I needed to drive her home, as her husband could not break away from work to pick her up. It was then I learned how anxious Francine’s husband was about her participation in our studies. We all three chatted briefly at their townhouse, and I left uncertain about her husband’s fears. By the time I left, Francine continued looking pale and shaken, but happy.
The dose she received turned out to be less than psychedelic for the other volunteers, and I raised it by 50 percent for the next set of trials. Francine called Laura, feeling as if she needed to “keep up” with the rest of the volunteers, not wanting to be considered a “lightweight tripper.” With some misgivings, I agreed to let her return.
The day got off to a rocky start, as she had moved the bed into the far corner of the room before Laura and I arrived. She didn’t want to move it back into the middle, its usual position. In addition, a visiting medical student had gone in to see her before we had introduced them, expressly against my wishes. Francine was extraordinarily attentive to anonymity issues, as she was a hospital employee. I would have first cleared with her the idea of a visiting student.
Both of these irregularities—the bed placement and the student—set up high anxiety in me before we started. I nearly cancelled the study, but everyone seemed willing to carry on.
Within 15 minutes of swallowing the psilocybin capsule, Francine became restless, frightened, and anxious. She accused me of “messing” with her mind. When her panicked cell-phone call to her husband disconnected mid-conversation, she blamed my “mind waves” for the technical difficulties. Francine could tolerate only Laura in the room, and she asked if the medical student and I would step out for a while. While we were at the nurses’ station deciding how to proceed, Francine’s husband raced down the hall, entered Room 531, and gathered her up. They pushed their way past Laura and flew out the Research Center’s double doors before I got my bearings. As her husband ran past me, he said, “I’ve seen her this way before.”
I thought, “Now he tells me.”
The security guards came too late. While peaking on psilocybin, Francine was loose in Albuquerque.
Thankfully, Francine remained under the watchful eye of her husband that day and came to no harm. Nevertheless, I needed to write up and send in reports to all the university committees and boards overseeing our research. The Food and Drug Administration and the National Institute on Drug Abuse also received copies of a narrative of the incident. I referred to Francine’s session as “an unfortunate, but not unexpected adverse reaction. Psychotic breaks do happen under the influence of these drugs, and they are nearly always brief. The volunteer recompensated quickly and is showing no ill effects of her session.”
Strictly speaking, this was true. Francine “felt fine” that next morning and went back to work as if nothing had happened. However, she remained convinced that leaving the Research Center against our advice, and under the influence of psilocybin, was the only thing—in fact, the courageously noble thing—to do. My “negative influence” left her little choice. Neither Laura nor I, after many months, could make even the slightest inroads into her fear and anxiety about what she began experiencing that morning.
We made some modifications in our protocols, requiring that we interview more carefully volunteers’ spouses in order to learn about the nature and basis for any serious misgivings on their part. We more clearly stated the requirement that the research team give final permission to leave the hospital. We also decided to begin with the administration of a high dose of DMT in anyone interested in the psilocybin project. By doing so, we could assess more carefully their ability to handle extreme psychedelic states.
Francine’s session also effectively dashed any hopes for taking the research out of the hospital.
I was deeply shaken. Francine was intelligent and experienced, and she had been through our DMT work before. On the one hand, she had warned us by saying she might never want any more psilocybin after her previous peak experience. On the other hand, I didn’t want to disappoint her by refusing further participation. Her unpleasant experiences on DMT could have warned us about her inability to let go into fully psychedelic states, but it was hard to tell at the time. In addition, I chose to ignore the warning signs that morning: the peculiar bed arrangement and the visiting medical student’s intrusiveness.
I began doubting my own judgment.
I also feared for giving fully psychedelic doses of psilocybin in the hospital. But if we didn’t give full, active doses, what was the point? We needed to study the psychedelic, not sub-psychedelic, properties of psilocybin. Lower doses would not do, and the setting could not hold higher doses.1
Research team conflicts also began emerging as the study progressed. A particularly difficult one involved a part-time graduate student who joined us after we completed the first dose-response study.
I handed over to Bob much of the initial screening of prospective DMT volunteers. He returned calls, asked the first series of questions regarding suitability, and explained the studies in which the caller might participate. He then met with Laura and me to discuss whether to move the person through the next step in the screening process. If we had additional questions, Bob would follow up with them as necessary. While his role was not crucial, it had taken several months to get him up to speed, and he got to know well many of the second wave of volunteers.
A relative latecomer to the psychedelic field, Bob was like a child in a candy shop. He exuded enthusiasm about the projects and was very helpful in recruiting new subjects. He found the volunteers fascinating and wanted to spend time with them. He loved attending meetings and conferences in which well-known psychedelic research scientists reminisced about the “good old days” and the next generation of investigators planned future studies.
However, he had a difficult time knowing when to stop. One of our volunteers invited Bob over to his house to take drugs, and he couldn’t pass up the opportunity. When I shared my concern about this, he looked hurt and replied, “You’ve been doing this for so long, I need to catch up.” I advised him against any more of this type of behavior, but came up short of flatly prohibiting it.
Soon, however, an unrelated “supervisory” incident showed me that I could not afford to be so casual. This wake-up call took place in the psychiatry clinic in which I saw patients for the university.
For some years, I had been prescribing medication for Leanne, an intelligent and personable young woman with manic-depressive illness. Later, Tom, a new social-work intern, joined the staff and came under my supervision. He asked me to find him a stable and psychologically minded patient to see in psychotherapy, and I naturally thought of Leanne. They began working together, and from each of their reports, therapy was going well. A little too well, as it turned out.
Leanne and Tom started having sex a few months after beginning therapy. Neither Leanne, in our medication visits, nor Tom, in our weekly supervisory sessions, mentioned this. Within a few months, Leanne demanded that Tom leave his wife and marry her. Tom panicked and broke off the relationship. Leanne sued Tom, the clinic, and the university. Tom then threatened to sue me for “lack of supervision” if the university didn’t let him leave without serious consequences. The university, wanting to avoid a lengthy, expensive, and highly public trial, settled the case out of court, and I avoided being named in a lawsuit. Learning from this experience how liable I was for the behavior of those working under me, even if I didn’t know what they were doing, I decided it was time to reign in Bob the wayward graduate student.
Crying and accusing me of being unfair, Bob did not take well to being told he could not take drugs with the volunteers. My department chairman suggested I let him go. However, our research team was small, and it would have taken months to train someone to take his place. I gave him a second chance and told him that he could continue with the research if he promised to avoid socializing with volunteers. The university attorney and my chairman recommended I make him sign a contract to that effect.
This would allow me to cleanly end his relationship with the project if he slipped up again.
Considering the enthusiasm with which Bob professed his involvement in the studies, it was surprising to hear him say he “needed time to think about it.” Within a week, he reluctantly agreed to sign the contract prohibiting him from inappropriate extra-research activities. However, his poor boundaries and desire to take drugs with those involved in the research spilled over into another area: wanting to take drugs with me.
Bob made the hour-long drive up to my house in the mountains behind Albuquerque one Saturday and appeared at my door unannounced. Beginning with the cheery, and unlikely, “I was in the area and thought I’d drop by,” the conversation quickly turned to his interest in “maybe taking psilocybin mushrooms with you.” I was surprised, and I asked him what was going on.
“I’ve got so much more to learn about psychedelics. I can’t take them with volunteers now. But you’ve got so much to teach. I want to tap some of that knowledge and experience. What better way than to trip with you in your home?”
Feeling as if I were dealing with a disturbed psychiatric patient, I focused on ending the conversation and the idea as quickly as possible.
“No. That’s not going to happen. You can trip with your friends, of course, but not with volunteers nor with me. What seems best, though, is that you get into some therapy to talk about this. You need to get a bit of professional distance on this, and it seems hard to do.”
Bob’s face turned red and he started crying again.
“I know I shouldn’t have dropped by! I’m sorry. I don’t know what’s come over me! I guess I’m lonely. I just want to fit in.”
“That’s okay.” I tried sounding supportive. “Have some lunch, and you can head back into town.”
That wasn’t the end of it. For the next several months, whenever Laura, Bob, and I would meet to discuss the research, Bob cried, or came close to tears, around the issue of taking drugs: either with the volunteers or with me. Worse, his feelings began spilling over in his dealings with prospective volunteers. People shared with me some of the comments he casually dropped while discussing the project with them:
“Rick’s pretty uptight about the research, you know.”
And, “It’s too bad Rick keeps so much to himself about his feelings and motivations for this work.”
He also wasn’t getting to the volunteers important forms to sign and articles to read.
Bob had to go, and it wasn’t easy telling him. He actually seemed relieved that he no longer had to labor under what he thought were such unreasonably restrictive conditions of employment. Unfortunately, he was now free to socialize and take drugs with whomever he desired. Despite his efforts to keep such activities to himself, I never stopped hearing about them.
Finally, I was having problems taking in and dealing with all that the spirit molecule was showing us it could do. I expected psychotherapeutic, near-death, and mystical experiences during our work. However, the lack of substantial change induced by them made me wonder about their validity.
I also was unprepared for the overwhelmingly frequent reports of contact with beings. They challenged my view of the brain and reality. They also stretched and frayed my ability to empathize and support our volunteers. The lack of any close psychiatric peer colleagues added to my sense of isolation and concern about how I was responding to these sessions.
The biomedical model was making it difficult to recruit volunteers, or to be encouraging about what awaited them. Long-term benefits seemed minimal, while adverse effects stood out more sharply and were accumulating. I could not comfortably accept nor incorporate the remarkably high frequency of being contact. Hoped-for colleagues did not join me or decided to compete for precious funds and collaborators. The hospital setting for a psilocybin study was impractical and possibly dangerous, thus making me pessimistic about working with full doses. Research team conflicts threatened what fragile hold I did maintain over the project.
Even Margot, my massage therapist, was worried, although I rarely spoke about my research during our sessions. She was a highly intuitive bodyworker I’d been seeing once or twice a month for years. During one particular session, she became restless and distressed while looking me over, lying on the table.
She said, “I see evil spirits hovering around you. They want to come through this plane, using you and the drugs. I’m worried. This does not look good to me.”
Margot was a little New Age, even for New Mexico. I laughed and replied, “Well, Margot, I won’t answer if they knock.”
She was, nevertheless, accurate. Whether metaphorical, symbolic, or real, there was a tremendous amount of negativity piling up around me. What to do? I didn’t have to wait much longer for the solution, nor did I directly choose it. Rather, it came my way in a frightening manner.
My former wife, Marion, suddenly developed cancer. Fortunately the tumor was localized, and the surgeon was confident none remained after the quickly scheduled operation. However, “just to be safe,” the physician recommended more radical surgery, which Marion refused, preferring instead to pursue alternative medical therapies. At the same time my stepson, Marion’s youngest child, had become depressed and dropped out of school while living with his father in Canada.
Marion asked if we could move to Canada to be near family while she recuperated, to help out her son, and to give me some breathing room. Uncertain as to how successfully I could commute to Albuquerque, I nevertheless agreed to the move.
Every two months I scheduled a two-week stay in New Mexico, and I tried running as many studies as we could during those visits. The wear and tear was tremendous, and I worried about local support when I was gone. No one knew the studies, nor the volunteers, as well as I did.
One of the research subjects for the dose-finding work with psilocybin began having problems. Vladan, about whose experiences we read in chapter 12, got stuck in a spiral of increasing pessimism with every psilocybin session—a “what’s the point?” attitude. He never had the breakthrough he thought would come with higher doses. Instead, he became more reclusive and preoccupied. When told we wanted him to take a break from further studies, he bought a semiautomatic weapon, “just in case of Armageddon.” He adamantly denied any intention of using it against us. I was not especially reassured, so I invited him to my office during one of my New Mexico trips to assess his dangerousness. I relaxed somewhat after a two-hour meeting, but Vladan did not want to give up the gun.
I obtained permission to begin an LSD study, but decided to wait. Conditions did not look promising for giving LSD at the Research Center.
Finally, my former Buddhist monastic community began criticizing my research and withdrawing their personal support at the same time. These events were the final ones that led me to discontinue the psychedelic research, and they are the focus of the next chapter.
20
Stepping on Holy Toes
There generally is little support for the incorporation of spirituality, with its nonmaterial and therefore non-measurable factors, into clinical research’s fold. We will see in this chapter that neither is organized religion, no matter how mystically inclined, open-minded and secure enough to seriously consider the spiritual potential of clinical research with psychedelics.
There are several places in this book where I refer to my interest in Buddhist theory and practice. In addition to theoretical and practical contributions to the research, I also received much personal support and guidance from decades of involvement with an American Zen Buddhist monastery. From the initial inspiration for the psychedelic research to the development of the rating scale and our methods of supervising sessions, my understanding of Buddhism pervaded nearly every aspect of working with the spirit molecule.
Being raised a Jew in southern California in the 1950s and 1960s, my religious training emphasized learning the Hebrew language and Jewish festivals, history, and culture. We also remembered the Holocaust and supported the newly f
ormed Jewish state of Israel. We learned little about how to directly encounter God. This was something for the ancient patriarchs alone: Abraham, Isaac, Jacob, and Moses.
There were moments of joy in my Jewish education. Singing Hebrew folk songs and prayers in large groups was ecstatic, although I didn’t use that word at the time. So were the complex swirling and whirling Israeli folk dances we learned. In addition, one of my religious school teachers did try teaching us to meditate. We closed our eyes when she did, and then looked around the room through half-shut lids to see who was peeking. Our teacher had a beatific expression on her face, sitting at her desk, fingers interlaced in front of her lap. Once or twice during this classroom meditation I glimpsed something inside that felt good, calm, and right, but I also was startled and a little uncomfortable contacting it.
I later found Eastern religious teachings and practices provided the most accessible methods to begin satisfying the desires for deeper truths that emerged during my college years. In this way I’m similar to many of my generation. These “new religions” included Zen and other forms of Buddhism, Hinduism, and Sufism. Their emphasis on mystical union with the source of all being resonated deeply with that need for ultimate truth. The personal certainty embodied in recently arrived Japanese, Indian, and Tibetan teachers, and the spiritual exercises that promised results confirmed by generations of practitioners, combined to make an irresistible package.
My introduction to the mysteries of the East came in the form of Transcendental Meditation in the early 1970s. I enjoyed the quiet and peacefulness of this practice, but the intellectual underpinnings did not appeal to me. Soon thereafter, I discovered in Buddhism both the practical and intellectual inspiration I was seeking.
Buddhism is a meditation-based religion, 2,500 years old, that in impartial, psychological, and relatively easily accessible terms describes and considers all the states of mind one could possibly imagine, whether horrific, beatific, neutral, helpful, or harmful. In addition, Buddhism offers practical, cause-and-effect moral codes that apply the insights of meditation to daily life.
DMT: The Spirit Molecule: A Doctor's Revolutionary Research into the Biology of Near-Death and Mystical Experiences Page 31