Episode Transcript
Kalea Wattles, ND, IFMCP:
Researchers continue to investigate the safety and efficacy of clinically administered psychedelic drugs as effective therapeutic agents for treating mental health conditions. Some studies demonstrate their positive benefits for treatment-resistant depression, anxiety, and PTSD, but limited clinical evidence and concerns over legal access prevent these agents from being widely used in practice. How do psychedelics affect the brain on a physiological and emotional level? And how can this insight pave the way for advances in mental healthcare?
On this episode of Pathways to Well-Being, we welcome noted psychiatric researcher Dr. Robin Carhart-Harris to discuss the potential of psychedelic-assisted therapies and to better understand how these agents may be applied therapeutically to support mental health and the brain. We're really excited for this conversation. Welcome to the show, Dr. Carhart-Harris.
Robin Carhart-Harris, PhD:
Thank you very much, lovely to be with you.
Kalea Wattles:
Well, I think this is, this conversation is coming up more and more among both clinicians and patients, and many practices are beginning to at least be curious about integrating psilocybin and ketamine into their treatment plans. So to get started today, I wanted to hear a little bit about how you initially became interested in psychedelic research.
Robin Carhart-Harris:
Sure, well, these days I tell the full and honest story partly because I am working on a book and I just think it's good to square with people. So I did have some personal psychedelic use early in my life, in my teens, an experience with LSD that was very profound and very unusual and triggered, I guess, the curiosity that's remained with me ever since. And that drew me, in a sense, inadvertently, unconsciously, somewhat, to psychology, to depth psychology. Thankfully, I became very studious. And that's the impact that psychedelics, that drugs in a sense had on me. I became very academic, and I really wanted to better understand like what the heck had happened there. It was so strange, I just wanted to understand. So, drawn to psychology, drawn to neuroscience, I finally, you know, got a big break to do a PhD in brain science and brain chemistry, something called psychopharmacology. And it was through that break that I got the opportunity to do what I was really passionate to do, which was human brain imaging with psychedelics. And that's how it all started.
Kalea Wattles:
Well, it's a very compelling origin story, and I do wonder when you started to explore this more academic side of these interventions, were you surprised by what you found? Or you just thought, wow, this really validates the outcome that I thought we were going to find based on my experience?
Robin Carhart-Harris:
In a sense, it was surprise all along. Surprise is like the lure, you know, sort of teasing you in. And I was surprised by the psychedelic experience initially. That was a major aspect of it was just like, how is that possible? I couldn't, you know, fathom how one could have a state of consciousness like that. It wasn't how I imagined, but I don't know if it's possible to imagine what it would be like. So that was the initial surprise. Then in, you know, having that privilege to look in the living human brain during magic mushroom trips, during LSD trips, during MDMA experiences, and so on, what I've been doing over the last 20 years or so now, yeah, early on, it was a big surprise. We really didn't know what to expect. There hadn't been much brain imaging research at all. The tools that we used to look in the brain hadn't been used before to look at the action of psychedelics. And so we started to see things that it was really, you know, uncharted territory. We started to see things that no one knew happened. And so the whole thing, you know, that's a great, great opportunity and privilege as a scientist to open these black boxes where you really don't know what you're going to find. You know you're going to find something, but you don't know what, so yeah, surprise is a major aspect of the journey.
Kalea Wattles:
Yeah, I imagine that's motivating to keep doing this type of research because the surprise is so alluring, what you'll find.
Robin Carhart-Harris:
Oh, very much, very much. You know, it's real, real frontier science, you know? It's like an inner cosmos rather than sort of, you know, going out into space, you're going into inner space. And in a sense, it's just as vast, you know? So yeah, it's very much the pull. If you only saw what you already suspected, then science would start to get a little tedious, maybe, and boring, and so I'm very lucky to be doing something that's so fresh and cutting edge.
Kalea Wattles:
Will you tell us a little bit about the structure of the brain and mental health and tell us some of the key regions of the brain that are involved in treatment with psychedelics? How does our brain change with these interventions?
Robin Carhart-Harris:
Yeah, well, it changes quite dramatically. Brain function or activity is what we tend to look at with functional brain imaging, methods like fMRI, functional magnetic resonance imaging, that allows us to look in the brain with a high degree of spatial resolution, like a, you know, high-definition TV. We can see really granular stuff, fine grain stuff. And then with techniques like EEG or MEG, these can look like swimming caps, at least EEG. MEG looks like an old-school hair permer. You know, you sit in this big machine with, goes around your head, and that records brain waves and gives us really high temporal resolution data, or it can pick up really fast activity in the brain. So these methods are complementary, and they're really our lenses. You know, they're our telescopes or microscopes that allow us to see further than and deeper than ordinarily we could.
So I guess, you know, a big insight into the action of psychedelics on the brain was the discovery that psychedelics, in a sense, scramble up brain activity. I call it an entropic brain effect. That means that there's more bits, independent bits of information in the ongoing brain activity. There's more to it. And through that insight, I developed something which can be regarded as a principle of how psychedelics work, which is called the entropic brain principle. And it basically says those, you know, that increase in the bits in the brain, or more in-brain activity, translates into more in conscious experience. So more going on in the brain, more going on in your subjective experience. So kind of complicated, but kind of simple, really, at least when articulated that way.
And, you know, if you look under the hood, look a little closer at what that means, brain activity seems to become faster. The waves get shallower and more rapid in their up and downs, you know, like ripples on a lake rather than big rollers in the ocean, and patterns, spatial patterns in brain activity get finer grained. They're more bitty, you know, like static noise rather than coarse-grained, big sort of swaths of whatever chunky, you know, chunky would be sort of low entropy and finer grained patterns like, you know, Arabic art or Persian, like a Persian mosque. You know, very granular and intricate and a lot there. That's what we see under psychedelics. So faster and finer brain activity is what we see. We see it all over the brain, but we especially see it in aspects of our brains that have expanded a lot in our species, aspects of our brains that other species, even monkeys and apes, don't really have. So that's quite cool as well. And it sort of fits that, you know, these compounds that have such a profound and unusual impact on consciousness, and we're weird animals with a weird quality of consciousness, and so it sort of fits that it's those, you know, consciousness bits, if you want, that get especially scrambled up by the action of psychedelics.
Kalea Wattles:
Hmm, so for someone who's been working through depression, anxiety, PTSD, how do these changes in their brain patterns translate into... their lived experience and their symptoms? I mean, do we see that there's some relationship?
Robin Carhart-Harris:
We do. And so another aspect of why we're weird animals is that we have mental illness in this seemingly quite, you know, complex way. We can get depressed, and it's not clear why we are depressed, and yet it can profoundly affect us, and we sort of hibernate away from the world. Or we get very anxious, and we might get anxious about weird things, you know, like phobias or even being in a social context. And so yeah, we have some strange behaviors and ways of thinking as human beings, and yeah, psychedelics appear to work on aspects of the brain. Again, they're these high-level aspects that humans especially have. These aspects seem to behave abnormally in mental illness. They're often implicated in depression and schizophrenia and all sorts of psychiatric disorders.
And we suspect that what happens to those systems is that they get overly engaged, in a sense, they get reinforced. It's as if we get, for example, in depression, stuck in our own heads and we forget, or we become kind of strangely disinterested in the outside world. We sort of retreat back and get stuck in loops of negative thinking and self-reflection. And so these systems and these patterns and these trajectories of patterns, these loops get reinforced over and over as we kind of practice that way of thinking and feeling. And so there you have a system that's become too rigid, is kind of stuck and reinforced. And so the solution is to try and unstick it. And that's what psychedelics do.
So they get in, they scramble up the activity that's become too regular. Psychedelics make the brain activity dysregular, or they dysregulate brain activity. So it's a useful kind of scrambling up, you know? I've likened it to shaking a snow globe where, you know, the snow might get settled in a particular way, but once we shake it up, we can change things. And that's where we could bring in this notion, this idea of plasticity, which means changeability, the ability to change one's mind, one's feelings, thoughts, behaviors, and you know, the main organ that is responsible for all those things that the brain…actually change the brain. So yeah, there's that shake-up during the trip. But then there's also a reset, a kind of recalibration action back to, you know, factory default settings. You know, back to something like the relative, you know, blank slate that you want to go again, you know, without unhealthy patterns, but rather a kind of fresh, you know, slate or piece of paper or, you know, blanket of snow. So that's the model. There's this sort of useful scrambling up that can reset and recalibrate things so that you can go again refreshed or, you know, reborn in a sense. That's the ideal, at least.
Kalea Wattles:
Now I'm so curious to know if those changes to the brain are enduring after one use of psychedelics, or does this require multiple experiences?
Robin Carhart-Harris:
So we don't know, you know? That's the nature of science is that we're always pushing on questions like that. So we have done some research where we've looked in the brain one month after someone's trip, and we have seen changes in brain function and in brain anatomy, even. This is a relatively recent finding, but I think that's going to start coming through. We did a study out of Imperial College London that's going to publish hopefully soon showing changes in the cabling of the brain after a single use of magic mushrooms. Cables that run from the prefrontal cortex into the middle of the brain appear to become kind of thinner or more compressed. We don't know what it means, but people changed on average in a direction of improved well-being on average, so they felt better and had better mood and life satisfaction and so on. So on that basis, you would say it's a good change. Their thinking also became more flexible, something we call cognitive flexibility. So that's intriguing.
There's work in other species, in rodents, showing changes in the branches that do the actual very sort of, you know, microscopic level communication between brain cells called neurons. The branches that are like an aerial, like a TV aerial or whatever, or the branches of a tree, you know, receiving sunlight. Those branches appear to actually grow after psychedelics. And that growth is even evident, at least in one study, one month after a single administration of psilocybin. So there's a few different clues here, you know, of a kind of, yeah, functional reset and anatomical maybe replenishment, maybe. This growth that we see in terms of neuronal branches could be a kind of recovery of brain cells that can atrophy, they can break down and become damaged with stress. And if you look at mental illness, it's so reliable that stress accompanies different aspects of mental illness. It's kind of like a solid rule that it goes kind of hand in hand. So stress, life adversity, seems to damage or atrophy the brain. And the big hope is that psychedelics could cause some kind of replenishment or recovery of those aspects of the brain that atrophy with stress.
Kalea Wattles:
You've mentioned in this conversation about psychedelics, which I'm thinking of as kind of an umbrella term. You've mentioned psilocybin and LSD, we know ketamine is coming into the conversation. Are there differences between how these agents work therapeutically? And do you have any advice about why would you choose one over the other?
Robin Carhart-Harris:
Yeah, there are differences. There's differences and similarities. So similarities, you might go to how these compounds excite the brain. They release something called glutamate, which is the main excitatory brain chemical, and most of them seem to do that. Ketamine does it. And then LSD, psilocybin, DMT, these all do that. Certain of these compounds, and actually, let me go back to similarities. The entropic brain effect, that scrambling action, ketamine does it, psilocybin does it, LSD does it, other drugs don't do it. So stimulants like methylphenidate or Ritalin, people might take for ADHD, that doesn't do it. Cannabis doesn't seem to reliably do it. Other drugs, sedatives actually reduce brain entropy, which probably explains why they reduce consciousness as well. Psychedelics dial entropy up and, in a sense, expand or enrich consciousness. Sedatives drop entropy down and drop consciousness. You know, you fall asleep with a big dose of a sedative or an anesthetic. So that's a similarity. A lot of these psychedelics or psychedelic-like compounds will scramble up brain activity and excite the brain.
But differences are often in their initial action. So a lot of the classic psychedelics, LSD, psilocybin, DMT, they work on the serotonin system, a certain brain chemical that is important for sort of tuning the brain, tuning it in a direction of flexibility and plasticity. So classic psychedelics like, yeah, the LSD, psilocybin, they'll increase flexibility and plasticity through a particular aspect of the serotonin system. Ketamine doesn't do that directly. It works actually directly on the glutamate system. MDMA, another psychedelic-like compound, that actually releases serotonin almost like a turbo antidepressant. Antidepressants increase slowly serotonin in the brain, whereas MDMA rapidly releases that brain chemical, which may explain why people often feel good on that drug, you know, otherwise known as ecstasy. So clue's in the name there. So yeah, they, there's similarities and differences.
If we want to be persnickety, and scientists are kind of allowed to do that, you know, then these classic psychedelics are the sort of prototypical psychedelics. It was only after research happened with mescaline, found in peyote cacti and San Pedro cacti and LSD coming along in the '40s and then really crossing over into science in the US and Europe more generally in the 1950s in a big way. Psilocybin, another kind of 1950s compound in terms of scientific work with it, also found in magic mushrooms, but scientifically, '50s, '60s, these classic psychedelics, they all hit the serotonin system in a quite specific way and promote that flexibility and plasticity. So those are the quintessential psychedelics, those ones that work on the serotonin system in that way.
Kalea Wattles:
Now that we're oriented towards the agents, I'm wondering is there a type of patient that you identify would benefit from this type of therapy? And I guess I'm thinking about in functional medicine, we always talk about pattern recognition and how can we look for patterns in someone's history or their symptoms that would point us towards a certain treatment? Or when I'm working with students, I try to help them build personas. If you see this type of persona, this is the type of treatment you should be thinking about. Have you identified that persona that you feel would be most, would most benefit from treatment with psychedelics?
Robin Carhart-Harris:
Yes, and I think it, patterns is a good term because it's the rigidity of patterns both in feelings, so emotional states, thinking, styles of thinking that become rigid, behaviors that become rigid and likely the brain circuitry that becomes rigid and overly reinforced. So it is that rigidity that's the problem. It might seem like a formula that's too simple. But in science and medicine, we love a simple model. All models are wrong, some are useful, but you know, a simple, useful model is very powerful. And so here it is, the idea that, you know, it could be rigid negative thinking and depression about oneself and the world, for example. It could be becoming anxious about being anxious in anxiety disorders, or there could be trigger-specific anxieties, say in PTSD, something that causes flashbacks. Phobias, those are quite clearly, you know, trigger-specific anxieties. Addiction disorders, very much characterized by rigidity, habits. Obsessive compulsive disorder may be, you know, regular, intrusive thoughts that compel then certain behaviors to try and kind of control those intrusive thoughts. Anorexia, again, intrusive thoughts, self-loathing, and then a desire to control, controls one's body most obviously, but also one's feelings through that chronic undernourishment.
There's so much of mental illness psychopathology that could be characterized as this rigidity. In fact, I've proposed that it's the main thing, the principal component of mental illness is this rigidity. I call it something called canalization. It's a term from evolutionary science. The metaphor is that of a canal dug into the earth that gets deeper and deeper with more flow along that particular canal, like a water in a ravine like the Grand Canyon, deeper and deeper and deeper over time. So it's both a process of that deepening, the canalization process, but also the product of it is that you then become rigid, stereotyped, you can only flow in that one particular direction. Freedom is lost, behavior and thinking and feeling becomes constrained. So I think that's the biggest chunk of mental illness. It's not all of it, you know? It's not a delirious state or an acute psychotic state, but it, those are exceptions. But, you know, the major chunk I think is this over-rigidity, this canalization. So yeah, that's the phenotype, but that's the persona, if you want. But it's so much, right?
And you know, and also you might not necessarily have a diagnosed illness like depression or something specific, but you might just have become very habitual in some other way that you could maybe do without or maybe isn't serving you, like, I don't know, becoming too rigid in your beliefs, say in your political beliefs, such that you can't see the other side, you know? So sometimes an argument can be made not just for treating the illness, but also refreshing the wellness, you know? So that's the model, yeah.
Kalea Wattles:
So it sounds to me that maybe this type of treatment isn't just indicated for someone who has a severe mental health diagnosis. Like you said, maybe it's refreshing wellness, and so there may be opportunities as research emerges to use these therapies in a way that is more supportive of vitality and resiliency in our mental health.
Robin Carhart-Harris:
Yes, I think so. And I'm just mindful now that I'm very much characterizing the ideal. You know, this is psychedelic therapy when it works best, it does all these things. It refreshes, it recalibrates, it can treat severe mental illness like anorexia, but it can also get someone who's just in a bit of a malaise, you know, back out and appreciating the world. That's the best case.
But there's a way that we do this work that combines the drug with a certain way of giving the drug. So we prepare people ahead of time, we always supervise them during their trips. That's a really, really important detail that people could overlook and then get into trouble. When you're under a psychedelic, ordinary judgment is impaired, you know? And so you can have accidents, you can do things that put your body into danger that you wouldn't do ordinarily. So that's why we have people supervised during their experiences. We do that best when we have a mental health professional, someone trained, who knows how to be supportive in the right way, to be, yeah, compassionate and encouraging of sort of exploration. So the preparation, the supervision, and then also what we call integration, the aftercare. And these are the three main components of a well-delivered psychedelic therapy: prep, supervision, integration.
And really, if you pull the drug away from those three things, you're changing the risk-benefit ratio in a dangerous direction. And that's why, you know, very powerful tools, that power could be used for, in a way that could be harmful. And so it's so important that you use that power in a way that can be beneficial. So there's a way of yielding or wielding that power. And that would be the psychedelic therapy combination. So, a combination treatment that isn't just drug, but it's a way of giving the drug, of having the experience.
Kalea Wattles:
I really want to spend a few minutes talking about the preparation and the supervision and the integration, like you said. So let's begin with the preparation. I mean, you said there, it's so hard to even imagine what the experience will be like. And I've heard you talk before and research participants have told you, wow, that was a level of consciousness that I've not ever experienced before. For someone who's never had an experience with psychedelics, how do you even begin to prepare them for what they might experience?
Robin Carhart-Harris:
Yeah, well, I go with a principle of I don't oversell it, you know, and I'm straight up, I'm transparent. So I'll say, look, this might feel like you're dying. Sounds pretty nasty that, right? This might feel like you're going insane, you know? And that can be how it plays out. So it can be really challenging. However, we're with you. And there is a way to approach that process that is one of letting go, one of surrender. You try and go with the flow rather than fighting the flow, even if it feels like the direction it's pulling you in is bad. Like, it feels like I'm dying, you know, it feels like I'm losing my mind. So the prep I think is a sort of exercise in honesty, almost. But when you do it that way, you're, I like to think you're inviting trust. Because people can see that you're not dressing it up. It also helps, I think, manage situations where people maybe don't feel ready for that or, and they can use their own volition and, you know, freedom of choice to say, I don't fancy that. Not for me, not right now. And so I think that's important as well. It's part of, you know, the ethics of things, that you inform people in the right and proper way.
Some people also might not want to change in the direction of open-mindedness. You know, they might say, I like the way I am, and I want to stay this way, thank you very much. And actually, you know, being serious in certain mental illnesses, the symptomatology, the way people are showing up or not showing up is defensive. It's serving them because of some, say, awful trauma that they've suffered. They feel they need to drink alcohol or, you know, escape with hard drugs or control their body and feelings in anorexia, they need that. It's like a desperate need. And so that has to be respected too. So when you lay it out and you're honest with people and they come back and say, "I can't do that," then you say, "It's fine, you don't have to do that," you know? So it's a good exercise in doing proper, you know, educated, informed consent.
And then otherwise, and this is sort of tied up, you're building rapport, you're building trust, and you're also inviting a willingness to open up even before the drug's given, like, there'll be no judgment here. You can tell me about, you know, deep, dark secrets, and we won't judge whatever you are willing to share. But the principle is that if you are opening in that way, then you can better navigate things. If it comes up under the drug, which is a thing that happens, you know, psychedelic means soul revealing, and the soul isn't all light, you know? It's just as much darkness, it's shadow. And so again, there's something in the honesty there that you're like, it all could come up. It could be like, you know, communion with God, but it could also be a tormenting, you know, by demons in hell. And that's the human psyche, you know? So yeah, I think that kind of honest, open prep is a good way to go about things. Even if it sounds as though it's scaring people, I just think better that, better you are straight up with people ahead of time than you dress it up and say, oh yeah, Michael Pollan's book or whatever, you know, Change Your Mind. It's click your fingers, one and done, miracle cure. You know, that would be dishonest and unethical. So, yeah.
Kalea Wattles:
You're really creating a container of trust so that the participants can, I think, genuinely and safely explore what's coming up for them. And I imagine sometimes, or maybe even often with the use of psychedelics, people are surprised by what comes up for them. Is that true?
Robin Carhart-Harris:
Oh yeah, very much. Yeah. You know, sometimes it's stuff they know about, they know that there's been an, some awful incident in their life or they know that they're going through a difficult period in their relationship, say, and that does come up. But also sometimes people are just like sideswiped by something that they weren't expecting at all. And that's one of the challenges here actually, you know? It's like how much can we trust the content that comes up? Sometimes people have apparent recovery of repressed memories. They might be memories of, say, childhood abuse, and they don't know what to do with it. They don't know if it's real. And that's very challenging. That's where some of the subtlety of good practice by those supervising these sessions and also providing the aftercare, that's where that sophistication of psychotherapy really comes in. And it's a very challenging thing.
You know, I'm mindful now not to put any obvious, not to put any too definite principles on things like, you know, saying it's always true and, or saying that it's always fantasy and always of the imagination. Sometimes the fantasy is appealing to a kind of reality. You know, an emotional reality that needs to be heard, needs to be explored. I think that would probably be the principle. Like, don't put a lid on it, you know, if this has come up, let's talk about it. Let's not make a judgment about its reality. Like, it definitely happened and now you've got to do something, you know, get justice or whatever. It's more, okay, that's come up, let's talk about it. You know, what, how was it for you? Tell me about it, you know, and providing a safe container for that.
However, you know, another one of the limitations or complexities of this treatment is that it can do this. That's a very powerful thing that the psyche opens in that way. But are you going to stick around? Meaning is the therapist going to stick around and see this through? Because some really deep and meaningful stuff has come up. So the analogy that I've heard, which is a very powerful one, is like open heart surgery and then left on the operating room table. You know, that would be unethical. You've really opened me up and now I'm super vulnerable and, in a sense, set back. So that's why I'd say to people, you know, you got to know what you're signing up for, both the patients themselves, but also the therapists. This might actually be more complicated than you realize. And do you feel you have the skills? Do you feel you have the staying power to stay with someone? And do they have the finances, you know, to stay with this and see it through? So while this treatment is very powerful, gets very deep, sometimes that depth of action can actually add complexity to the mental healthcare.
Kalea Wattles:
So the aftercare or the integration, you're really meaning continued care with the therapist to unpack all of these things that have come up.
Robin Carhart-Harris:
Yeah, that's it. You know, and in certain mental illnesses, there's so much complexity, it's so hard to change someone. Like, their illness is wrapped up in their personality, you know, for example, borderline personality disorder, a sort of personality level, emotional instability. It can express in a number of different ways, but it becomes part of the person. And so it's not realistic or necessarily safe to think you could change someone with a single experience and change someone for the better. You know, gold standard practice for treating, say, borderline personality disorder is a relatively long psychotherapy. And so this is the thing, you can't, you need to be reality bound with this treatment. And if you're going to go into such challenging waters, you really need to be prepared for what might play out. That it could be, you know, one step forwards, two steps back sometimes, and are you going to stick around and see it through? So yes, the rigidity is the target, and that expresses in so many different ways, but the complexity of a person is also the dangerous thing that you want to be careful with.
So, you know, if you want an easy win, something like a reactive depression would be a good target for this treatment. So someone who's suffered a recent bereavement and is struggling to get over it, like, there's a clear and somewhat obvious reason for your depression. I think those are the best cases. But when it's murky and the person's had depression for, you know, 30 years and it comes with a bunch of other symptoms and history of failed treatments, then you start wondering, oh goodness, this is something that's very much ingrained in the individual's personality. I don't think one treatment is going to do it. And it becomes a much more of a project to get that person well and keep them well and do it in a safe enough way.
Kalea Wattles:
I think that there's a lot of excitement or at least curiosity about the use of psychedelics, but just to speak frankly about it, there's some controversy, right? Because these agents are federally controlled, they're illegal in many areas. How do you see access and regulation evolving in the next five to 10 years so that these types of agents become more available?
Robin Carhart-Harris:
Yeah, it's a tricky situation. You know, they've been illegal and controlled in the highest sort of bracket of supposed harm since the 1970s with the war on drugs, Richard Nixon, and then carried on by, you know, Reagan and others. So there's been a portrayal of psychedelics like they're narcotics, they're dangerous drugs. They can be dangerous, but there's no, hasn't been a recognition of their medicinal value and how they can be used in a particular way to potentially save someone's life. And so there's been a lack of nuance, I would say, a lack of sophistication as a product, as a fallout of the war on drugs. And in a sense, those who could have benefited are the victims of that, you know, as well as other examples of victims of, you know, the war on drugs or indeed drug use, misuse. So that's a tragedy in a sense that's, that come about because of, I would say, political divisiveness in a sort of storytelling about psychedelics as only harmful. That's misleading and doesn't capture the whole picture, doesn't capture the truth, you know? Truth is a victim of any war. And that's what's happened with this war, the war on drugs is that yeah, truth has been a victim, and sadly, yeah, people that could have benefited from psychedelic therapy have lost out there too, tragically sometimes. So we need to do something about that, you know?
And science comes in to try and get closer to truth, try and put evidence under truth as its foundation and then bring that sophistication in, bring into the conversation the nuance around this isn't just about a drug, it's about a way of giving a particular category of drug that works on the brain and mind in a particular way, promoting plasticity, openness, flexibility, opening people up. That can be a fantastic thing that can save lives and transform people and they stay well for years and decades, but it can also be a very powerful thing that needs to be managed properly. So that's the kind of sophistication, nuance that I really hope defines this current era and the future development of psychedelic medicine, that we can honor that nuance and not dumb it down, dumb it down in a way that leads to mistakes and tragedies. So I really hope we get it right, yeah.
Kalea Wattles:
Well, you're certainly doing your part through awareness and advocacy and teaching. We know you shared about this topic at IFM's Annual International Conference, and I'm hoping you'll leave us with just a few of the most important takeaways for functional medicine clinicians, really, or patients who might be listening and wondering, what do I need to know? What am I looking for in the research? Or how do I find a clinician that might be open to talking to me about this?
Robin Carhart-Harris:
Yeah, what I love about functional medicine is that there's that desire to get to the root of a problem. And I think that demands that we understand how a problem works, you know? And here I believe we have a potential solution, a very powerful one, psychedelic therapy, that through understanding how it works, we shed a light on also the nature of the problem itself, in a sense how mental illness works, and the two are complementary. How does psychedelic therapy work? How does mental illness work? They each are casting light on each other. And I would say, you know, we failed for many years as a species to treat physical illness well because we didn't understand its nature. And, you know, once we got a handle on, you know, germ theory and so on, we realize the importance of sanitation. We share that knowledge and information, and all of a sudden, we start seeing people are living longer and living more healthily. And that happened 1850s kind of time.
Now we're in 2025, and we're doing a really, not a good enough job of treating mental illness, rates seem to be going up, especially in the young, it's kind of a mess. The treatments we have are really blunt tools that keep people on drugs every day for potentially years, have side effects. It's not a good situation. It's kind of like where we were with physical health a couple hundred years ago, almost. So what it took to make a big advance in physical health was a realization of how things work, you know, and could we do something similar in mental health? And I think we could. And so that kind of characterization of, in a sense, rigidity as the problem and plasticity, changeability as the solution or at least one half of the solution because you want to change people in a good direction, I'm excited about that. And I think, I feel that there's a good, it's a good combination, psychedelic therapy and the approach and functional medicine and the philosophy there. I'm excited about that partnership in a sense, yeah.
Kalea Wattles:
Beautifully said. I want to just take this opportunity to express gratitude for joining us at AIC and for sharing all of your insights today and for the brave and pioneering work that you do to advance the field of mental health research. So thank you so much for being with us today. It's just been a pleasure to chat with you.
Robin Carhart-Harris:
Well, thank you, it's been my pleasure and privilege.
Kalea Wattles:
We’ll see you next time, everyone.
Kalea Wattles [Voice over]:
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