dose effect study

  • on the Hood Mysticism Scale and the Pahnke-Richards

  • Mystical Experience Questionnaire, just showing clear dose-related

  • increases. This is interesting. The Hood Scale was developed

  • based on naturally-occurring mystical experiences, using

  • criteria developed by [Stace] in 1960, and it had never before

  • been used in any sort of drug study. We're getting robust increases

  • and it's those kinds of observations that make us feel quite

  • confident that this is an experience that really maps on to

  • naturally occurring mystical experiences. This just shows the

  • percentage of volunteers who fulfilled criteria for having

  • a so-called "complete" mystical experience, and I'll tell you

  • what that is in a second, but we get nice dose-related increases

  • in that with about 75% of volunteers fulfilling this criteria

  • at either the 20 and/or the 30mg/70kg dose. So the 75% of people

  • are meeting this criteria for having a complete mystical experience.

  • These are the phenomenological dimensions of mystical experience.

  • Again, this been covered in other talks. The core feature is

  • this sense of a unity, this interconnectedness of all people

  • and things, the sense that all is one, everything's interconnected.

  • This is accompanied by a sense of sacredness or reverence,

  • a noetic quality of encountering ultimate reality, that this is

  • more real and more true than everyday waking consciousness,

  • a deeply felt positive mood, sometimes described as universal

  • love, joy, peace, gratitude. Transcendence of time and space,

  • past and present collapsed into the present moment. That becomes

  • all there is. Space is vast, endless, the void, perhaps.

  • These experiences are described as being ineffable with people

  • who have had them. They're not simply put into words.

  • So those are the dimensions of the mystical experience.

  • The interesting piece of our work, fascinating to me, when we

  • initially started this work, was that the kinds of attributions

  • that are made to the experience really persist. So this is a questionnaire

  • given two months after sessions. We're asking people how personally

  • meaningful and spiritually significant...no, how personally

  • meaningful was this experience on a scale from an everyday

  • experience, once a week, once a year, up to top 10, top 5,

  • single most meaningful experience of my life. The fill bars are

  • psilocybin, striped bars are methylphenidate. So you can see this

  • remarkable effect where about 70% of people are saying this

  • experience that occurred over an 8-hour session in a Johns Hopkins

  • pharmacology laboratory is among the five most meaningful

  • experiences of their lives. It seemed so improbable to me when we

  • started this, and they would compare this to the birth of their first-born

  • child or the death of a parent. So they're really remarkable,

  • salient experiences. This is an equivalent questionnaire.

  • How spiritually significant was this experience? Thirty percent

  • of these people who were already spiritually inclined are saying

  • it's the single most spiritually significant experience of their lives

  • and again, about 70% are saying it's in the top five.

  • This shows similar data from the dose-effect study. This is percent

  • of volunteers rating the experience in the top five spiritually

  • significant of their lives. You can see we just get nice dose-related

  • increases, going up to 83% at the highest dose. This is single most

  • spiritually significant experience of their life, and here we're getting

  • 45% of these people after the 30mg/70kg saying it's the single

  • most spiritually significant experience of their life.

  • This shows effects that people talked about, again, two months

  • after sessions, when we asked them to complete a questionnaire

  • that rated 60 different items that probed changes in attitudes

  • about life and self, mood changes, altruistic positive social effects,

  • and positive behavioral change. Significant increases after psilocybin.

  • So the kinds of things that people are endorsing here, in attitudes,

  • they're more personal integration, meaning, enthusiasm,

  • patience, authenticity, self-confidence, mood, increased love,

  • open-heartedness, joy, inner peace. Social effects: more sensitive,

  • compassionate, tolerant, increased positive relationships.

  • This shows comparable data from the dose-effect study.

  • So this is robust, it's replicable, it's dose dependent.

  • You can see we get nice orderly increases in these same

  • four domains in this second study. These effects persist past

  • two months, so the longest we've gone out is 14 months.

  • Anecdotally, we've talked to volunteers years later, and I don't think

  • there's any diminishment of the attributions that people

  • are making to these experiences. So this is 14 months. This is

  • the methylphenidate study. So this is showing top five spiritually

  • significant experiences of the lifetime. This is after methylphenidate,

  • this is after psilocybin, two months after psilocybin; here's

  • 14 months after psilocybin. So no diminuition of effect, and

  • that's true of positive behavioral change and increased

  • sense of well-being or life satisfaction. This shows this

  • interesting correlation of the mystical experience score

  • immediately after psilocybin--this is the Hood Mysticism Scale--

  • and ratings of spiritual significance at 14 months. You can see

  • there's a strong correlation there, and this is different than

  • just magnitude of psilocybin effect. There's no relationship there.

  • So what that's telling us is there's something embedded

  • within the Hood Mysticism Scale, those questions, probing

  • the dimensions of mystical experience, that are picked up

  • and are reflected then 14 months later and obviously much longer

  • than that. That's the nature and I think the controlling event

  • that's so interesting here with these experiences. This is just

  • in volunteers' own words. So we asked them at 14 months,

  • "so, what was this like? Why are you saying this was a meaningful"

  • "experience?" and just pulled four quotes, but it's lovely

  • to hear people put this in their own words. "The part that continues"

  • "to stick out for me was the knowing, seeing, experiencing"

  • "with every sense and fiber of my being that all things are connected."

  • Another: "the sense that all is one, that I experienced the essence"

  • "of the universe, that knowing that God asks nothing of us except"

  • "to receive love." Another: "The feeling of no boundaries,"

  • "where I didn't know where I ended and my surroundings began."

  • "Somehow I was able to comprehend what oneness is."

  • Finally, and "the understanding that in the eyes of God, all people,"

  • "abusers, abused, Christian fundamentalists, Muslim fundamentalists,"

  • "atheists, were all equally important and equally loved by God,"

  • "and that, given the proper circumstances, I could be any one of them."

  • So these effects that are reported by volunteers aren't limited to

  • just that. We did telephone ratings with community observers;

  • these are friends, family members, co-workers, and asked them

  • a series of questions about the volunteer, probing things like

  • patience, optimism, interpersonal perceptiveness, compassion,

  • and expression of emotion like love, joy, gratitude, and these

  • were significantly elevated. This is two months after sessions.

  • Psilocybin significantly higher than methylphenidate in that

  • first study, and in the dose-effect study we just did pre/post

  • measures from baseline. Significantly elevated one month after

  • the study and continued elevated at 14 months. Dropped

  • a little bit, but still significant.

  • So these persisting changes and the kinds of attributions

  • people were making and that their community members

  • were observing in them led us to wonder about whether

  • psilocybin affects personality. Cross-cultural studies of

  • personality structure have demonstrated five reliable and stable

  • domains of personality. There's neuroticism, extroversion,

  • agreeableness, openness, and conscientiousness. The

  • gold standard for assessing this is something called the

  • NEO Personality Inventory. So, when Katherine MacLean came

  • to our unit, she re-analyzed the data for the two studies

  • combined, and showed that we're getting increases in this

  • personality domain of openness overall, and furthermore,

  • when you break it down, it turns out that it's the individuals

  • who fulfilled criteria for having had a complete mystical

  • experience that are showing these elevations in openness,

  • and those who don't do not.

  • This is interesting because openness encompasses aesthetic

  • appreciation, sensitivity, imagination and fantasy, broad-minded

  • tolerance of other people's viewpoints and values. Openness

  • is fundamental to creativity and predicts creativity in the arts,

  • the sciences and the humanities. So there's something really

  • interesting going on. As far as we can tell, there are no other

  • acute manipulations that have ever been done that change personality.

  • This is really thought to be a fixed characteristic of an individual,

  • and in fact the domain of openness generally decreases

  • across the lifetime, so this might be viewed as an anti-aging

  • effect of psilocybin. So I do want to touch on the fear, anxiety,

  • dysphoria which turn out to be inescapable effects; when you move

  • the dose of psilocybin up, some people are going to have difficult

  • experiences. In about a third of our volunteers, after the 30mg/70kg,

  • and none after placebo or methylphenidate, reported strong

  • or extreme ratings of fear some time during the session.

  • Interestingly, the onset of these feelings and the duration

  • had no predictable pattern. In other words, the onset could

  • come on late or early and it could be of short or longer

  • duration. In our dose-effect study, these effects occurred

  • almost exclusively at the highest dose. Only one of 18 volunteers

  • had such an effect at the 20mg/70kg. Twenty-six percent

  • of our volunteers had mild, transient paranoia or ideas

  • of reference, but despite these psychological struggles,

  • most of these participants rated the overall experience

  • as having personal meaning and spiritual significance,

  • and no volunteer rated having decreased their sense of

  • life satisfaction or well-being. I'll return to these observations

  • when we talk about our larger survey data that is ongoing,

  • but I'll give you some preliminary results. This simply shows

  • time course of monitor ratings of anxiety or fear in five

  • volunteers after the high dose of psilocybin. What it shows is

  • this erratic onset and offset of effects. So here's someone--

  • different colors are showing different subjects. So here's

  • someone who had no anxiety out until three hours, and then

  • peaked anxiety on the third hour, and then it was back down

  • almost to baseline very rapidly. So it came on probably close

  • to peak effects and then resolved really rapidly. Here's someone,

  • for instance, who had a peak of anxiety at, it looks like,

  • about 90 minutes, back to baseline, went up higher here

  • at about four hours and then decreased, and this volunteer

  • peaked anxiety right out of the gate and remained anxious

  • throughout most of her session. So it really underscores the

  • fact that the guides really need to be on their toes with respect to

  • providing support, because things can be going beautifully,

  • and people can be having transcendent experiences,

  • and then very quickly we can enter into dark places in these sessions.

  • The final thing I want to say about these studies is that within

  • the dose-effect study we had a cohort that had ascending

  • sequence of dose and another cohort that had decreasing

  • sequence of dose. They were blinded to the fact that there were

  • ascending and descending sequences, as were the guides,

  • and we intermixed placebo, so no one believed anything

  • other than that this was a random assignment of doses.

  • But the important point here is that the ascending sequence

  • of dose has some advantage over the descending sequence

  • in terms of optimizing well-being, life satisfaction,

  • and persisting positive mood at a month followup. So that's

  • led us to conclude that if we're going to run additional studies,

  • and we are, and this has been built into it, it's much better

  • to use ascending sequence than to blast people with a really

  • high dose right at the beginning. So I now want to segue

  • into a couple of studies on meditation.

  • Why meditation? How did we get involved with this? Personal

  • disclosure: meditation was actually the vehicle that brought me

  • to want to study psilocybin and these compounds, but apart from that,

  • we believe that there are some really intriguing points of convergence

  • between the psilocybin experience and meditation experience,

  • and Katherine MacLean talked a little bit about that in her presentation

  • yesterday. I think that meditation and psilocybin can actually

  • be viewed as very complimentary techniques for exploration

  • of the nature of mind and self, self being egoic or this bounded sense

  • of self that we have. Recent neuroimaging studies show that

  • meditation and psilocybin produce strikingly similar decreases

  • in brain circuits responsible for self-referential processing.

  • So, Robin Carhart-Harris will be presenting later today

  • some of their fMRI work in which they're showing, with acute

  • intravenous psilocybin, decreases in the default mode network.

  • That's a network in brain that's responsible, it's believed,

  • for self-referential processing. The interesting thing is, a year

  • before he reported those results, [Judd Brewer] reported

  • virtually identical results from meditation: a decrease in

  • default mode network. So there's a neurophysiological reason

  • for thinking there might be similarities. So again, complimentary

  • approaches. Meditation techniques have been developed

  • over millenia and they represent, clearly, a powerful approach

  • for investigating the nature of mind and self. If meditation

  • represents the systematic tried-and-true course of discovery

  • of the nature of mind and self, then psilocybin represents

  • the crash course, but they're headed in the same direction.

  • So, psilocybin is a pharmacological tool that helps people

  • recognize how it feels to embody the present moment. That

  • would be exactly true of meditation. Psilocybin helps people

  • dispassionately observe and let go of pain, fear, discomfort,

  • and that's what happens with short or long sitting meditation.

  • Psilocybin helps transform a conventional sense of self, that is,

  • an ego, or dissolve that sense of self. "You're not your mind"

  • "in any conventional sense" is the strong message that comes out

  • from using psilocybin, and that's a hallmark feature of meditation,

  • the non-self. Psilocybin helps you recognize that the mind's

  • capable of revealing knowledge not readily accessible in everyday

  • waking consciousness. That surely is true of meditation.

  • Finally, psilocybin, you can gain an authoritative sense of this

  • interconnectedness of all people and things, the mystical experience,

  • and of course that enlightenment experience is a hallmark

  • feature of meditation as well. So I'm going to talk a little bit

  • about an ongoing study that we have a little bit of preliminary

  • data for looking at the effects of psilocybin and meditation

  • in novice meditators. So here we're using a double-blind

  • design, examining whether psilocybin experiences can facilitate

  • people's engagement in meditation and other spiritual awareness

  • practices, thereby increasing sense of spirituality and altruism.

  • Seventy-five volunteers with little or no history with either

  • meditation or the classic hallucinogens participated. Two or three

  • psilocybin sessions over six to seven months, during which

  • participants received instruction and support in learning meditation,

  • as well as other spiritual practices. In this case, we used

  • mantra repetition during the day to help prompt people to

  • bring in this sense of awareness and awakening throughout

  • the day. So to help control for expectancy effects, the volunteers

  • as well as our study staff were provided incomplete information

  • about the study design. So this is something we've done in

  • past studies. No one is deceived, but there's incomplete

  • information. So both our study staff and volunteers were told

  • that the participants would have two or three psilocybin sessions

  • over six to seven months, all sessions would involve administration

  • of psilocybin, and that the range of doses could vary from low to high.

  • They were also told that by the end of two or three sessions,

  • they would have received one or more high doses of psilocybin.

  • The study began with a one-month meditation introduction,

  • followed by sessions one and two at one-month intervals,

  • and volunteers were informed whether or not they would

  • have a third session after the six-month followup. So what the staff

  • and volunteers didn't know was that the volunteers were

  • randomized to three conditions of 25 volunteers each. So this is

  • a parallel group design, and in terms of thinking about it,

  • it can be thought of as just a 2 x 2 design, with high-dose,

  • low-dose psilocybin, and standard support and high support,

  • in terms of the support we give them learning meditation

  • and spiritual practices. We're filling three of the four cells here,

  • so there was a low-dose psilocybin, standard support,

  • a high-dose psilocybin and standard support, so we can glean

  • information about dose effects, and then there was a high-dose,

  • high-support group. So we can look at the effects of support.

  • We're missing the cell that was... it was a painful cell to drop.

  • Two-by-twos are much more powerful if you can fill out all the cells,

  • but we simply didn't have the financial resources to do so.

  • The low-dose condition consisted of one milligram of psilocybin

  • in both sessions one and two. So this is close to a placebo dose.

  • We actually don't know what the absolute lower...detectable

  • dose is. As I showed you earlier, we get pretty substantial

  • effects at 5mg/70kg. But it also serves as an important

  • expectancy control, because we could tell everybody that they

  • would receive psilocybin on every session. The high dose was

  • 20mg/70 on the first session and 30mg on the second,

  • making use of the observation we gleaned from our dose-effect

  • study, that ascending doses are better than descending

  • doses. The support conditions: there was a standard support

  • involving seven hours of contact time, six meetings, versus

  • 35 hours of contact time and 26 group and individual meetings.

  • We've collected a range of measures. I actually won't go into this,

  • because I'm only going to present just a couple of outcome

  • measures here. But we're looking at a range of measures

  • that we would think might be changed through spiritual

  • practices, particularly in combination with psilocybin, and we're

  • also looking at some behavioral measures of impulsivity

  • and social behavior. The study's almost complete. It's frustrating

  • to me and to our research team that it's not complete. It had been

  • our hope that we would have a full set of data to present,

  • but we had stragglers in terms of getting enrollment completed.

  • We've done a preliminary analysis now of some of our data

  • from the followup questionnaire that occurs just three weeks

  • after the second session, and, remember, the session goes out

  • to a full six months, so this is preliminary. To anticipate

  • what I'm going to show you is that we're seeing dose effects

  • of psilocybin so far; we're not seeing effects of the support

  • manipulation, but this isn't unexpected, because, as I said,

  • this data that we're looking at is coming immediately after,

  • or closely after the second session. The differences between

  • the support conditions are actually greatest in the last three months

  • of the study. So here's a daily spiritual experience scale.

  • So this is asking questions such as "I experience a connection"

  • "to all of life," "I am spiritually touched by beauty and creation,"

  • and these are validated scales, and that scale is completed

  • on the basis of ratings that occur, with respect to, say, connection

  • to all of life, once in a while, on some days, on most days,

  • every day, many times within a day. You can see we're getting

  • pronounced effects of psilocybin on that scale. So embedded

  • within our spiritual practices, they're aware and they're also

  • practicing, very likely, mantra awareness throughout the day.

  • This is a forgiveness scale, interesting validated forgiveness

  • scale, in which it's transgression- specific. So volunteers here are

  • asked to "think of a person who's deeply hurt or offended you,"

  • and then there are a set of questions that probe different kinds

  • of forgiveness: revenge motivation, avoidance, and benevolence

  • motivation. Here what we're seeing--the effects of psilocybin--

  • is decreases in all three of those motivational components.

  • So statistically less revenge motivation, less avoidance

  • motivation, more benevolence motivation, increasing forgiveness.

  • This is a measure of coherence. This is existential well-being

  • increased by psilocybin. Death acceptance: this looks like it's

  • trending toward increases in the high-support group, but this

  • isn't significant, relevant, of course, to our cancer studies.

  • This is probing questions like "I think I'm generally less concerned"

  • "about death than those around me," or "since death is a natural"

  • "aspect of life, there's no sense in worrying about it."

  • So I now want to move on to our planned study, where we're going to

  • run our first pilot study subject next month, and this is in long-term

  • meditators. So recent research has shown that even in experienced

  • meditators, they can show significant improvements in important

  • psychological [attentional] domains if they participate in long-term

  • meditation retreats. I refer here to the shamatha project that

  • Katherine MacLean was involved with, where they showed a variety

  • of very interesting changes in people. This was after a three-month

  • meditation retreat. No study has investigated the effects

  • of psilocybin in long-term meditators. We're thinking they're

  • actually a really interesting group to investigate because of

  • their introspective skills at this point. One research question

  • of primary interest is whether long-term meditators experience

  • psychological or behavioral benefits or harms from psilocybin.

  • So, as you may know, in conventional Buddhist precepts,

  • there's a precept against the use of intoxicants, and that's

  • often interpreted as any intoxicant. So there are some teachings

  • that would suggest that a good Buddhist practitioner should not

  • ever touch a psychotropic drug. So it'll be interesting to see

  • our ability to recruit for these studies, but our preliminary

  • inquiries with significant meditation teachers lead us to believe

  • that there are people who have long-term meditation practices

  • that'll be interested in this. Our assessments here are going to

  • include psychological functioning, spirituality, health, prosocial

  • attitudes, behavior, and we're going to do fMRI brain function.

  • It's going to be a randomized, weightless, controlled design,

  • 40 participants, substantial meditation history. There are going to be

  • two psilocybin sessions. During some sessions we're going to

  • change what we normally do in our session room and we'll invite

  • people to take sitting meditation posture and then engage in

  • various meditation practices. What we're interested in is probing

  • focused concentration. That's a shamatha practice that might be

  • focusing on the breath, a loving kindness meditation, open awareness

  • meditation, and awareness of awareness, so shamatha without a sign.

  • So now that concludes the experimental work that we're doing.

  • What I now want to do is segue into our survey studies.

  • We've conducted two web-based anonymous survey studies

  • in large groups of individuals who reported on their experiences

  • after ingesting psilocybin mushrooms in non-research settings.

  • The reason we undertook these studies was to investigate

  • the generality of our laboratory findings. We're doing this

  • in an insular set of conditions and it's very important to know

  • questions about generality. The other power of doing web-based, large-

  • sample surveys: it allows us to refine some of our psychometric

  • instruments, assessing mystical experience and difficult

  • experiences, and the large sample size gives us the statistical

  • power to do factor analysis on that. So the first of these surveys

  • that was undertaken by Katherine MacLean focused on individuals

  • who endorsed having had a profound and personally meaningful

  • experience after taking psilocybin mushrooms. Almost 90% of these

  • people also rated these experiences as mystical, so we think of this

  • as our mystical experience cohort. The survey took 30 to 45 minutes

  • and we asked questions with questionnaires that we've used

  • within the laboratory. So we had over 1600 participants,

  • mean age 32, 50% male, so we constrained recruitment

  • into this survey to allow equivalent genders. Most college graduates,

  • 35% some college, 80% from the US. The magic of doing this

  • on the web is you can pull worldwide, so we had 45 different

  • countries represented. Interesting, pretty modest use of psilocybin

  • before the designated experience, a median of 2-5 times.

  • So you might imagine the range of psilocybin experience

  • was extreme, from this being the first psilocybin session

  • that they ever had, or the first exposure to any classic hallucinogen,

  • which was 15% of the sample, to people who literally had

  • hundreds of such experiences. The designated psilocybin

  • experience occurred on average 8 years before the survey,

  • when participants were about 25 years old. So, how personally

  • meaningful was this experience? So this questionnaire,

  • of course, was asking about meaningfulness, but you can certainly

  • appreciate the similarity of this distribution to that that we had

  • in the laboratory. So I think it's about 50% of people are endorsing

  • that it's in the 5 most personally meaningful experiences of

  • their lives. This is spiritually significant, and again the

  • distribution looks very similar to that that we saw in the laboratory.

  • It's a little lower in terms of absolute amounts, but the distribution

  • is really quite similar. Here's change in personal well-being

  • and life satisfaction. Again, very similar to what we saw.

  • We're having some people, very small numbers, say they had some

  • decreased well-being. One of the powers of this survey is

  • that then it allowed us to do a factor analysis of our results,

  • and so we factor-analyzed the mystical experience questionnaire.

  • I showed you earlier the six domains of mystical experience.

  • Well, those were developed by William Stace, used by Walter Pahnke

  • in the Good Friday experiment, and then developed into the

  • Pahnke-Richards Mystical Experience Questionnaire. But those

  • were descriptive labels that had never been factor-analyzed.

  • So if you subject these kinds of experiences to factor analysis,

  • we ended up with four factors. So there's one--I think of it as

  • the mystical experience domain-- that includes unity, the noetic

  • quality, that's the truth value, the ultimate reality value

  • of the experience, and then the sacredness. Then there's a factor

  • including positive mood, another factor, transcendence

  • of time and space, and then ineffability.

  • Our next step here, incidentally, is, after having finished

  • our long-term meditator study, we now have a sufficient n

  • to go back and do a confirmatory factor analysis within

  • our laboratory sample to just verify whether this factor structure

  • is robust and holds up. That's the way these kinds of questionnaires

  • are designed. This simply shows that the factor scores on

  • these derived factors predict personal meaning and well-being

  • attributed to the psilocybin session. So people who said that

  • this was among the most meaningful experiences of their lives

  • had higher scores on this scale than those who did not.

  • So, Matt Bradstreet has recently undertaken an interesting

  • extension of this work. So we have now conducted, or

  • are conducting, a survey study of people who endorse having had

  • difficult or challenging experiences after taking psilocybin

  • mushrooms, and they're being asked to complete this survey

  • on the basis of the single most psychologically difficult

  • or challenging experience, your worst bad trip. This survey,

  • incidentally, is still posted: www.shroomsurvey.com. So if you

  • feel inclined to contribute, by all means, do. It's a commitment

  • of time; it's 30 to 40 minutes to complete. So the demographics

  • of this sample are really remarkably similar to the mystical

  • experience sample: mean age 30, 50% college grads, 35% some college,

  • time of the designated session... more from out of the country;

  • only 67% from the US, modest prior use, with again 15% of the

  • sample, it was their first use of a classic hallucinogen. These are

  • two items that we didn't ask of the demographics in our first study

  • and wish we had. Twenty-seven percent of the sample are

  • daily tobacco users. Almost 40% are daily marijuana users,

  • which surprised me, but the power of having a big sample size

  • is then we can go back and determine what the influence of

  • chronic marijuana use would be on some of the dimensions

  • reported. For those who knew, the average dose was about

  • 4 grams of dried mushrooms or 40 grams of fresh mushrooms,

  • so that's equivalent to about 20mg of psilocybin, on average,

  • so huge differences in terms of potency of mushrooms, but it suggests

  • we're in the range of our intermediate dose, which is 20mg/70kg,

  • actually somewhat lower than that, because at least many of

  • our volunteers weigh over 70kg. So the question "how psychologically"

  • "difficult or challenging was this experience?" They're reporting

  • this on the basis of the most challenging experience they've ever had,

  • but I think it's impressive: about 40% are saying that it's in the

  • top 5 most difficult experiences of their lives...that's about 10%

  • saying that it's the single most challenging experience of their life.

  • I really regret that we didn't have this questionnaire in our

  • laboratory studies or in the study of mystical experience,

  • but we'll certainly add that to our laboratory studies. So what

  • do you think meaning is going to look like in this population?

  • They're filling this out on the basis of the most challenging

  • psilocybin experience ever. How personally meaningful

  • was the experience? The distribution is eerily similar to the

  • mystical experience questionnaire, so in spite of this being

  • among the most difficult experiences of their lives, it was

  • deeply personally meaningful. Here, just for comparison,

  • I've put the two surveys together. So the blue is the mystical

  • experience; the red is the bad trip survey. As you would expect,

  • there's somewhat more meaning here to the mystical experience

  • meaningful survey, and the bad trip survey tends to go out

  • at the lower end, but overall the distributions are really

  • remarkably similar. How spiritually significant was this experience?

  • Here we have really quite a flat distribution, and if you compare it

  • to the mystical sample, you can see that there's a considerable

  • difference. So these bad trips are less likely to, although meaningful,

  • they're less likely to be designated spiritual. Here's change in

  • personal well-being and life satisfaction, again skewed positively,

  • but if we compare the two samples, I think this seems strikingly

  • different to me, that if you looked at increased very much,

  • the mystical survey is running almost 50%, where the bad trip

  • survey is close to half of that. If you look at the other end of the

  • scale, decreased or no change, the bad trip survey is over-represented,

  • certainly as one would expect. I think what I take away from this

  • is there's far more meaning and well-being even among

  • the most difficult experiences. Here's a question: "despite"

  • "portions of the session being difficult or challenging, do you think"

  • "you benefited from the experience?" Here we have a resounding

  • 83% of people saying that they benefited from it. "Would you"

  • "want to take this again if all that happened continued to happen"

  • "including the difficult or challenging portions?" Here, we're dropping

  • to a little less than 50%, so a claim of benefit, increased

  • well-being, but want to do it again? Not so much, and that makes sense.

  • If you've been involved in a potentially traumatic experience,

  • a car crash, for instance, you may benefit from it; it may be

  • personally meaningful, but you sure don't want to do it again.

  • So this is a question that was probing conditions during

  • the sessions that were thought to be positive or supportive

  • to a positive experience, so asking "was social support"

  • "conducive...physical comfort... emotional state..." and these are all

  • being endorsed at fairly high levels. Interestingly, having

  • a sitter or guide present was only 25% of the samples,

  • and about 50% of those, the sitter was not sober.

  • "Indicate each thing you did to stop the bad trip that you believe"

  • "helped substantially." So here people are endorsing most helpful:

  • trying to calm their mind, changing their location; intermediate:

  • seeking out support, changing musical environment, social

  • environment; least effective: taking another drug, smoking

  • cannabis, another drug, drinking alcohol. So there's interesting

  • importance, I think, to the duration of the difficult experience.

  • So the median duration of these difficult experiences was one to two

  • hours, and it ranged from less than 10 minutes to the entire session.

  • The rating of the severity of the difficult experience overall,

  • as you might expect, correlated positively with the duration

  • of the difficult experience. Interestingly, the personal meaning,

  • the improved well-being attributed to the experience, and

  • the alleged benefit from the session, all correlated positively

  • and significantly with the degree of difficulty of the session experience,

  • and that's kind of what we saw before, all those distributions

  • of saying that it was really difficult but it was really meaningful.

  • So there was a positive correlation there, but there was not

  • a positive correlation with the duration of the difficult experience.

  • In some cases, the correlations were negative with the duration,

  • so we conclude that the longer the difficult experience,

  • the less likely there will be positive attributions to the experience,

  • That would be a very good reason to have a guide present,

  • to help foreshorten the duration of confusion and difficulty.

  • I also want to mention some other adverse events that respondents

  • endorsed. So, 10.6% of this sample reported that they put themselves

  • or others at risk for physical harm during the experience.

  • Two point eight reported behaving in a physically aggressive

  • or violent manner during their experience. Two and a half said

  • they sought help or got help from a hospital emergency department.

  • Two point eight of the sample who had no prior

  • treatment history sought out treatment for either fear, anxiety, or

  • depression after their experience because of their session experience.

  • Two point nine percent, without a history of symptoms that had

  • lasted over a year, reported fear, anxiety, or depression

  • persisting for greater than or equal to a year after their experience.

  • Finally, 7.4% reported decreased sense of personal well-being

  • or life satisfaction out of their experience. I have to say that in a

  • strange way I'm finding these results reassuring, for me, at least,

  • because they're relevant to a puzzle that I've been confronted with

  • during the past 13 years of conducting this research at Johns Hopkins,

  • and that is that a number of psychiatrists in my department

  • have a great suspiciousness toward the positive kinds of

  • effects that we have been reporting from psilocybin. The reason

  • for this is because, as Steve Ross talked about earlier this morning,

  • they're occasionally seeing psychiatric problems that they believe

  • have been precipitated by hallucinogen use. These data support

  • the contention that yeah, these things do occur, however

  • what the psychiatrists don't see and don't know is the denominator

  • here. What's the rate at which these experiences occur?

  • Remember, in this survey, we're asking people for their

  • very worst experience ever, so it's certainly the case that even

  • the most concerning of these events, and that would be precipitation

  • of a symptom profile in which people are seeking out psychiatric help,

  • really are extraordinarily uncommon. So I've come to think of the

  • psychiatrist who attends regularly on the acute psychiatric unit

  • and has become fearful of psilocybin and other psychedelics.

  • He may be analogous to an ER physician, who, if you asked about

  • whether snowboarding or motorcycle riding's a good idea, they would

  • say no, and that's based on their experience, and likewise,

  • the psychiatrists who have a very limited exposure to an at-risk

  • population under acute conditions are going to end up with a

  • biased expectancy set. So, for me, that's helpful in explaining

  • the kinds of resistances that I've come up against.

  • This just makes the point that I just made. These effects are

  • consistent with what is reported, certainly, by news media occasionally.

  • The other point that I want to make is

  • these kind of effects are incredibly uncommon in laboratory

  • studies of psilocybin. So when we have the advantage of screening

  • volunteers, preparing volunteers, administering psilocybin

  • under highly supported conditions, we can pretty confidently

  • say that these types of toxicities are going to be extraordinarily

  • rare. So let me end with some conclusions and implications.

  • So the conclusions from the experimental study is that with

  • careful volunteer screening and preparation, when sessions

  • are conducted in a comfortable, well-supervised setting,

  • moderate and high doses of psilocybin can be administered

  • safely. Despite extensive preparation and screening, about a third

  • of our volunteers reported significant fear or anxiety some time

  • during the session. Nine percent reported their entire high-dose

  • session was dominated by fear and anxiety. So this is an inescapable

  • piece of exposing individuals to psilocybin, but indeed,

  • it seems like it occurs out in the real world as well. So we just

  • need to develop context that can appropriately support

  • people in these sessions. Most interesting and important:

  • under the conditions of this study, psilocybin occasioned

  • discrete experiences that have marked similarities to naturally

  • occurring, classic mystical experiences. These experiences

  • produce persisting positive changes in attitudes, moods,

  • and behaviors. The implication here of the finding that psilocybin

  • can occasion, in most people studied, mystical experiences

  • virtually identical to those that occur naturally suggests

  • that such experiences are biologically normal. That is, the human

  • organism is wired for such experiences; given the requisite

  • pharmacological input, people will have these remarkable

  • experiences of opening, and that such experiences now are

  • amenable to systematic, prospective scientific study, so heretofore

  • these mystical kinds of experiences have been elusive,

  • and we have good experimental models in which we can occasion

  • these at high probability. So that's the way science works.

  • If you can do prospective studies, manipulate something,

  • and manipulate dose or randomize across conditions, we really

  • can get scientific traction. So it opens up a whole range of

  • research to be done. So I think, among the science types here,

  • we feel like kids in a candy shop. There's literally so many ways

  • to go with this research. So, biological psychiatry: how do factors

  • such as personality, genetics, personal intention, spiritual

  • orientation affect the likelihood of such experiences?

  • Neuroscience: What pharmacological and neuronal pathways

  • in brain are activated by such experiences? So we can do

  • reductionistic neuropharmacology studies to look at these experiences.

  • What about therapeutic application? So we have the cancer

  • application, addiction application, perhaps in depression as well.

  • I guess I want to finish just by saying that in spite of everything

  • that can be done, I think that all of us understand here

  • the importance of what this means. I mean, this is a wedge into

  • understanding the human impulse toward compassion,

  • love, it's the basic underpinnings of our moral and ethical

  • systems, and it's so important for us to understand and unpack

  • this for the survival of our species, for the reduction of

  • human suffering. Then, just one final comment, at the risk of

  • sounding a little goofy: at the end of each of our experiments,

  • I end up sitting down and talking to volunteers and expressing

  • my gratitude to them for participating in our research, because

  • it's a huge undertaking, and although they end up having

  • interesting experiences that they value very much, they usually

  • underestimate how much effort it's going to be. But also,

  • by the time they end up at the end of the study,

  • they clearly appreciate the importance of

  • what this study is about. They can see the

  • conviction of the research team and the involvement and the

  • passion with which we're entering into this, and it's really

  • easy to connect with them at that level, and I welcome them in

  • as our own study team members, because they're contributing

  • just as much as we are to the advancement of this, and so

  • I'd like to do something similar here, and just express my gratitude

  • to all of you. This is a community of like-minded people

  • who understand the importance of what we're doing here, and

  • we really appreciate your support and we have a lot of work

  • to do as a community to let this unfold, so, with great appreciation,

  • thank you.

  • [applause]

  • My question is, as a graduate of medical school, I really

  • appreciate and enjoy listening to, and get a lot from listening

  • to research studies. Sort of a downside and a gloomy note:

  • our culture apparently is moving in the direction of allowing

  • government-approved scientific and medical elites control

  • what in other societies is democratic, vibrant and free, i.e.

  • the South American indigenous, etc. Is this a good direction for

  • a culture to expand such scientific elite control of what are

  • really basic elements of human life?

  • Well, great question. I don't have a good answer. Being

  • a scientist, I'm viewing my role in this process as trying to

  • rehabilitate the psychedelics for research. I think there's so many

  • important things to be done with them. I think the potential

  • implications for understanding the neurobiology of this process

  • is remarkable. I would hope that this would not result in simple

  • elitism, and I don't see any evidence that it should. We're wearing

  • different hats, so I don't get into the drug policy stuff at all;

  • I try to avoid that so that I'm not confounded with that, but that's

  • a very important alternative track that some in the community are on.

  • Thank you, Roland. I really appreciated seeing the survey

  • about people who have bad experiences and what the conditions

  • were, because as someone who has been highly trained

  • to be an entheogenic facilitator for the last two decades,

  • I've spent a lot of time undoing the damage from other people's

  • experiences, either because they had sitters who were abusive,

  • unqualified, or they just went off and did it on their own and

  • got caught in material and they had to learn how to come out of it.

  • Because of my experience, I was able to work these people through

  • and bring them out on the other side, but I would really

  • invite you to look at that as another subject of study, because

  • I think that there's a lot of people in this population, who, because

  • there are not enough trained facilitators, go off and do it

  • on their own, and people can get stuck in their unconscious

  • material and it can be damaging for lifetime. So thank you for

  • showing that. It's really important.

  • I think your point's well taken. Hopefully we won't have

  • an opportunity to study that, because we're trying to minimize

  • those effects, but there's no question that there are casualties,

  • and they're serious, and we need to develop methodologies

  • for dealing with those.

  • I just had a question, excuse me, about, on one of your slides

  • you mentioned something about a default mental state.

  • Default mode network. So this is... apologize if I didn't cover that

  • very clearly, and Robin Carhart-Harris will probably be discussing

  • that in more detail. But they're networks within brain that speak

  • to one another under conditions in which people are not asked

  • to perform; they're just sitting in the scanner being conscious,

  • and in one of those interconnected pathways is something

  • called the default mode network, and that's where the brain

  • seems to go, or it's one of the patterns that emerges when there's

  • a lot of self-referential processing. That's all the internal

  • chatter that goes on. What acute psilocybin does is shut down

  • that default mode network, so that discursive, interpsychic

  • chatter stops. That's also shown in meditation. That's the similarity

  • between the meditation and the psilocybin. We're shutting down

  • that discursive self-talk, and I think that's what accounts for

  • the sense of bringing us into the present moment: be here now.

  • All of a sudden, if you let that chatter drop away, the salience

  • of our life experience elevates, and that's so much what people

  • often feel with entheogens: the vibrancy of the color, the vibrancy

  • of being here right now, the aliveness of everything.

  • Is that related to what I've heard Aldous Huxley and others

  • refer to as the reducing valve? The brain is the reducing valve

  • of consciousness?

  • Well, Robin Carhart-Harris has made speculations exactly

  • to that effect, and I don't think there's any easy way to translate

  • Huxley's ideas into default mode network, although perhaps

  • someone like Dave Nichols could do it.

  • I may have missed this, but how is the psilocybin prepared

  • and administered in your studies?

  • This was synthesized psilocybin. Dave Nichols synthesized

  • the compound. It's in powder form, administered in capsules,

  • taken orally with water.

  • This is a question about a possible therapeutic application.

  • My physician has recommended meditation, given me a copy

  • of a book that many of you are familiar with, been out many years,

  • on the relaxation response as a way to help manage borderline

  • high blood pressure. Now, if psilocybin's a crash course

  • in meditation, is there a possible use of psilocybin for managing

  • high blood pressure? If so, do we have a whole new kind of

  • therapeutic possibility?

  • Well, acutely, anyway, psilocybin increases blood pressure.

  • The trick is that psilocybin gives someone an acute experience.

  • Meditation is about sustaining that experience. So meditation

  • practice is just that. It's called a practice, and you're practicing

  • sitting to try to bring some of that mindfulness into

  • moment-to-moment awareness throughout the day, and I think

  • it would be that that would be important to modulating

  • blood pressure.

  • I was just wondering: you were mentioning that people found

  • the psilocybin experience to be profoundly meaningful regardless

  • of whether they had a good or bad trip, and it seems like this

  • sense of profound meaning more likely occurs with classic

  • hallucinogens than with salvia or ketamine. Even when people

  • have very intense experiences, people leave it not feeling

  • that it was as valuable as the traditional psychedelic experience.

  • So can you speak to the neurobiology behind that, why it occurs

  • with classic psychedelics and not with others?

  • No, I can't. But I think that's the hallmark feature of these

  • classic hallucinogens, that has something to do with embedded

  • meaning-making and how that's interpreted. There's so much

  • to be learned about the nature of these processes, and I certainly

  • don't understand the underlying neurobiology of it.

  • I wasn't clear on the initial study with the novice meditators

  • and how that was designed. So you brought people in and gave them

  • some introductory instructions about meditation, then they were

  • given psilocybin sessions, and then what were you measuring?

  • Whether they continued to meditate, or whether they were comparing

  • the experiences they had with meditation with the psilocybin?

  • it wasn't quite clear what you were looking at.

  • We have a whole host of measures. Basically we're interested

  • in the extent to which people engaged with the meditation practice

  • and then the consequences of that. We have a ton of different

  • measures of forgiveness and gratitude and that sort of thing,

  • but we're interested in whether those experiences, then, are

  • differentially sustained as a function of the amount of meditation.

  • Our basic working hypothesis is, because there is a convergence

  • of the meditation and the psilocybin experience, that perhaps

  • having such experiences is going to make meditation more salient

  • and more alive for these people, and so they're going to engage

  • more fully in those kinds of practices, so that by the end of

  • six months, they may look very different than people who simply

  • got a meditation instruction and didn't have a psilocybin experience.

  • In terms of your definition of mysticism, I think in my view it

  • be a lot more invigorating to the psychiatric community

  • if you were to use some of the definitions that were outlined

  • and delineating in the works of Carl Jung, in terms of looking at

  • a collective unconscious and looking at our typical variability

  • as a function of levels of mystical genesis. I think that would be

  • a lot more interesting to a world population of medical practitioners

  • either doing psychology or psychiatry, because it would give

  • a something that is recognized as a level of definition, and also,

  • some of the work of Joseph Campbell would further refine

  • this sort of paradigm, because there's obviously, looking at

  • the cross-cultural literature on the subject, there is a clear-cut

  • view that humans seem to have this desire, according to Carl Jung,

  • and I do concur with him, for a level of mystical genesis

  • or ontological genesis. I think that a much more profound

  • analysis of these would begin to really look at this as a phenomena

  • that is characteristic of the human psyche that's not being

  • activated or engendered in the current cultural milieu that we're

  • living in, and this would make the psychedelic experience,

  • whether using ayahuasca or psilocybin, a much more meaningful

  • and heuristic level of study.

  • Okay, well thank you for that comment. What we ended up doing

  • when we initiated these studies is looking in the literature

  • for the very best psychometric measures that were available,

  • and it turns out that I don't know of any validated scales

  • that are using a Jung typology. William James, starting at the

  • - turn of last century-- - The Varieties of Religious Experience.

  • Yes, and William Stace, building on that, developed this set

  • of criteria that turn out to be very useful and replicable

  • and psychometrically robust. I would welcome, if you or anyone else

  • - knows of any validated measures-- - I'd be happy to actually

  • work with you on that. I'm at a university and I am in a department

  • where I am involved with something like that, so I'd be willing to

  • get in contact with you and further entertain a dialogue

  • with you on this issue.

  • Good. Thank you.

  • I'm curious about your upcoming study with experienced

  • meditators and what kind of qualifications you're asking

  • from those meditators as far as length of experience and daily practice

  • and retreat experience, and also traditions, type of practice,

  • specific techniques, and why you made those decisions, and how.

  • Well, good question. I think we're going to logistically be

  • restricted to recruiting people in the Baltimore-Washington area

  • because of the number of study visits. We're thinking that

  • there would be some advantage to using a population of people

  • who have some kind of uniform practice. So...because there's

  • very active Vipassana community in these areas, it's likely that

  • that's what we're going to use, so that we don't have a lot of

  • heterogeneity across volunteers. As you might imagine,

  • the nature of the meditation,

  • the meditation objects and some of the conventional practices

  • around meditation can change radically depending on how

  • and where you've been trained. In terms of how much experience,

  • ideally, the more, the better. We'd love to recruit in people with

  • more than 20,000 meditation hours. We doubt that we're going to

  • find those people. We're thinking, probably, at a minimum,

  • five years of daily or almost daily meditation experience,

  • and some significant retreat experience, but ultimately

  • it's going to depend on who shows up when we start recruiting.

  • My question is sort of suggested by your top point up there,

  • but you mentioned that all participants came into the study

  • with intermittent spiritual practice, and even given the nature

  • of recruitment, I think, a lot of individuals had a propensity

  • to have a mystical-type experience. So I'm curious if you think

  • there would be such a high prevalence in individuals who identify

  • as an atheist, for example.

  • That's a great question, and we really wanted to run that study.

  • One comment I wanted to make is that in our cancer study,

  • and in Matt's smoking study, we haven't been recruiting

  • people differentially based on their spiritual interests, and I don't

  • think it's made much of a difference. I think if you have someone

  • who's a committed atheist, rigidly so, it could be that they'll never

  • endorse any question that has God or spirituality in it. That's

  • almost a meta-instructional set that's layered on this, but

  • we have found people who have come into the study without

  • any particular religious orientation who all of a sudden

  • have found this spiritual dimension and have been radically

  • changed by it.

  • Thank you for sharing your work. Y'all are a dream team

  • to pay attention to. I had two questions, but I think investigating

  • Matt's study about smoking cessation and psilocybin use will answer

  • the question about health behavior changes that happen after

  • psilocybin use and what other metrics can be measured from a

  • public health perspective. My current question: I would love to hear

  • your vision as to how to bring this to underserved populations,

  • minority populations. What's your strategy?

  • In terms of bringing it to underserved populations, right now

  • we're doing all we can just to do rigorous, replicable scientific

  • studies, and we'll worry about how that then is translated

  • into availability to the culture generally later. It is true that

  • in our studies, minority communities have been under-represented

  • in terms of volunteering for these studies. I'm not exactly sure

  • what the factors are there. There may be more suspiciousness

  • within some communities of engaging in drug research

  • generally. Our studies don't pay anything, so people have to

  • come into the study willing to volunteer large amounts of their time.

  • In terms of resultant health behavior changes, many people

  • report a desire to take better care of themselves, so it's

  • not uncommon for people to start losing weight or change their diet,

  • or start a meditation practice, or start on an exercise practice.

  • We've not evaluated that very systematically. Perhaps we should,

  • but that's not been a specific target of our intervention.

  • What I suspect is if that were a target of the intervention,

  • those kinds of changes could be remarkably effected.

  • My question would be about the doses that you used. As much as

  • I saw, the highest one was 30mg, and if we want to translate it

  • to in-vitro studies, do you have the information how much of it

  • comes to the brain?

  • How much what?

  • How much of it come to the brain, if you want to translate it

  • to in vitro studies, for example.

  • How much of the dose gets into brain? Let's see. I don't know that

  • offhand. Robin Carhart-Harris is running intravenous studies

  • right now, and perhaps he has more kinetic data, and I don't know

  • about the CNS penetration, so I'm sorry.

  • My question is about the idea of transmission, that is often

  • associated with both mystical experiences and with meditation

  • traditions, where there is a community of teachers, there's a

  • lineage, and in those traditionally it's regarded as very important.

  • So...maybe I didn't follow your presentation closely enough,

  • but what I was trying to figure out was how are you controlling

  • for the idea that you and your team have essentially become

  • transmitters of some set of values, maybe something spiritual,

  • that is accessible to science, but we haven't understood yet

  • how it's transferred, some emotional set...those sorts of things.

  • It wasn't clear to me how the design of these experiments...

  • whether it is even attempting to control for that kind of idea.

  • We're not controlling for that, and we do have a very powerful

  • team of individuals who are committed and authentically

  • engaged, and to the extent that that's affecting our outcomes,

  • that's what it's doing. But under those conditions, we get effects

  • that are vastly different than methylphenidate. We get dose effects,

  • so we know that the team and everything that we put into it

  • isn't sufficient for occasioning these kinds of experiences.

  • So I guess we then need to keep our eye out for other teams

  • doing similar things, or people who don't believe in these effects

  • conducting these kinds of studies. That's the control that might

  • ultimately tell us about that.

  • Yeah, there's some very interesting questions to be asked

  • about whether or not there are some kinds of effects that might

  • be very difficult for us to explain in conventional Western

  • psychological thinking. I know there's some laboratories

  • that are interested in doing that. It kind of bridges almost into

  • the paranormal, though, when you get into transmission

  • effects, and we have our hands full studying psilocybin,

  • and we don't need to cross it right now with paranormal stuff.

  • [Presented by: The Beckley Foundation]

  • [Council on Spiritual Practices]

  • [Heffter Research Institute]

  • [Multidisciplinary Association for Psychedelic Studies (MAPS)]

[Johns Hopkins Psilocybin Research Project:]

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