Dr. Julie Holland—a psychiatrist specializing in psychopharmacology and author of the recently-released book, Good Chemistry: The Science of Connection From Soul to Psychedelics—riffs with Paul F. Austin on oxytocin, music, death, and using psychedelics to activate our parasympathetic state of being.
Get ready for a ride that covers topics ranging from The Very Hungry Caterpillar to MDMA, cannabis, and PTSD.
Dr. Julie Holland, M.D.
Dr. Julie Holland is a psychiatrist specializing in psychopharmacology, with a private practice in New York City. She majored in the Biological Basis of Behavior at the University of Pennsylvania and received her M.D. in 1992 from Temple University School of Medicine. At Mount Sinai Medical Center, she completed a residency program in psychiatry, where she created a research project that treated people with schizophrenia with a new medication.
In 1994, she received the Outstanding Resident Award from the National Institute of Mental Health. From 1996 until 2005, she worked weekends running Bellevue Hospital's psychiatric emergency room. In addition to her autobiography of her time there, she has edited several books related to psychedelics and recently released a new book called Good Chemistry: The Science of Connection From Soul to Psychedelics.
Dr. Holland also provides expert testimony and forensic consultation on a range of drug-related behavior and phenomena, with a focus on PCP and MDMA.
00:00 Paul Austin: Welcome to The Third Wave Podcast. I'm your host, Paul Austin, here to bring you cutting edge interviews with leading scientists, entrepreneurs and medical professionals who are exploring how we can integrate psychedelics in an intentional and responsible way for both healing and transformation. It is my honor and privilege to bring you these episodes as you get deeper and deeper into why these medicines are so critical to the future of humanity. So let's go and let's see what we can explore and learn together in this incredibly important time.
00:39 PA: The Third Wave Podcast is brought to you by Magic Mind. Do you want more creativity, flow and energy in your day-to-day routine? Then go to magicmind.co and get the 2 oz shot that contains 12 magical ingredients scientifically designed to improve your productivity. I've been using Magic Mind over the last couple of months. It has replaced my morning coffee. It has Matcha, Lion's Mane, and a number of other nootropics, and I can't say enough about it. It's so, so useful. So if you're interested in Magic Mind, go to magicmind.co and enter promo code "THIRDWAVE" to get 10% off, and try it for yourself. As longtime listeners know, yoga and meditation have played a huge role as complementary practices to my own responsible psychedelic use. And that's why we're excited to be working with Halfmoon Yoga as a partner for the podcast. They carry everything from basic yoga supplies, to more advanced things like bolsters and sandbags, to meditation cushions that are super comfy to sit on. And right now, they're offering a 15% discount to Third Wave listeners with the promo code "THIRDWAVE". I'd encourage you to check them out at shophalfmoon.ca if you're looking for tools to support your yoga or meditation practice.
01:52 Julie Holland: I hear some lovely birds where you are. That's delightful.
01:56 PA: I'm in a garden. I'm at an Airbnb in Miami. I came here for COVID...
02:00 JH: Nice.
02:01 PA: To wait it out because I was in an apartment by myself in Oakland. And I was like, "I'm either in the city in Oakland by myself, or I get a place with a friend, and we have a big garden and a hammock." And I'm like, "I'll do this podcast outside. It's nice here."
02:13 JH: That's a really good idea.
02:16 PA: How is your situation? I see you've gotten a lot of family time, music recording in on Facebook.
02:21 JH: Yeah. [chuckle] For sure, we have been playing a lot of music. Yeah. When this first started, I really found myself almost every day playing my guitar and singing and crying, and singing and playing. And I recorded this Led Zeppelin song Going to California because it's about a girl who plays guitar and cries and sings, which is pretty much all I was doing. Not all, but at some point... Music is a great cathartic release for a lot of people, me included. And yes, we like to do it with a lot of other people around, and it's great to dance, whatever. But it still works if it's just you, and it's an easy way to open my heart. And I'm just trying to let things go through me and not get stuck in my body.
03:13 PA: Energetically, yeah.
03:14 JH: Yeah, it's a lot to take in. And many of us, and probably many people who are listening right now would consider themselves to be empaths or sensitive people. I think it sort of goes with the psychonaut territory for whatever reason. Where we think a lot. We think a lot, we feel a lot. So it's obviously, it's a lot to take in.
03:35 PA: In conversations that I've had with various people, this is sort of like the initiation, if you will, that a lot of people have been anticipating from medicalization of psychedelics or mainstream use of psychedelics. And it wasn't a MDMA or Psilocybin-assisted psychotherapy that did it. It was a virus because it's getting everyone to sort of go inwards and maybe reflect a little.
03:58 JH: Yeah, there are so many great metaphors for what's happening now. And the one that I keep talking about that really works for me is this sort of like The Very Hungry Caterpillar, where we were in this phase of consumption, taking in and destroying. Now, we are in the sort of intermission cocoon phase. And then the huge question that everybody has is like, "What are we gonna be like on the other side of this?" And, "Is this gonna be wasted? Will things be different? Will we build everything from the ground up again?" Great questions. [laughter] One of those, "Fuck if I know." I have my hopes and dreams. I have my deep, dark fears. It's so easy to project yourself into the future, and you can either envision a hellscape or rainbows and unicorns.
04:49 PA: It's seeming to me it'll be maybe a both end situation. There will both be the hellscapes of... I've been watching people talk about a Hunger Games-like society where you have the ultra-wealthy and then basically everyone else who's just getting energy extracted from them. But then also, a lot of people in my community and people I know are... They're buying land in Costa Rica, and setting up intentional communities, and really looking at what's beyond just capitalist, industrialist, urbanized societies.
05:16 JH: Well, I certainly love the idea of intentional communities. We ended up creating an unintentional community where we live. [chuckle] We really found our people. And I live in a very small town north of New York City, but it's kind of like you go back in time as you take the train northward. And it's... I don't know. It's more of a red state where I live, I would say, than the blue state of New York City. But we still have managed to sort of find our people and find a great community. And there's a lot of resonance up here, actually, with being near Woodstock or Millbrook, or not that far from Chasm. There's some very trippy farms all around Western Connecticut, Eastern New York. That has been really good for me.
06:00 JH: And when I see how our community comes together and how we support each other, and we've created this multi-generational community that's sort of based on farmers and a little bit on psychedelics and a lot on music, then I think like, "Oh, we're gonna be fine. We're gonna survive." But there's also the, we could spend an hour talking about my fears of this president and his pathology and how that could potentially play out. It's gonna be a very fucked up year. I tend to be very optimistic, and I had this idea that 2020 was gonna be like the year of clear vision. It's clear seeing, it's perfect vision, 2020. This is gonna be the year that we're just really gonna get it and everybody's gonna finally see the light. And maybe that is happening now, that what I tell my patients about sort of worrying about the future is you may have fear or pain or terrible things or scary things happen to you in the future. But why have that pain and fear twice? Why not wait till the [chuckle] bad thing happens to feel bad about it? Why not now pretend... If you pretend everything's gonna be great then you get to have pleasure twice. Or at least pleasure once if things suck later, you can pretend they were gonna be good now. So I'm really trying to figure out how things are gonna be good. But this one's a [chuckle] little more challenging than the average. [chuckle] Yeah, it's tricky.
07:23 PA: It's tough.
07:24 JH: And it keeps changing.
07:25 PA: It's tough.
07:25 JH: And I'm a very much like, when... I plan out when I'm gonna go to a conference and speak in six months or nine months. And I love knowing my calendar and this is just like a big unscripted... A snow day is basically how I think of it. Like when the kids had no school and we had no plans 'cause everything got canceled it was a snow day. And one snow day is great but a month of snow days, I'm gonna lose my shit [chuckle] I thought, I really was gonna lose my mind. But I'm not, pretty much, as far as I could tell. A lot of us are with our families. For instance, my daughter is coming from college to her childhood home and that can be very tricky. I remember being in that place where you think you know everything, and yet now all of a sudden you're sort of treated as a child again. That's hard.
08:15 PA: That's how we're all being treated, as children again. And it's not just the people coming back from college but I even feel it... And this is what it is. There's no judgment around the shelter in place and stay at home and house arrest and don't go near anyone and it does feel a little bit, obviously, necessary to minimize the exponential risk and also a little bit of a nanny state, in that the terms that are being dictated... There's this general saying that once a government takes certain rights away, it's gonna be difficult to get them back. And I think that's a feeling a lot of people have.
08:52 JH: Definitely. I know... Well, first of all, we all know that Trump has just got a huge hard-on for these other dictators, why wouldn't he wanna be a dictator also? Who does he really chum up with? So I'm sort of surprised he hasn't already made more of a grab. But also, there's so many things happening while we're focusing on the virus, like rolling back EPA and they're still fucking the planet basically, hard, and getting rid of a lot of supervision. There's so much fuckery going on. There's so much opportunity for anger and frustration and explosion. And we're all kinda still taking it. And it's... Really is everything's sort of done by degrees, like with an abusive lover or partner? Where it's just like they're slowly turning the screws and nobody's done anything. No one's being like, "What... Can we stop. Can this get... Can we just stop him yet?" [chuckle] Like, "What the fuck?"
09:49 PA: Right. What the fuck? Well, and yesterday recording this... It's Tuesday, April 14. Yesterday there were two big announcements within this vein, which was essentially California, and Washington, Oregon announced a three state pact to address coronavirus. And Donald Trump made it clear in his press conference that he has total authority.
10:12 JH: Right.
10:12 PA: Is a direct quote from him. So I think we are already seeing a potential secession in place and that when Trump becomes elected, which I think he will. I don't have much confidence in Joe Biden, whatsoever. That he will likely continue to grab power in the wake of COVID. So we are in for an interesting ride and I think what you... I don't wanna spend too much time on this just because it is a bit of a...
10:35 JH: No I was saying, we could easily talk an hour about politics. But you know... Here's where I wanna go.
10:39 PA: Yeah, excellent.
10:40 JH: Maybe... And which will lead us back to psychedelics. Is that sometimes when...
10:46 PA: Perfect.
10:46 JH: People have a positive experience with psychedelics, at the peak of that positive experience is a sense of oneness and this sense that everything is connected, that we are all connected, that it's all one thing, we're all on one planet, hurtling through space. And there's often this sense of belonging and connection, and that we're all in this together, and I can speak to the trees or I am one with the stars. [chuckle] And this is part of a mystical experience, the sense of oneness, and that you don't really have a sense of where you end and something else begins because it's all connected. And for many people that is a blissful place to begin. And for some of us, we come away from that place, and we remember that lesson, that we share the planet and we're all on the same team, and we're all connected and this kind of thing. But there's a certain style of government or a branch of government as opposed to, "Hey, we're all in this together," is a little bit more like, "Fuck you, I got mine, you get yours." Let's say. I don't have to worry about you and your enemies.
11:49 PA: And it's like a psychopathy.
11:50 JH: So... So right.
11:51 PA: It's like a psychopathy.
11:52 JH: And you can call it psychopathy, you can call it sociopathy but it is this sort of disregard for other people's needs or situation. And like, "I'm gonna do for me, or maybe me and mine but not you and yours." And this is why people keep talking about switching from me to we. And that's really [chuckle] socialism to some degree. Right? Is like, what do you need? What do I have? How can we share? How can we cooperate? How can we make sure there's enough for everybody? And there's democratic socialism and there's socialism but it's still this idea that we are all in this together and we need to share our resources. And then you have, sort of, capitalism or conservatism or just some sort of ultra right wing which is, "No, you're on your own. I'm gonna get my shit and here's my gun and I'm not gonna provide for you."
12:43 JH: And it's a really basic difference between parasympathetic and sympathetic. So sympathetic is something we all know about. That's fight-or-flight and it's a very fearful closed-down state. Parasympathetic is the opposite of sympathetic. So it's the opposite of fight-or-flight. So that's when you intend and befriend or connect and protect. It's where the body can digest. It's where the body repairs itself. It's when you can sleep. It's when you have sex. Although there's a little bit of sympathetic in sex, but mostly the parasympathetic state is what's better for your body. And that is an open state where you are open to learning, you are open to sharing, you're open to communicating and connecting. I have a book coming out in June, where I talk a lot about the sort of open versus closed and parasympathetic versus sympathetic. And right now, we've been more and more in this fear-based, fight-or-flight, I'm gonna do for me and you're on your own. We've been in that way of thinking more and more. And Trump is certainly more of I'm gonna do what's good for me, as opposed to I'm gonna do what's good for everybody. I'm very lefty liberal, and I care deeply about other people and their needs. And that's the kind of work I've always done, is really trying to give people what they need.
14:00 PA: You'd brought this up at Horizons, emphasize the parasympathetic state, the rest-and-digest state. Which, to be honest, is not that widely talked about in the psychedelics space. We hear a lot about the brain and neuroplasticity and the default-mode network and healing trauma, and things like this. But what I'd love for you to dig a little bit deeper into is what role do Cannabis, 'cause you've written a lot about Cannabis and know a lot about Cannabis, but also obviously psychedelics, how do these medicines help facilitate that parasympathetic state?
14:30 JH: Yeah, so this is the whole sort of message of... So I've a book coming out in June, it's called, "Good Chemistry," and the subtitle of Good Chemistry is, "The Science of Connection, From Soul to Psychedelics." So it's about the science. It really is a whole book about the parasympathetic nervous system, and about what it takes to be in para, and how we're all spending way too much time in sympathetic. And it's really bad for your body. It's bad for immune system, your body can't repair itself when it's in fight-or-flight. I've patients who work, and they're very stressed out at work, and then they go to the gym and they run on the treadmill, and then they get home, they can't sleep, and it's just like, "At some point, you have to switch gears, and you have to get off your computer, and stop thinking about work, and stop... " People get adrenalin fatigue... Adrenal fatigue. Excuse me. Many of us are in fight-or-flight too much. And so the book is about how to get into parasympathetic.
15:29 JH: I'm not saying that psychedelics will put you into parasympathetic, 'cause it's not that simple. But what I am saying is that there are various things that do put you in parasympathetic, that leave you very open to feeling connected, and in that we versus me state. And I would say that parasympathetic is all about connection, and opening, and bonding, and trusting, and going from me to we. And so, as much as adrenaline, and cortisol are the chemicals that fuel the sympathetic nervous system, the thing that really fuels the parasympathetic nervous system is oxytocin. So the book is very much about oxytocin, which is a hormone of trust and bonding. And common examples of high oxytocin states are orgasm, nursing, childbirth, hugging, even pats on the back, or pats on the butt if you're an athlete. This sense of like, "I get your back, I'm on your team, we belong together." And like good handshakes, eye contact, any of that, there's this sense of, "I can trust you. We can cooperate, we are on the same team." We're social primates, and we are really hardwired and designed to connect and to cooperate. And oxytocin is sort of the lubrication for all this social bonding behavior that happens.
16:50 JH: And there are certain drugs that also really markedly increase oxytocin. And the MDMA, which is a long-standing favorite of mine. My very first book is about MDMA. It was called, "Ecstasy: The Complete Guide: A Comprehensive Look at the Risks and Benefits of MDMA." And that was out in 2001. Right at 9/11 actually. I had my big book publicity push on 9/10.
17:14 PA: Wow. [chuckle] Good timing.
17:16 JH: I know. Yeah. It was fine. It all works out eventually. So MDMA increases oxytocin. And it turns out that at the peak of psychedelic experiences, which... We all know about 5-HT2A. Psychedelics are... They're agonist for the 5-HT2A receptor. So that's the receptor that they sort of tickle. But they also tickle other receptors like 1A, and I believe either 2C or 1C, I will tell you later on. The thing I learned a year ago, is that the 5-HT2A receptor actually creates a dimer, which is a receptor pair with another receptor, which is the oxytocin receptor. And there ends up being cross-talk between these two systems, between the serotonergic system and the oxytocinergic system, or the oxytocin receptor.
18:08 JH: And in Good Chemistry, I talk about this particular dimerization, because I was really floored to learn about it. But it made sense to me, because I kept... I know that there's a sense of oneness, and connection, and trust, and bonding, that happens with MDMA. But it also happens with the classical psychedelics. And so, how is that? Nobody ever talks about LSD increases oxytocin or Psilocybin. Believe me I looked. I couldn't find anything at all. But then I did finally learn about this dimerization of the receptor, which means that there's cross-talk. So indirectly, psychedelics do stimulate the oxytocin receptor. So that was really interesting, maybe more to me than other people who read this stuff, or are listening to me now. But I was really excited about that... Learning that.
18:51 PA: So is Cannabis a psychedelic then, according to that definition?
18:53 JH: So then here's the other thing, is that the Cannabis, the CB1 receptor dimerizes with 5-HT2A. So high dose THC stimulates the 5-HT2A receptor because there's dimerization and there's cross-talk between the cannabinoid receptors and the 5-HT2A also. I've gone down some rabbit holes recently looking at dimerization, looking at how often... Because we have this idea... First of all, the brain is way more complicated than I am explaining it, or that I could ever understand it, or that any of us could ever understand it. And that's the beauty of the brain. It's like if we could understand it, it wouldn't be very complicated, and neither would we. So it's not a one-to-one. It's not as simple as, "This drug affects this receptor. Period." First of all, most drugs are not... They're referred to as, clean, or dirty, or promiscuous, which I love. All the good drugs are promiscuous, they hit more than one receptor. It's very rare that you have one drug that just goes to one receptor and that's the end of it. At least in terms of the drugs that you and I tend to talk about, or that interests us.
19:57 JH: I do talk a lot about Cannabis in Good Chemistry. And the whole idea of Good Chemistry is that we naturally have all the great stash in our own brains, and there's all sorts of different ways to access it that you don't have to trip or get high to have an increase in endocannabinoids or phenylalanine. There's a line in Good Chemistry which is like your brain is also a stash box, you just have to know where to look. There are ways to make yourself feel high without using drugs. All that being said though, there's an awful lot of talk about drugs in this book because they interest me greatly. I like to try to explain sort of what I've figured out. I do dumb down the science, and there are people who are gonna want more details, but the good news is there will be tons and tons and tons of references and notes and links to full articles on the website for the book.
20:48 PA: You're a psychiatrist?
20:49 JH: I am. It's true.
20:51 PA: So you also, within this American medical system, a big part of the work of a psychiatrist is looking at pharmaceutical medications. So I'd love to hear your thoughts on, especially when you have people coming in, clients who are on pharmaceutical medications, what's that relationship between traditional SSRIs or SNRIs and how they affect neurochemistry compared to psychedelics and Cannabis?
21:17 JH: Well, first of all it gets really complicated to say too much about it definitively because there's absolutely no double-blind, placebo-controlled trials where they're looking at the interaction of prescription medicine and non-prescription medicine. So when I started out in the 90s, it was people who were very, very sick psychiatrically and didn't really know what to do and I had to explain, "Oh, you know there's medicines that can make you feel better and it's not so terrible and it doesn't make you a bad person if you have to take it. It's just an antidepressant." I would say something along the lines of, "You have a chemical imbalance, and this will fix it." I had to destigmatize and sort of explain, "Oh, you have symptoms of depression, and so you need these meds." And then 10 years later, in the early 2000s, there's no talk of that ever because everybody has heard about chemical imbalances and antidepressants, and so then it was people coming and saying, "I don't know if I should take Wellbutrin or Effexor. My friend says that Zoloft helps her and my pilates instructor, was saying that Seroquel was good." It's like people had questions about meds, and it wasn't a question of, "I don't know what's wrong with me, can you help me?" It was like, "Which medicines should I take?"
22:32 JH: But now I would say the patients that come to me, it's much more like, "I've been on these meds for many years, I tried this med and that med and this med. Nothing really helped me. I'm hearing about microdosing, I'm hearing about Ketamine, I'm hearing about MDMA therapy or Psilocybin therapy. Can you explain to me do I have to get off these medicines? Can I stay on these medicines and still microdose?" And so there's a few things that I do regularly. If anybody wants to get off their medicines, and I think that it would be okay, and that's a big if, but if I agree with that person that they want to be off their medicines because they want other options, then I will help them get off their medicines. Sometimes I'm like, "Oh you off medicines is not gonna go well, but there is a medicine that I can put you on that may work well for you and may allow you to do these other things." So I will say that there's particular mood stabilizer that I use with my patients who want to explore alternative therapies that aren't legal, but then I would say that if they wanted to try Ketamine, they don't have to get off their medicines.
23:38 JH: I often will talk to people about just starting with Ketamine because they don't have to change their meds, and also they don't have to break the law. Because right now, unless you're gonna sign up for a research program, you're gonna go to somebody underground. It's a really weird time to be a psychiatrist because a lot of the most promising therapies are still not legal. And I'm not going to disparage Ketamine because it really does help a lot of people, but it's not as good as some of the medicines that aren't yet FDA approved. I'm involved in the MDMA PTSD trials. I was involved in the Cannabis PTSD trials, they're over. I'm not personally involved with the Psilocybin trials, but I'm certainly an enabler and a cheerleader of those studies. And everything is sort of moving along, and again, we could talk an hour about this issue of medicalization versus decriminalization, and I'm happy to entertain those questions a bit. But I will say that things are more or less moving in the right direction, and more people know that this is an option. And most importantly, more people are already benefiting from MDMA-assisted psychotherapy or Psilocybin-assisted psychotherapy, whether it is happening in a research context or in an underground context. It's a really great, exciting time to be a psychiatrists, I will say.
25:05 PA: So from your perspective, what does it say about, particularly the American medical establishment, that they're starting to consider more and more of these alternative substances like Psilocybin, Ketamine, MDMA compared to traditional pharmaceuticals?
25:19 JH: Well it's great, and I would be lying if there wasn't some part of me that was like, "I fucking told you guys." [chuckle] I have been saying this shit since the 80s. There's a little part of me that feels vindicated because I have been a little bit of a Johnny One Note for 30-something years, saying there's something here and people should look. So it's great, but that doesn't necessarily have to disparage all psychiatric medication. I feel obligated to give a bit of a caveat here that there are people with bipolar disorder or schizophrenia or schizo-affective disorder, there are people that have serious, persistent, chronic, severe symptoms that are gonna need to stay on their meds. And right now it really wouldn't be prudent for those people to stop their meds for any reason or to stop their meds because they wanna try psychedelic assisted psychotherapy or MDMA assisted psychotherapy.
26:13 JH: The research is showing that it's safe in these situations when people are properly prepared, and there's a lot of therapy before hand, and there's a lot of therapy between the sessions and everyone's carefully monitored. I'm one of the medical monitors for the multi-center trials, and I was sometimes the medical monitor or one of the medical monitors for the earlier MDMA assisted psychotherapy research, and it was important to me, it was totally my job and not just my job to make sure that things were medically safe. We've had an amazingly good run of medical safety. And behavioral safety is a different issue, and I'm also willing to talk about that. But I think that the mainstream psychiatry is certainly hearing about it, they're certainly, unless their head is under a rock or whatever, head is in the sand, I think they understand that these are becoming viable options. We've got more psychedelic research centers cropping up. Hopkins made a big one, and Imperial College made a big one, and there's absolutely something brewing at Mount Sinai as well, and Columbia is talking about creating one and we know there is a center in NYU.
27:22 JH: So these centers are popping up, there's gonna be more and more research, there is gonna be different indications where they're gonna not just be looking at post traumatic stress disorder, but they will start to look more at addiction, and there's already studies of Psilocybin and cocaine and Psilocybin and nicotine addiction and Psilocybin and alcohol addiction. I think we'll continue to see more MDMA studies, not just PTSD but people looking at autism spectrum or eating disorders, there's so much. It's so rich because it's basically anything that would respond to really good intense psychotherapy is going to respond to Psilocybin assisted psychotherapy or MDMA assisted psychotherapy. So these are catalysts to make good therapy go deeper and go faster.
28:10 PA: And it comes back to what you were talking about before, which is this Oxytocin and how that leads to connection. Which on the one hand, is really great for people who maybe have had adverse childhood experiences who need to have catharsis around those traumas, who need to feel like they are connected again, 'cause it feels like a lot of the trauma that we have as humans is related to disconnection, whether that's disconnection to self or family or the Earth or community. And yeah, as you mentioned, there can be a dark side to that as well from a behavioral perspective. In that when people are more suggest-able in that state, it leads to issues of ethics.
28:51 JH: Right. So when I was putting together the ecstasy book back in late 90s, and I was basically assigning everybody a chapter. I was like, Dave Nichols, you do the chemistry and I don't remember right now, but anyway, I assigned chapters to different people, and I had assigned a chapter to a guy named Rick Ingrasci who was one of the original early pioneers of MDMA therapy and Ketamine assisted psychotherapy. And I heard back from a couple other people who I had assigned chapters to, 'cause I didn't do anything blind, and they were like, "Oh, we're not gonna be in this book if Ingrasci is in this book." And I was like, "What? What are you talking about?" And that was one of the first time that I learned that there had been any sort of impropriety and malevolent bad behavior around an assisted psychotherapy situation. Since that time, I have heard of a number of other instances, I will say a handful. I know that there are way more than that, if I'm just hearing about a handful, but it is absolutely clear that when any person is in an altered state, they are more vulnerable and there has to be tremendous oversight in what happens in those sessions.
30:03 JH: And I also think that there are situations where a person can have their own session and they don't necessarily need a sitter. We certainly know about and many of us have experienced just having a psychedelic session on our own, and maybe you have a notebook and a pen and you're your own therapist. But that's not sort of traditionally the way it's done. And there are people who went way over the line and did things they absolutely should not have done, period. And in some cases, people have broken the law, in other cases they haven't but they've made terrible, terrible choices that have jeopardized the safety of the people they're working with and the sanctity of the work that they're doing, not to mention an entire research project. So it's a really big deal, I would love you to do just a whole podcast about Shamans behaving badly, let's say.
31:00 PA: It could be a podcast series.
31:01 JH: Yeah.
31:01 PA: At this point.
31:02 JH: Well it certainly could be a documentary, and I have sort of pitched things to documentarians. As much as I am a fairy godmother and a cheerleader and a true believer in all of this work being done and everyone who needs it, having access to these medicines. I also think that there can be a place for a critical eye, and it's like a good parent, you don't just say like, "You're great. Keep going and growing. You're doing great Bobby." At some point you're like, "Bobby except that other thing. That thing, you don't do that. That's not good." That's part of being a good parent. Maybe you'd rather discipline your kid in private and that's fine, but the disciplining has to be done. And also just sometimes with a garden, there's a lot of growth and then you have to prune. And you have to cut the dead wood and you have to make some decisions about how big you want that plant to be, and you have to cut. You have to prune the bush. And when I'm writing and I've written 160,000 words and it's gotta be 120,000, I have to trim 40,000 words. You gotta kill your darlings. That's part of making art, is you've gotta pull back.
32:15 JH: And it's like unrestricted growth is what got us into a lot of problems in America with capitalism. And in medicine, unrestricted growth equals cancer. So you can't have unrestricted growth, you need pruning and shaping and disciplining. And maybe it's like in its adolescence, and so it's like testing limits. An adolescent needs to know where the limits are. They want to know they can't get away with everything and that they're not in charge.
32:46 PA: This is a great analogy.
32:47 JH: I'm glad that's coming through.
32:48 PA: I love this. You explain things so well. So what... As like a follow-up to that. If we're in this, let's say, adolescent stage specific to the psychedelic movement, if you will. And I think we're also in an adolescent stage as a culture, still people in that case as well. There's many fractals of this analogy, but specific to the psychedelic space what have you witnessed or what are you aware of in terms of guidelines being put into place? And I think this is where we get a little...
33:21 JH: Well, I think...
33:22 PA: Tricky between medicalization and decriminalization.
33:25 JH: Yeah.
33:26 PA: Like balancing those two.
33:26 JH: Well, there's a few guidelines that I look to. There's a few people that I've been looking to for guides of sort. I've known Bob Jesse for, I don't know, 20 something, 30 something years. Practically before the Internet, I think I've been in touch with him. Yeah, when I... I had a really, really early email address and he was one of the first people in my list. So I would say anyway, I trust... When Bob Jesse writes something and wants a bunch of people to sign on, I sign on. The open science manifesto, I think is one good place to start. I also think that Annie Oak at Women's Visionary Congress, she's somebody I have known forever and I absolutely trust her ethics, and they have a lot to say. WBC has a lot to say about these sort of egregious behaviors. And then I also... Bia Labate is somebody I've known for decades and Chacruna has some very clear guidelines. And they've spent a lot of time really thinking about this. And then there's Matt, and then there's Rick, and I've known Rick for 30 something years. And I don't know what I could possibly say about Rick that I haven't already said on some other interview or podcast. But here's what I often say about Rick, is I have this very clear visual of him, and he is like... And I do not mean this in a bad way at all because I love Rick and I've known him longer than I've known my husband, a really long time and since '85 and...
34:55 PA: Which is when MAPS started.
34:56 JH: Yeah, I knew him before MAPS, a little before MAPS. I call myself a charter member, if there is such a thing, because I was in pretty early. But the metaphor I always give for Rick is I think of this... It's like a three-year-old on a tricycle with a helmet, and they keep ramming into this brick wall over and over and over, and the brick wall very, very slowly crumbles. And like that to me is Rick where it's just like he's been battering... He's been like a battering ram against the DEA and for MDMA and just been single-minded in trying to get MDMA into the hands of people who need it for so, so, so long. And I've just watched him keep at it. And in the process, he's created a company. You know this like behind every great man is a great woman or whatever. It's like behind Rick is a bunch of great fucking women, a bunch of amazing women, and they are getting it done. And there's... You would not believe how much work it is. The multi-center trial, the phase 3, it's like it's so much paper work, it's so much ridiculous, bureaucratic conference calls and Zoom meetings and just stupid crossing every T and dotting every I. I cannot impress upon you the bureaucracy and bullshit that it takes to actually make this happen.
36:26 JH: And they're doing it, they're making it happen. And I really... I have a lot of respect for what's happening. But the Yensen thing is really bad. And I was hoping that it wouldn't bring down the whole house of cards, and I believe it didn't and it won't. And whether it should or shouldn't, I don't wanna say 'cause I think that's a rude thing to say. And I absolutely, really respect all the players, and I understand that people were absolutely psychically injured from what happened. Also, I've known Donna and Richard a really long time. I'm 54, and I've been in this community since '85. So, I know all the players, and it's important to me to know all the players. And I was pretty freaked out when I heard what happened, and a lot of people were really freaked out when they heard what happened. And I am just... Part of me, and maybe this is a callous part of me, but part of me is just like, 'keep your head down, keep going, get the data'. We are in the middle of this huge multi-center trial and if we can get the data to prove what we all know, then we will really have gifted the Earth something great for it to heal.
37:56 JH: And you think there's PTSD now, and from 9/11, wait till you see the PTSD fallout from this. I have got plenty of friends who are doctors and nurses who are in the thick of it, and they're gonna need a little help processing this when all is said and done. So unfortunately, we are creating more PTSD as we go, not less. So my heart absolutely goes out to the person who was 100% wronged by this experience. And my heart goes out to many other women who have been completely taken advantage of and victimized when they were in a vulnerable state, because I know it happens. And I've had patients come to me and tell me terrible things that happen to them at music festivals and parties. And I've also had men with methamphetamine and who have been raped. And then there's our great President who is a huge traumatizer. For my patients who have been sexually abused or assaulted, Trump is so triggering because he is such a predator.
39:10 JH: I just remember the way he was pacing around Hillary during the debate. He's a bully and a traumatizer and the whole Kavanaugh trial whether Blasey Ford was being believed or not, that was really hard on me and on my patients, and on every woman who's been in that position of being victimized and having to come forward, not being believed. And I absolutely believe that a lot of the people who have been victimized in these either Ayahuasca circles or individual sessions with toad or with MBMA therapy, I think not... Clearly not everybody who has been victimized has come forward and there's a lot of people who haven't for many reasons. I guess I personally would at least like to hear from more people about their experiences, because not everybody talks to me about it. And it's important to me that I know what's going on where.
40:07 PA: Do you mean with your patients or do you mean just generally speaking people can be more open about it?
40:12 JH: Well, my patients certainly come to me and tell me what happened. But you know I do think that there are are people who are afraid to come forward with what has happened to them, because of reprisals or because maybe they also are afraid that they don't necessarily want to bring the research down or stop the medicine from getting where it needs to go. But then, on the other hand there's this whole other faction of people who really reject the medical model and just, "I can grow mushrooms, I can grow Cannabis, why do I need anybody else? These are plants." I love the decriminalized nature platform and people and the whole idea of it and yes, of course. Of course, I should be able to grow whatever plants I want in my garden. I should be able to grow poppies and mushrooms and Cannabis and they're plants, I live on the Earth, I'm entitled to have a garden and I can ingest whatever I want and there's cognitive liberty or there should be. We should be allowed to ingest whatever we want, but unfortunately we're not there yet, as a society, and so people are trying to work within the parameters that they have, and also you can't grow your own MDMA.
41:25 PA: Sassafras, is like MDMA.
41:27 JH: But then the issue with sassafras or nutmeg is that you vomit if you ingest enough to really give you psychological effects, but there are other ways to increase oxytocin which do feel pretty good but they just don't last as long. [chuckle] That's the problem.
41:46 PA: Well, let's go into that because I feel like my own personal experience with psychedelics, I've been doing them for 10 years now. So, I'm 29 now, when I was 19 is when I first started working with LSD and Psilocybin at higher dose levels. I would say the core insight from that was because I'm so interconnected with everything around me, that it's really important that I know where my food comes from and then it's really important that I understand who my friends are and what their energy is. And it's really important that I take good care of myself. And something we teach through our microdosing course in particular is look, psychedelics, MDMA, Cannabis, anything that you're using as a catalyst for healing, it's not a magic pill formulation, because that's been the assumption that's been integrated into the American medical system. You take this, you'll be fixed, blah blah blah.
42:39 PA: A lot of this has to do with lifestyle changes like changing how we eat and changing our sleep patterns and changing who we interact with. So from your research and what you've gone into, what are, we can call them, complimentary practices that people can integrate to have more oxytocin and more serotonin, to be more connected, beyond just having an MDMA experience?
43:04 JH: Right. Well, so, one of the things I wrote about quite a bit in Good Chemistry is how the best thing you can do for oxytocin is be skin-to-skin, face-to-face, eye-to-eye, smelling each other's pheromones, cuddling, naked, that's gonna to give you a lot of oxytocin. So the problem right now with the social distancing is that becomes very tricky. There are other states which are very high oxytocin states like nursing and childbirth, which are not going to be available to everyone but some of us are going to really experience the joys of nursing and that's a pretty high oxytocin state, and if you have natural childbirth, it's a very high oxytocin state. But then there's just orgasm, which hopefully most of us have access to and again, that's why I was joking, it doesn't last very long. If with MDMA, you have these high oxytocin levels that go on for maybe an hour or two hours at the peak of it.
43:58 JH: I understand the MDMA experience goes on longer but I don't think that the whole time you're having an MDMA experience you're having these peak oxytocin levels. But Sting aside I think most of us can't have these sustained orgasms, so then we're just going to get a little burst of oxytocin. For instance, if I hold a baby... I'm not nursing anymore obviously, but even if I just hold my friend's baby and smell the baby's head and just hold the baby and feel love and compassion, and the sense that I want to protect the baby, that will give me an oxytocin increase. And I can feel it, because I've been paying attention to this for a really long time and babies make me feel a certain way.
44:40 JH: A couple of weeks ago I was on a FaceTime call with a friend of mine who's baby I'm very close to, and she just put the phone down so I could just watch the baby for a while and I'm watching the baby through my tiny little phone, and I am starting to feel that thing that I feel. I'm like, "Oh, I really... You know I am almost sure, really, that just looking at the baby through the screen, I am having a tiny little bit of an oxytocin hit from that." I don't know like I, all of a sudden, just got that like, "sigh" you know? So maybe we can, through our phones and through our Zoom contacts or whatever, maybe we can still, tiny bit feel that, that connection. But the book that I wrote was totally before coronavirus and I made the case in the book that we cannot. That our phones or the laptops, that is synthetic. Tapping a heart on Instagram or Twitter or whatever, is not the same as touching hearts, it's not really going to open up your heart. And I have this idea that because it's synthetic, you go for quantity instead of quality. There's this great quote, I love this quote which is like, "You can never get enough of something that almost works."
45:54 JH: So, you're pressing like and you're scrolling and you're scrolling and it's almost enough, but it's like if it were enough you would stop. It's not enough. And so you're sort of insatiable to have this little synthetic connection 'cause it's better than nothing. And it is better than nothing, but it's also not... It's scratching around an itch, it's not quite the real thing.
46:14 PA: There was a book I read by Cal Newport recently, I think it's called Digital Minimalism. In that book, he made the case where it's like tapping hearts on Instagram or liking things on Twitter, in fact, it has an overall a negative consequence because you feel as if you're connecting with others, but at the end of the day, you're actually not. And it's sort of like the analogy that's come up for me, it's like fast food. You're eating food, when you eat fast food, but it's... And it kinda feels like you're full, but at the end of the day, it's really just poison.
46:46 JH: Right it's not nutritional, right? It doesn't really like...
46:49 PA: Nourishing...
46:50 JH: It doesn't feed your soul. You would say.
46:51 PA: It doesn't nourish us. Yeah exactly.
46:55 JH: But on the other hand, it's like right now, it's better than nothing, and it is the thing that's sort of... It's like the drug that's just sort of soothing us until we can get out and get the real thing, it's like we are gonna have to just deal with a synthetic version for now. Although many of us who are quarantined with our family or are in some sort of a pod, you still are having that human contact. And the way that I wrote Good Chemistry, I sort of divided each chapter where I talked about feeling connected and feeling a sense of oneness, first of all, just with yourself being embodied and maybe being mindful, just being connected with yourself it can be a high oxytocin state where you feel relaxed and you're breathing through your nose, and you're in parasympathetic, and that is enough for you to feel like you belong and you're connected just in your body with yourself. And so that was the first chapter and then the second chapter is connecting with a partner.
47:56 JH: And I talk about opposites attracting and then repelling, 'cause that's sort of what happens in relationships. You find somebody who has all these things that you don't, and then it's like you complete me, but then you start fighting because the reason you don't have those things is that they were sort of beaten out of you, so to speak. And you learn that they were bad, and so you end up sort of projecting all that negativity onto your partner who has those things, even though those are the things that you said completed you. And there's also idea of rivalries, where people who are more indifferent end up feeling like they're opposites, but everybody else thinks that they're not. Anyway, that's the chapter. So the first chapter is connecting with self, second is with a partner, third is connecting with the family, and that's where I talk about the science of nursing and child birth and oxytocin. But I also talk about how fucking hard it is to be with your family, like how incredibly challenging it is, and how they push all your buttons, and how there's just... It's just triggers everywhere. And that's why I'm so pleasantly surprised at how well the four of us are getting along here on our interminable snow day because I was worried about that.
49:07 JH: And then the fourth chapter is about connecting with society and community, and that's where I talk a lot about politics and the science of politics. And this sort of lefty righty in terms of the parasympathetic versus sympathetic. And these open and closed states and how... Because the dirty little secret about oxytocin it's like, yes, it's about bonding and trust and blah, blah, blah, but also it's totally about, are you on my team or are you on the other team? I talk a lot about how us and them and that sort of mentality is also fueled by oxytocin and how that kind of xenophobia goes into politics. So I try to talk about oxytocin and politics and the science of connection versus disconnection in terms of red state, blue state, or liberal or conservative, those kind of labels. And then I talk about the connection with nature and the connection with Earth and the cosmos and death. So the last chapter is really a lot more about psychedelics and about this idea that everything is connected and we're all connected. And I really, honestly, I wanted to do a whole book about death, but my agent was just like, "Yeah no." She's like, "Nobody wants that." But the...
50:21 PA: Next book. Next book.
50:21 JH: But honestly, I think there's a few blind spots in medicine, and one of the biggest blind spots in medicine is around how we deal with dying people. And they're getting a crash course now in how to deal with dying people like never before, but... And now we can't do any sort of our usual rituals or rites around burial and grief, which is really gonna fuck up a lot of people, because it's nice when you lose somebody and everybody comes together and they support you and they talk about how great that person was and what they meant to them, and there was this closure, and none of us are having any of the rituals around grief right now. And I would say that we are all in a state of grief, first of all. Even before this virus, many of us were in the state of grief about our planet and about the state of our country. And this is just like trauma and grief on top of trauma and grief, and it's a lot for people to take.
51:15 PA: Why is it that death is so taboo, and why is it that we don't have a good relationship to it?
51:21 JH: Well, I think, first of all, we are kind of programmed to have a lot of anxiety around not existing anymore. And I think it's funny 'cause you and I are like, "Why... What... What's the big deal? Death? Who cares?" 'Cause it's like, yeah, I had 5 grams of mushrooms when I was 20-something, and I was like, "Yeah, death is cool." I went to a place where I didn't exist and it was fabulous. But I think the average person walking around, they just... They haven't had that. They don't know that letting go and not existing anymore, and that there's something bigger that will absorb you. Or there's an interconnected lattice work of light and energy around everything, and you'll just become one with that. If you start talking that way to the average person, it's not gonna go well. [unclear speech], but then luckily, maybe I'll be there to make sure you don't really belong there. So it's crazy talk, right? But the people who've had mystical experiences, who've had ego disintegration, who've quieted their default mode network, they've had these really blissful experiences of not existing and of everything being connected, and it's possible that they're less afraid of death and less afraid to talk about it and deal with the reality of it.
52:36 JH: But the average, whatever, Joe six-pack on the street, they're not there. They're not in that place, and so... And the easiest defense, and the one used by toddlers, but the one I used in 2016, is denial just like, "No we didn't, no, he's not, no this isn't happening." I was amazed how much I used all my brain power and energy for months after the election to just be, "No, we didn't, no he isn't, no it's not." because I had to, I wouldn't have been able to get out of bed. So I think we use denial a lot, and certainly we use it with death all the time. And the thing about COVID-19 is it's not gonna let you be in the state of denial about death anymore. We're all equally on the chopping block. And we need to have these talks. We need... As our population ages, we are gonna have to have the hard talks about quality of life and health span versus lifespan.
53:43 PA: And there are some people who would say, "We can have both." The longevity people. In fact, this is what I'm really interested in. We talk about, even with what's going on with COVID right now. There are certain things that people can do to improve the immune system, which is why it's looking like it affects mostly elderly people, although it also affects people in their 20s and 30s as well, but mostly elderly. And so there is this element now with all the knowledge and information that we have, where if someone wants to live a long lifespan and a really healthy lifespan, it's possible now more than ever. I think the tricky thing for a lot of people is how do you separate the signal from the noise, because there's so much information that it can be overwhelming to figure out, "Well, what's true and what's not?"
54:29 JH: Yeah, so, well, I will quickly address that, and then we may have to wrap up. But I voraciously read non-fiction books, Dave Asprey's books or things like that, people who are trying to game the system on longevity. It really all keeps coming back to a few basic ideas, but one idea that I will remind you of that we talked about earlier, is this idea of being in parasympathetic more. That when you're in parasympathetic, your immune system works better, your digestion works better, your metabolism works better, and it is the only time where your body initiates the repair protocols that it has access to. The body can repair itself a bit here and there, it does not do any repair when you are in fight-or-flight. So anything you can do to get into parasympathetic will help you not only feel calmer, but you will be healthier and live longer. It will put you more in the anti-inflammatory state.
55:27 JH: So for my patients, I encourage them to do anything that's anti-inflammatory. Stress is inflammatory, so anything that decreases stress is anti-inflammatory. So that includes things like, go outside in the woods, go to the ocean, breathe through your nose, take a yoga class, meditate. Just do nothing for five minutes. You don't have to meditate just fucking sit down without your phone for five minutes, maybe if you breathe through your nose, you'll be in parasympathetic. It's already good. Sleep is good. Being held, being soothed, cuddling, that is all great for parasympathetic. Playing with a baby, playing with a puppy, any interaction pretty much with your pets, seems to really help put you in parasympathetic. Floating, if you have the luxury of a hot tub or a lake or an isolation flotation device. Floating can put you in para. But really just breathing through your nose and thinking calming thoughts is enough to help your body be in a place where it can take advantage of the food you're eating, and really digest it well and help your metabolism, and help your immune system, and help the bodily repair that needs to go on. So it's an anti-inflammatory state.
56:40 JH: And the other thing I will say, is that Cannabis has got potent anti-inflammatory properties. And for many people, it helps to put you in a mindful state where you feel connected with your body or you feel connected with nature, or you feel more in touch with the music that you're playing or singing, and those are all enhancing parasympathetic states. So if you smoke too much and you get paranoid or upset or agitated or anxious, then no, for you, it was not a parasympathetic state, but for many other people, it is part of an anti-inflammatory lifestyle, and it does help to keep you in parasympathetic.
57:23 PA: Beautiful. Everything in moderation as they say. So Dr. Julie Holland, thanks so much for joining us on the podcast before, as a final wrap-up, if you could just the name of your book that's coming out. And just if people wanna find out more information about your work, like a website or a place they can check you out.
57:39 JH: Sure. So the book that's coming out in June is called Good Chemistry: The Science of Connection, from Soul to Psychedelics. And my website, there's so many ways to reach it, it's like Dr. Holland, thepotbook.com, naturalmood.com, moodybitches.com, it all brings you to the same place. And if you just Google "Julie ecstasy", you'll find me. I used to meet people at parties back in the 90s, and I'd be like, "Just Google Julie ecstasy, you'll find me." So that still works, which I love. So you'll find me. If anybody feels like pre-ordering this book... I think I am preaching to the choir, I know with your podcast audience, but I think people will really like this book. I featured a lot of women in this book because I love Michael Pollan. There's so many men in the psychedelic community, and they're lovely and I love them, but I want to sort of feature some of the women in the psychedelic community a little bit more in this book, so you may notice a bit more gender parity than you're used to in Good Chemistry.
58:39 PA: Beautiful. Well, thanks again so much.
58:41 JH: Alright, my pleasure Paul.