How to Change Your Mind

A few weeks ago I was fortunate to see Michael Pollan talk about his new book, How to Change Your Mind. He was interviewed by author Zoe Cormier, at a co-working space called Second Home in East London. Pollan is best known for books on food, including the excellent Cooked (2013), the first book of his that I read (and reviewed here). This led me to his earlier books The Omnivore’s Dilemma (2006) and The Botany of Desire (2001). Pollan views himself not strictly as a food writer, but as having written on food out of a broader interest in the ways in which humans interact with nature; it just so happens that agriculture is one of the most consequential ways that we do so. His earlier books were provocative and mind-opening; they changed what I ate and how I cooked. His new book seeks to open vistas of the mind in a different way. Ambitiously subtitled “What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence,” the book largely delivers on its wide remit, and I would recommend it to anyone, regardless of prior interest on the topic.

The book is perhaps foremost a history of the so-called “psychedelic” drugs, and specifically what are known as the “classical psychedelics.” The term “psychedelic” was coined by the psychiatrist Humphry Osmond in 1957, to mean “mind-manifesting”. This term caught on, unlike competing names for these drugs, which included “psychotomimetic” (imitating psychosis) and “psycholytic” (mind-loosening). The best-known examples of classical psychedelics are LSD and magic mushrooms—mushrooms from the genus psilocybes, also called psilocybin mushrooms after one of their psychoactive molecules. The class also includes potentially less familiar drugs like ayahuasca and DMT. Although some researchers opt to include MDMA (the amphetamine found in ecstasy), Pollan does not, as it operates quite differently from the others, which all act as strong partial agonists on specific serotonin (5-HT2A) receptors. The classical psychedelics have effects which are similar enough to each other to discuss them as close equivalents.

Osmond, who came up with the name “psychedelic”, is just one of a plethora of interesting characters described in this book. Not only was he the man to give Aldous Huxley the dosage of mescaline immortalised in his essay “The Doors of Perception” in 1954 (pdf)—after which the band The Doors was named—but he also gave British politician Christopher Mayhew mescaline in a session recorded with the intention of broadcasting it on the BBC’s Panorama in 1956. (Ultimately it was deemed too controversial to air, but you can read the amusing transcript here.) The drugs’ powerful effects seem to have attracted, inspired, and sometimes permanently altered many brilliant and unusual minds, from the moment they were introduced to the West some seventy years ago to the present day—with a rather long break in the middle due to aggressive legislation.

Few are likely to know the early history of psychedelics, or how promising and successful they had been in the psychiatric practice of the 1950s. A good portion of the book is devoted to covering the many high-quality studies performed with the drugs in the 1950s, before the exuberance of some (in particular Timothy Leary) led to the drugs being banned. This was a history mostly unknown to me, and apparently to Pollan, who discusses the precipitous rise and ignominious fall of this research at some length. Unlike much of the colourful cast that he depicts, Pollan himself was, when he began writing, inexperienced with psychedelics, and in fact quite hesitant to try them. Having been born in the mid-1950s, Pollan had come of age in the wake of the all-out offensive that characterised the start of the War on Drugs. Nixon called drug abuse “public enemy number one” and went so far as to single Leary out as “the most dangerous man in America.” The message was stark enough that many of Pollan’s generation took the terrifying rhetoric at face value, believing the effects of psychedelics to include madness, blindness, suicide, and other calamitous consequences. Misconceptions fuelled by the early propaganda persist, even among the medical and psychiatric communities, to this day. So whence his interest? Pollan was piqued after reading a 2010 article in the New York Times which described NYU and Johns Hopkins studies using magic mushrooms. These studies sought to determine whether the mushrooms might be able to alleviate “existential distress” in patients who had been given grave or even terminal cancer diagnoses.  As a result of his impressions about the psychological dangers of this class of drugs, Pollan was surprised to learn that psychedelics were being given to patients already in the grip of mortal terror.

As it happens, a man named Patrick Mettes, diagnosed with terminal cancer of the bile ducts, read precisely the same article in 2010, and managed to get himself a place in the NYU study. What the study showed was that a single high dosage of mushrooms, in a careful session with two therapists, could reliably alleviate the patients’ terror at facing imminent death. These sessions were not “psycholitic”—an earlier name for the psychedelic drugs that indicated the fact that, in low dosages, they can make one malleable for more traditional types of psychoanalysis or psychotherapy. Rather they involved high doses, and the therapists provided instructions and something more akin to moral support than therapy, not intervening during the trip unless the patient was in distress. (This would strictly apply to mental distress; the drug are remarkably non-toxic and, as with cannabis, there is no known lethal dose.) The patients thereafter underwent their own internal journeys, accompanied by music and shielded from the perceptual distractions of the outside world by eyeshades. They ventured into their mind, into their fear, and, often, into their cancer—and emerged, not terrified, but miraculously relieved. Pollan’s account of Patrick’s transformation, from a man in the depths of existential anguish to the radiantly beaming man who was consoling his therapists is incredible. Two months after his treatment, and about a year before his eventual death from his cancer, Patrick reported being the happiest he had been in his life.

As a result of this powerful story, Pollan wrote a piece in 2015 in the New Yorker, which seemed to hit a nerve. Pollan made plans to expand his inquiry into the history and efficacy of these drugs, and along the way, resolved, not without reluctance, to take not only magic mushrooms and LSD, but potentially less familiar drugs in the same class like ayahuasca and the extremely potent 5-MeO-DMT (procured from the dried venom of the Sonora desert toad).

So what do the classical psychedelics do? The question turns out to be difficult to answer concisely. Their popular image, as producing powerful visual hallucinations, while not inaccurate, does not do justice to their extremely varied effects. Stanislav Grof, a Czech psychiatrist who was important in the drugs’ early therapeutic studies during the time when they were legal, called them “unspecific amplifiers”, meaning that they would intensify emotional or mental processes indiscriminately. This is very different from most other psychoactive drugs, which tend to produce relatively predictable effects. More recently, Roland Griffiths showed in 2006 that psilocybin mushrooms can reliably occasion mystical experiences in “healthy normals”, rather fascinatingly producing experiences that rank among the most meaningful in healthy subjects’ lives (comparable to the death of a parent or the birth of a child). His TEDMED talk is well-worth a watch. Even newer research by addiction psychiatrist Judson Brewer intriguingly showed that fMRI scans of those on psychedelic drugs look very similar to those of advanced meditators, with both exhibiting reductions of activity in the “default mode network.” The decrease of activity in this network may be central to the drugs’ effects, which is critical as there is increasing evidence that this network is implicated in mental illnesses like anxiety and depression. The DMN, as it is abbreviated, is strongly involved in producing one’s sense of self, in memories and forecasting, in judging social situations, and in imagining what others might be thinking. This leads on to one of the most fascinating accounts of what these drugs do, in a paper by a researcher at Imperial College London named Robin Carhart-Harris. This paper makes a strong and utterly fascinating case that the psychedelic state may be similar to childhood consciousness, and even that it may be a sort of polar opposite to the type of consciousness found in depression, addiction, and obsession. I cannot do the paper justice here; Pollan’s summary is tantalising, but the paper itself is one of the most fascinating I have read.

To give an overview of the drugs’ history, LSD was discovered in Switzerland in the 1930s, manufactured in the 1940s, in wide medical use in the 1950s, part of the culture in the 1960s, and banned in the US in 1971. Magic mushrooms were used for hundreds or even thousands of years in Southern Mexico, but had been suppressed (though never wholly eliminated) by the Spanish missionaries. In one of the many surreal stories in this book, these mushrooms were first brought to the attention of the world by J.P. Morgan banker R. Gordon Wasson, following a disagreement with his Russian wife over the safety of wild mushrooms. They noticed that different cultures tend to exhibit either mycophilia or mycophobia (love or fear of mushrooms), and this discussion ultimately led to the couple becoming expert mycologists. After hearing rumours of ancient Mexican mushroom ceremonies still taking place, in 1955 Wasson travelled to Mexico and was allowed to partake. Two years later he published a widely-read account of his experiences in Life magazine. This led to an invasion of the previously secluded community first by beatniks and later by hippies, not to mention Bob Dylan, Mick Jagger, and John Lennon, and later to the identification of other psilocybes mushrooms (of which there are dozens of varieties growing all over the world). Their active compounds psilocybin and psilocin, interestingly, were identified in 1959 by the same Swiss scientist—Albert Hoffman—who had discovered LSD.

Most will have an impression of the role of these drugs went on to play in the heady days of the late 1960s, and Pollan treats this period in illuminating detail. One of his most interesting contentions is that the psychedelic trip, when first embarked upon by the youth of the 1960s, was not just a new rite of passage, but a new type of rite of passage. Normally, he argues, these rituals (like a bar mitzvah) are sanctioned by adults, and represent a transition from adolescence into adulthood. In the 1960s, young users of LSD and magic mushrooms in the West were venturing into territories totally uncharted by the older generation. Moreover they were entering this terra incognita without any moral framework or therapeutic oversight. Guidance and rituals had always accompanied magic mushrooms when taken in Southern Mexico, as well as most other examples of psychedlics used in pre-modern times, as, for example, seems to have been the case in the Eleusinian Mysteries of Ancient Greece. Lacking such a cultural context, Pollan argues, the youth of the 1960s were not only entering states of which their elders knew nothing at all, but they were doing so in a way that would make them even more susceptible to the potential dangers and often overpowering effects of these substances. All of this combined to create a great deal of fear.

Nixon’s reaction was cataclysmic, and the effects of the War on Drug are of course being felt throughout the Americas and the world to this day. However, psychedelics show signs that they may, in the near future, be decriminalised in the US. Unlike the populist movements which resulted in widespread marijuana legalisations, it looks more likely that psychedelics will be approved through the traditional FDA route, and quite possibly be used in the near future to treat depressionRick Doblin has already been successful in trialling MDMA for the treatment of PTSD, and his organisation MAPS (Multidisciplinary Association for Psychedelic Studies) is devoted to the legal study of psychedelic drugs. Other studies have shown psilocybin’s efficacy in helping people quit smoking, with a success rate that is currently much higher than any alternatives. All of this new research is happening alongside a re-examination of the old research, for example studies showing evidence that LSD can help alcoholics stop drinking; however, these studies were often not done to today’s standards, in particular failing to be double-blinded. Surprisingly, the powerful and obvious effects of psychedelics still present methodological problems for science today.

Several chapters of the book are devoted to Pollan’s own “trips.” One of the hallmarks of the psychedelic experience, as a subset of William James’ formulation of mystical experiences from which they are indistinguishable, is that they are ineffable. Pollan jokes that he has nonetheless “effed” them, and indeed he has done so with verve and clarity, despite the fact that the inadequacy of re-telling such experiences inevitably gives the sense of having done them injustice or even violence, and the added danger that the powerful experiences can turn to platitudes on the page. I won’t further diminish Pollan’s experiences by any summary of my own, but can highly recommend reading the book. I can also recommend his appearances on NPRSam Harris’ podcast, on Science Friday, and perhaps especially on Tim Ferriss’ podcast, all of which are fascinating. Pollan’s books have the great virtue that all of them are likely to change your mind; this one lives up to its title.

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