240. Are Psychedelics an Answer? with Dr. Hillary McBride

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You've stopped asking directions

to places they've never been.

Pod Squad, welcome to We Can Do Hard Things.

Today is going to be a wild ride.

We are to talk about

psychedelics

and the new wave of how people are understanding psychedelics.

If you live in LA like Abby and I,

it's all anyone's talking about.

If you're in the world of therapy like I am, it's a lot of what people are talking about.

And I don't know anything about it yet.

So I am really delighted to ask Dr.

Hilary McBride all of our questions about psychedelics.

This is going to be like psychedelic 101.

You all know Dr.

Hillary McBride for many reasons.

Episode 206,

Dr.

Hillary McBride joined us to talk about the wisdom of your body.

It's a beautiful episode.

Go back and check that one out.

Dr.

Hillary McBride is a registered psychologist, researcher, podcaster, author, and speaker in the areas of trauma, embodiment, eating disorders, and the intersection of spirituality and mental health.

Her research has focused on women's relationships with their bodies across the lifespan, and her books include Mothers, Daughters, and Body Image, Embodiment and Eating Disorders, and the bestseller, The Wisdom of Your Body.

Her next book, Practices for Embodied Living, will be released in 2024.

Yay!

That's very exciting.

Her podcast, Other People's Problems.

Ooh, Other People's Problems.

Yes.

That's a special interest of mine.

Was listed in the New York Times and Wall Street Journal as essential listening.

Welcome back.

And I think you told me to call you Hillary last time.

So I'm supposed to

love that.

Okay.

Welcome back, Hillary.

Thank you for the welcome.

I'm so delighted to be here.

This is, as you know, one of my favorite things to talk about.

So I just feel like the luckiest girl in town to talk about embodiment with you and psychedelics.

And

we are too.

You know, we didn't even really think about doing an episode about psychedelics until we were talking after we recorded our episode together.

And I think that you said that psychedelics were the approach

that you found most transformational in therapy.

And is that true?

Yeah, up there.

Okay, sure.

If you were doing a psychedelics for dummies, because my entire understanding of psychedelics is from

like Alan Ginsburg and Ram Das and the electric Kool-Aid acid test and college being on shrooms in a room where I thought I was at a campfire and actually I was sitting by a laundry basket the next morning I found out.

So that's not it.

That's not what we're talking about right these days.

What is it now?

What is it now?

Well, would it be okay to just talk a little bit about my personal experience with

the science?

Because there's something about psychedelics that are both, there's a strong

biological, chemical component to them, but there's also this phenomenological narrative lived experience quality to them.

We can explain, and I hope to do this later, what is happening in the neural action in the brain when you're having a psychedelic, but we know that that substrate, the chemical qualities of the psychedelic, really don't capture the magic of what it's like or the terror of what it's it's like to have a profound experience with the unknown, with the all or with your own trauma.

So is it okay if we situate ourselves that way?

Please, I'm already riveted.

Okay.

Also, when,

you know, when you go into your experience, like, how was it first suggested to you?

That whole story, I'm fascinated because you've been in the therapy world, in this world for so long.

And I'm curious when it first intersected with your awareness and experience and all of that.

So I have to start by saying that I grew up in a household where I was actually told, both my parents are therapists, and my dad had said that he had seen a patient who had used cannabis once and had a psychotic break and was schizophrenic

permanently.

And so my terror then of all substances was through the roof.

The fear-mongering worked for me, right?

This is your brain on drugs, the eggs frying in the frying pan.

I was like, that is going to be my brain.

Do you think that that was just a story that your mom and dad were like, here's what we say.

We say there was a psychotic brain.

Do you think that parents would like that to lie like that?

And not certainly not about a clinical population.

They probably just chose that experience or like there was often conversation at the dinner table, like, I'm working with this really interesting patient who has this presenting concern.

And here's what I'm learning.

And so we would talk about clinical hypotheses and.

you know, things like that.

So I suspect that they self-selected that narrative for a particular reason, but I believe that it actually happened.

And the data shows that that can be the case, right?

The wrong substance in the hands of a person who has a genetic vulnerability, we know, can promote certain neurological changes that, you know, perhaps would lead a person to experience psychotic spectrum disorder.

So we want to be careful about that.

That is a thing that hypothetically could happen.

Again, although very rarely it could happen.

So We go back in the story here, you know, oh my goodness, if I have cannabis, if I use a substance,

I'm going to lose my mind.

And then in my eating disorder experience, I actually had a brief psychotic episode.

So I experienced psychosis along with briefly delusions and some hallucinations.

And what that said to me was, I'm in the category of people who, if I use a psychedelic, I legitimately will lose my mind.

I will have schizophrenia permanently.

I won't be able to function in a normal society or do the things that I love to do.

So for me, it felt really important to put a really

long period of time between when I had that brief psychotic episode and when I was even ever going to have the conversation or think about introducing a substance into my life.

So I had this experience of finishing my dissertation, completing, defending that and finishing my PhD and then thinking, Okay, I've been hearing all of this research.

I was really tracking carefully the empirical research, the data that was coming out about neuroscientific change,

looking at the correlates of that structurally on our neuroanatomy and seeing in the people around me who had really challenging presenting clinical concerns that this was really changing their lives.

And not always because something easy and magical happened, but mostly because it put them in contact with something that they otherwise hadn't been able to be in contact with.

A memory, a feeling, a trauma, a knowing about themselves, that there was some sort of

struggle or negotiation wherein they learned something about themselves that they could take into their life when the psychedelic journey had ended.

So I finished school and I decided, okay, this is the time where I feel like I've had enough distance from my pre-psychotic episode and I have the right people and support around me.

I'm going to take this leap.

knowing that there is some risk that I could take, but that I'm surrounded by people who are saying, this is a good thing for you to do.

This is a safe thing for you to do.

And we're going going to be here to help you through it and after.

And what was fascinating about the experience is,

I mean, so many things, right?

How do you describe lifetimes in a moment?

But what it really brought me into awareness of was the process that was underneath the eating disorder for me.

I could have told you.

everything about the Canada food guide, right?

I could have told you everything about what caloric intake needed to be.

And I could have told you everything about what mechanical eating looked like.

But I still didn't have a really good understanding of why an eating disorder.

It didn't feel obvious to me about kind of the, what was the function that it was serving for me.

Yes, I could tell you again, theoretically, generically, oh, it was helping me manage my feelings.

It was helping me not feel.

It was helping me get agency over my body and in a way that was socially desirable.

But what was going on for me phenomenologically?

What was it about Hillary's experience that was way too painful to be with?

That I had to find a way to get out of it.

And in the process of the psychedelic journey, not only did I feel like I understood what was underneath the eating disorder for me, but I felt like I understood the way that the eating disorder was adjacent to all of these other behaviors in my life that were serving the same purpose, workaholism, certain avoidant behaviors in relationships, certain strategies for getting control even over my mind, right?

There were certain things that I didn't see as connected, almost as if this

stuff underneath was at the root.

And all of these other things, including the eating disorder, were the flowers that were blooming out of this bulb at the root.

How, Hillary?

Like, what's happening?

Is someone coming to you and saying, here's the root?

Here are the flowers.

Are you seeing a tree?

What was happening?

Before we go into that, can you explain like the actual process that how it begins?

How you find these people, where you are?

Because I know that the setting is very important before

you get into the process of it.

I think that our listeners would really love to know like the step-by-step process before we get into the how.

So I had connections because of my clinical work and because of the people that I knew who'd had psychedelic experiences with an experienced psychedelic guide.

So someone who was trained to sit with people and work with them therapeutically.

And again, this is really different than like taking mushrooms at a party and everybody's dosed and nobody knows if you're at the laundry pile or the campfire.

There was someone who was specifically there to help me move towards what was happening inside of me and also to give me space to make choices about what I needed in that moment.

And generally what happens in clinical settings where you're using psychedelics for clinical purposes, for therapeutic purposes, is you have a series of prep sessions where you are talking about what your intentions are, where you are deciding where it is that you want to head, the kind of the big questions that you might want to ask of the medicine.

of the psychedelics, of God, of yourself, whoever you're asking them of, and establishing a good therapeutic rapport with the person, because we know that those are really important predictors of outcomes.

The ability to have an alliance with the clinician, with the therapist, with the guide predicts how much you're able to go into those things.

And the work of neuroscientist Robin Carhart Harris has showed that if you are able to access what's inside and able to have some sort of emotional release, catharsis, experience connection to parts of you and potentially emotional expression connected to those parts of your life, that that predicts really good therapeutic outcomes.

So what you see is like the kind of this series of things that work together.

The setting, the set, the guide, the trust, the ability to say yes to the process and kind of surrender into it allows you to begin investigating what's going on inside of you.

And then what you usually have is a dosing session, which depending on which medicine you're using can last anywhere from, you know, two to three hours to eight to 12 hours, or in some cases, like Ibogaine Ibogaine or Eboga, 24 to 48 hours.

There can be longer medicines that you use, depending on what you're using.

Yeah, really, really big, long journeys.

And then what happens is you have integration and follow-up.

You have this container that you've been building along the way holding you to support you to then make meaning of what happened.

Because sometimes it's clear in the session and other times you just kind of get this information and then you're like, well, what do I do with this?

And you have a person who helps you weave weave it into a narrative that then you can take with you and hold on to in future moments, in difficult situations, to remind you of what you knew or experienced in that session.

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We've recorded with Priya Parker, which will air soon.

And she kept talking about like the math and the poetry, in that case, events, but I've been thinking about everything now as math and poetry.

And this, I hear the poetry about all of it.

And there's also a math component.

Can you talk about,

for those of us who are imagining, like, but what is actually happening?

I have heard it said in the way that rings true for my brain is that I do the same shit over and over.

I have the same thought patterns.

When something happens in my relationship, I do the same shit over and over and over.

My brain has all these possibilities and all these answers, but I have one well-trod road.

It is like cemented over

157 times.

So something comes in, and I go directly to that road.

And that's the only road I use.

Is that what this is doing?

Like when you are hallucinating,

this rigid brain becomes more

malleable and

I think neuroplasticity, so, so that you can have the possibility of going down a different route that you would never go down because of your concrete over route.

And then you're accessing something you'd never normally access so that then

that road now exists.

And then all the therapy after is like, now we need to practice going down that road over and over so that you can access that different road.

So, yes, exactly.

That makes sense from a math perspective to me.

Well, how about I'll fill in some of the details and give you some a little bit more of the science and the theory, but you basically have it exactly right.

So, we'll get back to that narrative of kind of the concrete and the path and the route that we take in just a second.

But I want to back up by saying this: the etymology of the word psychedelic comes from Humphrey Osmond.

It was created in the 50s, and he combined psyche and dilia, right?

Psychedelic, and psyche is mind, or if you're true to the the Greek, would mean soul.

And dilia or dulan, actually, would mean revealing or to make manifest.

So what that really means is mind manifesting or soul revealing.

There's something about the process, and this might be the poetry part of what you're talking about, the process of psychedelics, that they show us ourselves.

They show us the roads we have taken and the roads we could take.

They show us what gets.

what gets in the way of taking those new roads.

So think about that.

Hold that in your mind as I'm talking about the science of this and thinking about what the experiences could be like.

So, like the origins of psychology, when you think back to Freud and kind of the founding fathers of psychology, we think about the importance of revealing the unconscious, the things that are outside of our conscious awareness.

And unconscious might not be the right word, maybe like primary consciousness.

I think there's a kind of wisdom to what's going on underneath our defense strategies.

But the true psychedelics, things like psilocybin, LSD, DMT, and ayahuasca, they work on the serotonin 2A receptors in the brain.

Ketamine, MDMA, a couple other drugs work a little differently, although we sometimes lump those into the category psychedelic.

What we know is that based on analytics and data modeling, that psychedelics, when they're active in your brain in high doses, actually decrease activity in something called the default mode network.

So the default mode network is the series of interconnected networks in our brain that are responsible for introspection, self-directed thought, criticism, personal narrative, remembering, and also how we think about the future.

So what we know from recent publications in peer-reviewed academic journals is that we see changes in the brain in these neural networks connected to the default mode network that kind of decrease connectivity.

So that the tight, rigid connection that you're talking about starts to soften and dissolve, which means that there's room for more spontaneous brain activity.

And there's the release of something that we call brain-derived neurotropic factor, which is related to genes and proteins that actually increase neuroplasticity.

And what we see is that these effects outlast the dosing session.

So you have a dosing session and you're experiencing a lot of new kind of neural, in a way, connection and disconnection.

The things that were linked become unlinked and new spontaneous brain activity is possible, but that's ongoing.

And a recent study showed that even up to three weeks after the dosing session, do you have BDNF in your brain and you have more potential for neural change?

Cool.

So

the way that I describe this, and I'm not the first person to use this metaphor, is it's kind of like our minds are this orchestra that's playing.

And we have a conductor at the front.

who is in a way the default mode network play helping us play the specific music that we've always been playing.

And it's beautiful and it's perfect and it suits the mood until it doesn't, right?

Until the same song that we've been playing for 30 years doesn't work because we meet a new context or we have a new sheet music in front of us or there's a new conductor or we want to, we want the score to that beautiful movie to sound a little different.

And the way to think about it is that psychedelics pull the conductor.

and take away the sheet music.

So all of a sudden you can imagine a cacophony where, you know, the strings are like

doing this thing and the

drums are doing their own thing and you've got the tubas playing and it's out of sync.

But

yes, that could feel chaotic and new creative possibilities can emerge.

There could all of a sudden be the option for this synchronous sound to emerge between the strings and the horns that you never heard before and a new possibility for a new music that was never created or never lived by you could start to take place.

So, the chaos and the disorganization is often what people are a little scared of when they think of the psychedelics.

Because, what are we going to find?

What if it's horrible?

And there's the possibility of that.

In fact, there's often a challenging moment, if not many moments in psychedelic journeys, but then there's also something happening in the structures of your brain that say, Let's try something different.

Let's do it new.

Let's not play the same old song that we were playing before.

Damn.

Well, If this is an actual therapy journey, is then the follow-up like, I heard that music and I want that music in my life.

So what are the ways that I can think and the strategies and the therapy that I need to

keep playing that way instead of the tired way that I've been for the past 30 years?

Because you can't have the chaos all the time.

So is it settling it into a new tune?

So I have the privilege of being in relationship with lots of musicians.

So I hear how they're working on songs.

And what I hear is sometimes, you know, if you have a musician friend, they're like, I've got this riff in my head.

I've got this riff in my head.

And they sit at the piano and they tinker and they work with it and they turn that riff into this beautiful song.

And it's through nuance and repetition and remembering, or what we call in the case of psychedelic work, integration, where you or the person who is guiding you or supporting you help you figure out what was that riff?

What was that piece?

And let's pull it out.

And let's sit at the piano next to each other and play some, play,

the keys and see what else we can turn this into and keep coming back and keep playing that song and that riff and that melody.

And the more that you play that new melody, the more that it too becomes concretized in a way that that old melody that doesn't work for you anymore was concretized.

In the speculative imaging from the neurological function of psychedelics, what we see is it's almost like you said, there's this concrete terrain, or we could just say like a, you know, a landscape that has all of these deep holes in it.

And it's really easy if you're walking along that terrain to fall into one of those deep holes and get stuck.

And during a psychedelic experience, it's almost like the terrain becomes more level and everything becomes a possibility instead of this hole that you're trying to avoid or this mountain that you have to climb over.

And the effect of that decreases after the journey is complete, but still some of it remains that there's the holes aren't as deep, the mountains aren't as high, the terrain is a lot more accessible for you.

And that seems to be this kind of metaphor for what's happening neurocognitively for us, that we can do things a little differently even after the journey is done.

And really good integration and support helps us continue to keep taking new paths and choosing new possibilities and even coming up with new melodies, even when the drug is out of your system.

Can you tie what you talked about in the beginning with, in your particular case, I'm assuming you went into the psychedelic journey asking questions about your eating disorder because that's the information you got during the journey.

Can you explain to us how what you discovered was like the metaphor, was like an old song going away, an old conductor, and then a new song emerging?

What did that actually look like in your life?

Yeah.

There's another process that can happen, right?

There's the neural change that can level the terrain, which makes new possibilities an option.

And implicit in that is a softening of the defenses.

If one of these deep holes or one of the, you know, the peaks that we have to traverse mentally is don't go there, don't think about that, don't look at it, don't remember, then psychedelics in their softening of our process allow us.

to access things that maybe we forgot, maybe we intentionally don't want to move towards.

So actually, you know, what's fascinating about my journey is that I thought that I was done with my eating disorder.

I wasn't asking questions.

Oh, okay.

Okay.

My questions were

not about eating disorders.

My questions were about,

why is it so hard for me to feel these specific feelings?

The questions were about, you know, when this particular moment happens in my life, why is it hard for me to let people in to share that with me?

And where the medicine took me.

You can hear the language I'm using.

We often refer to it as having a kind of consciousness itself.

It's kind of, it directs you.

This is part of the poetry and the math, right?

I can tell you about the serotonin 2A receptors, but there is something really mystical and sacred about how, especially plant medicine works in our body and mycelium.

It took me to these places and it showed me, if it's okay with you, to share a little bit more of the story of what I saw.

Please.

I saw a younger version of myself who was walking through the world encountering painful experiences And the intensity and the reverberation in my body of those painful experiences was overwhelming to me.

And what I saw in the psychedelic journey was that as it was overwhelming in me, I was looking out at the people around me and they were becoming overwhelmed by how overwhelmed I was.

And so I developed this strategy.

Again, here's where it starts to get a little bit kind of mythical of holding this giant balloon behind my back.

And I saw that in my childhood, what I would do is a painful experience would impact me, it would reverberate through my body, and I didn't know where to put it.

And so I would funnel it into this balloon behind my back.

And experience after experience started to happen where I was filling the balloon up with all of these painful experiences and emotions and all the things that I felt and wanted to say, but couldn't say and felt alone in.

And then the balloon became so big that it wasn't hidden behind my back anymore.

It was bigger than me.

And so I had to find some way to disappear.

I had to find some way to make my entire existence go away so that not only was the pain that I was funneling into the balloon invisible, but me as a whole.

And that seemed to be where the origin for me of the eating disorder emerged is that it had this function of making everything go away.

But long before that,

I was funneling things into this secret strategy to avoid feeling it, to avoid showing it to anyone, to try to stay in connection with people around me.

So what I was able to do in this journey, which is often characteristic of psychedelic works, you can go back and redo during the experience.

You can go back to memories and do things differently.

What I imagined was that I could hold the hand of my partner and my best friend, and we walked into the mouth of the balloon together.

And I showed them everything that was inside of it.

And they held me and they loved me and they wept for me.

And we looked at every single thing that had ever gotten funneled in there and they were still there

and they weren't overwhelmed.

So what happened for me on the other side of the journey was realizing, okay, this is my pattern.

I almost don't feel anything, but I funnel it right into this, you know, thing that I keep just adjacent to me so that I don't really have to feel it.

And then other people around me don't have to feel it and I don't have to lose them.

So I need to be more in connection to what I'm feeling.

And I need to own that.

And I need to take the risk to let people close to me while I'm feeling that, knowing that it may overwhelm them, but it also may not.

And if it doesn't overwhelm them, then I don't have to be with it on my own.

Then I don't have to be carrying the enormity of the pain and the challenges and the beauty of life in my two hands alone.

I can can let the people close to me help me hold it.

So the practice has been like, okay, when I feel something, feel it in my body, but also I call that person up, right?

Or I call my husband.

I'm like, I don't know what this is called, but I need you to sit right here while I learn to see what happens next as I feel it in my body.

So are you laying in a bed?

I just want to know what exactly is happening while you're having this vision of yourself as a child with the balloon on your back.

Are you laying there?

Are you talking to the person who's facilitating?

Are they talking back?

And when you come back, what does that look like?

And do you already understand everything that's happened?

Or were there lots of conversations that helped you know what the hell that balloon was?

Yeah.

Typically, the way that it works in clinical trials, in clinical settings, is that you are in a comfortable space that feels a little and looks a little bit like a bed.

So you get to totally recline.

There are often eyeshades or headphones where you can hear music, but I think really good psychedelic work is tuned into the person who's in front of you, which means if a person doesn't want eyeshades on, they don't have them on.

If they don't want music, they don't have music on.

There can be something about music that accentuates the emotion and kind of directs you towards certain places inside of yourself and certain feelings.

So that's happening.

There's often a guide or two sitting next to you, checking in, asking how you're doing.

Sometimes people talk a lot.

Sometimes people don't talk at all.

And what's fascinating about the classic psychedelics is that you remember everything that happened.

There's nothing about what happened that you forget as soon as it happens.

You might need to make meaning of it and go, okay, why did that thing keep happening?

What was going on there?

But what's happening is, you know, sometimes the guide is sitting next to you, writing things down, taking notes, helping you remember important things.

There's something that often happens for me on psychedelics where I think I'm brilliant.

I'll be like, Write this down.

This is great.

Everybody's got to know this.

Guess what?

It's all good, or whatever.

You know, these classic things that people say when they're higher.

I'm like, no, no, no.

Love is everything.

Write this down.

Write this down.

You need to know this too.

But like, it feels so profound, right?

Yeah.

I have been the recipient of friends, huge discoveries.

And I just really think that it's like that.

It's like, Glennon,

love is everything.

And I'm like, I just think you need context of your personal story to really feel that.

But is it revolutionary?

Because it's like, we all say that shit, but we don't actually believe it or know it.

Is it revolutionary?

Cause you're like, hold on shit, y'all.

This is legit true.

Well, I think this is the difference about kind of cognitive work and embodied work.

Yeah.

That harkens back to our past conversation or bottom-up processing versus top-down processing.

I can tell you all of those things, but in the psychedelic experiences, it was the first time I felt it.

It was the first time that I experienced what goodness was like as my body, not just this abstraction or this idea of things that I say about these truths that we, or virtues or things that we know.

It was like, I didn't know it anymore.

I experienced it.

And I think that that does something for us.

There's a clinical trial that was just done at NYU and the results haven't even been published in a journal.

But what the study was, was looking at religious leaders of various faith traditions having a significant psilocybin experience.

And what they said

was that they knew God less, but they felt and loved God more.

Yes.

So there's something about taking these things that we know, even let's just take my experience or the experience of perhaps the people listening to the podcast.

What is it like to say I'm my body?

And what is it like to say my body is good because it's nature, because my body is alive?

And then what is it like to actually experience your body as having the same consciousness as the creator, as the animals around you, as like Mother Earth?

What is it like to experience that your cells

have goodness inside of them?

It radically changes our relationship to ourselves.

It radically changes the way we want to care for ourselves.

So, even the outcomes of this clinical trial of healthy, we call them healthy normals, the religious leaders who had been practicing these religious traditions for years and years and years, for them to go, oh,

the body of Christ isn't just this, you know, this piece of bread that I eat, but

it's my hands,

it's my eyes, it's me and you together in this cosmic dance

to feel ourselves experiencing something will always impact us more deeply than the idea of it.

And I think that's what's happening for people when they're telling you like

everything is love.

What they're trying to say is like,

oh i felt it nice i want you and i want everyone to feel it too

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It feels to me that I haven't heard anybody

tell me that it lessened their compassion.

Because if you are

discovering and experiencing for the first time the divinity, the miracle or whatever that is you, you are also knowing that for everybody else.

I assume it very much increases your reverence for other human beings.

as well, including your family members.

I've heard so many people having experiences that allow them to sense whatever forgiveness is.

It sense the humanity of the people who hurt them as well and free themselves of anger

absolutely yeah there's something characteristic about again the dissolving of the default mode network or what we might call ego death i don't love the term necessarily but the way that our sense of individual selfness begins to dissolve that helps us feel in an experiential way how we are the same or made of the same stuff as everyone around us our hero our enemy the person we have a grudge with the tree then that's not the experience that every person will have on psychedelics, but it is a more common than not experience to have,

to have that felt sense of interconnectedness in a new way that makes it really hard, at least during the trip and shortly after, to look at someone and go,

why won't you put the dishes in the dishwasher the way that I want you to?

We're like, oh, we're all just trying our best.

Isn't this a fun game that we're playing the dishes to go in the dishwasher a very specific way?

And I'm going to be right about that.

We're like, that's whatever.

Like you're alive and I'm alive too.

It injects into our experience a mysticism that I think that we are lacking as a result of post-rational hyper-cerebriality, our felt sense of being able to see what's happening here in a way that detaches us from our defenses and our irritations.

It just kind of, again, it softens that terrain.

that helps us in a way that helps us be more connected and empathic.

It might be about time to give a shout out to our sober community for whom this might feel

things, ways it has for me in the past.

It is my understanding

that

the man who wrote the big book,

when he talks about the spiritual experience that he had that led him to these 12 steps and sobriety, that his encounter with the higher power was an experience of psychedelics.

That AA

was largely launched from a singular experience of psychedelics.

True?

Not true.

Yeah, true.

So Bill Wilson was part of the research in Canada that was happening in the 50s and 60s using LSD to treat alcoholism.

So there is a long history of psychedelics and substance use disorder.

And what I've been learning about all of this is that Bill and Carl Jung wrote a series of letters to each other in 61 talking about the significance of spiritual experience as transforming relationship to substance and the process underneath that there needs to be a kind of spiritual awakening.

But what isn't common knowledge is that there was a letter that followed that in which Bill Wilson was saying to Carl Jung, LSD was responsible for this spiritual experience that I had.

And of course, he was using psychedelics legally as part of clinical trials and under the supervision in a research hospital of clinicians who were trained.

But that was at the origin of him identifying a higher power as a significant component or the foundation really of doing recovery work.

So

understandably, right, we need to think about substances so carefully because there can be use and misuse of anything.

I mean, eating disorders are a great example of that.

Like food is meant to nourish us.

And yet I have a history of abusing food.

Does it mean that food is bad?

You know, capital B bad?

No, but how I use it, under what context, what's happening for me, right?

Medicine is the same thing.

We want to think about what is our relationship to it.

Are we engaging in it thoughtfully?

Is it a bad idea for us based on our genetic vulnerabilities or, you know, our past history?

Do we want to make sure that we're not keeping it in the house because we're concerned about our use and therefore we're going to use it in a setting where we have good supervision around that?

I think it's important to ask all those questions.

And I think to extend beyond that as well, I would argue that when we think about use and misuse of substances, we also have to think about the history of Indigenous peoples who've been using plant medicine for a very, very, very long time, whose relationships to these medicine and sovereignty over how they're used is threatened as Westerners, as white folks come in and in the true fashion of colonization and capitalism, take medicines.

and misuse them in a way that maybe isn't, you know, me becoming addicted to the substance, but I'm harming my relationship with my kin.

I'm creating ruptures in relationship with the earth.

If we're milking toads for DMT and it's endangering the toad population, if people are using peyote or San Pedro in ways that are taking

colonizing

these medicines, we have to think about use and misuse, I think, more than just my individual self, but also what are the broader community effects of what medicine I'm using and how it feels to the people who have a tradition with that medicine?

Thank you for saying that.

It's such an interesting parallel that I've never thought of in terms of how now, you know, how many white entrepreneurs are getting rich off of the recreational cannabis situation, while how many hundreds of thousands of black and brown people who had, you know, $10 worth of pot in their pocket are still in jail.

And the Supreme Court just restored the right of Indigenous people to use their ceremonial ritual

medicines that they were outlawed for ever.

And now it's like, oh, well, we've discovered it and it's cool for everyone.

It's something to be very aware of in this conversation.

Can we also just touch on like maybe the history of the law?

And I think that maybe the fear-mongering happened throughout my life around drugs and like

just tripping LSD mushrooms itself, like it's its own like scary category.

Yeah, same, same.

I've never done anything like that because I was always like, oh, that's the bridge too far.

Everyone can smoke all the pot they want, but yikes with that stuff.

And is all the stuff you're talking about currently legal or is some of it legal and some of it not?

And do you need to like get a license the way some people in certain states get cannabis licenses?

These are important things to think about because I think many people will come to this conversation holding either this unreflective enthusiasm about psychedelics because it feels like they've had good experiences or they've seen people have good experiences in a way that maybe lacks critical thinking about who this is good for and who it's not good for.

And then the other side of it is we might hold an overgeneralization about these substances in a way that has us believing they're terrible and terrifying and dangerous when at their core, if they're used appropriately, could actually be part of what transforms our lives and engenders healing.

So, again, I want to hold the complexity of the dialogue in here and know that that's a hard thing to do when we want to be polarized in these conversations.

And I think the polarization is really well captured in the history of psychedelic use in North America, where there was the emergence of clinical research in the 50s and 60s, where we were seeing really promising, rigorous data about how this could change people's lives.

And in the hands of people who were perhaps cavalier,

individuals who were in the academy and then were engaging in psychedelic use, perhaps recklessly with students and boundaries were crossed.

Timothy Leary, is that who you're talking about right now?

Yeah.

Yeah.

Yeah.

That it becomes, I mean, even making public campaigns like to

tune in, drop out, to

drop out, drop out, tune in, something, drop in, drop out.

I think it was.

Something about tuning and dropping for sure.

Something, for sure.

Absolutely.

That That was in there.

That there was this idea proliferated, everyone should have psychedelics all the time.

It should be accessible to everybody.

And we just know that that's reckless and not good practice.

It doesn't treat these medicines or the people who are using them.

sacredly.

It's not holding the complexity.

So I think that because of that, right, this emergence of this movement at the same time as people are protesting the Vietnam War, particularly in the States, there becomes this conversation about how this is dangerous to the psyche of the American youth and how because of their free thinking and their

dropping out, so to speak, what are they dropping out of?

Institutions, systems, the draft, they're protesting these systems that the government is promoting is ideal or the right way to live.

And that creates a conflict for the government at that time.

I'm thinking particularly of the FBI.

CIA, and how at that point it became very important to schedule these drugs so that people, youth could be controlled, so the medicines could be controlled.

And we could argue for good purposes in some cases and also really politically oppressive.

And by schedule, just so everyone knows, schedule means basically like put them in the realm of highly regulated

government has the authority to say who does and does not get these drugs.

Yeah.

And then we have along with that, the, you know, the proliferation of the say no to drugs campaigns, which I think, again, were really helpful for some populations i'm thinking of moms and parents and folks like within high control religious communities who are really scared about thinking freely and consciousness extending between us and the the dissolving of ego and identity and perhaps like reckless sexual behavior that might happen if you were using a substance and so the control around substances really I think became a way of controlling bodies, black bodies and brown bodies, the bodies of youth, sexual bodies.

The way to restrict anything that stood in opposition to this very specific way of moving through the world that aligned with people who had the most power in North America.

And then the public campaigns that we all heard came out, the one I mentioned at the beginning of seeing an egg fry in a frying pan.

And I, like so many people, were like, I don't want that to happen to my brain.

Of course, that's not actually what happens to your brain.

It's a, it's a straw man argument used to create fear and terror and control.

Obviously, there are changes that happen in the brain when you're using substances, as there are if you're eating a chocolate bar or if you're having sex or if you see a sunset.

Changes in the brain are happening right now.

This is your brain on Hershey's.

Yes, that's right.

I want to see that public campaign, right?

This is your brain on a slip and slide at summer camp.

This is your brain on capitalism.

There you go.

Yeah.

exactly.

This is your brain on diet culture, right?

We can have the same conversations.

And what we're seeing is the emergence of, again, really good, robust clinical data that is suggesting in highly controlled clinical environments that not only can these psychedelics be safe for specific purposes with certain populations, but that they can actually be the mechanism that helps all of these intractable mental health issues heal.

And is it okay if I just talk about that for a minute?

Please do something important here.

Whenever you're looking at the research on psychedelics and clinical implications, you see things like: okay, huge potential there in depression populations, huge potential with eating disorders, anorexia and bulimia, complex PTSD, single-incident PTSD,

fibromyalgia, headache disorder, chronic pain, tobacco use, alcohol use, anxiety disorders.

Okay, so I'm listing all of these things that we would typically, in my field, put in very different categories.

An eating disorder would probably sit on the other end of the spectrum from tobacco use disorder or, you know, a complex PTSD.

We have these neat diagnostic categories.

Which makes us ask a very interesting question.

How can the same thing

be treating all of these different conditions?

What is the root in that garden, Dr.

Hillary McBride?

Well, there's this scholar who's now in the States named Robin Carhartt Harris who's written extensively about this.

And what he's identifying is that there might be a unifying

process underneath most of our presenting psychological concerns.

And what could that be?

It comes back to what you were saying, Amanda, about rigidity or what we call cannibalization, right?

The idea that things could be rigid or intractable, that underneath most of our presenting health concerns, we have a kind of a distinct process that our brain engages in that has very little flexibility.

We're in bed and we're depressed and we think the world is going to be horrible.

And I can tell you that with certainty because that's what I know to be true.

And that's the same thing that I think every day.

Or that food is terrifying.

I can't eat that food.

It's bad.

It's bad.

It's bad.

It's bad.

Or, oh, someone's going to see that I'm worthless, right?

They're going to see that I'm worthless.

I can't go out.

I can't go out.

The same potentially mechanism underneath most of our presenting concerns could be

this rigidity, right?

The kind of the stuckness of our mind working in a particular way.

And when you think about who psychedelics are not good for, it's people who don't have that rigid stuckness.

When we think about psychotic spectrum disorders, right?

It's chaos in the brain a little bit.

It's like, oh, there's a lot of spontaneous brain activity.

I'm seeing things that I wouldn't normally see, or my version of reality is a little extended beyond what someone else's version is.

So when you think about what psychedelics are doing, those particular brains don't need the help of psychedelics to have more flexibility and

neurogenesis and kind of

fluidity of reasoning.

It's the conditions that are most of what I would see or what we would see in clinical settings, seeking treatment, would be the kind of the rigidity, the stuckness that underlies most of what makes it hard for us to be in the world.

That is fascinating.

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How often do people have to do these journeys?

I've seen some documentaries and they say like one or two.

Like, how often are you needing to do them?

Or some people say like once a year they do them.

Does that depend?

It depends on the substance and the presenting concern.

So what we see in clinical trials, and this is like

the way that we have to research things to make them empirically valid means that there is, unfortunately, a certain kind of rigidity to it.

But what we see often creates the best outcomes is a bunch of prep, at least two dosing sessions, sometimes even a third,

and then really good follow-up.

That being said, there are reports of people taking high doses of DMT in clinical settings and saying,

I

never need to or want to do a psychedelic again because

it was everything that I needed to know and experience and learn and nothing could compare to that.

And so are we treating clinical issues that might have a resurgence?

Are people doing personal exploration and growth and looking at kind of spirituality and well-being and flourishing?

We know that there's use of psychedelics around high performance athletes.

So what is the presenting concern?

And it's a kind of irritating answer, I know, because it's saying, well, it depends, right?

But I think that good medicine is person-specific.

So we just have to wait for more clinical trials.

But I would say, yeah, it depends.

Do you believe we'll see this legalized and become a part of treatment?

Or is this, our pharmaceutical companies never going to allow this?

Because there's no business model for which to build

have one experience and then you're done.

I mean, I've been on antidepressants for 12 years, and I don't know that I'll ever get off.

So, is there room in our system for something that isn't hugely money-making?

Will Big Pharma allow that?

And also, if the crux of this experience is love and freedom and peace, why would our

culture allow that?

Do you know what I'm saying?

Like, we're not, nobody's going into these experiences, coming out and being like, oh my God, I've just realized I have to work harder for the man.

Right.

Our system depends on you being pissed about the dishwasher.

Right.

And not believing that there's freedom and love and that you're worthy no matter what.

Like hustle culture is not wanting us to know the truth.

So what's going to happen?

I firmly believe that the resilience of the human spirit is much more powerful than any man-made system that oppresses us.

It is a foundational belief of mine that nature wants itself to flourish and grow.

And you can imagine if a meteorite hit the earth right at this moment, how many weeks would it take before my house was overgrown with trees and the plants took on a life of their own?

There is something in nature that wants to dismantle the systems that work against it.

So it is my foundational belief that this is the direction that we're heading in.

And it may mean that we build new systems and it may mean that the things that don't work for us need to go.

And I think that part of experiencing our interconnectedness means that we become connected to the will and the courage and the fortitude and the love required to do the hard work and the beautiful, in some ways, gentle, easy work of dismantling what hurts us.

Damn.

Well, shit, Dr.

McBride.

That being said.

Nope, no, no more things.

That's it.

Goodbye.

No, go ahead.

Mushrooms are a plant.

Isn't it absurd?

that we have criminalized a plant?

Yeah, why do you consider that?

We have to ask them permission.

I can pull carrots from my backyard.

I know.

So I had them.

I know.

In Canada, in certain provinces, certain psychedelics are legal or decriminalized.

In certain states, psychedelics are legal or decriminalized.

Again, depending on which one and where and what setting.

I own and work in a practice that is connected to ketamine work.

Of course, ketamine has been legal for a very, very long time as an anesthetic that's used in a hospital setting.

The team doctor that I work with was the first to prescribe psilocybin clinically in Canada.

Wow.

Under Health Canada regulation, there is an exemption for a patient for end-of-life care.

So I think that there is a movement in that direction because I think at the heart of it, what we ultimately want and need, in spite of how hard it is to pull ourselves out from underneath these structures, I think that the human spirit knows the way and it is liberation for all.

It's healing for all.

It's medicine for all.

And knowing that not every medicine is right for every person, not every context is the right context, even if that right medicine would be right for that person in a different setting, it allows for people to have unique, diverse needs and for us to accommodate people to help them get what they need.

So, there's like things are moving in that direction.

Like I said, ketamine is legal.

It won't be long until MDMA is rescheduled in the States.

They're thinking 2024 based on the MAPS, Multidisciplinary Association of Psychedelic Studies, clinical trials that are ongoing specifically

for PTSD.

And yes, yes, big pharma might be angry about it.

And yes, there might be people who are trying to monetize mushrooms in some way.

But the VA in particular is overwhelmed

with the number of people who have PTSD coming out of combat situations.

Our medical system is not functioning.

Anyone who looks at it closely enough understands that we we are failing people greatly.

I don't think that big pharma is in any danger of losing at this moment their hold on the North American psyche because the concerns and the need is so far greater than what they're able to provide that I think it will be a little bit of time until we move away from mainstream big pharma being a part of everyday medical care.

it's important to recognize that right now people are being failed and we need new and better treatments but we need to do better and I think this is part of it.

Pod squad, we are going to pause this fascinating conversation right there and come back tomorrow with a short bonus discussion that you will not want to miss on how psychedelic therapy works for partnered couples or people trying to work on relational problems together or for strengthening connection and experiencing closeness and intimacy without the walls that we put up that keep us apart.

Don't miss it.

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I give you Tish Milton and Brandy Carlisle.

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Our final destination

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