Clinical Studies Reveal Uncharted Evolutionary Potential of Therapeutic Uses of Psilocybin
Dr. Robin Carhart-Harris is a pioneer for his clinical studies using psychedelics: how they affect the brain and corresponding therapeutic applications for mental health. His research demonstrates unprecedented positive outcomes in patients who have treatment-resistant depression (TRD). Through functional magnetic resonance imaging (fMRI), Robin's groundbreaking studies also illustrate a relationship between significant changes in patients' brain activity and their reported experiences of "ego dissolution" and "altered meaning."
Beginning with his first groundbreaking study in 2016, Robin continues to expand our understanding of how psychedelics could, if legalized, be used therapeutically to treat a variety medical conditions, while furthering our understanding of human consciousness in unprecedented ways.
A psychologist and neuroscientist, Robin is Head of the Centre for Psychedelic Research, Division of Brain Sciences, Faculty of Medicine, Imperial College London, and he is renowned for his published research, articles, and numerous talks including his TEDx talk, Psychedelics: Lifting the Veil, which has more than 680,000 views.
With his doctorate in psychopharmacology, background in depth psychology, and successful clinical trials, Robin continues to prove the value of exploring the functions of the brain, our consciousness, and our experience in a way that a therapeutic use of psilocybin facilitates.
Robin: I suppose it can be best defined as a desire to understand how taking psychedelics works. That naturally takes me to biology, and also it takes me to psychology because whenever we're looking at subjective experience, that requires that we equally weight our efforts to understand the mind, the experiential component, and the biological component.
Robin: It is. I have a master's degree in psychoanalysis and have had my own analysis. So, I combine that with how I'm more thoroughly trained, which is in psychopharmacology. It's quite a unique marriage to have that schooling in depth psychology, the approach to the human mind that assumes and studies the unconscious mind, assumes the existence of it, plus my schooling in the biology of the mind and brain.
Robin: We played a critical role in that link. In 2011 Charlie Grob at UCLA, a bit of an unsung hero, published in the American Journal of Psychiatry on a clinical trial in end-of-life distress. He reported significant changes in people's anxiety and depression scores. We cited that work, and we took inspiration from some brain imaging work that we've done with psilocybin in addition to our landmark brain imaging work with psilocybin which was the first fMRI research.
The work was published in PNAS, a prestigious journal. We found that psilocybin was altering brain activity in a way that was suggestive of it having antidepressant properties. And then people would say they felt really good afterwards.
So, putting that together with what Roland Griffiths had shown in healthy people and Charlie Grob had shown in end-of-life distress, we wrote a grant application to the UK Medical Research Counsel to do the first depression trial in this modern era.
Robin: Yes. In 2012 we wrote the grants, and then it took us three years to do the study and complete it once we were allowed to do the study and got the drug, which was a huge challenge. That was a long road, and we finally got there in 2015 and published the study in 2016.
It was wonderful. I mean, the road was hard, and carrying out the trial was very challenging.
Robin: Yes. You have to be careful in your screening, and then you're dealing with people's souls really. It's very deep treatment, so people come in who are profoundly suffering and have histories of profound suffering. And then you're giving them this huge experience that lays it all out, and it's draining. It's beautiful when it works, but it's a hero's journey for all concerned. It's not an easy process.
Robin: I use it in a poetic sense. I don't appeal to the supernatural.
Robin: My training consisted of having mentorship from a therapist who worked in the ‘60s with psychedelics, Bill Richards, and psychiatrist Jeffrey Guss. Bill Richards has written a wonderful book on psychedelic therapy called Sacred Knowledge. He would advise us on things like trust, let go, be open, be willing to confront whatever arises, work through material, don't try and bypass it.
It's asking the patient to bravely face and confront this stuff that hurts them. And in doing so the principle is that one can better assimilate whatever complex trauma one has in one's being and then process it, sit with it, accept it. That doesn't mean it goes away entirely, but you're okay with it and you can go forwards.
Robin: That's it. Absolutely. It's really bang-on in terms of what this treatment model is.
Robin: For the next five years I would love to see psychedelic therapy to be part of what is licensed and approved for people with specific psychiatric disorders. Psychotherapists are getting excited because there can be so much frustration, effort, and work and little progress. Now they're really seeing the progress when they add in this pharmacological catalyst. The clinical medical world is embracing this, and patients are embracing it.
And then people think, "Is there reason to think that we could open this up to healthy people as well that want to explore their minds and potentially benefit?"
I would love to see in the next 10 years fully licensed and are legal retreats where people go and take psychedelic plant medicines in a facilitated way.
Robin: You don't, but it's kind of fun to try and predict the future. If people through having psychedelic experiences are changing in a positive way in terms of changing their lifestyle in a healthier way, changing their awareness in a healthier way where they're being kinder to themselves and feeling more connected within themselves and to other people and to nature, then one would like to think that that broadening awareness could have carryover effects into their behaviors around diet in terms of the impact of the farming industry, on the climate and on the meat industry.
If change is happening in a positive way through an upscale and responsible use of psychedelic plant medicines, and if people who have direct exposure are being healed in a healthier way then culture will change.
That's what I'm hoping for: a positive cultural shift away from individualism towards a healthier collectivism, which is what we need when we all share this one spaceship, planet earth spinning around the sun.