Psychedelic Insights From One of the Earliest Researchers – Dr. Charles Grob – HPP 103
For decades, Dr. Charles Grob has been researching applications of MDMA, psilocybin, and ayahuasca for a variety of human conditions including end of life anxiety, PTSD, depression, addiction, and more. His contributions have significantly shaped what we know about psychedelics today and how much of an impact it has on our patients.
In today’s episode, we hear about the early challenges in psychedelic research, and learn about Dr. Grob’s perspectives about what elements of a psychedelic-assisted therapy session are essential. We explore the exciting new developments at the intersection between the medical and the spiritual dimensions of healing.
Early Fascination in Psychedelics – 03:00
“And one night at three in the morning, staring at EEG tracings and reading, I had this epiphany that I knew what I wanted to do. I wanted to study psychedelics. So I told my father who was a physician, and I explained why I thought psychedelics are so fascinating, you know, they really teach us so much about the human condition, then there are these very novel intriguing treatment models that seem to work for people for whom conventional treatments don’t work”
Rediscovering Psychedelics – 10:22
“And that would have been around 1980 or so, the summer of 1980, and I found a bookstore near my school that had a section on psychedelics. So it’s like, another discovery and new books by Stan Grof had just come out, LSD Psychotherapy. Lester Grinspoon’s book, Psychedelics Rediscovered, came out in ‘79. That was a very important book. Rediscovering the literature again pulled me in”
Struggling For Approval with The IRB – 14:14
“I presented a protocol on MDMA. They didn’t know what to do with it. So they did the expected, they shot it down very quickly. So I spoke with the head of the IRB who suggested that I attend the next meeting, and describe what the rationale of the study was, what we plan to do, safety parameters and answer whatever questions or concerns they might have”
A Look into What Psychedelics Brings – 20:04
“And then you’re moving even outside of the realm of psychiatric treatment, would be used in a religious-spiritual context. I spent some time in Brazil in the 90s and early 2000s studying one of the ayahuasca churches on the other edge of town. And I was very impressed with how they had incorporated, how they had evolved and the kind of ritual they had and how it facilitated within the context of their culture very, very positive outcomes of people who were joining their churches”
Easy Accessibility of Psychedelics in The Future – 25:53
“So in that context, for sure. The work of Willis Harmon dating back to the mid-60s was James Fadiman, looking at how these compounds may facilitate creative problem solving. They had some very intriguing early data—So I think there’s certainly potential. The rate at which it will become feasible to explore this, who knows? A lot of it will depend on how obviously the use and treatment will be rolled out initially”
Set And Setting Is Critical – 28:35
“I think not only did the early pioneer researchers understand the value of set and setting, but if you look at indigenous structures, how they incorporated plant hallucinogens, it was all about set and setting. And the observation consistently over time has been the better you can control set and setting, the better the outcomes”
Dr. Will Van Derveer, Keith Kurlander, Dr. Charles Grob
Dr. Charles Grob 00:00
Other areas that psychiatry doesn’t do well, eating disorders, that could be a challenging condition or a psychedelic model, and yet, our conventional models more often than not fail. So again, another area that we should be looking into is the chronic PTSD work often very tough attractable disturbance maps his work with MDMA has been quite impressive.
Dr. Will Van Derveer 00:30
Thank you for joining us for The Higher Practice Podcast. I’m Dr. Will Van Derveer, with Keith Kurlander and this is the podcast where we explore what it takes to achieve optimal mental health. One aspect of optimal mental health which has been gaining a lot of momentum recently in the popular press, as well as in research halls, institutional review boards, protocols that are being carried out across the country with various substances is the new development of psychedelic assisted psychotherapy. Today’s guest Dr. Charles Grob is a true pioneer and original leader and thinker in this movement, who has been doing psychedelic research for several decades. Dr. Charles Grob is a Lundqvist Institute investigator and Professor of Psychiatry and bioBehavioral Sciences at the UCLA School of Medicine, and he is also the Director of the Division of Child and Adolescent Psychiatry at Harbor UCLA Medical Center. Dr. Grob and his colleagues have conducted research for many years into the medical uses of various psychedelics. More recently, his work has focused on psilocybin research his 2011 paper in the archives of general psychiatry, a pilot study of psilocybin treatment for anxiety in patients with advanced stage cancer showed that psilocybin significantly decreased existential distress of people nearing death, improving their quality of life, in May of 2021. Just last month, Dr. Grob published along with CO editor Jim Grigsby, the new medical textbook called Handbook of medical hallucinogens, the first medical textbook on the topic of medical applications for psychedelics. We’re especially honored that Dr. Charlie Grob is also going to be teaching in our new psychedelic assisted therapy program. Let’s welcome Dr. Grob to the show. Welcome Dr. Charles Grob to the show.
Dr. Charles Grob 02:25
It’s good to see you.
Dr. Will Van Derveer 02:27
It’s wonderful to have you. You’re a legend in the field. And when people talk about standing on the shoulders of giants, I think about people like you in this field who have been in it for how long four decades.
Dr. Charles Grob 02:40
It’s been a while. It’s been quite a while, I guess our first efforts at a research study was over 30 years ago. I had a strong interest in even predating that really got back to the early 70s when I stumbled across the psychiatric and medical literature on psychedelics and was just fascinated.
Dr. Will Van Derveer 03:00
Wow. And so were you in medical school at that time in the early 70s? Or what was it?
Dr. Charles Grob 03:06
Yeah, well, in the early 70s, when I kind of made this unexpected discovery I had left college and had traveled back to New York had not yet gone back to school and wasn’t sure what I wanted to do. And ended up getting a job as a research assistant in a sleep dream research study in Brooklyn at my Modernities Medical Center, the dream Research Laboratory. And to stay up all night I needed to read and one of the investigators, Stanley Krippner, who’s still around, he’s still a senior professor at Saybrook Institute in San Francisco and he was on my monitor. He’s nearly seven days one of the creators of this study, he had a great library in his office and everything that had been written on psychedelics today, books, articles and various kinds of literature’s and he allowed me to borrow and so this is how I would spend my nights reading the history of psychedelics. And one night at three in the morning, I had this staring at EEG tracings and reading, I had this epiphany that I knew what I wanted to do. I wanted to study psychedelics. So I told my father who was a physician, and I explained why I thought psychedelics are so fascinating, you know, they really teach us so much about the human condition, then there are these very novel intriguing treatment models that seem to work for people for whom conventional treatments don’t work. So I laid all this out and he said, Well, son, there may be something to what you say, but no one will listen to you unless you get your credentials. So then I knew I had to go back to school, which I did. You know, I did my pre med at Columbia and then I went to medical school and I started medical school in 75. And by then psychedelic research had pretty much disappeared. And in fact, even discussion of the topic was virtually taboo. We had an assignment, I think it’s second year medical school, this would have been the fall of 76. And an assignment to each of us: go through the literature, medical literature, come up with a research article and distill the article down and present, what was done and what the findings were and what the issues and implications were to the class, I found. Stan Groff 1973 article in the International Journal of pharmaco, psychiatry describing his work at Spring Grove, Maryland, treating people with terminal cancer related anxiety and depression with either LSD or DPT and intramuscular triptomy, and it was a very moving article. I really, I was very much inspired by it. And so I created a presentation out of the article, I think I made a pretty succinct and got all the right points across and presented it to my class. Now the way to step back waited for comments or questions, and there was Zilch, nothing sound you could hear a pin drop was, no one wanted to talk about this topic. And I realized, whoa, I gotta keep my interest to myself.
Keith Kurlander 06:08
Well, you this time a young person of like the late 60s, early 70s. Were you actually having experiences with psychedelics or was this purely academic for you?
Dr. Charles Grob 06:18
I went off to college in ’68 and I went to a progressive school in the Midwest, Oberlin College. And by the spring of freshman year, I was really struck by the stories I was hearing from some of my friends who had had experience with psychedelics. And I became very intrigued, even though previously, I had had no interest in speaking up. But towards spring or freshman year, I had a couple of experiences more than next fall. And then I quickly realized that while these were fascinating compounds, and I was having very powerful, meaningful experiences, taking them within the context of a college dormitory was too unpredictable. And I realized back then you needed controls over this, you needed people needed to be in a protective bubble. And that you couldn’t always guarantee that in a dormitory full of 18 and 19 year old kids.
Keith Kurlander 07:15
It’s pretty amazing that you had that awareness, at such a young age, I did not have that awareness. It was amazing that you had that awareness starting to show up and you were like, Hey, this is something here. But we need to contain this in some way and get us out of it.
Dr. Charles Grob 07:30
That’s right. I got bit by the bug. And I was fascinated with these compounds. Where did they come from? How were they discovered? How have they been utilized? How are they used by indigenous people, which was a real revelation to have heard that? How were they examined by that Pioneer Generation of researchers and the 50s and 60s, so I was very interested. And when I came across Stanley scriveners library, it was, wow, I’d hit paper. This is fascinating material. So I stay up every night just devouring all these articles and books and really immerse myself in what was known about psychedelics at that point. At times, I always had the dream lab and 72 and 73.
Dr. Will Van Derveer 08:12
Thank you for sharing the story of your presentation of Stan’s research article. It’s a fantastic story. I am curious after that sort of fell flat in terms of the level of interest in the audience. And you said you had to kind of keep it to yourself. Did your interest kind of go underground for you or become more private?
Dr. Charles Grob 08:32
Somewhat, I had my own special ritual, which is at the beginning of every month, I go into the Medical Library at my medical school, and I go make a beeline for the latest issue of index medicus. Remember index medicus before the internet? You would do your searches of these tomes, which had collated every article published in medicine and the preclinical sciences, everything. So I would look up categories, lysergic acid diethylamide or hallucinogen to see what was the latest what was being done. This would have been in the mid late 70s. And nothing of interest, no human studies at all.
Dr. Will Van Derveer 09:11
Dr. Charles Grob 09:11
Maybe you could learn something about the reflex in a salamander or the ocular effects in cats but nothing addressing the human condition which is what had self intrigued me. And there was no discussion in my medical school classes or rotations through psychiatry. It was as if the psychiatric research was that hallucinogens had never occurred. That was the sense you had.
Keith Kurlander 09:37
Well, that’s probably still going on in many programs where it’s not being discussed.
Dr. Charles Grob 09:42
Right, but less and less so. The media is really jumping in as they were antagonistic towards the topic of psychedelics decades ago. They’re now embracing it, almost going overboard I think, at times. So I mean last weekend or last Monday, we had a front page article in The New York Times.
Keith Kurlander 10:04
Right. Yeah, that was a big article.
Dr. Charles Grob 10:07
A very big article. I think, fairly revealing of the state of the field.
Keith Kurlander 10:12
Sure. Well tell us a little bit about what came next. So this was the late 70s 80s. Like what came next in your trajectory around getting involved in the research?
Dr. Charles Grob 10:22
So in medical school, honestly, I was disappointed in psychiatry. I felt they had turned their back on what had been a very exciting area of research that had inspired me to go to medical school. And I wasn’t really caught up with mainstream psychiatry. I ended up going into internal medicine. My father was an internist. This is how we connected by talking about cases, medical cases. I’ve liked learning how to be a doctor and medicine seemed to be the core of being a doctor. And so I had some medical residency training, then I thought that wasn’t quite what I was looking for, and went into neurology. I realized that was definitely not what I was looking for, and then finally made the jump into psychiatry. And that would have been around 1980 or so. The summer of 1980 I found a bookstore near my school that had a section on psychedelics. So it’s like, another discovery and I knew books by Stan Grof had just come out LSD psychotherapy, Lester Grinspoon, his book, psychedelics, rediscovered came out in 79. That was a very important book, rediscovering the literature again, pulled me in, but around ’83, I transferred to Johns Hopkins in Baltimore, where again, no one was doing any psychedelic studies as long before Roland Griffis started to do the kind of work that he became well known for. The chairman at Johns Hopkins was very antagonistic towards any suggestion that psychedelic should be explored. But I did finish my training there. I was on the faculty there and enjoyed it very much, but felt a pull to come back out to the west coast. It really had a lot to do with my own vision of working with psychedelics, I felt Hopkins will be too restrictive and I was in too Junior role to have any say about doing anything controversial. So I went out and I was recruited by a few places. It took off, right UC Irvine, and there in the late 80s. Right 87-88 I met Roger Walsh, who is a senior Professor, highly respected, one of the major psychiatrists in the world of transpersonal psychiatry. I spoke with him about my old interest in psychedelics and said How unfortunate it was and it didn’t appear this was going to go anywhere. And he said, Oh, contraire, I think this is a really important area, I resonate with your interest. And if you’ve got the determination to jump in there, I urge you to write a review paper, write a case study, write a protocol. So he was encouraging me to get into the field. Then I made the acquaintance of one of the other guys on the junior faculty at UC Irvine, Gary Bravono, and he strongly connected with my visions about psychedelics and had a very similar wish to work in this area. So we collaborated, we then made a connection with anthropologists who live out here, barely dokkan Duryea did a lot of the early work on ayahuasca use in Peru, and really contributed a number of outstanding publications to the field of the anthropological perspective on psychedelics. She passed away a few years ago, unfortunately, but she also provided a lot of encouragement. So my experience was basically, you know, I got my credentials, I established myself in the field. And then I started to talk about my interest, and some senior people understood what I was talking about, agreed with my premise, and with my goals, and strongly encouraged me to speak up, to write, to accept speaking engagements, to submit protocols, which is what happened. It took a long time, I got very old in the process. I didn’t start off with a white beard, you know. But it was what it was, and still going on.
Dr. Will Van Derveer 14:14
In those early years, was it difficult to get an IRB to look at a protocol on psychedelics?
Dr. Charles Grob 14:21
Well, they’d look at it, but then they shut it down, often very quickly. When I submitted a protocol for what turned out to be my first study administering a psychic MDMA, when I first set my protocol into the IRB at Harbor UCLA, where I’ve been for the last 28 years is when I just first got there. No one knew me from anyone else. I presented a protocol in MDMA. Didn’t know what to do with it. So they did the expected, they shot it down very quickly. So I spoke with the head of the IRB who suggested that I attend the next meeting, and describe what the rationale of the study was, what we plan to do, safety parameters and answer whatever questions that concerns them might have. So I spent an hour I think with the committee going over this going over the history of the field. And then a few days later, the head of the IRB called me up and he said, Well, Charles, I have good news and bad news. So what is it? He said? Well, the good news is the committee has unanimously approved your protocol. That was a big relief. What’s the bad news? You may not consider it bad news. But the committee would also like to invite you to join the IRB as a committee member, which I had to accept, but this is a huge commitment of time. And energy, which I you know, I did it for over 10 years, I was the vice chair for a while of the committee, and then I rotated it off, but I was surprised I had to pay because I’ve had a lot of support at Harbor UCLA, the research institute here is called webquests Research Institute, previously with la biomed. They’ve been very supportive. And I think they get it, what I’m trying to do and now it’s becoming so well known publicly, and approved off, one would think that I think they feel their debt is paying off for them.
Dr. Will Van Derveer 16:14
I’m curious what’s happening currently with research at the center?
Dr. Charles Grob 16:20
Well, what I’m doing at this point is putting together a new protocol, we’re working closely with Tony Bosses and Brian Anderson. We actually, previously worked with someone in the palette to field Ira Byock who had a big impact on our process, but we’re putting together a multi site study, which would involve studying the use of a silicided treatment model. In the palliative care setting, with people approaching end of life, who had severe reactive demoralisation existential anxiety, kind of a follow up on a previous study we did working with advanced cancer patients here, we would open it up to other medical illnesses beyond cancer as well, if there was a limited life expectancy, and people were already enrolled in a palliative program, calling it a pragmatic approach, because part of the study will involve training palliative care practitioners, and how to administer the treatment.
Dr. Will Van Derveer 17:20
Training is such a big issue, getting people trained. I mean, when I think about people like you and Michael and Annie Midhoffer and some of the other folks who have been providing assisted therapies, whether it’s psilocybin or MDMA for a couple decades, one of the things that’s challenging from my perspective is how do we get people up to a very high level of competency in a much shorter period of time to meet this bottleneck?
Dr. Charles Grob 17:47
It’s a huge challenge. Because of it, it looks like there may very well be opportunities to treat large numbers of patients. And we don’t have a critical core of experience and credential facilitator. There’s certainly a very, and has been a very active undergrad, as some of these practitioners are very, very capable, but then not all are and what kind of process is gonna have to be put into place to figure out who’s appropriate for this task and who’s not. That’s a lot of important structural decisions. Terminations have to be made over the next year or two. We’ve got Oregon, which is decriminalized, I believe there’s a time lag, which is good, but I believe the state’s supposed to come up with a system, what kind of oversight on psychedelic psychotherapy should be, could be provided. Honestly, I don’t know where the state is in that process.
Keith Kurlander 18:42
It’s interesting because psychotherapy hasn’t faced this before in the sense that there’s never been sort of a new modality that gets unleashed overnight. And now we need thousands of practitioners in that modality overnight, like that’s never happened in this way before. So it’s a very interesting road we’re at in the field of psychotherapy, we have a whole new wave of psychotherapy that’s coming within years. And we need tens of thousands of practitioners trained.
Dr. Charles Grob 19:10
That’s right. I don’t know how we’re going to be able to create this critical mass of facilitators, it’s just not going to be possible. So we’ll have to see how the process goes if the phase threes are as successful as the earlier phase studies. And as the regulatory agencies, and Congress also moved to reschedule these compounds, opening them up, what would credentials look like? What kind of background would an individual need? What kind of prior experience? Would it be open up to just about anyone or would it be opened up to individuals who are already health or mental health professionals who had an active clinical license of one sort or another.
Keith Kurlander 19:54
Right. Yeah, lots of unanswered questions. Lots of unanswered questions.
Dr. Charles Grob 19:59
Yeah, I don’t have the answers. I know some of the questions, but I don’t have the answer.
Keith Kurlander 20:04
I mean, we’ve definitely, our institute stuff has a program right now that we’re enrolling in and getting people trained in. So we have training, I don’t know if you’re aware of that, that we’re trying to address this issue. It’s a big issue. But it’s also an exciting issue, obviously, because it’s a whole new wave of healing modality. It’s very exciting. So I’m curious about going back to the research for a second for you. I know a lot of the research is really focused on we could say mental health disorders, and really this medical examination, and to how these medicines could help people. I’m curious, like, some of your excitement that you probably had, from the beginning of like, what types of research programs you would really want to get deeply into to see like, what do these substances actually do? And like, what are a lot of the thoughts that are going around in your head about what we need to research with these substances?
Dr. Charles Grob 21:04
I’ve always been a believer that the best indications for a psychedelic treatment model are those conditions which do not respond well to conventional treatments. Yeah. So you know, at the top of that list, I’d say treatment of chronic alcohol abuse. Medicine still does relatively poorly, treating alcoholics but if an alcoholic walks into your office, you probably refer them to a 12 step group. And if it’s a good fit, that can be it that could really help propel them into a much healthier lifestyle. But with a lot of people, it’s not the right fit. So what else is there for them. The work with alcoholics dating back to Humphry Osmond in the late 50s in Canada has been remarkably positive and easy to measure. There are people who are either drinking or not drinking. So that’s an area I would like to see that we should invest a lot into. And there is a good study now at NYU with Michael Bowgun Shoots. He was formulating a University in New Mexico and decided on NYU, and he’s getting some, I think, some good data. Another area would be the kind of work that I’ve done working with people at the end of life, Stan grof, Walter Panky, Eric Cass, Gary Fisher, Sidney Coe, and Bill Richards, these guys had all been involved in treating people with terminal cancer and really with very, very positive results in terms of enhancing quality of life in the remaining time and merely writing the level of anxiety or mood disturbance, even allowing patients to start to heal some relationship or if they had with significant others it was a whole ripple effect of therapeutic outcome. That’s an area as well. So we did our study in the early 2000s on psilocybin, and a population of advanced cancer patients. And we were quickly followed up with studies at Hopkins at NYU. So it’s good to see that happen. And now we’re trying to really catalyze more activity in that area. Other areas that psychiatry doesn’t do well, eating disorders. That could be a challenging condition or a psychedelic model, and yet, our conventional models more often than not fail. So again, another area that we should be looking at. The chronic PTSD work is often very tough and tractable disturbance. MAPS’ work with MDMA has been really quite impressive. I’d like to see classic psychedelic supplies also like a moderate dose level of psilocybin, for chronic PTSD, I think would be very interesting. And then you’re moving even outside of the realm of psychiatric treatment would be used in a religio-spiritual context. I spent some time in Brazil in the 90s and early 2000s, studying at one of the ayahuasca churches on the other edge of town. And I was very impressed with how they had Incorporated. They had evolved and how and the kind of ritual that had and how it facilitated within the context of their culture, very, very positive outcomes and people who were joining their churches. I mean, I interviewed quite a number of people in the UDV and I was very, very impressed with their accounts, many of them had started at the bottom rungs on the socioeconomic ladder, very, very dysfunctional substance problems galore problems with aggression. Some of them had spent time in jail, they had entered this church, which used Iosco as a psychoactive sacrament twice monthly, and they’ve had transformative experiences. That’s certainly something worth following up. Also the work looks at effects on individuals who are in the criminal justice system. Peter Hendricks at Alabama has done some very good work, looking at data from the Alabama prison system of drug use data before incarceration and then recidivism rates after release and finding that exposure to psychedelics prior to incarceration was a predictor of a low recidivism right down the line. I thought that was fascinating. Good work periodically looking at the Santo Daime has a process in Brazil, where they are, at least for a while we’re taking prisoners who were given passes to one of their Iosco retreat centers and that barrus and these guys would participate in all day or all evening ceremonies be brought back to their prison The next day, and from the reports I read, had very positive outcomes. So there’s a host of applications, both within medical or psychiatric treatment system, as well as outside with individuals who sensibly don’t have mental health issues, but want to use a psychedelic as part of the spiritual process.
Dr. Will Van Derveer 25:53
Well, I like to ask you to speculate about something which is sometimes the researcher doesn’t want to speculate too far ahead in the future. But what you’re talking about in regards to the application of periodic or maybe even single psychedelic session exposure for people who don’t have a full blown or diagnosable DSM condition reminds me of the Bob Jesse comment about the betterment of well people. Michael Pollan proposes that sometime in the future, we might see mental health clubs where you’re on your birthday, you could go and have a psilocybin journey to sort of clear out the cobwebs. Do you think that something like that is possible and in our future?
Dr. Charles Grob 26:32
I think so. Perhaps not the immediate future, but I think so. I mean, back in the early 2000s, an ayahuasca case went to the Supreme Court, I was the expert medical witnesses case because it involved the UDV. A very conservative federal judge ruled in favor of the UDV to protect their freedom of religion rights that got appealed to the appeals court in Denver. And then also, subsequently to the Supreme Court, which ruled unanimously that essentially healthy individuals who were part of a religion had the right to take a psychedelic sacrament, specifically ayahuasca, but other sacraments as well could conceivably be provided legal test. So in that context, for sure. The work of Willis Harmon dating back to the mid 60s was James Fadiman, looking at how these compounds may facilitate creative problem solving. They had some very intriguing early data, they unfortunately were shut down prematurely, but they were exploring potentials of how these compounds could be used outside of a treatment context. So I think there’s certainly potential. The rate at which will become feasible to explore this, who knows, right. A lot of it will depend on how obviously the use and treatment will be rolled out initially. It’s going to be critical that this process go well, and that subsequent studies, you know, have strong safety data to report that they’ve ensured strong safety parameters, they’ve ensured strong ethical parameters gotta be essential that the function of the field be optimized. And that happens, it will, I think, become more feasible, or these compounds for use in other facets of life, with the overriding structure that everything be done in an optimally safe manner.
Dr. Will Van Derveer 28:23
Sure, step by step.
Dr. Charles Grob 28:24
Yeah. It’s gonna take a lot of public education that really has to be an early step,
Keith Kurlander 28:30
Which is now starting in a much bigger way with a lot of the media attention.
Dr. Charles Grob 28:34
Keith Kurlander 28:35
And I’m curious about what you would say you mentioned at the beginning that you very early on in college like hey, this might not be best to just keep doing this in a random way in the dormitory. I’m curious what now with all this time you’ve had like, what are the kind of drawbacks of doing psychedelics in uncontained ways, set and setting isn’t defined, versus what we can do by really controlling set and setting and kind of balancing those two stories? What have you learned here?
Dr. Charles Grob 29:10
I think not only did the early pioneer researchers understand the value of set and setting, but if you look at indigenous structures, how they incorporated plant hallucinogens, it was all about set and setting. And the observation consistently over time has been the better you can control set and setting, the better the outcomes, right. Again, it’s going to have to be involved in an educational process where people need to understand that you want to have a positive experience with a low likelihood of any adverse outcome, you do it in a safe context. You do it, let’s say in a contained space, through someone and let them walk around the streets of a crowded city. I can tell you about a case of a college student in a Big East Coast City, who didn’t have a mental health history as far as was no Minimal psychedelic use background, seemingly impulsively on a weekend afternoon, took some mushrooms and started walking through the streets of the city got seemingly got very disoriented, and no one’s quite sure what happened. But he ended up jumping off of the size of a building on a high floor. So this is an example of a kid who didn’t really understand the need to structure the need to have a container and the need to prioritize keeping things safe. In the end, it’s gonna come down to that one of the problems from the 60s was too many kids were taking it older people too, but mostly kids taking it in uncontrolled unmonitored settings. And look, some of them had fabulous experiences that had a big impact on the subsequent course of their lives in a positive way. Some of these kids, most likely the more vulnerable ones to begin with, got pushed off the edge, most of these kids kind of clawed back to some semblance of normalcy. And were able, hopefully to learn from something like that. But some stayed in a terribly de-compensated state for years for the remainder of their lives.
Keith Kurlander 31:15
What’s your sense of when people are in an uncontrolled environment and they get very decompensated? Does it have to do with a trauma history that has to do with like, what’s your sense these days of just why that decompensation might happen?
Dr. Charles Grob 31:31
Well, yeah, again, it’s really important to know what someone’s baseline vulnerabilities are, then you may be able to predict who would be at higher risk. So certainly, the existence of prior trauma could be a predictor of rough outcome, what’s going on around the individual, if suddenly, the space is intruded upon by outside forces, and it can have a very kind of disorienting, scrambling kind of impact, people could get just thrown off of their being grounded and kind of lose themselves in a swirl of interest psychic activity, they could become quite confused, and start to act out impulses.
Dr. Will Van Derveer 32:11
Right. I’ve seen a number of folks in my practice, in my psychiatry practice, who had what I would call psychedelic trauma from taking a compound at a festival and then either getting very paranoid, just as a part of maybe what’s happening inside of their journey, inside of their mind, but also in the interaction with the destabilizing, swirling, environmental effect, and sometimes getting involved with law enforcement, which is a disaster when that happens it’s just horrible. Yeah, it’s horrible. So I agree with you. I think there’s a huge public education need here.
Dr. Charles Grob 32:45
There’s this tendency to look at these compounds as being used in a recreational manner. That’s problematic. Recreation is all about fun. It could also mean mixing it with other drugs or alcohol, another recipe for disaster.
Keith Kurlander 33:01
Just I think you’re speaking to the context of these medicines being used in a recreational setting. Yeah, yeah. And, of course, that sort of like any medicine, right, like, medicines, certain medicines are designed for certain settings. There’s medicines that are designed for surgery, and they’re not designed to be taken in different contexts. I think you’re speaking to the context.
Dr. Charles Grob 33:22
These compounds, there’s a therapeutic application. And there’s an application in a religious spiritual context as well. But again, when people just do it to have fun, to party, to have weird experiences. And I remember, I was at an event one night. One individual said, this is an ayahuasca session, he said, his goal, his intention was to experience the dark side. And I thought, Oh, my God, this is gonna be a long night. And it was, he completely decompensated and had to be carried out of the room, kicking and screaming. I ran into this guy months later, it was interesting, and I had imagined he might have had some permanent decompensation. But interesting, what he said was shortly after this experience, which is a very sobering humbling experience for him. He had met someone with whom he said he had established since then, the most meaningful relationship that he had. So there was a positive outcome, but one would never have known had given his behavior and his experiences that night of the session.
Dr. Will Van Derveer 34:31
That’s a tough prayer, you got to be careful what you ask for.
Dr. Charles Grob 34:36
Exactly, yeah, intention. Individuals thinking through their intentions ahead of time, I think, are very, very important and sometimes get lost and all the commotion is really focused and even write it out. talk it out. What do you hope to get out of this? Are there issues of healing decisions you need to make? Need to reflect on an old experience, whatever it is, Fill it out to yourself or talk it out with a friend or a therapist. Because more often than not that intention comes back and becomes integral to the experience. You may not become aware of it until afterwards looking back, but it often plays a key role. So giving time and consideration to intention. Why do you want to have this experience and why at this time? And why was it in this context, I think it is important that it often gets overlooked.
Dr. Will Van Derveer 35:28
Here here. I agree. Let’s talk a little bit about this new handbook that just came out. All right, good. Racing. Tell us about the idea behind the book and why you decided to fill it together.
Dr. Charles Grob 35:43
Right. So along with Jim Grigsby, I was approached by a publisher A few years ago, Guilford press, to essentially edit what I believe is the first formal textbook on psychedelics or hallucinogens, however you want to call them our sense was this field is on the cusp of really taking off, there’s incredible potential that’s been kind of kept under wraps for decades, and now the covers are being lifted, it’s going to really get out there and there’s going to be a need for information. And this is going to be a topic taught in schools, particularly graduate schools, medical schools, and psychiatric training. So any of that to publish or Guilford was very eager that we take on this project. We felt we could do a good job. So we’ve pulled together 30 different chapters, different writers and writing teams looking at the common hallucinogens, you know, LSD, psilocybin, mescaline, as you know, MDMA, ketamine, salvia, Ibogaine, and then applications, separate chapters and application is used with substance use disorders, specifically with alcoholism, working in a palliative setting or treating depression. And then, you know, some other issues like the role of music or some philosophical considerations, it was released by Guilford in March and publication was delayed because of the pandemic. As it turns out, the high grade paper they’re reliant upon is from Southeast Asia, where their supply chain issues arose because of the pandemic. So there were paper shortages. So everything got pushed back about six months, but we published in March, and it’s been very well received, sales are very good. We’ve got it out in a hardcover version, which I think presents very well. And the plan is by the end of the year to have a soft cover version as well. Okay, robotics. It’s a large book, I think it’s upwards to 700 pages. Too tall, it’s heavy. Don’t want to carry more than two or three at a time, I found that
Dr. Will Van Derveer 37:51
it’s comprehensive, that’s for sure.
Dr. Charles Grob 37:53
Yeah, I think we’ve covered a lot of material. Oh, we got some great writers. Yeah. David Nichols, Dennis McKenna. In the first two chapters, they kind of anchor the book. And they’re the experts in each of their specific fields, pharmacology and ethnobotany. And that’s the foundation from this.
Dr. Will Van Derveer 38:11
Dr. Charles Grob 38:12
So all the chapters are also on the history parama. Jeannie did a really lovely, long chapter, looking at historical issues.
Dr. Will Van Derveer 38:20
It’s really helpful to have all of that information in one place, even in the age of the internet. And some ways the internet is difficult to navigate, because it’s hard to actually tell what’s in it. Sometimes separating the wheat from the chaff is not so easy.
Dr. Charles Grob 38:34
Yeah. Here, the individual authors have already curated the information for the reader. They’re presenting what’s been distilled down as the most essential information to be aware of.
Dr. Will Van Derveer 38:46
Right, right, kind of a set and setting curated by the authors for the reader. Yeah, this is so great to connect with you, Charlie, I really appreciate all the work that you’ve done and continue to do in the field and your leadership and your heart is really exceptional. And just so grateful for the energy that you bring
Dr. Charles Grob 39:08
to this work. Well, I’ve been fascinated ever since I was a kid and was fortunate enough to come across people, more senior than me, who gave me a lot of encouragement to keep moving down this path and speaking up. I felt this strongly. I should feel empowered to speak my mind and I do it now a lot of people are speaking up now. They supported me in speaking up early on when it was still a taboo topic. And it’s been very gratifying for me. I’ve benefited personally from my acquaintance with psychedelics and working with them being able to manifest the dream I had going back some almost 50 years. That’s been very special. Beautiful.
Dr. Will Van Derveer 39:52
Thank you for being on the show with us.
Dr. Charles Grob 39:53
Sure. Well, really good talking with you guys.
Dr. Will Van Derveer 39:56
Yeah, thank you.
Keith Kurlander 39:57
Well, we didn’t ask our last question. Oh, Yeah, we forgot. Do you want to ask that?
Dr. Will Van Derveer 40:02
Sure. Sure. Sorry. I missed that. So we have a standard question we ask every guest Shirley as we wrap up, which is if you had a billboard thing you could put a few sentences on that everyone in the world would see once in their lives. What would you put on the Billboard?
Dr. Charles Grob 40:18
Oh, be kind to your brothers and sisters. Be kind to all beings. Love will prevail.
Dr. Will Van Derveer 40:25
Beautiful. Thank you.
Dr. Charles Grob 40:27
Okay. All right.
Dr. Will Van Derveer 40:28
Thank you so much
Dr. Charles Grob 40:29
Dr. Will Van Derveer 40:30
Great connecting with you.
Dr. Charles Grob 40:31
Dr. Will Van Derveer 40:37
Here at IPI. We’re very excited about the possibilities offered by very encouraging results coming in around psychedelic assisted therapy for various conditions. So much so that we launched a psychedelic assisted therapy training, which begins in mid July of 2021. If you’d like to hear more about the training, you can navigate to psychiatryinstitute.com/psychedelic or you can apply to the program. That’s psychiatryinstitute.com all lowercase, all one word, psychiatry institute.com forward slash psychedelic. We look forward to connecting with you again on the next episode of the higher practice podcast where we explore what it takes to achieve optimal mental health.