How Psychedelics Work
10:18 minutes
So how do psychedelics work?
How are they helping people recover from mental illness and addiction with such high success rates to receive breakthrough therapy status from the FDA? I am going to explain how psychedelics work using mostly analogy, keeping the science-speak to a minimum.
The human body is a highly intelligent, fleshy computer.
From the day we are born, and up until this moment, we are learning and adapting to the environment around us, essentially creating unique “programming” for each one of us fleshy computers.
Things that we repeatedly experience become automated; things like tying our shoes or driving a car are obvious examples of this. We don’t need to think at all about what our hands are doing with our shoelaces or how to put our car in reverse to back out of a parking spot. And it’s helpful that they become automated. We don’t want to spend the same amount of energy tying our shoes everyday as we did when we were six years old. However, it’s not just our motor skills that become automated. It is also how we view ourselves, how we relate to others, and our perception of the world we live in.
Some of what we learn creates automated behaviors and thoughts that are healthy for us, and well, some of what we learn doesn’t. Big, obvious traumatic experiences do impact us, but the daily things that weren’t great are often equally, if not more, impactful. For example, having a parent who regularly criticizes you about your appearance or behavior, or is emotionally immature, can create just as harmful programming as being in a severe car accident or witnessing an extremely violent act.
The earlier harmful programming is put in place, the harder it is to change, which is one reason why folks with childhood trauma, minority stigma, and intergenerational trauma have the highest incidence of illness and treatment resistance. Just like a dirt road with deep tire marks, the more we repeat a thought pattern or behavior, the deeper the grooves get established within our brain and nervous system, making change more difficult. The trickiest part about this early programming, is that it is so old and automated, it is not even in our conscious awareness. It’s a biological truth buried deep in our body.
To make matters even more complicated, our physiology was built for an era we no longer live in. For 99% of human history, our species lived as foraging nomads living in small tribes. The bodies we’ve inherited actively resist change because they want to keep us safe, which was wonderful and necessary for that time, but not so helpful now. So even when we can identify issues we’d like to address in our thought and behavior patterns, it is very difficult to change.
Let’s call back the definition of psychedelic - “to make the mind/soul visible” If we have buried programming in our bodies (aka our fleshy computers) does this mean that psychedelics can help us see what’s not normally seen? Precisely.
Psychedelic medicine can help us not only identify unhelpful programming (thought and behavior patterns) but they also help us to make changes more easily.
Each psychedelic medicine works a bit differently but Peyote, San Pedro, Ayahuasca, Psilocybin, 5-Meo-DMT, LSD, and Ketamine all act to drastically reduce activity in a specific network in the brain called the Default Mode Network (DMN). The default mode network is like a complex interstate system that we have built over our lives that connects several different regions of our brain. Operating together, they create the components that make up our five major aspects of our sense of self:
Self-reflection and Personal Identity - how we think about ourselves, our values, and our experiences
Memory Consolidation - how we consolidate and view memories of ourselves, in order to learn from past mistakes and successes
Social Cognition and Empathy - how we understand other people’s thoughts and feelings, which is mostly utilized in social interactions
Creativity - how we solve problems and come up with new ideas
Future planning - how we imagine future scenarios and plan for future events; both to anticipate challenges and opportunities
So what happens when the default mode network is reduced? Do we disappear? Not quite.
While some people may experience something called an “ego death” where they feel they are a part of something larger, for a lot of people it acts like a hard reboot on their computer. When the default mode network reduces, there is an increase in something called global brain connectivity. All of these other parts of the brain that normally don’t get to talk to each other because the DMN is running the show, finally get to talk. This creates a window of freedom from some pretty intense, long standing programming, and allows insights into hidden feelings, motivations, and sometimes it even uncovers repressed memories.
This window of time ranges depending on the medicine, but no matter the length, it is typically impactful. The insights gained in this time, as well as the memory of freedom from our rigid ways of being, can be life changing. Mystical experiences can also occur. They vary widely and are unique to each individual, but tend to leave people feeling different about themselves and the world around them. Science cannot yet explain these mystical experiences, but people who have them, tend to have higher treatment success rates.
MDMA was the only psychedelic that I didn’t list in the group impacting the DMN.
When MDMA is ingested in a therapeutic context, it does several things:
Reduces Fear & Anxiety - this occurs from an increased release of serotonin into the system (a neurotransmitter that regulates mood and overall well-being) and also by reducing activity in the part of the brain called the amygdala - where fear and emotional responses are processed.
Enhances Emotional Connection - this happens due to a boost in oxytocin - a bonding and love hormone - that helps to foster trust, empathy, and social connection.
Facilitates the Reprocessing of Trauma - all people, and especially people with PTSD, can have issues with the part of the brain called the hippocampus, which is involved in memory formation and emotional experiences. MDMA helps to regulate activity in this part of the brain and allows memories that have gotten stuck as a present-day threats, to move to the past. This is aided by a release of dopamine - a “reward” neurotransmitter that signals feelings of pleasure and well-being. This helps ease the reprocessing of past traumas.
All of the psychedelics I’ve mentioned also induce something called neuroplasticity - the brain and nervous system’s ability to form new neural connections and restructure existing ones.
This gives our fleshy-computers a super charged boost in developing and maintaining new thought and behavioral patterns within our brain and body. Heightened neuroplasticity exists in windows of a few days to a few weeks after working with psychedelic medicine, which is why integration is so important (more on that later.)
Please keep in mind that this is a high level overview of what we understand so far. The research is relatively new, and is likely just the tip of the iceberg in our understanding of how psychedelic medicine works. Now let’s move onto a topic that doesn’t require me to use the word “neurotransmitter” - how psychedelic feel.
