How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence

by Michael Pollan

To cite one obvious example, conventional drug trials of psychedelics are difficult if not impossible to blind: most participants can tell whether they’ve received psilocybin or a placebo, and so can their guides. Also, in testing these drugs, how can researchers hope to tease out the chemical’s effect from the critical influence of set and setting? Western science and modern drug testing depend on the ability to isolate a single variable, but it isn’t clear that the effects of a psychedelic drug can ever be isolated, whether from the context in which it is administered, the presence of the therapists involved, or the volunteer’s expectations.

Is mental illness a disorder of chemistry, or is it a loss of meaning in one’s life? Psychedelic therapy is the wedding of those two approaches.”

“We are born

into an egoless world,” Cohen wrote, “but we live and die imprisoned within ourselves.”

Many of the cancer patients I interviewed described an experience of either giving birth or being reborn, though none quite as intense as Patrick’s. Many also described an encounter with their cancer (or their fear of it) that had the effect of shrinking its power over them.

A few key themes emerged. All of the patients interviewed described powerful feelings of connection to loved ones (“relational embeddedness” is the term the authors used) and, more generally, a shift “from feelings of separateness to interconnectedness.” In most cases, this shift was accompanied by a repertoire of powerful emotions, including “exalted feelings of joy, bliss, and love.” Difficult passages during the journey were typically followed by positive feelings of surrender and acceptance (even of their cancers) as people’s fears fell away.

In his view, which is informed by his psychoanalytic training, the ego is a mental construct that performs certain functions on behalf of the self. Chief among these are maintaining the boundary between the conscious and the unconscious realms of the mind and the boundary between self and other, or subject and object. It is only when these boundaries fade or disappear, as they seem to do under the influence of psychedelics, that we can “let go of rigid patterns of thought, allowing us to perceive new meanings with less fear.”

Love for specific individuals, yes, but also, as Patrick Mettes came to feel (to know!), love for everyone and everything—love as the meaning and purpose of life, the key to the universe, and the ultimate truth.

So it may be that the loss of self leads to a gain in meaning. Can this be explained biologically?

She had the “humbling” realization that “everything in the universe is of equal importance, including yourself.

This is why it is important to understand that “psychedelic therapy” is not simply treatment with a psychedelic drug but rather a form of “psychedelic-assisted therapy,” as many of the researchers take pains to emphasize.

“So much of human suffering stems from having this self that needs to be psychologically defended at all costs. We’re trapped in a story that sees ourselves as independent, isolated agents acting in the world. But that self is an illusion. It can be a useful illusion, when you’re swinging through the trees or escaping from a cheetah or trying to do your taxes. But at the systems level, there is no truth to it. You can take any number of more accurate perspectives: that we’re a swarm of genes, vehicles for passing on DNA; that we’re social creatures through and through, unable to survive alone; that we’re organisms in an ecosystem, linked together on this planet floating in the middle of nowhere. Wherever you look, you see that the level of interconnectedness is truly amazing, and yet we insist on thinking of ourselves as individual agents.”

“Alcoholism can be understood as a spiritual disorder,” Ross told me the first time we met, in the treatment room at NYU. “Over time you lose your connection to everything but this compound. Life loses all meaning. At the end, nothing is more important than that bottle, not even your wife and your kids. Eventually, there is nothing you won’t sacrifice for it.”

Watts’s interviews uncovered two “master” themes. The first was that the volunteers depicted their depression foremost as a state of “disconnection,” whether from other people, their earlier selves, their senses and feelings, their core beliefs and spiritual values, or nature.

The second master theme was a new access to difficult emotions, emotions that depression often blunts or closes down completely.

We shouldn’t forget that irrational exuberance has afflicted psychedelic research since the beginning, and the belief that these molecules are a panacea for whatever ails us is at least as old as Timothy Leary. It could well be that the current enthusiasm will eventually give way to a more modest assessment of their potential.

Also, the placebo effect is usually strongest in a new medicine and tends to fade over time, as observed in the case of antidepressants; they don’t work nearly as well today as they did upon their introduction in the 1980s. None of these psychedelic therapies have yet proven themselves to work in large populations; what successes have been reported should be taken as promising signals standing out from the noise of data, rather than as definitive proofs of cure.

Yet the fact that psychedelics have produced such a signal across a range of indications can be interpreted in a more positive light. When a single remedy is prescribed for a great many illnesses, to paraphrase Chekhov, it could mean those illnesses are more alike than we’re accustomed to think. If a therapy contains an implicit theory of the disorder it purports to remedy, what might the fact that psychedelic therapy seems to address so many indications have to tell us about what those disorders might have in common? And about mental illness in general?

“The DSM categories we have don’t reflect reality,” Insel said; they exist for the convenience of the insurance industry as much as anything else. “There’s much more of a continuum between these disorders than the DSM recognizes.”

in his view, all these disorders involve learned habits of negative thinking and behavior that hijack our attention and trap us in loops of self-reflection. “What started as a pleasure becomes a need; what was once a bad mood becomes continuous self-indictment; what was once an annoyance becomes persecution,” in a process he describes as a form of “inverse learning.” “Every time we respond [to a stimulus], we strengthen the neural circuitry that prompts us to repeat” the same destructive thoughts or behaviors.

Mendel Kaelen, a Dutch postdoc in the Imperial lab, proposes a more extended snow metaphor: “Think of the brain as a hill covered in snow, and thoughts as sleds gliding down that hill. As one sled after another goes down the hill, a small number of main trails will appear in the snow. And every time a new sled goes down, it will be drawn into the preexisting trails, almost like a magnet.” Those main trails represent the most well-traveled neural connections in your brain, many of them passing through the default mode network. “In time, it becomes more and more difficult to glide down the hill on any other path or in a different direction. “Think of psychedelics as temporarily flattening the snow. The deeply worn trails disappear, and suddenly the sled can go in other directions, exploring new landscapes and, literally, creating new pathways.” When the snow is freshest, the mind is most impressionable, and the slightest nudge—whether from a song or an intention or

The Hopkins researchers use a similar metaphor to make the same point: psychedelic therapy creates an

interval of maximum plasticity in which, with proper guidance, new patterns of thought and behavior can be learned.

The two are of course closely related: without the ability to remember our past and imagine a future, the notion of a coherent self could hardly be said to exist; we define ourselves with reference to our personal history and future objectives. (As meditators eventually discover, if we can manage to stop thinking about the past or future and sink into the present, the self seems to disappear.) Mental time travel is constantly taking us off the frontier of the present moment. This can be highly adaptive; it allows us to learn from the past and plan for the future. But when time travel turns obsessive, it fosters the backward-looking gaze of depression and the forward pitch of anxiety. Addiction, too, seems to involve uncontrollable time travel. The addict uses his habit to organize time: When was the last hit, and when can I get the next?

“think of the old cliché about ‘the mind being an excellent servant but a terrible master.’ This, like many clichés, so lame and unexciting on the surface, actually expresses a great and terrible truth,” he said. “It is not the least bit coincidental that adults who commit suicide with firearms almost always shoot themselves in the head. They shoot the terrible master.”

OF ALL THE PHENOMENOLOGICAL EFFECTS that people on psychedelics report, the dissolution of the ego seems to me by far the most important and the most therapeutic.

The usual antonym for the word “spiritual” is “material.” That at least is what I believed when I began this inquiry—that the whole issue with spirituality turned on a question of metaphysics. Now I’m inclined to think a much better and certainly more useful antonym for “spiritual” might be “egotistical.” Self and Spirit define the opposite ends of a spectrum, but that spectrum needn’t reach clear to the heavens to have meaning for us.

The PCC is believed to be the locus of the experiential or narrative self; it appears to generate the narratives that link what happens to us to our abiding sense of who we are. Brewer believes that this particular operation, when it goes awry, is at the root of several forms of mental suffering, including addiction. As Brewer explains it, activity in the PCC is correlated not so much with our thoughts and feelings as with “how we relate to our thoughts and feelings.” It is where we get “caught up in the push and pull of our experience.” (This has particular relevance for the addict: “It’s one thing to have cravings,” as Brewer points out, “but quite another to get caught up in your cravings.”) When we take something that happens to us personally? That’s the PCC doing its (egotistical) thing. To hear Brewer describe it is to suspect neuroscience might have at last found the address for the “But enough about you” center of the brain.

“People don’t say, simply, we’re gonna give psychedelics. They talk about ‘psychedelic-assisted psychotherapy.’ . . . I think it’s a really novel approach.”

Normally Big Pharma foots the bill for such trials, but thus far the pharmaceutical companies have shown scant interest in psychedelics. For one thing, this class of drugs offers them little if any intellectual property: psilocybin is a product of nature, and the patent on LSD expired decades ago. For another, Big Pharma mostly invests in drugs for chronic conditions, the pills you have to take every day. Why would it invest in a pill patients might only need to take once in a lifetime?

Psychiatry faces a similar dilemma: it too is wedded to interminable therapies, whether that means the daily antidepressant or the weekly psychotherapy session. It is true that a psychedelic session lasts several hours and usually requires two therapists be present for the duration, but if the therapy works as it’s supposed to, there won’t be a lot of repeat business. It’s not at all clear what the business model might be. Yet.

people afterward integrate the powerful experiences they have had in order to make sense of them and render them truly useful. Tony Bossis paraphrases the religious scholar (and Good Friday Experiment volunteer) Huston Smith on this point: “A spiritual experience does not by itself make a spiritual life.” Integration is essential to making sense of the experience, whether in or out of the medical context. Or else it remains just a drug experience.

the insights don’t come from nowhere, and they certainly don’t come from a chemical. They come from inside our minds,* and at the very least have something to tell us about that

And about that my psychedelic journeys have taught me a great many interesting things. Many of these were the kinds of things one might learn in the course of psychotherapy: insights into important relationships; the outlines of fears and desires ordinarily kept out of view; repressed memories and emotions; and, perhaps most interesting and useful, a new perspective on how one’s mind works.

For me, the experiences have become landmarks to circle around and interrogate for meaning—meanings about myself, obviously, but also about the world. Several of the images that appeared in the course of my trips I think about all the time, hoping to unwrap what feels like a gift of meaning—from where or what or whom, I cannot say.

That plants are intelligent I have believed for a long time—not necessarily in the way we think of intelligence, but in a way appropriate to themselves.