So like trying to mix oil and water. Most people assume that science and spirituality don’t play well together, but it’s not true. Einstein said that the most beautiful and profound emotion we can experience is the sensation of the mystical. He said it’s the source of all true science. Today, I want to tell you about research with the classic psychedelic psilocybin that is showing that, “under supportive conditions psilocybin can occasion mystical-type experiences associated with enduring positive changes in attitudes, mood, and behavior”. The results are fascinating. In their own right have implications for medical therapeutics and implications as well for the nature of consciousness and ethics and altruism.
So by way of background, I’ve been conducting research on mood-altering drugs for the past 40 years. About 20 years ago, I started a meditation practice that profoundly shifted my worldview and got me very curious about the nature of spiritual experience, became reacquainted with research conducted mostly in the 1950s and 60s, showing that under some conditions, classic hallucinogens like psilocybin could occasion mystical experiences that look very much like those that occur naturally and that had been reported by mystics throughout the ages.
I became interested in psilocybin. Psilocybin is the principal psychoactive component of the philosophy genus of mushroom. Psilocybin in the form of these mushrooms had been used for hundreds, possibly thousands of years within various cultures for healing and spiritual purposes. While I was interested in studying psilocybin, research with this whole class of compounds had been blocked for decades because the risks which are real, but they’re manageable, were thought to totally outweigh the benefits. So it seemed like a long shot at the time that my colleagues and I saw it and ultimately obtained approval to administer psilocybin to healthy volunteers who had never before had an experience with this class of drugs.
And as I’ll show you, the results were life-changing for many of those participants and turned out to be career-changing for me because psilocybin has become one principal focus of my research program. So what I want to do today is tell you about the Johns Hopkins Psilocybin Research Project. It’s in its 15th year. We’ve given psilocybin to over about 250 volunteers over 600 sessions. I’m going to tell you about psilocybin studies in healthy volunteers, in cancer patients, smokers, long-term meditators, and end with some conclusions.
So we’ve conducted 3 rigorous double-blind studies in healthy volunteers. We’ve looked at dose effects with added controls for expectancy kinds of things. And, these sessions for these studies are held in a living room-like environment. Before the first session, volunteers develop a trusting relationship with our session monitors, which reduces the adverse effects of psilocybin. On session days, volunteers come in. They swallow a capsule. They’re encouraged to lay on a couch, use eye masks, and headphones through which they listen to a musical program and direct their attention inward. If fear or anxiety arises, then the monitors are there to provide reassurance.
So, not surprisingly, a high dose of psilocybin under these conditions produces hallucinogen like effects. So there are perceptual changes like visual illusions. There’s greater emotionality like an increased sense of joy, less frequently fear, and their cognitive changes. But to me the most interesting effect was that in most volunteers studied, psilocybin produced great increases in questionnaires that had been specifically designed to measure naturally occurring mystical experiences. These experiences are characterized by a sense of unity, feeling that all people and things are connected, accompanied by a sense of sacredness, a sense of positive mood, love, joy, and a deeply felt sense of encountering ultimate reality. These experiences are felt to be more real and more true than everyday waking consciousness.
Now psilocybin is a relatively short-acting drug. So by the end of the session day, these effects are gone, but vivid memories for these salient experiences endure. In one study, we had volunteers return a month after each session to complete some questionnaires. 80% of the volunteers in that study, after having one or two high doses of psilocybin reported that the experience was among the 5 most personally meaningful and spiritually significant experiences of their lives. In fact, about 50% said it was the single most personally and spiritually significant experience of their life comparing it, for instance, to the birth of a firstborn child or death of a parent. These are stunning and remarkable findings.
Long term follow up of these kinds of effects shows that they’re sustained. These positive effects are sustained for at least a year and probably longer. And it wasn’t just the volunteers who reported these effects. We did structured interviews with friends, family members, and colleagues at work and these statistically verified the volunteers’ reports.
So we’ve continued this whole line of research over the last several years and studied other populations. The first of which is psychologically distressed cancer patients. So we’ve recently completed a study in 51 cancer patients with a life-threatening cancer diagnosis who met clinical criteria for having depression or anxiety disorder. These volunteers were randomly assigned to receive either a low dose or a high dose of psilocybin under double-blind conditions.
Now, these results are still preliminary, but they’re very promising. And what this graph shows is the percentage of volunteers showing clinically significant improvement in a depressed mood. The orange bar shows that 92% of those people who received the high dose of psilocybin, 5 weeks after the session were reporting or were showing clinically significant improvements much greater than the green bar that shows the effects after the low dose of psilocybin. The blue bar shows that the effects of this high dose of psilocybin are sustained out to 6 months. So about 80% are contained to show clinically significant improvement and in fact, in 70% of these, the symptoms have remitted to the normal range, we’re showing similar effects for anxiety.
These effects are really quite remarkable. What we’re showing here is a single exposure to a substance producing substantial and enduring antidepressant and anxiolytic effects. Such an effect actually is unprecedented within the field of psychiatry.
Another population we’ve looked at are cigarette smokers seeking abstinence. These are long term smokers, multiple failed quit attempts. In our first pilot study, 15 volunteers integrated cognitive behavior therapy for smoking cessation with our supported psilocybin intervention. In this study, volunteers had up to 3 psilocybin sessions. The first session corresponding with their target quit date.
And this graphic shows urinary cotinine, which is the major metabolite of nicotine over the course of the study. You can see in the first 5 weeks, volunteers are showing high levels of cotinine. And that’s consistent with the fact that this is the period where they’re learning the cognitive approach to smoking cessation prior to their quit date. And we hit that target quit date. Urinary cotinine falls dramatically, remains down. At 6 months, we have an 80% abstinence rate. So like the cancer data, these data are remarkable, because 6-month smoking cessation rates generally run in the order of 15 to the best about 30%. So we’re now proceeding with control clinical trials.
Another population I want to talk about is long-term meditators. So I’ve come to think of meditation and psilocybin as being complementary processes for investigation of the nature of mind. And in fact, neuroimaging studies show that they both produce similar changes in brain regions related to a sense of self. Well, if meditation represents the tried and true course for investigation of the nature of mind, then psilocybin surely represents the crash course. And in this case, we’re interested in whether long-term meditators are showing beneficial or perhaps detrimental effects of psilocybin exposure. Again, the data are preliminary, but I can share that most long-term meditators find these experiences to be remarkably insightful, and they report beneficial effects to both their sitting and their non-sitting awareness practices, although none would claim that psilocybin is a substitute for meditation which results in much more stable day to day awareness.
So stepping back, the basic finding here is that psilocybin under these supported conditions can occasion in most people studied mystical-type experiences, having positive long-term changes in attitudes, mood, and behavior.
I want to conclude with 3 implications.
The first is scientific. This is a really interesting effect. And the fact that we can show it reliably, dose-dependently means that we can now turn the tools of science to prospectively investigate the causes and consequences of these effects. We can look at things like neuro brain mechanisms and the effects for instance of genetics or personality or expectation on these effects.
The second implication is the medical therapeutics. Our data with cancer patients are being used by two private sector organizations now, the Heffter Research Institute and the Usona Institute; to ask FDA whether we can now proceed with large scale clinical trials with a goal of seeking approval of psilocybin for the treatment of cancer-related end of life distress. And, obviously, ultimately, end of life distress is not limited to just cancer.
In terms of smoking cessation, our work and studies from other laboratories suggest that there might be a very substantial application of this approach to the treatment of addictions and quite possibly other behaviorally based medical or psychiatric disorders. And there’s a very recent preliminary data suggesting the possibility that psilocybin may have efficacy in treatment-resistant depression.
But the final implication and the one that’s most interesting to me is this. The fact that psilocybin can occasion most people studied mystical-type experiences, virtually identical to those that occur naturally suggests that such experiences are biologically normal. And it raises the question, why are we wired to have this salient, felt to be sacred experiences of encountering the ultimate reality of the interconnectedness of all people and all things, experiences that arguably provide the very basis of our ethical and moral codes common to all the world’s religions.
I think there’s something about the mystical experience that relates intimately to the very nature of consciousness. Just reflect on the mysterious truth, that if you direct your attention inward, you become aware that you’re aware, an indisputable and profound inner knowing arises that we can all access individually and perhaps collectively. I think this inner knowing is at the core of our humanity. We recognize at some deep level that we’re all in this together. And there’s an impulse that arises for mutual caretaking.
I further believe that investigation of this inner knowing through contemplative and other spiritual practices can give rise to profound worldview shifts of an uplifting kind and awakening to a sense of freedom, peace, joy, and gratitude that most people simply find unimaginable.
Excitingly, exploration of the psilocybin occasion, mystical experience seems to provide a model system for rigorous and prospective investigation of these awakening experiences. Further research will surely reveal underlying biological mechanisms of action, which will likely result in an array of therapeutic applications. And more importantly, because such experiences are foundationally related to our moral and our ethical understandings, further research may ultimately prove to be crucial to the very survival of our species.