How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence (2018)

Earlier chapters discussed the possible psychedelic treatments for groups of people suffering from various mental states. This chapter focuses on three instances where psychedelics were used, in recent years, to treat terminal cancer patients, addiction, and depression.

The chapter first focuses on the use of psilocybin as a way to ease a terminally ill patient’s anxiety over death. Patrick Mettes was a volunteer for New York University’s psilocybin cancer trial, which studied how psychedelic experiences affect depression and anxiety over terminal diagnoses. Mettes was guided by Tony Bossis and Stephen Ross, who helped to direct the trial as well (332). This trial, a sister trail to Roland Griffiths’s study, also looked to pick up the research that was lost in the 1970s.

In 2010 Mettes learned that his cancer had progressed and become terminal. In that same year he saw an article in the New York Times about research being done at New York University, using psilocybin to treat end-of-life anxiety in cancer patients. He immediately called and requested to volunteer.

On the day of his trial Mettes was given flight instructions for his trip and asked to state his intentions. He said that he wanted to “learn to cope better with the anxiety and depression he felt about his cancer and to work on what he called his ‘regret in life’” (340). Shortly after he was given the psychedelic and launched into his journey. He felt as if he was launched by a rocket into space (341). Mettes saw family members who had died of cancer, and they acted as a tour guide through the experience. Mettes felt as if he was being reborn; this feeling translated into physicality, and he moved his knees as if he was actually giving birth. The rest of his journey was filled with love and compassion, which “seemed to emanate from a single point of light…and it vibrated…I could feel my physical body trying to vibrate in unity with the cosmos” (342). In that moment love was the only thing that mattered to him.

Mettes then found himself traveling through his body and to his lungs, where he saw two spots (343). He felt as if he was being told not to worry about the cancer, as there were more important things than “an imperfection of [his] humanity” (343). His trip ended with a moment in death. He found that he was not quite ready to die yet, as he still had a bit of work to do, but he would be ready when the time came. In a follow-up session after his trip, Patrick Mettes seemed like a completely different person, one who found more time to meditate and better live in the present moment. He felt as if he loved his wife and the people around him even more, and reported feeling the happiest he had felt in his entire life (347).

Mettes lived for 17 months after his experience, and that time was filled with happiness and acceptance of death. He came away from the experience feeling that he still had things to do, love, and care for. His wife said he had increased patience and joy that he didn’t have prior to his trip. In his final days, his biggest sadness wasn’t that he was going to die, but that he was leaving his wife. Even so, “he was not afraid” (357).

The NYU trial determined that 80% of the cancer patients showed reduced anxiety and depression, with the relief of their symptoms corresponding to the intensity of their psychedelic journey. In a follow-up study that interviewed patients about their experiences, every patient described feeling more connected to their loved ones and more interconnected with the world (351). This feeling was accompanied by “joy, bliss, and love” (352).

The existential anxiety and depression that a person can experience when confronted with the end of their life is very similar to the way a rigid brain creates obsessive thought patterns and negative thinking (353). Psilocybin can diminish ego for a short while and allow new thought patterns, which tended to create a sense death and rebirth for the cancer patients. Another common theme was the overwhelming sense of love for people in their lives and the world around them. This allowed most patients to live their final days with less anxiety and more intention.

The chapter next talks about using psychedelics to treat addiction. Matthew Johnson, a protégé of Roland Griffiths, took on a smoking cessation study to see if psychedelics could help curb addictions that resisted other treatment methods. Though his initial pilot study was small and not randomized, it still had incredible results. Six months following their psychedelic experience, “80 percent of the volunteers were confirmed as abstinent; at the one-year mark, that figure had fallen to 67 percent, which is still a better rate of success than the best treatment now available” (361).

Many of the volunteers took away very simple and mundane insights rather than grandiose spiritual ones. One volunteer concluded that “everything in the universe is of equal importance, including yourself,” which make smoking seem “kind of stupid” to her (362). She has not smoked since this experience. Another volunteer found that smoking was irrelevant, and that “other things had become so much more important” to him (363). One volunteer even saw herself as a smoking gargoyle, which she found disturbing. That image stuck with her enough to keep her from smoking when cravings arose (364).

Most smokers are aware that their habit is not healthy or helpful, but it isn’t until they have their psilocybin experience that this knowing takes on a new weight and becomes influential. It gives them a chance to see the short- and long-term impacts of smoking, and gives them more authority over their addiction (364).

Using psychedelics to treat addiction has been around for generations, as Native Americans used peyote as a treatment for alcoholism. Thousands of people were treated with LSD for their alcohol abuse in the 1950s and ’60s, during the first wave of research (368). It wasn’t very clear what the definitive results of the studies were, but a 2012 analysis of the best six studies previously done showed that psychedelics had a statistically significant impact on curbing alcohol abuse (369). The authors concluded, “Given the evidence for a beneficial effect of LSD on alcoholism […] it is puzzling why this treatment has been largely overlooked” (369).

Finally, the chapter looks at using psychedelics to treat depression. When Roland Griffiths hoped to get more funding for psilocybin clinical trials, he found that the FDA also asked them to expand their focus into testing whether psilocybin could be used to treat depression, especially the variety that was classified as treatment resistant.

Robin Carhart-Harris directed a small study in the use of psilocybin to treat depression and found that in a population of 12 (without a control group), “all of the volunteers showed improvement in their symptoms, and two-thirds of them were depression-free, in some cases for the first time in years” (376). The study was then expanded to 20 volunteers; six remained in remission after 6 months, and the rest relapsed to a degree, which suggests that the treatment may need to be administered more than once (376-77).

Two main themes emerged from these studies. The first was that majority of volunteers saw their depression as a disconnect from people, themselves, feelings, senses, and their beliefs (377). After their psychedelic treatment, one volunteer said, “It was like a holiday away from the prison of my brain. I felt free, carefree, reenergized” (378). Another volunteer mentioned that their mind worked entirely differently after the experience, and they found themselves overthinking less. Many also reconnected with themselves, feeling more like they used to before depression overwhelmed them (378).

The second main theme was the volunteers’ ability to access emotions that were tucked away or dampened down. For many people, depression represses painful emotions because feeling them is too much to handle. Psychedelics allowed many of the volunteers to confront those emotions, helping to relieve the weight of unaddressed trauma (380).

It’s important to remember that these studies have not been shown to work in larger populations, and that these successes aren’t proof of psychedelic drugs’ effectiveness as treatment, though they do indicate trends that prove there is something to be studied. The fact that psychedelics can impact such a wide range of mental disorders also suggests there are connections between the disorders and how they impact our brain (382). Some scientists have even used this trend to build a unified theory of mental illness. The idea is that there “is a common mechanism underlying addiction, depression, anxiety, mania, and obsession,” and that “these disorders involve learned habits of negative thinking and behavior that hijack our attention and traps us in loops of self-reflection” (383-84). Psychedelics have helped shed light on the underlying mechanisms that impact multiple mental disorders, and that information could become critical to developing new treatments and therapies.

In 2017 the Oakland Convention Center for Psychedelic Science became a hub for the international psychedelic community and many psychedelic organizations. The six-day convention brought scientists, shamans, therapists, and entrepreneurs together to hear more about the current boom in psychedelic research (398). One of the most memorable panels was called “The future of Psychedelic Psychiatry,” which featured Paul Summergrad, MD (former head of the American Psychiatric Association) and Tom Insel, MD (former head of the National Institute of Mental Health) (398). The panel made it clear to all attendees that there was “recognition of psychedelic therapy by the mental health establishment” (399). The two also warned that while there was a lot of promise, there were also several issues with scientific rigor and safety that could pose challenges.

The medicalization of psychedelic therapy will not be an easy road, as drug testing faces many regulatory hurdles during the clinical trial process. There is also the issue of funding, as many pharmaceutical companies will not be able to make money on the drug, as psilocybin comes from nature and the LSD patent is expired (400). On top of that, pharmaceutical companies are less likely to invest in drugs that aren’t used for chronic conditions or taken every day (400). Most people who hope to see psychedelic therapy become more commonplace also recognize the need for trained psychedelic guides, who perhaps have board certification, to help people make sense of their experiences and ensure a good trip.

Today’s cultural landscape is also quite different from the first wave of psychedelics, with people being more openminded and willing to talk about death, cancer, depression, and other mental illnesses. Rick Doblin notes that psychedelics are commonly known because of that first wave of psychedelic research, and perhaps this is the “true legacy of Timothy Leary” (403). As Doblin observes, “There would be no second wave if Leary hadn’t turned on a whole generation” (403). While Leary was partly responsible for ending a generation of psychedelic research, he was just as responsible for bringing psychedelics into common public knowledge.

As for Pollan, his experiences in writing this book have left him with the opinion that psychedelics shouldn’t be outright legalized but made available for people to take with the experience of a trained guide, just as he did (405). He also found value in exploring new states of mind, which allow a person to see their normal daily experience in a new light. The ordinary experience begins to seem less ordinary, and has more to offer, when compared to a unordinary experience.

Pollan clarifies that although he had these experiences, he hasn’t become a highly spiritual or transcendent person. Rather, his experience “opened a door to a specific mode of consciousness” that he can return to in his meditative practice (408). Overall, his experience with psychedelics, his research into psychedelic treatment, and his conversations with experts led him to conclude that there is more to the headspace that we normally exist in than most people suspect. In closing, he writes, “I can say with certainty: the mind is vaster, and the world ever so much more alive, than I knew when I began” (414).