Thanks Michael, a great piece. I think that we should definitely be critical of psychedelics given the Aztec proclivity for using them in rituals involving beheadings to the gods and that RfK is health sec because Aubrey Marcus had a DMT trip and then text RfK saying that the alien gods told him he needs to save the US or some nonsense!
A few thoughts:
1) Check out Chris Lethaby's book on the Philosophy of Psychedelic Experiences. A lot of the issues in this field are conceptual ones and I think he does a great job engaging with the empirical research and disentangling the conceptual knots.
2) We need to disambiguate the role of psychology as a science from claims we are not making in a scientific capacity about human culture/politics. We should do all this WHILST acknowledging that science is not and cannot be apolitical. Science can study culture and attempt to offer robust operationalised explanations about world control -- our inquires are also operationalised in conjunction with our values and aims. In the case of psychedelics we shouldn't drop our (rightly) high standards for making specific, well operationalised claims about effects. If they are there we want to find them, if they are not, we want to know that too!
3) With respect to the politics and values, I think that the philosophical caution about the conceptual issues AND the scientific caution about the claims we make about well understood effects are completely correct and we should have and promote this caution more broadly in the cultural conversation around psychedelics. However, politically, we should also be making clear evidence around harms and risks and criminality. I think a lot of the concern about a psychological blog post like this is how it will be received politically and what that might mean in our current contexts -- leading scientist says xyz about them being good/bad therefore science tells us ... As an example, if we consider our grounds for criminality to be harms and risks how do these things compare to other normalised substances people use we are fine with? If we consider our grounds for this that the sorts of thoughts they produce are dangerous, perhaps we should hold a lens up to our culture which says that. What is it about the sorts of claims people make who take these substances that is so threatening as to be deemed deviant or criminal? Do the people who take them report harms? -- this is where we have to be cautious to disentangle, or make clear the dependencies between scientific and political claims we are making (i.e. should and so on).
I've been one of those "crazy" psychedelic advocates for many years now. The benefits they can offer are indeed potentially life-saving...but only potentially. As you correctly point out, hyping these drugs to the extent of suggesting they can be used by anyone, in any setting, can lead to disastrous outcomes. We've seen similar problems of misuse arise after the legalization of marijuana in some U.S. states. Potent psychedelics should always be used responsibly.
Appreciate the pushback, Chris. Here are a few choice quotes from important figures in the field. Rick Doblin called them an “antidote to evil” (https://www.theatlantic.com/ideas/archive/2024/10/psychedelics-medicine-science/680286/). Stanislav Grof said, “Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy.” In a paper published by Roland Griffiths, he claimed to find sustained personality change a year after tripping out on psylopsybin a few times...in a study with as few as 17 people (https://journals.sagepub.com/doi/10.1177/0269881111420188). These are central figures in the field, quoted in mainstream publications and peer-reviewed journals. If that’s not hype, I’m tripping.
And sorry just to add more specifically to my criticism: "Don’t promise me oceanic boundlessness—yes, an actual scientific term—when what you mean is that it will deliver moments where you think you’ve unlocked some deep mysteries that have been holding you back, only to realize later it was just some half-baked epiphany that makes little sense when you’re not tripping balls."
This to me is misleading, because the truth in my experience is that a single psychedelic experience can in fact lead you to radically re-interpret a past experience in such a way that your life improves.
I'm not defending this "oceanic boundlessness" term, and it's surely true that there are many charlatans operating in this space, but I believe it is a mistake to trivialize the insights one can arrive at during a psychedelic experience.
Counter-example. I have had numerous "epiphanies" while under the influence and they all faded away as nonsense or trivial a day or two later. This is true of everyone I know who experimented in the 90s and 00s. How can the same drug lead to this magic only a decade or two later? Do expectations/placebo have something to do with it? I don't want to ruin your trip, though. If you find it useful, wonderful. But to make recommendations for a wider public, we need good studies that clarify which outcomes are related to expectations vs from the drug itself.
Great piece, as per usual. I’m strongly of the view that many of these studies showing beneficial effects of psychedelics when combined with CBT would be replicated by swapping out lsd/mushies/ketamine with 2-3 beers. As for a mechanism, the most obvious candidate is disinhibition and that box is ticked by a number of drugs. If I’m wrong, and psychedelics do possess some special power, then the researchers in the area need to up the methodology and tone down the rhetoric—especially when conversing with journos who love this stuff.
I have a few family members that have engaged in Psychedelic therapy. It was not an easy or inexpensive proposition. The therapy was in the care of an accredited psychologist along with an experienced administer of the drugs (LSD I believe). The therapy was held over the course of a weekend. One participant and the two trained guys. The cost approached $10k. So def not for the faint of heart or wallet. Both family members speak highly of the experience and the insights gained. For me, I have no pressing issues that I would be willing to throw $10k at but if I did, I might be tempted.
Psychedelics and marijuana can create stress, and flip the schizophrenia switch if you have that proclivity. In addition, many people think that theyre a mental health panacea.
Psychedelics aka entheogend are merely a tool. Maybe more of an accelerant. You can eat 5 dried grams of psilocybin in the woods by yourself, go through hours of brutal introspection, and gain massive amounts of insight, but choose to keep being the same person, or even regress, the next day. Many do. Change is painful. This is why trip support, and ongoing support are crucial. We need community and the guidance of small actionable steps too.
This is an important post and I agree with most of it! Been thinking of writing something like this myself.
"When participants know what condition they’re in, their expectations can run wild, and it’s possible that it is these expectations—not the drug itself—that shape any downstream effects."
First, doesn't CBT and other psychotherapies face precisely the same problem? Also, SSRI studies are hard in somewhat similar ways because all the participants know that they are in a study, and perhaps many of them falsely believe they got the drug?
Second, and more importantly:
To be fair, the claim is that psychedelic assisted therapy has these effects, isn't it? NOT the drug itself.
Consider the possibility that in the future psychedelic assisted therapy really is shown to be very powerful and effective, as backed up by rigorously collected data that shows consensus by clinicians, patients, and the patients families. The control groups are people that are on waiting lists or that receive other kinds of treatment.
Consider also that 'all' the drug does is boost your expectations and believe that they are realised. The same drug may be used to boost negative expectations in almost everyone in a culture where psychedelics have a bad rep, and the clinicians believe it's gonna have mostly bad effects.
I think it's fair to say that psychedelic-assisted therapy is efficacous in such a scenario. It se no reason that we demand it be culture-independent, no more than specific psychotherapies must be culture-independent. But it certainly shouldn't be so frail that it depends on a current hype-wave.
Thanks Michael, a great piece. I think that we should definitely be critical of psychedelics given the Aztec proclivity for using them in rituals involving beheadings to the gods and that RfK is health sec because Aubrey Marcus had a DMT trip and then text RfK saying that the alien gods told him he needs to save the US or some nonsense!
A few thoughts:
1) Check out Chris Lethaby's book on the Philosophy of Psychedelic Experiences. A lot of the issues in this field are conceptual ones and I think he does a great job engaging with the empirical research and disentangling the conceptual knots.
2) We need to disambiguate the role of psychology as a science from claims we are not making in a scientific capacity about human culture/politics. We should do all this WHILST acknowledging that science is not and cannot be apolitical. Science can study culture and attempt to offer robust operationalised explanations about world control -- our inquires are also operationalised in conjunction with our values and aims. In the case of psychedelics we shouldn't drop our (rightly) high standards for making specific, well operationalised claims about effects. If they are there we want to find them, if they are not, we want to know that too!
3) With respect to the politics and values, I think that the philosophical caution about the conceptual issues AND the scientific caution about the claims we make about well understood effects are completely correct and we should have and promote this caution more broadly in the cultural conversation around psychedelics. However, politically, we should also be making clear evidence around harms and risks and criminality. I think a lot of the concern about a psychological blog post like this is how it will be received politically and what that might mean in our current contexts -- leading scientist says xyz about them being good/bad therefore science tells us ... As an example, if we consider our grounds for criminality to be harms and risks how do these things compare to other normalised substances people use we are fine with? If we consider our grounds for this that the sorts of thoughts they produce are dangerous, perhaps we should hold a lens up to our culture which says that. What is it about the sorts of claims people make who take these substances that is so threatening as to be deemed deviant or criminal? Do the people who take them report harms? -- this is where we have to be cautious to disentangle, or make clear the dependencies between scientific and political claims we are making (i.e. should and so on).
I've been one of those "crazy" psychedelic advocates for many years now. The benefits they can offer are indeed potentially life-saving...but only potentially. As you correctly point out, hyping these drugs to the extent of suggesting they can be used by anyone, in any setting, can lead to disastrous outcomes. We've seen similar problems of misuse arise after the legalization of marijuana in some U.S. states. Potent psychedelics should always be used responsibly.
If someone tells you that psychedelics will solve all your problems, they are wrong. I have never myself encountered anyone who makes that claim.
If someone says taking psychedelics once can be a life-changing experience, they are right.
Some of your points here strike me as strong and correct, but in my view you are largely beating up on strawmen in this piece.
You seem to me to be arguing in "vibes" that psychedelics are overrated and should have their status lowered, which I'm not so sure is true.
Appreciate the pushback, Chris. Here are a few choice quotes from important figures in the field. Rick Doblin called them an “antidote to evil” (https://www.theatlantic.com/ideas/archive/2024/10/psychedelics-medicine-science/680286/). Stanislav Grof said, “Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy.” In a paper published by Roland Griffiths, he claimed to find sustained personality change a year after tripping out on psylopsybin a few times...in a study with as few as 17 people (https://journals.sagepub.com/doi/10.1177/0269881111420188). These are central figures in the field, quoted in mainstream publications and peer-reviewed journals. If that’s not hype, I’m tripping.
And sorry just to add more specifically to my criticism: "Don’t promise me oceanic boundlessness—yes, an actual scientific term—when what you mean is that it will deliver moments where you think you’ve unlocked some deep mysteries that have been holding you back, only to realize later it was just some half-baked epiphany that makes little sense when you’re not tripping balls."
This to me is misleading, because the truth in my experience is that a single psychedelic experience can in fact lead you to radically re-interpret a past experience in such a way that your life improves.
I'm not defending this "oceanic boundlessness" term, and it's surely true that there are many charlatans operating in this space, but I believe it is a mistake to trivialize the insights one can arrive at during a psychedelic experience.
<3
Counter-example. I have had numerous "epiphanies" while under the influence and they all faded away as nonsense or trivial a day or two later. This is true of everyone I know who experimented in the 90s and 00s. How can the same drug lead to this magic only a decade or two later? Do expectations/placebo have something to do with it? I don't want to ruin your trip, though. If you find it useful, wonderful. But to make recommendations for a wider public, we need good studies that clarify which outcomes are related to expectations vs from the drug itself.
Appreciate the response and I love your substack <3
Thanks Chris!
A well-considered and thoughtful post—I hate it.
Great piece, as per usual. I’m strongly of the view that many of these studies showing beneficial effects of psychedelics when combined with CBT would be replicated by swapping out lsd/mushies/ketamine with 2-3 beers. As for a mechanism, the most obvious candidate is disinhibition and that box is ticked by a number of drugs. If I’m wrong, and psychedelics do possess some special power, then the researchers in the area need to up the methodology and tone down the rhetoric—especially when conversing with journos who love this stuff.
I have a few family members that have engaged in Psychedelic therapy. It was not an easy or inexpensive proposition. The therapy was in the care of an accredited psychologist along with an experienced administer of the drugs (LSD I believe). The therapy was held over the course of a weekend. One participant and the two trained guys. The cost approached $10k. So def not for the faint of heart or wallet. Both family members speak highly of the experience and the insights gained. For me, I have no pressing issues that I would be willing to throw $10k at but if I did, I might be tempted.
A typically trenchant, accessible and sensible piece. Keep up the great work.
Thank you. We need much more of this to fight back against a cult which is polluting clinical practice.
Psychedelics and marijuana can create stress, and flip the schizophrenia switch if you have that proclivity. In addition, many people think that theyre a mental health panacea.
Psychedelics aka entheogend are merely a tool. Maybe more of an accelerant. You can eat 5 dried grams of psilocybin in the woods by yourself, go through hours of brutal introspection, and gain massive amounts of insight, but choose to keep being the same person, or even regress, the next day. Many do. Change is painful. This is why trip support, and ongoing support are crucial. We need community and the guidance of small actionable steps too.
This is an important post and I agree with most of it! Been thinking of writing something like this myself.
"When participants know what condition they’re in, their expectations can run wild, and it’s possible that it is these expectations—not the drug itself—that shape any downstream effects."
First, doesn't CBT and other psychotherapies face precisely the same problem? Also, SSRI studies are hard in somewhat similar ways because all the participants know that they are in a study, and perhaps many of them falsely believe they got the drug?
Second, and more importantly:
To be fair, the claim is that psychedelic assisted therapy has these effects, isn't it? NOT the drug itself.
Consider the possibility that in the future psychedelic assisted therapy really is shown to be very powerful and effective, as backed up by rigorously collected data that shows consensus by clinicians, patients, and the patients families. The control groups are people that are on waiting lists or that receive other kinds of treatment.
Consider also that 'all' the drug does is boost your expectations and believe that they are realised. The same drug may be used to boost negative expectations in almost everyone in a culture where psychedelics have a bad rep, and the clinicians believe it's gonna have mostly bad effects.
I think it's fair to say that psychedelic-assisted therapy is efficacous in such a scenario. It se no reason that we demand it be culture-independent, no more than specific psychotherapies must be culture-independent. But it certainly shouldn't be so frail that it depends on a current hype-wave.