
Psychedelics and Psychotherapy - Hooke
http://m.timeline.com/stories/psychedelic-drugs-clinical-use-anxiety-terminally-ill-mdma-ecstasy-molly-lsd-magic-mushrooms
======
evincarofautumn
I used to suffer from pretty bad anxiety, particularly existential anxiety,
and would sometimes have panic attacks. My doctor recommended SSRIs, but I
declined due to the increased risk of suicide.

Taking psilocybin mushrooms in a positive environment with my friends was
perhaps the single most therapeutic and rewarding thing I’ve ever experienced.

In the months since, my anxiety has evaporated, my panic attacks have stopped,
and I’ve been taking better care of myself and my environment. For me, it has
been a wonder-drug.

Above all, I have a lasting sense of well being—that everything is going to be
alright. And I think to deny that experience to people, particularly people
who are grappling with death as I was, is simply inhumane.

~~~
udp
I haven't commented on HN for a long time, but this hit far too close to home
not to respond to.

I have had exactly the same kind of existential anxiety from a very young age
(I remember discussing this extensively with my parents at ~7 year old). It
used to be something that only happened late at night when I was alone - until
the first time it hit me in a completely normal situation. I was literally mid
conversation and suddenly all I could think about was my inevitable mortality.
I can not describe the feeling of shock and helplessness. The floor
disappeared beneath me.

I walk out of the house every morning and look at the people in the street,
and I just don't understand how they can function normally in the face of
certain death. Terminally ill people are often anxious because they're going
to die. But _everyone_ is going to die. We are all terminally ill with this
fatal disease called "life".

It's nothing to do with wanting to accomplish more before I die. It's the very
idea of not existing that I can't comprehend. I'm sure anyone would agree that
the world ending would be a fairly grim prospect. When you die, the world
ends. Game over, even if everyone else continues.

Alcohol is a wonderful escape from an over-active mind, but guzzling a
substance that's likely to screw with your health long term... isn't exactly
ideal for an existentialist and hypochondriac. SSRIs seem to help regulate
things until - months in - you realise they are actually pretty nasty drugs
with too many observable side effects to count on both hands.

Maybe shrooms are the answer, indeed, though having never dared touch them
from - strangely enough, fear of their inducing a panic attack - I've yet to
be able to comment on that.

~~~
vinceguidry
> guzzling a substance that's likely to screw with your health long term...

Low-to-moderate alcohol use has been shown to have significant health benefits
over the long-term.

For me, three beers is enough to have a strong enough stress-reduction effect,
two if they're strong. My mind just unwinds and I relax. I used to think I'd
develop a tolerance and start needing more and more to get the same effect, I
no longer think so after many years of roughly the same level of consumption.

Alcohol is generally not a problem unless you start really young or had the
kind of abusive childhood that leads to addictive behaviors.

~~~
DanBC
> Low-to-moderate alcohol use has been shown to have significant health
> benefits over the long-term.

There is a well publicised study that claims that, but it's been pretty
heavily criticised. It turns out that only women over 65 get benefits from
moderate drinking. Everyone else needs to restrict themselves to light
drinking to get the benefits.

That's an important distinction because few people know how much they actually
drink. People tend to under-estimate the number of glasses they have, and
under-estimate the size of the glasses, and under estimate the amount of
alcohol in each glass.

You've said that 3 beers produces a de-stress result. It's not clear what you
mean by "strong" \- 5%? 8%? 10%? Three pints of beer at 5% ABV are 2.8 units
each, about 8.5 units for all three. This is no where near risky drinking
(unless you do it more than twice a week) but it is wrong to suggest that it
is a healthy activity.

Alcohol is not just a problem for those who start yumg or who've had abusive
childhoods. Alcohol is a causal factor in many deaths and accidental injuries;
alcohol is involved in many suicide attempts; alcohol is involved in a lot of
violence. It is wrong to suggest that all those people started drinking young
or had abusive backgrounds.

[http://www.bmj.com/content/350/bmj.h384](http://www.bmj.com/content/350/bmj.h384)

[https://news.ycombinator.com/item?id=9043577](https://news.ycombinator.com/item?id=9043577)

[http://www.psmag.com/health-and-behavior/put-down-the-
booze-...](http://www.psmag.com/health-and-behavior/put-down-the-booze-
drinking-may-not-be-good-for-you)

~~~
vinceguidry
> Alcohol is not just a problem for those who start yumg or who've had abusive
> childhoods. Alcohol is a causal factor in many deaths and accidental
> injuries; alcohol is involved in many suicide attempts; alcohol is involved
> in a lot of violence. It is wrong to suggest that all those people started
> drinking young or had abusive backgrounds.

Alcohol is involved in a lot of things because it's the only legal
consciousness-altering drug available in many countries. If you're going to
start making statements for or against alcohol, you need to account for this
cultural fact.

> People tend to under-estimate the number of glasses they have, and under-
> estimate the size of the glasses, and under estimate the amount of alcohol
> in each glass.

They do because they have a reason to, nobody wants to be seen as a drunk. If
they didn't they'd self-report more accurately. Studies on the social effects
of alcohol probably don't account for this, considering the difficulty of
doing so.

> You've said that 3 beers produces a de-stress result.

The beer I typically drink is 3.2%. At my bar they serve 14 oz pints. Strong
beers can be anywhere from 5-10%. I know roughly how much I've been drinking
both because I keep track of my intake and because different amounts feel very
different.

For me, the line between "comfortable buzz" and "achey, dizzy, ready to throw
up" is a skinny one. So in order to keep my nights and weekends fun, I have to
moderate pretty strictly. On weekends, I've learned to have a few beers during
the day, go home for a few hours, then go back out for the evening. At bars
there's pressure to drink more, I mostly manage to avoid that pressure simply
because it can ruin my night fast.

> it is wrong to suggest that it is a healthy activity.

I honestly don't know whether it's healthy or not, I personally have a tough
time understanding what is meant exactly by "healthy", but there's some recent
archaeological results that suggest that our evolutionary history with ethanol
is long, meaning our brains and bodies would have had ample time to adapt to
it.

Personally, I'm convinced that stress, both self-induced and external, has a
far worse effect on a person's quality of life over time than any of the
physiological effects of moderate drinking. So to compare the effects of
drinking alcohol to not drinking alcohol, you also have to understand the
effects of the stress that's being relieved. Of course, there are social costs
that one can incur as well, the most dramatic of which seems to be DUIs or
worse, alcohol-induced accidents, but again, I suspect that on the whole,
especially if one can avoid getting those, a stressed person is better off
drinking moderately and letting it go than he is holding it in. Of course,
there are other ways of relieving stress, but they may not be as effective or
as cheap. Alcohol is incredibly reliable at doing this, that should count for
a lot.

------
davidwaters
I have a vivid and fond memory of one particular experience with psilocybin
many years ago. I was not "tripping" or in any way lacking in function, but it
was as if a switch had flipped and every ounce of self-consciousness, anxiety,
and depression was replaced with feelings of contentment and goodwill towards
everyone around me. That was the only day in my life where I was a true
extrovert. Unfortunately I have never had that experience again, but it gives
me hope that someday researchers will discover and refine whatever caused that
transformation and this will lead to breakthrough therapies.

------
chisleu
I used to have an unconventional hobby. I collected information. More
correctly, I collected Ebooks, converted them to text format, and printed
them. I had access to a free printer at school and would do 20-50 pages a day
and take them home with me.

The e-books were almost exclusively survivalist material, but I ran out of
things to print and started printing educational manuals of all sorts. Math,
Chemistry, Biology, etc, etc. I was doing this because I was scared the world
as we know it was going to end at any time. I was constantly researching
firearms, and survival gear. I was going to the doctor for sinus infections to
get antibiotics that I didn't need, just in case.

It was pretty borderline behavior.

It continued until I discovered DMT. I smoked roughly 2 grams over the course
of a few months and had some very tremendous experiences. Early on in the
process, It was always a continuing experience, starting up where the last
trip had let off.

Long story short, I met "god", this multi-dimensional being that assured me
that this state of life wasn't the end. It expressed to me that what comes
after this is just as splendid and precious as the life I have now.

I smoked DMT too much. 2 Grams is roughly 60-80 doses. I smoked until I
arrived at too much of a peace with death. I didn't care if I lived or died.
Not that I wanted to die, mind you, but it just didn't bother me anymore. When
that thought crossed my mind, it was a shock. I got rid of what was left and
never dosed again.

I am very excited to see psychedelic research done. We stopped learning 50
years ago because uneducated old people were scared. It is time to grow up and
let science do what science does. Almost all research done has been
overwhelmingly positive. A smart man once said something like the war on drugs
is a war on Americans. This is such good news.

------
rsuelzer
I have always been fascinated by the intersection of technology and
psychedelic use. As in, that I feel as if a higher percentage of those of us
in the tech space have experimented with these drugs than in other fields.
Although, this observation is purely anecdotal.

I think that I read a good article about this intersection but I am having a
hard time finding it.

These comments remind me how out-of-touch society is about who actually uses
psychedelics. My educated guess is everyone here who has admitted to their
past or current use of psilocybin/lsd/etc is a highly intelligent and
"productive" member of society. I wonder if a tipping point on the stigma
around these drugs will be reached in our lifetime, of if the exploration of
our own consciousness will continue to be forbidden.

~~~
briandear
There's an excellent book by Timothy Leary he wrote right before he died about
cyber culture and LSD; makes the same point. That book is what planted the
seed for me: computers and their communities as shared consciousness. I can't
remember the title but it connected rave culture hacker culture and such with
a very convincing line of thought.

------
d357r0y3r
The possibility that excites me the most is the effect of MDMA on sociopathic
individuals. Maybe it won't lead us to a "cure" for sociopathy, but it can at
least tell us more about the brain and how it gets wired up.

~~~
throwawaytime
This presupposes there's something wrong with sociopathy. Note that most
sociopaths are living in society without causing harm to others, so who are we
to say their state of being is inherently wrong or that we should be vested
with authority to change them?

If they're voluntarily seeking help, then that's different, of course. How
often does that happen? (Genuine question. I have no idea, and I'd love to
find out.)

~~~
Zigurd
> _without causing harm to others_

Not all of them all the time, of course. And some of them never. But the same
could be said of pedophiles. Whatever you may think of the DSM, sociopathy is
listed as a disorder. It is associated with violent crime and crimes against
humanity.

Or, look at it this way: Let's say you're not a sociopath and a taking MDMA is
just a pleasant experience. Wouldn't it be worthwhile to administer it
prophylactically? Or in vocations, like policing, where there's a large risk
of developing sociopathy. Might make your next flight less dicey.

~~~
electronvolt
If you replaced your argument for treating potential sociopaths with "treating
potential gay people", do you see why that's a kind of dangerous approach to
psychiatric diseases?

It's pretty dicey to just say "it's a disorder in the DSM associated with
(negative things) and therefore we should push for administration of treatment
to otherwise healthy/happy people."

It isn't too long ago now that being gay was also in the DSM. Respected
scientists claimed all sorts of "harm" that the "gay lifestyle" caused to
people in it and outside of it.

I suppose my question is: your logic would you suggest that it is worthwhile
or valuable to administer prophylactic treatment to every DSM disorder, for
those considered "at risk." You assert that MDMA is "just a pleasant
experience", but I'd counterclaim that no drug is always just a pleasant
experience, and you always need to consider the side effects (which for MDMA
read like the side effects of many legal psychiatric drugs that affect the
seratonin/dopamine/norepinephrine system). Keeping in mind that psychiatric
disorders are some of the few disorders where the consent of the patient still
isn't absolutely legally necessary to administer treatment, that means that
you are arguing that these should be at least considered for administration to
actively unwilling patients.

Given the difficulty of diagnosing these illnesses in the first place and the
possibility of misdiagnosis (see also:
[http://en.wikipedia.org/wiki/Rosenhan_experiment](http://en.wikipedia.org/wiki/Rosenhan_experiment)),
I think it's important to be careful of the arguments made for treatments.
Treatments often are applied to involuntary patients (who may be considered
incapable), and both the DSM and psychology (as a science) are not some be-
all, end-all bible of things that can be stated to be definitively negative or
harmful or unwanted which exist outside of the culture they're formed in.

~~~
Zigurd
You missed my point: In the use of MDMA, is there a downside to misdiagnosis?
Let's say MDMA was effective treating alcoholism, but had no therapeutic
effect, nor any harmful effect, on anyone else. Lots of people take it
recreationally. We can certainly find out if that population is suffering any
negative consequences.

I take your point about the dubiousness of some parts of the DSM. But what's
your theory about sociopaths? Are you seriously suggesting sociopathy will be
redeemed in some way?

------
keane
To take the opposing position, use of hallucinogens or other psychotropic
agents will physically alter the brain and may cause real, permanent effects,
e.g. HPPD¹. The consequences and danger are something I choose to avoid and I
would encourage others to reconsider as well.

1:
[https://en.wikipedia.org/wiki/Hallucinogen_persisting_percep...](https://en.wikipedia.org/wiki/Hallucinogen_persisting_perception_disorder)

------
tyho
This is fantastic, it really is, but I am uncomfortable with the idea that
there has to be something medically wrong with you in the first place for you
to be able to benefit from psychedelics.

Me and a group my friends take psychedelics regularly but not often. Every
single one of us reports not only enjoying the experience but more importantly
IMHO, we feel long lasting positive effects.

Our favourite thing to do is a `candyflip' which is taking LSD and then MDMA a
few hours afterwards. You can read about what the drugs do individually
elsewhere, but I will attempt to describe the combination briefly here.

One of the effects of LSD is that it makes your emotions very slippery, and
what I mean by that is that you can very easily and quickly transition from
feeling intense happiness to intense feelings of negativity and anxiety
without apparent cause. I describe the MDMA as propping up the emotions you
experience during the LSD trip so that they are entirely positive. It allows
you to access and talk about memories that are usually repressed, in my case
childhood bullying, without fear or dread^1. LSD on it's own can produce
intense euphoria with the right set and setting, but it is certainly easier to
achieve it with a little bit of MDMA ;-) .

Since taking psychedelics I have noticed that I have become more open minded,
more accepting of who I am and have a greater ability to appreciate the time I
am living in now as opposed to waiting for 'life to get good'^2.

One of the long term effects I have enjoyed the most is a greater ability to
empathize with others, I am not only much more aware of my own mind, it's
fallibility, emotions and thought processes, but when in a crowd, I can't help
but feel awe at the hundreds of minds surrounding mine that are all equally
complex as mine. Everyone has emotions, difficulties, hopes, dreams and
desires as I do, this is something I had never really thought about before.

Finally, I am now at peace with the idea that I will in all likelihood not be
a silicon valley billionaire or even wealthy at all^3. I understand now that
success is not just measured by economic and social status. A normal person
living in a normal house with a normal family could very well be more
`successful' in my opinion that anybody else in the world, so long as they are
happy, and content with their situation in a way that I am finding difficult
to put into words. I am reaching here to describe such a person and the word
that is coming to mind is enlightened.

Unfortunately, if I had come across a post such as this a year ago, before
trying psychedelics, I would have dismissed the author as a hippy, somebody
who is making excuses for their own failure or even perhaps somebody with
mental illness.

Psychedelics are really something that must be experienced to be understood,
we do not yet have the language to accurately describe to an outsider the
happenings of ones own mind outside of a strict subset of feelings and
emotions such as happy, hungry or sad.

Prohibition is a terrible event that is forcing people to live without ever
experiencing these things. Your brain is normally limited to the inputs it
receives from your senses. Psychedelics allow you do disconnect from such a
sober world and invent your own inputs to an extent and it is wonderful. To
think that most people never get the opportunity to do that is painful to me.

^1: This is characteristic of MDMA in isolation as well.

^2: Of course this is anecdotal and is difficult to distinguish from a placebo
effect. I can't imagine a double blind experiment that could prove this, when
asked about long term effects, the active drug group are going to be very
aware what group they were in, but the question you want to answer is not did
you notice the drug, but did it have a long term effect on you.

^3: I come from a moderately wealthy background and there was a huge amount of
indirect pressure to have a stable career and earn lots of money.

------
badusername
Tangential to the conversation, but the website (Timeline) is new to me, and
it is quite interesting.

Does it seem to anyone else that the design is completely backwards? After
reading a news article, I'd wanna learn about what has been happening recently
with the issue, and dig a little deeper slowly. This forces a model where some
small bit of news is followed by a wikipedia entry of sorts.

------
bunkydoo
Well, another one of these posts. Let's beat this topic to death even more.

But real talk, it would be cool if steps were taken forward to change the way
these substances were treated legally and what-not.

~~~
wavefunction
There are those ahead of you, and behind you, all of us a continuum of
experience, lesser and greater, reaching towards the light.

Remember not that you have already reached for the light, but that others
right now are reaching for it, and guide them instead towards it instead of
flipping the switch to "off."

~~~
nemo1618
"We're all just walking each other home." ― Ram Dass

~~~
bunkydoo
One love brother <3

