NYT Food Columnist Michael Pollan Talks Psychedelics, Science and Mental Health
Longtime Michael Pollan fans will find How To Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence is a different book from his past work - mostly. Although in the past, Pollan wrote about food and agriculture, his love of nature carries through to his new book, especially in one section when he forages for magic mushrooms with mushroom expert Paul Stamets. As in past books, he uses an engaging, first-person style of telling a story by introducing readers to the people he meets along the way who teach him about various topics. Unlike previous books, instead of teaching him about food and agriculture, the characters you'll meet in this book teach about psychedelic drugs. Specifically: LSD, psilocybin (the psychedelic compound in magic mushrooms), ayahuasca, and the dried and smoked venom of a toad that Pollan and others refer to as "the toad."
The new book is divided into distinct parts (six, instead of four this time). Pollan reviews the history of psychedelics: how they were discovered, researched for various medical uses, popularized as a part of the counterculture, criminalized and abandoned scientifically, and how they are now coming back within science and medicine in what he calls a renaissance. He reviews the current science of psychedelics: how they affect the brain, how they might be used in medicine to treat addiction, depression, and the fear of death faced by terminal cancer patients, and how they might improve the lives of "healthy normals" too. And, in a chapter titled "Travelogue" (since he went on several trips), he tries the drugs himself and writes about his experiences.
Pollan distinguishes psychedelics from "drugs of abuse" - opioids, meth, or even tobacco, each of which are toxic and addicting. Comparatively, psychedelics are fairly safe (Pollan even got the green light to try them from his cardiologist). That is not to say he endorses unlimited use of psychedelics. With only one exception, Pollan takes his trips with the help of guides. Although the guides are "underground" (not acting legally), they are trained specialists who screen out anyone who cannot safely take psychedelics, prepare each client for a safe trip, stay with them during the trip to ensure safety, and then help them debrief and process what happened afterward.
One of the most interesting themes of the book concerns the tension between psychedelics and science. For one thing, in the 1950s and 1960s, scientists had been doing promising psychedelic research in many areas (such as treating alcohol addiction) when the backlash against psychedelics led to the drugs becoming illegal and all of the research shelved and - for many - forgotten. We often view science as objective truth, but in this case, social and cultural factors led scientists to abandon research even as it was producing hopeful results.
Testing the effects of psychedelics using the normal protocols for testing other drugs is difficult to impossible. (He writes about the 1962 Good Friday Experiment in which ten divinity students received psilocybin while another ten received a placebo: "Telling them apart was not difficult, rendering the double blind a somewhat hollow conceit: those on the placebo sat sedately in their pews while others lay down or wandered about the chapel, muttering things like "God is everywhere" and "Oh, the Glory!")
Even more difficult for the current method of testing the effectiveness of drugs to handle are the importance of set and setting: "Set is the mind-set or expectation one brings to the experience, and setting is the environment in which it takes place." Both are crucial factors in influencing the trip one takes and how it affects them. On one hand, researchers can provide a set and setting to prime participants to have good trips that will maximize the benefits they gain. On the other hand, doing so introduces variables and bias in a way that many scientists would find unacceptable.
However, it appears that psychedelics do provide medical benefits for many when used carefully and with the care of a trained therapist or guide. Should we disregard psychedelics unless we can measure them using our current scientific paradigm? Or can we find a way to harness their benefits in a responsible way even though set and setting introduce variables that cannot be perfectly controlled?
I spoke to Pollan by phone and he answered a few questions about his new book.
JR: You always write yourself into your books, but the information you revealed about yourself in this book felt more personal. Why did you choose to open up more about yourself in this book and how do you feel about having done so?
MP: You're right in your observation. It is a much more personal book and it definitely exposes more of myself than previous books and in general I've used the first person as a narrative tool as much as anything, a place to stand to look at a story. But in this case, if you're having psychedelic experiences, they bring up lots of material. You can't make sense of it on the page without explaining who you are. The molecules lower your defenses and so when your defenses are lowered, you're more exposed. If you are going to be true to the experience you are having, you're going to reveal more about yourself.
And I also made a decision early on I was going to refuse to be embarrassed by what I wrote and that if I really wanted to be honest about the experience I had to put aside how it made me look and what I might be revealing about myself. The experiences are hard enough to write about as it is and then if you're also trying to spin them to hide yourself or make yourself look better than you are, you're not going to provide a very satisfying account to the reader. So it's not like I'm on a new confessional jag as a writer but it was really part and parcel of the experience. I just don't know how you would describe them without - it's not the molecule that's creating the experience, it's you. The molecule is amplifying mental processes that are already at work and if you want to describe those mental processes, well, they are you. Or me.
JR: I love that when we got a picture into your mind, you're still thinking about plants. On that note, there was one part of this book felt very familiar to me when you went looking for Psilocybin mushrooms with Paul Stamets. I felt like, while this is a different sort of book, it's still Michael Pollan. I noticed, you seem to have given mushrooms the Botany of Desire treatment, speculating why they evolved psychoactive compounds.
MP: Even though they are not exactly a domesticated creature, I always think about the other species' point of view too. And I have since Botany of Desire. I actually think of that chapter as the Botany of Desire-ish chapter of this book because I really am trying to get inside the mushroom's head or whatever it is.
MP: Yeah, cap, right. And since I said that, there's been some interesting new research on what's in it for the mushroom and why they have this chemical. There was a really cool study that came out that found that this gene to produce psilocybin has spread amongst several different kinds of mushrooms. It's not a single evolutionary path. It's been kind of horizontally transferred because of its usefulness. And the authors hypothesize that the mushroom's competing with arthropods for a food source. For decaying plant matter and animal feces and things like that. And the chemical helps the mushroom prevail in that competition presumably by discombobulating the insects so they don't feed as efficiently.
MP: Yeah, really interesting. So that would suggest it is a defense chemical of a certain kind that - I guess I do say this in the book - that it makes more sense to confuse the predator than to kill it because if you kill it, you'll select for resistance whereas if you confuse it, it will just go like, "What was I doing here? Where was that cow patty?" And it will just kind of lose interest. And also, psychedelics do diminish appetite. I was never hungry during my trips. So we're still in the realm of speculation but it is very interesting to think about why this chemical would be preserved in natural selection because it fits so well into the serotonin receptor.
JR: You comment kind of repeatedly throughout the book about the ineffability of the psychedelic experience. When you were interviewing the other people who have already taken psychedelics, had you already tried them? Were you already speaking their language?
MP: Especially in the chapter on the renaissance, I hadn't tried them yet. I hadn't tried them yet. And so I listened carefully and worked very hard to convey their experiences as best I could and the variety of the experiences and the intensity. But I didn't speak their language yet.
I kind of get it more, because when people describe this, you sort of imagine an uncontrollable hallucination when someone says, "I traveled into my body and looked at my cancer, or my fear." But it isn't quite like that. It's sort of more like a waking dream or a particularly intense daydream. You can turn it off. You can move. You can decide to go somewhere else.
Hallucination isn't exactly the right word for it. I don't know what is the right word for it. Someone called it an intrapsychic movie and that's sort of close. But it's not completely out of your control in the way a schizophrenic's hallucination would be. You know you're not really inside your body but you've kind of gone there imaginatively. So those accounts make more sense to me now than they did before.
JR: I'm curious what it was like for you to try to describe the indescribable and, I'm just imagining your perspective having listened to others describe it when you couldn't relate, and then you could relate, and trying to describe your own, and how that changed your perspective and what the challenges are to write a book that is based on this experience that can't be described.
MP: Well, it's not that it can't be described. It's difficult to describe. Anything can be described - it's how close do you get to the reality of the experience and that's the challenge. You can describe it poorly, or partially, or sketchily.
I found a few approaches. I did approach that chapter - the Travelogue chapter - with a great deal of trepidation. Like, how am I going to do this? How am I going to keep this interesting? You know, you don't like hearing about other people's dreams. There's nothing more boring than that. And they are sort of like dreams, although they have a lot more coherence, I think.
I found that two things were helpful. One was writing about the experience sort of the way a memoirist writes about childhood. When you read a good memoir of childhood or any earlier phase of someone's life, they toggle back and forth between their adult perspective and the child's perspective. And it really is in the tension between those two, or the space between those two perspectives that the writing acquires a certain force and credibility. If you were just in the child's perspective, you would learn a lot less than you would when you toggle back and forth and the adult weighs in and then the child weighs in. It's the same person, but there's a switch back and forth in perspective.
So I sort of did the same thing and that was to be inside the experience as the person who is tripping, who is believing everything and seeing all of these crazy things and then stepping outside to kind of frankly acknowledge how crazy it sounds, how implausible it is. There's a little riff in the book where I talk about - on the LSD trip - these powerful feelings I had of love. I well understood how thin they sounded but they were so powerful and I just talked about it. I kind of broke the fourth wall, like an actor turning to the audience, and I felt that was the best way to deal with it. To just be really frank and say it feels like this, but I know it reads like this. And that was one helpful technique. It's obviously for the reader to judge if this all works, but that was helpful to me.
The other was when I was experiencing things that were so far beyond the usual conventions of narrative such as the toad trip where not only have I lost a sense of self, character to write about, but I've lost a sense of time and a sense of place, because material reality was obliterated too. Time was obliterated. How do you write a story without those three ingredients? You really need those three ingredients.
So I resort to metaphor. Metaphor is really how - it's how poets deal with the ineffable. You get the right metaphor and it crystallizes a whole complex of emotion and insight if you choose it well. So I just kind of threw a couple metaphors at the wall. One was being blown up in a thermonuclear blast and being in the middle of one of those houses they erected in the Bikini Atoll and then blew up so they could see the force of the nuclear explosion. Another was being strapped to a rocket and feeling the G-forces mount as you climb through the atmosphere completely unprotected. And then the third was let's go back to before the Big Bang - not that any of us remember this - but from what we know from the cosmology, there was no time and there was no matter, there was just pure energy and that's what it felt like. And I said, it was a little like that. And so we can use metaphor to go places we really can't go descriptively. And I don't know if those are brilliant or original metaphors, but they helped. They helped.
It turned out to be a really enjoyable thing to write. I just loved the challenge of it. As someone who usually works as a journalist in this tight little box of checkable facts, here I was describing a purely imaginary world and that was very liberating.
JR: I'll bet. As an aside, this is something I relate to. As I am healing from PTSD, I'll have these incredibly profound experiences, and I can describe it, like you said, but I can't convey how profound it feels, the magnitude of it. And it sounds crazy. But it feels real. I'll come off of it and I'll want to tell somebody that something big happened, but there are no words. So I related to what you wrote because I've had that experience.
MP: I think that's it. The amplitude, the intensity of the experience. You can describe it but it's kind of cloaked in this emotional power that is very hard to get across.
JR: How did your body feel when your ego had entirely dissolved while on your trip?
MP: There is a bodily sensation. The sensation of merging. Very soft. You feel kind of unbounded. Like your skin is permeable. Everything is permeable. It starts as kind of a heady experience but it did have a physical component, and it was very pleasant.
JR: A running theme throughout this book is the difficulty science has in measuring the effects or benefits of psychedelic drugs. Do you think we should continue to seek ways to study psychedelics using the current scientific paradigm that calls for double-blinded studies under controlled conditions by researchers who are unbiased outsiders, or do you think perhaps psychedelics have something to teach us about how we need to change science?
MP: Psychedelics really are a challenge. It is very hard to blind these studies, although they have had some success. Roland Griffiths talks about how he can fool not just his volunteers but his guides, his therapists, I forget what the percentage is, where they mistook the placebo session for a psychedelic session. It's really hard to do. I think it's worth trying.
There is a value in double blind studies if only a rhetorical value in that they persuade the FDA and the regulators so if you are going to try to - if you want to move these medicines to approval by the FDA you have to play by the rules you have. But you need to recognize the limitations. And when they talked to the FDA about this, the FDA was not troubled by the whole problem, interestingly enough. They had a pretty broad attitude about it, but I think they respected the efforts to try.
There's so many elements. One is reducing the number of variables. What do you do with the music? There's this weird variable. You're playing Bach, you're playing Pat Metheny, and then there is of course the attitude of the therapist which has a profound effect on the experience.
You know maybe the challenge is to stop calling it psychedelic therapy and acknowledge it really is a package that you're testing. And I don't know if the FDA will have a pathway for that but you have really a psychedelic-assisted type of therapy. And some of the papers used that term but I noticed when they are doing the official drug trial papers they just say "psychedelic therapy" because of the FDA tests drugs, they don't test a whole therapeutic package that involves talk therapy and pharmacology.
I think academically it's really interesting the questions it raises about the conventions we have for testing drugs, which we should realize are historical artifacts. We didn't start testing drugs that way until 1962 and there may be better ways to do it that need to be developed and applied for things like psychedelics. I'm not sure. But it certainly makes you think about the whole regime as not necessarily inevitable or the only way to do it.
JR: It seems like, as with any type of psychotherapy, there's an interaction between the patient and the therapist, or the patient and the music even. Even if you gave everybody the same music, not everybody likes the same music.
MP: That's right. And what if you don't like the music that you're hearing? It affected my experience. So that's a weird variable but it seems to be very important to the success of the session.
JR: I noticed at one point you wrote they were trying psychedelics in very sterile, hospital-like conditions and...
MP: And it got bad results. People freaked out. There are little odd things that kind of prime you for a spiritual experience in America. They give you the pill in a chalice instead of a little paper cup. And there's a Buddha in the room and a ceramic mushroom, and so the rooms are priming a spiritual experience. I don't think it's an accident that the American researchers hear a lot more about mystical experiences from their volunteers than the English do. They do hear about ego dissolution, and those two things may actually be the same but with different labels. That's what I suspect. But there's no question that the orientation of the researchers is affecting the results they are getting. And that's why I think that going to phrase 3 which will be much bigger trials conducted by people somewhat less invested in the outcome, the results might be not as good.
JR: Most of psychedelic use you describe is done in the care of a therapist or guide of some sort. However, many Americans take psychedelics on their own, without such precautions. I've got a question, but I'd like to give you the context first. First of all, where I live, a native plant produces psychoactive compounds that were traditionally used by Native Americans when men came of age.
MP: What is it called?
JR: Datura wrightii. Some people have died taking it. Second, I told my therapist that I am reading your book and joked that, because I made my own sourdough starter and baked bread and made cheese after reading Cooked, I'd probably end up taking drugs after reading this one.
MP: [Laughs] How did she react?
JR: She told me, "Please do not do that. That would interfere with what we are trying to do here." I did not ask why. It's possible she's just not open to drugs because they are drugs.
MP: There are a lot of people like that in psychiatry. They are very troubled by psychedelics because the symptoms present as psychosis and that's what they are trained to see. There was a Letter to the Editor in the New York Times on Sunday in response to an article I wrote two weeks ago about guides, and then I describe one of my own experiences from the book, and the psychiatrist who is on the faculty at UPenn writes this letter saying people should not use these drugs, they result in psychotic episodes such as the one I had had. So this guy was willing to diagnose my trip as a psychotic episode from a distance of 3000 miles and he was wrong.
And they've been wrong all through this history. They originally thought that the drugs induced psychosis, they called them psychotomimetics as a result. But it never occurs to them that maybe their diagnostic criteria have a problem.
JR: He just violated the Goldwater rule.
MP: I know! I know! That was the other thing. I was tempted to write him back. They are so persnickety about that, and there he was. But it was more revealing of him than me so it was interesting.
JR: I am curious if you heard of any circumstances or cases in which somebody should not do this, or a reason they should not do it. If you have a therapist or a guide vetting you and making sure you have a safe trip, did you hear of any pitfalls that would lead someone to be a bad candidate for taking psychedelics?
MP: One of the things you want from a guide is for them to screen you, to make sure you're not at risk either because of some other drug you're taking or because you are at risk for schizophrenia or you have family history. Even the underground guides take a medical history and ask you lots of questions and ask you what meds you're on. And that kind of care I think is really important.
There are people who should not take these drugs. They are definitely not for everyone. If you are at risk for schizophrenia, you will get screened out of any of the university trials. And it's interesting, many of the guides reject people. Someone comes to them, they think they have a serious mental illness, and they don't want to work with them because of the risk.
So I think that is a very important issue, and it's one of the values of having a guide. How are you going to make that judgment about yourself? I guess some people can make that judgment, you know, I've got a brother who is schizophrenic or maybe I shouldn't mess around with these drugs. But it's hard to generalize. I've been saying this in my interviews, but then I got this very moving letter from a woman who did have psychosis of some kind and had found psychedelics very helpful. So there are some people, I am sure, who were helped, but you don't recommend people who are in that extreme state to roll the mental dice. And you are rolling the mental dice with a psychedelic. There are psychological risks.
JR: Toward the end of the book, you comment briefly on the inadequacies of the mental health care system. And you kind of give some ways in which psychedelics could help and also some reasons why maybe our system won't let them in. Where do you see psychedelics as fitting in mental health care?
MP: Well, a lot of it depends on the receptivity of the community of therapists and doctors. I think that they are becoming more receptive than they were just a few years ago. When NYU first started studying cancer patients [using psychedelics to help terminal cancer patients cope with fear of death], the oncologists would not refer people to them. The oncologists were really negative about the whole thing. They thought it represented giving up and just kind of accepting that you'd failed to successfully treat a cancer. They see every death as a personal defeat. It's kind of the mindset. But now, I was just at this training program for psychedelic guides, there were three or four oncologists there who want to add psychedelic therapy to their oncology practice. So I think that it's moving quickly right now.
Although somebody just sent me a study, a survey of psychiatrists. And they were still very skeptical of psychedelic therapy. They all agree there should be more research but they were more skeptical. So I think it will take a little while, but it's happening.
And I'm meeting many psychiatrists and MDs at my events. They seem very open-minded. Of course they are a self-selecting group to come to my events. But the strongest criticism I hear is "we need more research," and I agree with that. We need more research. So I think if psychiatry and mental health practitioners more generally embrace this, it will be because the science proves that it's a valuable medicine, and they definitely need new tools. They have so little innovation since the SSRIs antidepressants and there's a general recognition that they are not working as well as they used to, and there's many people that they don't help. If only out of desperation, they should be taking a look at this. And I think that they will.
You know, many of the psychiatric drugs that are commonly prescribed are far more toxic than LSD or psilocybin. The side effects - I'm not talking about SSRIs, although they have their own side effects that people don't like - I'm talking about the antipsychotics - the Stelazine and Thorazine and those drugs. Really serious side effects. The toxicity of psychiatric medicines is really serious, and that you would not deign to study a drug that has essentially little or no toxicity is kind of remarkable.
JR: You talk a bit about not just using psychedelics to treat sick people, but giving them to so-called "healthy normals" too. Do you think there's a benefit to that?
MP: I think that there is. You know, "the betterment of well people" as Bob Jesse put it in the book. I mean, look, I got benefit from it. And I'm fairly healthy, fairly normal - I don't want to overstate the case.
It appears that psychedelics are helpful for depression, addiction, anxiety, obsession. We all have those illnesses to one degree or another in that we're all stuck in habits of thought that don't serve us well. Especially as we get older, we get more and more ossified and the idea of something that could lubricate cognition - or "shake the snowglobe" - could be useful for lots of people.
In the same way that garden-variety neurotics go to receive benefits from going to therapy, those folks would stand the benefit from psychedelic therapy possibly. You don't have to have a diagnosis of a serious mental illness to get psychotherapy. It benefits people who are sad, it benefits people who are confused about life decisions or have problems of various kinds or suffer from grief. Grief is not a mental illness, but people seek therapy for that. So, in that whole universe of people seeking help, many of them, it would be a shame if it were not somehow made available to them. I don't know how we'd do that exactly. There's a lot of work to be done figuring out how to incorporate these medicines in the culture if indeed they prove out - when they go into the next stage of trail. But I think it's something we need to address and work on.