“How To Change Your Mind,” a new four-part documentary about psychedelics, has been hovering around Netflix’s Top 10 this summer. As someone who benefited immensely from therapeutic psychedelics, I am encouraged each time a documentary like this emerges into the mainstream, another sign that these important and beneficial medicines are gaining wider social acceptance.
Yet I find myself surprised by this documentary’s presentation, with each episode focusing on the chemistry and history of a different psychedelic agent. Yes, the molecules are different, but they all take you to the relatively same place: What matters for therapy and healing is how the experience is processed when the drug wears off.
A leading underground clinician in the psychedelic therapy space once told me, “If MDMA [Ecstasy] cured PTSD, then anyone who attended a rave would be healed of their experiences of trauma.”
These words rang true for me, given my experience in the once shadowy world of therapeutic psychedelics, which helped to treat the severe PTSD I had been living with for more than a decade after surviving the 2008 terrorist attack in Mumbai. It was a transformative healing experience, and I am grateful to the guides and clinicians who supported me through the process.
But these treatments are expensive and hard to access. Having had the good fortune of an early and successful hedge fund career, I was in a position to afford them, and could then afford to become a venture capitalist and philanthropist in the therapeutic psychedelics space. My strategy: focus on the delivery, not the drug. Here’s why:
As discourse around the mental and physiological benefits of psychedelic-based treatment moves more into the mainstream, the popular press and the investment dollars that follow — a $2 billion market in 2020 that is estimated to grow to nearly $11 billion by 2027 — are almost entirely focused on the development and testing of molecules.
To be sure, these substances facilitate profound phenomenological experiences. But the difference between a profound drug experience and profound therapy experience has everything to do with context and container — everything surrounding the psychedelic experience to make sure it is beneficial, safe, and integrated into one’s life — not the chemicals themselves. Psychedelics by themselves are nonspecific personality amplifiers. They blow through defense mechanisms, making a user more comfortable with and less defensive about who they are on the inside. This is a powerful experience, but not necessarily a healing one.
Stripping away psychological defenses is an experience often described as temporary ego death, but it also induces the sort of neuroplasticity that can actually reshape the brain in a more lasting way, if done as part of therapeutic work with a skilled clinician. Otherwise, any epiphanies or catharses fade out of memory and, without doing the therapeutic work that changes the body’s physiological responses to traumatic memories and lived experiences, a person will fail to break out of the recursive psychological loops that are causing their suffering.
In a focused, discerning setting guided by a well-prepared clinician, individuals can take advantage of this neuroplasticity to rewire associations with past events and current lived truths. That’s what this sort of healing is all about: finding physiological calm with the lived experiences and truths of one’s life by rewiring harmful brain pathways that otherwise would have remained in place. The experience allows a person to ask, “What energy do I want to bring to this memory or fact of life that has caused my suffering? What adaptations have I used in the past that are no longer working? How might I re-adapt?”
Psychedelic therapy is an opening to this process of changing associations, not the end.
Some practitioners have the skill to guide this process, and some don’t. (I try not to hold a grudge against the underground guide, well-credentialed in her above-ground field, who overdosed me with a methamphetamine-infused version of MDMA.) To receive safe treatment, individuals must work with therapists or healers who know their stuff.
Each of the elements that creates context and container for psychedelic therapies would benefit from concerted scientific study. I hope the next wave of investment will shift its focus to delivery, to context and container — not on finding new drugs but how to incorporate them into affordable, accessible therapeutic settings. My investment strategy focuses on modes of treatment, not molecules, because at the end of the day, that’s what matters most to the healing process. Investing in research on the therapeutic process, and continuing to replicate and learn from best practices, will facilitate the implementation, refinement, and standardization of protocols and procedures that yield healing results.
The lessons and best practices unearthed by clinical research into psychedelic-based treatment will help establish standards and, in the process, make this treatment something almost everyone can access and afford. This sort of concerted study, along with advocacy and regulation, will lead to a wider societal acceptance of psychedelic therapy as a valid and effective mode of mental health treatment. Without it, these treatments will never reach many of the people who could most benefit from them.
Different psychedelics have been in use in different cultural and historical contexts for centuries, if not millennia. Focusing on the differences in these substances makes for compelling television, but it is the shared potential for facilitating experiences of healing that makes this new frontier in mental health treatment so exciting and necessary — and demonstrates the need for a robust research agenda to create a therapeutic framework that embraces this truth.
Michael Pollack is the founder of the SCA Charitable Foundation, a New York-based foundation supporting social entrepreneurs.