‘Magic Medicine’: It's hard to ignore the therapeutic potential of psychedelics
15 November 2018 12:38
At one point in Monty Wates’ sensitively probing documentary about a psychedelic drug trial, one of the volunteers compares the experience to ‘ingesting a very good psychotherapist’. It’s an illuminating moment; one that gets close to the core of this fascinating, inconclusive area of research.
After decades spent on the fringes of medical research, psychedelics are facing something of a resurgence. Mid-20th century experiments on LSD and other hallucinogens fell by the wayside during the era of Nixon’s anti-drug rhetoric, with ‘Schedule I’ categorisation in the US meaning these substances were deemed to have ‘no recognised medicinal value’. Now, a tentative number of trials are driving renewed interest in the therapeutic benefits of these often maligned drugs.
Wates’ film follows three subjects of a trial headed by Dr Robin Carhart-Harris at Imperial College London, investigating whether psilocybin – the active compound in magic mushrooms – can cure depression. All three volunteers have suffered long-term from the condition, seemingly resistant to any kind of treatment. Can a powerful psychedelic experience succeed where other approaches have failed?
The film follows the three men as they visit Imperial for a preliminary dose, undertaken in a clinical room decked out with candles, muted curtains and atmospheric music. It looks a tad unconvincing, as if someone set up a massage parlour in a hospital ward, but it seems to put the volunteers at ease. Two doctors are in the room for guidance, holding a hand or offering a soothing word when needed. The first dose is followed a week later by a second, much stronger, and then the real trip begins.
‘In normal waking consciousness, we are operating in what’s called the default mode,’ Dr Rosalind Watts, a clinical psychologist on the trial, tells me. ‘This is your standard behaviour patterns; what the brain goes into when you’re not being distracted by anything else.’
What psilocybin seems to be able to do, Watts explains, is shake up that default mode of thought: ‘One way of thinking about it is that if you sledged down a mountain on the same track again and again, you’d make a very deep, rigid pathway. Psilocybin is a bit like a snow plow, introducing a state of acute plasticity; introducing chaos. From that place of flexibility, new pathways can emerge.’
It’s grueling to watch the footage of the trips themselves. There’s little in the way of pleasant hallucination and contagious giggling. One man, Andy, seems to fight against a traumatic childhood memory. Another, John, wants to leave but is eventually convinced to stay. Later, he describes it as one of the worst experiences of his life. In most cases, though, there’s a sense that something important has been unearthed in the process.
‘It’s a position of a lack of control,’ says Watts. ‘You’re daily consciousness is trying to keep you in control. This is like a total act of surrender. You’re surrendering to chaos; the fullness of you and your life. What we’ve seen in that, in that situation of flexibility, what tends to come up is the really important stuff, like it’s identifying a glitch in the system.’
It is Andy who goes on to compare taking psilocybin to ingesting a very good psychotherapist. Watching the self-revelation he in particular undergoes during the trial, it’s tempting to see the whole thing as an amped-up version of therapy. Instead of months and years spent digging through fears, impulses and family relationships, the power of the shroom has helped him locate a root pain in a matter of hours. Like a thorn in a thumb, it can be plucked out and the healing can begin.
But any sense of psilocybin as a panacea is swiftly put to bed, as the mental plasticity and renewed sense of self is shown, sadly, to fade. This is at its most heartbreaking with John, who regains a degree of involvement with his family only for old ways of thinking to creep back in the ensuing weeks. So little is known about what shape therapy with psilocybin could take, and regulation continues to make it difficult for doctors to develop long-term plans, or who responds to what. One of the three subjects, Mark, doesn’t seem to undergo any kind of mental jolt from the drug.
Trials such as the one at Imperial are nudging our understanding of psilocybin; with Watts predicting availability of the drug on the NHS within 10 years, but there are challenges – and not all of them are regulatory. A recent investigation by Quartz highlighted the work of Compass Pathways, a for-profit company that’s aiming to be the first legal provider of psilocybin. It counts amongst its investors the Silicon Valley libertarian Peter Thiel, a prominent supporter of Donald Trump’s 2016 presidential campaign. Critics have questioned the firms aims, and whether it is rushing to bring the drug to market.
The fact money is coming into the equation is ruffling feathers in the psychedelic community, but it’s also perhaps a sign that the therapeutic use of psychedelics is teetering towards the mainstream. Whether or not Compass Pathways’ for-profit approach is a betrayal of the field, or an inevitability on the part of the pharmaceutical industry, there’s a feeling that if things are rushed or handled poorly now, it could end up pushing psilocybin back into the peripheries.
Ultimately, these larger shifts around the policy and business of psychedelics aren’t the focus of Wates’ film. The director tells me he wanted his documentary to be a human story, and while the trial is the backbone of Magic Medicine, it’s the depiction of long-term depression in the three volunteers that lingers longest.
Watching the hope of the men, and the awakening in the days after, whittle and subside is testament not only to the incompleteness of the therapy, but to just how pervasive depression can be. With his delicate line of questioning, Wates draws out the ungraspabability of the condition; its lack of clear causes and solutions. Psilocybin might shake up the mind’s groundwork, but new pathways are by no means an easy thing to carve.
In a standout scene, months after the trial, John is walking his dog in the countryside. The light is gentle, the grass is luminous. Self-aware, he says he knows to some people this might seem like paradise, but to him it’s hell.