Doctors came to see her singly and in consultation, talked much in French, German, and Latin, blamed one another, and prescribed a great variety of medicines for all the diseases known to them, but the simple idea never occurred to any of them that they could not know the disease Natasha was suffering from, as no disease suffered by a live man can be known, for every living person has his own peculiarities and always has his own peculiar, personal, novel, complicated disease, unknown to medicine. - Leo Tolstoy
Psychedelics: again the pilgrimage - current experience, low/moderate dose
"The universe is full of magical things patiently waiting for our wits to grow sharper." Eden Phillpotts
"You'll never enjoy the word aright, until the sea itself floweth in your veins, till you are clothed with the heavens and crowned with the stars." Thomas Traherne
A couple of days before I had taken a classic high-dose psychedelic trip, complete with eye shades, headphones, playlist and trip-sitter ... described in this earlier post. And that experience was immense for me ... deeply special. But today I was interested in doing something more low key and a bit more off-piste. So I took a 15gm dose of truffles and did some exploring of the Hague on my own. Now this isn't necessarily a great idea. As I've said about walking alone in the Scottish mountains ... "I may get killed or badly damaged doing this, but I don't want to get into trouble out of stupidity. So I may take some risks, but only when I've planned them, taken precautions, and decided the balance of gain over risk is reasonable for me." And that pretty accurately described my approach to this lower dose trip. I knew fairly well what this batch of Cosmic Connector truffles was like (having taken 30gm a couple of days earlier). I was only taking half the dose, but actually it was even weaker than that as my brain 5-HT2AR receptors were down-regulated due to taking the high dose a couple of days before. I have once taken just 5gm of truffle to test its effects at very low dose - for me, the experience was subtle and slight (a little quieting of the 'ego' and some mild increases in sensitivity to nature, emotions, and other people). Of course, people do vary a good deal both in how they metabolise psychedelics and how they react to the changes that are produced. I estimate this 15gm, taken two days after 30gm, was equivalent to what maybe 10gm would have been like - taken clear of any earlier trip effects. It was certainly a good deal stronger than 5gm - when taken well clear of any other intake - has been. I already had plenty of experience from my student days of navigating the world on considerably higher doses of psychedelics than this. And I also waited for over 90 minutes after taking this 15gm dose to assess how high I'd gone and how functional I was - see the diagram below from the recent 2018 paper by Geiger & colleagues on the metabolism & pharmacology of psilocybin. So a bit risky, but not very risky.
And how was it? Fascinating ... and a lot richer than I'd expected. Interestingly I had a lower key version of the turbulence I reported at about 60 minutes into the trip on the high dose a couple of days earlier. This time though, I simply 'waited it out', and after another quarter of an hour or so I was out and into a quieter, calmer state again (suggesting the experience - slightly upsetting body sensations & anxiety - was partly due to a stage of the psilocybin absorption sequence with this particular batch of truffles). Over 90 minutes after taking the 15gm of truffle tea, I decided I was pretty competent and made my way carefully down the stairs and into the street. Great to be outside. Interestingly, if anything, I felt a little safer than usual ... in that I was very present and paying lots of attention to my surroundings. Walking across grass where there was occasional dog shit, I clearly felt that I was less likely to step into it than usual! I wasn't off into day dreams and thought patterns, my ego activity felt quietened ... while my senses, emotions, sensitivity to others felt heightened. In a strange, very interesting way, I felt a better version of myself. On this moderate dose of psilocybin, I was happy, full of wonder, joyful. The buddleia had never smelt so delicious. Seeing young children reuniting with parents at the end of their school day was precious & moving. The trees were so alive and beautiful. Crossing roads took up clear attention in a way that felt safe. I remember thinking, this is what I have hoped mindfulness meditation practice could help me be (and which with my nearly 50 years of meditation practice I haven't reliably achieved). Here's the picture I drew the next day:
And I walked to the GEM - the museum of contemporary art. I laugh with happiness just remembering it. Although this was my first outside-in-the-world (moderate dose) trip for decades, I was routinely out in the world when I took LSD as a student, so I'm sure this experience was much easier for me than it would have been for someone naive to these states. And the art gallery was so moving, rich, multi-multi-layered ... my 'best art gallery visit ever'. Breathtaking, in some ways outside time ... but later, when I scored myself on the Mystical Experiences Questionnaire (MEQ30), I was nothing like as high as I had been on previous high-dose trips with eye shades, headphones & led by the path of the music playlist. Such different experiences in many ways. And on my way back to my Airbnb (coming down off the trip now) I stopped at the delightful Blossom Cafe and such a precious, fun, delicious stop-over it was.
(It was only some time later that a friend pointed out parallels with the intriguing book 'The museum dose: 12 experiments in pharmacologically mediated aesthetics')
So what did I learn? Personally, in some ways, this moderate dose trip was easier than the high dose trip to link to my day to day life. In some ways it highlighted understandable, internal changes I can maybe make or slip into, that are more obviously applicable to daily life than the more deeply extraordinary, ego-dissolved high dose experiences. Note this was a low/moderate dose trip ... not at all microdosing which involves taking only 5-10% of a usual full psychoactive dose. So microdosing would involve maybe taking only 1gm of truffles ... or very roughly 1mg psilocybin ... while today I was taking at least 10 times this dose. For more on this see, for example, the 2019 papers by David Nutt & colleagues "Microdosing psychedelics: more questions than answers? An overview and suggestions for future research" and by the Sydney-based Australian pair Polito & Stevenson "A systematic study of microdosing psychedelics" ... and Torsten Passie's recent book "The science of microdosing psychedelics". Microdosing is very intriguing ... it cries out to be better researched ... but this wasn't the territory I was exploring today.
I was taking a moderate dose trip (10+mg/70kg body weight). And what does the research say about this? Back in 2004, Felix Hasler & colleagues from the Heffter Research Centre in Zurich looked at the effects of varying psilocybin doses in eight volunteers in their paper "Acute psychological and physiological effects of psilocybin in healthy humans: a double-blind, placebo-controlled dose-effect study". The doses they used were equivalent to approximately: Placebo (PL) 0mg; Very Low Dose (VLD) 3mg; Low Dose (LD) 8mg; Medium Dose (MD) 15mg; High Dose (HD) 22mg per 70kg body weight. The volunteers seemed to have been tracked rather exhaustively over the six or so hours of each of their five trips ... being assessed with a whole series of repeated physical tests and questionnaires (so not, it seemed, the current standard eye blinds/headphones environment of most research/intervention studies). One of the main measures used was the "Altered States of Consciousness Rating Scale (5D-ASC)". You can see, from the diagram below how increasing the dose progressively increased scores on the 5D-ASC (I personally had taken somewhere between the LD and MD doses today and considerably higher than their HD dose a couple of days ago).
And more recently, the team at John Hopkins looked at the effects of changing dose strength in eighteen healthy adults in their 2011 paper - "Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects". They used 0, 5, 10, 20 & 30mg/70kg body weight. Although again the participants were subjected to regular tests during their trips, the researchers were explicit that participants were encouraged to use the typical therapeutic mix of eye shades, headphones & music playlists. Trained monitors rated the participants regularly on overall behaviour & mood (amongst a series of measures). Here - on a 0 to 4 scale - are their estimates for the different dose effects over the trips' 6 hour duration:
Of particular practical interest, they gave half the participants the 0-5-10-20-30mg psilocybin monthly dose sequence in ascending order and half in descending 30-20-10-5-0 order. As is typical in psychedelic research, higher doses are both more likely to be valued and also more likely (at some point during the trip) to produce high anxiety. As you can see from the chart below showing well-being/life satisfaction rating a month after each trip, taking doses in ascending sequence produced better outcomes.
Ratings (of how personally & spiritually meaningful the experiences were, and of how much sense of well-being & life satisfaction improved) were significant at one month follow-up ... and even more so at fourteen month follow-up! The researchers commented that "The domains of change most frequently cited were better social relationships with family and others, increased physical and psychological self-care, and increased spiritual practice."
Good ... and overall my own experience and the available research suggests that (if one isn't too daunted by the time & expense) a starting dose of about 10mg psilocybin/70kg body weight (approximately 10gm of truffles) is sensible for those who have no previous experience of psychedelics (with the option to top up by 5-10gm at 60-75 minutes into the trip if one wants). Subsequently one would probably aim to increase dose to 20-30mg/70kg body weight (as this increases the chances of transpersonal/mystical/peak experiences, which in turn increases the chances of better long term benefits) ... so about 20gm initial dose with an option to top up by 10gm or so after about an hour. Having taken second doses of psychedelics at two day and three day intervals after high first doses, there seems clearly to be some receptor down-regulation with the second dose ... but less than one might expect (so possibly just a 20% or so reduction in the 'power' of the second trip when leaving two clear days after the first). As always there will be a good deal of variation depending on truffle strength, individual metabolism, and psychological readiness.
An interesting further question I'm left with is how important for therapeutic benefit from psychedelic trips is the current emphasis on eye blinds, headphones & musical playlists. There are research papers suggesting considerable value from such practices - see for example "The hidden therapist: evidence for a central role of music in psychedelic therapy" - and quite probably researchers may find it safer to have participants kept to well-monitored therapy rooms. However the large scale survey - "Predicting responses to psychedelics: a prospective study" - reported (to the investigators' apparent surprise) in the discussion of "Set, setting, and drug dose as predictors for acute psychedelic experience measures" that "According to this study's finding, being in a therapeutic environment did not seem to influence the nature of the psychedelic experience in any particular way. This somewhat surprising finding might be interpreted as suggesting that it is not necessarily essential that the environment be carefully designed with therapeutic ends in mind, which would put fewer constraints on the requirements for designing the environment for psychedelic experiences. However, what "being in a therapeutic setting" means to an individual is subjective and variable, and we did not pre-define what we meant by it." Intriguing. It's probably going to be a very long time before anyone gets funding for research that contrasts different therapeutic settings, but I personally would be interested in taking a moderately high dose trip in nature and a similar dose trip with blinds/headphones/music to explore more fully the similarities & differences. Remember that psychedelics can be so much about freeing us from our 'small minds' and increasing connection ... researchers have noted "The domains of change most frequently cited were better social relationships with family and others, increased physical and psychological self-care, and increased spiritual practice."
Overall, the take-home messages for me are the potential value of moderate dose trips both for learning/benefits in their own right ... and also as helpful stepping stones to high-dose experiences. And for the briefer & final fourth post in this sequence, see "Psychedelics: again the pilgrimage - current experience, lessons".
Addendum: I said above "It's probably going to be a very long time before anyone gets funding for research that contrasts different therapeutic settings, but I personally would be interested in taking a moderately high dose trip in nature and a similar dose trip with blinds/headphones/music to explore more fully the similarities & differences." Well I have now explored this personally. As they say "The plural of anecdote is not data" and my personal experience is interesting & informative, but it's important to be cautious about assuming others would have similar experiences. So I took two twelve & a half gram trips ... using the same Cosmic Connector truffles I've already described. On the first of these I went out into nature and on the second pretty much identical dose I both used an eye mask & playlist and, for an hour in the middle of the trip, simply used silent sitting & walking meditations. Wonderful. On the Mystical Experience Questionnaire my scores were 76 and 68% ... so technically both trips were 'complete mystical experiences' and fascinatingly I went 'higher' in nature than I did with the playlist. These MEQ scores were higher than during the museum trip I've described above, but not up at the 89% of the 30 gram trip I've described earlier (and not so prolonged either). I'm getting a good deal more experienced with psilocybin, but I would be cautious and plan carefully before considering taking a dose as high as 30 grams away from a safe, monitored environment.
[Towards the end of 2019, a further research study emerged that throws further light on the tripping-out-in-nature issue - "From egoism to ecoism: psychedelics increase nature relatedness in a state-mediated and context-dependent manner" - with its abstract stating "(1) Background: There appears to be a growing disconnection between humans and their natural environments which has been linked to poor mental health and ecological destruction. Previous research suggests that individual levels of nature relatedness can be increased through the use of classical psychedelic compounds, although a causal link between psychedelic use and nature relatedness has not yet been established. (2) Methods: Using correlations and generalized linear mixed regression modelling, we investigated the association between psychedelic use and nature relatedness in a prospective online study. Individuals planning to use a psychedelic received questionnaires 2 weeks before (N = 654), plus one day, 2 weeks, 4 weeks, and 2 years after a psychedelic experience. (3) Results: The frequency of lifetime psychedelic use was positively correlated with nature relatedness at baseline. Nature relatedness was significantly increased 2 weeks, 4 weeks and 2 years after the psychedelic experience. This increase was positively correlated with concomitant increases in psychological well-being and was dependent on the extent of ego-dissolution and the perceived influence of natural surroundings during the acute psychedelic state. (4) Conclusions: The here presented evidence for a context- and state-dependent causal effect of psychedelic use on nature relatedness bears relevance for psychedelic treatment models in mental health and, in the face of the current ecological crisis, planetary health." You can see from the text I've underlined that there seem quite specific context-dependent advantages to taking trips in nature. Fascinating.]
So what are some of my impressions from this experiment? Well, I think there are plenty of advantages to the well-researched trip format involving lying down with eye mask, headphones & playlist. However my experience is that being in nature can involve just as deep a trip ... but obviously there are safety issues to consider. As far as playlists are concerned, I've now used the ones available from John Hopkins and from Imperial College as well as one I put together myself. I found the home-made one most deepening, followed by the John Hopkins, followed by Imperial's. However I absolutely understand that this is hugely about 'taste'. I have now also spent sizable chunks of trips both dancing and meditating. I recommend both (although again, dose may affect what one feels capable of).
I think it would be fascinating to be involved in a meditation retreat using psychedelics (without music) as already reported by Smigielski & colleages earlier this year - see "Psilocybin-assisted mindfulness training modulates self-consciousness and brain default mode network connectivity with lasting effects". I strongly believe that psychedelics have the potential to enrich & deepen most forms of spiritual practice. I think the personal intention one has going into the trip and the choices one makes in the trip itself (for example to surrender to the experience as fully as possible) are of real importance when it comes to psychedelic associated spiritual experience. There's a good deal of interesting work emerging. See, for example, three papers from last year that explore this territory - "Psychedelics, meditation, and self-consciousness", "Classic hallucinogens and mystical experiences: phenomenology and neural correlates" and the classic "Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors". And another paper published this year also speaks to these overlaps - "Survey of subjective "God encounter experiences": Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT", as will the "Religious leader study" at John Hopkins. As an initial proposal, how about a six day retreat - day one, arrive, meet, begin the standard sitting/walking retreat schedule; day two, continue the schedule but add 10gm of truffle (with an option at about one hour to increase by a further 5gm); day three, continue with the sitting/walking meditation schedule with some space for discussion of day two's experience; day four, the schedule but with an added 20gm trip (with an option to top up to 30gm); day five, schedule, review, integration intentions; day six, schedule, with the retreat ending in the afternoon. It's likely this (or something like it) would be a helpful format ...
And overall, it's no surprise that if one wants to get to know something better (e.g. psychedelic states of consciousness), it's often helpful to approach the area from different angles ... for example, varying dose, music, time in nature, use of meditation/dance/art, on one's own, with another, in a group ...
And the next post is "Psychedelics: again the pilgrimage - current experience, lessons".