[What Can Buddhist Meditation Teach us about] [Psychedelic Science? Katherine MacLean] [April 20th, 2013] I wanted to take a moment to reflect on what Bob Jesse called the "arc" of lineage and of all the people who allow you to be in a certain place in a certain time, and it's really interesting to actually notice when you're standing in the middle of that arc, and I can see all of the past and all of the future branching out from here. It's amazing to have all of you here, and amazing to be working with the people that I am at Hopkins. Of course, the acknowledgements extend beyond the Hopkins team. When I arrived in graduate school at UC Davis, we were embarking on this totally crazy project to take a bunch of Westerners and send them into the mountains and have them meditate for three months at a time. It all happened because we had a family rather than just a group of collaborators or academic people or scientists. One of the collaborators from that study, a family member, is here, Erica Rosenberg. So that's exciting to see her, and also the wonderful priestess from my wedding came just for this afternoon, so Sarah, thank you so much. So, yeah, it's just so many people to thank. But I got to give you guys a talk, not just a bunch of thank-yous. So what does Buddhist meditation have to teach us about psychedelic science? I'm sure most of you know about Buddhism, at least a little bit. There's the kind of historical Buddha, Siddharta Gautama, there is the myth, the legend of who he was, and then there is the real cosmic Buddha. The interesting thing about Buddhism is it was just a normal human being who was dissatisfied, even though he had everything he possibly needed to be happy, and he embarked on this quest to find out where true happiness is. Around the age of 29, he left everything that he was familiar with, and was just seeking this enlightenment, this happiness. It was actually, I think, exactly 2,500 years ago this year that he sat under a tree and said, "I'm not going to move until I figure this out." Buddha just means "awakened one." We come from that ancient tradition of mind training, thousands of years old, and the overarching idea of my talk is "how do you take an ancient practice and" "turn it into modern medicine?" I think that Buddhist meditation is a success story in alternative and complimentary medicine that it would behoove us to pay attention to. I think, if we want to take the ancient traditions of psychedelic healing and make them into modern medicine and make them mainstream, we have a really good example in contemplative science, and it's happening right now, and it's a big success story, so that's kind of the gist of my talk. So meditation comes over to the West probably in the late 1800's, but definitely in the 1950's and '60's. It wasn't until the '80's that someone came up with this idea of turning "meditation" into a nice secular term that everyone could get behind, and that's "mindfulness." So we can thank Jon Kabat-Zinn for coming up with a term that Americans could get behind; it wasn't challenging their religion. Mindfulness has now been used in various capacities for treatment of sick people, for pain, mood disorders, addiction; you might be familiar with mindfulness-based stress reduction; there's also relapse prevention. It's also been used to study mental training in healthy people, so looking at optimal functioning, pushing the limits of what we consider to be healthy and well, and it's also been a cornerstone of basic science into neuroplasticity, so, how it is that the brain can change in structure and function in adulthood. I like this little graph down here, because it shows that this was a study, not related to meditation, where people were either physically practicing piano sequences or mentally practicing the sequences in their mind, and it turns out that the brain doesn't care. If you physically practice something or mentally practice something, you get the same change in brain representation of that skill. That's a lot of how we've talked about contemplative science, trying to explain to people what happens when you're just sitting there "doing nothing." Your brain is actually re-learning all sorts of new habits and skills that then can be applied in other contexts. I'll give you just the example of the experience I had as a grad student working on this project called the Shamatha Project. It was the brainchild of Cliff Saron, who is an American neuroscientist, and Alan Wallace, who was born in America, traveled to Asia, and then came back, so he was our bridge to the Tibetan Buddhist culture. They had this idea from the first time they traveled to India togethe hy don't we study normal Americans engaging in intensive meditation training and try to show people whether it's not just kind of where you were born, that you were treated like a god from the age of two, or that you were living in a monastery with no concerns, but that normal people who had committed their lives to this very intensive mental training could change in certain ways. So we conducted two three-month retreats. The original study design was something like a year-long retreat, and it was probably a good idea that we didn't begin with a year, because we're still trying to churn through the data and that's only from three months worth of meditation. But 60 brave souls were willing to sign up, actually more than that; this was about 50% of the people who applied, and each person came to Shambhala Mountain Center in Colorado and meditated every day for three months, and some of us lucky scientists got to live there with them, and we were doing the marathon science mental training instead of meditation. I don't know how many of you have tried meditation or are familiar with any of these papers, but shamatha meditation is a concentration practice. I think it appeals to our sense of getting somewhere, so there's a goal of trying to attain perfect concentration. We begin with the breath, and you focus on the breath. I won't take you guys through this, because people don't really...I don't know; if you like mediation then you're like "ooh, yay; we get to meditate!" But if you haven't done it before you just are kind of fidgeting and getting uncomfortable. So essentially you're bringing all of your awareness to the sensations of breathing, and then as soon as your mind wanders, you notice that it has wandered, and you bring it back, and you just do this over and over and over again, and something really profound happens. The more that you do that, your mind settles down. Maybe before it settles down it goes through all sorrts of other things, but eventually you get to this level of calm abiding, where you have the ability to stay present in the moment and use your attention at will. So it's really simple, but you have to do it. I like this little image here. Very simple; you just sit, focus on your breath, and all sorts of amazing things will happen. These are our group of meditators. ... When they signed up for the study they knew that they would either get assigned to an initial retreat in the winter and spring of 2007, or they would be wait-list controls and get assigned to a second retreat in the fall. So, as you can imagine, this is a luxurious thing to undertake. You have to have quite a bit of money, about $5,000, although it's cheaper than if people had paid a retreat center to do it on their own, so there's a discount for being in the scientific study, but it costs a lot of money, it takes a lot of time. You had to be willing to give up three months of your life at different points in the year, and still we managed to get a pretty...not diverse group, but it's a range of ages, a range of backgrounds, all the way from 22-year-olds who are straight out of college or in the middle of graduate school and taking a break all the way up to some people who had been meditating their whole lives and wanted to just engage in another intensive retreat. This is the lodge where all the meditators lived and where the scientists lived in the first retreat. I don't know how many of you have been to Shambhala Mountain Center. It's outside of Fort Collins and Red Feather Lake, so it's really, really beautiful. This is the stupa on the property. Most of the meditation occurred in the lodge that they were staying in, and they could go around the property. It was a pretty loose structure; it wasn't like a Vipassana retreat where everyone's doing the same thing every day; there was a flexibility, and that was the teacher, Alan Wallace's style. We built labs there so that we could conduct behavioral and neuroscience testing on-site, so that people didn't have to be disrupted in the middle of their retreat. So yeah, these are our portable laboratories. I know that looks like a dungeon, but it was our attempt to create a soundproof and controlled-lighting environment so that we could basically mimic the really expensive and permanent neuroscience and psychology laboratories that exist at universities. You might also notice there's a camera that's pointing straight at the person as they sit in front of the computer, but that was actually covered up during the testing so that we could unobtrusively measure people's emotional responses to certain stimuli. The woman I mentioned earlier, Erica Rosenberg, has created this work of art, which is a 4,000-word, beautiful paper that... I can't say much about it because it's under review right now, but it's so exciting that soon the world is going to see all of this amazing...what happens after three months of basically just paying attention to your breath and sitting to the ability to be with depictions of graphic human suffering, in terms of facial expressions of emotion and self-report. We eventually actually debriefed people, so we had to measure it and not tell them1 that we were measuring their facial expressions, and then people1 could opt in to the data at the end of the study, once they were1 debriefed. That's us collecting data, so that's where we sat1 for many hours every day for three months. We collected,1 also, brain measures of electrical activity at the scalp, so EEG,1 we collected physiology measures... so that's one of our volunteers.1 That's [Stephen Ikely]; he's one of the research scientists1 on the study. We collected blood and saliva, all sorts of different1 biomarkers. The approach here was, "we may never get to do"1 "something like this ever again, so we're going to collect"1 "as much data as possible." That was both a blessing and a curse,1 because now we have more data than we know what to do with.1 So, I'll just take you through one example of a nice demonstration1 of how meditation improves your ability to control your mind1 and your behaviors. We developed this really boring and also1 frustrating task that involves looking at single lines appearing1 at the center of the screen, flashing on and off, and most1 of the lines are long, and you respond when you see a long line,1 and then sometimes a line is short, and you withhold. It's very1 frustrating to do, because you get in this mode of continually1 responding, and then you can't withhold. People do really badly1 at this kind of task, especially when it's about half an hour long.1 What we found is that after about a month and a half of training,1 people were able to improve their performance in inhibiting1 their responses, and it actually translated into how they1 self-reported that they felt at the end of three months of retreat,1 so we used these fancy statistical models to show that1 the better you did at that computer task--which seems really silly--1 predicted how good you felt in all these different domains1 in terms of well-being, mindfulness, empathy, different personality1 measures, how you feel in terms of interpersonal relationships,1 anxiety, and being able to regulate your emotions. I think this1 demonstrates that it's nice to combine very mechanistic1 tasks with something that's real-world. I'll come back to that1 later with respect to psychedelic science. So the bottom line i :10meditation is really good for you. I think everyone should do it.1 I think it's funny--I want to take a step back--that with the Hopkins1 team, we didn't plan this, but we're really taking you guys1 to church this afternoon. [laughter] Beginning with Bob1 and religion and reframing religion, and Brian and Mary1 sharing so deeply about our experiences with volunteers,1 and now I'm trying to tell everyone to practice meditation,1 but that's just our style, I guess. So we found improvements1 in perception, concentration, biomarkers of stress and aging,1 changes in brain structure and function, and there are tons of1 other studies that have looked at changes in the amount of1 grey and white matter in people's brains as they go through1 training and also brain function. It's an exponential growth1 in papers on meditation training, both in adepts and in beginners,1 people who are healthy and who are sick. To sum up what1 contemplative science is now, there are longitudinal studies1 of healthy people, people who are beginning meditation1 practice and long-term meditators, and that has allowed us1 to foray into a much larger field, which is interested in neuroplasticity--1 basically how the brain can change once you're through1 major development and into adulthood. We have mindfulness-based1 therapies for depression, addiction, chronic conditions that1 involve autoimmune disorders. More recently, there's this movement1 toward resilience training. So I included public schools1 along with prison and military because I think sometimes1 we forget that public school is really, really, really challenging1 and suffering for a lot of people. We see this; we're in Baltimore,1 and we see it every day, that while we are having people1 have mystical experiences on a couch, there are people1 who are in acute suffering right next door. I think that what1 contemplative science has offered is that something, a practice1 that's really simple--it's free; once you learn it, you have it--1 that can be used in all sorts of different contexts; it doesn't1 matter who you are. It's also, I think, giving us a tool into1 actually training meditation practitioners to be scientific1 tools, so they can report to us about phenomena that normal people1 may not have access to. I think that there's a kind of correlate1 there with psychonauts, so people who actually practice1 journeying may be better at telling us things about the mind1 than people who don't. So we keep that in mind going forward1 for basic science and psychedelics. Finally, you'll hear this1 if you're going to the dinner tonight, I hope you'll hear more1 about this idea of wisdom and compassion and altruism1 that is coming out of the basic and clinical science in the1 realm of meditation. Okay, so what does all this have to do1 with psychedelic science?1 I'm just giving you an example of one of the findings from1 our studies. It's the one I can take credit for because I was there1 when it happened, and so anything that's good or bad about1 this finding, it's all on me, so that's why I use it. This is1 an example of what happens when you do a longitudinal1 study of healthy people; you can look at how changes in their1 functioning over the long term are affected by a particular1 experience on a psychedelic, in this case psilocybin. Extending1 that forward, you could imagine all sorts of interesting research1 with creativity; openness is related to inspiration, number of1 inventions and patents that people have. There was an Australian1 study that showed that one standard deviation increase1 in openness over time was equivalent to a $60,000 increase1 in annual income in terms of general happiness. You could1 imagine all sorts of interesting applications for psychedelic-based1 therapy, which we've heard a lot about this weekend, for1 treatment-resistant major depression, and we have a couple groups1 in the world now, in the UK and other places, about to embark1 in this direction, looking at brain mechanisms, neurochemistry,1 changes in the brain in terms of stimulating neuroplasticity.1 That all sounds very exciting. However--this is where I'm going to1 say my piece about how psychedelic science should watch out--1 I actually don't think that there is any amount of data or enthusiasm1 that is going to be enough unless we reach out to the people1 who don't think that psychedelic science is such a great idea,1 and not just psychedelic science but psychedelic healing.1 So I would remind people that now mediation is mainstream.1 That's a picture of a congressman from Ohio who's big into1 meditation and mindfulness all of a sudden. He was basically1 at his wit's end and he went on a Jon Kabat-Zinn1 mindfulness-based stress reduction retreat and it changed his life.1 So he wrote this book, Mindful Nation,1 and he passed it out to Congress. I mean, this is1 so mainstream it's almost hard to imagine where meditation1 came from. I think it was not an easy sell at first. I came toward1 the tail end of meditation being accepted, but even when I was1 in grad school, starting in 2004, many of our faculty members1 and fellow academics basically thought that meditation1 was just totally wacky, and why would you waste your time1 on this kind of study? ...All the stuff about mystical experience1 is so powerful at the personal level and in terms of when1 the person goes back into society, but I think we have to be careful,1 because sometimes it sounds really too wacky for people.1 It sounds unfamiliar; it can be scary. We are all celebrating1 this idea of not being tied to a permanent self, but most people1 like the idea of a permanent self [laughter] and when you1 say that "oh, well, this kind of experience can show you that"1 "all is one," it's like "no, no, no. Everything isn't one; it's me"1 "and everything else." So keeping in mind that this is1 the perspective that some people are coming from. Finally,1 this is something that is obvious, I think, and unfortunate,1 that because psychedelics are Schedule I--some psychedelics1 are not Schedule I, but they're all basically illegal for most people1 to use, and illegal is assumed to be dangerous. That's going to1 take a long time to change that kind of thinking, and it's just1 what we have to deal with. So I think going forward we can1 use contemplative science as a model, so we should continue1 with clinical trials, and that's not just, I think, getting FDA-approved1 medications, which a lot of people have talked about at this1 conference. A lot of exciting research is going on in that area.1 But it's presenting a new model for health care and especially1 for palliative care. Contemplative science, too, is offering1 a new model of health and well-being and how to approach1 various points along the life trajectory, especially in death1 and dying. So I think we should keep that in mind, that we1 may not just be suggesting new medicines; we're suggesting1 a new model. Longitudinal studies in healthy peopl don't think1 we can forget how important basic science is in this whole1 enterprise. ...Obama just had this brain initiative, and the public1 loves to see brain images and think about, "oh, I can just"1 "change my brain. It's not something that's wrong with me;"1 "it's just, I need to re-pattern, rewire and train my brain,"1 and doing studies with healthy people can help to show that1 especially with psychedelics, as well as1 contemplative science. I think we should look at both beginners,1 so people who are hallucinogen-naive, and adepts, and I'm using1 the term adept...I mean, this is maybe a little bit sacrilegious,1 depending on your take on Buddhism, but we court monks1 and adepts into the lab, and people who've dedicated tens1 of thousands of hours to sitting with their mind, and we don't1 have that same kind of respect for people who spent tens1 of thousands--well, hopefully not tens of thousands, but1 hundreds of hours journeying with psychedelics, and so I think2 that maybe there's a shift in perspective in how we respect2 the different members of our community who are willing to2 take these journeys, even if we're not, especially because2 they're illegal, so they're taking a risk.2 This is kind of a preachy part, but I think that contemplative2 science has been really successful because the people who2 practice meditation continue to show society how they are helping,2 and there is a very strong ethic of compassion and service,2 and when you're just sitting with your own mind, or journeying2 on psychedelics, it can seem very self-centered. I think2 there's a risk for narcissism and elitism of "I know everything"2 and "I'm just saving myself." In particular, Zen, the approach2 i e sit so that we can be of service. I think that we can2 think about that. Related to the adept idea is that we trip so that2 we can be of service. The better role model that you are2 in society, the better this will help the whole psychedelic2 science movement. This is not a new idea; in 1996, combining2 psychedelics and contemplative science, Joan Halifax,2 Ram Dass, other Zen teachers, Jack Kornfield got together2 and said "well, are psychedelics a help or a hindrance in"2 "contemplative science?" Jack Kornfield said, "I see psychedelics"2 "as one of the most promising areas of modern consciousness"2 "research. I would not be surprised if at some point there"2 "comes to be a useful marriage between some of these"2 "sacred materials and systematic training or practice."2 So we would do well, also, to take the training manuals and2 all of the work that has been done with contemplative science2 and consider how maybe they've provided a nice platform2 and psychedelics provide a nice fuel, and we can merge2 those two together, and I think it'll be mutually beneficial.2 As Brian and Mary talked about, if you were here earlier,2 psychedelics are actually really good contemplative tools.2 So they teach you how to be here now, maybe not without2 a lot of struggle, but most people get to a point of being2 in the present moment at some point in their sessions,2 at least in the sessions that I've seen. It's basically an awareness2 and acceptance of the moment-to-moment experience.2 In different forms of Buddhism, they talk about specific2 experiences that are enlightening in and of themselves.2 If you look at the list I have here from Theravadan Buddhism,2 we're all familiar with mindfulness and concentration, but then2 there are all these other ecstatic states that are actually2 considered prerequisites for enlightenment, and if we can2 give people an access to that state, then we can actually2 study whether that helps people along the contemplative2 path. Going back again to the lineage, Leary and Alpert2 (who became Ram Dass) and Ralph Metzner put together2 a really nice guide for psychedelic experience. It's not a perfect2 translation at all of the Tibetan Book of Living and Dying,2 but it talks about the connections between psychedelics2 and contemplative practice. I would also suggest that a lot2 of people--I've learned with being with long-term meditators2 and watching people go through retreat that you can actually2 meditate a long time before you learn how to let go and you2 learn how to accept your inherent impermanence and2 interconnectedness with the world. I think that psychedelics2 can serve as a tool, beginning meditators, middle of the path,2 even long-term meditators, to test your assumptions about2 your own practice. ...You can read this quote. This sounds2 really hardcore, but some people I've met have had experiences2 like this where they come face-to-face with this fear, and2 anecdotally, speaking to meditation teachers, sometimes2 people who have experiences with psychedelics are able to2 be familiar with that kind of state in their meditation and2 move through it.2 At Johns Hopkins, we are undertaking--we just completed2 a study of beginning meditators who started a meditation2 practice and also received psilocybin, and Roland Griffiths2 will be talking about that tomorrow. I'm not sure what he'll say2 because I've been blind to the study design since 20092 when I joined the team, so I'm actually really excited for his talk2 tomorrow. We're about to embark on a new research study2 with psilocybin in long-term meditators, and we have tentatively2 a session plan for as soon as we get back. These kind of things2 take a long time. I'm not sure many people appreciate how long2 it takes to get a psychedelic research trial going, but there's2 a lot of paperwork, a lot of bureaucracy. It's all very necessary2 at some level, but by the time we actually run a volunteer,2 we've probably been thinking about the study for about2 two to three years, if not much longer.2 Robin Carhart-Harris--are you speaking tomorrow, Robin?2 Yeah. So Robin will be talking about this tomorrow, but2 there's some really intriguing new findings from last year that2 seem to actually continue to replicate, which is that with2 IV psilocybin there are decreases in default mode networks2 that are important for maintaining a sense of self in space2 and time. My friend Judd Brewer at Yale had found a very2 similar pattern of brain activity in long-term meditators2 when they were meditating versus at rest. When Robin's2 paper came out, Judd called me immediately, and he said,2 "it looks like from the exact same figure from my paper."2 Judd's not the first person who's found...there are other2 papers that have found something similar, and so we're2 thinking about ways to test the overlap and differences2 between a selfless state on something like psilocybin and2 a selfless state during meditation. Finally, because I'm just2 out of time, I want to bring us back to this idea of meditation2 turning into something like mindfulness. The interesting2 thing is, once you give people a hook, you don't actually2 have to get rid of any of the other stuff. It's just simply a way2 to make a connection. So right now, the contemplative science2 field is finally moving beyond this idea of "oh, it's just mindfulness"2 "training; it's just concentration training." We're actually2 starting to re-investigate some of the more mystical, religious,2 ethical practices that originally came over with meditation2 from Asia. There's also been a lot of debat id Jon Kabat-Zinn2 do a disservice by taking a religious ancient tradition and2 turning it into something secular? I don't think so, because2 I don't think it would have been possible to as quickly get2 Americans on board with the idea of sitting with their mind2 if they didn't have this hook of this secular, very neutral-sounding2 mindfulness term. I don't know what the hook is for psychedelics.2 There are limits to the analogy with dreaming, but it works2 for a lot of people. People who haven't had altered states2 of consciousness, dreaming is sometimes the only thing2 that they've had happen to them that is dramatically different2 than real life. There's a hook with a creativity enhancement2 technique or imagination. Disney World is one of the most2 successful classic American enterprises, and it's because2 Americans love imagination and creativity and entertainment,2 and so that might be a hook. Awe and wonder's2 a little bit more challenging, but people like the idea of wonder.2 Being more wild in the wilderness, rites of passage...2 as you go down this list, we get to, oh wow, you just saw dying.2 That's scary; that's not going to be the hook, but it might be.2 So we're going to have a lot of people in our country, currently2 and also very soon, who are in states of not quite out of this life2 but not quite in it, so in very serious pain, disability, sitting2 by themselves in hospitals, and going through the dying2 process, and we don't have a way to deal with that in this country.2 I think that psychedelics may actually be coming around2 at just the right time to help our country finally come to terms2 with these transformations, not just at the beginning of life2 or in the middle of life, but at the end of life.2 I had the honor to sit with Joan Halifax at her retreat center2 in December, and I was just so amazed by how there are2 actually allies for our movement in psychedelic science2 in other field n palliative care, in midwifery, in so many2 other areas that it hasn't even occurred to them. It occurred to2 Joan Halifax a while ago; she's no longer a proponent,2 I think, directly, of psychedelic science. She's kind of a supporter2 on the sidelines, because she's a Zen priest now, so she's got2 a long tradition to uphold, but there are these allies in all these2 different areas that we can reach out to, and I think we need to2 remind ourselves that we're not just teaching people the new model;2 there are also models out there that we can use in psychedelic2 science to help people get more familiar with everything2 that we're doing, so that they can appreciate some of the2 enthusiasm and maybe say, "well, you know what, I don't"2 "want to do this, but a family member of mine is really sick,"2 "and they deserve to die with dignity and with peace." So I will2 leave you with that; thank you so much. We have so much2 ahead of us, [applause] and there's a lot of momentum,2 so thank you. [applause]2 [Presented b he Beckley Foundation]2 [Council on Spiritual Practices]2 [Heffter Research Institute]2 [Multidisciplinary Association for Psychedelic Studies (MAPS)]