“After the Ecstasy, the Laundry”
Shayla Love's Take on Psychedelics in 2022
Shayla Love is a journalist based in Brooklyn. She writes about science, health, and the intersection of history, culture, and philosophy with present day research. She has a master’s degree in science journalism from Columbia University, and her work has appeared in Vice, The New York Times, Scientific American, Wired, The Washington Post, Stat, The Atlantic, Mosaic, and more.
Part of our Year in Review series
In the opinion of the Psychedelic Alpha team, journalist Shayla Love is one of the most astute observers of the nascent psychedelics industry. As such, we are thrilled to open our Year in Review series with Love’s account of the themes that shaped the psychedelics space in 2022, plus her hopes and predictions for the coming year…
At a psychedelics conference last year, I got a pin that says, “Ask me about psychedelics,” in bubbly rainbow text.
I showed it to friends, who laughed because people do come to me with their psychedelic questions. They ask about the latest news article on mushrooms and depression, if they should go to an expensive retreat, and what I think about Oregon.
Yet, after last year, I have much less certainty when answering such queries. The industry and community are grappling with what it means to give birth to a new mental health treatment, and define its relationship to culture and the existing systems in our society. I have felt a bit like a character in Waiting for Godot, standing around and anticipating the arrival of a titular character, who may or may not arrive.
What am I waiting for? For Oregon to begin its psilocybin services, for FDA approval on psilocybin or MDMA, for more states to pass decriminalization or legalization bills, to see if patents get enforced, to know the actual cost of these therapies, if health insurance will cover them, and if we’ll decide on an integration protocol that we know works better than others. These aspects (and many more) are, in my opinion, all unresolved.
But all this uncertainty indicates growth. If I donned that psychedelic pin a few years ago, my answers might have been more confident. I would have been sure that these compounds were worth researching, but the nuances of how they fit into the patent system or Medicaid wouldn’t be on my radar because that wasn’t on the table. In the last year, the integration of psychedelics into our world became real, and as we all know, integration is the tough part. As Jack Kornfield wrote: After the ecstasy, the laundry.
I welcome the laundry as a signifier of maturation, not as a source of conflict to be defensive against. What I’ve learned from reporting on mental health is that I don’t need certainty. In fact, the one thing that turns me off a purported mental health treatment is the promise that it will cure everyone—it’s how I know it’s rubbish. My hope for psychedelics from the last year, and for the future, is that we embrace this uncomfortable new position where the answers are becoming less clear. While we are waiting, the vibe is—safe to say—shifting. Here is my take on the tectonic plates I’ve seen move in 2022.
The Varieties of Psychedelic Experience
It’s common for media articles to open with an anecdote. For psychedelics, this usually includes somebody’s visualizations, a breakthrough from their childhood, and ends with the person overcoming a blockage. In 2022, we’ve started to see a wider variety of psychedelic experiences reported on, including ones that are confusing, upsetting, or involve abuse and sexual assault.
Last year Rachael Petersen wrote an essay about her second psilocybin dose in a clinical trial, one she had trouble integrating and suffered side effects from. She noted how in the past, experiences like hers have been “dismissed as statistical outliers, flukes resulting from flaws in set and setting or vulnerabilities in the patient.”
But variety is a truer reflection of life, and embracing it will better reveal what psychedelics will be like as more people take them: there will be trips that are healing, fun, transcendent, traumatizing, that cause long-lasting effects like Hallucinogen Persisting Perception Disorder (HPPD), or trips that don’t do much at all.
One group is now conducting a psychedelics adverse events study, one of the first that will seek to qualitatively evaluate this variation, and its ramifications. Contained within this project is the sign of a big cultural shift: We don’t need to present every single trip as a clean, magical ride fit to open a news article.
Alongside an examination of the varieties of psychedelic experience, we’re also starting to ask what the role of experience is at all. This question is novel to the current “psychedelic renaissance,” because the capabilities of organic chemistry and novel molecule design are more advanced than they were in the 1950s.
Outside of the scientific possibility of doing so, it’s an investigation into how important the role of consciousness is in the psychedelic experience. We won’t know until we can test these experiences without, and there’s been attempts to do so by delivering ketamine with anesthesia, or psilocybin alongside a sedative. These are the first steps in teasing apart the different components of psychedelic experience, and getting at an intriguing proposition: is there anything that’s not necessary?
The 2021 paper, Right-Wing Psychedelia: Case Studies in Cultural Plasticity and Political Pluripotency put a spotlight on an uncomfortable topic that continued to dominate in 2022: Psychedelic use and enthusiasm can be affiliated with political ideologies that don’t match what people traditionally think of when they think of psychedelics (tree-hugging hippies).
That stereotype is long over. Psychedelic culture now includes tech bros, venture capitalists, billionaires, Burning Man aficionados, suburban moms, Erewhon shoppers, and QAnon shamans. This much is clear: psychedelics do not come with a consistent political bent. A person does not have to be liberal or left-leaning to be into psychedelics. And we’ve seen collaborations and financial affiliations with people like Steve Bannon, Rebekah Mercer, Peter Thiel, Rick Perry, and Jordan Peterson. Now what? There is an open question of how psychedelic advocacy groups, nonprofits, and researchers should interact with people whose actions and values don’t align with their own—and what impact those interactions will have.
If You Don’t Have Anything Nice to Say, Don’t Say It At All?
For decades, advocates have been pushing back against the idea that psychedelics should be illegal, that they have no medical value, and that they’re dangerous. But criticism has been evolving. It no longer says these substances don’t have potential, but asks how to create ethical frameworks for state services, counter sexual assault, avoid the guru complex, ensure that research is rigorous—all with a shared starting point that psychedelic therapy has value.
There’s been more scrutiny and higher standards put on psychedelic research. Before, getting any psychedelic study published seemed like a big deal, no matter the sample size or follow-up period. Those days are done. People are demanding more from studies, and scientists from outside the community are putting high-profile publications under a microscope.
These critiques can still trigger a knee-jerk reaction: that they need to be wholly resisted in order to push psychedelic medicine and legalization forward. As criticism shifts to include constructive criticism—not denying psychedelics’ merits, but caring about its stewardship into society—the ability to respond to such criticism also needs to adjust.
This has not been going very well. At the Wonderland psychedelic business conference hosted by Microdose in Miami, critical psychedelic journalists from Psymposia were banned from entering, as an anonymous psychedelic Twitter account reported. Comments on the methodology of a psilocybin paper in Nature Medicine were responded to with defensive accusations about motives. On a much smaller scale, I have found that raising concerns around patents or safety brought on condescending accusations of “hand-wringing” and “moralizing.”
In The Will to Believe, William James wrote about two ways of approaching knowledge: One is to seek out the truth and the other is to avoid error. James says these are two separate processes, and that “by choosing between them we may end by coloring differently our whole intellectual life.”
What he means is that we can dedicate ourselves to avoiding error, but that means we might sometimes miss out on the truth. Or, we can go after the truth, but sometimes be wrong. I regularly dwell on this difference in the clashes I’ve observed in psychedelics. Some people are pursuing how psychedelics work, who they might treat, and for what conditions, and there will be mistakes made along the way. Others’ goal is to point out those errors. I don’t find these two modes incompatible. Rather, I think they need one another for the field to continue to grow.
Is It Therapy, or Not?
An ongoing deliberation throughout the implementation of Measure 109 in Oregon is whether or not the bill provides therapeutic or non-therapeutic psilocybin use. To be clear: technically, it’s non-therapeutic. You don’t have to be a therapist in order to get a license to provide psilocybin services.
But it’s been confusing, and this topic needs attention as more states pass laws that either decriminalize or legalize psychedelic drugs, as Colorado just did. The line between therapy and not-therapy is blurry, because “non-therapeutic” psilocybin use can still be therapeutic, just like therapeutic psilocybin use can be spiritual, or recreational.
State legalization is emerging right when we are trying to understand what psychedelic therapy is at all, and it’s demanding us to define something that we don’t have answers for yet: What are the conditions that we expect this to treat with consistency and efficacy? What are the situations that require mental health professionals, and which do not? Determining whether a service is therapeutic or non-therapeutic guides training and the laws around the licensing for who is able to be a guide or facilitator.
We’re in an ecosystem where media articles talk about psychedelics almost entirely in the context of mental health treatments. Whether or not you call something therapy, people are going to be seeking this out for mental health purposes.
I’ve relied on the concept of triage before: how depending on what you want out of an experience and your individual needs, my hope would be that people are triaged to the care that’s best suited for them. A person would have options available to them in terms of ease of access and also cost. State legalization is going to be our trial run for what this triage process might look like.
Business vs. Legalization
Last year exposed the tensions that can exist between business and advocacy. Right now, companies have a vested interest in some form of drug policy progress because it’s difficult to make money off illegal substances. But there are limitations to these shared goals.
In 2022, there was a successful petition against the The Drug Enforcement Administration’s proposed scheduling of five novel tryptamine compounds, from a group effort from lawyers, businesses, academics, and media professionals.
This wasn’t across the board, however. Field Trip’s Chief Scientific Officer, Nathan Bryson, wrote a submission to the DEA during the public comment period that agreed with the DEA’s proposal to schedule four of those compounds, excluding only the compound they were working on.
Psychedelics will eventually have multiple access points, through FDA approval, decriminalization, or legalization—and we don’t know if all these moving parts will work together, or actively work against each other. But it’s safe to say that not everyone in the business of psychedelics will be an advocate for widespread drug legalization, decriminalization, or rescheduling.
I had hoped that calling psychedelics a brain “reset” or “reboot” would have gone out of fashion, but this metaphor continues to persist.
We have to be more careful about the way we talk about the potential mechanisms of action for psychedelics. Describing them as automatic, easy, or fast does a disservice to people who are trying to educate themselves about what their experience may be like.
There are disconcerting similarities between the way antidepressants like SSRIs have been talked about, and the way psychedelics are being communicated about. Biology is being over simplified, and stories and narratives are being culturally embedded. Ironically, this is happening while psychedelics are pitted against SSRIs, and there’s a strong anti-medication ethos being cultivated that doesn’t help those who are trying to navigate their options for how to feel better.
This is a shame because within psychiatry there is a push to be more cognizant of social determinants of mental health, the philosophy of mental illness, concepts like neurodiversity, and disability justice. By moving forward with the message that one drug—and just because it’s a plant doesn’t mean it’s not a chemical substance—can single handedly “solve the mental health crisis,” we ignore these conversations that are finally happening, and actively undermine them.
Hopes and Predictions
Humbly, here are my predictions and hopes for the coming year.
There’s going to be a deeper examination of what we mean when we say “mystical experience.” It’s been said that a mystical experience is correlated with good outcomes, but there will be exploration into exactly how that’s defined, and whether there are other words that better describe these experiences.
I hope that we move away from celebrity psychedelic stories, because I’m not convinced they have relevance to a mental health treatment for regular folks. We need to acknowledge that people have different material conditions, and I’d like a stronger focus on the interaction of class and psychedelics.
We move away from promising to solve the “mental health crisis.” Mental illness is not one thing; people cannot agree upon what its definition is, even on an individual level, over the course of a lifetime. A large mental health burden involves what are called “serious mental illness,” or SMI, which includes psychotic disorders. Not only are psychedelics thought to incur a small risk of causing psychosis, they are currently contraindicated for psychosis. When psychedelic advocates promise that psychedelics are going to end mental illness, they exclude a large number of people who are the most affected, most likely to end up in jail, and face most of the stigma.
This next year, as always, I wish for an embracing of pluralism for what these substances mean to different people: whether it’s good or bad, who is drawn to them, and who uses them for what purpose. But this pluralism has a cost that we should recognize.
I often come back to an idea from Jake Jackson, a philosopher of psychiatry, who says that people with mental health concerns are “epistemically adrift.” He means that having to navigate mental distress and combing through all the “expert disagreements, and cultural debates as to what disorders are and how to treat them,” is exhausting.
We can make it less tiring. Psychedelics do not need to start from scratch. There are many areas of study that are relevant to psychedelics. I hope psychedelics will start recognizing those common threads and bringing in outsiders to expand the pool of knowledge.
I want to see more collaboration between philosophy, anthropology, cultural studies, history, other areas of psychology and neuroscience— people who can help us to understand the ways that psychedelics interact with the world around us. These substances aren’t like Lipitor, which lowers cholesterol. They interact with people, therapists, what’s being done in the sessions, and what the person reads before and after.
I hope to see less fighting between researchers who could share expertise with each other. Adversarial studies are done in other fields; I want to see people who do not agree work together to design a study, and try to answer a scientific question.
When I first started writing about psychedelic patents, I thought that calling out individual bad patents might make a difference, and I was wrong. Now, I think what psychedelic patents better represent is how the psychedelic industry works within pre-existing flawed systems. I personally have turned my focus to the larger systemic issues in the patent system more broadly, and this approach applies outside of the USPTO.
Psychedelics are not contained within an insular bubble anymore. If you have a vested interest in psychedelics improving the world, I call on you to look at the larger systems that psychedelics are going to be operating within and tackle those systems rather than just expect psychedelics to do all the work. If you’re worried about psychedelic therapy being inaccessible, look at how psychotherapy is inaccessible because of the flaws in healthcare. If you care about decriminalization of psilocybin, look to the struggles of legalization and harm reduction of other drugs. Those are the kinds of things we could be advocating for: patent reform, universal healthcare, increased social services, decrim, and cultivating lives that provide emotional and spiritual support. These are all external changes that benefit psychedelics, but make the world a better place outside of psychedelics alone.