Transforming Mental Healthcare with Telemedicine Psychedelic Therapy

Podcast Highlights

• COVID-19, The Sovereign Individual, and the potential for mass exodus from urban centers.
• Centralization of society and technology vs. moving towards decentralized nodes, neo-tribes, and intentional communities.
• Why multiple approaches are needed to increase access to psychedelic medicines.
• How Mindbloom is creating a next generation mental health and wellbeing platform.
• Making ketamine therapy more affordable, approachable, and available.
• Telemedicine, remote healthcare, and the Ryan Haight Act.
• Old medicine vs. new medicine and why people need to think critically.
• The shadow side of pioneering psychedelic medicines.

Show Links

1. Mindbloom
2. The Sovereign Individual
3. Alvin Toffler
4. The Third Wave (Toffler book)
5. Were LSD & Marijuana the Secret to Steve Job’s Billions?
6. Centralization and Decentralization
7. Ready Player One
8. Psycho-Pass
9. Ryan Haight Act
10. What is Telemedicine?
11. Influence, by Robert Cialdini
12. Doorway to the Numinous, by Stan Grof
13. Dylan Beynon Linkedin

Podcast Transcript

Paul Austin: This week's episode is with Dylan Beynon, CEO of Mindbloom, one of the most innovative companies in the world today who do telemedicine with delivery ketamine. Tune in to learn more about Mindbloom and how you can take advantage of a special offer that we'll announce towards the end.

PA: 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.

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 two ounce 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 is 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.

PA: As long-time 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 sand bags, 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.

PA: Hey listeners. Welcome back. I'm your host, Paul Austin, here to bring you another episode, this one with Dylan Beynon, CEO of Mindbloom, frankly, one of the most innovative companies in the world today, especially in the post-COVID era. Dylan has set up a fascinating system, we're now in eight different states, New York, New Jersey, Florida, California, there are a handful of others as well, you can get ketamine delivered at home to you in lozenge form, and then use Mindbloom's telemedicine platform to have guidance through your journey and experience. So we talk about that in the podcast today, we talk about Dylan's personal journey with psychedelic medicine, a few of his favorite books. Dylan in many ways is like, I would say, a soul brother to me. We come from similar backgrounds, we have very similar interests. He is a much, much better operator than I could ever be, and what he's building with Mindbloom is phenomenal.

PA: So if you're interested in getting Mindbloom, so going through that experience, getting more details, go to Mindbloom.co and enter THIRDWAVE as a promo code, and that will get you a discount on Mindbloom's incredible telemedicine service. So if you have anxiety, depression, anything like that and you qualify based on Mindbloom's criteria, go to Mindbloom.co, put in THIRDWAVE as a the promo code, and you'll get a discount on that healing process with Mindbloom. Okay, without any further ado, I bring you Dylan Beynon, CEO of Mindbloom.

PA: So you're in New York. How's that going?

Dylan Beynon: Yes, I'm holding down the fort. It's actually going pretty well. I'm on a meditation cushion on my balcony. It is a beautiful Spring day, which is a big deal out here, the sun is shining. As you noted earlier, cars are honking, which is a good sign. [chuckle] When you have cars honking for a good six weeks, it's a little surreal. So it will be interesting to see when the city comes back to life, what the short and long-term cultural, healthcare implications of COVID are. This will definitely be an interesting place to observe them.

PA: Are you planning to get out of New York? Or are you just gonna stick it out and be like, "Fuck it. I'm a New Yorker, I'm hanging out here for the future."

DB: It's a good question. I think it depends on what the long-term implications of coronavirus are. It's certainly... If we're not able to implement infrastructure that allows us to test, find a vaccine, widespread serological testing, then city life is gonna become a little drab. And I imagine there's gonna be a mass exodus. Have you ever read The Sovereign Individual?

PA: I think so, or I've seen something about the book. I used to follow Simon Black's stuff, Sovereign Man, which I think may have been influenced by that book. Remind me what the book is about. I think that would be a good launching off point.

DB: Sovereign Individual is a very much, has been the zeitgeist, for the Silicon Valley crowd. It was a prognostication book, written in I think 1990, that was painting the future of, "Okay, there's this new thing called the internet on the horizon, and we think it's gonna be pretty big." And as we enter the Information Age, the hypothesis was that the returns to violence are gonna plummet, so whereas over time, the returns to taking other people's stuff increased, which is why we saw agricultural societies, feudal societies, industrial societies, and the massive nation states we have today. Well, once everyone has their stuff online and works online, well then you can't take it from them. And what's so stupendous about this book is he got like everything right. But one thing that it doesn't get right is it predicts a mass exodus out of urban centers, because if you can work from anywhere in the world, why would you live here in New York City in a tiny box where you're paying a ton of money, paying a lot of state and city taxes, when you can go live on a farm? What's really interesting...

PA: And you were saying they didn't get that part right. Not yet, at least.

DB: Not yet. [chuckle] And so I was thinking about coronavirus is potentially the unexpected, one of the many second-order consequences will be an exodus from cities and urban centers. People would be afraid. The benefits of really close propinquity and networking amongst people are gonna decrease. We might see that this be the catalyst that drives people out of urban centers. So I'm holding strong, but if I'm locked in my apartment for a month or two at a time for my and others' safety, every six months. Well, I think we'd probably get out of here.

PA: Yeah, yeah, it's interesting that you bring it up, Dylan, we've had, at this point, we've had two long conversations that have been just to get to know you, and then we had a really long conversation. I've always loved the dynamic between us, because you bring up something, where I'm like, "That's fascinating." Then I can come back with something. Then you come back with something. And what's coming up for me right now with you talking about The Sovereign Individual is, there's a guy named Alvin Toffler, who's a futurist. He used to be the editor-in-chief of Fortune, I believe, and he wrote three books. He wrote a book in 1970, a book in 1980, and a book in 1990. And these three books sort of laid out the future in a post-industrial society. And the second book that he wrote was coincidentally entitled Third Wave, and I didn't find out about this until a year and a half after I started Third Wave.

DB: Impossible to have one idea, right?

PA: Right. And one of our subscribers reached out to me, he was like, "Hey, Paul have you seen this book, Third Wave, by Alvin Toffler?" And I was like, "Holy shit, no, but I'm gonna go check it out." And in that book, he describes exactly what you're saying, in fact, I wouldn't be surprised if The Sovereign Individual was influenced by Alvin Toffler's work, because it was written in 1980. And what he talks about is the first wave was agricultural, second wave was industrial, and Third Wave was the Information Age. And I think this actually dovetails really nicely with our conversation, because in many ways, psychedelics kicked off the Information Age. And the integration of psychedelics in the 50s and 60s, which led to the computer revolution, many people would say, and the semi-conductor and all that. Steve Jobs saying that LSD was one of the most influential things that he's ever done.

DB: Buckminster Fuller.

PA: Buckminster Fuller as well. And so now with this Information Age, we've sort of been in this state of decadence of industrial society for the last 60 years, really ever since World War II, and we're now sort of finally going through those final breaches, and I think with the COVID, the opportunity is to fully introduce this Information Age. And so my first sort of big question for you is, you're the CEO and founder of Mindbloom, which is one of the most innovative companies that I'm aware of. What you've done in response to the COVID epidemic, I think embodies these concepts of anti-fragility that will be so important for businesses going forward, and I'm wondering, based on your pretty clear understanding of historical trends and where we see ourselves going, kind of just so we start with a small bite of the sandwich, what is Mindbloom currently doing to adapt to this new sort of world that we're living in, in COVID?

DB: One, thank you for the introduction. [chuckle] We're really proud of what we're doing, and it's an insane honor and privilege to get to work with and support these trailblazing clinicians, that I, from afar, was just rooting for, for the last decade of my therapeutic, psychedelic use. I think you're speaking to an ally of me. One, I think that the way that technology in general is going, is gonna be really fascinating to watch. The Information Age, it looks like it's gonna go one of maybe two directions, centralized or decentralized.

DB: Is it centralized artificial intelligence, or is it like decentralized blockchain technology? Is it centralized China or decentralized America in democracy? Is it centralized communism or socialism, or is it decentralized capitalism or some sort of post-capitalist society? In terms of... And I just... Something I'm thinking about a lot, and I think it's gonna be fascinating to watch.

PA: To hop in there, Dylan, quick, before you go into the Mindbloom like this is what we're seeing even in the COVID era with all these conspiracy theorists. If you look at David Icke, for example, a lot of people are scared of this one government global technocratic society that runs on AI and just as humans exists as a way to get energy extracted from us. Whereas that's the very dark, dark, dark, apocalyptic sort of perspective. Whereas my perspective, and I'm assuming it's a perspective that you share as well, is optimism and healing and sort of these decentralized nodes, what I'm calling neo-tribes, that are in some ways like Burning Man. And that we see as we were talking about earlier, people moving out of cities and moving into intentional communities that are resilient, that are adaptable, that grow their own food, that have their own culture, that maybe run a business within it, some of these sorts of things. So that's my hope.

DB: I think that's right. I don't think centralization can work. It sounds like you read Nassim Nicholas Taleb as well, and his non local and centralized. I think there's some great idealism around what if we could centralize everything and make decisions that are in the best interest of everybody, but in practice, that is very challenging. There's obviously a lot of incredible thought exercise like the trolley problem, like how do you program an Uber that is backed by AI when it has a decision to kill the driver or swerve and kill three people with... Protect the driver, who makes that decision? My favorite piece of art on this, there's an anime called Psycho-Pass, takes place in the distant future where there is a societal AI where everybody has a score and they're all surveilled at all times, and there are like police, similar like Minority Report who will get criminals before they commit anything. And society is working really well ostensibly but there's a lot of angst, and ultimately that's ruining it but you come to find out that there is no AI. There's just an oligarchy of 200 people who are keeping themselves immortal or their brains immortal.

DB: Yeah, I think that decentralization and a focus on, like you were saying, local and sustainable, isn't just maybe a, I wanna say, moral imperative, but I just think in practice is something that actually can work and harkens a lot more to our ancestral roots, which if I had one prevailing philosophy, it's that a lot of the issues that we're facing, especially like mental healthcare, and just a lack of meaning and purpose that seems to be pretty prevalent, it is a result of us just being so distant from where our brains and bodies are evolved to be in. We really haven't evolved in the last 100,000, 200,000 years and modern world, we're just ill equipped to deal with it. There's certainly no way back, only through, so what do we create that is modern, but is aligned with maybe what we're really from or what we're evolved or adjusted to how we are to be, or the environment that we may need to be in, the sort of connections we need to have, is something that is I'm also really excited about.

PA: So let's go back to that balance versus centralization versus decentralization. And I think the parallel that I'll draw is in this psychedelic space. On the one hand, the centralization approach is the medical model. You go through the FDA... It's the industrial model, you go through the FDA, you get these medicines approved, they'll be available to treat depression, addiction, anxiety, etcetera, etcetera. The decentralized model is the decriminalization model. There doesn't need to be any significant regulations. No one can actually charge for the substance itself, you can only charge for the time, the energy, the effort. So when it specifically comes to psychedelics, how do you think about that relationship between the centralization and the decentralization?

DB: Interesting, let me ask you this, before I get into that. So decriminalization, my understanding is that when somebody is decriminalized, I am from Southern California, where even before Marijuana was decriminalized, it felt pretty decriminalized. But not the case down here in New York for instance. So when something's decriminalized, it still cannot be... I wanna say commercialized, but distributed. It still is illegal, it's just not... It's legal to sell, it's legal to cultivate, depending on what the statutes are, but it is not a criminal offense to possess a certain amount. Do I have that right?

PA: You're correct in that. And I think let's go beyond that a little bit, and I'll clarify one of my assumptions within that question. I think my main assumption is we will see, especially with microdoses of Psilocybin mushrooms, a similar trajectory of growth as we saw with CBD and Cannabis. Where even though CBD was technically illegal, it was still sold widely because it was perceived as being fairly harmless. And so although the laws didn't... Basically, the laws didn't reflect actual human behavior. And so...

DB: Yeah this is the Uber and Airbnb argument, right? Like Uber and Airbnb...

PA: Correct.

DB: Illegal? Probably still illegal, but creates so much consumer surplus that we say, Hey, laws can't keep up. And so as maybe entrepreneurs or even as a society, we're okay pushing some of these things, it's a little tough for Schedule 1 drugs though.

PA: Well, Cannabis is Schedule 1. Keep that in mind.

DB: Yeah, I know.

PA: So Cannabis is Schedule 1. And I hear you, it's different with psychedelics because psychedelics are not Cannabis. Sorry. They're much more intense. So maybe the better question is, how do you perceive the centralization versus decentralization tension in the psychedelic space?

DB: I guess I'm like surprised there is any tension, and that's been one of the things... I think that there's been a lot of things that have surprised me. Going from a psychedelic enthusiast for the last 10 years to now somebody working in psychedelic medicine and mental healthcare for the last two years, is that people are really fired up about their approach. I am fired up about our approach, because it's the best way for me to bring my skills and resources and experience to try to make the change that I wanna see in the world most happen, which is to help transform lives today, so that we can hopefully transform the world tomorrow, unless humanity runs into a brick wall going 1,000 miles an hour, which might be the path we're headed on. But I'm like agnostic to other approaches, and I hope that people try a lot of approaches. That's how we are gonna find the one that works best within the confines of what's obviously safe for people, the law, and being thoughtful about what could potentially maybe slow things down for everybody, and that's something we're really thoughtful about in Mindbloom and our approach. In terms of what...

PA: What is... Go ahead.

DB: In terms of legalization versus centralization, I was on the phone recently with an exec head from one of the other very large psychedelic medicine companies, very well funded, and they were talking to me about why they think that regulation is so important, and I think I surprised them. I was like, "If I had my druthers, if I had a magic wand to wave, I would push legalization." I think the evidence is pretty clear coming out of Portugal. I think that the war on drugs has been a massive failure. And I grew up with a family member who had severe mental, my mother, who had severe mental illness, and was an addict, and it's not like drugs being illegal stopped, stops people from accessing them. Education and not putting people in prison, but rehabilitation, I think is gonna, not I think, I think it's pretty proven, is the direction to go. The reason that we're taking what you might call a centralized approach, maybe we don't think about it so much that way, and Mindbloom is, I just think that's the way that it's gonna head.

DB: That's gonna be the medicalization and FDA approval of these medicines, at least for a while, if not now, at least for a while, are going to be overseen by clinicians and doctors, until maybe there's a point in time which there's so much data around how safe it is and how successful it is, and how few adverse events there are, that we can go for making it medical, so for medical indications. At Mindbloom, it's depression and anxiety right now, there are other indications like PTSD and OCD and addiction that some of these medicines can be used for, to one day elective and then maybe one day ubiquitous, without the need of trade medical professionals. But I just don't foresee that happening in the next several years, but I'm rooting for all approaches because these medicines are powerful and profound, and they've been huge for me, and huge for so many people I know, and the more approaches that are thoughtful, I think the better.

PA: Right, because that level of complexity creates an anti-fragile system, so that way it becomes easy to adapt, it becomes easy to grow. Because as we're experiencing with COVID, COVID is just the next sort of disruption. The chances are we'll have another greater disruption after that, and a greater disruption after that because of climate change and these other things. So it's critical that we have multiple approaches and multiple lanes, so to say.

DB: Yeah, it's just more breaks. If there's a breakthrough technology, you wanna figure out what's the application this technology that helps the most amount of people, and there might be, for different people or different use cases, the same application of this technology, and there are a lot of different considerations bringing something to market. Sometimes it's regulatory considerations as well, so I just think we have these breakthrough technologies, whether it's Ketamine therapy, which is what Mindbloom is doing currently, 'cause it's the only prescribable medicine in the US, or MDMA, Psilocybin, or LSD, or DMT Ayahuasca, or Ibogaine, and the more approaches for how do we help people get the most out of these medicines, and how do we increase access to these, and where people can actually get them and use them.

DB: I think it's great. I'm continually surprised at how fired up people are about whatever their approach is. As long as people are approaching it thoughtfully with good intentions, intelligence, wisdom and passion, and a real focus on safety and a real focus on viability. [chuckle] I think anyone focusing on this space is doing great work, and my Buddhism, I'm not Buddhist, but I study a lot of Buddhism and big fan, might call it rightful or skillful livelihood.

PA: It's getting to the brass tacks a little bit. What is Mindbloom doing? How are you helping people with psychedelic-assisted psychotherapy?

DB: Our goal is to really build a next-generation mental health and well-being platform. We're starting with Ketamine therapy, 'cause we think it's the most effective, science-backed medicine available today that is drastically inaccessible and under-utilized. In terms of our approach with Ketamine therapy specifically, from day one, we thought, okay, I mean I guess I'll give you the story. About two years ago now, I was working with my personalized medicine physician, a friend of mine, who does the bio-hacking thing with me, so he really helps me try to optimize our thing, top to bottom, it's like a nerdy hobby of mine.

PA: Me too.

DB: Yeah, me too. And I had founded two companies before Mindbloom, and I was leaving to start something, and I really wanted to do something in mental health care. Like I said, I have a family member who was mentally ill, well actually, several family members who have pretty severe psychiatric illness, and just really felt like we're still in the second inning of mental health, which now I think were in the first inning, now that I've been in it for two years. I didn't realize how bad it was yet, and I kept going back to psychedelics being the thing that was most impactful for me and my growth and development, and the thing that I just thought like, "The future is already here, it's just not evenly distributed." I know a lot of people are getting incredible results from it. I'm following the research, but it's still so early. There's so much work to be done to really bring this to more people. And he blew my mind when he was like, "Oh yeah, I know that there are a lot of people prescribing Ketamine legally right now for mood disorders." And that's psychedelic medicine. And so I became a Ketamine therapy patient myself.

DB: I've found that it was just as profound as a lot of the experience I've had with a lot of other medicines, but super expensive, very clinical, the way it's practiced in most centers or clinics and really hard to access. Just really not every where for people. And even for somebody who'd be getting six infusions at a local urban center, they had to drive 45 minutes both ways, they have to bring someone with them 'cause they're gonna be impaired and it just becomes really challenging. And so I had a couple friends of mine who had found that other consumer healthcare companies were really using telemedicine to increase access in their verticals. I think one of the things, even as an Internet entrepreneur, I continue to just get picked in the teeth on is seeing something, and thinking no that can't go online. One of my really close friends is the founder of Candid, they're a big direct to consumer Invisalign company, and I remember when they started building Candid, I thought, you can't do Invisalign online. That's insane. That's bonkers, bananas. Totally wrong. On a long enough timescale, everything is gonna go online up until when some or all humans will plug their brains into a computer. Everyone will be like floating in a little black box around space.

PA: Like augmented reality, essentially.

DB: Yeah, I would say that's just virtual reality. Augmented reality would be layering a digital world on top of the existing world, but when we can live in a virtual reality that is indistinguishable from reality or even better than reality.

PA: Like Ready Player One. Have you seen Ready Player One?

DB: I have. I've also read Ready Player One. If you've seen it, the movie is okay. The book is incredible, though. Really fun. I like reading but I'm real [unintelligible].

PA: So Mindbloom, psychedelic existence, psychotherapy, Ketamine. Let's go a little bit deeper into then, because of COVID, how has your business model shifted and adapted, and why do you think it was so essential to adapt it the way that you did?

DB: Yes, that's right. So from day one we wanted to make Ketamine therapy more accessible. We thought there were sort of three As there, more affordable, more approachable and more available, while also increasing the quality of experience and really demonstrating clinical outcomes for people, people are getting symptom relief from depression and anxiety, and it's the last [unintelligible] for them. We thought to make it more affordable as well as to make it more approachable and easy to use, improve the experience, we're gonna need to leverage technology to do it. At the beginning, the way that our model works was we launched a center here in New York. It's really nice, it's like a pilot center, where clients would come in for their first, at least couple sessions. They meet with a clinician after they've already done an online work up and consult, they would do preparation work with the psychiatric clinician and all our clinicians are really passionate about psychedelic medicine, trained in harm reduction.

DB: Our lead psychiatric clinician has been volunteering in the Zendo project for a long time, and our director is Principal Investigator at MAPS, Dr. Casey Paleos. So everything has already grounded and backed in best practices of psychedelic medicine clinicians and psychiatrists to... This and something clients would do an hour treatment, usually starting sublingually, also options for intramuscular injection, and there's an integration room for journaling and an integration session with the clinician. For people who are a medical fit, they would have the ability to then at the clinician's discretion, continue treatments remotely. And throughout the whole process, we have the application that helps people get content on preparation, setting intentions, sort of like a virtual guiding video series with our Medical Director, Dr. Casey Paleos holding additional programs geared towards different areas of depression and anxiety to help people get through it.

DB: When the coronavirus epidemic occurred, we as an essential medicine had the opportunity to keep the space open, but for the safety of our clinicians, for the safety of our clients, thought that there was a better way to continue to drive towards our goal to increase access to these medicines, not just by making them more approachable and affordable, but by making them also more available to people outside of even New York City. So when the pandemic happened, both federal and state governments have brought down a whole host of both short and what looks like will be long-term changes to the medical regulatory landscape. One of the ones that was most important for Mindbloom was a suspension of what's called the Ryan Haight Act 2009.

DB: The Ryan Haight Act was an Act in 2009 and essentially it says that all controlled substances, and there are a lot of them, need to be prescribed from an in-person visit. The reason we passed the Ryan Haight Act was because in 2009, some unsavory character started selling pain pills on the internet. And of course we were like, "Okay, we shouldn't allow people to sell pain pills on the Internet, that's dangerous." And then in typical government... True bureaucratic fashion, just had sweeping regulations said in that case, let's make all controlled substances require an in person visit not able to be prescribed online. A lot has changed with telemedicine and medicine over the past 12 or 11 years now. And so in 2018, Trump signed legislation asking the DEA to promulgate new special registrations around the Ryan Haight Act especially focused on mental healthcare and psychiatric medicine and addiction medicine.

DB: It's actually really bonkers. Psychiatry and mental healthcare and behavioral health are without a doubt, some of the most broken areas of healthcare today. There is a massive shortage of psychiatrists and therapists to treat people and prescribe medicines and they are also the least insured specialty. So whereas most specialties like 80% to 90% will be insured, in psychiatry, less than 60% are able to accept insurance. It's a really tough situation where we have this mental health epidemic, and we can talk more about it but after coronavirus, there's gonna be a massive mental healthcare epidemic. There's data back based on what happened with the much smaller SARS epidemics. And you got people who just can't get these treatments and they're not covered by insurance, they're expensive, they're stigmatized.

DB: So, fortunately one upshot of Coronavirus is the government did move very swiftly to help increase access to healthcare, and has, at least temporarily, dropped the requirements around the Ryan Haight Act, which is allowing Mindbloom and a lot of other companies, and just individual psychiatrists and individual doctors, physicians, to prescribe controlled substances through telemedicine, which has thusly enabled us to completely move to a remote model, at least temporarily.

PA: And to me, going back to our decentralized versus centralized conversation, that feels like a very decentralized way of being.

DB: Yeah, Mindbloom is interesting in that regard. We are a platform, in a way, that is providing services to affiliated clinicians and partners. So, Mindbloom doesn't provide medical services, Mindbloom supports the trailblazing clinicians, and psychiatrists, and therapists, coaches, that provide their services. In a way, there's centralized protocols that people are asked to follow to make sure that the quality of care is really high, but all of the clinicians and therapists that are partnering with Mindbloom to provide that care, are still providing it with their individual medical judgment. But yeah, our goal is to help, again, bring down the cost, make this more approachable to people. I don't know if you've ever heard the... Have you heard of the curse of knowledge, cognitive bias?

PA: No, tell me about it.

DB: Yes, the curse of knowledge says that once you know something, it is near impossible to remember what it was like before you knew that thing. [laughter] Example, and this is probably an odd example that maybe a lot of people today don't really recall, but like giving someone directions, you're like, "Oh yeah, how you get there, you took a left here, a right there, and left there, a right there. You got that?" and like, "No". You just forgot what it was like not to know this thing. Well, I think people like you and me who are experienced with psychedelic medicine, probably forget how terrifying psychedelics are before you experience them. And I think one challenge to making psychedelic medicine more accessible to people is just make it more approachable to people. That's not cheapening it or that's not telling people that like, "Yeah, don't worry, this ain't no thing", but it is making it a little more friendly, less sterile, simpler, less complex and convoluted.

DB: One of the things that we've learned is, psychedelic therapy is not the same as therapy. There's a lot that goes into it. Setting intentions, there's how you take medicine, there's even how you navigate the experience. A lot of people don't know like, "What do I do when I take the medicine? Do I meditate? Do I think about stuff? What do I do?" There's journaling, and there's actually, probably, the most critical part of the actual integration process to make these changes, 'cause the medicine is really just a catalyst for change, that's putting you in a neuroplastic state, giving you the insights, and then have something to work with. So, just simplifying that for people and teaching them how to do it effectively, so they're not overwhelmed and scared the whole time, is making it more accessible.

PA: Well, and I think this is fundamentally, this is basic behavioral psychology. I think there was a book called Influence by Robert Cialdini, which I'm assuming you know of or have read. And he talks about that process of, if you get a person to take the initial step, step one so to say, then yeah, exactly. And it's interesting our approaches, 'cause our approaches are very parallel. You've chosen Ketamine lozenges. I've chosen microdosing. But the sort of fundamental truth behind them is the same, how do we simplify this and make this easy for people to start to work with these somewhat mysterious medicines so that they realize the healing potential in the medicine themselves, yes, but I think more importantly, it's really the healing potential that's within ourself and I think that's where what Mindbloom is doing is so interesting and a lot of psychedelic companies, the wedge that they will create in the medical approach will be... Right now, we put a lot of our faith and trust, and I would say power, in the hands of doctors, and unfortunately, that power, especially over the last 40 years, has not been used so well with pharmaceutical medications, and the over-prescription of pharmaceutical medications in particular, in the United States.

PA: And to me, the opportunity with psychedelic medicine is giving people their power back, giving people their agency back, helping people realize that they have a choice to be healthier because of those elements of neuroplasticity, like you mentioned, in Ketamine. It's an exciting time to be at the forefront of this, and I'm curious to dive deeper into that, what sort of burdens have you felt? What sort of difficulties have there been along this process? For me, it seems like a lot of rainbows and butterflies, and it's fun and it's exciting and it's sexy to be doing this work, and there's a tremendous shadow side to it as well, so I'd be curious to hear, what hasn't gone so well? Where have those burdens been? What sucks sometimes with what's going on?

DB: Yeah, so let's definitely dive into that, and before we do, I think we should talk a little bit about what you just brought up around people taking control of their own health. I was actually surprised to learn, it's actually from our head of clinical operation, who has a really impressive healthcare background, that this is already a huge movement in medicine over the past several years. It's this idea of patient-centered versus doctor-centered care. There's old medicine, which is reactive, let's treat the symptoms, and it's that you have this parochial doctor authority figure who tells you what you should do for you. And the new approach, new medicine, is more proactive, we talked a little bit about biohacking, it's about as proactive as it gets. It's probably unsafe. Proactive, less about treating disease and more about living a healthy, fulfilled, vital life, and one which the patient is the one who owns their own care. And it's been a transition that's been, I think, happening pretty quickly, but still challenging. Maybe it started from a lot of doctors having clients come in, or patients come in, who have done their research on WebMD, and that's frustrating to them. Now we're seeing patients who are well-educated, thoughtful, and are really taking a stake in their own health, which is gonna become increasingly important.

PA: And this just speaks again to the information age, 'cause all the information is now there. It's not held by some sort of authority figure, but it's literally you go on fucking Wikipedia, or you search on Google and you can find shit all over the place.

DB: I mean, it's fascinating too. On the one hand, I think independent thinking has gotta be one of the most important critical values that at least I hold, and I think others... And so on one hand independent thinking is great, but what do you do when you have a search engine that is just an engine for confirmation bias, where whatever you search you can find. You can really take any two conditions, any medicine and any side effect almost, put it in a search engine. Something will come up. Likely a really solid looking study that's inclusive will come up and verify that confirmation bias. And 20% of Americans are clinical hypochondriacs. And right now, you got, who knows, probably 80%. It's fascinating to see how much that number shifts because of this pandemic.

PA: What I'm hearing is objectivity is also important, so yes, everyone can find information, but we've also seen the dark side of that, which is... Now, half the people in the world is, it seems like, think that lizards are taking over them. I mean it's a downside.

DB: Yeah, maybe that's why the most important thing is teaching people how to think, teaching people what our cognitive biases are, would be one of the best inputs. And I think that's a big part of what psychedelics does. It shakes the snow globe, it gives people perspective, it raises them to look at things from a different perspective or even different level, and ultimately you are changing how people think and how they make decisions and how they filter the world, that is a lead domino to everything that they're gonna do, their relationships with others and what they're gonna create in the world.

PA: Sussing out the signal from the noise. I think that's super critical for all of this. So let's get into that question that I asked before then. What burdens do you feel, what challenges do you find yourselves facing, what are the frustrations with the work that you are currently doing?

DB: It's pretty high pressure. This is my third company. My first was a consumer platform for politics and elections, really looking to help engage voters connect with local politicians. My last company was in a combination of legal FinTech data, and so is this, really trying to help people get better from the justice system. We dealt with a lot of financial regulations, a lot of people who we are meeting on the worst day of their lives who've been really injured and down and out, and were really getting taken advantage of, we're trying to help. But when you're dealing with health care, mental health care, with medicines this powerful, it's a huge burden. I don't wanna say its a burden, it's a privilege and an opportunity and a blessing I'm grateful every day to get to work on something like this. It's like a combination of Art, Commerce, Science and contribution. It's really exciting. But the stakes are high. We have a lot of visibility on us, not just from the health care field, but also from people in the psychedelic community.

DB: There's a lot of scrutiny on what we're doing and how we're approaching it, and we feel the full weight of that responsibility to be really thoughtful into 100% prioritized patient safety, our clinicians and the greater cause. In terms of maybe the medicine itself... It's early. Our partner clinician's been treating patients, clients since October. We've booked probably nearing a 1000 sessions at this point. Nobody's had an adverse outcome, and I think even our clinicians and even our Medical Director, Casey, who's been doing this for 10 years across MDMA trials, phase three and phase two, some early Psilocybin for cancer anxiety study, early Ketamine for depression studies. Even he's been stunned at the results that people have been having. Without a doubt, there will be a day where there's a problem and a patient has an adverse outcome or maybe has a breakdown that maybe it's because of the medicine, maybe they were gonna have it any ways but we were involved, our clinicians have a Hippocratic oath and duty to help these patients. We don't take it lightly.

PA: You can't take it lightly because there is a gravity to it, there is an element of back to the sort of cliche saying, "With great power come great responsibility," and these medicines are quite powerful even in just Ketamine lozenge form, which frankly are... I've done a Ketamine lozenge. It's fairly subtle. You're not getting totally blasted off into hyperspace, like you might with an IV.

DB: Maybe for you. So I have a high tolerance to Ketamine lozenges as well. So as a Ketamine patient myself, I find that I need an intravascular injection dose in order to get to a therapeutic level that's helpful for me. There are a fair amount of clients who come in, who on very light doses of Ketamine lozenges, have very, very strong experiences. And the clinicians start people at a low dose and titrate them up over multiple sessions to get them to the therapy dose, they're really just careful about that. Some people can really get there, and it's fascinating, it's been challenging to predict. They're collecting a lot of data on this that hopefully we expect to publish at some point. There are like, 6'2", 240-pounds, very experienced with psycho-active substances men who come in, who have very much light weights. They'll get... Having very strong experience on a small dose. We'll have a small, 90 pound woman who has no experience with psychedelic medicines, just psycho-active medicines and is just like an absolute tank and maybe requires a power dose to get there. It's pretty variable. We're trying to figure that out.

PA: I think one resource to dig deeper into is Stan Grof wrote about this in his book Doorway to the Numinous, that he wrote in I believe the 70s or 80s, about the thousands of experiments that he did with LSD. And what he noticed is, the biggest indicator was not necessarily the physical body, although I think that is one of the leading indicators, but the biggest indicator was a level of neuroticism. And those who were more neurotic needed much higher doses. In fact, in that book he wrote about how there would be some people where he would give fucking 1000 micrograms of LSD to and they'd just be tapping their foot, like this ain't nothing but a thing, because they were so neurotic, it couldn't break through their ego structure. And so whenever... And when I was hosting retreats for Synthesis, and when I've done my own medicine work with friends, even my own perspective, when I'm doing medicine myself, I always noticed that when I am in a more neurotic state or when I have friends who are very neurotic, they often need a lot more medicine, whereas those who have maybe a low level of neuroticism don't need as much. And of course, neuroticism is one of those big five personality traits. So I feel like that would be a pretty easy assessment.

DB: Yeah. That's wild that you say that. So, one, the treatment philosophy is all based on Stan Grof's work. That's our medical director, Casey's, hero. We literally start the program by talking about the inner healing. He talks about it in to clients and through our video series, The Inner Healing Intelligence, which is Stan Grof's work. That's like the treatment philosophy that everything's surrounded in. But, two is, I need to talk to the clinicians because I think they've been talking about this, they... But didn't know that there was already research behind this. And their hypothesis is that when people come in and they're really anxious, is the word they've been using, have high anxiety, and they treat people with anxiety, depression, they have difficulty getting into the experience. And when people maybe have a mindfulness practice already and some mindfulness skill sets, a skill set around mindfulness, are able to relax into it, that is people who are able to get deeper into it. One of even the biggest indicators or maybe biggest dimensions or environmental conditions that we've seen affect anybody's individual dose, this isn't surprising, it's the setting, but it surprised us how critical the setting is. Like if somebody has a pet and they're doing a remote session, it can destroy the entire session, and if somebody has their phone on that's beeping, it can destroy the entire session.

DB: I think it might be a little, I wanna say unique, but a little unique to Ketamine, where it seems to be a mess and you can really sink deep into and then just kind of like be out of it, maybe a little bit more manageable versus something like that strong dose of Psilocybin or LSD where you're probably along for the ride no matter what. But that's really interesting you say that, Paul, I'm gonna go back and talk to the team about that.

PA: And this is where even a practice like breath work is so useful in terms of grounding for those levels of neuroticism, and I think that's... We gotta wrap up the conversation you're producing, so we can't go much further, but I think that would be a good bookmark for next time is when you're looking at healing with Ketamine lozenges or psychedelic medicine, what supporting modalities are also useful in that process. Dylan, its been an honor. It's always a pleasure, but this time it's been an honor because this is in public. So I just appreciate you taking the time out of your day to sit down and chat about Mindbloom and what you all are up to. Really appreciate the work that you're doing. Totally understand the burden, and sort of the stress and the complexity, and also the privilege that we have to do this work. It is a work of extremes, which is, I think, why it's so exciting. So thanks for coming on the podcast, and just before we end today, if you could just let our listeners know where they can find out more information about Mindbloom, and that way they can go check it out after they're done listening.

DB: Yeah, thanks for having me on Paul. I'm a huge fan of what you're doing to educate people. The longer I work in the space, I see how important educating people really is, especially right now, so early. People have a lot of questions and they're important questions. You can find us in [email protected]. And even if you're not interested in Ketamine therapy, we also have some resources to learn more about psychedelic therapy or just Ketamine as a medicine itself.

PA: Great. Well again, Dylan, thanks so much and I look forward to the next time we get to chat.

DB: You too Paul, great chatting.