the answer used to be: yes, there's always a case for skepticism and critical analysis of a scientific topic
but in today's enlightened discussion climate one must also consider the magnitude of the shit-storm of personal attacks one will face before voicing that skepticism. you even have to consider that before you make a comment like this one.
Based on past performance there is a strong case for skepticism of <insert psychological theory, psychometric test, or treatment here>. The brain is perhaps the most complex structure in the known universe.
In addition psychedelics are a notoriously YMMV thing. It's not like you take LSD and get a deterministic result. Every individual will have an individual experience and some can be quite negative. I have known people who had life changing positive experiences and really negative experiences that left them with PTSD-like symptoms. Set and setting matter a lot but so does the pre-existing content of your brain and I suspect your biology.
> But recent discussion has been so overwhelmingly positive that it’s worth reviewing whether there’s a case for skepticism
I think people are overwhelmingly positive about the thought of psychedelics facing clinical trials again, less so that they are a clear super drug. Skepticism is fine, but the limited data available was largely positive yet research was basically banned.
Exactly this. People are excited that an entire branch of research has opened up after being prohibited for decades due to ... reasons.
Skepticism is the most important tenet of science, so of course there's room for it regarding the value or use of psychedelics. But the blanket ban on ever researching psychedelics was inappropriate, and the fact that there is a good possibility that these substances can significantly help with until-now untreatable conditions is definitely cause for excitement.
> the limited data available was largely positive yet research was basically banned.
Which is prima facie insane; these drugs are named for their ability to affect the brain, and have some of the most diverse and potent effects of known mind-affecting drugs. Especially since some of the most-wanted drugs, treatments for depression, are not that easy to tell from a placebo.
When we treat an infection, a cancer, or an autoimmune response, we have a huge range of medicines including incredibly potent scorched-earth stuff. When it comes to the mind, our most powerful drugs are... lithium? Adderall? To be fair, we have very powerful antipsychotics but when it comes to more mundane disease we are just really underpowered. Adderall is a band-aid and even lithium isn't that great.
We're crippling ourselves by not investigating more drugs. I don't expect to figure out the core mechanisms underlying the brain in the same way we can figure out, say, antibiotics and antivirals, but there are a huge number of psychoactive drugs and any of them could just be waiting to be weaponized.
I kind of agree with you but I don't like some of this.
> Especially since some of the most-wanted drugs, treatments for depression, are not that easy to tell from a placebo
Anti-depressents have a good track record, though imperfect.
> our most powerful drugs are... lithium?
What are you saying, that lithium has a short name so it's crap? That it's a simple compound so it's crap? That it's a metal compound so it's crap? What?
I've known people on lithium, if it works, you're beyond grateful for it (I've not been on lithium but prozac for me treated a life-destroying depression).
Please don't slag off drugs so casually without posting statistical evidence. Those of us who've had successful treatments can attest to their value, mixed as it can be. It's better than the appalling alternative.
> Anti-depressents have a good track record, though imperfect.
Antidepressants and particularly SSRIs are incredibly important and I think we should continue to prescribe them as we currently do. I even think that their lackluster performance in double blind trials is not really representative of how effective they are, and that they save huge numbers of lives. Brains are hard and we cannot expect a cure to depression any time soon.
Still... antidepressants suck. You can stick an antibiotic line in someones femoral artery and clear up illnesses in hours. Medicines are capable of incredible things. Each life saved by antidepressants is a miracle but like... We have no last line antidepressant. Theres nothing we can do for suicidally depressed people except maybe sedate them.
Depression is the bubonic plague.
Its one of the most lethal diseases out there. Every single antidepressant is like throwing a z-pac at the black death. It's a tiny glimmer of hope, but that's it. For people making repeated suicide attempts, they would normally be put on something stronger with more side effects. Say something that just made them happy all the time, but maybe didnt help them work out any issues. Just a bandaid. We have nothing like that.
> What are you saying, that lithium has a short name so it's crap? That it's a simple compound so it's crap? That it's a metal compound so it's crap? What?
That despite being one of the most heavyweight treatments for a psychological disorder, its just not that great. It does work at very high doses, but it's more like a second line of defence. Its like one of the reserve antibiotics; maybe a little hard on your kidneys, but seldom used so nothing is resistant to it. Lithium works slightly more often when other things don't, but it isnt a silver bullet of the kind we have to treat other things.
> Please don't slag off drugs so casually without posting statistical evidence. Those of us who've had successful treatments can attest to their value, mixed as it can be. It's better than the appalling alternative.
Absolutely. These drugs are incredibly important. For millions of people they're the one thread tenuously connecting them to a normal life. I rely on adderall to function, and clinical trials show that past 5-10 years its statistically equivalent to placebo. And I know that is wrong. You, I, and millions of others deserve better medicines. The fact that the existing medicines are barely holding us together does not make them less important. Just the opposite.
I tend to disagree. I see as many comments along the lines of "We need to be using psychedelics, now", how great they are, far more than "we need to be clinically testing these drugs, now". Many have made up their mind, and the trials (in their eyes) are only a confirmation / barrier to the adoption.
Certainly they were in wide public use for decades without catastrophic effects. I’m a little concerned that rapid legalization would lead to some unexpected problems, but maybe I’m too cautious given the history of widespread use.
As someone who's had some positive mental benefits from psychedelics with depression and anxiety, I wouldn't recommend the way I went about it at all. I would very much like to see proper controlled clinical tests, guided usage, proper dosages figured out, how these drugs affect the brain and why they bring about the results they do.
The thing is though, with some psychedelics, such as peyote, psilocybin, ayahuasca, there is actually hundreds of years of usage. Most of those were used for centuries by the people local to the areas they grew and there are records of it.
But in general, I personally would enjoy seeing far more studies done to learn about all these different drugs that affect our brains in such spectacular ways.
Agree with TaylorAlexander people are saying psychedelics are great because they have used them in their own lives with positive effects. Granted we need to proceed very cautiously as they aren’t good for everyone and can go very wrong
>Many have made up their mind, and the trials (in their eyes) are only a confirmation / barrier to the adoption.
Have you asked these people if they feel testing is unnecessary? Proponents are generally arguing against the ongoing prohibition, and their certainty and urgency could still involve clinical trials.
This is by far the weakest article of Scott's I've ever read. Granted, these were only "reasons for skepticism", but there's always reason for skepticism, this list as written seems more like advocacy for not even bothering to try, although perhaps I'm reading it more critically than the spirit in which he wrote it.
1. "...for example, a study two years ago found that psilocybin did not permanently increase the Openness personality trait. This was one of the most exciting studies and had shaped a lot of my thinking around the issue. Now it’s gone."
Increases in openness were not permanent, therefore nothing of interest remains (for example, medium term increases, that can potentially be reinstated)?
2, 3, 4: Eventual disappointing outcomes of other over-hyped approaches.
5. Between 10% and 50% of Americans have tried psychedelics. If psychedelics did something shocking, we would already know about it.
Largely depends on what he means by "did something shocking" I suppose. Regardless, they do indeed, and I'd wager that less than 10% of the population (despite his statistics seemingly indicating otherwise) has a remote clue about what they can do. Set and setting are not just important, they are crucial - doing psychedelics at a party at college and laughing it up with your friends is one thing, doing them while sitting alone in a quiet room with your eyes closed for several hours is something else entirely.
6. In my model of psychedelics, they artificially stimulate your insight system the same way heroin artificially stimulates your happiness system. This leads to all those stories where people feel like they discovered the secret of the universe, but when they recover their faculties, they find it was only some inane triviality.
Well sure, many people say very silly things after using psychedelics (which is why people always say integration is so important). I suspect this would strongly correlate to intelligence or styles of thinking (say, high correlation with a lack of critical thinking, which is often found in spiritual communities in my experience). But this in no way implies there's nothing valuable among all the nonsense.
7. Even if all of the above are wrong and psychedelics work very well, the FDA could kill them with a thousand paper cuts. Again, look at ketamine: the new FDA approval ensures people will be getting the slightly different esketamine, through a weird route of administration, while paying $600 a pop, in specialized clinics that will probably be hard to find.
This is a problem with the FDA, not psychedelics.
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If I was able to choose one person on Earth to do psychedelics and write about it afterwards, Scott Alexander would be my #1 pick by far.
EDIT: I'm extremely curious about the reason behind downvotes, any explanations would be appreciated.
> If I was able to choose one person on Earth to do psychedelics and write about it afterwards, Scott Alexander would be my #1 pick by far.
Huh, I just realized that for all the years I've been reading about him (and the adjacent communities) talk about psychedelics, I've been implicitly holding the assumption that Scott had done psychedelics.
Considering the strangeness of the subject matter, I would think whether one has personal experiences in the field would factor quite heavily into interpretation of the writing of others, as well as the level of purely speculative content in opinions on a forum.
It is a weird thing to wonder about whether LSD does ‘something shocking’. If it didn’t do something shocking, nobody would use it and it wouldn’t be illegal. It clearly has a profound effect on people.
Perhaps the studies are weak because we can’t study it easily. In any case, the drugs aren’t that harmful so we might as well give it a good shit to see if they work. I’d prefer them being legal even for the short term effects.
If you watch Joe Rogan you'll often hear something like "if only more people took psychedelics, the world would be a much better place".
There are places, like Peru, where psychedelics were in widespread usage for a thousand years. Yet Peru is not associated with an utopia, the best place to be on Earth, or anything of that sort.
This is somewhat suggestive, but due to a massive amount of other variables involved, for it to be more conclusive you'd want to compare to another extremely similar country with minimal usage (or, spawn an alternate universe).
I'm not sure if it's constructive to dispel super vague opinions with logical fallacies. In fact, I'm not sure what the point of the comment was at all, in retrospect.
The world can be a much better place while still being nowhere near a utopia. There's a lot of ground to cover between the status quo and such an ideal.
Sure, and claims that socialized healthcare systems don't wreck the economy are definitively falsified by the existence of Cuba.
Or....the counterfactual isn't "arbitrary country without socialized healthcare (or history of psychedelic use)" , it's a hypothetical Cuba minus socialized healthcare (or a hypothetical Peru minus psychedelic use).
Your conclusion is not remotely how basic logic works.
Also regular life is fairly traumatic and alternating. Doing therapeutic fun things with friends is rejuvenating and helpful for everyone not just those facing serious issues.
> > Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key — it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting. Set denotes the preparation of the individual, including his personality structure and his mood at the time. Setting is physical — the weather, the room's atmosphere; social — feelings of persons present towards one another; and cultural — prevailing views as to what is real. It is for this reason that manuals or guide-books are necessary. Their purpose is to enable a person to understand the new realities of the expanded consciousness, to serve as road maps for new interior territories which modern science has made accessible.
— Timothy Leary, The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead
You can have a transcendent experience without any drugs at all. Your brain can perform all the chemical manipulations required in a much safer manner than e.g. flooding your system with synthetic LSD.
If you have a therapeutic system that works in the first place then drugs would be a sideshow at best. Adding LSD to ineffective scattershot therapies will just amplify random aspects of the subject's psychology.
- You can have a transcendent experience without any drugs at all.
- Your brain can perform [all] the chemical manipulations required in a much safer manner than e.g. flooding your system with synthetic LSD.
- If you have a therapeutic system that works in the first place then [drugs would be a sideshow [at best]].
- Adding LSD to ineffective scattershot therapies will just amplify random aspects of the subject's psychology.
The first point seems consistent with anything I've read on the subject, but the rest don't seem backed by anything I've read, if not contrary. (I've added brackets for emphasis on specific parts where applicable).
If you could point me in any direction to some reading I've missed it would be appreciated.
EDIT:
I assume the reply below ("Do not try to weasel out of this statement...") is directed at the parent to my post?
No, the brain cannot flood itself with serotonin on demand ever.
Dopamine, sort of maybe but only in extreme situations.
Norepinephrine, maybe, likewise.
Endocannabinoids, nope.
Ampakines, way no.
Glutamate, only in extreme conditions.
Other neuropeptides, likely no.
Do not try to weasel out of this statement without providing actual evidence that any "mental" treatment comes close to drug effects. Or other unsourced statements about "scattershot". Research had barely started.
(Not efficacy. Efficacy requires also psychological work, which can be enhanced or retarded by drugs. Also to be evaluated.)
Experiences are unrelated to efficacy for treatment most of the time, unless they are. I point you to studies of efficacy of prayer - not very.
I think a different threads of conversation are conflated here. Both parties are in an agreement, I suspect, that the LSD itself has no long term effect, as least as acute psychological treatment. The therapeutic value is in how you use the time. I think the parent poster who quoted O’Leary was saying that the drug is not necessary for the therapy to happen in the first place. Without that already reliable system of therapy in place, the chemical effects of the drug are not going to give consistently therapeutic results.
Other ergoloids are used for breaking really hard to treat migraines. They work exceptionally well at that.
MDMA or analog could be a novel antidepressant.
Ibogaine (also a psychedelic) is already used for smoking cessation sometimes. Works relatively well, all things considered, but not without risks (cardiac). Now they're trialing it for alcoholism in Brazil. Maybe a chemical variant that is safer could be devised if not for the dumb prohibitions.
In re: effective therapy I can recommend what's called Neurolinguistic Programming. It's pretty much an OS for the mind. Specifically, I can recommend two books on hypnosis: "TRANCE-Formations" by Bandler and Grinder, and "Monsters and Magical Sticks" by Steven Heller.
For "higher" states of consciousness there is actually a simple and effective algorithm called "Core Transformation Process" It's taught by these folks: https://www.coretransformation.org/
For the deeper spiritual aspects of psychological healing I can recommend the works of Sir David R. Hawkins, M.D., Ph.D., who was a very successful therapist who underwent enlightenment and has been able to describe it in terms accessible to the modern mind. https://veritaspub.com/dr-hawkins/#Biography%20Summary
Indeed, there are a wide variety of approaches in this space (and I'm an advocate of combining multiple if necessary, the perfect approach is unknown, and varies by person), but any claims that they can achieve the same results (comprehensively) as psychedelics is a misrepresentation.
Dunno man, YMMV, I can "trip" on hypnosis all kinds of ways.
I once (once) managed to have the "Kundalini" experience. It was wonderful. No drugs involved. Yet it was easily as psychedelic as any drug.
I didn't try to do it again because I'm relatively conservative and I am not one to experiment with my own body recklessly. I.e. if something had gone wrong you can't show up at the emergency room and tell them "It was Kundalini" and expect them to have a coherent, educated response. This is a huge biological and psychological "event" or process (akin in depth and significance to orgasm) that is entirely unknown to Western medicine and science.
Not only can the mind re-create drug states, it can also obviate actual drug states. (I.e. you can drink a pint of whiskey and remain sober.)
> any claims that they can achieve the same results (comprehensively) as psychedelics is a misrepresentation.
With caveats about the exact definitions of "they" and "results" and "comprehensively", I will go ahead and claim that the kind of results that people go to therapists to get can be got without using any external drugs at all, at all.
Psychedelics just get you "high as a lord". They just shake up your thought-gland. Any therapeutic value they have is in the "set and setting", as Dr. Leary (the "LSD guy" himself) insists.
If you want to get high, or just experience your subjectivity getting all jangly, then yeah LSD is great. If you want to solve your personal problems you can do that without taking drugs.
It's not impossible to use psychedelics as part of a therapeutic system, but it's important to realize that there's no magic cure in the acid tab or magic mushroom.
> I once (once) managed to have the "Kundalini" experience. It was wonderful. No drugs involved. Yet it was easily as psychedelic as any drug.
Do you say this having semi-substantial first hand experience with psychedelics (your relatively conservative comment suggests perhaps not)? If not, then how could you compare, but if so, then I'm interested. Well, I'm interested anyways, but I'd be super interested.
> With caveats about the exact definitions of "they" and "results" and "comprehensively", I will go ahead and claim that the kind of results that people go to therapists to get can be got without using any external drugs at all, at all.
Depends what kind of a therapist visit you're talking about of course.
> Psychedelics just get you "high as a lord". They just shake up your thought-gland. Any therapeutic value they have is in the "set and setting", as Dr. Leary (the "LSD guy" himself) insists.
Maybe, maybe not. We don't know for sure exactly what they're doing.
> If you want to get high, or just experience your subjectivity getting all jangly, then yeah LSD is great. If you want to solve your personal problems you can do that without taking drugs.
Sometimes, sometimes not, depending on the situation and the individual.
> It's not impossible to use psychedelics as part of a therapeutic system, but it's important to realize that there's no magic cure in the acid tab or magic mushroom.
They're not a magical elixir, but thousands of people disagree on whether they've been a practically "magic" cure for their personal issues.
This Hawkins fellow sounds quite interesting, do you happen to know if there are any particularly good videos of him that you could recommend? I will check out Wilson as well.
Thanks for the interesting conversation and recommendations!
> Do you say this having semi-substantial first hand experience with psychedelics
I am extremely reluctant to give details in this (public and recorded) forum, even in today's relatively relaxed milieu, but, yeah, you can assume I know what I'm talking about in re: psychedelics. ;-)
FWIW, I was practicing a combination of Mantak Chia's meditations and manipulations of breathing and diaphram and perineal muscles along with what's called the "Core Transformation process". The specific incident involved a "blooming" of energy at or from the first chakra that proceeded up the spine and along the nerves, reaching the brain and expanding out into the aura. Physical and biological sensations were orgasmic but non-sexual (if that makes any sense) and there was higher perception (of which I can offer no description.)
As I said, the entire process was so intense and so beyond anything in Western knowledge that I did not attempt to do it again. I was getting (less dramatic) results anyway, and other life events were happening.
> They're not a magical elixir, but thousands of people disagree on whether they've been a practically "magic" cure for their personal issues.
I probably sound like I'm anti-drugs but that's not where I'm coming from. I'm saying that we can and should analyze what happens for those people and see if we can do the same thing for others without dosing them, that's all. I know people who have had great trips and people who wrecked themselves. I'm not denying that drugs can work I'm saying that there are safer ways. Some people get a lot out of xanax, eh?
> Depends what kind of a therapist visit you're talking about of course.
Indeed!
I happen to be a proponent of something called Neurolinguistic Programming, both because I understand the underlying structure of how it evolved and why it works, and because I was cured of clinical depression while under hypnosis by Dr. Bandler. One time treatment, lifelong severe depression disappeared. (And no drugs.) So I'm coming from a POV where there is already an effective therapy modality that can do the analysis and, in fact, already has. E.g. using hypnosis you can recreate the subjective experience of cannabis or even LSD or MDMA; you can also do things like dial back your degree of drunkenness from real alcohol you consumed. Plus a lot of other weird and awesome stuff.
> This Hawkins fellow sounds quite interesting, do you happen to know if there are any particularly good videos of him that you could recommend?
To me he seems like the real deal. I've only ever watched one video on youtube, I don't have it bookmarked, sorry. Just do a search. I get a lot out of his books. Start with "Power vs. Force", as they kind of build up in intensity.
> I will check out Wilson as well.
RAW isn't to everybody's taste, but IMO he is one of the most important thinkers and philosophers in the last N hundred years. He connected with the NLP people before he passed away, so there's a good chance that everything is going to turn out okay after all. :-)
In any event, if you are interested in intense internal experiences pick up a copy of Prometheus Rising and do the exercises. :-) Catch ya in the flow!
I don't know if psychedelics will turn out to have any medical value in the end, but I wouldn't be surprised if much of its failure stems from the way we try to fit it into the existing structures of medicine.
Psychedelics amplify the perceived significance of many experiences, but what experience are you likely to be getting at a hospital or psychiatric facility? Every encounter I have had with modern medicine has been uncomfortable or even slightly demeaning.
The way we practice medicine today has bought us repeatability and accountability of treatment, but with it comes an overwhelming air of impersonality. That's not an issue if you needed surgery, but if you're prescribed a transformative experience I'd say that might be a show stopper.
Yes, it’s good to be skeptical when big claims are made. I have had one (heroic) experience of LSD and while it was one of the most peak experiences of my life I cannot say if it was positive or negative just that it was extreme. Fixes for some will come at a price for others in my opinion. As my friend said while looking me deep into the eyes at the end of our trip together “It’s not exactly what you would call recreational is it?”.
Also I’d add that older minds find these experiences much more difficult to process/deal with. I believe research is good but can it be used if 5% of people have very negative reactions?
>Psychedelics have mostly been investigated in small studies run by true believers.
This looks like ascertaining what it should prove. How do we know they were "true believers"? Because they did psychedelic studies?
>Back when psychoanalysis was new, the whole world was full of people telling their amazing success stories about how Dr. Freud helped them obtain true insight and get real closure. I think of psychotherapy as a domain where people can get as many amazing success stories as they want whether or not they’re really doing anything right, for unclear reasons.
Not an argument.
>Between 10% and 50% of Americans have tried psychedelics. If psychedelics did something shocking, we would already know about it.
Which psychedelics, under what conditions, how often? Also, I seriously doubt anywhere close to 25% has taken psychedelics, for example (a number halfway between the 10 and 50%). I don't have the numbers, but I'd say 50% was not even true in 1967 San Francisco...
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[ 4.1 ms ] story [ 108 ms ] threadbut in today's enlightened discussion climate one must also consider the magnitude of the shit-storm of personal attacks one will face before voicing that skepticism. you even have to consider that before you make a comment like this one.
If they are going to fall off a cliff, the faster it happens, the better for everyone.
I agree with your first sentence. I have upvoted your post.
Unfortunately the second sentence is not always true. We all suffer from the insane democratic majority and the related media.
In addition psychedelics are a notoriously YMMV thing. It's not like you take LSD and get a deterministic result. Every individual will have an individual experience and some can be quite negative. I have known people who had life changing positive experiences and really negative experiences that left them with PTSD-like symptoms. Set and setting matter a lot but so does the pre-existing content of your brain and I suspect your biology.
(A nit: "set" refers in part to the "pre-existing content of your brain and ... biology.")
I think people are overwhelmingly positive about the thought of psychedelics facing clinical trials again, less so that they are a clear super drug. Skepticism is fine, but the limited data available was largely positive yet research was basically banned.
Skepticism is the most important tenet of science, so of course there's room for it regarding the value or use of psychedelics. But the blanket ban on ever researching psychedelics was inappropriate, and the fact that there is a good possibility that these substances can significantly help with until-now untreatable conditions is definitely cause for excitement.
Which is prima facie insane; these drugs are named for their ability to affect the brain, and have some of the most diverse and potent effects of known mind-affecting drugs. Especially since some of the most-wanted drugs, treatments for depression, are not that easy to tell from a placebo.
When we treat an infection, a cancer, or an autoimmune response, we have a huge range of medicines including incredibly potent scorched-earth stuff. When it comes to the mind, our most powerful drugs are... lithium? Adderall? To be fair, we have very powerful antipsychotics but when it comes to more mundane disease we are just really underpowered. Adderall is a band-aid and even lithium isn't that great.
We're crippling ourselves by not investigating more drugs. I don't expect to figure out the core mechanisms underlying the brain in the same way we can figure out, say, antibiotics and antivirals, but there are a huge number of psychoactive drugs and any of them could just be waiting to be weaponized.
> Especially since some of the most-wanted drugs, treatments for depression, are not that easy to tell from a placebo
Anti-depressents have a good track record, though imperfect.
> our most powerful drugs are... lithium?
What are you saying, that lithium has a short name so it's crap? That it's a simple compound so it's crap? That it's a metal compound so it's crap? What?
I've known people on lithium, if it works, you're beyond grateful for it (I've not been on lithium but prozac for me treated a life-destroying depression).
Please don't slag off drugs so casually without posting statistical evidence. Those of us who've had successful treatments can attest to their value, mixed as it can be. It's better than the appalling alternative.
I can't find my posts but here's one that accords with my horrible experiences https://news.ycombinator.com/item?id=16435140
"f I hadn't gotten a prescription for Prozac I probably would have killed myself by now"
Antidepressants and particularly SSRIs are incredibly important and I think we should continue to prescribe them as we currently do. I even think that their lackluster performance in double blind trials is not really representative of how effective they are, and that they save huge numbers of lives. Brains are hard and we cannot expect a cure to depression any time soon.
Still... antidepressants suck. You can stick an antibiotic line in someones femoral artery and clear up illnesses in hours. Medicines are capable of incredible things. Each life saved by antidepressants is a miracle but like... We have no last line antidepressant. Theres nothing we can do for suicidally depressed people except maybe sedate them.
Depression is the bubonic plague. Its one of the most lethal diseases out there. Every single antidepressant is like throwing a z-pac at the black death. It's a tiny glimmer of hope, but that's it. For people making repeated suicide attempts, they would normally be put on something stronger with more side effects. Say something that just made them happy all the time, but maybe didnt help them work out any issues. Just a bandaid. We have nothing like that.
> What are you saying, that lithium has a short name so it's crap? That it's a simple compound so it's crap? That it's a metal compound so it's crap? What?
That despite being one of the most heavyweight treatments for a psychological disorder, its just not that great. It does work at very high doses, but it's more like a second line of defence. Its like one of the reserve antibiotics; maybe a little hard on your kidneys, but seldom used so nothing is resistant to it. Lithium works slightly more often when other things don't, but it isnt a silver bullet of the kind we have to treat other things.
> Please don't slag off drugs so casually without posting statistical evidence. Those of us who've had successful treatments can attest to their value, mixed as it can be. It's better than the appalling alternative.
Absolutely. These drugs are incredibly important. For millions of people they're the one thread tenuously connecting them to a normal life. I rely on adderall to function, and clinical trials show that past 5-10 years its statistically equivalent to placebo. And I know that is wrong. You, I, and millions of others deserve better medicines. The fact that the existing medicines are barely holding us together does not make them less important. Just the opposite.
The thing is though, with some psychedelics, such as peyote, psilocybin, ayahuasca, there is actually hundreds of years of usage. Most of those were used for centuries by the people local to the areas they grew and there are records of it.
But in general, I personally would enjoy seeing far more studies done to learn about all these different drugs that affect our brains in such spectacular ways.
Have you asked these people if they feel testing is unnecessary? Proponents are generally arguing against the ongoing prohibition, and their certainty and urgency could still involve clinical trials.
Harm reduction activists documented quite a few horror stories, seizures/deaths from LSD + lithium, HPPD, etc.
Psychedelics are promising, sure, but I doubt anyone serious thinks are some kind of panacea.
There is just not enough money in this whole thing yet to sweep skeptics under the rug.
1. "...for example, a study two years ago found that psilocybin did not permanently increase the Openness personality trait. This was one of the most exciting studies and had shaped a lot of my thinking around the issue. Now it’s gone."
Increases in openness were not permanent, therefore nothing of interest remains (for example, medium term increases, that can potentially be reinstated)?
2, 3, 4: Eventual disappointing outcomes of other over-hyped approaches.
5. Between 10% and 50% of Americans have tried psychedelics. If psychedelics did something shocking, we would already know about it.
Largely depends on what he means by "did something shocking" I suppose. Regardless, they do indeed, and I'd wager that less than 10% of the population (despite his statistics seemingly indicating otherwise) has a remote clue about what they can do. Set and setting are not just important, they are crucial - doing psychedelics at a party at college and laughing it up with your friends is one thing, doing them while sitting alone in a quiet room with your eyes closed for several hours is something else entirely.
6. In my model of psychedelics, they artificially stimulate your insight system the same way heroin artificially stimulates your happiness system. This leads to all those stories where people feel like they discovered the secret of the universe, but when they recover their faculties, they find it was only some inane triviality.
Well sure, many people say very silly things after using psychedelics (which is why people always say integration is so important). I suspect this would strongly correlate to intelligence or styles of thinking (say, high correlation with a lack of critical thinking, which is often found in spiritual communities in my experience). But this in no way implies there's nothing valuable among all the nonsense.
7. Even if all of the above are wrong and psychedelics work very well, the FDA could kill them with a thousand paper cuts. Again, look at ketamine: the new FDA approval ensures people will be getting the slightly different esketamine, through a weird route of administration, while paying $600 a pop, in specialized clinics that will probably be hard to find.
This is a problem with the FDA, not psychedelics.
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If I was able to choose one person on Earth to do psychedelics and write about it afterwards, Scott Alexander would be my #1 pick by far.
EDIT: I'm extremely curious about the reason behind downvotes, any explanations would be appreciated.
Huh, I just realized that for all the years I've been reading about him (and the adjacent communities) talk about psychedelics, I've been implicitly holding the assumption that Scott had done psychedelics.
There are places, like Peru, where psychedelics were in widespread usage for a thousand years. Yet Peru is not associated with an utopia, the best place to be on Earth, or anything of that sort.
Or....the counterfactual isn't "arbitrary country without socialized healthcare (or history of psychedelic use)" , it's a hypothetical Cuba minus socialized healthcare (or a hypothetical Peru minus psychedelic use).
Your conclusion is not remotely how basic logic works.
Think of how good pop music will be again!
> > Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key — it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting. Set denotes the preparation of the individual, including his personality structure and his mood at the time. Setting is physical — the weather, the room's atmosphere; social — feelings of persons present towards one another; and cultural — prevailing views as to what is real. It is for this reason that manuals or guide-books are necessary. Their purpose is to enable a person to understand the new realities of the expanded consciousness, to serve as road maps for new interior territories which modern science has made accessible.
— Timothy Leary, The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead
You can have a transcendent experience without any drugs at all. Your brain can perform all the chemical manipulations required in a much safer manner than e.g. flooding your system with synthetic LSD.
If you have a therapeutic system that works in the first place then drugs would be a sideshow at best. Adding LSD to ineffective scattershot therapies will just amplify random aspects of the subject's psychology.
- Your brain can perform [all] the chemical manipulations required in a much safer manner than e.g. flooding your system with synthetic LSD.
- If you have a therapeutic system that works in the first place then [drugs would be a sideshow [at best]].
- Adding LSD to ineffective scattershot therapies will just amplify random aspects of the subject's psychology.
The first point seems consistent with anything I've read on the subject, but the rest don't seem backed by anything I've read, if not contrary. (I've added brackets for emphasis on specific parts where applicable).
If you could point me in any direction to some reading I've missed it would be appreciated.
EDIT:
I assume the reply below ("Do not try to weasel out of this statement...") is directed at the parent to my post?
Dopamine, sort of maybe but only in extreme situations. Norepinephrine, maybe, likewise.
Endocannabinoids, nope. Ampakines, way no. Glutamate, only in extreme conditions. Other neuropeptides, likely no.
Do not try to weasel out of this statement without providing actual evidence that any "mental" treatment comes close to drug effects. Or other unsourced statements about "scattershot". Research had barely started.
(Not efficacy. Efficacy requires also psychological work, which can be enhanced or retarded by drugs. Also to be evaluated.)
Experiences are unrelated to efficacy for treatment most of the time, unless they are. I point you to studies of efficacy of prayer - not very.
Other ergoloids are used for breaking really hard to treat migraines. They work exceptionally well at that.
MDMA or analog could be a novel antidepressant.
Ibogaine (also a psychedelic) is already used for smoking cessation sometimes. Works relatively well, all things considered, but not without risks (cardiac). Now they're trialing it for alcoholism in Brazil. Maybe a chemical variant that is safer could be devised if not for the dumb prohibitions.
And don't even start on THC and CBD.
For "higher" states of consciousness there is actually a simple and effective algorithm called "Core Transformation Process" It's taught by these folks: https://www.coretransformation.org/
For the deeper spiritual aspects of psychological healing I can recommend the works of Sir David R. Hawkins, M.D., Ph.D., who was a very successful therapist who underwent enlightenment and has been able to describe it in terms accessible to the modern mind. https://veritaspub.com/dr-hawkins/#Biography%20Summary
I once (once) managed to have the "Kundalini" experience. It was wonderful. No drugs involved. Yet it was easily as psychedelic as any drug.
I didn't try to do it again because I'm relatively conservative and I am not one to experiment with my own body recklessly. I.e. if something had gone wrong you can't show up at the emergency room and tell them "It was Kundalini" and expect them to have a coherent, educated response. This is a huge biological and psychological "event" or process (akin in depth and significance to orgasm) that is entirely unknown to Western medicine and science.
Not only can the mind re-create drug states, it can also obviate actual drug states. (I.e. you can drink a pint of whiskey and remain sober.)
> any claims that they can achieve the same results (comprehensively) as psychedelics is a misrepresentation.
With caveats about the exact definitions of "they" and "results" and "comprehensively", I will go ahead and claim that the kind of results that people go to therapists to get can be got without using any external drugs at all, at all.
Psychedelics just get you "high as a lord". They just shake up your thought-gland. Any therapeutic value they have is in the "set and setting", as Dr. Leary (the "LSD guy" himself) insists.
If you want to get high, or just experience your subjectivity getting all jangly, then yeah LSD is great. If you want to solve your personal problems you can do that without taking drugs.
It's not impossible to use psychedelics as part of a therapeutic system, but it's important to realize that there's no magic cure in the acid tab or magic mushroom.
Just to wrap up, let me recommend "Sex and Drugs: A Journey Beyond Limits" by Robert Anton Wilson http://rawilson.com/sexdrugs.html
Do you say this having semi-substantial first hand experience with psychedelics (your relatively conservative comment suggests perhaps not)? If not, then how could you compare, but if so, then I'm interested. Well, I'm interested anyways, but I'd be super interested.
> With caveats about the exact definitions of "they" and "results" and "comprehensively", I will go ahead and claim that the kind of results that people go to therapists to get can be got without using any external drugs at all, at all.
Depends what kind of a therapist visit you're talking about of course.
> Psychedelics just get you "high as a lord". They just shake up your thought-gland. Any therapeutic value they have is in the "set and setting", as Dr. Leary (the "LSD guy" himself) insists.
Maybe, maybe not. We don't know for sure exactly what they're doing.
> If you want to get high, or just experience your subjectivity getting all jangly, then yeah LSD is great. If you want to solve your personal problems you can do that without taking drugs.
Sometimes, sometimes not, depending on the situation and the individual.
> It's not impossible to use psychedelics as part of a therapeutic system, but it's important to realize that there's no magic cure in the acid tab or magic mushroom.
They're not a magical elixir, but thousands of people disagree on whether they've been a practically "magic" cure for their personal issues.
This Hawkins fellow sounds quite interesting, do you happen to know if there are any particularly good videos of him that you could recommend? I will check out Wilson as well.
Thanks for the interesting conversation and recommendations!
> Do you say this having semi-substantial first hand experience with psychedelics
I am extremely reluctant to give details in this (public and recorded) forum, even in today's relatively relaxed milieu, but, yeah, you can assume I know what I'm talking about in re: psychedelics. ;-)
FWIW, I was practicing a combination of Mantak Chia's meditations and manipulations of breathing and diaphram and perineal muscles along with what's called the "Core Transformation process". The specific incident involved a "blooming" of energy at or from the first chakra that proceeded up the spine and along the nerves, reaching the brain and expanding out into the aura. Physical and biological sensations were orgasmic but non-sexual (if that makes any sense) and there was higher perception (of which I can offer no description.)
As I said, the entire process was so intense and so beyond anything in Western knowledge that I did not attempt to do it again. I was getting (less dramatic) results anyway, and other life events were happening.
https://en.wikipedia.org/wiki/Mantak_Chia
https://www.coretransformation.org/
> They're not a magical elixir, but thousands of people disagree on whether they've been a practically "magic" cure for their personal issues.
I probably sound like I'm anti-drugs but that's not where I'm coming from. I'm saying that we can and should analyze what happens for those people and see if we can do the same thing for others without dosing them, that's all. I know people who have had great trips and people who wrecked themselves. I'm not denying that drugs can work I'm saying that there are safer ways. Some people get a lot out of xanax, eh?
> Depends what kind of a therapist visit you're talking about of course.
Indeed!
I happen to be a proponent of something called Neurolinguistic Programming, both because I understand the underlying structure of how it evolved and why it works, and because I was cured of clinical depression while under hypnosis by Dr. Bandler. One time treatment, lifelong severe depression disappeared. (And no drugs.) So I'm coming from a POV where there is already an effective therapy modality that can do the analysis and, in fact, already has. E.g. using hypnosis you can recreate the subjective experience of cannabis or even LSD or MDMA; you can also do things like dial back your degree of drunkenness from real alcohol you consumed. Plus a lot of other weird and awesome stuff.
> This Hawkins fellow sounds quite interesting, do you happen to know if there are any particularly good videos of him that you could recommend?
To me he seems like the real deal. I've only ever watched one video on youtube, I don't have it bookmarked, sorry. Just do a search. I get a lot out of his books. Start with "Power vs. Force", as they kind of build up in intensity.
> I will check out Wilson as well.
RAW isn't to everybody's taste, but IMO he is one of the most important thinkers and philosophers in the last N hundred years. He connected with the NLP people before he passed away, so there's a good chance that everything is going to turn out okay after all. :-)
In any event, if you are interested in intense internal experiences pick up a copy of Prometheus Rising and do the exercises. :-) Catch ya in the flow!
Thank you too.
Edit: field studies → clinical trials
Psychedelics amplify the perceived significance of many experiences, but what experience are you likely to be getting at a hospital or psychiatric facility? Every encounter I have had with modern medicine has been uncomfortable or even slightly demeaning.
The way we practice medicine today has bought us repeatability and accountability of treatment, but with it comes an overwhelming air of impersonality. That's not an issue if you needed surgery, but if you're prescribed a transformative experience I'd say that might be a show stopper.
Also I’d add that older minds find these experiences much more difficult to process/deal with. I believe research is good but can it be used if 5% of people have very negative reactions?
This looks like ascertaining what it should prove. How do we know they were "true believers"? Because they did psychedelic studies?
>Back when psychoanalysis was new, the whole world was full of people telling their amazing success stories about how Dr. Freud helped them obtain true insight and get real closure. I think of psychotherapy as a domain where people can get as many amazing success stories as they want whether or not they’re really doing anything right, for unclear reasons.
Not an argument.
>Between 10% and 50% of Americans have tried psychedelics. If psychedelics did something shocking, we would already know about it.
Which psychedelics, under what conditions, how often? Also, I seriously doubt anywhere close to 25% has taken psychedelics, for example (a number halfway between the 10 and 50%). I don't have the numbers, but I'd say 50% was not even true in 1967 San Francisco...