In this episode, Joe interviews Dr. Andrew R. Gallimore: computational neurobiologist, chemical pharmacologist, researcher, and writer of Alien Information Theory: Psychedelic Drug Technologies and the Cosmic Game.
Gallimore feels that DMT is the most efficient and effective reality switching molecule we’ve seen, and that there is no other psychedelic experience that is so in your face: If we really could communicate with entities not of our known universe (who may have created our universe), how can so many dismiss that as a hallucination? Why would we not want to pursue something so mind-bending and revolutionary? His hope for his newest book, Reality Switch Technologies: Psychedelics as Tools for the Discovery and Exploration of New Worlds, is that it will be the quintessential guide for how psychedelics work in the brain from all levels of organization, what happens when you perturb the brain, and the future: how we might be able to fine-tune our brains to access different realities at will.
He discusses the element of design used in his books; why understanding something as complex as DMT is a multidisciplinary practice; the genius of Terence McKenna; what Alien Information Theory was about; his work with Rick Strassman in researching intravenous infusion DMT pumps to keep someone in the DMT verse; Conway’s Game of Life and the unpredictable levels of complexity that can arise from simple rules; lucid dreaming; John Mack, alien abductees, and trusting a patient’s experiences as real; psilocybin yeast; and much more.
This one will definitely make you think!
Notable Quotes
“It’s always felt a little bit sci-fi in a way, in that you’re planning basically a program of inter-dimensional citizenship. It feels like that. I mean, Terence McKenna used to [say] ‘galactic citizenship,’ and it’s almost like we’ve leapfrogged over galactic citizenship and we’re now going straight to inter-dimensional, trans-dimensional citizenship (whatever you want to call it) where we’re interfacing and communicating with an intelligence not of this universe. I mean, that’s a wild idea. And we have the technology now. To me, this infusion technology; this is the way to do it.”
“We’re just at the beginning now. You take virtual reality technology and the way that that is progressing, then you add artificial intelligence into the mix, and then you add pharmacology and neuropharmacology, chemical pharmacology and other neural manipulation systems, and you begin to realize that our brain is this tool – this world-building machine that we can learn to tune to access other worlds.”
“There’s also deja vu of course, the sense of having been there before – this very profound, deep sense of deja vu; not like we’ve all had, that occasionally you get that sense of deja vu that something has happened before. This is like, ‘I really, really have been here before. This is the most bizarre place I couldn’t possibly have imagined or conceived of; an impossible place of impossible geometry, and yet at the same time, it seems bizarrely familiar. ‘Why? Why would some place that should be the most unfamiliar place possible– There isn’t a more unfamiliar realm that you could imagine than the DMT world, and yet people think, ‘Oh my God, I’ve come home.’ And the entities, the elves will sing and cheer and bells will ring and lights will flash and [they’ll] say, ‘He has returned! The one has returned home! Welcome back! We’re so pleased to see you!’ This great uproar, this great celebration as you burst into this space. Why would that happen?”
In this week’s episode, Joe and David meet up to talk about Vital, Convergence, and the latest news:
-Tryp Therapeutics and Mass General signing a letter of intent for a Phase 2 clinical trial investigating the effects of psilocybin-assisted psychotherapy for the treatment of Irritable Bowel Syndrome – interesting because it further highlights the likely effect of psychedelics on the brain-gut connection and that psychotherapy is involved;
-New York lawmakers pre-filing a bill to legalize DMT, ibogaine, mescaline, psilocybin and psilocyn (and remove them from the state’s banned substances list) for 2023;
-New York’s first cannabis dispensary finally opening on December 29;
-British Columbia responding to their opioid crisis (the latest data reports 14k deaths since 2016) by beginning a Portugal-like decriminalization model, allowing people 18 years and older to carry a combined 2.5 grams of drugs (heroin, fentanyl, cocaine, methamphetamine and even MDMA);
and finally, an interesting but confusing (maybe a follow-up is necessary) article showing that what we’re learning about ketamine could lead towards a better understanding of psychosis and schizophrenia.
In this week’s episode, Joe and Kyle are together again before Kyle sets off for a 2-month road trip centered around Vital retreats, where we hope he’ll be able to report in from live while in Jamaica.
In this week’s episode, Joe and David team up again to discuss what news interested them the most this week: the DA dropping a felony drug charge against a mushroom rabbi in Denver due to the passing of Proposition 122; Numinus Submitting a Clinical Trial Application to Health Canada that would give in-training practitioners the ability to experience psychedelics with their psilocybe-containing EnfiniTea; and a University of Exeter-led trial moving forward with the next step in a study using ketamine for alcohol use disorder (with 2/3 of the money coming from the National Institute for Health and Care Research).
They also review a paper that analyzed the economics of psychedelic-assisted therapies and how insurers come into play; as well as The Journal of the American Medical Association stating that, based on current trajectories compared to cannabis legalization, they believe the majority of states will legalize psychedelics by 2037. So nice to see these continued steps in the right direction!
And if you missed it, we just announced that applications are open for the next edition of Vital. There are incentives to paying in-full by certain dates, so if you missed out on last year’s edition or have been curious, attend one of our upcoming Q+As!
In discussing these articles, much is covered: methylation and genetic memory; addiction; gut biome; cesarian births; how much inequality is built into the “psychedelic renaissance” due to it primarily evolving out of inherently unequal Western societal paradigms; permaculture; new ways to be together; Burning Man; the concept of the nuclear family; the power in working with your hands; creativity; harm reduction and the lack of readily available drug testing kits; and more.
In this week’s episode, Joe and Alexa talk about the excitement brewing around our first conference-meets-festival, Convergence (March 30 – April 2 at the Wisdome in LA), and some of the sponsorships starting to come in (interested? email Alexa@psychedelicstoday.com).
Then, they dive into what intrigued them the most this week: a study looking into potentiality and possible causes of 5-MeO-DMT reactivation (and what reactivation actually is); New York cannabis farms sitting on $750 million worth of cannabis as the government drags its feet on licenses; and the story of a woman who used cannabis and psilocybin as an adjunct to standard therapy in the treatment of advanced metastatic breast cancer.
In this episode, Victoria hosts a bit of a microdosing roundtable, speaking with three champions of microdosing: “The Father of modern microdosing,” James Fadiman, Ph.D.; Adam Bramlage, Founder/CEO of Flow State Micro (a functional mushroom company and microdosing educational platform); and Conor Murray, Ph.D., a neuroscientist at UCLA who conducted the world’s first EEG microdosing study.
Fadiman and Bramlage recently launched a very popular course through our Psychedelic Education Center: “Microdosing Masterclass,” which covers the history and science of microdosing, as well as best practices for microdosing safely and effectively. They discuss the roots of microdosing, decriminalization and concerns over the corporatization of psychedelics, what we’ve seen so far in research, and how we’re finding ourselves in an era where people are going to be allowed to actually help themselves.
Murray is hoping to make big waves in the promotion of microdosing with the world’s first take-home EEG microdosing study: participants will be mailed a wireless headband that will be able to track brain activity in real world scenarios – the citizen science we’ve so desperately needed in comparison to lab studies that couldn’t be more different from how people actually live day-to-day. There is no criteria to participate, and, in contrast to lab studies, they want all data possible: people who are in therapy or not, people following different microdosing protocols, people microdosing for different reasons, etc. Will microdosing improve brain scores on cognition and emotion? Will participants see measurable improvements? And how will these numbers look when comparing scores months after initial peak neurological windows?
If you’d like to participate, head to psynautics.com and sign up. The first 50 people to do so will receive the wireless EEG to track their brain for one month for only $40.
Notable Quotes
“Because it’s inherently interesting for people to find that their consciousness can be improved (not necessarily changed) and that their whole physical system can also be improved, microdosing has found a natural niche which is: it might be good for you, and as far as we can tell, it’s very, very, very, very, very rarely bad for you. And that’s a nice risk/reward ratio.” -James
“It’s hard to fool the brain. You can maybe have a good placebo effect if you’re trying to ask someone: how much do you think your cognition’s improving today or emotion’s improving today? But it’s harder to fool the brain into having a different answer.” -Conor
“There’s so many people who will not buy into this until it’s proven by modern science, and that’s why Conor and his work is so important, and this new study with the wireless headbands and the idea that every citizen scientist on the planet can write Conor at Conor@psynautics.com and be a part of this study and get a wireless headband – I mean, that is fascinating. That is taking microdosing out of a sterile lab and putting it into the natural environment where it came from, as hunter-gatherers, for hundreds of thousands of years.” -Adam
“That’s really the metaphor, which is: the more windows, the more you see different views, and there’s nothing good or bad about any particular window except how clean it is. …We’re opening up bigger windows in more directions than has been the case in the past.” -James
This week features David Drapkin, Joe Moore (for the first part), and introduces Alexa Jesse, who you’ve probably heard in ads, but who makes her first appearance on the podcast.
They discuss two big political moves in the advancement of psychedelics: the creation of the Congressional Psychedelics Advancing Clinical Treatments (PACT) Caucus (led by Representatives Lou Correa (D-CA) and Jack Bergman (R-MI)), and the filing of the Breakthrough Therapies Act by Senators Cory Booker (D-NJ) and Rand Paul (R-KY).
And they talk about the story of Jim Harris overcoming paralyzation through psilocybin; NICE (National Institute for Health and Care Excellence) determining that Esketamine is not cost-effective; new progress in Germany and Finland; MDMA-assisted therapy (and other psychedelics) showing alleviation of chronic pain; a ramp up in LSD research for Alzheimer’s studies; and more.
Plus, we hear a bit of Alexa’s story, wish Joe and Johanna happy birthdays, and talk about what’s most immediate in the PT world: Early Bird pricing ending today for our first conference, Convergence (use code PTINSIDER10 for a 10% discount!), and the next round of Navigating Psychedelics launching next week.
I had years of experience in cold water training from my Aikido career, but as my depression had increasingly grown worse, I developed a severe cold intolerance. It had become painful to stand under the shower, with my scalp almost spasming in contraction, when I used to be able to stand in late winter melt-water waterfalls and rivers with ease. But post-dosing, my cold tolerance came roaring back; allowing me to stand under a cold shower for minutes at a time with no numbness and no pain – it was almost like it was happening to someone else or there was a micro-force field on the surface of my skin. I found myself having to leave the shower because I just had other things to do. Cold water tolerance is a gold-standard for measuring pain response in clinical trials, and in fact, later that year, the Department of Psychopharmacology at Maastricht University, sponsored by the Beckley Foundation, conducted the first LSD and pain study in nearly 50 years, showing that low-dose LSD significantly increased cold water tolerance without interfering with day-to-day activities.
I had been known for my mobility and flexibility throughout my career and my ability to train others to achieve the same results, but mine had been compromised for a good while at this point. But the day after my session, I was able to resume positions that I hadn’t been able to comfortably acquire in months, if not years. Movement now felt smooth and effortless once again, and I swear there was even improvement in the tissue quality in areas that had become “crunchy.”
There was also a significant change in my inflammatory baseline. Depression is seen as a disorder that also includes fairly significant neurological inflammation and is often bi-directional with chronic pain, but many of the same receptors that psilocybin operates on are also contained within the gastrointestinal tract, and mine had altered sensation for a month afterward. I believe my systemic inflammation significantly improved during that period because within three months of my dosing, I reacquired personal training records that had become elusive, and by summer, I passed those PRs and set new ones. I also felt incredibly less “puffy.” Accidentally banging into something didn’t hurt anymore and persistent joint aches and lack of motor activation disappeared. There were additional improvements in neurological issues that will be described in a future case study, but that was just as immediate and impactful.
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Lockdown Leads to the Lowdown on the First Psychedelic Pain Studies
Within the training and recovery world, patients and trainees can loosely be categorized as super, normal, non, and negative responders. I had stopped being responsive to both training and rehabilitation efforts at the peak of my depression, and was entering negative-responder territory, which was severely distressing. Fascinatingly, I now seem to be trending somewhere between a normal and high responder. I began proclaiming to the researchers at NYU that psychedelics were going to completely change chronic pain treatment within five years. And I also had a secret; the day after my dosing session, I had what’s referred to as a huge download: I realized that if you could consider things like depression, PTSD, and severe anxiety to be nociplastic outputs of the Central Nervous System (CNS) that causes iterative rumination (a.k.a. looping maladaptive outputs), that was no different from the looping maladaptive outputs that characterize chronic pain – the neurology of which I had been studying for years at that point. Due to the extreme visual qualities of the psychedelic experience and the rapidity of my own remission, I saw, in a flash, that since psilocybin was an impact booster for neuroplasticity, it would enhance the impact of mirror box therapy for phantom limb pain or likely any other neuromodulation.
“Remapping” is the term describing the tactic of using visual or other sensory receptor inputs to modify and change nociplastic or noxious/painful outputs of the brain. As this is part of the Z-Health process, I had been introduced to the concept of mirror box therapy years earlier as part of my certifications, but I thought I had come up with a whole new approach and kept it to myself, barely hinting at what I believed I had uncovered. But, since NYC was locked down and I was unable to work, I had nothing to do but go online and research what had happened to me.
Within two weeks or so, I found an old photocopied English abstract from a 1962 study in Japan, by Kuromaru, et al., using low-dose LSD to treat phantom-limb pain with 50% of its participants going into instant remission by the end of their session, and the authors pointedly declaring that stacking the LSD with movement had a far stronger impact on resolving both phantom limb pain and phantom limb syndrome. Stacking inputs is a common practice within the neuromodulation world for pain treatment, often coupling a weaker input with a stronger one, and I realized that this was what had clearly happened to me while I was in my post-dosing neuroplastic window. It finally felt like I was getting traction again; that drills and exercises were once again effective, and crucially, maintaining their own momentum. I didn’t have to be hypervigilant anymore in my daily routine for these drills to become “sticky.” I also realized that the Kuromaru study had, in fact, been released earlier than the Kast study from 1964 investigating the analgesic properties of LSD for terminal cancer and other painful conditions, which is frequently and incorrectly cited as the first psychedelic pain study. I became aware of other previous psychedelic pain studies, as well as recent ones like Dr. Charles Nichols’ work on the anti-inflammatory properties of psychedelics, and studies involving Dr. Robin Carhart-Harris’ REBUS model and cortical reorganization, which is what happens when a stimulus results in the creation of a new cortical map (essentially a vertical column in the brain cortex consisting of neurons performing specific processes).
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Both of these discoveries are crucial because cortical reorganization (or remapping) and inflammation are key drivers of chronic pain. Conditions like depression and anxiety are characterized by rigid, fixed beliefs or frameworks where the same negative thought loop keeps reoccurring repeatedly, with no amount of incoming contrary information able to alter that belief. It becomes what’s known as a “strong prior” in neurology, becoming a top-down driven process in the CNS, actively suppressing any bottom-up sensory input error correction. The same mechanisms of action occur with chronic pain, where, despite the healing or resolution of an injury; a rigid, fixed pain signal is continually being sent out by the brain as a maladaptive response of the CNS’ protective suite. These are referred to as nociplastic or noxious neurological conditions. The same is true for multiple chronic pain conditions where inflammation causes maladaptive signaling and perceptions, leading to negative structural or nociplastic changes in the peripheral and central nervous system. In psychedelic-assisted psychotherapy, a non-rigid, chaotic state is induced, which allows the cortical landscape to reorganize into a more efficient and positive state.
Landmark Study in Pain and Psychedelics Confirms Insights
I sat speechless for at least five minutes, shaking my head in a feeling of wonder and disbelief, as if the universe itself had just delivered this paper to me. Other than my remission and the pandemic, I had thought of nothing else but the application of how these two approaches could be combined. Of course someone else had invented it well before me; of course they had. I knew that resourceful, capable people had been working on this for a while, and chronic pain is a singular motivator, but it was still astonishing to see my vision so vividly applied and executed.
Check out this podcast with Court and Joe interviewing Dr. Castellanos and Dr. Timothy Furnish of PHRI!
I had learned in 2015 that cluster headaches had been effectively treated with psilocybin for 25 years, and of mirror box therapy a few years before that. I had even blogged about it because people in the rehab and training communities thought that my using visual inputs to treat pain was so weird they called it “voodoo.” But there is a neural hierarchy, and many pain and performance conditions in the body actually have higher-order components within the visual and vestibular systems. That’s often why, no matter how much manual/physio therapy one does, it is often a downstream compensation within the body in order to reconcile perceptual discrepancies between the visual and vestibular system. The visual system lets you assess the surrounding environment and predict any threats that exist within it, and the vestibular system helps you orient within that space, keeping your body in balance so that you might be able to execute any motor actions in response to any perceived threats. If your eyes are telling you the horizon is 5° tilted to the left, but your vestibular system, a.k.a. your inner ear, is telling you that it’s 5° to the right, your body will compensate so that those discrepancies are reconciled and you maintain a stable, level “sight picture” – your viewscreen of the world. Having an unstable sight picture makes for poor predictions; in other words, in an evolutionary survival context, having a “shaky cam” is not so great for avoiding saber-tooth tigers.
So, those downstream bodily compensations that keep your viewscreen steady are creating distortions and possible maladaptations in the structure of your body, and are now being cemented due to repeated compensatory use. The nervous system will protectively reduce motor output and increase pain perception as a response, to slow you down in order to avoid potential injury and survive another day. Ultimately, the body has evolved towards survival, not performance. And pain is an alarm/action signal designed to keep you alive.
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Mirror Box Therapy and Pain as An Output of Perception From the Brain
When we look at phantom limb pain, what we’re seeing is the phenomenon known as deafferentation: the loss of afferent or ascending inputs from the peripheral nervous system up to the brain. No limb equals no signal, and the loss of signal is very dangerous within an evolutionary context because limb loss due to injury or infection will mean, at the least, loss of sensation and loss of coordination for motor outputs/muscle contraction/movement, meaning a lost ability to gather food or to avoid threats. Or worse, it could mean signaling that you’re going to bleed to death in a matter of minutes.
Multiple pain conditions could be considered sub-clinical deafferentation: peripheral neuropathy from conditions like diabetes or shingles, or different types of phantom limb pain where the limb is still present but the nerves are so injured that they no longer transmit afferent signals – such as we see in cancer, stroke, or crush injuries. That loss of signal gets hardwired into the cortical representations of that limb, and never gets a counterbalancing signal, so the CNS registers it as an ongoing sense of threat. That creates a huge alarm signal in the form of pain perception.
What mirror box therapy does is replace that loss of signal with the image of an intact limb, generating input that dampens down that pain signal. And when you touch the remaining limb (which is generating normal signals) while seeing it reflected in the mirror in place of the missing or injured limb, it can immediately cause the pain signals to cease; so powerful are visual representations within the somatosensory cortex of the brain. Essentially, through seeing a limb appear where it wasn’t before, one tricks their own brain into thinking it’s still there, and the pain signals from the CNS for that lost limb stop being sent.
Mirror box therapy is often not enduring though; only being effective for as long as you do it, and that was the case with Albert Lin. It often takes a lot of repetition for it to become “sticky.” Neuroplasticity requires novelty and intensity, usually in the volume of work. But that can be hard to achieve, thus the issue in pain treatment that I had experienced directly as a practitioner and as a patient; everything works, nothing lasts. When it was suggested to Lin that psilocybin had strong neuroplastic properties that could impact cortical reorganization for chronic pain, he tried it a few times, taking a high dose of psilocybin mushrooms, which gave him approximately 3-12 pain-free hours, depending on the dose. But then the pain came back with a vengeance. Within the cluster headache communities, this is known as a “slapback effect” and can actually be a sign that the nervous system is adjusting and more permanent relief could be imminent.
Then, Lin’s wife suggested combining (stacking) mirror box therapy with psilocybin. He went out to the desert with a closet door mirror, and while under high-dose psilocybin, he would stare at the reflected image of his remaining leg and then at the space where his amputated limb had been, while repeating the phrase “You are safe. You are totally safe,” for approximately 45 minutes. This met all the conditions for driving neuroplasticity: novelty, intensity, and volume of work with deep assurance of emotional and physical security. Amazingly, it worked, immediately putting him into remission for the next 20+ hours, with 50% reduced pain for nearly two weeks. He shared his success with the lab, and experiments with different types of visual neuromodulation while under high-dose psilocybin quickly began.
Lin was dealing with a persistent pain in his phantom foot that felt as if a railroad spike was being driven through, suspected to be a sensory remnant from when the bones in his foot were surgically pinned together as they attempted to save it before ultimately deciding to amputate. An artificial foot and a pen with a telescoping pointer was introduced, and they covered the space between his stump and the plastic foot with a blanket, then “pulled” the telescoping pen out of his foot at the site of pain, mimicking the action of removing pins (or really, removing the pain). He felt instant relief.
Another experiment involved a novelty Halloween-store “flame” (bright light with orange and yellow fabric and a fan underneath that makes it flutter). Lin chuckled when he saw it, but when they brought it near his representational foot, he actually felt heat from the “flame,” which was intensely relieving.
Through these experiments and continued work, Lin went into full remission after five weeks, and has been free of chronic pain ever since. It’s worth noting that he had a top research team working with him that was extremely creative in creating novel inputs, and he is known for being an almost Michelangelo-type character, with a high degree of inventiveness and novelty-seeking, allowing him to discover unique, lateral approaches to solve problems. And, it bears repeating: chronic pain is a singular motivational force.
Additionally, post-dosing, cortical reorganization was happening during a psychedelically-induced “critical period reopening”; when the brain has a metaplastic quality that allows it to reset to an almost-new condition. As described in the work by Dr. Gül Dölen, critical period reopening happens during crucial phases of nervous system development in childhood, such as when toddlers can learn multiple languages without an accent or when adolescents are uniquely sensitive to social cues from peer pressure (and/or support), allowing them to quickly adopt different social customs and frameworks. This reopening is also seen post-stroke, when there is a limited window for rehabilitating from brain injury, so this likely applies very well here with chronic pain. We know that veteran groups like the Heroic Hearts Project, VETS (Veterans Exploring Treatment Solutions), and The Mission Within, who are employing psychedelics for treatment, are having striking results both in recovery from combat-induced PTSD as well as traumatic brain injury – typically seen as treatment-resistant conditions.
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Conclusion
If there’s anything I would like you to understand after reading this article, it’s that:
We don’t have to prove that psychedelics are effective for treating chronic pain; we have to establish that this has already been proven.
Psychedelics are not an instant cure for chronic pain, but they are strong impact boosters for neuroplasticity and can make physiotherapy/neuromodulation become “sticky,” creating enduring relief.
We know that many mechanisms that create psychiatric conditions that are responsive to psychedelic-assisted psychotherapy are extremely similar in nature to the same mechanisms that generate chronic pain; it’s just that psychiatric conditions have gotten far more focus in psychedelics, perhaps because the non-ordinary states of consciousness they are known for producing seem more applicable to conditions more traditionally thought to be related to the mind.
But both arise out of the central nervous system and are rigid, fixed states of cognition and perception. With depression, you have negative outlooks and self-perceptions: “Nothing I do makes a difference,” “People are just saying that to make me feel better,” etc. At one point, these thoughts may have helped you to cope with a traumatic incident, environment, or upbringing, but now they’re maladaptive, weigh you down, are out of step with reality, and have actually caused (or are the result of) structural deficits in the neurology of your brain. It’s the same with chronic pain: when there is an acute injury or even the possibility of one, pain is part of the protective suite of responses from our nervous systems to prevent further injury and allow healing to occur – an alarm bell/action signal to change a behavior. But it can be so overprotective that it gets embedded and cemented with movement, emotions, and surrounding environments long after all tissue healing is done – getting triggered by seemingly innocuous events, maladaptively hardwired into your neurology in a negative loop of conditioned responses.
This is exactly what happened to me when I went through NYU’s psilocybin trial; an adverse financial and work environment, repeated (and under-recovered) musculoskeletal stress/injuries, and (likely) sub-clinical post-concussion syndrome and PTSD, all topped off by the sudden death of a close friend releasing long-suppressed grief and leading to a significant nociplastic output in the form of increasingly treatment-resistant depression and moderate chronic pain. Many recovery efforts were attempted using every modality I knew, but there was too much of a deficit to overcome – until psilocybin was introduced to the mix. That life-changing experience allowed for metaplasticity, cortical reorganization, descending inhibition, and anti-inflammatory properties to take root, giving all post-dosing interventions the opportunity to gain traction and for me to flourish once again.
Future articles in this “Pain and Psychedelics” series will focus on old assumptions vs. new science, additional case studies, the suspected mechanisms of action behind the interaction between psychedelics and pain, and best practices and safety concerns for working with psychedelics to alleviate chronic pain.
An NYU psilocybin depression study participant discovers an unforeseen application for psychedelics: the treatment of chronic pain. Part 1 of the series: Psychedelics and Chronic Pain.
Everything Worked, but Nothing Lasted
In the fall of 2020, I was living a pretty successful and happy life – on paper. I had co-founded a very popular, leading-edge CrossFit gym in NYC; one of the first in the world. I held multiple advanced certifications in applied neurophysiology through Z-Health, helping clients with challenging pain and performance issues. As an early adopter of kettlebell training, I became a nationally top-reviewed instructor and trained Team 6 Navy SEALs, astronauts, pro athletes, wounded veterans, and members of the FBI, NYPD, NYFD, and ROTC. I was featured in Men’s Fitness, the NY Times Sunday Routine, and USA Today. I had 30 years in the pain & performance field, training and teaching at a high level, and was becoming widely known for helping people with difficult mobility problems or chronic pain, using unique methods from the leading edge of neurological rehabilitation. On top of all of that, I was 17 years sober.
However, not all that glitters is gold. A now ex-business partner was committing a Ponzi scheme to the tune of millions, and his case followed him like a shadow, turning my life’s passion into an emotionally and financially toxic nightmare that economically devastated my family. My best friend, Kirk MacLeod, who I had completely rehabbed from chemo & cancer surgery, died six months after being declared in remission. My first son had developed undiagnosed GERD and couldn’t sleep more than an hour and half at a time, which meant my wife and I slept even less.
Unsurprisingly, my episodic depression returned after more than a decade and a half, and I was now increasingly treatment-resistant; unresponsive to psychiatric drugs that had previously worked. All my pain neuromodulation interventions that worked on my clients no longer worked for me, and I had developed chronic pain myself.
I share all my background here to demonstrate that I was not under-resourced in either knowledge, networks, or diversity of approaches, practice, or experiences. I poured over all my certification materials looking for anything I had missed, but had fallen into an increasingly deeper recovery hole; everything worked, but nothing lasted. I was hitting a new bottom in my life, deeply sinking into the midst of an increasingly treatment-resistant depression episode that had likely been ongoing for five years.
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But then I became aware of ongoing studies on psilocybin for depression happening locally in NYC. I had experienced a few high-dose psychedelic sessions nearly a quarter century ago and had been an avid Terence McKenna fan (even speaking with him directly after a lecture in Seattle), but I had never taken psychedelics therapeutically, and my recreational interest had effectively vanished once I became sober from alcohol. Intrigued, I connected with the local clinical research coordinator, Leila Ghazhal, at the NYU for the clinical trial of Psilocybin for Major Depressive Disorder study (sponsored by the Usona Institute), and took all the online and over-the-phone assessments, passing them easily. The primary investigator (PI) on my study was Dr. Stephen Ross, who had been leading psychedelic research at NYU for more than a decade. Amazingly, I made it into the trial within a month and a half, learning that I’d actually beat out 8500 other applicants for just 100 spots nationwide.
Trying Not to Hope
When I first entered the trial, I was in a state of denial about how severe my depression was, but once I took the MADRS assessment, there was no avoiding that I had moderate to severe depression with suicidal ideation.
I remember a specific moment very well during this process, when I was finally cleared to enter the study and the study coordinator was speaking with me about the results of my assessment and my upcoming participation. I asked what would happen if I didn’t receive psilocybin during my session, and he reassured me that they would not just drop me off in the middle of the ocean to dog paddle – that there were other interventions and studies available and they would be sure to find me something, but there was a good chance I would receive psilocybin and hopefully get some good results. At this point, my mask cracked a little bit and some protective cynicism came out, and I quipped with a bit of a shrug: “Well, we’ll see.” I hadn’t meant it to be dismissive or sarcastic but it came out that way, and the conversational atmosphere rapidly shifted. He looked right at me and suddenly he wasn’t the primary investigator anymore, lost in the myriad details and logistics of a very involved study. Now he was the deeply experienced clinician and therapist, and, having heard something within the tone of my voice, dropped all the way in and asked softly: “What’s going on behind that, Court?” Suddenly, all the masking dropped and there was no more place to hide because I was so, so tired at this point, and had been waiting for this moment. In and out of therapy for years, dozens if not 100 self-help books, so many modalities, so many somatic systems, and here I was with a chance for something new to help me. When I realized why there was cynicism behind my statement, my voice cracked, I started crying, and I answered him: “Trying not to hope.”
The one glimmer of hope I did have was reading a 2018 paper by lead author Calvin Ly describing psychedelics’ neuroplastic activity in the prefrontal cortex. As someone who had studied the neurology of pain for years, this was revelatory. Many pain conditions are, in fact, nociplastic or noxious conditions arising out of the central nervous system (CNS); there’s no more injury or damage if there ever was, but your CNS is still continuing to put out a maladaptive alarm signal that is perceived as pain. So learning that psilocybin was creating actual structural change within my cortex – not “just” psychological change – was completely astonishing.
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My dosing date was on March 5, 2020, and I remember looking down at the capsule sitting in the cup, saying to it: “I really hope that’s you.” I was terrified inwardly that I would receive the placebo, that I wouldn’t respond to the psilocybin, or that it would only work just a little bit, only for its effects to slowly fade. But within half an hour, there was no denying that I had received psilocybin, and I earnestly pursued all the procedures everyone on my care team at NYU had worked with me on for weeks in preparation for this day.
I was genuinely shocked at the sheer volume of psychological material from my childhood and early adulthood that came up. I had profound transpersonal experiences and healing, revisiting instances that were pivotal in my childhood. I had an encounter with the first woman I had ever loved, who had committed suicide three years after we had broken up. Her death had caused a profound grief in me that drove my drinking for a decade after. I thought I had released the majority of my grief around her once I got sober, but clearly, there was so much more to heal that had been deeply suppressed as I tried to move forward with my life.
Reset, Renewed, and Reborn
The biggest shock of all, though, was waiting for me at the end of the day when one of my facilitators casually pitched a seemingly routine question while closely watching me out of the corner of his eye: “So, how do you feel?” Without thinking, I reflexively replied, “Good,” but then, just as reflexively, scanned more deeply inward, and in a sudden rush, realized my depression was completely gone – not just better, but vanquished, exclaiming: “Good! That fast? Are you fucking kidding me, that fast? Is it gone already?”
It felt as if a huge mass had been surgically removed from me or as if an entire continent within my interior was now suddenly revealed. No matter how many times you read the word “remission” and the percentages behind it in scientific studies, very little will prepare you for the shocking reality of it. The contrast between before and after was profound. All of the iterative rumination was gone, and it took no effort for that to happen. And it only seemed to strengthen as the days passed. Miraculously, all suicidal thoughts ceased on that day and never returned.
Shockingly, only ten days after my dosing session, NYC went into a complete pandemic lockdown, my entire industry closed, and my two young boys were now at home with me 24/7, tele-learning. I cannot imagine what 2020 would have been like for me if I had received the placebo. It’s almost unimaginable.
For more on this topic, make sure to check out episode 369, where Court and Joe interview Timothy Furnish, MD & Joel Castellanos, MD of UC San Diego’s Psychedelics and Health Research Initiative (PHRI).
But here is where the story takes an even more profound and impactful turn. During the session, my leg started intensely tremoring/spasming. I had been evaluated for musculoskeletal pain and dysfunction that I had acquired through a host of injuries over the years of my performance career, and in fact, had just been in the doctor’s office a few months earlier trying to determine if I had arthritis or something worse. But right there in the session room, I started having a neurological revision, with my muscles and nerves in my right inner thigh firing in an effort to recalibrate the sensory and motor inputs and outputs in that part of my kinetic chain. It was almost like a self-generated TENS unit (Transdermal Electromagnetic Nerve Stimulation, used to generate muscle contractions and neuromodulate pain signals with micro-electric pulses) getting my leg back online by creating intense motor activity in the muscles of my thigh.
I’ve since spoken with spinal injury survivor Jim Harris and read a case series from UC San Diego’s Psychedelics and Health Research Initiative (PHRI) published in PAIN Journal where the exact same thing occurred to them under the effect of psilocybin with the same positive results, but at the time, the facilitators were concerned enough to ask the primary investigator to come and evaluate me during the session. I had to explain to him, somewhat hilariously as I was going into my peak, that, in fact, the tremors felt intensely good. I’m grateful that he let them continue because it has made all the difference.
While I partially understood what had happened, I was understandably beyond eager to learn more, and to see where else this realization could take me: Why did this work so well? Has our understanding of chronic pain been wrong? And if psychedelics are the answer, what does treating chronic pain with psychedelics actually look like?
This is part 1 of a 2-part piece and part of a larger series on chronic pain and psychedelics. In part 2, I will dive into the research around remapping and mirror box therapy, and why my psychedelic experience seemed to be so effective.
Future articles will focus on:What is pain and what causes chronic pain, old assumptions vs. new science, the suspected mechanisms of action behind the interaction between psychedelics and pain, and best practices and safety concerns for working with psychedelics to alleviate chronic pain.
In this Veteran’s Day episode, Joe checks in with two members of the Heroic Hearts Project: Founder and President, Jesse Gould, and Chief of Operations, Zach Riggle.
Heroic Hearts’ mission is to create a healing community that helps veterans suffering from military trauma recover and thrive through helping them gain access to psychedelic treatments, professional coaching, and ongoing peer support – and we’re always happy to have them on the podcast to remind listeners about the extremely important work they do.
Among other projects, they are currently running several studies: psilocybin for gold star wives (spouses of fallen soldiers), ayahuasca for combat veterans, and ibogaine for special operations veterans through the University of Texas at Austin Dell Medical School’s Center for Psychedelic Research & Therapy; a study with the University of Georgia on personality change through psychedelics; a gut microbiome study with University of Colorado Boulder; and a psilocybin for head trauma study through Imperial College London. And today, they released the short film, “It’s Time – A Documentary of Veterans and Pro Athletes Seeking Healing Through Psychedelics.”
Gould and Riggle discuss the growth in interest and acceptance in psychedelics they’ve seen over the last few years; the importance of people telling their stories; relative trauma and how people too often wait to seek help; how trauma isn’t always due to a single event; Colorado’s Proposition 122 (which passed!); the need to have standard measurements in psychedelic studies; and how people who go through trauma together can heal together.
Notable Quotes
“At what point do we ask for help? I think, just as a society, we feel like things have to be in full-on crisis before we need to seek some sort of assistance. And we want to put [it] out there that that doesn’t have to be the case – that if you’re able to look at your life and realize that there may be some areas where things could improve and you might need some help in improving them, then don’t be afraid to reach out, because we’re not going to turn you away.” -Zach
“In the standard medical world, the physicians [or] the psychologists are looking at that qualifying incident and trying to heal that, trying to address that. And there’s some things that are pretty effective …but they’re working largely on that single incident, and ignoring all the other things that may have happened over time. And that’s where psychedelics can be so beneficial, is that they address that whole issue with a full system reset.” -Zach
“You take a population that largely (due to their illness) has been isolating, pushing everyone away, and just sitting back and looking at how amazing everyone else’s life is while theirs continues to deteriorate. Well, we plug them back into a community, bring them in, and help them to heal together. That’s a powerful thing to realize: that communities that were traumatized together; they heal better together.” -Zach
In this episode, Joe invites Court Wing to co-host, interviewing two members of UC San Diego’s Psychedelics and Health Research Initiative (PHRI): Joel Castellanos, MD (Associate Medical Director of PHRI and board-certified physical medicine and rehabilitation and pain medicine physician), and Timothy Furnish, MD (Medical Director of PHRI and Associate Clinical Professor of Anesthesiology and Pain Medicine).
As one of the early participants of a psilocybin-for-depression trial in NYC, Court Wing (of REMAP Therapeutics) discovered that immediately after the session, his chronic pain had miraculously gone away. He began researching how psychedelics could be used (with or without other therapies) to continue the alleviation of pain psychedelics had brought him. Through the Psychedelics and Health Research Initiative, Drs. Castellanos and Furnish are following that that same road, and are currently recruiting for a randomized controlled trial on psilocybin for phantom limb pain.
They talk about the relationship between the mind and chronic pain: how people confuse pain with the simple act of nerves firing, but how it’s so much more. And they discuss how pain can become part of one’s identity (and how the Default Mode Network could be contributing); how physical therapy is related to neuroplasticity; mirror box therapy; microdosing for chronic pain; the unusual nature of phantom limb pain; and where the mystical psychedelic experience may come into play. If this topic is as fascinating to you as it is to us, stay tuned – we will be featuring much more on chronic pain and psychedelics, including a blog series from Court Wing coming soon.
Notable Quotes
“One of the things that may be unique about or interesting about chronic pain is that the longer it goes on, the more people start seeing pain as a part of their identity and that Default Mode Network is probably playing a role in that. And it’s possible that something like psychedelics could open up the possibility of changing that internal story so that pain is no longer so much a part of one’s identity.” -Tim “I think that people oftentimes confuse pain with simply nerves firing. …[But] there is this rich interplay between the way we think about pain, the way we perceive pain, and how we feel about it.” -Tim “When you’re not really dealing with chronic or severe pain on a daily basis, it’s really hard to think about how life-changing that is or can be.” -Joel
“When we hear things like ‘It’s only just in your head,’ I don’t think people quite get [that] the head can be a scary place to be trapped sometimes.” -Court
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