TRANSCRIPT – Psychedelics & Post Traumatic Stress Disorder | Rick Doblin [EP18]

 
This interview was originally produced as a podcast episode. We strongly encourage you to listen to the audio, which includes emotion and emphasis that’s not on the page. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please check the corresponding audio before quoting in print.

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LL: Hello powerful visionaries of EntheoNation. This is Lorna Liana, your host today, and we are here with a researcher in the world of psychedelics and legalization. His name is Rick Doblin and he’s the founder and executive director of the Multidisciplinary Association for Psychedelic Studies, otherwise known as MAPS.
He received his doctorate in Public Policy from Harvard Kennedy School of Government where he wrote his dissertation on the regulation of the medical uses of psychedelics and marijuana. Rick studied with Dr. Stanislov Grof and was one of the first to be certified as a Holotropic Breathwork practitioner. His professional goal is to become a legally licensed psychedelic therapist.
So welcome to the show today Rick. I’d love to hear more about the work that you do through MAPS. Would you share that with us please?
RD: Yeah. Thank you Lorna. It’s a pleasure to be here with you and all the people that are participating here. MAPS Is basically a non-profit psychedelic and medical marijuana pharmaceutical company and our goal is to develop these drops into federally legal FDA approved and European Medicines Agency approved prescription medications. At the same time we have some public education missions so we have a lot of educational work that we do and we also are trying to facilitate the main streaming of these drugs, not just for medical purposes but for other purposes.
And one of the ways that we do that is through envisioning a post-prohibition world and looking at how we can do psychedelic harm reduction. And we’re looking at festivals like Boom Festival in Portugal, Burning Man, Africa Burn, Envision in Costa Rica.
LL: I’ll be there!
RD: Oh you’re gonna go to Envision? Great! Well we’re gonna have a MAPS group there that owns the sanctuary space. So we try to provide trained therapists, sometimes physicians, others to facilitate when people get into difficult experiences and show that difficult is not the same as bad and if you can recognize that things come up and you need to work through them, then people often in a short period of time can go back to the party. Whereas otherwise they might’ve been arrested or taken off to an emergency room and tranquilized or something like that.
LL: Oh my gosh, the ultimate buzz kill right there.
RD: Yeah. So we’re trying to facilitate the transition through difficult experiences and also in our culture at large to do that. And then we also look at areas where science is being blocked by political reasons. And right now, ironically, it’s easier to do research with LSD than with marijuana. And so we do a lot of work with medical marijuana research and the federal obstructions and barriers to research.
We recently got a $2 million grant from the state of Colorado for marijuana PTSD studies. We’re also going to be working with some veterans, U.S veterans who go down to Peru for ayahuasca to help them deal with their Post Traumatic Stress Disorder and we’re primarily doing work with MDMA for Post Traumatic Stress Disorder. So MAPS is both pharmaceutical drug research, public education, and then some political work to open the door to scientific research.
LL: Wow that’s really interesting the work that you’re doing. And so I wanna just dive into different aspects of this, starting with the festival work that you do. I remember hearing about the sanctuary years ago and I thought it was just utterly cool and like very needed to have a safe space for people that were just having a visionary experience in an environment like the playa where it can be very dehydrating, very confusing, and hot. And so to be able to find a place to go to where you can just chill out and drink water and rehydrate yourself and not have to deal with emergency services and people rushing you on a stretcher or some ambulance, when really just all you need is like shade and water.
I thought that was an amazing thing and so hearing about the sanctuary and the fact that you work with people who are trained and who are therapists is wonderful. So tell me more about these services that you provide in these festival environments. How does it work and what are you typically dealing with, and how do you deal with them?
RD: Well in addition to food and water, or shade and water, people need to feel safe. That’s the fundamental things. So vice president Biden was a senator in round 2000 and passed a bill that criminalized harm reduction efforts. It was called the “RAVE” Act – Reducing America’s Vulnerability to Ecstasy. And happened earlier before during the crack epidemic is that laws had been passed that criminalized people that ran abandoned buildings and owned them or that rented out houses where people would go to do crack, and it criminalized the landlords.
And so that same statute idea, what it did was if people offered harm reduction services that meant that they were aware that drugs were being used in their facilities and then they could be prosecuted for that. So it had a perverse affect in that it make drug use more risky rather than less risky. So that’s the environment. So what we try to do is look internationally. And so we’ve worked in Portugal at the Boom Festival, which is the world’s example of psychedelic harm reduction. There’s police on the fest and we’ve worked at Burning Man and Africa Burn and Envision and other festivals around the world.
And so the essence of what we do is to provide places where therapists, physicians, people who are volunteers in these areas, we’ll provide safe space for people to work through challenging emotional issues. We screen them for physical issues and if there’s anything physical they go off to the medical staff. And so we’ve got four basic principles of how we operate; and the first is to create a safe space because they need to feel protected. And that’s similar to what we do in the therapeutic world; people in our research, people know that they are safe that they can explore inner worlds, that they’re protected from intrusion, that they don’t have to respond to the phone or the door, that no one can abuse them or steal their stuff or anything like that and they can relax and go inner and they can deal with what’s working with them.
So the other principle for us is that we are sitting, not guiding. And what that means is that sometimes when people come to us in these festivals, most of the time you’ve never seen them before. We’re not their guide, that’s a common word used in psychedelic circles where you’re guiding somebody. Or a shaman is your guide or something like that. So our view is that the person’s unconscious is the guide, that their own inner healing intelligence is really the guide and we have a non-directive approach. So we are sitting with people, we’re helping facilitate them to deal with what’s coming up.
But what we’re following is their own inner guide, and that’s really helpful because we often think that in a therapeutic situation the therapist has to know the person’s history, they have to spend all this time with in order to be therapeutic. And we find that that’s very helpful, the more knowledge there is about the person that you’re with, the better. But at the same time, you can be therapeutic and support people through difficult experiences without ever having met them before because the non-directive approach and letting them be the guide with what they’re – and you offer questions, you offer support, you sometimes can give insights of what it seems like to you. But you’re a safe, supportive presence for them to do the work.
And it’s also, in some ways I make a distinction between certain kinds of shamanism, where the classic example the shaman takes the drug and he heals you. Like a doctor heals you. And this is the opposite of that where the power dynamics there, the shaman is the one that’s healing you. You’re not healing yourself. And so we’re saying that people heal themselves and that’s the way that they become the most independent and the strongest and grow the most. And we do that by honoring the inner guide, the inner intelligence. We support that, we are sitting, not guiding.
Then the third principle of the work that we do at festivals and the psychedelic harm reduction, we call this “talk through, not talk down”. And what that means is we guide people into the problems. By guide I mean ask them questions, draw their attention to, but still the guide is their own inner unconscious. But the idea here is that we’re not saying to people, “Look, you’ve taken a drug, it’s going to go away in a certain period of time, and so just think about happy things for as long as you can. And eventually it’ll be all okay. Look at this beautiful flower!” That’s the idea of talking somebody down.
But we talk them through. We’re like, “Okay, what is bothering you? What are you scared of?” “Oh I’m scared I’m gonna die.” “Well what makes you think you’re dying? What does that feel like? Could that be interpreted as ego death rather than physical death?” Because we also have medical staff to screen them to make sure they’re not actually dying.
LL: [Laughs] That’s key!
RD: So it’s like the symbolic ego death and so it’s the death-rebirth process that we encourage people to think in that kind of metaphor. Talk through, not talk down. And then the fourth principle is that difficult is not the same as bad. And I think that’s really important. For people, actually a lot of times at festivals where they’ve got to have a good time, and they’ve taken these drugs and they’re with their friends and they’re in a party setting, and then something get’s difficult. They remember a past trauma or they feel lonely, or they feel isolated or lost, or something starts spiralling them down into this sort of negative emotions and they think, “Okay this is now a bad trip. I gotta get out of it.”
And again we say, “This is difficult, but it’s valuable. Don’t run away from it. There’s something that you can learn from it. This is really important. Honor whatever is happening.” And that’s actually sort of mindfulness meditation, that you watch what’s happening. You don’t try to push it away, you don’t try to get attached to it, but that you honor whatever’s coming up and you let it flow through you. And so we’re saying if something difficult is coming up, there’s a good chance that there’s something there for you to learn. And don’t shut it down by deciding that it’s a bad trip. Think about it as a difficult experience, you can even say like exercise is difficult, but you grow stronger from it.
And so we help reframe people’s perception that this is something that they have to resist – it’s a bad trip that they have to resist and we say the way out is through. This is something that your psyche is bringing to your consciousness for healing purposes, for you to grow, for you to learn, and you’re safe. And then we usually have, we try to have a male-female team. We try to have heavily staffed sanctuary centres or we call it the ‘Zendo Project’ at Burning Man, Africa Burn it’s ‘Sanctuary Project’, different names in different places. ‘Cosmic care’ is what it’s called at Boom Festival and we try to say that if we can have a male-female team, cause people will feel the safest in that way.
And also that the people that are with them have 6-8 hour shifts. And so we can be with people for hours and hours and hours. People can actually spend days in these centres while they go through stuff, they fall asleep, they feel better, then they go off to party. So there’s a window of safety that extends for days sometimes where people get support. Now people will go off their shift and other people will come help them, but that’s the basic idea.
And so what we’re trying to show is that if we can overcome the criminalization of these harm reduction efforts that a post-prohibition world is not gonna end drug problems, particularly when we talk about powerful psychedelics. That a post-prohibition world needs to have ways in which people are supported when problems arise and often, even in the therapy, what we notice is that it’s not so much about the experience – although it is very much about that – but it’s about the integration. What happens after you’ve had the experience.
Let’s say you’ve had the greatest insights, but how do you put it into practice in your life? How do you reinforce what happened in this non-ordinary state of consciousness to make it so that it makes a fundamental change in your ordinary state of consciousness? And that requires work, that requires maturity, that requires integration process, and we don’t often have that opportunity when people come at festivals. But in a therapeutic setting and sometimes even at festivals, you try to keep in touch with people because it’s about what you bring back from these experiences more so than the short term “what happens when you’re there”.
LL: Okay that’s like really valuable work that you’re doing because that is an area in the psychedelic world that is really kind of vastly lacking, which is that integrative support system and then also like especially the harm reduction too. Because I think it’s because you’re working with such powerful psychedelic substances, you’re really opening your psyche up in ways that normally your ego has your internal world rather protected. And so by opening yourself up in such a way, especially in an environment that can be a little extreme or where there’s a lot of stimulus, the potential for emerging from that experience can be even more traumatized could be quite high.
So I’m really glad that you’re doing this layer of work that’s very needed. I’m curious to know about the other body of research you’re doing around working with psychedelics and Post Traumatic Stress Disorder because they do seem very sort of aligned or linked in a certain way. In one case we’re dealing with kind of situational, potential situational trauma and easing away of that, mitigating those traumas. And then in the other case we’re dealing with individuals that have been experiencing perhaps prolonged trauma in scenarios like war, or with abuse.
So what have you seen in terms of which psychedelic substances have you found to be the most effective in treating PTSD, and do they work in different ways?
RD: Yes, that’s a very good question. So I think what we’re wanting to get to is the legitimization of psychedelic psychotherapy where different psychedelics can be used at different times in the healing process. And they all have their different benefits and different challenges. Right now because of the research we’re only able to research one thing at a time. But we are trying to develop an expertise in treating trauma. So we’ve got a series of studies that we’ve been doing over the last 10 years with MDMA for Post Traumatic Stress Disorder. We just got a $2 million grant for the state of Colorado to study marijuana for Traumatic Stress.
We’re also doing an observational study that’s just in the design stage now, of veterans from the U.S who’ve been down to Peru to take ayahuasca for Traumatic Stress Disorder. So what we found is that the essence of Traumatic Stress Disorder is that people have been traumatized, sometimes over an extended period of time, sometimes just once and that forever reason they can’t get beyond it. They can’t integrate it into their lives, and they can’t sort of forget it so that it’s more present all the time. Wherever they are they are jumpy, they feel anxious, they withdraw, they’re in emotional numbing, they’re hyper reactive. There’s a whole series of intrusive behaviors that happen.
So what we are looking at with MDMA, I think that I would say that both MDMA and ayahuasca are more in the direction of trying to help people get to the core of their issues. And ‘cure’ is a delicate word, but durable remission of symptoms. Where are marijuana is a reduction of symptoms but it’s a daily medication that people need to keep using. So it doesn’t, it’s more about palliative care with marijuana whereas MDMA or ayahuasca or psilocybin or LSD are more about trying to get to a cure.
But MDMA offers an advantage over ayahuasca, psilocybin, LSD, in that it’s more gentle and it has a more direct effect reducing the fear response to emotional trauma. And we find that MDMA actually in some neuroscience studies has been shown to reduce the processing of the amygdala, the part of the brain where fear is processed, so that people can sort of recall traumatic experiences without feeling so fearful. And then MDMA also stimulates oxytocin and prolactin, which are hormones of nurturing, bonding with nursing mothers, that it connects people. It’s the opposite you could say of this feeing of alienation and fear. It’s the feeling of connection.
And in fact, there’s been a scientific paper by a Dr. Torsten Passie comparing the post-orgasmic state to the MDMA state and finding a lot hormonal similarities. And so I think in a ways that’s one of the best ways to think about MDMA as like the post-orgasmic state. It’s like you’re there, you’re not striving, you’re feeling connected, you’re feeling warm, you’re feeling loving. And that is the peaceful state then that we help people go to look at their trauma from that grounding in the peacefulness.
And so our basic approach with MDMA is a three month therapy process where there’s weekly non-drug psychotherapy for about three weeks. Then to prepare people to build a therapeutic alliance, we have male-female co-therapist themes. Then people have a day long MDMA experience, eight hours from 10 in the morning till six at night. Usually around 100-125 milligrams per kilogram and then after two hours of so there’s a supplemental dose of half the initial dose to prolong this therapeutic plateau.
Then people spend the night in the treatment centre to reflect, to give themselves time. MDMA can be exhausting for people so you need to rest afterwards. And then there’s integrative psychotherapy for several hours the next day, then people go home and we call them every day on the phone for a week, checking in on how they’re integrating. And then they come back for weekly non-drug psychotherapy for about a month and integrating what happened and preparing for the next experience. And then we repeat that cycle three times.
So they get three MDMA experiences a month apart, each a month apart, and then we have several weeks of non-drug psychotherapy, and then we check them at two months and one year. Or in our first study since it took a long time to do, we check people on average of three and a half years. And that’s our basic model and we’re trying to help it so that people don’t need any drugs after it.
Marijuana is a different model; Marijuana is daily use of marijuana at night to help people not have nightmares, to focus them more on the present, to build a little bit of a positive more. Some people marijuana makes more anxious, so again it’s not gonna work for everybody, but it does – it’s a palliative treatment. Ayahuasca is more about helping people have this kind of unitive spiritual experience and at the same time it also helps people work through issues of their biography, things that have happened to them in their lives.
So ideally I would say in the future situation, maybe 10 years from now, legally we would probably start people who had trauma with MDMA, give them a couple experiences for how you can deal with fearful things from a safe perspective. Then we would switch to something like ayahuasca or LSD or psilocybin for more of this sort of transcendence of the spiritual unitive experience. And then we would sort of finish up with more MDMA to help integrate and ground. And then during this period people could use marijuana if they wanted to, but not during the treatment – not during the acute treatment periods. Cause you want actually the symptoms to increase before hand so that they’re closer to the surface so that when we do the therapy.
So we require people to stop all their psychiatric medications that they’re on, to taper off of them. Actually people do get worse sometimes in terms of their symptoms, but at the same time people start getting hope for this treatment. So sometimes they get in a position and they’re so relieved to be off the psychiatric medications, which usually just tranquilize, dampen, don’t really solve the problems, they’re meant to be daily medications. You know they’re meant to be major profit centres for the pharmaceutical industry. But they’re not really ideal for treatment of trauma.
So that’s sort of the general overview of how it is that we are trying to treat trauma. We think that by the summer of 2015 we’ll have treated about 90 people for Post Traumatic Stress Disorder with MDMA. It will cost us about $4 million, we’ll have spent to that point. It’s really expensive to do this research. We anticipate we’re gonna need to treat around 400 more at a cost of about $18 million. So we’re looking for donors to MAPS, it’s all tax-deductible – Maps.org.
And we are anticipating by 2021 that we’ll have all the research available for presentation to the European Medicines Agency and the FDA to make MDMA into a prescription medicine and it will then only be available by prescription by trained therapists probably in special treatment centres like kidney dialysis or methadone centres where you go to a special place that’s really set up for this with people that are trained in it’s use. And the model for us there is the hospice centre.
So in the 60’s people were scared of dying, birth was medicalized, women were tranquilized, yoga was weird, meditation was a weird import. And so in 1974 was the first hospice centre where people weren’t sort of medicated out of awareness as they died, but were helped to have kind of a more conscious death. And by 2004, 30 years later, there was over 3,500 hospices in pretty much every city of a certain size in America.
And that’s what we anticipate will happen with psychedelic treatment centres, that starting in 2021 we’ll have these legal medicines, MDMA and probably also psilocybin through the Hefter group, and we’ll set up these psychedelic clinics and they will proliferate gradually so that maybe 30-35 years from now we will have a fully mainstream psychedelic psychotherapy options. And we’ll have gone beyond prohibition, people will have these experiences legally for therapy, for personal growth, for religious inspirations, for celebrations at festivals where we’ll have harm reduction in place.
And I think that’ll be a key towards really helping our species get more spiritual and more able to survive. Less able to demonize the others, more sense of “we’re all in it together”. And I think that psychedelics and the mainstreaming of psychedelics can take a major role in the transformation of the human psyche and the survival of the human species.
LL: Wow I commend you on this tremendous work that you’ve done. It sounds like it was a very prolonged battle to get your MDMA research the spar, so I really do hope that we find ourselves getting closer to that vision that you just shared with us. I would love to ask you to share a little bit about what you’ve seen with the use of psilocybin and end of life work.
RD: Yeah. It’s a little bit harder for me to speak about that because MAPS is not funding that research. That’s funded by the Hefter Research Institute. And so I would just encourage you to interview some people from Hefter to talk about that. We are however, we just finished a study with LSD for end of life work. So LSD, you know, there’s a psychedelic renaissance right now, there’s more research with psychedelics than at any time in the last 40 years, and the classic psychedelic boogyman is LSD.
And so the research with LSD was the last of the psychedelics to really get approved for research and the way we were able to do that was in Switzerland with people that were anxious about a life threatening illness. And so that’s pretty similar to the psilocybin work, the work with LSD for end of life. And what I’m most proud of is that in that study of 12 people, 11 of the 12 had never done LSD before. So what we’re showing is that this drug, which sort of dissolves the ego, brings things to the surface, helps people deal with their fears and then also can help people have the spiritual sense of connection from which they can draw strength. It gives them a certain transcendence of time and space sometimes, the sense of this enormous billions and billions of years of the sweep of human history. So people can relax about dying, they see that it’s a natural process, that there would be no life without death, that it’s not something to be feared, it’s something to be appreciated, that it makes you appreciate life even more while you have it, it’s even more precious.
So that the work that we did with LSD was published in the Journal of Nervous and Mental Disease and we were able to demonstrate that in people who had not come from the psychedelic culture who were just facing life threatening challenges and were anxious about it that through LSD-assisted psychotherapy they were able to come to a better appreciation of the life that they did have left and that their anxiety and depression would go down. And we’re about to start a study in San Anselmo, California, north of San Francisco with MDMA for people with life threatening illnesses with anxiety. And I think that our culture in general, people are more scared of dying than they are of drugs.
LL: [Laughs]
RD: So if we can use drugs wisely to help people with the death process and the dying process, then that will be a big doorway into the culture, and I think that’s what’s happening. And so working with PTSD, working with end of life, and then the third main area is treating addiction with psychedelics. So we’ve done work with researching ibogaine and ayahuasca in the treatment of addiction. So I think that, you know, Bill W. started AA. He had an LSD experience in the 50’s and he thought that that could be really helpful in helping people overcome alcoholism. And he’s written about it in the book “Pass it On”. He previously was sober, but then he tried LSD and found that it could be even more helpful.
So I think the idea with people struggling with addiction, a lot of times it’s sort of interrupted spirituality. They feel isolated, they feel alone, they reject themselves. And if you can help people through psychedelics to look at what they’ve previously tried to deny, look at what they’ve suppressed, accept themselves, feel a spiritual connection. And then it’s a way to show the culture that it’s not the drugs that are good or bad in themselves, it’s how they’re used.
And that that’s really the fundamental flaw of prohibition is that it’s invested certain properties; “These are good drugs, they’re legal. These are bad drugs, they’re illegal.” And it’s about the relationship rather than the thing itself that really determines benefits or risks and that that’s what we really need to get our culture back to, to throw away prohibition and focus on these relationships. And I think with psychedelics and the treatment of addiction that’s a really obvious lesson in a way; that if we can use drugs that are considered schedule 1 drugs of abuse, to help people with drug abuse problems, people will start thinking, “Okay, it’s how they use it that really matters.”
And then the fourth main area of research is really just psychedelic neuroscience; how it is that we can learn about the brain, learn about consciousness by studying the brain under the influence of psychedelics and also psychedelic spirituality. So all of this is really helping me have confidence that over the next generation and then sooner in some ways that we will be able to mainstream psychedelics just in time because we desperately need it as a human species.
LL: I love it. Thank you so much for sharing with us your vision for a more visionary world, and especially with the tapping into the power of therapy and healing that psychedelics can offer us if used in the right ways.
So we’re at the end of our interview, I’d love to leave with you a question that I love to ask visionaries. So Rick, would you mind sharing with us, what was the most visionary or out of the world experience you’ve had and how did it affect you so that you were able to derive lasting wisdom from that experience?
RD: Okay well, I don’t wanna – I usually resist this idea of “this was the one most best”, but I’ll just share one of a series of experiences that stands out. And this was under the influence of MDMA, I was camping out by myself in California on the edge of the cliffs right by the ocean. I found a little spot that the waves didn’t come to, so I just had – and I did it at night. So with the vast starry expanse and the ocean roaring in front of me and the mountain cliffs coming right behind me.
And at one point I felt like I would just disappear into the universe, and it was a little bit scary. Like I was such a small little speck in this enormous universe. And then I started recognizing that for some reason I wasn’t disappearing and I started thinking that there was something woven into the structure of the universe that sort of kept me there. And I felt that that was gravity, and I felt that somehow or other then this gravity was like cradling me. It was like the arms of a woman; I was being cradled in the arms of gravity and I felt this warmth and it was like this connection to love of a universal nature.
And I was also trying to ponder that same night about the life of a monk. Brother David Steindl-Rast is a Roman Catholic monk that I have a lot of respect for and I learned a lot from. And I started wondering, “Why would somebody want a celibate life? And what is that like?” And so during this experience of being cradled in the arms of gravity, it felt like a human. It felt like I was in a woman’s arms. It felt like I was sort of personalizing the universe in a way. So it was like that transcendent universal love. And I’ve kept that feeling with me and I’ve never felt as lonely, ever, since then.
LL: Fantastic. Thank you so much for sharing that experience with us. How can we best stay in touch with you Rick?
RD: Well Maps.org, we have a monthly email newsletter and if you wanna ask any questions of me personally, askmaps@maps.org, and staff will filter it and it’ll come to me. If you have questions for me or any general questions. And of course people can donate to MAPS and become a MAPS member, but if everybody just gives what they can. One week we got a donation of $250,000 from one person and then we got a letter from a drug lord prisoner that had 8 stamps, which was the extent of his worldly goods. And that was more of what he had than the person who gave us the $250,000. And so, you know, we’ll all just work together and eventually we’ll have a psychedelic culture.
LL: I love it! Thank you so much. You have a beautiful day.
RD: Thank you Lorna.
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