Psilocybin for Smoking Cessation: A New Era of Psychedelic Research


Episode 174

Matthew W. Johnson, Ph.D.

Matthew W. Johnson, Ph.D. joins Paul F. Austin to share his studies of psilocybin for smoking cessation, cancer distress treatment, and more

In this episode, we feature another special interview recorded at the 2022 Wonderland conference in Miami, FL.

Matthew W. Johnson, Ph.D. is the Susan Hill Ward Endowed Professor of Psychedelics and Consciousness Research at Johns Hopkins. Working with psychedelics since 2004, he is one of the world’s most widely published experts in the field. He has published research on psychedelics and mystical experience, personality change, tobacco smoking cessation, cancer distress treatment, and depression treatment. In 2021, as principal investigator, he received the first grant in 50 years from the US government for a treatment study with a classic psychedelic, specifically psilocybin in the treatment of tobacco addiction. He is also known for his expertise in behavioral economics, addiction, sexual risk behavior, and research with a wide variety of drug classes.

Podcast Highlights

  • How Dr. Johnson’s own life has changed as a result of his years of research, including psilocybin for the treatment of cancer distress.
  • Dr. Johnson’s study on psilocybin for smoking cessation; the first US government-funded study on the therapeutic use of a psychedelic in 50 years.
  • The initial findings of psilocybin vs. nicotine patch as smoking-cessation treatments.
  • How Dr. Johnson plans to contribute to psychedelic research and oversight as the industry grows.
  • Dr. Johnson cautions psychedelic therapists against inappropriately pushing spiritual or religious frameworks onto patients.

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Podcast Transcript

0:00:00.3 Paul Austin: Hey, and welcome back to the Psychedelic Podcast by Third Wave. Today I'm speaking with Dr. Matthew Johnson, professor of psychiatry at Johns Hopkins University.

0:00:10.4 Matthew Johnson: It's the first funding by the US government for a therapeutic study to administer a classic psychedelic for therapeutic reasons since that earlier era, you know, that ended in the late '60s, early '70s. More important than this study that me and my colleagues are going to run is that I think it's a signal to young scientists that there's a future in this area, because it's obviously not going to be the last funding for administering a psychedelic for therapeutic reasons by the government.


Welcome to the Psychedelic Podcast by Third Wave, audio mycelium, connecting you to the luminaries and thought leaders of the psychedelic renaissance. We bring you illuminating conversations with scientists, therapists, entrepreneurs, coaches, doctors, and shamanic practitioners, exploring how we can best use psychedelic medicine to accelerate personal healing, peak performance and collective transformation.


0:01:20.6 PA: Hey listeners, I'm so excited to have Dr. Matthew Johnson on the show today. We go deep into the topics of psilocybin for smoking cessation. We talk about Matt's personal journey as he's been deeper and deeper into the space. Matt has been doing research for a very long time in psychedelics so we've also heard his thoughts and perspectives on how he has grown as an individual, how being involved in some really intense psychedelic research has impacted him. He held space in a number of these clinical trials for end of life anxiety, depression, and addiction.

0:01:54.9 PA: So we go, we talk a lot about the research, but we also talk about how Matt has been personally impacted. We recorded this episode at the Wonderland Conference in Miami. Matt had a little bit of a hoarse voice, so we kept it on the shorter side. I think the interview ended up being about 40 minutes in length. But regardless, I really do hope that you enjoy the overall podcast.

0:02:15.6 PA: Dr. Matthew Johnson has been a pioneer in psychedelic research, has really helped to formalize and educate people around the efficacy of psilocybin for a range of clinical indications and it was really an honor to be with him on the podcast episode today. Before we dive into today's episode, a word from our sponsors.

0:02:34.7 PA: Hey, listeners. Today's podcast is brought to you by the Apollo wearable. I first started wearing the Apollo in the midst of the COVID quarantine over two years ago. It helped my body to regulate itself, to calm down, to stay more focused, and to meditate in the morning. And I use it to really regulate my nervous system in a time of incredible stress, and I've continued to use it on a day-to-day basis. It is indispensable in my daily routine. Here's the thing. The Apollo is a wearable that improves your body's resilience to stress by helping you to sleep better, stay calm, and stay more focused. Developed by neuroscientists and physicians, the Apollo wearable delivers gentle soothing vibrations that condition your nervous system to recover and rebalance after stress. I tell folks that it's like a microdose on your wrist that helps you to feel more present and connected, especially when in the midst of a psychedelic experience. It's a phenomenal compliment to any psychedelic experience.

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0:04:28.1 PA: Welcome back to the psychedelic podcast. We are live from Wonderland brought to you by Microdose. And just as a note, we're shooting in a warehouse. There's planes that are flying. You might hear some other things. So just bear with us if you're doing this audio only. Video is a little bit easier to track.

0:04:44.6 PA: And today we have our fourth interview from this Microdose conference. And we are here with Dr. Matthew Johnson, professor of psychiatry at Johns Hopkins. Matt, we've been meaning to do this conversation for a long time. Matt's voice is, he's been he's been having a good time and he's a little talked out. So we're going to keep this opener a little more brief, get into some juicy questions right away. And then we'll have a part two that will come at some point where we can allow things to be fleshed out a little bit more.

0:05:19.0 PA: So Matt, what I'd love to start is just a little bit about, I feel like you have likely changed so much as a result of all of this research that you've been involved with at Johns Hopkins. And I'd love if you could just sort of reflectively track from when you first started doing this research in...

0:05:37.2 MJ: 2004.

0:05:37.7 PA: 2004 to where you are now as a person 18 years later, how have you yourself grown and evolved by being a pioneer in this psychedelic research world?

0:05:50.3 MJ: Yeah, yeah. Well, my life personally has changed a lot. I've got a 5-year-old and wonderful wife and we were together, I think not married when I first started at Hopkins in 2004 doing the psychedelic research. But personally I can certainly say I've grown as a really the interactions with countless volunteers, ones I've guided, ones that I've not guided, but I've spoken with them at length, like the cancer patients.

0:06:22.8 MJ: In that study, I talked at length with them like at least an hour before, during the screening process and then as they went through the study at different times. And yeah, it's hard not to be changed by being involved with people with that level of struggle and then this intervention that's just so psilocybin helping them with their distress about their cancer.

0:06:50.0 MJ: It's just, yeah, nothing works for everyone, but gosh, so many people, like the majority were like so substantially benefited. It just, it's very moving. And it's not about, of course, like what psilocybin does or doesn't. It's like the fact that it's like the psychedelic sessions allow people to just access really important human material.

0:07:13.2 MJ: You know, people come into grips with like having those discussions with their family that they hadn't had in the face of a potentially or in sometimes a frankly terminal illness. So yeah, that's just my understanding of the nature of psychiatric disorders has just radically evolved.

0:07:34.8 MJ: It might be just an extension of where I lean before, but the DSM or the psychiatric Bible being just purely descriptive and there's just so much bullshit in terms of like how we label things. It's a necessary evil for a lot of reasons in the practice of psychology medicine, but I don't know.

0:08:00.2 MJ: Another thing related to that is that the line between what we call "healthy normal", like someone in the study that's not seeking treatment for whatever, depression, addiction, versus someone in a therapeutic study that has one of those disorders. This is just, it's all the same. And then we're working with like long-term meditators, like people with thousands of hours under their belt. And you think, "Oh, these are the people that have done all their inner work and everything." You get high doses of psilocybin.

0:08:31.6 MJ: It's like you're crying about being the second child and your parents. It's like just go right to the bottom. And so humans are humans. Everyone has some degree of trauma if you've lived long enough. And I don't know, it's just humbling kind of, seeing how some of those, it kind of brings you to the big picture.

0:08:56.5 PA: It's that. It's like the softening, the compassion, the humility. And also I think, there's not necessarily a fundamentalist attitude, but there is sort of a strong belief in the power of what psychedelic medicine can do for people. Right? And seeing, I mean, you firsthand seeing those transformations with end of life anxiety, with what they went through with that, I can imagine that in just being engaged in those conversations, the way that it would shift your own... I mean you're facing death in some ways, not yourself, but every day, by just being involved in that work. Which is a lot.

0:09:34.0 MJ: Mm-hmm. And it reminds you that like we all are really facing death at some point, you know? It could happen 10 minutes from... I cross the street to get back to the venue of the conference. It could, hopefully it's in whatever I got left. I don't know. Maybe, maybe 50 years. I don't know. Like if I'm really, really lucky. But yeah, it's going to happen for sure.

0:09:57.1 PA: It's gonna happen. So one of the big announcements over the last, I want to say year to year and a half, I can't remember the exact timing of it, you will know more about this, is the NIH is funding or has funded a clinical trial to treat nicotine addiction with psilocybin, which I believe is the first clinical trial funded by the NIH for psychedelics in over 50 years.

0:10:19.6 MJ: With a few clarifications. Because of course there have been many millions of dollars spent on, for example, MDMA neurotoxicity and harmful effects of any type of drug. So in terms... It's the first funding by the U S government for therapeutic study to administer a classic psychedelic for therapeutic reasons. Since that earlier era, you know, that ended in the late '60s early '70s, where there was federal government funding for LSD research back then. So I think it really is an important point.

0:10:57.3 MJ: The really important thing, and of course I'm excited to do the work, it was about a year ago we got the grant, we're about ready to start the study. It's taken about a year to get all the approvals in line. But more important than this study that me and my colleagues are going to run is that I think it's a signal to young scientists that there's a future in this area.

0:11:18.1 MJ: Because it's obviously not going to be the last funding for administering a psychedelic for therapeutic reasons by the government. I heard stuff when I was, when I first kind of jumped into this area, you know, different mentors saying, "Oh gosh, you've got such a good pedigree so far."

0:11:38.9 PA: "Do you wanna go into this?" [chuckle]

0:11:43.2 MJ: Like, "Don't fuck it up. What are you doing with this psychedelic thing?" And so I had to kind of push past that. And also hedging my bets, 'cause I had a career in other science, like addiction related science not involving psychedelics, and behavioral economics, understanding the decision-making that goes along in addiction, different addiction treatments. But that kind of, I was truly interested in that stuff, but frankly not as much as the psychedelics, but that kind of kept me afloat. And so I basically have had once in two careers for the last couple of decades.

0:12:17.6 MJ: You don't necessarily need to do that now if you're going into psychedelic research like that. And if you're at a place like a medical school it's, the way it works is you basically got to, if you want to do research, you got to bring in your own grant funding. Places like Hopkins, they don't pay you. Like they technically pay you, but you bring in, they say, "You eat what you kill." You bring in the grants from an external organization, philanthropy or the US government.

0:12:42.8 MJ: And that's a big one. Like if you don't have like R01 NIH grants, you're at places like that, you're kind of look down upon, like you're haven't really made it. So there is a potential for young scientists, like yeah, it's very possible, very plausible that you can land R01 grants from NIH studying straight up psychedelics.

0:13:04.8 MJ: So I think those are the seeds that gosh, fast forward 10 years, when all of those other younger scientists have now gotten their grants and things are just gonna mushroom. That's on purpose. [chuckle]

0:13:18.7 PA: And why smoking cessation?

0:13:20.7 MJ: Well, that's a line of research that my colleagues and I have been working on for, I guess like a dozen years or so.

0:13:28.6 PA: Is that when the first pilot study was kicked off in?

0:13:31.0 MJ: I got a protocol when I first started drafting the pilot study was I think 2007. So what's that? 15 years. [chuckle]

0:13:40.6 PA: 15 years.

0:13:41.0 MJ: I think we started it in 2008. So yeah, 14, 15 years.

0:13:45.7 PA: Wow.

0:13:47.4 MJ: So a small pilot study that we had hardly any money to run, but kind of did it on the back burner. I ran all of the sessions myself as one of the guides. I developed the therapy manual for it. So it was really a labor of love, like a lot of that early psychedelic research. And it was only had the funding for like a small pilot study. So open label, meaning it's not double blind or blinded.

0:14:18.2 MJ: And it's not randomized, it's just, "Hey, let's take these 15 people, give 'em what we think might work and just see the results." And so nothing you do is going to tell you for sure whether it was the psilocybin, but it can tell you whether you're on the right track, whether it's worthy of followup. And so with those 15 people, they were serious smokers, about a pack a day. Six months later, 12 out of the 15, 80% were smoke free.

0:14:44.2 PA: Wow.

0:14:46.7 MJ: And so we trust but verify, we take their urine and their breath samples and their self report. And so we're really sure about those people not smoking at that time. And for those who aren't familiar, success rates for even really like the most effective medications, your success rates at that point will be something, you know, 15, 20, 25, sometimes upto 30.

0:15:08.6 PA: Like Chantix or something like that?

0:15:10.6 MJ: Chantix, the various forms of nicotine replacement, which are all ways of... I mean, Chantix is sort of a partial agonist at the nicotine receptor, which is, if you think of it like Suboxone for the opioid, it's a partial, like buprenorphine is a partial agonist rather than a full agonist like morphine or methadone or heroin.

0:15:30.7 MJ: So these are all different ways of kind of quelling the receptor system that mediates the primary drug effects, just like methadone kind of, you know, quells your... It's the same type of drug, but extended over a longer period of time and in a form that's not as harmful, because smoking tobacco that's into the lungs is harmful, not the nicotine itself for the most part. In fact there may be it appears some health advantages to nicotine perhaps.

0:16:00.0 PA: As a cognitive enhancer.

0:16:00.9 MJ: Yeah, like maybe for dementia later in life. It is a very clear, it's one of the very few compounds that not just through stimulation, like you can stay up all night on amphetamine and study for that test and you'll do better in that test because you were able to stay up versus falling asleep, but it doesn't act, it hasn't been shown to enhance learning. Nicotine does.

0:16:20.8 MJ: Nicotine actually enhances learning. The acetylcholine system, nicotine, the nicotinic acetylcholine receptor, it's one type of acetylcholine receptor. It mediates learning. So in fact, this kind of conversation reminds me of it's part of the talk therapy in preparing people is like, "Hey, there's good things about smoking. There's bad things about smoking. Let's like not lie to ourselves. Let's get it on the table."

0:16:41.6 MJ: It's like, "Oh, I like smoking. It helps me meet friends. You know? I like to take a break at work." And so then you can like explore different like, "Okay, do you ever just take a walk around work? You can do that too. What about different ways to meet new people?" Just kind of explore that stuff.

0:16:56.1 PA: It's also culturally interesting, Europeans versus Americans. Europeans, a lot of people smoke casually one or two a day, or on the weekend they may have that. Whereas in America, it's very much seen as a blue collar, very negative health impacts. There's a lot more more divisiveness in a way around that compared to Europe.

0:17:16.9 MJ: In fact, a couple of scientists that I know say they, they picked up smoking when they were in a university earlier in their training in Europe. They were like, "That's how you meet people. Like you go to the pub and you ask for a cigarette."

0:17:30.5 PA: A smoke and whatnot. Yeah. Yeah.

0:17:34.4 MJ: Yeah.

0:17:35.4 PA: And you enjoy it.

0:17:35.4 MJ: Yeah, yeah. So the success rates to that first study were really high, so we were able to get funding from the Heffter Research Institute to do a much larger, an 80 person study that we've now, we've recruited the last people into it, but it's still gonna be about a year before we have the final results. We'll have the first round of results in six months. That's our primary outcome measure. So around then hopefully we'll have a better idea of how it's doing.

0:18:02.6 MJ: And I should say the current study, that randomized study, it's an open label, but a randomized study. So it's not a double blind study. I actually thought that was the next best thing. And I think we need more of this in psychedelic science. There is no one perfect like study design. They all compliment.

0:18:23.5 MJ: And the real answer doesn't come through any meta-analysis, even though there's value there, but it's like a thinking person looking at the different types of studies and just triangulating against, using their wisdom and their experience to figure out where the data, what the data is telling them in aggregate.

0:18:36.7 MJ: And so I thought the next best step really to even convince myself that this was really working as good as I hoped it was, was hey, take people that are willing to do whatever, psilocybin or nicotine patch in this case, and randomize them to either group. And we had some clever parts of the design like, because understandably people might be interested in the shiny new thing. I would. The psilocybin, that we hope is going to be much better.

0:19:03.8 MJ: But you know, the other, the other is an approved, the nicotine patch definitely works better than placebo patch. It helps people, but your success rates might be 20% versus 10%. Hey, I'll take 20 over 10, but tons of room for improvement. So it's like this gold standard. Well, or a known standard, I should say, versus the shiny new thing. And so we allow the nicotine patch group after six months to cross over, in other words, to get a psilocybin session, whether or not they've quit.

0:19:34.4 MJ: So anyway, we've had to design it because we don't want differential dropout. Because you're told, unlike a blinded study, you're told once you randomize, you're in the whatever group. Now this type of study design is more common with psychotherapy where blinding isn't possible, and like thousands of research papers and a really good knowledge base has been built up on that, all without blinded research.

0:19:56.9 MJ: We know a lot about things like dialectic behavior therapy, cognitive behavioral therapy for all kinds of different disorders, like prolonged exposure therapy for PTSD. And none of that is based on blinding. So not to say blinding doesn't have value and I've conducted dozens of blinded studies.

0:20:13.6 MJ: And the other thing to keep in mind with blindings moreso with psychedelics than other compounds, a lot of people don't realize this, and it hits home to me because I've been in dozens and dozens of sessions as a guide with people. It's a weird thing when you say, when you prepare people and you really... Like high dose psilocybin, "You might think you're going to die. This might be the most frightening."

0:20:34.3 MJ: And I tell people, everybody, I've had military vets with combat experience that say, "This has been, this has replaced combat as the most intense experience of my life." I've never been in combat so that's just like so humbling to me. So I share that with people, like how do you express the ineffable, but you can at least try. And so that's, you use methods like that.

0:20:53.3 MJ: So you go through this, you know, like heavy thing, but we're going to be the ones holding your hand through it when you think you might be dead. And so it's this like heavy, heavy, unlike anything else. And then you say, "Oh yeah, well, but it could be a placebo or it could be... " You know?

0:21:11.2 MJ: And then on that, on that day, it's been a half hour, "Am I feeling something? Maybe not." An hour later, "Oh God, yeah. No, I don't, I'm not feeling anything." And this frustration and kind of... That's not going to happen in clinical practice. It's like, "Today we're giving you a 25, 30, whatever milligrams of psilocybin."

0:21:31.1 PA: And it'll be delivered.

0:21:32.7 MJ: Yeah. And if you don't feel anything, that's very unusual. [chuckle]

0:21:37.5 PA: It can happen, but it's unusual.

0:21:39.9 MJ: We've had about like two people or so out of hundreds where something like a 30 milligram dose didn't appear to have any response. And I've gone down to the pharmacy and said, "Let me check your records. I'm just double checking." Who knows something about serotonin receptor density or something about psychological defensiveness, or maybe those are two sides of the same coin. But yeah, yeah, yeah, yeah. But it's very rare, but you're pretty much guaranteed, 30 milligrams of psilocybin.

0:22:08.1 PA: Which is equivalent to like 7 grams of dried mushrooms maybe.

0:22:10.6 MJ: Based on, and the caveat is there's so much variability of course, but based on the, I think the most relevant data with psilocybe cubensis, which is the most common type of course in the illicit market, about 5 dried grams. Which is right at what Terence McKenna called the "heroic dose", which is nothing to be taken lightly, to put it mildly.

0:22:34.6 MJ: And so it creates a weird thing when with these double blind sessions where you're modeling something that's just very different in terms of quality than what you're going to get. You're not going to have someone guessing for like an hour, "Am I, is this going to be so intense I'm going to have a mystical experience I might've heard about? Or think I'm going to die and see monsters? Or I'm just going to be bored stiff."

0:23:00.5 MJ: And of course we encourage them to just focus on the experience, not whether you've gotten a substance, and your inner experience regardless, like, "I'm having an inner experience now. I can pay attention to... " Like in meditation. But nonetheless, people are people. [chuckle] Understandably. It's like, "What the fuck? Did I get the real thing or not?"

0:23:17.5 MJ: So anyway, I thought there was a lot of value. I thought it was the next best step for me to get into myself that we were onto something, just treat it like a new psychotherapy, randomize people to one or the other, people will need to be both. And so far about 60 people have gotten to the one year followup and the success rates are, I think last I checked like 59% versus like 28% with the psilocybin having the 59% at a year out.

0:23:44.1 MJ: So just in terms of being twice as effective. And by the way, those rates are very good for nicotine patch, you know? So it's not like we're doing a lightweight job there. Which is important to note in the context of an open label, 'cause we could theoretically just purposefully do a shitty job with that other group. That's one of the limitations. I think we're doing a really kick ass job with it.

0:24:06.5 MJ: Those success rates kind of suggest that, yeah, we're doing really good with our nicotine patch group, you know? But results could change, to be sure, because the real answers come... 'Cause it's not blinded, I can peak whenever I want, but they're not the official results until we get those 80 some people through. But it looks really good.

0:24:26.3 MJ: And early data from that study, as well as the pilot study, were able to help us land that NIH grant, which is not only double blind because we need to do that. And again, there's no perfect experiment. So we need to do the double-blind work. It's a requirement really to move it, to get it FDA approved. So it's a multi-site double-blind study.

0:24:49.5 MJ: So with Michael Bogenschutz at New York University and Peter Hendricks at the University of Alabama, Birmingham, who are just, I mean, they're at the very, very, if I had to list like five of my most trusted, best, most knowledgeable colleagues, but also just like good people that you can trust. They're in that very, very top group in the field. They're just excellent scientists who have worked with psilocybin.

0:25:16.1 MJ: So Michael in the context for alcohol use disorder and Peter in the context of cocaine use disorder, cocaine addiction. And I should say Peter is also just known also for his work in smoking, like I do also outside of psychedelics work in understanding tobacco and nicotine and all of that. And so does Peter helping people quit with other ways. So I think we've got a great team and excited to hopefully get those last regulatory approvals so that we can start in the new year.

0:25:47.7 PA: So we talked a little bit about how you've changed and grown through this work. You went into depth on the NIH funded trial, smoking cessation nicotine. The other topic that I wanted to open up is, as this ecosystem is sort of growing into the mainstream for-profit versus nonprofit, how do you see your role as both a researcher and advisor?

0:26:15.1 PA: How do you want to be involved as this continues to grow and evolve, knowing that there's a marketplace out there and it will be important and necessary to the adoption of psychedelic medicine?

0:26:25.4 MJ: A few things. I think one thing in terms of studies, even though I'll continue to do studies looking at different disorders to see the potential therapeutic effects of psilocybin and different psychedelics like soon to be LSD, like a study for chronic pain. But in the big picture I need to do more than that.

0:26:51.8 MJ: I really wanna do more work that's relevant to really understanding what's going on behaviorally in commonality. Really understanding psychedelic behavior change, like what's really going on under the hood, and not just at the biological level, but really there's a strong behavioral science of learning. We know things about parameters that make for better or worse associative learning.

0:27:22.7 MJ: You've got this emerging rodent research suggesting neuroplasticity is going on, if we can get some hold of what that window looks like or some way to measure it, and then what can we do during that time? Integration means almost nothing. It means just a discussion now. People do idiosyncratic things. Some people say, "Well, can I get a copy of the session music?" Some people take it home. I remember one guy, he's listened to it every night and found it really meaningful. It's just the idiosyncratic things.

0:27:54.9 MJ: If you're an artist, maybe try to like... But what can you do? There's amazing research on all kinds of techniques like journaling, things that have a real effect to facilitate behavior change. Gosh, even like in terms of supplements, if it's something like what if we can enhance protein synthesis in some way, if we have a better understanding of what's happening in that window that we can concretize, make it more likely that this learning process sticks. So stuff in that flavor.

0:28:34.9 MJ: Then I also see a big role, and I've been trying to speak more about it recently, in just letting people know about some of these big picture things that are like risks, not like high blood pressure or like schizophrenia and bad trips, but just watch out for the sexual boundaries thing, especially as it's moving into clinical practice and how you navigate that.

0:29:00.3 MJ: There will be, and I think one of the speakers at the conference here yesterday reminded folks, there's some really staggering, really discouraging data on just the rates of sexual inappropriate therapists outside of psychedelics having sexual relationships with patients. We need to keep our eye on that. You're going to get clinicians that are having the session at their house with, I don't know, maybe several young ladies who are their clients on a Saturday night, stuff like that.

0:29:37.6 PA: Something's fishy here.

0:29:41.8 MJ: Right. And another related but different thing on the sexual angle is just I really see a lot of, and I see this in researchers, not all, but definitely some, really a pushing of their own spiritual vibe. I'm not talking about spirituality, such a...

0:29:58.7 PA: And you published a paper on this about a year ago, year and a half ago.

0:30:00.7 MJ: Yes, yeah. And so the humanistic side, in other words the rapport, the empathy, the unconditional positive regard. The psychologist Bill Miller said it's difficult in English, but in Greek it's "agape". You need to love, that humanly brotherly sister. You need to love your patient. That's confusing in our language because, of course, sexual love is something you want to avoid, but you need to care for your patient.

0:30:33.1 MJ: So of course you need that, and your job is not to... The person says they think they had a Jesus experience, your job isn't to say, "No, no, no, those are just neurons in your brain." Whether it's Jesus, Buddha, or whatever. It's not that. You're not being cold and telling the person they have to be materialist or any of that. It's just let them drive the bus.

0:30:57.1 MJ: I see too much, even at the subtle level, like for example, pushing the perennial philosophy, which for those who aren't aware, and it's a great, lovely idea that the scholars of religion disagree about, but the idea that all of the world's religions are built on the same core.

0:31:14.2 PA: One that came from Aldous Huxley, who published a book called The Perennial Philosophy, in 1945.

0:31:18.8 MJ: Exactly. And so he popularized this concept. It is intriguing. Just personally, I think there's, at least to some degree, there's probably some... There may be some truth to that. That's not me speaking as a scientist, but because again, the people who know far more about that in terms of the study of religion, the scholarly study of religion, don't even agree on it.

0:31:41.2 PA: He also wrote that right after World War II, or during World War II. There's also, I think a time and cultural context that in this massive period of war and divisiveness, he's trying to make sense out of, "Well, what do we actually have in common and share in common?"

0:32:00.9 MJ: Which is beautiful. It's the same sentiment that, as a psychologist I think of that really was in World War II it's basically sowed the seeds for social psychology. It's like, how could this happen in Germany? Were all German people randomly evil people during that period? No. This happens to the human being. This can happen to us. We're all in this together.

0:32:21.9 MJ: Even, gosh, I think of getting here at the meeting, Rick Doblin. I've probably seen his a dozen times, but his story, how he got started in this psychedelic world with his family's history and the Holocaust. It's like so many in the world woke up, "Whoa, we really can totally annihilate ourselves. We may not survive." I totally get that. So a beautiful thing that the world religions might have a common core.

0:32:48.6 MJ: That's also something that you could let someone come to if they come to that conclusion when they're on psilocybin. Great. They come to some other conclusion. It's just not on us to push this idea of having the Buddhas in the room and different religious iconography. There might be some, and I was also clear, like, "Hey, anyone can bring any of that stuff. If you like the Buddha, absolutely. You can bring 10 Buddhas."

0:33:17.3 MJ: I also see that in the future as something like where this stuff gets approved, it's like people might think, "Oh, that's not for me." I grew up Southern Baptist, I had relatives, aunts and uncles died of cancer. Maybe they could have benefited from this. But they probably would have seen that and not disagree, but they might think, "Oh, that's a different religion. " Maybe even of the devil. If it's not Christianity, it's like something wrong. Hey, you can agree or disagree, but that's still a human being that could very likely benefit from this.

0:33:53.4 MJ: If it's like Richard Dawkins, an atheist, it's like I've seen atheists benefit from this. I've seen political conservatives, military vets, you name it. You name it as the furthest away from this psychedelic stereotype. This can work on the human being.

0:34:14.5 PA: It's interesting that the perspective shift that can occur, and it also, like I've heard so many stories of atheists going beyond atheism. I've also heard stories of people who had no prior spiritual context or spiritual anything. They have this experience with 5-MeO-DMT and they're like, "What the fuck?" And their entire then worldview shatters and they can't put it back together.

0:34:42.8 PA: So I think there's also, and this speaks to coherence, there is a sense of a splitting apart with the self in some ways, a total dissolution of it. And so lot of the therapeutic support and community support is, how do we create cohesiveness after the falling apart?

0:35:05.3 MJ: Right, right. You can bring it back together.

0:35:08.6 PA: It can be challenging at times to do that. I think to your point, as we do more and more of this, we have so much more to learn still about how people work with this, about what the effects are, about what the benefits are, about what the risk profiles are. We're in this place and space that we've never been in before where psychedelics have been underground for thousands and thousands of years.

0:35:35.1 PA: And now potentially, they're legal and they're not the counterculture, as Rick [Doblin] says, they are the potential mainstream culture. We live in interesting times, is often what I come back to.

0:35:46.7 MJ: Right. And I should clarify regarding my sort of like, don't push the kind of the spirit. And by "spiritual" again, I don't mean the humanistic, but more of the stuff you can't... Like yeah, the supernatural stuff, metaphysical stuff. I definitely, I'm not talking to any religions, I'm not talking to the Native American church, I'm not talking to the UDV, Santo Daime. I'm talking about clinical psychologists, psychiatrists, mainstream. I would never dictate. Those religions have the right to do what they're doing.

0:36:19.6 PA: You're saying like when psilocybin becomes approved by the FDA and it's delivered in the clinician's office, to be very mindful of how a person is primed with religious iconography.

0:36:31.6 MJ: Right. If it is in a secular context, don't kind of sneak this stuff in the back door. But there's even exceptions to that, like Brian Muraresku, who wrote The Immortality Key. Fascinating book. Everyone should read it. Fascinating guy. But he's got this kind of like vision of like, can this be brought back? You know, the Kykeon, the idea.

0:36:54.8 MJ: I think his book kind of makes it more likely than not in terms of evidence that there was an, got to write an LSD-like compound in this sacrament used for thousands of years by the ancient Greeks. But part of his vision is, "Hey, maybe this could be brought back?" He's a Roman Catholic, and maybe this can be brought in and bring some heart back into his religion.

0:37:16.2 MJ: So if, I don't know, if someone is a Christian therapist and there are things like this out there, there's no... Hey, if it's on your sign, like that's fine. I'm not talking to those people either. You know? As long as you're like, "This is a Catholic psychedelic therapy session, we're gonna be talking Jesus and Mary," all power to you. I'm not talking those people.

0:37:37.0 MJ: As long as that context is clear up front.

0:37:39.2 MJ: Yes. Yeah, yeah.

0:37:40.8 PA: It's important from an expectation perspective to know what people are coming into.

0:37:43.1 MJ: Right. Right, right.

0:37:46.0 PA: Yeah. Well Matt, this has been beautiful, illuminating. It's been fun as well.

0:37:48.0 MJ: Absolutely.

0:37:51.7 PA: I appreciate you taking the time in the Wonderland sort of chaos to sit down with us and chat a little bit. Just any final words or kind of, as people listen to this, websites or things to do, or just places that you would potentially want to point them after they listen to this podcast?

0:38:12.8 MJ: Well, I guess I would... I mentioned the smoking cessation work and I've got some other studies for chronic pain, PTSD that are going, with psychedelics are going to be coming up in the next... Those studies aren't ready to roll yet, but pretty soon. So keep your eyes peeled to Or yeah, keep their eyes posted, to see when those things start up if they're interested.

0:38:39.6 PA: Beautiful. So if you're interested in enrolling in clinical trial, Matt?

0:38:44.7 MJ: And I'm sorry if I said it wrong,

0:38:50.8 PA:

0:38:51.4 MJ: Yeah. And as another final word, just thank you for doing what you do and connecting people and encouraging kind of bigger picture conversations.

0:38:58.7 PA: Education's important. Community's important. You know, one of the things that I kind of to our conversation that I've really been mindful of or aware of, is the importance of providers and being able to find a qualified, ethical, trained provider that you can work with. And that is really becoming quickly our focal point, is how can technology and a really trustworthy provider network help to ensure that this is properly integrated?

0:39:27.6 PA: Because we are in this sort of new, brave new world and it requires all hands on deck. And we got to go deep into the research element today. There's so much with decrim and state by state, like it is a symphony that we're sort of existing within. Absolutely.


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