Episode 21: The Psychedelic Renaissance with Dr. Ingmar Gorman and Dr. Elizabeth Nielson
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"The word psychedelic was coined by Humphry Osmond. Psyche comes from the Greek word for spirit or soul, and delic means manifesting. So psychedelic means manifesting the mind."
In this episode of the Mindspace podcast, Dr. Joe speaks with Dr. Elizabeth Nielson and Dr. Ingmar Gorman on the renaissance of psychedelics in western medicine and culture. Psychedelic-assisted psychotherapy has the potential to transform how a wide range of mental health problems are treated. Elizabeth and Ingmar are both at the forefront of this renaissance.
Elizabeth is a clinical psychologist specializing in addictive and mood disorders. She is the Director of Education and Training for the Psychedelic Education and Continuing Care Program at the Center for Optimal Living. She is also involved as a researcher and therapist on studies of psilocybin and MDMA, most notably with Multidisciplinary Association for Psychedelic Studies (MAPS) the Experimental Therapeutics Research Laboratory at NYU Langone School of Medicine.
Ingmar is also a clinical psychologist. He works with populations who have had experiences with psychedelics and other psychoactive compounds. He is the Director of the Psychedelic Education and Continuing Care Program at the Centre for Optimal Living. He is the site co-principal Investigator and therapist on a MAPS Phase 3 clinical trial MDMA for post-traumatic stress disorder. And he is an NIH-funded fellow at NYU and a board member of Horizons Media.
In this episode Joe, Elizabeth, and Ingmar discussed:
The history of psychedelics and how we arrived at the psychedelic renaissance
Current science and applications of psychedelics
The subjective experience of these compounds and their clinical action
The role of mindfulness in psychedelic-assisted therapy
Future directions in this field
Mindspace will be hosting Ingmar and Elizabeth in Montreal on Friday, November 1st. They will be offering a brief presentation and Q&A for the public. And on Saturday and Sunday, they will be leading an introductory workshop on psychedelic-assisted psychotherapy for healthcare professionals. You can register and find more information here.
More information can be found on Dr. Ingmar Gorman on his site and Dr. Elizabeth Neilson here.
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Here are some highlights from the interview:
It really strikes me that probably the most important factor for why we're here talking about this is that the science has really started to get traction on this issue.
So I wonder if one of you could just give a high level summary of the most developed scientific literature.
Ingmar: Generally the studies that have been completed or are ongoing are in what's called Phase 2 research. These are studies with relatively small sample sizes of about 20 participants. And this is where new indications are explored. Indication meaning ailment.
So this is where an organization will say, 'Well, let's look at the potential of psilocybin to treat smoking cessation.' And a small study will be conducted. And so there are quite a few, maybe a dozen, maybe half a dozen different indications that have been looked at in these trials. And there are more and more of these Phase 2 trials that are beginning.
Phase 3 trials are ones where which would permit a substance like MDMA or psilocybin to become a prescribable medicine. And this is where you're looking at sample sizes of about 200 to 300 participants.
Right now you see Phase 3 trials with MDMA-assisted psychotherapy for PTSD, and what is very likely to be initiating soon is psilocybin for treatment resistant depression and psilocybin for alcohol use disorder.
There are also new requests for funding to look at new indications like eating disorders or opioid use disorder. And there are many, many more.
The vast majority of these studies are funded by donors. So the amount of money that's been raised through donors has been substantial enough to get us to this point of being able to do Phase 3 research. But it's still a drop in the bucket when compared to any kind of pharmaceutical study.
I've also heard about the work around end of life anxiety. Is that research fairly well developed?
Elizabeth: So I think what you're referring to there would be what's commonly known as the cancer trial. Which was a study conducted at both Johns Hopkins and NYU, published in 2016.
It wasn't for end of life specifically. It was for people who were experiencing continued distress after cancer diagnosis. So some people were in remission, but were continuing to experience severe anxiety around the return of cancer. While others were closer to the end of life. It actually built on substantial literature about the use of psilocybin and LSD in the treatment of end of life anxiety that had been developed in the 1950s and 60s.
But that particular study wasn't restricted to people that had any kind of terminal diagnosis. It did show a really great sustained reduction in anxiety and emotional distress for the participants.
Are there any other conditions that you want to mention on this list?
Elizabeth: Well, in addition to research on the use of psilocybin in the treatment of alcohol use disorder that's currently ongoing, there are also studies on the psilocybin assisted treatment for psychostimulant cocaine use disorder.
There was also a study of psilocybin-assisted treatment for smoking cessation that was conducted at Johns Hopkins. Smoking is a notoriously difficult habit to break. And this study again showed some really substantial gains, much much clearer positive results than some of the approved treatments that we have.
So I believe that not just for alcohol use, we're going to see psilocybin become, hopefully, a front line treatment, if it's fully approved and fully studied and documented, for the treatment of addictions in the near future.
Dr. Joe Flanders is the founder and director of MindSpace. He obtained his PhD in Clinical Psychology from McGill University and completed a postdoctoral fellowship at the University of Wisconsin–Madison. Dr. Flanders is an assistant professor in the McGill University Psychology Department