Episode 89 - Psychedelics

Transcript

David: 0:04

Hello and welcome to Overthink.

Ellie: 0:16

The podcast where two friends who are also professors share philosophical perspectives on all manner of things.

David: 0:22

I'm David Peña Guzman.

Ellie: 0:23

And I'm Ellie Anderson. And you know, David, we just started this episode, like sounding all professional and stuff because we are in fact recording in a real life podcast studio, not in our closets on zoom, but wow, it has been a morning!

David: 0:40

A morning from hell. So we have been struggling with this fancy equipment in a recording studio in the middle of the Pigalle neighborhood in Paris. We just burnt about two hours battling with technology that we don't understand, but Ellie kind of does, much better than me. So thanks, Ellie, for finally getting it to work.

Ellie: 1:01

And thanks to our audio editor, Aaron, for hopping on a last minute Zoom call to help us because in short, this is an anti-advertisement for Studio Mati in Paris. We're going to burn them. They just had somebody open the door for us for the studio, taught us nothing about how to use this technology. We're philosophy professors. We are not professional audio people. So yeah, we thought we were going to start recording two hours ago, and we didn't. And we're hoping that all of the audio now is gonna be fine. Okay, we'll get into it, though. David, take a breather.

David: 1:37

I need a whole yoga class right now.

Ellie: 1:41

I know. David was so stressed out.

David: 1:43

Which is so rare for me.

Ellie: 1:44

Oh my God. I'm actually a little nervous about this episode topic too, in addition to the stressful situation because it's such a hot topic right now and we're learning more about it every day. And so I'm super excited, but I've also been a little nervous about it because there's tons of scientific literature on the topic, which we're not going to be able to do justice to. I just want to remind everyone we are first and foremost a philosophy podcast, so we'll do our best to make some claims about how psychedelic research relates to philosophy specifically, including Jean Paul Sartre's experience with the lobster. And I want to start with something I learned as we were researching this episode, which is that the term psychedelic was only coined in 1956. It was coined by the English psychiatrist Humphrey Osmond in a letter to Aldous Huxley. And this was actually two years after Huxley's classic book, The Doors of Perception, was published. That was in 1954. So Huxley didn't even have that term available to him when he was writing this book.

David: 2:46

Yeah. And this is something that comes up in Michael Pollan's book, How to Change Your Mind, which I've read and I've taught in a class entitled Mind, Brain, and Culture. And my students loved it. But he talks about how in the 1950s, when there is this sudden interest in psychedelics, one of the big questions that emerges is what do we actually call the substances that have very clear psychoactive effects. And the term that we now have, psychedelics, was actually a late comer in those discussions. But initially there was a back and forth between experts in this field where they proposed different terms that if they had won out, nowadays we would be calling this something else. And I will want to come back to that debate over terminology a little bit later in the episode. But first, let's do a little quick tour of the history of psychedelics and psychedelic research, because Pollan talks about the fact that right now we are in the middle of a psychedelics renaissance. The chemist Albert Hoffman first synthesized and ingested LSD in 1943. And that led to an explosion of initial research in the 40s into psychedelic compounds. And so that's the first, let's say, that's like the naissance of our interest in these drugs, at least from a scientific perspective.

Ellie: 4:07

Naissance just means birth for those of you who don't speak French. David's been spending too much time in Paris. Yikes.

David: 4:14

Sorry. Sorry. Sorry. It's la gestation. Anyway, so it's the birth of widespread interest in psychedelics. Again, from a Western scientific perspective, of course, they were, they've been used in other contexts for a very long time. Then you have a first renaissance in the 1960s, of course, with the countercultural movement. Then after the 1960s, there is a dip in interest in psychedelic research, partly because federal law intervenes and bans research into these substances, but also people start expressing concerns about"bad trips" and a lot of the mental health issues that maybe surround them. And so a lot of people start thinking about psychedelics as dangerous. And now it's coming back with a second renaissance. So it's the third wave of interest.

Ellie: 5:09

Yeah. And the resurgence of psychedelics in the public consciousness is really fascinating. It has so many factors that we aren't going to really be able to focus on in this episode. But I want to mention that we actually did an episode on intoxication a couple of years ago that ended up being mostly about psychedelics. So I would recommend checking that out if you haven't listened already, because there we talk quite a bit about ayahuasca. And the ancient Greek Eleusinian mystery rites, more or less. This hypothesis that a lot of the ancient Greek philosophers were on psychedelics. Yeah. And even though that episode was called intoxication, we ended up talking about drunkenness only for a few minutes.

David: 5:46

I know. So we were obviously already more interested in psychedelics, which maybe explains why we now wanted to go back and do a whole episode on the subject. But let's talk now a little bit more about the term. psychedelic itself.

Ellie: 6:00

So it means soul-manifesting. And in the letter to Huxley, in which he coined the term, Osmond wrote this little rhyme to fathom hell or sore angelic. Just take a pinch of psychedelic delos to manifest end of quote. And Osmond later stated that he likes the term. I know it's cute, right? He liked the term because it suggested that psychedelics enrich the mind and enlarge vision.

David: 6:26

And this is happening at the time that the debate over terminology is raging. And Michael Pollan talks about how in the 1950s, especially in the first part of the decade, the term that people originally proposed for thinking about what we now call psychedelics is Psychotomimetics, which basically means mimicking psychosis because the idea was that when you take a psychedelic, you're essentially inducing a psychosis through this substance. And so you have a window into the workings of pathology, really psychopathology. And the particular condition that many researchers thought that it mimics was either schizophrenia in some cases, or more commonly delirium tremens, which again is a kind of state that you go into, especially when you withdraw from a particular substance that has created dependence like alcohol. So when you're quitting alcohol and you have those seizures, those bodily tremors. That's what people at the time refer to as delirium tremens. Now, the problem that people face with this is that they realize that there's a big difference and that is that nobody speaks positively about conditions schizophrenia or delirium tremens. But people do speak positively about their experience on psychedelics. And so then they moved away from the term psychotomimetics because it's not really the same thing.

Ellie: 7:56

Or even if it is the same thing, they didn't want to associate the two because there's a more positive connotation with a trip.

David: 8:03

Yeah, exactly. And so that positive mind expanding quality was getting lost with this pathologizing label. And so in the mid fifties, a new term was proposed and that was Psycholitic, which means mind loosening. And so this is where it moves from a clinical context to a therapeutical context because people realize that when somebody takes a psychedelic substance, their ego defenses go down. And, there is a lot that you can do with that in the context of talk therapy. People are more willing to talk about deep traumas, about early childhood memories. So it loosens the barriers that our ego normally throws up in the way of therapeutic relief. And so people started using it, especially in places like LA and San Francisco, as a way of speeding up recovery or aiding the therapeutic encounter.

Ellie: 9:01

That was already being used?

David: 9:03

Yeah. Yeah. In the 1950s, people were using psychedelics in the therapeutic context, but it was very new. And the problem is that at the time people weren't able to really distinguish between the therapeutic use and a recreational use. So sometimes you had these like therapists giving it and calling it therapy, but in what clearly seemed like a recreational context, like, Oh, everybody come to my fancy house in LA and let's just all do LSD. And we'll say that it's a kind of collective therapy. And so there were some problems around that. Anyways, finally, I'm getting to the last term here. In the second half of the 50s, that's when the term psychedelic is introduced, as you point out, Ellie, by Humphrey Osmond in a correspondence that he had back and forth with Aldous Huxley. And what they really liked about this term, once it was proposed with this little rhyme that you read us, is that it avoided references to quote unquote madness, but also it avoided limiting it to a therapeutic setting. And so they really wanted something that captured the importance of perspective. It's something that expands the mind, but in what direction it expands it will depend on the perspective that you bring into the experience. And so the term psychedelic was meant capture that.

Ellie: 10:24

Today, we're talking about psychedelics.

David: 10:26

How do hallucinogenic experiences differ from everyday perceptions?

Ellie: 10:31

What do they teach us about the nature of reality?

David: 10:34

And what are the promises and risks of psychedelic assisted therapies?

Ellie: 10:47

Psychedelics raise interesting questions about consciousness, the nature of experience, and even knowledge. Do we think that insights we gain during a psychedelic trip are true or false? That goes back to that question about terminology that you mentioned, David. Is there a breaking down of psychic barriers that happens through psychedelic experiences and allows us to have a direct experience of reality itself without the usual veils of illusion? Or is it more like inducing psychosis, which is removing us from the world as it really is?

David: 11:22

Yeah. And not just questions about consciousness, questions about reality. Are we really walking through the doors of perception as the title of that famous Huxley book indicates, uh, walking that is into another realm of reality that potentially could be set to justify new forms of mysticism, maybe some forms of panpsychism, who knows? Or is all of this just a chemically induced hallucination that doesn't really reveal anything about the nature of reality? It just reveals something about our central nervous system. Well, and on top of that, what is the difference between the hallucinations that we have while we're on psychedelics and normal waking perception?

Ellie: 12:04

And there's an influential theory around this that has come to the fore in neuroscience recently. And that is the view of Anil Seth. Anil Seth is a cognitive scientist who has developed what we might call a hallucinatory theory of perception. Because for him, the distinction between the hallucinations that we have while on psychedelics or in certain psychotic experiences is different only in degree from our normal waking perception, not different in kind. Let me say a little bit about why he thinks this is the case. So Seth argues, and this is based on cutting edge neuroscience, what we know about the brain, that perception is predictive. And predictive is not in the sense of future oriented, but in the sense of modeling, a statistical notion of prediction. Our brains are continually modeling our world by creating inferences to the best explanation that are constantly being updated and adjusting our understanding as needed. So for instance, let's say that I see something white out of the corner of my eye and I presume that it is a door. In fact, there is a white door in the studio right now. Yeah, I'm using an example there.

David: 13:17

Your brain is doing well right now.

Ellie: 13:19

It's doing great. Thank you. You're confirming. But then if I turn my attention to that door, if I, instead of just seeing it out of the corner of my eyes, I actually look toward the door, that prediction is going to be updated. Either it's going to be bolstered by the fact that, yeah, it still seems to be a door or it's going to be changed like, oh, it's actually a mattress up against the wall. And I can tell that because the texture doesn't match with that like sort of prediction for what a door would be, right? So there's a sensory, there are sensory inputs that we're receiving all the time. And our brain is updating its best guess as to what those sensory inputs correspond to at all times. So, in this sense, both our everyday perception and what we usually think of as hallucinatory experiences, both have the same source, right? And that is this, like, predictive machinery, we might call it, of the brain. It's just that perceptions are a little bit more closely connected to causes in the world, whereas hallucinations have lost their grip on the world. Hallucinatory experiences, when we're on psychedelics, for instance, are less closely connected to the sensory signals and the constant updating of them.

David: 14:42

And for our listeners who don't know this, Ellie has been lobbying for everybody that she knows to read this Anil Seth book. She loved it and she, I think it's probably right that there is a lot of really great insights to it to the point that I now need to read it in its entirety as well.

Ellie: 14:56

Okay. So I don't actually know though, because I did really enjoy this book when I read it over the summer, but then now I'm in Copenhagen at the Center for Subjectivity Research and there's been a lot of pushback to it. Dan Zahavi, the director of the center thinks that the book has some like gaping errors in it. And he sort of convinced me about that as well.

David: 15:14

You're so impressionable!

Ellie: 15:16

No, I think I was just I'm impressionable at first. And you know, in the sense that... so I guess that means I'm impressionable. But I think I was reading the book with a lot of excitement and energy. And then once I put on a more critical hat through having discussions about it with, you know, like somebody who had been thinking about it from a more critical perspective, I came to see that some of the problems were more persistent. So anyway, we don't need to go into that now. I will just say I did enjoy the book, but I maybe don't have quite as strong endorsement of it as I did over the summer. I was a little surprised that you were so gung ho about it because I, I have read some of his work before and I know that he is basically a computationalist and a Bayesian about the brain, meaning that he sees everything as Mathematical predictions based on statistics and calculations.

David: 16:07

And I was like, this doesn't seem like the Ellie that I know from like phenomenology of embodiment and affect. So it was surprising to me, but you know. There, there are probably a lot of resonances since it's about our physical embodied experience of the world.

Ellie: 16:24

Yeah, definitely. And I think part of what I liked about it, because you're right that it doesn't seem like the kind of book that I would initially gravitate towards, but part of what I liked about it is that he actually, as a neuroscientist, really grants that philosophers have been developing similar views for a very long time. And I found that to be refreshing just because I think a lot of times neuroscientists fail to integrate the insights of philosophy. Speaking of which, though. There's a different view of the relation between hallucination and perception that we get in Merleau Ponty, who's a phenomenologist whom Seth is kind of influenced by, but they differ on this point about the relation between hallucination and perception, because Merleau Ponty is really insistent on the fact that there is a fundamental difference between hallucinatory experiences and perception. regular perception in the everyday sense. And he does quite a few times talk about mescaline in his book, The Phenomenology of Perception. We'll come back to what he says specifically about mescaline a bit later in the episode. But I just want to mention his general view of why Perception and hallucination are different. For Merleau Ponty, hallucination and perception are different modes of consciousness because hallucinations lack what he calls the plenitude and internal articulation of the things out there in the world. It's as though the objects that we encounter in the world present themselves to us as having other sides that we cannot see. And the further we probe, the more information we get about those objects. But when we hallucinate, we have just this vague and inarticulate sense of things around us. Like, let's say I hallucinate a shimmer out of the corner of my eye. Once I actually turn my attention towards that shimmer, it's liable to either remain the same or disappear.

David: 18:08

It doesn't really present itself to me as something that I can see from various different perspectives. It doesn't have what Merleau Ponty calls little perceptions that sustain it in existence. Yeah, so there would be no virtuality to it, or at least the object wouldn't reveal new facets of it that would allow you to interact with it in more meaningful ways. And so hallucinations in this view would be somewhat disordered, phenomenologically speaking, from Merleau Ponty's perspective, because they don't have that stability that comes from learning more about them over time. And that notion of disorder is also at the center of some contemporary neuroscientific research on psychedelics. And I'm here thinking in particular about the work of the researcher Robin Carhart Harris, who really put psychedelics on the map of neuroscience in the last couple of decades by exploring the way in which psychedelics essentially affect neural pathways, neural structures, so on and so forth. And at the center of his entropic theory of psychedelics is this notion of disorder or what he calls entropy. So normally our waking experience of the world is maintained by a basic sense of me-ness or of I am here, I am now a very rudimentary sense of self that informs our relationship to the world. And that according to Carhart Harris is maintained by a very complex set of neural dynamics that are centralized in what is known as the default mode network. Now, the default mode network or the DMN refers to a set of cortical areas. So parts of the cortex in the brain.

Ellie: 19:59

Don't worry, guys, we're gonna get to lobsters. Stick with us. Stick with us.

David: 20:04

Ellie's got you on the lobsters. I've got you on the default mode.

Ellie: 20:07

Yeah, I just I just want to make sure we're not losing our non-neuroscientifically inclined girlies because I'm one of them. And I don't and I don't mean girlies in like this, like, girls cannot do neuroscience. I mean, people in general.

David: 20:22

Well, but we all know that this is actually the juicy part and people are loving my discussion of the DMN.

Ellie: 20:27

The, the girlies love the neuroscientific parts.

David: 20:30

Yeah. So again, we have this set of interconnected areas in the cortex called the D M N. And that is activated when we are sort of just like existing without really doing anything particular. So when you're not trying to solve a problem, you're not trying to talk to other people.

Ellie: 20:48

When you're driving on the freeway home from work the same way that you go every day, or even when you're just like laying there and experiencing the world.

David: 20:56

So think about your most basic sense of self. That is the achievement of the DMN. It is our default subjective state, and it's our sense basically of subjective presence. That's how we could describe it. Now, this state of subjective presence is default according to Carhart Harris, but that's not to say that it is primary or basic. In fact, again, it's quite complex because in order for us to have that sense of subjective stability, All these things need to happen and be in place in the default mode network. The default mode network itself has to be organized relative to its own parts and it has to enter into the right kind of dynamics with other circuits and networks in the brain. So there's a lot of organization that is required for us to get that.

Ellie: 21:52

We're complicated creatures.

David: 21:54

We're complicated creatures! And that's exactly where Psychedelics kick in. What psychedelics do to the human brain is that they minimize the normal operations of the default mode network, and they decouple not just its internal components, but also the network itself from its normal collaborations with other brain networks. And so it introduces disorder, which is why I sort of latched onto that from your description of Merleau Ponty's theory of perception versus hallucination.

Ellie: 22:29

And this is where I think somebody might be thinking, well, this does mean that psychedelics is giving us an experience of the real world as it is, because what it's doing is removing that sort of, uh, what we might call the ego of the default mode network, or this like sense of self that helps us persist in the world. Of course, it doesn't seem like that's necessarily a valid conclusion to draw, because who's to say that the default mode network is less close to reality than the disruption of the default mode network, right? They're just two different ways of relating to reality. And for the record, I think this is actually where the views of Merleau Ponty and Anil Seth are compatible because even though they differ on the question of whether hallucination and perception are fundamentally different modes of consciousness or only different in degree. For both of them, there is certainly a sense that all experience is mediated on the part of the subject who's actively creating their relation to the environment. You know, actively creative doesn't mean that you have to be aware of that in a reflective sense at the time, but that is what we as organisms are doing.

David: 23:39

That's a really important clarification, Ellie, because for Carhart Harris, the point is not that we return to reality when we do psychedelics, but he does believe that there's a kind of return of sorts, where essentially our brain returns to a more primitive, disorganized, entropic state. And he says that this is where we actually find a spectrum between non traditional modes of perception and consciousness like psychedelic use. He also says when we are in REM sleep, for example, that's also a more primitive because disorganized mental state. And he also says the same thing about the early stages of psychosis, that what all of these things have in common is that they create a hyper plastic, hyper connected, wild brain that is not as constrained by all these rules of how it should be behaving. And actually, that's also what babies experience. Babies haven't developed the default mode network, right?

Ellie: 24:48

And at least in the way that adults have, I presume. But the part that's not speculation is that another one of my favorite books that I read this past summer and completely took at face value, because there's a difference for me between a book that I'm enjoying and then something that I am subjecting to scrutiny as a philosopher, was Alison Gopnik's book, The Philosophical Baby, she's also a cognitive scientist, and she talks about how babies are basically tripping at all times.

David: 25:13

Yeah. And it's because their brains are making more connections without following the same rules. And the whole point here, and this is going to connect back to your discussion of Anil Seth's theory of the brain as a predictive machine that allows us to gain more information and then correct our perceptions and our predictions, is that for Carhart Harris what happens when all this hyper connectivity starts taking over is that our mental priors start breaking down. And mental priors is just another way of talking about expectations and predictions that we normally have as part of the normal functioning of our mature brain. So think about like facial recognition. You know, I see two round balls with a line in between them. My brain is predisposed to interpret that as a face, but when I'm on a psychedelic trip, it's almost as if my mental prior doesn't kick in or doesn't kick in in the normal way, and either I don't see faces when I should be seeing them because there is a person in front of me, and I'm like, Oh, there is a faceless creature in front of me. I'm tripping. Or, I see faces when I shouldn't be seeing them. I'm looking at the grass or at the clouds, and suddenly I think that there is a person there.

Ellie: 26:31

Or, you look in the mirror, and your face is the scariest effing thing you've ever seen in your life.

David: 26:37

And then I know that it's actually a perception, and not a trip.

Ellie: 27:03

Now that we've discussed the relation of psychedelic experiences to perception in everyday life, I think it's time to tackle a question that I think about a lot when it comes to psychedelics. And this is actually a question that we have already asked before, but I want to ask it again and think about it a little bit more, which is about whether these experiences give us greater access to reality or not. Because you often hear people talking about them as though they do. I think that's a big assumption, at least in the circles that I run in Los Angeles.

David: 27:33

Oh, I see. I see.

Ellie: 27:34

Yeah. Where it's like, expand your mind by going on psychedelics. Like get out of your ego where the assumption is that the ego is limiting you from seeing reality as it really is. And I think the idea is that they're in breaking down our usual filters and structures of consciousness, our ego and our hangups, psychedelics, let us see the world as it really is. And if this is the case, This is what interests me about this question, because if this is the case, then it would seem like philosophers should be more interested in psychedelics than anyone else, because it is our job to try and understand reality as it really is. It's like our job description to start doing psychedelics. I literally, I mean, I think I had a little bit about where I teach, but I think I had a student when I was teaching at Pitzer who like actually really thought that, and I was like, I can not sanction that as your professor. But it is an interesting question, right? Because then, on the other hand, some might suggest that psychedelics by making us hallucinate actually remove us from the real world and put us in the space of illusions. So the question is, which one is it? Are psychedelics giving us greater access to reality or are they removing us from reality? Or is it neither? And how seriously do philosophers need to take psychedelic experiences?

David: 28:49

Yeah, unfortunately, I don't think we're going to be able to give a definitive answer to whether he gives us more or less access to reality in this podcast episode.

Ellie: 28:59

Stay tuned for the Patreon episode where we drop acid and then record! Just kidding, just kidding. It's not going to happen.

David: 29:06

Or is she? I mean, actually, our recording drama this morning made me feel like I already had a bad trip, so I think I'm good on that. But what we can do, even if we can't crack that mystery is.

Ellie: 29:25

Yeah, because indeed, a lot of philosophers in the 20th century and today have been very interested in what psychedelic experiences can teach us. I always think about that line from a Foucault interview where he says, We need to do more drugs, and we need to do good drugs.

David: 29:41

And I mean, by good drugs, he meant probably psychedelics, and we know that he dropped acid. Tell us super quickly about that, David. I mean, we'll talk about this more in the Patreon bonus segment. That is what we're actually doing in the Patreon bonus. Yes, yes, yes, yes. But I mean, he came to California, and I should say, went to California since we're physically in Paris right now, but he went to California, dropped LSD.

Ellie: 30:04

With a professor from Claremont Graduate University, which is part of the consortium in which I teach.

David: 30:09

Yeah. Yeah. Who took seriously psychedelics and it really changed Foucault's perspective. Again, I'll say more about this in the bonus segment, but it led him to shift gears in his own research by putting on hold the trajectory that he had envisioned for the history of sexuality. Oh, and then switched gears and wrote an entirely different version of the history of sexuality than what he had originally intended.

Ellie: 30:36

Okay. Okay. And then we have the lobsters. Okay, so yeah, it's obvious I've been excited to talk about this. Jean Paul Sartre was injected with mescaline by his old friend who's a psychiatrist at a hospital in Paris in January 1935. So Sartre basically was really interested in what kind of insights mescaline could provide. And so he underwent like this very professional seeming trip with a psychiatrist in the thirties. And this was part of Sartre's interest, which was just developing at the time in phenomenology, which he had started studying just a couple of years earlier. So this is like before he wrote Being and Nothing, this is actually before he wrote any of his books. And mescaline seemed like a pretty obvious point of reference for Husserl's claim that we need a new way of looking at things. And so phenomenology is a school of philosophy that is all about developing a new way of looking at things by going back to the things themselves, by trying to remove the usual assumptions that we bring to our daily experience. And so taking mescaline for Sartre seemed like, you know, a good go to. But Sartre ended up having quite a bad trip. And there's an interesting Paris Review article about this where I'm getting some of this from, and he said that there was like a very sinister experience that he had because there were just, there was a distortion of all of these different sensations. And famously, he saw crustaceans. He was like tormented by lobster like creatures that were scuttling beyond his field of vision. And Sartre himself had pretty bad eyesight. And the effect of this trip on him was that he continued to see these lobster like creatures for a very long time after. So this was like classic bad trip. It was bad during the time, but then he also had a kind of mental health crisis.

David: 32:41

Oh wow, like leftover effects.

Ellie: 32:43

Yeah, yeah, and then that included, but was not limited to, seeing these lobster like creatures for a very long time afterward.

David: 32:50

Wait, how long of a time? Are we talking about hours? Are we talking about months?

Ellie: 32:53

No, no, no, no. For sure weeks. Oh, wow. Maybe even longer than that. I think it might have been a year or two, but I'm seeing in this Paris Review article it only says for weeks.

David: 33:03

Weeks is a long time.

Ellie: 33:06

Yeah. And Beauvoir wrote about this in her memoirs. Beauvoir scholars sometimes refer to Sartre's lobster face.

David: 33:14

I am entering my lobster era as a philosopher. Although now I wonder whether Deleuze was on mescaline when he said God was a lobster.

Ellie: 33:25

I don't know what Deleuze was on, but it probably was something. And also he did have some like mental health challenges as well. Yeah, that's not that we're not related to psychedelics specifically. But okay. So quick, last thing on the lobster though. So I mentioned that Merleau Ponty talks a little bit about mescaline in his book, The Phenomenology of Perception. And he quotes, this is so amazing to me, he quotes Jean Paul Sartre's unpublished self observations while he was on mescaline in The Phenomenology of Perception, which is a 500 page kind of masterwork of phenomenological philosophy. And he's like, here's what my buddy Sartre said about his experience on mescaline. And I'm just going to read you a little quote from this. So, Sartre said the following, I see a world of swellings. It is as if the key of my perception was suddenly changed. As if I were made to perceive in C or in B flat. At that moment, all of my perception transformed. And for a second, I felt myself somehow equipped such that I could not perceive otherwise. I was overcome with the belief that the world is as such. So he had these, this really strong perception. It sounds like definitely synesthetic as well, right? He was seeing things, kind of almost hearing them like in the key of C or in B flat. And when he was in this state, he couldn't kind of think himself out of it. He was convinced, like, no, this actually is how the world is. But then, he says, later, another change took place. Everything seemed simultaneously pasty and scaly, like certain large snakes that I have seen uncoiling at the Berlin Zoo. And then I was seized by the fear of being on an island surrounded by snakes.

David: 35:10

Okay, so he's hallucinating lobsters, he is having synesthetic experiences, and the world is snaky and scaly for Sartre. Yeah. I mean, anytime you describe a bad trip, it's always wild like that. This is just like making me think of my original trip with psychedelics, which I described in the episode on intoxication, um, which was also quite negative. And for me, any negative experience, any slight discomfort just got amplified and magnified such that it took on a psychological quality. So you know, if the environment was dark, my mind. And my thoughts became dark If something was abrasive, I became abrasive. So I think this also raises questions about how to talk about psychedelic trips.

Ellie: 36:02

Um, tell us what you think about that.

David: 36:04

I don't really think of psychedelics as giving us direct access to reality in an absolute sense as opening the doors to another realm. But I do think that they open some form of door to ourselves, and also to the relationship between experience and language, because there has been some research around this about how our experience of psychedelics, literally the content of the things that we experience, depends on the language that is floating around in our culture to make sense of those experiences. So your experience of certain cultural tropes, to certain cultural metaphors about these substances will take the reins of the experience of doing the substances themselves. And this is actually a point that Levi Strauss had already made in the 20th century concerning hallucinations. He says that when people have a hallucination, they will always describe what happens in the hallucination by reference to what he calls the latent cultural discourse of their society. So for example, if you're in an animistic society where objects have a soul or an anima, then you will describe the content of your hallucinations as animated things. Whereas if you live, let's say, like I did in Mexico, in a Catholic society where there are god's and angels and demons, you will describe your hallucinations in terms of like demons coming out of the shadows or angels who descended upon me to give me grace. And so what really draws me to this discussion is the fact that our experience of the world is not just constructed by. our subjectivity by our nervous system, by our body, but also by culture itself. And that raises a question of how do you talk about a psychedelic trip? Is it beyond language? And even what's the genre that lends itself to its description? So for example, should you write a philosophy treatise about your trip. Yeah. Should you write a novel? Should you write a memoir? Should you write a poem? You know, how to capture the indescribable.

Ellie: 38:21

Yeah, yeah. And can you, right? Because I think there is something so private. For all of the talk of like ego death as being an integral part of psychedelics, I feel like there is a really and private dimension of the experience that is incommunicable and that can have really long lasting effects, you know, on the way that you are actually perceiving the world. And yeah, I wonder to what extent those incommunicable experiences are shaped by that latent content of our culture or not. I mean, certainly we know that also the same is true of mental health crises. The experiences of people with schizophrenia like the content of the voices that talk to them are super different from the U.S. than they are in India. I remember reading about that. I might have actually mentioned on a podcast episode one time, but that there's a lot more schizophrenic voices among Americans that encourage them toward violence, and you know, that's related to like the sort of violent nature of American culture. But I also wonder whether there might be some dimensions of that psychedelic experience that are not, that are shaped. Okay. Sure. Psychedelic experiences are shaped by the latent content of our culture, but I wouldn't want to say that they are reducible to that. I think there would be, of course, some transcultural dimensions to psychedelic experiences, because I think you do hear some pretty consistent narratives throughout time. I mentioned that we'd talked about ayahuasca and its use for a very long time in indigenous communities in our intoxication episode. And so whether it's, ego death or just like this opening to different ways of perceiving things, that animism, that kind of coming alive of the world and a different relation to the world. Like I would say that those, yeah, aren't just determined by our culture.

David: 40:12

Yeah, no, I think that's right. And I mentioned that I taught this class on mind, brain and culture where we talked quite a bit about psychedelics and some of the transcultural research into the psychedelic experience tries to identify those cross historical constants. And some of them are, of course, a greater sense of unity with nature, a decreased sense of egocentricity. But also there are some very basic phenomenal features of the psychedelic experience that recur, like basic geometrical shapes being hallucinated, certain kinds of arabesques being experienced when you look at grass or when you look at the clouds. And so there does seem to be some basic things that you can rely on psychedelics to produce in you as an experience. But at the same time, that's not really what people report about their trip, right? People usually report the meaning of the whole experience, and that's where they have to reach for those cultural tropes for the discourse. And although I agree with you that there is something deeply private about these experiences that is untranslatable into language. There is also this deep desire to translate it into language, right? Like to have other people recognize this experience and make it real by sharing it with others.

Ellie: 41:41

And I also think for oneself to be able to put it in the context of a narrative of one's life is really essential for a lot of people. This is why there's so much focus in therapeutic context on integrating the experience. And I think that also speaks to just how the way that we treat the psychedelic experience after the fact shapes the psychedelic experience itself as well, right? Um, like, what sort of effects is it having afterward and how are we able to integrate it or not integrate it into our lives?

Segment: 42:23

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David: 42:44

Earlier this year the New York Times published an article entitled What does good psychedelic therapy look like where the author talks about what psychedelic assisted therapy entails. So very briefly think about a meeting between a classic Western clinical encounter. So think doctor, patient relationship, and a shamanistic spiritual journey involving a guide and a follower. So what happens in this therapy is that you basically agree to participate in a clinical trial. And then you have a number of sessions ahead of your experience of taking the drugs with the researcher who is in charge of the study. And they explain everything to you. They talk about the risks and also about what to expect. Then you take the substance. It can be psilocybin, LSD, MDMA, ketamine. So it can be a classic or a non classic psychedelic. And when you take the substance, the researchers will make sure that you find yourself in a positive environment with a positive ambience, you know, a nice room, maybe some comforting music in the background, maybe some snacks available to you. And The clinician slash researcher will be there to quote unquote, walk you through the journey of your psychedelic experience and offer support in case you need anything, right? Like a bathroom break, a glass of water, perhaps. And at the end of the therapy session, it is often the case that you then have to have what are known as post exposure sessions where you integrate the experience into your sense of self by talking it out with the therapist researcher.

Ellie: 44:36

The more I hear about this, the more intriguing it seems, right? I think this clinical context can obviate a lot of people's concerns about like a bad trip, right, or being unsafe, et cetera. And I know it's been getting a lot of traction among the communities that I hang out with in California. So I, I mean, I wonder like how you select such a therapist for this. You can't go into psychologytoday.com filter for psychedelic assistive therapy.

David: 45:07

Yeah, there's a section on Craigslist. You're actually getting to something here, because the authors of this piece in the New York Times point out that you should be very careful about choosing a therapist because bottom line is that there is a lot of quacks out there. So you need to ask about expertise. You need to ask about training, about methods, and about past experience. Because, I mean, you don't want your psychedelic trip to be ruined by the bad vibes of some random quack. Yeah. And you know, I find this idea of psychedelic assisted therapy super promising, but obviously you and I are not mental health professionals, so here we'll talk about it from a philosopher's standpoint more than a clinician's one.

Ellie: 45:53

So if you are thinking about this, we encourage you to speak with an actual expert on the subject. We are not endorsing or suggesting this for anyone in our capacity as, in our capacity as podcasters or educators. Definitely not.

David: 46:10

Yeah. I mean, Oh my God. Are we the quacks? I think we're the quacks.

Ellie: 46:16

I think we're joining a very long line of podcasts that have decided to talk about psychedelic assisted therapy without being experts on the topic. So I guess at least we're experts on something because I am an expert on phenomenology, which we have been talking about. Oh my God.

David: 46:33

Well, at least we're not administering it.

Ellie: 46:35

But yeah, so tell us more about psychedelic assisted therapy and what all the fuss is about it and what its applications are.

David: 46:42

Sure. Yeah. So it is showing pretty impressive results when applied to a lot of conditions that have been resilient to the straight up pharmaceutical interventions that are typically privileged by Western medicine. So here we're talking about things like major depression, anxiety, substance abuse issues, although the research on substance abuse, I have to say, is a little bit more tenuous.

Ellie: 47:05

Really? Okay. Because I've heard a lot of people talking about that. Yeah.

David: 47:08

And also conditions like anorexia. Okay. And the key in a lot of this research is precisely what I talked about in connection to the neuroscience of psychedelics, which is the way in which psychedelics impact the default mode network, that set of cortical structures that give us our sense of self and sustain our ego. And they especially target Two parts of the brain that are a part of this network known as the medial prefrontal cortex and the posterior cingulate cortex. And without going into unnecessary detail, the point is that substances like psilocybin decrease activity in these areas. Now, normally these areas are what are known as hubs, meaning that they are relay stations where a lot of information coming from various parts of the brain gets centralized, processed, and then integrated to give rise to more coherent, stable, organized percepts, thoughts, experiences, so on and so forth. And so these hubs, you can think of them as almost like, think about a ratchet system where you make some progress in the integration of information and they lock it in at a higher level of organization.

Ellie: 48:24

Okay, yeah, yeah, yeah. Oh, that's a great metaphor. Did you come up with that? Yeah, I just did. I'm kind of shocked. That's pretty good. That was good. I mean, you also, you're doing like a cool movement right now with your hand, which our listeners can't see. Ratcheting it up, I think is what it's called, right?

David: 48:37

And so they, they stabilize patterns of experience. And again, when you're just normally there, the activity in the default mode network is, you know, medium to high. And so it stabilizes who you are. And again, this is where psychedelics come in. They decrease the ability of these hubs to do their ratcheting function. And so neural activity starts becoming disordered, disorganized. entropic, and it leads to that hyper connected brain state that allows us to make new connections, have new experiences, have bizarre, non traditional experiences. And that's what contributes to creating this sense of loosening our relationship, both to ourselves. And to the world. And this can have a significant impact on these conditions that I just mentioned, right? Like depression and anxiety.

Ellie: 49:37

Yeah. Yeah. And so can you say more about the, this impact of that decrease on the stability with the conditions that you just mentioned, including depression?

David: 49:47

Let's focus on depression for a hot second because what defines depression is an over-stable state. that is rigidly pessimistic. So when you are depressed, you're just stuck in this loop of thinking, you know, I'm not good enough. I can't do it. so it creates an unbreakable cycle of thinking, which is associated with a hyper activated default mode network. So you have negative thoughts and they are over anchored or let's say over ratcheted. they're just like, Too stable and you can't get out of that thought pattern.

Ellie: 50:24

I don't think the over ratcheted metaphor works there, but you could say they're stable. They're kind of like fixed.

David: 50:29

Yeah, they're fixed. They're ratcheted. I think that's, yeah, like they're locked in.

Ellie: 50:33

Yeah, that's not, that's not the same as... Okay, you're getting a little too excited about the ratchet.

David: 50:42

I know, you know that sometimes I have good metaphors, but then I run with them until they break apart.

Ellie: 50:47

Okay. They're over anchored.

David: 50:49

Yes, they're over anchored. And so this is what most therapies for depression ultimately try to get the patient to do to break out of that thought pattern out of that negative thinking loop. And so psychedelics can aid in that. And a similar thing happens actually with anorexia nervosa, where there is another pathway to efficacy, especially through the amygdala. Now, psychedelics also decrease what is known as amygdalar reactivity. So we have the amygdala, which is about processing fear responses. And some people who struggle with anorexia have an overreactive amygdala, especially in connection to the sight of food. So they see food and they, they sense a kind of fear that makes them want to stay away from it. And when they are given psychedelics, especially psilocybin, it decreases their reactivity of their amygdala so that they can be around food, whether that's pictures of food or actual food, without having that gut fear reaction, which then allows clinicians to slowly reintegrate food into the patient's world and experience without having that kind of resistance that would normally kick in.

Ellie: 52:11

Wow. That's really interesting. I hadn't known that about its applications for anorexia. I've definitely heard a lot about the depression side of things, but you know it's really interesting to me just how many conditions are showing promise in light of psychedelics with. success rates that far surpass those of traditional treatments. And I hear a lot of narratives about how this is like very scary to big pharma because with just like a small number of treatments, sometimes even one, you can have more benefits in the case of depression than you would for like years of being on SSRIs. Yes. And so I think there are like concerns about how our very messed up capitalist healthcare system might intervene in that. Um, because I also read the Michael Pollan book, but I read it like a few years ago and I don't have it with me here in Europe. So, everything you said at the beginning was just kind of new to me, but he talks a quite a bit about that in the success rates in that book. And he mentions as well that the data shows that they help with substance abuse, right? Which we mentioned earlier. And also with chronic headaches as well as helping people who have terminal illnesses come to terms with their end of life.

David: 53:19

Yeah. Yeah. He makes a big deal about this, which I think he's right to do. The way in which, especially like people with late stage cancer change their perspective on mortality when they do this. And I think this is why there has been this explosion of research into the clinical potential off of psychedelics, but also it's precisely for that reason that I want us to talk a little bit about the risks of psychedelic assisted therapy because it is new and we're only now in the process of figuring out best practices around it. And there are some risks that people should be aware of. For instance, people with a family history of bipolar disorder should not do PAT because if you have a strong predisposition to it, then psychedelics can trigger a psychotic break. And that's a straightforward medical danger. But then there are also other risks that apply to psychedelics that don't really apply to other medical treatments. And In the literature on the philosophy of psychedelics, some people refer to these dangers as epistemic risks.

Ellie: 54:26

Okay. Like what, what does that mean?

David: 54:28

Well, think about what I mentioned a few minutes ago, that psychedelics are psychological interventions. They're not purely physiological ones. They change the way you think and see the world, And some people have said that they even give you false beliefs, right? Like a number of people go into a psychedelic experience as atheists, and then they come out on the other side talking about God.

Ellie: 54:56

We're talking about how the pine tree has a soul. No, I'm just kidding. I'm not saying that's a false belief.

David: 55:00

Well, but you know, like from a scientific perspective, let's just say that, it does give you at least a false belief relative to the worldview that maybe you had before the experience. And so there is this, risk that it changes your epistemology, or maybe you also go in thinking that you're a really good person. You unearth some dark desires during your trip, and then you no longer think that you're a good person. So how do we think about that risk when we give psychedelics to somebody as therapy? And, you know, the question here is, is that really a harm in the technical sense of the term? Well, maybe, it all depends on how you conceptualize harm.

Ellie: 55:41

Yeah, I don't think that would count as a harm for me, but certainly a risk. But I think that that question then leads us to maybe reconsidering your metaphor of ratcheting, which is like, it might be, it might not necessarily be ratcheting up your like new affective experience. It could also be sideways or down. I don't know. We're redirecting at least, right? Which I think brings us back to what we were talking about earlier, you know, in terms of like whether psychedelic experiences give you greater access to reality or not. And I think it's probably clear from our discussion at this point that we don't necessarily think so. They're different ways of relating to reality, whether it's a difference in degree, as Anil Seth says, or a difference in kind, as Merleau Ponty suggests. and those differences can be extremely beneficial, but that's not just because like you are suddenly having an unfiltered experience of reality. We have about run out of time, but I want to just mention one other quick risk, which is the vulnerability that patients have when they're undergoing psychedelic assisted therapy under the assistance of another person. For instance, what are the boundaries that the therapist has to draw with the person? Are they allowed to touch, right? Sometimes like touch can be super comforting when you're undergoing this psychedelic experience, but it can also feel threatening to people. Or you might consent to it beforehand and then not really want it when you're undergoing the trip, but perhaps not know how to communicate that. So you can see how there are issues that arise with medical ethics because you have sober doctors touching patients who are vulnerable and under the influence. And what happens if like a patient wants, say, a certain kind of touch that maybe the doctor is willing to do, but after the fact, the patient is like, well, actually, no, I wasn't really in a position to say yes to that.

David: 57:37

Yeah, no, that's a really tricky issue because a lot of people in the context of psychedelics, because they feel that sense of unity with the world, with other people, increased empathy with those around them, often seek a kind of light touch. And so there is discussion about this in the literature on psychedelic therapy, with some people saying, well, maybe like a pat on the shoulder is okay, because if you are a therapist and you withhold touch completely, then the patient is in a trip with another person that they know is a real human being, right? The doctor who is being weirdly inhuman towards them and cold and distant and scientific. And so. Withholding touch entirely can also potentially trigger a negative trip because you're like, Who the hell is this person who is not kind towards me? So I think what I saw, especially the New York Times article, is that a handshake is good. A pat on the shoulder that is comforting is good. Mm hmm. Everything else seems to cross a line that we're not ready and shouldn't be ready to cross.

Ellie: 58:47

Well, David, that's it for today. Thank you all so much for listening and for our patrons. We will see you over on the other side for our segment talking more about Foucault.

David: 59:00

Yeah.

Segment: 59:01

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