Dr. Robin Carhart-Harris: The Science of Psychedelics for Mental Health | Huberman Lab Podcast
发布时间 2023-05-22 12:00:34 来源
Welcome to the Huberman Lab podcast where we discuss science and science-based tools for everyday life. I'm Andrew Huberman and I'm a professor of neurobiology and Ophthalmology at Stanford School of Medicine. Today my guest is Dr. Robin Carrhart Harris. Dr. Carrhart Harris is a distinguished professor of neurology and psychiatry at the University of California, San Francisco. He is one of the leading researchers in the field of psychedelics and how they change neural circuitry in the brain. His laboratory is responsible for understanding for instance how psilocybin also sometimes referred to as magic mushrooms, change neural circuitry in the brain such that new ideas and new forms of learning occur.
欢迎收听Huberman Lab播客，在这里我们讨论科学以及基于科学的日常生活工具。我是Andrew Huberman，斯坦福医学院的神经生物学和眼科学教授。今天我的嘉宾是Dr. Robin Carrhart Harris。Carrhart Harris博士是加州大学旧金山分校的一位杰出的神经学和精神病学教授。他是迷幻药研究领域的顶尖研究者之一，专注于研究这些药物如何改变大脑的神经回路。他的实验室致力于理解如灵魂药，也称为“魔法蘑菇”，如何通过改变大脑神经回路，使得新想法和新形式的学习得以发生。
His laboratory is also responsible for carrying out various clinical trials, some of which have demonstrated that appropriate dosages of psilocybin can alleviate major depression in more than 67% of people that take the drug. Now, this is not to say that everybody should take psilocybin and today's discussion describes both the clinical trials and why treatments with psychedelics in some cases work and in some cases do not work in order to treat major depression.
他的实验室还负责进行各种临床试验，其中一些试验表明，适当剂量的裸盖菇素可以缓解超过67%的服药者的重度抑郁症。 但这并不意味着每个人都应该使用裸盖菇素。今天的讨论介绍了这些临床试验，并探讨了为什么用迷幻药治疗重度抑郁有时有效，有时无效的原因。
As well as discussions around psilocybin, Lycurgic acid diethylmide sometimes also referred to as LSD as well as DMT and how these change the brain and how those brain changes can relate to changes in mental health as it relates to depression and other psychiatric challenges as well as how psychedelics are being applied in order to change neural circuitry for sake of expanding different aspects of the human mind including creativity, intelligence and much more.
在探讨裸盖菇素（psilocybin）的同时，人们也常常提到麦角酸二乙酰胺（Lysergic acid diethylamide），通常被称为LSD，以及DMT（二甲基色胺）。这些物质如何改变大脑，以及这些脑部变化如何与抑郁症和其他精神健康问题相关联，已经成为重要话题。此外，研究还关注这些致幻剂如何被用来改变神经回路，从而扩展人类心智的不同方面，包括创造力、智力等多个方面。
During today's discussion Dr. Carhartt Harris teaches us about the history of the study of psychedelics as well as how the legislature that is the laws surrounding psychedelics are evolving in the United States and elsewhere for the use of psychedelics to treat psychiatric challenges. By the end of today's discussion you will have a thorough understanding of how psychedelics work both in the short term during the actual journey or trip in fact much of my discussion today with Dr. Carhartt Harris talks about the different aspects of the psychedelic journey and how those relate to therapeutic outcomes.
在今天的讨论中，Dr. Carhartt Harris 向我们介绍了迷幻药研究的历史，以及美国和其他地区关于迷幻药法律法规的发展，特别是如何利用迷幻药治疗精神疾病。在今天的讨论结束时，你将对迷幻药的作用机制有一个深入的理解，包括在实际体验中的短期效果，事实上，我今天与 Dr. Carhartt Harris 的大部分讨论都围绕迷幻体验的不同方面，以及这些方面如何与治疗效果相关。
And of course by the end of today's discussion you will also understand the long term effects of psychedelics that is how they can actually rewire the brain. Before we begin I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme I'd like to thank the sponsors of today's podcast.
当然，在今天讨论结束时，你们也将了解迷幻药物的长期影响，也就是它们如何实际地重塑大脑。在开始之前，我想强调一下，这个播客与我在斯坦福的教学和研究工作是分开的。尽管如此，它仍然是我希望为公众提供免费科学信息和科学相关工具的一部分。按照这个主题，我想感谢今天播客的赞助商。
Our first sponsor is 8 Sleep. 8 Sleep makes smart mattress covers with cooling heating and sleep tracking capacity. I've talked many times before on this podcast about the fact that sleep is the foundation of mental health physical health and performance. One absolutely critical variable to getting excellent sleep is the temperature of your sleeping environment. That is in order to fall and stay deeply asleep at night your body temperature needs to actually drop by about 1 to 3 degrees.
我们的第一个赞助商是8 Sleep。8 Sleep制造的智能床垫套具备制冷、加热和睡眠追踪功能。在这个播客中，我已经多次谈到，睡眠是心理健康、身体健康和表现的基础。要获得出色的睡眠，其中一个绝对关键的因素就是你睡眠环境的温度。为了能够快速入睡并保持深度睡眠，你的身体温度实际上需要降低大约1到3度。
And in order to wake up in the morning feeling refreshed and alert your body temperature has to increase by about 1 to 3 degrees. There are a lot of ways to control the temperature of your sleeping environment but one of the best ways it's to control the temperature of your actual mattress. The surface that you're sleeping on. With 8 Sleep you can do this very easily. There's a simple to use app where you can program in the temperature of your mattress across the night.
为了让早晨醒来时感到神清气爽，身体的温度需要上升约1到3度。有很多方法可以调节睡眠环境的温度，而其中一个最有效的方法是调节你实际躺在上面的床垫的温度。使用8 Sleep，你可以很轻松地做到这一点。它有一个简单易用的应用程序，可以让你在整夜间设置床垫的温度。
So you can make it slightly cool at the beginning of the night getting cooler putting you into deep sleep and then rapid eye movement sleep. And all of that in terms of its impact on your sleep can be tracked within the same app. I've been sleeping on an 8 Sleep mattress cover for more than two years now and it has completely transformed my sleep. If you'd like to try 8 Sleep you can go to 8 Sleep.com slash Huberman for their exclusive memorial day savings now through June 5th 2023.
因此，您可以在入睡初期把温度调得稍微凉爽一些，使身体慢慢进入深度睡眠和快速眼动睡眠状态。所有这些效果都可以通过同一个应用程序来追踪。我已经使用8 Sleep的床垫套超过两年了，它彻底改善了我的睡眠。如果您想尝试8 Sleep，可以访问8Sleep.com/Huberman，在2023年6月5日之前享受他们纪念日的独家优惠。
8 Sleep currently ships in the USA, Canada, United Kingdom, select countries in the EU and Australia. Again that's 8 Sleep.com slash Huberman. Today's episode is also brought to us by levels. Levels is a program that lets you see how different foods affect your health by giving you real time feedback on your diet using continuous glucose monitor. One of the most important factors in terms of your energy levels and your immediate and long term health are your blood glucose or blood sugar levels as they're commonly called.
8 Sleep目前在美国、加拿大、英国、部分欧盟国家和澳大利亚提供服务。再次提醒，网址是8Sleep.com斜杠Huberman。今天的节目还由Levels赞助。Levels是一个项目，它通过持续的血糖监测器，向你提供有关饮食的实时反馈，让你了解不同食物如何影响你的健康。影响你能量水平以及短期和长期健康的一个重要因素是你的血糖水平，也就是通常所说的血糖。
With levels you can assess how different foods and activities impact your blood glucose levels. When I did this it taught me several things. First of all it taught me that certain foods really spike my blood glucose levels. And while spikes in blood glucose aren't always a bad thing I was able to assess how certain foods were spiking my blood glucose too much such that I would have. Post-eating dips in energy levels and by removing those foods and substituting in other foods really evened out my energy levels. So if you're interested in learning more about levels and trying a continuous glucose monitor yourself. Go to levels.link slash Huberman right now levels is offering an additional two free months of membership. Again that's levels.link slash Huberman.
通过使用“levels”系统，你可以评估不同食物和活动对你的血糖水平的影响。我自己使用了这个系统后，学到了很多。首先，它让我意识到某些食物确实会让我的血糖水平急剧上升。虽然血糖飙升不一定总是件坏事，但我可以评估哪些食物引起的血糖飙升过大，以至于会导致餐后能量水平下降。通过去掉这些食物并用其他食物代替，我的能量水平变得更加稳定。所以如果你对了解“levels”系统感兴趣，并想亲自尝试持续血糖监测仪，可以访问 levels.link/huberman 这个网站。目前，levels 还额外提供两个月的免费会员服务。再次提醒，网址是 levels.link/huberman。
Today's episode is also brought to us by HVMN ketone IQ. Ketone IQ is a ketone supplement that increases blood ketones. And most people have heard of the so-called ketogenic diet but most people including myself are not on the ketogenic diet. That is I and most people eat complex carbohydrates, fruits and things of that. So in addition to quality proteins etc. It turns out that even if you're not following a ketogenic diet increasing your blood ketones can still have benefits.
今天节目由HVMN的Ketone IQ赞助。Ketone IQ是一种酮类补充剂，可以增加血液中的酮体。很多人都听说过所谓的生酮饮食，但包括我在内的大多数人并不遵循这种饮食方式。也就是说，我和大多数人都会食用复杂的碳水化合物、水果等等，当然也包括优质蛋白质等。事实证明，即便你不进行生酮饮食，增加血液中的酮体仍然能带来一些好处。
So for instance I use ketone IQ and each time I want to do extended bouts of focused work preparing for podcasts, research, writing grants. And if I ever want to exercise but I don't have time to eat or I don't want to have my gut full of food. Taking ketone IQ and thereby increasing my blood ketones allows me to do cognitive work or physical workouts without getting hungry and with plenty of energy and cognitive focus. If you'd like to try ketone IQ you can go to hvmn.com slash Huberman to save 20% off. Again that's hvmn.com slash Huberman.
例如，我会在需要长时间专注于准备播客、研究和写资助申请时使用 Ketone IQ。如果我想锻炼但没有时间吃饭或者不想让胃里装满食物，我也会用它。服用 Ketone IQ 后，我的血液中酮体水平升高，这让我能够在不感到饥饿的情况下进行认知工作或体力锻炼，同时还能保持充沛的能量和专注力。如果你想尝试 Ketone IQ，可以访问 hvmn.com/Huberman，享受 20% 的优惠。再次提醒一下，网址是 hvmn.com/Huberman。
I'm pleased to announce that I will be hosting two live events in September of 2023. The first live event will take place in Toronto on September 12. The second live event will take place in Chicago on September 28. Both live events will include a lecture and a question and answer period and are entitled the brain body contract during which I will discuss tools and science related to mental health, physical health and performance. I should mention that a lot of that content will have absolutely no overlap with content covered previously on the Huberman Lab podcast or elsewhere. If you're interested in attending either of both of these events please go to hvmn.com slash tour and enter the code Huberman to get early access to tickets.
我很高兴地宣布，我将在2023年9月举办两场线下活动。第一场活动将于9月12日在多伦多举行，第二场则在9月28日于芝加哥举行。这两场活动都包括一个讲座和一个问答环节，主题为“大脑与身体的契约”，我将在活动中讨论与心理健康、身体健康和表现相关的工具和科学。我需要提到的是，这些内容大多是此前在Huberman Lab播客或其他地方没有涉及过的。如果你有兴趣参加其中一个或两个活动，请访问hvmn.com/tour，并输入代码Huberman，以便抢先获取门票。
Once again that's HubermanLab.com slash tour and use the code Huberman to access tickets. I hope to see you there. And now for my discussion with Dr. Robin Carrhart Harris. Dr. Carrhart Harris, welcome. I've been wanting to talk to you for a long time. I certainly have known who you are for quite a while because I place you in this very small but very special and important category of researchers who has been pioneering the use of psychedelics for the treatment of specific clinical conditions and really carrying the torch for essentially the entire field.
再次提醒，访问 HubermanLab.com/tour 并使用代码 Huberman 获取门票。我希望在那里见到你。现在进入我与罗宾·卡哈特-哈里斯博士的讨论。卡哈特-哈里斯博士，欢迎你。我一直以来都想和你交流。因为在我看来，你属于这个既小众又非常特别和重要的研究者群体，你们在探索使用迷幻药来治疗特定临床疾病方面开辟了先河，真正肩负起了整个领域的重任。
So I want to start with a voice of gratitude and say thank you for doing this incredibly important work. Could you tell us a little bit about what psychedelics are? In fact I'm curious as to how the name psychedelic ever came to be. And what do you think they potentially reveal about the workings of the brain? And then we'll talk about the clinical applications. Sure well, even that one is kind of hot one because opinions differ on how to define psychedelic. But perhaps a good starting place is to start with the etymology where did the word come from.
首先，我想以感激之情开始，感谢你们从事这项极为重要的工作。你能给我们简单介绍一下什么是迷幻药吗？其实，我对“迷幻药”这个名字的由来很感兴趣。你觉得迷幻药可能揭示了大脑的哪些运作方式？然后我们来讨论一下它们的临床应用。当然，这个问题实际上争议颇多，因为对于如何定义“迷幻药”意见不一。不过，也许可以从词源学的角度入手，来探讨这个词的来源。
And it was a Brit, excommunicated living in Canada, Humphry Osmond, who was due to present a paper at a National Academy of Sciences meeting on psychotomometics drugs that mimic aspects of psychosis in their action. And certain drugs like mescaline, let's see 1956 and LSD were on the bill. And he felt dissatisfied with them being under this category of psychotomometics and felt that the signature psychological effects of these compounds went beyond just mimicking psychotic symptoms. And so he wanted to find a more apt term to speak to in a sense the principal component of their action.
是一位住在加拿大的英国人，休姆弗里·奥斯蒙德，他曾被教会革除教籍。他准备在国家科学院的一个会议上发表关于精神病模拟剂的报告，这些药物在作用上模仿了精神病的一些特征。其中有些药物，如麦司卡林和 LSD 等，当时被列在1956年的会议上。奥斯蒙德对这些药物被分类为精神病模拟剂感到不满，因为他认为这些化合物的显著心理效应不仅仅是模拟精神病症状。因此，他想找一个更合适的术语来描述这些化合物的主要作用成分。
And he jotted down a few different possibilities about it does not so I think. And one of them was psychodelic actually it started as and ended up being psychedelic. And he had a correspondence going on with another Brit also living in the US all this Huxley, where they were playing with some terms to refer to these compounds. And in the end, Osmond won with psychedelic and he had this little ditty of to fathom hell or saw angelic just take a pinch of psychedelic. That's for you for the disclaimer.
他写下了几种不同的可能性，关于它并不是我想的那样。其中之一其实是“psychodelic”（迷幻），一开始是“psychodelic”，而最终变成了“psychedelic”（致幻）。他还和另一个也住在美国的英国人阿道司·赫胥黎有通信，他们在为这些化合物想一些名称。最后，奥斯蒙德赢了，用了“psychedelic”这个词，他还写了一句小诗：“想要探索地狱或看到天使，只需来一点致幻剂。”这就是你的免责声明。
And so what does that mean it's to ancient Greek word psyche means the human mind or if we're being actually true to the ancient Greek it means soul. And then the other component means to make clear or to make visible or to make manifest or to reveal so all of those work. And it's it's a neologism it's a made up word but it does have that ancient Greek origin and it's speaking to this principle that these compounds reveal aspects of the psyche. Of the human mind the soul that are ordinarily not entirely visible. And so that's yet emology and it's wonderfully poetic but I happen to think it's also very accurate. It's a useful term because it's sort of you might say valence non-specific. It doesn't say you're going to have a great time or that you're going to go mad. It's more that it reveals psyche and it could be hellish but it could be heavenly.
这段文字表达的意思是，一个新造的词源自古希腊语的两个词。第一个词“psyche”在英文中通常指代“人类的心灵”，如果追溯其古希腊语的真意，它其实指的是“灵魂”。另一个组成部分则表示“清晰地展现、显露或揭示”。虽然这个词是新造的，但有古希腊语的起源，它表达了这些化合物可以揭示平时不那么明显的人类心灵或灵魂的某些层面。
这个词的词源不仅富有诗意，我认为它也非常准确。它是一个有用的词，因为它在情感上是中性的。它并不意味着使用这些化合物会有美好或疯狂的体验，而是说明它们会揭示“心灵”的部分。这种揭示可能是地狱般痛苦的，也可能是天堂般美好的。
And so that's the etymology and also a bit of the psychology and sort of you know pointing to the phenomenology the subjective experience. But there's also a pharmacology here and quite recently there was put out a consensus statement about psychedelics that's really referring to what we call the classic psychedelics to say that these are all compounds that work on a particular receptor in the brain, the serotonin 2A receptor. And that's another way that we could define these compounds. I said this one's a little hot because I'm of the view that while the pharmacology is really useful, how the drugs work chemically you can't avoid the phenomenology.
这就是该词的词源，还有一点心理学的背景，某种程度上也是指向现象学，即主观体验。不过，这里还有药理学的内容。最近有一项关于迷幻药物的共识声明，主要是指我们称之为经典迷幻药物的那些，它们都是作用于大脑中一种特定受体——5-羟色胺2A受体——的化合物。这是定义这些化合物的另一种方式。我觉得这个话题有些棘手，因为虽然药理学很有用，了解药物的化学作用方式也重要，但我们不能忽视现象学的内容。
And if we're true to the etymology where the term came from then we must recognize and we cannot neglect the subjective experience. Thank you for that beautiful description of what brought us to today in terms of using the word psychedelics and now it's thrown around all the time. Yeah, too much. Yeah, too much and I'm guessing, well not guessing, I'm certain that it's also used to describe many compounds that don't touch the 5-H-T2A, the serotonin 2A receptor. So there is a broader categorization by most people and it'll be interesting to see where all the nomenclature naming goes.
如果我们忠于这个术语的词源，那么我们必须承认并不能忽视主观体验。感谢你对我们今天使用“迷幻药”一词的精彩描述，现在这个词被频繁使用。是的，使用得太多了，我敢肯定它也用来描述许多与5-HT2A，即5-羟色胺2A受体无关的化合物。所以大多数人对这个词的分类更广泛，未来这些命名如何演变将会很有趣。
For the time being, I'd love for you to tell us a bit more about this idea that psychedelics, however one defines them, can reveal something about the mind that can't be revealed otherwise. Are you talking about the subconscious? I mean, you know, psychologists and most famously Freud but also Jung and all, also neuroscientists, I think about subconscious processing. I think perhaps the most salient example for me that's outside the realm of anything psychedelic would be blind sight. This phenomenon that you take people that are blind, but still have some connectivity in their brain and you present them a board with or computer screen with different number of dots on each side and you say, how many dots are on each side of the screen?
目前，我很想请你多谈谈这个想法：关于迷幻药（不论如何定义）可以揭示一些关于大脑的东西，而这些东西是通过其他途径无法揭示的。你是在谈论潜意识吗？我指的是，心理学家中最著名的弗洛伊德，还有荣格等等，包括神经科学家，都在思考潜意识处理的信息。我认为，也许让我印象最深刻的一个例子就是所谓的“盲视”。这种现象是指有些盲人虽然看不见，但大脑中仍有一些连接。当你给他们展示一个板子或者电脑屏幕，上面每侧有不同数量的点，然后问他们每边屏幕上有多少个点时，他们还能作出一些判断。
And they say, what do you mean? I can't see the screen, I'm blind. And you say, well, just guess. And their guess rate is accurate far more than chance would predict. So they have so-called blind sight and people have said, well, this is the subconscious revealing itself. There's no psychedelic drug involved, but what you're describing is a pharmacologic-induced state that reveals something that normally should we assume is masked or that we are oblivious to even though it's expressing itself. But what does it mean for these drugs to be revealing something about the workings of the mind that would not be obvious to us otherwise?
他们说，“这是什么意思？我看不到屏幕，我是盲的。” 然后你说，“那就猜吧。” 结果他们的猜测准确性远远超出随机预测的几率。这就是所谓的“盲视”，有人说这是潜意识的显露。这种情况下并没有涉及迷幻药，而你所描述的是一种药物引发的状态，这种状态揭示了一些通常被掩盖或我们无法察觉的东西，即使这些东西正在自我表达。但这些药物揭示了心灵运作的一些我们通常无法察觉的内容，这意味着什么呢？
Yeah. So the example of blind sight is interesting, but it's different. Blind sight would be referring to non-conscious processing, maybe implicit processing. So stuff going on in the mind, in perception in a sense that is below the threshold of conscious awareness, but yet is influencing you. So it's sort of kind of related, but it's different. So in depth psychology, psychoanalysis, psychodynamic psychology, you know, sigma Freud, Carl Jung and so on, we talk about the unconscious.
是的，“盲视”这个例子很有趣，但有所不同。盲视指的是无意识的处理，也许可以称为隐性处理。这是指那些发生在心灵中的活动，即在感知方面的影响，虽然低于意识觉察的阈值，但仍然对你产生影响。因此，与其有点关系，但还是不同的。在深度心理学、精神分析、心理动力学心理学中，比如西格蒙德·弗洛伊德和卡尔·荣格的理论中，我们会谈到无意识。
And there it's more about the kind of blood and guts of the human condition, the human nature, both the personal unconscious, so things that you might not want to necessarily be conscious of, because it's painful. So that's the repression aspect pushing it out of conscious awareness. Repressed memories in particular? Yeah, like traumatic memories, difficult relationships, it could be complex trauma, not necessarily just the specific, you know, index trauma, but a series of trauma. And then you have the collective unconscious, which was really Carl Jung's contribution to say that, you know, there's a transpersonal quality to the unconscious.
这段话谈论的是关于人类状况和人性的一些本质问题，尤其是涉及到个人无意识的那些方面。这些可能是你不愿意面对的东西，因为它们太痛苦了。这就是压抑机制，将这些内容从意识中排除。特别是被压抑的记忆？是的，比如创伤记忆、困难的关系，这些可能是复杂的创伤，并不一定只是某个单一的创伤事件，而是一系列的创伤。此外，还有集体无意识，这是卡尔·荣格的贡献，他认为无意识具有跨个人的特质。
There's aspects about humans, not just this individual human, there's aspects to our minds, our psychies that are not fully available to conscious awareness, but can come up in certain states, you know, psychoanalysis, when crazy for dreaming as their royal road to a knowledge of the unconscious, that was Freud. But we now know with psychedelics, and this was what drew me into the area, was discovering literature that was speaking to this particular action, the psychedelic action, was saying that when these drugs, like LSD, cellosybin, it found in magic mushrooms, when they're used in psychotherapy material comes up that maybe may have been repressed, that is of therapeutic value and awareness and insight of this material seems to catalyze the therapeutic process with strong emotional release, these cathartic experiences, and insights, you know, whether they're insights to the personal, or whether they're transpersonal.
人类的心智中有一部分内容，并不仅仅是特定个体，而是我们的大脑和心理结构中，有些方面并不是完全可以通过意识感知获取的，但在某些状态下这些内容可以显现出来。你知道的，精神分析特别重视梦境作为了解潜意识的绝佳途径，这是弗洛伊德的理论。但我们现在已经了解，通过迷幻药物，比如 LSD 和存在于神奇蘑菇中的裸盖菇素等，我们可以在治疗过程中让一些可能被压抑的内容显现出来，这些内容具有治疗价值。对这些内容的认识和领悟似乎能够加速治疗过程，并伴随强烈的情感释放，这种宣泄性的体验和领悟，无论是关于个人的理解，还是超个人的见解，都是非常有意义的。
But for me, this is really where the meat of it is with psychedelics and classic psychedelics, in particular, the likes of compounds like LSD and cellosybin, I would say that if it wasn't for this action by classic psychedelics, we wouldn't be so interested in psychedelics. I think if we only had compounds like ketamine, NMDMA, cannabis, that could be said broadly speaking to be psychedelic like, I don't think it necessarily would have captured the world's attention as psychedelics are right now. I actually think it's a major gap to feel is this principle action of the classic psychedelics. What does this mean that I'm referring to psyche revealing? What is that?
对我来说，这就是经典迷幻药的关键所在，特别是像LSD和裸头草素这样的化合物。如果不是因为经典迷幻药的这种作用，我们可能不会对迷幻药如此感兴趣。我认为如果只有像氯胺酮、NMDMA、大麻这样的化合物，它们可以被广义地称为类似迷幻药的物质，那么迷幻药可能不会像现在这样引起全球的关注。我实际上认为经典迷幻药的这项核心作用是一个重要的空白需要填补。我所说的“心灵显现”究竟是什么意思呢？
And I suppose where I'm going with this is what is that in terms of the biology as well? What's going on in the brain and the body when people become aware of things that previously they weren't fully aware of? I'd like to talk about some of the clinical trials that you've been involved with in particular looking at psilocybin, as you mentioned, the principle hallucinatory psychedelic agent in magic mushrooms. I'd like to start with a kind of nuts and bolts question just so that everyone's on the same page. I've read the papers that you've published and that others have published in this area and typically the dosages used in these trials are 25 milligrams of psilocybin. We talk about one recent trial in particular that compared 25 to 10 milligrams to more frequent use of very small amounts, 1 milligram over three weeks for instance.
我想说的是，从生物学的角度来看，这意味着什么呢？当人们开始意识到之前没有完全了解的事情时，大脑和身体会发生什么变化？我想讨论一下你参与的一些临床试验，特别是关于你提到的迷幻蘑菇中的主要致幻剂——裸盖菇素（psilocybin）。首先，我想从一个基本问题开始，以便大家都能理解清楚。我阅读了你和其他人在这个领域发表的论文，这些试验中的常用剂量通常是25毫克的裸盖菇素。我们讨论一个最近的试验，这个试验比较了25毫克和10毫克的剂量，以及每天服用非常小剂量（比如1毫克）的效果，这种较小剂量的使用频率可以持续三周，例如。
However, when people talk about magic mushrooms, they often talk about gram doses of the mushroom because I'm assuming that they contain milligram dosages of psilocybin. Here we're not encouraging use of any kind. These are clinical trials, but for clarity of understanding, what is the conversion typically? One gram of magic mushrooms will contain how many milligrams of psilocybin on average because of what I'm trying to do here is calibrate people to this idea of micro dosing versus macro dosing and that's fairly straightforward to do with respect to the clinical trials. But then in the lot of the lay discussion around this, you hear about heroic doses versus micro doses. I think there's a lot of confusion.
然而，当人们谈论迷幻蘑菇时，他们常常以克为单位来讨论蘑菇的剂量，因为这些蘑菇通常含有毫克级别的裸盖菇素。这里我们并不提倡任何形式的使用。这些只是临床试验中的数据，但为了帮助理解，通常的换算关系是什么？一克迷幻蘑菇平均含有多少毫克的裸盖菇素？因为我想让大家对微剂量和大剂量这个概念有一个准确的认识，这在临床试验中是相对容易理解的。但是在普通大众的讨论中，你可能会听到关于“英勇剂量”和“微剂量”的说法，我认为这其中存在很多混淆。
If you would, educate us on this idea of what's a micro dose and perhaps also how many milligrams of psilocybin are contained in a gram of, quote, unquote, magic mushrooms. Sure. Well, a micro dose is neither of these are that simple, but they're fun. It's a fun challenge. But micro dose, one definition is that it's a dose of typically a classic psychedelic like LSD or psilocybin that has sub perceptible psychedelic effects. It doesn't put you into a noticeable state of consciousness that feels like you're tripping. If that was LSD, it looks as though the threshold is around about 10, 11, 12 micrograms.
当然。我来解释一下什么是微剂量，以及所谓的“魔幻蘑菇”中含有多少毫克的裸盖菇素（psilocybin）。首先，微剂量的定义有些复杂，但讨论起来很有趣。通常来说，微剂量是指像LSD或裸盖菇素这类经典致幻剂的剂量，它的心理效应不明显，不会让你有明显的意识变化或产生幻觉。如果是LSD，微剂量的临界值大约是10到12微克。
Micrograms. On the very clear here, micrograms. So 10 micrograms of LSD are you saying will not induce visual hallucinations in most people? So it's that's threshold level. That's about the level that some people who are sensitive could feel it. But if you were to talk to the microdose in gurus, they might say that that's kind of the ballpark for an LSD dose that you would consider a micro dose and then you would take sort of semi-regulately. It's typically something like one day on one day off or one day on two days off this kind of thing. There's different protocols.
微克。在这里要明确的是，微克。所以你是说10微克的LSD对大多数人来说不会引发视觉幻觉？这是一个临界水平。一些对LSD敏感的人可能会有感觉。但如果你问对微剂量非常了解的人，他们可能会说这是被认为是微剂量的LSD范围。微剂量通常是半定期服用的，比如一天服用一天不服用，或者一天服用两天不服用，有不同的方案。
And yeah, so you know, some like Jim Faderman, one of the popularizers of microdosing, I think would say that a true microdose should be sub perceptible. You shouldn't feel it yet. The assumption is it's going to change you in some way on a kind of trait level, more than a state level, maybe behaviorally. And the typical story goes it will improve well-being and maybe, maybe, it could improve certain aspects of cognition, say related to creative thinking. I emphasize the maybe there because that's another angle with microdosing. We're kind of waiting for some compelling evidence.
好的，那么你知道，像吉姆·法德曼这样推广微量服用的人，可能会说真正的微量服用应该是不可被察觉的。你不应该感觉到它，但假设它会在某种程度上在特质层面上改变你，可能是在行为上，而不是状态层面上。一般的说法是它会改善幸福感，也许、也许，它还能改善某些认知能力，比如与创造性思维相关的方面。我强调“也许”是因为关于微量服用的另一个角度是，我们正在等待一些令人信服的证据。
As things stand right now, I'd say we lack that compelling evidence. There's some suggestive stuff, but often the study designs aren't that strong. It's really hard to do a study with microdosing because you need to have permission to give people a microdose that, you know, for practical reasons, they would go home with. And otherwise, you're requiring them to be in the lab, say three times a week for X number of weeks to meet the criteria of a course of microdosing, which might be, you know, two or three times a week for, say, a month. And that's a hard thing to do in a lab study.
根据目前的情况，我认为我们缺乏令人信服的证据。有一些暗示性的证据，但很多研究设计并不够严谨。进行微剂量研究非常困难，因为需要获得许可，让参与者携带微剂量回家出于实际原因使用。否则的话，你就得要求他们每周来实验室三次，持续几周，以满足微剂量疗程的标准，比如说每周两到三次持续一个月左右。这种安排在实验室研究中很难实现。
It's expensive. You'd need to do that against a suitable control, so a placebo control. And there is a study that's been done in New Zealand that has some interesting preliminary data that did, I think, kind of did the design right. But it hasn't been published yet. I've seen some positive findings presented around improvements in mood, but it's a bit early to get too excited about that. These two guys appear for a few and all that. But as things stand, you know, the evidence is pretty thin.
这很贵。你需要在适当的对照组下进行，比如安慰剂对照小组。新西兰有一项研究得到了一些有趣的初步数据，我认为他们的设计非常好。但是，这项研究还没有发表。我看到了一些积极的发现，表明情绪有所改善，但现在兴奋还为时尚早。这两个人只出现了一段时间。目前来看，证据还相当薄弱。
And we have to be honest about that. We did quite a creative study with my colleagues at Imperial, the guy leading that Balash, Shigeti, Hungarian chap, did a really creative design, very much his brainchild, he instructed people to do their own blinding, their own placebo-controlled blinding of their own microdosing. So this was a classic citizen science study, like do it yourself science, where they would get their LSD tabs and chop them up, put them into gel capsules, so pick and have other capsules that are the placebos that they just close, empty capsule.
我们必须对此保持诚实。我们与我在帝国理工学院的同事进行了一项相当有创意的研究，这项研究主要由巴拉什·希盖蒂领导，他是个匈牙利人，设计非常有创意，这个研究几乎完全是他的创意。他指导参与者自己进行盲测和安慰剂对照实验。 这实际上是一个典型的公民科学研究，类似于自己动手做科学实验。参与者会拿到LSD，然后将其分割，再放入胶囊中，一部分是有作用的胶囊，另一部分是仅有空胶囊的安慰剂。
And then there was a whole barcode scan technique so that you kind of shuffle them up, you know, but they've got the barcode in, the QR code. So you can break the code later on, but once you've shuffled them up, you know, long enough which ones had the microdose in and which ones are empty. Was this LSD? This was LSD, also tried it with mushrooms, but the issues with the mushrooms was people would burp sometimes, it belch and then they have this mushroom taste.
接着，我们使用了一种条形码扫描技术，把它们混合在一起。每一个都带有条形码和二维码，因此之后你可以解码，知道哪些是含有微剂量的，哪些是空的。那么这说的是LSD吗？是的，这是LSD，我们也尝试过用蘑菇，但蘑菇的问题是人们有时会打嗝，然后会有蘑菇的味道。
So then he instructed people to get some non-psychoactive mushroom material to put it in. So it's really an easy study. Not an easy study and it was, I love that kind of science, you know, real creative first mover kind of science. And the result is fascinating because the short story is that the microdosing didn't compellingly beat the placebo. It did not. It didn't and he controlled because he asked, he controlled for expectancy. So people was positive expectancy, which is in a sense the vehicle that carries the placebo response.
然后，他指导人们去获取一些非致幻蘑菇材料来进行研究。所以，这实际上是个简单的研究。但也不算简单，这种真实的、创造性的先驱科学让我非常喜欢。结果非常有趣，简而言之，微剂量研究并没有明显超过安慰剂。确实没有超过。他还通过控制参与者的预期进行了控制，因为积极的预期在某种意义上是承载安慰剂效应的载体。
It's why you have a placebo; the positive expectancy can drive a therapeutic effect to, you know, a large extent. So he measured that pretrial and then used it to kind of correct for the response and how did it work? Those who got a placebo, but thought they got a microdose, did as well as those who thought they got a microdose and did get a microdose. So it was the bigger effect that the majority of the effect was in thinking that you got a microdose. So in a sense, it was a victory for the power of the placebo response.
这就是为什么会有安慰剂：积极预期可以在很大程度上引发治疗效果。他在试验前对此进行了测量，然后用它来调整反应效果，那么结果如何呢？那些服用了安慰剂但以为自己服用了小剂量的人，与那些真正服用了小剂量且知道自己服用的人效果一样好。也就是说，主要的影响来自于觉得自己服用了小剂量的想法。因此，从某种意义上说，这证明了安慰剂效应的巨大力量。
And it's created all sorts of controversy. People don't want to believe it, you know, that kind of thing. Well, that's the beauty of science, isn't it? That science is not about what you want to believe. That right there is the beauty of science, really. I love that experiment of kudos to them. I'm not going to attempt to say his last name correctly. I tried.
这引发了各种争议。人们不愿意相信这一点，你知道，就是这样的情况。这正是科学的魅力所在，不是吗？科学不是关于你想相信什么，而是关于事实。这实在是科学的美妙之处。我很喜欢那个实验，给他们点赞。我就不试图去正确念他的姓了，我试过了。
Yeah, but you made a mess of it. No, no, I think you got it. You were involved in a clinical trial that was published last year comparing 25 milligrams of psilocybin to 10 milligrams of psilocybin is a very to a drug called ESKIT telepram. Yeah, yeah, lexapro. Yeah, yeah. And this one milligram over three week dosage. I in wanting to discuss the results of that study a bit and some of the other trials that you've done involving psilocybin for depression, the treatment of depression, could we calibrate ourselves? 25 milligrams of psilocybin is that what wouldn't? It's going to be a perceptible dose, presumably hallucinations and all that.
是的，但你搞砸了。不，不，我认为你理解了。你参与了一项去年发表的临床试验，该试验比较了25毫克的裸盖菇素与10毫克的裸盖菇素以及一种叫做ESKIT telepram的药物。是的，是的，乐喜普，是的，是的。并且是以一毫克的剂量在三周内进行的。我想讨论一下这项研究的结果以及你所做的其他关于使用裸盖菇素治疗抑郁症的试验，我们可以先沟通一下吗？25毫克的裸盖菇素会是一个明显的剂量，可能会引起幻觉等现象。
And is that what one would find in I'm guessing here, if I'm accurate, this does not mean that I have experience here, but two grams of mushrooms. More than that. We think. Yeah, sorry, I missed that one. We're not fun. at tangent, but, yeah, 25 milligrams of psilocybin would be, we don't know. And it's important that I say that because I wouldn't want people to hear my answer here and then use it to calibrate their own dosing of mushrooms and get it way off.
这句话翻译成中文是：我猜测一下，如果我没猜错，两克的蘑菇中可能会有这些成分。但我没有经验，所以不确定。我们想，可能会有超过这个数量。但非常抱歉，我错过了之前的一部分内容，我们偏离主题了。不过，是的，25毫克的裸盖菇素，我们也不确定。重要的是，我必须说明这一点，因为我不希望有人根据我这里的回答来调整自己使用蘑菇的剂量，从而严重错估。
So it's guesswork and I would love to see someone do proper study on it and, you know, look at the psilocybin content in a given mass of psilocybin mushrooms, magic mushrooms. But to my knowledge, that hasn't really been done. Someone like Paul Stamets would give a better answer here, but I think the percentage within the mushroom mass is some of psilocybin in the mushroom mass and psilocybin, which is the metabolite of psilocybin, is something in the 1% a little bit higher, maybe range. Okay, so one one gram, 1000 milligrams of magic mushroom would contain about 10 milligrams of psilocybin. Is that right? Broadly speaking.
所以这只是猜测，我希望能有人对这个问题进行认真研究，比如研究特定质量的赛洛西宾蘑菇（即魔幻蘑菇）中的赛洛西宾含量。但据我所知，目前还没有人真正进行过这样的研究。像Paul Stamets这样的人可能会给出更好的答案，不过我认为在蘑菇中，赛洛西宾占其质量的百分之一左右，可能稍高一些。大致来说，一克（1000毫克）的魔幻蘑菇大约含有10毫克的赛洛西宾，对吗？大体上是这样的。
Yeah. Great. That helps calibrate. And I think, again, just allows the layperson to understand a bit more of where we're headed with these psilocybin trials and the results. So we don't have to restrict our discussion to just that one clinical trial, but if we include that one and compare to some of the other trials that you've done, I mean, your laboratory is seeing phenomenal, in my opinion, phenomenal results in the treatment of otherwise intractable depression, major depression, which so many people suffer from, from two, I suppose there are two sessions of using psilocybin in these ranges of 10 to 25 milligrams. Do I have that correct?
是的，这很好地帮助校准。我认为，再次强调，这让普通人能更好地理解我们在这些迷幻药试验中的方向和结果。因此，我们不必仅限于讨论那一个临床试验，但如果将它与您做的一些其他试验进行比较，我认为您的实验室在治疗难以治愈的抑郁症和重度抑郁症方面取得了惊人的成果，这些疾病困扰了许多人。通过两次使用剂量在10到25毫克之间的迷幻药来进行治疗。这样说对吗？
Yes. Okay. Could we talk a little bit about what people typically experience during those sessions that allows this phenomenal transformation of mood and state and trait as well? And I'm especially interested in whether or not it is the experience during those sessions that is the trigger that's necessary for the transformation from a depressed to a non-depressed state. Because the impulse is to think it is that what one thinks and sees and hallucinates is, and here is so vital. But of course, these drugs can create neuroplasticity changes in our neurowiring, presumably for long periods of time.
好的。可以聊聊人们在这些疗程中通常会经历什么，以及这些经历如何带来情绪和性格的显著变化吗？我特别感兴趣的是，在这些疗程中经历的事情是否是从抑郁状态转变为非抑郁状态的关键因素。人们通常认为，关键在于那些想法、看到的事情和幻觉非常重要。当然，这些药物能够引起神经可塑性变化，使我们的神经网络在很长时间内发生变化。
So what are your thoughts on the experience itself? And maybe for those who have not done these compounds before, you could explain a little bit about what's typical for people. And what you think is leading to that incredible positive and pervasive change in mood, state and trait. I would say that it's more than impulse that is leading us to think that the experience is important. It's really data and converging evidence now. So independent teams, independent studies are converging on the magnitude of certain kinds of experience rated, yes, with subjective rating scales, is predicting therapy to outcomes pretty, pretty strongly and very reliably.
您对这种体验本身有什么看法？对于那些没有尝试过这些物质的人，您可以简单解释一下人们通常会有什么样的体验吗？您认为是什么导致了那种显著的、积极的心情和状态上的变化。我想说，这不仅仅是凭冲动让我们觉得这种体验很重要。实际上，是数据和多方面的证据汇聚在一起告诉我们。在多个独立团队和研究中，那些通过主观评分量表评估的某些体验的强度与治疗结果有很强且可靠的关系。
And so that's guiding us. Now, could you say, well, maybe those experiences are some kind of epiphenominant of, say, a central brain action? Well, absolutely, but then all experiences and epiphenominant by that principle. And yet we care about it, you know? And it matters to us and in our human relations with each other. So I think it does matter to a human being when they're in a, say, a cello-sybony therapy session. And as the drug effects begin to come on and the body starts to feel a little strange and tingly.
这就是我们的指导原则。现在，你可能会问，那些体验是否可以被看作是大脑中某种核心活动的附属现象？当然可以，但如果根据这样的原则，所有的体验都是附属现象。然而，我们对此是关心的，对我们以及我们之间的人际关系来说，这都非常重要。因此，我认为，对于正在进行比如说使用迷幻药（psilocybin）治疗的情况下的人来说，这确实是重要的。当药物效果开始显现，身体开始感到有些奇怪和刺痛时，这种体验对人是有意义的。
And there's some initial anxiety. And then in their minds, I, they start to notice patterns and maybe colors. And then maybe those patterns deeper in their dynamic and they have this fascinating organic quality. Are they patients in your studies typically using an eye mask? So they're in the eye mask. So eyes close. That's why you said mind's eye as opposed to looking out into the clinical study. And that's one of the major differences to psychedelic therapy versus taking a psychedelic, because you shut your eyes, you know?
翻译这段文字：起初会有一些焦虑，然后在他们的脑海中，他们开始注意到一些模式和颜色。接着，这些模式也许在动态中显得更深刻，而且它们具有一种迷人的有机特性。在你的研究中，受试者通常会戴眼罩吗？所以他们戴着眼罩，也就是闭上眼睛。这就是你说的“心灵之眼”不同于在临床研究中睁眼观察的原因。这也是迷幻疗法与直接服用迷幻药物之间的主要区别之一，因为你闭上了眼睛。
And it's a world away from taking a psychedelic, yeah, a rave or something, you know? In a sense, good luck with that. But in psychedelic therapy, yeah, it's, you know, settled conditions. There's music, playing, and what I'm describing here is very much the default. There's actually, you know, very little variability between the different sites that have done this work on these conditions. Typically, it's two people. Ideally, mental health professionals, at least one who's a psychiatrist or a clinical psychologist or some other kind of psychedelic therapist or psychiatric nurse. But ideally, two who meet those criteria with a individual who's ingested the drug and music playing throughout, kind of run way into taking the drug and then throughout.
这与参加迷幻音乐派对或狂欢夜完全不同。在迷幻治疗中，环境是静谧的，有背景音乐，这种情况通常是默认的设置。在进行这些治疗的不同场所之间，其实变化很小。通常会有两个人参与，理想情况下是精神健康专业人士，至少有一位是精神科医生、临床心理学家、其他类型的迷幻治疗师或精神科护士。最理想的是两位都符合这些标准，并且他们会陪伴一个服用了药物的个体，整个过程都伴随着音乐。
So there's continuity, music with lyrics or without lyrics to begin with. And the music typically is spacious to begin with. And then builds and becomes atmospheric. There might be, I don't know, some tribal drums in the distance or something as it develops, or like the sound of a bird in the distance, you know, a bird's call. And then as it gets into more stronger drug effects, the music starts to coax emotion. And very intentionally, you know, strings, for example, would come in. And it's, it would be an interesting experiment of what we'd love to do actually to see whether if you were to pull that out, whether the psychedelic experience would be as emotionally intense as it is in psychedelic therapy when you have music there as a default.
为了保持连贯性，开头的音乐可以带或不带歌词。音乐通常一开始是开阔的，然后逐渐变得有氛围感。随着进程的发展，可能会在远处听到一些部落鼓声，或者类似鸟叫的声音。当药物效果变得更强烈时，音乐开始唤起情感。而且这种转变是非常有意图的，比如说，弦乐会加入进来。我们很希望进行一个有趣的实验，看看如果去掉音乐的话，是否在迷幻疗法中，迷幻体验的情感强度还会像有音乐作为默认背景时那样强烈。
And across the board, people should find this remarkable because it kind of is. All of the published studies that are now, you know, having such an impact on psychiatry and beyond have music there as a staple component. And we just take it as assumption that it needs to be. I tend to share that assumption, but it's remarkable that it hasn't been tested properly. But it's that. And, you know, if you were to run with that, and if you were, you know, had a kind of critical agenda, you would say, well, this is music therapy, you know, why are you making all this fuss about psychedelics?
总的来说，人们应该对此感到惊讶，因为这确实是一件不寻常的事。所有现已发表的研究，在精神病学及其相关领域产生了重大影响，而这些研究中都把音乐作为基本组成部分。我们习惯性地认为音乐是必需的。我也倾向于这样认为，但令人惊讶的是，这个假设并没有被充分验证。不过，如果你从批判的角度来看待这个问题，你可能会说，这就是音乐治疗，那为什么大家还要对迷幻药大惊小怪呢？
Well, it's music that's there in all of these trials is all these fantastic findings. So there is something to that, you know, and this will team you up probably to talk about psychedelic therapy being a combination treatment. We have a hyphen between the two because I share the hypothesis, the assumption that should be tested better, that there is a positive interaction between the two that there's a synergy between the two. That's why it's psychedelic therapy.
嗯，这段话的意思是，音乐在所有这些实验中都扮演着重要角色，所有这些奇妙的发现中都有它的存在。所以，音乐确实有它的独特之处。可能这会引导我们去讨论迷幻疗法，而迷幻疗法是一种结合治疗。我认为这两者之间有一种积极的互动，是相辅相成的关系，因此我们称之为“迷幻疗法”。这一假设值得进一步验证。
Yeah. Just like hard hard. I'd like to take a quick break and acknowledge one of our sponsors, Athletic Greens. Athletic Greens now called AG1 is a vitamin mineral probiotic drink that covers all of your foundational nutritional needs. I've been taking Athletic Greens since 2012. So I'm delighted that they're sponsoring the podcast.
好的。就像非常非常辛苦一样。我想稍微休息一下，并感谢我们的赞助商之一：Athletic Greens。Athletic Greens，现在称为AG1，是一种维生素、矿物质和益生菌饮品，可以满足你所有的基础营养需求。我从2012年开始就一直在喝Athletic Greens，所以我很高兴他们赞助了这个播客。
The reason I started taking Athletic Greens and the reason I still take Athletic Greens once or usually twice a day is that it gets to be in the probiotics that I need for gut health. Our gut is very important. It's populated by gut microbiota that communicate with the brain, the immune system and basically all the biological systems of our body to strongly impact our immediate and long-term health. And those probiotics and athletic greens are optimal and vital for microbiotic health.
我开始服用Athletic Greens，并且至今每天服用一次或通常两次的原因是，它里面含有我所需的益生菌，有助于肠道健康。我们的肠道非常重要，里面的微生物与大脑、免疫系统及身体的其他生理系统进行交流，严重影响我们的短期和长期健康。而这些益生菌和Athletic Greens对于维持肠道微生物的健康是至关重要的。
In addition, Athletic Greens contains a number of adaptogens, vitamins and minerals that make sure that all of my foundational nutritional needs are met. And it tastes great. If you'd like to try Athletic Greens, you can go to AthleticGreens.com slash Huberman. And they'll give you five free travel packs that make it really easy to mix up Athletic Greens while you're on the road and the car on the plane, et cetera. And they'll give you a year supply of vitamin D3K2.
此外，Athletic Greens 含有多种适应原、维生素和矿物质，确保满足我所有的基础营养需求。而且味道很好。如果你想尝试 Athletic Greens，可以访问 AthleticGreens.com/Huberman。他们会赠送你五包免费的旅行装，方便你在旅途中、车上或飞机上方便地调配 Athletic Greens。此外，他们还会免费为你提供一年的维生素 D3K2。
Again, that's AthleticGreens.com slash Huberman to get the five free travel packs and the year supply of vitamin D3K2. This is extremely useful to hear because I think most people think, okay, psychedelic, whether or not they have experience with psychedelics or not. It's a visual hallucination, some auditory hallucination, some synesthesia, some visual auditory blending, some adicensation, rubbing a surface and being able to elicit the sounds in one's mind, of course, et cetera.
再次，请访问AthleticGreens.com并输入Huberman，以获得五包免费的旅行装和一年的维生素D3K2补给。这段信息非常有用，因为我认为大多数人会觉得，使用迷幻药，无论他们自己是否有过这样的经历，都会伴随着视觉幻觉、听觉幻觉、共感觉、视觉听觉的融合，以及一些感官混淆，比如触摸一个表面并在脑中触发声音等等。
But so seldom do we actually hear about the specifics of these clinical trials in a way that, for instance, points to music as one of the perhaps key variables. Now, you mentioned that as people enter these psychedelic states that there's a little bit of initial anxiety. Out a year and a half ago, I had a discussion with Dr. Matthew Johnson who's running some psilocybin trials at Johns Hopkins, as you know. And he mentioned the critical importance, at least in his mind, to this idea of the patient, quote, unquote, letting go or allowing the experience to take them someplace mentally as opposed to trying to constrain their sensory and cognitive experience. I'm curious what your reflections are on that idea. And why it might be so valuable clinically.
但是，我们很少听到关于这些临床试验的具体细节，例如，指出音乐可能是其中一个关键变量。现在，您提到，当人们进入这些迷幻状态时，会有一些初期的焦虑。大约一年半前，我与您所知的约翰霍普金斯大学正在进行一些迷幻蘑菇试验的Matthew Johnson博士进行了讨论。他提到，至少在他看来，这个让患者“放松”或允许体验带领他们进入某种精神状态的想法非常重要，而不是试图约束他们的感官和认知体验。我很好奇您对此观点有何看法，以及为什么它在临床上可能如此有价值。
And this ties back to this earlier discussion we were having about the unconscious or about psychedelics revealing something that's there all the time, but that we don't have access to. And again, I'm struggling to find the right language for this, because we don't really have a neural mechanism like top down inhibition or something like that to explain how this unconscious might be uncorked in the psychedelic experience. But to make it quite simple and direct, how important do you think it really is for the patient to feel like they are quote, unquote, letting go and what in the world is letting go in biological terms?
这和我们之前讨论的无意识或迷幻剂揭示的那些一直存在但我们无法接触到的事物有关。再次强调，我在寻找合适的语言表达这一点时遇到了困难，因为我们并没有一个像自上而下抑制那样的神经机制来解释在迷幻体验中这个无意识是如何被释放的。但简单直接地说，您认为让患者感到“放手”有多重要？从生物学角度来看，“放手”究竟意味着什么？
Yeah, yeah. Well, I think we'll get there in terms of having the neural correlates of the mind revealing itself to itself, you know, the emergence of unconscious, the unconscious into consciousness or unconscious material into conscious awareness. It's a wonderful challenge. It's a huge challenge, but it's a challenge to embrace. And letting go very much is again a staple component of how the different teams do this work in terms of encouraging a willingness to let go.
好的，我认为我们将能够通过研究大脑的神经关联来更好地理解自己的心灵，这也就是无意识如何进入意识或将潜意识的内容转化为有意识的觉察。这是一个很棒的挑战，也是一个巨大的挑战，但我们应该积极迎接这个挑战。学会放下依然是各个团队在进行这方面研究时的一个关键要素，他们通过这种方式来鼓励人们愿意放下。
And when we started out doing our depression work and did that first trials, the first of a psychedelic in formerly diagnosed depression, you know, where that was the target population and depressed population. It was the first modern study to do that. And we visited Hopkins, friends there and were mentored on how to do the guiding, Bill Richards, Mary Cosimano. They were just so brilliant and you know, wise in their guidance to us as to how to do the guiding in our trial. And so this phrase of trust, let go be open, you'll hear a lot. I don't know who fairly it should be attributed to, but I would attribute it to Bill Richards.
当我们开始研究抑郁症并开展首次试验的时候，这个试验是针对曾被诊断为抑郁症的患者，目标群体就是抑郁人群。这是现代进行这类研究的首例。我们访问了霍普金斯大学的朋友，并在指导工作上得到了他们的建议，特别是比尔·理查兹和玛丽·科西姆诺。他们在指导我们的试验过程中给予了非常聪明和智慧的建议。其中一句经常提到的话是“信任，放下，开放”，我不知道这应该准确归功于谁，但我会把它归功于比尔·理查兹。
Yeah, everything's borrowed. You probably got it from someone else, but it's such a key principle. It's almost like a mantra that you're trying to instill in people's trust. Let go be open. And those different components where the trust is about the therapeutic report that again, you know, this goes beyond just intuition now. We formally measured therapeutic report. We do it even with just a single item, a visual analogue scale item, a subjective rating scale item, on the morning of dosing. And we find that it's a significant predictor of the quality of the experience that you have under the drug in the psychedelic therapy and then the therapeutic outcomes X weeks or months later.
是的，一切都是借来的。你可能从别人那里得到了这个理念，但它是一个非常重要的原则。就像一个咒语，你试图在别人心中建立信任。放下，敞开胸怀。在这些不同的组成部分中，信任涉及到疗愈关系，而这不仅仅是直觉。我们已经正式测量了疗愈关系。即使只用一个项目来衡量，比如一个视觉模拟量表项目，一个主观评分量表项目，在服药的早晨进行评价。我们发现，它能显著预测在迷幻疗法中你所体验到的感受质量，以及之后几周或几个月的疗效。
So very powerful kind of chain of sort of predictive components there, but trust, essentially important. And again, not just intuition, but the data pointing to that. Let go. There's a readiness, a readiness to surrender to let go, to not resist. And we do measure that too and see that it's predictive of response. And then the being open is about a willingness to go there to confront to be inquisitive. Something that's easier said than done can be terrifying. When you're dealing with a very vulnerable population, it's probably more the rule than the exception that they're carrying some significant adversity, life adversity or frank trauma that they've suffered.
这是一个非常强大的预判成分链条，但信任是基本且重要的。这不仅仅是直觉的问题，还有数据表明了这一点。放下吧，有一种准备好的状态，准备好去放手，不再抗拒。我们确实测量这种状态，并发现它可以预测反应。开放意味着愿意去面对、去探索、去提问。这说起来容易做起来难，有时甚至让人感到恐惧。当你面对一个非常脆弱的群体时，他们很可能经历过重大的逆境、生活困难或明显的创伤，这可能更像是常态而不是例外。
And so that message of the open, be willing to confront and to go there is really, you know, it's really powerful. And that that's how it plays out. And often there is struggle. There's something going on that is I don't want to be feeling this, make it stop that can be night marriage at times, but it's very, very strong. And with these big doses that we give, it's very strong. And actually, a student that I've worked with, I think now doing a PhD, Ari Brower, is working on a fantastic project, characterizing the different phases of the psychedelic experience, where the early phase is dominated by negative emotions and negative, negative, the valanced feelings of anxiety and struggle.
这个信息强调了保持开放、愿意面对和探索的重要性，这种态度真的非常有力量。在实际过程中，常常会面临挣扎。有时候，我们会有“不想感受这种情绪，让它停下来”的念头，这可能就像一场噩梦一样，但这样的感觉非常强烈。尤其是我们在使用大剂量的时候，这种感受会更加明显。我和一个叫Ari Brower的学生合作，他现在可能已经在攻读博士学位，正在进行一个非常出色的项目，研究迷幻体验的不同阶段。在早期阶段，往往是以负面情绪和焦虑、挣扎等负面感觉为主。
And then it's a different story and the latter half. Could I ask about that? First of all, I think that's fascinating and important to analyze the different phases. And again, I'm delighted here because people typically hear about a psychedelic journey, but we never really hear about the kind of stereotypic components of the beginning, middle, and end of that journey. We know that there's a peak and that there's a kind of a parachuting down and, etc.
然后就是另外一个故事了，以及后半部分。我可以问一下这个吗？首先，我认为分析不同阶段非常有趣且重要。而我在这里很高兴，因为人们通常只听说过关于迷幻旅程的整体情况，但我们很少听到关于旅程开始、中间和结束的典型组成部分。我们知道有一个高潮阶段，还有一个如同滑降下来的阶段等等。
But when you say that typically there's an anxiety, maybe some negative valence in the early stage, do you mean about the sensations people are experiencing or about some prior event that's being called to mind that they're remembering? Likewise, for the positive phase of the psychedelic journey or trip, are people, do they still call it a trip? For the, I guess we'll use trip. For the psychedelic trip, are people feeling positive about the experience like, ah, like there's been some sort of breakthrough or they're in a, in a calmer state or is it that they tend to be focusing on prior events that were positive?
当你说在早期阶段通常会有焦虑感，可能有一些负面情绪时，你指的是人们正在经历的感觉，还是他们记起了一些之前发生的事情？同样，在迷幻旅行或旅程的积极阶段，人们会对这种体验感到积极吗，比如“啊，我好像有所突破”或觉得自己处于更平静的状态？还是说他们倾向于关注之前的积极事件？
So in other words, is there a threading through of some concept that comes to mind for people, maybe about an earlier trauma or maybe about a sense of self or a sense of other forgiveness, you know, it could be any of these things? But what do we know about the kind of finer details of all that? I would say the initial struggle is more against the general drug effects than pinning it on something specific. It's more that, you know, normal waking consciousness, we have a sense, generally speaking, if we're well or well enough, a sense of assuridence about what's what, you know, as a table here and so on.
换句话说，是不是有一种贯穿的概念，让人在想到某事时，比如早期的创伤、自我认知或对他人的宽恕，任何这些事情都有可能？但我们对这些细节了解多少呢？我认为，最初的挣扎更多是与药物的整体效应对抗，而不是特定原因的问题。通常来说，在我们清醒时，我们会有一种对现实事物的确定感，比如这是一张桌子等等。
And we have that assuridence to an extent about ourselves as well. It might be a loseery, but we have it. And what the drug's doing is it's breaking down all of that, and it's scary as hell, you know. And if it's a big dose, it's just like human nature to, you know, rage against that a bit and a bit like dying, you know, I don't want this. It feels like I could be dying. I might lose my mind. Yeah, that's to never come back. Those two of the classics is all but I might, you know, I might know that I've taken a psychedelic and I might even know a bit about psychedelics, but I still fear that I'm going to go mad.
我们对自己也有某种程度的自信。也许这种自信是虚幻的，但我们确实拥有它。而药物所做的就是打破这一切，这非常可怕。如果剂量很大，人类的天性会让我们对此感到愤怒，就像面临死亡一样，我不想这样。我感觉我可能快死了，我可能会失去理智，那是无法回头的。虽然我可能知道我服用的是致幻剂，甚至对致幻剂有所了解，但我仍然害怕自己会变得疯狂。
Or that I know that, you know, generally speaking, these drugs don't have a high, you know, fertility risk. I still think I'm going to die, you know. And it's just, it's very palpable and that comes up. So yeah, that's, I mean, those are the core fears that those two and very reliably that comes up. And it's really like a basic drug action. It's dose dependent, but it's a basic drug action that is forcing something about the nature of the mind and the way it's made up that makes it feel that way.
或者我知道，一般来说，这些药物没有很高的生育风险。我仍然觉得我会死。这种感觉非常强烈，而且时常出现。所以，是的，那是核心的恐惧，这两种恐惧是非常常见的。这真的是一种基本的药物作用。它依赖于剂量，但这种基本药物作用迫使我们去面对心灵的本质和它的构成方式，使人有那样的感觉。
Oh, but it feels like I'm losing my mind. Or it feels like I could lose my mind or that I could go insane or that maybe I'm dying here and this is bad. Yeah. You've talked many times before and have done really wonderful work looking at the changes in communication between different brain areas while under, while people are under the influence of psychedelics. And I think the gestalt of those data, correct me if I'm wrong, is that compared to the non-psychedelic state that under psychedelic influence, there is far more, let's just call it interconactivity or communication between a brain areas that typically aren't communicating, which is not surprising to people given the subjective effects of these drugs.
哦，但我感觉好像快要失去理智了。或者是觉得我可能会失去理智，甚至感觉自己可能快要疯狂了，或者我可能快要不行了，这太糟糕了。是的。你之前多次谈到并且做了非常出色的研究，关注在服用迷幻药时，不同大脑区域之间的交流变化。我想，那些数据总体上来说——如果我错了请纠正我——显示与非迷幻状态相比，在迷幻药的影响下，通常不怎么交流的大脑区域之间会有更多的连接或交流。考虑到这些药物给人的主观影响，这不令人意外。
What is the evidence that after the psychedelic journey is over that some or perhaps all of that enhanced communication across brain areas is maintained? And if so, what role do you feel that could play in these incredible positive therapeutic outcomes? Yeah. So we've had some recent findings in that direction where yes, it's true. And the picture that says a thousand words, some people might be familiar with are these two circles, a project that we did in collaboration with some researchers, where ordinarily the communication is going on within systems.
在迷幻体验结束后，有哪些证据表明脑区之间增强的沟通有可能被维持下来，甚至可能是全部维持下来？如果是这样，你认为这对那些令人难以置信的积极治疗效果可能起到什么作用？
是的，我们最近在这个方向上有了一些新的发现，确实如此。有一幅图可以很形象地说明这个情况，可能有些人已经见过。这幅图展示了两个圆，来自我们与一些研究人员合作的项目，通常情况下，沟通是在系统内部进行的。
Like other regions of the visual system will be speaking mostly within the visual system. There'll be a kind of clikish clikishness or modularity to the quality of the communication in the brain. And then the cool finding with Salasibim was the first paper is the communication, yes. It sort of transcends these modules and becomes much more intermodular crossing different modalities. And that effect correlated with the magnitude of the subjective effects and then we replicated it with LSD using different methods and new paper will come out soon with D&T showing a similar effect.
在视觉系统中，像其他区域一样，主要是在视觉系统内进行交流。这种交流有一种类似小团体的特点，或者说在大脑中的交流具有某种模块化的性质。而在研究Salasibim时，我们发现一个有趣的现象：这种交流实际上可以超越这些模块，变得更加跨模块，并涉及不同的感官形式。这种效果与主观体验的强度相关。随后，我们使用不同的方法在LSD的研究中验证了这一点，并且即将推出的新论文将展示DMT具有类似的效果。
It's a bit of a debate about what regions are most implicated, but the general effect of an increase in global functional connectivity is what we call it or global communication in the brain. And this is while under the influence of these drugs. It's putting people into a brain scanner while they are under the influence of the drug. That itself must be quite an experience given that these scanners are small tubes. You're in a bite bar, you've got a bite bar in your mouth. That's quite a study. You don't always have a bite bar. At least with the psychedelics, but yeah, you've got to keep your head still. And you have the loud MR scanner noise going. But because it's regular, there aren't too many surprises. So it's actually surprisingly tolerable. And you're in a hospital setting, so you're not worried about what would happen if you had a cardiac event. You've got professionals around and most people generally tolerate that setting quite well, surprisingly well.
关于哪些大脑区域最受影响一直存在一些争论，但总体效果是全球功能连接的增加，或称之为大脑的全球通信。这是在这些药物影响下的表现。研究人员是在受试者服用药物后，把他们放进脑成像扫描仪中进行观察。考虑到扫描仪是个狭小的管道，并且需要用牙托固定住头部，这本身就很具挑战性。当然，并不总是需要使用牙托，尤其是在研究迷幻药时，但确实需要保持头部不动。此外，扫描过程中会有很大的噪音，但因为是有规律的声音，所以不会有太多意外。因此，这种体验其实出乎意料地可接受。而且，由于是在医院环境中进行，你也不用担心如果发生心脏事件会怎么办，因为周围有专业的医护人员，大多数人能够相对轻松地适应这种环境，体验还算不错。
But yeah, we do all that and yes, we do see that opening up of the communication across systems in the brain. And it does speak to kind of intuition about the subjective experience that different modalities might be blending with each other. Sorry for interrupting, but I have to ask, is it thought that the activation of the serotonin 2A receptor is what's responsible for the increased communication between brain areas that under normal circumstances would not be communicating? Yes, so there's a few reasons why some modeling work, the computational modeling work that first identifies whether 2A receptor is and then looks at models, its basic effects on your electivity will recapitulate the or recreate the effect that we see actually in the data with the scanning.
好的，我们确实做了这些研究，也确实观察到了大脑系统之间的交流增加。这也印证了这样一种直觉：不同的感官体验可能会相互交融。抱歉打断一下，我想问一下，是不是认为5-HT2A受体的激活导致了通常情况下不怎么交流的大脑区域之间的沟通增加？是的，确实如此。有一些理由支持这一点，其中包括建模工作。首先，计算模型会识别5-HT2A受体的位置，然后再通过模型分析它对脑电活动的基本影响，这样就能够再现我们在扫描数据中实际观察到的效果。
So doing the computational modeling, you can see the same effect by knowing whether to where the key receptors are and then making them do a certain thing that we know psychedelics do. I can imagine two possibilities and I think it's important to distinguish between these two. One possibility is that the activation of this serotonin 2A receptor leads to increased connectivity and thereby auditory and visual hallucinations emerge, changed patterns of thinking emerge, etc. That's sort of the obvious interpretation, but the scientist in me has to ask, is it possible that all of that increased connectivity is occurring and yet that is a distinct phenomenon layered on top of some other effect of the psychedelic drugs impacting access to the unconscious hallucinations.
通过进行计算建模，你可以通过知道关键受体的位置，观察到相同的效果，并让它们实现我们已知致幻剂会导致的某种行为。我可以想象出两种可能性，我认为区分这两种可能性是很重要的。一种可能性是，激活5-HT2A受体会导致连接性增加，从而引发听觉和视觉幻觉，思维模式也会发生变化。这是一个比较明显的解释，但作为一名科学家，我不得不问，是否有可能所有这些增加的连接性是一个独立的现象，而在此之上还有其他的致幻药效果影响着对无意识幻觉的访问。
In other words, is it the increased connectivity that's leading to the subjective experience or are those two things happening in parallel? Well they happen in parallel and they map to each other, but the question of causality, what causes what is the tricky thing where I would suggest that the causality is circular, that they influence each other and this gets a bit philosophical, but it kind of matters because otherwise there's a trap that it's easy to fall into where you're thinking that it's all about the brain action causing the subjective experience and that's typically what we do in cognitive neuroscience.
换句话说，是增强的连通性导致了主观体验，还是这两者是同时发生的呢？实际上，它们是并行发生的并且相互对应。但因果关系的问题——到底是什么导致了什么——是比较棘手的。我认为因果关系是循环的，它们相互影响。这有点哲学性的讨论，但很重要，否则很容易陷入一个思维陷阱，即认为一切都是大脑活动导致的主观体验，而这通常是我们在认知神经科学中所做的假设。
It's kind of like the sort of first port of call kind of materialist approach, but one can be a materialist essentially, but still appreciate that circular causality that mind also interacts with brain and it's so hard to pick the two apart and there is a kind of essential dualism where subjective experience is the thing in and of itself, but that's not to divorce it from what's going on on the biological level. The reason I ask is because as I understand it nowadays there's a bit of a movement within the scientific community that studies psychedelics to develop drugs that can essentially cure or alleviate many of the symptoms of depression or trauma that are built off our understanding of how psychedelics like psilocybin and here I'll throw MDMA in there, although classically non-psychedelic it kind of gets lumped in when you get back to that later, but that do not produce hallucinations or massive changes in subjective experience.
这有点像一种基本的物质主义方法，但一个人可以在本质上是物质主义者，同时仍然认可思维与大脑的交互作用。这两者很难区分，存在一种本质上的二元论，即主观体验本身就是一回事，但这并不意味着要把它与生物层面的变化分离开来。我之所以这样问，是因为据我了解，目前科学界内有一种趋势，他们研究致幻剂，希望能够开发出一些药物，这些药物可以在不引发幻觉或巨大主观变化的情况下，治疗或缓解许多由抑郁症或创伤引起的症状。开发这些药物的基础是我们对致幻剂如裸盖菇素（psilocybin）的理解，顺便说一下，尽管MDMA在传统上不被认为是致幻剂，但在这个话题的讨论中它常常被归为一类。
Actually, I think this is what initially got us into conversation on Twitter as I had learned about this paper published out of a group at UC Davis that essentially modifying psychedelics so that they have potential therapeutic application for the treatment of depression, but zero hallucinogenic properties. And I thought, wow, this is going to be a very controversial thing in the world, right? Because the history of psychedelics, as you pointed out, has been one of people accessing different modes of thinking, feeling, seeing things these and letting go, trust, etc., a therapeutic relationship.
实际上，我认为这就是我们最初在推特上交流的原因。当时我了解到加州大学戴维斯分校的一个研究小组发表了一篇论文，这篇论文的核心是通过改造迷幻药，使其具备治疗抑郁症的潜在疗效，但没有任何产生幻觉的特性。我想，这在全世界范围内会是一个非常有争议的话题，对吧？正如你所指出的，迷幻药的历史一直与人们在不同思维模式、情感体验和视觉感受方面的探索有关，它们涉及放下防备、建立信任等治疗性关系。
And here we have, I don't want to say pharma because it's not really pharma, but we have laboratories who are trying to tease apart the activation of receptors independent of all that subjective experience in order to essentially treat the same conditions. I'd love for you to comment on this where you think it might be going. And whether or not you think that's the right or the wrong approach, if it has any validity at all, it is pharma is just smaller pharma, sort of start up pharma.
这里我们看到的是，我不太想用“制药”这个词，因为这并不完全是制药，但我们有实验室在尝试分离受体的激活机制，而不涉及所有主观体验，其目的基本上是为了治疗相同的疾病。我很想听听你对此的看法，你认为这种研究可能会走向何方。以及你是否认为这种方法是正确的或错误的，它是否有任何有效性，这其实也是制药，只是规模较小的制药，可以说是初创制药公司。
Okay, so pharma would like to have drugs that can cure depression, but don't make people hallucinate. Is that called? They would. And patients might and the system would love it because the system is used to it. It's medicine. Right. And it doesn't give this mental imagery of the summer of love in San Francisco or of kaleidoscopies. It's more, you could imagine the more to be careful with my wording here. Those who would not be inclined toward that might embrace a therapeutic that is strictly effective at treating depression with no hallucinations.
好的，制药公司想要研发能够治疗抑郁症但不会让人产生幻觉的药物。是这样吧？他们当然希望如此。患者也可能希望有这样的药物，而整个医疗体系会非常欢迎，因为这符合医疗常规。这就是医学嘛。而且这样的药物不会让人联想到“旧金山的爱之夏”或万花筒般的幻象。可以想象，有些人可能更倾向于选择这种没有副作用的、仅仅用于治疗抑郁症的有效药物。
Yeah, and it doesn't look like an individual lying on a sofa, crying their eyes out about the life that they've lived. And that deep catharsis being life transforming. It's very different from that model. I'm skeptical of it for a few reasons. And one is that I can't see the logic. I can't see the pieces fit in a way that's compelling. And I'm also skeptical because I think it could easily be wishful thinking because of that point that patients would like it and the system would like it.
是的，这种情况不太像一个人躺在沙发上，为他们所经历的生活痛哭流涕，然后经历一种能够改变生活的深刻情感释放。这与那种模式非常不同。我对此持怀疑态度的原因之一是我看不出其中的逻辑，我觉得各个部分没有以一种令人信服的方式结合在一起。我还怀疑，这可能只是因为患者和系统都希望这样，所以才产生的一种一厢情愿的想法。
And I just, you got to bear that in mind as well. So wouldn't it be convenient if it were true and you could get the therapeutic action without the psychedelic effects? Well, in a way, that's a little bit of what microdosing seems to be designed to do. Like you said, take dosages there below that perceptual or some awareness of some effect threshold over a longer period of time in an attempt to ping the circuits or twist, you know, alter the circuits, but not hallucinate, not have a catharsis.
我想说，你也要记住这一点。如果能够在没有迷幻效果的情况下获得治疗作用，那该多好。好了，从某种程度上讲，这正是微剂量似乎被设计来实现的目的。就像你所说的，以小于感知阈值或某种效果意识的剂量，长期服用，旨在触发或改变神经回路，但不产生幻觉，也不经历情感宣泄。
So if microdosing can do that and it's sub perceptible, the microdosing isn't psychedelic action because where's the psychedelic action? When psychedelic when defined means psyche revealing, you're not getting that effect. You might be getting the pharmacology, you might be getting some direct serotonin to a receptor agonism that could be driving a therapeutic response, but you can get that with SSRIs as well, you know. And so my point is, what's new?
所以，如果微剂量可以做到这些，而且它是次感知的，那么微剂量就不是造成迷幻作用的，因为迷幻作用在哪里呢？当迷幻被定义为揭示心灵时，你并没有获得那种效果。你可能在得到药理作用，或者通过直接的5-羟色胺对受体的激动作用，从而促使治疗反应，但你知道吗，用SSRI（选择性5-羟色胺再摄取抑制剂）也可以做到这一点。所以我的意思是，有什么新颖之处呢？
Okay, maybe it's a bit new in people are now developing direct to a agonist rather than indirect through a serotonin release. I like the selective serotonin reuptake inhibitors, the SSRIs like lexapro, you know. Are there any SSRIs that selectively agonize, which folks, by the way, means activate in a good way, agonist sounds terrible to those non-former might think that mean that disrupt, but they can activate the serotonin to a receptor.
好的，也许这有点新颖，人们现在正在开发直接作用于激动剂，而不是通过释放血清素的间接方式。我喜欢选择性血清素再摄取抑制剂（SSRI），比如来士普。是否有任何SSRI可以选择性地激动——顺便说一下，激动意味着良性激活，可能听起来吓人，让没有医学背景的人以为是干扰，但实际上可以激活血清素的接收器。
Are there any drugs that will do that that are not psychedelic? I'm not aware of any, but then again, I'm not a psychophonic college. There are. I mean, are there any that are licensed and used as medicines in psychiatry? I actually had this debate recently on social media and I couldn't see, I couldn't see a compelling example. I saw two agonists that we use for other things. You have a compound like Lissaride used in treating Parkinson's, but actually it's more of a dopamine agonist.
有没有任何非致幻药物能够实现那个效果？我不太清楚，因为我不是药理学专家。确实存在这样的药物，不过它们是否已经被批准用于精神病学中作为药物使用？我最近在社交媒体上和别人讨论过这个问题，但没有看到一个有说服力的例子。我看到有两种激动剂是用于其他目的的。有一种叫Lissaride的化合物用于治疗帕金森症，但它实际上更像是多巴胺激动剂。
Right. And they're always hitting other things, right? Yeah. Yeah. They're always saying tapping other neurochlorotronium. All there being drugs are things. So is there a selective serotonin to a receptor stimulator, an agonist, that it isn't psychedelic, that is therapeutic in psychiatry and the answer firmly is no. I haven't seen it yet. Well, they develop one. Well, for patients, say, I hope so because it would be great.
好的，那么他们总是在涉及其他事物，对吗？是的，是的。他们总是在触碰其他神经氯化物。而这些要么是药物，要么是其他东西。那么，有没有一个选择性作用于5-HT2A受体的激动剂是不致幻，但在精神病学方面有治疗作用的呢？答案是明确的：没有。我还没见过。那他们会研发出这样的药物吗？对于患者而言，我希望如此，因为那会很棒。
Let's wait and see. If they do, I doubt it will be psychedelic and I doubt it would have much to do with psychedelic therapy. And it would be much more like the system we're used to of chronic pharmacotherapy. Take your drug every day. Let's hope they find it and it works for patients sake. But as things stand right now, I'm a little skeptical.
让我们等等看。如果他们真的这样做，我怀疑这会与迷幻药物有关，也怀疑这会与迷幻疗法有多大关系。更有可能的是，它会像我们习惯的慢性药物治疗系统一样，每天服药。希望他们能找到解决办法，并且对患者有效。但从目前的情况来看，我有些怀疑。
Now, some of the findings that are being seen that are really exciting, fantastic work being done, showing things like increases in the communication components of neurons, dendritic growth, spine growth, synaptic spine growth. Yeah. By the way, folks, just I'll interrupt for the data necessarily spine, the bone, you know, the not the cerebral column, but spines are these little tiny twigs with bulbs on the end of neurons that allow for communication points between neurons.
现在，有一些研究发现令人非常兴奋，相关领域的工作也很出色。这些研究表明，比如神经元的通信组件增加，树突增长，突触棘（连接点）增长等。顺便说一下，大家注意，这里的“spine”不是指骨头或脊柱，而是指神经元上的小分支末端的突起，它们是神经元之间进行交流时的连接点。
So neuroplasticity is often associated with growth of dendrites and spines and so forth, which is what Robyn's referring to. That reminds me and I just want to make sure that we close the hatch on the early answer because I interrupted you. Is the increased connectivity between or communication between brain areas that's observed while people are under the influence of the psychedelic also observed later after the effects of the drug wear off.
神经可塑性通常与树突和棘的生长等相关，这是Robyn所指的内容。这让我想起之前的话题，我想确保我们完整地回答了，因为我之前打断了你。人们在服用迷幻药时，大脑区域之间的连接或交流增加，这种现象在药效消退后是否也会继续观察到呢？
And then I'll just throw in another question there because we're on to this topic now. To what extent do we think that neuroplasticity, structural changes in neurons, functional changes in neurons are responsible for that? And how long does that last?
然后我会再抛出一个相关问题，因为我们现在正谈到这个话题。我们认为神经可塑性、神经元的结构变化和功能变化在这其中起了多大作用？这些变化能持续多久呢？
Let's say I take let's say I come into your clinic. I'm a I mean subject in your experiment. I take do come in in the morning. I do my psychedelic journey five or six hours later, parachuting back to reality as we call it. And then I go home, increase connectivity lasts for how long and how long are the structural brain changes occurring?
假设我来到你的诊所，成为你实验中的一名受试者。我在早上进行迷幻之旅，大约五到六个小时后，我们称之为“降落回现实”。然后我回家，那么脑连接的增强效果能持续多长时间？结构性脑变化又会持续多久？
Well, you're asking fantastic questions and partly because we don't have the answer yet, but we do have some we do have some data. And so we have looked first of all in a sense the functional plasticity or what we assume it to be or at least the functional changes the increase in communication across systems that increase in global connectivity, functional connectivity. Do we see it after the trip? We know we see it during the trip pretty well replicated correlating with intense drug effects. Do we see it after the trip? Well, the answer is we've seen it in two different depression cohorts, psilocybin therapy for depression. In one study where we look the next day, we saw it kind of residual effect similar to what you see acutely being seen the next day. And then in a subsequent study, we saw it also three weeks later.
你提出的问题非常好，部分原因是我们还没有完全的答案，但我们确实有一些数据。首先，我们研究了一种功能的可塑性，或者说我们假设它是这样的，至少是功能上的变化，即系统之间的交流增加以及全球连接性、功能连接性的增强。这种现象在服药后是否仍然存在？我们知道，在旅行期间（指服用迷幻药后的感受），这种现象已经被很好地重复验证，与强烈的药物效果相关。那么在药效过后，我们还会看到这样的现象吗？答案是，我们在两个抑郁症患者群体的研究中发现了这一点，尤其是与使用裸盖菇素（psilocybin）治疗抑郁症有关的研究。在一项研究中，我们在用药的第二天观察到了类似急性效果的残留效应。而在后续的研究中，我们甚至在三周后也观察到了这种效应。
So we've seen it in two independent data sets. This decrease in modularity is how we measure it. It's the same thing essentially, broadly speaking, it's the same thing, an increase in global connectivity, functional connectivity. And actually unpublished, we've seen it in healthy volunteers on a correlational level, not on an absolute change level. But if you look at its relationship to a mental health outcome, and this is an important thing to stress with the depression work, we saw a relationship between the magnitude of that change, the decrease in modularity or increase in global connectivity and the improvement in symptom severity. So interesting.
我们在两个独立的数据集中观察到了这一现象，我们通过测量模块化程度的下降来衡量它。简单来说，本质上说的是同一件事，即全球连接性、功能性连接性的增加。即使是尚未发表的研究中，我们在健康志愿者中也观察到了这种现象，不过是在相关性层面，而不是绝对变化层面。但如果你看这种变化与心理健康结果之间的关系——这是在研究抑郁症时需要强调的重要一点——我们发现这种变化的幅度，也就是模块化程度的下降或全球连接性的增加，与症状严重程度的改善之间存在联系。非常有趣。
Yeah. I mean, and just a state of a different way. So what Robyn's referring to is when you say modularity is neuroscientists, we think of the different modular networks of the brain that, you know, the eye talks to a region of the thalamus involved in vision, which talks to the visual cortex, which, you know, eventually converges with auditory information, of course. But there's a separation or modularity of function. This increased connectivity is cross modular in during the trip. But afterwards as well. And you're saying that that correlates very strongly with the strength of the therapeutic outcome for depression.
好的，我的意思是，以另一种方式表达出来。罗宾所指的是，当你提到模块化的时候，作为神经科学家，我们会想到大脑中不同的模块化网络。比如，眼睛会传递信息到与视觉有关的丘脑区域，然后再传到视觉皮层，当然，最终可能会与听觉信息汇合。但在功能上是有分隔或模块化的。在使用过程中，这种连接性是跨模块的，而且在使用后也是如此。而你提到这种连接性与治疗抑郁症的效果强烈相关。
I mean, the logical extension of that is that extreme modularity of brain function is depressive in some way. Now, we don't want to go too far, but what does that mean that increasing crosstalk between different modules of the brain is so strongly correlated with a positive therapeutic outcome? We don't know other than that there's a relationship. I mean, this is this is the thing. We need to be a little careful not to run with it too far. I mean, there's some things that it suggests. I think it suggests a more flexible mode of brain functioning. If you're not getting stuck in modules or the modules aren't excessively cut off from each other.
我的意思是，从逻辑上推断，脑功能的极端模块化在某种程度上可能是负面的。不过，我们也不想走得太远。增加脑部不同模块之间的交流与正面的治疗效果之间有如此强烈的相关性，这意味着什么呢？除了它们之间存在关系之外，我们并不知道其他的东西。我的意思是，这就是关键所在。我们需要小心，不要过度延伸这个想法。不过，这确实暗示了一些事情。我认为，这可能表明大脑的运作模式更具灵活性，也就是说，它不会被卡在某个模块中，或者模块之间不过于隔绝。
But you see different things with different presentations. If you were to look at cognition, sharper cognition is actually associated with more modularity. So it's a rule that's a little slippery and we need to be careful with it. I just again, I'll forgive me for engineering, but I think I have friends who are, I would say, are on the spectrum who are very linear in their thinking and extremely intelligent in the kind of classic sense of being able to ratchet through hard problems to arrive in a solution. Then I have friends who are, let's just call them, they are from the creative communities outside of science that are very expansive.
不同的表现形式会让你看到不同的事物。比如说，当我们观察认知能力时，较高的认知能力其实与更多的模块化相关。所以这个规律有点难以捉摸，我们需要谨慎对待。请原谅我的工程师视角，但我有一些朋友，他们可能属于自闭症谱系，思维非常线性，以较为传统的标准来看，他们能够循序渐进地解决困难问题，非常聪明。然后我还有一些朋友，我们称之为来自科学之外的创意群体，他们的思维非常开放。
They see connections between many different things, but sometimes you have to, not all of them, but you have to catch their ideas with a butterfly net. Oftentimes what they're saying doesn't, sometimes just doesn't make any sense. Now, they also produce incredible creative works, but to have a conversation with them is anything but a linear experience. They're not random thought generators, but there's a non-linearity or randomness to their processing that's distinct from these other folks that I'm describing as on the spectrum. And of course, it's a spectrum. There's a whole range in between.
他们能够在不同事物之间看到联系，但有时候，你不得不用捕蝶网去捕捉他们的想法。他们所说的话，很多时候听起来没有什么意义。然而，他们也会创作出令人惊叹的作品，与他们对话绝不是一段线性体验。他们并不是随机思维生成器，但他们的思维过程确实表现出一种不同于我提到的谱系中其他人的非线性或随机性。当然，这是一种光谱，中间有着各式各样的表现形式。
It sounds to me like there's some therapeutic value to being able to move along this continuum from the more linear to the non-linear. Is that correct? It's resonating what you're saying, it's speaking to my intuition that you could be very passy, passing things up, chopping things up like an analytical scientist. A splitter as we say in science. You're either a limper or a splitter. The way I'm being very particular about what went to call something psychedelic, that kind of pass the analytical way of thinking you might associate with a more modular system.
听起来，让自己在从线性到非线性这个连续体上移动，似乎有一定的治疗价值。是这样吗？你说的话让我产生共鸣，它呼应了我的直觉，你可能非常仔细地分析事物，就像分析科学家一样，把事情分解开来。在科学中，我们称这种人为“分解者”。要么是“整合者”，要么是“分解者”。我对什么可以称为迷幻物质非常讲究，这种通过分析的方式思考问题，你可能会将其与一个更加模块化的系统联系起来。
Whereas the system that's more globally interconnected and open might be more flexible and creative and divergent in the associations and so on. Yes, that's speaking to my intuition to how you're describing it. I imagine if you take severe psychopathology, severe mental illness, like a depression, I've always thought that there's something intuitive about the term itself, like a depression in a landscape, which is a whole physical depression, that it's easy to fall into and if you do, it's hard to get out of.
一个更加全球互联和开放的系统可能在联想方面更加灵活、有创意和多样化。是的，这正好符合我的直觉，与你的描述一致。我想，如果讨论严重的心理病理现象，比如重度抑郁症，我一直认为这个术语本身就有某种直观的感觉。就像地形中的凹陷，是一个整体的物理凹陷，容易陷入其中，而一旦陷入，就很难摆脱。
So, almost if I understand what you're saying correctly, almost like getting stuck at what location on this continuum, because most people don't reside at one extreme or the other full time and kind of migrate back and forth between expansive states and more linear states. Like you do with low mood, if you're healthy and inverted commas, you can feel your low mood, your disappointment, but you can spring back. But someone with you. You know you can spring back.
所以，如果我理解你的意思正确的话，这几乎就像是在这个连续体上的某个位置陷入困境，因为大多数人不会一直处于一个极端状态，而是会在扩展状态和更线性的状态之间来回切换。就像情绪低落时一样，如果你是"健康的"（用引号表示健康），你会感受到自己的低落情绪和失望，但能够很快恢复。而有些人可能就像你这种情况，你知道自己可以恢复。
Right. Residus suicidal depressive person or to a cytolid depressed person. Somehow, at least in my understanding, there's something about the extreme depressive states and extreme anxiety states, something my laboratory is a bit more familiar with anxiety, which alters the perception of time such that people feel like that negative state is going to go on forever or that if it goes away, that it's going to return at random. Kind of a vulnerability to the time domain.
好的，根据我的理解，严重抑郁状态或极度焦虑状态的人在时间感知上会有变化。他们总觉得这种负面状态会永远持续下去，或者即使暂时消失了，也会随时再次出现。这让人对时间产生一种脆弱感。
Yeah. Yeah, that's it. It's so tragic, but that cognitive bias in depression that everything's hopeless and that there is no light at the end of the tunnel. Yeah, so, you know, if you were to get stuck in that rut and have that bias, then you're cut off from other things, other sensory modalities or modules, you know, cut off from the world, cut off from other people, stuck in your inner rut. And so, yes, I think we're sharing this intuition that a decrease in modularity or an opening up of the system, the brain, could relate to an opening up of the mind that is kind of enduring after the psychedelic dosing session.
是的，就是这样。这真的很悲哀，但抑郁症中的认知偏见会让一切看起来无望，感觉隧道尽头没有光明。所以，如果你困在那种状态，带着那种偏见，就会与其他事物、其他感官模式或模块隔绝，与你的世界隔绝，与他人隔绝，被困在自己的内心。是的，我认为我们有这样的直觉：如果大脑的模块化程度降低，或者系统开放，这可能会导致心灵的开放，而这种开放可能会在使用迷幻药之后持续下去。
And yeah, and the third replication was to see in healthies an improvement in well-being because they're healthy. We don't look at depression. So, these are people that are healthy walking into the trial. Yeah. Take psilocybin twice. Well, actually, they do, but the first dose is 1 milligram, which they don't feel it's a placebo dose. What a quote, micro.
好的，第三次试验是为了观察健康人群中幸福感的提升，因为他们本身就是健康的。我们不研究抑郁症。这些参与者在进入试验时是健康的。他们服用两次赛洛西宾。实际上，他们确实服用两次，但第一次剂量是1毫克，这被认为是安慰剂剂量，即所谓的微剂量。
Yeah, we sticky geo on the heads to measure their brain waves during each dose and 1 milligram, you see no change. So, we think that you, microdose, or so, I'm just kidding. I think again, the microdoses, I've always just been a little bit skeptical based on my conversations with the scientists actually doing the work with psychedelics. It seems like the answer keeps coming back.
好的，我们在受试者的头上贴上测量脑波的设备，在每次施用药物时进行监测。当剂量达到1毫克时，我们观察到没有显著变化。因此，我们猜测微剂量可能会这样，但其实我是开玩笑的。实际上，我一直对微剂量持有一点怀疑态度，这基于我与那些实际研究迷幻药的科学家们的对话。似乎答案总是回到同一个结论。
Do 1 or 2, maybe 3 macrodoses in a controlled safe setting? Well, that's compelling. The evidence for that is compelling and that's what's making all the difference right now. And microdosing is just appealing, but again, you know, science isn't about what we want to believe. It's about what's actually coming through and what seems to hold up, you know, to testing.
在一个安全可控的环境中进行1至2次，也许3次大剂量体验？嗯，这很有吸引力。证据显示这确实很有吸引力，这也是目前产生巨大变化的原因。而微剂量疗法也很吸引人，但你知道，科学不是关于我们想相信什么，而是关于实际证明和经受住测试的东西。
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我想简单休息一下，感谢一下我们的赞助商之一——Element。Element是一种电解质饮料，提供你所需的一切，而不含多余成分。这意味着它富含盐、钠、镁和钾，这些都是所谓的电解质，但不含糖。盐、镁和钾对你身体所有细胞的正常功能至关重要，特别是对神经细胞（也称为神经元）的功能尤为关键。
And we now know that even slight reductions in electrolyte concentrations or dehydration of the body can lead to deficits in cognitive and physical performance. Element contains a science-backed electrolyte ratio of 1000 milligrams, that's 1 gram of sodium, 200 milligrams of potassium and 60 milligrams of magnesium. I typically drink element first thing in the morning when I wake up in order to hydrate my body and make sure I have enough electrolytes. And while I do any kind of physical training and after physical training as well, especially if I've been sweating a lot and certainly I drink element in my water when I'm in the sauna and after going in the sauna because that causes quite a lot of sweating. If you'd like to try element, you can go to drink element, that's elementy.com slash Hubertman to claim a free element sample pack with your purchase. Again, that drink element lmnt.com slash Hubertman.
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Would you say that's right? The one or two or three sessions and how far apart are those typically spaced in time? Typically one, two, three weeks across the site is the way people are doing the psychedelic therapy, dicing sessions, two sessions, you know, Hopkins Imperial, NYU, that's been a kind of default too. We actually used three in a current anorexia trial, psilocybin therapy for anorexia. Two patients left to see after 19 who gone through the trial. Very exciting results there. You're seeing a alleviation of the obsessive thought about food and willingness to consume healthier amounts of food.
您认为这样说对吗？通常情况下，人们进行迷幻疗法时会安排一到三次会议，这些会议的间隔时间通常为一到三周。这种安排在许多地方都很常见，比如霍普金斯、帝国学院和纽约大学也是如此。在我们目前进行的厌食症试验中，我们实际上使用了三次会谈，这是使用裸盖菇素进行的疗法。目前还有两位患者即将完成试验，结果非常令人振奋。您可以看到患者对食物的强迫性思维有所缓解，并且更愿意摄入更健康的食物量。
Yeah, even improved weight the long follow up. So critical. When we did an episode on eating disorders and I learned that anorexia neurosa, which by the way, folks, the rates of are not increasing. It's been pretty stable through time despite what's said about social media and etc. But anorexia neurosa being the most deadly of all psychiatric illnesses, which is a big statement because, you know, manic depression, so-called bipolar depression, as a 20 to 30 times the typical suicide rate. Basically, many anorexia people with anorexia, I think is how it's now. It's what one says, not anorexics, but people with anorexia often die. Many of them die.
好的，即使体重有所改善，长期跟踪仍然非常关键。我们曾做过一期关于饮食失调的节目，在那期节目中我了解到神经性厌食症——顺便说一下，大家可能会觉得它的发病率因为社交媒体等原因在增加，但实际上一直以来都比较稳定。不过，神经性厌食症是所有精神疾病中致死率最高的，这样说是因为，像躁郁症，也就所谓的双相情感障碍，自杀率通常是普通水平的20到30倍。基本上，许多患有神经性厌食症的人常常会死去。所以，应该说是患有厌食症的人，而不是称他们为厌食症患者，因为他们中的许多人确实去世了。
Yeah, yeah. So tragic, so often young people as well. Similarly, with suicide in terms of premature death. So the tragedy with psychiatry is so strong and so rewarding to be doing that trial and to be seeing good results. I have to check myself a little bit that I'm reporting on it in this really promissory way. And the trial isn't yet publicly released and published, so it's still ongoing as well. But there was three sessions. There is three sessions and I can't say what the dosage is because we still have, there is a blinding component, but there are three dosing sessions in there. Let's see now, I think there are two weeks apart and we do the follow up.
是的，是的。这确实很让人感到悲痛，尤其是很多年轻人面临这样的困境。同样地，自杀也是一种过早的死亡，这种悲剧在精神病学中非常普遍。参与这个试验并看到好的结果让我觉得非常有成就感。但我得提醒自己，不能过于乐观地报告这些结果，因为试验还没有正式公开和发表，目前仍在进行中。这个试验包含了三个阶段，我不能透露具体的剂量信息，因为我们还有一个盲测的部分要进行。不过，每个阶段之间大约隔两个星期，然后我们会进行后续的跟进。
Yes. I'd like to close out this description of the journey and the trip by extending past the day when people actually take the drug into this, what I've heard described is the integration phase. You have to reintegrate. All this increased connectivity during the session hallucinations, insights, anxiety, letting go, maybe revelation, maybe epiphany. Okay, great. At what point is that consolidated? Meaning are these patients or subjects and studies having daily conversation with their therapist? Are they journaling every day?
好的。我想在描述这个过程和旅程时，不仅限于人们实际服用药物的那一天，而是延伸到我听说的所谓“整合阶段”。在这个阶段，你需要重新整合。在会话期间的幻觉、洞见、焦虑、放手，也许会有启示，也许会有顿悟。那么好，这一切在什么时候被巩固呢？也就是说，这些患者或研究对象是否每天都与他们的治疗师进行谈话？他们是否每天做日记？
And I want to keep in mind that most people are not going to be part of a clinical trial. And of course, here we're not suggesting what people do or not do, but let's just put it this way. We're people to use psychedelics. What is the way that people can maximize on the neuroplasticity and the brain changes in a positive way in the days and weeks afterwards? In other words, how long does this so-called integration last? And you know, how far can we take this? I mean, I could imagine that how often one chooses to think about the insights could also have an impact.
我要记住，大多数人不会参与临床试验。当然，这里我们并不是在建议人们该做什么或者不该做什么，但不妨这样说：如果人们使用迷幻药，怎样才能最大程度地在神经可塑性和脑部变化上获得积极影响呢？换句话说，这种所谓的整合效果持续多长时间？我们能够将其带到多远的程度？我想象一下，人们选择多频繁地思考这些心得也可能产生影响。
Because clearly people went to raves. Clearly people did psychedelics in the 60s. We don't know if clearly people do psychedelics now, but we don't have data on those people. You have access to the understanding of how they're spending their time and the therapeutic outcomes, which we haven't gotten to the numbers yet, but again, are incredibly impressive. In upwards of, as I understand it, 60 percent or more people getting relief from depression. 70 percent, incredible, especially when compared to the typical anti-depressant treatments and so on.
很显然，人们过去参加狂欢派对。在60年代，人们也显然使用过迷幻药。现在我们不清楚人们是否仍在使用迷幻药，因为我们没有关于这些人的数据。但你了解他们是如何利用时间以及从中获得的治疗效果的数据，尽管我们还没有谈到具体的数字，不过这些结果已经非常惊人。据我了解，有超过60%的人从抑郁中得到缓解。与常规的抗抑郁治疗相比，这个70%的效果令人难以置信。
So what is this business of integration? How is it done properly? Yeah, yeah, gosh, well, how long does it last as well? A lifetime, you know, life is a journey, like a trip is a journey. And there's always work to do. And I was Jack Cornfield says after the ecstasy de laundry. And yeah, there'll be other good ones as well. But yeah, so the work's ongoing and there, yeah, but this gives you a foot up. It enables people to do the work more easily. And that's true. The classic psychedelics is also true, very true of MDMA therapy for post-traumatic stress disorder. It's really giving you a leg up, making it easier to do very, very difficult work going back to a trauma, trying to digest it, process it, integrate it. So it's such an essential component of the treatment model. But one has to be realistic as well. So, you know, by saying our integration lasts a lifetime, well, people delivering a service can't be there for a lifetime.
那么，整合究竟是什么？应该如何做好整合呢？嗯，是啊，天哪，还有，整合能持续多久呢？其实是一辈子的事情。生活就像一段旅程一样，总有事情需要去做。正如杰克·科恩菲尔德所说，"狂喜之后是洗衣服的琐事"。确实，还有其他好的表达，但工作的确是持续不断的。整合能够助你一臂之力，帮助人们更轻松地进行这项工作。对于经典的致幻剂疗法，尤其是对治疗创伤后应激障碍的MDMA疗法来说，这一点非常正确。这种方法确实让你在回顾创伤、尝试消化、处理和整合时变得更轻松，所以这是治疗模型中一个至关重要的部分。但我们也要保持现实。即使我们说整合工作终生持续，但提供服务的人不可能陪伴一生。
So what's the answer there? And people are wrestling with that issue right now. And I think one of the solutions might be that it's in a sense on you to a point, you know, the therapeutic team can treat you to a point and then it becomes what you might call practice. In a similar way, that meditation is a practice. It's something that you have to keep up. And if it slips, then things could slip. And that's the way it is. Or you have another psychedelic treatment, you know. So people have even used this term of practice in relation to psychedelics, where there's a psychedelic practice, like there's, you know, a meditation practice. But I'm using meditation intentionally here because they actually think that meditative practice, spiritual practice, elements of spiritual practice could be a very important complement to psychedelic therapy.
那么这个问题的答案是什么呢？现在很多人在努力解决这个问题。我认为其中一个解决方案可能是，你自己也需要承担一部分责任。治疗团队可以在一定程度上帮助你，但之后就需要你自己去“练习”，就像冥想也是一种练习一样。这是你必须坚持的东西，如果松懈了，情况可能就会变糟。事情就是这样。或者你可以进行另一轮迷幻药治疗。有人甚至把这种方法称为“练习”，就像有冥想练习一样。但我特别提到冥想，是因为他们认为冥想练习、精神练习或者精神实践的某些部分，可能是迷幻药治疗的一个非常重要的补充。
And I think it's probably doing something similar in terms of promoting an ability to sit with a former colleague of mine said it quite well in relation to psychedelic therapy versus chronic pharmacotherapy or like SSRI being on them all the time. So psychedelic therapy allows you to sit with rather than sit on. And I thought that's quite good. Yeah, so, you know, the meditation, the mindfulness, the ability to yes, be present-centred, but also present-centred and accepting. So if things come up, you can watch and process and then let go. That holy grail of mindfulness, you know, awareness without reactivity responds. I grew up in the Bay Area and you'd hear this language, right? And I'm not being disparaging this, I have friends that are on the board of Esselin and work down there, you know, and I've gone there and it's, you know, and yet you hear these terms, right? Be responsive, not reactive, which to a neuroscientist is like, greats on me, which probably just means I have issues.
我认为，这可能在某种程度上是为了促进一种能力，这种能力可以让我和一位以前的同事共同讨论过——这位同事很好地表达了关于迷幻疗法与长期药物治疗（如长期服用SSRI抗抑郁药）的区别。所以，迷幻疗法是让你“与之共存”而不是“被其覆盖”。我觉得这个说法非常不错。这就像冥想和正念一样，培养的是一种能力，不仅是活在当下，而且是以一种接受的态度来活在当下。因此，当事情发生时，你可以观察、处理，然后放下。这就是正念所追求的目标——意识到事物但不对其产生情绪反应。 我在湾区长大，你常常会听到这样的语言，我并不是在贬低这种说法，我有朋友在Esselin的董事会工作，我也去过那里。你会听到这样的术语，“做出响应，而不是反应，”对我这样一个神经科学家来说，这些话听起来有些刺耳，这可能只是说明我自己有些问题。
But then surely I do. But, you know, it is like, what does that mean, right? It's sort of saying like, oh, to be the observer, but not be drawn into the experience, you know, and again, I don't want to be overly reductionist, but what I find so compelling about the emerging data, because it really is data on psychedelics as treatments for depression and trauma, namely, psilocybin and MDMA, is that it really seems to allow people this space that is so commonly thrown around, you know, giving space between stimulus and reaction. I mean, Victor Frankl talked about this, but you know, I've been reading a wonderful book called The Prince of Medicine, good dates back to the origins of medicine, very dense book. People have been talking about this stuff and thinking about this stuff for thousands of years.
但是，我当然明白。我是说，这是什么意思，对吧？就像，是在说要做一个观察者，但不被卷入体验之中。再说，我不想过于简化，但我觉得新兴数据中最引人注目的部分，尤其是关于使用迷幻药治疗抑郁和创伤的数据，主要是指裸盖菇素和亚甲二氧甲基苯丙胺，它似乎真的能够给人们提供一种在刺激和反应之间留出空间的能力。维克多·弗兰克尔曾谈到过这点。同时，我还在读一本非常出色的书，叫《医药之君》，这本书可以追溯到医学的起源，信息量很大。几千年来，人们一直在讨论和思考这些问题。
Psychedelics seem to give people access to that better version of self, which is remarkable. What's also remarkable, it's perhaps worth pointing out, is that five years ago, I never would have been comfortable having this conversation. I would have been afraid to lose my job. Stanford magazine this week just published an entire issue about psychedelics with how ketamine works, MDMA, psilocybin, with the appropriate cautionary notes in there, but clearly times are changing. Speaking of which, I know you're doing a trial on first time use of psychedelics. What inspired that and what are you observing? And as you tell us that, please give us a few of the key contours. What's the dose? How old are these subjects? I'm assuming it's men, women, are they suffering from depression or not? What's the landscape of that study?
迷幻药似乎能让人们接触到更好的自我，这一点非常了不起。同样值得一提的是，五年前，我绝不会舒服地进行这种对话。当时我担心会因此丢掉工作。然而，本周《斯坦福杂志》刚刚刊登了一整期关于迷幻药的报道，讨论了氯胺酮、MDMA、裸盖菇素的作用，并附有适当的注意事项，很明显时代正在变化。说到这里，我知道你正在进行关于首次使用迷幻药的试验。是什么激发了这个研究？你观察到了什么？请为我们概述一下关键点。剂量是多少？这些研究对象多大年龄？我假设他们包括男性和女性，他们是否患有抑郁症？这个研究的整体情况如何？
And I realized this is still early days of the study, or maybe it's close to completion. It's not yet published, however, correct? It's not published, it's not submitted, it is completed. So this was one of another one of our COVID studies, in a sense, meaning COVID hit and we had to finish the study, and it was hard to finish the study because of COVID. That was true about psilocybin therapy versus esitalopram, lexapro trial, which is published, New England Journal of Medicine, but the... This was 20... That paper, by the way, folks, will provide a link to. in the show note captions, as well as some of Robyn's other papers. I think that 2022 New England Journal paper is really fabulous, given it's the different dosages and comparison to essentially what is microdosing and the comparison to esitalopram.
我意识到这项研究还处于早期阶段，或者可能已经接近完成。不过，它还没有发表，对吗？确实没有发表，也没有提交，但已经完成。这是我们关于疫情的研究之一，意思是说，疫情爆发后，我们不得不完成这项研究，而因为疫情，完成这项研究非常困难。关于裸头草素（psilocybin）治疗与艾司西酞普兰（esitalopram，即乐沙弗）的试验，这项研究已经发表在《新英格兰医学杂志》上。顺便说一下，那篇文章提供了链接，会在节目说明中标注，还有一些罗宾的其他论文。我认为2022年《新英格兰医学杂志》的那篇文章非常精彩，因为它涉及不同剂量的比较，基本上是微剂量与艾司西酞普兰的对比。
Yeah, that's interesting that you link the way we gave small doses of psilocybin to microdosing. We didn't think of it that way. We thought it was just a necessary placebo for the big, big dose, the 25 milligrams, so that we could say to everyone, we're giving esitalopram and not be lying. For those who got esitalopram, lexapro for six weeks, they got a very, very low dose of psilocybin, but it allowed us to standardize all the psychotherapy and so on. But the other study that you're referring to was in healthy volunteers, middle aged average age, I think it was 40, so not your typical student study that is so often the case in psychology research, all the undercreds and volunteering for your study.
是的，很有趣，你提到我们以小剂量给予赛洛西宾与微剂量的联系。我们当时没有这样考虑。我们认为这只是一个为大剂量——25毫克——准备的必要安慰剂，这样我们可以告诉每个人我们正在给予艾司西酞普兰，而不是撒谎。那些服用六周艾司西酞普兰（乐喜普）的参与者确实获得了非常低剂量的赛洛西宾，但这让我们能够标准化所有心理治疗等过程。但你提到的另一个研究是对健康志愿者进行的，这些志愿者的平均年龄是中年的大约40岁，所以不像心理学研究中经常遇到的那种典型的学生研究，所有本科生都来报名参加你的研究。
So this is more of an age range and also I think it was an equal proportion of male and female. All the staff actually were female, which the staff were very proud of. Although it produces its own potential confound, to have all one sex of staff. Possibly. Yeah. They did a good job in the sense that we saw significant improvements in well-being at the end of the trial. So let me describe the design. It was a repeated measures design meaning. People come in, you collect your baseline data and do a brain scan and you give people a placebo. We gave people a placebo and actually let me rewind a little bit. Everyone's healthy volunteers, middle aged, never taken a psychedelic in their life. None of them entirely fresh, virgin people coming in and the plan is to give them their first ever psychedelic experience.
这其实是一个年龄范围的问题，而且我认为他们的男性和女性比例是相等的。所有的工作人员实际上都是女性，这也是她们感到骄傲的一点。尽管这样的安排可能会带来一定的问题，因为全部都是同一性别的员工。然而，从某种意义上来说，她们确实做得很好，因为我们在试验结束时看到了显著的幸福感提升。让我来描述一下这个设计。它采用了重复测量的设计，这意味着人们进来时，我们会收集他们的基线数据并进行脑部扫描，然后给他们安慰剂。我们给了参与者安慰剂，其实让我倒回一下。所有人都是健康的中年志愿者，他们之前从未接触过迷幻药。可以说，他们完全是初次体验者，我们的计划是让他们首次接触迷幻药体验。
So that's what we did in the study. But to do it, we have this repeated measures design where they'll first get a placebo. And we have the placebo so that we can do all the procedures, all the therapy, all the music listening, but not give a whopping dose of psilocybin. Again, we gave them a placebo dose of psilocybin, 1 milligram. We stick EEG headsets on during the experience to record the brain activity from the scalp, the oscillating electrical activity. And we do the MRI scanning before and after to see deeper into the brain. And we can look at the functional connectivity that we were referring to earlier and also properties of brain anatomy, which we did in this study.
所以我们在研究中就是这样做的。不过，为了进行这个研究，我们采用了重复测量设计，参与者首先会接受安慰剂。我们使用安慰剂是为了能够进行所有的程序、所有的治疗、所有音乐聆听的环节，同时避免给予大剂量的裸盖菇素。我们给他们服用的是1毫克的裸盖菇素安慰剂。体验过程中，我们会在参与者头上戴上EEG头套，以记录来自头皮的脑活动，即大脑震荡的电活动。我们还在体验前后进行MRI扫描，以便更深入地观察大脑。这样，我们可以研究之前提到的功能连接性，还可以研究大脑结构的特性，这也是我们在这项研究中所做的。
So the short story is that all of the changes that we saw both psychologically and neurobiologically were seen with the 25 milligrams. It all happened with that big whopping dose. And what did we see? Well, we did see significant improvements in psychological well-being. We saw what I call the entropic brain effect, which is actually formally quite accurate. We see an increase in the informational complexity of ongoing brain activity recorded with EEG on the dose of psilocybin. The activity becomes more complex. It's harder to predict across time. It's more informationally rich. And that effect correlates as it does very reliably with the magnitude of the subjective effect. So the bigger the trip, the bigger the centropic brain effect, now pretty well replicated finding.
简短来说，我们观察到心理和神经生物学上所有的变化都发生在服用25毫克剂量时。也就是说，这一高剂量的服用引发了所有这些变化。那么我们看到了什么呢？我们确实看到心理健康有显著改善。我称之为熵增脑效应，这实际上在学术上是相当准确的。具体来说，我们通过脑电图（EEG）观察到服用裸盖菇素剂量后，脑活动的信息复杂性增加。脑活动变得更加复杂和难以预测，信息量更丰富。这一效应与主观体验的强度有可靠的相关性。换句话说，体验强烈时，熵增脑效应也更明显，这是一个已经反复验证的发现。
But then the MRI, seeing deep into the brain, was probably our most exciting result where we didn't just see some functional brain changes, but we've seen some anatomical brain changes as well. And we used a technique called diffusion tensor imaging that looks at the cabling of the brain, the white matter tracks. And we saw a change in major tracks. So we sort of limited our search space to really thick tracks, really thick fibers. And the fibers that came through as changing were ones that traveled between the prefrontal cortex and the thalamus and the striatum. There were two tracks, two prefrontal tracks that changed. And they changed in the direction of a decrease in axial diffusivity, which could be interpreted as tracked integrity, where a decrease would be an increase in tracked integrity.
但是，能够深入大脑的 MRI 检查可能是我们最令人兴奋的结果。我们不仅观察到了一些大脑功能的变化，还发现了一些大脑结构上的变化。我们使用了一种名为扩散张量成像的技术，它可以查看大脑中的白质纤维走向。我们观察到了主要纤维束的变化，所以我们将搜索范围限制在非常厚的纤维束上。经过观察，发现发生变化的纤维是那些在前额叶皮层和丘脑以及纹状体之间传递信号的纤维。有两条前额叶纤维束发生了变化，它们的变化方向是轴向扩散率的下降，这可以解释为纤维结构的完整性增强，因为下降意味着纤维完整性的提高。
It is something that you see in the developing brain that axial diffusivity decreases as a brain goes from being a baby to being an adult axial diffusivity goes down. And then in aging and folages of aging axial diffusivity goes up. So this is in the opposite direction of the results you talked about earlier in terms of brain connectivity of a sort of increased communication across areas. If I understand correctly, and I'm perfectly happy to be wrong, by the way, that this decrease in axial diffusivity translates to a higher fidelity of communication between the prefrontal cortex and the thalamus and striatum as opposed to less.
在发育中的大脑中可以看到这样一种现象：当大脑从婴儿发育到成人时，轴向弥散度（axial diffusivity）会降低。而在衰老过程中，尤其是老年阶段，轴向弥散度又会升高。这与您之前提到的有关大脑连通性的结果是相反的，之前提到的是脑区之间的通信增加。如果我理解正确的话（当然我也很乐意接受指正），这种轴向弥散度的降低意味着前额叶皮质（prefrontal cortex）与丘脑（thalamus）和纹状体（striatum）之间的通信精度更高，而不是降低。
And your description of this is somewhat like the transition from babyhood and childhood to adulthood speaks to the same where we know that there's a massive calling of connections as opposed to growth of connections. So in other words, as we get older, we get better at doing certain things and less good at doing potentially most everything else. Is that right? Ish, because the change was anatomical and not functional. So the other stuff is really measuring communication in the brain by looking at how the activity fluctuates across time and whether those fluctuations in activity, a synchronous between regions.
你的描述有点像从婴儿期和童年过渡到成年的过程，这说明我们知道在这个过程中，连接的减少比连接的增长更为显著。换句话说，随着年龄的增长，我们在某些领域会变得更擅长，而在其他许多领域可能会变得不那么擅长。是这样吗？不完全是，因为这种变化是解剖上的，而不是功能性的。其他部分实际上是在通过观察大脑活动如何随时间波动，以及这些活动在不同区域之间是否同步，来测量大脑的沟通能力。
And if they are, we say they're functionally connected and we infer that they're talking to each other because they go up and down in synchrony. But when it comes to the anatomy, we're talking about the just static material stuff. And so we're seeing the fibers in a property of the fibers change. At least that's what we think. And recently we had an independent person come in and re-analyze the data because one of those things, incredible finding requires incredible evidence, really strong evidence.
如果它们是同步升降的，我们就说它们在功能上是连接的，并推断它们彼此之间在“交谈”。但说到解剖学，我们指的是静态的物质，所以我们观察到了纤维以及纤维性质的变化。这至少是我们的想法。最近我们请了一位独立人士重新分析这些数据，因为一个令人难以置信的发现需要非常强有力的证据来支持。
And I would say the evidence at the moment is one study. So we need to be cautious on that. But we did re-analyze it and use this correction procedure, free water correction, to be more sure that it was a change in the actual microstructure rather than something to do with the extracellular space, the water surrounding the fibers. And it came through. In fact, the change was strengthened by doing this correction step. This is neuroplasticity as the consequence of one first time session with 25 milligrams of psilocybin.
目前的证据来自一项研究，因此我们需要对此保持谨慎。不过，我们对数据进行了重新分析，并使用了自由水校正程序，以更确定这些变化确实是源于实际的微观结构，而不是与纤维周围的细胞外空间或水分有关。经过这个纠正步骤，结果更加明显。这一变化展示了神经可塑性，这是一次性服用25毫克迷幻蘑菇素的结果。
Yeah. So we're excited. And the two different, you know, the second analyst coming in wasn't sure she believed it. And then she thought this correction technique might kind of kill the result and then it came through. And she's like, okay, now I'm excited too. So we'll see, we don't know what it means. What does it mean functionally? We don't know how did the people change? Well, psychologically, as I said, well being improved, we did look at their cognition.
是的，所以我们感到很兴奋。第二位分析师进来的时候，她不太相信这个结果。她当时觉得这种修改技术可能会让结果失效，但最后结果出来了，她也开始感到兴奋了。所以我们拭目以待，但目前我们还不清楚这意味着什么。从功能上来说这意味着什么？我们不太了解人们发生了怎样的变化。不过，从心理上来说，正如我提到的，他们的幸福感提高了，我们确实检查了他们的认知能力。
And we use the cognitive flexibility paradigm that looks at people's ability to notice a rule change. And then flexibly adapt their behavior based on noticing this rule change. And people improved after the 25 milligrams and didn't significantly improve after the placebo dose. There weren't correlations with the DTI change, the cabling change and the psychological outcomes. But you know, with these studies in smaller sample sizes, you don't always see those correlations come through.
我们采用认知灵活性范式来研究人们察觉规则变化的能力，以及在察觉到规则变化后灵活调整行为的能力。结果显示，使用25毫克剂量后，人们的表现有所提升，而使用安慰剂后则没有明显改善。在纤维束成像（DTI）的变化、脑连接的变化和心理结果之间并没有显著的相关性。然而，在这些小样本的研究中，我们并不总能看到这些相关性明显展现。
So it's something we don't know what it means, but it's a change in brain anatomy that's in the opposite direction to what you see in an aging brain or with pathology of aging. And it's what you see in a healthy brain as it goes from, you know, normal, neurodevelopment into adulthood. Very, very exciting and intriguing. And I appreciate that you highlighted that it's just one study, although from everything you said, it sounds like it's been done with immense rigor.
所以这是一种我们不知道具体意义的变化，但这是大脑解剖结构的一种变化，其方向与衰老大脑或衰老病变中的变化相反。这种变化是在健康大脑中看到的，从正常的神经发育发展到成年期。这是非常令人振奋和引人入胜的。我感谢你强调这只是一项研究，尽管从你所说的一切来看，它似乎是经过非常严谨的研究得出的。
So we will eagerly await the publication of that study and so we can produce all the data and the subsequent studies. I want to hear a bit about the study that you have been carrying out on the use of psilocybin for the treatment of fibromyalgia. I'm intrigued by fibromyalgia because I have a good friend who also I won't reveal who it is. And no, it's not me. This isn't I have a friend thing who also is a scientist who's sits at a fairly high position in the National Institutes of Health who quietly has expressed to me that they are incredibly frustrated with the fact that the standard medical community has largely ignored fibromyalgia.
我们非常期待这项研究的发表，以便我们可以生成所有数据和后续研究。我想了解一下你们正在进行的关于使用裸头草碱（psilocybin）治疗纤维肌痛的研究。纤维肌痛这个问题让我很感兴趣，因为我有一个好朋友也有类似的情况。我不会透露具体是谁，而且，不，不是我。还有，这不是"我有一个朋友"这样的说法。这个朋友是一位科学家，在美国国立卫生研究院（NIH）担任相当高的职位，他私下里对我表示，他们对标准医疗界在很大程度上忽视纤维肌痛的事实感到非常沮丧。
And that for many years it was kind of lumped with things like chronic fatigue syndrome and other so-called again so-called I'm not saying this but people offer them for these as oh it's psychosomatic that's all in your head which is a neuroscientist is a ridiculous statement to hear because it's all in your head your brain is in your head after all your physiology and your psychology are influencing each other of course and the world is starting to appreciate that more.
多年来，它常常被归类为类似慢性疲劳综合症之类的疾病，有时被所谓的，注意我是说所谓的，不是我这样认为，而是很多人认为这是“心理作用”，只是“想太多”。作为一个神经科学家，听到这样的说法非常荒谬，因为不管是什么病，都是和大脑有关系的，毕竟你的大脑就在头脑中，而生理和心理是会相互影响的。当然，世界也正开始更加重视这一点。
But first of all maybe you could tell people what fibromyalgia is what inspired you to do a study on fibromyalgia using psilocybin of all things because that's surprising to me and if you are allowed to or if you have access to the data in mind share with us a little bit about what you're discovering in that in that study. Sure yeah happy to so again it's psilocybin therapy and the population is fibromyalgia syndrome so this is people presenting with a generalized chronic pain so unlike some other pain disorders where the pain is focused you can say it's my lower back which is very common chronic lower back pain this is more generalized and for that reason it's hard to sort of know what it is and that's why it's been a controversial space in medicine and it's been yeah it's had that charge thrown at it that maybe it's psychosomatic and just to your point is anything ever you know independent of the mind anyway.
首先，也许你可以向大家介绍一下纤维肌痛症是什么，以及是什么激发了你用裸盖菇素治疗纤维肌痛症的研究兴趣，因为对我来说这很令人惊讶。如果可以的话，或者如果你能访问到相关数据，能否分享一下你在这项研究中发现了什么？当然可以，我很乐意分享。我们的研究使用的是裸盖菇素疗法，研究的人群是纤维肌痛综合征患者。这类患者表现出全身性的慢性疼痛，不同于某些其他疼痛疾病，比如常见的慢性下背痛，这些疼痛通常集中在某个部位。而纤维肌痛症的疼痛更加广泛，因此难以确知其原因。这也是它在医学界一直存在争议的原因，有人指责它可能是心理性的。任何事情是否能完全独立于心理，这也是值得思考的问题。
But this is actually a fascinating space for how you know subjective experience the lived experience and the mind can influence the body because there's some really interesting literature around the etiology like the how the pain has come about in a sense like what caused the pain what's the story there and ahead of the trial I would say to my colleagues let's just be careful because there is some fascinating literature around things like a background of trauma and how that can relate to issues related to inflammation and how that can express into things like fibromyalgia syndrome. I just said be very careful there because if you go in with an assumption that there's some very trauma for example then there's that whole other side of psychoanalysis that massively tripped it up around false memory and so on and so please don't hold prior assumptions that you're going to uncover very trauma in every case.
这实际上是一个非常有趣的领域，因为我们可以看到主观体验、生活经历和心灵如何影响身体。有一些非常有趣的文献讨论了病因学，比如疼痛是如何产生的，是什么导致了疼痛，这背后有什么故事。在试验开始前，我会对同事们说，我们要小心一些，因为有一些有趣的文献讨论了创伤背景如何与炎症问题相关，以及这如何表现为例如纤维肌痛综合征等疾病。我只是想提醒大家要非常谨慎，因为如果你带着某种假设去进行研究，比如认为每个案例都有创伤背景，那么就可能陷入精神分析中的某些误区，比如伪造记忆等。因此，请不要预先假设你会在每个案例中发现重大创伤。
Now the team are treated I think eight people and it's going it is going very well again I just want to be careful with how I describe it to you know to manage expectations and not get too carried away but I check in with the team every way and they're still based in London doing the work and it's remarkable what I hear about the profound experiences that people have under the drug in this study we only give one dose it's a very mechanistic study we actually have the EEG cap on in the sessions like in the healthy volunteer study but this time now taking into a clinical population and so they're in the I'm they're they are wearing an I mask under the influence of 25 milligrams of psilocybin most of them probably have not done psilocybin before so it's a little bit like the first time study in some sense they have fibromyalgia that's debilitating in some way they don't they don't want they don't want it obviously and during the session are they thinking about their pain are they being told to think about their pain they're not being told to think about the pain.
现在团队正在治疗，我想，我们有八个人参加，这一过程进展得非常顺利。不过，我想谨慎地描述这一进展，以管理预期并不过于激动。我每周都会与团队沟通，他们依然在伦敦进行工作，听到的一些信息让人感到惊讶，受试者在药物影响下的体验非常深刻。在这项研究中，我们只给予一次药物剂量，这是一个非常机械化的研究，我们在会上使用了脑电图帽，就像在健康志愿者研究中一样，但这次我们针对的是临床人群。他们在药物影响下佩戴眼罩，服用的是25毫克的裸盖菇素。大多数人可能以前没有使用过裸盖菇素，所以在某种意义上这对他们来说像是第一次研究。他们患有纤维肌痛，这在某种程度上是具有衰弱性的疾病，显然他们不想要这种病。在治疗过程中，他们是否在想着自己的疼痛？我们并没有让他们必须去想他们的疼痛。
In fact as I understand it while there is a therapeutic model around acceptance of the pain it isn't unlike some of the PTSD work you aren't encouraging them to focus on you know the index trauma and then you know work through it and try and digest it we don't we don't do that with the pain so the pain's there but there isn't an invitation to focus on it and that's probably one of the differences with classic psychedelic therapy versus MDMA therapy arguably MDMA therapy is more like it's a bit closer to traditional talk therapy but there is more dialogue people are able to talk on MDMA in the MDMA trials do you know whether or not they used I masks or because it seems to be an important distinction between as you describe the therapeutic trip versus the trip that one does you're going into the woods and taking you know take a psilocybin in the woods or at a party or while staring at a poster or or a leaf again I'm not trying to trivialize those experiences I mean obviously they can be profound but so I'm told.
事实上，据我了解，虽然在接受疼痛方面有一种治疗模型，但这与某些 PTSD 工作有相似之处：你并不鼓励他们专注于创伤事件，然后努力消化它。我们不会对疼痛采取这样的方式，所以疼痛是存在的，但我们不会邀请个体去专注于它。这可能是经典的迷幻药物治疗与 MDMA 治疗之间的区别之一，可以说 MDMA 治疗更接近于传统的谈话疗法，但对话更多。在 MDMA 的临床试验中，人们能够在药物作用下交谈。你知道他们是否使用了眼罩吗？因为这似乎是你描述的治疗性体验与在户外使用迷幻药、参加派对或盯着海报或树叶看的体验之间的重要区别。当然，我并不是要轻视那些经历，因为显然它们也可能是深刻的体验。
But the MDMA trials seem to involve as you said more more directed dialogue and sometimes even kind of empathic connection between people by they're actually looking at one another you know the eyes and eye contact being such a key part of the human social cognitive connective networks so do you know if they put I-masks on people during the third people I'm pretty sure that they have the I-masks there right because a lot of the MDMA work and I was part of an MDMA trial it was as I understand geared toward developing because it's an empathogen empathy toward the self yeah yeah I'm pretty sure they have the I-masks there but they probably and it's a great question because you can formally test this if probably don't use them as much the thing is with the classic psychedelics if you're looking at your guides your facilitators and their faces are melting I don't know you know an MDMA you just might really start to if you're more connected to your mind, especially beautiful.
MDMA试验似乎涉及更多的引导性对话，正如你所说，有时甚至人与人之间会产生一种同理心的连接，因为他们实际上是在注视对方。眼神交流是人类社会认知连接网络的关键部分。那么，你知道他们是否在第三次试验中给人们戴上了眼罩吗？我很确定他们是有眼罩的，因为许多MDMA的研究（我也曾参与过一次MDMA试验）都是为了发展同理心，尤其是对自我同理心的研究。对，我很确定他们是有眼罩的，但他们可能不常用。这是个很好的问题，因为如果正式测试的话，可能用得不多。问题在于，当使用经典致幻药时，如果你看到引导者或协调者的面孔在"融化"，你就不知道会发生什么，而在使用MDMA时，你可能会更加专注于自己的内心，这种体验会更加美好。
Sure. And yeah, there's that fascinating effect of loving the people. that you're with. And so yeah, I imagine they talk more and use the eye shades less. And it is more interpersonal rather than like intra-personal going inside. They do use a fascinating terminology that some people have critiqued, but it's a very interesting phenomenon. And it's this notion of the inner healer. They use that language a lot. It's been critiqued because it sounds very suggestive. And that's probably one of the vehicles here driving the therapeutic process is suggestion. I think we have to be honest about that.
当然可以。而且，确实有一个很有趣的现象，就是你会更爱与自己在一起的人。因此，我想他们说话会更多，用眼罩的时间会更少。这种交流更倾向于人际间的互动，而不是内心自省。他们使用了一些有趣的术语，其中一个是"内在疗愈者"的概念。虽然有人批评这个说法，认为它很具暗示性，但这个现象确实很有趣。暗示可能是这里推动治疗过程的一个因素，我们对此要保持诚实。
But so when they go inside, that's another term that we use very much in the classic psychedelic therapy work you go inside, you know, you put the eye shades on and people are encouraged to go inside, you know. But when they do that in the end of Maywork, especially they might be told explicitly and listen to the inner healer, you know, and that kind of language. So you could see how a cynic or a skeptic could come in and see that as some kind of like suggestive priming or biasing. I think they have a point. Skeptics often do, but I don't think it's all of the story.
但是，当他们进入内在时，这是我们在经典迷幻治疗中经常用的一个术语。你知道，他们戴上眼罩，人们被鼓励去内心探索。而在"结束工作"中，尤其是这样，他们可能会被明确告知要倾听内在的治愈力量。这种语言可能会让一个怀疑论者认为这是一种暗示性的引导或偏见。我认为他们的观点有一定道理，怀疑者往往有道理，但我认为这并不是事情的全部。
And just briefly, because it's an interesting point, speaking to that point a bit, in our cello-sybin therapy versus S-tallopran trial, we measured pre-trial expectancy and we did it for both conditions. So, you know, what kind of improvement do you expect with the lexapro, the S-tallopran at the end of the trial? And what kind of improvement, if you go into the cello-sybin arm and get a big two big doses of cello-sybin, what kind of improvement do you think you'll see in that? In that. And of course it was a coin flip as to what arm people went into and there was no crossover.
简单地说一下，因为这是一个有趣的点。我们在小提琴素（cello-sybin）治疗与艾司西酞普兰（S-tallopran）试验中，测量了试验前的预期，我们对两种情况都进行了测量。也就是说，你期望在试验结束时，使用来士普（Lexapro，即艾司西酞普兰）会有怎样的改善？如果你进入小提琴素组，并接受两次大剂量的小提琴素治疗，你认为会有怎样的改善？当然，试验中的分组是随机的，像抛硬币一样决定，没有交叉试验。
And what we found was that it was true that we had a sample bias. So most people had higher expectations on average of a higher expectations for cello-sybin and its efficacy or effectiveness versus the S-s-s-or-i, the lexapro. However, when we looked at the correlation or the predictive relationship between pre-trial expectancy and response, we saw that pre-trial expectancy for the S-tallopran predicted response to S-tallopran across virtually every single measure, all these different measures of depression and anxiety and well-being. And I think none of the scales, I'm pretty sure it was none of about 12 or so mental health rating scales, was there a relationship between pre-trial expectancy? Even though it was high, it didn't predict, pre-trial expectancy, didn't predict response to the S-s-s-s-i-bin therapy.
我们发现我们的样本确实存在偏差。大多数人平均期待更高，认为赛洛西宾（cello-sybin）的疗效或效果优于艾司西酞普兰（lexapro）。然而，当我们查看试验前期望与反应之间的相关性或预测关系时，我们发现试验前对艾司西酞普兰（S-tallopran）的期望可以预测几乎所有测量项目中的反应，包括抑郁、焦虑和幸福感的不同指标。我认为，在大约12种心理健康评分量表中，试验前期望和疗效之间没有关系。即使试验前期望值很高，它也不能预测赛洛西宾疗法的反应。
So that was a bit of a smash on the head for the idea that the classic psychedelic therapy is some kind of placebo response. And I think it's so important to address that question because if it doesn't come through, as it didn't come through, then it opens up even more intrigue about, well, what is it then? If it's not just a placebo response or a super-pulcibo response, like an amplification of the placebo response, then it must be something else. And how intriguing it has a direct therapeutic action, it must be something.
这对认为经典迷幻药疗法仅仅是一种安慰剂反应的想法来说，真是当头一棒。我认为解决这个问题非常重要，因为如果这个问题没有得到答案，就无法理解其本质，也就像现在那样，让人更好奇：那它究竟是什么呢？如果这不仅仅是一个安慰剂反应，或是某种增强的安慰剂反应，那么它一定是其他东西。令人好奇的是，它竟然有直接的治疗效果，这一定是某种独特的东西。
And we don't yet know what it is. I talked about the residual increase in global connectivity. That's one possibility. But the truth is, we're just scratching the surface. And yet, the therapeutic outcomes are, again, just so marvelously impressive. I'm curious as to why, well, there are that many labs, but the laboratories that are focused on classic psychedelics for the treatment of depression, and now, as you mentioned, promising results for anorexia and fibromyalgia as well, although preliminary, very promising.
我们还不知道那到底是什么。我之前提到过全球连通性的残余增加，这是一个可能性。但说实话，我们才刚开始探索。而且，治疗效果又是如此令人惊叹。我很好奇，虽然有很多实验室，但为什么有那么多实验室专注于用经典的迷幻药治疗抑郁症，而现在正如你提到的，对于厌食症和纤维肌痛的研究结果也很有前景，尽管这些结果还是初步的，但确实很有希望。
Why the lack of attention toward LSD is it that the LSD trips are just too long? Is it that they are qualitatively different? Are there any data on non-microdosis of LSD? And here I want to be very careful, because I learned through my interactions on social media that this term, microdosis, is very misleading. And in some cases, can be dangerously misleading, because, as you mentioned earlier, the effective psychedelos, or the effective meaning that can induce a real trip with hallucinations, et cetera, of LSD is actually in the microgram range.
为什么人们对LSD的关注不足？是因为LSD的体验时间太长了吗？还是因为它的体验质量有所不同？有没有关于非微量服用LSD的数据？在这里我需要非常小心，因为通过在社交媒体上的互动，我了解到“微量”这个词其实很容易让人误解。在某些情况下，这种误解可能会非常危险，因为正如你之前提到的，LSD的致幻效果实际上是在微克范围内发生的。
So some people hear microdose, and they think microgram of LSD is a micrograms is a microdose, when, in fact, a macrodose of LSD can be measured in micrograms. So this is where, in the absence of scientific training, people can really go astray. Or even in just a lack of understanding of the metric system. And since now you're a recent rival to the US, fortunate for us. Sorry, England's loss is the US is gained by a Robin's move from England to the United States recently.
有些人听到“微剂量”这个词时，会以为微克的LSD就是微剂量。然而，实际上，LSD的大剂量也是以微克为单位来衡量的。因此，在缺乏科学训练的情况下，人们可能会产生误解。甚至对公制系统缺乏理解也可能导致这种误解。幸运的是，你最近刚到美国，对我们来说是个好消息。抱歉，英国的损失就是美国的得益，因为Robin刚从英国搬到了美国。
So score one for us. But why isn't there more use of LSD in these trials? It probably is the duration of the trip. It used to be stigma. And it was easier to get your psilocybin study through, because others were. They were getting that through. So there was the Franz-Volomvider in Zurich, in Switzerland, and then Roland Griffiths coming along and doing the psilocybin work at Hopkins. So you could appeal to that president and say, well, they're doing it over there. Can we not do it in little England?
因此，这算我们取得了一些进展。但为什么在这些试验中没有更多使用LSD呢？可能是因为LSD体验的持续时间较长。过去是因为污名化。而且，获得开展迷幻蘑菇（psilocybin）研究的批准比较容易，因为其他研究已经成功了。比如，苏黎世的Franz-Volomvider以及Roland Griffiths在霍普金斯大学开展的迷幻蘑菇研究。研究人员可以引用这些例子来说，他们在那里可以开展，为什么我们不能在小小的英格兰也进行这样的研究呢？
So that's how it worked for us. We did actually go on and do an LSD study once we kind of laid the foundations for doing this kind of work. And it was a brain imaging study. It was a really extensive one, actually, where we use both MRI and another modality called MEG, sort of super EEG, in a sense. But why didn't we, why didn't that turn our heads to think, oh, should we not be doing our trials with LSD?
所以这就是我们当时的做法。实际上，在我们为开展这类工作打下基础后，确实进行了一项LSD的研究。而且这是一项脑成像研究，非常全面，我们使用了MRI和另一种叫做MEG的技术，可以说是超级脑电图。然而，这并没有让我们转变思路去考虑：我们是否不应该用LSD来进行试验呢？
It does have something to do with a pragmatics, like a study day with psilocybin is long enough. So four to six hour trip? Yeah. And the FDA asked us to have the people in the lab until eight hours post dose. With personally, I think, could be quite excessive, especially if it's a low dose. And if you have that in the placebo condition as well, it becomes impractical.
这与实用性有关，比如用裸盖菇素进行的研究日就足够长了。那么，应持续四到六小时吗？是的。然而，FDA要求我们让参与者在服药后在实验室待八小时。我个人认为这可能有些过头了，特别是如果药量较低的话。而且如果在安慰剂情况下也要求这样，那就不切实际了。
Yeah, scientists are not paid nearly enough to warrant the... There's no such thing as overtime in for the graduate students and postdocs. Yeah, and it's often that there's more junior members that are doing that really hard work. It was described very well to me by a student when I was a graduate student said to me, they really can't afford to pay us by the hour.
是的，科学家的收入远远不够令人满意…… 对于研究生和博士后来说，是没有加班费这种说法的。是啊，通常情况下，那些做着真正辛勤工作的往往是更年轻的成员。有位学生在我还是研究生时很形象地对我说，他们真的付不起按小时支付我们的工资。
Because we used to work. He was an electrophysiologist, so he would run experiments. No joke, folks. Three to five day experiments, sleeping in bouts of two hours here or there, in a dark room with a bunch of equipment and recordings. So these are long, long acute physiological, electrophysiological recordings. So, yeah, no scientists does it for the money. I promise you that there is money in pharma, there is not money in personal income.
因为我们以前一起工作过。他是一位电生理学家，所以他会进行实验。不是开玩笑，各位。这些实验通常持续三到五天，只能间歇性地睡两个小时，到处都是仪器和记录设备，整个过程在一个黑暗的房间里进行。这些是非常漫长的急性生理和电生理记录。因此，相信我，科学家们并不是为钱而工作的。制药行业有钱赚，但个人收入并不高。
It's not lucrative for the basic scientist. So, yeah, LSD is what, anywhere from eight to 15 hours? Something like that. Yeah, 15 would be a little long. You'd be a bit worried if you were still tripping at that time. Maybe with a really big text. No, just kidding. But yeah, eight hours plus and dose dependent, yeah, if it's a bigger dose, it's a longer experience. But if you're gonna dose, say 10 a.m. in the morning, which is more or less how it often goes, then that's six p.m. still feeling the effects, and then how long do you wait now to close things out before they can go home?
这对基础科学家来说并不是很赚钱。那么，LSD的效果持续时间是多少呢，可能在8到15小时之间吧？大概是这样。其实15小时有点太长了，如果你还在那个状态中，你可能会有点担心。也许是因为剂量很大，不过开个玩笑啦。总之，通常是8小时以上，而且效果的持续时间取决于剂量，如果剂量大，体验时间就更长。但如果你在早上10点开始服用，通常是这个时间段，那么到下午6点你可能还会有感觉。然后，你要过多久才能结束这种状态，让他们可以安全回家呢？
Even with solar cyber, yeah, people still work into the evening and the staff are always there later, of course, because they've got to pack up. Yeah, so these are long days, and it's just, it's too much, you know? That makes sense. Practical was constraints. I learned from a recent guest on this podcast that we recorded with Dr. Sachin Pandu, who was a colleague of mine when I was down at the Salt Institute, is a pioneer to a lot of the studies on so-called intermittent fasting, that the reason the intermittent fat, that the eating period in these studies in animals and now on humans is eight hours, the sort of feeding window in these studies because the graduate student was going to otherwise lose their relationship because there's significant others as listen, you can be in the lab for 12 hours.
即使在有太阳能网络的情况下，人们仍然会工作到晚上，员工们当然也会更晚离开，因为他们需要收拾好东西。这些日子真的很漫长，实在是太累人了，你知道吗？这确实有道理。我从最近一位嘉宾那里学到了一些实际限制，我们在这个播客中与萨钦·潘杜博士录制了一期节目，他是我在盐研究所时的一位同事。他是关于所谓间歇性禁食研究的先锋人物之一。这些研究在动物和现在的人身上将进食时间限制在8小时内，是因为如果不这样的话，研究生可能会失去他们的感情关系，因为他们的伴侣会说：“听着，你不能整天在实验室呆12个小时”。
That meant some hours before the experiment, then eight hours and then some hours afterwards, but you can't stay in there longer, and many people use the eight hour feeding window as a consequence. So the science has to exist and be carried out in real world frame. It does. It does. MTA maze a little bit shorter, right? It's about a four to, it's also about four to seven. It's kind of similar to Salasaybin. Yeah, it is. And actually in the maps work, they reduce after a certain point. So the boost, the boost, yeah. They have a boost, they're optional booster, yeah. So, so there is that.
这意味着在实验前几个小时，然后是八个小时，然后在实验后的一些小时，但你不能在那待得太久，许多人因此使用八小时的进食时间窗口。因此，科学必须在真实世界的框架内存在并进行。确实是这样，确实是这样。MTA迷宫稍微短一点，对吧？大约是四到七个小时。这有点类似于赛洛西宾。是的，确实如此。而在地图的研究中，它们在达到某个点后会减少。所以，会有额外的增援，对，就是这种增援，它们有一个可选的增强剂。就是这样。
And now people are thinking, well, even the Salasaybin sessions are long and expensive. And if you have to have two staff members there all the time, that's expensive. That's where most of the expense is in the staffing. So can we abridged the experience, make it shorter, and get away with it, and get similar kind of therapies to outcomes? So there's a lot of interest in that direction.
现在，人们开始思考，连 Salasaybin 疗程都很漫长且昂贵。如果需要一直有两名员工在场，这会非常费钱。大部分的花费都在员工的薪资上。因此，我们能否缩短这个过程，让疗程变得更短，同时也能获得类似的治疗效果？很多人对此很感兴趣。
They ask about, sorry to interrupt, but I want to make sure I don't forget to. Ask about combination Salasaybin MDMA therapies. The reason I ask about this is, and here truly not me, but I know people who do self-administered combination Salasaybin and MDMA. I think I have this right. I think it's called a hippie flip. There's another one that involves LSD too. Again, I'm not suggesting people do these kind of drug combinations, but the way it was described to me was that the Salasaybin, because it's so serotonergic, sometimes can be not a downer, but can have a bit of a kind of a murky feel to it, some real deep introspection, sometimes in the darker realms of one's psyche, depressive thoughts, et cetera, not that it necessarily stays that way throughout the trip.
他们询问关于，抱歉打断一下，但我希望确保不会忘记。询问关于结合使用赛洛塞宾和MDMA的治疗。我之所以问这个问题，是因为虽然不是我自己，但我确实知道有些人自己组合使用赛洛塞宾和MDMA。我想我没弄错，这似乎被称为“嬉皮翻转”。还有另一种涉及LSD的组合。同样，我并不是建议人们尝试这种药物组合，但据我所知，赛洛塞宾因为它的强烈的5-羟色胺作用，有时不是一种让人低落的感觉，但可能会带来一种有些阴郁的感觉，导致非常深入的自省，有时会进入个人内心比较阴暗的领域，产生抑郁的想法等等，当然这并不意味着整个旅行过程中都会如此。
But that the MDMA, because it has a very strongly serotonergic, but also dopamineergic, I mean, so it has an emphetamine component, a cocaine-like, in fact. If you've ever seen someone in an MDMA, their pupils are about the size of quarters for a reason there, and extremely, extremely autonomic or ausal compared to a sedative, which, by the way, would constrict the pupils. So they describe the use of MDMA to kind of balance out the kind of affect component of it. What are your thoughts on combination, Salasaybin MDMA? Does this hold any therapeutic potential?
MDMA 的作用非常强烈地影响到血清素系统，同时也影响多巴胺系统。实际上，它有安非他命和可卡因类似的成分。如果你见过服用 MDMA 的人，他们的瞳孔常常会放大得像硬币一样。而且，MDMA 会让人极度的兴奋，与镇静剂的效果相反，镇静剂通常会让瞳孔收缩。所以，有人描述使用 MDMA 来平衡情感上的影响。你对将 psilocybin 和 MDMA 结合使用有什么看法？这是否有治疗潜力？
This is obviously a backyard chemistry in the sense that people are, or kind of, cowboying this stuff on their own, which, again, I don't really recommend. I like to see the science go first, but I understand this is how it works in the real world. Yeah, what are your thoughts on combining compounds? Yeah, well, I guess they're cowboying it in recreational contexts, but also underground therapists do work with this combo. That's what I'm referring to. So I'm not talking about people partying with this stuff. I'm talking about, there are thousands now of therapists that offer psychedelic therapies illegally, really, because it's not legal, at least, not in the US, to possess or sell. But that are doing this.
这显然是一种“后院化学”的做法，意思是人们在自己动手尝试这种东西，这种做法我并不推荐。我倾向于让科学先行，但我也理解这就是现实世界的运作方式。那么，你对化合物的组合有何看法呢？我猜他们在娱乐环境中玩这些，但也有地下治疗师在使用这种组合进行工作。这就是我想说的。我不是在谈论人们用这些东西去聚会，而是说现在已经有数以千计的治疗师在提供非法的心理治疗，因为至少在美国，持有或销售这些东西是不合法的，但他们仍在这样做。
So that's really why I'm asking. Yeah. And I think there's something to be said for when I have to be careful with this as a scientist. But if they're doing it, are they using some kind of trial and error, the same is true, of course, with the longer history of psychedelic plant medicine use by plants. We include the fungi as well, say, in the extended sense plants. There will have been trial and error there. It might not be as systematic as the science we do today. But maybe there's been a learning process. And maybe what they do, they've come to because they found it works. So by that principle, I'm interested in that combination and whether it does offer some advantages, maybe in certain patients.
这就是我提问的原因。我认为作为科学家，我需要谨慎对待这个问题。不过，如果他们在使用某种尝试和错误的方法，当然，植物在使用致幻植物药物的悠久历史中也是这样。这里我们还包括真菌，从广义上来说，它们也算作植物。在这个过程中可能经历了很多尝试和错误。虽然这可能不像我们今天的科学研究那么系统，但可能存在一个学习的过程。也许他们的做法是因为发现这个方法有效。因此，基于这个原则，我对这种组合很感兴趣，想了解它是否能在某些患者中提供某些优势。
If we, one of the buzz terms in medicine these days is precision medicine, precision medicine and personalized medicine. So maybe there are certain cases where introducing, say, Solaceibin after the MDMA or the other way round could offer some advantages. And the differences are interesting. Solaceibin can get you to deep places, maybe the kernel of your suffering and major life experiences and complexes that are causally linked to whatever the pathology that you're presenting with. But it can do it sometimes quite aggressively.
近年来医学领域的一个热门术语是精准医学，精准医学和个性化医学。因此，在某些情况下，在使用MDMA后再引入塞洛西宾（或者反过来）可能会带来一些优势。不同之处是很有趣的。塞洛西宾能够带你深入内心，也许能够触及你痛苦的核心，以及与你目前病症因果相关的重大生活经历和复杂情感。但有时这种方式可能比较激进。
And if it's, say, post-traumatic stress disorder, it can be overwhelming. And you can fight it. And really it's that. It's that the resistance is really challenged and they fight back. And the therapeutic breakthrough and the progress isn't happening because you've agitated the defense mechanisms. Whereas what MDMA offers is something arguably more directionally reliable in terms of the valence. Like it's more directionally positive generally an MDMA experience. Hard to have a bad time on MDMA.
如果是创伤后应激障碍，它可能会让人感到不知所措。你可以努力去对抗，但这确实是一个挑战。你的抵抗力会受到巨大挑战，而他们则会反抗。然而，由于你的防御机制被激化了，因此无法实现治疗上的突破和进展。而MDMA提供的则是一种在情感方向上更可靠的体验。一般来说，MDMA的体验更倾向于积极的方向，很难在MDMA上有不好的经历。
Yeah. To be quite blunt. I mean, one of the concerns I had with MDMA, I've never done it recreation. I have had not and have not ever done it recreationally. But when it was done in this therapeutic setting, I realized because there was music on at the beginning, I actually asked them to turn it off. Because I realized that the music was becoming such an attractor to my attention that I suddenly was starting to think about music and my love of music, which was not the focus of the session that I was there for. And I'm glad that they did turn the music off because the moment they did, I was able to drop in within the IMS to this sort of go inward and address some certain issues that at least to me felt key and productive.
好的，直截了当地说，我有一些对MDMA的顾虑。我从来没有在娱乐环境下使用过它。我从没在娱乐环境中用过它。但是，当我在一个治疗环境中使用它时，我意识到因为一开始有音乐在播放，我实际上要求他们把音乐关掉。因为我注意到音乐吸引了我太多的注意力，让我开始想起我对音乐的热爱，而这并不是我来这里的重点。我很高兴他们关掉了音乐，因为一旦他们这么做了，我就能够沉浸在这次体验中，转向内心，处理一些对我来说非常重要和有成效的问题。
So that seems to be the kind of hazard with MDMA is that it's such an empathogen that one could start to you could go down any number of different rabbit holes. Yeah. Yeah, but it's also a strength because you, well, the classics like Salisibin can take you there very reliably, but maybe a bit aggressively, MDMA makes it easier to go there. And that's its strength. And that's why that marriage of MDMA therapy for PTSD in particular is a good combo. It works because you are going to go there in a sense you have to really make the therapeutic progress.
MDMA 的风险在于它是一种强效的移情剂，可能会让人陷入各种不同的情绪漩涡。然而，这也是它的一个优势。虽然像赛洛西宾这样的经典药物可以很可靠地让你进入这种状态，但可能有些激烈，相比之下，MDMA 则让这一过程变得更容易。这正是为什么 MDMA 在治疗 PTSD 时效果很好的原因。它能够帮助你在治疗中深入情感世界，从而真正取得治疗进展。
You're going to have to go back there. But we're going to set it up so that you can go back there and feel safer and more trusting and be able to go back there whereas you've never otherwise been able to go back there without dissociating or having horrible flashbacks and so on. So that's the strength that it offers. I guess the limitation would be that maybe it doesn't take you as deep as the classic psychedelics. And I tend to think I'm biased on this one but there's a kind of honesty to the classics in that it is hell as well as heaven, you know? And that's the psyche. It isn't all roses.
你将不得不回到那里。但我们会进行安排，让你在回去时感到更安全、更信任，以便能够面对过去，而不是一回忆就出现分离或可怕的闪回。因此，这就是它带来的优势。我觉得它的限制可能在于，它可能不像经典迷幻剂那样带你深入体验。我承认我在这方面可能有偏见，但我认为经典迷幻剂有一种诚实性，因为它既能带来天堂般的体验，也会让人经历地狱般的感受。这就是心理状态，它不总是鲜花盛开。
I really appreciate that you bring that up because I think that there's such a fear of so-called bad trips. There's such a fear in non-psychotic states to avoid the painful and everything, everything we know from trauma and the treatment of trauma. We've had several guests on here. My close colleague, close, close colleague at Stanford, Dr. David Speegler, associate chair of psychiatry, clinical hypnotist, amazing, amazing human being and scientist and clinician. As really just, you know, like embedded this in my mind that the only way to deal with trauma is to get right up next to that trauma to the point where some relief is experienced. There is no other real way.
我非常感谢你提到这个问题，因为我认为有一种对所谓“糟糕体验”的恐惧。在非精神病状态中，人们很害怕经历痛苦，这一切都是我们从创伤和创伤治疗中了解到的。在这里我们请来过几位嘉宾，我在斯坦福的亲密同事，精神病学副主任、临床催眠师David Speegler博士，他是一位了不起的人、科学家和临床医生，他在我脑海中深植了这样一个理念：应对创伤的唯一方法就是直接面对创伤，直到感受到一些缓解。这是唯一真正有效的方法。
So I really appreciate that you're saying that the classic psychedelics may offer the, with a very strong nudge, perhaps, the opportunity to get into the uncomfortable in a way that MDMA or some non-classical psychedelics perhaps do not. We were talking about time frames or duration of trips and these different compounds and how they differ and how they're similar. I'd love for you to educate me on DMT and some of the work that you're doing with DMT. My understanding is that it's a very brief trip, minutes. People I know who have done this, again, therapeutically, actually, I'll just point to one very exciting, I think, group and initiative, which is the Veteran Solutions Initiative, which is a group, this is carried out in Mexico, but in conjunction with laboratories at Stanford and elsewhere who are evaluating the neural changes.
我非常感谢你提到经典迷幻药或许能给予我们一个很强的推动力，让我们去面对那些不太舒服的情境，而MDMA或一些非经典迷幻药可能没有这种效果。我们之前谈论的是不同化合物的体验时间或持续时间，以及它们之间的异同。我希望你能为我讲解一下DMT以及你在这方面的工作。据我了解，它的作用时间很短，只是几分钟。我认识的一些人曾经在治疗中使用过。我想提到一个非常令人兴奋的组织和计划，那就是退伍军人解决方案计划。这是在墨西哥进行的一个项目，与斯坦福大学及其他地方的实验室合作，评估神经变化。
And this involves IBAGain, which is EboGO, which is a very long duration psychedelic, 22 hours or more, followed by, I think, one or two doses of DMT, this is for veterans to deal with any number of issues, appears to be working with great success and I've spoken to several of people who've gone through this and the way that they described DMT, almost across the board was quote, here I'm just pulling quotes, right, anecdote. The most profound experience of my entire life, even greater than the birth of my children, quote, like being attached to the shock wave of an atom bomb, quote, there's no way I would do another dose because the first one was so unbelievable, interesting, by the way, I think most of us, including me would think, why wouldn't you want to do it again, then, but this idea that that was just beyond anything.
这涉及到IBAGain，它是一种名为EboGO的长效致幻剂，效果持续时间达22小时或更长。随后，可能会有一到两剂DMT。这种治疗方法主要用于帮助退伍军人应对各种问题，并且看起来效果显著。我曾与几位经历过这种治疗的人交谈过，他们几乎都描述DMT的经历是他们一生中最深刻的体验，甚至超过了孩子出生时的感受。有的人形容这就像被原子弹的冲击波击中。还有人表示，他们绝不会再尝试第二次，因为第一次的体验实在是太难以置信。顺便说一句，我想我们大多数人，包括我自己，可能都会想，为什么不再尝试一次呢？但事实上，这种体验超越了一切幻想。
So these are significant statements coming from individuals who have existed at the extremes of human experience to begin with, right? These are so-called tier one operators within the special operations who exit and may or may not have trauma, but DMT sounds like a big deal. Short duration, really big deal. What do we know about its chemistry? What do we know about how it's impacting brain networks and what in the world is going on that people are describing it as the ways I just mentioned a few moments ago? Yes, it's a rocket ship. If the Salasai bin is like a ship leaving port, then, yeah, this is a rocket ship into craziness.
这些言论来自那些曾在极限情况下生活过的人士，可以说是非常重要的，对吧？他们是所谓的特级行动人员（Tier One Operators），他们在离开服役后可能有创伤，也可能没有，但DMT听起来是个大事情。持续时间很短，却影响很大。我们对它的化学成分了解多少？它如何影响大脑网络？为什么人们会用我刚才提到的那些方式来形容它？是的，这就像一枚火箭。如果说赛洛西宾（致幻蘑菇中的一种化学物质）像是一艘离港的船，那么DMT就是一辆通往疯狂的火箭。
Is it serotonin 2A? It is, yeah. So it is a classic psychedelic. It's a direct agonist, a direct stimulator of the serotonin 2A receptor. It's an order of magnitude less potent than Salasai bin, but potent season funny thing because it's dose dependent. So that doesn't mean that the experience with DMT is less than that of Salasai bin. It's just that you give more of the drug. But it has, let's match by its stickiness for the serotonin 2A receptor, which is this kind of golden rule in psychedelic science is that it was discovered in the mid 1980s, this tight relationship between the affinity or the stickiness or the binding potential of a psychedelic for the 2A receptor in particular, serotonin 2A, and its potency, and the stickier the drug, the more potent. So LSD really sticky, very, very potent. You only need those tiny microgram doses.
这是血清素2A受体吗？是的。它是一种经典的迷幻药，是一种直接作用于血清素2A受体的致效剂。它的效力比裸盖菇素（通常称为“神奇蘑菇”的主要成分）低一个数量级，但“效力”是一个有趣的概念，因为它依赖于剂量。这并不意味着DMT的体验比裸盖菇素弱，只是需要增加药物的剂量。 其效力可以通过与血清素2A受体的结合能力来衡量。在迷幻科学中，有一个“黄金法则”，即在20世纪80年代中期发现了迷幻药物与2A受体（尤其是血清素2A受体）结合潜力与其效力之间紧密的关系：药物越能紧密结合受体，它的效力就越高。因此，LSD与受体的结合非常紧密，效力非常高，只需要微克级别的小剂量。
So DMT by its affinity is a little less potent, but by its effects, when you give a standard dose, it's just wild. And DMT, because there's another compound called five-method, CDMT, which is a bit different pharmacologically and subjectively. Similar in terms of its kinetics, it's another rocket ship. Both compounds in the wild, so to speak, are smoked often, DMT and five MEO, people are vaping both actually now. There are vape pens that have been developed for people to administer this, but more traditionally it's been a smoking thing. This is clinically not recreationally, or both. Both now. I mean, you know, underground practitioners are using the vape pens. They like them because people titrate the dosage.
所以，从亲和力来看，DMT的效力稍微低一点，但从效果来说，当你给予标准剂量时，它的效果非常狂野。还有一种叫做5-MeO-DMT的化合物，它在药理学和主观体验上有些不同。但从动力学上看，这两者类似，也是一种快速起效的化合物。这两种化合物，一般来说，都是以吸烟的方式使用，DMT和5-MeO-DMT其实现在有人在用电子烟吸了。为此已经开发出了电子烟笔供人们使用，但更传统的是通过吸烟来摄取。这可以用于临床，也可以用于娱乐，或者两者兼有。我的意思是，地下从业者正在使用电子烟笔。他们喜欢电子烟笔，因为人们可以自行掌握剂量。
They get a feel for what it is to be going into this state so that they feel they can let go and go into it. But and actually, I think some of the veterans work might be giving five MEO after the eye began. Phenomenologically, if there's a difference between DMT and five MEO, people might put it on five MEO being more of a reliable ego dissolution experience, less visual and more kind of all round immersion in the greater whole loss of self identity and just immersion and everything. Yeah, maybe we could just talk about ego dissolution for a second, just such a sticky, interesting idea. I can take a step back as a neuroscientist and say, okay, ego dissolution, this idea that the, from a very early age, we have a concept of self and that, you know, I wake up every morning and I know I'm me and not somebody else and presumably you do the same and most people do the same, I would hope.
他们体会到进入这种状态的感觉，因此他们觉得能够放开自我，进入这种状态。实际上，我认为一些退伍军人的经验可能是在眼睛看到之后使用五类 MEO。从现象学的角度看，如果 DMT 和五类 MEO 之间存在差异的话，人们可能认为五类 MEO 更能可靠地导致自我消解体验，视觉效果较少，更像是一种全面沉浸于更大整体中的体验，失去自我认同，完全融入一切。是的，也许我们可以简单谈谈自我消解，这真是一个既复杂又有趣的概念。作为一个神经科学家，我可以退一步说，自我消解这种理念，即从很小的时候开始，我们就有了自我概念。每天早晨醒来时，我知道自己是谁，而不是别人，想必你也是如此，大多数人也是这样，我希望如此。
But that and that there are objects in the world and people in the world beyond us. But every time I hear about ego dissolution, it sounds like it's a kind of a temporary elimination of the idea that things stop and start and stop between us and everything else. Almost like, you know, in a kind of a, here I'm not trying to sound philosophical or metaphysical, but they're sort of the molecular continuity of life, right? Or all that, it's all just little bits. Which is true, which is true, right? Not a functional way to go through the day, right? Because you want to make a cup of coffee, you don't really want to get lost in that if your goal is to make a cup of coffee.
意思是说，虽然我们周围有物体和其他人存在，但是每次我听到“自我消解”这个概念时，总感觉它像是暂时消除了我们与外界事物之间界限的想法。就好像，尽管我不想听起来太哲学或玄学，但生活中存在某种分子延续性，对吧？或者说，万物都是由小碎片构成的。这种想法是对的，确实如此，对吧？但在日常生活中这样思考并不实用。因为当你想泡一杯咖啡时，如果沉浸于这种思考，可能会偏离目标，也就是泡咖啡这件事。
But what is the power of ego dissolution? Is it the idea that we belong? Is it a sense of meaning? Is it the sense that we're not as important as we think, which of course could be a wonderfully useful way to go through life, you know, to think that we're not as, and as we are vitally important, but we're not the only thing, right? Because I do believe connection is vital as most people do. What is ego dissolution? And why would this serotonin to a activation cause that? That's remarkable. Yeah. Great questions. I mean, what is it you alluded to it with the start stop, I think, you know, because you could define it by boundaries in a sense what it, what isn't me is as valid here as a developing sense of what is me that a child develops at whatever age.
但是自我解构的力量是什么呢？是否意味着我们归属某个整体？是否是一种意义感？或者是让我们感觉自己并没有想象中那么重要，这种想法当然可能是应对生活的一种极为有效的方式。我们的存在固然重要，但我们不是唯一，正确吗？因为我确实相信，与他人建立连接是至关重要的，正如大多数人所认为的那样。什么是自我解构？为什么这种与5-羟色胺2A受体的激活有关呢？这很令人惊讶。是的，这些都是很好的问题。我想你刚才提到的启动和停止，可能可以从边界的角度来定义它。对于一个孩子来说， "什么不是我" 与“我是什么”的发展认知同样重要。
And so a major characteristic of the ego dissolution experience rather than just a negative thing going away, my sense of self going away is the positive, oh, now I feel interconnected with other people in the world at large and I realize, you know, that there is that molecular continuity, and actually that's a ground truth. And oh, maybe the ego thing is somewhat illusory or at least the construction of my mind. And indeed it is, right? Well, it is. Yeah, I mean, there's no transcendentalism about that. It's just like logic. I think about it a little bit like family. I mean, we all know what immediate family is, but you know, sort of like, um, forgive me for interrupting myself. I do it all the time anyway. Um, when I teach neuroanatomy, you know, some clever student always figures out, okay, well that's connected to that and that's connected. But ultimately everything in the brain is connected to everything else.
这种自我消解体验的一个主要特点，不只是消极的东西消失，比如自我感的消失，而是会产生一种积极的感觉：哦，现在我感到自己与世界上其他人紧密相连，我意识到，我们之间是有分子联系的，这实际上是一个基本事实。于是，我可能会想，所谓的自我可能是一种错觉，或者至少是我心智的构造。实际上，确实是这样。是的，我是说，这一点没有什么超自然主义的色彩，仅仅是逻辑而已。我对这样的感觉有点像对家庭的看法，我们都知道什么是直系亲属，但，就像我在教学的时候——请原谅我打断自己，不过我经常这样做——当我教神经解剖学时，总有聪明的学生会发现，这个连接到那个，那个又连接到另一个，但归根结底，脑中一切都相互连接。
Yeah. There's just no way around that. That's a true statement. Yeah. And so you really just have to decide where you draw the boundaries between. Wait, just really. out. Where are the modules? What are the modules? You could say the brain is just one big macro module. Yeah. And then you also want to include the body. And now fortunately, people are starting to embrace this idea that it's not mind body. It's both because the nervous system extends through both. Of course. So as the same could be said of family, like we're related, right? Not just by virtue of the fact that we're human beings. If we did our genealogical charts, we would find a convergence at some point. Yeah. And of course, you know, this becomes a bit of a game. But then one realizes that where you draw the boundaries, and if you draw them at brother, sister, parents, biological parents, et cetera, that's a game too.
是的。这是不可回避的，这是一句真话。所以你真的需要决定在哪儿划定界限。等等，真的，就在那里。模块在哪里？模块是什么？可以说大脑就是一个大的宏模块。然后你也需要把身体包含进来。幸运的是，人们现在开始接受这样一个理念，即不仅仅是心理或者身体，而是两者兼顾，因为神经系统贯穿于两者之间。当然，这就像家庭一样，我们之间有关系，不仅因为我们都是人类。如果我们追溯家谱，某个点上会发现交汇。是的，这当然有点像游戏，但是你会意识到，划定界限的地方，比如兄弟、姐妹、父母、生父母等，其实这也是一种游戏。
And so it is just a construct. Yeah, I mean, it is a fun game, you know, where do you draw the line and when to pass and when to collapse? It's also a classic consideration in science, when to pass and when to... The lumber versus the slitter. You can. It's brilliant. Yeah. But you asked this question, like, well, why does psychedelics do it? And there we think psychedelics do it because the target receptors, at least, you know, classic psychedelics do it. And that's important to stress. So MDMA doesn't really do it in the same way. Might soften the ego a bit, but yeah, that's debatable. My experience with MDMA is that it's such a strong and pathogen.
这只是一个构想。是的，我的意思是，这就像一个有趣的游戏，你知道，就是在你该划清界限和选择放弃与崩溃的时候，也是科学上的经典考量。木材和切纸工之争。你是可以的。这很妙。不过你问了这样一个问题，为什么致幻剂会这样？我们认为，至少传统的致幻剂会这样，因为它们作用于靶向受体。这一点非常重要。需要强调的是，MDMA并不会以同样的方式起作用。它或许会稍微软化自我，但这也是有争议的。根据我的经验，MDMA更像是一种强效诱导共情的物质。
Yeah. And that it can cause empathy for others. Certainly you could imagine situations where one in MDMA journey and afterwards says, you know, oh, these my oppressors, you know, are the people that harm to me, they... And here I'm not referring to my experience, but you know, they did the best with what they have. Actually have empathy for them, forgiveness, but also for oneself. That there's an empathy for self. I know I said this earlier, that is very hard for most people to access. Perhaps it's not the narcissist out there listening. They'll be like, of course, empathy for self. But everyone else, I think, all the other healthy people, or the healthy people, other than narcissists and not picking on narcissists, I have to imagine they suffer too.
好的。这段话可以翻译成：
是的，这还能引发对他人的共情。你可以想象，有人可能在使用 MDMA 的过程中，或者之后，会说："你知道吗，我的压迫者，那些伤害我的人，他们...这里我并不是在谈论我自己的经历，但他们尽其所能做到最好。"实际上，会对他们有共情和宽恕，同时也包括对自己的自我理解。我之前提到过，这对大多数人来说是很难做到的。也许不是那些在听的自恋者。他们可能会觉得，自我共情是理所当然的。但我认为，其他所有健康的人，或者说自恋者以外的健康人，我得想象他们也在受苦。
In fact, I think that's the root of their narcissism. That empathy for self is not something that comes reflexively for most people. And here I'm not talking about self-love or self-respect, but this notion of being able to see the self as not just deserving of love and care, but actually holding that in place while in confrontation with something challenging, in a way that allows more, not less, access to adaptive responses to that challenge. I think that's the way I kind of conceptualize it. Yeah, yeah. But I mean, drugs offer a great... They offer great... They are great scientific tools for tackling this question.
实际上，我认为这就是他们自恋的根源。大多数人并不会自然地对自己产生同理心。在这里，我说的不是自爱或自尊，而是一种能够在面对挑战时，不仅觉得自己值得被爱和关心，还能保持这种观念的方法。这种方法可以让我们以更适应的方式应对挑战。我想这就是我的理解方式。是的，是的。不过，我的意思是，药物为解决这个问题提供了很好的科学工具。
What is ego dissolution and why do drugs modulate it? And what does that tell you about the brain? Because other drugs like cocaine, releasing more of a different neurotransmitter, dopamine, more than serotonin. The opposite is the case with MDMA, is more of an ego inflator, right? Oh, absolutely. People become hyperlinear, hyperlinked to their own desires and wishes and future outcomes become an obsession. It's the stuff of kind of American psycho and the kind of cliches and stereotypes of the 80s cocaine culture. Yeah, yeah. We did a study once actually looking at dose-dependent relationship with ego inflation on one axis, an ego dissolution on the other and saw that it just massively passed or differentiated between cocaine and psychedelics.
什么是自我解体，为什么药物会影响它？这说明大脑有什么特点？因为像可卡因这样的药物会释放更多的多巴胺，而不是血清素。而MDMA的作用正好相反，更像是自我膨胀剂，对吧？哦，绝对是这样。人在这种情况下会变得非常关注自己的欲望和未来的结果，甚至可能变成一种执念。这就像美国精神病人和80年代可卡因文化的刻板印象和陈词滥调。是的，是的。我们曾经做过一项研究，研究药物剂量与自我膨胀和自我解体之间的关系，发现它在可卡因和迷幻药之间有显著差异。
It's quite a neat study. So cocaine makes people's egos superinflated. Yeah, and it doesn't touch dissolution and the opposite is the case with psychedelics. At least to keep you from imagining to explain how cocaine does that. That would be a great study. Yeah, great idea. We should do that. I have a sabbatical coming up. I've got 12 months of sabbatical coming up. Yeah, I don't want to. I'm going to show up in your lab. Yeah, that's a really good one. If it's right to finish the thread on why psychedelics and ego dissolution, we do know some things or we have some hypotheses and it's that the target receptor is a serotonin to a receptor as a classic psychedelics hit.
这是一个相当有趣的研究。可卡因会让人的自我膨胀得厉害。而且，它不会影响到自我解离，这和致幻剂的作用正好相反。至少这是为了让你在想象中解释可卡因是如何做到这一点的。那将是一个很棒的研究。是的，绝妙的主意。我们应该做这个研究。我即将迎来一个学术休假，有12个月的时间。是的，我不想。我会去你的实验室。这真是一个很好的课题。如果要结束关于为什么致幻剂和自我解离的讨论，我们确实知道一些事情或者有一些假设，那就是经典致幻剂的作用靶点是5-HT2A受体。
I heavily expressed in what these days I like to call recent brain because evolutionarily it's recent brain. It's cortex that humans have more than any other species. If you look at a mapping of cortical expansion from say Macac or Chimp to human, it's the very same map that you'll find the two A receptors in. So that's the target. It's just easy to think that, oh, well, that could be the egoic brain. You know, and the classic psychedelics come in. They kind of they scramble up the activity. That's the entropic brain action. And in terms of the start stop, the boundaries, that entropic action sort of spreads out the system. It doesn't shut it off. It sort of spreads it out, you know? Disolution. Yeah.
我最近常常提到我的“最近大脑”，因为从进化的角度来看，这就是最近发展起来的大脑。人类的皮层比其他任何物种都要发达。如果你查看从猕猴或黑猩猩到人类的皮层扩展图，就会发现这也是你会找到两种A受体的地方。因此，这是目标所在。我们很容易认为，这可能是自我的大脑，你知道的，这时候经典的致幻剂便起作用了。它们能搅乱大脑的活动，这就是所谓的熵脑行为。从开始到结束，边界，这种熵的作用在大脑系统中扩散开来。它不是关掉大脑，而是扩展它，你懂的，那种解构。
And you know that you were talking about the headspace as well. So that fits if it's more capacious, it sort of fits. The big qualifier with psychedelic therapy that people rightly bring up is it doesn't last. That's the paradox of it. The paradox of ego dissolution. So the ego might go away during the trip and you have these profound insights about the molecular continuity and how we're all one and interconnected. And then you calm down. And however long later, you know, the ego comes back, but maybe with a vengeance.
你也提到过“心理空间”的概念。如果这种空间更大，那么它确实能“容纳”得下。人们常提到一个与迷幻疗法相关的重要限定因素，那就是其效果并不持久。这也是其中的一个悖论——自我解体的悖论。在体验过程中，自我可能会消失，你会获得一些深刻的见解，比如分子层面的连续性，以及我们如何是一体、相互连接的。但在你冷静下来后，随着时间的推移，自我会重新回归，可能以更加强烈的方式复原。
And sadly, you know, things can go right when people haven't done the work, perhaps haven't done the integration work. And maybe ego defenses come back and, you know, and it's not a pretty picture. How often do you see that in the trials that you do? What percentage of the people coming through, do you think end up with worse than they were before the trial? It's very rare in the trials that we've done. Yeah, but you see defenses come back. So you do see people relapse. That's more, you know, if you're pushing out to like three months plus in something like treatment, resistant depression, that's more the rule than the exception.
很不幸的是，有时候事情可能会在没有充分准备或整合工作的情况下发展顺利。然而，当自我防御机制再次出现时，情况可能就不那么乐观了。 您在进行试验时多常遇到这种情况？您认为有多少人经过试验后情况变得比之前更糟？在我们进行的试验中，这种情况非常罕见。但是，您会看到防御机制的回归，所以确实有人会出现复发。在处理像难治性抑郁这样的情况时，如果时间拉长到三个月以上，复发反而是常态，而不是例外。
Sadly, people relapse. If their histories are, you know, histories of chronic depression, then while you might give them a window of wellness, sadly, it doesn't last. It's not to say that it doesn't ever last. It does. And we have people who are in our first treatment, resistant depression trial, who are well to my knowledge today, back at work, doing fantastically well. But sadly, the majority of relapse to my knowledge and need to do more psychedelic journeys.
遗憾的是，人们会复发。如果他们有长期抑郁的历史，那么即使你可能给他们一段健康的时间，这段时间通常也不会持续太久。这并不是说它永远不会持续。实际上，有些人在我们第一次针对顽固性抑郁症的试验中表现得很好，到目前为止，他们已经康复，重新回到工作中，表现得非常出色。然而，遗憾的是，据我所知，大多数人会复发，并且需要更多的迷幻治疗来帮助他们。
Well, they can't because it's illegal. That's been the really difficult situation that we've been up against is that we do a trial where all of a sudden this schedule one drug becomes a medicine in the trial, or at least an experimental medicine. We give the treatment. It works fantastically well. It gives people a remission that they've never really had for however long. And then the trial ends and they're denied that treatment and were still, if they were to have that treatment, they would be committing a crime. It's sort of a sick joke in a way, but that's the situation that we've been in.
嗯，他们不能这么做，因为这是违法的。这一直是我们面临的一个非常困难的局面。在我们的试验中，一种被列为一级管制的药物突然变成了药物，或者至少是实验性药物。我们提供治疗，效果非常好。它让很多人获得了他们从未有过的缓解。然而，试验结束后，他们却被拒绝继续接受这种治疗。更糟糕的是，如果他们自行使用这种治疗，他们将触犯法律。这有点像是在开恶劣的玩笑，但这就是我们所处的状况。
And that's a perfect segue for what I want to talk about now, which is what is the current state of legality in terms of or the progression towards legality. I'd also like to touch on the role of, let's just say incoming big pharma. There are a lot of startup companies now trying to capitalize on these discoveries that you and others have made. The landscape out there is very unclear to me. Maybe I'll just call out some silos as I see them. And maybe we can draw some bridges between them if they exist.
这正好引出了我现在想要讨论的话题，那就是目前在合法化方面的现状或进展。我还想谈谈大型制药公司在其中扮演的角色。现在有许多初创公司试图利用你和其他人所取得的发现来获利。对我而言，目前的形势不是很清楚。也许我会指出一些我所看到的独立领域，看看它们之间是否存在联系，我们可以尝试建立一些桥梁。
At the ground level, not the grassroots, but at the ground level, I look to laboratories like yours, Matthew Johnson's, Roland Griffiths, some laboratories at Stanford, Nolan Williams, laboratories studying the effects of psychedelics in human beings, so not animal models, in terms of their clinical application for the treatment of depression andorexia. I don't know, fiber myalgia trauma. Let's lump MDMA in there as well, assuming that it all works in an equivalent way at the level of kind of where the legislature is taking things.
在实际操作层面上，我关注像你们这样的实验室，比如马修·约翰逊、罗兰·格里菲斯，以及斯坦福大学的一些实验室，诺兰·威廉姆斯等，这些实验室都在研究迷幻药对人类的影响，而不是动物模型，主要是研究它们在临床上治疗抑郁症、神经性厌食症和纤维肌痛创伤等方面的应用。我们也可以把MDMA算进去，假设在立法机构推动下，这些药物的运作方式在某种程度上都是相似的。
Okay, so labs using government money, philanthropy, et cetera. Then there are the therapists out there that are accessing what we believe are clean sources of MDMA, psilocybin LSD to do this. They are doing it illegally. This is in the US or other Western European countries because obviously it's gonna differ by country who are administering these things. Sort of on the basis of what they're reading in these studies that you all are publishing, but also expanding on and experimenting, hippie flips and combination drugs and ketamine and et cetera. But let's leave ketamine out right now because it's legal, but there's that.
好的，所以有些实验室使用政府资金、慈善捐助等进行研究。此外，还有一些治疗师在美国或其它西欧国家，他们从我们认为可靠的渠道获取MDMA、赛洛西宾和LSD等物质进行治疗。他们的做法是非法的。根据国家不同，情况也会有差异。他们进行这类活动的依据是你们发表的研究成果，同时也在探索和尝试，例如混合使用不同药物和结合药品等。不过，我们暂时不讨论氯胺酮，因为它是合法的，但类似情况也存在。
Then there's the, I don't wanna say, it's a recreational slash open market, black market. And here I wanna raise a flag to the fact that Dr. Peter Tia did a terrific podcast on this recently in his own podcast, The Drive, the fact that a fentanyl, Lacing with fentanyl is now showing up in MDMA and psychedelics that are purchased on the street. So serious caution to those getting it. from uncertain sources. And then you've got pharma and then as an umbrella for all of this, you've got the FDA and law enforcement agencies which currently say this stuff is illegal unless it's being used in a clinical trial, selling it or possessing it can get you charged with a crime ranging from, I don't wanna say, because I don't know, but up to felonies, right? Years in prison. Okay, so can't take it through airports, can't, don't get caught with it, don't buy it, don't sell it, kind of thing.
然后有一个, 我不想说, 是一个娱乐性/开放市场，黑市。我要在这里提醒大家注意，Dr. Peter Tia 最近在他自己的播客 The Drive 中做了一期精彩的节目，提到现在街头购买的 MDMA 和致幻剂中发现了掺有芬太尼的情况。因此，那些从不确定来源获取这些物品的人需要特别小心。其次是制药行业，而作为这一切的上层，你有 FDA（美国食品药品监督管理局）和执法机构。目前，他们表示这种东西是非法的，除非用于临床试验，否则销售或持有可能会导致你被指控犯罪，可能达到重罪，对吧？多年监禁。所以，不能带它通过机场检查，不能被抓到持有它，不能买，不能卖，就是这样。
So where are we going from that picture of these silos? I know things are in clinical trials now. Most people including myself are not familiar with how the different phases relate to the proximity to legality. Can you just kind of give us the landscape and touch on how long you think it will be before the people that come through your trials could then go get a prescription for psilocybin or potentially buy it without the risk from a reliable source, one would hope, without the risk of getting thrown in jail. I used to live in Oakland, California. My understanding and please correct me if I'm wrong folks, don't trust this information and get in trouble. My understanding is that psilocybin is decriminalized in Oakland, but that's not the same as being legal. So what is going on out there?
那么，从这些筒仓的图片来看，我们接下来会去向哪里呢？我知道现在有些东西正在进行临床试验。大多数人，包括我自己在内，都不熟悉不同的阶段是如何与合法性相关联的。你能否给我们介绍一下整体情况，并谈谈您认为还有多长时间，通过您的试验的人们可以获得处方使用psilocybin（裸盖菇素），或者可能可以从可靠的来源购买而不必担心会被逮捕。我曾住在加利福尼亚的奥克兰。据我了解，如果我错了请大家纠正，不要相信这些信息以免惹上麻烦。我的理解是，psilocybin在奥克兰已经去罪化，但这不等同于合法。那么，那里的情况如何呢？
Wow, well so much. Yeah, I just asked 55 questions, but feel free to answer just a subset of them if you like. Well, Oakland's a funny one. I live close to Oakland. There are head shops in Oakland, that might be selling cannabis and cannabis related paraphernalia that are selling mushrooms as well, psilocybin mushrooms. That's a fact. Opened it. Yeah. That's a fact. I can verify. I haven't purchased them, but I've gone in and kind of checked it out like what's going on here. Yeah.
哇，真是太多了。是的，我刚刚问了55个问题，不过你可以只回答其中的一部分。关于奥克兰，这个地方还挺有意思的。我住在离奥克兰很近的地方。奥克兰有一些商店出售大麻及其相关产品，其中还有卖蘑菇，比如赛洛西宾蘑菇。这是事实。我确实去过那些店。虽然我没有买过，但我进去看了看，了解了一下情况。是的，这是真的，我可以确认。
Yeah, so, you know, the police aren't going to prioritize that activity, the purchasing of those mushrooms as a crime now in Oakland because of the decriminalization. So those head shops shouldn't strictly be selling, well, they shouldn't be selling. They won't have a license to be selling. Licenses don't exist yet for that here. But let's see whether they get shut down. They probably will. I don't know. But there's a church, you know, in Oakland that have sort of say that they're selling and it's part of sort of religious rights that they're using that church model as a loophole. You know, the way that Native Americans can use Piote and they have a more genuine case, I think. Because there is a history there that they're trying to kind of piggyback on that.
好的，你知道，现在由于去罪化，警察在奥克兰不会优先考虑处理购买那些蘑菇的行为作为犯罪。所以那些商店不应该出售蘑菇，实际上，他们根本不应该卖。因为这里没有相关的销售许可证颁发。我们看看他们是否会被关闭，他们很可能会。我不确定。但是你知道，在奥克兰有一个教会声称他们在出售这种蘑菇，这是他们宗教仪式的一部分，他们利用教会这个模式作为法律漏洞。有点像美洲原住民可以合法使用佩奥特，因为他们有更正当的理由和历史背景。那些教会似乎想利用这种情况。
Anyway, that's sort of, you know, close to where we are right now. But federally, which is really the major inflection point is the FDA and the licensing of psychedelics as medicines to be legally prescribed across the country, across the US and beyond. That is close because the key phase, there are different phases of clinical trials and the key one to know about is phase three. A phase three trials, a licensing trials, if they're successful and typically you have to do at least two successful ones, show the results to the regulators who are the FDA, the medicine regulators and say, is this good enough now for you to give me a license so that I can sell and provide this medicine that we've demonstrated as a medicine.
无论如何，这大致就接近我们现在所处的位置。但在联邦层面，真正重大的转折点是美国食品药品监督管理局（FDA）以及将致幻剂作为药物获得许可，以便可以在美国及其他地区合法开处方。这一突破临近的原因是，临床试验有不同阶段，而关键阶段是第三阶段。第三阶段试验是获得许可的试验，如果它们成功——通常你需要至少两个成功的试验——然后将结果提交给FDA等药品监管机构，并询问他们：现在这够不够好，可以给我许可，以便我能够销售和提供我们已经证明有效的药物。
So that work has been done with MDMA therapy for post-traumatic stress disorder maps have led that work and done two-phase three trials. I think they've already publicly announced that the second trial had results consistent with the first. We know the results of the first because they're published and they were remarkably good. Something like 67% remission rates. And long term, I understand me as some of those remission rates for trauma or years, which is different than what you're describing for psilocybin where people might need ongoing dosing. That's true, yeah, yeah. But of course, just for trauma in those trials. My understanding is those MDMA trials were not focused on depression.
这项工作是关于使用 MDMA（摇头丸）治疗创伤后应激障碍（PTSD）的。MAPS 组织（多学科协会研究迷幻研究）主导了这项工作，并进行了两个三期试验。我认为他们已经公开宣布第二个试验的结果与第一个试验一致。我们了解第一个试验的结果，因为它已经发表了，结果相当好，约有67%的缓解率。而且从长远来看，我了解到一些创伤缓解率可以持续数年，这与您描述的需要持续服用的迷幻蘑菇不同。确实是这样的，不过这些试验仅针对创伤。我了解到，MDMA 的这些试验并不专注于抑郁症。
Yes, yes, focused on trauma. So that's something because that data is being filed now to my knowledge like as we speak and they're anticipating a decision maybe this year with rollout happening as early as next year. I mean, that's sort of best case, I think. Could I ask you when you say rollout, who's, and it's the appropriate term for MDMA because it's so-called rolling, about 20% of my audience, maybe 50, we'll understand that not funny joke that I made.
好的，是的，专注于创伤。这件事情的数据正在被整理，据我所知，就在我们交谈的时候，他们预计可能会在今年做出决定，推出时间最早可能是在明年。我想这算是最好的情况吧。我可以问一下，当你提到"推出"时，是谁负责的，"推出"这个词对MDMA来说是合适的，因为它所谓的"滚动"发布，我的观众中可能只有20%甚至50%的人会理解我刚才那个不好笑的玩笑。
Who's going to roll it out? Is this where would one get the MD, the clean source of MDMA, meaning not lace with fentanyl, not laced with methamphetamine, not undergone any chemical conversion to some other drug which can happen with extended shelf life, et cetera. Are people going to go to their psychiatrist to get MDMA? And who's going to be providing it? Is it going to be some big major pharma? This seems like a serious set of issues. It is and I don't have all the answers.
谁将推出这个计划呢？在哪里可以得到纯净的 MDMA，也就是没有掺入芬太尼、甲基苯丙胺，没有经过任何化学转化成其他药物（比如长时间储存可能导致的化学变化）的 MDMA？人们会去找他们的精神科医生获取 MDMA 吗？谁会提供这种药物？会是某个大型制药公司吗？这些问题看起来都很严肃。目前确实如此，我也没有所有的答案。
I do know that maps would be providing because they've done the work and they have set themselves up in a sense to potentially become the provider whether as a pharma company, which is the big question they're wrestling with at the moment. It's very expensive to become a pharma company. And yet they probably deserve to make the choice because they put in so many years of hard work when all of this stuff was considered like rava, culture, party, drug. They were the ones that spotted the therapeutic potential.
我知道地图公司会提供服务，因为他们已经完成了相关工作，并为自己定位为潜在的供应商，无论是作为制药公司（这是他们目前正在思考的一个大问题）。成为制药公司非常昂贵。然而，他们可能有资格做出这个选择，因为多年来在这些东西还被认为只是文化、派对用药时，他们是发现其治疗潜力的人，并为此付出了大量努力。
I mean, we knew there was therapeutic potential based on work going back many decades, but points to them and I think that in my opinion, they should have the agency to make those decisions. Yeah, it's a remarkable thing that's been achieved and I think they've done it all on philanthropic donations. I think so. Yeah, so there is this big question mark in the FDA. I'm also asking questions about to your question, who can provide this?
我的意思是，我们早在几十年前的研究中就知道这方面有治疗潜力，但我认为他们应该有自主权来做出这些决定。这确实是一个了不起的成就，我想他们完全是依靠慈善捐赠完成的。我觉得是这样的。不过，美国食品药品监督管理局（FDA）对此仍有很多疑问。关于你提到的问题，谁能提供这种治疗？我也在询问中。
Because in the phase three work and up until this point, there's been a maps training, a maps therapist training and you have to do this formal training in order to be a practitioner within the trials. But now there's a question from the FDA whether that maps training can be the training that a clinician has to have to now be a provider. And when I say rollout, it's like offering this as a service, essentially.
在第三阶段的工作中，直到目前为止，已经开展了一种MAPS培训和MAPS治疗师培训。为了成为试验中的一名从业者，必须接受这种正式培训。然而，现在美国食品药品监督管理局（FDA）提出了一个问题：这种MAPS培训是否可以作为一种标准培训，使临床医生能够成为正式的提供者。当我提到"推广"时，意思是将其作为一种服务来提供。
And so where would the referral come from? That's a good question that I'm not 100% on the answer, whether it would have to come from a psychiatrist or whether someone's sort of general physician could do that referral, but they will be going to a provider who is licensed, certified and will have done some training. And there will be a consensus on what constitutes good enough training to provide. There will also be some stipulations on the basic underlying professionalism of the clinician who provides.
那么推荐信应该从哪里来呢？这是个好问题，我不太确定答案。推荐信是否必须由精神科医生提供，或者是否可以由一般医生开具。但是，他们会去找一位具有执照、认证并接受过某些培训的供应者。而且，对于什么样的培训才算足够也会有共识。提供服务的临床医生的基本专业素养也会有一些规定。
So I imagine there'll have to be a mental health professional. I don't think they would have to necessarily be a psychiatrist. They could be a clinical psychologist. For all the dosings, I think, without question, there would have to be a physician present or at least within ready access in case of an emergency. Yes, especially with MDMA because of the propensity for cardiac issues because of the amphetamine properties.
所以我认为必须要有一位心理健康专业人士。我不认为一定非得是精神科医生，他们可以是一名临床心理学家。在所有药物剂量管理的场合，我认为毫无疑问，必须要有一位医生在场，或至少能够在紧急情况下随时联系到。是的，尤其是使用MDMA时，因为其安非他命特性可能引发心脏问题。
And where is psilocybin in terms of the phase trials? Is it in phase two, phase three? It's in phase three. There's psilocybin therapy work being done for treatment-resistant depression by a company called Compass, those trials, which are always multi-site. So there's always a bunch of teams or labs, in a sense, geographically spread out that are each contributing to data that then gets massed together and is then submitted as part of the phase three trial results.
赛洛西宾现在处于哪个阶段的试验？是第二阶段还是第三阶段？它处于第三阶段。Compass公司正在进行赛洛西宾治疗用于难治性抑郁症的研究。这些试验通常在多个地点进行。因此，在地理位置上分散的多支团队或实验室会分别收集数据，然后将这些数据汇总作为第三阶段试验结果的一部分提交。
So that's happening with Compass right now. It's psilocybin therapy for treatment-resistant depression. Those trials have just started. And I think the earliest estimate that I heard in a journalistic article was because I don't think Compass would say, or they wouldn't say publicly, something like 2026. 2026. Wow. So MDMA is ahead of psilocybin?
目前，这就是Compass正在进行的事情。这是使用裸盖菇素进行顽固性抑郁症的治疗。这些试验刚刚开始。我在一篇新闻文章中听到的最早预计时间是，因为我认为Compass不会说，或者他们不会公开说，可能是2026年。2026年。哇，所以说MDMA在裸盖菇素之前吗？
Oh, yeah. Yeah, it's quite a few years ahead. And it's more of a not a certainty, but it's very, very strong position with MDMA, whereas the work's only just begun with psilocybin in terms of the phase three trials. But then you have this other situation of, like, however many psychedelic research centers there are now, across the globe.
哦，是的。是的，这还需要好几年。而且MDMA的研究已经取得了很强的优势，尽管这不是绝对确定的，而在psilocybin（迷幻蘑菇成分）方面，三期临床试验才刚刚开始。但与此同时，全球各地已经有许多研究中心在进行关于迷幻药物的研究。
It was nice to, you know, we had the first one in London in 2019. First one in 2019 is 2023 now, and I don't know how many there are. But so much has happened in such a small space of time. Yes, but, you know, all these different indications I've been able to tell you about anorexia and fibromyalgia syndrome, trying to do a trial with a colleague of mine at UCSF in methamphetamine use disorder.
你知道，在2019年，我们在伦敦举办了第一次活动。第一次是在2019年，而现在已经是2023年了。我不知道现在有多少个这样的活动。但在这么短的时间内，发生了很多事情。是的，可是我告诉你，这些年来我们在厌食症和纤维肌痛综合症上得到了不同的指示，还尝试与我在加州大学旧金山分校的同事一起研究甲基苯丙胺使用障碍的试验。
He's got a trial going on in Parkinson's disease and chronic lower back pain and bipolar disorder. I mean, there's so much going on, OCD, almost the full gamut of psychiatric disorders, not schizophrenia. To my knowledge, are being looked at. So there's so much ground, ground, you know, ground swell of activity. And I think these small investigator-led studies, typically they're small because trials are expensive, are going to be reporting positive results. I know what we're seeing, and it will be, you know, for at least four trials, or with really positive results, in very difficult to treat disorders. And that's just us. And I know there's so much elsewhere, addiction disorders as well. You know, in my Johnson's work, obviously, Michael Boagenshoots. So all this compelling ground swell, it's really something. And yet, you know, the system to really make a big breakthrough in terms of licensing is of course, slow.
他正在进行关于帕金森氏症、慢性下背痛和双相情感障碍的试验。我是说，这个领域涉及的范围很广，有强迫症，几乎涵盖了大多数精神疾病，但不包括精神分裂症。据我所知，这些疾病正在被研究。因此，我们可以看到有很多活跃的研究和实验。而且我认为这些由研究人员主导的小规模研究，通常规模小是因为试验成本很高，会带来积极的结果。我知道我们已经看到的至少四个试验在治疗非常难治的疾病方面有了非常积极的结果。这只是我们这边的情况，我也知道其他领域还有很多，比如成瘾性疾病。在例如约翰逊和迈克尔·博根舒特的研究工作中，可以看到这种令人信服的研究热潮确实存在。然而，获得许可的系统要实现重大突破，当然还是很慢的。
And it's so that can frustrate people, but it has to be done properly. Yeah, else we revert back to what happened in the 70s, where there was a lot of interest in psychedelics. It's kind of interesting to me. There was a close juxtaposition of meditation and kind of behavioral approaches to self-directed state change and psychedelics. Meditation kind of made it through the hatch. I mean, there were some years where it was considered kind of counter-culture, woo, magic carpet, weirdo stuff by Western science. But now, I mean, there are tens of thousands, is not an overstatement of quality studies exploring how meditation can provide advantages for the mind and even for mental health. And psychedelics are now catching up, but they used to be close cousins in the cultural framework.
这件事可能会让人感到沮丧，但必须正确实施。否则，我们就会回到70年代的情况，当时人们对迷幻药很感兴趣。我觉得这挺有意思的，当时冥想和一些行为方法用于自我引导的状态改变，与迷幻药紧密地交织在一起。冥想最终通过了检验。我是说，有些年头它被西方科学视为一种反主流文化的东西，仿佛是魔毯或怪异的玩意儿。但现在，有成千上万的优质研究在探索冥想如何对心灵乃至心理健康带来益处。而迷幻药现在也在追赶，但在文化框架中它们曾经是密切的“亲戚”。
But the problem was, I think psychedelics were viewed as making people crazy. And university professors lost their jobs for having discussions like the one that E and I are having right now. And some people went to jail, but mostly people either left academic institutions or lost their jobs, whereas now these are some of the studies of the sort that you are doing and that are taking place at Stanford and Hopkins and elsewhere are some of the greatest magnetic pull for philanthropy for universities. Donors are very interested in supporting these sorts of studies because they and their family members and people they know suffer from psychiatric illness for which the current big pharma approaches simply have not worked.
问题在于，我认为当时迷幻药被视为让人发疯。而且，大学教授因为进行像我和E这样的话题讨论而失去了工作。一些人甚至可能入狱，但大多数人要么离开了学术机构，要么丢掉了工作。与之相对，现在，您正在进行的研究类型以及斯坦福、霍普金斯等地正在进行的研究，成了吸引慈善资助的最大热点。捐赠者非常愿意支持这类研究，因为他们自己、他们的家人或者他们认识的人受到精神疾病的困扰，而当前大型制药公司的治疗方法对他们毫无效果。
So it's sort of interesting to me that what once was seen as kind of poison is now being viewed as a potential therapeutic. It's not just interesting, I think it's hopefully it speaks to the evolution of the human species. People seem to be coming more open-minded about becoming more open-minded. That's right, that's a good one. Yeah, and yet, yeah, there's so much that's happening so fast and there are elements of, it's complexifying the space. There is critique, there's been some bad practice in psychedelic therapy boundary crossing issues that have caused some scandals. That's too bad, isn't it?
所以让我觉得有趣的是，曾经被视为“毒药”的东西，现在被认为可能有治疗作用。这不仅仅是有趣，我希望这反映了人类的发展。人们似乎变得更加开放，愿意接受新事物。对的，这很重要。然而，事情发展得如此之快，这个领域变得更复杂了。这样的快速发展伴随着批评，因为在迷幻治疗中出现了一些糟糕的实践和越界问题，导致一些丑闻。这确实令人遗憾，不是吗？
Yeah, well, I think to the gene therapy, right? It just takes one bad incident. Gene therapy was on a fast track three decades ago and then what, sadly, a child died in a gene therapy trial and it's like shut down gene therapy practically for half a decade and then it slowly started ratcheting up again, gene therapy broadly defined. And now we're in the age of potential directed gene therapy using CRISPR and things of that sort, which makes people, some people cringe and other people are very excited. If you have Huntington's in your family, CRISPR is like the most exciting technology ever because you could potentially eliminate it from your family line going forward, of course.
是的，我想谈谈基因治疗，对吧？只需要一次不好的事件就能带来影响。基因治疗在三十年前曾被快速推进，但不幸的是，一个孩子在基因治疗试验中去世，结果基因治疗几乎被叫停了半个十年，然后才慢慢开始重新发展。现在，我们进入了使用CRISPR等技术进行定向基因治疗的时代，这让一些人感到担忧，也让另一些人感到非常兴奋。如果你的家族里有亨廷顿舞蹈症，CRISPR技术可能是最令人激动的技术，因为它可以让你的家族未来摆脱这种疾病。
So I just really hope that we can be balanced as this all plays out because it could go similar way, given the stigma, given the history that people be very twitchy with some isolated incidents and over generalize them perhaps in a sense, shining a light on them, I think is important that that has happened recently is important because it really drills home how important it is that this work be done right and what the necessary safeguards and standards should be. Yeah, it won't be an easy road forwards, but we've got to hope that it succeeds because current treatments, people talk about the mental health crisis and to your point earlier about anorexia rates, it's not always actually the case when you look at the epidemiology, when you look at the data that you see a big inflection in diagnoses or cases of psychiatric illness, I would say it's more that the treatments haven't moved, they haven't really progressed, they haven't got any better since the 1950s more or less and new drugs have been more of the same.
所以我真的希望我们在这件事情的发展过程中能够保持平衡，因为鉴于偏见和历史，人们可能会对一些孤立事件过分敏感，并且可能会过度泛化。最近，某些事件被突出出来是很重要的，因为这进一步强调了这个工作的正确执行及其必要的保障和标准的重要性。是的，这将不是一条容易的路，但我们必须希望它能够成功，因为当前的治疗并没有改善，尽管人们谈论心理健康危机以及你之前提到的厌食症发生率问题，但如果我们看流行病学和数据，实际上并没有看到精神疾病诊断或病例的大幅增加。我认为更多的问题是在于治疗方法并没有进步，自1950年代以来没有真正改善，新的药物也不过是旧药的翻版。
So there haven't been any paradigm shifts and that's why I get a little impassioned when I talk about psychedelic therapy and that point that this is something different, it's not a drug every day, that system, it's not cutting it. We really want to keep on with that system? Sure, not everyone will want to trip and that will terrify some people so much that they'll just want to be on their lexapro or a non-psychedelic psychedelic or whatever and of course you should be allowed to have those options, of course, and the more options are better. But I think there is great value in really understanding what psychedelic therapy is and I think when you do, you realize that it is a major paradigm challenge on many levels and the fact that it's different might be its greatest appeal at the moment, I think.
所以，这还没有出现任何范式转变，这就是为什么每当我谈到迷幻疗法时会有些激动，因为这是与以往不同的东西。它不是每天都得服用的药物，而现有的系统也无法解决问题。我们真的想继续维持这个系统吗？当然，不是所有人都愿意尝试迷幻体验，有些人会感到如此害怕，以至于宁愿继续服用乐瑞卡或者其他非迷幻药物的替代品。当然，我们应该有选择这些的自由，而且选项越多越好。但我认为，真正理解迷幻疗法的价值是很重要的，我相信当你明白这一点时，你会发现这是对许多层面的重大范式挑战，而它的不同之处可能正是其目前最大的吸引力。
Well, I am certainly grateful for your passion for the potential for psychedelics to be added to the array of potential treatments and I really also appreciate how much you put it in there alongside the other treatments. Maybe even combination with other treatments as opposed to saying this is the thing that's gonna cure everything and yet the passion that you have for this potential paradigm shift, the one that really appears to be happening at the level of clinical data now is so important. So I want to extend a voice of gratitude for that and for the work that you're doing. I mean, I've been outside of this field but as a neuroscientist, I've been paying careful attention to it really for the last five, seven years or so and it's abundantly clear that it is a small group of individuals who are really thinking in terms of how the system works now and what needs to be done in order to change the system for the better, like yourself, that are really the driving force behind this new movement or paradigm shift that without question is going to lead to improvements in mental health and physical health outcomes. So I just want to say thank you for that.
我非常感谢您对将迷幻药物纳入潜在治疗方法的热情，同时我也很感激您能将其与其他治疗方法一同考虑，甚至可能与其他治疗结合使用，而不仅仅是说这可以治愈一切。您对这种可能的范式转变表现出的热情是非常重要的，这种转变现在在临床数据上似乎确实正在发生。因此，我想对您所做的工作表示感谢。虽然我不在这个领域，但作为一个神经科学家，我在过去的五到七年里一直在仔细关注这一领域。可以清楚地看到，正是像您这样的一小部分人，正在思考现有系统的运作方式，以及需要采取什么措施来改进系统，这些人是真正推动这一新运动或范式转变的力量，而这无疑将改善心理健康和身体健康的结果。所以我只想对您表示感谢。
Also thank you so much for joining us today to share this immense knowledge set about the history of psychedelics, what they are, what they aren't. Their clinical applications as seen in your laboratory and other laboratories. I'm sure people already noticed this but you're incredibly generous in terms of attribution and also in your caution about explaining how some of the results in particular on anorexia fibromyalgia are perhaps preliminary but very exciting. They're not published yet anyway, we wouldn't call them preliminary. And also for touching on mechanism that is not just about people feel better but pointed to some potential underlying mechanisms in terms of connectivity changes and on and on. So thank you so much for your time today. Thank you for the work that you're doing and thank you for the work that is sure to continue.
非常感谢您今天加入我们，分享关于迷幻药历史的丰富知识，包括它们是什么，不是什么。以及您实验室和其他实验室中看到的临床应用。我相信大家已经注意到了，您在引用方面非常慷慨，同时在解释某些结果，特别是在厌食症和纤维肌痛方面时非常谨慎，尽管这些结果或许还只是初步的，但已经非常令人兴奋。它们尚未发表，不过我们也不称之为初步研究。此外，您还谈到了不仅让人感觉更好的一些潜在机制，尤其是在连接性变化方面。再次感谢您今天的时间，感谢您所做的工作，并感谢您将继续进行的研究。
We will provide links to studies in your laboratory, links to your laboratory so people can learn more and support in the ways that they deem appropriate for them but just thank you, thank you, thank you. Such important work you're doing Robin. Thank you, Andrew, it's been a pleasure. Thank you for joining me today for my discussion with Dr. Robin Carhartt Harris. I hope you found it to be as informative about the science and clinical uses of psychedelics as I did. If you'd like to learn more about Dr. Carhartt Harris' research or support that research or inquire into being a research subject in one of his laboratory studies, please see the links in the show note captions.
我们将提供您的实验室相关研究的链接，以及实验室的链接，以便人们可以了解更多信息，并以他们认为合适的方式给予支持。谢谢，谢谢，谢谢。Robin，您正在做的工作非常重要。Andrew，谢谢您，真的很荣幸。感谢您今天加入我和Robin Carhartt Harris博士的讨论。我希望您能像我一样获取有关迷幻药科学和临床应用的信息。如果您想了解更多关于Carhartt Harris博士的研究，支持他的研究，或有兴趣成为他实验室研究的受试者，请查看节目说明中的链接。
In addition, please see the links to his Twitter account and other social media accounts also in the show note captions. Also in the show note captions, you'll find a link to Dr. Carhartt Harris' Twitter account where he regularly posts about new advances in the field of psychedelic science. If you're learning from Endor and join this podcast, please subscribe to our YouTube channel. That's a terrific zero-cost way to support us. In addition, please subscribe to the podcast on both Spotify and Apple. And on both Spotify and Apple, you can also leave us up to a five-star review.
此外，请查看节目备注中的链接，其中包含他在 Twitter 和其他社交媒体账户的链接。在节目备注中，您还可以找到 Dr. Carhartt Harris 的 Twitter 账户链接，他经常在上面发布关于迷幻科学领域的最新进展。如果您从 Endor 学习并喜欢这个播客，请订阅我们的 YouTube 频道。这是支持我们的一个绝佳零成本方式。此外，请在 Spotify 和 Apple 上订阅我们的播客。在 Spotify 和 Apple 上，您还可以给我们留下最高五颗星的评价。
Please also check out the sponsors mentioned at the beginning and throughout today's episode. That's the best way to support this podcast. If you have questions for me or comments about the podcast or suggestions about guests you'd like me to include on the Heuberman Lab podcast, please put those in the comment section on YouTube. I do read all the comments.
请查看在今天节目开头和整个过程中提到的赞助商。这是支持本播客的最佳方式。如果您对我有任何疑问、对播客有任何评论，或者有关于希望我邀请哪些嘉宾到Huberman Lab播客的建议，请在YouTube的评论区留下。我会阅读所有评论。
Not so much on today's episode, but on many previous episodes of the Heuberman Lab podcast, we discuss supplements. While supplements aren't necessary for everybody, many people derive tremendous benefit from them for things like improving sleep, hormone support, as well as focus. The Heuberman Lab podcast is proud to have partnered with Momentus Supplements. If you'd like to see the supplements discussed on the Heuberman Lab podcast, you can go to LivMomentus spelled O-U-S, so it's LivMomentus.com slash Heuberman.
在今天的节目中不太涉及，但在之前的许多集《Heuberman Lab》播客中，我们都有讨论过保健品。保健品并不是每个人都必需的，但很多人在改善睡眠、激素支持和提升专注力等方面从中得到了极大的好处。《Heuberman Lab》播客很荣幸能与Momentus Supplements合作。如果你想查看在《Heuberman Lab》播客中讨论过的保健品，可以访问LivMomentus.com/Heuberman，注意Momentus是M-O-M-E-N-T-O-U-S的拼写。
If you're not already following me on social media, I am Heuberman Lab on all platforms. So that's Facebook, LinkedIn, Twitter, and Instagram. And on all those platforms, I post about science and science-related tools, some of which overlaps with the content of the Heuberman Lab podcast, but much of which is distinct from the content on the Heuberman Lab podcast. So again, it's Heuberman Lab on all social media platforms.
如果你还没有在社交媒体上关注我，我在所有平台上的用户名都是 Heuberman Lab，包括 Facebook、LinkedIn、Twitter 和 Instagram。在这些平台上，我发布关于科学和科学相关工具的内容，其中一些和 Heuberman Lab 播客的内容有重叠，但很多内容是独立于播客的。再次提醒，我在所有社交媒体平台上的用户名都是 Heuberman Lab。
If you haven't already subscribed to our neural network newsletter, the neural network newsletter is a monthly newsletter in which we distill down the essential points of particular podcasts, and we list out toolkits, such as toolkits for sleep, toolkits for neuroplasticity, toolkits for optimizing dopamine, and on and on, all of which is available at zero cost. You simply go to HeubermanLab.com, go to the menu, scroll down a newsletter, and supply your email, and we do not share your email with anybody.
如果您还没有订阅我们的神经网络通讯，我建议您订阅。我们的神经网络通讯是每月一期的通讯，我们会提炼出特定播客的要点，并列出各种工具包，比如用于改善睡眠的工具包、神经可塑性工具包、优化多巴胺的工具包等等。所有这些内容都是免费提供的。您只需要访问 HeubermanLab.com，进入菜单，向下滚动找到通讯选项，输入您的电子邮箱即可订阅。我们保证不会与任何人分享您的邮箱信息。
Thank you once again for joining me for today's discussion with Dr. Robin Carthart-Harris, and last, but certainly not least, thank you for your interest in science.
再次感谢您参与我与罗宾·卡特哈特-哈里斯博士的讨论，最后但同样重要的是，感谢您对科学的关注。