- It's truly my pleasure to introduce you Professor
and one of my colleagues Doctor Charles Raison.
Doctor Raison, an MD in Psychiatry
is the Mary Sue and Mike Shannon Chair and Professor
in the School of Human Ecology.
Specifically in the Department of Human Development
and Family Studies.
He also holds a joint appointment in psychiatry
in the medical school on campus.
So we get to share him with med school.
Doctor Raison received his undergraduate degree
from Stanford University
and his MD from Washington University,
one of the really premier medical schools in the nation.
Doctor Raison is internationally recognized
for his work in depression and he's going
to tell us today about how ancient practices
can help all of us become happier in modern society.
So without further ado please welcome Doctor Chuck Raison.
(audience clapping)
- Well, thank you I'm glad to be here today.
I'm going to talk about depression.
I'm going to try not to be too depressing.
But that is the issue with depression.
The fact that it causes intense emotional suffering
from the people that are afflicted with it.
And I am sure that there are plenty
of people in this room that have had a go with it.
You've had family members had a go with it.
We know actually that if you look
at overall disability from illness,
depression just recently became number one in the world.
And we know rates of depression are higher in the US
than they are in many other places.
We know they're higher in women by a two to one
compared to men, especially earlier in life.
So young women in America are carrying
a massive load of pain and suffering.
It's everywhere.
But it's especially trenchant and horrible here.
I've got slides and what this slide shows.
Blue means depression is worse.
Red means the other thing is worse.
And yellow means it's a tie.
Heart means they've had a heart attack within the last month.
So what you can see is that people
are more disabled from even in this study
mild depression than they are from everything
but just had a heart attack.
It is a killer.
It is the primary cause of suicide in the world.
This is a horrible problem.
And you know unlike things like schizophrenia
that occur in very few people,
maybe one or 2% of the population,
about 20 to 40% of people will have a go around with this
in their lifetime depending how you ask them.
This is a way that humans come apart under adversity
and all over the world from hunter gatherers out
in the jungle to people in the high rises of New York,
humans have this same syndrome.
And it is really a big problem.
Unfortunately it seems to be getting more common
and probably worse.
These are recent data in the United States.
The graph on your far upper right
or your far upper left actually
shows this steady increase from 2005 to 2015.
Now it's interesting it's not all groups.
It's young people and old folks.
So people between the ages of 12 and 25 and over the age
of about 60 are having the largest increases.
Middle class folks are doing better
than either the very poor or the wealthy.
You know as gaps grow in a society people on both ends
of the inequality suffer in different ways.
And this shows that psychological suffering.
You see the same thing with education.
But the point is, lots of data that this is something
of a modern contagion that despite having
an increased GDP,
our HDP, our happiness quotient, seems to be dropping.
It's not equal by state.
You'll see that Wisconsin is about middle.
It's not the best, it's not the worst.
We do manage to edge by Minnesota.
I don't know what's going on up there.
(laughter)
But it's everywhere.
Now, this says, "Okay maybe I need to change my life.
"Or maybe you could just tweak my medication."
And that really gets at the essence
of how psychiatrists like myself
and patients deal with depression in the United States.
If you're lucky you can go and get therapy
but most people are in this world.
And have been now for 30 years, 40 years.
There are all sorts of antidepressants to treat depression.
You've all seen the ads on the TV.
And to quote Chekhov,
"When a lot of remedies are suggested for a disease,
"it means that it cannot be cured."
The reason we have so many treatments for depression
is because none of them work as well
as we'd like them to work.
And in fact I'm going to try to--
I'm going to show you a graph here
and I want to tell you something about antidepressants
that's really important and this is actually relevant.
If you get depressed or if a family member is depressed.
So here's how these kind of graphs work.
On the up axis, the Y-axis, is depression score.
And as you go down it means
the person's getting less depressed.
Going this way on the X-axis is time.
So in this study it's weeks. One week out to eight weeks.
This is a data set of about 3000 people
that either got an antidepressant,
one of several types of antidepressants or a placebo.
And a placebo is just a sugar pill.
Doesn't have any active ingredient. It helps you with depression.
But placebos make people better because people feel hopeful.
In studies like this they're not sure
if they're getting the placebo or the active medicine.
So it really has an effect.
And you may have heard that there's been
this sort of re-examination of depression,
antidepressants in the last decade,
People say they don't work.
It's on data like this that
that conclusion is drawn.
So you see the green line is placebo.
Do you see that most of the down movement
over eight weeks is shared.
The red line's not much better is it?
It's about three points better.
That's why antidepressant studies need hundreds of people
'cause you need a lot of people to accurately see that kind of difference.
Now this has been thought to sort of suggest
that antidepressants don't really work very well.
But the truth, the truth is both more hopeful
and more discouraging.
It's brighter and it's darker.
Because when you do a bit of complicated math
to figure out whether people,
whether the people in the antidepressant group
represent one homogeneous population.
And whether the people in the placebo group represent
one homogenous population or whether within those lines
there's other hidden lines that are truer.
You see this.
And what this says is that about 75%
of people who get antidepressants
are in that red line, the lower one.
Do you see how much better it is now than the green line?
Now that's a significant difference.
Anybody could tell that difference.
About 3/4 of the people that take antidepressants
do a lot better than people that take
a placebo over the short term.
Antidepressants have other problems
when people have to take them for long periods.
That's the light part. The dark part is that upper line is the 25%
of people who do much worse
when they take an antidepressant.
Isn't that interesting?
Now how come we don't recognize this typically?
Because when was the last time your doctor gave you a placebo?
Right? So what this says in fact is that if you start
an antidepressant or your family member starts
an antidepressant and you're two or three weeks in
and you're really not feeling well.
You should be getting a salt pill or a sugar pill.
That antidepressant is doing something in your brain
that's really not helping you.
So and again we know that antidepressants often fade with time.
They have side effects.
When you stop an antidepressant almost everybody
that has any kind of chronic depression
will crash and burn usually within a month.
So these agents are life savers.
I'm a psychopharmacologist. You come to see me as a patient
and I will write you a script for an antidepressant.
But I've spent much of my life trying
to put myself out of business, in that regard.
And trying to find things that will supplant
or transcend or at least be good partners
to these other agents that we currently have.
And that's really what I want to spend the bulk
of my time talking to you about today.
So everybody knows in mental health,
everybody in psychiatry knows that we're sort
of been stuck for about 30 years.
You know unlike cancer where survival rates
have just skyrocketed compared to 1980.
Rates of depression and suicide are getting worse.
So we're not helping anymore now
and maybe we're helping less.
So there's generally two approaches
that the field is taking.
And the top picture is by far the most common approach.
Which is to basically re-engineer human beings.
So there are very active research programs looking
at sticking wires in people's brains.
They stick it here, they stick it there.
It's sort of like dart throwing right?
They try different brain areas.
They stick wires on your chest
and activate nerves that go up.
The military is working on bionic implants.
Computer chips that they're putting in people's brains
that are soldiers that have PTSD.
This is the movement of the field.
The other thing that the field is trying to do is re-engineer our DNA.
That's turning out to be very difficult.
I think that frankly we will begin to see
human computer sort of cyborg-y type solutions
before we see completely redone DNA.
The DNA has really been a challenge.
But this I call it sort of the Robocop future. That seems to be.
There's a lot of money in it. There's a lot of industry in it.
Humans like to fiddle with things.
It's just the way we are.
And so I think over the next 30, 40 years,
you will see this very powerful transformation
and whether that's good or bad is an interesting question.
I don't know if you know if we have a little wire
in our head that makes us silly happy all the time,
we'll look a little bit like Brave New World.
I'm not sure that that's the greatest thing.
You can see that once we figured out how to do plastic surgery
all the movie stars started looking alike.
I worry that once we figure out how to do
the equivalent in the brain we'll all start thinking
and feeling alike, which will have
some real detrimental things and partly because of that,
and partly because I'm kind of a nostalgic fellow.
I am one of the people that are involved
in a very different approach.
Which is trying to understand how,
what kind of animals humans are. What we evolve to be.
What that evolutionary pathway has sort of made necessary
for us to feel well.
And try to figure out are there ways that we can optimize
what we are right now as regular old human beings.
Someday yeah, they'll put the chip in my head.
Meanwhile there's a lot of potential
that most of us a squandering.
If we reach back into some of these more ancient ways,
what kind of potential do they hold
actually for enhancing emotional
and mental well-being in the modern world.
And as Soyeon mentioned we've come to call these
ancient practices and there's many of them.
They all share in common certain features.
So the first thing to say about them
is that they have this ability to--
I use the word supercharge as I did
in the title of my talk.
That is the ability to supercharge
or really push or drive pathways in the brain and body
that when stimulated improve health
and enhance emotional well-being.
Now they do this, and this is interesting,
because these pathways in capacities
are things that evolved that we need stimulated to feel our best.
I'll give you an example of something I'm not going to talk about today.
So humans generally don't do very well
when they're really isolated.
So the worst thing you can do to a person in prison
is stick them in solitary.
Humans evolve to need certain types
of input from other people.
When I come to the reception tonight you know,
if you walk up to me and say man that lecture really stunk.
Oh God I could barely keep my eyes open. (disgusted sound)
I'm going to feel very differently than if you come up
to me and say wow I really liked that. That was interesting.
Those are two very different types of input
and humans do much better with the second input
than they do with the former input.
So, please don't give me the former input.
I don't want to know. (audience laughing)
Because we need these inputs and because the modern world
has separated us from a lot of them actually.
And some of the ones that we're most separated from
I'm not going to talk about today because I only have 45 minutes with you.
But in general the modern world
is bizarrely unnatural
to the type of environments that we evolve with.
It's a wonderful place.
But the problem is if we're not getting
these ancient inputs that we need
to feel like we're succeeding in life,
it makes the modern world very very hard to handle.
So my proposition is that if you really want
to make the most of modernity and all these wonderful things
it has to offer we need to reach back
into the past not for the purpose of sort
of being all nostalgic and going back
to hunter gatherer days.
But to try to figure out how can we
incorporate these types of inputs?
For instance like, we all need to feel good about ourselves
and sometimes in the anonymity of the modern world
that can be a hard thing to find.
We would do better if we had close friends
who were honest with us but were positive right?
So I mean we can think of all sorts of examples of this.
My suggestion is that there are these
very interesting practices and procedures
that can be harnessed to help us
do that in the modern world.
And that because we're talking about depression,
turn out to be novel antidepressant strategies.
I'm going to tell you about two brand new ways
of treating depression that are both very very old.
And that's what we're going to turn to next.
Before we do that though, let me present something that I sometimes call
the grief to ecstasy continuum.
So we're talking about these signals
that we need from our bodies, from the environment,
from other people, that we need these signals.
We evolved as a species to need these signals to feel our best.
There is a continuum. So they can be absent.
They can be present at a normal level.
Or again they can actually have this sort
of supercharge at a super level.
When they're absent and I've just written down.
I sort of free associated.
When they're absent you feel bad, you ruminate.
Your body goes into inflammatory state.
When they're absent you tend to feel depressed and anxious.
When they're present you have a nice balance
of optimism and pessimism.
You're realistic but hopeful.
Your body is generally in a good shape.
You tend to feel like you can do things in the world.
You have agency, you're happy to get up in the morning.
And you're euthymic. You feel pretty good, you're glad to be alive.
And then you can take these same signals
and you can really ramp them up
and there are some benefits and some risks of doing that.
So when you really push them
you can produce these very intense experiences
where people will have sometimes euphoric states.
Or they'll feel connected with everything in the universe.
Or sometimes they'll have very frightening states.
You get these very sort of profound states
that can be activated when these signals are really pushed.
And sometimes it can be a little bit frightening.
These are the moments in your life that are transcendent.
These are the moments where you feel like
oh, my God, this world is, you know.
As opposed to the quotidian world
that we're in today right now.
So let me give you an example
of one of these signaling inputs.
And let me show you what happens
when it's absent, present, and supercharged.
Let's do warmth.
So we know that human beings require skin to skin contact
really to live, to survive.
Babies that don't get that don't grow up
to be normal functioning human beings.
That'd be for instance those Romanian orphans right?
They're never never right.
You need it not only for your brain to develop,
for your emotions to develop.
But babies require the presence
of skin to skin contact to thermoregulate.
To control their own body temperature.
This is a hard core evolved human need.
When it's absent in primates it is a problem.
This is the hard picture to see.
This is from the University of Wisconsin
back in the day from Harlow's lab
and he did an experiment that was really rough.
He took these little baby monkeys.
Took them away from their mother.
Put 'em in solitary and either gave them
a wire mother that had milk
or a terry cloth mother that did not.
And the monkeys would starve to death holding
on to that terry cloth mother.
There's another picture of a little guy like this
holding on to the mother and trying to reach over
to try to get some of the milk.
And that about says it all, doesn't it?
This is the power when it's absent.
So I mentioned that when primates,
when humans don't have that early skin to skin contact,
it messes up their ability
to control their body temperature.
Not widely known, but depression is a state
of abnormal body temperature
and abnormal body temperature regulation.
This is a study done by one of my old professors at UCLA.
He rounded up a bunch of depressed people.
You can see the slides all the colors are kind
of whacked out on this thing but whatever you get the idea.
The blue is the depressed people.
And he convinced them to wear a rectal probe
for three days which was quite an accomplishment.
And he convinced a bunch of normal folks,
many of whom were psychiatry residents,
so quasi normal, to do the same thing.
And over the course of a couple of days,
here's an example of a day.
The depressed people are hot. They run a fever.
This has been shown over and over again.
Now in this study these were desperately depressed people.
He gave them electric shock therapy
which is very powerful at fixing depression.
When he did that and measured them a few days later
boom, their body temperature returned to normal.
Also not very well known is the fact
that the depressed people don't sweat. Yeah.
This is such a powerful thing that they wanted
to make it a diagnostic test for depression back in the 80s.
They don't sweat sitting around.
They don't sweat when they're stressed.
You see it in children as well as adults.
When you don't sweat you've got
an increased risk of suicide if you're depressed.
Some studies suggest that when you treat people they sweat better.
Some studies it's a little bit ambiguous.
But it's a very very widespread thing, just to go back.
Then of course, maybe if you've taken an antidepressant many
of them make you sweat and you say well that's a problem.
But it's probably a signal that they
are balancing out this problem
with the body temperature in depression.
So you can see that depression
has that same sense of absence around an ability
to appropriately thermoregulate.
There's something about temperature
and our emotional state that's very striking.
So what about when it's present at a normal level?
Have you ever asked yourself
why do we say things like, "Why is she a warm person?"
"Why did he give me the cold shoulder?"
We think about these as being metaphorical, right?
But you know one of the things I've learned doing science
for the last probably 20 years or so
is that many things that appear to be metaphoric
are actually biological.
And this is one of the best examples of that.
There are a number of studies that show this.
I want to tell you-- Well, before I show you that.
Literally, it's true.
These are your body temperature under different emotions.
Do you see depression on the bottom?
You're all constricted up.
Your core temperature's elevated.
But you're not able to relax.
You're not getting any of the blood out to the skin.
On the other hand when you get really angry.
Pissed off suddenly. You know, hot blooded?
You see it's really something.
So here's one of my favorite little experiments.
They rounded up a bunch of normal folks
and they told them a false story
about what the study was about.
But to get up to where the study was
everybody had to ride an elevator.
So a young research assistant
got them into the elevator and he
and she would be carrying a whole bunch of stuff
and a cup of liquid.
And they said, "Oh, you know, my God,
"my hands are so full would you hold the cup for me while we ride the elevator."
50% of the percent of the people got a cup with warm liquid.
50% of the people got a cup with cold liquid.
That's all they did right.
Then they took them upstairs
and they took those people and they showed them
a bunch of pictures and asked them to rate--
these are all just strangers,
just like if I took pictures of your faces-- how warm or cold.
You know, how affectionate. Rate these people for me.
And amazingly the people that held
the warm cup of liquid rated people
that they'd never seen before as more trusting, as warmer.
Put up the Dalai Lama. I mean there you go, there's a warm face for you.
They thought people like Dalai Lama.
You hold the cold cup and you go,
"Eh, I don't like the way that guy is looking at me."
Then we'll get a task where they had a chance
to give part of the money they were getting paid for
the experiment to strangers.
The people that held the warm up gave away more money
than the people that held the cold cup.
This has been replicated five or six times in different ways.
Just holding a warm cup of liquid changes who you are.
Isn't that amazing?
So that's the power of these things when they're present.
What about when you supercharge them?
Well, remember I said that I like
to invent new treatments for depression
that are actually very old treatments.
Which means I'm not inventing them.
I'm actually ripping them off. I'm like a retrofit guy.
I'm like the guy who goes through the junk yard of history,
looking for things that maybe nobody has thought of
as a way to treat depression.
Heat is one of the greatest examples of this,
because all over the world in almost every culture,
heat has been used for health,
healing, or spiritual purposes.
On this continent, especially in places like Wisconsin,
sweat lodges were ubiquitous.
Now anybody here ever done a sweat lodge?
Remember how wonderful it was?
It's suffocatingly hot. It's pitch black.
You're claustrophobic as all get out. You can barely breathe.
It's so hot you think you're going to die.
You're thinking you got to run for the door.
People would do this every day in indigenous groups.
You have to ask yourself why, right?
And there is really an answer.
And the answer is that heat is an antidepressant.
So now modern people who have gotten into this.
This is not going to solve these guys' problems,
but they can kind of dream on.
They need to explore some ancient dietary ancient practices.
And this explains one of
the great mysteries of modern civilization.
So, if you like yoga,
so many days you could go out and do it on the lawn
under a blue sky and birds singing.
No. You pay your good money to go into a stiflingly hot,
stinky, sweaty room and do yoga in miserable heat.
Anybody ever wondered why are these crazy people
doing this right, you know?
Not only that, why are they addicted to it?
People get in to this and they cannot stop.
I mean it really is a thing for them.
Because heat is not just an antidepressant,
it's also a mood elevator
and it's also a pro-social thing.
That's why sweat lodges work.
Heat to the body and why should it not be this way?
Think about mommy holding you, right?
You push it and you move into this state of,
"Oh, I just I feel so warm and open and connected."
It's very hard to feel depressed in that state.
About eight or nine years ago
one of my closest colleagues Christopher Lowry in Colorado.
The only other person I know of that's utterly obsessed
with depression and body temperature.
He and I are just like only two of us.
His wife, the first time we met, had to separate us
after five hours of just gazing
into each other's eyes, you know.
(laughter)
He did a study where he took a rodent's mice.
He gave half of them the equivalent of Prozac.
He gave half of them a heating up.
He heated them up in a little box.
And he said oh my God,
heating them up works just like the antidepressant.
They have little tests for rodent depression things.
At the same time I had a couple of buddies.
I used to teach in Austria.
One of them got a PhD here,
Walter Johnson here later at Sohi.
These two dudes found an old hypothermia chamber
in the bottom of this crazy alternative treatment hospital
and one of them was kind of an engineer.
He rebuilt the thing and we decided
to stick depressed people in it.
To see if we cooked 'em up would it make a difference.
And so we cooked up about 16 of them
to a temperature of 101.3
which is very hot.
Safe, but hot.
And they all got like way better.
So we were like whoa, let's really do this right.
And what is doing it right means in this case, it means--
Remember I talked about placebo and that little sugar pill
that's so powerful?
So if I take you and stick you in a fancy box
and the lights are on and you're getting hot and I'm listening to you.
That is a pretty powerful antidepressant.
So you got to account for that.
How do you know it's really the heat and not just
that you know you're making a big deal about things.
So you need to compare trickin' folks
to something that's believable, right?
And this was really-- Walter, like I said,
who got a PhD degree here,
it was largely his brainiac idea.
So the comparison was we took the depressed people
and half of them got the real deal.
Do you see the big barrel lights? Those barrels.
Those are big infra-red lights.
They're beaming all this heat down on the body.
At the bottom of the box are these coils that heat up.
So your whole body gets hot.
It gets to about 140, 150 degrees in there. So it's hot.
There's a fan that's making noise, and okay.
So what Walter did was he went down to Target,
bought four desk lamps. Do you seem 'em up there?
Painted 'em yellow.
Built a baffle around it so nobody could see it.
Put a fake fan in the back.
And half the people got that.
And just to confuse them further we turned on
those little coils at the bottom of the box so they got warm.
And in fact this wasn't a placebo.
Some of them actually got hot enough
that they got an antidepressant effect.
But be that as it may,
when we'd ask the people the minute they got out
of the box did you get the real treatment
or did you get the fake treatment?
71% of the people who got the fake treatment
said, "Oh, I got the real treatment."
And not all the people that were depressed
that got the real treatment, thought they got the real treatment.
They're pouring sweat.
They're huffing and puffing but there's a masochism to depression.
And it was like it wasn't bad enough.
There must be something worse than that, right.
So this was a really great blind.
And because of that this paper got published
in a very high impact journal.
What did we find? Well we found a bunch of stuff.
I'm only going to show you a little bit of it today.
The first thing we found, and again remember how these graphs go.
Down is good. Down means your depression is dropping.
Time is across the bottom. These are days now.
This is the first week after one treatment up to 101.3.
The blue line now is the fake treatment.
The red line is the real treatment. And down is good.
You don't need to be a statistician to see what this says.
Boom within a day.
Actually immediately people come out of the box.
They felt better if they got the real heat.
But within a day they're feeling a lot less depressed.
Amazingly it lasted for six weeks.
So you can see that the fake treatment,
it helped people some.
You know they didn't get worse.
But the real treatment, they got this big drop
over the first two weeks and then they maintained it.
Single treatment.
Think of how different that is
than anybody that's ever taken an antidepressant.
Every day you're taking it, taking it. Taking it right?
Why mental health got this idea
that mental illnesses were like high blood pressure.
And not something that could be boom, treated.
And then maybe you could do something to the body
and brain where they would take on a life of their own
and be able to function better without
that constant medicine you know kind
of getting in your system.
It's a good question why it's only now
that we're beginning to think about this.
But this is an example of that phenomenon
and it's a great example of how ancient practices:
heat, sweat lodges, ofuro baths, Roman baths.
How something that, saunas, right.
How those sorts of ancient practices
can be repurposed as an antidepressant.
There's a couple reasons why we think it works.
One is there are these neural pathways
that run from the skin to the brain.
It's like deep brain stimulators. you heat up the skin,
and it sends not brain signals everywhere,
it's like a needle.
It goes right up to this area called the dorsal raphe
in the mid-brain which is the serotonin part of the brain.
Which then goes up to parts of the brain
that set you up to be happy or depressed.
So it's like sticking a needle in somebody's brain
except we're reverse engineering
what nature has already given us.
And it's very exact and that's why
we think we see this effect. It's not just depression.
There's a study of 2,300 men in Finland.
Finland would be one of the only countries
where you could divide people between men
who only did sauna one to three times a week
versus four to seven times a week.
The men that did sauna four to seven times a week
followed for 30 years had a 60% risk reduction
in dementia, 60% reduction in cardiac deaths,
60% reduction overall deaths
and about the same size reduction in psychotic stuff.
They were also less likely to develop,
to lose touch with reality. Isn't that amazing?
So if you like saunas, let me encourage to you
to get in it tonight and then Saturday and Sunday.
It's really something.
In our data there's a little whisper
that women did better than men.
So just 'cause this is men, should not discourage
you ladies that we think probably
you'd get even more benefit.
All right. That's one ancient practice.
Let me tell you in the time I have left about another ancient practice.
Another ancient drive.
So you know all of life,
every living organism is self-centered.
If you don't survive and reproduce,
if you don't eat things,
often other living things that are
like walking around like animals,
you're not going to make it.
So trying to escape from the burden of the ego
is swimming against a massive tide of evolutionary history.
And yet it's something that higher mammals begin to do
and humans really begin to do it.
And being able to set that over winning concern
about the self and the self's place in the world
and the self's place compared to other people,
is a massive psychological release.
And humans have evolved a capacity to do this.
What about when that type of capacity is absent?
What does it have to do with depression?
This is a study with basically 29, 30 patients.
They come into an inpatient unit.
They record their speech and they analyze
how often they use the words me and mine.
And then they look to see how depressed they are
over the succeeding months.
The more often people are me, mine, me, me, me,
the more depressed they get.
If you are a new mother.
54 new mothers, they got six-months-old infants.
They have them do a five-minute, free-speech test.
Just tell me about you and your kid.
They count up the me's, the my's, the I's.
And then they go in and they actually watch
the mother with the little baby.
How warm is she? Is she a good mother?
What they find is A, the more me, my, my, my,
the more depressed the mother is.
The more me, my, my, I, I, the less warm she is with her kids.
And it's not because she's depressed. You can take out the depression.
It's because that self-centered approach
locks people out of the ability
to sort of fully benefit and in this case
from the modern world because so much of it's interconnected.
But from this human thing of being deeply interconnected with other people.
Now you know when you're depressed,
that me, I, my, it's not usually, "Oh I'm great. I'm wonderful, everybody else is."
No, it's the opposite. It's, "I'm so bad, I'm so terrible."
"I'm so ashamed, I'm embarrassed."
"Oh, my God, I'm in front of all these people and I--
And it's torture. But it's focused on the self-right.
There's ruminations.
There are types of thought about the self,
that are exactly the opposite.
And one of them and you're going to see me talk about this,
as we talk about the next ancient practice is insight.
So, insight is sort of the opposite of rumination.
When you're depressed and you're down.
You keep going to why'd she dump me? Why'd she dump me?
Maybe this, no no.
You're not going anywhere. The wheels are spinning,
but you're in the mud. You're stuck.
Insight is that moment where you go ah ha.
I need to be less needy. I see it.
I've done this in all my relationships.
I need to man up. I'm just making this up on the spot.
But you could make up different things,
but that is a moment of insight.
And then your next relationship,
you do differently and you get a different outcome.
Insight, this is a mathematical model in this big study
of Japanese college kids.
The more insight somebody has the less depressed
and anxious they are.
So that's when it's present.
Are there ways to supercharge
this human urge to somehow optimally temper
one's obsession with the self?
Are there ways to just transcend it
where you maybe can set yourself aside in some deep way.
At least for a little while. The answer is oh yeah there are.
This is one of them. This is a Sufi woman
putting herself into a state called hal, H A L.
This mystical state of spinning.
If you've ever seen a Sufi really go at it,
it's really something to see.
I am not a dancer.
And I get carsick.
And I just can't even ride on a merry-go-round.
So the Sufi business is out for me.
It's also a specialty interest.
But here's what's in.
And maybe some of you folks been hearing about this,
because it's gone from being fringy
to being completely oversold as the next great white hope
in the world of mental health.
Psychedelic medicines.
And the reason I'm talking to you is because
I'm the guy in charge of the science
as I'll show you at the end, of trying to get these approved if they do indeed work.
So you're getting this from the horse's mouth today in terms of this.
This is an ancient practice.
That's Maria Sabina, the woman that was doing it
down in Mexico when they found these hallucinogenic mushrooms
that produce psilocybin which is what we study.
Almost every society in the world has had psychedelics.
I come from Central California. I have a kind of hobbyist interest
in the indigenous people who were wiped out
pretty much before the white folks got there.
But like all indigenous groups,
they had psychedelic practices.
In most indigenous groups people would do psychedelics once
and it was usually at puberty.
Now in Central California, they did not have cactus,
they didn't have mushrooms.
They didn't have good psychedelic substances
but they felt it was so important for their children,
their young people to have this experience.
Because they would go looking for their spirit animal
and these things in their world.
That they would strip the kids down naked.
And lay them on these big ant hills.
And the ants would cover their entire bodies
and bite them, in formic acid.
And it would be enough to give them a hallucinogenic experience.
That's how serious these things were taken to be
in many indigenous cultures.
We have reasons to take them very seriously in modern culture.
There are now three studies, two done in the United States
in depressed and anxious cancer patients.
And this one done by a colleague of ours in the UK
in people that are healthy but they have bad, treatment resistant depression.
These are people that have failed
kind of all the antidepressants.
You take these people.
You give them one treatment with a psychedelic.
This thing called psilocybin.
They have a very intense experience
and then you look at their depression.
So this is a little bit complex.
There's a little black dot on your far left.
Up is bad. That's where they start.
Look where they go. Three months out, six months out.
They're starting to creep back up at six months.
But they are looking way way better
and they've had no other treatment.
Again this is the shocking thing. You give people one treatment.
It's doing something to their brains and bodies
that produces this-- It takes on a life of its own.
You don't need to keep taking a psychedelic every day.
In fact you do that, they stop working.
So what is it that's making this effect happen?
Every study suggest it has something to do
with the quality of the psychedelic experience
people have in these studies.
And there's a couple of things but one of the things
that is strongly related is that insight.
People have these deep profound experiences
where they gain, "Oh my God, I never X Y Z."
And they see their life differently.
And they come out and they've seen their life
in a way that gives it more purpose.
More meaning, more hope.
They see themselves as better integrated
into the larger world around, because that's the truth of the matter.
Especially when you're depressed.
You think you're all by yourself but you're not.
So it actually is this sort of moment.
Even though the experiences are often bizarre,
what the take home from that is this powerful sense of,
"Oh, I see my life in a new way."
Classic example: there was a woman a number of years ago
in a study who was an alcoholic.
She did not recognize she was an alcoholic,
but her husband managed to get her
into a study with a psychedelic.
She had this horrible psychedelic trip experience
where she had this hallucination that she was cutting
her children open with knives and forks and eating them.
The worst thing that ever happened to her.
And then right toward the end she realized
that her drinking was the equivalent
of cutting her children open with a knife and fork and eating them.
That's an example. That's insight.
And she stopped drinking.
So, how do they work?
Well, we're beginning to get an idea.
We know what they do acutely.
Why am a showing you an airline hub map right?
This is the way your brain works.
When sitting here today, your brain,
every cell is not talking to every cell.
Your brain is like the Delta or the United
or the American airline system. It's built around hubs.
And they talk to each other some, but they're all kind of
lined up with each other, right?
Psychedelics are like Southwest Airlines.
They go everywhere.
They're not a hub system.
Here's the proof. This is actually EEGs of brains.
So you know if you're a normal placebo.
You see that the dots are different brain areas.
You see all the purples are mostly connected with the purples.
The blues are connected with the blues.
There's some lines that go across right?
You do psilocybin would you agree there's more lines going across?
They're going crazy right.
Parts of the brain that never talked to each other
are having a chat.
And parts of your brain that never get a hearing,
sometimes very painful parts of your brain,
all of a sudden are talking to you.
And your people are like oh, right?
So that's what these things do.
We think that they break down these ossified hard
maladaptive patterns and when the brain opens up
like that it gives a chance: A for insight,
and B, when the brain comes back together again.
There's a moment where it can come back together
in a new pattern.
We think that's what's going on.
So what's it like to be in one of these studies?
One of the studies we're getting ready to do
and studies that have been over the last few years?
Well it's not like taking your Prozac at home.
It's like this.
So when people come in to our studies,
they come in to a very special room.
The room tends to be beautifully attired.
They take the medicine.
We encourage them to lay down on a couch.
We encourage them to wear an eyeshade
so that they can kind of go deeper into themselves.
Psychedelic medicines make people very very moved by music.
And so we tend to have a music soundtrack
that we offer and encourage people to listen to
because that really heightens the effect.
And then there's always two guides.
Traditionally a man and a woman.
These are very famous guides: Bill Richards and Mary Cosimano at Hopkins.
The place that really started this in many ways in the US
in its current form.
And they will spend eight hours with that patient.
That's a patient that was dying of cancer
who actually had quite an amazing response.
Very often people won't say anything for eight hours.
They're off, they're gone.
But again when they come back
they have this very transformative experience.
So that's what it's like. There's one session.
And that's the treatment.
Now I'm at the end of my time.
But let me just make two sort of pragmatic comments.
So I serve as the Director of Clinical
and Translational Research for something called
Usona Institute which is based in Madison, Wisconsin.
It's a very novel thing.
It's a medical research organization,
but we're also a pharmaceutical company.
But we're a non-profit pharmaceutical company.
We don't need to make any money
and our goal is to do studies to see
is it really true that a treatment with psilocybin
produces that kind of antidepressant effect
that lasts for six months?
Because studies have been done but they're small studies.
The FDA is, they're pretty rough, right?
You have to do these big studies. They're super super rigorous.
So we're about a year away from starting the first one
and producing this sort of pharma grade substance
that the FDA requires.
But the cool thing about what we're doing
is because we don't need to make a profit
and we don't need to recoup our development costs
because it's all donor based,
we hope to be able to offer the drug almost for nothing.
Which is really interesting.
We are the first pharmaceutical company
in history that I know of that is spending
all of this money to produce a generic medication.
It's basically what it comes down to.
So stay tuned and what we're doing is really interesting.
The colors are all crazy but
there's an exciting development.
UW may well be a site for that study.
But we're in the early phases of doing
a study at UW that I will lead
that I think is going to be very very impactful.
Because remember I said
that it looks like these agents work
by giving people these experiences.
So people have these very powerful
experiences where sometimes they'll have these very kind
of mystical experiences or they'll have
these insight-filled experiences.
And the more that happens the more undepressed they get.
Every study shows that.
But nobody's actually looked to see is it true?
That what's makes people feel better? How would you test that?
The way to test it of course is to put people to sleep.
Give them the medicine and then anesthetize them
and see if it still works.
Because if indeed it is consciousness that's driving
the effect, then people will wake up
and go well that didn't do anything for me.
On the other hand if they wake up and say I don't know why
but I feel like a totally different person.
Then we have a real mystery on our hands, don't we? Trying to understand.
So this is a collaborative study
that will be led interestingly by the School of Human Ecology.
Anybody here think of the School of Human Ecology
as a cutting-edge place
for the investigation of consciousness?
It is. Isn't that interesting?
Yeah, it's really cool, but we're also collaborating
with the Department of Anaesthesiology and Family Medicine
and the School of Pharmacy.
So this is looking to be a really broad based
and fascinating study that we are gearing up
to do at the University of Wisconsin. So stay tuned.
These are things that are very much related
to you being here today at Sohi.
They're very much related to you being connected to UW.
And as a human being of course,
who like all of us suffers and hopes
and sometimes gets depressed.
Important to us as human beings, also.
So with that I shall stop, thank you.
(audience clapping)