Book Review – How To Change Your Mind

I first heard about Michael Pollan’s new book about six months ago, but it wasn’t until I was reading it that I remembered this wasn’t the first time I had read his writings on the subject. A few years ago in a New Yorker article entitled ‘The Trip Treatment’, he talked about the beginnings of a resurgence into scientific and clinical research involving psychedelic compounds. Treading lightly on one of the more sensitive and pre-charged emotional areas in research, initial studies from places like Johns Hopkins University and Imperial College London had shown unprecedented effectiveness of psychedelic-assisted psychotherapy in clinics trials involving addiction and end of life anxiety for terminal cancer patients. Now, several years later, Pollan has dived headfirst down the rabbit hole and emerged with a fascinating tale that is half science history / half trip log about How to Change Your Mind.

The book is divided broadly into three sections:

1) The discovery of psychedelics and their use in research before the 1970s

2) Pollan’s trip logs of three different sessions with underground guides involving psilocybin (the active ingredient in “magic mushrooms”), LSD, and 5-Me-O-DMT (or “the toad”, named for the dried venom of the Sonoran desert toad that is smoked).

3) Current research being conducted during psychedelics’ resurgence.

Here are a few interesting takeaways that I gathered:

One of the first introductions of psychedelics into popular knowledge in the US came until 1957 when R. Gordon Wasson went to a remote village in Mexico to write a cover article on the elusive “magic mushroom” for Life magazine. While this tradition was widespread before the arrival of Europeans, it had been driven underground and was practiced in select few places. Not long before, LSD had been first synthesized in Switzerland and the pharmaceutical company that owned the rights hoped to find a clinical use for it. So they offered unlimited free LSD to any researchers looking to use it in research. Pretty soon, combined with Hollywood stars like Carey Grant reporting how it changed his life and young women had never found him so attractive, the Beaver Cleaver society of the early 1960s was transfixed by the promise of these miracle compounds.

Research was widespread and promising, but along came a few controversial figures, perhaps none more than the Harvard professor Timothy Leary. I’ll let you read the book for yourself as the full story merits a longer format, but suffice it to say that the ‘give everyone this sacrament of the gods’ movement timing with increasing troubles in Vietnam didn’t mesh well with the government, and soon these compounds were made illegal and conducting further research was scientific suppuku.

Pollan’s accounts of his guide-supervised trips help bring words to an experience that most of the patients from clinical trials have a hard time describing. Sometimes euphoric, sometimes ‘strapped to a rocket’ terrifying, they give a fascinating and nuanced portrayal of a charged subject. My favorite part was during his psilocybin trip.

There is an illusion called the rotating mask test in which a computer rendered 3D mask slowly turns.

Because our brains are so accustomed to seeing a face as convex, we immediately flip the image in our minds when we see the concave side. Apparently young children, who do not have the same wealthy of convex face memories, are one group who don’t experience this particular phenomenon. The other, according to a scientist with whom Pollan has previously spoken, are people under the influence of psychedelics. So before consuming the psilocybin-containing mushroom, he cued the video up on his computer to test the theory.

Before we started, I had cued up the video on my laptop, and now I clicked to run it. The mask on the screen, gray against a black ground, was clearly the product of a computer animation and was uncannily consistent with the visual style of the world I’d been in. (During my integration session with Mary the next day, she suggested that it might have been this image on my laptop that had conjured the computer world and trapped me in it. Could there be a better demonstration of the power of set and setting?) As the convex face rotated to reveal its concave back, the mask popped back out, only a bit more slowly than it did before I ate the mushroom. Evidently, Bayesian inference was still operational in my brain. I’d try again later.

Before I put on my eyeshade, I attempted to conduct the rotation mask test a second time…and it was a complete bust, neither confirming nor disproving the hypothesis. As the mask began to rotate, gradually bringing its back side into view, the whole thing dissolved into a gray jelly that slide down the screen of my laptop before I could determine whether the melting mask I was watching was convex or concave. So much for conducting psychological experiments while tripping.

The book finishes by investigating how current research using sophisticated equipment like functional magnetic resonance imaging (fMRI) imaging technology is discovering that the compounds bind to the 5-HT2A serotonin receptor and calm the default mode network: the default patterns that broadly define our ego and run much of our daily lives. (Interestingly, the fact that LSD works at such small concentrations directly led to research seeking how compounds work in the brain and the discovery of serotonin and the SSRI class of antidepressants.) This same network is interestingly also quieted in much the same way in experiences meditators. The compounds provide an injection of noise to the system that allows patterns that have been difficult to break (e.g. addictions, depressive thoughts, obsessions, post-traumatic flashbacks) to be revisited without the same emotionally charged nature and new pathways to be constructed.

The scientists with whom Pollan spoke are incredibly optimistic about the findings, as is the US Federal Drug Administration, which has green lit priority status to psilocybin and MDMA for a fast-track clinical trial process. But there is also trepidation based on still very real fears in the cultural zeitgeist left over from the 1970s. They emphasize that these are incredibly powerful compounds that, while not having any physical toxicity, should not be taken lightly. Additionally, they make a point to stress that they are not giving people psychedelics, but conducting psychedelic-assisted psychotherapy. “Set” (the person’s current mindset) and “setting” (where the compounds are being taken) are well known factors in contributing to how a trip goes, and the extensive before and after sessions with a therapist appear to greatly contribute to the efficacy of these treatments. So while there is a ton of optimism for new solutions to notoriously treatment-resistant and dangerous conditions (i.e. opioid addiction), the members of the community choose their words carefully and tread lightly to avoid another Leary-esque backlash.

I’ll conclude by just saying that I think Michael Pollan was also the perfect person to write this book. A serious academic with strong journalistic credentials, he also has a dash hippy that may not seem surprising for a Berkeley professor. His engrossing writing style also lends itself well to the “I’m a curious beginner wanting to learn about a subject, so come with me on this adventure as we learn together” feel of many of his books. This particular subject being one of the most triggering ones outside of religion and politics that I can think of (or maybe even more so), the choice of narrator and tone were particularly important. As a scientist, I’m fascinated by the investigation into the physiological mechanisms that make us tick. As a human, I’m hopeful that some of these compounds can soon be used in therapy to treat patients who have long been suffering with no good medical option. We live in scary times and this can be a scary subject, but I encourage you to give this book a read. It might just change your mind.

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