#478 — The Psychedelic Mind

Sam Harris speaks with Robin Carhart-Harris about the current landscape of psychedelic science and clinical trials. They discuss the market correction following the initial hype, regulatory hurdles like the FDA's denial of MDMA therapy, and the future of psilocybin research.

Robin Carhart-Harris discusses the FDA's denial of the MAPS MDMA petition and its implications for the psychedelic medicine market. He contrasts the advocacy-led approach of MAPS with more traditional clinical models, emphasizing the essential role of therapeutic context in psychedelic treatments.

Robin Carhart-Harris and Sam Harris discuss the critical role of psychological support, preparation, and integration in psychedelic therapy. They address the risks of therapist dogmatism, particularly regarding the potential for false recovered memories in highly suggestible states.

Sam Harris and Robin Carhart-Harris discuss the complexities of recovered memories during psychedelic sessions. They share clinical cases of psilocybin therapy, illustrating both the risks of psychological turbulence and the potential for profound emotional breakthroughs.

Robin Carhart-Harris discusses the highly consistent and positive clinical trial results of psychedelic therapies, despite some challenges in settings like MRI scanners. He details various trials for psilocybin, MDMA, and LSD targeting conditions like anorexia, PTSD, and anxiety, while also highlighting risk factors for individuals with personality disorders.

Sam Harris and Robin Carhart-Harris discuss the clinical risks of psychedelics, noting that trials often screen out individuals with histories of psychosis or borderline personality disorder. They contrast the unpredictable, ego-dissolving nature of classic psychedelics like LSD and psilocybin with the more stable, relational, and 'heart-opening' effects of MDMA.