Dr. Roland Griffiths is the director of the Center for Psychedelic and Consciousness Research at the Johns Hopkins University School of Medicine. He has a wealth of experience in connection with psychedelics, and a fascinating background in the field.
00:25:24.580They take a capsule containing the drug. They're in the presence of two therapists or sitters or guides, as they're sometimes called. And the purpose there is just to let the person go inward and have their own experience.
00:25:47.480So people are laying on the couch after taking this. They have headphones through which they're listening to music. They have eye shades just to have them go inward. And the support, the therapists or the guides or the sitters are there just to provide a safe container for them to have their own experience.
00:26:12.260And the basic instruction is very simple. It's just go in, explore, see what comes up. You're safe. Yeah, we're here to support you. But it's not guided in the sense that people are going in with a problem to work on.
00:26:34.880You know, we're therapeutic. Let me ask you a couple. Let me ask you a couple of quick questions just so we can get the outlines of this. How long after you take the capsule, does it kick in?
00:26:46.240By 30 minutes, most people are beginning to feel effects, sometimes as early as 10 to 15 minutes. It reaches peak effect at about two to three hours.
00:26:57.520Oh, boy. That was my second question. So like, how long is this experience? How long do you, should you plan on being out of question?
00:27:03.840It's a day-long session. So people, as I said, they usually come in, they take the capsule at between eight and nine. The peak effects are occurring two to three hours later. And by four in the afternoon, they're pretty well back down to baseline.
00:27:24.520They complete some questionnaires. No, they're not allowed to drive home. They need a pickup person, a family member or friend who will accompany them home and make sure they're doing fine.
00:27:41.320By the next day, could they operate heavy machinery?
00:27:43.680Yes, they could. But we ask them to come in the next day. We want to interview them the next day, make sure they're okay. But there's no-
00:27:56.680I'm just trying to get my- Before we get to the effects and all that, I'm just trying to get to the sort of the setup.
00:28:00.840Did you ever have- Has it ever happened that somebody like ran screaming and yelling out of the room? Like, oh my God, like an unexpected reaction.
00:28:12.500No, not running the screen out of the room. We've never had that. But we've had people that might have liked to run and scream and get out of the room.
00:28:26.660And that's the very purpose of developing this relationship of trust and support because those therapists, guides, sitters can ground people.
00:28:42.860And we do a lot to prepare people for what they might encounter. And we give them a lot of instructions about how to navigate that experience. And that's very important, critically important.
00:29:00.100Because there really are risks associated with taking these compounds, particularly under unsupervised conditions. Because people can't- As a matter of fact, the most common and probable bad outcome is that people will have some kind of panic attack.
00:29:20.080And then they'll engage in some kind of dangerous behavior. And that can turn very ugly. People can commit suicide, homicide, but more often, they're confused, they're panicked, they could run out into the street, they could just get themselves into trouble.
00:29:43.820This is why we do not do this alone. You do not go pick the mushroom in your backyard and eat it. You do this under the care of a professional if you do it at all.
00:29:53.040Well, that's certainly my inclination. But as you know, there are state initiatives now, city initiatives that are moving toward decriminalization and legalization.
00:30:06.060And so one of my concerns is that our culture does not get ahead of what we know to safely protect people.
00:30:15.680And then as long as we're on all the dangers of these compounds. So number one is panic behavior, but that's just more probable.
00:30:29.500A worse outcome is that it appears that some vulnerable people can develop long-term psychotic disorders.
00:30:39.720So someone in their probably early 20s, if they have a vulnerability towards schizophrenia, the concern is, and we actually don't have scientific proof of this,
00:30:54.640but we have enough case reports to make me believe it. The concern is that someone that already has a tendency towards psychotic disorder,
00:31:05.720that exposure to these kinds of compounds might be enough just to push them over the edge.
00:31:11.900And there's no returning from a diagnosis of schizophrenia. Once that's in play, that's a lifelong condition.
00:31:19.160And that's horrible. And so we go way overboard in terms of screening people as much as we possibly can who might have such tendencies.
00:31:32.620So we disallow people to enroll if they even have a second degree relative with a history of schizophrenia.
00:31:43.160That may be overly conservative, but it's a real risk. And in the widespread cultural enthusiasm that we have right now, I think it's being underplayed.
00:31:56.260Would that be something, Roland, that you could tell before the person left the room at the end of the day?
00:32:01.200Would you be able to tell? Oh, my God, he crossed over.
00:32:05.420Oh, yes. Yes. So we've never had any volunteer develop long-term psychotic illness.
00:32:15.120People can be destabilized because of the magnitude of the effect.
00:32:19.500But that's very low. I mean, the incidence in which we have had to do aftercare, and we now have treated, I think it's 400, almost 500 people, 480, I think.
00:32:35.920And the incidence in which we've had to support people after exposure to psilocybin is kind of very, very small.
00:32:51.320I mean, I think we could count them on one hand.
00:32:54.360And what that meant for those people is that they required some additional counseling afterwards above and beyond what we would have normally provided.
00:33:04.520So we certainly haven't had any enduring psychotic processes.
00:33:09.460But to me, this is further evidence that, forget the mushroom in your backyard, that's in a class of its own.
00:33:15.960But like Colorado and Oregon, which are now, Oregon's making this, it has made this legal, and Colorado's on its way.
00:33:24.100They're saying, okay, you'd have to go to a clinic to get it.
00:33:28.760Is it like some 24-year-old guy who had this experience himself, and he's just going to hold my hand?
00:33:34.140Or am I going to get somebody like a Roland disciple who actually knows the right questions to ask if I'm a 24-year-old man with schizophrenia in my family history?
00:33:42.760That's, you know, now we're on sketchy ground.
00:34:07.800And so then these drugs will be available for medical, under medical conditions.
00:34:18.880But I don't think the FDA, I know the FDA has not yet settled specifically on what kind of training requirements are going to be necessary in order to offer this kind of therapy.
00:34:31.780And you can be sure that it's going to be much stricter within the structure of the medical system than it's going to be at the state level.
00:34:44.580And so the state level training is, I haven't looked into it closely, but my sense is that the quality of the therapist could vary widely in terms of how good they are.
00:34:59.680And so it's a source of concern, frankly.
00:35:09.520I want to talk about what you found in 2006 and now where it is today, because you did a truly groundbreaking work after that that's advanced this understanding of people who are suffering from cancer, people who are, I mean, think about what cancer victims go through, not only the diagnosis and the fear of end of life, but the treatments, which can be so devastating.
00:35:28.780So Roland did another study on folks like that.
00:35:31.960We're going to get into all of it when we come back with Dr. Roland Griffiths in two minutes.
00:35:39.640Okay, Roland, so you take in a bunch of healthy people, you subject them to a bunch of questioning, you set the table for the experiment, they take the capsules, and what did you find?
00:35:54.500So psilocybin, as we certainly expected, produced the whole array of psychedelic-like effects.
00:36:02.880So there's visual phenomena, visual distortions, visual imagery comes up.
00:36:08.840There may be greater emotionality, and that can be very positive, sometimes transcendent-like experiences, but also experiences of fear or unstabilizing kinds of experiences.
00:36:27.720And then there can be somatic effects, the sense of body has changed.
00:36:35.400And there can also be cognitive changes, and so people can think and imagine different things, including some paranoid thinking.
00:36:51.320And that comes, that's very low, but that can occur.
00:36:54.460So all those kinds of effects occurred.
00:36:58.080And then at the end of the day, we gave people a whole set of questionnaires.
00:37:04.540And one set of questionnaires had been developed originally to measure mystical experiences brought about naturally.
00:37:16.900These are religious type of mystical experiences.
00:37:21.220And we've since refined that questionnaire, and we call it the mystical experience questionnaire.
00:37:25.740But what was really interesting is that people endorsed very highly the components of mystical experience that had been described by religious people throughout the ages in terms of discussing these.
00:37:45.200And we could talk about the qualities of those.
00:37:47.740But the key quality is this sense of connectedness to everything, and that can be experienced as a connection with the divine in religious terminology.
00:42:38.420Well, one of the features, Megan, of these experiences that defines them is that they're ineffable.
00:42:46.120The first thing that people say is that I can't even describe it.
00:42:50.260And so what you just described were experiences all in the visual realm, but this goes beyond that.
00:42:58.600There may be people who have no visions at all, but yet these experiences take on that sense of meaning.
00:43:06.400So I don't think we understand well enough, and certainly our neuroscience isn't refined well enough to know, you know, precisely what components of these experiences result in this incredible meaning-making.
00:43:25.640But in terms of visualization, I mean, that can show up in innumerable different ways.
00:43:33.160And it can show up just as a carnival-like atmosphere, but it can also turn to sacred imagery or a sense of approaching something that is just beyond description.
00:44:00.220And so if we're religiously inclined, they might use the word God and encounter with God.
00:44:09.200And I'm getting a little ahead of myself, but if you're going to use this to help somebody with stopping smoking or addressing their anorexia, do you have to steer them?
00:44:19.180Like, we're going to conquer the smoking, picture the cigarette, you know, or even in this study.
00:44:27.960If you're dealing with depression, do you need to sort of say, we're going to focus on your depression so that you're kind of pushing them toward resolving the thing you're targeting?
00:44:40.940So in therapeutic studies, there's a built-in intention for the session, and that it's going to be helpful for them in terms of managing whatever therapeutic condition they have.
00:45:00.420Now, there's also research underway for approval of MDMA or ecstasy for treatment of PTSD.
00:45:14.560And that's a, it's not a classic psychedelic, it's kind of like psychedelics though, but there the therapy session very explicitly focuses on, or the expectation is that people are going to talk about their traumatic experience.
00:45:36.340With a drug like psilocybin, we don't invite people to talk at all.
00:45:41.400I mean, if, and if some people are moved to talk, uh, we'll listen, but very often, uh, as soon as you start putting something in the ineffable range into words, it pulls you out of the experience.
00:45:56.660So our counsel to people is to just stay with the experience, just trust, trust the process, be interested and curious about it.
00:46:09.720So the, if somebody goes in and we'll talk about the anxiety, depression, but somebody goes in to do this, to see if it'll help with depression.
00:46:17.100And then you don't have to direct them.
00:46:34.300So we'll talk about what's happening, you know, what's actually happening physically in your brain.
00:46:40.260What is doing this and what's the difference between psilocybin and ketamine and MDN, MD, MDMA, uh, and all the, like, does it matter?
00:46:51.040You know, you should take LSD or does it matter?
00:46:52.780So anyway, we have a lot more to get to, uh, including the remarkable lasting effects of these sessions and how you might be able to get one.
00:47:00.480Dr. Roland Griffiths sticks around for the whole show today.
00:48:29.060So the, the meaning that people take from these experiences is going to be very much intertwined with the set and setting, the kind of intention that people brought into the experience and the support that they receive after the experience in terms of making use of that.
00:48:51.040But if, but if, if we take just the, uh, healthy volunteers that had this experience, uh, so many of them end up reporting.
00:49:02.060And this is, in fact, it's years later, they continue to use this as a touchstone, uh, experience much in the same way that, that you might relate to the birth of your children.
00:49:16.880And, and, and, and for me, this is very relatable.
00:49:20.140My number one most meaningful experience was the birth of my first child, my daughter.
00:49:26.760And, and, and, and for me, that changed my worldview.
00:49:30.760I, I came, I came to an understanding of what the human race was truly about.
00:49:38.900And it was, uh, it's magnificent and I wouldn't trade it, uh, for anything.
00:49:49.300Very often people made, I don't want to say similar kinds of attributions,
00:49:56.040but they, they really felt that they had a new view of the world, a new worldview, a different sense of self, often one that was felt to be more interconnected, more alive in the, in the world.
00:50:12.940Um, it's, yeah, it's very hard to draw generalities, but I think there's a positivity that comes out, out of this, a sense of self-efficacy.
00:50:26.040That they have real choices to make in their lives and they end up making what appear to be positive choices about their lives going forward.
00:50:37.400And that's in fact, why we think this has cross diagnostic generality with respect to treatment of very divergent kinds of psychiatric disorders.
00:50:49.360And that's because you fundamentally change a worldview and, and someone's sense that they can make a difference, that they can change themselves.
00:50:59.420And that, and that's why in the therapeutic context, these experiences are often set within a therapeutic framework.
00:51:08.960So to give you an example, the work that we've done at Johns Hopkins on cigarette smoking, this was led by, uh, my colleague, Matt Johnson, uh, cigarette smoking is a very difficult, uh, habit to break, addiction to break.
00:51:26.220And people come in having failed multiple times to, uh, uh, quit smoking and essentially they're self-labeling themselves as an addicted smoker.
00:51:40.360And this kind of experience, uh, and, and, and, and telling them how they can approach quitting going forward.
00:51:48.220But this kind of experience frees them from that self-identified label as being addicted.
00:51:55.740And so people can come out saying, well, yeah, I, I, I, I've failed many, many times, but in fact, I can put up with a little suffering.
00:52:06.620I can put up with a discomfort of, of quitting.
00:52:09.740I realized that that's going to be transient and I'm committed, you know, to the objective of being smoke free.
00:52:17.660And so it's, it's, it's enough to push people into a cycle of making choices that benefit them going forward.
00:52:26.820And so I think that it would be true in many respects with eating disorders and, uh, depression and anxiety and depression and cancer patients.
00:52:38.500So how many sessions do you need to go to and how long are the results?
00:52:47.040So, uh, our, we've done studies with single sessions.
00:52:53.380So a single high dose of psilocybin, uh, appears to be efficacious.
00:52:58.760We've also done studies with, uh, uh, two or three sessions.
00:53:05.440Uh, I, I think when this is initially medically approved, I'm imagining it'll be initially for just a single, a single session.
00:53:14.560Uh, but the, we're in our infancy in terms of understanding optimal use of these kinds of compounds and understanding at, at a, at both a deep physiological neurochemical level, how they work, but also at the psychological level, how they work and how these experiences can be best, uh, packaged in a way to produce enduring change.
00:53:42.560So we're, we're, we're really just at the beginning of understanding this as a, as a therapeutic intervention.
00:53:49.620And in terms of the duration, you know, how, how much bang you get for your buck?
00:53:57.980So, so we, the first study we ran was in, uh, cancer patients who had a life-threatening cancer illness and they were anxious and depressed.
00:54:08.380And what we saw is rapid decrease in that anxiety and depression.
00:54:17.420Another group at NYU that ran a very similar study did a five-year follow-up and, and those results were sustained out to five years.
00:54:29.340This, you know, this, this is, it's remarkable within the domain of treatment of psychiatric conditions, right?
00:54:39.720Because most psychiatric meds are temporary interventions.
00:54:44.740They're intervening, you know, to, um, well, to, to block a receptor or to enhance, uh, something going on.
00:54:54.760You know, you know, antidepressants are, are given chronically over, over a lifetime.
00:55:01.240Uh, and this is a single exposure in a single afternoon producing enduring changes for, for years out.
00:55:11.560And, and if you think about it, if in fact it is that people have a different worldview, a different sense of self, they start changing their behavior themselves.
00:55:21.660Then you can understand that, that very well could be a process that endures in perpetuity.
00:55:31.900I mean, just to think about, as you point out the number of antidepressants that people are taking and the self-medication they do with alcohol or drugs or what have you.
00:55:39.940And potentially one day could completely change the way you see things.
00:55:46.100Now, and I want to get into the cancer study in a little bit more detail, but before we do, can we just spend a minute on the differences between psilocybin, ketamine, LSD, and MDMA?
00:55:57.980So, uh, so, uh, so psilocybin is what we call a classic psychedelic and, uh, other classic psychedelics, although they're not identical, but they're, they're more similar than not, are, uh, LSD and DMT, which is in ayahuasca used in South America.
00:56:18.820It's an admixture, uh, it's also, it's also, it's also, uh, uh, uh, uh, mescaline used by Native Americans and their religious ceremony, uh, is also a classic hallucinogen.
00:56:34.520So MDMA is, uh, is pharmacologically, uh, different.
00:56:39.820It, it, it, it works at some of the same receptor systems, but it's not a classic psychedelic and it, uh, it more than the classic psychedelics produces this flooding of, uh, empathetic response.
00:56:57.960And it's very often felt to be a heart opener, but, um, but it looks like it, it's very useful in terms of treatment of post-traumatic stress.
00:57:21.480It's related to PCP, which is, uh, not good.
00:57:28.000Uh, it, uh, it does produce these dissociative effects.
00:57:32.740It doesn't have some of the depth of meaning and, and, uh, and the, and the,
00:57:39.460or the colorfulness of, uh, visualizations, uh, uh, and it is physically addicting in the sense that classic psychedelics are not.
00:57:52.040So, uh, uh, it produces a classic withdrawal syndrome and so people can, if they get involved with ketamine, can increase the dose and become dependent on it.
00:58:04.000And, uh, and that can be a result in, in tragic outcomes.
00:58:09.820However, ketamine is effective as an antidepressant, uh, but it differs from the classic psychedelics in that its effects are relatively short-lived.
00:58:24.600Uh, and so very often, uh, people will emerge from their depressive, uh, symptomatology, but that's only temporary.
00:58:34.960And over the course of a week or two weeks or a little bit more, uh, their depression will recur.
00:58:44.500It sounds much better than, than the ketamine.
00:58:47.500Well, they're, they're, they're very different experiences.
00:58:51.240And, uh, and I think, uh, a high dose of psilocybin is likely to be more psychologically challenging than a high dose of ketamine.
00:59:02.000Uh, so it's apples and oranges really.
00:59:04.580Yeah, but I was joking with the team before we started about what kind of a difference could this make in one's personality and outlook?
00:59:11.460Like if I, if I were to go through this psilocybin or you mentioned MDMA or MDMA, the, the, the heart opener, would I come back on and say, you know, I really see Megan Markle's point.
00:59:22.660Maybe it really is Prince William's fault.
00:59:24.420You know what I, would I start to see, would it change my whole outlook on people?
00:59:38.600I think, I think you would feel changed fundamentally, uh, you know, and to what extent, what extent your major worldview would shift is, is not, is not, uh, determined by, by the drug.
00:59:56.920But I, I, I don't have any, I don't, well, I shouldn't say you specifically, cause I don't, yeah, I, yeah, I don't know where you would react within the spectrum, but, but, but people feel changed and they feel like the change and what they have learned from the experience is really a value, a very special value to them.
01:00:24.480And so, and so, I think people would put different words around, you know, how that changed them.
01:00:35.900I mean, yeah, if they're, if they're happy in their life, otherwise, uh, they're not going to make radical, uh, radical changes.
01:00:45.560Uh, but I'm sure all of us could, all, all of us are not leaving, uh, living absolutely optimal lives.
01:00:57.820And so there's plenty of room for fine tuning.
01:01:03.040I don't want to go too deep in the science because I think, you know, just a little, we'll go a long way there, but what's it, what's, what's it doing to our brain to allow all of this to happen?
01:01:13.440Well, well, I, I, I wish we knew, uh, we're not entirely ignorant that the basic neuroscience of this and, and our understanding of this is accumulating at an astonishing, uh, rate, uh, but we're still deeply ignorant.
01:01:35.700So just very quickly, we know where drugs like psilocybin bind in the brain.
01:01:43.860We know what receptors they bind to serotonin 2A.
01:01:47.560We know where those receptors are in brain.
01:01:50.540We know how those areas of the brain are activated or deactivated when someone takes psilocybin.
01:01:57.700And we know something about the brain interconnectedness and how those patterns within the brain, what parts of the brain are talking to other parts.
01:02:07.460We know a little bit about how that, uh, that's functioning under the influence of these, uh, drugs.
01:02:14.480And, and, and, and there's some suggestion that there's a down regulation of a system that's responsible for self-referential processing, this kind of obsessionality that we have with ourselves.
01:02:28.560But there, the trail gets very thin because we're really talking at the core here about the nature of consciousness, the nature of our own experience, and how do we hold ourselves in the, in the world?
01:02:47.040And, uh, and, uh, and, yeah, we are, we're in grade school, kindergarten, maybe a nursery school, uh, with respect to our understanding about that, uh, from a, from a reductionistic scientific standpoint.
01:03:07.380But because it's at this higher level psychological, uh, you know, about the sense of self and the sense of meaning, the sense of purpose, that's all getting intertwined in here in some way that feels magnificently profound and reorganizational.
01:03:30.300Uh, so, so, so people will use the term feeling reborn, uh, in, in, in a sense that things are new in a way that they hadn't experienced them before.
01:03:42.980But is there a, I was going to say, is there a limit on how many of these sessions you can do?
01:03:49.740You know, is it, does it, does it cause brain damage if you go back too many times?
01:05:11.580Well, I'm not going to recommend, uh, they do so unless it's in, uh, you know, under, uh, a regulated protocol, you know, that's been approved by the FDA and has the, all the constraints built, uh, uh, built into it.
01:05:28.560So, uh, so, uh, so I, I think right now it's, uh, buyer beware, although our culture is making these drugs available.
01:05:38.500And, uh, and I don't know how that's going to roll out at the state levels and the, and the county levels.
01:05:46.000Uh, uh, uh, you know, but I, I certainly be reluctant to encourage anyone to, uh, uh, to seek that out unless they're very carefully screened.
01:06:00.080And we talked about, uh, and during psychotic illness, you certainly don't want that.
01:06:05.740And, uh, and, uh, and you'd like to be under optimal clinical care before, during, and after these sessions because they can be disorienting and, uh, and, and, uh, you know, the motto is do, do no harm.
01:06:33.560So let's talk about the cancer patient study, because that is a profound group of, of people who are suffering mightily.
01:06:42.880And if you want to talk about, you know, depression and people who are facing the end of their life, who have to go through chemotherapy and radiation and so much, just so much heartache and physical ache at one time, that's where you'd go to find patients dealing with all of that.
01:06:57.220Um, when you went into that study, I read that you said something to the effect of.
01:07:01.500I really wanted to be careful because the last thing I wanted to do was add to their disappointment, their agony, their physical or other challenges.
01:07:11.580I mean, that, that must've been a tough one for you emotionally, mentally to take on.
01:07:20.600Uh, and, uh, as I think we'll end up talking about my, I now have personal empathy with these people that I didn't at the time.
01:07:29.540But, but, but yes, so this was our first therapeutic study and, and it was in people who were depressed or anxious because of this cancer diagnosis.
01:07:41.740And how can one not have empathy for that, uh, particularly in our, uh, particularly in our, our culture?
01:07:50.860I mean, that is kind of the deepest existential question, isn't it?
01:07:55.100What, what, what, what, what are we doing here?
01:08:00.060And that's a source of tremendous fear for some, for some people, uh, other, others not, depending on what your worldview beliefs are.
01:08:11.660But for many, it is, and it's a completely understandable one.
01:08:17.520And so, I, uh, again, this was our first therapeutic study and I thought, do we know what we're doing here?
01:08:25.060And, uh, and, uh, and, and we need to be careful because whatever that is like to lean into that question about the, the termination of life, uh, we wouldn't want to make that worse in people.
01:08:40.020Uh, but there had been an older literature from the 60s that suggested that this kind of intervention would be helpful.
01:08:50.740And, uh, and it turned out, and indeed it was.
01:08:54.560And, uh, and so I was relieved as that study, uh, progressed.
01:09:00.580There was, uh, actually at, when we initiated the study, we did so at, uh, at our highest dose of psilocybin.
01:09:09.640And we just had a couple of people whose response, you know, wasn't as good as I would have hoped.
01:09:18.620And we, we dropped the dose of psilocybin down.
01:09:22.360I don't know now in retrospect, whether that was necessary or not, or whether I was just being overly cautious.
01:09:30.080But when you're, when you're working with new compounds under new conditions, I'm going to default to being overly cautious.
01:09:37.760And in any case, the dose we gave produced these profound effects.
01:09:42.700Most people having these remarkable experiences, many of them reporting a changed sense of, uh, of death and, and what that, and what that means.
01:09:59.680And I think that came out differently for different people.
01:10:03.820Some people put it into a religious context and they, and they now were sure that they would encounter an afterlife.
01:10:13.400Uh, other people didn't put it into a religious context per se, uh, yet they felt that there was something, uh, that existed after death.
01:10:28.740Um, and some just felt that there was a, there was some kind of benevolence in, in this whole, in this whole story that we're involved with.
01:10:40.060There's some beauty and elegance in this and dying was okay.
01:10:44.880Boy, I think the, I think what I found to be most touching about the outcomes of, of those, uh, patients and their stories is very often they came out of these experiences in this really uplifted state in which they ended up consoling their caretakers.
01:11:07.820I mean, there was a role reversal, they had family members who were really worried about them and wanted to do right by them.
01:11:16.580And they almost, a number of them just turned that back on their caretakers and were providing assurances to their caretakers that this is sad.
01:11:33.040And it's beautiful and everything's going to be all right.
01:11:36.700And to hear, hear those stories, I mean, it still kind of makes the hair on the back of my neck stand up because of the emotional significance that had for everyone that they came in contact to.
01:11:49.560Oh my God, I was tearing up just thinking about that.
01:11:52.440What a, what a difference and what a tool in the arsenal, you know, to help these people who are suffering so much.
01:12:00.860I, I'm so moved by, I want to get it for my mom.
01:12:05.080But I, I would love to just see how it changes life perspective for her.
01:12:09.180You know, I just, this could be used on, you know, far and wide for anybody who's suffering or feeling down or facing end of life issues.
01:12:16.660And that does lead me to your story, Roland, which is, you know, I said, and I know you don't look at it like this, but I said to my team, um, I'm really not looking forward to the part where we have to break the audience's hearts and tell them what's going on with Roland.
01:12:32.480Because that study on the terminally ill cancer patients would become relevant to you personally.
01:12:58.040I exercise, uh, and came out with, in short order, a stage four cancer diagnosis that's been, uh, resistant to treatment.
01:13:10.240So, so, so the irony is that all of a sudden I was in the position, uh, of the patients that I'd spent so much time with and talking about their views on what death and dying is about.
01:13:24.920But, uh, but, uh, but Megan, the astonishing thing about this is that it's rather than being depressed and anxious for me, it's, I consider the whole thing to be a blessing.
01:13:40.460And it's been this just remarkable experience of joy and gratitude.
01:13:49.080And I don't quite know how I came to have this experience, but I, but I, I have an idea.
01:13:55.720Um, you know, um, you know, I had a long history of practicing meditation.
01:14:01.160And so I was accustomed to going in, in interrogating my thoughts, feelings, emotions as they come up.
01:14:11.220And, and this is what you learn to do in meditation.
01:14:14.600Although, uh, I don't want to soft pedal it.
01:14:18.100Meditation's hard because most people, and, and I was one of those initially, get very discouraged very quickly, uh, feeling that they're, there's nothing here or, or that they're a failure.
01:14:30.920And, and, and the, so it's tricky working with meditation, but, but what one comes to learn is that, uh, you don't need to identify with the narrative self, the voice in your head.
01:14:45.960You don't actually need to identify with emotions or feelings that come up that, that, that, that the voice in your head, those feelings, uh, exist within this kind of larger context, this larger frame of mind.
01:15:05.800And if you don't identify with that, then it's going to pass it.
01:15:12.200And, and, uh, but if you lock into a narrative story about what's happening, then it's, that's becomes your world.
01:15:20.820It's like the addicted cigarette smoker identifying as addicted, and then they are.
01:15:26.020And if you identify as being anxious or depressed, that's where you find yourself.
01:15:31.840So with the diagnosis, I, uh, at first there was this sense of, it was just unreal.
01:15:40.880I just, it was just a bad dream, frankly, uh, and my wife and I cried, uh, a lot, uh, but it was confusing.
01:15:49.740And then this happened just over a few days.
01:15:52.540And then I went through and started sorting through kind of the emotional states that would emerge.
01:15:59.040And, you know, one would be anxiety or depression, you know, or resentment, uh, toward a medical system that maybe put me at a screening interval that was inappropriate, you know, or, or going to combat with the cancer or denial.
01:16:18.180And, and none of those struck me as being pleasant places to be, uh, and, uh, and so that's, I, I, I really didn't want to go there.
01:16:29.740What, what I recognized was that, that this was a springboard into gratitude, just gratitude for the preciousness of our lives.
01:16:43.620And it's something we, we all know, right?
01:16:46.980This is something really remarkable that we find ourselves as these highly evolved sentient creatures walking the earth surface, talking in the middle of culture, you know, but what's going on here?
01:17:02.880How did this, what's the backstory behind this?
01:17:09.400How do we account for the fact that we can even be aware that we're aware that we know that we know something?
01:17:17.780And for me, when you contemplate that gratitude comes up, this is life is a precious gift is precious beyond belief.
01:17:27.780And so my choice then became to deeply practice gratitude and use the, the so-called problems that arise from a diagnosis like that.
01:17:42.720And there are plenty of opportunities with surgery and chemotherapy and all the side effects and dealing with the medical, uh, profession.
01:17:51.520You could, you could, there's all kinds of opportunities to collapse into different states, but they can be used in, in a way that just reflects back as a reminder that each moment is precious.
01:18:09.680And that's what this 14 months has been like for me.
01:18:13.780So it's a gift, it's a blessing and, and, uh, my wife and I often talk about what a tragedy it would have been had I just been run over by a bus on that day that I was walking out to that screening colonoscopy appointment because I wouldn't have had this.
01:18:31.620I, I, I thought I, I thought I was pretty awake to the joy and miracle of, of life before this, but it's much more so now.
01:18:42.640And so I'm moved to talk about it just because, uh, I think in principle, we can all wake up much more than we are.
01:18:54.040And I want to encourage people to do that absent a terminal diagnosis.
01:18:59.100Mm-hmm, Roland, thank you for sharing that.
01:19:02.600My God, I'm, I'm definitely, I feel more emotional about it than, than you do, but I know you've dealt with it and there's so much wisdom in what you just said there.
01:19:10.980The, the thought, uh, we don't need to identify with thoughts or emotions as they arise that what a concept.
01:19:19.100So it's there, the anger, maybe a feeling of betrayal of getting gypped of why me, what could have been like they're, they're marching by you like ants in a parade, but you don't have to accept them.
01:19:37.140Yeah. I mean, you can, you can take advantage of that. So if, you know, so, so anger comes up, right. And, and kind of the immediate response, if you kind of query what's going on is, yeah, you want to get back.
01:19:52.400And, you know, however you're going to manifest that, but, but there's energy that comes. And if you go inside and kind of query that, uh, you can recognize that there's all this energy and you've given it a label of anger and you, you don't have to act on that.
01:20:10.240In fact, you can just repurpose that toward gratitude. Like, yeah. Oh my God. I'm here. I mean, why? And, and it's not going to serve me to, to act on that anger. I mean, sometimes it will. I mean, you know, some, we, we have these conserved, uh, evolutionary conserved tendencies, you know, for some good reasons.
01:20:37.180But, but, but a lot of times within our culture, you know, we're, uh, acting out primitive responses that just don't serve us or the people we're reacting to optimally.
01:20:51.340And so let me just restate that. So make sure I understand it. So you're, so if in my analogy of the little answer walking by with anger, bitterness, you know, betrayal, it's not that you're saying I reject you and I reject you and I reject you.
01:21:04.260It's that you're changing what's written on their sign. You're saying, I'll take all the energy on your sign of that very big emotion that is available to me.
01:21:12.040And I'm going to, I'm going to, on the opposite side of that sign, I'm going to write gratitude and I'm going to use all that energy to funnel toward that.
01:21:20.940Yeah. Yeah. Yeah. Yeah. I'll take it one step forward. You can, you can thank the little aunt or whatever the condition is, you know, for providing you this further wake up call. You're just not going to go with the message that's on their side.
01:21:37.220Oh, that's extraordinary. That's so helpful. I love the way you're saying that. So did you have to, because I know we never sort of got to the point where in the midst of your research, at some point you did try the psilocybin in a serious way, not, not the sort of cursory, you know, twenties things you talked about.
01:21:58.880Did you need to do it again, Roland, you know, after the diagnosis, did you, did you choose to do it again or was, were the earlier experiences enough for you?
01:22:09.360Yeah. Well, let's see. So the, the way I handled the diagnosis initially, um, and, and of course the, because I'm known for the psychedelic research, people ask me, oh, are you going to take psilocybin?
01:22:24.960And in fact, that was the last thing in the world that I wanted to do. I, I felt that I was in the, in this altered state, more awake, alive, joyful with greater equipoise than I'd ever been before.
01:22:41.880And I actually thought, no, why, why would I ever want to, uh, disturb that? So, so, so, you know, but also at that point, I'd done a lot of meditation and I did have some interesting psychedelic experiences that may have informed my ability to respond like that.
01:23:03.240But I wasn't, but I wasn't, I wasn't drawn to that. I, I have subsequently, since the diagnosis, uh, had one experience with a, with a psychedelic in which I made, which I just used it for some self inquiry that was, was very interesting.
01:23:21.000Uh, but, uh, uh, it, uh, it doesn't explain much about what I'm encountering now, how I'm responding to the diagnosis and, and my eagerness to, uh, uh, to communicate about that, uh, including wanting to launch a whole research program that speaks to this very issue.
01:23:46.900Mm-hmm. The, the study you did on cancer patients showed large decreases in depression, anxiety, death, anxiety, and increases in feelings of quality of life, meaning of life, optimism, sustained after a six month follow-up.
01:24:05.460So now for you, you don't sound fearful, death, anxiety, you certainly don't seem to have that. I mean, I think a lot of us who don't have your diagnosis have that.
01:24:16.900And I wonder how is it possible, right? Like I, people of faith often say they don't fear death, but how is it possible that actually facing it, you don't fear it? Is that a connection to a higher power? Like what, what's the, what's going on in your mind as you think about it?
01:24:34.200Yeah. So, so I, so I'm, I, I, yeah, I don't know how unique I am, but I'm a scientist. I'm a skeptic. It's really hard to get me to say that I believe in anything, right? Because the very nature of science is to be skeptical and want proof.
01:24:54.540And so I, I don't know and don't have any strong beliefs about what happens when we die.
01:25:06.180Because I'm bred within a scientific reductionistic tradition. I'm inclined to put low probability on afterlife, at least as it's described very often in, in beautiful religious traditions in which you're, you know, assured this glorious coming together with family.
01:25:35.460And friends and friends and, and the divine. And, and, and I, and I, I, I, I certainly would put that at low probability, but also as a skeptic, I, if someone said that that was a certainty, I would be skeptical of that.
01:25:58.320So there's, so, so there's, so, so, so I do maintain, albeit a very low probability of, of something that survives death.
01:26:10.080I do remain intensely curious about that, you know, and it can be very low probability to still maintain that curiosity.
01:26:23.300And, and so, so that certainly is at play.
01:26:27.540And then I, but, you know, more, more than that, it's the gratitude practice, the leaning into the preciousness of life.
01:26:36.280It just means every day, every moment, every minute is, is one that we need to choose, how we're going to show up, whether we're going to be present with that.
01:26:49.340But, but, but, but all of the magnificence of, of this entire adventure that we all as sentient creatures find ourselves in is in principle available to us every moment if we allow ourselves to stay awake to that.
01:27:12.000And I think that's, and I think that's, and I think that's what I want people more than anything to do, to contemplate that.
01:27:19.460And what I really want is ultimately, and I don't want to sound like Timothy Neri, but I, but I, I think it's attainable eventually, and this is going to be multi-generational,
01:27:31.800that the, our cultures are going to awake to this, and that we need to see and feel at a deeper level, the magnificence of what this process is, and at some fundamental level, we're all in this together.
01:27:51.600We're all, we're all, we share the same dilemma, right, of the one thing that we know to be true is that we're conscious.
01:28:03.200That's probably the only thing we can affirm, and I can affirm it for me, I can't affirm it for you or anyone else.
01:28:10.160And we're all stuck in that, that very real situation, unless you haven't thought about it very deeply, you know.
01:28:19.460And so from that, there's this sense of compassion that opens up, at least for me, for everyone.
01:28:26.060I mean, I see everyone's, or most of us are stuck in some ways.
01:28:35.640And so the long-range vision is that if we're going to survive as a species, and I do mean survive as a species,
01:28:45.100we've got to figure this out before we terminate ourselves by all these existential opportunities, be it bioweaponry or nuclear war, AI risk, or, you know, what have you.
01:29:02.080And I'm not, you know, and I'm not thinking that that's around the corner next week or tomorrow, and it can get overblown for sure.
01:29:10.540But in the longer run, we've got to sort this out.
01:29:16.400And wouldn't it be lovely if we could?
01:29:23.240I'm thinking of him now as I listen to you, and also a man of science in a different way.
01:29:28.620And on his passing, was reported to have said, wow, oh, wow, oh, wow, dying of pancreatic cancer.
01:29:39.820And I've always thought there could have been something, you know, for a man like that, that he was seeing and communicating in his own way back to us.
01:29:48.280And I believe it'll be there for you, and I believe it'll be there for me too, and I hope and I pray it'll be there for my family and me as well.