Dr. Andrew Huberman interviews Dr. Robin Carhart-Harris, a leading researcher in the field of psychedelics, on the Huberman Lab podcast, delving into the science, clinical applications, and evolving legal landscape of these mind-altering substances.
Carhart-Harris begins by explaining the etymology of the term "psychedelic," emphasizing its meaning as "mind-revealing" and its relevance to the subjective experiences elicited by these compounds. He clarifies that while the classic definition of psychedelics involves their interaction with the serotonin 2A receptor in the brain, the subjective, phenomenological aspects are equally critical to understanding their effects.
The discussion explores the ability of psychedelics, particularly psilocybin (found in magic mushrooms) and LSD, to reveal aspects of the psyche usually hidden from conscious awareness. Carhart-Harris connects this to depth psychology, explaining how psychedelics can bring repressed memories and insights to the surface, catalyzing therapeutic progress.
Huberman and Carhart-Harris dissect the nuances of microdosing versus macrodosing. Carhart-Harris defines a microdose as a sub-perceptible dose, typically around 10 micrograms of LSD, intended to induce subtle, long-term changes in well-being and cognition. However, he cautions that compelling scientific evidence supporting microdosing's effectiveness is currently lacking. Carhart-Harris's work highlights the efficacy of macrodoses of psilocybin, typically 10-25 milligrams, in controlled clinical trials for conditions like major depression, anorexia and fibromyalgia.
The importance of the psychedelic experience itself is emphasized, citing converging evidence indicating that the magnitude of certain subjective experiences strongly predicts therapeutic outcomes. Carhart-Harris describes a typical psychedelic therapy session, characterized by eye masks, carefully curated music, and the presence of two mental health professionals to provide guidance and support. He highlights the importance of "trust, let go, be open" as a mantra to encourage patients to surrender to the experience and confront difficult emotions.
The conversation touches on the brain changes induced by psychedelics. Carhart-Harris explains that these drugs increase communication between brain areas that typically don't interact, leading to a more intermodular and less modular mode of brain functioning. This increased connectivity, observed during the psychedelic journey, can persist for weeks afterward and correlate with improved symptoms in depressed individuals. The relationship between increased connectivity and altered subjective experience remains an area of active research.
Huberman and Carhart-Harris discuss a growing movement to develop non-hallucinogenic psychedelics for therapeutic use. Carhart-Harris remains skeptical, arguing that the subjective experience, the “psyche-revealing” aspect, is essential for the unique benefits of psychedelic therapy. He states, that if a selective serotonin to a receptor stimulator, an agonist, that isn't psychedelic, it would be therapeutic in psychiatry and the answer firmly is no.
The importance of "integration," is described, after the psychedelic experience. The point of integration is how people can maximize on the neuroplasticity and the brain changes in a positive way in the days and weeks afterward. To that, Carhartt Harris argues integration lasts a lifetime, saying the journey of the mind doesn't stop.
The conversation closes by covering the legal status of psychedelics in the US and the role big pharma can play in that legal space.